unbridled systemic hyperinflammation. Our investigative effos have Focused onthe puhogneis of ey posiry MOF in wich we propose the “wor” hypebesis fe inal Waumatie sat pines the ilsetary cseade such Wat semndoy, obese iseevus, il an ge 3 ‘oggud respons ding ths vulerable prod. In pura this pate, ‘se dvloped a rodent mode of esnee UR induced MOF Sad denied te Pubolog sequsce: 2) gt FLA, is strated drng Scns b) PMN ae ‘Mantle thgt during ely reperfusion and become pried for; gveaton ia platelet setvaing factor (PAF), c) primed PMN appesr in. the poral Circulation and subsequely inte ssa, d) pm PMING gust be lungs and nt nde) when ated by low dase codtoi, PMN ree hese tue ages vias CDIINCDI pend mecbanism. We fre hractrod the PMN rept PAF in vio, nd and CDI beep eegustin vat foncordnt priming fr 0; greon al lstse ease. Toe he laa televanes of PMN peng. we stro rn patient a ik fc MOF (SS 2225 er SS = 15 and GU ROCII2 he) during he fet 72 hr psi Giealaing PINs were mscedy primed for Of kate (expense to MLD) betvosn and 24 Be and smulsacoaiy he nereeed CDIIb expen Traum pate plasma ebsiea drag this ie period ao pried sted noml PINS. In empaig MOF vera ot-MOF patents, cresting PMN Ibs incensed 3 he postr bu lama by 6 supgesing ety tue sequeaton. Colectney, od sugges PIN pining sa waver respons fo sve injry and renders the aint at isk for MOF. The "seca IN, ding tis vulrable pera, aver PAINE forthe rks of i ‘jie pred, relied eleally by enol lak and paencymal ‘function 9 SIRS, CARS AND MARS CHAOS Roger C. Sone, M0 Purpose and Summary: Our current understanding of sepsis and multiple Sorgen dysfunction needs to bevrevised, aa the unifornly negative results of new therapies for these disorders. suggest. Previous theories for the pathogenesis ef these conditions sre incomplete; reasons for this Snelude the following. First, the surrogate aogels that have been used. £0, study these. dis~ Orders are not enslogous to the clinical sitva- Uon. Second, patients vho have less severe Banifestation’ of these diseases are often over- Tooked. And third, patients’ preexisting condi- tlons have not beet taken into’ account. Consider able new evidence indicates that, in addition toa nessive prolnélamatory’ reaction a compen: the onset of there disofderss At a Local site of injuey or infection and during the Sntieiel appeafance of prov and anti- inflazastory media tofs in the cifeuiation, the beneficial effects of these nediatore outweigh thelr haraful effects. Griy'when the balance between these two forces {s lose do these mediators. become harmful Sequelae of an unbelanced systemic. proinfianna~ tory reaction Include shock, transudation into organs, and defects in coagulation. An unbalanc~ ed systente conpensatory anti-inflansacory Fesponse can result in anergy and {mmunosuppres- Sony The prointlamnatory and antivinflanmatory forcds nay Ultinately reinforce each other, ereating ¢ state of increasingly destructive {Riunolggie “afssonance: Bush-Presby terian-St. Luke's Medical Genter 600"S<"Pauline, suite 200 Chicago, TL 60612, 10 ‘The Role Of The Bene Marrow (Cora K. Ogle PO The prodvten of macophages om Sone race precursor cel sa eynaricad igh regutee process. We have hypatheazed Dot thermal jury can nates se perptuting eyelet pecan of eecive ine cll Thermal nay italy fects he cbeusng sense cls, Abstracts 3 iting te tered seceton cf heatoplti growth actors (HGF 5 GMCSF. THF a, 8, TGFE) ang ole fone mediators, teadeg tunetonay egnicanchangesnhamalpotas. Monona ca yllées suport eral pars of his pate. Wie have vesbate ie otto oeyetne, beter munoreguaon,andintanmeloy ‘natons of macreshapes dered ude be suo of harmal yan ‘ave shown ne elvan the poenlpaophysogy of pest ‘urn necton, eye nsramatn ana mt-st organ ae Ione suc be preducton ot tains by naa an bur bone ‘rarow deed cas uted fo 5 and aye win HGP was Getemined {Gyrtneprsucion wes much rater afer 9 days m compar 08 ys eure. At 8 ayaa cutie Dre was a age rsease TNF ag 8 Producten by bur cl corpeed to nonbum cats, tied wih fer GM (CSF andlor. Furhermor be PCE, lvls wor icant deceased. ‘in adstonl suds we heve Bogn o examie Pe Penelope owt acre (HOF) hat have bean shown conta facta, ht end Grete sage cf prlleraoneal cya, ererdason and maluraton ot ene marrow eaten bash rama and poe-aumate sae. Each of ese GPs exerts mule eects on to fae of roger and erature tone tar cla. Recon ta on be eet of catinatone cece coe have shown can HGFs to ave npr erpct on th tarertiton and ‘Taturaon of ese frcionlyaterea meceprapes Ou suser Mave Begun to extablsn a Ink betwen aera hemstopoas pos-sermat iy and subsequent bur read compleaions cep, entre and Sesh ore K. Ose, PhO Shinar Hota For Chiron 3229 Bumet Avenue inca, O4 4229-0006 1 MECHANISM? Mix Wer T-LaMele, C. Wien, Radner ins fon mars) rene eis aon erin yen Renee te a tgs it Sn etm alte ny eee ae pee Sroputie ascent aa Rua wo Upteeaes Seer anmtennpeyensig CP noon WO naae Sinvalaeicrivensron merearetr avi Wei tpn ck TOS t LPS at at simran nsecn tae oun, eb ee (roe att ie kn oe Cicyae k tn pected Cant NE ae ‘tbton bated Lp im penn ontered We ‘Sree out Ste dc pane 1 ppg of Ure ast orn Toney oe ee eget res 25 Steen ber ta Ecco Cat pte a sis psy me mses Ts pe ane Gx) Hea as oul wa dy me Seema ton’ tee Cgc: a Pe erat SSP rye hr pany ts ven a. Taree oe fatty tb wean HF ced te Seer iritarslccnaete tea Bie aioe ears Sohne seo Cro Paso Us sea eel Sa os emg etn se wees pe RS ere CU pa waa ge tit we ued ao SO en Souder cena fd nb regi w 8 hia nominee ey hed Eran tem ton pen Sh ine orleans nce hoe Lh “SpufeacKn gaye apr Nae 12 ACUTE RENAL FAILURE X. Santieben Nophrology Dept., Medical Clinic 1, university Hospital Munich-Grossnadern, Ludwig-Maxintlians University, munich, Sepsis is an important cause of acute renal