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Biomedical subjects

W Gee

Publications and source records attributed to W Gee.

At least 19 recordsLinked to original sources
PubMed1992

Risk factors for stroke after coronary artery bypass.

To determine the prevalence of stroke after coronary artery bypass grafting and to evaluate risk factors, we reviewed the records of 1000 patients undergoing coronary bypass within a 1-year time period. Demographic and perioperative data were evaluated by chi 2 analysis. A history of diabetes, evidence of mural thrombus, positive oculopneumoplethysmography findings, increased age, aortic calcification, and postoperative arrhythmias all correlated with increased risk of permanent neurologic deficit for the patient undergoing coronary bypass. Risk factors were analyzed with stepwise logistic regression. A history of diabetes, presence of mural thrombi, and aortic calcification carried a higher probability that the patient would have a permanent neurologic deficit.

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PubMed1989

Duplex ultrasound and ocular pneumoplethysmography concordance in detecting severe carotid stenosis.

Concordance between two independent tests should serve to increase the accuracy of diagnosis. A combination of ocular pneumoplethysmography and duplex ultrasound, which uses high-resolution B-mode imaging plus spectral analysis, was used to evaluate 289 consecutive patients prior to biplane carotid angiography. Where there was concordance, the noninvasive tests predicted the presence or absence of hemodynamically severe carotid stenosis (75% or greater cross-sectional area reduction) with a sensitivity of 96.8%, a specificity of 95.9%, an accuracy of 96.2%, and positive and negative predictive values of 91.0% and 98.6%, respectively. Of the 538 study arteries, only four (0.74%) angiographically severe lesions escaped detection by both noninvasive tests. Sources of diagnostic error for both tests were defined. We believe that the combination of duplex ultrasound and ocular pneumoplethysmography significantly improves the overall assessment of carotid atherosclerosis.

Carotid Artery Diseases↗
PubMed1989

Abnormal ocular pneumoplethysmographic results in unilateral neovascular glaucoma.

Little is known about the predictive value of ocular pneumoplethysmography in patients with ophthalmic disease. We evaluated eight patients with unilateral increased intraocular pressure due to neovascular glaucoma who did not have evidence of severe extracranial carotid stenosis by duplex scanning and continuous-wave Doppler ultrasound. The ophthalmic systolic pressure measured by ocular pneumoplethysmography was decreased in the affected eye of all eight patients, indicating that neovascular glaucoma may be a cause of abnormal ocular pneumoplethysmographic results. Patients with neovascular glaucoma tended to have larger interocular ophthalmic systolic pressure differences than other patients with false-positive ocular pneumoplethysmographic results by noninvasive criteria.

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PubMed1989

Ocular pneumoplethysmography can help in the diagnosis of giant-cell arteritis.

We compared the results of ocular pneumoplethysmography in nine patients who had a temporal artery biopsy (TAB) diagnostic of giant-cell arteritis with results of ocular pneumoplethysmography in nine patients with normal TAB results and 112 patients with anterior ischemic optic neuropathy or central retinal artery occlusion assumed to be nonarteritic. The mean +/- SD ocular pulse amplitude with ocular pneumoplethysmography was 3.9 +/- 1.8 mm in the group with abnormal TAB results and 10.6 +/- 4.0 mm in the group with normal TAB results. Every patient with abnormal TAB results had an average calculated ocular blood flow less than 0.60 mL/min, while only one patient with normal TAB results fell in this range. The average calculated ocular blood flow had a sensitivity of 100% and a specificity of 93.4% in the diagnosis of giant-cell arteritis, with a diagnostic accuracy of 93.9%. These results rival the diagnostic accuracy of the erythrocyte sedimentation rate and TAB results.

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PubMed1989

Collateral compensation of severe carotid stenosis.

In 516 patients who had endarterectomies for unilateral severe carotid stenoses, arteriography demonstrated no contralateral severe stenoses or occlusions. Pre and postoperative ocular pneumoplethysmography (OPG-Gee) measured simultaneous bilateral ophthalmic systolic pressures (OSP). Immediately after each OPG test a brachial systolic pressure (BSP) was measured with a stethoscope, cuff and manometer. Bilateral ophthalmobrachial systolic pressure (OBSP) indices were calculated from the three pressures measured with the combined testing. Analysis of these OBSP data indicates that the severe stenoses were relatively well compensated in 314 of the 516 patients (61%) whereas there was limited collateral compensation in the remaining 202 patients (39%). The data also suggest that the latter group incurs a greater element of compensatory central hypertension, which is reversed by carotid endarterectomy.

Blood Pressure↗
PubMed1988

Ocular pneumoplethysmography after lens implantation.

A series of letters in this journal discussed the safety of ocular pneumoplethysmography (OPG-Gee) in pseudophakic patients. In the interval since these letters, experience with OPG-Gee tests performed on 115 pseudophakic eyes demonstrated no ocular morbidity associated with these procedures.

Blood Pressure↗
PubMed1987

Accessory nerve injury during carotid endarterectomy.

Injury to the accessory nerve (cranial nerve XI) during carotid endarterectomy is rare; to date only three cases have been reported in the literature. Traction on the sternocleido-mastoid muscle was the proposed mechanism of injury in all three cases. Four cases of accessory nerve palsy occurred in 850 carotid endarterectomies performed between 1978 and 1986 at this institution, an incidence of 0.47%. All four patients had classic signs and symptoms of accessory nerve injury, which developed between 20 and 60 days after operation. The three most recent cases were examined specifically for accessory nerve injury in the immediate postoperative period and exhibited normal trapezius function. None had any other central nervous system dysfunction. Two of these patients regained full accessory nerve function and the most recent case is showing signs of reinnervation with conservative therapy. Isolated central nervous system and spontaneous accessory nerve palsies are exceptionally rare, and since any traction injury or transection should have been detected by postoperative examinations in three of four patients, we propose surgical scar formation as a mechanism of accessory nerve palsy after carotid endarterectomy. If such a palsy develops in the postoperative period, we recommend conservative therapy.

Accessory Nerve Injuries↗