著者
太田 富雄 和賀 志郎 半田 肇 斉藤 勇 馬杉 則彦 竹内 一夫 鈴木 二郎 高久 晃
出版者
一般社団法人 日本脳卒中の外科学会
雑誌
脳卒中の外科研究会講演集 (ISSN:03878031)
巻号頁・発行日
vol.3, pp.61-68, 1975-06-06 (Released:2012-10-29)
参考文献数
15
被引用文献数
1

Disturbance of consciousness in acute stage, so far, has been classified by using a set of technical terms such as coma, stupor, somnolence, confusion and so on. However, the definition of such terms has a different nuance from one clinic to another, and this made the comparison of the data on the same topics incomplete and incorrect. Because of this, it is true in most neurosurgical clinics in Japan that the severity of the disturbance of consciousness has long been described with grades of the responsiveness to different stimuli laden to the patients.In order to obtain an universal classification on this matter, possibility ef quantitative and qualitative gradings has been searched by means of combining the following three factors; arousal, responsiveness to mechanical and verbal stimuli, and the contents of consciousness. Table shows our proposal of quantitative and partially qualitative grading of the disturbance of consciousness in acute stage. Deep coma, coma and semicoma in the contemporary usage belong to grade III in our classification; stupor, lethargy, hypersomnia, somnolence, and drowsiness belong to grade II, and delirium, confusion, and senselessness belong to grade I.Features of this new grading of the disturbance of consciousness in acute stage have been discussed.Table: New grading of level of consciousness in acute stage (So-ocalled 3-3-9 formula) Grade III. The patient is unable to be arousen with any forceful mechanical stimulus, and(300) 3. is not responsive at all except for change of respiratory rhythm,(200) 2. is responsive with slight movements including decerebrate response, or(100) 1. is responsive with combative oropurposeful movements. Grade II. The patient is able to be arousen with mechanical or verbal stimuli, and(30) 3. is barely arousen with repeated mechanical stimuli,(20) 2. is arousen with loud voice or shaking shoulders, or(10) 1. is arousen easily with usual voice. Grade I. The patient is awake without any stimulus, and(3) 3. is quite senseless and cannot tell even his own name or date of birth,(2) 2. is disorientated to time, place, and person, or(1) 1. is seemingly alert but not fully so. “R” and“Inc” are added to the grading in case of restlessness and incontinence.
著者
藤本 文朗 太田 富雄 加瀬 進 小川 克正 河相 善雄 玉村 公二彦 後藤 容子
出版者
滋賀大学
雑誌
基盤研究(B)
巻号頁・発行日
1997

本研究は、障害児教育教員の免許制度(養成・採用・研修に関する懸案事項)を解決するため盲・聾・養護学校並びに都道府県教育委員会・教員養成大学の実情を把握することとともにこの制度についての歴史的研究と国際比較を通して、総合的な観点から免許制度と教師教育の在り方について立案することを意図した。(1)第3年次としてまとめの年で今後あるべき方向として障害児学校の教師には研修として総合的な障害児教育の基礎免許状(教員養成大学学部)を義務づけ、障害別の免許状は大学院専攻科レベルで取れるとしてそのカリキュラムを草案として示した。(2)又ベトナムホーチミン市に障害児教育師範大学(2年、現取対象)の創立、カリキュラム教師派遣に援助して発展途上国の教師教育について討議した。
著者
八田 徳高 福永 真哉 太田 富雄
出版者
川崎医療福祉学会
雑誌
川崎医療福祉学会誌 = Kawasaki medical welfare journal (ISSN:09174605)
巻号頁・発行日
vol.27, no.2, pp.449-455, 2018

