Host Defense Dysfunction in Trauma, Shock and Sepsis

Section 1 General Aspects/Perspectives.- Progress in Trauma Care Through Understanding the Cell Biology of Injury.- Trauma, Sepsis and Immune Defects.- Clinical Factors Influencing Host Defense Integrity.- The Intensive Care Unit of Tomorrow.- Section 2 Host Defense Integrity-Response and Stress.- How the Immune System Discriminates Infectious Nonself from Noninfectious Self.- Signal Transduction Mechanisms: Pathophysiologic Alterations.- Neuroendocrine Regulation of Immune Function.- Beneficial Effects of Stress Response Blockade on Patients Undergoing Surgery.- The Impact of Preexisting Disease Conditions for Host Defense Integrity in Traumatized and Critically Ill Patients.- Section 3 From Injury to Multiple Organ Failure: Sequential Steps of Host Defense Impairment.- 3.1 Shock and Ischemia.- Oxygen Radical-Mediated Endothelial Cell Injury.- Characteristics of Neutrophil Dysfunction.- Endothelial Dysfunction as an Early Critical Event in Ischemia and Shock.- Role of Oxidants, Proinflammatory Agents, and Granulocytes in the Post Ischemic Intestine.- Hepatic Parenchymal and Nonparenchymal Cells in Hemorrhage and Ischemia.- Acute Lung Injury Following Shock and Major Trauma.- Hemorrhage-Induced Alterations in Cell-Mediated Immune Function.- 3.2 Intermediate Inflammatory Phase.- Sepsis and Multiple Organ Failure: The Result of Whole Body Inflammation.- Multiple Organ Failure (MOF), and Whole Body Inflammation After Multiple Trauma.- Neutrophils, Cytokines, Oxygen Radicals, and Lung Injury.- The Role of ?2- Leukocyte Integrins In Vivo.- The Angry Macrophage and Its Impact on Host Response Mechanisms.- Eicosanoids, Cytokines and Altered Metabolic Control in the Evolution of the Posttraumatic Host Defense Failure Syndromes (Adult Respiratory Distress Syndrome and Multiple Organ Failure Syndrome).- Diagnostic Role of New Mediators and Markers of Inflammation in Multiple Injured Patients.- Intravascular Activation of Polymorphonuclear Neutrophils in Critically Ill Anergic Patients.- Mediators of Remote Lung Injury.- 3.3 Sepsis.- Immunologic Dyshomeostasis in Multiple Organ Failure: The Gut-Liver Axis.- Tumor Necrosis Factor and Other Cytokines as Mediators of Clinical Sepsis.- The Protein C System in Septic Shock.- Leukocyte-Endothelial Interactions in Trauma and Sepsis.- Role of Oxygen Radicals in Multiple Organ Failure.- Arachidonic Acid Metabolism in Endotoxemia and Sepsis: Therapeutic Approaches.- Section 4 Immune Mechanisms for the Control of Infection Under Physiologic and Stressful Conditions.- Biology and Function of Cytotoxic T-Cells.- Immune Response of Heat Shock Proteins.- Prostaglandins Mediate the Expression of a 72-kDa Heat Shock Protein in Human Fibroblasts.- Glucocorticoid-Immune System Interactions in Injury and Sepsis.- Hemorrhagic Shock Inhibits Myelopoiesis Independent of Bacterial Translocation.- Monocyte HLA-DR Antigen Expression: Its Reproducibility in Asymptomatic Volunteers and Correlation with Clinical Infection.- Phenotypic and Functional Characteristics of Peripheral Blood Lymphocytes in a Defined Group of Polytrauma Patients.- Cell-Mediated Immunity During and After Cardiopulmonary Bypass.- Alterations in Function and Phenotype of Monocytes from Patients with Septic Disease: Predictive Value and New Therapeutic Strategies.- Effects of Exercise on the Immune System with Special Reference to Natural Killer Cells.- Interaction of Immune, Interferon, and Opioid Systems in Professional Athletes.- Section 5 Inflammatory Mechanisms in Traumatic and Septic Injury.- White Cells in Burn Patients.- Fibronectin Degradation: An In Vitro Model of Neutrophil Mediated Endothelial Cell Damage.- Adenosine Inhibits Postischemic Leukocyte Adherence to the Endothelium of Postcapillary Venules via A2-Receptor.- Prostaglandin E1 Inhibits the Stimulation of Neutrophils In Vitro and In Vivo and Improves Cardio-Respiratory Functions in Multiply Traumatized Patients at Risk of Adult Respiratory Distress Syndrome.