Pyridoxylated hemoglobin (PLP-Hb), a possible substitute for red cells as artificial oxygen carrier, was prepared and characterized physicochemically. The followings are the main points of our analysis.
1) The yield of the pyridoxylation reaction was determined by electrophoresis on cellulose acetate and high performance liquid chromatography (HPLC).
2) Pyridoxylation rate of stroma-free hemoglobin (SFH) from outdated blood was 68.5±4.4% by electrophoresis and 50.5±1.0% by HPLC and significantly higher than that from fresh blood. The pyridoxylation rate of SFH from fresh blood was 59.7±2.9% by electrophoresis and 40.2±1.0% by HPLC.
3) PLP-Hb was separated from unmodified Hb by using ion-exchanger, DEAE Sephadex A-50.
4) There appeared to be two species of PLP-Hb (PLP-Hb-1 and PLP-Hb-2) which could be distinguished each other by electrophoretic charge and P₅₀ value. The P₅₀ value of PLP-Hb-1 and PLP-Hb-2 were 17.5mmHg and 24.5mmHg respectively whereas the P₅₀ value of unmodified Hb was 10.5mmHg.
5) PLP-Hb was stable at 4°C without any significant change of P₅₀ value at least for one month.

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From 1980 to 1984, resections of esophageal cancer were performed upon 167 out of 281 patients in our department.
The volume of blood loss and blood transfusion in those patients were analyzed. The average blood loss in operation was 1021±554ml, and each case required about 5 units blood transfusion. 10 units packed cells and 10 units fresh frozen plasma were prepared in cases of radical operation for esophageal cancer. This volume was sufficient for the maximum surgical blood order schedule (MSBOS) for esophageal cancer surgery.
In order to study the usage of colloid in all resectable cases in 1981 and 1982, various hemodynamic indicators were investigated using a Swan-Ganz flow directed catheter. Plasma colloid osmotic pressure (PCOP) was measured by membranosmometer, and alveolar-arterial oxygen difference (A-aDO₂) calculated by the blood gas analysis was measured. The results were obtained as follows: in the early postoperative period, values of PCOP-PA (mean pulmonary pressure) decreased remarkably, and A-aDO₂ increased, compared with the preoperative values of those factors. Those results indicate that pulmonary water retension may be estimated by calculating those factors and the patients who underwent radical surgery for esophageal cancer may be easily susceptible to pulmonary complications, especially, pulmonary edema.
Transfusion of fresh frozen proteins (FFP) is effective in maintaining normal plasma protein level and plasma albumin level during the catabolic phase after operation, but the usage of albumin as nutritional support is not recommended from the metabolic point of view.
Hyperalimentation by active and appropriate combination of enteral and parenteral nutrition is one of the most practical and important therapies for patients with hypoproteinemia throughout the course of treatment for cancer of the esophagus.

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A quantitative index of the change in the shape of red blood cells during storage, a morphology score, was devised. The score is calculated from the percentage of red cells of each of the four morphological types multiplied by the following factors: discocyte x3, echinocyte-I x2, echinocyte-II x1 and spherocyte x0. The decrease in the morphology score of red cells during stroage was similar to that in ATP levels, though at a little slower pace. The pattern of changes in the morphology score showed an almost negative relationship to that of hemolysis. A comparison of the data of these indicies with those of post-transfusion viability suggested that the morphology score correlates more directly to in vivo viability than ATP levels and hemolysis do. The score was used to evaluate various artificial preservatives containing adenine and the integrity of modified red cells such as washed red cells and frozenthawed red cells during storage. We think that the morphology score is useful as an index for judging the storage condition of red blood cells.

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EIA and PA test are simple, rapid and reliable methods for detection of anti-ATLA antibodies and suitable for mass screening of sera from blood donors. These methods, however, have some non-specific reactions in the procedures and sometimes show discrepancies in the detection rate. In this report comparative study using these methods and Weatern blotting method are performed.
ETA and PA test showed coincidence in the detection of sera with relatively high titer antibodies, whereas discrepancy was observed in the screening of sera with low titer reactions. Only PA test gave positive reactions in the early phase of seroconversion after transfusions. Non-specific reactions were recognized in the sera with antinuclear antibodies and in the sera of patients with malignant tumor. In ETA, inhibition tests are required on the sera among cut off index (usually 0.10OD) and 0.30OD. In PA test, re-examinations using Western blotting method or other method are required in the sera with antibody titer among 1:16 and 1:64.

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CPD has been routinely introduced as anticoagulant preservative in Japanese Red Cross Blood Centers since 1983. It has been well known, however, that irreversible macroscopic aggregates of platelets often occur during preparation of platelet concentrates (PC) from CPD blood, which cause some trouble on PC supply. The daily occurrence rates of PC products with the aggregates, which were determined by a definite category in terms of their quantity and size, have been recorded after overnight storage since the CPD adoption in our blood center. They have suddenly increase from 11.6% to 23.6% and to 28.1% (p<0.001) since September in 1984, due to twice modifications of triple bags (new and newest ones) for blood collection.
As factors affecting the formation of the irreversible macroscopic aggregates, air volume in bags and some enviromental conditions (temperature, humidity, climate, seasons, transportation and so on) were scrutinized. It was found that the development of small particles of the irreversible aggregates was greatly related to the air content in the units. By complete removal of air in them, its rate decreased from 30.0% to 17.3% in the newest bags, and from 10.7% to 5.3% in the old ones, respectively. The former was much higher than the latter, even if air was excluded. This means that a little minor changes of the properties of bags per se have great influence on the formation of irreversible aggregates in PC products.
Out of the other conditions, both low temperature less than 14°C and low humidity less than 60% had significant relationships with the appearance of the irreversible aggregates.

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A present status of utilizing the reference system of patients' transfusion information during the 19 months from May 1, 1984 to Nov. 30, 1985 was monitored in Kyoto University Hospital. The reference frequency was 6411 in the Blood Transfusion Service and 476 in the polyclinic divisions, and was approximately constant in the former but high in June and July in the latter. The results of the transfusion examination and the transfusion histories of patients were the reference items with almost equal frequency in the Blood Transfusion Service but the latter was the major one in the polyclinic dividions. A high significant correlation (r=0.87) was observed between the reference frequency and the supplied units of the blood preparations in each clinic division. To clarify the reason of the low reference frequency in the polyclinic division, the doctors' opinions about the reference system were researched. Only 58% of the doctors had the license necessary for the reference and 41% of the doctors did not know about the reference system. Thus, the low reference frequency seems to be ascribed to the facts that PR for the doctors about the reference system is lacked, and that the rate of the doctors have the license for the reference is 58% and that the doctors in the clinical division were informed of the results of each transfusion examination by another transmission procedure.

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