文献一覧: 一般社団法人日本血栓止血学会 (出版者)

1 0 0 0 血管内凝固症候群とショック

著者: 松田保小河原緑平林直子関俊子横内正利村上元孝島田馨三船順一郎
出版者: 一般社団法人日本血栓止血学会
雑誌: 血液と脈管 (ISSN:03869717)
巻号頁・発行日: vol.9, no.2, pp.208-212, 1978

Recently, growing interests had been devoted largely to disseminated intravascular coagulation (DIC), because of its frequency and clinical importance. It has been known that shock is a frequent complication of DIC, although it has not been elucidated whether shock is a cause of DIC rather than a result. This study was made to clarify relationship between DIC and shock in 699 consecutive autopsied cases, almost all of whom was over age sixty, in Tokyo Metropolitan Geriatric Hospital. The diagnosis of DIC was established when coagulation analysis revealed presence of consumption coagulopathy. Among these cases, 106 had evidences of DIC and 30 had clinical and pathological findings highly suggestive of DIC although the coagulation findings were not specific. Shock was complicated in 38 of the former and 10 of the latter. Eight of these 48 patients with DIC complicated with shock revealed consumption coagulopathy simultaneously with the development of shock. 24 cases had not clea r-cut evidences of DIC immediately after the development of shock in coagulation findings, although they showed marked coagulation abnormalities indicating DIC after the shock developed. 44% of conditions associated with the shock in these patients was gram-negative septicaemia. The other underlying pathologic conditons in these cases consisted of cancer, peptic ulcer, acute myocardial infarction and pneumonia. Onset of shock was observed in 16 cases in whom diagnosis of DIC had been already established by coagulation analysis. 11 cases of these had cancer with metastases, primary organs of which were stomach, colon or biliary tracts. 70% of these patients were febrile. Acute renal failure, purpura, petechiae, melena, coma, epileptic seizure, systemic peripheral gangrene and/or red cell fragmentation in peripheral blood smear were main symptoms in DIC with shock. Four cases, excluding two cases in whom DIC developed following development of acute myocardial infarction, showed ECG findings indicating development of acute myocardial infartion, although myocardial infarction was evident in only one cases by postmortem examination. Presence of fibrin thrombi was confirmed in 36 cases out of the 48 autopsied cases with DIC accompained with shock. Terminal hemorrhagic necrotizing enteropathy was observed in 15 of those cases. Hemorrhage from adrenal was observed in 4 cases. From these results, it is concluded that shock does frequently cause DIC and that shock in gram-negative septicaemia is especially important because of its high incidence to result DIC.

2020-08-31 16:51:16
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1 0 0 0 Hypercoagulability と血栓

著者: 松田保
出版者: 一般社団法人日本血栓止血学会
雑誌: 血液と脈管 (ISSN:03869717)
巻号頁・発行日: vol.1, no.4, pp.485-495, 1970

2020-08-31 16:51:16
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1 0 0 0 老年者の血液粘度

著者: 松田保児玉直子秀野啓子小河原緑松崎俊久村上元孝山之内博
出版者: 一般社団法人日本血栓止血学会
雑誌: 血液と脈管 (ISSN:03869717)
巻号頁・発行日: vol.7, no.2, pp.146-150, 1976

