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1.
Genes Brain Behav ; 12(5): 479-89, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23647582

ABSTRACT

The endocannabinoid (eCB) system regulates emotion, stress, memory and cognition through the cannabinoid type 1 (CB1 ) receptor. To test the role of CB1 signaling in social anxiety and memory, we utilized a genetic knockout (KO) and a pharmacological approach. Specifically, we assessed the effects of a constitutive KO of CB1 receptors (CB1 KOs) and systemic administration of a CB1 antagonist (AM251; 5 mg/kg) on social anxiety in a social investigation paradigm and social memory in a social discrimination test. Results showed that when compared with wild-type (WT) and vehicle-treated animals, CB1 KOs and WT animals that received an acute dose of AM251 displayed anxiety-like behaviors toward a novel male conspecific. When compared with WT animals, KOs showed both active and passive defensive coping behaviors, i.e. elevated avoidance, freezing and risk-assessment behaviors, all consistent with an anxiety-like profile. Animals that received acute doses of AM251 also showed an anxiety-like profile when compared with vehicle-treated animals, yet did not show an active coping strategy, i.e. changes in risk-assessment behaviors. In the social discrimination test, CB1 KOs and animals that received the CB1 antagonist showed enhanced levels of social memory relative to their respective controls. These results clearly implicate CB1 receptors in the regulation of social anxiety, memory and arousal. The elevated arousal/anxiety resulting from either total CB1 deletion or an acute CB1 blockade may promote enhanced social discrimination/memory. These findings may emphasize the role of the eCB system in anxiety and memory to affect social behavior.


Subject(s)
Anxiety/genetics , Memory , Receptor, Cannabinoid, CB1/genetics , Adaptation, Psychological , Animals , Anxiety/metabolism , Arousal , Freezing Reaction, Cataleptic , Male , Mice , Mice, Inbred C57BL , Mice, Knockout , Piperidines/pharmacology , Pyrazoles/pharmacology , Receptor, Cannabinoid, CB1/antagonists & inhibitors , Social Discrimination
2.
J Clin Endocrinol Metab ; 78(5): 1153-8, 1994 May.
Article in English | MEDLINE | ID: mdl-8175972

ABSTRACT

Molecular scanning techniques, such as denaturing gradient gel electrophoresis (DGGE), greatly facilitate screening candidate genes for mutations. We have used DGGE to screen for mutations in the insulin receptor gene in a family in which four of five daughters were affected by type A insulin resistance in association with acanthosis nigricans and hyperandrogenism. DGGE did not detect mutations in any of the 22 exons of the insulin receptor gene. Nevertheless, Southern blot analysis suggested that there was a deletion of exon 3 in the other paternal allele of the insulin receptor gene. Analysis of the father's cDNA confirmed that exon 3 was deleted from mRNA molecules derived from one of his two alleles of the insulin receptor gene. Furthermore, the father was found to be hemizygous for a polymorphic sequence (GACAsp at codon 234) in exon 3 that was not inherited by any of the five daughters. Instead, all five daughters inherited the paternal allele with the deletion mutation. We did not detect mutations in the mother's insulin receptor gene. Furthermore, the clinical syndrome did not segregate with either of the mother's two alleles of the insulin receptor gene. Although the youngest daughter inherited the mutant allele from her father, she was not clinically affected. The explanation for the incomplete penetrance is not known. These results emphasize the importance of specifically searching for deletion mutations when screening candidate genes for mutations. Furthermore, the existence of apparently asymptomatic carriers of mutations in the insulin receptor gene, such as the father in the present study, suggests that the prevalence of mutations in the insulin receptor gene may be higher than would be predicted on the basis of the observed prevalence of patients with extreme insulin resistance.


