著者
小野寺 誠 小泉 範高 藤野 靖久 菊池 哲 井上 義博 酒井 明夫 遠藤 重厚
出版者
一般社団法人 日本救急医学会
雑誌
日本救急医学会雑誌 (ISSN:0915924X)
巻号頁・発行日
vol.25, no.7, pp.307-312, 2014-07-15 (Released:2014-11-01)
参考文献数
18

症例は30代の女性。東北新幹線乗車中に下腹部痛が出現し救急要請となった。救急隊が病院選定を行う際に自分は医師であると話し前医へ搬送となったが,診察をめぐってトラブルとなったため当院紹介となった。救急隊からの連絡で身分証明書の提示を拒否していたこと,インターネット検索をした結果,氏名と所属が一致しないことを確認したために薬物依存の可能性を考え,前医に医師会への報告を依頼するとともに当院精神科医師による診察を依頼した。当院搬入時,下腹部の激痛を訴えており,一刻も早い鎮痛剤の投与を希望していた。患者によると,子宮頸管狭窄症の診断で海外の病院や都内大学病院で大腿静脈よりペンタゾシンとジアゼパムを静脈内投与していたと主張していた。精神科医師による傾聴後,痛み止めは施行できない旨を伝えていた最中に荷物より所持品が落下した。某大学病院や某研究機関研究員など多数のIDカードを所持しており名前も偽名であった。その直後に突然激高し,看護師の腹部を蹴り,当院から逃走した。30分後,当院より約10km離れた地点で救急要請した。搬送となった病院でセルシン® とソセゴン® を筋注したが10分程で再度除痛するよう訴えた。直後に岩手県医師会から「不審患者に関する情報」がFAXで届き,警察への通報を考慮していたところ突然逃走した。医師会を通じて調査したところ,前日には宮城県,翌日には秋田県の医療機関を同内容で受診していることが判明した。本症例を通して,救急医療機関においては,問題行動のある精神科救急患者を受け入れた際の対応マニュアルを,あらかじめ整備しておくことが望ましいと思われた。
著者
酒井 明子 渥美 公秀
出版者
日本グループ・ダイナミックス学会
雑誌
実験社会心理学研究 (ISSN:03877973)
巻号頁・発行日
pp.1824, (Released:2019-10-29)
参考文献数
37
被引用文献数
1

本研究は,災害という大きな困難に直面した被災者が新たな安定状態を回復する過程に着目した質的研究である。災害時の心理的ストレスは,単線的な心理的回復過程が暗黙のうちに前提とされている。しかし,今日の大規模な災害による被害の甚大さや避難所・応急仮設住宅の設置期間の長期化等は,大切な家族や住み慣れた家を失い生きる意欲を失った人々や自力で生活展望を考えることが困難な高齢者の孤立死や自殺,閉じこもり問題を加速化させており,心理的回復過程も長期化し複雑さを増していると考える。そこで,本研究では,東日本大震災後7年間の心理的回復過程を被災者の語りから分析した。その結果,被災者の心理的変化の特徴は6つのパターンに分類された。また,心理的回復過程には,潜在的な要因及びストレスを慢性化させる要因が影響していた。そして,個々の被災者の心理的変化ラインの時間軸を重ね合わせた結果,1年目,4年目,7年目の回復過程には調査回によって異なる特徴が見出せた。これらの結果を踏まえ,慢性化する可能性のあるストレスを抱えた被災者の長期的な心理的変化と影響要因について論じた。
著者
酒井 明夫
出版者
日本評論社
雑誌
こころの科学 (ISSN:09120734)
巻号頁・発行日
no.95, pp.114-121, 2001-01
著者
酒井 明子 渥美 公秀
出版者
日本グループ・ダイナミックス学会
雑誌
実験社会心理学研究 (ISSN:03877973)
巻号頁・発行日
vol.59, no.2, pp.74-88, 2020 (Released:2020-03-10)
参考文献数
37
被引用文献数
3 1

