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Autoren:
Verlag:
Springer-Verlag Weitere Titel dieses Verlages anzeigen
I Biologische Grundlagen | ||
1 | Einleitung | 3 |
1.1 | Genetik - Schlüsseldisziplin der modernen Medizin | 3 |
1.2 | Häufigkeit genetischer Krankheiten | 3 |
2 | Molekulare Grundlagen | 6 |
2.1 | DNA | 6 |
2.2 | Gene | 9 |
2.3 | Repetitive Sequenzen und Kopienzahlvariabilität | 12 |
2.4 | Vom Gen zur mRNA | 14 |
2.5 | Von der mRNA zum Protein | 17 |
2.6 | RNA | 20 |
2.7 | Chromosomen | 21 |
2.8 | Besonderheiten der Geschlechtschromosomen | 24 |
2.9 | Mitose und Meiose | 27 |
3 | Mutationen und genetische Variabilität | 31 |
3.1 | Begriffsklärungen | 31 |
3.2 | Mutationstypen | 33 |
3.3 | Zahlenmäßige Chromosomenstörungen | 35 |
3.4 | Strukturelle Chromosomenstörungen | 36 |
3.5 | Genmutationen | 40 |
3.6 | Dynamische Mutationen, Trinukleotidrepeats | 44 |
4 | Pathomechanismen genetischer Krankheiten | 51 |
4.1 | Vom Genotyp zum Phänotyp | 51 |
4.2 | Dominant und rezessiv | 53 |
4.3 | Epigenetik und genomisches Imprinting | 59 |
4.4 | Mosaike | 68 |
5 | Vererbungsformen | 72 |
5.1 | Mendel-Regeln | 72 |
5.2 | Autosomal-dominante Vererbung | 72 |
5.3 | Autosomal-rezessive Vererbung | 74 |
5.4 | X-chromosomale Vererbung | 76 |
5.5 | Y-chromosomale Vererbung | 78 |
5.6 | Mitochondriale Vererbung | 78 |
5.7 | Multifaktorielle Vererbung | 81 |
6 | Mehrlingsschwangerschaften | 83 |
6.1 | Zwillingsschwangerschaften | 83 |
6.2 | Doppelfehlbildungen | 84 |
7 | Tumorgenetik | 85 |
7.1 | Krebs ist eine genetische Erkrankung | 85 |
7.2 | Onkogene | 86 |
7.3 | Tumorsuppressorgene | 88 |
8 | Aitern und Genetik | 91 |
8.1 | Veränderungen auf Proteinebene | 91 |
8.2 | Veränderung auf DNA-Ebene | 92 |
9 | Pharmakogenetik | 94 |
9.1 | Grundlagen des Arzneimittelstoffwechsels | 94 |
9.2 | Pharmakogenetik in der Praxis | 95 |
9.3 | Pharmakogenetische Krankheiten | 96 |
9.4 | Pharmakogenomik | 97 |
II Humangenetik als ärztliches Fach | ||
10 | Humangenetik als ärztliches Fach | 101 |
10.1 | Diagnose genetischer Krankheiten | 101 |
10.2 | Patientenbetreuung und Koordination ihres interdisziplinären Managements | 102 |
10.3 | Humangenetische Beratung | 102 |
10.4 | Humangenetische Grundlagenforschung | 102 |
11 | Genetische Beratung | 103 |
11.1 | Begleitung und Beratung | 103 |
11.2 | Aufgaben und Ziele der genetischen Beratung | 103 |
11.3 | Besondere Beratungssituationen | 104 |
11.4 | Nondirektivität | 107 |
12 | Zugang zum Patienten | 108 |
12.1 | Eigenanamnese | 108 |
12.2 | Familienanamnese und Stammbaumanalyse | 109 |
12.3 | Klinisch-genetische Untersuchung | 110 |
12.4 | Verhaltensauffälligkeiten | 114 |
12.5 | Weiterführende Untersuchungen | 114 |
12.6 | Ratschläge für »Syndromologen in spe« | 115 |
13 | Fehlbildungen und andere morphogenetische Störungen | 116 |
13.1 | Embryologie | 116 |
