Polycystic Ovaries - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

POLYCYSTIC OVARIES A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J...

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POLYCYSTIC OVARIES A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Polycystic Ovaries: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84551-4 1. Polycystic Ovaries-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on polycystic ovaries. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON POLYCYSTIC OVARIES ............................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Polycystic Ovaries ........................................................................ 4 E-Journals: PubMed Central ....................................................................................................... 13 The National Library of Medicine: PubMed ................................................................................ 14 CHAPTER 2. NUTRITION AND POLYCYSTIC OVARIES ..................................................................... 57 Overview...................................................................................................................................... 57 Finding Nutrition Studies on Polycystic Ovaries ....................................................................... 57 Federal Resources on Nutrition ................................................................................................... 61 Additional Web Resources ........................................................................................................... 61 CHAPTER 3. CLINICAL TRIALS AND POLYCYSTIC OVARIES ........................................................... 63 Overview...................................................................................................................................... 63 Recent Trials on Polycystic Ovaries ............................................................................................ 63 Keeping Current on Clinical Trials ............................................................................................. 65 CHAPTER 4. PATENTS ON POLYCYSTIC OVARIES ........................................................................... 67 Overview...................................................................................................................................... 67 Patents on Polycystic Ovaries ..................................................................................................... 67 Patent Applications on Polycystic Ovaries.................................................................................. 69 Keeping Current .......................................................................................................................... 71 CHAPTER 5. PERIODICALS AND NEWS ON POLYCYSTIC OVARIES ................................................. 73 Overview...................................................................................................................................... 73 News Services and Press Releases................................................................................................ 73 Academic Periodicals covering Polycystic Ovaries...................................................................... 78 CHAPTER 6. RESEARCHING MEDICATIONS .................................................................................... 79 Overview...................................................................................................................................... 79 U.S. Pharmacopeia....................................................................................................................... 79 Commercial Databases ................................................................................................................. 80 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 85 Overview...................................................................................................................................... 85 NIH Guidelines............................................................................................................................ 85 NIH Databases............................................................................................................................. 87 Other Commercial Databases....................................................................................................... 89 The Genome Project and Polycystic Ovaries ............................................................................... 89 APPENDIX B. PATIENT RESOURCES ................................................................................................. 93 Overview...................................................................................................................................... 93 Patient Guideline Sources............................................................................................................ 93 Finding Associations.................................................................................................................... 97 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 99 Overview...................................................................................................................................... 99 Preparation................................................................................................................................... 99 Finding a Local Medical Library.................................................................................................. 99 Medical Libraries in the U.S. and Canada ................................................................................... 99 ONLINE GLOSSARIES................................................................................................................ 105 Online Dictionary Directories ................................................................................................... 106 POLYCYSTIC OVARIES DICTIONARY.................................................................................. 109 INDEX .............................................................................................................................................. 149

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with polycystic ovaries is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about polycystic ovaries, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to polycystic ovaries, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on polycystic ovaries. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to polycystic ovaries, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on polycystic ovaries. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON POLYCYSTIC OVARIES Overview In this chapter, we will show you how to locate peer-reviewed references and studies on polycystic ovaries.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and polycystic ovaries, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “polycystic ovaries” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Polycystic Ovary Syndrome Source: Diabetes Self-Management. 18(6): 56-57,59. November-December 2001. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Website: www.diabetes-self-mgmt.com. Summary: This article discusses polycystic ovary syndrome (PCOS), a disorder characterized by high levels of male hormones (androgens) and chronic anovulation (failure to ovulate) in females. In addition, PCOS is associated with insulin resistance, the key problem underlying type 2 diabetes. In insulin resistance, body tissues, particularly muscle, fat, and liver cells, do not respond properly to insulin. As a result, more insulin than normal is needed to keep a person's blood glucose (sugar) level in the

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normal range. Diabetes develops in about one-third of all women with PCOS. Effective treatments are available for PCOS, and early diagnosis gives a woman the best chance of avoiding long term complications. The symptoms of PCOS typically develop during puberty and progress slowly. Symptoms can include increased body hair, thinning of scalp hair (alopecia), persistent acne, erratic menstrual cycles (two to six times a year), obesity, symptoms of low blood sugar after eating significant amounts of carbohydrate, and difficulty conceiving. Treatment usually includes weight reduction, exercise, and following a low carbohydrate diet. Additional therapy is tailored to the woman's main complaint, whether that is acne, hirsutism (excessive hair), alopecia, uncontrollable appetite, or infertility. Drugs used to treat PCOS can include oral contraceptives, androgen-blocking agents, and insulin-sensitizing agents. The author concludes that a multidisciplinary health care team is most appropriate for treating women with PCOS. One sidebar offers resources for readers who wish to obtain additional information about PCOS, its diagnosis, clinical features, potential complications, and treatments. •

Polycystic Ovary Syndrome: Sister to Type 2 Source: Diabetes Forecast. 53(6): 114-116. June 2000. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article discusses a condition known as polycystic ovary syndrome (PCOS). In women who have PCOS, the ova mature in the ovary but are not released. This failure to ovulate results in decreased frequency of menstrual periods and causes cysts to develop in the ovaries. PCOS also causes elevated blood levels of male sex hormones such as testosterone. This condition is the most common cause of infertility among women in the United States. Type 2 diabetes and PCOS have insulin resistance as a common feature. Most women who have PCOS have insulin resistance, and women who have PCOS are at risk for type 2 diabetes and other disorders such as high blood pressure, abnormal lipids, and heart disease. Although not all women who have insulin resistance will develop type 2 diabetes, they may have elevated insulin levels in the blood. This condition, known as hyperinsulinemia, appears to have a role in the development of PCOS and may impede ovulation and contribute to infertility. Treatments for type 2 diabetes and obesity can also be used for PCOS. The first line of treatment for all three problems is diet and exercise. Drugs that improve sensitivity to insulin, such as metformin, pioglitazone, and rosiglitazone, may be needed. The article recommends that women who have irregular menstrual periods or have excess hair growth inform their doctor because of the interrelated nature of type 2 diabetes, infertility, excess hair growth, high blood pressure, and abnormal lipids.

Federally Funded Research on Polycystic Ovaries The U.S. Government supports a variety of research studies relating to polycystic ovaries. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. 2

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to polycystic ovaries. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore polycystic ovaries. The following is typical of the type of information found when searching the CRISP database for polycystic ovaries: •

Project Title: ANDROGENS AND SUBCLINICAL ATHEROSCLEROSIS IN YOUNG WOMEN Principal Investigator & Institution: Siscovick, David S.; Medicine; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 30-SEP-2001; Project End 31-JUL-2004 Summary: (provided by applicant): This revised application represents an ancillary study to the Coronary Artery Risk Development in Young Adults (CARDIA) Study, a large cohort study supported by the NHLBI. Several studies have demonstrated crosssectional associations of hyperandrogenism, the primary biochemical feature of clinically-diagnosed polycystic ovarian syndrome (PCOS), with coronary risk factors and atherosclerosis. We propose to examine whether serum androgens, measured earlier in life, and variation in genes related to androgen synthesis, metabolism, and signaling are associated with early-onset subclinical coronary atherosclerosis in young adult women from the community. Additionally, we will examine whether the clinical features of PCOS are associated with subclinical coronary atherosclerosis in young adult women, after taking into account serum androgens. CARDIA provides a unique platform to address these questions; and, the proposed ancillary study will add the laboratory and clinical measurements to CARDIA needed to examine these questions. In the prospective component of the proposed study, we will examine the associations of serum androgens and genetic polymorphisms and haplotypes in ten candidate genes with the presence of coronary artery calcium (CAC) by CT. Androgen and genotyping measures will be made using stored serum and DNA samples collected from 1550 women 5 and 13 years prior to the assessment of CAC at age 33 to 45 years. In the crosssectional component, we will use information collected at a proposed ancillary study visit in Year 16 to examine the associations of the clinical features of PCOS, including the presence of polycystic ovaries detected using trans-vaginal ultrasound, menstrual irregularities, infertility, and hirsutism, with the presence of CAC at Year 15 (n= 1200). Secondarily, we will determine whether longitudinal changes in obesity, physical inactivity, and insulin levels influence the prospective associations of serum androgens and genetic variants in candidate genes with subclinical coronary atherosclerosis. In short, the proposed study addresses a potentially important and relatively unexplored area of investigation related to women's cardiovascular health. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EGR-1 AND SF-1 AND LH BETA PRODUCTION Principal Investigator & Institution: Sadovsky, Yoel; Associate Professor; Obstetrics and Gynecology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-MAR-2004

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Summary: A set of well-orchestrated signals that regulate gonadotropin gene expression drive reproductive function. Gonadotropin production is primarily directed by hypothalamic gonadotropin releasing hormone (GnRH), and modulated by feed-back signals from the pituitary and gonad. This proposal focuses on female reproduction, centering on the mechanisms that direct expression of the unique beta-subunit of luteinizing hormone (LHbeta). Along with the common alpha-subunit, the two subunits constitute the "mature" hormone. Among the signals that operate through discrete elements within the LHbeta gene promoter and determine its expression, two transcription factors are distinguished for their prominent role: 1. Egr- 1, a prototype of a family of early growth response (Egr) gene products and essential for LHbeta expression; and 2. The nuclear receptor steroidogenic factor-1 (SF-1), which is potent activator of LHbeta promoter, albeit not required for basal LHbeta production. Through meticulous examination of the transcriptional function of these proteins, our lab has recently unveiled a powerful synergy between these proteins in regulation of LHbeta transcription. The mechanism of Egr-1 and SF-1 synergy, as well as the role of this synergy in reproductive biology, remain elusive. Our proposed experiments build on these findings, and are designed to test the hypothesis that synergistic interaction of SF1 with Egr-1 and its family members determines gonadotrope expression of LHbeta gene in vitro and in vivo. To test this hypothesis, we will address four questions central to female reproduction: What is the mechanism or SF-1-Egr-1 synergy? Which other proteins play a role in this synergy? Are Egr-1 and SF-1 targets for regulation by GnRH? Does insulin-mediated enhancement of LHbeta production occur through the cooperative interaction of, Egr-1 and SF-1? Both in vitro and in vivo approaches will be used to answer these questions. Our study is of paramount significance to the analysis of LHbeta regulation. Enhanced expression of LHbeta disrupts normal reproductive homeostasis in the female, and is implicated in the pathophysiology of diseases such as polycystic ovary syndrome (PCOS), characterized by infertility, hyperandrogenism, and polycystic ovaries. Our examination of SF-1 and Egr-1 function does not imply that these proteins play a role in the pathophysiology of PCOS. However, our results are likely to shed light on mechanisms that lead to enhanced LHbeta expression, and they may therefore provide a framework for a novel therapeutic intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GENES, ANDROGENS AND INTRAUTERINE ENVIRONMENT IN PCOS Principal Investigator & Institution: Dunaif, Andrea F.; Chief, Division of Women's Health; Medicine; Northwestern University 633 Clark Street Evanston, Il 60208 Timing: Fiscal Year 2002; Project Start 27-SEP-2002; Project End 31-JUL-2007 Summary: (provided by applicant): PCOS is among the most common disorders of adolescent and premenopausal women, affecting approximately 710% of this population. It is a high priority and overarching women's health problem with substantial reproductive and metabolic morbidities throughout the lifespan. Dunaif's recent studies on the mechanisms of insulin resistance in PCOS have revealed the surprising finding that defects in skeletal muscle insulin action are acquired secondary to a factor (or factors) in the in vivo environment (Project 1). Dunaif and colleagues' family studies have shown that hyperandrogenernia is the major reproductive phenotype in PCOS kindreds (Figure 3). Urbanek and colleagues have compelling evidence that this phenotype is linked with a marker, D19S884, on chromosome 19p in the region of the insulin receptor gene (Project 2). This marker is also associated with a metabolic phenotype in PCOS women as well as in their brothers characterized by

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decreased insulin secretion, particularly in response to sulfonylurea (Project 1). Abbott and colleagues have shown that many of the phenotypic features of PCOS, such as ovarian hyperandrogenism, polycystic ovaries, increased LH levels, anovulation, central adiposity and decreased insulin secretion can be produced in rhesus monkeys by intrauterine testosterone exposure (Project 3). Levine has obtained evidence that one mechanism for some of these androgen actions is decreased function of ATP-sensitive potassium channels (K+ATP channel) in gonadotropin releasing hormone (GnRH) containing neurons and in pancreatic islet P-cells (Project 4). Sulfonylureas stimulate insulin secretion through activation of one of these channels, known as the sulfonylurea receptor, and the same channel complex appears to function in GnRH neurons. These observations have led to a paradigm shift in our concept of the pathogenesis of PCOS. Exposure of the fetus to androgens could result in the reproductive phenotype and the pancreatic P-cell dysfunction characteristic of PCOS. We propose to test the hypothesis that hyperandrogenernia resulting from variation in a gene in linkage disequilibrium with D I 9S884 causes many of the phenotypic features of PCOS by prenatal androgen programming. This hypothesis will be directly tested in two animal models and in translational human studies. The metabolic phenotype associated with the chromosome 19p PCOS susceptibility gene will be defined and this susceptibility gene will be identified. These studies will elucidate the pathogenesis of PCOS and provide the potential for molecular diagnosis of the syndrome. These objectives will be accomplished in four highly synergistic and interactive research projects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INSULIN SIGNALING IN THECA CELLS FROM POLYCYSTIC OVARIES Principal Investigator & Institution: Magoffin, Denis A.; Professor; Cedars-Sinai Medical Center Box 48750, 8700 Beverly Blvd Los Angeles, Ca 900481804 Timing: Fiscal Year 2002; Project Start 21-AUG-2002; Project End 30-JUN-2007 Summary: (provided by applicant): Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disease in women of reproductive age. Approximately three-quarters of women with anovulatory infertility have PCOS, thus accounting for approximately one-third of women with secondary amenorrhea and approximately 90% of women with oligomenorrhea. Other consequences of PCOS are hirsutism, markedly increased incidence of recurrent early pregnancy loss, an estimated 11-fold increased risk of myocardial infarction between the ages of 50-61 years, and an increased risk of endometrial cancer at a young age. A consistent finding in women with PCOS is that the ovaries produce abnormally high amounts of androgens. There is good evidence to conclude that elevated androgens interfere with selection of dominant follicles and cause PCOS. Importantly, there is an association between insulin resistance and the androgen excess of PCOS. It is clear that insulin can stimulate ovarian androgen production, but a paradox exists: how can insulin hyperstimulate ovarian thecal androgen production in an insulin resistant woman? One of two hypotheses could explain the seeming paradox. Either the ovarian theca cells are not insulin resistant in insulin resistant women or there are distinct insulin signaling mechanisms regulating glucose metabolism and androgen production in theca cells. The purpose of the proposed studies is to determine if ovarian theca cells are insulin resistant in insulin resistant women, to explore the intracellular signaling mechanisms by which insulin regulates androgen biosynthesis, and to determine if there are differences in the concentrations and/or activities of key molecules mediating insulin action in theca cell from polycystic ovaries. To accomplish these goals, we will measure the sensitivity of

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skeletal muscle and ovarian theca cell glucose uptake in response to insulin to determine the relative sensitivity of these tissues to insulin in insulin sensitive and insulin resistant women with and without PCOS. We have established a human theca cell culture model in which we can examine the molecular details of insulin signaling. Importantly, increased androgen production and steroidogenic enzyme mRNA over-expression persist in the cultured cells in vitro. We propose to use this model to systematically determine the intracellular signaling pathway for insulin stimulation of CYP 17 activities and mRNA expression and then to compare the concentrations and activities of the signaling molecules between regularly cycling control women and women with PCOS. The results of these studies are expected to yield specific molecular targets for novel therapies to treat women with PCOS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOLECULAR REGULATION IN REPRODUCTION Principal Investigator & Institution: French, Frank S.; Professor; Pediatrics; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2002; Project Start 07-APR-1997; Project End 31-MAR-2007 Summary: The Laboratories for Reproductive Biology proposes to continue its Specialized Cooperative Center for Research in Reproduction with focus on molecular mechanisms regulating reproductive processes. Four interrelated subprojects will utilize three core facilities. I. "Endometrial integrins and uterine receptivity". Bruce A. Lessey, M.D., Ph.D., will further delineate the endometrial signaling pathways required for uterine receptivity to embryo implantation and determine the mechanism by which polycystic ovaries with hyperandrogenism causes loss of uterine receptivity. II. "Molecular determinants of androgen receptor function", Elizabeth M. Wilson, Ph.D., will analyze androgen receptor (AR) gene mutations causing androgen insensitivity syndrome (AIS) to test the hypothesis that multiple intra and intermolecular domain specific protein interactions control ligand-AR mediated gene activation. Focus will be on structural determinants of the NH2/carboxyl-terminal interaction, AR degradation signals, p160 coactivation, and AR interaction with other coregulators. Androgen resistant fibroblasts that lack an AR gene mutation will be analyzed to identify a missing co-activator required for AR action. III. "Function of glyceraldehyde 3-phosphate dehydrogenase- S (GAPDS) during spermatogenesis and fertilization", Deborah A. O'Brien , Ph.D., will analyze GAPDS knockout and transgenic mice to identify defects in sperm function and test the hypothesis that anchoring of GAPDS to the fibrous sheath is essential for normal sperm glycolysis, hyperactivated motility and fertilization. Sperm proteins that interact with GAPDS will be identified, and the role of GAPDS in assembly of sperm glycolytic enzymes will be investigated. Key amino acids responsible for the novel enzymatic properties of GAPDS will be established. IV. "Functional characterization of the testis-specific histone binding protein, NASP, during spermatogenesis", Michael G. O'Rand, Ph.D., will test the hypothesis that NASP is important for normal spermatogenic cell function during both mitosis and meiosis. This proposal seeks to establish the role NASP plays in the transport and transfer of specific histones to chromatin during meiosis and mitosis. It will determine how NASP is regulated and whether NASP stores and/or transports transition proteins and protamines to the DNA during spermiogenesis. Each project will be assisted by Cell Separation and Tissue Culture, Immunotechnology-Histochemistry, and Administrative Cores. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PATHOPHYSIOLOGIC POLYCYSTIC OVARY SYNDROME

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Principal Investigator & Institution: Chang, R Jeffrey.; Professor & Chairman; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 920930934 Timing: Fiscal Year 2002 Summary: Polycystic ovary syndrome (PCOS) is the most common reproductivemetabolic disorder of women during their child-bearing years affecting 5-10% of this population. The major clinical features include infrequent and irregular menses, excessive hair growth and infertility as result of an ovulation and hyperandrogenism. In recent ears, late age health concerns for these patients have grown largely due to the emergence of insulin resistance and hyperinsulinemia as constitutive components of this disorder. These risks include endometrial cancer, insulin-dependent and noninsulindependent diabetes mellitus, hypertension, stroke and cardiovascular disease. Efforts to elucidate the pathogenesis of PCOS have demonstrated distinct abnormalities at each level of the reproductive system as reflected by increased pituitary LH secretion, excessive theca interstitial cell androgen production and arrest of ovarian follicle development. In all of these target tissues insulin had been shown in vitro to enhance cell function, including studies which have utilized both PCOS and normal ovaries. Unfortunately, corresponding in vivo human studies have not been able to corroborate the in vitro results of insulin action. The overall goal of this proposal is to examine in women with PCOS the effect of hyper- insulinemia on the functional capacity of pituitary LH secretion, theca cell androgen production and granulosa cell estrogen production. Our hypothesis is that hyperinsulinemia perpetuates the recognized abnormalities of PCOS by altering these major target tissues. Following baseline studies to determine target tissue responsiveness and sensitivity, PCOS and normal women will have their serum insulin levels raised by the hyperinsulinemic, euglycemic clamp method and the studies will be repeated. Subsequently, subjects will be treated with an insulin enhancing drug, Troglitazone, to reduce hyperinsulinemia after which they will be retested. While on Troglitazone, insulin levels will again be raised and the baseline studies repeated. The results of this vigorous and thorough proposal will allow us to identify in vivo the effects of insulin at each target tissue and determine the clinical impact of hyperinsulinemia on reproductive dysfunction in PCOS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PEDIATRIC BIPOLAR COLLABORATIVE MOOD STABILIZER TRIAL Principal Investigator & Institution: Scheffer, Russell E.; Psychiatry; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 30-JUN-2003 Summary: (Adapted from Applicant's Abstract): Bipolar disorder (BPD) in children and adolescents is increasingly recognized as a common and virulent disorder, but evidencebased treatment approaches are lacking. This revised, proposed study develops evidence to address this significant knowledge gap, and helps to develop more empirically based treatments of child and adolescent BPD. This three-site, collaborative treatment study proposes to evaluate the acute phase, comparative efficacy of two mood stabilizers, lithium (LI) and divalproex sodium (DVP) versus placebo (PBO) in outpatient children and adolescents with symptomatic, nonpsychotic BPD I in the mixed or manic phase. Investigators at 3 sites (UTSW, Case Western Reserve & Univ. of Cinn.) will randomize 150 patients over 3 years. To our knowledge, this represents the first

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randomized, controlled the comparing the efficacy of each mood stabilizer versus placebo in this population. This will be accomplished by randomly assigning subjects in a double-blinded fashion to 8 weeks of treatment with either LI, DVP, or PBO. The primary aim of this project is to compare the efficacy of LI, DVP, and PBO in the acute phase treatment of symptomatic bipolar I disorder, in children and adolescents ages 8-17 yr. Our hypothesis is that differential efficacy will be observed with the following predicted order of response: DVP equals LI > PBO. The secondary aims are: 1)To provide descriptive data and effect size estimates of combined treatment with LI and DVP in patients who do not respond acutely to either one alone; 2) To collect systematic safety data on the incidence of weight gain, polycystic ovaries, and hyperandrogenism, in bipolar adolescent females treated with LI, DVP, or LI + DVP; 3) To collect data on possible predictors of acute treatment response to the two active treatments; 4) To provide descriptive information on the stability of acute phase response to monotherapy with either LI or DVP over 16 weeks of continuation phase treatment. We will systematically collect data concerning the short- and long-term safety and tolerability of mood stabilizers in children and adolescents. No studies have looked at the question of weight gain, polycystic ovaries, and endocrine abnormalities in female bipolar adolescents treated with mood stabilizers. Because of the frequent use of mood stabilizers in bipolar adolescents, this is an important area to systematically collect prospective data on. We will also be able to provide descriptive data and effect size estimates of combined treatment with LI and DVP in patients who do not respond acutely to either one and collect data on possible predictors of acute treatment response to the two active treatments. Lastly, this trial will provide descriptive information on the stability of acute phase response to monotherapy over a 16 week continuation phase. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PEDIATRIC BIPOLAR COLLABORATIVE MOOD STABILIZER TRIALS Principal Investigator & Institution: Kowatch, Robert A.; Professor; Children's Hospital Med Ctr (Cincinnati) 3333 Burnet Ave Cincinnati, Oh 45229 Timing: Fiscal Year 2002; Project Start 07-SEP-2000; Project End 31-AUG-2004 Summary: (Adapted from Applicant's Abstract): Bipolar disorder (BPD) in children and adolescents is increasingly recognized as a common and virulent disorder, but evidencebased treatment approaches are lacking. This revised, proposed study develops evidence to address this significant knowledge gap, and helps to develop more empirically based treatments of child and adolescent BPD. This three-site, collaborative treatment study proposes to evaluate the acute phase, comparative efficacy of two mood stabilizers, lithium (LI) and divalproex sodium (DVP) versus placebo (PBO) in outpatient children and adolescents with symptomatic, nonpsychotic BPD I in the mixed or manic phase. Investigators at 3 sites (UTSW, Case Western Reserve & Univ. of Cinn.) will randomize 150 patients over 3 years. To our knowledge, this represents the first randomized, controlled the comparing the efficacy of each mood stabilizer versus placebo in this population. This will be accomplished by randomly assigning subjects in a double-blinded fashion to 8 weeks of treatment with either LI, DVP, or PBO. The primary aim of this project is to compare the efficacy of LI, DVP, and PBO in the acute phase treatment of symptomatic bipolar I disorder, in children and adolescents ages 8-17 yr. Our hypothesis is that differential efficacy will be observed with the following predicted order of response: DVP equals LI > PBO. The secondary aims are: 1)To provide descriptive data and effect size estimates of combined treatment with LI and DVP in patients who do not respond acutely to either one alone; 2) To collect systematic

