37-Year-Old Woman with Leg Weakness and CK Elevation
Fig. 14.1 Lipid storage myopathy. (a), HE stain shows many fibers containing multiple small sarcoplasmic vacuoles . Gomori trichrome stain (GT) shows these vacuoles are not red rimmed; a few…
75-Year-Old Man with Slowly Progressive Leg and Hand Weakness
Fig. 6.1 Inclusion body myositis. Hematoxylin & eosin stain (a) shows lymphocytic invasion into viable myofibers. Gomori trichrome stain (b) shows a myofiber with sarcoplasmic red rimmed vacuole. COX/SDH stain…
28-Year-Old Woman with Proximal Limb Weakness and Scapular Winging
Fig. 11.1 Quadriceps muscle biopsy shows mild chronic active myopathy . (a), Chronic features include marked fiber size variation, split fibers (black arrows) and frequent internalized nuclei (white arrows). (b),…
33-Year-Old Woman with Pain and Swelling in the Right Calf and Persistent Fever
Fig. 10.1 Necrotizing granulomatous fasciitis and myositis with the presence of AFB positive micro-organisms. Muscle cross sections with hematoxylin and eosin (HE) and acid fact bacilli (AFB) stains show necrotizing…
63-Year-Old Woman with Debilitating Muscle Pain
Fig. 9.1 H&E stain (a and b) shows transmural inflammation involving several perimysial blood vessels (arrows), destruction of blood vessel walls with deposition of fibrinoid material (asterisks), and occlusion of…
61-Year-Old Woman with Progressive Distal Limb and Deltoid Muscle Weakness
Fig. 8.1 Non-caseating granulomatous myositis . Muscle cross sections stained with hematoxylin & eosin (HE) show several endomysial and perimysial granulomas (red arrows) consisting of multinucleated giant cells (green arrow)…
20-Year-Old Man with Acute Multi-organ Failure and Rhabdomyolysis
Fig. 4.1 (a) HE stain shows a rare atrophic fiber (arrow) but no myofiber necrosis or inflammation. (b) ATPase pH 9.4 stain shows normal fiber type distribution with no vacuolar…
A Proposal for Innovation in Psychoanalytic Education
CHAPTER 16 A Proposal for Innovation in Psychoanalytic Education In this chapter, I propose that psychoanalytic education needs to advance into two apparently contradictory but essentially linked and…
The Long-Term Effects of the Mourning Process
CHAPTER 15 The Long-Term Effects of the Mourning Process In an earlier paper (Kernberg 2010), I pointed to some aspects of the mourning process that in my view…
The Denial of Reality
CHAPTER 14 The Denial of Reality What follows is the exploration of a frequent complication in the psychoanalytic psychotherapy of severe personality disorders, and one that we also…
