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BACKGROUND Simulation studies were performed to predict the future supply and demand for blood donations, and future shortfalls. STUDY DESIGN AND METHODS Using data from all donations in 2006 to 2009, the Markov model was applied to estimate future blood donations until 2050. Based on data concerning the actual use of blood products, the number of blood products needed was estimated based on future population projections. RESULTS We estimated that the number of blood donations increased from 5,020,000 in 2008 to 5,260,000 in 2012, but will decrease to 4,770,000 units by 2025. In particular, the number of donors in their 20s and 30s decreased every year. Moreover, the number of donations required to supply blood products would have been increased from 5,390,000 in 2012 to 5,660,000 units in 2025. Thus, the estimated shortfall of blood donations is expected to increase each year from 140,000 in 2012 to 890,000 in 2025 and then more than double to 1,670,000 in 2050. CONCLUSION If the current blood donation behaviors continue, a shortfall of blood availability is likely to occur in Japan. Insufficient blood donations are mainly related to a projected reduction in population of 20 to 30 year olds, a significant group of donors. Thus, it is crucial to recruit and retain new donors and to develop recommendations for proper use of blood products to minimize unnecessary use. This study provides useful information that can be used by governments to help ensure the adequacy of the blood supply through promoting donations and conserving blood resources.

Simulation studies were performed to predict the future supply and demand for blood donations, and future shortfalls.Using data from all donations in 2006 to 2009, the Markov model was applied to estimate future blood donations until 2050. Based on data concerning the actual use of blood products, the number of blood products needed was estimated based on future population projections.We estimated that the number of blood donations increased from 5,020,000 in 2008 to 5,260,000 in 2012, but will decrease to 4,770,000 units by 2025. In particular, the number of donors in their 20s and 30s decreased every year. Moreover, the number of donations required to supply blood products would have been increased from 5,390,000 in 2012 to 5,660,000 units in 2025. Thus, the estimated shortfall of blood donations is expected to increase each year from 140,000 in 2012 to 890,000 in 2025 and then more than double to 1,670,000 in 2050.If the current blood donation behaviors continue, a shortfall of blood availability is likely to occur in Japan. Insufficient blood donations are mainly related to a projected reduction in population of 20 to 30 year olds, a significant group of donors. Thus, it is crucial to recruit and retain new donors and to develop recommendations for proper use of blood products to minimize unnecessary use. This study provides useful information that can be used by governments to help ensure the adequacy of the blood supply through promoting donations and conserving blood resources.

The Japanese Red Cross Blood Center routinely uses the copper sulfate (CS) method to exclude anemic blood donors, because of its simplicity, speed and minimal expense. With this method the level at which a drop of donor blood becomes stationary varies according to its specific gravity (SG). The CS method procedure is described in the AABB's technical Manual and in many papers, but the manner of interpretation of the stationary level is not specified.The drop is delivered from about 1cm above the CS solution in a 100ml glass bottle (6cm high, 46mm in diameter) from an SG needle (Kawasumi, Japan). Momentum carries the drop 1 or 2cm below the surface, and it will then rise, become stationary, or continue to fall. We studied the method using stationary drops at only 4 levels: level A, 3.0cm below the surface; B, 1.5cm below; C, 1.0cm below; and D, 0.5cm below. The SG of these 4 blood samples were measured by pycnometer. The samples were of whole blood containing citrate-phosphate-dextrose (SG approximately 1.052). In Japan, the minimum condition for donors giving 200ml whole blood or undergoing plasmapheresis is hemoglobin (Hb)≥12.0g/dl or SG≥1.052. Temperature affects SG, which was measured at 30-32°C with an SG needle in a catheter probe (Terumo, Japan), and blood drop tests were done after incubation at 30°C. The CS solution (d2020=1.0521) was warmed from 15 to 35°C.Pycnometer values for blood SG varied according to the drop level in the CS solution and to the solution temperature, the average difference between positions A and D at 20°C being 0.0014. At 20°C, a drop in the D position, 5mm below the surface, had the same SG as the solution (1.0522±0.0002, n=3). Routine screening of position D showed that only 5 percent of eligible donors would have been rejected for low Hb. Although the CS method has a higher donor rejection rate than the Hb procedure, its rejection rate varied with the drop stationary level.

