NMR characteristics of intracellular K in the rat salivary gland: a 39K NMR study using double-quantum filtering

Intracellular K of the perfused rat mandibular salivary gland was measured by 39K NMR spectroscopy at 8.45 T. Multiple-quantum NMR arising from multiple-exponential decay was used to eliminate the resonance due to extracellular K in the perfused gland at 25 degrees C. The resonance due to intracellular K consisted of two Lorentzian signals stemming from the [spin 1/2 to -1/2] coherence (sharp resonance) and the [spin -1/2 to -3/2], [spin 3/2 to 1/2] coherences (broad resonance). The transverse relaxation time (T2) corresponding to the [spin 1/2 to -1/2] coherence was ca. 2.5 ms, and that corresponding to the [spin -1/2 to -3/2], [spin 3/2 to 1/2] coherences was ca. 0.4 ms. The relaxation time of the double-quantum coherence of rank 3 (originating from product operators like Ix2Iz) was determined to be ca. 0.2 ms. These results suggest the possibility of the presence of a single homogeneous population of intracellular K with a correlation time of ca. 2.5 x 10(-8) s and a quadrupolar coupling constant of ca. 1.4 MHz.

Energetic recovery from hypothermic preservation in the rat liver

Changes in energy metabolism induced by norepinephrine were observed in liver perfused immediately after dissection and in liver stored in Euro-Collins solution at 0 degrees C for 24 hr. Oxygen consumption, glucose output, ATP content, and tissue pH were measured in isolated perfused rat liver at 37 degrees C. In fresh liver, a two-fold increase in glucose output and oxygen consumption was induced by norepinephrine (1 microM), while changes in ATP content and tissue pH were minimal. In stored liver, the cumulative increments in glucose output and oxygen consumption induced by norepinephrine were 30 and 27% those of fresh liver, respectively. ATP content of the unstimulated liver was 76% that of the fresh liver, then decreased to 50% during stimulation. A transient decrease in tissue pH (0.14 pH unit) was significant compared with that of fresh liver. These results suggest that norepinephrine stimulation is useful for assessing energetic and functional recovery of reperfused liver following hypothermic storage.

[Partial volume effect in MRI--a phantom study]

According to the direction and the thickness of the imaging slice in tomography, the border between the tissues becomes unclear (partial volume effect). In the present MRI experiment, we examined border area between fat and water components using phantom in order to investigate the partial volume effect in MRI. In spin echo sequences, the intensity of the border area showed a linear relationship with composition of fat and water. Whereas, in inversion recovery and field echo sequences, we found the parameters to produce an extremely low intensity area at the border region between fat and water. This low intensity area was explained by cancellation of NMR signals from fat and water due to the difference in the direction of magnetic vectors. Clinically, partial volume effect can cause of mis-evaluation of walls, small nodules, tumor capsules and the tumor invasion in the use of inversion recovery and field echo sequences.

Direct measurement of K movement by 39K NMR in perfused rat mandibular salivary gland stimulated with acetylcholine

The intracellular K content (Kin) of the isolated perfused rat mandibular gland was measured by 39K NMR spectroscopy at 25 degrees C, using an inversion recovery technique based on the fact that the spin-lattice (T1) relaxation of Kin is much faster than that of the extracellular K. Kin decreased by 30-34% of the resting level and reached a plateau level during secretion evoked by a sustained infusion of 1 mumol/l acetylcholine. Addition of 1 mmol/l ouabain decreased Kin by an additional 41% of the resting level. The K net flux to the blood and saliva was calculated from the K concentrations and flow rates of the effluent and the saliva. At an initial stage of secretion the gland lost K to the vascular side at a rate of 12.6 +/- 1.8 mumol/g-min (mean +/- SEM, n = 7). During sustained secretion, the gland took K up from the vascular side at a rate of 3.3 +/- 0.7 mumol/g-min (n = 7), and the same amount of K was secreted into the saliva (4.7 +/- 1.1 at 5-10 min, 2.8 +/- 0.8 mumol/g-min at 20-30 min), resulting in no net K movement from the gland. Addition of 1 mmol/l ouabain stopped salivary secretion and caused a transient K release to the vascular side at a maximum rate of 12.8 +/- 1.1 mumol/g-min. Withdrawal of acetylcholine and ouabain induced K uptake from the vascular side (6.5 +/- 0.7 mumol/g-min) and the amount of K released was completely restored when Kin recovered completely.(ABSTRACT TRUNCATED AT 250 WORDS)

