内科セミナーBLD1 動的血液学

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内科学の急速な進歩・発展は、細分化と専門化をもたらし、近年、ますますその度を深めております。それに伴い、臨床家に要求される知識の量は急増の一途をたどっており、質的にも知識のlife cycleはますます短縮し、日々新しい医学へと脱皮しているのが現状であります。このことは、専門外の知識・情報について疎遠になりがちなspecialistや、最新の情報を吸収しきれないgeneralistの増加という情況をうみ出しております。内科セミナーは、このような認識のもとに企画された内科治療全書であり、up to dateな知識・情報を、迅速に、かつ総合的に提供して、今日の要求に応えようとするものであります。

目次

  • 表紙
  • 執筆者
  • 目次
  • 1. 血球代謝の理論と臨床
  • §1. 血液幹細胞
  • はじめに
  • I. 造血幹細胞とその分化
  • 1. 幹細胞とその種類
  • 2. 幹細胞の同定
  • 3. 幹細胞の形態と性質
  • 1) 形態
  • 2) Turnover
  • 3) 移動性
  • 4. 幹細胞の分化
  • 1) 体液性因子
  • 2) リンパ球, マクロファージの関与
  • 5. 造血の微小環境
  • II. 造血幹細胞の病態生理学的意義
  • 1. 赤血球系細胞の異常
  • 1) 再生不良性貧血
  • 2) 赤芽球癆
  • 3) 鉄芽球性貧血
  • 4) その他の貧血症
  • 5) 真性多血症
  • 2. 顆粒球系細胞の異常
  • 1) 急性白血病
  • 2) 慢性骨髄性白血病
  • 3) その他の顆粒球系疾患
  • 3. その他の血球系の異常
  • 終わりに
  • 文献
  • §2. エリスロポエチンの作用機序
  • I. エリスロポエチンによる赤芽球の誘導
  • II. EPOのtargetとしての赤血球系幹細胞
  • III. EPOの作用機序
  • IV. 赤血球系細胞に対するEPOのその他の作用
  • V. EPOの作用とその臨床血液学的意義
  • 1. 貧血とEPO
  • 2. 多血症とEPO
  • 3. EPOの治療的応用
  • 文献
  • §3. 鉄代謝
  • I. 鉄代謝の概略
  • 1. 鉄の吸収
  • 2. 鉄の輸送
  • 3. 未熟赤血球の鉄利用
  • 4. 貯蔵鉄
  • 5. 鉄の排泄
  • II. 鉄の必要量
  • III. 鉄代謝異常症診断のための検査法
  • 1. 血清鉄および鉄結合能
  • 2. 血清フェリチン値
  • 3. フェロキネティクス
  • 4. 骨髄シデロブラスト
  • IV. 鉄欠乏症と鉄過剰症
  • 文献
  • §4. ポルフィリンおよびその合成系
  • I. ポルフィリンの構造と所在
  • II. ポルフィリンの生合成
  • 1. ALAの合成
  • 2. ALAからPBGへ
  • 3. PBGからウロポルフィリノーゲンIIIへ
  • 4. ウロポルフィリノーゲンIIIからコプロポルフィリノーゲンIIIへ
  • 5. コプロポルフィリノーゲンIIIからプロトポルフィリン9へ
  • 6. プロトポルフィリン9への鉄挿入
  • III. ポルフィリン生合成の異常
  • 1. 赤芽球増殖性ポルフィリン症
  • 2. 赤芽球増殖性肝性ポルフィリン症
  • 3. 肝性ポルフィリン症
  • 1) 急性間欠性ポルフィリン症
  • 2) 混合ポルフィリン症
  • 3) 遺伝性コプロポルフィリン症
  • 4) 晩発性皮膚ポルフィリン症
  • 4. 鉄芽球性貧血
  • 1) 一次性鉄芽球性貧血
  • 2) 二次性鉄芽球性貧血
  • 文献
  • §5. 赤血球寿命
  • I. 赤血球の老化と崩壊
  • 1. 赤血球の老化
  • 2. 赤血球の崩壊
  • 3. ヘモグロビンの分解
  • II. 赤血球寿命の測定
  • 1. Ashbyの分別凝集法
  • 2. アイソトープ標識赤血球を用いる方法
  • 1) 赤血球の集団 (cohort) 標識
  • 2) 赤血球の無選択 (random) 標識
  • 3. その他の測定方法
  • III. 赤血球回転
  • 文献
  • §6. 異常ヘモグロビン
  • I. 定義
  • II. 歴史
  • III. Hbの構造と機能
  • IV. Hbの生合成
  • V. 異常Hb症の遺伝
  • VI. 異常Hb症の本態
  • 1. 一点突然変異
  • 2. 二点突然変異
  • 3. 停止コドンの延長をおこす点突然変異
  • 4. 不均等交叉によるフレーム・シフト
  • 5. 不均等交叉による重複または欠落
  • 6. 融合遺伝子
  • 7. Th症候群
  • 8. HPFH症候群
  • VII. 臨床症状
  • 1. 無症状異常Hb症
  • 2. 鎌状貧血
  • 3. 不安定Hb症
  • 4. チアノーゼを伴うHbM症
  • 5. 赤血球増多症を呈する異常Hb症
  • 6. サラセミア症候群
  • 1) α-Th
  • 2) β-Th
  • 3) HPFH
  • VIII. 分布
  • IX. 診断
  • 1. 赤血球の形態
