TPPV

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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.

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...

In 9-month-old-infants adjustments in the reaching pattern to sudden changes in object location were examined. An attractive ball was presented to the infants at their midline and on some trials (perturbation trials) the ball suddenly changed position 15 cm to the right or left during the reach. For the perturbed trials the movement times approximately doubled compared to the control trials and significantly fewer balls were grasped. The results indicate that infants need to finish the first movement before being able to redirect the reach to a new destination...