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Articles by C. M Wood
Total Records ( 3 ) for C. M Wood
  C. U Lee , C. M Wood , G. K Hesley , N Leung , M. D Bridges , J. T Lund , P. U Lee and M. R. Pittelkow

Objectives  To estimate and stratify the risk of development of nephrogenic systemic fibrosis (NSF) in well-defined at-risk subpopulations from a large single institution, and to perform a single-institution case series study of patients with biopsy-proven NSF.

Design  Retrospective cohort of patients exposed to gadolinium-based contrast agents (GBCAs) at a single institution during an 8-year period (January 1, 1999, to December 31, 2006), and a case series study of patients with biopsy-proven NSF.

Setting  A primary, secondary, and tertiary health care center that treated more than 2.2 million outpatients and had 135 000 hospital admissions in 2007.

Patients  A total of 94 917 patients exposed to GBCAs; patients at risk for NSF (3779 patients on hemodialysis, 1694 patients with renal transplants, and 717 patients with liver transplants, a well-defined subgroup that includes patients at risk for reduced renal function); and 61 patients with a clinical diagnosis of NSF.

Main Outcome Measure  Risk estimate for NSF.

Results  The risk of development of NSF is 1.0% for patients who undergo hemodialysis (8 of 827), 0.8% for patients with renal transplantation (4 of 527), and 0% for patients with liver transplantation at our institution (0 of 327).

Conclusions  Despite the limitations, this study, which reviewed a large number of patients who underwent intravascular GBCA injections, demonstrates a 77-fold higher risk of NSF among patients who undergo hemodialysis and a 69-fold higher risk in patients with renal transplantation. This increased risk is thought to be associated with poor clearance of most GBCAs.

  J Fatima , T Schnelldorfer , J Barton , C. M Wood , H. J Wiste , T. C Smyrk , L Zhang , M. G Sarr , D. M Nagorney and M. B. Farnell

Objective  To assess the effect of R0 resection margin status and R0 en bloc resection in pancreatoduodenectomy outcomes.

Design  Retrospective medical record review.

Setting  Mayo Clinic, Rochester, Minnesota.

Patients  Patients who underwent pancreatoduodenectomy for pancreatic adenocarcinoma at our institution between January 1, 1981, and December 31, 2007, were identified and their medical records were reviewed.

Main Outcome Measure  Median survival times.

Results  A total of 617 patients underwent pancreatoduodenectomy. Median survival times after R0 en bloc resection (n = 411), R0 non–en bloc resection (n = 57), R1 resection (n = 127), and R2 resection (n = 22) were 19, 18, 15, and 10 months, respectively (P < .001). A positive resection margin was associated with death (P = .01). No difference in survival time was found between patients undergoing R0 en bloc and R0 resections after reexcision of an initial positive margin (hazard ratio, 1.19; 95% confidence interval, 0.87-1.64; P = .28).

Conclusions  R0 resection remains an important prognostic factor. Achieving R0 status by initial en bloc resection or reexcision results in similar long-term survival.

  C. M Wood , F. I Iftikar , G. R Scott , G De Boeck , K. A Sloman , V Matey , F. X Valdez Domingos , R. M Duarte , V. M. F Almeida Val and A. L. Val
  Chris M. Wood, Fathima I. Iftikar, Graham R. Scott, Gudrun De Boeck, Katherine A. Sloman, Victoria Matey, Fabiola X. Valdez Domingos, Rafael Mendonca Duarte, Vera M. F. Almeida-Val, and Adalberto L. Val

Earlier studies demonstrated that oscars, endemic to ion-poor Amazonian waters, are extremely hypoxia tolerant, and exhibit a marked reduction in active unidirectional Na+ uptake rate (measured directly) but unchanged net Na+ balance during acute exposure to low PO2, indicating a comparable reduction in whole body Na+ efflux rate. However, branchial O2 transfer factor does not fall. The present study focused on the nature of the efflux reduction in the face of maintained gill O2 permeability. Direct measurements of 22Na appearance in the water from bladder-catheterized fish confirmed a rapid 55% fall in unidirectional Na+ efflux rate across the gills upon acute exposure to hypoxia (PO2=10–20 torr; 1 torr=133.3 Pa), which was quickly reversed upon return to normoxia. An exchange diffusion mechanism for Na+ is not present, so the reduction in efflux was not directly linked to the reduction in Na+ influx. A quickly developing bradycardia occurred during hypoxia. Transepithelial potential, which was sensitive to water [Ca2+], became markedly less negative during hypoxia and was restored upon return...

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