13.2 | Morphologische Einzeldefekte | 118 |
13.3 | Multiple morphologische Defekte | 120 |
13.4 | Teratogene Faktoren | 123 |
14 | Risikoberechnung | 131 |
14.1 | Wahrscheinlich oder unwahrscheinlich? | 131 |
14.2 | Regeln der Risikoberechnung | 132 |
14.3 | Hardy-Weinberg-Gesetz | 135 |
14.4 | Faktoren, die das Hardy-Weinberg-Gleichgewicht stören | 138 |
15 | Genetische Labordiagnostik | 141 |
15.1 | Zytogenetik | 141 |
15.2 | Molekulargenetik | 147 |
16 | Stoffwechseldiagnostik und Neugeborenenscreening | 156 |
16.1 | Stoffwechseldiagnostik | 156 |
16.2 | Grundlagen des Neugeborenenscreenings | 157 |
Inhaltsverzeichnis | ||
16.3 | Durchführung des Neugeborenenscreenings | 158 |
16.4 | Wichtige im Neugeborenenscreening erfasste Krankheiten | 159 |
17 | Pränataldiagnostik | 162 |
17.1 | Nichtinvasive Untersuchungsmethoden | 163 |
17.2 | Invasive Untersuchungsmethoden | 166 |
18 | Humangenetik - eine ethische Herausforderung | 169 |
18.1 | Ethische Prinzipien | 169 |
18.2 | Pränataldiagnostik und Schwangerschaftsabbruch | 169 |
18.3 | Präimplantationsdiagnostik | 171 |
18.4 | Genetische Untersuchungen im Versicherungsbereich und im Arbeitsleben | 172 |
18.5 | Eugenik | 173 |
III Klinische Genetik | ||
19 | Angeborene Fehlbildungssyndrome | 177 |
19.1 | Numerische Chromosomenaberrationen | 177 |
19.2 | Strukturelle Chromosomenaberrationen | 188 |
19.3 | Multiple angeborene Fehlbildungen als Folge einzelner Gendefekte | 192 |
20 | Haut und Bindegewebe | 195 |
20.1 | Erbliche Hautkrankheiten | 195 |
20.2 | Erbliche Bindegewebekrankheiten | 198 |
21 | Kreislaufsystem und Hämatologie | 204 |
21.1 | Angeborene Herzfehler | 204 |
21.2 | Kardiomyopathie | 209 |
21.3 | Erbliche Herzrhythmusstörungen | 210 |
21.4 | Blutgruppen | 210 |
21.5 | Anämien | 211 |
21.6 | Erbliche Blutungsneigung | 216 |
21.7 | ErblicheThromboseneigung (Thrombophilie) | 218 |
22 | Atmungssystem | 220 |
22.1 | Monogene Lungenkrankheiten | 220 |
22.2 | Multifaktorielle Lungenkrankheiten | 224 |
23 | Verdauungssystem | 225 |
23.1 | Entwicklung und Gliederung | 225 |
23.2 | Fehlbildungen | 225 |
23.3 | Leberfunktionsstörungen | 228 |
23.4 | Ikterus und Hyperbilirubinämie | 231 |
24 | Stoffwechselkrankheiten | 233 |
24.1 | Störungen des Intermediärstoffwechsels | 233 |
24.2 | Störungen des lysosomalen Stoffwechsels | 241 |
24.3 | Störungen des Lipidstoffwechsels | 242 |
24.4 | Störungen anderer Stoffwechselwege | 244 |
25 | Endokrinium und Immunsystem | 247 |
25.1 | Diabetes mellitus | 247 |
25.2 | Adrenogenitales Syndrom | 248 |
25.3 | Autoimmun-Polyendokrinopathien | 251 |
26 | Skelett und Bewegungssystem | 253 |
26.1 | Abnorme Knochenbrüchigkeit | 253 |
26.2 | Skelettdysplasien | 253 |
26.3 | Kraniosynostosen | 255 |
26.4 | Metabolische Knochenkrankheiten | 258 |
26.5 | Multifaktorielle angeborene Skelettfehlbildungen | 259 |
27 | Harntrakt | 262 |
