ALTERED MICROCIRCULATION IN SEPTIC SHOCK.

Retrospective data analysis of microcirculation in septic shock was conducted. Sepsis is characterized by a severe microvascular dysfunction that persists despite fluid resuscitation and leads to multi-organ failure even after normalization of hemodynamics in response to fluid resuscitation, vasopressors and the treatment of infection. Several clinical studies suggest that microcirculatory alterations in severe sepsis are stronger predictors of outcome than global hemodynamic variables.

Vasoplegia in septic shock (review).

Vasoplegia is considered as a key factor responsible for the death of patients with septic shock, due to persistent and irreversible hypotension. The latter associated with vascular hyporeactivity to vasoconstrictors is a significant independent prognostic factor of mortality in severe sepsis. Loss of control of the vascular tone occurs through the complex, multifactorial mechanism and implicates deeply disrupted balance between vasoconstrictors and vasodilators.

Myocardial dysfunction during septic shock (review).

Patients with septic shock frequently develop myocardial dysfunction evidenced by severely depressed ejection fraction with ventricular dilatation, as measured by an increase in mean systolic and end diastolic ventricular volumes. The pathophysiology of myocardial dysfunction is complex and involves a multitude of factors. The current review describes individual contributing factors and mechanisms such as upregulation of proinflammatory cytokines (IL-1, TNFα, IL-2, IL-6, IFN-γ), reduced myocardial responsiveness to ß-adrenergic stimulation, elevated circulating endothelin levels, Impaired calcium uptake and release from calcium sarcoplasmic reticulum storage, and decreased calcium channel sensitivity, overexpression of inducible NOS and increased production of Nitric oxide.

[Somatic mutations of the P53 gene in stomach cancer].

The paper deals with a study of p53 gene somatic mutations in tumor cell genomes from patients with stomach cancers of different histological patterns. It used sequential and molecular cloning methods. The former involved amplicones characterized by abnormal volatility following SSCP analysis of plasmids from 9 tumors.

[Immunogenetic prognosis and long-term results of surgery for gastric cancer].

A link between HLA allelic variants and long-term results of surgery for gastric tumors was established on the basis of a 10-years follow-up of 112 cancer patients (stage I-II--37.9, III-IV--62.1%; radical surgery--44.