T cell responsiveness correlates differentially with antibody isotype levels in clinical and asymptomatic filariasis

To establish the relationships among T and B cell responses, active infection, and clinical manifestations in lymphatic filariasis, filarial-specific lymphocyte proliferation, IgG antibody isotypes, and IgE levels were determined in an exposed population: 31 asymptomatic amicrofilaremics, 43 microfilaremics, 12 symptomatic amicrofilaremics, and 52 elephantiasis patients. Lymphocyte proliferation was higher in elephantiasis patients and asymptomatic amicrofilaremics than in microfilaremics (P < .004). A proportion of asymptomatic amicrofilaremics (32%), elephantiasis patients (37%), and symptomatic amicrofilaremics (58%) showed antigen-specific lymphocyte unresponsiveness, and lymphocyte proliferation to filarial antigens correlated negatively with specific IgG4 levels (rho = -0.315, P < .001). As elevated specific IgG4 is an indicator of active infection, it is argued that active infection may result in lymphocyte hyporesponsiveness irrespective of clinical category. Of those with elevated specific IgE levels and high T cell proliferative responses, 70% had elephantiasis, suggesting these factors have a role in pathology. However, the existence of a proportion of elephantiasis patients with low anti-filarial IgE and T cell unresponsiveness to filarial antigens suggests that elephantiasis can be caused by distinct processes.     

Visual functions after photorefractive keratectomy

1. 45 myopes (-3.0 to -6.0 D) were examined before and 1 and 6 months after photorefractive keratectomy (PRK). Visual acuity (VA) was tested using Snellen and logMAR charts. Contrast sensitivity (CS) was measured using a computerized system. 2. Preoperative best corrected VA (BCVA) in myopes was significantly lower in comparison with a control group using logMAR charts only. A reduction of BCVA by both methods at 1. month and its return after 6 months nearly to original values was noted. 3. Significantly lower values of CS were found in patients before PRK compared to the control group. After 1 and 6 months stayed the values on preoperative level.     

Racial aspects of blood pressure in children and adolescents

I have discussed a model of the psyche comprising two different modes of thinking, one non-psychotic and the other psychotic. I have related these modes of thinking to our modern myth of Jekyll and Hyde, the study of which could in my opinion give us some insight into their nature. In my view a non-psychotic state of mind belongs to a person who has a history, with particular parents, a particular development, particular conflicts, and operates in the depressive position. A psychotic state of mind belongs to a person who lives in a still and timeless present, with no origin, no development and no conflict, and operates in the paranoid-schizoid position. On the basis of this model I have subsequently described the life history of a psychotic patient and an analytic session in detail, showing how psychotic and non-psychotic states alternate and interact with each other within the same individual and between patient and therapist. The use of my countertransference, moving from a concrete to a symbolic position, has enabled me to make an interpretation. The result of this interpretation has been double, leading to a negative therapeutic reaction. An upsurge of psychotic fury was followed by increased patient/therapist communication, with a small movement from the paranoid-schizoid to the depressive position.