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Ryoichi Kurisaki, Satoshi Yamashita, Tetsuro Sakamoto, Natsue Maruyoshi, Kazutoshi Uekawa, Makoto Uchino, Yukio Ando
OBJECTIVES: We retrospectively evaluated the decision-making process of amyotrophic lateral sclerosis (ALS) patients on noninvasive positive pressure ventilation (NPPV) concerning respiratory management with tracheostomy positive pressure ventilation (TPPV) in the future. PATIENTS AND METHODS: We investigated the clinical characteristics of 29 consecutive ALS patients who had been introduced to NPPV during a 7-year period from September 2001 to August 2008 at our institution...
October 2014: Clinical Neurology and Neurosurgery
O A Mamer, G Just, C S Li, P Préville, S Watson, R Young, J A Yergey
Several acylating reagents are synthesized and used to introduce quatemary phosphonium or ammonium or ternary sulfonium functions into a simple model of a peptido leukotriene (PLT). One of these reagents was selected for further study with LTE4, LTD4, and LTC4. We demonstrate that acylation of the free amine function of PLTs to produce the 5-triphenylphosphoniumvaleryl-amide (TPPV) derivatives enhances chemical stabilities and significantly increases responses in fast-atom bombardment and continuous-flow liquid secondary ion mass spectrometry (CF-LSIMS) relative to the native PLTs...
April 1994: Journal of the American Society for Mass Spectrometry
Anne-Chantal Heritier Barras, Dan Adler, Ruxandra Iancu Ferfoglia, Bara Ricou, Yvan Gasche, Igor Leuchter, Samia Hurst, Monica Escher, Pierre Pollak, Jean-Paul Janssens
QUESTION UNDER STUDY: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with a poor prognosis. Survival and quality of life of ALS patients have improved through the implementation of multidisciplinary approaches, the use of percutaneous gastrostomy and of noninvasive (NIV) or invasive ventilation. The question of whether or not to propose invasive ventilation (by tracheostomy: TPPV) to ALS patients remains a matter of debate. METHODS: The study reviews the medical literature, the practice in three Swiss and two large French ALS expert centres and reports the results of a workgroup on invasive ventilation in ALS...
2013: Swiss Medical Weekly
Takehiro Yamada, Kyoko Itoh, Koushun Matsuo, Yoshihiro Yamamoto, Youhei Hosokawa, Takashi Koizumi, Kensuke Shiga, Toshiki Mizuno, Masanori Nakagawa, Shinji Fushiki
A 74-year-old man gradually developed muscular weakness in the upper extremities, followed by dyspnea and dysarthria over a 6-month period. He was admitted to our facility and diagnosed as having amyotrophic lateral sclerosis (ALS) based on clinical and neurophysiological findings. Two months later, transtracheal positive pressure ventilation (TPPV) was started. During his clinical course, orthostatic hypotension occurred a few times. He also had two episodes of transient cardiac arrest, and he died 15 months after disease onset...
April 2014: Neuropathology: Official Journal of the Japanese Society of Neuropathology
Gulnur Com, Dennis Z Kuo, Martin L Bauer, Claire V Lenker, Maria M Melguizo-Castro, Todd G Nick, Christopher M Makris
BACKGROUND: Long-term outcomes for children who survive on tracheostomy and positive-pressure ventilation (TPPV) at home are not well known. METHODS: A retrospective review of 20 years of clinical data at a single institution was performed. Outcome measures included 5-year survival, decannulation rate, and neurocognition. RESULTS: A total of 91 children were categorized under neuromotor dysfunction (52%), chronic lung disease (29%), and congenital anomalies (20%)...
January 2013: Clinical Pediatrics
Yukako Takechi
The unprecedented earthquake(magnitude-9 in the Japanese seismic intensity scale)hit off the east coast of Japan on March 11, 2011. Consequently, there were planned power outages in the area nearby Tokyo to avoid massive blackouts caused by a stoppage of Fukushima nuclear plants.Our clinic located in Kawasaki city was also hit by the earthquake(magnitude- 5).During the period of two months(March and April 2011), we had a total of 52 patients with home respiratory care (5-TPPV, 11-NPPV and 36-HOT)at that time...
