Hypertension: cation transport and the physical properties of erythrocytes.

In recent years, many reports have appeared describing altered Na+ and K+ transport in erythrocytes of individuals with essential hypertension. Collectively, the interpretation of these results has been unclear. Our studies revealed that the active ouabain-sensitive K+ influx, the furosemide-sensitive K+ influx and the residual passive K+ influx in both human and rat erythrocytes can vary considerably among individual persons or rats and that these measurements alone can not be used to distinguish normotensive from hypertensive individuals. The only consistent cation transport difference observed was an increased Na+ permeability in spontaneously hypertensive rat (SHR) erythrocytes. We have also examined certain physical properties (equilibrium density distribution and sedimentation velocity) of erythrocytes from normotensive Wistar-Kyoto (WKY) and SHR rats, since these characteristics may be altered in response to abnormalities of ion transport. It was found that the erythrocytes from geographically, environmentally, and age-matched littermates of WKY and SHR rats have identical equilibrium density distributions. It was also found that the density distribution of erythrocytes can vary among geographically dispersed colonies of the same strain of rat, and even among successive litters of the same rat colony. However, the sedimentation time required for erythrocytes to reach their equilibrium density was always shorter in the normotensive WKY samples than in the matched SHR. Utilizing a simple centrifugation method, we were able to clearly show that for any population of erythrocytes with the same upper limit of cell density, normotensive WKY cells always sediment at a faster rate than those of the hypertensive SHR.(ABSTRACT TRUNCATED AT 250 WORDS)

A comparison of the mobilities and thermal transitions of retrovirus lipid envelopes and host cell plasma membranes by electron spin resonance spectroscopy.

The lipid bilayers of several type-C retroviruses and selected host cells were spin labeled with 5-doxyl stearic acid, and intact viruses and cells were subjected to electron spin resonance spectroscopy in order to measure lipid mobility. Thermal transition profiles generated for four different retroviruses were dissimilar; differences in the values of the hyperfine splitting constant 2T parallel and in the positions of thermal break points reflect variations in mobility which can be correlated with the phospholipid/cholesterol molar ratios of the viral envelopes. Moreover, removal of virion surface projections by protease digestion altered the mobility of the envelope and in the positions of thermal break points, but the effect observed depended upon the particular retrovirus examined. Studies on retrovirus-infected and uninfected host cells have revealed that persistent virus infection can elicit changes in host plasma membrane mobility and in the positions of thermal break points, the direction and magnitude of which are highly dependent upon the particular retrovirus-host cell system under consideration.

Hypertension: spectrum of problems and guidelines for management.

Hypertensive patients may present to the emergency department with one of three general problems: high blood pressure due to labile hypertension, chronic hypertension, accelerated hypertension, or a hypertensive emergency; side effects from antihypertensive drugs; or acute medical or surgical illness whose management may be affected by hypertension or by drugs taken for hypertension. We describe these problems and recommend an approach to each that is appropriate in the emergency department.

Comparative analysis of emergency department treatment of patients with chest pain.

A vital function of the emergency physician is separating patients with chest pain who require intensive immediate treatment from those who require minimal care. The care of 701 patients presenting with chest pain in two Baltimore hospitals was evaluated using medical record data and follow-up questionnaires to discharged patients. Twenty per cent were admitted. There was a significant difference between the two hospitals in admission rates. Thirty-five per cent of the discharged patients felt no better two weeks after emergency department discharge. Plans for further research include a study to clarify the difference in admission rates and the characteristics of individuals who remained symptomatic at two weeks.

Hydrogen sulfide intoxication. A case report and discussion of treatment.

The toxicity of hydrogen sulfide is thought to be due primarily to reversible inactivation of the respiratory enzyme, cytochrome oxidase, with resultant inhibition of aerobic metabolism. A patient with severe hydrogen sulfide poisoning and consequent profound metabolic acidosis was treated successfully with nitrites and oxygen. The nitrite-induced methemoglobin, by competitively binding the toxic hydrosulfide anion until detoxified, presumably reactivated and protected cytochrome oxidase and therby aided the patient's recovery by enhancing aerobic metabolism. His rapid recovery adds clinical support to the efficacy of nitrite therapy in sulfide poisoning. Therefore, we recommend that severe cases of sulfide poisoning be treated with nitrite-induced methemoglobinemia in addition to vigorous supportive care.