Splenic histiocytosis associated with thrombocytopenia

Two young Jamaican women of Chinese descent with idiopathic thrombocytopenic purpura were found to have lipid-laden histiocytes in their spleens; their condition has improved following splenectomy. The electron microscopic appearances of the spleens suggest that platelet destruction contributed to the accumulation of lipid (AU)

Pathology of idiopathic cardiomegaly in Jamaica

Twenty-one cases of idiopathic cardiomegaly which came to necropsy have been reviewed. Investigations included injection and x-ray studies, careful microscopical examination and skip serial sectioning of the conduction systems. The obvious feature was gross cardiomegaly in the absence of atheroma of the large coronary vessels and an associated fibrosis of the right and left bundle-branches. Three hearts showed thickening of the intramural vessels of 80æ to 400æ diameter. We suggest that such changes may be one of the causes of the ischaemic electrocardiographic findings reported in previous epidemiological surveys.(AU)

Emphysema in a non-industrialized tropical island

Whole lung sections (Gough-Wentworth) have been prepared after formalin liquid distension of the lungs from 643 necropsies performed in Jamaica. These included 572 Negro (African), 18 East Indian, 25 Chinese, and 28 white cases. Emphysematous change was assesssed visually by comparision with a standard set of sections from Cardiff which were similar to those adopted by the Ciba Guest Symposium in 1959. Severe destructive emphysema was present in 1.8 percent of males and in 1.0 percent of females. Emphysema was more severe, and more frequent, in males than in females, while both sexes showed an increasing frequency and severity with advancing years. No appreciable racial difference was seen, except that 'focal' emphysema, which includes the centrilobular type, was somewhat more frequent in East Indians than in the other racial groups. These observations indicate the occurence of emphysema of the more common types in a hot climate which is apparantly free of atmospheric pollution.(AU)

Congenital mitral atresia

The clinical and pathological features of 9 cases of congenital mitral atresia are described. Six cases were associated with aortic atresia or hypoplasia and one with transposition of the great vessels. The usual clinical presentation was sudden onset of dyspnoea and cyanosis in the neonatal period followed by rapid deterioration, a picture producing diagnostic difficulties that are often increased because of coexisting cardiac anomalies. A correct anatomical diagnosis can be made at necrops by careful inspection of the heart and great vessel, aided in some cases by microscopical examination.(AU)

Myocarditis in Jamaica

A review of the histology of heart muscle from 3000 necropsies in Jamaica has shown 102 cases with myocarditis (3.4 percent). The relevant clinical and pathological features are documented. Excluding 30 cases of rheumatism, myocarditis was most frequently associated with some form of septicaemia, wheras tropical diseases were of minor importance. An attempt to relate mycocarditis with unexplained heart enlargement in Jamaica was inconclusive. The results are discussed with reference to the findings in some earlier reported series (AU)

Emphysema in Jamaica: a preliminary report

A study of the type and degree of emphysema has been carried out at the University Hospital of the West Indies using Gough-Wentworth whole lung sections. The lung tissue was obtained from a series of consecutive, unselected autopsies in 125 adults of both sexes, ages 17 years and over. The results show that both the incidence and severity of emphysematous change is greater in males than in females. The overall incidence of what is gauged to be clinically significant emphysema is similar to findings in temperate countries. Reservation must be taken in this comparison because the material was not compared with any from Europe or North America. It is possible that the disease is caused by factors different from those operating in temperate countries. Alternatively, the emphysema-producing processes in temperate and tropical countries are similar, but in temperate areas, clinical prominence results from secondary infection, which does not occur in Jamaica (AU)

Some observations on emphysema in Jamaica

A study of 150 consecutive autopsies has been made to establish the extent of emphysema in Jamaica. This has been done by preparing large lung sections (Gough-Wentworth). From these it has been possible to classify and roughly grade the types of emphysema occurring in Jamaica and to correlate the changes with the sex and age of the patients. The results suggested that the incidence of the anatomical changes are similar to those found in temperate zones. This is surprising because, firstly causative factors such as cold, damp atmosphere and industrial pollution do not appear to operated in Jamaica, and secondly clinical lung disease does not play a very great part in the overall morbidity of the Jamaican community (AU)