27.1 | Angeborene Nierenfehlbildungen | 262 |
27.2 | Zystische Nierenkrankheiten | 262 |
27.3 | Krankheiten des Nierentubulussystems | 263 |
28 | Genitalorgane und Sexualentwicklung | 264 |
28.1 | Störungen der Geschlechtsentwicklung | 264 |
28.2 | Genitalfehlbildungen | 266 |
29 | Augen | 268 |
29.1 | Angeborene Störungen des Farbensehens | 268 |
29.2 | Katarakt | 269 |
29.3 | Blindheit | 269 |
30 | Ohren und Gehör | 272 |
30.1 | Erbliche Formen der Gehörlosigkeit | 272 |
30.2 | Umweltfaktoren und Taubheit | 273 |
31 | Neurologische und neuromuskuläre Krankheiten | 274 |
31.1 | Neurodegenerative ZNS-Krankheiten | 274 |
31.2 | Andere ZNS-Krankheiten | 282 |
31.3 | Krankheiten des peripheren Nervensystems | 293 |
31.4 | Erbliche Muskelkrankheiten | 294 |
32 | Tumorerkrankungen | 298 |
32.1 | Leukämien und Lymphome | 298 |
32.2 | Solide maligne Tumoren des Kindesalters | 299 |
32.3 | Brust-und Ovarialkrebs | 301 |
32.4 | Kolorektale Tumoren | 304 |
32.5 | Multiple endokrine Neoplasien (MEN) | 309 |
32.6 | Hamartosen | 311 |
32.7 | Störungen der DNA-Reparatur | 316 |
32.8 | Andere familiäre Krebsprädispositionssyndrome | 319 |
IV Besondere klinische Probleme | ||
33 | Sterilität und Infertilität | 323 |
33.1 | Infertilität des Mannes | 323 |
33.2 | Sterilität/Infertilität der Frau | 327 |
Inhaltsverzeichnis | ||
34 | Fehlgeburten | 329 |
34.1 | Ursachen von Fehl-und Totgeburten | 329 |
34.2 | Habituelle Aborte | 330 |
35 | Wachstumsstörungen | 332 |
35.1 | Kleinwuchs | 332 |
35.2 | Großwuchs/Überwuchs | 335 |
35.3 | Adipositas | 335 |
35.4 | Dystrophie | 337 |
36 | Abnormer Kopfumfang | 339 |
36.1 | Mikrozephalie | 339 |
36.2 | Makrozephalie | 341 |
37 | Erhöhte Infektanfälligkeit | 343 |
V Patientenberichte | ||
38 | Patienten und deren Familien berichten | 349 |
38.1 | Felix | 349 |
38.2 | Zum 50. Geburtstag einer Frau mit Triple-X-Syndrom | 350 |
38.3 | Simon | 351 |
Stichwortverzeichnis | 353 | |
A
ABO-Blutgruppensystem 55,211
ABL /-Protoonkogen 37, 298
Abort 329
absence of heterozygosity (AOH) 340
Achondroplasie 253,333
Achromasie 268
Acylcarnitin 156,234
Additionssatz 132
Adenin (A) 6
Adenom, kolorektales 304
Adenoma sebaceum 315
Adenosindesaminase-(ADA-)Mangel 343
Aderlass 229
adrenogenitales Syndrom (AGS) 248, 266, 328
- Neugeborenenscreening 159
advanced glycation end product (AGE)
91
Agammaglobulinämie 343
AGE 91
Ahornsirupkrankheit, Neugeborenen- screening 160
Akinesie, fetale 260
akute intermittierende Porphyrie 97
akute lymphatische Leukämie (ALL) 299
Alagille-Syndrom 231
Albinismus 195
Albright'sche hereditäre Osteo- dystrophie (AHO) 259
Alkoholembryopathie 126
- Mikrozephalie 340
Allel 32
Allelfrequenz, Einflussfaktoren 139
allelische Krankheiten 52
Alphal-Antitrypsin-Mangel
(a1-Antitrypsin-Mangel) 224
Alphafetoprotein (AFP) 165, 284 17-Alpha-Hydroxylase-Mangel
(17a-Hydroxylase-Mangel) 249 5-Alpha-Reduktase (5a-Reduktase) 264
