6 results on '"Osann KE"'
Search Results
2. Talaporfin sodium-mediated photodynamic therapy alone and in combination with pulsed dye laser on cutaneous vasculature
- Author
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Kelly, KM, Moy, WJ, Moy, AJ, Lertsakdadet, BS, Moy, JJ, Nguyen, E, Nguyen, A, Osann, KE, and Choi, B
- Subjects
Dermatology & Venereal Diseases ,Clinical Sciences ,Oncology and Carcinogenesis - Published
- 2015
3. Survival after unilateral versus bilateral lung volume reduction surgery for emphysema
- Author
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Serna, DL, Brenner, M, Osann, KE, McKenna, RJ, Chen, JC, Fischel, RJ, Jones, BU, Gelb, AF, and Wilson, AF
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Oncology and Carcinogenesis ,Clinical Research ,Clinical Trials and Supportive Activities ,Lung ,Emphysema ,Chronic Obstructive Pulmonary Disease ,Evaluation of treatments and therapeutic interventions ,6.4 Surgery ,Age Factors ,Aged ,Cohort Studies ,Confidence Intervals ,Dyspnea ,Female ,Follow-Up Studies ,Forced Expiratory Volume ,Humans ,Longitudinal Studies ,Male ,Oxygen ,Pneumonectomy ,Proportional Hazards Models ,Pulmonary Emphysema ,Residual Volume ,Risk Factors ,Surgical Stapling ,Survival Rate ,Thoracic Surgery ,Video-Assisted ,Total Lung Capacity ,Treatment Outcome ,Vital Capacity ,Cardiorespiratory Medicine and Haematology ,Respiratory System ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
ObjectiveBilateral staple lung volume reduction surgery (LVRS) immediately improves pulmonary function and dyspnea symptoms in patients with advanced heterogeneous emphysema to a greater degree than do unilateral procedures. However, the long-term outcome after these surgical procedures needs to be critically evaluated. We compare 2-year survival of patients who underwent unilateral versus bilateral video-assisted LVRS in a large cohort treated by a single surgical group.MethodsThe cases of all 260 patients who underwent video-assisted thoracoscopic stapled LVRS from April 1994 to March 1996 were analyzed to compare results after unilateral versus bilateral procedures. Overall survival was calculated by Kaplan-Meier methods; Cox proportional hazard methods were used to adjust for patient heterogeneity and baseline differences between groups.ResultsOverall survival at 2 years was 86.4% (95% CI 80. 9%-91.8%) after bilateral LVRS versus 72.6% (95% CI 64.2%-81.2%) after unilateral LVRS (P =.001 for overall survival comparison). Improved survival after bilateral LVRS was seen among high- and low-risk subgroups as well. Average follow-up time was 28.5 months (range, 6 days to 46.6 months) for the bilateral LVRS group and 29.3 months (range, 6 days to 45.0 months) for the unilateral LVRS patients.ConclusionsComparison of unilateral versus bilateral thoracoscopic LVRS procedures for the treatment of emphysema reveals that bilateral LVRS by video-assisted thoracoscopy resulted in better overall survival at 2-year follow-up than did unilateral LVRS. This survival study, together with other studies demonstrating improved lung function after bilateral LVRS, suggests that bilateral surgery appears to be the procedure of choice for patients undergoing LVRS for most eligible patients with severe heterogeneous emphysema.
- Published
- 1999
4. Survival after unilateral versus bilateral lung volume reduction surgery for emphysema.
- Author
-
Serna, DL, Brenner, M, Osann, KE, McKenna, RJ, Chen, JC, Fischel, RJ, Jones, BU, Gelb, AF, and Wilson, AF
- Subjects
Lung ,Humans ,Pulmonary Emphysema ,Dyspnea ,Oxygen ,Total Lung Capacity ,Residual Volume ,Vital Capacity ,Forced Expiratory Volume ,Thoracic Surgery ,Video-Assisted ,Treatment Outcome ,Surgical Stapling ,Pneumonectomy ,Survival Rate ,Confidence Intervals ,Proportional Hazards Models ,Risk Factors ,Cohort Studies ,Longitudinal Studies ,Follow-Up Studies ,Age Factors ,Aged ,Female ,Male ,Thoracic Surgery ,Video-Assisted ,Respiratory System ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences - Abstract
ObjectiveBilateral staple lung volume reduction surgery (LVRS) immediately improves pulmonary function and dyspnea symptoms in patients with advanced heterogeneous emphysema to a greater degree than do unilateral procedures. However, the long-term outcome after these surgical procedures needs to be critically evaluated. We compare 2-year survival of patients who underwent unilateral versus bilateral video-assisted LVRS in a large cohort treated by a single surgical group.MethodsThe cases of all 260 patients who underwent video-assisted thoracoscopic stapled LVRS from April 1994 to March 1996 were analyzed to compare results after unilateral versus bilateral procedures. Overall survival was calculated by Kaplan-Meier methods; Cox proportional hazard methods were used to adjust for patient heterogeneity and baseline differences between groups.ResultsOverall survival at 2 years was 86.4% (95% CI 80. 9%-91.8%) after bilateral LVRS versus 72.6% (95% CI 64.2%-81.2%) after unilateral LVRS (P =.001 for overall survival comparison). Improved survival after bilateral LVRS was seen among high- and low-risk subgroups as well. Average follow-up time was 28.5 months (range, 6 days to 46.6 months) for the bilateral LVRS group and 29.3 months (range, 6 days to 45.0 months) for the unilateral LVRS patients.ConclusionsComparison of unilateral versus bilateral thoracoscopic LVRS procedures for the treatment of emphysema reveals that bilateral LVRS by video-assisted thoracoscopy resulted in better overall survival at 2-year follow-up than did unilateral LVRS. This survival study, together with other studies demonstrating improved lung function after bilateral LVRS, suggests that bilateral surgery appears to be the procedure of choice for patients undergoing LVRS for most eligible patients with severe heterogeneous emphysema.