December 2011: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Arshed Malik, Ian Dooley, Usman Mahmood
PURPOSE: To evaluate the role of postoperative prone posturing for a single night in the outcome of trans pars plana vitrectomy (TPPV) with internal limiting membrane (ILM) peel and 20% perfluoroethane (C2F6) internal tamponade for idiopathic macular hole. METHODS: This prospective trial enrolled 14 eyes in 14 consecutive patients with idiopathic macular hole. All eyes underwent TPPV with vision blue assisted ILM peeling with and without phacoemulsification and intraocular lens (IOL) for macular hole...
May 2012: European Journal of Ophthalmology
S Subedi, M K Sharma, B R Sharma, I Kansakar, K Dhakwa, R K Adhikari
BACKGROUND: Trans-pars plana vitrectomy (TPPV) is an effective surgical procedure to retain the useful vision in vitreoretinal diseases. OBJECTIVE: To evaluate the surgical outcome of pars plana vitreoretinal surgery. STUDY DESIGN: Retrospective non-comparative interventional case series. MATERIALS AND METHODS: A hospital-based retrospective interventional study of series of cases was carried out in retina clinic of Lumbini Eye Institute, Nepal, over a period of one-and-a-half years...
January 2010: Nepalese Journal of Ophthalmology
James S Schutz, Nikolaos A Mavrakanas
PURPOSE OF REVIEW: Posterior-assisted levitation (PAL) is a surgical maneuver for dealing with rupture of the posterior capsule or zonular dehiscence with threatened or actual subluxation of the nucleus or entire lens into the vitreous during phacoemulsification. PAL is often unknown or overlooked, especially by young or inexperienced surgeons. RECENT FINDINGS: The advantages of PAL are, first, that it often enables completion of phacoemulsification and intraocular lens placement without conversion to an open eye with nuclear expression and second, it prevents luxation of nucleus, nuclear fragments, or the lens into the vitreous avoiding the necessity for trans pars plana vitrectomy (TPPV)-lensectomy...
January 2010: Current Opinion in Ophthalmology
Yoh Horikawa
In 1965 I became a member of the newly-established department of neurology in Brain Research Institute of Niigata University. One of the most important theme for clinical neurologist was to offer medical care after discharge from hospital for serious or intractable neurological disease patients who would soon become unable to come to outpatient clinic. In 1978 Shinrakuen hospital in Niigata City launched the Continuing Medical Care Section providing home visit by doctors and periodical home nursing for medically dependent homecare patients...
November 2008: Rinshō Shinkeigaku, Clinical Neurology
Naoki Atsuta, Hirohisa Watanabe, Mizuki Ito, Fumiaki Tanaka, Akiko Tamakoshi, Imaharu Nakano, Masashi Aoki, Shoji Tsuji, Tatsuhiko Yuasa, Hiroki Takano, Hideaki Hayashi, Shigeki Kuzuhara, Gen Sobue et al.
PURPOSE: To profile the detailed clinical features of sporadic amyotrophic lateral sclerosis (ALS) on large-scale samples in Japan. METHODS: We assessed the clinical features of sporadic ALS patients in Japan, based on the nationwide registration system of the Ministry of Health, Labor and Welfare of Japan. We described 3,428 new cases registered cases between 2003 and 2006 to analyze initial symptoms and related clinical features, 4,202 cases registered in the single year of 2005 to describe the cross-sectional overview of the ALS patients, and a total of 2,128 cases with tracheostomy positive pressure ventilation (TPPV) from all of the registration data from 2003 to 2006 to describe the features of ALS patients with TPPV...
January 15, 2009: Journal of the Neurological Sciences
Akihiro Kawata, Kouichi Mizoguchi, Hideaki Hayashi
We conducted a nationwide survey of ALS patients on tracheostomy positive pressure ventilation (TPPV) who had developed a totally locked-in state (TLS) during the period from August to November 2006, in Japan. TLS occurred in 89 of 709 (13%) ALS patients on TPPV. On the second investigation, 29 of 41 patients with TLS showed complete palsy of more than two voluntary motor systems out of 4 motor systems [respiratory, pontine and medullar (bulbar), limb and external ocular motor systems] successively during a certain six months...
July 2008: Rinshō Shinkeigaku, Clinical Neurology
A F Meinesz, G Bladder, J F Goorhuis, J M Fock, A L Staal-Schreinemachers, J G Zijlstra, P J Wijkstra
OBJECTIVE: To find out which patients with Duchenne muscular dystrophy are eligible for starting home mechanical ventilation and what the survival rate is. DESIGN: Retrospective. METHOD: In 48 patients with Duchenne muscular dystrophy who were treated with home ventilation from 1987, the results were assessed in the follow-up visit in February 2005. Initially, ventilation was only given through a tracheotomy (TPPV), but after starting up a multidisciplinary neuromuscular consultation, non-invasive ventilation (NIPPV) was offered in an earlier stage of the disease...