- Production and Characterization of Peptide-Specific Monoclonal Antibodies that Recognize a Neoepitope on Hog C5a.- The Oxidative Burst Reaction of Neutrophils is Reduced by the Acute Phase Serum Amyloid-A Protein.- Interaction of Pentoxifylline and Adenosine in the Inhibition of Superoxide Anion Production of Human Polymorphonuclear Leukocytes.- Adhesive Interactions of Neutrophils with Endothelial Cells.- Endothelial Cell Stimulation by Anti-CD9 Antibodies.- Decrease in Leukotriene Synthesis from Leukocytes Isolated in Septic Patients.- Aggravation of Ischemia-Reperfusion Injury in the Striated Muscle Microcirculation by Acute Endotoxemia.- Selective Inhibition of Polymorphonuclear Leukocyte Oxidative Burst and CD11b/CD16 Expression by Prostaglandin E2.- The Role of Lysosomal Cysteine Proteinases as Markers of Macrophage Activation and as Nonspecific Mediators of Inflammation.- Endothelin Mediates a Ca2+ Activation Signal in Human Monocytes.- Nitric Oxide Synthesis in Sponge Matrix Allografts Coincides with the Initiation of the Allogeneic Response.- Neutrophil Elastase Induces Lung Injury Following Lower Limb Ischemia.- PMN Elastase in Local Infection.- Opioids from Immune Cells Interact with Receptors on Sensory Nerves to Inhibit Nociception in Inflammation.- Section 6 Hepatocellular Injury in Ischemia, Trauma and Sepsis.- An In Vitro Model of Hepatic Failure in Septic Shock.- Ischemia-Reperfusion Injury of the Liver: Role of Neutrophils and Xanthine Oxidase.- Nitric Oxide Regulates Prostaglandin E2 Release by Rat Kupffer Cells.- C3a and C5a in Liver Transplantations During Bypass, Reperfusion and the Postoperative Phase.- Effect of Superoxide Dismutase on Altered Hepatic Calcium Regulation During Gramnegative Sepsis.- Role of Liver Macrophages (Kupffer Cells) in Bacterial Cell Wall-Induced Hepatic Inflammation.- Tumor Necrosis Factor Alpha Inhibits Hepatocyte Mitochondrial Respiration and Induces Release of Cytoplasmic Enzymes.- Modulation of Hepatic Mitochondrial Fat Oxidation and Hepatic Gene Transcription by Tumor Necrosis Factor.- Increased Leukocyte Adhesion in Liver Sinusoids Following Superior Mesenteric Artery Occlusion in the Rat.- Section 7 Cytokines and Modulation of Cytokine Action.- Gene Knockout: New Approach to the Physiology of Cytokines.- The Role of Interleukin-1 and Other Macrophage-Derived Cytokines in Macrophage-T-Cell Interactions.- Interleukin-1-Induced Hypotension and the Effect of an Interleukin-1 Receptor Antagonist.- Interleukin-8 (Neutrophil-Activating Peptide-1) and Related Chemotactic Cytokines.- Cellular and Molecular Mechanisms that Regulate the Production of Interleukin-8: The Potential Role of Chemotactic Cytokines in Acute Respiratory Distress Syndrome and Multiple Organ Failure.- Generation and Properties of Neutrophil-Activating Peptide 2 (NAP-2).- Soluble and Cell Surface Receptors for Tumor Necrosis Factor.- Regulation of Cytokine Synthesis Through Cyclic Nucleotides.- Removal of Circulating Cytokines by Hemodialysis Membranes In Vitro.- Modulation of Monokine Production In Vitro by Human Intravenous Immunoglobulin.- Transforming Growth Factor ?1 Upregulates the Interleukin-2 Receptor ? Promoter.- Section 8 Cytokines in Acute Phase States and Trauma.- Interactions of Immunopathological Mediators (Tumor Necrosis Factor-?, -?, Prostaglandin E2) in Traumatized Individuals.- In Vitro Production and Secretion of Interleukin-1 by Human Monocytes After Surgical Trauma.- The Biological Characteristics of Cytokines and Their Interactions with Prostaglandins Following Hemorrhagic Shock.- The Response of Interleukin-1 and Interleukin-6 in Patients Undergoing Major Surgery.- Possible Role of Cytokines in the Stress Response of the Hypothalamo-Pituitary-Adrenal Axis During Upper Abdominal Surgery.- The Synthesis of Stress Proteins in Cultured Cardiac Myocytes Is Induced by the Interleukins and Tumor Necrosis Factor.