Seroreaction tests for syphilis are indispensable before blood donation, at pre-marital health examination and during pregnancy, and the exclusion of biological false positive reaction (BFP) may be regarded as an urgent social problem, for the solution of which no efforts should be spared.
Since August, 1969, our blood center has adopted TPHA (Treponema Pallidum Hemagglutination Test) with a view to minimizing the appearance of BFP, but we have found that this method, too, is not free from defects. Accordingly in January, 1970 we began to employ FTA-abs (Fluorescent Treponemal Antibodies Absorption Test) together with TPHA. The sera of blood donors which positively reacted to CL-antigens were subjected to the above two methods in order to clarify the essential nature of BFP. The sera of some healthy persons, pregnant women and patients of the dermatological clinic were also used in this investigation.
It is inferred from results of the present investigation that a fairly large percentage of BFP is inevitable with two methods of CL reaction (slide and Ogata's tests).
TPHA and FTA-abs proved themselves excellent methods, and their results were generally in correspondence, but not in all cases. In FTA-abs non-specific reactions were sometimes not completely absorbed in the 1:5 serum dilution. Non-specific fluorescence was noted in 10% of healthy persons and in 13% of pregnant women. That is, with the 1:5 serum dilution very sensitive reactions were noted, but at the same time specificity was also fairly reduced.
Therefore, in FTA-abs serum dilution should be prepared in two gradations. Results obtained with the 1:20 dilution should be used for reading with especial reference to those with the 1:5 dilution.
Several interesting cases of the dermatological clinic were also reported in detail.

View full abstract

Denaturation of hemoglobin is one of the intracellular factors which disturb red cell metabolism and lead to the hemolysis. Although there are many pathways to reduce methemoglobin to hemoglobin in packed cell, it seems to be most important to keep hemoglobin intact during storage.
Oxydation of hemoglobin to methemoglobin by the oxygen has been shown to occur in reduced hemoglobin rather than the oxygenated hemoglobin by Brooks in 1948.
Sase reported in 1965 that oxygenated hemoglobin decreased methemoglobin products as compared with half to half mixture of oxygenated and reduced hemoglobin.
The red cell membrane is known to possess many sulfhydryl units, especially in the inner layer.
Inhibition of the sulfhydryl units of the red blood cell has been shown to result hemolysis. (H. S. Jacob & J. H. Jandl)
Reduced glutathione is also effective in maintaining sulfhydryl groups of the red blood cell membrane.
In the present study, the influence of the oxygenation and an addition of reduced glutathione on the red cell fragility and hemolysis was determined.
The experiments consisted of the following four groups.
1) Venous blood collected into ACD solution (VA)
2) Venous blood collected into ACD solution with reduced glutathione (VAGSH)
3) Oxygenated blood in ACD solution (OA)
4) Oxygenated blood in ACD solution with reduced glutathione (OAGSH)
Results
1) Plasma free hemoglobin during a five week storage
It was least in the OA and OAGSH groups.
2) Red cell fragility test
This was tested against a series of 0.9% to 0.2% sodium chloride solution. At the level of 0.8% NaCl, an addition of GSH was effective to keep weak resistant red cell from destruction.
OAGSH tolerated well at the level of 0.8%, however, damage of the cell membrane of the well resistant young red cell was prominent.
3) Serum lactate and pyruvate levels
On lactate to pyruvate ratio, except control group (VA), the other stored blood groups reached to its maximum value within 2 weeks and reduced gradually to its initial level.
On the contrary, VA reached to its maximum value after 3 weeks storage. The reduced glutathione increased lactate to pyruvate ratio higher but did not change the time to its maximum value.
Conclusion
Oxygenation and the addition of reduced gluthatione have proven to give a veneficial effects on anti-hemolysis and fragilty change during a 5 weeks RBC storage.

View full abstract