Vector electron paramagnetic resonance spectroscopy with first and second harmonic displays of ferrihemoglobin

Superimposed plots of electron paramagnetic resonance spectra with the first and second harmonic displays of ferrihemoglobin at pH 9.1 and 90 K were measured at 20 degree intervals of phase angle using a phase-sensitive detector. The high spin signal in the g = 6 region was observed in both displays, and a small splitting of the signal was found in the calculated amplitude spectrum of the second harmonic display, with g values of 5.95 and 6.05. Low spin signals were observed at g = 2.55, 2.25 and 1.82 in both harmonic displays. A signal in the g = 2.05 region was observed only in the second harmonic display. The signal is probably associated with the low spin spectrum; however, its origin is obscure.

[A case of epidermoid in the fourth ventricle associated with bronchial asthma-like symptom]

A case of large epidermoid located in the fourth ventricle is presented, and the patient's uncommon symptomatology of bronchial asthma-like episode is discussed. The value of magnetic resonance imaging (MRI) is also emphasized in the diagnosis of intracranial epidermoid. A 41-year-old male noticed nausea and vomiting on getting up in the morning about 5 years ago. This was followed by bronchial asthma-like dyspnea one year later. About one week prior to admission, headache and gait disturbance started. On neurological examination, he had choked disk and horizontal nystagmus at lateral gaze bilaterally. His gait was slightly ataxic. Computerized tomography (CT) showed a low density mass with a sharp and irregular margin in the mid-portion of the posterior fossa. That lesion was not enhanced with contrast medium. The MRI appearance was that of an inhomogenous and low signal intensity mass with a slightly irregular margin on T1-weighted spin echo (SE) sequences using TR500 msec/TR30 msec (TR500/TE30). The tumor extended into the aqueduct upward and the C1 level of spinal column downward. T2-weighted SE sequences using TR2000/TE90 showed an inhomogenous and high intensity mass with an irregular margin more apparent than in normal brain tissue. The patient was tentatively diagnosed as having a large fourth ventricle tumor. Suboccipital craniectomy was carried out on 4, March, 1988. The tumor was removed totally and histologically, it turned out to be epidermoid. He was discharged without neurological deficit 2 months after surgery. First, with respect to clinical symptomatology, as specified by Bailey, it is characterized by difficulty in standing or walking, vertigo, and less constantly, psychic disturbance.(ABSTRACT TRUNCATED AT 250 WORDS)

Capillary tube isotachophoresis of proteins in early postmortem serum, cerebrospinal fluid and pericardial fluid

Serum, cerebrospinal fluid (CSF) and pericardial fluid (PDF) obtained from 22 early cadavers were subjected to capillary tube isotachophoresis. Separated proteins were grouped into three main fractions, namely, Fr. 1, Fr. 2 and Fr. 3, in order of their decreasing effective (net) mobilities. The percentages of main fractions to total content were calculated by UV absorbance integration. It was found that Fr. 1 decreased and Fr. 2 increased in all three kinds of specimens with an increase in time following death. In serum and also in CSF, the degree of these changes between 6 and 58 hours following death seemed large enough (about 30%) to be used for crude estimations of early postmortem intervals. Changes in PDF proceeded more gradually than in serum and or in CSF, with only 5-20% changes during this period.

Intracellular pH during secretion in the perfused rabbit mandibular salivary gland measured by 31P NMR spectroscopy