Apparent blood viscosity was measured on freshly shed blood from 127 healthy subjects, ages 21 to 88, and patients hospitalized in Tokyo Metropolitan Yoikuin Geriatrics Hospital, over age 60. Determination of blood viscosity was performed at 37°C using rotational viscometer at shear rates between 0.07 and 4.6sec-1. Mean blood viscosity in 43 healthy older subjects over age 60 (mean age: 74±6) was 45±25cp at 0.07sec-1 and 8±2cp at 4.6sec-1, respectively. Yield stress was calculated from Casson plot at very low shear rates (between 0.44 and 0.07sec-1) by the method of least squares. Mean value of yield stress in the healthy older subjects was 0.011 dynes/cm2. Blood viscosity in the healthy subjects was significantly correlated with hematocrit values. Yield stress in these subjects was also correlated with hematocrit values and blood viscosity at very low shear rates. In these healthy subjects, blood viscosity, yield stress and hematocrit values were highest in the group at age 30-39. Blood viscosity and yield stress showed a slight decline with age in the healthy older subjects. In the hospitalized patients, blood viscosity was higher than 70cp at 0.07sec-1, and/or higher than 11cp at 4.6sec-1 in 107 measurements (86 cases) out of 1443 determinations from December 1973 to October 1974. These patients with blood high viscosity included 12 cases of cancer (one of them was accompanied with disseminated intravascular coagulation (DIC); three of them developed DIC thereafter), 5 cases of acute myocardial infarction, 4 cases of acute cerebral infarction, 5 cases of angina pectoris, 6 cases of old myocardial infarction, 18 cases of old cerebrovascular diseases, 11 cases of diabetes mellitus, and 5 cases of stress polycythemia or polycythemia vera. In these cases, viscosity at 4.6sec-1 was significantly correlated with hematocrit values, whereas viscosity at 0.07sec-1 was not. All patients with blood high viscosity and relatively low hematocrit values suffered from cancer. In 6 cases of acute myocardial, cerebral of renal infarction, in whom changes in blood viscosity, yield stress and hematocrits were investigated before and after the development of infarction, changes in blood viscosity and yield stress were parallel with hematocrits. From these results, it was concluded that high hematocrits caused blood high viscosity and were regarded as one of the risk factors in the pathogenesis of thrombosis, although the other factors than hematocrits might also influence blood viscosity at very low shear rates.

2020-08-31 16:51:16
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1 0 0 0 血液粘度の低温における変化とその意義

著者: 松田保小河原緑三浦玲子関俊子横内正利
出版者: 一般社団法人日本血栓止血学会
雑誌: 血液と脈管 (ISSN:03869717)
巻号頁・発行日: vol.12, no.1, pp.13-15, 1981

Viscosity of blood at 37°C and 25°C was compared in various blood samples using coaxial cylinder viscometer which operates on the couette principle. Ratios of blood viscosity measured at 25°C to one at 37°C at shear rate of 0.39sec-1 were significantly correlated with fibrinogen content of blood (n=49, r=+0.62, p<0.001). However, there was no significant correlation between ratios of blood viscosity at body temperature to one at the lower temperature and hematocrit values (n=49, r=-0.22, n. s.). To confirm important role of fibrinogen in elevation of blood viscosity when temperature falls, following experiment was carried out. Red blood cell suspentions with various amount of fibrinogen were prepared from combinations of packed red cells, bentonite adsorbed plasma, which contains no fibrinogen, normal plasma and human fibrinogen solution. Elevation of viscosity at 25°C was more pronounced when amount of fibrinogen in the suspension increased. Significance of elevated viscosity of blood with increased fibrinogen content at low temperature in development of Raynaud's phenomenon was discussed.

2020-08-31 16:51:16
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1 0 0 0 Ellagic acid の凝血・線溶系に及ぼす影響

著者: 村上元孝松田保万見新太郎平丸三樹大江国広
出版者: 一般社団法人日本血栓止血学会
雑誌: 血液と脈管 (ISSN:03869717)
巻号頁・発行日: vol.1, no.6, pp.857-864, 1970

2020-08-31 16:51:16
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1 0 0 0 Trasylol の線溶・凝血系に及ぼす影響

著者: 村上元孝松田保万見新太郎平丸三樹
出版者: 一般社団法人日本血栓止血学会
雑誌: 血液と脈管 (ISSN:03869717)
巻号頁・発行日: vol.2, no.3, pp.411-417, 1971

2020-08-31 16:51:16
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1 0 0 0 ボストン留学記

著者: 森下英理子
出版者: 一般社団法人日本血栓止血学会
雑誌: 日本血栓止血学会誌 (ISSN:09157441)
巻号頁・発行日: vol.27, no.6, pp.694-696, 2016

2020-08-31 16:51:16
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1 0 0 0 OA 間葉系幹細胞からの血小板創製技術の医療応用研究

著者: 松原由美子
出版者: 一般社団法人日本血栓止血学会
雑誌: 日本血栓止血学会誌 (ISSN:09157441)
巻号頁・発行日: vol.31, no.4, pp.432-438, 2020 (Released:2020-08-12)
参考文献数: 13

