Edward A. Gall

Myocarditis and Myocardosis: A Clinicopathologic Appraisal

Search of 3,141 autopsies found 108 examples of myocardial disease of which 77 were inflammatory (nonrheumatic) and 31 noninflammatory but degenerative and not due to sclerosis or hypertension. These are designated myocardosis. Myocarditis was associated with infections in a manner often described; myocardosis was associated with a variety of noninfectious disorders. A discussion of the use of this term is elaborated. Clinical records also were studied to find what part such lesions played in causing death and how such myocardial lesions could be diagnosed with more certainty.

Renal cortical necrosis: Clinical and pathologic features in twenty-one cases

Abstract Twenty-one cases of bilateral renal cortical necrosis encountered at necropsy over a five-year period are reviewed. Thirteen of these were observed during a seventeen-month period and represented at least 20 per cent of all cases of acute renal failure treated during this interval. A variety of conditions antedated the renal failure; in only three instances were there preexisting obstetrical complications. Severe renal ischemia is recognized as the most probable common factor accounting for the development of cortical necrosis in these cases. The clinicopathologic features of the twentyone cases were analyzed to attempt to differentiate the clinical course of patients with cortical necrosis from those with other causes of acute renal failure. It is apparent that total anuria and severe prolonged oliguria are prominent features of cortical necrosis. Gross hematuria and pain in the flanks also may be important diagnostic clues. Detailed analysis of these twenty-one cases failed to explain the sudden increase in the incidence of renal cortical necrosis at the Cincinnati General Hospital. It is unlikely that massive cortical necrosis has been overlooked in routine necropsy material. It is conceivable, however, that minor degrees of the process may not have been recognized in the absence of this special interest. No features of therapy were uncovered to explain the heightened incidence, nor were any common epidemiological findings noted in the survey.

Progression of acute hepatitis to postnecrotic cirrhosis

Abstract Five patients are described in whom progression of acute hepatitis to postnecrotic cirrhosis was documented by serial histologic observations. The hepatitis was assumed to be of viral etiology in view of the characteristic histologic and clinical features and the absence of other known infectious or hepatotoxic agents.