During study of the characteristics of various brain tumors in tissue cultures, it was found that craniopharyngiomas showed a unique growth pattern, different from other brain tumors including glioma. Reports on tissue cultures of craniopharyngioma have been few, probably due to the difficulty of in vitro propagation. The present report concerns some in vitro growth patterns of this epithelial tumor. The biopsied materials were cut into small fragments, about 1-2 mm in diameter, and directly cultured at 37°C in 199 medium containing 10% calf serum, 100 units/ml of penicillin and 100 μg/ml of dihydrostreptomycin. The medium was changed every three days. By this simple methods, six tumors out of nine different cases were successfully cultured. Four to five days after being placed in a glass bottle, a monolayer sheet developed from each fragment extending out in eccentric direction from the center. The cells of the monolayer sheet had a polygonal, rich cytoplasm and an oval nucleus, and were in close contact with each other. In the marginal zone, cells with an extremely large cytoplasm and acellular circular spaces were frequently seen. The free margin of the cell sheets was always sharp without any surrounding scattered cells. In electron microscopy (plate parallel sectioning method), abundant desmosomes and tonofilaments could be seen as in the original tumors. On the other hand, in scanning electron microscopy, the surface of this cultured cell was relatively smooth and abundant microvilli were observed. From these findings, it was concluded that the cultured cells in the monolayer sheets originated mostly in the epithelial cells of craniopharyngioma but not in glial cells of fibrocytes. The growth rate of the epithelial cell sheets could be estimated by measuring the area of the cell sheets. During the initial ten days, most sheets increased two to five times in area and grew less rapidly for 30 to 40 days until the diameters of the sheets became 5 to 15 mm. Thereafter, they were not enlarge but survived for 150 to 430 days. In these experiments, in vitro propagation of cells seemed independent of whether or not the patients received previous irradiation or administration of chemotherapeutic agents such as bleomycin. In addition, it seemed also likely that trypsin digestion was inadequate for long-term proliferation of cells. Cultured craniopharyngiomas may be useful for studying distinct characteristics from various aspects including screening of the effects of chemotherapeutic agents.

The effects of d1-2-(3'-t-butylamino-2'-hydroxypropylthio)-4-(5'-carbamoyl-2'-thi enyl) thiazole hydrochloride (S-596) were evaluated in 9 normal volunteers. Exercise echocardiography was performed in the semi-supine position before and 2, 4 and 24 hours after the oral administration of 15 mg of S-596. Two hours after administration, resting heart rate was unchanged, compared with control, but systolic blood pressure at rest was slightly decreased (114 +/- 6 vs 106 +/- 10 mmHg, p less than 0.05). Left ventricular dimensions were unchanged, but shortening fraction was increased in the resting state (30.3 +/- 4.6 vs 33.1 +/- 4.8%, p less than 0.05). During exercise on oral S-596, heart rate and systolic blood pressure responses were reduced (127 +/- 11 in control vs 108 +/- 6 beats/min on S-596, 198 +/- 25 vs 168 +/- 23 mmHg, p less than 0.001 and 0.05, respectively). Left ventricular end-diastolic dimension was not significantly altered by S-596 compared with the preceding control exercise test; however, end-systolic dimension was significantly larger after beta blockade with S-596 (2.6 +/- 0.4 vs 3.0 +/- 0.4 cm, p less than 0.05). Shortening fraction and cardiac output decreased significantly (43.7 +/- 3.7 vs 40.0 +/- 5.7%, 9.5 +/- 1.4 vs 8.4 +/- 1.3 L/min, p less than 0.05 and 0.01, respectively). These effects of S-596 were maximal at 2 hours after oral administration with reduced response of heart rate to exercise lasting for 24 hours. Compared with the effects of propranolol (30 mg, given orally) in the same subjects, beta-adrenergic blockade during exercise with S-596 was equivalent to or greater than that of propranolol. Thus, S-596 has little, if any, effect on resting left ventricular performance, but demonstrates potent negative chronotropic and inotropic effects during exercise in normal human subjects. Its beta-adrenergic blocking action also has long acting properties, especially its chronotropic effect.

We performed dual M-mode exercise echocardiography, which records left ventricular (LV) and left atrial (LA) echocardiograms simultaneously, in 10 normal subjects to investigate mechanisms of cardiac adaptation to dynamic exercise. The LV end-diastolic dimension (EDD) increased significantly as exercise increased from mild to moderate (3-5%, p less than 0.05 and 0.001). At peak exercise the EDD was slightly increased, but it returned to the baseline during recovery. The LV end-systolic dimension (ESD) showed a progressive decrease with the severity of exercise (5-13%, p less than 0.05 and 0.001). It decreased further immediately after exercise (17-20%) and then returned to the resting value. The LV stroke dimension and fractional shortening increased as exercise changed from mild to moderate and reached a plateau at peak exercise. During recovery, they showed a transient increase and then decreased. By contrast, the LA dimensions, both maximum and minimum, increased significantly as exercise changed from mild to moderate (15-16% and 16-19%, p less than 0.01 and 0.001, respectively), but they were lower at peak exercise (12 and 14%). They returned rapidly to the resting values immediately after exercise. Thus, during exercise, LV function is augmented by the Frank-Starling mechanism in combination with increased contractility, while the LA is enlarged to receive the increased venous return accompanying dynamic exercise. These exercise-induced changes in LV performance return gradually to the resting state, but LA size recovers rapidly after the cessation of exercise.