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safety data on the incidence of weight gain, polycystic ovaries, and hyperandrogenism, in bipolar adolescent females treated with LI, DVP, or LI + DVP; 3) To collect data on possible predictors of acute treatment response to the two active treatments; 4) To provide descriptive information on the stability of acute phase response to monotherapy with either LI or DVP over 16 weeks of continuation phase treatment. We will systematically collect data concerning the short- and long-term safety and tolerability of mood stabilizers in children and adolescents. No studies have looked at the question of weight gain, polycystic ovaries, and endocrine abnormalities in female bipolar adolescents treated with mood stabilizers. Because of the frequent use of mood stabilizers in bipolar adolescents, this is an important area to systematically collect prospective data on. We will also be able to provide descriptive data and effect size estimates of combined treatment with LI and DVP in patients who do not respond acutely to either one and collect data on possible predictors of acute treatment response to the two active treatments. Lastly, this trial will provide descriptive information on the stability of acute phase response to monotherapy over a 16 week continuation phase. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PEDIATRIC BIPOLAR COLLABORATIVE MOOD STABILZER TRAIL Principal Investigator & Institution: Findling, Robert L.; Director; Psychiatry; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 31-AUG-2004 Summary: (Adapted from Applicant's Abstract): Bipolar disorder (BPD) in children and adolescents is increasingly recognized as a common and virulent disorder, but evidencebased treatment approaches are lacking. This revised, proposed study develops evidence to address this significant knowledge gap, and helps to develop more empirically based treatments of child and adolescent BPD. This three-site, collaborative treatment study proposes to evaluate the acute phase, comparative efficacy of two mood stabilizers, lithium (LI) and divalproex sodium (DVP) versus placebo (PBO) in outpatient children and adolescents with symptomatic, nonpsychotic BPD I in the mixed or manic phase. Investigators at 3 sites (UTSW, Case Western Reserve & Univ. of Cinn.) will randomize 150 patients over 3 years. To our knowledge, this represents the first randomized, controlled the comparing the efficacy of each mood stabilizer versus placebo in this population. This will be accomplished by randomly assigning subjects in a double-blinded fashion to 8 weeks of treatment with either LI, DVP, or PBO. The primary aim of this project is to compare the efficacy of LI, DVP, and PBO in the acute phase treatment of symptomatic bipolar I disorder, in children and adolescents ages 8-17 yr. Our hypothesis is that differential efficacy will be observed with the following predicted order of response: DVP equals LI > PBO. The secondary aims are: 1)To provide descriptive data and effect size estimates of combined treatment with LI and DVP in patients who do not respond acutely to either one alone; 2) To collect systematic safety data on the incidence of weight gain, polycystic ovaries, and hyperandrogenism, in bipolar adolescent females treated with LI, DVP, or LI + DVP; 3) To collect data on possible predictors of acute treatment response to the two active treatments; 4) To provide descriptive information on the stability of acute phase response to monotherapy with either LI or DVP over 16 weeks of continuation phase treatment. We will systematically collect data concerning the short- and long-term safety and tolerability of mood stabilizers in children and adolescents. No studies have looked at the question of weight gain, polycystic ovaries, and endocrine abnormalities in female bipolar adolescents treated with mood stabilizers. Because of the frequent use of mood stabilizers in bipolar adolescents, this is an important area to systematically collect

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prospective data on. We will also be able to provide descriptive data and effect size estimates of combined treatment with LI and DVP in patients who do not respond acutely to either one and collect data on possible predictors of acute treatment response to the two active treatments. Lastly, this trial will provide descriptive information on the stability of acute phase response to monotherapy over a 16 week continuation phase. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SIGNALING PATHWAYS REGULATING GNRH SECRETION Principal Investigator & Institution: Weiner, Richard I.; Professor; Obstetrics, Gynecology and Reproductive Sciences; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 30-NOV-2007 Summary: (provided by applicant): GnRH pulses are tightly regulated for the maintenance of reproductive cycles. Pulsatile GnRH release is an intrinsic property of GT1 GnRH cells and endogenous GnRH neurons. Based on findings in GT1 cells, we hypothesize that the cAMP signaling pathway participates in the stimulation of GnRH secretion and the timing of GnRH pulses. Our findings show that increases in cAMP stimulate GnRH secretion by opening cAMP-gated cation (CNG) channels leading to increased excitability and depolarization of the neuron. Increased neuron excitability is reflected in increased action potentials, Ca2+ oscillations and GnRH secretion. Increased cAMP levels also activate PKA that appears to initiate negative feedback pathways. We will study the role of these signaling molecules on the regulation of GnRH secretion in vitro in the GT1 GnRH cell lines and in vivo in transgenic rats. We will decrease neuron excitability by lowering cAMP levels by expressing the constitutively active phosphodiesterase, PDE4D1, or inhibiting CNG channel activity by expressing a dominant/negative (D/N) mutant of the CNG2 channel subunit (DMCNG2). We will increase neuron excitability by inhibiting the PKA negative feedback pathway by expression of the D/N mutant of the regulatory subunit of PKA mRAB and by increasing cAMP levels by expressing a constitutively active soluble adenylate cyclase (sAC). In GT1 cells we will use adenovirus vectors to target expression of the genetic probes. We will study changes in GT1 neuron excitability (Ca2+ oscillations) and the frequency and amplitude of GnRH pulses. We have now shown that expression of PDE4D1 in GT1 cells inhibits Ca2+ oscillations and pulsatile GnRH release. Genetic probes shown to be effective in experiments with GT1 cells will be cell specifically targeted to GnRH neurons in transgenic rats using the rat GnRH gene promoter/enhancer. We have now shown that targeted expression of PDE4D1 in a line of transgenic rats decreased the frequency of LH pulses in castrated males and females. Females were infertile and had blunted LH ovulatory surges or polycystic ovaries. In addition to advancing our knowledge of the signaling pathways involved in timing pulsatile GnRH secretion these animals will provide important models for studying the effects of alterations in GnRH pulsatility on reproductive function. Potentailly these findings may be relevant to the understanding of human disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “polycystic ovaries” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for polycystic ovaries in the PubMed Central database: •

A paradigm for finding genes for a complex human trait: Polycystic ovary syndrome and follistatin. by Odunsi K, Kidd KK.; 1999 Jul 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=33617

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Diagnostic and treatment characteristics of polycystic ovary syndrome: descriptive measurements of patient perception and awareness from 657 confidential self-reports. by Sills ES, Perloe M, Tucker MJ, Kaplan CR, Genton MG, Schattman GL.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=55341

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Evidence for a genetic basis for hyperandrogenemia in polycystic ovary syndrome. by Legro RS, Driscoll D, Strauss JF III, Fox J, Dunaif A.; 1998 Dec 8; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=24557

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Molecular Basis of Aromatase Deficiency in an Adult Female with Sexual Infantilism and Polycystic Ovaries. by Ito Y, Fisher CR, Conte FA, Grumbach MM, Simpson ER.; 1993 Dec 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=48046

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Steroid-induced polycystic ovaries in rats: effect of electro-acupuncture on concentrations of endothelin-1 and nerve growth factor (NGF), and expression of NGF mRNA in the ovaries, the adrenal glands, and the central nervous system. by Stener-Victorin E, Lundeberg T, Cajander S, Aloe L, Manni L, Waldenstrom U, Janson PO.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=155675

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Targeted Overexpression of Luteinizing Hormone in Transgenic Mice Leads to Infertility, Polycystic Ovaries, and Ovarian Tumors. by Risma KA, Clay CM, Nett TM, Wagner T, Yun J, Nilson JH.; 1995 Feb 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=42511

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The management of infertility associated with polycystic ovary syndrome. by Homburg R.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=280720

3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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Thirty-seven candidate genes for polycystic ovary syndrome: Strongest evidence for linkage is with follistatin. by Urbanek M, Legro RS, Driscoll DA, Azziz R, Ehrmann DA, Norman RJ, Strauss JF III, Spielman RS, Dunaif A.; 1999 Jul 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=17558

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Using an electrocautery strategy or recombinant follicle stimulating hormone to induce ovulation in polycystic ovary syndrome: randomised controlled trial. by Bayram N, van Wely M, Kaaijk EM, Bossuyt PM, van der Veen F.; 2004 Jan 24; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=318481

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with polycystic ovaries, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “polycystic ovaries” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for polycystic ovaries (hyperlinks lead to article summaries): •

11 beta-hydroxyandrostenedione in plasma, follicular fluid, and granulosa cells of women with normal and polycystic ovaries. Author(s): Owen EJ, Holownia P, Conway GS, Jacobs HS, Honour JW. Source: Fertility and Sterility. 1992 October; 58(4): 713-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1426315

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17 beta-Hydroxysteroid oxidoreductase activity in the endometrium of normal women and patients with pelvic pain and polycystic ovaries. Author(s): Bonney RC, Dalby MC, Newton CJ, Franks S, Beard RW, James VH. Source: J Steroid Biochem. 1989; 34(1-6): 535-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2626048

6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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17 beta-Oestradiol, androstenedione and inhibin levels in fluid from individual follicles of normal and polycystic ovaries, and in ovaries from androgen treated female to male transsexuals. Author(s): Pache TD, Hop WC, de Jong FH, Leerentveld RA, van Geldorp H, Van de Kamp TM, Gooren LJ, Fauser BC. Source: Clinical Endocrinology. 1992 June; 36(6): 565-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1424181

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45 X Turner's syndrome in association with polycystic ovaries. Case report. Author(s): Hague WM, Adams J, Reeders ST, Jacobs HS. Source: British Journal of Obstetrics and Gynaecology. 1989 May; 96(5): 613-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2667634

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5' polymorphism of the CYP17 gene is not associated with serum testosterone levels in women with polycystic ovaries. Author(s): Gharani N, Waterworth DM, Williamson R, Franks S. Source: The Journal of Clinical Endocrinology and Metabolism. 1996 November; 81(11): 4174. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8923880

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A case of bilateral dermoid cysts, insulin resistance, and polycystic ovarian disease: association of ovarian tumors with polycystic ovaries with review of the literature. Author(s): Futterweit W, Scher J, Nunez AE, Strauss L, Rayfield EJ. Source: The Mount Sinai Journal of Medicine, New York. 1983 May-June; 50(3): 251-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6353212

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A case of Chiari-Frommel syndrome associated with polycystic ovaries. Author(s): Zarate A, Villalobos M, Valenzuela S. Source: American Journal of Obstetrics and Gynecology. 1968 August 15; 101(8): 1131-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5690918

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A case of extrapuerperal galactopoiesis associated with polycystic ovaries, primary amenorrhea and sterility, successfully treated by ovary wedge resection and clomiphene. Author(s): Maraz A. Source: Acta Eur Fertil. 1970 March; 2(1): 25-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5538517

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A comparison of in vitro maturation and in vitro fertilization for women with polycystic ovaries. Author(s): Child TJ, Phillips SJ, Abdul-Jalil AK, Gulekli B, Tan SL. Source: Obstetrics and Gynecology. 2002 October; 100(4): 665-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12383531

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A controlled study comparing patients with and without polycystic ovaries undergoing in-vitro fertilization. Author(s): MacDougall MJ, Tan SL, Balen A, Jacobs HS. Source: Human Reproduction (Oxford, England). 1993 February; 8(2): 233-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8473426

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A low-dose stimulation protocol using highly purified follicle-stimulating hormone can lead to high pregnancy rates in in vitro fertilization patients with polycystic ovaries who are at risk of a high ovarian response to gonadotropins. Author(s): Marci R, Senn A, Dessole S, Chanson A, Loumaye E, De Grandi P, Germond M. Source: Fertility and Sterility. 2001 June; 75(6): 1131-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11384638

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A prospective study of the prevalence of clear-cut endocrine disorders and polycystic ovaries in 350 patients presenting with hirsutism or androgenic alopecia. Author(s): O'Driscoll JB, Mamtora H, Higginson J, Pollock A, Kane J, Anderson DC. Source: Clinical Endocrinology. 1994 August; 41(2): 231-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7923828

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A Turner's syndrome variant with polycystic ovaries and idiopathic myocardial hypertrophy. Author(s): Williams GH, Rose LI, Jagger PI, Lauler DP. Source: Annals of Internal Medicine. 1969 March; 70(3): 571-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5775036

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Abnormal electromyographic activity of the urethral sphincter, voiding dysfunction, and polycystic ovaries: a new syndrome? Author(s): Fowler CJ, Christmas TJ, Chapple CR, Parkhouse HF, Kirby RS, Jacobs HS. Source: Bmj (Clinical Research Ed.). 1988 December 3; 297(6661): 1436-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3147005

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Acromegaly with polycystic ovaries, hyperandrogenism, hirsutism, insulin resistance and acanthosis nigricans: a case report. Author(s): Unal A, Sahin Y, Kelestimur F. Source: Endocrine Journal. 1993 April; 40(2): 207-11. Erratum In: Endocr J 1993 January; 40(3): Following 372. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7951506

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Activity of testosterone 5alpha-reductase in the hair follicles of women with polycystic ovaries. Author(s): Miyazaki M, Takayasu S, Karakawa T, Aono T, Kurachi K, Matsumoto K. Source: The Journal of Endocrinology. 1978 September; 78(3): 445-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=712302

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Altered expression of insulin and insulin-like growth factor-I receptors in follicular and stromal compartments of polycystic ovaries. Author(s): Samoto T, Maruo T, Matsuo H, Katayama K, Barnea ER, Mochizuki M. Source: Endocrine Journal. 1993 August; 40(4): 413-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7920895

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An evaluation of the inter-observer and intra-observer variability of the ultrasound diagnosis of polycystic ovaries. Author(s): Amer SA, Li TC, Bygrave C, Sprigg A, Saravelos H, Cooke ID. Source: Human Reproduction (Oxford, England). 2002 June; 17(6): 1616-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12042287

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An unusual case of Cushing's syndrome, hilus cell tumor and polycystic ovaries. Author(s): Korth-Schutz S, Levine LS, Merkatz IR, New MI. Source: The Journal of Clinical Endocrinology and Metabolism. 1974 May; 38(5): 794-800. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4363071

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Androgen production by human isolated components of normal and polycystic ovaries in vitro. Author(s): Nakamura Y, Yoshimura Y, Kamei K, Izumi Y, Sawada T, Iizuka R. Source: Endocrinol Jpn. 1982 June; 29(3): 307-17. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7173112

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Androgen receptor gene CAG trinucleotide repeats in anovulatory infertility and polycystic ovaries. Author(s): Mifsud A, Ramirez S, Yong EL. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 September; 85(9): 3484-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10999852

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Androgen-producing bilateral large cortical adrenal adenomas associated with polycystic ovaries in a young female. Author(s): Micic D, Zoric S, Popovic V, Jankovic R, Jancic M, Han R, Manojlovic D, Micic J. Source: Postgraduate Medical Journal. 1992 March; 68(797): 219-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1589384

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Androgens and prolactin levels in hirsute women with either polycystic ovaries or “borderline ovaries”. Author(s): Buvat J, Siame-Mourot C, Fourlinnie JC, Lemaire A, Buvat-Herbaut M, Hermand E. Source: Fertility and Sterility. 1982 December; 38(6): 695-700. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6754462

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Aromatase activity of human granulosa cells in patients with polycystic ovaries treated with dexamethasone. Author(s): Bider D, Pariente C, Dor J, Zolti M, Mashiach S, Ben-Rafael Z. Source: Fertility and Sterility. 1990 October; 54(4): 597-600. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2209879

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Aromatase mRNA expression in individual follicles from polycystic ovaries. Author(s): Jakimiuk AJ, Weitsman SR, Brzechffa PR, Magoffin DA. Source: Molecular Human Reproduction. 1998 January; 4(1): 1-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9510005

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Association between polycystic ovaries and extent of coronary artery disease in women having cardiac catheterization. Author(s): Birdsall MA, Farquhar CM, White HD. Source: Annals of Internal Medicine. 1997 January 1; 126(1): 32-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8992921

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Augmented androgen production is a stable steroidogenic phenotype of propagated theca cells from polycystic ovaries. Author(s): Nelson VL, Legro RS, Strauss JF 3rd, McAllister JM. Source: Molecular Endocrinology (Baltimore, Md.). 1999 June; 13(6): 946-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10379893

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Autoimmune oophoritis associated with polycystic ovaries. Author(s): Lonsdale RN, Roberts PF, Trowell JE. Source: Histopathology. 1991 July; 19(1): 77-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1916689

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Bilateral polycystic ovaries with a dermoid cyst of one ovary. Author(s): Kushner DH, Ahn JY. Source: Med Ann Dist Columbia. 1967 December; 36(12): 746-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5237427

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Binge-eating and polycystic ovaries. Author(s): McCluskey SE, Lacey JH, Pearce JM. Source: Lancet. 1992 September 19; 340(8821): 723. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1355813

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Bioactive LH in women with polycystic ovaries and the effect of gonadotrophin suppression. Author(s): Mavroudis K, Evans A, Mamtora H, Anderson DC, Robertson WR. Source: Clinical Endocrinology. 1988 December; 29(6): 633-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2978466

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Brain damage, hypertrichosis, and polycystic ovaries. Clinical evaluation of 7 cases. Author(s): Bartuska DG, Eskin BA, Smith EM, Dacou C, Dratman MB. Source: American Journal of Obstetrics and Gynecology. 1967 October 1; 99(3): 387-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6042616

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Carcinoma of endometrium and polycystic ovaries in a 22-year-old patient. Author(s): Cirns JD, Noble AJ, Bryant ME. Source: Can Med Assoc J. 1967 June 3; 96(22): 1473-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6025724

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Characterization of normal and polycystic ovaries using three-dimensional power Doppler ultrasonography. Author(s): Jarvela IY, Mason HD, Sladkevicius P, Kelly S, Ojha K, Campbell S, Nargund G. Source: Journal of Assisted Reproduction and Genetics. 2002 December; 19(12): 582-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12503891

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Circulating tumor necrosis factor (TNF)-alpha in normally cycling women and patients with premature ovarian failure and polycystic ovaries. Author(s): Naz RK, Thurston D, Santoro N. Source: American Journal of Reproductive Immunology (New York, N.Y. : 1989). 1995 September; 34(3): 170-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8561874

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Classification of normogonadotropic infertility: polycystic ovaries diagnosed by ultrasound versus endocrine characteristics of polycystic ovary syndrome. Author(s): van Santbrink EJ, Hop WC, Fauser BC. Source: Fertility and Sterility. 1997 March; 67(3): 452-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9091329

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Clinical features in women with polycystic ovaries: relationships to insulin sensitivity, insulin gene VNTR and birth weight. Author(s): Michelmore K, Ong K, Mason S, Bennett S, Perry L, Vessey M, Balen A, Dunger D. Source: Clinical Endocrinology. 2001 October; 55(4): 439-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11678825

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Clinical utility of adjuvant growth hormone in the treatment of patients with polycystic ovaries undergoing in vitro fertilization. Author(s): Artini PG, de Micheroux AA, Taponeco F, Cela V, D'Ambrogio G, Genazzani AR. Source: Journal of Assisted Reproduction and Genetics. 1997 January; 14(1): 4-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9013300

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Combined luteinizing hormone releasing hormone analogue and exogenous gonadotrophins for the treatment of infertility associated with polycystic ovaries. Author(s): Homburg R, Eshel A, Kilborn J, Adams J, Jacobs HS. Source: Human Reproduction (Oxford, England). 1990 January; 5(1): 32-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2108981

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Comparison of follicle steroidogenesis from normal and polycystic ovaries in women undergoing IVF: relationship between steroid concentrations, follicle size, oocyte quality and fecundability. Author(s): Teissier MP, Chable H, Paulhac S, Aubard Y. Source: Human Reproduction (Oxford, England). 2000 December; 15(12): 2471-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11098013

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Comparison of the estrogen feedback control mechanism between women with normal and polycystic ovaries. Author(s): Lopez JM, Migeon CJ, Jones GS. Source: American Journal of Obstetrics and Gynecology. 1969 February 15; 103(4): 55565. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5764182

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Concentration of unconjugated adrenogenic hormones and their precursors in normal and polycystic ovaries. Author(s): Gyory G, Kiss C, Feher T, Poteczin E. Source: Endokrinologie. 1975 January; 64(2): 181-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=125194

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Concentration of vascular endothelial growth factor released by cultured human luteinized granulosa cells is higher in women with polycystic ovaries than in women with normal ovaries. Author(s): Agrawal R, Jacobs H, Payne N, Conway G. Source: Fertility and Sterility. 2002 December; 78(6): 1164-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12477505

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Cystic prolactinoma of the pituitary following surgery for polycystic ovaries. Author(s): Kurisaka M, Tindall SC, Takei Y. Source: Neurol Med Chir (Tokyo). 1983 January; 23(1): 55-60. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6188983

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Cytokine levels in follicular fluid of polycystic ovaries in patients treated with dexamethasone. Author(s): Zolti M, Bider D, Seidman DS, Mashiach S, Ben-Rafael Z. Source: Fertility and Sterility. 1992 March; 57(3): 501-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1740194

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Decreased expression of tissue inhibitor of matrix metalloproteinases in follicular fluid from women with polycystic ovaries compared with normally ovulating patients undergoing in vitro fertilization. Author(s): Lahav-Baratz S, Kraiem Z, Shiloh H, Koifman M, Ishai D, Dirnfeld M. Source: Fertility and Sterility. 2003 March; 79(3): 567-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12620441

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Definition and significance of polycystic ovaries. Author(s): Dewailly D. Source: Baillieres Clin Obstet Gynaecol. 1997 June; 11(2): 349-68. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9536215

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Development of polycystic ovaries in rats actively immunised against T-3-BSA. Author(s): Hillier SG, Groom GV, Boyns AR, Cameron EH. Source: Nature. 1974 August 2; 250(465): 433-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4859273

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Diet-induced changes in sex hormone binding globulin and free testosterone in women with normal or polycystic ovaries: correlation with serum insulin and insulinlike growth factor-I. Author(s): Kiddy DS, Hamilton-Fairley D, Seppala M, Koistinen R, James VH, Reed MJ, Franks S. Source: Clinical Endocrinology. 1989 December; 31(6): 757-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2697481

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Distribution of steroidogenic enzymes involved in androgen synthesis in polycystic ovaries: an immunohistochemical study. Author(s): Kaaijk EM, Sasano H, Suzuki T, Beek JF, van Der Veen F. Source: Molecular Human Reproduction. 2000 May; 6(5): 443-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10775648

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Diurnal change of serum androstenedione and testosterone and response to hCG and dexamethasone in women with polycystic ovaries, adrenal hyperandrogenism and unexplained hirsutism. Author(s): Lisse K, Schurenkamper P, Friedrich W, Rutkowsky J. Source: Acta Endocrinol (Copenh). 1980 February; 93(2): 216-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7189630

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Dyslipidaemia is associated with insulin resistance in women with polycystic ovaries. Author(s): Robinson S, Henderson AD, Gelding SV, Kiddy D, Niththyananthan R, Bush A, Richmond W, Johnston DG, Franks S. Source: Clinical Endocrinology. 1996 March; 44(3): 277-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8729522

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Effect of celioscopic ovarian resection in patients with polycystic ovaries. Author(s): Campo S, Garcea N, Caruso A, Siccardi P. Source: Gynecologic and Obstetric Investigation. 1983; 15(4): 213-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6220946

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Effect of gonadotropins, insulin and IGF I on granulosa luteal cells from polycystic ovaries. Author(s): Andreani CL, Pierro E, Lanzone A, Lazzarin N, Capitanio G, Giannini P, Mancuso S. Source: Molecular and Cellular Endocrinology. 1994 December; 106(1-2): 91-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7895919

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Effect of weight loss and antiandrogenic therapy on sex hormone blood levels and insulin resistance in obese patients with polycystic ovaries. Author(s): Pasquali R, Fabbri R, Venturoli S, Paradisi R, Antenucci D, Melchionda N. Source: American Journal of Obstetrics and Gynecology. 1986 January; 154(1): 139-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3511703

