Steven-Johnson Syndrome: A Rare but Serious Adverse Event of Nivolumab Use in a Patient With Metastatic Gastric Adenocarcinoma.

Nivolumab is a humanized monoclonal anti-programmed cell death receptor-1 (PD-1) antibody that has been authorized for use in the treatment of advanced malignancies. Cutaneous reactions are the most common immune-related adverse events reported with anti-PD-1 agents, and they range broadly from mild localized reactions to rarely severe or life-threatening systemic dermatoses. The occurrence of Steven-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) with nivolumab use is an exceedingly rare phenomenon that was only documented in a handful of cases in the current literature, but it deserves careful attention as SJS/TEN may be associated with fatal outcomes.

[Local circulatory regulation: the characteristics of the behavior of vascular smooth muscles].

The general law of local regulation of the circulation and the "law of behaviour" of vascular smooth muscle are proposed on the basis of precise definition of hierarchically interrelated aims of the circulation: 1) stabilization of substances and heat fluxes through the tissue, 2) stabilization of the tissue environment at farthest points from the supplying vessels, and 3) minimization of circulating blood volume. The laws allow to unite modern theories of metabolic, myogenic and neurogenic regulation of vascular tone. A mathematical model of the vascular bed functioning in accordance with these laws, simulates the behaviour of real preparations in changes of arterial, venous or tissue pressure as well as of arterial blood composition and tissue metabolism.

[Organization of the process of autoregulation of cerebral blood flow].

Continuous recording of local blood flow in the cat cerebral cortex (the technique of electrochemical generation of hydrogen in brain tissue) revealed dynamic characteristics of autoregulation of the cerebral blood flow (CBF) during changes in the systemic arterial blood pressure. The autoregulation has a three-component character due to joint functioning of the mechanisms of myogenic, neurogenic and metabolic nature. The myogenic mechanism seems to protect the vascular bed of the brain from the impact of sharp changes in the intravascular pressure and is but indirectly involved in the CBF regulation, the latter being accomplished mainly by the hierarchically interacting nervous and metabolic mechanisms.

[Regulation of local cerebral blood flow: the concept of the homeostatic range].

Multichannel recording of the intensity of local blood flow in neighbouring microareas of the cortex was performed in acute experiments on cats under the conditions of: a) changes of systemic arterial pressure and b) asphyxia by the method of electrochemical generation of hydrogen. On the basis of data obtained a hypothesis was formulated on the existence of "homeostatic range" of local blood flow intensity and its displacement when the metabolic demand of nervous tissue and/or the degree of arterial blood saturation with oxygen are altered. The hypothesis explains the causes of temporal and amplitude differences in characteristics of changes of local blood flow in neighbouring microareas of the cortex under the effects of general character as well as the mechanism responsible for the development of posthypoxic hyperemia.