Metabolic interrelationship between carbohydrate and amino acid was investigated for the change of blood sugar, glucose tolerance, blood pyruvate and lactate, plasma levels of urea and free amino acids through the administration and/or loading of different carbohydrates as glucose, fructose, sorbitol and xylitol in early post-opera-tive period following elective abdominal surgery.
Blood sugar was conspicuously raised during the time of completion of surgery and the first post-operative day. The glucose tolerance was markedly delayed after twenty-four hours. Pyruvate and lactate were not significantly raised after surgery excluding a slight elevation of pyruvate in the administered xylitol cases and of lactate in the administered fructose cases on the operative day.
The depletion of all amino acids by the preoperative and the third post-operative glucose or xylitol loading was recognized except for a slight elevation of glycine by xylitol loading, however, these glucogenic amino acids, particularly alanine in the glucose loading and glycine in the xylitol loading, are rather increased on the first post-operative day.
These facts indicated that carbohydrate utilization is depressed during the first few days after abdominal surgery, and, the difference between glucose and xylitol loadings on changes of individual glucogenic amino acids in early postoperative period is suggested that a considerable part of the post-operative metabolic impairment is derived from the relative shortage of insulin action.

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Clinical evaluation of screening test by SGO-T determination for blood donors were studied with using simple rapid procedure (Whetzel method) in order to seek for possibility of preventing viral hepatitis after blood transfusion.
More than 74, 000 blood donors were tested by this screening procedure. Comparative studies on the incidence of viral hepatitis after transfusion were made by observation in 5, 375 cases of recipients who were given with the screened blood and in the control group of 6, 830 cases of recipients given with the blood which was not screened. The results obtained were summarized as follows:
1) A linear relationship was found to exist between the regular Reitman-Frankel procedure and simple rapid screening test in the determination of SGO-T level with the base of judgement fixed in 40 units. It was fou nd that SGO-T screening test has a sufficient accuracy and specificity for blood donor screening.
2) Approximately 7% of paid donors and 2% of voluntary donors were screened out by simple rapid procedure of SGO-T determination.
3) The incidence of viral hepatitis after blood transfusion was observed at the rate of 6.2% in the cases of recipient who were given with the blood screened by Whetzel simple rapid procedure. This rate of the incidence was only a half in comparison with cases of recipients with the blood which was not screened as control.
These results suggest that SGO-T screening test for blood donor by Whetzel procedure is useful to reduce the incidence of hepatitis caused by blood transfusion.

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The author studied upon the clinical cases with more than 200ml. of blood loss in operation without blood transfusion and devised a formula with which the permitted quantity of blood loss can be calculated, in other words, how much blood loss a patient can tolerate without risk during operation and postoperative course. Furthermore, the author discussed control of the postoperative hypovolemia, safety limit of hemodilution, and recovery from it upon the above cases and came to the following conclusions.
1) In the early stage after operation, approximately 10% decrease of the total blood volume was found because of functional decrease of the extracellular fluid. As it is difficult to prevent the decrease of the total blood volume even with blood transfusion, it is reasonable to put a landmark around 10% decrease of the total blood volume when surgeons control the hypovolemia after non blood transfusion operation.
2) When plasma expander of more than 1.2 times of volume of total blood loss and fluid of 5.0ml/kg/hr were given intravenously in non blood transfusion operation, decrease of the total blood volume was 8% on the average if total blood loss remained within permitted quantity regardless of age and bleeding speed during operation.
3) It was established that normal blood constituent was lowered up to 30% without any trouble in both operative and postoperative course.
4) During a few days after non blood transfusion operation, the data suggesting low production and accelerating destruction of red blood cells were obtained. Red blood cell volume showed decrease due to blood loss and this was followed by further slight decrease as postoperative course progressed.
5) At the beginning of the second postoperative week, production of the red blood cell became remarkably active and the greater was the dilution the faster was the production of red blood cell. The most cases recovered from anemia to normal value at the time of discharge from the hospital.
6) From the above data, the author devised the formula which was supposed to be reasonable pathophysiologically.
Y=V (1-b/Z)
Y: permitted quantity of blood loss
V: total blood volume
Z: preoperative hematocrit
b: possible hematocrit by dilution

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The prevention of viral hepatitis caused by blood transfusion is the most serious problem at this present, as hepatitis viral agent has not been identified, and there is no specific measure to detect a silent carrier of viral agent.
In 1961, isolation of agent, with using a human embryonic lung cell culture, from the blood of volunteers who developed serum hepatitis after inoculation of U. S. N. I. H. icterogenic plasma pool No. 6 has been reported by Bolin.
HIM (Hepatitis-Infectious Mononucleosis) test is a serological examination for detecting a specific antibody in serum with using agglutination of latex particles which are coated with its viral agent isolated by Bolin. This viral antigen has many problems which must be solved since not being out of the position of candidate. From the view of a high positive rate found by Bolin and also by us in screening the cases of Suspective Viral Hepatitis, this study was made to seek for possibility of preventing viral hepatitis after the blood transfusion by applying the HIM test to screen donor's blood before transfusion. The results obtained were summalized as follows:
1) Total 4, 009 cases of normal donors sera were screened by HIM qualitative test and 42.8% of these specimens gave positive result.
2) A little difference was shown in the positivity of HIM screening test between the groups of donor classified by age, sex and blood groups.
3) A linear relationship was not found to exist between the results obtained by HIM screening test and SGO-T screening test for the same donors serum.
4) By the HIM qualitative screening test with the use of the serum dilution of 1:5, the blood which had been shown to be under 40 units by SGO-T screening test (Whetzel method) were sort out to HIM positive blood and negative ones. These blood were transfused to the patients who had needed the blood transfusion except of liver and bile duct deseases. Recipients were classified with using these HIM positive blood or negative ones by the blood transfused to each group. Each recipient group was followed up for about a 6 month on their clinical conditions and liver function (mainly Serum transaminase level).
The incidence of liver dysfunction was investigated in both these two recipient groups, and the incidence of liver dysfunction in HIM negative blood recipients group was only a half as in HIM positive blood recipient group. In case of excluding the cases which had been suffered from cancer from all the followed-up cases, the incidence of dysfunction in the HIM negative recipient group was only one third as in the HIM positive blood recipient group. This difference was found to be statistically significant at 5% level.
Thus, from these findings, it is suggested that HIM screening test is effective for the donor screening method to prevent the viral hepatitis after transfusion.

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