Robert Rosenfield

..abstract:..

..Improved treatment of hirsutism awaits improved understanding of the nature of the interaction between androgens and other determinants of hair follicle biology...

..For example, we are unable to diagnose ovarian dysfunction before puberty or in early puberty, and the relationship of "physiologic adolescent anovulation" to PCOS remains to be defined...

..Polygenic influences appear to account for about 70% of the variance in pathogenesis. In view of this evidence for congenital contributions to the syndrome, childhood manifestations may be expected...

..Suggestions are made for improving the balance between the need for research in children and adolescents and its regulation...

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..We compared attainment of stage 2 breasts, stage 3 (sexual) pubic hair, and menarche in the Third National Health and Nutrition Examination Survey sample of children with normal BMI with those with excessive BMI (> or =85th percentile)...

..The data are compatible with the possibility that excess adiposity may paradoxically subtly suppress hypothalamic-pituitary-gonadal function in early puberty although it is known to contribute to the early onset of puberty...

..The objective of this study was to determine the source of androgen excess in the one-third of PCOS patients who atypically lack this type of ovarian dysfunction (PCOS-A)...

..Optimizing pubertal estrogen replacement in girls with Turner syndrome is important...

..These data suggest ligand-dependent, complex interactions between cAMP and the other signal transduction pathways involved in sebocyte growth and development...

..In addition, they may play roles in keratinocyte growth and differentiation and the inhibition of skin inflammation by diverse mechanisms not necessarily related to fat metabolism...

..Treatment of PCOS with antidiabetic insulin-lowering agents may improve ovarian function and androgen levels; it remains to be determined whether it will benefit the pilosebaceous unit manifestations of the disorder...

..Our objective was to determine the ovarian function of asymptomatic volunteers with a polycystic ovary (V-PCO)...

..CONCLUSIONS: An inhibin-B-FSH feedback loop exists prior to the onset of puberty in girls older than 5 years. Sex differences in activin-A and inhibin-B concentrations may be responsible for sex differences in serum FSH concentrations...

..These results indicate that members of the Sp family of transcription factors play an important role in regulating constitutive and stimulated expression of the HSD17B5 gene in H295R cells...

..CONCLUSIONS: Intractable prepubertal obesity was recognized to culminate in early childhood pseudo-Cushing's syndrome or pseudo-acromegaly, which are manifestations of insulin-resistant hyperinsulinism, and to herald adolescent PCOS...

..We also found that follicular development was present in the absence of FSH. These antral follicles had apparently developed normally, since estradiol and inhibin B increased promptly after FSH administration...

..Our objective was to determine whether excessive adiposity is associated with alteration of the normal hormonal changes of early pubertal girls...

..The typical polycystic ovary syndrome (PCOS) phenotype includes 17-hydroxyprogesterone (17OHP) hyperresponsiveness to GnRH agonist (GnRHag) testing. Functionally atypical PCOS lacks this feature...

..This article reviews the definition, clinical features, diagnosis, and treatment of PCOS...

..However, about half have a subclinical PCOS type of ovarian dysfunction; it is unknown whether this indicates a genetic carrier state or a risk for anovulation...

..Type 5 17beta-hydroxysteroid dehydrogenase (17beta-HSD5) appears to be the major testosterone-forming 17beta-HSD isoenzyme in females...

..We present evidence for KLF15 as a transcriptional regulator of the human 17beta-hydroxysteroid dehydrogenase type 5 gene (HSD17B5) and its potential role in the pathogenesis of hyperandrogenism...

..Detailed studies are necessary to develop more uniform guidelines...

..Proband prevalence of MBS was 27.8%, 3-fold greater than expected for obesity status. CONCLUSION: Familial factors related to paternal MBS seem to be fundamental to the pathogenesis of PCOS...

..Girls deficient in oestrogen should receive replacement in physiological doses. Aromatase inhibitors and anti-oestrogens may prove to be useful therapeutic tools in some types of abnormal puberty...

..Advances in research on the interaction of hormone target genes with the biological processes involved in hair morphogenesis and cycling can be expected to improve management of hirsutism and alopecia...

..7%). All four mutations were in anosmic/hyposmic men making the prevalence 4/63 (6.3%) in this group of patients. No mutations were found in the 29 female patients. KAL1 mutations are an uncommon cause of Kallmann syndrome...

..Our objective was to develop clinical practice guidelines for the evaluation and treatment of hirsutism in premenopausal women...

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..The overall goal of this proposal is to understand the factors regulating the production of testosterone in women, particularly in their ovaries. ..

..abstract_text> ..

..Human sexual hairs and fibroblasts, rat vibrissae, and rat preputial glands will be studied using tissue and organ culture. Androgen metabolism and androgen receptor sites will be studied in these cultured PSA cells...

..The hypothesis that LH is insensitive to modest decrements of plasma testosterone will be tested by acutely lowering plasma testosterone levels in normal volunteers with aminoglutethimide...