本研究は,災害という大きな困難に直面した被災者が新たな安定状態を回復する過程に着目した質的研究である。災害時の心理的ストレスは,単線的な心理的回復過程が暗黙のうちに前提とされている。しかし,今日の大規模な災害による被害の甚大さや避難所・応急仮設住宅の設置期間の長期化等は,大切な家族や住み慣れた家を失い生きる意欲を失った人々や自力で生活展望を考えることが困難な高齢者の孤立死や自殺,閉じこもり問題を加速化させており,心理的回復過程も長期化し複雑さを増していると考える。そこで,本研究では,東日本大震災後7年間の心理的回復過程を被災者の語りから分析した。その結果,被災者の心理的変化の特徴は6つのパターンに分類された。また,心理的回復過程には,潜在的な要因及びストレスを慢性化させる要因が影響していた。そして,個々の被災者の心理的変化ラインの時間軸を重ね合わせた結果,1年目,4年目,7年目の回復過程には調査回によって異なる特徴が見出せた。これらの結果を踏まえ,慢性化する可能性のあるストレスを抱えた被災者の長期的な心理的変化と影響要因について論じた。

2 0 0 0 OA 電界蒸発

著者
酒井 明
出版者
公益社団法人 応用物理学会
雑誌
応用物理 (ISSN:03698009)
巻号頁・発行日
vol.53, no.3, pp.183-188, 1984-03-10 (Released:2009-02-09)
参考文献数
46

高電界下で金属の原子がイオンとなっで表面から飛び出してゆく現象は,電界イオン顕微鏡(FIM)の創始者であるMüllerによって発見され,電界蒸発と名づけられている.この電界蒸発はFIMやアトム・プローブの基本原理として活用されているが,その基礎過程はなかなか複雑である.ここでは電界蒸発の基礎的な面に関する理論と実験について述べるとともに,最近の電界蒸発の実験についても言及する.
著者
酒井 明夫
出版者
医学書院
巻号頁・発行日
pp.725, 2010-07-15

著者ラアリーはアナール学派の俊英ジャック・ル=ゴフに学んだ歴史家である。まずは順序通りル=ゴフの序文から目を通すと,いきなりこの書の重要な位置づけが目に飛び込んでくる。ル=ゴフによれば,『中世の狂気』はジャッキー・ピジョーの一連の著作とミシェル・フーコーの『狂気の歴史』の間を埋めるものなのである。 周知のようにフーコーの前掲書は17,18世紀古典主義時代の狂気の諸相を提示し,その意味を考察した名著である。精神医学史を超えてこれが思想界全体に与えた影響は計り知れない。一方のピジョーは古代の狂気を独自の手法で読み解き,そこに詩的ともいえる深い洞察を加えた碩学である。ピジョーの視野には医書ばかりでなくおよそ古代世界の名だたる文献類がとらえられている。ピジョーとフーコーを両脇にした本書には,したがってきわめて高い評価が与えられていることになる。
著者
酒井 明司
出版者
ロシア・東欧学会
雑誌
ロシア・東欧研究 (ISSN:13486497)
巻号頁・発行日
vol.2007, no.36, pp.84-97, 2007 (Released:2010-05-31)

