Abner Golden

Abscesses of the Valve Rings of the Heart, a Frequent but Not Well Recognized Complication of Acute Bacterial Endocarditis

Abscesses of the valve rings of the heart were encountered at autopsy in 86 per cent of patients with acute bacterial endocarditis who had received antibiotic therapy. The abscesses, which appeared to arise from mycotic aneurysms in the valve rings, represented in most instances the only persistent focus of acute inflammation. They may account in part for the unsatisfactory results in the treatment of acute bacterial endocarditis, and their frequent occurrence suggests a relationship to antibiotic therapy.

Concurrence of hyperplasia and neoplasia of the parathyroid glands

Abstract The concurrence of parathyroid hyperplasia and neoplasia in a group of six patients is reported. Two patients had long-standing renal disease with azotemia and hyperphosphatemia. In both hypercalcemia developed while they were under observation and they were found to have parathyroid adenomas as well as hyperplasia of the other glands. A third patient followed an apparently similar course. One patient with primary hyperparathyroidism due to a large mediastinal adenoma displayed hyperplasia of other glands in association with moderate renal insufficiency. Two patients with primary generalized parathyroid hyperplasia were found to have superimposed neoplastic lesions: multiple adenomatous nodules in one, adenocarcinoma in the other. These observations add new dimensions to the diagnosis and therapy of parathyroid disorders. They indicate the necessity of examining all four parathyroid areas at time of surgery. They also emphasize that hypercalcemia developing in patients with chronic renal disease is a manifestation of autonomous parathyroid function.

Cushing's syndrome produced by a pituitary basophil carcinoma with hepatic metastases

Abstract A basophil cell carcinoma of the anterior pituitary, with multiple liver metastases, was found at autopsy in a young Negress with classic Cushings syndrome. These findings indicate that in rare instances the adenohypophysis may be the site of the initiating lesion of this disorder.

Quadrivalvular rheumatoid heart disease associated with left bundle branch block.

Abstract The clinical and necropsy findings are described in a sixty-five year old woman with rheumatoid arthritis and rheumatoid nodules in the heart, lungs, joints and subcutaneous tissue. Signs of aortic and mitral regurgitation, congestive cardiac failure and left bundle branch block were observed clinically and necropsy revealed numerous rheumatoid nodules in all four cardiac valves as well as in the adjacent myocardium and in the pericardium. The extensive nature of the cardiac involvement by rheumatoid granulomas is the most unusual aspect of this patients illness.

Pituitary Basophile Hyperplasia and Crooke's Hyaline Changes in Man After ACTH Therapy

Summary The administration of ACTH appears to have produced morphologic changes in the anterior pituitary of two patients. These changes consisted of an increase in the total number of basophiles, Crookes hyaline cytoplasmic changes in these cells and basophilic stippling of many of the chromophobes. It is possible that these changes reflect the storage of endogenous ACTH following stimulation of the adrenal cortex by the therapeutic administration of this hormone.

The diagnosis of dissecting aneurysm of the aorta by angiocardiography: Report of a case

Abstract A case of dissecting aneurysm of the thoracic aorta is presented. A definitive diagnosis was made by angiocardiography and was later confirmed at operation.

Cytologic changes in rat adenohypophysis following administration of adrenocorticotrophin or cortisone.

Summary 1. Adult male rats were treated with adrenocorticotrophic hormone or cortisone, or subjected to stress at 4°C. One control group received 0.5% phenol, and another was untreated. The percentage of pituitary basophile cells was calculated and the basophiles were examined for Crookes hyaline change. 2. Animals receiving cortisone and those exposed to cold stress were found to have a significant increase in the percentage of pituitary basophiles. The ACTH and 0.5% phenol-treated animals failed to show this response. Crookes change was prominent in animals receiving ACTH or cortisone and was also seen in the cold stress group but not in either control. 3. In the rat, the percentage of anterior pituitary basophiles and the presence of Crookes change cannot be correlated with increased or decreased demand for endogenous adrenocorticotrophin. The fact that basophilic granules and the hyaline masses of Crookes cells stain histochemically for glycoprotein makes it apparent that they are not ACTH. 4. The absence of increased numbers of basophiles or Crookes change in human pituitaries following prolonged stress points to important species differences in the occurrence of these findings.

Alterations of the Lesions of Acute Rheumatic Myocarditis during Cortisone Therapy

The changes in the cardiac lesions of a patient dying with acute rheumatic heart disease treated with cortisone are reported. The findings indicate that the effect of this hormone upon the lesions consists in an inhibition of the inflammatory reaction without demonstrable alteration of the collagen injury.

Syncope associated with exertional dyspnea and angina pectoris

Abstract Cases of syncope associated with exertional dyspnea and angina pectoris have been presented. Serveral of the common types of heart disease are included in the group. The patients described in remarkably the same manner the sequence of events leading to syncope. Syncope was always preceded by both exertional dyspnea and angina, and was prone to occur at times when congestive heart failure was most marked. Physical examination failed to reveal anything other than the usual features of the underlying disease. With one exception, carotid sinus stimulation and hyperventilation produced no abnormal responses. The various common types of cardiovascular syncope have been considered in connection with these patients. The cause of their syncope remains obscure, but it is suggested that exertion beyond the capacity of the cardiac output and reflexes arising from engorged lungs and an ischemic myocardium may be important factors.