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Effects of luteinizing hormone and dibutyryl adenosine 3',5'-monophosphate in cultured granulosa cells from polycystic ovaries. Author(s): Nakamura Y, Yoshimura Y, Sugimura K, Tamaoka Y, Iizuka R. Source: The Journal of Clinical Endocrinology and Metabolism. 1986 November; 63(5): 1156-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3020077

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Effects of metformin on ovulation rate, hormonal and metabolic profiles in women with clomiphene-resistant polycystic ovaries: a randomized, double-blinded placebocontrolled trial. Author(s): Ng EH, Wat NM, Ho PC. Source: Human Reproduction (Oxford, England). 2001 August; 16(8): 1625-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11473953

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Elevated free androgen index as an indicator of polycystic ovaries in oligomenorrhoea without obesity or hirsuties. Author(s): Eden JA, Place J, Carter GD, Jones J, Alaghband-Zadeh J, Pawson M. Source: Annals of Clinical Biochemistry. 1988 July; 25 ( Pt 4): 346-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2975154

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Elevated serum TNF-alpha levels in normal-weight women with polycystic ovaries or the polycystic ovary syndrome. Author(s): Sayin NC, Gucer F, Balkanli-Kaplan P, Yuce MA, Ciftci S, Kucuk M, Yardim T. Source: J Reprod Med. 2003 March; 48(3): 165-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12698773

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Endocrine abnormalities in ovulatory women with polycystic ovaries on ultrasound. Author(s): Carmina E, Wong L, Chang L, Paulson RJ, Sauer MV, Stanczyk FZ, Lobo RA. Source: Human Reproduction (Oxford, England). 1997 May; 12(5): 905-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9194637

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Endocrine changes and clinical outcome after laparoscopic ovarian resection in women with polycystic ovaries. Author(s): Campo S, Felli A, Lamanna MA, Barini A, Garcea N. Source: Human Reproduction (Oxford, England). 1993 March; 8(3): 359-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8473448

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Endocrine features in eutestosteronemic women with polycystic ovaries. Author(s): Wada K, Imai A, Itoh T, Nishigaki-Nakagawa M, Misao R, Tamaya T. Source: Gynecologic and Obstetric Investigation. 1994; 37(2): 106-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8150364

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Endometrial cancer associated with polycystic ovaries in young women. Author(s): Smyczek-Gargya B, Geppert M. Source: Pathology, Research and Practice. 1992 October; 188(7): 946-8; Discussion 948-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1448386

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Endometrial phospholipases A2, polycystic ovaries and pelvic pain. Author(s): Bonney RC, Watson H, Beesley JS, Higham JM, Rogers V, Franks S. Source: British Journal of Obstetrics and Gynaecology. 1992 June; 99(6): 486-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1637765

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Estradiol production by granulosa cells of normal and polycystic ovaries: relationship to menstrual cycle history and concentrations of gonadotropins and sex steroids in follicular fluid. Author(s): Mason HD, Willis DS, Beard RW, Winston RM, Margara R, Franks S. Source: The Journal of Clinical Endocrinology and Metabolism. 1994 November; 79(5): 1355-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7962330

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Evidence for a single gene effect causing polycystic ovaries and male pattern baldness. Author(s): Carey AH, Chan KL, Short F, White D, Williamson R, Franks S. Source: Clinical Endocrinology. 1993 June; 38(6): 653-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8334753

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Evolution of polycystic ovaries in a girl with delayed menarche. A case report. Author(s): Stanhope R, Adams J, Brook CG. Source: J Reprod Med. 1988 May; 33(5): 482-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3290478

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Expression of insulin-like growth factor (IGF), IGF-binding protein, and IGF receptor messenger ribonucleic acids in normal and polycystic ovaries. Author(s): Voutilainen R, Franks S, Mason HD, Martikainen H. Source: The Journal of Clinical Endocrinology and Metabolism. 1996 March; 81(3): 10038. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8772565

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Familial insulin resistant diabetes associated with acanthosis nigricans, polycystic ovaries, hypogonadism, pigmentary retinopathy, labyrinthine deafness, and mental retardation. Author(s): Boor R, Herwig J, Schrezenmeir J, Pontz BF, Schonberger W. Source: American Journal of Medical Genetics. 1993 March 1; 45(5): 649-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8456839

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Familial polycystic ovaries: a genetic disease? Author(s): Hague WM, Adams J, Reeders ST, Peto TE, Jacobs HS. Source: Clinical Endocrinology. 1988 December; 29(6): 593-605. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3076848

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Features of Turner's syndrome in women with polycystic ovaries. Author(s): Givens JR, Wilroy RS, Summitt RL, Andersen RN, Wiser WL, Fish SA. Source: Obstetrics and Gynecology. 1975 June; 45(6): 619-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1143721

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Fetal growth, length of gestation, and polycystic ovaries in adult life. Author(s): Cresswell JL, Barker DJ, Osmond C, Egger P, Phillips DI, Fraser RB. Source: Lancet. 1997 October 18; 350(9085): 1131-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9343501

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Follicular fluid renin concentration in patients with polycystic ovaries treated with gonadotrophins in an in vitro fertilisation programme. Author(s): Vrtacnik-Bokal E, Meden-Vrtovec H, Osredkar J, Verdenik I. Source: Clinical Chemistry and Laboratory Medicine : Cclm / Fescc. 2003 May; 41(5): 663-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12812264

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Follicular fluid steroid and epidermal growth factor content, and in vitro estrogen release by granulosa-luteal cells from patients with polycystic ovaries in an IVF/ET program. Author(s): Volpe A, Coukos G, D'Ambrogio G, Artini PG, Genazzani AR. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1991 December 13; 42(3): 195-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1773873

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Follistatin concentrations in follicular fluid of normal and polycystic ovaries. Author(s): Erickson GF, Chung DG, Sit A, DePaolo LV, Shimasaki S, Ling N. Source: Human Reproduction (Oxford, England). 1995 August; 10(8): 2120-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8567852

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Free alpha-subunit response to gonadotropin-releasing hormone in women with polycystic ovaries. Author(s): Rezai P, Scommegna A, Zbella EA, Lessing J, Brenner S, Weiss G, Benveniste R. Source: Fertility and Sterility. 1987 February; 47(2): 249-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2434364

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Functional integrity of granulosa cells from polycystic ovaries. Author(s): Almahbobi G, Anderiesz C, Hutchinson P, McFarlane JR, Wood C, Trounson AO. Source: Clinical Endocrinology. 1996 May; 44(5): 571-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8762734

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Functional studies of aromatase activity in human granulosa cells from normal and polycystic ovaries. Author(s): Erickson GF, Hsueh AJ, Quigley ME, Rebar RW, Yen SS. Source: The Journal of Clinical Endocrinology and Metabolism. 1979 October; 49(4): 5149. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=479344

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Galactorrhea and amenorrhea with polycystic ovaries. Del Castillo syndrome or polycystic ovarian syndrome. Author(s): Lavric MV. Source: American Journal of Obstetrics and Gynecology. 1969 July 15; 104(6): 814-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5815671

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Gonadotrophin regimens and oocyte quality in women with polycystic ovaries. Author(s): Franks S, Roberts R, Hardy K. Source: Reproductive Biomedicine Online. 2003 March; 6(2): 181-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12675997

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Granulosa cells of polycystic ovaries: are they normal or abnormal? Author(s): Erickson GF, Magoffin DA, Garzo VG, Cheung AP, Chang RJ. Source: Human Reproduction (Oxford, England). 1992 March; 7(3): 293-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1587932

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Heterogeneity of late-onset adrenal 3 beta-ol-hydroxysteroid dehydrogenase deficiency in patients with hirsutism and polycystic ovaries. Author(s): Moran C, Tena G, Herrera J, Bermudez JA, Zarate A. Source: Archives of Medical Research. 1994 Autumn; 25(3): 315-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7803981

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High prevalence of mullerian anomalies diagnosed by ultrasound in women with polycystic ovaries. Author(s): Appelman Z, Hazan Y, Hagay Z. Source: J Reprod Med. 2003 May; 48(5): 362-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12815910

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High prevalence of polycystic ovaries and associated clinical, endocrine, and metabolic features in women with previous gestational diabetes mellitus. Author(s): Holte J, Gennarelli G, Wide L, Lithell H, Berne C. Source: The Journal of Clinical Endocrinology and Metabolism. 1998 April; 83(4): 114350. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9543131

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HLA associations in patients with polycystic ovaries and in patients with congenital adrenal hyperplasia caused by 21-hydroxylase deficiency. Author(s): Hague WM, Adams J, Algar V, Drummond V, Schwarz G, Bottazzo GF, Jacobs HS. Source: Clinical Endocrinology. 1990 April; 32(4): 407-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2347091

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Hormonal effects of wedge resection of polycystic ovaries. Author(s): Katz M, Carr PJ, Cohen BM, Millar RP. Source: Obstetrics and Gynecology. 1978 April; 51(4): 437-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=662227

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Hormonal studies on women with polycystic ovaries diagnosed by ultrasound. Author(s): Obhrai M, Lynch SS, Holder G, Jackson R, Tang L, Butt WR. Source: Clinical Endocrinology. 1990 April; 32(4): 467-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2140734

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Hormone profile & polycystic ovaries in acne vulgaris. Author(s): Jebraili R, Kaur S, Kanwar AJ, Kataria S, Dash RJ. Source: The Indian Journal of Medical Research. 1994 August; 100: 73-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7927560

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How common are polycystic ovaries and the polycystic ovarian syndrome in women with Cushing's syndrome? Author(s): Kaltsas GA, Korbonits M, Isidori AM, Webb JA, Trainer PJ, Monson JP, Besser GM, Grossman AB. Source: Clinical Endocrinology. 2000 October; 53(4): 493-500. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11012575

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How common are polycystic ovaries in normal women and what is their significance for the fertility of the population? Author(s): Clayton RN, Ogden V, Hodgkinson J, Worswick L, Rodin DA, Dyer S, Meade TW. Source: Clinical Endocrinology. 1992 August; 37(2): 127-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1395063

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How to discriminate between normal and polycystic ovaries: transvaginal US study. Author(s): Pache TD, Wladimiroff JW, Hop WC, Fauser BC. Source: Radiology. 1992 May; 183(2): 421-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1561343

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Hypersecretion of androgens by polycystic ovaries: the role of genetic factors in the regulation of cytochrome P450c17 alpha. Author(s): Franks S, White D, Gilling-Smith C, Carey A, Waterworth D, Williamson R. Source: Baillieres Clin Endocrinol Metab. 1996 April; 10(2): 193-203. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8773744

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Hypersecretion of androstenedione by isolated thecal cells from polycystic ovaries. Author(s): Gilling-Smith C, Willis DS, Beard RW, Franks S. Source: The Journal of Clinical Endocrinology and Metabolism. 1994 October; 79(4): 1158-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7962289

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Hypogonadotropic patients with ultrasonographically detected polycystic ovaries: endocrine response to pulsatile gonadotropin-releasing hormone. Author(s): Schachter M, Balen AH, Patel A, Jacobs HS. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 1996 October; 10(5): 327-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8915662

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Immunoactive interleukin-1 beta and tumour necrosis factor-alpha in thecal, stromal and granulosa cell cultures from normal and polycystic ovaries. Author(s): Jasper M, Norman RJ. Source: Human Reproduction (Oxford, England). 1995 June; 10(6): 1352-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7593494

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Immunohistochemical detection of plasminogen activator inhibitor-1 in polycystic ovaries. Author(s): Atiomo WU, Hilton D, Fox R, Lee D, Shaw S, Friend J, Wilkin TJ, Prentice AG. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 2000 June; 14(3): 162-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10923276

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Immunohistochemical study and quantitative estimation of beta-endorphin in polycystic ovaries. Author(s): el-Tabbakh GH, el-Sayed OK, Hamza MA. Source: Asia Oceania J Obstet Gynaecol. 1987 December; 13(4): 485-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2962564

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Impaired carotid viscoelastic properties in women with polycystic ovaries. Author(s): Lakhani K, Seifalian AM, Hardiman P. Source: Circulation. 2002 July 2; 106(1): 81-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12093774

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Implications of ultrasonically diagnosed polycystic ovaries. I. Correlations with basal hormonal profiles. Author(s): Abdel Gadir A, Khatim MS, Mowafi RS, Alnaser HM, Muharib NS, Shaw RW. Source: Human Reproduction (Oxford, England). 1992 April; 7(4): 453-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1522185

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Implications of ultrasonically diagnosed polycystic ovaries. II. Studies of dynamic and pulsatile hormonal patterns. Author(s): Abdel Gadir A, Khatim MS, Mowafi RS, Alnaser HM, Muharib NS, Shaw RW. Source: Human Reproduction (Oxford, England). 1992 April; 7(4): 458-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1387880

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In vitro fertilization treatment in patients with polycystic ovaries. Author(s): Shulman A, Dor J. Source: Journal of Assisted Reproduction and Genetics. 1997 January; 14(1): 7-10. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9013301

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In vitro maturation and fertilization of oocytes from unstimulated normal ovaries, polycystic ovaries, and women with polycystic ovary syndrome. Author(s): Child TJ, Abdul-Jalil AK, Gulekli B, Tan SL. Source: Fertility and Sterility. 2001 November; 76(5): 936-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11704114

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Incidence of polycystic ovaries in patients with late-onset or persistent acne: hormonal reports. Author(s): Betti R, Bencini PL, Lodi A, Urbani CE, Chiarelli G, Crosti C. Source: Dermatologica. 1990; 181(2): 109-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2147009

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Increased insulin secretion in patients with multifollicular and polycystic ovaries and its impact on ovulation induction. Author(s): Filicori M, Flamigni C, Cognigni G, Dellai P, Michelacci L, Arnone R. Source: Fertility and Sterility. 1994 August; 62(2): 279-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8034073

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Increased peripheral androgen activity in infertile Korean women with polycystic ovaries. Author(s): Roh JS, Yoo JB, Hwang YY. Source: Human Reproduction (Oxford, England). 1999 August; 14(8): 1934-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10438402

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Increased production and release of prostaglandin-E2 by human granulosa cells from polycystic ovaries. Author(s): Navarra P, Andreani CL, Lazzarin N, Pierro E, Mirtella A, Lanzone A, Mancuso S. Source: Prostaglandins. 1996 September; 52(3): 187-97. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8908619

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Infertility, megalocystic and polycystic ovaries: differential response to LHRH therapy. Author(s): Tucker M, Adams J, Mason WP, Jacobs HS. Source: Upsala Journal of Medical Sciences. 1984; 89(1): 43-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6377641

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Inhibition of oestradiol production by epidermal growth factor in human granulosa cells of normal and polycystic ovaries. Author(s): Mason HD, Margara R, Winston RM, Beard RW, Reed MJ, Franks S. Source: Clinical Endocrinology. 1990 October; 33(4): 511-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2121397

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Insulin action in human granulosa cells from normal and polycystic ovaries is mediated by the insulin receptor and not the type-I insulin-like growth factor receptor. Author(s): Willis D, Franks S. Source: The Journal of Clinical Endocrinology and Metabolism. 1995 December; 80(12): 3788-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8530637

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Insulin and C-peptide levels in obese patients with polycystic ovaries. Author(s): Pasquali R, Venturoli S, Paradisi R, Capelli M, Parenti M, Melchionda N. Source: Hormone and Metabolic Research. Hormon- Und Stoffwechselforschung. Hormones Et Metabolisme. 1982 June; 14(6): 284-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6749626

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Insulin as a factor of increased androgen production in women with obesity and polycystic ovaries. Author(s): Pasquali R, Antenucci D, Casimirri F, Venturoli S, Paradisi R, Fabbri R, Melchionda N, Barbara L. Source: J Endocrinol Invest. 1987 December; 10(6): 575-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3326891

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Insulin resistance and lipid profile in women with polycystic appearing ovaries: implications with regard to polycystic ovary syndrome. Author(s): Cenk Sayin N, Gucer F, Balkanli-Kaplan P, Ali Yuce M, Yardim T. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 2003 October; 17(5): 387-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14710586

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Insulin resistance in patients with polycystic ovaries: its relationship to body weight and androgen levels. Author(s): Pasquali R, Casimirri F, Venturoli S, Paradisi R, Mattioli L, Capelli M, Melchionda N, Labo G. Source: Acta Endocrinol (Copenh). 1983 September; 104(1): 110-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6137924

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Insulin resistance, acanthosis nigricans, and polycystic ovaries associated with a circulating inhibitor of postbinding insulin action. Author(s): Harrison LC, Dean B, Peluso I, Clark S, Ward G. Source: The Journal of Clinical Endocrinology and Metabolism. 1985 May; 60(5): 1047-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3884647

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Insulin stimulation of lactate accumulation in isolated human granulosa-luteal cells: a comparison between normal and polycystic ovaries. Author(s): Lin Y, Fridstrom M, Hillensjo T. Source: Human Reproduction (Oxford, England). 1997 November; 12(11): 2469-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9436687

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Insulin-like growth factor binding protein-2, 28 kDa and 24 kDa insulin-like growth factor binding protein levels are decreased in fluid of dominant follicles, obtained from normal and polycystic ovaries. Author(s): Schuller AG, Lindenbergh-Kortleve DJ, Pache TD, Zwarthoff EC, Fauser BC, Drop SL. Source: Regulatory Peptides. 1993 October 20; 48(1-2): 157-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7505462

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Internal carotid artery haemodynamics in women with polycystic ovaries. Author(s): Lakhani K, Constantinovici N, Purcell WM, Fernando R, Hardiman P. Source: Clinical Science (London, England : 1979). 2000 June; 98(6): 661-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10814602

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Internal carotid-artery response to 5% carbon dioxide in women with polycystic ovaries. Author(s): Lakhani K, Constantinovici N, Purcell WM, Fernando R, Hardiman P. Source: Lancet. 2000 September 30; 356(9236): 1166-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11030301

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In-vitro maturation of oocytes from unstimulated polycystic ovaries. Author(s): Tan SL, Child TJ. Source: Reproductive Biomedicine Online. 2002; 4 Suppl 1: 18-23. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12470331

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Is valproate pharmacotherapy associated with polycystic ovaries? Author(s): Chappell KA, Markowitz JS, Jackson CW. Source: The Annals of Pharmacotherapy. 1999 November; 33(11): 1211-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10573322

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Laparoscopic electrosurgical furrowing technique for the treatment of polycystic ovaries. Author(s): Pelosi MA, Pelosi MA 3rd. Source: The Journal of the American Association of Gynecologic Laparoscopists. 1996 November; 4(1): 57-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9050713

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Laparoscopic ovarian diathermy in the management of anovulatory infertility in women with polycystic ovaries: endocrine changes and clinical outcome. Author(s): Armar NA, McGarrigle HH, Honour J, Holownia P, Jacobs HS, Lachelin GC. Source: Fertility and Sterility. 1990 January; 53(1): 45-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2136836

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Laparoscopic ovarian drilling with diathermy in the treatment of infertile women with polycystic ovaries. Author(s): Su HY, Ding DC, Chen DC, Hwang KS, Ko CS. Source: J Chin Med Assoc. 2003 August; 66(8): 492-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14604314

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Laparoscopic treatment of polycystic ovaries with insulated needle cautery: a reappraisal. Author(s): Felemban A, Tan SL, Tulandi T. Source: Fertility and Sterility. 2000 February; 73(2): 266-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10685526

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Laparoscopic treatment of polycystic ovaries with the holmium:YAG laser. Author(s): Asada H, Kishi I, Kaseda S, Nakagawa H, Maruyama T, Yoshimura Y. Source: Fertility and Sterility. 2002 April; 77(4): 852-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11937150

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Laparoscopic treatment of polycystic ovaries: is it time to relinquish the procedure? Author(s): Pirwany I, Tulandi T. Source: Fertility and Sterility. 2003 August; 80(2): 241-51. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12909478

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Laser laparoscopy for polycystic ovaries. Author(s): Cohen BM. Source: Fertility and Sterility. 1989 July; 52(1): 167-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2526030

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Length of gestation and polycystic ovaries in adulthood. Author(s): van Hooff MH, Lambalk CB. Source: Lancet. 1998 January 24; 351(9098): 296. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9457129

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Length of gestation and polycystic ovaries in adulthood. Author(s): Edozien L. Source: Lancet. 1998 January 24; 351(9098): 295-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9457128

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Leptin, polycystic ovaries and polycystic ovary syndrome. Author(s): Jacobs HS, Conway GS. Source: Human Reproduction Update. 1999 March-April; 5(2): 166-71. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10336020

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Lipid profiles in women with hirsutism and polycystic ovaries. Author(s): Senoz S, Ozaksit G, Turhan NO, Gulekli B, Gokmen O. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 1994 March; 8(1): 33-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8059615

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Luteal phase progesterone excretion in ovulatory women with polycystic ovaries. Author(s): Joseph-Horne R, Mason H, Batty S, White D, Hillier S, Urquhart M, Franks S. Source: Human Reproduction (Oxford, England). 2002 June; 17(6): 1459-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12042261

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Luteinizing hormone receptor, steroidogenesis acute regulatory protein, and steroidogenic enzyme messenger ribonucleic acids are overexpressed in thecal and granulosa cells from polycystic ovaries. Author(s): Jakimiuk AJ, Weitsman SR, Navab A, Magoffin DA. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 March; 86(3): 131823. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11238527

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Magnetic resonance imaging of normal and polycystic ovaries. Preliminary results. Author(s): Maubon A, Courtieu C, Vivens F, Tailland ML, Saucerotte H, Bringer J, Mares P, Rouanet JP. Source: Annals of the New York Academy of Sciences. 1993 May 28; 687: 224-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8323176

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Malignant mixed Mullerian tumor of the endometrium in a young woman with polycystic ovaries. Author(s): Chumas JC, Mann WJ, Tseng L. Source: Cancer. 1983 October 15; 52(8): 1478-81. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6311395

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Medical implications of ultrasonically detected polycystic ovaries. Author(s): Swanson M, Sauerbrei EE, Cooperberg PL. Source: Journal of Clinical Ultrasound : Jcu. 1981 May-June; 9(5): 219-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6787087

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Metabolic and steroidogenic alterations related to increased frequency of polycystic ovaries in women with a history of gestational diabetes. Author(s): Koivunen RM, Juutinen J, Vauhkonen I, Morin-Papunen LC, Ruokonen A, Tapanainen JS. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 June; 86(6): 2591-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11397859

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Miscarriage rates following in-vitro fertilization are increased in women with polycystic ovaries and reduced by pituitary desensitization with buserelin. Author(s): Balen AH, Tan SL, MacDougall J, Jacobs HS. Source: Human Reproduction (Oxford, England). 1993 June; 8(6): 959-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8345091

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Modulation by insulin of follicle-stimulating hormone and luteinizing hormone actions in human granulosa cells of normal and polycystic ovaries. Author(s): Willis D, Mason H, Gilling-Smith C, Franks S. Source: The Journal of Clinical Endocrinology and Metabolism. 1996 January; 81(1): 3029. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8550768

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Molecular basis of aromatase deficiency in an adult female with sexual infantilism and polycystic ovaries. Author(s): Ito Y, Fisher CR, Conte FA, Grumbach MM, Simpson ER. Source: Proceedings of the National Academy of Sciences of the United States of America. 1993 December 15; 90(24): 11673-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8265607

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More on valproate and polycystic ovaries. Author(s): Johnston HF. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1999 April; 38(4): 354. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10199101

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Most women with acne have polycystic ovaries. Author(s): Bunker CB, Newton JA, Kilborn J, Patel A, Conway GS, Jacobs HS, Greaves MW, Dowd PM. Source: The British Journal of Dermatology. 1989 December; 121(6): 675-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2532926

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No association between the -308 polymorphism in the tumour necrosis factor alpha (TNFalpha) promoter region and polycystic ovaries. Author(s): Milner CR, Craig JE, Hussey ND, Norman RJ. Source: Molecular Human Reproduction. 1999 January; 5(1): 5-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10050654

