Acute lung injury (ALI) is an infrequently recognized complication of transfusion therapy. Although the role of passive transfer of leukoagglutinating antibodies has been acknowledged, there is little documentation of the relationship of these antibodies in transfused blood to the human leukocyte antigen (HLA) phenotype of the recipient. Recently, we observed 5 cases of transfusion-related ALI, and in all cases leukoagglutinating and lymphocytotoxic antibodies were found in serums of the transfused blood products. In 3 cases, the antibodies corresponded to the HLA antigens of the recipient. Multiparous blood donors whose plasma contains these antibodies represent a potential transfusion hazard. It is recommended that blood component usage from donors implicated in these reactions be restricted to frozen or washed red blood cells. The incidence of leukoagglutinin-associated ALI may be more frequent than previously appreciated. Current concepts of the mechanism of microvascular pulmonary injury are discussed in relation to these cases.

For the past eight years, an automated anesthesia record keeping system, COMANDAS (COMputerized ANesthesia Data Acquisition System) has been used in the cardiovascular operating rooms at Mayo Clinic. The automated anesthesia record is designed to match the traditional hand-written record and becomes part of the official medical record. COMANDAS is interfaced with the physiologic monitor and mass spectrometer in each OR, and a number of other computers within the Mayo Medical Center. Since the introduction of COMANDAS over 24,000 surgical procedures have been charted. The anesthesia record is more complete, consistent in organization, and legible when compared to a hand-written record. Recently, it was determined that the computers and peripherals that make up COMANDAS were wearing out and that the vendors would no longer support or replace the equipment. A process to find a replacement for COMANDAS was then begun. Although the cardiovascular anesthesia group was satisfied with the automated anesthesia record, there were a number of areas in which improvement was desired. A systematic evaluation of the system was begun with a survey of the users. The majority of those surveyed felt that COMANDAS was a useful system which made parts of their job easier. The user interface, method of manual data entry, time to produce the record and difficulty learning the system were the source of the greatest dissatisfaction. Artifacts, networking, interfacing with other devices and computers were also issues for the replacement system. Most commercial systems were found wanting in one or more areas of significance. The most practical solution appeared to be the modification of a currently available intensive care unit patient data management system.

Crack surface interference under cyclic shear loads is studied by an analytical method. The proposed model simulates the effects arising from both the residual stresses and the asperity interactions. A closed‐form and a discrete approach are presented in obtaining the crack surface interference solutions. Backlashes of shear displacements, peeling or group sliding behaviours and induced cyclic mode I stress intensities are predicted under three configurations of residual stress distributions. The effects of a static mode I load, the facet angle and the frictional angle are also analysed. The predicted relationship between the effective shear mode stress intensity range and the R‐ratio is discussed together with the experimentally observed ‘contrasting’ R effects.

Study design. The protective effects of the natural antioxidant caffeic acid (CA) on behavioral tasks and lipid peroxidation were tested in an excitotoxic model produced by unilateral intrastriatal injection of quinolinic acid (QUIN), and in striatal slices incubated in the presence of the same toxin. CA (20 mg/kg) was administered intraperitoneally to rats every day for five days; then, rats received QUIN (240 nmol/µL). Six days later, motor asymmetry was quantified by the preferential use of forelimbs and the circling behavior tests. Rat striatal slices (300 µm thick) were incubated in the presence of CA (30-300 µM) and/or QUIN (100 µM) to estimate oxidative stress. Results. QUIN induced motor asymmetry in lesioned rats and increased lipid peroxidation in striatal slices when compared to control values. CA prevented the QUIN-induced toxic endpoints in a concentrationdependent manner. Conclusion. Our results support the neuroprotective role of CA in neurotoxic paradigms recruiting excitotoxic events.

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