The erythrocyte membrane in essential hypertension. Modified temperature-dependence of Li+ efflux.

The rate of ouabain-resistant Li+-efflux was studied in erythrocytes of normal controls and of patients with essential hypertension. Despite variability in rate, erythrocytes from normotensive persons revealed a uniform pattern of temperature dependence of the efflux, with two slopes (K = 9.4 and 19.1 kcal/mol, respectively) and a transition at about 25 degrees C. Erythrocytes from the patients showed both a higher rate of Li+ efflux and significant changes in the temperature response, with essentially a single slope (Ka = 14 kcal/mol). The data indicate localized changes in the membrane organization of hypertensive erythrocytes, involving lipid-protein interaction.

Multiple autoimmune manifestations in a splenectomized subject with HLA-B8.

Idiopathic thrombocytopenic purpura developed in a 31-year-old man, and he underwent a splenectomy because of his failure to respond to steroid therapy. Subsequently, during a six-year follow-up, chronic active hepatitis, Coombs' positive hemolytic anemia, and pulmonary interstitial fibrosis developed. Since such a clustering of autoimmune manifestations in a single subject is unusual, possible contributing factors were sought. We suggest that both the splenectomy and the histocompatibility antigen HLA-B8, which the patient was found to carry, may have contributed to this rare clinical syndrome.

Abnormalities in bilirubin and liver enzyme levels in adult patients with bacteremia. A prospective study.

Eighty-four patients with bacteremia were surveyed prospectively for biochemical markers of liver damage. Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and bilirubin levels were elevated in 44 (53%), 39 (47%), 45 (54%), and 5 (6%) of the patients on the first determination (2.0 +/- 0.1 days after onset of fever) and in 11 (13%), 17 (20%), 26 (31%), and 1 (1%) on the second determination (5.4 +/- 0.2 days after onset of fever), respectively. The elevation rarely exceeded three times the upper limit of normal. One patient had severe jaundice. An abnormality of at least one of these values was found in 55 patients (65%). There were no differences in site of infection, bacteria isolated, and outcome between patients with and without biochemical abnormalities. We conclude that in adult patients with bacteremia, elevation of liver enzymes and bilirubin is common, usually mild, of short duration, and of no prognostic significance.

Essential hypertension: improved differentiation by the temperature dependence of Li efflux in erythrocytes.

Kinetic and thermodynamic properties of red cell lithium (Li) efflux were examined in patients with essential hypertension; the maximal rate of Li efflux as affected by temperature was measured at the range of 12 degrees to 42 degrees C. Fifty-two patients with essential hypertension and 22 normotensives were studied. The mean Li efflux, both into sodium (Na) medium and Li-Na countertransport, was higher in hypertensive than in normotensive persons, but the distinction between the two groups was limited by extended scatter and overlap. The distinction could be markedly improved by determining the effect of temperature on Li efflux. While all the normotensives exhibited Arrhenius plots of Li efflux with a change in slope ("break") around 30 degrees C, the corresponding "break" for most (75%) of the hypertensives was about 20 degrees C. Consideration of both the rate and the temperature dependence of Li efflux further improved the differentiation of hypertensive patients. Analysis of normotensive offspring of hypertensives and of patients with secondary hypertension indicates that the temperature dependence of Li efflux may serve as a genetic marker for essential hypertension.

The use of gallium-67 liver imaging for the early diagnosis of Budd-Chiari syndrome.

A gallium-67 study, performed in a rare case of Budd-Chiari syndrome (BCS) in a 6-yr-old child, showed marked concentration of the tracer in the left and caudate lobes of the liver. Ten days later, a less specific and clear-cut appearance of left- and caudate-lobe concentration of Tc-99m phytate was obtained. The possible use of Ga-67 citrate imaging to diagnose BCS in its earliest stage is suggested, although no firm conclusion can be made from this single case.

Membrane-protein phosphorylation in the Bacillus subtilis cell cycle.

Sphingosine, an inhibitor of Ca(2+)-dependent protein kinases in eukaryotic cells, inhibited initiation of DNA replication in Bacillus subtilis at a concentration of 10 microM, without inhibiting elongation. The tumor promoter 12-tetradecanoyl 13-phorbol acetate, (TPA), an activator of protein kinase C in eukaryotic cells, partially counteracted the inhibition of initiation by sphingosine. Phosphorylation of polypeptides was observed in vivo at initiation of DNA replication in B. subtilis. Sphingosine, TPA, and vancomycin affected this protein phosphorylation.