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Normal development and metabolic activity of preimplantation embryos in vitro from patients with polycystic ovaries. Author(s): Hardy K, Robinson FM, Paraschos T, Wicks R, Franks S, Winston RM. Source: Human Reproduction (Oxford, England). 1995 August; 10(8): 2125-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8567853

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Normal ovulatory women with polycystic ovaries have hyperandrogenic pituitaryovarian responses to gonadotropin-releasing hormone-agonist testing. Author(s): Chang PL, Lindheim SR, Lowre C, Ferin M, Gonzalez F, Berglund L, Carmina E, Sauer MV, Lobo RA. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 March; 85(3): 9951000. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10720029

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Observations on clinically polycystic ovaries. Author(s): Tervila L. Source: Ann Chir Gynaecol Fenn Suppl. 1965; 140: 1-32. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5293814

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Oestrogen and androgen states in oligo-amenorrhoeic women with polycystic ovaries. Author(s): Fox R, Corrigan E, Thomas PG, Hull MG. Source: British Journal of Obstetrics and Gynaecology. 1991 March; 98(3): 294-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1827032

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On the relationship between endocrine and ovulatory abnormalities, and polycystic ovaries as diagnosed by ultrasonography. Author(s): Takahashi K, Yoshino K, Nishigaki A, Eda Y, Kitao M. Source: Int J Fertil. 1992 July-August; 37(4): 222-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1354209

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Oocyte quality in polycystic ovaries revisited: identification of a particular subgroup of women. Author(s): Cano F, Garcia-Velasco JA, Millet A, Remohi J, Simon C, Pellicer A. Source: Journal of Assisted Reproduction and Genetics. 1997 May; 14(5): 254-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9147238

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Ovarian follicular fluid beta-endorphin levels in normal and polycystic ovaries. Author(s): Aleem FA, Eltabbakh GH, Omar RA, Southren AL. Source: American Journal of Obstetrics and Gynecology. 1987 May; 156(5): 1197-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2953243

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Ovarian morphology in patients with polycystic ovaries and in an age-matched reference material. A statistical evaluation of 149 cases. Author(s): Lunde O, Hoel PS, Sandvik L. Source: Gynecologic and Obstetric Investigation. 1988; 25(3): 192-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3391430

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Ovarian stromal blood flow in women with polycystic ovaries--a possible new marker for diagnosis? Author(s): Zaidi J, Campbell S, Pittrof R, Kyei-Mensah A, Shaker A, Jacobs HS, Tan SL. Source: Human Reproduction (Oxford, England). 1995 August; 10(8): 1992-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8567828

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Ovarian stromal echogenicity in women with normal and polycystic ovaries. Author(s): Buckett WM, Bouzayen R, Watkin KL, Tulandi T, Tan SL. Source: Human Reproduction (Oxford, England). 1999 March; 14(3): 618-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10221685

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Peripheral catecholamine metabolites and menstrual irregularity in patients with polycystic ovaries. Author(s): Yoshino K, Takahashi K, Eda Y, Nishigaki A, Kitao M. Source: Int J Fertil Menopausal Stud. 1993 July-August; 38(4): 225-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8401681

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Plasma androgens and oestradiol during oral glucose tolerance test in patients with polycystic ovaries. Author(s): Tiitinen A, Pekonen F, Stenman UH, Laatikainen T. Source: Human Reproduction (Oxford, England). 1990 April; 5(3): 242-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2191000

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Plasma androgens and sex hormone binding globulin in women with polycystic ovaries diagnosed by transvaginal ultrasound. Author(s): Yoshino K, Takahashi K, Eda Y, Okada S, Kitao M. Source: J Reprod Med. 1993 November; 38(11): 858-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8277481

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Plasma FSH and LH levels and ovarian morphology in patients with polycystic ovaries. Author(s): Valkov IM, Dokumov SI, Georgiev TN. Source: Endokrynol Pol. 1980 November-December; 31(6): 501-10. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6781883

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Plasma homocysteine, fasting insulin, and androgen patterns among women with polycystic ovaries and infertility. Author(s): Sills ES, Genton MG, Perloe M, Schattman GL, Bralley JA, Tucker MJ. Source: The Journal of Obstetrics and Gynaecology Research. 2001 June; 27(3): 163-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11561833

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Plasma testosterone and urinary 17-ketosteroids in women with hirsutism and polycystic ovaries. Author(s): Lloyd CW, Lobotsky J, Segre EJ, Kobayashi T, Taymor ML, Batt RE. Source: The Journal of Clinical Endocrinology and Metabolism. 1966 March; 26(3): 31424. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4286019

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Plasma testosterone and urinary steroids in Japanese women with polycystic ovaries. Author(s): Kurachi K, Miyazaki M, Mizutani S, Matsumoto K. Source: Acta Endocrinol (Copenh). 1971 October; 68(2): 293-302. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5171467

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Polycystic ovaries and associated clinical and biochemical features in young women. Author(s): Michelmore KF, Balen AH, Dunger DB, Vessey MP. Source: Clinical Endocrinology. 1999 December; 51(6): 779-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10619984

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Polycystic ovaries and associated metabolic abnormalities in Indian subcontinent Asian women. Author(s): Rodin DA, Bano G, Bland JM, Taylor K, Nussey SS. Source: Clinical Endocrinology. 1998 July; 49(1): 91-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9797852

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Polycystic ovaries and coronary artery disease. Author(s): McBride NM. Source: Annals of Internal Medicine. 1997 September 15; 127(6): 491. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9313010

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Polycystic ovaries and eating disorders: Are they related? Author(s): Michelmore KF, Balen AH, Dunger DB. Source: Human Reproduction (Oxford, England). 2001 April; 16(4): 765-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11278230

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Polycystic ovaries and endometriosis: a possible connection. Author(s): Brincat M, Galea R, Buhagiar A. Source: British Journal of Obstetrics and Gynaecology. 1994 April; 101(4): 346-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8199085

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Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy. Author(s): Isojarvi JI, Laatikainen TJ, Pakarinen AJ, Juntunen KT, Myllyla VV. Source: The New England Journal of Medicine. 1993 November 4; 329(19): 1383-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8413434

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Polycystic ovaries and levels of gonadotrophins and androgens in recurrent miscarriage: prospective study in 50 women. Author(s): Leigh AJ, Peattie AB. Source: British Journal of Obstetrics and Gynaecology. 1994 March; 101(3): 275-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8193110

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Polycystic ovaries and levels of gonadotrophins and androgens in recurrent miscarriage: prospective study in 50 women. Author(s): Tulppala M, Stenman UH, Cacciatore B, Ylikorkala O. Source: British Journal of Obstetrics and Gynaecology. 1993 April; 100(4): 348-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8494836

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Polycystic ovaries and polycystic ovary syndrome. Author(s): Jacobs HS. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 1987 March; 1(1): 113-31. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3332534

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Polycystic ovaries and premature male pattern baldness are associated with one allele of the steroid metabolism gene CYP17. Author(s): Carey AH, Waterworth D, Patel K, White D, Little J, Novelli P, Franks S, Williamson R. Source: Human Molecular Genetics. 1994 October; 3(10): 1873-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7849715

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Polycystic ovaries and recurrent miscarriage--a reappraisal. Author(s): Rai R, Backos M, Rushworth F, Regan L. Source: Human Reproduction (Oxford, England). 2000 March; 15(3): 612-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10686206

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Polycystic ovaries and the risk of breast cancer. Author(s): Gammon MD, Thompson WD. Source: American Journal of Epidemiology. 1991 October 15; 134(8): 818-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1951277

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Polycystic ovaries are a common finding in untreated female to male transsexuals. Author(s): Balen AH, Schachter ME, Montgomery D, Reid RW, Jacobs HS. Source: Clinical Endocrinology. 1993 March; 38(3): 325-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8458105

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Polycystic ovaries are inherited as an autosomal dominant trait: analysis of 29 polycystic ovary syndrome and 10 control families. Author(s): Govind A, Obhrai MS, Clayton RN. Source: The Journal of Clinical Endocrinology and Metabolism. 1999 January; 84(1): 3843. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9920059

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Polycystic ovaries as a relative protective factor for bone mineral loss in young women with amenorrhea. Author(s): Di Carlo C, Shoham Z, MacDougall J, Patel A, Hall ML, Jacobs HS. Source: Fertility and Sterility. 1992 February; 57(2): 314-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1735481

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Polycystic ovaries associated with congenital adrenal hyperplasia. Author(s): Lucis OJ, Hobkirk R, Hollenberg CH, MacDonald SA, Blahey P. Source: Can Med Assoc J. 1966 January 1; 94(1): 1-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5901591

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Polycystic ovaries disease: one ovary too many? Author(s): Hamerlynck J. Source: Lancet. 1982 October 23; 2(8304): 937-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6126783

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Polycystic ovaries in adolescents and the relationship with menstrual cycle patterns, luteinizing hormone, androgens, and insulin. Author(s): van Hooff MH, Voorhorst FJ, Kaptein MB, Hirasing RA, Koppenaal C, Schoemaker J. Source: Fertility and Sterility. 2000 July; 74(1): 49-58. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10899496

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Polycystic ovaries in association with mullerian anomalies. Author(s): Ugur M, Karakaya S, Zorlu G, Arslan S, Gulerman C, Kukner S, Gokmen O. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1995 September; 62(1): 57-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7493710

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Polycystic ovaries in association with mullerian duct anomalies. Author(s): MacDougall MJ, Patel A, Jacobs HS. Source: British Journal of Obstetrics and Gynaecology. 1992 June; 99(6): 520-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1637773

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Polycystic ovaries in association with pelvic endometriosis in infertile women diagnosed by laparoscopy. Author(s): Kichukova D. Source: Folia Med (Plovdiv). 1996; 38(3-4): 71-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9145594

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Polycystic ovaries in childhood. Author(s): Brook CG, Jacobs HS, Stanhope R. Source: British Medical Journal (Clinical Research Ed.). 1988 March 26; 296(6626): 878. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3129057

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Polycystic ovaries in childhood: a common finding in daughters of PCOS patients. A pilot study. Author(s): Battaglia C, Regnani G, Mancini F, Iughetti L, Flamigni C, Venturoli S. Source: Human Reproduction (Oxford, England). 2002 March; 17(3): 771-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11870134

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Polycystic ovaries in female-to-male transsexuals. Author(s): Pache TD, Fauser BC. Source: Clinical Endocrinology. 1993 December; 39(6): 702-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8123169

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Polycystic ovaries in Hirsute women with normal menses. Author(s): Carmina E, Lobo RA. Source: The American Journal of Medicine. 2001 December 1; 111(8): 602-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11755502

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Polycystic ovaries in non-obese and obese patients: possible pathophysiological mechanism based on new interpretation of facts and findings. Author(s): Insler V, Shoham Z, Barash A, Koistinen R, Seppala M, Hen M, Lunenfeld B, Zadik Z. Source: Human Reproduction (Oxford, England). 1993 March; 8(3): 379-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7682564

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Polycystic ovaries in patients with hypogonadotropic hypogonadism: similarity of ovarian response to gonadotropin stimulation in patients with polycystic ovarian syndrome. Author(s): Shoham Z, Conway GS, Patel A, Jacobs HS. Source: Fertility and Sterility. 1992 July; 58(1): 37-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1624021

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Polycystic ovaries in pre and post-menopausal women. Author(s): Birdsall MA, Farquhar CM. Source: Clinical Endocrinology. 1996 March; 44(3): 269-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8729521

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Polycystic ovaries in women with gestational diabetes. Author(s): Anttila L, Karjala K, Penttila RA, Ruutiainen K, Ekblad U. Source: Obstetrics and Gynecology. 1998 July; 92(1): 13-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9649084

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Polycystic ovaries treated by laparoscopic laser vaporization. Author(s): Daniell JF, Miller W. Source: Fertility and Sterility. 1989 February; 51(2): 232-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2912769

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Polycystic ovaries, obesity and insulin resistance in women with epilepsy. A comparative study of carbamazepine and valproic acid in 105 women. Author(s): Luef G, Abraham I, Haslinger M, Trinka E, Seppi K, Unterberger I, Alge A, Windisch J, Lechleitner M, Bauer G. Source: Journal of Neurology. 2002 July; 249(7): 835-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12140666

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Polycystic ovaries, precocious puberty and acquired hypothyroidism: The Van Wyk and Grumbach syndrome. Author(s): Chattopadhyay A, Kumar V, Marulaiah M. Source: Journal of Pediatric Surgery. 2003 September; 38(9): 1390-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14523827

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Polycystic ovaries. Author(s): Lakhani K, Seifalian AM, Atiomo WU, Hardiman P. Source: The British Journal of Radiology. 2002 January; 75(889): 9-16. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11806952

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Polycystic ovaries. Author(s): Kelly C, Petrie J, Lyall H, Gould G, Connell J. Source: Lancet. 2000 January 1; 355(9197): 68-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10615913

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Polycystic ovaries. Author(s): Katz M. Source: Clin Obstet Gynaecol. 1981 December; 8(3): 715-31. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7318303

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Polycystic ovaries. Presentation and response to wedge resection. Author(s): Adelusi B, Aimakhu VE, Wright EA. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1976; 14(3): 232-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13009

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Polycystic ovaries: do these represent a specific endocrinopathy? Author(s): Abdel Gadir A, Khatim MS, Mowafi RS, Alnaser HM, Alzaid HG, Shaw RW. Source: British Journal of Obstetrics and Gynaecology. 1991 March; 98(3): 300-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2021568

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Polycystic ovaries: implications of diagnosis with MR imaging. Author(s): Kimura I, Togashi K, Kawakami S, Nakano Y, Takakura K, Mori T, Konishi J. Source: Radiology. 1996 November; 201(2): 549-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8888256

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Polycystic ovaries: MR imaging. Author(s): Mitchell DG, Gefter WB, Spritzer CE, Blasco L, Nulson J, Livolsi V, Axel L, Arger PH, Kressel HY. Source: Radiology. 1986 August; 160(2): 425-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3726121

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Polycystic ovaries: pathophysiology. Author(s): Ahmed AS. Source: J R Soc Health. 2003 June; 123(2): 78. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12852187

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Polycystic ovaries: presentation and response to wedge resection. Author(s): Adelusi B, Aimakhu VE, Wright EA. Source: Ghana Med J. 1975 September; 14(3): 181-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1234678

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Polycystic ovaries: question of definition. Author(s): Mason H. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 1998 September; 12(3): 154-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9793185

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Polycystic ovaries: the role of insulin. Author(s): Ahmed AS. Source: J R Soc Health. 2003 June; 123(2): 78-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12852188

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Polycystic ovaries: treatment strategies. Author(s): Ahmed AS. Source: J R Soc Health. 2003 September; 123(3): 152-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14526751

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Polycystic ovaries--a common finding in normal women. Author(s): Polson DW, Adams J, Wadsworth J, Franks S. Source: Lancet. 1988 April 16; 1(8590): 870-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2895373

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Pregnancy following the laparoscopic bipolar electrocoagulation of polycystic ovaries resistant to medicamentous ovulation induction--a case report. Author(s): Barisic D, Grizelj V, Corusic A. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1999 April; 83(2): 225-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10391538

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Pregnancy induced with menotropins in a woman with polycystic ovaries, endometrial hyperplasia, and adenocarcinoma. Author(s): Muechler EK, Bonfiglio T, Choate J, Huang KE. Source: Fertility and Sterility. 1986 November; 46(5): 973-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3096789

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Prevalence of polycystic ovaries by transvaginal ultrasound and serum androgens. Author(s): Takahashi K, Yoshino K, Eda Y, Kitao M. Source: Int J Fertil. 1992 September-October; 37(5): 290-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1358841

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Prevalence of polycystic ovaries in women with acne. Author(s): Peserico A, Angeloni G, Bertoli P, Marini A, Piva G, Panciera A, Suma V. Source: Archives of Dermatological Research. 1989; 281(7): 502-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2532876

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Prevalence of polycystic ovaries in women with androgenic alopecia. Author(s): Cela E, Robertson C, Rush K, Kousta E, White DM, Wilson H, Lyons G, Kingsley P, McCarthy MI, Franks S. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2003 November; 149(5): 439-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14585091

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Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism. Author(s): Gordon P, Treasure JL, King EA, Wheeler M, Russell GF. Source: British Medical Journal (Clinical Research Ed.). 1986 October 11; 293(6552): 9567. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3094734

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Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism. Author(s): Adams J, Polson DW, Franks S. Source: British Medical Journal (Clinical Research Ed.). 1986 August 9; 293(6543): 355-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3089520

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Primary amenorrhea associated with polycystic ovaries. Endocrine, cytogenetic and therapeutic considerations. Author(s): Canales ES, Zarate A, Castelazo-Ayala L. Source: Obstetrics and Gynecology. 1971 February; 37(2): 205-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4321732

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Production of transforming growth factor-alpha by normal and polycystic ovaries. Author(s): Mason HD, Carr L, Leake R, Franks S. Source: The Journal of Clinical Endocrinology and Metabolism. 1995 July; 80(7): 2053-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7608254

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Randomised controlled trial of the use of human chorionic gonadotrophin in recurrent miscarriage associated with polycystic ovaries. Author(s): Pearce JM, Hamid RI. Source: British Journal of Obstetrics and Gynaecology. 1994 August; 101(8): 685-8. Retraction In: Br J Obstet Gynaecol 1995 November; 102(11): 853. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7947503

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Re: “Polycystic ovaries and the risk of breast cancer”. Author(s): Toniolo P, Whittemore AS. Source: American Journal of Epidemiology. 1992 August 1; 136(3): 372-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1415155

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Recurrent early miscarriage and polycystic ovaries. Author(s): Sagle M, Bishop K, Ridley N, Alexander FM, Michel M, Bonney RC, Beard RW, Franks S. Source: Bmj (Clinical Research Ed.). 1988 October 22; 297(6655): 1027-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3142597

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Recurrent miscarriage: screening for polycystic ovaries and subsequent pregnancy outcome. Author(s): Liddell HS, Sowden K, Farquhar CM. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1997 November; 37(4): 402-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9429701

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Regression of Polycystic Ovaries by Estrogen Therapy. Author(s): Gambrell RD Jr. Source: Obstetrics and Gynecology. 1976 May; 47(5): 569-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=131262

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Relationship between polycystic ovaries, body mass index and insulin resistance. Author(s): Cresswell J, Fraser R, Bruce C, Egger P, Phillips D, Barker DJ. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2003 January; 82(1): 61-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12580842

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Reproductive performance and three-dimensional ultrasound volume determination of polycystic ovaries following laparoscopic ovarian drilling. Author(s): Tulandi T, Watkin K, Tan SL. Source: Int J Fertil Womens Med. 1997 November-December; 42(6): 436-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9459090

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Response of plasma beta-endorphin and insulin to oral glucose tolerance test in nonobese women with polycystic ovaries. Author(s): Laatikainen TJ, Tiitinen AE, Salminen-Lappalainen KR, Pekonen F. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 1989 September; 3(3): 241-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2531535

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Responses of serum gonadotrophins to LH-releasing hormone and oestrogens in Japanese women with polycystic ovaries. Author(s): Aono T, Miyazaki M, Miyake A, Kinugasa T, Kurachi K, Matsumoto K. Source: Acta Endocrinol (Copenh). 1977 August; 85(4): 840-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=196471

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Role of obesity and hyperinsulinemia in the insulin resistance of obese subjects with the clinical triad of polycystic ovaries, hirsutism and acanthosis nigricans. Author(s): Wajchenberg BL, Giannella-Neto D, Lerario AC, Marcondes JA, Ohnuma LY. Source: Hormone Research. 1988; 29(1): 7-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3397043

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Serum 11 beta-hydroxyandrostenedione as an indicator of the source of excess androgen production in women with polycystic ovaries. Author(s): Polson DW, Reed MJ, Franks S, Scanlon MJ, James VH. Source: The Journal of Clinical Endocrinology and Metabolism. 1988 May; 66(5): 946-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3129451

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Serum androgen and gonadotropin levels decline after progestogen-induced withdrawal bleeding in oligomenorrheic women with or without polycystic ovaries. Author(s): Anttila L, Koskinen P, Kaihola HL, Erkkola R, Irjala K, Ruutiainen K. Source: Fertility and Sterility. 1992 October; 58(4): 697-702. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1426312

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Serum progesterone concentration is raised during early follicular phase in women with polycystic ovaries. Author(s): Bojanic S, Lake R, Place J, Jones L, Laycock JF, Carter GD, Alaghband-Zadeh J. Source: Annals of Clinical Biochemistry. 1991 January; 28 ( Pt 1): 105-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2024923

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Serum vascular endothelial growth factor and Doppler blood flow velocities in in vitro fertilization: relevance to ovarian hyperstimulation syndrome and polycystic ovaries. Author(s): Agrawal R, Conway G, Sladkevicius P, Tan SL, Engmann L, Payne N, Bekir J, Campbell S, Jacobs H. Source: Fertility and Sterility. 1998 October; 70(4): 651-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9797093

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Serum vascular endothelial growth factor concentrations and ovarian stromal blood flow are increased in women with polycystic ovaries. Author(s): Agrawal R, Sladkevicius P, Engmann L, Conway GS, Payne NN, Bekis J, Tan SL, Campbell S, Jacobs HS. Source: Human Reproduction (Oxford, England). 1998 March; 13(3): 651-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9572428

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Sex steroid receptors in polycystic ovaries. Author(s): Brentani MM, Baracat EC. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1993 September; 42(3): 277-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7901089

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Significance of atretic follicles as the site of androgen production in polycystic ovaries. Author(s): Mori T, Fujita Y, Nihnobu K, Aso T, Sakamoto Y, Nishimura T. Source: J Endocrinol Invest. 1982 July-August; 5(4): 209-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6757308

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Sonographic incidence of polycystic ovaries in a gynecological population. Author(s): Botsis D, Kassanos D, Pyrgiotis E, Zourlas PA. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 1995 September; 6(3): 182-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8521067

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Steroid responses to ACTH in women with polycystic ovaries. Author(s): Hague WM, Honour JW, Adams J, Vecsei P, Jacobs HS. Source: Clinical Endocrinology. 1989 April; 30(4): 355-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2532082

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Steroid, follicle-stimulating hormone, and luteinizing hormone profiles in identical twins with polycystic ovaries. Author(s): McDonough PG, Mahesh VB, Ellegood JO. Source: American Journal of Obstetrics and Gynecology. 1972 August 15; 113(8): 1072-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4344063

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Steroidogenesis of cultured granulosa cells from normal and polycystic ovaries: differences in responsiveness to luteinizing hormone and follicle-stimulating hormone. Author(s): Yoshimura Y, Nakamura Y, Kamei K, Oda T, Higaki K, Iizuka R. Source: Endocrinol Jpn. 1981 December; 28(6): 697-707. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6809450

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Studies on the influence of ovarian small cysts on endocrine in patients with polycystic ovaries. Author(s): Takahashi K, Uchida A, Yamasaki H, Ozaki T, Yoshino K, Kitao M. Source: Gynecologic and Obstetric Investigation. 1994; 38(2): 117-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7959338

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Studies on the polycystic ovaries of rats under continuous auditory stress. Author(s): Singh KB, Rao PS. Source: American Journal of Obstetrics and Gynecology. 1970 October 15; 108(4): 557-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5528222

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Study of nucleolar organizer in women with galactorrhea, or polycystic ovaries, or using oral contraceptive. Author(s): Li XZ, Zhou XT. Source: American Journal of Medical Genetics. 1983 August; 15(4): 567-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6193710

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Subjects with polycystic ovaries without hyperandrogenaemia exhibit similar disturbances in insulin and lipid profiles as those with polycystic ovary syndrome. Author(s): Norman RJ, Hague WM, Masters SC, Wang XJ. Source: Human Reproduction (Oxford, England). 1995 September; 10(9): 2258-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8530647

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Suppression of testosterone and androstenedione porduction rates with dexamethasone in women with idiopathic hirsutsm and polycystic ovaries. Author(s): Bardin CW, Hembree WC, Lipsett MB. Source: The Journal of Clinical Endocrinology and Metabolism. 1968 September; 28(9): 1300-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4300558

