There is no area in medicine that has affected biological psychiatry more pro 15 years in en foundly than the developments that have occurred in the last docrinology and more specifically in neuroendocrinology. In the 1960s, the regulation of endocrine function was considered to rest primarily in the feed back system between the pituitary and the secretions of various target organs. In R. H. Williams' Fourth Edition of the Textbook of Endocrinology published in 1968, the chapter on neuroendocrinology did refer to the median eminence gland with a relatively brief mention of various releasing factors that were the subject of ongoing studies. Only six years later, in the Fifth Edition published in 1974, Seymour Reichlin's chapter on neuroendocrinology listed nine specific hypothalamic releasing factors of which three had already been isolated and purified and thus were referred to as hormones. Most recently in the current Sixth Edition, published in 1981, the chapter on neuroendocrinology contains a detailed description of the physiology of the various hypothalamic releasing factors and hormones, but also significant emphasis is given to the various neurotransmitters that have been shown to regulate the synthesis and release of these important hypothalamic hormones. In addition, there appeared for the first time in this classic textbook a chapter on psychoendocrinology. One may wonder why there is so much interest not only in endocrinology but more recently in psychology and psychiatry about psychoneuroendocrine It has been known for some time function. Several reasons may be suggested.
The discovery of new molecules that function in neuronal communication can be viewed as a progression of steps beginning with the identification of the molecular structure, moving to the understanding of the mecha nisms mediating the synaptic action, and to the appraisal of the involve ment of the new molecules in various neuronal mechanisms, and finally reaching the evaluation of this molecule's role in brain function and the consequences that are triggered by its abnormalities. Enkephalins have followed such a pattern, and the present publication expresses the salient points of the last two phases in this succession. Enkephalins were discovered in December 1975; in addition to pain threshold regulation, their participation in other brain functions was soon ascertained. Perhaps, there are multiple recognition sites for multiple molecular forms of endogenous enkephalins; similarly to other transmitter recognition sites, these are coupled with ionic and nucleotide amplifying systems; thus, when activated, they can modify membrane funtion and ionic permeability of membranes. The present publication probes the current status of our knowledge concerning the consequences related to abnormalities in enkephalin storage, release, and synthesis. However, since our basic understanding of enkephalins is incomplete, the views reported should be considered to be in a state of flux.
This outstanding and original work goes to the heart of South Africa's political problems - doubts as to the sustainability of the post-apartheid settlement, beset with divisions in the ruling ANC, factionalism, corruption and the widening of fault-lines in state and society. The 'leadership issue' has become key and this will be the first specific examination of leadership in the light of Mandela's legacy and its effect on his successor as potential and actual leaders - all in 'the shadow of Mandela' as the architect of the transition from apartheid to democracy, and with overarching moral authority and international reputation. Alexander Johnston shows how his successors are judged against Mandela's achievements, including the potentially impressive 'lost' leaders and concentrating on his immediate successors, Thabo Mbeki and Jacob Zuma. The book concludes with an in-depth assessment of new president Cyril Ramaphosa's potential to be a leader for a 'new dawn'. This is an objective and critical work by a close observer who acknowledges the achievement of South African leadership but is acutely aware of the doubts as to the sustainability of South Africa's hard won democratic settlement. An essential read for all readers interested in leadership and in the traumatic history and future of Africa's leading state, as the continent rises to global importance.
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