  • 1) 正球性正色性赤血球であるが奇形赤血球
  • 2) 小球性低色性赤血球で標的または奇形赤血球
  • 2. 電気泳動
  • 3. 熱変性試験
  • 4. 分光学的検査その他
  • 5. 異常鎖の決定
  • 1) 解離電気泳動
  • 2) 新種形成試験
  • 6. 異常部位の決定
  • 1) 異常鎖の分離
  • 2) フィンガープリント
  • 3) アミノ酸置換の決定
  • 7. α, β鎖合成比の検討
  • 8. その他の病態生理
  • X. 治療と予防
  • 1. 対症的療法
  • 1) 輸血
  • 2) 摘脾
  • 3) 除鉄剤
  • 4) ステロイド
  • 2. その他の療法
  • 3. 予防方策
  • 文献
  • §7. ロイコカイネティクス
  • はじめに
  • I. 骨髄における好中球の動態
  • 1. 増殖細胞群
  • 2. 非増殖細胞群
  • 3. 骨髄好中球系の各成熟段階への細胞流量率
  • II. 血液における好中球の動態
  • 1. 3H-TdR標識好中球の血液への出現の状況
  • 2. 血液の好中球プール
  • 3. 血液好中球のプール・サイズ, T1/2および好中球交替率 (GTR)
  • III. 血管外における好中球の動態
  • まとめ
  • 1. 恒常性からみた好中球動態
  • 2. 骨髄における成熟好中球の備蓄
  • 文献
  • §8. 血小板の寿命
  • I. 血小板の機能
  • II. 巨核球からの血小板産生と血小板の特性
  • III. 流血中の血小板寿命と測定法
  • 1. 血小板寿命測定の意義
  • 2. Cohort labelling
  • 3. Random (population) labelling
  • 4. Na2 51CrO4法による血小板寿命の測定
  • 1) 血小板の分離と標識
  • 2) 被検者よりの経時的採血と測定
  • 3) 血小板寿命測定値の解析
  • 4) 減衰曲線が直線的な場合の平均寿命値の比較
  • 5) 減衰曲線が指数関数的な場合の平均寿命値の比較
  • 5. アスピリン負荷血小板寿命値測定
  • 1) 試料の作製
  • 2) 測定方法
  • 3) データ分析
  • IV. 臨床的意義
  • 1. 血小板減少症
  • 2. 血栓症
  • 3. 抗血小板剤の治療効果と判定の指標としての有用性
  • 1) ジビリダモール
  • 2) 抗炎症剤
  • 4. 動脈硬化の発症と血小板動態
  • 文献
  • 2. 血液学的特殊検査
  • §1. 血球酵素
  • はじめに
  • I. 赤血球系酵素
  • 1. pyruvate kinase異常症
  • 2. Glucose-6-phosphate dehydrogenase (G&PD) 異常症
  • II. 白血球系の酵素
  • 1. アルカリ性ホスファターゼ
  • 2. 酸性ホスファターゼ
  • 3. エステラーゼ
  • 4. ペルオキシダーゼ
  • 5. ムラミダーゼ (リゾチーム)
  • 6. Terminal deoxynucleotidyl transferase
  • 7. Adenosine deaminase
  • 8. Hexosaminidase
  • 9. N alkaline phosphatase
  • III. 血小板の酵素
  • 1. プロスタグランディン代謝
  • 1) phospholipase A2
  • 2) cyclooxygenase
  • 3) Thromboxane synthetase
  • 2. プロスタグランディン代謝以外の代謝
  • 文献
  • §2. LE細胞
  • 文献
  • §3. シンチグラフィ―
  • はじめに
  • I. 血球の標識
  • II. 血小板動態
  • 1. 正常者
  • 2. 特発性血小板減少性紫斑病
  • 3. 特発性血小板減少性紫斑病
  • 4. うっ血性脾腫
  • 5. 血小板動態観察の意義
  • III. リンパ球動態
  • 1. 慢性リンパ性白血病
  • 2. 悪性リンパ腫 (B細胞型)
  • 3. 悪性リンパ腫 (T細胞型)
  • 4. 成人型T細胞型白血病 (摘脾例)
  • 5. 中心に壊死巣を伴った脾腫
  • 6. リンパ球動態観察の意義
  • おわりに
  • 文献
  • §4. 染色体分析
  • はじめに
  • I. 染色体分析技術
  • 1. 通常法
  • 2. 分染法
  • 3. 染色体自動分析法
  • II. 染色体分析の血液学への応用 (最近のトピックから)
  • 1. FAB 分類と染色体変化
  • 1) "lymphoblastic" leukemia
  • 2) myeloid leukemias
  • 3) dysmyelopoietic syndromes (DMPS)
  • 2. 慢性骨髄性白血病の病態と染色体変化
  • 3. 共通した染色体変化とそのphenotype
  • まとめ
  • 文献
  • §5. 造血細胞培養
  • I. 顆粒球系コロニー法
  • 1. 意義
  • 2. 方法
  • 3. 顆粒球系コロニー形成細胞の性質
  • 1) 好中球マクロファージコロニー形成細胞
  • 2) 好酸球コロニー形成細胞