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Surface ultrastructure of polycystic ovaries as viewed by electron microscopy. Author(s): Hafez ES, Makabe S. Source: Acta Eur Fertil. 1979 September; 10(3): 119-29. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=545978

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Targeted overexpression of luteinizing hormone in transgenic mice leads to infertility, polycystic ovaries, and ovarian tumors. Author(s): Risma KA, Clay CM, Nett TM, Wagner T, Yun J, Nilson JH. Source: Proceedings of the National Academy of Sciences of the United States of America. 1995 February 28; 92(5): 1322-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7877975

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Testosterone and androstenedione blood production rates in normal women and women with idiopathic hirsutism or polycystic ovaries. Author(s): Bardin CW, Lipsett MB. Source: The Journal of Clinical Investigation. 1967 May; 46(5): 891-902. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6025489

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The diagnosis of polycystic ovaries in subfertile women. Author(s): Eden JA, Place J, Carter GD, Jones J, Alaghband-Zadeh J, Pawson ME. Source: British Journal of Obstetrics and Gynaecology. 1989 July; 96(7): 809-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2527554

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The diagnosis of polycystic ovaries in women with oligo-amenorrhoea: predictive power of endocrine tests. Author(s): Fox R, Corrigan E, Thomas PA, Hull MG. Source: Clinical Endocrinology. 1991 February; 34(2): 127-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2022063

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The effect of short-interval laparoscopic lysis of adhesions on pregnancy rates following Nd-YAG laser photocoagulation of polycystic ovaries. Author(s): Gurgan T, Urman B, Aksu T, Yarali H, Develioglu O, Kisnisci HA. Source: Obstetrics and Gynecology. 1992 July; 80(1): 45-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1534881

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The effects of insulin and insulin-like growth factors-I and -II on estradiol production by granulosa cells of polycystic ovaries. Author(s): Erickson GF, Magoffin DA, Cragun JR, Chang RJ. Source: The Journal of Clinical Endocrinology and Metabolism. 1990 April; 70(4): 894902. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2108185

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The effects of the somatostatin analogue octreotide on ovulatory performance in women with polycystic ovaries. Author(s): Prelevic GM, Ginsburg J, Maletic D, Hardiman P, Okolo S, Balint-Peric L, Thomas M, Orskov H. Source: Human Reproduction (Oxford, England). 1995 January; 10(1): 28-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7745065

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The evolution of polycystic ovaries in a girl with hypogonadotropic hypogonadism before puberty and during puberty induced with pulsatile gonadotropin-releasing hormone. Author(s): Stanhope R, Adams J, Pringle JP, Jacobs HS, Brook CG. Source: Fertility and Sterility. 1987 May; 47(5): 872-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3552755

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The hormonal profile of women with acne and polycystic ovaries. Author(s): Bunker CB, Newton JA, Conway GS, Jacobs HS, Greaves MW, Dowd PM. Source: Clinical and Experimental Dermatology. 1991 November; 16(6): 420-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1839616

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The importance of gonadography and gonadometry in the diagnosis of polycystic ovaries. Author(s): Tassopoulos CN, Papadimitriou GC, Triantafyllou D, Panopoulos C, Zis J. Source: Int Surg. 1973 September; 58(9): 619-22. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4744420

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The mechanism of action of epidermal growth factor and transforming growth factor alpha on aromatase activity in granulosa cells from polycystic ovaries. Author(s): Misajon A, Hutchinson P, Lolatgis N, Trounson AO, Almahbobi G. Source: Molecular Human Reproduction. 1999 February; 5(2): 96-103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10065863

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The polycystic ovary. V. Alternate pathways of steroid aromatization in normal, pregnancy and polycystic ovaries. Author(s): Axelrod LR, Goldzieher JW. Source: The Journal of Clinical Endocrinology and Metabolism. 1965 September; 25(9): 1275-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5830946

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The predictive power of endocrine tests for the diagnosis of polycystic ovaries in women with oligoamenorrhea. Author(s): Turhan NO, Toppare MF, Seckin NC, Dilmen G. Source: Gynecologic and Obstetric Investigation. 1999; 48(3): 183-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10545743

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The prevalence of polycystic ovaries in healthy women. Author(s): Koivunen R, Laatikainen T, Tomas C, Huhtaniemi I, Tapanainen J, Martikainen H. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1999 February; 78(2): 137-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10023877

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The prevalence of polycystic ovaries in patients with congenital adrenal hyperplasia and their close relatives. Author(s): Hague WM, Adams J, Rodda C, Brook CG, de Bruyn R, Grant DB, Jacobs HS. Source: Clinical Endocrinology. 1990 October; 33(4): 501-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2225492

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The prevalence of polycystic ovaries in the hepatic glycogen storage diseases: its association with hyperinsulinism. Author(s): Lee PJ, Patel A, Hindmarsh PC, Mowat AP, Leonard JV. Source: Clinical Endocrinology. 1995 June; 42(6): 601-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7634500

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The prevalence of polycystic ovaries in thin oligomenorrhoeic, anovulatory women. Author(s): Eden JA, Place J. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1989 February; 29(1): 70-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2787631

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The prevalence of polycystic ovaries in women with a history of gestational diabetes. Author(s): Kousta E, Cela E, Lawrence N, Penny A, Millauer B, White D, Wilson H, Robinson S, Johnston D, McCarthy M, Franks S. Source: Clinical Endocrinology. 2000 October; 53(4): 501-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11012576

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The prevalence of polycystic ovaries in women with infertility. Author(s): Kousta E, White DM, Cela E, McCarthy MI, Franks S. Source: Human Reproduction (Oxford, England). 1999 November; 14(11): 2720-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10548608

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The prevalence of polycystic ovaries in women with type 2 diabetes mellitus. Author(s): Conn JJ, Jacobs HS, Conway GS. Source: Clinical Endocrinology. 2000 January; 52(1): 81-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10651757

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The prevalence of polycystic ovaries on ultrasound scanning in a population of randomly selected women. Author(s): Farquhar CM, Birdsall M, Manning P, Mitchell JM, France JT. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1994 February; 34(1): 67-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8053879

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The relationship of insulin insensitivity to menstrual pattern in women with hyperandrogenism and polycystic ovaries. Author(s): Robinson S, Kiddy D, Gelding SV, Willis D, Niththyananthan R, Bush A, Johnston DG, Franks S. Source: Clinical Endocrinology. 1993 September; 39(3): 351-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8222298

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The rise of estradiol and inhibin B after acute stimulation with follicle-stimulating hormone predict the follicle cohort size in women with polycystic ovary syndrome, regularly menstruating women with polycystic ovaries, and regularly menstruating women with normal ovaries. Author(s): Elting MW, Kwee J, Schats R, Rekers-Mombarg LT, Schoemaker J. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 April; 86(4): 158995. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11297588

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The treatment of patients with polycystic ovaries undergoing IVF. Author(s): Franks S. Source: Journal of Assisted Reproduction and Genetics. 1997 January; 14(1): 12-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9013303

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The use of laparoscopic ovarian electrocautery in preventing cancellation of in-vitro fertilization treatment cycles due to risk of ovarian hyperstimulation syndrome in women with polycystic ovaries. Author(s): Rimington MR, Walker SM, Shaw RW. Source: Human Reproduction (Oxford, England). 1997 July; 12(7): 1443-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9262275

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Theca function in polycystic ovaries of a patient with virilizing congenital adrenal hyperplasia. Author(s): Erickson GF, Magoffin DA, Jones KL. Source: Fertility and Sterility. 1989 January; 51(1): 173-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2642810

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Transvaginal ultrasound-guided follicular aspiration in the management of anovulatory infertility associated with polycystic ovaries. Author(s): Mio Y, Toda T, Tanikawa M, Terado H, Harada T, Terakawa N. Source: Fertility and Sterility. 1991 December; 56(6): 1060-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1743322

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Treatment with pulsatile luteinizing hormone-releasing hormone modulates folliculogenesis in response to ovarian stimulation with exogenous gonadotropins in patients with polycystic ovaries. Author(s): Homburg R, Kilborn J, West C, Jacobs HS. Source: Fertility and Sterility. 1990 October; 54(4): 737-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2120089

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Twenty-four-hour serum growth hormone, insulin, C-peptide and blood glucose profiles and serum insulin-like growth factor-I concentrations in women with polycystic ovaries. Author(s): Prelevic GM, Wurzburger MI, Balint-Peric L, Ginsburg J. Source: Hormone Research. 1992; 37(4-5): 125-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1490653

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Ultrasonographic appearance of polycystic ovaries is associated with exaggerated ovarian androgen and oestradiol responses to gonadotrophin-releasing hormone agonist in women undergoing assisted reproduction treatment. Author(s): Suikkari AM, MacLachlan V, Montalto J, Calderon I, Healy DL, McLachlan RI. Source: Human Reproduction (Oxford, England). 1995 March; 10(3): 513-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7782424

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Ultrasonographic patterns of polycystic ovaries: color Doppler and hormonal correlations. Author(s): Battaglia C, Artini PG, Salvatori M, Giulini S, Petraglia F, Maxia N, Volpe A. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 1998 May; 11(5): 332-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9644772

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Ultrasound diagnosis of polycystic ovaries in women who have no symptoms of polycystic ovary syndrome is not associated with subfecundity or subfertility. Author(s): Hassan MA, Killick SR. Source: Fertility and Sterility. 2003 October; 80(4): 966-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14556819

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Ultrasound diagnosis of polycystic ovaries. Author(s): Fox R, Hull M. Source: Annals of the New York Academy of Sciences. 1993 May 28; 687: 217-23. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8323175

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Ultrasound examination of polycystic ovaries: is it worth counting the follicles? Author(s): Jonard S, Robert Y, Cortet-Rudelli C, Pigny P, Decanter C, Dewailly D. Source: Human Reproduction (Oxford, England). 2003 March; 18(3): 598-603. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12615832

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Unexpected effect of a nitric oxide donor on uterine artery Doppler velocimetry in oligomenorrheic women with polycystic ovaries. Author(s): Lees C, Jurkovic D, Zaidi J, Campbell S. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 1998 February; 11(2): 129-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9549840

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Unilateral massive ovarian edema and polycystic ovaries. A case report. Author(s): Guvenal T, Cetin A, Tasyurt A. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2001 August; 97(2): 258-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11451562

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Unilateral massive ovarian edema in a woman with polycystic ovaries. Author(s): Guvenal T, Cetin A, Tasyurt A. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2001 November; 99(1): 129-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11604203

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Use of human urinary follicle-stimulating hormone in infertile women with polycystic ovaries. Author(s): Flamigni C, Venturoli S, Paradisi R, Fabbri R, Porcu E, Magrini O. Source: J Reprod Med. 1985 March; 30(3): 184-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3923189

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Uterine growth in the follicular phase of spontaneous ovulatory cycles and during luteinizing hormone-releasing hormone-induced cycles in women with normal or polycystic ovaries. Author(s): Adams JM, Tan SL, Wheeler MJ, Morris DV, Jacobs HS, Franks S. Source: Fertility and Sterility. 1988 January; 49(1): 52-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3275552

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Vaginal adenosis and polycystic ovaries during infancy and childhood. Author(s): Doshi N, Fujikura T, Kanbour A. Source: American Journal of Obstetrics and Gynecology. 1977 October 15; 129(4): 374-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=910815

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Valproate and polycystic ovaries. Author(s): Eberle AJ. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1998 October; 37(10): 1009. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9785710

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Valproate and polycystic ovaries. Author(s): Irwin M, Masand P. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1998 January; 37(1): 9-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9444888

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Valproate treatment and the risk of hyperandrogenism and polycystic ovaries. Author(s): Soares JC. Source: Bipolar Disorders. 2000 March; 2(1): 37-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11254018

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Valproate, hyperandrogenism, and polycystic ovaries: a report of 3 cases. Author(s): Isojarvi JI, Tapanainen JS. Source: Archives of Neurology. 2000 July; 57(7): 1064-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10891991

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CHAPTER 2. NUTRITION AND POLYCYSTIC OVARIES Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and polycystic ovaries.

Finding Nutrition Studies on Polycystic Ovaries The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “polycystic ovaries” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

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Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “polycystic ovaries” (or a synonym): •

A comparative study of fixed-dose, step-down, and low-dose step-up regimens of human menopausal gonadotropin for patients with polycystic ovary syndrome. Author(s): Department of Obstetrics and Gynecology, Gunma University School of Medicine, Maebashi, Japan. Source: Andoh, K Mizunuma, H Liu, X Kamijo, T Yamada, K Ibuki, Y Fertil-Steril. 1998 November; 70(5): 840-6 0015-0282

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An attempt to alter the pathophysiology of polycystic ovary syndrome using a gonadotrophin hormone releasing hormone agonist--Nafarelin. Author(s): Academic Department of Obstetrics and Gynaecology, Royal Free Hospital, London, UK. Source: Williams, I A Shaw, R W Burford, G Clin-Endocrinol-(Oxf). 1989 September; 31(3): 345-53 0300-0664

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Arginine vasopressin secretion in non-obese women with polycystic ovary syndrome. Author(s): University Clinics of Internal Medicine, School of Medicine, University of Parma, Italy. Source: Coiro, V Volpi, R Capretti, L Bacchi Modena, A Cigarini, C Bianconi, L Rossi, G Gramellini, D Chiodera, P Acta-Endocrinol-(Copenh). 1989 December; 121(6): 784-90 0001-5598

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Assisted conception using buserelin and human menopausal gonadotrophins in women with polycystic ovary syndrome. Author(s): Manchester Fertility Services, BUPA Hospital, Whalley Range, UK. Source: Wada, I Matson, P L Troup, S A Lieberman, B A Br-J-Obstet-Gynaecol. 1993 April; 100(4): 365-9 0306-5456

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Circulating hormone concentrations in hypothyroid rats with induced polycystic ovaries. Author(s): Department of Biological Sciences, Kent State University, Ohio 44240. Source: Lee, M T Adams, W C Bruot, B C Proc-Soc-Exp-Biol-Med. 1991 November; 198(2): 737-41 0037-9727

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Differential activity of the cytochrome P450 17alpha-hydroxylase and steroidogenic acute regulatory protein gene promoters in normal and polycystic ovary syndrome theca cells. Author(s): Department of Cellular and Molecular Physiology, Pennsylvania State University College of Medicine, Hershey 17033, USA. Source: Wickenheisser, J K Quinn, P G Nelson, V L Legro, R S Strauss, J F McAllister, J M J-Clin-Endocrinol-Metab. 2000 June; 85(6): 2304-11 0021-972X

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Does ethnicity influence the prevalence of adrenal hyperandrogenism and insulin resistance in polycystic ovary syndrome? Author(s): Cattedra di Endocrinologia, Universita di Palermo, Italy. Source: Carmina, E Koyama, T Chang, L Stanczyk, F Z Lobo, R A Am-J-Obstet-Gynecol. 1992 December; 167(6): 1807-12 0002-9378

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Effects of electro-acupuncture on corticotropin-releasing factor in rats with experimentally-induced polycystic ovaries. Author(s): Department of Obstetrics and Gynecology, Goteborg University, Sweden. [email protected] Source: Stener Victorin, E Lundeberg, T Waldenstrom, U Bileviciute Ljungar, I Janson, P O Neuropeptides. 2001 Oct-December; 35(5-6): 227-31 0143-4179

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Effects of growth hormone administration in addition to gonadotrophins in normally ovulating women and polycystic ovary syndrome (PCO) patients. Author(s): Department of Obstetrics and Gynaecology, University of Cagliari, Italy. Source: Volpe, A Artini, P G Barreca, A Minuto, F Coukos, G Genazzani, A R HumReprod. 1992 November; 7(10): 1347-52 0268-1161

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Effects of multiple injections of luteinizing hormone on secretion of pregnane compounds from polycystic ovaries of rats exposed to constant light. Author(s): Department of Animal Reproduction, College of Agriculture, University of Osaka Prefecture, Japan. Source: Sawada, T Kosaka, T Ichikawa, S Acta-Endocrinol-(Copenh). 1987 November; 116(3): 390-4 0001-5598

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Elevated serum progesterone on the day of HCG administration in IVF is associated with a higher pregnancy rate in polycystic ovary syndrome. Author(s): Department of Obstetrics and Gynecology, University of Milan, H.San Raffaele Scientific Institute, Milano, Italy. Source: Doldi, N Marsiglio, E Destefani, A Gessi, A Merati, G Ferrari, A Hum-Reprod. 1999 Mar; 14(3): 601-5 0268-1161

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Gonadotropin-releasing hormone agonists administration in polycystic ovary syndrome. Effects on bone mass. Author(s): Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Facolta di Medicina e Chirurgia, Universita Federico II, Napoli, Italy. Source: Lupoli, G Di Carlo, C Nuzzo, V Vitale, G Russo, D Palomba, S Nappi, C JEndocrinol-Invest. 1997 September; 20(8): 493-6 0391-4097

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Induction by estradiol-17 beta of polycystic ovaries in the guinea pig. Author(s): Department of Biological Sciences, University of Wisconsin Milwaukee 53201-0413. Source: Quandt, L M Hutz, R J Biol-Reprod. 1993 May; 48(5): 1088-94 0006-3363

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Induction of ovulation by Sairei-to for polycystic ovary syndrome patients. Author(s): Department of Obstetrics and Gynecology, Nippon Kokan Hospital, Kanagawa, Japan. Source: Sakai, A Kondo, Z Kamei, K Izumi, S Sumi, K Endocr-J. 1999 February; 46(1): 217-20 0918-8959

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Menstrual abnormalities and polycystic ovary syndrome in women taking valproate for bipolar mood disorder. Author(s): Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada. [email protected] Source: O'Donovan, Claire Kusumakar, Vivek Graves, Gillian R Bird, Diane C J-ClinPsychiatry. 2002 April; 63(4): 322-30 0160-6689

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Metformin and intervention in polycystic ovary syndrome. Endocrine Society of Australia, the Australian Diabetes Society and the Australian Paediatric Endocrine Group. Author(s): Department of Obstetrics and Gynaecology, University of Adelaide, SA. Source: Norman, R J Kidson, W J Cuneo, R C Zacharin, M R Med-J-Aust. 2001 June 4; 174(11): 580-3 0025-729X

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•

Native gonadotropin-releasing hormone for triggering follicular maturation in polycystic ovary syndrome patients undergoing human menopausal gonadotropin ovulation induction. Author(s): Rambam Medical Center, Bruce Rapport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa. Source: Blumenfeld, Z Lang, N Amit, A Kahana, L Yoffe, N Fertil-Steril. 1994 September; 62(3): 456-60 0015-0282

•

Neuroendocrine control in polycystic ovary-like syndrome. Author(s): Department of Obstetrics and Gynecology, Free University Hospital, Amsterdam, The Netherlands. Source: Schoemaker, J Gynecol-Endocrinol. 1991 December; 5(4): 277-88 0951-3590

•

On the association between valproate and polycystic ovary syndrome. Author(s): Centre Saint Paul, Marseille, France. [email protected] Source: Genton, P Bauer, J Duncan, S Taylor, A E Balen, A H Eberle, A Pedersen, B Salas Puig, X Sauer, M V Epilepsia. 2001 March; 42(3): 295-304 0013-9580

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Ovarian hyperstimulation in polycystic ovary syndrome during therapy with leuprolide acetate. Author(s): Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710. Source: Walmer, D K Haney, A F Dodson, W C Fertil-Steril. 1989 November; 52(5): 858-9 0015-0282

•

Ovulation and the polycystic ovary syndrome. Author(s): Department of Reproductive Endocrinology and Infertility, King George V Memorial Hospital, New South Wales. Source: Jansen, R P Aust-N-Z-J-Obstet-Gynaecol. 1994 June; 34(3): 277-85 0004-8666

•

Ovulation of a single dominant follicle during treatment with low-dose pulsatile follicle stimulating hormone in women with polycystic ovary syndrome. Author(s): Department of Obstetrics and Gynaecology, St Mary's Hospital Medical School, London. Source: Polson, D W Mason, H D Saldahna, M B Franks, S Clin-Endocrinol-(Oxf). 1987 February; 26(2): 205-12 0300-0664

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Predictive value of serum androstenedione basal levels on the choice of gonadotropin or laparoscopic ovarian electrocautery as ovulation induction in clomiphene citrateresistant patients with polycystic ovary syndrome. Author(s): Department of Obstetrics and Gynecology, University of Bari, Italy. Source: Vicino, M Loverro, G Bettocchi, S Simonetti, S Mei, L Selvaggi, L GynecolEndocrinol. 2000 February; 14(1): 42-9 0951-3590

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Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome. Author(s): Department of Medicine, University College and Middlesex School of Medicine, London, UK. Source: Conway, G S Agrawal, R Betteridge, D J Jacobs, H S Clin-Endocrinol-(Oxf). 1992 August; 37(2): 119-25 0300-0664

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The role of aberrant hypothalamic opiatergic function in generating polycystic ovaries in the rat. Author(s): Department of Physiology, McGill University, Montreal, Que., Canada Source: Carriere, P D Farookhi, R Brawer, J R Can-J-Physiol-Pharmacol. 1989 August; 67(8): 896-901 0008-4212

Nutrition

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Thecal and interstitial cells in polycystic ovaries (PCO) in the rat. Author(s): Department of Anatomy, McGill University, Montreal, Quebec, Canada. Source: Convery, M Brawer, J R Anat-Rec. 1991 November; 231(3): 324-32 0003-276X

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Troglitazone improves defects in insulin action, insulin secretion, ovarian steroidogenesis, and fibrinolysis in women with polycystic ovary syndrome. Author(s): Department of Medicine, University of Chicago, Illinois 60637, USA. Source: Ehrmann, D A Schneider, D J Sobel, B E Cavaghan, M K Imperial, J Rosenfield, R L Polonsky, K S J-Clin-Endocrinol-Metab. 1997 July; 82(7): 2108-16 0021-972X

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Utero-ovarian arterial blood flow and hormonal profile in patients with polycystic ovary syndrome. Author(s): Department of Obstetrics and Gynaecology Ljubljana, University Medical Centre Ljubljana, Slovenia. Source: Vrtacnik Bokal, E Meden Vrtovec, H Hum-Reprod. 1998 April; 13(4): 815-21 0268-1161

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDHealth: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to polycystic ovaries; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Minerals Calcium Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. CLINICAL TRIALS AND POLYCYSTIC OVARIES Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning polycystic ovaries.

Recent Trials on Polycystic Ovaries The following is a list of recent trials dedicated to polycystic ovaries.8 Further information on a trial is available at the Web site indicated. •

Treatment of Infertility in Women With Polycystic Ovary Syndrome Condition(s): Polycystic Ovary Syndrome; Infertility; Pregnancy Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Child Health and Human Development (NICHD) Purpose - Excerpt: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting up to 10% of women. The primary symptoms of PCOS are menstrual irregularities, increased body and facial hair, acne, and infertility. This study will test a combination of medications in women with PCOS to determine which works best to overcome infertility. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00068861

•

Androgens and Subclinical Atherosclerosis in Young Women - Ancillary to CARDIA Condition(s): Cardiovascular Diseases; Coronary Arteriosclerosis; Heart Diseases; Polycystic Ovary Syndrome Study Status: This study is no longer recruiting patients.

8

These are listed at www.ClinicalTrials.gov.