Subject(s)
Gene Deletion , Insulin Resistance/genetics , Receptor, Insulin/genetics , Adolescent , Adult , Alleles , Amino Acid Sequence , Base Sequence , Blotting, Southern , Child , Exons , Humans , Molecular Sequence Data , Mutation
3.
Vestn Statistiki ; (3): 50-6, 1988.
Article in Russian | MEDLINE | ID: mdl-12178706

ABSTRACT

PIP: Methods that have been used or suggested to improve the accuracy of the U.S. census are reviewed. The author notes that self-completed questionnaires yield better results than those completed by census enumerators. The use of sample surveys carried out as part of the census process is described.^ieng


Subject(s)
Censuses , Data Collection , Evaluation Studies as Topic , Reproducibility of Results , Sampling Studies , Surveys and Questionnaires , Americas , Developed Countries , Developing Countries , North America , Population Characteristics , Research , Research Design , United States
4.
Eur J Clin Invest ; 17(3): 266-74, 1987 Jun.
Article in English | MEDLINE | ID: mdl-3113971

ABSTRACT

A non-steady state dose-response study was designed to quantitate peripheral sensitivity to insulin and pancreatic responsiveness to glucose, and to assess their relative contribution to glucose intolerance in Type 2 diabetes (Type 2 DM, non-insulin-dependent). Eleven lean and eleven obese patients with mild diabetes (fasting plasma glucose, FPG, 10.3 +/- 1.0 and 9.4 +/- 0.6 mmol l-1, respectively) were examined; twenty-six lean and twelve weight-matched obese subjects served as controls. Pancreatic response was measured by sequential injection of 0.1, 0.3 and 0.9 g kg-1 glucose; peripheral sensitivity to insulin was determined from the rate of clearance (Kgluc) of 0.3 g glucose injected sequentially together with 25, 50 and 100 mU insulin kg-1 or with 0, 12.5 and 50 mU kg-1, under somatostatin infusion. The mean dose-response curve describing glucose-induced insulin release showed increased maximal capacity to secrete insulin in obese controls, while the responses of lean as well as obese Type 2 DM were reduced by more than 80%. The mean dose-response curves relating plasma exogenous insulin levels to Kgluc were similar in lean diabetics and lean controls. The curves of both obese controls and obese diabetics were shifted to the right, demonstrating similar insulin resistance. In four lean controls, sensitivity to insulin was tested also during a hyperglycemic clamp set at 10.3 +/- 0.6 mmol l-1. Hyperglycemia reduced the Kgluc at all insulin levels. Individual dose-response curves were transformed to single weighted numerical pancreatic responsiveness scores [PRS], and peripheral sensitivity scores [PSS].(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Blood Glucose/metabolism , Diabetes Mellitus, Type 2/physiopathology , Insulin Resistance , Insulin/metabolism , Pancreas/physiopathology , Adult , Dose-Response Relationship, Drug , Female , Glucose/administration & dosage , Homeostasis , Humans , Insulin/administration & dosage , Insulin Secretion , Male , Middle Aged
5.
Endocrinology ; 119(2): 737-45, 1986 Aug.
Article in English | MEDLINE | ID: mdl-2426087

ABSTRACT

The mechanisms by which somatostatin (SRIF) inhibits CRF-induced ACTH secretion from AtT20 cells were characterized by comparing the effects of SRIF on cAMP production, adenylate cyclase activity, and activation of cAMP-dependent protein kinase isoenzymes with its effects on ACTH release. In isolated membranes, CRF (100 nM) stimulated adenylate cyclase activity 4- to 5-fold. SRIF inhibited CRF-stimulated adenylate cyclase in a concentration-dependent manner. However, maximal inhibition was 50%. SRIF did not inhibit basal adenylate cyclase or forskolin-stimulated cyclase in the absence of guanine nucleotides and had only small effects on forskolin-stimulated cyclase when assayed in the presence of guanine nucleotides. CRF (100 nM) induced small rises (2-fold) in intracellular cAMP levels which produced maximal ACTH release. SRIF inhibited basal and CRF-stimulated ACTH release in a concentration-dependent manner, and there was a good correlation between inhibition of ACTH release and inhibition of the activation of cAMP-dependent protein kinases in these cells. Thus, the effect of SRIF on CRF-induced ACTH release appeared to result from its effect on inhibition of adenylate cyclase. In the presence of 3-methylisobutylxanthine (MIX), CRF increased cAMP levels 20-fold and activated a greater proportion of cAMP-dependent protein kinase, but did not stimulate ACTH release more than CRF alone. Under these conditions, SRIF (100 nM) inhibited cAMP accumulation by 90%. ACTH release was also inhibited, but higher concentrations of SRIF were required to block ACTH release compared to cells incubated in the absence of MIX. Sufficient cAMP levels were achieved so that activation of cAMP-dependent protein kinases was only partially blocked. There was still sufficient cAMP to activate cAMP-dependent protein kinase to an extent equal to that seen with CRF without MIX. Similar effects of SRIF on cAMP accumulation and protein kinase activation were seen when cells were stimulated with forskolin. Our results demonstrate that SRIF inhibits ACTH release from AtT20 cells by inhibiting hormone-sensitive adenylate cyclase and thereby prevents the activation of cAMP-dependent protein kinases. However, under conditions where cAMP-dependent protein kinases are still sufficiently active to induce ACTH secretion, high concentrations of SRIF can inhibit ACTH release by a mechanism independent of cAMP-dependent protein kinase.


