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Biomedical subjects

A B Wong

Publications and source records attributed to A B Wong.

9 recordsLinked to original sources
PubMed1995

Factors associated with postoperative pulmonary complications in patients with severe chronic obstructive pulmonary disease.

The purpose of this study was to determine the incidence of different postoperative pulmonary complications (PPCs) and their associated risk factors in patients with severe chronic obstructive pulmonary disease (COPD) (forced expiratory volume in 1 s [FEV1] < or = 1.2 L and FEV1/forced vital capacity (FVC) < 75%) undergoing noncardiothoracic operations. Thirty-nine of 105 patients (37%) had one or more PPCs (death, pneumonia, prolonged intubation, refractory bronchospasm, or prolonged intensive care unit (ICU) stay). Thirty-eight of 39 patients (97%) with a PPC had an anesthetic duration > 2 h. Our study patients had a 47% 2-yr mortality rate. We determined specific risk factors for each PPC by analyzing potential preoperative and intraoperative risk factors. Pulmonary factors alone do not predict the likelihood of PPCs in severe COPD patients. Multiple logistic regression identified composite scoring systems, such as the ASA physical status, as the best preoperative predictors of PPCs, probably because they include both pulmonary and nonpulmonary factors. During the intraoperative period, avoiding general anesthesia with tracheal intubation may decrease the risk of postoperative bronchospasm. Shortening the duration of surgery and anesthesia may decrease the risk of prolonged ICU stay.

Aged↗
PubMed1990

Frames of reference for allocating attention to space: evidence from the neglect syndrome.

With respect to what frames of reference, or spatial coordinate systems, is attention allocated to locations in space? We posed this question about the spatial attention system that has been damaged in neglect patients, distinguishing among three possible types of spatial reference frame: viewer-centered, according to which locations are coded with respect to the viewer, environment-centered, according to which locations or coded with respect to the environment, and object-centered, according to which locations are coded with respect to an object. The three candidate frames of reference were decoupled from one another by rotating either the viewer or the stimulus object. Visual search performance suggested that the neglected hemifield was defined with respect to both viewer-centered and environment-centered frames of reference, but not with respect to an object-centered frame of reference. The role of objects in the allocation of attention to space, and the relation between our findings and the "two cortical visual systems" hypothesis, are discussed.

Aged↗
PubMed1989

Parietal lobe mechanisms of spatial attention: modality-specific or supramodal?

Is the spatial attention system divided into separate, modality-specific subsystems, or is there a supramodal spatial attention system? More specifically, does the role of the parietal lobe in spatial attention involve modality-specific or supramodal mechanisms? We addressed this question using a variant of Posner's spatial cuing task. Parietal-lesioned patients performed a simple reaction time task to lateralized visual target stimuli, preceded on each trial by either non-predictive lateralized visual cue stimuli or non-predictive lateralized auditory cue stimuli. With both types of cues, we found disproportionate slowness in responding to invalidly cued contralesional targets, indicative of an impairment in disengaging attention from the ipsilesional to the contralesional side of space. The finding of an attentional disengagement impairment for visual targets with auditory cues implies that the parietal lobe's attentional mechanism operates on a representation of space in which both visual and auditory stimuli are represented, in other words, a supramodal representation of space.

Adult↗
PubMed1989

A comparison of radial, brachial, and aortic pressures after cardiopulmonary bypass.

Previous investigations have identified falsely low radial artery pressures after cardiopulmonary bypass (CPB). The present study investigates the relationship among radial, brachial, and aortic arterial pressures in 33 cardiac surgical patients following CPB. Two minutes after separation from CPB, clinically important (greater than or equal to 10 mmHg) underestimation of systolic aortic pressures occurred in 17 of 33 (52%) radial artery catheters, while occurring in seven of 33 (21%) brachial artery catheters. Radial artery mean pressure underestimated aortic mean pressure by greater than or equal to 5 mmHg in 21 of 33 (61%) patients two minutes after CPB, while an equivalent aortic-to-brachial artery mean arterial pressure difference occurred in nine of 33 (27%) patients. The incidence of aortic-to-radial mean arterial pressure differences greater than or equal to 5 mmHg decreased to 40% (four of ten patients) by ten minutes after CPB, although interpretation is complicated by decreased availability of aortic pressure measurements. Multivariate analysis failed to identify factors predisposed to central-to-peripheral pressure gradients. Radial and brachial arterial pressures were compared both before and after CPB in all 33 patients. Brachial artery systolic and mean pressures were higher than corresponding radial artery measurements two minutes after CPB (P less than 0.05), followed by gradual resumption of a normal brachial-to-radial pressure relationship over 60 minutes. Either vasospasm in the brachial and radial arteries or profound arteriolar vasodilation in the upper extremity might cause the observed central-to-peripheral arterial pressure differences. The progressive central-to-peripheral decrease in mean arterial pressure favors the latter mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Thoracic bioimpedance and Doppler cardiac output measurement: learning curve and interobserver reproducibility.