A new blood collection device was developed, which consisted of a blood filter (Sepacell R-500) to remove leukocytes, a hollow-fiber module (BCC 400) to filtrate plasma from whole blood and two blood collection bags.Eleven units of 400ml whole blood fleshly collected were investigated. They had mean volume 456 (SD 8)ml with mean heamatocrit value 41.6 (SD 1.8)%, which were passed through the devices in mean time 9′42″ (SD 2′35″) and were divided directly into mean volume 326 (SD 17)ml of concentrated red cells (CRC) with mean heamatocrit value 65.7 (SD 5.0)% and 149 (SD 10)ml of plasma.In the CRC 95.6% of white blood cells and 98.8% of platelets were removed on average, while 81.0% of red blood cells were recovered. There were no significant differences between the pretreated whole blood and the treated CRC at the levels of ATP and 2, 3-DPG in red blood cells, osmotic fragility and the value of platelet factor 4, C3a and C5a in plasma. During 28 days storage, ATP, 2, 3-DPG, free hemoglobin and pH levels in the treated CRC showed the same changes as those in the CRC prepared with centrifugation as usual.These results indicate that the leukocyte-depleted CRC passed through this device can be simply prepared in a closed system at donating blood, so that their shelf-life will have to be as long as that of conventional CRC.

To investigate left ventricular size and performance during graded submaximal exercise, 14 normal subjects with a mean age of 21 years exercised in a supine position to achieve the target heart rate. Using two-dimensional echocardiography, we recorded and analysed the left ventricular (LV) cross-sectional area and internal dimension at the level of the tips of the mitral valve at rest and during mild, moderate and severe exercise. The heart rate and systolic blood pressure increased substantially from rest to peak exercise (71 +/- 11 to 162 +/- 10 beats/min, 122 +/- 10 to 204 +/- 22 mmHg). The end-diastolic cross-sectional area and internal dimension (EDA & EDD) increased by 1.1-2.2 cm2 (7-13%) and 0.2-0.3 cm (4-7%), respectively, from mild to moderate exercise, (p less than 0.05-0.001). At peak exercise, however, these decreased and showed no statistically significant difference from the values at rest. The end-systolic cross-sectional area and internal dimension (ESA & ESD) decreased by 1.1 to 1.6 cm2 (14-20%) and 0.2-0.3 cm (7-10%), respectively, from moderate to severe exercise (p less than 0.01-0.001). However, the end-systolic values during mild exercise were not significantly different from those at rest. The stroke area (EDA-ESA) and dimension (EDD-ESD) increased by 1.6-2.6 cm2 (19-31%) and 0.2-0.6 cm (25-38%), respectively, during all levels of graded exercise (p less than 0.05-0.001). The percent change of LV cross-sectional area and internal dimension during systole increased gradually from rest to moderate exercise (51.0 +/- 7.1 to 61.9 +/- 4.4%, 35.4 +/- 3.9 to 45.0 +/- 3.7%), respectively, and showed no further increase during peak exercise. The mean circumferential fiber shortening velocity increased sharply from rest to peak exercise (1.27 +/- 0.14 to 2.25 +/- 0.21 circ/sec). These results suggest that the Frank-Starling mechanism operates during mild to moderate exercise, and contractility increases markedly at moderate to severe exercise levels as cardiac performance is augmented during graded submaximal exercise.

In Japan which has old history the fruits-tree is a new commercial crop, but it scarcely happens that new villages are established for orchards. Ueno Village, Mino Kamo City, Gifu Prefecture is a rare case. This village has been formed on the hill since 1924. The following are the distrinctive economic characters of the village.1) Because it is the infertile tertiary hill, this upland was abandoned as a grass land with little pines till 1924.2) Thus this upland was wild and public land, so its rent was low compared with private land. Moreover, the village office did readjustment of fields and national government gave a subsidy of reclamation. Such factors were advantageous to poor pioneers.3) Many pioneers (now 87 families) gathered not merely from near villages but also from many other places. Formerly they were farmers, merchants, officials, and so on. Movement of farmers in this village is great as compared with near old villages, and they lack the unity of their community.4) The farmers have wider orchards than subsidiary fruit producers, but they have little paddy fields.5) At first they planted peach-trees and vines which bear fruit sooner than other trees, but now they grow intensive Japanese pears (Nijisseiki) and a little Japanese persimmons (Fuyu), and in some degree grapes and peaches.6) In Japan cultivated fields are generally scattered in many places, but in this village orchards are gathered around farmhouses. This is very advantageous to the farmers.7) The larger scale farmers have an effective disinfection equipment.8) The most advantageous size for family enterprise is about 2 acres, and when they have many employees it is larger than about 4 acres. Of the farmers these who have 6-10 tan (1 acre=about 4 tan) are the top and 10-15 tan are the next.9) The joint shipping has not been done sufficiently. Its markets are Nagoya, Gifu, Tokyo, etc.10) There are other villages about this village which stimulated by Ueno Village have started fruits production. But in many other villages fruits production is not developed, and they still grow rice and carry on sericulture. This is because labour in sericulture and fruit production comflicts and rice crop is more stable than the above.