- Mangel 266
Alpha-Synuclein (a-Synuclein) 274
Alport-Syndrom 273
Alter, erhöhtes väterliches 200
Altern, Genetik 91
Altersstar (? auch Katarakt)
- grauer 269
Amelie 125
Aminoacyl-tRNA 19
Aminoacyl-tRNA-Synthetase 17
Aminoazidopathie 235
Aminosäure, Codierung 17
Aminosäurenstoffwechselstörungen
235
Amish 139
Ammoniak (NH3) 238
Amnion 83
Amnionband 119
Amniozentese 167
- Interphase-FISH 145
Amplifikation, MYCN 300
Amsterdam-Il-Kriterien 307
amyotrophe Lateralsklerose (ALS) 279
Analatresie 225
Anämie, hämolytische 211
Anaphase 28
Androgenbiosynthese, Störungen 266
Androgene 264
Androgeninsensitivität 265
Androgenrezeptor, Defekt 265
Anenzephalie 283
Aneuploidie 35,177
- fetale 329
Angelman-Syndrom (AS) 64-66
- Mikrozephalie 340
Angiofibrome, faziale 315
Angiomyolipome, Nieren 316
Ankyrin 212
Anomalie 118
Anticodon 17
Antiepileptikumembryopathie 125
Anti-Müller-Hormon (AMH) 264
Antiphospholipid-Syndrom 331
Antithrombin-Ill-Mangel 219
a1-Antitrypsin-Mangel 224
Antizipation 45
- paternale 276
Aorta ascendens, Dissektion 200
Aortenaneurysma, familiäres thorakales 203
Aortenwurzelaneurysma 200
APC-Gen (adenomatöse Polyposis coli) 305
APC-Resistenz 218
Apert-Syndrom 257
A-posteriori-Wahrscheinlichkeit 133
A-priori-Wahrscheinlichkeit 133
Arachnodaktylie 200
- kongenitale kontrakturale 203
Arthrogryposis multiplex congenita
(AMC) 260
Arzneimittelreaktion, ungewöhnliche 94
Arzneimittelstoffwechsel, Grundlagen 94
Aspermie 324
Assoziation 121
Asthenozoospermie 324
Asthma bronchiale 224
Ataxia teleangiectatica (AT) 198, 278
- Immundefizienz 344
Ataxien 277
Atherosklerose 242
Atresie, im Bereich des Gastrointesti-
naltrakts 225
Autismus-Spektrum-Störungen (ASS) 292
Autoantikörper, habitueller Abort 331
Autoimmunerkrankung 247
Autoimmun-Polyendokrinopathien 251
Autoimmunsyndrom, polyglanduläres 251
Automutilation 114,246
Autonomie, Medizinethik 169
Autosom 21
autosomal-dominante Vererbung 72
autosomal-rezessive Vererbung 74
Autosomen, Störungen der Anzahl 177
Autozygotiekartierung 153
Azidose, renal-tubuläre (RTA) 263
Azoospermie 324
- bei Mukoviszidose 221
- obstruktive 326
B
B-Allel-Frequenz (BAF) 146
Bänderungstechniken, zytogenetische 141
Bannayan-Riley-Ruvalcaba-Syndrom 342
Bardet-Biedl-Syndrom 270
- Adipositas 337
Barr-Körperchen 26
Bartter-Syndrom 263
Basalganglienkrankheiten 274
Basalzellnävussyndrom 319
Basenexzisionsreparatur 316
Basenfehlpaarung 316
Basenpaar, komplementäres 6
Basisrisiko 162
Bauchwanddefekt 225
Bayes-Theorem 133
BCR-ABL-Fusionsprotein 37,298
Beals-Syndrom 203
Becker-Muskeldystrophie (BMD) 294
Beckwith-Wiedemann-Syndrom 301,
335
- Omphalozele 226
Befundmitteilung 106
Behinderung, geistige 286
Benefizienz, Medizinethik 169
Beratung
- humangenetische 102
Beratungsbrief 102-104
Beratungsprozess, 3-stufiger 105
Beratungssituationen, klassische 131
Beta-Catenin (ß-Catenin) 305
A-D