Intracellular pH (pHi) was measured in the isolated, perfused rabbit mandibular salivary gland by 31P NMR spectroscopy. In the unstimulated gland perfused with HCO3-/CO2-buffered Ringer's solution, pHi was 7.27 +/- 0.01. Continuous stimulation with acetylcholine elicited dose- and time-dependent changes in pHi. 10(-6) mol/l acetylcholine caused a brief intracellular acidosis (-0.19 +/- 0.06 pH units) followed by an increase in pHi to a more alkaline steady-state value (7.33 +/- 0.02). In the absence of perfusate HCO3- or in the presence of 10(-4) mol/l DIDS (4,4'-diisothiocyanatostilbene-2,2'-disulphonic acid), the transient acidosis was abolished and pHi increased rapidly to give a sustained alkalosis (7.49 +/- 0.03 and 7.44 +/- 0.03 respectively). In the presence of 10(-3) mol/l amiloride, the response to acetylcholine was a rapid decrease in pHi to 7.02 +/- 0.02. The data suggest that, during perfusion with HCO3-/CO2- buffered solutions, stimulation with acetylcholine results in a transient loss of HCO3- from the acinar cells (causing a transient acidosis), and, independently, the activation of Na+-H+ exchange (causing a sustained alkalosis). In the unstimulated gland, DIDS and the HCO3- -free perfusate caused decreases in pHi to 7.12 +/- 0.02 and 7.04 +/- 0.01 respectively. In contrast, amiloride had little effect. The relatively high value of pHi maintained by the unstimulated gland is therefore probably not due to Na+-H+ exchange.

Acetylcholine-induced metabolic changes in the perfused rabbit mandibular salivary gland studied by 31P-NMR spectroscopy

Changes in the content of high-energy phosphates, intracellular pH (pHi) and the ratio of MgATP to total ATP ([MgATP]/[ATP]t) resulting from continuous stimulation with acetylcholine (10(-9) to 10(-4) M) were measured by 31P-NMR spectroscopy in the isolated, perfused rabbit mandibular gland at 37 degrees C. With 10(-9) to 10(-7) M acetylcholine, no significant changes in these parameters were observed. On stimulation with 10(-6) M acetylcholine, the optimal concentration for sustained secretion, the content of ATP decreased by 28 +/- 10% (mean +/- S.E.; n = 8) of its control value. pHi decreased initially by approx. 0.05 pH unit, then showed an alkalinization of 0.09 +/- 0.02 pH unit (n = 8). With 10(-5) and 10(-4) M acetylcholine, changes in ATP and pHi were similar to those induced by 10(-6) M acetylcholine: the total content of high-energy phosphates remained at approx. 70% of the control value and no decrease in [MgATP]/[ATP]t was observed. As possible causes of the reduced secretory rate observed with higher concentrations of acetylcholine (10(-5) to 10(-3) M), we can exclude depletion of high-energy phosphates, inhibition of metabolism caused by intracellular acidosis, and inhibition of ATP usage caused by a decrease in MgATP availability.

[Coronary artery blood flow velocity non-invasively measured using a vessel-tracking pulsed Doppler system]

A newly-developed noninvasive method was used to measure left coronary blood flow during phantom experiments. Two techniques were used in which: (1) the sample position can always be set in a fluctuating vessel using a wall echo-tracking method with a phase-locked-loop, and (2) the Doppler reference signal was generated separately synchronous with the wall echo signal. These techniques were combined, using a commercially available pulsed Doppler apparatus (SSH-40B: Toshiba). Basic experiments were performed using a blood vessel phantom to verify the validity of these systems. Blood flow velocity in the fluctuating tube could be measured clearly using a vessel-tracking method. The blood flow velocity of the left anterior descending artery was measured in three normal subjects and in seven patients from the third intercostal space along the left sternal border. The velocity pattern was characterized by a crescendo-decrescendo shape in diastole. The peak velocity which appeared in diastole ranged from 19 to 69 cm/sec, with no difference by disease entity. However, in all cases, the blood flow velocity signals were marred by extraneous signals, making it impossible to measure blood flow velocity during systole. Further improvement of the system is mandatory in order to use this flowmeter clinically.

Phosphorous compounds studied by 31P nuclear magnetic resonance spectroscopy in the taenia of guinea-pig caecum