  • 3) 好塩基球コロニー形成細胞
  • 4. 臨床的応用
  • II. 赤芽球コロニー法
  • 1. 意義
  • 2. 方法
  • 1) 血漿凝塊法
  • 2) メチルセルローズ法
  • 3. 赤血球系前駆細胞の性質
  • 4. 臨床的応用
  • III. 巨核球コロニー法
  • 1. 意義
  • 2. 方法 (血漿凝塊法)
  • 3. 臨床応用
  • IV. 混合コロニー法
  • 1. 意義
  • 2. 方法
  • 3. 混合コロニー形成細胞の形質
  • 4. 臨床応用
  • V. 白血病芽球コロニー形成細胞
  • 1. 意義
  • 2. 方法
  • 3. 白血病芽球コロニー形成細胞の性質
  • 4. 臨床的応用
  • 文献
  • 3. 赤血球の物理的特性とその異常 (循環血液量・血液比重・血液粘度の異常と赤血球膜)
  • はじめに
  • I. 循環血液量とその異常
  • II. 血液比重とその異常
  • III. 血液粘度と赤血球の物理的特性
  • 1. ずり速度, ずり応力と粘度の定義
  • IV. 血液粘度の決定因子について
  • 1. 血漿粘度
  • 2. 細胞濃度
  • 3. 赤血球変形能
  • 1) 外力の作用
  • 2) 赤血球自体の変形能
  • 4. 赤血球凝集とその異常
  • 1) 赤血球凝集の測定法
  • 2) 赤血球凝集の機序
  • 3) 赤血球凝集に影響を与える諸因子
  • V. 血液粘度決定要因間の関連について
  • 1. 温度
  • 2. 滲透圧
  • 3. pH
  • 4. ヘモグロビン酸素化
  • 5. 代用血漿
  • VI. 血液粘度の生理的変動について
  • 1. 年令・性別
  • 2. 季節変動と日中変動
  • 3. 運動と姿勢
  • 4. 食事
  • VII. 血液粘度と赤血球rheologyの異常
  • 1. 血液疾患
  • 1) 赤血球数 (濃度) の変化
  • 2) 赤血球変形能の低下
  • 2. 血液疾患以外の諸疾患
  • 1) 循環ショック
  • 2) 心血管障害
  • 3) 糖尿病
  • 4) 外科手術・麻酔
  • 5) 呼吸器疾患
  • おわりに
  • 文献
  • 4. 血液学的正常値とその変動
  • はじめに
  • 1. 生理的変動
  • I. 赤血球数
  • 1. 成人の正常値
  • 2. 生理的変動
  • II. 白血球数
  • 1. 成人の正常値
  • 2. 生理的変動
  • III. 血色素
  • 1. 成人の正常値
  • 2. 生理的変動
  • IV. ヘマトクリット
  • 1. 成人の正常値
  • 2. 生理的変動
  • V. 赤血球平均恒数
  • VI. 網赤血球数
  • 1. 生理的変動
  • VII. 血小板数
  • 1. 成人正常値
  • 2. 生理的変動
  • VIII. 白血球像
  • 文献
  • 索引
  • 奥付

この書籍の参考文献

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本参考文献は電子書籍掲載内容を元にしております。

1. 血球代謝の理論と臨床

P.20 掲載の参考文献
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2. 血液学的特殊検査

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3. 赤血球の物理的特性とその異常 (循環血液量・血液比重・血液粘度の異常と赤血球膜)

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20) Evans, E. A. and La Celle, P. L:Intrinsic material properties of the erythrocyte membrane indicated by mechanical analysis of deformation. Blood 45:29-43, 1975.
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4. 血液学的正常値とその変動

P.298 掲載の参考文献
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2) 山口延男:自動血球計数法新版日本血液学全書13, 血液学的検査, 正常値 13, 丸善 1979.
 
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6) 三輪史郎, 大場康寛:血液学的正常値. 新版日本血液学全書13, 血液学的検査, 正常値, 867, 丸善 1979.
 
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12) 山本和子, 佐藤陽子, 森川佳代子, 峠岡健司, 河野端枝, 杉村明美, 照屋節子:抗凝固剤の中での血小板集塊形成を起す偽性血小板減少症の実態とその測定法. 京都府衛検技会誌5:62, 1978.
 
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