Introduction

Biography


INTRODUCTION

AM COMMITTED TO EXCELLENCE IN PATIENT CARE, RESEARCH AND TEACHING. As a clinical endocrinologist, I have devoted 37 years to the study of polycystic ovary syndrome (PCOS) and its pathophysiology, treatment and manifestations. To that end a combined total of over 2500 patients, many of whom are still being actively followed, and others archived, are to serve as part of a proposed multisite study to evaluate the natural history of PCOS. This will allow a look at potential complications of associated dyslipidemia, metabolic complications secondary to hyperinsulinism and/or insulin resistance and the potential of micro- and macrovascular complications.

My endocrine training started with a Fellowship at Mt. Sinai Hospital (MSH), New York City, in 1960. The second year of my training consisted of pure research in gas chromatography of androgens with Dr. Ralph Dorfman, at the Worcester Foundation of Experimental Biology, Shrewsbury, Massachusetts. During that time I published the first paper on the determination of testosterone in human urine and its application to hyperandrogenic disorders. On returning to MSH, I received a 2-year NIH grant for the study of androgens utilizing the assay I developed at the Worcester Foundation. Thus my foundation for the interest in androgens and women’s health stems from my early training as a clinical endocrinologist and researcher with particular interest in androgens.

Over the years at MSH and the Mt. Sinai Medical Center, I was promoted to the rank of Clinical Professor of Medicine and participated in numerous symposia on PCOS. Numerous articles, reviews, abstracts, textbook chapters and a book on PCOD was published (self-authored in 1984). Recent contributions and chapters are listed in the Published Articles & Studies and Textbooks & Chapters Authored sections of the website. In the 1970s, I described the association of PCOD and pituitary adenomas and the manifestations of hyperandrogenism on the patients with PCOS, the ultrasonographic criteria for diagnosis, correlation of ultrasound of pelvis with clinical features of the syndrome, and variants of PCOS. My laboratory was the first to define a direct role of androgens in inducing morphologic changes of PCOS in the human ovary in 1986 (JCEM). I have published more than 70 articles, abstracts and textbook chapters on PCOS (from 1975 to the present). My patients were utilized with Dr. Andrea Dunaif in our collaboration at MSH thereby defining the role of insulin dynamics in PCOS and the demonstration of metabolic complications of the disease.

For the past 5 years, I have been active in national and international meetings in developing proposed guidelines for endocrinologists who treat PCOS. This has included the American College of Endocrinology, and I have lectured with Dr. Dunaif and Dr. R. Rosenfield at meetings designed to educate and inform clinicians about the disease and the potential of metabolic and cardiovascular complications. In a recent satellite meeting hosted by Harvard Medical School and the University of Athens in Athens, I chaired the session on treatment of PCOS and presented an overview of treatment of the disease (Nov 1998). The meeting was hosted by Dr. Andrea Dunaif and Dr. G. Tolis and firm criteria were finally agreed upon for the definition of the disease. My recent intensive review article that was published in Obstet Gynecol Survey in June 1999 was an invited one by Dr. Robert Jaffe, Editor of Obstet Gynec Survey. Hopefully this will serve as a major source for current perspectives and applications of new therapies in the treatment of PCOS. I have been elected to the advisory board of PCOSA, a national organization of women with PCOS and am active in lecturing at their meetings, and organized the annual national program in San Francisco in 2000.

My research efforts are now focused on the follow-up of women with PCOS and seeking the clinical and biochemical data which possible identify those women with PCOS at risk for metabolic sequelae of insulin resistance including conversion or worsening of glucose intolerance and lipid abnormalities. Recent data studied with a joint team of the Endocrine Division of The Mount Sinai School of Medicine has defined a gene marker in women with PCOS near the insulin receptor region of chromosome 19. This may be involved with the tendency to inherit the entity and play a role in the pathogenesis of PCOS. Much work has to be done in further defining this gene and its role in PCOS, and perspectives and applications of new therapies in the treatment of PCOS.

Recently my studies of non-alcoholic fatty liver disease and associated insulin resistance in PCOS have been a new area of interest in the widening spectrum of the metabolic syndrome and PCOS. A recent Holt (Publ.) book for women with PCOS was published, “A Patient’s Guide to PCOS” which hopefully may help the woman with PCOS. I dedicate myself fully to important research areas in PCOS and the potential of possibly reducing the metabolic and cardiovascular risks in this common syndrome.