Subject(s)
Adenylyl Cyclases/metabolism , Adrenocorticotropic Hormone/metabolism , Cyclic AMP/pharmacology , Isoenzymes/metabolism , Protein Kinases/metabolism , Somatostatin/pharmacology , 1-Methyl-3-isobutylxanthine/pharmacology , Animals , Cell Line , Colforsin/pharmacology , Corticotropin-Releasing Hormone/pharmacology , Cyclic AMP/biosynthesis , Enzyme Activation/drug effects , Guanosine 5'-O-(3-Thiotriphosphate) , Guanosine Triphosphate/analogs & derivatives , Guanosine Triphosphate/pharmacology , Guanylyl Imidodiphosphate/pharmacology , Mice , Pituitary Neoplasms/metabolism , Thionucleotides/pharmacology
6.
Isr J Med Sci ; 21(11): 905-11, 1985 Nov.
Article in English | MEDLINE | ID: mdl-3908398

ABSTRACT

The biological efficacy of biosynthetic human insulin (BHI) of recombinant DNA origin was compared with that of highly purified pork insulin in subjects with normal (lean persons) and decreased (obese persons) sensitivity to insulin. Sequential i.v. administration of glucose with increasing insulin doses under somatostatin coverage was used to establish the dose-response characteristics of insulin-induced glucose clearance [insulin vs. Kg (glucose disappearance rate, %/min). Insulin was also given s.c. prior to an oral glucose tolerance test (OGTT) performed under somatostatin blockade; the appearance of insulin in serum and the modification of glucose levels were followed. The insulin vs. Kg dose-response curve was flatter and shifted to the right in obese persons compared with lean persons, demonstrating insulin resistance. In both lean and obese subjects, BHI and pork insulin had comparable effects on glucose clearance. Similarly, the effect of s.c. insulin on the serum glucose values during OGTT was the same when BHI or pork insulin were used. The absorption characteristics from the injection site were similar for both insulins. Thus, in man, human and pork insulin have similar pharmacokinetic and biological characteristics.


Subject(s)
Glucose Tolerance Test , Insulin/pharmacology , Obesity/blood , Recombinant Proteins/pharmacology , Administration, Oral , Adult , Animals , Dose-Response Relationship, Drug , Female , Humans , Injections, Intravenous , Male , Metabolic Clearance Rate , Swine
7.
J Biol Chem ; 259(16): 10289-95, 1984 Aug 25.
Article in English | MEDLINE | ID: mdl-6088492

ABSTRACT

The properties of the cAMP-dependent protein kinases in AtT20 mouse pituitary tumor cells were characterized by a combination of immunological and biochemical techniques. Ninety per cent of the total cAMP-dependent protein kinase was in the 40,000 X g supernatant fraction. Protein kinases I and II were immunoprecipitated with specific antisera directed against their regulatory subunits. The immunoprecipitated kinases bound [3H]cAMP and were catalytically active when incubated with [gamma-32P]ATP-Mg and protamine or histone H2B. Immunoprecipitated protein kinases I and II bound [3H]cAMP with apparent Kb values of 1.5 and 15 nM, respectively. Regulatory subunit concentrations in AtT20 cells were measured by immunoprecipitation of [3H]cAMP-R complexes. R-I and R-II levels were 2.7 and 3.0 pmol of [3H]cAMP binding activity per mg of cytosolic protein, respectively, however, the ratio of protein kinase II to protein kinase I was 2.5 indicating the presence of a significant amount of free R-I. This was confirmed by DEAE-cellulose chromatography and the isolation of immunoreactive R-I devoid of protein kinase activity. A significant amount of R-I also coeluted with protein kinase II when AtT20 cell extracts were subjected to DEAE-cellulose chromatography. In quantitative immunoprecipitation experiments, 0.1 microliter of anti-brain R-II serum complexed up to 0.5 pmol of the [3H]cAMP-binding activity of protein kinase II prepared from bovine and rat brain, and AtT20 cells while 2 microliter of anti-brain R-II serum was required to precipitate an equal amount of protein kinase II from bovine skeletal muscle showing that the protein kinase II in AtT20 cells contained the neural-specific R-II subunit.