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Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To examine whether serum androgens, measured earlier in life, and variation in genes related to androgen synthesis, metabolism, and signaling are associated with early-onset subclinical coronary atherosclerosis in young adult women from the community. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00037245 •

Risk of Coronary Heart Disease in Women with Polycystic Ovary Syndrome Condition(s): Atherosclerosis; Cardiovascular Diseases; Heart Diseases; Carotid Artery Diseases; Coronary Disease; Polycystic Ovary Syndrome Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To investigate whether women with Polycystic Ovary syndrome (PCOS) have evidence of an increased prevalence rate of subclinical atherosclerosis as measured by the presence of plaque, increased intima-medial carotid artery wall thickness and lower brachial artery flow mediated vasodilation. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005459

•

Phase II Study of the Effect of Leuprolide Acetate and Spironolactone on Insulin Resistance in Hyperandrogenic Women with Polycystic Ovarian Disease or Hyperandrogenism Insulin Resistance Acanthosis Nigricans Syndrome Condition(s): Acanthosis Nigricans; Polycystic Ovary Syndrome Study Status: This study is completed. Sponsor(s): National Center for Research Resources (NCRR); Baylor College of Medicine Purpose - Excerpt: Objectives: I. Evaluate insulin resistance in thin and obese hyperandrogenic women with polycystic ovarian disease or hyperandrogenism insulin resistance acanthosis nigricans syndrome and in thin and obese controls, using an estimation of tissue sensitivity to insulin. II. Evaluate the effect of androgen suppression with leuprolide acetate and spironolactone on insulin secretion and resistance. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004311

•

Randomized Study of Decreased Hyperinsulinemia on the Ovulatory Response to Clomiphene Citrate in Women With Polycystic Ovary Syndrome Condition(s): Polycystic Ovary Syndrome; Hyperinsulinism Study Status: This study is completed. Sponsor(s): National Center for Research Resources (NCRR); University of Virginia

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Purpose - Excerpt: Objectives: I. Determine whether reduction of serum insulin levels by metformin increases ovulatory response to clomiphene citrate in women with polycystic ovary syndrome. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005104 •

Randomized Study of the Effect of Decreased Hyperinsulinemia on the Ovulatory Response to Clomiphene Citrate in Obese Women With Polycystic Ovary Syndrome Condition(s): Hyperinsulinism; Polycystic Ovary Syndrome Study Status: This study is completed. Sponsor(s): National Center for Research Resources (NCRR); University of Virginia Purpose - Excerpt: Objectives: I. Determine whether reduction of serum insulin levels by metformin increases ovulatory response to clomiphene or spontaneous ovulation in obese women with polycystic ovary syndrome. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005654

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “polycystic ovaries” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

•

For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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•

For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 4. PATENTS ON POLYCYSTIC OVARIES Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “polycystic ovaries” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on polycystic ovaries, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Polycystic Ovaries By performing a patent search focusing on polycystic ovaries, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 9Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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The following is an example of the type of information that you can expect to obtain from a patent search on polycystic ovaries: •

Use of thiazolidinedione derivatives in the treatment of polycystic ovary syndrome, gestational diabetes and disease states at risk for progressing to noninsulindependent diabetes mellitus Inventor(s): Antonucci; Tammy (Thousand Oaks, CA), Lockwood; Dean (Ann Arbor, MI), Norris; Rebecca (Kewadin, MI) Assignee(s): Warner-lambert Company (morris Plains, Nj) Patent Number: 5,874,454 Date filed: May 15, 1997 Abstract: Novel methods of using thiazolidinone derivatives and related antihyperglycemic agents to treat populations at risk for developing noninsulindependent diabetes mellitus (NIDDM) and complications arising therefrom are disclosed In one embodiment, the compounds of the invention are used to treat polycystic ovary syndrome in order to prevent or delay the onset of noninsulindependent diabetes mellitus. In another embodiment, the compounds of the invention are used to treat gestational diabetes in order to prevent or delay the onset of noninsulin-dependent diabetes mellitus. Excerpt(s): The present invention pertains to a number of compounds which can be used to treat certain disease states in order to prevent or delay the onset of noninsulindependent diabetes mellitus (NIDDM). More specifically, the present invention involves in one embodiment administering to a patient certain known thiazolidinedione derivatives and related antihyperglycemic agents which treat disease states such as polycystic ovary and gestational diabetes syndrome which are at increased risk in the development of NIDDM, thus preventing or delaying the onset of NIDDM or complications resulting therefrom. Diabetes is one of the most prevalent chronic disorders worldwide with significant personal and financial costs for patients and their families, as well as for society. Different types of diabetes exist with distinct etiologies and pathogeneses. For example, diabetes mellitus is a disorder of carbohydrate metabolism, characterized by hyperglycemia and glycosuria and resulting from inadequate production or utilization of insulin. Reports indicate that insulin secretion is often enhanced early-on, presumably as compensation for the insulin resistance. People who actually develop NIDDM appear to do so because their B-cells eventually fail to maintain sufficient insulin secretion to compensate for the insulin resistance. Mechanisms responsible for the B-cell failure have not been identified, but may be related to the chronic demands placed on the B-cells by peripheral insulin resistance and/or to the effects of hyperglycemia to impair B-cell function. The B-cell failure could also occur as an independent, inherent defect in "pre-diabetic" individuals. Web site: http://www.delphion.com/details?pn=US05874454__

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Patent Applications on Polycystic Ovaries As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to polycystic ovaries: •

Methods and compositions for the benefit of those suffering from polycystic ovary syndrome with chromium complexes Inventor(s): Katz, David P.; (Dobbs Ferry, NY) Correspondence: Knobbe Martens Olson & Bear Llp; 620 Newport Center Drive; Sixteenth Floor; Newport Beach; CA; 92660; US Patent Application Number: 20020086065 Date filed: October 25, 2001 Abstract: Compositions comprising chromium complexes such as chromium picolinate or chromium nicotinate are administered to a subject presenting with Polycystic Ovary Syndrome. The compositions may further comprise at least one of a chelating agent, cyclooxygenase inhibitor, a mucolytic, and/or a salicin-containing herb. Excerpt(s): This application claims priority to Provisional Application No. 60/244,791 entitled METHODS AND COMPOSITIONS FOR THE BENEFIT OF THOSE SUFFERING FROM POLYCYSTIC OVARY SYNDROME WITH CHROMIUM COMPLEXES filed on Oct. 31, 2000. The subject matter of the aforementioned application is hereby incorporated by reference. The disclosed invention relates to compositions comprising chromium complexes and uses of these compositions in treating Polycystic Ovary Syndrome (PCOS). Polycystic Ovary Syndrome (PCOS) or Stein-Leventhal Syndrome affects an estimated 5% to 10% of women. The condition is characterized by 1) irregular or absent menses, 2) numerous cysts on the ovaries, 3) high blood pressure, 4) acne, 5) elevated insulin levels, insulin resistance, or type II diabetes, 6) infertility, 7) excess hair on the face or body, 8) male-pattern baldness, 9) abdominal obesity, and 10) abnormal lipid profiles. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

Methods and compositions for treating polycystic ovary syndrome Inventor(s): Hathaway, David R.; (Lincoln, NE) Correspondence: Arnold & Porter; IP Docketing Department Room 1126b; 555 Twelfth Street NW; Washington; DC; 20004-1206; US Patent Application Number: 20040029784 Date filed: December 11, 2002 Abstract: The present invention relates to methods of treating polycystic ovary syndrome (PCOS) comprising administering glucagon-like peptide-1 (GLP-1) to subjects suffering therefrom. Excerpt(s): The present invention relates to endocrinology and pharmacology. More particularly, it relates to methods and compositions for treating subjects suffering from

10

This has been a common practice outside the United States prior to December 2000.

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polycystic ovary syndrome (PCOS). Polycystic ovary syndrome (PCOS), also known as polycystic ovarian disease or Stein-Leventhal syndrome, affects an estimated 6-10% of women in the United States. PCOS is characterized by anovulation (irregular or absent menstrual periods) and hyperandrogenism (elevated serum testosterone and androstenedione). Additional etiological and clinical symptoms of this disease can include abnormal uterine bleeding, enlarged multifollicular ovaries, infertility, obesity, insulin resistance, hyperinsulinemia, hypertension, hyperlipidemia, type-2 diabetes mellitus, excess facial hair growth, hair loss and acne. Insulin resistance and hyperinsulinemia are highly prevalent in patients with PCOS and are thought to underlie the pathophysiology of this disease (Udoff, L., et al., Curr. Opin. Obstret. Gynecol. 7:340-343 (1995); Barbieri, R. L., Am. J. Obstet. Gynecol. 183:1412-8 (2000); Kim, L. H. et al., Fertility and Sterility 73:1097-1098 (2000); Iuorno, M. J. et al., Obstet. Gynecol. Clin. North Am. 28:153-164 (2001); Zacur, H. Z., Obstet. Gynecol. Clin. North Am. 28:2133 (2001)). Recent studies suggest that the hyperandrogenism associated with PCOS is caused by an increase in ovarian androgen production (e.g., testosterone and androstenedione) and a decrease in serum androgen-binding globulin concentration, due to hyperinsulinemia. Insulin has been shown to directly stimulate production of androgens by the ovary, at least in part by increasing the activity of P450c17.alpha., an enzyme involved in the production of testosterone in the ovarian theca cells (Iuorno, M. J. et al., supra). At the level of the pituitary axis, hyperandrogenism suppresses follicle stimulating hormone (FSH) secretion, alters gonadotropin-releasing hormone (GnRH) release and increases lutenizing hormone (LH) secretion. These abnormalities, along with the local effects of androgens on the ovaries, lead to follicular involution, anovulation, and infertility. Similarly, oligomenorrhea and amenorrhea occur and are interspersed with heavy vaginal bleeding. Hyperinsulinemia may also lead to high blood pressure and increased clot formation and has been implicated in the development of cardiovascular disease, stroke and type-2 diabetes (Iuorno, M. J. et al., supra; Zacur, H. A., supra). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Use of PDE5 inhibitors in the treatment of polycystic ovary syndrome Inventor(s): Ghazzi, Mahmoud Nizar; (Ann Arbor, MI), Koppiker, Nandan Parmanand; (Sandwich, GB), Westbrook, Simon Lempriere; (Sandwich, GB) Correspondence: Pfizer INC.; Patent Department, Ms8260-1611; Eastern Point Road; Groton; CT; 06340; US Patent Application Number: 20040029891 Date filed: September 2, 2003 Abstract: The present invention relates to the use of a pyrazolopyrimidinone PDE5 inhibitor such as sildenafil for the treatment of polycystic ovary syndrome. Excerpt(s): The present invention relates to the treatment of polycystic ovary syndrome (sometimes referred to as PCOS) and to compounds and compositions for such treatment, as well as the uses thereof of said compounds and compositions. In particular the present invention relates to the use of pyrazolopyrimidinone inhibitors of cyclic guanosine 3',5'-monophosphate phosphodiesterase type five (PDE5 or PDE V) for treatment of PCOS. The present invention more particularly relates to the use of the compound sildenafil, for the treatment of PCOS. A cyclic guanosine 3',5'monophosphate phosphodiesterase type five inhibitor is sometimes referred to as a cGMP PDE5 inhibitor or a cGMP PDE5i. It is estimated that about 5% of pre-

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menopausal women suffer from PCOS. Women with PCOS are likely to experience problems with ovulation, and may have either a small amount of menses or no menses. Women with PCOS may experience hyperandrogenicity due to their increased levels of circulatory androgens and as such are likely to display symptoms of hirsuitism, virilisation and acne. The most common symptoms associated with PCOS are infertility, obesity, oligimenorrhoea and hirsuitism. Further symptoms frequently found in women with PCOS are amenorrhea, seborrhoea, acne, alopecia and impaired glucose tolerance. Rarer symptoms include hypertension, endometrial cancer and ovarian tumors. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with polycystic ovaries, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “polycystic ovaries” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on polycystic ovaries. You can also use this procedure to view pending patent applications concerning polycystic ovaries. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. PERIODICALS AND NEWS ON POLYCYSTIC OVARIES Overview In this chapter, we suggest a number of news sources and present various periodicals that cover polycystic ovaries.

News Services and Press Releases One of the simplest ways of tracking press releases on polycystic ovaries is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “polycystic ovaries” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to polycystic ovaries. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “polycystic ovaries” (or synonyms). The following was recently listed in this archive for polycystic ovaries: •

Diagnostic criteria for polycystic ovary syndrome revised Source: Reuters Medical News Date: January 30, 2004

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•

Sibutramine benefits obese women with polycystic ovary syndrome Source: Reuters Industry Breifing Date: December 30, 2003

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Asymptomatic polycystic ovaries not tied to infertility Source: Reuters Health eLine Date: October 15, 2003

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Asymptomatic polycystic ovaries not associated with infertility Source: Reuters Medical News Date: October 15, 2003

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Visceral fat may signal risk of metabolic complications in polycystic ovary syndrome Source: Reuters Medical News Date: July 11, 2003

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Polycystic ovary syndrome increases risk of coronary atherosclerosis Source: Reuters Medical News Date: June 06, 2003

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Short-term rosiglitazone enhances ovulation in polycystic ovary syndrome Source: Reuters Industry Breifing Date: April 08, 2003

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Caloric restriction linked to improvement in polycystic ovary symptoms Source: Reuters Medical News Date: January 23, 2003

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Hyperinsulinemia seen as central in pathogenesis of polycystic ovary syndrome Source: Reuters Industry Breifing Date: January 03, 2003

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N-acetyl-cysteine treats hyperinsulinemia in polycystic ovary syndrome Source: Reuters Medical News Date: July 08, 2002

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Combination OCs effective for polycystic ovary syndrome in adolescent girls Source: Reuters Medical News Date: June 12, 2002

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Metformin restores glucose tolerance in teens with polycystic ovary syndrome Source: Reuters Industry Breifing Date: May 08, 2002

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Ovarian drilling again shown to ameliorate polycystic ovary disease, improve fertility Source: Reuters Medical News Date: March 20, 2002

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Polycystic ovary syndrome linked with early cardiovascular disease Source: Reuters Medical News Date: February 05, 2002

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Elevated LDL cholesterol common in women with polycystic ovary syndrome Source: Reuters Medical News Date: January 15, 2002

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Low-dose IVF stimulation protocol safe, effective in women with polycystic ovaries Source: Reuters Medical News Date: July 13, 2001

Periodicals and News

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Metformin plus clomiphene induces ovulation despite polycystic ovary syndrome Source: Reuters Industry Breifing Date: February 15, 2001

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Polycystic ovary syndrome linked to premature atherosclerosis Source: Reuters Medical News Date: November 09, 2000

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Metformin reduces miscarriages in women with polycystic ovary syndrome Source: Reuters Medical News Date: April 19, 2000

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Insmed receives $34.5 million for diabetes, polycystic ovary research Source: Reuters Medical News Date: February 01, 2000

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Metformin can attenuate symptoms of polycystic ovary syndrome Source: Reuters Medical News Date: January 24, 2000

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Drug boosts pregnancy rate in polycystic ovary disease patients Source: Reuters Health eLine Date: October 01, 1999

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Metformin increases pregnancy rate in women with polycystic ovary disease Source: Reuters Medical News Date: September 30, 1999

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Low-dose ketoconazole attenuates ovarian response in polycystic ovary syndrome Source: Reuters Medical News Date: July 28, 1999

•

Women with polycystic ovary syndrome a heterogeneous group Source: Reuters Medical News Date: July 26, 1999

•

Polycystic ovary syndrome may protect against bone loss Source: Reuters Medical News Date: July 23, 1999

•

Follistatin gene linked to polycystic ovary syndrome Source: Reuters Medical News Date: July 20, 1999

•

Gene linked to polycystic ovary syndrome Source: Reuters Health eLine Date: July 19, 1999

•

D-chiro-inositol reverses metabolic abnormalities in polycystic ovary syndrome Source: Reuters Medical News Date: April 29, 1999

•

New drug treats polycystic ovary syndrome Source: Reuters Health eLine Date: April 28, 1999

•

Polycystic ovary syndrome a risk factor for glucose intolerance, type 2 diabetes Source: Reuters Medical News Date: January 26, 1999

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•

Polycystic ovaries in adolescents associated with menstrual irregularities Source: Reuters Medical News Date: October 07, 1998

•

Women with polycystic ovaries at high risk for gestational diabetes Source: Reuters Medical News Date: July 28, 1998

•

Polycystic ovary syndrome does not increase risk of CVD mortality Source: Reuters Medical News Date: July 24, 1998

•

Metformin improves ovulation in obese women with polycystic ovary syndrome Source: Reuters Medical News Date: June 25, 1998

•

Metformin Therapy Beneficial For Women With Polycystic Ovary Syndrome Source: Reuters Medical News Date: April 21, 1998

•

Polycystic Ovary Syndrome With Obesity Linked To Low HDL Lipid Source: Reuters Medical News Date: October 27, 1997

•

Polycystic Ovaries Associated With Prolonged Gestation, High Birthweight Source: Reuters Medical News Date: October 17, 1997

•

Leuprolide Acetate Plus An OC Effective In Patients With Polycystic Ovaries Source: Reuters Medical News Date: March 10, 1997

•

Coronary Disease Severity Linked To Presence Of Polycystic Ovaries Source: Reuters Medical News Date: January 02, 1997

•

Cabergoline Normalizes Androgen Levels In Polycystic Ovary Syndrome Source: Reuters Medical News Date: October 14, 1996

•

Reduction of Insulin Levels Ameliorates Polycystic Ovary Syndrome Source: Reuters Medical News Date: August 29, 1996

•

Pulsatile GnRH: Induces Ovulation In Clomiphene-Resistant Polycystic Ovary Syndrome Patients Source: Reuters Medical News Date: August 16, 1996

•

Hormone Analysis Permits Diagnosis Of Polycystic Ovary Syndrome Source: Reuters Medical News Date: March 05, 1996

•

IVF With Embryo Transfer Often Successful Despite Polycystic Ovary Syndrome Source: Reuters Medical News Date: January 23, 1996

•

Young Women With Polycystic Ovary Syndrome At High Risk For CHD Source: Reuters Medical News Date: July 19, 1995

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “polycystic ovaries” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “polycystic ovaries” (or synonyms). If you know the name of a company that is relevant to polycystic ovaries, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “polycystic ovaries” (or synonyms).

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Academic Periodicals covering Polycystic Ovaries Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to polycystic ovaries. In addition to these sources, you can search for articles covering polycystic ovaries that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 6. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for polycystic ovaries. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with polycystic ovaries. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).

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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to polycystic ovaries: Diuretics, Potassium-Sparing •

Systemic - U.S. Brands: Aldactone; Dyrenium; Midamor http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202206.html

Estrogens and Progestins Oral Contraceptives •

Systemic - U.S. Brands: Alesse; Brevicon; Demulen 1/35; Demulen 1/50; Desogen; Estrostep; Estrostep Fe; Genora 0.5/35; Genora 1/35; Genora 1/50; Intercon 0.5/35; Intercon 1/35; Intercon 1/50; Jenest; Levlen; Levlite; Levora 0.15/30; Lo/Ovral; Loestrin 1.5/30; Loestrin 1/20 http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202228.html

Progestins for Noncontraceptive Use •

Systemic - U.S. Brands: Amen; Aygestin; Crinone; Curretab; Cycrin; DepoProvera; Gesterol 50; Gesterol LA 250; Hy/Gestrone; Hylutin; Megace; Prodrox; Prometrium; Pro-Span; Provera http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202758.html

Urofollitropin •

Systemic - U.S. Brands: Fertinex; Metrodin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202586.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html.

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Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

11

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

12

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “polycystic ovaries” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 2338 58 898 3 27 3324

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “polycystic ovaries” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

14

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

15

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

The Genome Project and Polycystic Ovaries In the following section, we will discuss databases and references which relate to the Genome Project and polycystic ovaries. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).22 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 19 Adapted 20

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 22 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “polycystic ovaries” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for polycystic ovaries: •

Polycystic Ovary Syndrome 1 Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=184700 Genes and Disease (NCBI - Map)

The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •

Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html

•

Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html

•

Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html

•

Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html

•

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html

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•

Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html

•

Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez

Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •

3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

•

Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

•

NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

•

Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

•

OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

•

PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

•

ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

•

PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

•

Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

•

Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then

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select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “polycystic ovaries” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database23 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database24 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “polycystic ovaries” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

23

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 24 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on polycystic ovaries can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to polycystic ovaries. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to polycystic ovaries. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “polycystic ovaries”:

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Hormones http://www.nlm.nih.gov/medlineplus/hormones.html Infertility http://www.nlm.nih.gov/medlineplus/infertility.html Ovarian Cysts http://www.nlm.nih.gov/medlineplus/ovariancysts.html Reproductive Health http://www.nlm.nih.gov/medlineplus/reproductivehealth.html

Within the health topic page dedicated to polycystic ovaries, the following was listed: •

General/Overviews Ovarian Cysts http://www.nlm.nih.gov/medlineplus/tutorials/ovariancystsloader.html Ovarian Cysts Source: American College of Obstetricians and Gynecologists http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZEB8EN97C& sub_cat=9 Ovarian Cysts Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00129 Ovarian Cysts Source: National Women's Health Information Center http://www.4woman.gov/faq/ovarian_cysts.htm

•

Diagnosis/Symptoms Laparoscopy Source: American College of Obstetricians and Gynecologists http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZODAA697C &sub_cat=8 Polycystic Ovary Syndrome Frequently Asked Questions: Diagnosing PCOS Source: International Council on Infertility Information Dissemination http://www.inciid.org/faq/pcos2.html Ultrasound-Pelvis Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/content/ultrasound-pelvis.htm

•

Treatment Polycystic Ovary Syndrome Frequently Asked Questions: Treating Infertility Due to PCOS Source: International Council on Infertility Information Dissemination http://www.inciid.org/faq/pcos5.html

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Polycystic Ovary Syndrome Frequently Asked Questions: Treating PCOS When Not Trying to Conceive Source: International Council on Infertility Information Dissemination http://www.inciid.org/faq/pcos8.html •

Specific Conditions/Aspects Hemorrhagic Cysts in the Ovary Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00485 Insulin Resistance Syndrome Source: American Academy of Family Physicians http://familydoctor.org/660.xml Polycystic Ovary Syndrome Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00423 Polycystic Ovary Syndrome (PCOS) Source: National Women's Health Information Center http://www.4woman.gov/faq/pcos.htm Polycystic Ovary Syndrome Frequently Asked Questions: Cosmetic Concerns Source: International Council on Infertility Information Dissemination http://www.inciid.org/faq/pcos10.html Polycystic Ovary Syndrome Frequently Asked Questions: Emotionally Speaking Source: Polycystic Ovarian Syndrome Association http://www.inciid.org/faq/pcos11.html Polycystic Ovary Syndrome Frequently Asked Questions: Increased Miscarriage Rate with PCOS Source: Polycystic Ovarian Syndrome Association http://www.inciid.org/faq/pcos6.html Polycystic Ovary Syndrome Frequently Asked Questions: Pregnancy with PCOS Source: Polycystic Ovarian Syndrome Association http://www.inciid.org/faq/pcos7.html Polycystic Ovary Syndrome Frequently Asked Questions: The Connection and How to Treat It Source: International Council on Infertility Information Dissemination http://www.inciid.org/faq/pcos4.html

Insulin

Polycystic Ovary Syndrome Frequently Asked Questions: The Syndrome and the Symptoms Source: International Council on Infertility Information Dissemination http://www.inciid.org/faq/pcos1.html Polycystic Ovary Syndrome Frequently Asked Questions: Weight, Diet & Exercise for Women with PCOS Source: International Council on Infertility Information Dissemination http://www.inciid.org/faq/pcos9.html

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Organizations International Council on Infertility Information Dissemination http://www.inciid.org/ National Institute of Child Health and Human Development http://www.nichd.nih.gov/ National Women's Health Information Center Source: Dept. of Health and Human Services http://www.4woman.gov/

•

Research Disorders Associated with Infertility Source: National Institute of Child Health and Human Development http://www.nichd.nih.gov/womenshealth/infertility.cfm Oral Diabetes Drug Shows Promise in Preventing Miscarriage in Common Infertility Source: National Institute of Child Health and Human Development http://www.nih.gov/news/pr/feb2002/nichd-27.htm

•

Teenagers Coping with Polycystic Ovary Syndrome Source: Nemours Foundation http://kidshealth.org/teen/sexual_health/girls/pcos.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to polycystic ovaries. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.