- Effects of Tumor Necrosis Factor on the Hypothalamic-Pituitary-Adrenal Axis.- Interleukin-2-Modulated Cytokine Secretion in Thermally Injured Patients.- Cytokine Treatment of Radiation-Induced Hemopoietic Suppression: Results of Interleukin-6 and Granulocyte Colony-Stimulating Factor in a Murine Radiation Model.- Circulating Tumor Necrosis Factor in Active Inflammatory Bowel Disease.- Interleukin-1 and Tumor Necrosis Factor-? Suppress Hypoxia-Induced Production of Erythropoietin In Vitro.- Neopterin, Interferon-?, and Immunodeficiency States.- Systemic Cytokine Response to Strenuous Exercise.- Section 9 The Mediator Role of TNF in Sepsis.- Activation of Neutrophils by Tumor Necrosis Factor-? During Sepsis.- Distinct Subpopulations of Human Peripheral Blood Monocytes Characterized by Absence of the CD14 Surface Marker, and Distinguished by High or Low Intracellular Glutathione.- The Role of Endotoxins in Burns: Anomalies in Cytokine Regulation of Immunity.- Role of Tumor Necrosis Factor on Pseudomonas Aeruginosa Infection and on Antitumor Activity in Relation to Arachidonic Cascade.- Survival from Cecal Ligation and Puncture and the Formation of Fibrous Adhesions in the Peritoneal Cavity Depend on Endogenous Tumor Necrosis Factor.- The Cellular Mechanisms of Tumor Necrosis Factor-Induced Mortality: A Possible Role for Platelet Activating Factor and/or the Eicosanoids.- Section 10 Endotoxin-Mechanisms of Action and Protection from Shock.- Molecular Mechanisms of Lipopolysaccharide-Induced Cytokine Production by Monocytes.- Natural Endotoxic Shock Protection by Soluble CD14.- Use of Monophosphoryl Lipid A as a Prohylactic for Sepsis and Shock.- Hemodynamic and Pulmonary Response to Treatment with On-Line Adsorption on Polymyxin B During Endotoxemia in Pigs.- Apolipoprotein A-I Enriched Lipoprotein Attenuates Tumor Necrosis Factor Production and Shock in an Anesthetized Rabbit Endotoxemia Model.- Escherichia Coli-Induced Septic Shock in the Baboon: An Animal Model for the Evaluation of Neutralising Monoclonal Antibodies to Phospholipase A2.- Leukotriene Inhibitor and Antagonist Prevent Endotoxin Lethality in Carrageenan-Pretreated Mice.- Effect of Type-Specific Antiserum on the Pulmonary Hypertensive Response to Group B Streptococcus in Piglets.- Detection of IgE Reactive with Lipopolysaccharide in Plasma of Traumatically Injured Patients.- Altered Guanine Nucleotide Protein Function: Potential Role in Endotoxin Tolerance.- Section 11 Clinical Aspects of Multiple Organ Failure.- The Pattern of Organ Failure Following Severe Trauma-A Postmortem Study.- Hypertonic Volume Therapy: A Feasible Regimen to Contribute to the Prevention of Multiple Organ Failure?.- A New Sepsis Scale for Burns: Correlation with Endotoxin and Host Response.- Multiple Organ Failure: Clinical Characteristics of Gut-Origin Septic States.- Intraperitoneal Infections and Multiple Organ Failure.- The Role of Empirical Laparotomy in the Management of Sepsis and Multisystem Organ Failure.- Management of the Wound as Therapy for Multiple Organ Failure.- Aggressive Enteral Nutrition Reduces Sepsis in the Hypercatabolic Injured Patient.- Clinical-Mediator Correlations of Multiple Organ Failure and Preventive/Therapeutic Strategies: To Block Stimulate or Replace? That is the Question.- Section 12 The Pathophysiologic Impact of Bacterial Translocation and Strategies for Its Prevention.- Bacterial Translocation Following Major Thermal Injury in Rats, Sheep, and Mini-Pigs.- Does Early Portal Bacteremia/Endotoxemia Prime for Postinjury Multiple Organ Failure?.- Prevention of Bacterial Translocation with Early Enteral Feeding-A Feasible Approach?.- Gut-Derived Infectious-Toxic Shock Syndrome: Therapeutic Chances with Polyspecific Immunoglobulins.- Maintenance of Gastrointestinal Integrity After Burn Injury with Specific Dietary Supplementation and Epidermal Growth Factor.- Selective Decontamination of the Digestive Tract: Open Questions and Controversies.