Subject(s)
Pituitary Neoplasms/enzymology , Protein Kinases/analysis , Affinity Labels/pharmacology , Animals , Antigen-Antibody Complex , Azides/pharmacology , Cell Line , Cyclic AMP/analogs & derivatives , Cyclic AMP/metabolism , Cyclic AMP/pharmacology , Immune Sera , Kinetics , Macromolecular Substances , Mice , Protein Binding , Protein Kinases/metabolism
8.
J Biol Chem ; 259(16): 10296-302, 1984 Aug 25.
Article in English | MEDLINE | ID: mdl-6088493

ABSTRACT

The hormonal regulation of adenylate cyclase, cAMP-dependent protein kinase activation, and adrenocorticotropic hormone (ACTH) secretion was studied in AtT20 mouse pituitary tumor cells. Corticotropin releasing factor (CRF) stimulated cAMP accumulation and ACTH release in these cells. Maximal ACTH release was seen with 30 nM CRF and was accompanied by a 2-fold rise in intracellular cAMP. When cells were incubated with both 30 nM CRF and 0.5 mM 3-methylisobutylxanthine (MIX) cAMP levels were increased 20-fold, however, ACTH release was not substantially increased beyond release seen with CRF alone. The activation profiles of cAMP-dependent protein kinases I and II were studied by measuring residual cAMP-dependent phosphotransferase activity associated with immunoprecipitated regulatory subunits of the kinases. Cells incubated with CRF in the absence of MIX showed concentration-dependent activation of protein kinase I which paralleled stimulation of ACTH release. Protein kinase II was minimally activated. When cells were exposed to CRF in the presence of 0.5 mM MIX there was still a preferential activation of protein kinase I, although 50% of the cytosolic protein kinase II was activated. Complete activation of both protein kinases I and II was seen when cells were incubated with 0.5 mM MIX and 10 microM forskolin. Under these conditions cAMP levels were elevated 80-fold. CRF, isoproterenol, and forskolin stimulated adenylate cyclase activity in isolated membranes prepared from AtT20 cells. CRF and isoproterenol stimulated cyclase activity up to 5-fold while forskolin stimulated cyclase activity up to 15-fold. Our data demonstrate that ACTH secretion from AtT20 cells is mediated by small changes in intracellular levels of cAMP and activation of only a small fraction of the total cytosolic cAMP-dependent protein kinase in these cells is required for maximal ACTH secretion.


Subject(s)
Corticotropin-Releasing Hormone/pharmacology , Diterpenes/pharmacology , Isoproterenol/pharmacology , Pituitary Neoplasms/enzymology , Protein Kinases/metabolism , Adenylyl Cyclases/metabolism , Adrenocorticotropic Hormone/metabolism , Animals , Cell Line , Colforsin , Cyclic AMP/metabolism , Enzyme Activation , Kinetics , Mice , Pituitary Neoplasms/metabolism
9.
J Steroid Biochem ; 19(1B): 675-81, 1983 Jul.
Article in English | MEDLINE | ID: mdl-6310249

ABSTRACT

Some patients with either fully developed, mild or even hidden forms of congenital adrenal hyperplasia have both 21-deoxycortisol and increased 11-deoxycortisol in their blood and excrete "pregnanetriolone" and "tetrahydro-S" in their urine. The simultaneous presence of these compounds suggests two enzymic deficiencies, which are expressed in C21- and C11 beta-hydroxylases, respectively. However, these deficiencies have been inferred to derive from a single aberration in C11 beta-hydroxylase, whereby the enzyme acquires an affinity towards 21-deoxy precursors (i.e. 17-OH-progesterone) of cortisol and diminishes its activity against its regular 21-hydroxy intermediate 11-deoxycortisol. Depending on the severity of the aberration varying amounts of 21-deoxycortisol (expressing the aberrant 11 beta-hydroxylase) and of 11-deoxycortisol (expressing the normal 11 beta-hydroxylase) will be formed. An apparent two-level inhibition of cortisol biosynthesis will result from: (1) the low activity of normal 21-hydroxylase on the derivative 21-deoxycortisol, produced by the action of the aberrant 11 beta-hydroxylase, and (2) the low supply of 11-deoxycortisol for the regular but decreased (due to the aberration) 11 beta-hydroxylase. Thus a single defect will mimic at one and the same time a 21-hydroxylase and a 11 beta-hydroxylase deficiency.


