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
Blood is thicker than water der Glîchezære. The 13th-century Heidelberg manuscript reads in part, "ouch hoer ich sagen, das sippe blůt von wazzere niht verdirbet" (lines 265-266). In English it reads, "I also hear it said, kin-blood is not spoiled by water." which may in part refer to distance not changing familial ties or duties, due to the high seas being tamed. In 1412, the English priest John Lydgate observed in "Troy Book", "For naturally blood will be of kind / Drawn-to blood, where he may it find." By 1670, the modern version was included in John Ray's collected "Proverbs", and later appeared in Sir