August 18, 2007: Nederlands Tijdschrift Voor Geneeskunde
Makoto Yamamoto
We experienced long-term ventilation for 30 patients mostly with amyotrophic lateral sclerosis (ALS). For long-term ventilation by tracheostomy positive pressure ventilation (TPPV), we must set tidal volume (TV) over 600 ml, because setting 400 ml as TV usually applied in Japan, often develops atelectasis which causes frequent or serious pneumonia. To avoid both the elevation of airway pressure and hyper ventilation, the following intervals are needed: 10 times/min for breathing frequency and 2 seconds for exhaling time...
December 2006: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Reiko Namba
Palliative care at the end of life for intractable neurological diseases has come into discussion recently. According to the care guidelines for amyotrophic lateral sclerosis (ALS), suggested by the Japan Neurology Societies, neurological doctors should primarily aim at reducing patients' pain, share decisions with patients, and care for breathing difficulties, pain, and anxieties positively with the use of narcotics, like the care for cancer patients. Between June 2003 and June 2006, 58 of 79 patients (73%) refused a treatment to prolong their life, such as tracheal positive pressure ventilation (TPPV), and 19 of 24 (79%) patients desired to remain at home; these patients represented the majority...
December 2006: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Grant D Innes, Robert Stenstrom, Eric Grafstein, James M Christenson
BACKGROUND: A reliable emergency department (ED) workload measurement tool would provide a method of quantifying clinical productivity for performance evaluation and physician incentive programs; it would enable health administrators to measure ED outputs; and it could provide the basis for an equitable formula to estimate ED physician staffing requirements. Our objectives were to identify predictors that correlate with physician time needed to treat patients and to develop a multivariable model to predict physician workload...
September 2005: CJEM
David J Berlowitz, Karen Detering, Linda Schachter
Previous studies have demonstrated that domiciliary ventilatory support improves survival, quality of life and cognitive function in motor neuron disease (MND). These benefits are partly attributed to better sleep quality and less hypoxia. In a retrospective analysis we compared the effect of non-invasive (NPPV, n = 52), tracheostomy (TPPV, n = 23) and no ventilation (n = 43) on sleep and survival in MND patients over a seven-year period. The TPPV and NPPV groups had more sleep arousals (AI, p = 0.024), more respiratory events (p = 0...
June 2006: Amyotrophic Lateral Sclerosis
Hsiu-Mei Huang, Min-Lun Kao, His-Kung Kuo, Shih-Hao Tsai, Yung-Jen Chen, Chi-Chang Liu
BACKGROUND: The aim of this study is to determine the relationship between the cause of lens dislocation and visual outcomes with complications in patients undergoing trans pars plana vitrectomy (TPPV) and trans pars plana lensectomy (TPPL) for lens dislocation. METHODS: This retrospective study was carried out from July 1995 through November 2003. After excluding patients with previous retinal detachment or combing lens dislocation and post-TPPV/TPPL follow-up intervals of less than 6 months, 36 eyes from 36 patients who had undergone vitrectomy and lensectomy for lens subluxation or dislocation due to trauma or intraocular surgery were examined...
June 2004: Chang Gung Medical Journal
Hideaki Hayashi, Edward Anthony Oppenheimer
Seventy patients with ALS using tracheostomy positive pressure ventilation (TPPV) were evaluated for impaired communication. Severely impaired communication is divided into the totally locked-in state (TLS) and the minimal communication state (MCS). TLS occurred in 8 of 70 (11.4%). In the 33 patients on TPPV for more than 5 years, TLS developed in 6 (18.2%) and MCS in 11 (33.1%). Respiratory management for ALS allows long-term survival if mechanical ventilation is used.
July 8, 2003: Neurology
Z Song, Y Hui, L Wang, X Cao, Q Gao
PURPOSE: To observe the effect of preservation of anterior capsule on the incidence of complications associated with silicone oil. METHODS: 82 patients (82 eyes) accepted trans pars plana vitrectomy (TPPV) combined with lensectomy of whom, 30 eyes with preservation of anterior capsule (PAC) and 52 eyes with no preservation of anterior capsule (NPAC). Analysis of the incidence of complications associated with use of oil. RESULTS: The incidence rate was 50...
March 2001: Yan Ke Xue Bao, Eye Science
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