Subject(s)
Adrenal Hyperplasia, Congenital/metabolism , Steroid Hydroxylases/deficiency , Adolescent , Adrenal Cortex/metabolism , Adrenocorticotropic Hormone , Adult , Female , Glucocorticoids/metabolism , Gonadal Steroid Hormones/metabolism , Humans , Hydrocortisone/biosynthesis , Microsomes/metabolism , Mitochondria/metabolism , Ovary/enzymology
12.
J Clin Endocrinol Metab ; 54(1): 76-82, 1982 Jan.
Article in English | MEDLINE | ID: mdl-6798060

ABSTRACT

A family of three generations is described in which six females had hyperthyroidism secondary to chronic overstimulation of the thyroid by pituitary TSH. In the untreated state, their basal levels of T4 ranged between 14-22 microgram/dl, T3 levels ranged from 205-300 ng/dl, T3 resin uptake ranged from 43-61%, TSH ranged from 5-26 microU/ml, and PRL ranged from 33-75 ng/ml. Basal metabolic rate (BMR) was elevated in all patients (+32 to +100%). There was no evidence of pituitary tumor, In spite of elevated circulating thyroid hormones, TRH stimulated TSH and PRL to 25-57 microU/ml and 120-300 ng/ml, respectively. Serum TSH could be suppressed to normal after 1 week of T3 administration (25 microgram three times per day). Concomitantly, serum T3 and T4 levels fell, and the TSH response to TRH became normal. In contrast, T4 (200 microgram/day) administered for 1 and 4 weeks, respectively, to two patients did not suppress the pituitary-thyroidal axis. A long term therapeutic trial was performed in three patients with T3 and a single morning dose of 25-50 microgram. TSH gradually returned to normal, as did thyroid hormone levels and the BMR. The clinical manifestations of hyperthyroidism regressed, and complete remission was achieved after 2-3 months of T3 therapy, which persists to data as long as medication is continued. The inappropriate TSH secretion of our patients appears to be due to partial unresponsiveness of the thyrotroph to thyroid hormone. It is suggested that either the pituitary T4 monodeiodinase is deficient in our patients, resulting in low intracellular T3 levels, or the thyrotroph has reduced sensitivity to T3 and therefore can shut off TSH only when serum T3 is raised to high levels, albeit intermittently.


Subject(s)
Hyperthyroidism/genetics , Thyrotropin/metabolism , Triiodothyronine/therapeutic use , Adolescent , Adult , Aged , Child , Female , Humans , Hyperthyroidism/drug therapy , Hyperthyroidism/etiology , Hyperthyroidism/physiopathology , Pituitary Gland/physiopathology , Prolactin/blood , Thyrotropin-Releasing Hormone , Thyroxine/blood , Triiodothyronine/blood
13.
Br J Pharmacol ; 75(1): 213-7, 1982 Jan.
Article in English | MEDLINE | ID: mdl-6280800

ABSTRACT

1 The synthesis of several butyrophenone analogues of haloperidol is described. 2 The effects of these compounds on alpha-adrenoceptors were evaluated by examining their ability to reduce alpha 1-stimulated K+ release from rat parotid slices and to displace [3H]-phentolamine from human platelet membrane alpha 2-adrenoceptors. 3 The affinity of haloperidol and its analogues for alpha 1-receptors was found to be 1 to 2 orders of magnitude greater than that for alpha 2-adrenoceptors. These observations suggest that most of the alpha-adrenoceptor activity of butyrophenones results from their interaction with alpha 1-adrenoceptors. 4 The relatively high affinity of the butyrophenones for alpha 1-adrenoceptors suggests that they may be useful as probes in studies of alpha 1-adrenoceptors in these and other tissues.


