The author reviews his ideas on subjectivity, objectivity, and the third position in the psychoanalytic encounter, particularly in clinical work with borderline and narcissistic patients. Using the theories of Melanie Klein and Wilfred Bion as a basis, the author describes his concept of triangular space. A case presentation of a particular type of narcissistic patient illustrates the principle...

A patient is reported who presented with a single lesion on the face which, on histopathological examination, was found to be borderline lepromatous leprosy. The importance of doing skin smears as a routine in all patients to differentiate Multibacillary from Paucibacillary disease is emphasized.

A 62-year-old male with controlled hypertension, coronary artery disease, and borderline diabetes presented to the emergency room after experiencing a gradual one-month progression of slurring of speech and difficulty reading. The patient maintained his vital signs throughout his ambulance ride to the hospital and was clinically stable at time of arrival to the emergency department.

An old borderline-lepromatous leprosy patient, treated initially with DDS monotherapy followed by MDT, 11 years later during surveillance presented with 3-month-old asymptomatic cystic swelling, arising from the right ulnar nerve without exhibiting any evidence to document relapse of the disease. It responded promptly to corticosteroid therapy. This unusual clinical presentations of ulnar nerve...

Clinical evidence for failure with beta-lactam therapy has been lacking for patients with borderline oxacillin-resistant Staphylococcus aureus (BORSA) infections. We describe a failure of cloxacillin for a patient with endocarditis due to BORSA. The isolate also had false-negative thermonuclease and coagulase test results.

A patient with neuritic leprosy developed borderline skin lesions. Later, another skin lesion developed on the left side of the forehead with clinical involvement of the supraorbital branch of the ophthalmic division of the trigeminal nerve. Simultaneously, paralysis of the occipitofrontalis and mild paresis of orbicularis oculi occurred.

Corticosteroids are the drugs of choice for treatment of type 1 leprosy reactions, but when these agents cannot be used because of their adverse effects, alternative treatments are needed. We report the first case, to our knowledge, of a type 1 leprosy reaction that was successfully treated with methotrexate in a patient intolerant to corticosteroids who had borderline lepromatous leprosy.

Dapsone-induced agranulocytosis is a rare adverse effect. There are various reports of agranulocytosis in patients treated with dapsone for malaria prophylaxis and other dermatological diseases. However, this adverse reaction in leprosy is not often encountered. We describe agranulocytosis in a young patient who was taking dapsone (100 mg) for borderline-tuberculoid leprosy in a rural environment.

Prostatic stromal tumors are rare neoplasias that include benign, malignant and borderline lesions. Stromal tumor of uncertain malignant potential (STUMP) has been recently described and only a few reports exist in the literature. This article describes the clinical and medical imaging features of this rare and distinct neoplasia, with histopathological correlation in a patient with prostatic S...

Psychodynamic concepts about borderline personality disorder are reviewed and the literature concerning psychotherapeutic treatment of this group is examined. The treatment contexts considered include: psychoanalysis and intensive (expressive) psychoanalytic psychotherapy, supportive psychotherapy, group psychotherapy, family therapy, in-patient treatment, the therapeutic community, cognitive-b...