Research, to which so much discussion and thought will be devoted at this symposium, appears to have been downgraded in our society. Yet, learning and education per se rank high in our set of values, from the point of view of both lay people and profes­ sional workers. For some reason, we fail to detect the illogic inherent in this value system--for, what is research but the learning of new information? Apparently our society associates "learning" only with known, long-gathered information. This symposium, I believe, will generate new information about shock through the integration of knowledge of many investi­ gators, who have come to share a common meeting ground. Hopefully, the worth of this and similar endeavors will gain the recognition and, more important, the support of the public. In the next decade or so, I believe that shock research workers will be channeling their efforts more and more into investigating the repair of damaged cells. The individual cell and its products must be scrutinized just as carefully as we examine the whole organism or its collections of cells. Shock is an exciting area of research, but it involves years of painstaking work. Moreover, the society which will reap its fruits must be persuaded to share the burden of its support. John A. Sehilling~ M.D. lAbstracted from Dr. John A. Schilling's Opening Statement at the symposium on October I, 1971.

Inhalt

Introduction: An Overview of the Shock Problem.- Session I: Shock and the Cardiovascular System.- Introductory Remarks.- Proposed Reclassification of Shock States with Special Reference to Distributive Effects.- Discussion.- Participation of Endogenous Vasoactive Agents in the Pathogenesis of Endotoxin Shock.- Discussion.- Pulmonary Dysfunction in Shock.- Discussion.- The Lung Lesion in Shock.- Physiologic Mechanisms in Clinical Shock.- Role of Leukocytes in the Lung After Endotoxin Administration.- Fate of Endotoxin in the Circulation.- Discussion.- Splanchnic Blood Flow in Experimental Shock.- Discussion.- Are Adrenergic Overactivity and Splanchnic Vasoconstriction the Prime Pathophysiological Events in Shock?.- Effects of Endotoxin on the Vascular Architecture of Intestinal Mucosa.- Role of Vasopressin and Angiotensin in Response of Splanchnic Resistance Vessels to Hemorrhage.- Platelet, Hemodynamic, and Respiratory Changes in Shock, Sepsis, and Trauma.- Discussion.- Session II: Shock and Metabolism.- Introductory Remarks.- Immunochemical and Physiologic Insulin Lack During Lethal E. coli Septicemia in the Subhuman Primate.- What Mechanisms Influence Oxygen Transport and Oxygen Tissue Delivery in Endotoxic and Hemorrhagic Shock?.- Oxyhemoglobin Dissociation Curve in Hemorrhagic and Septic Shock.- Effects of Endotoxin and E. coli Shock on the Metabolism of Lipids and Carbohydrate.- The Mechanism of the "Lung Lesion" in Shock.- Irreversibility in the Post-Transfusion Phase of Hemorrhagic Shock.- Histamine Release in Endotoxin Shock: Effect of Dexamethasone Administration.- Dopamine in the Treatment of Shock.- Liver Metabolism and Energy Production in Staphylococcus aureus Septic Shock in Mice.- Myocardial Metabolism During Acute Hemorrhagic or Endotoxic Shock.- Metabolic Changes in Hemorrhagic Shock.- General Discussion.- Session III: Toxic Factors in Shock.- Introductory Remarks.- Release of Toxic Agents in Septic Shock.- The Relationship Between Oxygen Uptake and a Toxic Factor in Septic Shock.- Discussion.- Role of the Pancreas in the Pathogenesis of Circulatory Shock.- Vascular Lesions in Endotoxemia.- The Role of Targets and Mediators in Endotoxin Shock.- Discussion.- Liberation of Vasoactive Materials from Mast Cells in Anaphylactic Shock.- Proteases and Antiproteases in Experimental Low-Flow States.- Prolylcarboxypeptidase in Biological Fluids.- Discussion.- Does Endotoxin Have Direct or Indirect Effects on the Heart?.- Pulmonary Dysfunction After Shock and Trauma.- Discussion.- Biochemical-Biophysical Basis of Shock.- Afterword.- Participants and Special Guests.- General Subject Index.