Platelets are released from mature megakaryocytes (MKs) and are used for therapeutic application, especially platelet transfusion. Platelet concentrates used for platelet transfusions are currently supplied by volunteer donors. Due to their short shelf life (4 days in Japan and 5 days in US), however, donor-dependent platelet concentrates are associated with practical problems, such as the limited supply and the risk of infection. Thus, new strategies for manufacturing MKs and subsequently platelets from a donor-independent source are urgently needed. Mesenchymal stem cells (MSCs) are known to be non-hematopoietic multipotent progenitor-cells. We found that MSCs/stromal cells differentiated into MKs and platelets. The clinical needs for platelet transfusions are increasing. Adipose tissue-derived MSCs/stromal cells are an attractive candidate cell source because inducing these cells into MK-lineages requires no gene transfer and only endogenous transcription factors containing p45NF-E2/Maf, an MK-inducing factor and endogenous thrombopoietin, a primary cytokine that drives MK lineages. Thus, we developed a manufacturing system for platelets from donor-independent cell source, human adipose-derived mesenchymal stromal/stem cell line (ASCL). ASCL satisfied the minimal criteria for defining MSC by The International Society for Cellular Therapy. ASCL-derived platelets (ASCL-PLT) were obtained with a peak at Day 12 of culture using MK lineage induction media. We observed that CD42b-positive cells expressed a MSC marker CD90 in relation to cell adhesion. The pattern of in vivo kinetics after being infused into irradiated immunodeficient NSG mice was similar to that of platelet concentrates. ASCL-PLT has characterization observed in other platelet populations and might have additional function as MSC. The present protocol is a simple method that requires no feeder cells, further enhancing the clinical application of our approach.

2020-08-18 11:02:51
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1 0 0 0 OA ヘパリンによる血小板凝集作用機序の検討

著者: 上野良樹奥和代
出版者: 一般社団法人日本血栓止血学会
雑誌: 日本血栓止血学会誌 (ISSN:09157441)
巻号頁・発行日: vol.17, no.2, pp.175-182, 2006 (Released:2006-05-30)
参考文献数: 26

HITのII型は免疫学的な機序によって起きることが明らかにされているが, I型のHITなどに見られるヘパリンによる血小板への作用は必ずしも明らかにはなっていない. われわれはこれまで全血を用いたin vitroの系においてヘパリンによる血小板凝集が起きる場合に物理的刺激による血小板の活性化と, RGD配列をもつ粘着蛋白のGPIIb/IIIa complexへの結合とそのクラスタリングが必要であることを報告してきた. 今回血小板の凝集を誘起するヘパリンの条件を検討するために未分画ヘパリンによる血小板凝集作用をかきまぜ刺激あるいは寒冷刺激下において低分子ヘパリンおよびヘパリン類似物質(ヒルドイド, ダナパロイド)と比較した. 低分子ヘパリンはかきまぜ刺激下では有意の血小板凝集効果を示したが, 寒冷刺激下ではその作用はほとんど認められなかった. ダナパロイドは寒冷刺激下で軽度ではあるが有意の血小板凝集効果を示した. しかし, ヒルドイドはいずれの刺激下でも未分画ヘパリンより有意に強力な血小板凝集作用を示した. この作用は未分画ヘパリンと同様にRGDSにより阻害された. これらの結果より, ヘパリンによる血小板凝集作用にはその分子量や硫酸化の状態が関与しているものの非特異的な作用であると考えられた.