標準純音聴力検査の結果は正常であるが,日常生活,特に職場での聞こえの困難さを訴える成人2例に対して,聴覚情報処理に関する検査を実施し,聞こえの困難さについて分析を行った.また,聞こえの問題と同時に注意や記憶など他の背景要因の関連についても検討するために神経心理学的検査を実施した.その結果,2名とも聴覚情報処理に関する問題をもっていることが明らかになった.1名は,神経心理学的検査の結果では成績の低下はなく,聴覚情報処理障害の可能性が考えられた.もう一方の症例は,記憶及び注意に関する検査においても成績の低下がみられたことから,他の要因からくる聞こえの困難さが疑われる結果となった.このことから聴覚情報処理機能の評価では,神経心理学的検査を実施し,その背景にある要因について検証することの重要性を確認することができた.
著者
太田 富雄
出版者
日本医学哲学・倫理学会
雑誌
医学哲学 医学倫理 (ISSN:02896427)
巻号頁・発行日
vol.10, pp.122-131, 1992-10-23 (Released:2018-02-01)

At the beginning, I would like to express my opposition to the Ad Hoc Committee on Brain Death and Organ Transplantaion in Japan. Although I have treated many brain dead patients as a neurosurgeon, my conclusion seems not to be derived from scientific knowledge, but from an unexplainable but perhaps natural reaction to Japanese culture. I know very well as a scientist that brain dead patients are all but dead as a human beings. However, they are usually not dying alone, but have their deeply sorrowful family members around them. Their psychological states can never be relieved or be replaced by "humanism" in such moments. Rather, I would like to let them die in dignity, withholding further active treatments, acting instead as the representative of God or as a priest at the farewell ceremony between the dying patient and the family members and close friends. I would also like to avoid organ transplantations. The reason is that I think there is a severe shortage of donors in Japan, unlike in the United States or the European countries. The health care system in our country is so complete that every patient who wants and has a reasonable indication of the need for transplantation has the right to be so treated. It would be chaos in Japan, much more severe than in any other country, if patients realized that transplantation works very well and they were in competition for donors.
著者
太田 富雄
出版者
日本医学哲学・倫理学会
雑誌
医学哲学 医学倫理 (ISSN:02896427)
巻号頁・発行日
vol.7, pp.102-112, 1989-07-31 (Released:2018-02-01)

Once people said that medicine was the art of ethics. However, it is now impossible for a practitioner to treat a patient in such a manner. Revolutionary advances in medicine have placed the problem of ethical attitude in the field of practice. Considering these points, it has been asked why the statements about the right to the choice of treatments have been proposed. Of course, it is true even now that patients can not be satisfied without the devotion of medical teams. However, it is really in the field of the most advanced medical technique that ethical problem should be resolved. Here we have discussed the subject of organ transplantation in relation to the brain-dead and persistently vegetative patients, with whom we neurosurgeons are so familiar. In fact, organ transplantation as a medical practice must be one of the major subjects of philosophy, not only as an ethical problem, but also since it involves the existence of human being in the 21th century. Since human life is so transitory, we should search for harmony by identifying ourselves with the universe. Brain-dead and persistently vegetative patients should not be recognized as dead, but respected as among the poorest human beings. Now it is essential, in order to establish the harmony of the universe, that we create a God who is more appropriate in the modern age.
著者
太田 富雄 KUROIWA Toshihiko KAJIMOTO Yoshinaga
出版者
日本脳神経外科学会
雑誌
Neurologia medico-chirurgica (ISSN:04708105)
巻号頁・発行日
vol.39, no.7, pp.548-550, 1999-07-15
参考文献数
11
被引用文献数
2 6

Flushingとdroppingの機能を備え、さらにjet irrigationも可能な、volume-limited bipolar diathemy forcepsを新しく開発した。Bipolarのfoot switchに同期して作動するroller pumpによって洗浄液が送られ、bipolar両側の先端部から流出する。作動開始時にはflushing機能が働き、これにより出血点が確認できる。直後にdropping機能だけとなり、これにより先端部の焦げ付きを押さえ、そして熱による周囲組織の傷害を防ぐことができる。さらにjet irrigationにより、血腫やdebrisの洗い流しも可能である。これらの選択は、本体で流量を設定しておけば、一つのfoot switchだけですべて可能である。このbipolarは、脳神経外科領域の手術で極めて有用である。