We can find easily dozens of media and academic articles over the past 1-2 years that foretell and warn of Russia's aggressive foreign policies to her neighbours by means of her energy-exporting power in oil and gas. Many of them are the products of the gas dispute between Russia and Ukraine in the early 2006, which also reminds some authors of Russia's oil cut-off of the Baltic countries in the early 90's. In their arguments they seem to share a common understanding that Russia has firm intentions and aims in her foreign policies—to decelerate, if not to exclude fully, democratization of her FSU neighbours and to extract maximum diplomatic concessions from them and the EU members, concluding that her oil and gas resources are political instruments these purposes.After having a look at each oil/gas pipeline project of Russia, however, we feel this conclusion may not match reality. In this article the current main oil and gas pipeline projects of Russia (to Europe—BTS, Burgas-Alexandropoulis, Nord Stream, and South Stream; and to Asian countries—East Siberia-Pacific Ocean (VSTO) and Altaj) are briefly reviewed, and it is hard to see her aggressive diplomatic intentions in them. The main motive of new pipeline construction by Russia to Europe is to bypass as many transit countries as possible or to avoid transportation bottlenecks. They are of a commercial character rather than a political one, though the current transit countries which may lose their position by newly routed pipelines of Russia fear the theoretical worst that they will be under a full energy supply control by Russia. The construction plans of eastbound pipelines to Asian countries and the Pacific Ocean have a primary task to develop the areas of East Siberia and the Far East of Russia, accompanied by again commercial tactics in avoiding transit countries and a single destination route of the energy export.We have to pay more attention to the fact that Russia's energy export policy is hardly reliable in the world energy market, not because of her politicized aggressive stance to consumers but because it only plays a passive role against what the world market expects to one of the main oil and gas exporters. Though Russia reacts to given conditions like transit countries, she does not seem yet to involve herself into market coordination and adjustment of demand/supply balances in cooperation with other producers and consumers.
著者
酒井 明
出版者
The Surface Science Society of Japan
雑誌
表面科学 (ISSN:03885321)
巻号頁・発行日
vol.20, no.8, pp.554-562, 1999-08-10 (Released:2009-08-07)
参考文献数
43
被引用文献数
2 2

When the contact size becomes comparable to electron Fermi wavelength, the electron transport through such a small point contact shows various quantum phenomena. Quantization of conductance is a marked example of such quantum effects. In the case of metal contacts, one has to fabricate atom-sized contacts for observing the quantized conductance. However, thanks to recent developments in nanotechnology, it is now possible to investigate experimentally some properties of quantized conductance in various metallic nanocontacts. In this article, I will give a brief survey of previous studies of quantized conductance in metal nanocontacts. Since this field is relatively new, many aspects of quantized conductance still remain to be identified.
著者
大塚 耕太郎 酒井 明夫 浅利 宏英
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.18, pp.55-65, 2000-12-15 (Released:2018-02-01)

Two cases of schizophrenia (A : paranoid type, B : residual type according to the ICD-10 criteria) were studied, both of which were referred from a psychiatric hospital to the surgical and psychiatric departments of a University Hospital for the treatment of physical complications. Both patients were diagnosed with cancer and surgical treatment was recommended. Although case A underwent surgery along with the full informed consent requirement, case B was treated through proxy consent by her family due to impaired capacity. The difference in competence between these patients seemed to be related to their negative symptoms, for example apaty, abulia, withdrawal, and slowed thought of case B was more severe. In addition, this case study revealed that "reduction of restriction produced by phenomenological disturbances in subjective time in chronic disease" and "coordination of medico-cultural differences between psychiatry and other medical specialties" are necessary to improve the QOL of schizophrenic patients with physical complications. It is suggested that consultation-liaison psychiatry in a broad sense, including sufficient aspects of bioethics and philosophy of medicine, would be useful for the treatment of physical complications of psychiatric patients.
著者
酒井 明夫
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.16, pp.175-182, 1998-10-01 (Released:2018-02-01)