1. In the isolated taenia (0.4-0.6 g) of guinea-pig caecum, the intracellular phosphorous compounds and pH were investigated using 31P nuclear magnetic resonance (NMR) under various metabolic conditions. 2. The ratios of the intracellular concentration of phosphocreatine ([ PCr]) and inorganic phosphate [( Pi]) to nucleotide triphosphate ([ NTP]) were 1.71 +/- 0.14 and 0.58 +/- 0.11 (n = 25), respectively, in normal solution (32 degrees C). The intracellular pH estimated from the chemical shift of Pi was 7.05 +/- 0.06 (n = 25), agreeing well with those previously obtained. 3. In the absence of glucose, the [PCr] and [NTP] were decreased to almost a half after 150 min exposure to 40 mM-K+ solution, while [Pi] was increased 3-fold. These changes were much faster than the rate of decline in tension. When glucose was readmitted, the contractile response to K+ fully recovered in 50 min. However, this was accompanied with only a partial recovery of [PCr] and [Pi], but no recovery of [NTP]. The intracellular pH was lowered by about 0.2 of a unit, suggesting an increase in glycolysis. 4. In Ca2+-free solution, respiratory inhibition with hypoxia or CN (1 mM) only decreased [PCr], leaving [NTP] nearly unchanged. On the other hand, respiratory inhibition in excess-K+ solution containing Ca2+ (2.4 mM) severely depleted PCr and decreased [NTP] to 40%. Increasing glucose to 50 mM did not prevent these changes, although it increased tension development. 5. The simultaneous decrease of [NTP] and [PCr] during K+ contracture suggests that the activity of creatine phosphokinase is low. The recovery from respiratory inhibition was much better for [PCr] than for [NTP]. Slow, but perfect, recovery of all NTP peaks was produced by adding 1 mM-adenosine to normal solution. 6. It was suggested that tension development is closely related to the turnover rate of ATP, and not to its concentration, and that deamination of adenosine is a limiting factor in the recovery of ATP after excessive consumption.

NMR-invisible ATP in rat heart and its change in ischemia

The subcellular compartmentalization of adenosine 5'-triphosphate (ATP) in isolated perfused rat heart and its relation to energy depletion in ischemia were examined by 31P nuclear magnetic resonance (31P-NMR) spectroscopy and chemical analyses. The signal intensities of the beta-phosphate of ATP and creatine phosphate in the 31P-NMR were standardized by the intracellular volume ratio measured with 23Na-NMR to determine the actual content of each. During aerobic perfusion the ATP content determined by NMR (13.7 +/- 2.2 mumol/g dry weight) was significantly lower than that found by chemical analysis (22.4 +/- 0.7 mumol/g dry weight), while the creatine phosphate contents determined by the two methods were the same. During ischemia at 33 degrees C, the signal of the beta-phosphate of ATP in the 31P-NMR spectrum decreased progressively, disappearing completely after 16 min. But at this time 5.7 +/- 1.7 mumol/g dry weight of myocardial ATP was still detected by chemical analysis. These results indicated that there were two different compartments of intracellular ATP in the heart, only one of which is detectable by 31P-NMR spectroscopy, and that during ischemia the ATP that is detectable, which seems to be the free ATP in the cytosol, decreased more rapidly than the ATP in the other compartment.

Dissociation of fluid secretion and energy supply in rat mandibular gland by high dose of ACh

The effects of a high dose of acetylcholine (ACh) on oxygen consumption (VO2) and changes in phosphorus energy metabolites during secretion were studied in isolated perfused mandibular gland of rats at 24 degrees C. Sugar phosphates (SP), Pi, phosphocreatine (PCr), and ATP were identified by phosphorus-31 nuclear magnetic resonance spectroscopy. One micromole ACh induced a tachyphylactic secretory response, a persistently elevated VO2, and decreased PCr and ATP; 1 mM ACh caused an initial burst of secretion that was followed by suppression of secretion and a rapid increase in the VO2 to the same level as that with 1 microM ACh. These findings indicate a dissociation between secretion and VO2. During stimulation with 1 mM ACh, the level of PCr first decreased and then partially recovered, but the level of ATP continued to decrease and the levels of Pi and SP increased markedly. These findings suggest compartmentalization of creatine phosphokinase (CPK) systems and the possibility that a high concentration of ACh interferes with the transport of PCr between one CPK system near adenosinetriphosphatase and another system near mitochondria in acinar cells.

Cortical blindness caused by acute general cerebral swelling

A 7-year-old girl who suffered from acute general cerebral swelling as a result of a traffic accident showed cortical blindness. Computed tomography (CT) scan on admission revealed marked slitlike ventricles and narrowing of the perimesencephalic cisterns, which indicated general cerebral swelling. While hospitalized, the patient developed transtentorial herniation twice on day 3, and CT scans at herniation episodes showed disappearance of the perimesencephalic cisterns. After recovery of consciousness, the patient showed cortical blindness, and during gradual recovery she showed pure alexia without agraphia. The visual evoked potentials at 8 weeks, 16 weeks, and 3 years 4 months after trauma showed normalization of the pattern, but revealed left occipital inactivity.