- Selective Decontamination of the Digestive Tract (SDD): Review of Available Clinical Studies.- Nonselective Gut Decontamination for Avoidance of Bacterial Translocation in Shock.- Section 13 Antibiotic Interactions with Host Defenses.- Antibiotics and Phagocytic Cell Function: A Critical Review.- Interaction of Antibiotics with the Phagocyte Oxidative Burst.- Intraphagocytic Cell Penetration and Intracellular Bioactivity of Antibiotics.- Extraphagocytic Killing of Bacteria in the Presence of Antibiotics.- Cell Wall Inhibitors and Bacterial Susceptibility to Phagocytosis.- Protein Synthesis Inhibitors and Bacterial Susceptibility to Phagocytosis.- Section 14 The Role of Nutrition in Host Defense.- Augmentation of Host Defense Reactivity with Special Nutrients.- The Role of Structured Lipids in Host Defense Interactions.- Manipulation of Cytokine Synthesis Through Dietary Lipids.- Dietary Fish Oil Prevents Postischemic Leukocyte/Endothelium Interaction Through Inhibition of Leukotriene Biosynthesis.- Dietary Requirement for Preformed Purine and Pyrimidine Bases for Intact Function of Cellular Immune Response: A Review.- Relationship of Plasma Acute-Phase Protein to Amino Acid Levels During High-Dose Branched Chain Amino Acid Support in Sepsis.- Section 15 New Insights into the Mechanisms of Wound Healing.- Wound Management and the Stress Response.- The Role of the Wound in Posttraumatic Immune Dysfunction.- The Role of Growth Factors in the Regulation of Wound Repair.- An Adverse Wound Environment Reduces Leukocyte Phagocytosis and Protein Synthesis.- Basic Fibroblast Growth Factor Inhibits the Release of Oxygen Radicals by Human Granulocytes.- The Influence of Liver Regeneration on Skin Wound Healing and Lymphocyte Growth Features.- Section 16 Therapeutic Immunomodulatory Approaches: Prevention.- Therapy of Secondary T-Cell Immunodeficiencies with Biological Substances and Drugs: An Update.- Progress in Antiinfective Perioperative Immunomodulatory Therapy with Simultaneous Administration of Blocking and Enhancing Agents.- Effect of Immunomodulation of Skin Test Reactivity Following Trauma.- Therapeutic Use of Cytokines: Animal Models.- The Rationale for Gamma-Interferon Administration in Trauma Patients.- Immunomodulators of the Thermal Injury Response.- Section 17 Endotoxin Neutralization with IV-Immunoglobulins and Monoclonal Antiendotoxin Antibodies.- Antiendotoxic Therapy with Polyclonal and Polyvalent Immunoglobulins: In Vitro and In Vivo Studies.- The Use of Polyvalent Immunoglobulin G in Patients with Sepsis and Multiple Organ Failure.- Clinical Effects of Immunoglobulin Administration in Patients with Major Burn Injury.- Treatment of Gram-Negative Septic Toxic Diseases with an Immunoglobulin Preparation Containing IgG, IgM, and IgA: A Prospective Randomized Clinical Trial.- Immunotherapeutic Strategies for Passive Immunization Against Pseudomonas aeruginosa.- Binding Characteristics of the Antiendotoxin Antibody Xomen-E5 to Bacterial Whole-Cell Antigens.- Immunotherapy with Human Antiendotoxin Antibodies in the Treatment of Gram-Negative Sepsis: Practical Considerations.- The Use of Antibody Specificity and Affinity in Determining the Protectiveness of Human Monoclonal Antibodies Against Fatal Infections with Nosocomial Gram-Negative Bacteria.- Section 18 Interventional Strategies in the Therapy of Septic Shock.- Potential Benefits of Platelet Activating Factor Receptor Antagonists in Endotoxemia/Sepsis.- Phospholipase A2: A New Target for Monoclonal Antibody Therapy in Sepsis.- Administration of Antiadhesion Molecules: A Feasible Approach?.- Local Administration of Interleukin-2 Protects Mice from Lethal Intra-Abdominal Bacterial Sepsis.- Murine Intraabdominal Abscess: Immune Modulation with Interferon-?.- Acute Resuscitation and Antioxidant Therapy.- Clinical Indications for the Administration of Oxygen Radical Scavengers.- First Experiences with Recombinant Human Superoxide Dismutase Therapy in Polytraumatized Patients.