Apparent mineralocorticoid excess syndrome Apparent mineralocorticoid excess syndrome Apparent mineralocorticoid excess (AME) is an autosomal recessive disorder causing hypertension (high blood pressure) and hypokalemia (abnormally low levels of potassium). It was found by Dr Maria I. New at Weil Cornell Hospital in New York City. It results from mutations in the "HSD11B2" gene, which encodes the kidney isozyme of 11β-hydroxysteroid dehydrogenase type 2. In an unaffected individual, this isozyme inactivates circulating cortisol to the less active metabolite cortisone. The inactivating mutation leads to elevated local concentrations of cortisol in the aldosterone sensitive tissues like the kidney. Cortisol at high concentrations can cross-react and activate
Organ (music) of the pipes can be replaced. Non-piped organs include the reed organ or harmonium, which like the accordion and harmonica (or "mouth organ") use air to excite free reeds. Electronic organs or digital organs, notably the Hammond organ, generate electronically produced sound through one or more loudspeakers. Mechanical organs include the barrel organ, water organ, and Orchestrion. These are controlled by mechanical means such as pinned barrels or book music. Little barrel organs dispense with the hands of an organist and bigger organs are powered in most cases by an organ grinder or today by other means such as an