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Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to polycystic ovaries. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with polycystic ovaries. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about polycystic ovaries. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “polycystic ovaries” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received

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your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “polycystic ovaries”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “polycystic ovaries” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “polycystic ovaries” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.25

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

25

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)26: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

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California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

26

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries 101

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Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on polycystic ovaries: •

Basic Guidelines for Polycystic Ovaries Stein-Leventhal syndrome Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000369.htm

•

Signs & Symptoms for Polycystic Ovaries Amenorrhea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003149.htm Hirsutism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003148.htm Obese Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003101.htm Obesity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003101.htm

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Diagnostics and Tests for Polycystic Ovaries Biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm Cysts Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003240.htm Follicle-stimulating hormone Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003710.htm FSH Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003710.htm Laparoscopy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003918.htm LH Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003708.htm Pregnancy test Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003432.htm Serum HCG Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003509.htm Testosterone Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003707.htm

•

Background Topics for Polycystic Ovaries Virilization Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002339.htm Weight reduction Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001940.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

Online Glossaries 107

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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POLYCYSTIC OVARIES DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 17-Ketosteroids: Steroids that contain a ketone group at position 17. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Ablate: In surgery, is to remove. [NIH] Ablation: The removal of an organ by surgery. [NIH] Abortion: 1. The premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. Premature stoppage of a natural or a pathological process. [EU] Acanthosis Nigricans: A circumscribed melanosis consisting of a brown-pigmented, velvety verrucosity or fine papillomatosis appearing in the axillae and other body folds. It occurs in association with endocrine disorders, underlying malignancy, administration of certain drugs, or as in inherited disorder. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Action Potentials: The electric response of a nerve or muscle to its stimulation. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenovirus: A group of viruses that cause respiratory tract and eye infections. Adenoviruses used in gene therapy are altered to carry a specific tumor-fighting gene. [NIH] Adenylate Cyclase: An enzyme of the lyase class that catalyzes the formation of cyclic AMP and pyrophosphate from ATP. EC 4.6.1.1. [NIH] Adhesions: Pathological processes consisting of the union of the opposing surfaces of a wound. [NIH]

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Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from

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which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgen suppression: Treatment to suppress or block the production of male hormones. Androgen suppression is achieved by surgical removal of the testicles, by taking female sex hormones, or by taking other drugs. Also called androgen ablation. [NIH] Androgenic: Producing masculine characteristics. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Androstenedione: A steroid with androgenic properties that is produced in the testis, ovary, and adrenal cortex. It is a precursor to testosterone and other androgenic hormones. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anovulation: Suspension or cessation of ovulation in animals and humans. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU]

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Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatase: An enzyme which converts androgens to estrogens by desaturating ring A of the steroid. This enzyme complex is located in the endoplasmic reticulum of estrogenproducing cells including ovaries, placenta, testicular Sertoli and Leydig cells, adipose, and brain tissues. The enzyme complex has two components, one of which is the CYP19 gene product, the aromatase cytochrome P-450. The other component is NADPH-cytochrome P450 reductase which transfers reducing equivalents to P-450(arom). EC 1.14.13.-. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Aspiration: The act of inhaling. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]

Axillary Artery: The continuation of the subclavian artery; it distributes over the upper limb, axilla, chest and shoulder. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary

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movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Beta-Endorphin: A peptide consisting of amino acid sequence 61-91 of the endogenous pituitary hormone beta-lipotropin. The first four amino acids show a common tetrapeptide sequence with methionine- and leucine enkephalin. The compound shows opiate-like activity. Injection of beta-endorphin induces a profound analgesia of the whole body for several hours. This action is reversed after administration of naloxone. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH]

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Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Artery: The continuation of the axillary artery; it branches into the radial and ulnar arteries. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Buserelin: A potent and durable analog of naturally occurring gonadotropin-releasing hormone (GnRH). [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Carbamazepine: An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of phenytoin; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiac catheterization: A procedure in which a thin, hollow tube is inserted into a blood vessel. The tube is then advanced through the vessel into the heart, enabling a physician to study the heart and its pumping activity. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH]

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Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Aggregation: The phenomenon by which dissociated cells intermixed in vitro tend to group themselves with cells of their own type. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH]

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Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clomiphene: A stilbene derivative that functions both as a partial estrogen agonist and complete estrogen antagonist depending on the target tissue. It antagonizes the estrogen receptor thereby initiating or augmenting ovulation in anovulatory women. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix

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'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary

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arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cultured cells: Animal or human cells that are grown in the laboratory. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyst: A sac or capsule filled with fluid. [NIH] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Defense Mechanisms: Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Deoxyribonucleic: A polymer of subunits called deoxyribonucleotides which is the primary genetic material of a cell, the material equivalent to genetic information. [NIH] Deoxyribonucleic acid: A polymer of subunits called deoxyribonucleotides which is the

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primary genetic material of a cell, the material equivalent to genetic information. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermoid: A benign mixed tumor, usually congenital, containing teeth, hairs, skin glands, fibrous tissue, and other skin elements, rarely found in the limbal region of the eye and orbit. [NIH] Dermoid Cyst: A benign mixed tumor, usually congenital, containing teeth, hairs, skin glands, fibrous tissue, and other skin elements, rarely found in the limbal region of the eye and orbit. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Retinopathy: Retinopathy associated with diabetes mellitus, which may be of the background type, progressively characterized by microaneurysms, interretinal punctuate macular edema, or of the proliferative type, characterized by neovascularization of the retina and optic disk, which may project into the vitreous, proliferation of fibrous tissue, vitreous hemorrhage, and retinal detachment. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diathermy: The induction of local hyperthermia by either short radio waves or highfrequency sound waves. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become

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blended; not running together; separate. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]

Endometriosis: A condition in which tissue more or less perfectly resembling the uterine

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mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enhancer: Transcriptional element in the virus genome. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach.

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[NIH]

Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Eye Infections: Infection, moderate to severe, caused by bacteria, fungi, or viruses, which occurs either on the external surface of the eye or intraocularly with probable inflammation, visual impairment, or blindness. [NIH] Facial: Of or pertaining to the face. [EU] Fallopian tube: The oviduct, a muscular tube about 10 cm long, lying in the upper border of the broad ligament. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fertilization in Vitro: Fertilization of an egg outside the body when the egg is normally fertilized in the body. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolysis: The natural enzymatic dissolution of fibrin. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fold: A plication or doubling of various parts of the body. [NIH]

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Follicles: Shafts through which hair grows. [NIH] Follicular Fluid: A fluid consisting of sex steroid hormones, plasma proteins, mucopolysaccharides, and electrolytes that is present in the vesicular ovarian follicle (Graafian follicle) surrounding the ovum. [NIH] Follicular Phase: The period of the menstrual cycle that begins with menstruation and ends with ovulation. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH]

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Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glyceraldehyde 3-Phosphate: An aldotriose which is an important intermediate in glycolysis and in tryptophan biosynthesis. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycogen Storage Disease: A group of inherited metabolic disorders involving the enzymes responsible for the synthesis and degradation of glycogen. In some patients, prominent liver involvement is presented. In others, more generalized storage of glycogen occurs, sometimes with prominent cardiac involvement. [NIH] Glycolysis: The pathway by which glucose is catabolized into two molecules of pyruvic acid with the generation of ATP. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosuria: The presence of glucose in the urine; especially the excretion of an abnormally large amount of sugar (glucose) in the urine, i.e., more than 1 gm. in 24 hours. [EU] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonadorelin: A decapeptide hormone released by the hypothalamus. It stimulates the synthesis and secretion of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. [NIH] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulosa Cells: Cells of the membrana granulosa lining the vesicular ovarian follicle which become luteal cells after ovulation. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological

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therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Haplotypes: The genetic constitution of individuals with respect to one member of a pair of allelic genes, or sets of genes that are closely linked and tend to be inherited together such as those of the major histocompatibility complex. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterodimers: Zippered pair of nonidentical proteins. [NIH] Hirsutism: Excess hair in females and children with an adult male pattern of distribution. The concept does not include hypertrichosis, which is localized or generalized excess hair. [NIH]

Holmium: An element of the rare earth family of metals. It has the atomic symbol Ho, atomic number 67, and atomic weight 164.93. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1

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isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperandrogenism: A state characterized or caused by an excessive secretion of androgens by the adrenal cortex, ovaries, or testes. The clinical significance in males is negligible, so the term is used most commonly with reference to the female. The common manifestations in women are hirsutism and virilism. It is often caused by ovarian disease (particularly the polycystic ovary syndrome) and by adrenal diseases (particularly adrenal gland hyperfunction). [NIH] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hyperstimulation: Excessive stimulation. [EU] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hypertrichosis: Localized or generalized excess hair. The concept does not include hirsutism, which is excess hair in females and children with an adult male pattern of distribution. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypogonadism: Condition resulting from or characterized by abnormally decreased functional activity of the gonads, with retardation of growth and sexual development. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH]

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Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunology: The study of the body's immune system. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhibin: Glyceroprotein hormone produced in the seminiferous tubules by the Sertoli cells in the male and by the granulosa cells in the female follicles. The hormone inhibits FSH and LH synthesis and secretion by the pituitary cells thereby affecting sexual maturation and fertility. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inositol: An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1379) Inositol

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phospholipids are important in signal transduction. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH] Integrins: A family of transmembrane glycoproteins consisting of noncovalent heterodimers. They interact with a wide variety of ligands including extracellular matrix glycoproteins, complement, and other cells, while their intracellular domains interact with the cytoskeleton. The integrins consist of at least three identified families: the cytoadhesin receptors, the leukocyte adhesion receptors, and the very-late-antigen receptors. Each family contains a common beta-subunit combined with one or more distinct alpha-subunits. These receptors participate in cell-matrix and cell-cell adhesion in many physiologically important processes, including embryological development, hemostasis, thrombosis, wound healing, immune and nonimmune defense mechanisms, and oncogenic transformation. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intravascular: Within a vessel or vessels. [EU] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Involuntary: Reaction occurring without intention or volition. [NIH] Involution: 1. A rolling or turning inward. 2. One of the movements involved in the gastrulation of many animals. 3. A retrograde change of the entire body or in a particular organ, as the retrograde changes in the female genital organs that result in normal size after delivery. 4. The progressive degeneration occurring naturally with advancing age, resulting in shrivelling of organs or tissues. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction

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of a blood vessel. [EU] Islet: Cell producing insulin in pancreas. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Ketoconazole: Broad spectrum antifungal agent used for long periods at high doses, especially in immunosuppressed patients. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Labyrinthine: A vestibular nystagmus resulting from stimulation, injury, or disease of the labyrinth. [NIH] Lactation: The period of the secretion of milk. [EU] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leuprolide: A potent and long acting analog of naturally occurring gonadotropin-releasing hormone (gonadorelin). Its action is similar to gonadorelin, which regulates the synthesis and release of pituitary gonadotropins. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Linkage Disequilibrium: Nonrandom association of linked genes. This is the tendency of the alleles of two separate but already linked loci to be found together more frequently than would be expected by chance alone. [NIH] Lipid: Fat. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders.

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[NIH]

Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Major Histocompatibility Complex: The genetic region which contains the loci of genes which determine the structure of the serologically defined (SD) and lymphocyte-defined (LD) transplantation antigens, genes which control the structure of the immune responseassociated (Ia) antigens, the immune response (Ir) genes which control the ability of an animal to respond immunologically to antigenic stimuli, and genes which determine the structure and/or level of the first four components of complement. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH]

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Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Melanosis: Disorders of increased melanin pigmentation that develop without preceding inflammatory disease. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Glycoproteins: Glycoproteins found on the membrane or surface of cells. [NIH] Menarche: The establishment or beginning of the menstrual function. [EU] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menotropins: Extracts from human menopausal urine containing FSH and LH activity. They are used to treat infertility disorders. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]

Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the

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second trimester. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monophosphate: So called second messenger for neurotransmitters and hormones. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Mucolytic: Destroying or dissolving mucin; an agent that so acts : a mucopolysaccharide or glycoprotein, the chief constituent of mucus. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive

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antagonist at mu, delta, and kappa opioid receptors. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Growth Factor: Nerve growth factor is the first of a series of neurotrophic factors that were found to influence the growth and differentiation of sympathetic and sensory neurons. It is comprised of alpha, beta, and gamma subunits. The beta subunit is responsible for its growth stimulating activity. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the

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chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nystagmus: Rhythmical oscillation of the eyeballs, either pendular or jerky. [NIH] Oestradiol: Growth hormone. [NIH] Oligo: Chemical and mineral elements that exist in minimal (oligo) quantities in the body, in foods, in the air, in soil; name applied to any element observed as a microconstituent of plant or animal tissue and of beneficial, harmful, or even doubtful significance. [NIH] Oligomenorrhea: Abnormally infrequent menstruation. [NIH] Oligomenorrhoea: Markedly diminished menstrual flow; relative amenorrhea. [EU] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Oncogenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH] Oocytes: Female germ cells in stages between the prophase of the first maturation division and the completion of the second maturation division. [NIH] Oophoritis: Inflammation of an ovary. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovarian Follicle: Spheroidal cell aggregation in the ovary containing an ovum. It consists of an external fibro-vascular coat, an internal coat of nucleated cells, and a transparent, albuminous fluid in which the ovum is suspended. [NIH] Ovarian Hyperstimulation Syndrome: Syndrome composed of a combination of ovarian enlargement and an acute fluid shift out of the intravascular space. The enlargement is caused by ovarian cyst formation and the fluid shift may result in ascites, hydrothorax, or generalized edema. The syndrome is most usually seen as a complication of ovulation induction, a treatment for infertility. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovulation Induction: Techniques for the artifical induction of ovulation. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor

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molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Parturition: The act or process of given birth to a child. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenytoin: An anticonvulsant that is used in a wide variety of seizures. It is also an antiarrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch.

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Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma;

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plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polycystic Ovary Syndrome: Clinical symptom complex characterized by oligomenorrhea or amenorrhea, anovulation, and regularly associated with bilateral polycystic ovaries. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potassium Channels: Cell membrane glycoproteins selective for potassium ions. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Pregnancy Outcome: Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo transfer or fertilization in vitro. [NIH] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH]

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Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progestogen: A term applied to any substance possessing progestational activity. [EU] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH]

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Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Radio Waves: That portion of the electromagnetic spectrum beyond the microwaves, with wavelengths as high as 30 KM. They are used in communications, including television. Short Wave or HF (high frequency), UHF (ultrahigh frequency) and VHF (very high frequency) waves are used in citizen's band communication. [NIH] Radioactive: Giving off radiation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptivity: The condition of the reproductive organs of a female flower that permits effective pollination. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of

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treatment. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Reproduction Techniques: Methods pertaining to the generation of new individuals. [NIH] Reproductive system: In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). The reproductive system in men includes the prostate, the testes, and the penis. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Ribonucleic acid: RNA. One of the two nucleic acids found in all cells. The other is deoxyribonucleic acid (DNA). Ribonucleic acid transfers genetic information from DNA to proteins produced by the cell. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rosiglitazone: A drug taken to help reduce the amount of sugar in the blood. Rosiglitazone helps make insulin more effective and improves regulation of blood sugar. It belongs to the family of drugs called thiazolidinediones. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH]

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Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Seborrhoea: 1. Excessive secretion of sebum; called also hypersteatosis 2. Seborrhoeic dermatitis. [EU] Sebum: The oily substance secreted by sebaceous glands. It is composed of keratin, fat, and cellular debris. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Seminiferous tubule: Tube used to transport sperm made in the testes. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell

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differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Channels: Cell membrane glycoproteins selective for sodium ions. Fast sodium current is associated with the action potential in neural membranes. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatic cells: All the body cells except the reproductive (germ) cells. [NIH] Somatostatin: A polypeptide hormone produced in the hypothalamus, and other tissues and organs. It inhibits the release of human growth hormone, and also modulates important physiological functions of the kidney, pancreas, and gastrointestinal tract. Somatostatin receptors are widely expressed throughout the body. Somatostatin also acts as a neurotransmitter in the central and peripheral nervous systems. [NIH] Sonogram: A computer picture of areas inside the body created by bouncing sound waves off organs and other tissues. Also called ultrasonogram or ultrasound. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spermatogenesis: Process of formation and development of spermatozoa, including

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spermatocytogenesis and spermiogenesis. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Stabilizer: A device for maintaining constant X-ray tube voltage or current. [NIH] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Submaxillary: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Symphysis: A secondary cartilaginous joint. [NIH]

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Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Testicle: The male gonad where, in adult life, spermatozoa develop; the testis. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Theca Cells: The connective tissue cells of the ovarian follicle. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH]

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Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Traction: The act of pulling. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transforming Growth Factor alpha: Factor isolated in a variety of tissues including epithelium, and maternal decidua. It is closely related to epidermal growth factor and binds to the EGF receptor. TGF-alpha acts synergistically with TGF-beta in inducing phenotypic transformation, but its physiological role is unknown. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transvaginal ultrasound: A procedure used to examine the vagina, uterus, fallopian tubes, and bladder. An instrument is inserted into the vagina, and sound waves bounce off organs inside the pelvic area. These sound waves create echoes, which a computer uses to create a picture called a sonogram. Also called TVS. [NIH] Triad: Trivalent. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Trinucleotide Repeats: Microsatellite repeats consisting of three nucleotides dispersed in the euchromatic arms of chromosomes. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH]

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Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Valproic Acid: A fatty acid with anticonvulsant properties used in the treatment of epilepsy. The mechanisms of its therapeutic actions are not well understood. It may act by increasing GABA levels in the brain or by altering the properties of voltage dependent sodium channels. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virilism: Development of masculine traits in the female. [NIH] Virulent: A virus or bacteriophage capable only of lytic growth, as opposed to temperate phages establishing the lysogenic response. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH]

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Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zygote: The fertilized ovum. [NIH]

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INDEX 1 17-Ketosteroids, 38, 109 A Abdomen, 109, 114, 129, 130, 135, 140, 143 Abdominal, 69, 109, 135, 140 Aberrant, 60, 109 Ablate, 109, 120 Ablation, 109, 111 Abortion, 109, 137 Acanthosis Nigricans, 16, 24, 31, 47, 64, 109 Acetylcholine, 109, 133 Acne, 4, 27, 29, 35, 44, 50, 63, 69, 70, 71, 109 Acne Vulgaris, 27, 109 Action Potentials, 12, 109 Adenine, 109 Adenocarcinoma, 44, 109 Adenosine, 22, 109, 136 Adenovirus, 12, 109 Adenylate Cyclase, 12, 109 Adhesions, 50, 109 Adjuvant, 20, 110 Adrenal Cortex, 110, 111, 121, 126, 138 Adrenal Glands, 13, 110 Adrenal Medulla, 110, 115 Adverse Effect, 110, 136, 141 Affinity, 110, 142 Agar, 110, 136 Age of Onset, 110, 145 Agonist, 36, 54, 58, 110, 116, 132 Algorithms, 110, 113 Alkaline, 110, 114 Alleles, 110, 129 Allergen, 110, 119 Alopecia, 4, 16, 45, 71, 110 Alternative medicine, 77, 110 Amenorrhea, 7, 15, 26, 40, 45, 70, 71, 105, 110, 134, 137 Amino acid, 8, 110, 111, 112, 113, 124, 129, 131, 135, 139, 141, 143, 145 Amino Acid Sequence, 111, 113 Analog, 111, 114, 129 Anatomical, 111, 112, 115, 119, 127, 141 Androgen suppression, 64, 111 Androgenic, 16, 45, 111 Androgens, 3, 5, 7, 18, 28, 37, 39, 40, 44, 63, 64, 70, 71, 110, 111, 112, 126

Androstenedione, 15, 22, 28, 49, 60, 70, 111 Anemia, 91, 111 Aneurysm, 111, 146 Angiogenesis, 111, 130 Angiotensinogen, 111, 140 Animal model, 7, 111 Anomalies, 26, 40, 111 Anovulation, 3, 7, 45, 70, 111, 137 Anticonvulsant, 111, 114, 135, 146 Antifungal, 111, 129 Antigen, 110, 111, 117, 126, 127, 128 Anti-inflammatory, 112, 119, 123 Anus, 112, 114, 116, 128 Arachidonic Acid, 112, 138 Arginine, 58, 112, 133 Aromatase, 13, 18, 26, 35, 51, 112 Arterial, 61, 112, 117, 126, 139, 144 Arteries, 112, 113, 114, 117, 118, 131, 132, 139 Artery, 5, 18, 32, 38, 55, 60, 64, 111, 112, 118 Aseptic, 112, 143 Aspiration, 53, 112 Ataxia, 90, 91, 112, 144 Atrial, 112, 117, 145 Atrioventricular, 112, 117 Atrium, 112, 117, 145, 146 Atrophy, 90, 112 Auditory, 49, 112 Axillary, 112, 114 Axillary Artery, 112, 114 B Bacteriophage, 112, 136, 146 Basal Ganglia, 112 Basal Ganglia Diseases, 112 Base, 109, 113, 118, 129 Benign, 113, 119, 133 Beta-Endorphin, 28, 36, 46, 113 Bilateral, 15, 17, 18, 113, 137 Bile, 113, 123, 130, 143 Biochemical, 5, 38, 110, 113, 141 Biological therapy, 113, 125 Biotechnology, 13, 14, 77, 87, 89, 90, 91, 113 Bladder, 113, 138, 145, 146 Blastocyst, 113, 117, 120, 136 Blood Coagulation, 113, 114

150

Polycystic Ovaries

Blood Glucose, 3, 54, 113, 125, 128 Blood pressure, 4, 69, 70, 113, 115, 126, 132, 139, 142 Blood vessel, 111, 113, 114, 115, 117, 121, 129, 131, 136, 143, 144, 146 Body Fluids, 113, 120, 142 Body Mass Index, 46, 113 Bone Marrow, 114, 123, 132, 143 Bowel, 114, 119, 143 Bowel Movement, 114, 119, 143 Brachial, 64, 114 Brachial Artery, 64, 114 Bradykinin, 114, 133, 136 Branch, 103, 114, 135, 142, 144 Buserelin, 34, 58, 114 C Calcium, 5, 62, 114, 116, 130, 142 Carbamazepine, 42, 114 Carbohydrate, 4, 68, 114, 124 Carbon Dioxide, 32, 114, 136, 140 Carcinogenic, 114, 127, 134, 138, 143 Carcinogens, 114, 116, 134 Cardiac, 18, 114, 117, 122, 124, 132, 143 Cardiac catheterization, 18, 114 Cardiovascular, 5, 9, 63, 64, 70, 74, 114, 115, 141 Cardiovascular disease, 9, 70, 74, 115 Case report, 15, 16, 24, 44, 55, 115 Catecholamine, 37, 115, 135 Catheterization, 115 Cell Adhesion, 115, 128 Cell Aggregation, 115, 134 Cell Division, 90, 115, 124, 130, 132, 136, 138 Cell membrane, 115, 119, 136, 137, 142 Cell Survival, 115, 124 Central Nervous System, 13, 109, 115, 141 Cerebellar, 112, 115, 139 Cerebral, 112, 115, 139 Cerebral Cortex, 112, 115 Cerebrovascular, 113, 115, 144 Cerebrum, 115, 145 Cervix, 109, 115, 140 Chin, 32, 115, 131 Cholesterol, 74, 113, 115, 118, 143 Chromatin, 8, 116, 130 Chromium, 69, 116 Chromosomal, 116 Chromosome, 6, 116, 129 Chronic, 3, 68, 90, 109, 116, 121, 127, 129, 137 Chronic renal, 116, 137

Clamp, 9, 116 Clinical trial, 5, 63, 65, 87, 116, 117, 120, 139 Clomiphene, 15, 23, 60, 64, 65, 75, 76, 116 Cloning, 113, 116 Cofactor, 116, 139 Collagen, 111, 116, 122, 130, 137 Colon, 90, 116, 129 Complement, 116, 128, 130, 136 Computational Biology, 87, 89, 117 Conception, 58, 109, 117, 122, 137, 143 Conjugated, 117, 118 Connective Tissue, 114, 116, 117, 122, 131, 144 Connective Tissue Cells, 117, 144 Contraindications, ii, 117 Controlled study, 16, 117 Cor, 58, 117 Coronary, 5, 18, 38, 60, 63, 64, 74, 76, 115, 117, 118, 131, 132 Coronary heart disease, 115, 117 Coronary Thrombosis, 118, 131, 132 Corpus, 118, 130, 135, 138 Corpus Luteum, 118, 130, 138 Cortex, 118, 139 Cortical, 17, 118, 141, 144 Cortisone, 118, 119 Cultured cells, 8, 118 Curative, 118, 144 Cyclic, 70, 109, 118, 125, 133, 136, 138 Cyst, 118, 134 Cytochrome, 28, 58, 112, 118 Cytoskeleton, 118, 128 D Decidua, 118, 136, 145 Defense Mechanisms, 118, 128 Degenerative, 118, 140 Dendrites, 118, 133 Density, 113, 118, 142 Deoxyribonucleic, 118, 140 Deoxyribonucleic acid, 118, 140 Depolarization, 12, 119, 142 Depressive Disorder, 119, 129 Dermatitis, 119, 141 Dermoid, 15, 18, 119 Dermoid Cyst, 15, 18, 119 Desensitization, 34, 119 Dexamethasone, 18, 21, 22, 49, 119 Diabetes Mellitus, 9, 26, 68, 70, 119, 124, 125 Diabetic Retinopathy, 119, 136 Diagnostic procedure, 67, 77, 119

