It should be clearly understood that no evidence was uncovered to indicate an unequivocal etiology for this uncommon disease. One is tempted to qualify "uncommon" in that it no longer connotes the same extreme degree of rarity that would appear from medical literature. Over the same period that these cases were collected an equal number were recognized but unavailable for study for various reasons. Unfortunately, the size of our series precludes statistical analysis. The apparent tendencies to hypercholesteremia, blood-group predilection, and increased incidence of abnormal hemoglobin types are in need of further exploration. One would be remiss not to note at this point that at least one report 20 related several instances of familial incidence of postpartal heart disease. We are more certain of the significance of malnutrition as a factor in the genesis of this syndrome, although we are unable to assign a precise role. Similarly, the deleterious effects on such patients of hypertension, pyelonephritis, and full-term pregnancy have impressed us, although we can make no judgment as to their frequency of occurrence. Probably, as so often happens, we are most certain of our single pre-investigatory premise that postpartal heart disease is a serious and pernicious syndrome, quite different from that described in most of the literature. That prolonged bed rest is not a panacea is obvious. It is of sufficient merit, however, to warrant use in all such patients, for periods up to 1 year at least.
Abstract An electron microscopic investigation was made on lysosomes and morphologically related structures found in cardiac muscle. The tissues used in this investigation were obtained from normal and functionally altered rat hearts and human hearts from patients with cardiomyopathy. Structures morphologically similar to lysosomes were encountered in all hearts, but were especially numerous in the damaged hearts, both human and rat. These structures were extremely variable in size, the smaller ones being located in the Golgi region where they appeared to originate. Lipofuscin granules were especially numerous in pathological hearts, and have several morphological features in common with lysosomes. Other bodies were also frequently encountered in these cells which in many ways resembled lysosomes, but contained mitochondria, fragments of mitochondria and myelin figures. The structural similarities between lysosomes and these other elements lead us to consider the possibility that the latter structures may be modified, degenerate, or simply functional stages of lysosomes.