Psychiatric practice in modern Japan has a history of about 100 years. In the early stages, legal regulations placed more emphasis on the protection of society in general rather than the protection of the patients with mental disease. However, in the Mental Health and Welfare Law as currently enforced, it is stressed that the human rights of each patient must be esteemed as much as possible and the core of the policy is on the liberalization of the therapeutic environment. Hence the history of legislation for psychiatric practice in Japan may be interpreted as a process with liberalistic tendencies gradually influencing this legislation. On the other hand, when we look at the physician-patient relationship in psychiatric practice in severe cases, in particular, in the cases of schizophrenia, volition and individual thinking are often disabled in both content and application. In these cases, where mental disorders reach such a stage that human judgment is impaired, informed consent cannot be obtained, and medical treatment by the "autonomy model" is practically impossible to perform. In this case, we might say that from the beginning psychiatric practice has gone beyond the frame of liberalism. The patients are often confined in a certain morbid thinking and cognitive system, and they can speak only from inside a certain framework, and the disease is based on "lack of freedom in thinking". The purpose of psychiatric practice is to help the patients be free from such morbid world and to help them speak freely and openly. In this sense, the treatment for the patients may be defined as an attempt to acquire liberalism. Therefore, perhaps as in other countries, psychiatric practice in Japan may be defined as a process toward the restoration or establishment of liberalism both in the historical sense and in each individual physician-patient relationship.
著者
酒井 明夫
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.13, pp.123-131, 1995-10-01 (Released:2018-02-01)

In the history of medicine, some periods can be divided by the change in the physician's role concerning the course and prognosis of disease. In ancient times, the principal factor in determining the prognosis of a disease shifted from divine or supernatural forces to natural principles that were advocated by the authors of the Hippocratic corpus. During this period when both physician and patient maintained their relationship in account with natural principle, prognosis was so heavily dependent on natural forces that the physician's role was limited to a supplementary one. After a long medieval period, the physician's role underwent a change from advocacy to subjugation of natural principles. In the eighteenth century, as Foucault indicated, the old clinic was replaced by anatomically articulated medicine. With this change, the age of paternalism came, sustained by the clinical effectiveness of the physician's experience and skill. However, as biomedical knowledge was accumulated and enhanced, people's expectation and confidence moved from physician's skill to the corpus of biomedical knowledge, that actually controlled the outcome and prognosis of disease. The concept of informed consent, first introduced on October 22, 1957, not only signified the epochmaking addition of the patient's will to the decisive factors for outcome and prognosis of disease, but also reflected that the physician's role hand become that of a catalytic agent between the sum of medical knowledge and patient. The introduction of informed consent, on the one hand, eliminated the physician's image as representative of healing, and on the other hand, gave the contemporary physician a new task, the investigation of the patient's uniqueness and the formation of a comprehensive notion of the clinic in the context of the physician-patient relationship.
著者
酒井 明夫
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.9, pp.15-28, 1991-07-31 (Released:2018-02-01)

Psychoactive drugs - e.g., antipsychotics, antidepressants, antimanics, anxiolytic sedatives - are now widely prescribed in industrialized countries. However the misuse and frequent over-use of these drugs, especially the tranquilizers, has often been discussed in the extant literature. While the public's understanding of the negative aspect of taking psychoactive agents has become more widespread, physicians (not only psychiatrists) often remark that there is a tendency on the part of patients to demand and acquire these drugs by exerting great pressure on physicians for whom it is often difficult not to comply. J. D. Wallace, M. D., has dubbed this the "tranquilizer on demand" syndrome. However, the patient's demand should not in itself be simply rejected by the physician, rather his or her demand should be taken into account. We need to consider the basis for the demand. The literature suggests that patients' knowledge concerning their own mental health and its appropriate treatment (e. g., psychoactive drugs) is typically limited and not based on an adequate understanding of medicine. Therefore physicians should consider very carefully (within the context of the physician-patient relationship) each patient's autonomy and unique response to the treatment modality. If the patient's demand for psychoactive medication is not warranted on the basis of sound medical judgement, then the quality of the demand itself should be analyzed. Only then can the physician transform the "demand" into the most beneficial treatment plan. The necessary conditions for this transformation are : (1) that the doctor has sufficient knowledge concerning the natural history of the presumed psychiatric disorder, (2) that the patient is fully informed and understands the appropriateness of his or her original demand, and (3) that the patient is prepared to accept the authority (though perhaps only limited) of the physician.