Index 151

Diastolic, 119, 126 Diathermy, 32, 119 Digestion, 113, 114, 119, 130, 143 Digestive system, 66, 119 Dihydrotestosterone, 119, 139 Dilatation, 109, 111, 119, 146 Dilatation, Pathologic, 119, 146 Dilation, 114, 119, 146 Direct, iii, 6, 79, 119, 139 Discrete, 6, 119 Double-blind, 10, 11, 23, 120 Double-blinded, 10, 11, 23, 120 Drive, ii, vi, 6, 8, 57, 120, 129 Drug Interactions, 80, 120 Duct, 40, 115, 120, 140 Dysplasia, 91, 120 Dystrophy, 90, 120 E Eating Disorders, 38, 120 Edema, 55, 119, 120, 134 Efficacy, 9, 10, 11, 120 Elective, 120 Electrocoagulation, 44, 120 Electrolyte, 120, 137, 142 Embryo, 8, 76, 109, 113, 120, 127, 137, 143 Embryo Transfer, 76, 120, 137 Endocrine System, 120 Endogenous, 12, 113, 120, 145 Endometrial, 7, 8, 9, 23, 24, 44, 71, 120, 121 Endometriosis, 38, 41, 120 Endometrium, 14, 19, 34, 118, 120, 121, 131 Endothelium, 121, 133, 137 Endothelium-derived, 121, 133 Endotoxin, 121, 145 End-stage renal, 116, 121, 137 Enhancer, 12, 121 Enkephalin, 113, 121 Environmental Exposure, 121, 134 Environmental Health, 86, 88, 121 Enzymatic, 8, 111, 114, 117, 121, 122 Enzyme, 8, 34, 70, 109, 112, 121, 123, 125, 131, 136, 139, 140, 141, 147 Epidermal, 25, 30, 51, 121, 131, 145 Epidermal Growth Factor, 25, 30, 51, 121, 145 Epidermis, 121, 139 Epithelial, 109, 118, 121 Epithelial Cells, 121 Epithelium, 121, 145 Erythrocytes, 111, 114, 121 Esophagus, 119, 121, 143

Essential Tremor, 90, 121 Estradiol, 24, 50, 53, 59, 121 Estrogen, 9, 20, 25, 36, 46, 112, 116, 121, 138 Estrogen receptor, 116, 121 Excitability, 12, 122 Exogenous, 20, 53, 120, 122, 145 Extracellular, 117, 122, 128, 130, 142 Extracellular Matrix, 117, 122, 128, 130 Extracellular Matrix Proteins, 122, 130 Eye Infections, 109, 122 F Facial, 63, 70, 122 Fallopian tube, 122, 140, 145 Family Planning, 87, 122 Fat, 3, 74, 112, 114, 117, 118, 122, 129, 141 Fatty acids, 122, 138 Fertilization in Vitro, 122, 137 Fetus, 7, 109, 122, 136, 137, 143, 146 Fibrin, 113, 122, 136 Fibrinogen, 122, 136 Fibrinolysis, 61, 122 Fibroblasts, 8, 117, 122 Fibrosis, 91, 122, 141 Fold, 7, 122 Follicles, 7, 15, 18, 31, 48, 54, 123, 127 Follicular Fluid, 14, 21, 24, 25, 36, 123 Follicular Phase, 47, 55, 123 Forearm, 113, 123 G Gallbladder, 109, 119, 123 Gas, 114, 123, 125, 133 Gastric, 121, 123 Gastrin, 123, 125 Gastrointestinal, 114, 123, 141, 142, 143 Gastrointestinal tract, 123, 141, 142 Gene, 6, 8, 12, 15, 17, 20, 24, 39, 58, 75, 91, 92, 109, 110, 112, 113, 123, 134 Gene Expression, 6, 91, 123 Gene Therapy, 109, 123 Genital, 123, 128 Genotype, 123, 135 Germ Cells, 123, 130, 134, 144 Gestation, 25, 33, 76, 123, 136, 143 Gestational, 26, 34, 42, 52, 68, 76, 123 Gland, 110, 118, 123, 124, 126, 135, 138, 141, 143, 144 Glucocorticoid, 119, 123 Glucose, 7, 37, 46, 71, 74, 75, 90, 113, 116, 119, 123, 124, 125, 127, 128, 140 Glucose Intolerance, 75, 119, 124 Glucose tolerance, 37, 46, 71, 74, 124

152

Polycystic Ovaries

Glucose Tolerance Test, 37, 46, 124 Glyceraldehyde 3-Phosphate, 8, 124 Glycine, 111, 124, 133 Glycogen, 51, 124 Glycogen Storage Disease, 51, 124 Glycolysis, 8, 124 Glycoprotein, 122, 124, 132, 145 Glycosuria, 68, 124 Gonad, 6, 124, 144 Gonadal, 124, 143 Gonadorelin, 124, 129 Gonadotropin, 6, 7, 25, 28, 36, 41, 47, 50, 58, 59, 60, 70, 114, 124, 129 Governing Board, 124, 137 Grafting, 124, 127 Granulosa Cells, 14, 18, 21, 22, 24, 25, 26, 30, 34, 35, 48, 50, 51, 124, 127, 130 Growth factors, 50, 124 Guanylate Cyclase, 125, 133 H Hair follicles, 17, 125 Haplotypes, 5, 125 Heart attack, 115, 125 Heme, 118, 125 Hemoglobin, 111, 121, 125, 129 Hemoglobinuria, 90, 125 Hemorrhage, 119, 120, 125, 143 Hemostasis, 125, 128, 141 Hepatic, 51, 124, 125 Hereditary, 125, 140 Heredity, 109, 123, 125 Heterodimers, 125, 128 Hirsutism, 4, 5, 7, 16, 22, 26, 33, 38, 45, 47, 49, 105, 125, 126 Holmium, 33, 125 Homeostasis, 6, 125 Hormonal, 23, 27, 29, 50, 54, 61, 112, 125 Hydrogen, 113, 114, 122, 125, 132, 134 Hydrolysis, 126, 136 Hydroxyproline, 111, 116, 126 Hyperandrogenism, 5, 6, 7, 8, 9, 10, 11, 16, 22, 38, 52, 56, 58, 64, 70, 126 Hyperglycemia, 68, 126 Hyperlipidemia, 70, 126 Hyperplasia, 27, 40, 44, 51, 53, 126 Hypersensitivity, 110, 119, 126 Hyperstimulation, 60, 126 Hypertension, 9, 70, 71, 115, 126 Hyperthermia, 119, 126 Hypertrichosis, 19, 125, 126 Hypertrophy, 16, 117, 126, 145 Hypogonadism, 24, 41, 50, 126

Hypothalamic, 6, 60, 126 Hypothalamus, 121, 124, 126, 142 Hypothyroidism, 42, 126 I Id, 61, 90, 94, 95, 97, 102, 104, 126 Idiopathic, 16, 45, 49, 126 Immune response, 110, 111, 118, 127, 130, 143, 146 Immunodeficiency, 90, 127 Immunology, 19, 110, 127 Immunotherapy, 113, 119, 127 Impairment, 112, 122, 127, 131 Implantation, 8, 117, 127 In vitro, 6, 8, 9, 12, 16, 17, 20, 21, 25, 29, 35, 47, 115, 120, 123, 127 In vivo, 6, 9, 12, 123, 127 Indicative, 127, 135, 146 Induction, 59, 111, 119, 127, 134, 138 Infancy, 55, 127 Infarction, 127 Infection, 112, 113, 122, 127, 143 Inflammation, 109, 112, 119, 122, 127, 134, 137, 140 Ingestion, 124, 127 Inhibin, 15, 53, 127 Initiation, 127, 145 Inositol, 75, 127 Insulin-dependent diabetes mellitus, 128 Insulin-like, 17, 21, 24, 30, 31, 50, 54, 128 Integrins, 8, 128 Interleukin-1, 28, 128 Interleukin-2, 128 Internal Medicine, 16, 18, 38, 58, 120, 128 Interstitial, 9, 61, 128 Intestinal, 124, 128, 130 Intestines, 109, 123, 128 Intoxication, 128, 147 Intracellular, 7, 127, 128, 133, 137, 138, 141 Intravascular, 128, 134 Intrinsic, 12, 110, 128 Involuntary, 112, 121, 128, 132 Involution, 70, 128 Ions, 113, 120, 125, 128, 137, 142 Ischemia, 112, 128 Islet, 7, 129 K Kb, 86, 129 Ketoconazole, 75, 129 Kidney Disease, 66, 86, 91, 129 L Labyrinth, 129 Labyrinthine, 24, 129

Index 153

Lactation, 129, 138 Laparoscopy, 33, 41, 94, 106, 129 Large Intestine, 119, 128, 129, 139, 142 Lethargy, 126, 129 Leucine, 113, 129 Leukemia, 90, 123, 129 Leukocytes, 114, 129, 132, 145 Leuprolide, 60, 64, 76, 129 Libido, 111, 129 Library Services, 102, 129 Ligament, 122, 129, 138 Ligands, 128, 129 Linkage, 7, 14, 129 Linkage Disequilibrium, 7, 129 Lipid, 31, 33, 49, 69, 76, 128, 129 Lithium, 9, 10, 11, 129 Liver, 3, 109, 112, 113, 119, 123, 124, 125, 130 Localized, 125, 126, 127, 130, 136 Lutein Cells, 130, 138 Lymphocytes, 111, 128, 129, 130 Lymphoid, 130 Lymphoma, 90, 130 Lytic, 130, 146 M Macrophage, 128, 130 Major Histocompatibility Complex, 125, 130 Malabsorption, 90, 130 Malignancy, 109, 130 Malignant, 34, 90, 109, 130, 133 Malnutrition, 112, 130, 132 Mania, 130 Manic, 9, 10, 11, 129, 130 Matrix metalloproteinase, 21, 130 Medial, 64, 130 Medical Staff, 120, 130 MEDLINE, 87, 89, 91, 130 Meiosis, 8, 130 Melanocytes, 131 Melanoma, 90, 131 Melanosis, 109, 131 Membrane, 115, 117, 119, 121, 122, 131, 132, 135, 136, 140, 142, 145 Membrane Glycoproteins, 131 Menarche, 24, 131 Meninges, 115, 131 Menopause, 131, 137 Menotropins, 44, 131 Menstrual Cycle, 4, 24, 40, 123, 131, 138 Menstruation, 110, 118, 123, 131, 134

Mental, iv, 4, 24, 66, 86, 88, 92, 115, 126, 130, 131, 139, 141 Mental Disorders, 66, 131 Mental Retardation, 24, 92, 131 Mesenchymal, 121, 131 Metabolic disorder, 9, 124, 131 Metastasis, 130, 131 Methionine, 113, 131 MI, 17, 45, 52, 54, 68, 70, 75, 106, 131 Microorganism, 116, 131, 147 Microscopy, 49, 131 Miscarriage, 34, 39, 45, 46, 95, 96, 131 Mitosis, 8, 132 Modification, 111, 132 Molecular, 7, 8, 13, 18, 22, 35, 39, 51, 58, 87, 89, 113, 117, 122, 132, 136, 138, 145 Molecule, 111, 113, 117, 121, 126, 132, 134, 139, 141 Monitor, 132, 133 Monocytes, 128, 129, 132 Mononuclear, 132, 145 Monophosphate, 22, 70, 132 Monotherapy, 10, 11, 132 Morphological, 120, 131, 132 Morphology, 36, 37, 132 Motility, 8, 132, 141 Mucolytic, 69, 132 Mucosa, 132, 138 Mucus, 132 Muscle Fibers, 132 Muscular Atrophy, 90, 132 Muscular Dystrophies, 120, 132 Myocardial infarction, 7, 118, 131, 132 Myocardium, 131, 132 Myotonic Dystrophy, 90, 132 N Naloxone, 113, 132 NCI, 1, 65, 85, 133 Need, 3, 98, 116, 124, 130, 133, 144 Neoplasia, 90, 133 Neoplasm, 133, 145 Neoplastic, 130, 133 Nephropathy, 129, 133 Nerve, 13, 109, 112, 115, 118, 133, 140, 141, 143, 146 Nerve Growth Factor, 13, 133 Nervous System, 90, 115, 133, 135 Neurons, 7, 12, 118, 133 Neurophysiology, 119, 133 Neurotransmitter, 109, 111, 114, 124, 133, 141, 142, 143 Nitric Oxide, 55, 133

154

Polycystic Ovaries

Nitrogen, 111, 122, 133, 145 Nuclear, 6, 112, 133 Nuclei, 123, 132, 133 Nucleic acid, 133, 134, 140 Nucleus, 112, 116, 118, 130, 132, 134, 138, 144 Nystagmus, 129, 134 O Oestradiol, 15, 30, 37, 54, 134 Oligo, 36, 50, 134 Oligomenorrhea, 7, 70, 134, 137 Oligomenorrhoea, 23, 134 Oncogene, 90, 134 Oncogenic, 128, 134 Oocytes, 29, 32, 134 Oophoritis, 18, 134 Opiate, 113, 121, 132, 134 Orbit, 119, 134 Outpatient, 9, 10, 11, 134 Ovarian Follicle, 9, 118, 123, 124, 134, 144 Ovarian Hyperstimulation Syndrome, 47, 53, 134 Ovary, 3, 4, 6, 7, 9, 13, 14, 15, 18, 19, 23, 29, 31, 33, 39, 40, 49, 51, 53, 54, 58, 59, 60, 61, 63, 64, 65, 68, 69, 70, 73, 74, 75, 76, 90, 94, 95, 96, 111, 118, 121, 124, 126, 134, 137 Ovulation, 4, 9, 14, 23, 29, 44, 59, 60, 65, 71, 74, 75, 76, 111, 116, 123, 124, 134 Ovulation Induction, 29, 44, 60, 134 Ovum, 118, 123, 134, 138, 147 Oxidation, 118, 134 P Palliative, 135, 144 Pancreas, 109, 119, 128, 129, 135, 142 Pancreatic, 7, 90, 135 Pancreatic cancer, 90, 135 Paroxysmal, 90, 135 Parturition, 135, 138 Pathogenesis, 7, 9, 74, 135 Pathologic, 117, 126, 135 Pathophysiology, 6, 43, 58, 70, 135 Pelvic, 14, 24, 41, 121, 135, 138, 145 Pelvis, 94, 109, 134, 135, 146 Penis, 135, 140 Peptide, 30, 54, 69, 111, 113, 135, 139, 144 Perception, 13, 135, 141 Peripheral Nervous System, 133, 135, 142, 143 Pharmacologic, 135, 144 Pharmacotherapy, 32, 135 Phenotype, 6, 18, 135

Phenytoin, 114, 135 Phosphodiesterase, 12, 70, 136 Phospholipases, 24, 136, 142 Phospholipids, 122, 128, 136 Phosphorus, 114, 136 Photocoagulation, 50, 136 Physiologic, 110, 131, 136, 138, 139 Physiology, 58, 60, 120, 133, 136 Pilot study, 41, 136 Placenta, 112, 121, 136, 138 Plants, 114, 123, 132, 136, 140 Plaque, 64, 136 Plasma, 14, 37, 38, 46, 115, 122, 123, 124, 125, 136, 140, 141 Plasma protein, 123, 136 Plasmin, 136, 137 Plasminogen, 28, 136, 137 Plasminogen Activators, 136, 137 Platelet Aggregation, 133, 137 Platelets, 133, 137, 141 Pneumonia, 117, 137 Polymorphism, 15, 35, 137 Posterior, 112, 135, 137 Potassium, 7, 80, 137 Potassium Channels, 7, 137 Potentiates, 128, 137 Practice Guidelines, 88, 137 Precursor, 111, 112, 121, 136, 137, 145 Pregnancy Outcome, 46, 137 Premenopausal, 6, 137 Prenatal, 7, 120, 137 Prevalence, 16, 26, 44, 45, 51, 52, 58, 64, 137 Progesterone, 34, 47, 59, 138, 143 Progestogen, 47, 138 Progression, 111, 138 Progressive, 116, 124, 128, 132, 138, 145 Prolactin, 18, 138 Promoter, 6, 12, 35, 138 Prophase, 134, 138 Prospective study, 16, 39, 138 Prostaglandin, 30, 138 Prostaglandins A, 138 Prostate, 90, 138, 140 Protein S, 91, 113, 139 Proteins, 6, 8, 111, 115, 116, 122, 125, 128, 130, 132, 133, 135, 136, 139, 140, 141, 145 Protocol, 16, 74, 139 Psychic, 129, 131, 139, 141 Psychoactive, 139, 147 Psychomotor, 114, 139 Puberty, 4, 42, 50, 139

Index 155

Public Policy, 87, 139 Pulmonary, 113, 117, 139, 146 Pulmonary Artery, 113, 139, 146 Pulmonary hypertension, 117, 139 Pustular, 109, 139 R Radio Waves, 119, 139 Radioactive, 126, 127, 133, 134, 139 Randomized, 10, 11, 23, 64, 65, 120, 139 Receptivity, 8, 139 Receptor, 6, 8, 17, 24, 30, 34, 111, 139, 141, 145 Recombinant, 14, 139 Rectum, 112, 114, 116, 119, 123, 129, 138, 139 Red Nucleus, 112, 139 Reductase, 17, 112, 139 Refer, 1, 116, 139, 146 Refractory, 120, 139 Regimen, 120, 135, 139 Renin, 25, 111, 140 Reproduction Techniques, 137, 140 Reproductive system, 9, 140 Resection, 15, 22, 23, 27, 43, 140 Respiration, 114, 132, 140 Retina, 119, 140 Retinoblastoma, 90, 140 Retinopathy, 24, 119, 140 Retrograde, 128, 140 Retroperitoneal, 110, 140 Ribonucleic acid, 24, 34, 140 Ribose, 109, 140 Risk factor, 5, 60, 75, 138, 140 Rod, 116, 140 Rosiglitazone, 4, 74, 140 S Salivary, 119, 135, 140, 143 Salivary glands, 119, 140 Saponins, 140, 143 Schizoid, 140, 147 Schizophrenia, 141, 147 Schizotypal Personality Disorder, 141, 147 Sclerosis, 90, 141 Screening, 46, 116, 141 Seborrhoea, 71, 141 Sebum, 109, 141 Secretion, 7, 9, 12, 29, 58, 59, 61, 64, 68, 70, 109, 121, 124, 126, 127, 128, 129, 132, 141 Seizures, 114, 135, 141 Semen, 138, 141 Seminiferous tubule, 127, 141 Serotonin, 133, 135, 141, 145

Serum, 5, 9, 15, 21, 22, 23, 44, 46, 47, 54, 59, 60, 64, 65, 70, 106, 116, 124, 141, 145 Sex Characteristics, 111, 139, 141, 144 Sex Determination, 91, 141 Side effect, 79, 110, 113, 141, 144 Signal Transduction, 128, 141 Skeletal, 6, 8, 111, 116, 132, 142 Skeleton, 138, 142 Small intestine, 125, 128, 142 Sodium, 9, 10, 11, 142, 146 Sodium Channels, 142, 146 Somatic, 130, 132, 135, 142 Somatic cells, 130, 132, 142 Somatostatin, 50, 142 Sonogram, 142, 145 Sound wave, 119, 142, 145 Specialist, 97, 119, 142 Species, 130, 132, 142, 147 Spectrum, 129, 139, 142 Sperm, 8, 111, 116, 141, 142 Spermatogenesis, 8, 142 Sphincter, 16, 143 Spinal cord, 114, 115, 131, 133, 135, 143 Spontaneous Abortion, 137, 143 Sporadic, 140, 143 Stabilizer, 10, 11, 143 Steel, 116, 143 Sterility, 14, 15, 16, 18, 19, 21, 25, 29, 32, 33, 40, 41, 42, 44, 47, 50, 53, 54, 55, 70, 127, 143 Steroid, 13, 14, 20, 25, 39, 48, 51, 111, 112, 118, 123, 140, 143 Stillbirth, 137, 143 Stimulus, 120, 143, 144 Stomach, 109, 119, 121, 123, 124, 125, 128, 142, 143 Stool, 116, 129, 143 Stress, 49, 115, 143 Stroke, 9, 66, 70, 86, 115, 143 Stromal, 17, 28, 37, 47, 121, 143 Subclinical, 5, 63, 64, 127, 141, 143 Subcutaneous, 120, 143 Submaxillary, 121, 143 Substance P, 138, 141, 143 Suppression, 19, 49, 111, 143 Symphysis, 115, 138, 143 Symptomatic, 9, 10, 11, 144 Synergistic, 6, 7, 138, 144 Systemic, 80, 113, 127, 144, 145 Systolic, 126, 144 T Telangiectasia, 91, 144

156

Polycystic Ovaries

Testicle, 124, 144 Testicular, 112, 144 Testis, 8, 111, 121, 144 Testosterone, 4, 7, 15, 17, 21, 22, 38, 49, 70, 106, 111, 139, 144 Thalamic, 112, 144 Thalamic Diseases, 112, 144 Theca Cells, 7, 18, 58, 70, 130, 144 Therapeutics, 81, 144 Threshold, 122, 126, 144 Thrombolytic, 137, 144 Thrombosis, 128, 139, 143, 144 Thyroid, 126, 144 Thyrotropin, 126, 144 Tolerance, 124, 144 Toxic, iv, 121, 144 Toxicity, 120, 144 Toxicology, 88, 144 Trace element, 116, 145 Traction, 116, 145 Transcription Factors, 6, 145 Transfection, 113, 123, 145 Transforming Growth Factor alpha, 51, 145 Translation, 111, 145 Translational, 7, 145 Transvaginal ultrasound, 37, 44, 53, 145 Triad, 47, 145 Tricuspid Atresia, 117, 145 Trinucleotide Repeats, 17, 145 Tryptophan, 116, 124, 141, 145 Tuberous Sclerosis, 91, 145 Tumor Necrosis Factor, 19, 145 Tumour, 28, 35, 145 Type 2 diabetes, 3, 4, 52, 75, 145 U Ultrasonography, 19, 36, 145 Unconscious, 118, 126, 146 Urethra, 135, 138, 146 Urinary, 38, 55, 146

Urine, 113, 121, 124, 125, 131, 146 Uterus, 109, 115, 118, 120, 121, 131, 134, 138, 140, 145, 146 V Vaccine, 110, 139, 146 Vagina, 115, 131, 140, 145, 146 Vaginal, 5, 55, 70, 146 Valproic Acid, 42, 146 Vascular, 21, 47, 121, 127, 133, 134, 136, 137, 146 Vascular endothelial growth factor, 21, 47, 146 Vasodilation, 64, 146 Vasodilators, 133, 146 Vein, 111, 133, 146 Venous, 139, 145, 146 Ventricle, 112, 117, 126, 139, 144, 145, 146 Ventricular, 117, 145, 146 Vesicular, 123, 124, 146 Vestibular, 129, 146 Veterinary Medicine, 87, 146 Virilism, 126, 146 Virulent, 9, 10, 11, 146 Virus, 112, 121, 136, 146 Vitamin A, 127, 147 Vitro, 6, 9, 16, 32, 34, 53, 147 Vivo, 6, 9, 147 W Weight Gain, 10, 11, 147 Withdrawal, 47, 147 Womb, 140, 146, 147 Wound Healing, 128, 130, 147 X Xenograft, 111, 147 X-ray, 133, 143, 147 Y Yeasts, 135, 147 Z Zygote, 117, 147

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