Nine previously untrained health professionals learned to measure cardiac output (Qt) by suprasternal continuous-wave Doppler ultrasound (QtDopp) and by thoracic bioimpedance (Qtbi). Each received standardized written, videotaped, and individual instruction. First the novice, then the reference examiner, measured QtDopp or Qtbi in triplicate in an adult male subject. The reference examiner was blind to the novice measurements and the novice was not informed of the reference measurements. Each novice repeatedly measured QtDopp or Qtbi in different subjects until the mean novice QtDopp or Qtbi was within 10% of the corresponding mean reference measurement in three of four consecutive subjects. The novice observers required an average of 12.9 +/- 3.5 trials to learn to measure QtDopp, and an average of 8.4 +/- 4.5 trials to learn to measure Qtbi. The likelihood of novice agreement with the reference improved with experience. The same degree of intraobserver variability as reported for Qt measured by thermodilution (coefficient of variance less than or equal to 10%) was achieved with Qtbi in 150 (99%) of 152 triplicate measurements and QtDopp in 216 (97%) of 222 triplicate measurements. More importantly, interobserver agreement (within 10%) was achieved with both Qtbi and QtDopp. Reproducible noninvasive Qt measurement will allow these techniques to be used to monitor trend changes in Qt.

Cardiac Output↗
PubMed1988

Effect of butoconazole nitrate cream and wax insert on the barrier property of contraceptive devices.

A new method was developed to assess the quality of the barrier property of several types of commonly used contraceptive devices (diaphragm, cervical cap, and condom). Our data showed that butoconazole nitrate cream and wax inserts did not affect the barrier property of the contraceptive devices when the products were placed in contact with the devices for up to 72 hours at 37 degrees C.

Antifungal Agents↗
PubMed1983

Stability constants for complex formation between alpha-cyclodextrin and some amines.

Complex formation of alpha-cyclodextrin with 15 amines (including seven 4-substituted anilines) was studied by the potentiometric method, supplemented by direct UV spectrophotometry and a competitive indicator spectrophotometric method. The data were analyzed in terms of 1:1 and 1:2 complexes (amine-cyclodextrin ratios) and the stability constants K11a, K12a, K11b, and K12b were evaluated; the subscripts indicate the stoichiometry and conjugate acid-base form. For all amines K11b was greater than K11a and K12a was 0. On the basis of the relationship of complex stability to amine structure, it was concluded that the primary binding site in anilines is the 4-substituent.

Amines↗
PubMed1982

Potentiometric study of molecular complexes of weak acids and bases applied to complexes of alpha-cyclodextrin with para-substituted benzoic acids.

The theory of the potentiometric methods of studying complexes of ionizable substrates was developed, nd graphical techniques are described for obtaining stability constant estimations from the data. The method described is for a system in which the conjugate acid and base forms of the substrate (S), are capable of forming 1:1 (SL) and 1:2 (SL2) complexes with the ligand (L). It was applied to complexes of alpha-cyclodextrin (cyclohexaamylose) with 10 para-substituted benzoic acid derivatives. Letting K11a and K12a be stability constants for the conjugate acid forms of the substrates, and K11b, K12b for the conjugate base forms, it was found that K12b is zero for all substrates, K12a is zero for seven of the substrates, and K11a greater than K11b in every case. Hammett plots yielded p11a and p11b values of -0.31 and 0.77, respectively, which was interpreted to mean that K11a mainly represents binding at the carboxylic acid site, and K11b describes binding at the site of the para-substituent. This model of the complexing suggests that K12a represents binding at the para-substituent, and therefore K12a should vary roughly with substituent as K11b does; this trend was observed.

Acids↗