2020-06-30 13:45:47
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1 0 0 0 OA 【編集者への手紙「久志本成樹:日本血栓止血学会DIC 診断基準暫定案は適切に評価されたのか?」へのコメント】「日本血栓止血学会DIC 診断基準2017 年版」の展望

著者: 朝倉英策和田英夫
出版者: 一般社団法人日本血栓止血学会
雑誌: 日本血栓止血学会誌 (ISSN:09157441)
巻号頁・発行日: vol.28, no.6, pp.759, 2017 (Released:2017-12-15)
参考文献数: 2
被引用文献数: 1

2020-05-29 11:03:21
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1 0 0 0 OA 肺血栓塞栓症の画像診断

著者: 小泉淳
出版者: 一般社団法人日本血栓止血学会
雑誌: 日本血栓止血学会誌 (ISSN:09157441)
巻号頁・発行日: vol.24, no.4, pp.370-379, 2013-08-01 (Released:2013-09-10)
参考文献数: 13

a.急性胸痛・呼吸困難・失神などから急性肺血栓塞栓症が疑われてショック症状を呈する広汎型患者に対しては,ベッドサイドで低侵襲に施行可能な心臓超音波検査や胸部単純X線写真で拾い上げ,PCPSなどで管理しつつ血管内治療を兼ねた肺動脈造影で確定診断することになる.b.非広汎型では下肢静脈を含めたCTが第一に推奨される.c.ヨード系造影剤の使えないアレルギー,腎機能低下症例や,妊婦,臨床的に強く疑われるのにCTで陰性であった場合(末梢性のshower embolismなど),血栓溶解療法の際の治療効果判定例などに核医学検査を施行する.d.MRIは患者管理の困難性,空間分解能の低さ,撮像時間の長さにやや難があるが,CTを施行できない場合の代替手段として,また血栓のagingやperfusionなど,CT,核医学検査同等以上の情報を提供しうる.

2020-05-03 16:12:21
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1 0 0 0 OA Factor V がいよいよ面白くなってきた:血栓症をおこしたFV Nara 変異とAPC レジスタンス

著者: 篠澤圭子野上恵嗣
出版者: 一般社団法人日本血栓止血学会
雑誌: 日本血栓止血学会誌 (ISSN:09157441)
巻号頁・発行日: vol.25, no.4, pp.482-493, 2014 (Released:2014-09-03)
参考文献数: 45
被引用文献数: 1

要約:APC レジスタンス(APCR)の原因として発見されたFactor V R506Q(FV Leiden)変異は,欧米白人における主要な静脈血栓症のリスクファクターであるが,これまでアジア人からは検出されていない.今回私達は,血漿FV 活性が低下しているにもかかわらず,重篤な深部静脈血栓症をおこした日本人少年のFV 遺伝子からW1920R(FV Nara)変異を同定し,日本人において初めてAPCR に関連する血栓性素因を報告した.FV-W1920R は,APC から受ける不活性化と,APC によるFVIIIa の不活性化におけるコファクターとしての機能の,両者の機能障害によってAPCR を示すことを解明した.とくに,APC によるFVIIIa の不活性化に対するFV-W1920R のコファクター機能は,FVIII のR336 の開裂を完全に阻止することにより,FV-R506Qよりも強い機能不全であることを明らかにした.

2020-03-08 09:57:09
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1 0 0 0 妊娠を契機に発症し cyclosporine A が奏効した後天性血友病A

著者: 小林達之助海渡健大坪寛子薄井紀子相羽恵介
出版者: 一般社団法人日本血栓止血学会
雑誌: 日本血栓止血学会誌 = The Journal of Japanese Society on Thrombosis and Hemostasis (ISSN:09157441)
巻号頁・発行日: vol.20, no.4, pp.443-449, 2009-08-01
参考文献数: 20

39歳,女性.2007年5月帝王切開直後からAPTT延長を伴う出血傾向を認め当院入院.APTT71.6秒,FVIII activity 3%,FVIII inhibitor 6BU/mlであり後天性血友病Aと診断.頻回かつ大量の遺伝子組換え活性化第VII因子(rFVIIa)製剤を使用し出血症状は軽減.FVIII inhibitorには副腎皮質合成ステロイド薬による免疫抑制療法を開始したが軽快せず,cyclosporine A(CyA)を併用したところ,inhibitorは約6ヶ月後に消失した.分娩後発症の後天性血友病ではFVIII inhibitorは自然経過にて消失するとの報告もあるが,本例では早期からのステロイド薬とCyAの併用が著効を呈した.分娩後発症の後天性血友病Aはしばしば重篤な出血症状を呈するため,止血療法としてのバイパス療法の施行基準及びCyAを含めた適切な免疫抑制療法の解析が必要である.