The present report concerns with the observation on kidney function following normovolemic blood transfusion in the mongrel dogs, in which hemorrhagic hypotension, such as 50, 80 or 100mmHg, has been sustained for a certain period.
1. Disturbance of kidney function depends not so much on the volume withdrawan as on the degree of hypotension due to hemorrhage.
2. Response of the circulatory system to massive hemorrhage is grade-wise, which is also evidenced in kidney function as demonstrated in its degree of disturbance and recovery.
3. Hemorrhage which is not severe enough to induce hypotension below 80mmHg exerts no critical irreversible effect on the kidney, even if it is sustained for a long period of time.
4. The degree of failure on recovery of kidney function following normovolemic blood transfusion is correlated with the classified stages (bleeding, balanced and back-flow) which correspond to the changes of blood withdrawn.

View full abstract

The entire course of sustained hypotension in 50mmHg induced by modified Lamson's bleeding bottle method in mongrel dogs is divided into 3 stages: bleeding, balanced and back-flow stadia, regardless of individual differences in response of circulatory system. The present report concerns with the observation on the changes of extracellular fluid after successive transfusions of either massive saline or blood (100cc per Kilogram) with reinfusion of total withdrawn blood in each stage above mentioned. The extracellular fliud was calculated by Na, following modified Kaltreider's method.
1) The average value of the sodium space of 20 dogs was 29.8 percent of body weight. It stood in equilibrium for ten hours or more, so that it allowed frequent determinations throughout the experiment.
2) After blood reinfusion and saline transfusion in the bleeding stage the sodium space demonstrated a rapid increase which corresponded almost to the volume of transfused saline and followed by a gradual decrease as urine volume increased. The sodium space after the same procedures in the back-flow stage showed a rapid and remarkable increase without any tendency to decrease subsequently. This pattern of sodium space which responded to transfusion can be detected in the latter half of the balanced stages.
3) It is thought that the sodium permebility of red cell membrane is remarkably increased in the back-flow stage from the results of B/P (blood counts/plasma counts)and BC/P (red cell counts/plasma counts) ratio. This is considered to be one of the major factors participating in the increase of the sodium space in the back-flow stage.
4) Changes of urinary volume, urinary excretion of Na and U/P (urine counts/plasma counts) ratio in these three stages revealed apparent gradients.
5) It is considered that these changes above mentioned are due to peripheral cellular origin.

View full abstract

There are several reports on the properties and the methods for separating and estimating properdin, and attempts have been made to obtain it in highest activity. However, the separation methods heretofor employed, such as zymosan absorption method and ethanol fractionation method, are small scale methods and the raw materials used have been limited to fresh sera or plasm of bovine and human blood, and large scale fractionation of properdin has not been reported up to date.
The author made an attempt to obtain properdin from the by-products in the commercial production of γ-globulin by methods 6 and 9 of Cohn, and made the assays of these fractions.
The method of assays used for this purpose follows the Pillemer's zymosan assay method and is almost the same as the Isliker's modified method.
As to the results of these assays, the author found that, in solubility, properdin was similar to prothrombin which was concentrated from PII+III, via PIII, to the SIII₂ in method 9, but properdin appearing in SIII₂ is only a small part, larger part going into PI of method 6.
By ammonium sulphate subfractionation from PI, properdin appears in the 1/4-1/3 saturated fractions only. This fraction has a titer of about 7 times that of fresh serum.