Subject(s)
Blood Platelets/metabolism , Haloperidol/analogs & derivatives , Parotid Gland/metabolism , Receptors, Adrenergic, alpha/drug effects , Receptors, Adrenergic/drug effects , Animals , Cell Membrane/metabolism , Haloperidol/chemical synthesis , Haloperidol/pharmacology , Humans , In Vitro Techniques , Phentolamine/metabolism , Potassium/metabolism , Rats , Receptors, Adrenergic, alpha/metabolism
15.
Scand J Rheumatol ; 9(1): 17-23, 1980.
Article in English | MEDLINE | ID: mdl-6769149

ABSTRACT

Monocytes derived from peripheral blood of patients with rheumatoid arthritis (RA) had a marked defect in their bactericidal activity against Staphylococcus albus and Listeria monocytogenes; whereas the phagocytic capacity of monocytes from RA patients for both Staph. albus and Shigella flexneri was similar to that of monocytes from healthy subjects. There were no significant differences between the patient and control groups with regard to antibody dependent cellular cytotoxicity (ADCC) of monocyte against antibody-coated EL4 leukemia tumor cells. No correlation was observed between the rheumatoid factor (RF) titer in the serum of RA patients and the ADCC capacity of their monocytes. The ADCC of normal monocytes was reduced markedly following their incubation with serum from RA patients. It suggested that the defect in bactericidal activity in monocytes from RA patients may explain, at least in part, the susceptibility of RA patients to infections.


Subject(s)
Arthritis, Rheumatoid/immunology , Monocytes/immunology , Adolescent , Adult , Aged , Antibody-Dependent Cell Cytotoxicity , Arthritis, Rheumatoid/microbiology , Cells, Cultured , Female , Humans , Listeria monocytogenes , Male , Middle Aged , Phagocytosis , Shigella flexneri , Staphylococcus
17.
Perspect Biol Med ; 22(1): 104-14, 1978.
Article in English | MEDLINE | ID: mdl-733451

ABSTRACT

Clinical and neuropharmacological evidence indicates the involvement of dopaminergic mechanisms in Parkinson's disease and schizophrenia, as well as in iatrogenic Parkinsonism and drug-induced schizophrenia-like syndrome. The evidence hitherto presented stresses the existence of a reversed relationship between Parkinson's disease and schizophrenia and implicates the possibility that dysfunction of dopamine-receptors may be a central phenomenon in both diseases. In view of the recent demonstration of two separate dopamine-receptors, it is postulated that a striatal receptor blockade may cause Parkinson's disease, whereas a limbic receptor blockade may result in schizophrenia. The recent discovery that several autoimmune diseases, such as myasthenia gravis, are the result of an immunopharmacological block at receptor sites, together with several observations of immunological disorders in Parkinson's disease and schizophrenia, suggests the possibility that certain types of Parkinson's disease and schizophrenia might be the consequence of an autoimmune blockade of striatal or limbic dopamine-receptors, respectively.


Subject(s)
Autoantibodies , Autoimmune Diseases/metabolism , Parkinson Disease/etiology , Receptors, Dopamine/immunology , Schizophrenia/etiology , Antibody Formation , Corpus Striatum/metabolism , Humans , Limbic System/metabolism , Parkinson Disease/metabolism , Receptors, Dopamine/metabolism , Schizophrenia/metabolism , Substantia Nigra/metabolism
18.
Lancet ; 2(8046): 1038, 1977 Nov 12.
Article in English | MEDLINE | ID: mdl-72944
19.
Isr J Med Sci ; 13(10): 1013-21, 1977 Oct.
Article in English | MEDLINE | ID: mdl-591294

ABSTRACT

Two patients with chronic mild to moderate renal failure presenting with unexplained hyperkalemia were studied, and found to have hyporeninemic hypoaldosteronism. Hyperkalemia, generally uncommon in nonoliguric stable renal failure, resulted from the combination of apparent insensitivity of the diseased kidney to aldosterone and variable degrees of impairment in the reninaldosterone axis. The clinical picture, the methods of establishing the diagnosis, the therapeutic alternatives and the possible pathogenetic mechanisms involved are described.


Subject(s)
Aldosterone/deficiency , Hyperkalemia/etiology , Kidney Failure, Chronic/complications , Renin/blood , Cryoglobulins , Heart Failure/complications , Humans , Immunoglobulin G , Immunoglobulin M , Male , Middle Aged , Paraproteinemias/complications , Syndrome
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