Tuberous sclerosis (TSC) is an autosomal dominant genetic disorder characterized by development of distinctive nonmalignant tumors termed hamartomas and hamartias, in several organ systems. Tuberous sclerosis hamartomas involve the skin, brain, and kidneys in most TSC patients. Tuberous sclerosis is due to inactivating mutations in either the TSC1 gene, which encodes the protein hamartin, or the TSC2 gene, which encodes the protein tuberin. Most TSC lesions follow the first germline hit-second somatic hit tumor suppressor gene paradigm, such that complete loss of either hamartin or tuberin leads to tumor development.
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The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.