RESUMEN
An improved technique for the fabrication of uniform output couplers for far-infrared lasers has been developed. The technique includes a process for uniformly removing material from the back side of the coupler's substrate to tune the coupler's reflectivity precisely to the specified value for a particular laser line. Depending on the condition of the coupler after use, it can be retuned to another laser line, which lies within the coupler's reflectance envelope. Furthermore, when there is the possibility of lasing at two different laser wavelengths (as happens with some far-infrared lasers), it is possible to optimize the coupler for one wavelength while at the same time detuning the other wavelength. The fabrication and optimization of these devices are discussed.
RESUMEN
OBJECTIVE: To determine the cause of absent sexual development in a 17-year-old girl with end-stage renal disease. DESIGN: Case study. PARTICIPANT: Seventeen-year-old girl with end-stage renal failure. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: The patient had phenotypically normal external female genitalia, müllerian duct hypoplasia, and no ovaries. Her serum gonadotropin levels were in the castrate range at baseline and after gonadotropin-releasing hormone stimulation. Her karyotype, in lymphocytes and cultured fibroblasts, was 46,XX. Analysis of genomic DNA, following polymerase chain reaction-amplication with oligonucleotide primers corresponding to the Y-encoded zinc finger protein ZFY and the testis-determining SRY gene, showed Y chromosome material in a male control but none in the patient. CONCLUSIONS: The results suggest a diagnosis of Frasier syndrome, a disorder characterized by true gonadal dysgenesis and end-stage renal disease occurring in normal phenotypic girls. Although previously reported only in individuals with a 46,XX karyotype, our studies indicate that Frasier syndrome may also occur in 46,XX girls. Delayed puberty is not uncommon in renal failure. This case illustrates the importance of measuring gonadotropin levels in teenage girls with delayed puberty and renal failure, particularly if the origin of the renal disease is obscure.
Asunto(s)
ADN , Disgenesia Gonadal/diagnóstico , Fallo Renal Crónico/complicaciones , Adolescente , Hormona Adrenocorticotrópica , Secuencia de Bases , Diagnóstico Diferencial , Estradiol/sangre , Femenino , Hormona Folículo Estimulante/sangre , Disgenesia Gonadal/complicaciones , Disgenesia Gonadal/genética , Hormona Liberadora de Gonadotropina , Humanos , Cariotipificación , Hormona Luteinizante/sangre , Datos de Secuencia Molecular , Fenotipo , Reacción en Cadena de la Polimerasa , Síndrome , Testosterona/sangreRESUMEN
This article describes a public policy agenda developed for the American Psychological Association (APA) by the APA Ad Hoc Advisory Panel on Homelessness, which met May 31-June 1, 1991. The agenda is intended to inform APA staff in their legislative and policy work with Congress and Executive Branch agencies on issues relevant to homelessness.