View full abstract

1. In order to discide the method by which the platelet count in the circulating blood might be measured as accurately as possible, both Olef's and Fonio's methods were investigated. Glass and polymethyl methacrylate plates were used in both methods. Olef's method with glass plate was proved to be the best of the four methods, since it was accompanied by the least error, great convenience and comparatively good protective action on the platelets.
2. The change of the platelets following the transfusion of 200cc of the compatible blood was investigated by measuring the platelet count prior to, and 30min., 1 hour, 2 hours and 24 hours after the transfusion in 30 patients. The red blood cell showed little change in number and the change of the white blood cell count was not consistent. The platelet count in the circulating blood, on the hand, revealed a marked change.
A. Change of the platelet count
a) Transfusion of ACD containing, preserved blood in 10 cases;
The peak of the change came one hour following the transfusion, and ranged from 24 to 56 percent decrease in 8 cases, and from 20 to 57 percent increase in 2 cases.
b) Transfusion of sodium citrate containing, fresh blood in 10 cases;
Decreased in 8 cases and increased in 2 cases. The changes and their recovery in this group occurred earlier than in a).
The rate of the change in this group was about the same as in a).
c) Transfusion of heparin containing, fresh blood in 10 cases;
Decreased in 6 cases and increased in 4 cases. The rate of change, especially the increase rate, was more marked than in a) and b).
B. Incidence of complications
The most frequent of all complications associated with blood transfusion was urticaria.
In sodium citrate group of twenty patients, there was mild urticaria in 4 cases and pruritus in 1 case, i. e. 25% out of 20 patients.
There was thrombocytopenia in all patients with complications. No correlation between the severity of thrombocytopenia and the symptomatology of complications was detected.
In the heparin containing fresh blood group of 10 patients, there were 4 cases of urticaria (severe in one and mild in three) and 1 pruritus out of 6 thrombocytopenic patients, and 2 (moderate in one associated with coughs and severe in another associated with fever) out of 2 thrombocytotic patients. The thrombocytosis of the last 2 patients was as marked as up to 75 and 73 percent in increase.
3. In another group of 30 patients who were administered 20cc of intravenous MgSO₄ solution 30min. prior to the transfusion of 200cc ACD preserved blood, the changes of the platelet count and complications following the transfusion were investigated. MgSO₄ was administered in 10% in water in 10 cases and 10% in 5% glucose solution in 20 cases.
The variation of the r. b. c. count was the same as the one encountered in 5 cases (17%) out of 30 patients in this group and, on the other hand, 15 cases (75%) out of a control or sodium citrate group of 20 patients. The difference above mentioned was statistically significant with less than 0.1% of significance level.
As to the complications, there were two cases of urticax is (6.9%) in this group. The difference of the incidence of urticaria between this group and the control was again statistically significant with 7% of significance level.

View full abstract

The author produced acute citric acid intoxication experimentally in with mongrel dogs by the rapid administration of large quantities of sodium citrate solution, and then investigated the change of hemodynamics concerning alterations in blood pressure, as-well as metabolic and histological changes of heart muscle.
The result obtained were as follows:
1) Peripheral vascular resistance fell in parallel to blood pressure, when sodium citrate was injected rapidly, the curve showing two-phasic changes. The fall in blood pressure is largely due to the peripehral factor.
2) There was no appreciable change in the venous return volume (cardiac output) measured by the right heart by-pass method.
3) The fall in blood pressure was remarkable, while the coronary venous return volume continued to increase.
4) The carbohydrate metabolism of the heart was slightly disturbed.
5) Histologically, no remarked change were seen, except for the dilatation of capillaries and some degeneration in heart muscle.
6) It may be concluded that the cardiac standstill by injecting sodium citrate rapidly is not attributed to disturbed carbohydrate metabolism or to histological changes but abnormal metabolism of electrolytes in the heart muscle.

View full abstract

The author investigated anti-A and anti-B antibodies of group O sera of adult donors and cord blood (both mothers and babies belong to group O) and obtained following results.
1) A new evidence that the placentatransmissible anti-A and anti-B antibodies are of incomplete form is presented.
2) In adult group O sera, titers estimated by the saline agglutination, the conglutination and the enzyme-treated red cells method run roughly parallel with each other, but in those by the indirect antiglobulin method and especially in those by the hemolysis of ficin-treated red cells things are quite different.
3) By the indirect antiglobulin method, positive reactions are observed in nearly sixty five percent of cases and slightly exceeded in anti-B (anti-A 64.1%, anti-B 67.5%). This is quite different from those obtained and reported in other countries. On the contrary, by the hemolysis quite reverse result is obtained (anti-A 66.4%, anti-B 22.4%).
4) By the estimation of its immune properties of antibodies of adult group O sera, it must be tested by different methods as many as possible.
5) By clinical use of group O blood to recipients of other blood groups it is confirmed that reactions observed during the first 24 hours after transfusion are more manifest in cases of “immune” type of group O blood.

View full abstract