Phosphorus nuclear magnetic resonance in isolated perfused rat pancreas

Phosphorus nuclear magnetic resonance spectroscopy was applied to measure phosphorus energy metabolites in isolated perfused rat pancreas. The gland was perfused with a modified Krebs-Henseleit solution at room temperature (25 degrees C). 31P resonances of creatine phosphate (PCr), ATP, ADP, inorganic phosphate (Pi), and phosphomonoesters (PMEs) were observed in all the preparations of pancreas. In different individual preparations, the resonance of PCr varied, but those of ATP were almost the same. The initial levels of PCr and ATP in individual preparations, however, remained almost unchanged during perfusion with the standard solution for 2 h. When the perfusion was stopped, the levels of ATP and PCr decreased, while the levels of PME and Pi increased. At that time, the Pi resonance shifted to a higher magnetic field, indicating that the tissue pH decreased. On reperfusion, the tissue levels of phosphorus compounds and the tissue pH were restored to their initial resting levels. Continuous infusion of 0.1 microM acetylcholine caused marked and sustained increases in the flow of pancreatic juice and protein output. During the stimulation the tissue levels of phosphorus compounds remained unchanged, while the tissue pH was decreased slightly (0.05 pH unit).

An experimental approach to 31P spin-lattice relaxation time measurement in biological systems

The accuracy of measurement of the spin-lattice relaxation time (T1) in biological systems using the variable nutation angle method is discussed using computer simulations. This method could reduce the time required for measurement to 10% of that using the inversion recovery method. In the perfused salivary gland of the rat (310 K), the T1 values of sugar phosphates, creatine phosphate, gamma-phosphate, and beta-phosphate of nucleotide triphosphates determined by this method were 5.2, 4.8, 0.9, and 0.8 s, respectively. During secretion of saliva, the T1 value of sugar phosphates decreased to 3.7 s, which could be due to an increased chemical exchange of phosphate in glycolysis.

[A case of colon cancer with pulmonary metastasis treated effectively by uracil futraful]

A 57-year-old female was admitted for advanced ascending colon cancer with a solitary pulmonary metastasis measuring 1.5 cm in diameter. As laparotomy revealed an absolute noncurable tumor of stage V (H0, p2, s2 n1 (+], palliative right hemicolectomy was performed. A pathological diagnosis of well differentiated adenocarcinoma was made postoperatively. A daily dose of 400 mg of UFT was given orally. After 8 months, plain chest film and tomography revealed a reduction in the size of the pulmonary metastasis to 1.0 cm in diameter. The metastatic lung tumor was controlled for a period of 1 year and 9 months. It was suggested that UFT was rather effective for pulmonary metastasis from colon cancer.

Evaluation of intraoperative radiotherapy for carcinoma of the pancreas: prognostic factors and survival analyses

Among 145 patients with carcinoma of the pancreas who had been admitted to three institutions between 1976 and 1985, 117 were entered into a prognostic factor analysis system according to Cox's proportional hazards model. The treatment was classified into four modalities: bypass surgery, single-dose intraoperative radiotherapy (IOR), IOR combined with external irradiation, and resection with or without various radiations. The most important prognostic factors for treatment were identified as location of tumor, TNM stage, and relief of back pain. Adjusting the imbalances among the treatment groups using Cox's model, the superiority of IOR with external irradiation was confirmed for both bypass and single-dose IOR. With this adjustment, the survival rates proved to be more meaningful than the simple Kaplan-Meier estimates.

[Serum concentration of 5-FU and tegafur (FT-207) after administration of tegafur (FT-207) suppository with the colostomy]

