著者

若杉 葉子 戸原 玄 中根 綾子 後藤 志乃 大内 ゆかり 三串 伸哉 竹内 周平 高島 真穂 都島 千明 千葉 由美 植松 宏

出版者

一般社団法人 日本摂食嚥下リハビリテーション学会

雑誌

日本摂食嚥下リハビリテーション学会雑誌 (ISSN:13438441)

巻号頁・発行日

vol.12, no.2, pp.109-117, 2008-08-31 (Released:2021-01-22)

参考文献数

64

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現在行われている多くのスクリーニングテストは誤嚥のスクリーニングテストであり,不顕性誤嚥(SA)をスクリーニングすることは難しいとされている.今回,我々はクエン酸の吸入による咳テストを用いたSAのスクリーニングの有用性について検討を行った.対象は何らかの摂食・嚥下障害が疑われた18歳から100歳までの患者204名 (男性131名,女性73名,平均年齢69.90±11.70歳).超音波ネブライザより1.0重量%クエン酸生理食塩水溶液を経口より吸入させ,1分間での咳の回数を数える.5回以上であれば陰性 (正常),4回以下であれば陽性 (SA疑い)と判定し,VFもしくはVEの結果を基準とし,SAのスクリーニングの感度,特異度,有効度,陽性反応的中度,陰性反応的中度を計算した.咳テストによるSAのスクリーニングの結果は,感度0.87,特異度0.89,有効度0.89,陽性反応的中度0.74,陰性反応的中度0.95であった.次いで主要な原疾患別に咳テストの有用性を検討した.脳血管障害患者におけるSAのスクリーニングの結果は,感度0.76,特異度0.82,有効度0.79,陽性反応的中度0.73,陰性反応的中度0.84であった.頭頚部腫瘍患者におけるSAのスクリーニングの結果は,感度1.00,特異度0.97,有効度0.98,陽性反応的中度0.93,陰性反応的中度1.00であった.神経筋疾患患者におけるSAのスクリーニングの結果は,感度0.83,特異度0.84,有効度0.84,陽性反応的中度0.56,陰性反応的中度0.95であった.呼吸器疾患患者におけるSAのスクリーニングの結果は,感度0.67,特異度0.81,有効度0.76,陽性反応的中度0.67,陰性反応的中度0.81であった.気管切開のある患者におけるSAのスクリーニングの結果は,感度0.71,特異度1.00,有効度0.78,陽性反応的中度1.00,陰性反応的中度0.50であった.認知症患者におけるSAのスクリーニングの結果は,感度1.00,特異度1.00,有効度1.00,陽性反応的中度1.00,陰性反応的中度1.00であった.以上より,クエン酸吸入による咳テストはSAのスクリーニングに疾患によらず有用であると考えられた.

著者

後藤 志乃風

出版者

日本西洋古典学会

雑誌

西洋古典學研究 (ISSN:04479114)

巻号頁・発行日

vol.57, pp.30-40, 2009-03-26

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Bion's Epitaphium Adonidis can be seen to consist of three scenes: 1) Adonis' death and the mourning for him on the part of Aphrodite, Loves, and natural beings in the forest (1-39), 2) Aphrodite's lamentation on his last (40-66), and 3) the funeral in her palace (67-98). In its narrative style, it presents 'a mixture of mimic and diegetic narration' by telling the mythic story in the ritual context of Adonia. Aphrodite's lament (42-61) occupies the central part of the mythic tale, and at the same time plays an important role for the ritual. This paper tries to examine the essential features of the lament to inquire how it contributes to the unity of E. A.. As pointed out by M. Alexiou, The Ritual Lament in the Greek Tradition, Cambridge 1974, 56, Aphrodite's lament has the qualities both of a lament and also of a love song. I focus on them below. Firstly, I compare it with Il. 24. 719-76, a typical scene of women's lament in epic. The topic of 'the deceased's widow and orphan' found in Andromache's lament for Hector is used also in Aphrodite's lament for Adonis. Her lament is also similar to Helene's lament in grieving over the deceased's death as well as over her own distress it causes. Secondly, I examine the elements related to love'. Aphrodite misses Adonis' last kiss in return for the kiss she has given him. It means the pleasure of love exalted by kissing can no longer be reciprocated. The motif of 'fleeing(φευγειν) and chasing(διωκειν)' implies as if Adonis would leave Aphrodite of his own free will. Yet the impossibility of her chasing him across Acheron means that such emotional interchanges as courtship, acceptance or denial are no longer possible between them. And Aphrodite addresses Persephone as a successful rival in love, because Adonis has gone to Hades, Persephone's realm. In the last part of the lament, Adonis is said to 'have died' explicitly, and also longing (ποθοσ)' and kestos, Aphrodite's magic item of allurement, are said to have vanished. It shows that they can no longer enchant and excite each other, namely that the love is over. These elements of 'love' in her lament show that Adonis' death brings the end of Aphrodite's love. In addition, Bion depicts his death as if an irrecoverable one, weakening the image of his resurrection characteristic of the ritual as in Theoc. 15. The goddess can neither recover him nor her love. In this sense, her pain is similar to that of human beings and easy to make them feel sympathy for her. In the third scene (67-98) following the lament, the narration has denser fusion of the mythic and the ritual contexts than in the first scene (1-39). Especially in 67-78, where the scene changes to the funeral of Adonis, the participants of Adonia performs ritual actions fulfilling the role of Aphrodite. This fusion of mythic and ritual contexts is facilitated by the overarching emotional unity with Aphrodite, which is aroused by the goddess' lament. In conclusion, Aphrodite's lament reveals that she grieves for a loss of love with Adonis in a similar way to human beings, so as to make the participants of Adonia feel the emotional unity with her. This is how her lament in the mythic context leads naturally to the third scene with the ritual context and thus brings about unity of E. A..