Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant endocrinopathy syndrome caused by mutations (mostly truncating) in the MEN1 gene (chromosomal locus 11q13). MEN1 gene is a tumor suppressor gene that consists of 10 exons and its product is a 610-amino acid protein called menin.[16-18] MEN 1 syndrome is characterized by various combination of endocrine tumors involving the parathyroid glands (HPT is usually the first manifestation with near 100% penetrance by age 50), entero-pancreatic islet cell tumors (gastrinoma in 40%, insulinoma in 10%, nonfunctioning in 20%), and anterior pituitary adenomas (prolactinoma is the most common and occurs in 20% of patients).[12,19] Less prevalent tumors include adrenal cortical tumors, foregut carcinoid tumors, and lipomas. Pheochromocyto-mas are rare in MEN 1. Neuroendocrine tumors of the pancreas are often multifocal and malignant, and are the leading cause of mortality in patients with MEN 1. Genetic testing for MEN 1 is commercially available using single-strand conformation analysis (SSCA) and sequencing. It can identify mutation in the MEN 1 gene in approximately 80-90% of probands from well-defined MEN 1 families.[20-23] It is generally offered to patients with clinical criteria of MEN 1, their at-risk relatives, and to confirm diagnosis in cases with features atypical for MEN 1. Presymptomatic MEN 1 genetic testing for family
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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.