Tegafur (FT-207) suppositories were administered at a rate of 750 mg via the artificial anus (ST Group) following surgery of rectal cancer. Comparative studies were conducted of changes in blood concentrations of 5-FU and tegafur at the time of initial administration and following one week of continuous use for the low-anterior resection cases (LA Group) and the rectal administration cases (RE Group). FT-207 concentration at initial administration was low in the ST group compared to those for both LA and RE groups which received anal administration of the drug, but only little changes were noted. Blood concentration one hour after administration was 11.1 micrograms/ml, elevated to 14.3 micrograms/ml at two hours, and remained at 10 micrograms/ml and above for six hours following administration. The ST group 5-FU concentrations at two, four and six hours after administration were significantly lower than those in the RE group but the changes were little. Blood concentrations were 0.015 microgram/ml at one hour after administration, 0.017 micrograms/ml at two hours and maintained virtually the same level thereafter. An effective concentration of 0.012 microgram/ml was maintained even at ten hours following administration. After one week of administration of the suppositories, the ST group showed the lowest concentration among three groups, but it was approximately double compared to the initial concentration; FT-207 showed nearly the same concentration in the LA group and 5-FU blood concentration was 0.025 microgram/ml at one hour after administration, reached to a maximum of 0.030 microgram/ml at two hours and maintained 0.020 microgram/ml and higher at ten hours. 5-FU concentration in the LA and RE groups after one week of continuous administration showed a dual-peaked pattern. No patient with an abnormal artificial anus was involved in this study. The artificial anus is thought to be an adequate and effective administration route of FT-207 suppositories.

Direct measurement of Na influx by 23Na NMR during secretion with acetylcholine in perfused rat mandibular gland

Intracellular Na content (Nain) in the perfused rat mandibular gland was measured by using a 23Na NMR spectroscopy at 24 degrees C. An aqueous chemical shift reagent, dysprosium triethylenetetramine-N,N,N',N",N"'N"'-hexaacetic acid [Dy(TTHA)] was used in order to discriminate between the intracellular and the extracellular Na signal. The mandibular gland of rat was perfused arterially with a modified Krebs solution containing 10 mM Dy(TTHA). At rest, Nain was not changed by blocking the Na+/K+ ATPase with ouabain (1 mM) and atropine (3 microM), implying that, in the absence of stimulation, the spontaneous Na influx across the plasma membrane must have been negligibly small. Following onset of stimulation with acetylcholine (1 microM), Nain increased by 9.1 +/- 1.5 mmol/l intracellular fluid (mean +/- SEM, n = 13), and remained at this level during stimulation. In the initial phase of secretion (0-5 min), about 50 mmol/min/l intracellular fluid of Na was secreted into the luminal space (estimated from the secretory rate by assuming an isotonic primary secretion) but, in spite of the higher secretion rate, Nain increased only at an initial rate of 4.1 mmol/min/l intracellular fluid. During the steady phase of secretion (15-30 min) evoked by acetylcholine (1 microM), ouabain (1 mM) caused an increment of Nain of 44 +/- 8 mmol/l intracellular fluid (mean +/- SEM, n = 4). From the rate of Nain increment, the Na influx rate at the steady phase was estimated as 4.5 mmol/min/l intracellular fluid. These results suggest that the influx of Na is caused by stimulation with acetylcholine.(ABSTRACT TRUNCATED AT 250 WORDS)

High resolution 23Na-nuclear magnetic resonance study of stroke-prone spontaneously hypertensive rat erythrocytes

The intracellular Na+ content of washed erythrocytes from stroke-prone spontaneously hypertensive rats (SHRSP) and Wistar-Kyoto normotensive rats (WKY) was measured by a high resolution 23Na-nuclear magnetic resonance (NMR) technique using a non-permeant aqueous shift reagent, dysprosium triethylenetetramine hexaacetic acid, Dy(TTHA)3-. The initial intracellular Na+ of freshly isolated and washed erythrocytes was very low (approximately 5 mmol/l) and increased progressively with prolonged incubation in isotonic salt solution at 37 degrees C. There was no significant difference in the erythrocyte Na+ concentration between SHRSP and WKY over the entire period of measurement, nor was any difference detected in their osmotic fragility or total cellular volume, although the osmotic fragility decreased with incubation time. The high energy phosphate metabolites were also studied in the same erythrocytes by 31P-NMR. The level of intracellular ATP decreased with incubation at 37 degrees C but showed no difference between the SHRSP and WKY samples. Inclusion of 1 mmol/l ouabain in the incubation medium substantially retarded the breakdown of intracellular ATP and resulted in a concomitant increase in intracellular Na+. However, neither the ouabain-sensitive nor the ouabain-insensitive component of Na+ influx altered in SHRSP erythrocytes compared with WKY erythrocytes in paired experiments. Our results do not support the hypothesis that altered Na+ transport, resulting in an increase in erythrocyte Na+ concentration, is associated with spontaneous hypertension.