- Published
- 1999
5. Patient selection criteria for lung volume reduction surgery
- Author
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McKenna, RJ, Brenner, M, Fischel, RJ, Singh, N, Yoong, B, Gelb, AF, and Osann, KE
- Subjects
Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Sciences ,Clinical Research ,Biomedical Imaging ,Chronic Obstructive Pulmonary Disease ,Emphysema ,Lung ,Respiratory ,Age Factors ,Aged ,Contraindications ,Female ,Humans ,Male ,Patient Selection ,Pneumonectomy ,Prednisone ,Pulmonary Emphysema ,Radionuclide Imaging ,Respiratory Function Tests ,Tomography ,X-Ray Computed ,Treatment Outcome ,Cardiorespiratory Medicine and Haematology ,Respiratory System ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
ObjectiveOur intent was to refine the patient selection criteria for lung volume reduction surgery because various centers have different criteria and not all patients benefit from the procedure.MethodsPatient information, x-ray results, arterial blood gases, and plethysmographic pulmonary function tests in 154 consecutive patients who underwent bilateral thoracoscopic staple lung volume reduction surgery were compared with clinical outcome (change in forced expiratory volume in 1 second and dyspnea scale) with t tests and analysis of variance.ResultsThree hundred thirty-three of 487 (69%) patients evaluated for lung volume reduction surgery were rejected for lack of heterogeneous emphysema (n = 212), medical contraindications (n = 88), hypercapnia (n = 20), uncontrolled anxiety or depression (n = 10), or pulmonary hypertension (n = 1). Two patients died during the evaluation process. When tested by analysis of variance, there was no difference in clinical outcome associated with preoperative forced expiratory volume in 1 second, residual volume, total lung capacity, single-breath diffusing, and arterial oxygen or carbon dioxide tension. All patients selected for the operation had a heterogeneous pattern of emphysema. The upper lobe heterogeneous pattern of emphysema on chest computed tomography and lung perfusion scan was strongly associated with improved outcome with a mean (95% confidence interval) improvement in forced expiratory volume in 1 second of 73.2% (63.3 to 83.1) for the upper lobe compared with a mean (95% confidence interval) improvement of 37.9% (22.9 to 53.0) for the lower lobe or diffuse pattern of emphysema.ConclusionThe most important selection criteria for lung volume reduction surgery is the presence of a bilateral upper lobe heterogeneous pattern of emphysema on chest computed tomography and lung perfusion scan. After patients have been selected on the basis of a heterogeneous pattern of emphysema, clinical factors and physiology are not associated with clinical outcome well enough to further refine patient selection criteria. These results do not support the arbitrary patient selection criteria for lung volume reduction surgery reported in the literature.
- Published
- 1997
6. Patient selection criteria for lung volume reduction surgery.
- Author
-
McKenna, RJ, Brenner, M, Fischel, RJ, Singh, N, Yoong, B, Gelb, AF, and Osann, KE
- Subjects
Lung ,Humans ,Pulmonary Emphysema ,Prednisone ,Tomography ,X-Ray Computed ,Radionuclide Imaging ,Respiratory Function Tests ,Treatment Outcome ,Pneumonectomy ,Age Factors ,Patient Selection ,Aged ,Female ,Male ,Contraindications ,Respiratory System ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences - Abstract
ObjectiveOur intent was to refine the patient selection criteria for lung volume reduction surgery because various centers have different criteria and not all patients benefit from the procedure.MethodsPatient information, x-ray results, arterial blood gases, and plethysmographic pulmonary function tests in 154 consecutive patients who underwent bilateral thoracoscopic staple lung volume reduction surgery were compared with clinical outcome (change in forced expiratory volume in 1 second and dyspnea scale) with t tests and analysis of variance.ResultsThree hundred thirty-three of 487 (69%) patients evaluated for lung volume reduction surgery were rejected for lack of heterogeneous emphysema (n = 212), medical contraindications (n = 88), hypercapnia (n = 20), uncontrolled anxiety or depression (n = 10), or pulmonary hypertension (n = 1). Two patients died during the evaluation process. When tested by analysis of variance, there was no difference in clinical outcome associated with preoperative forced expiratory volume in 1 second, residual volume, total lung capacity, single-breath diffusing, and arterial oxygen or carbon dioxide tension. All patients selected for the operation had a heterogeneous pattern of emphysema. The upper lobe heterogeneous pattern of emphysema on chest computed tomography and lung perfusion scan was strongly associated with improved outcome with a mean (95% confidence interval) improvement in forced expiratory volume in 1 second of 73.2% (63.3 to 83.1) for the upper lobe compared with a mean (95% confidence interval) improvement of 37.9% (22.9 to 53.0) for the lower lobe or diffuse pattern of emphysema.ConclusionThe most important selection criteria for lung volume reduction surgery is the presence of a bilateral upper lobe heterogeneous pattern of emphysema on chest computed tomography and lung perfusion scan. After patients have been selected on the basis of a heterogeneous pattern of emphysema, clinical factors and physiology are not associated with clinical outcome well enough to further refine patient selection criteria. These results do not support the arbitrary patient selection criteria for lung volume reduction surgery reported in the literature.
- Published
- 1997
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