Environmental and genetic factors of hypertension in a biracial Beduin population.

This study attempts to understand the various factors involved in the pathophysiology of hypertension in black Beduins. Parameters known to differentiate US black from white hypertensives were examined. Sixty Beduin families (thirty families each of black and white, total of 205 subjects) were evaluated for environmental risk factors: a traditional nomad shepherd life-style compared with working in a city, living in tents or in western style housing and dietary habits related to cardiovascular risk factors. Blood pressure, body mass index (BMI), sodium-lithium counter transport rate and 24 hour urinary sodium excretion (UNa) were measured and the data obtained were compared between normotensives and hypertensives, within each racial group. The mean value of the BMI of the white population was greater than that of the black population while the BMI of hypertensives was greater than that of the normotensives in each of the racial groups. The mean systolic BP of black hypertensives was greater than that of the corresponding whites. There were no significant differences in UNa between the four groups. Sodium-lithium countertransport was significantly higher in the hypertensive whites compared with the normotensive population (0.46 versus 0.22 mmol Li efflux/IRBC/hr). The countertransport rate for black hypertensives was lower than that of white hypertensives (0.20 versus 0.46). Black families had lower socio-economic scores than did white families and families with a hypertensive member scored lower than did families with a normotensive history. These results demonstrate some similarities between the American and Beduin black hypertensive populations, in spite of entirely different life-styles, indicating that in these populations genetic factors, rather than environmental influences, appear to be dominant in the pathophysiology of hypertension.

Risk indicators after envenomation in humans by Echis coloratus (mid-east saw scaled viper).

To determine the frequency, severity and predictors of bleeding and azotemia after envenomation in humans by Echis coloratus, a retrospective survey of 68 cases in Israel between 1970 and 1989 was carried out. We used univariate and multivariate analyses of clinical variables on admission for the outcome variables of bleeding, hemoglobin and platelet levels, and blood urea. Within hours or days after envenomation, a major bleeding episode occurred in 18% of the victims, a drop in hemoglobin to 10 g/dliter or less in 14%, and an increase in blood urea to 9 mmole/liter or more in 15%. These complications correlated with time interval between envenomation and hospital admission, and the following admission variables: degree of bleeding, hemoglobin level, platelet and white blood cell counts, blood urea and proteinuria. Complications were unlikely in patients who were presented with all of the following: a hemoglobin level of 13 g/dliter or more, a platelet count of 100,000/mm3 or more, a blood urea level of 7 mmole/liter or less, no proteinuria and no bleeding. Treatment on admission with a specific monovalent antiserum was associated with a shorter duration of hemostatic failure and a reduced incidence of anemia and thrombopenia. Infusion of fresh frozen plasma on admission did not appear to be effective in preventing complications.

"Intermittent" and transient ST-segment elevation following direct current cardioversion.

Transient ST-segment elevation immediately following direct current cardioversion is a clearly documented occurrence in a small percentage of cases. Two main explanations have been suggested: myocardial injury or coronary vasospasm. We report two cases of "intermittent" and transient ST-segment elevation after cardioversion. Such intermittent elevation of the ST segment has not been reported previously. We hypothesize that this electrocardiographic observation is explained by a timing difference induced by electroshock in the action potential between the epicardium and endocardium.

Expression of chromosomally inserted bacillus thuringiensis israelensis toxin genes in bacillus sphaericus

Bacillus thuringiensis israelensis delta-endotoxin genes were inserted into transposon Tn917 in plasmid pTV51Ts and cloned into the chromosome of Bacillus sphaericus 2362. Many of the transformants reacted with antibody to the 135-, 128-, 65-, and 28-kDa B.t.israelensis toxin proteins and were approximately 10 times more toxic to A. aegypti larvae than the untransformed host. Some of the transformants differed physiologically and morphologically from the wild-type B. sphaericus. The toxicity of the transformed phenotype was maintained through many transfers in the absence of selective pressure. Copyright 1998 Academic Press.