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This patient is demonstrating symptoms consistent with virilization. Virilization in adolescent or adult women involves the acquisition of clitoral enlargement, increased muscle mass, acne, hirsuitism, frontal or crown hair thinning, deepening of the voice, and menstrual disruption with annovulation.56 The etiology is one of androgen excess, which may be caused by: r Polycystic ovarian syndrome r Androgen-producing tumors of the ovary, adrenal glands, or pituitary glands r Hypothyroidism r Anabolic steroid exposure r Congenital adrenal hyperplasia due to 21hydroxylase de ciency (late onset) Virilization should not be confused with hirsuitism, which is one of the symptoms of virilization but can occur as an isolated benign condition without other virilizing signs or symptoms. Hirsuitism is de ned as excessive terminal hair that appears in a male pattern in women.57 It can be distinguished from hypertrichosis, which is excessive hair growth in a nonsexual pattern not caused by androgen excess.58 The etiology of hirsuitism is androgen exposure (both relative amount, and hair follicle sensitivity to the hormone) causing increased development of terminal hairs, which are thicker and more pigmented. It is free testosterone that exerts this effect, and therefore it is associated with conditions that increase total testosterone or androgens, or those that involve a reduction in sex-hormone binding globulin. Benign conditions such as idiopathic hirsuitism and PCOS make up the majority of causes of hirsuitism. However, when the development of hirsuitism is abrupt and short in onset,

Alternatively, you can simply rotate the condenser turret until light passing through the condenser iris diaphragm hits one edge of the condenser lens This condition is analogous to using an illuminating slit as already discussed The image of the offset condenser aperture is now offset in the conjugate back aperture of the objective lens Many of the rays diffracted by an object that would be brought to a position peripheral to the offset aperture are blocked by the edge of the lens and become excluded from image formation In this case, the function of the knife edge at the aperture plane is provided by the edge of the lens itself While the delivery of light is not well controlled resolution is good because diffracted waves are included on one side of the 0th order spot in the back focal plane of the objective.

The arrangement of components in a modulation contrast microscope resembles the design of the schlieren optical system described above The slit and knife edge of the schlieren system occupy conjugate focal planes, and placement of the eye just behind the knife edge allows these planes to function as the condenser and objective aperture.

Figure 8-10 The axis of polarizability corresponds to the slow axis of the wavefront ellipse. In biological materials composed of linear arrays of macromolecules, the axis of strongest polarizability is usually determined by the direction of carbon-carbon bond alignments. Because polarizability and refractive index are highest in the direction parallel to the axis of bond alignment, this direction corresponds to the slow axis of the wavefront ellipsoid for this material.

There are several inherent qualities of therapeutic jurisprudence as a theory that make it an exciting and pertinent enterprise for social science researchers: de ned and measurable constructs, a focus on process and the link to outcomes, and an emphasis on context each make it amenable to research. Broadening the scope of who is included in the research is another inherent quality. Lastly, therapeutic jurisprudence provides a rationale for incorporating behavioral science into legal practice.

of their professional skills to gain the active cooperation of the pupil (NASP-PPE, III, B, #3). Every student/client has the right to be fully informed about the scope and nature of the assessment process whether they are given a choice to assent to (or refuse) services. Practitioners are obligated ethically to explain the assessment process to the pupil in a manner that is understood by the student. This explanation includes the uses to be made of assessment information, who will receive information, and possible implications of results (NASP-PPE, III, B, #2). Even preschoolers and children who are developmentally disabled should receive an explanation in a language they can understand as to why they are being seen by the school psychologist (Standard 8.4).

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