Bacteremic Moraxella catarrhalis pneumonia in a patient with immunoglobulin deficiency.

A-75-year old woman with agammaglobulinemia developed Moraxella catarrhalis bacteremic pneumonia. M. catarrhalis pneumonia is rarely associated with bacteremia, and neutrophils have been reported as a significant factor in the host defense system against this bacteria. This case suggests that immunoglobulin also plays a key role in the host defense system against M. catarrhalis.

Sympathetic nervous function and erythrocyte cation transport systems in normotensive individuals with family history of hypertension.

To investigate the influence of heredity to the sympathetic nervous function and the cell membrane cation transport systems, we studied the blood pressure and plasma catecholamine response to supine exercise testings by bicycle ergometer, the pressure response to noradrenaline infusion tests and the heart rate response to isoproterenol infusion tests in 88 healthy Japanese sedentary normotensive men with and without a family history of essential hypertension [FHH(+) and FHH(-)]. Several erythrocyte monovalent cation transport parameters were also measured in 74 of these individuals. In the results, (1) the systolic blood pressure response to exercise testings and noradrenaline infusion tests were larger in FHH(+) than FHH(-): (2) there was no difference between FHH(+) and FHH(-) in the heart rate response to isoproterenol infusion tests: (3) there was no significant difference between FHH(+) and FHH(-) in the increased plasma catecholamine levels to exercise testings: (4) the intraerythrocytic sodium content was significantly higher in FHH(+) than in FHH(-): and (5) several erythrocyte monovalent cation transport systems (Li-Na countertransport, Na-K cotransport and Na-K pump activity) were clearly accelerated in FHH(+). We concluded that in spite of normotension there were abnormalities of sympathetic nervous function, intracellular sodium content and several cell membrane cation transport systems in individuals with a family history of essential hypertension.

[Echocardiographic manifestations of postinfarction perforation with extensive dissection of the interventricular septum: report of an autopsied case].

This is a report of the echocardiographic features of postinfarction perforation associated with dissection of the interventricular septum (IVS) in a 61-year-old woman. She had acute myocardial infarction and was admitted to a nearby hospital, and later admitted to our CCU because hemodynamic deterioration. On admission, she was somnolent and hypotensive (90/64 mmHg), with sinus tachycardia, marked cyanosis, and peripheral edema. On auscultation there were a harsh holosystolic murmur over the LLSB and moist rales in both lung fields. An ECG revealed extensive anterior and inferior infarctions. Catheterization data confirmed O2 step-up in the right ventricle. Two-dimensional echocardiograms demonstrated extensive dissection of the IVS characterized by an echo-free lumen extending from the apex to the cardiac base in the long-axis and partly reaching the left ventricular free wall in the short-axis with the concomitant paradoxical movement of the IVS. Autopsy disclosed marked hemorrhagic infarction and extensive dissection of the IVS forming a lumen (5 X 5.5 X 2 cm3) corresponding exactly to the echocardiographic free space. In addition, a shunt between the right and left ventricles was confirmed by the presence of two perforations near the apex on the right and left sides of the IVS, whose diameters were 6 and 10 mm, respectively.