• Journal of Chest Surgery
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• v.15 no.3
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• pp.267-273
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• 1982

We have observed 360 cases of spontaneous pneumothorax from Jan. 1971 to Dec. 1981 at the department of Thoracic and Card iovascular Surgery, Yonsei University College of Medicine. The patients age ranged from 2 days to 95 year-old. The associated pulmonary lesions were shown pulmonary tuberculosis in 158 cases[43.9%], bullae in 35, pulmonary emphysema In 32, pneumothorax in 10, paragonimiasis In 7 and unknown underlying pathology in 109 patients. 70 [51.1 %] out of 1 37 cases who received conservative medical treatment Including thoracentesis were cured completely, but the 67 cases [48.9 %] of remaining uncured patients were treated by surgical procedures. The 290 patients who received surgical management were recovered without recurrent pneumothorax. The surgical procedures were closed thoracotomy drainage or explothoracotomy. The choice of treatment should be based on the extent of pneumothorax or the presence of underlying pulmonary disease. Tube thoracotomywas the most effective procedure in achieving the expansion of collapsed lung. On the other hand, open thoracotomy could be a good approach to recurrent pneumothorax, persistent air leakage, incomplete expansion of the lung and bilateral pneumothorax. The minithoracotomy Is the best procedure to recurrent pneumothorax.

• Journal of Chest Surgery
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• v.25 no.7
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• pp.763-768
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• 1992

To prevent recurrence of spontaneous pneumothorax, 23 patients were operated through median sternotomy for simultaneous resection of bilateral bullae, And 27 patients with spontaneous pneumothorax were treated with unilateral thoracotomy, We studied the number, duration and sites of recurrence including findings of CT scan, as well as comparing the both operated group. The incidence of spontaneous pneumothorax was 88% in patients with the ages between 16 to 35 Forty one patients[82%] were operated with the indication of recurrent pne-umpthorax. The number of pneumothorax attack was 2.34 per patient with recurrent pneumothorax. The 87.8% of recurrence was occured within 6 months from last attack. Ips-ilateral recurrnet pneumothorax was 56.1% and contallateral involve was 43.9%. The bilaterality of visible bullae was 90.9% in the findings of chest CT scan and 91.3% in the operative finding. The sensitivity and accuracy for bulla detection with chest CT were 92.6%, respectively. Exclude one case of complicated median sternotomy infection, the postoperative hospital stay was shorter in median sternotomy approached group[P<0.05]. In conclusion, the bullous lesions of the lung have tendency of bilaterality so that median sternotomy for simultaneous resection of bilateral bullae should be considered in patients with contralateral visible bullae with chest CT.

• Journal of Chest Surgery
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• v.24 no.8
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• pp.757-764
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• 1991

We have observed 360 cases of spontaneous pneumothorax from January 1980 to May 1991 at the department of Thoracic and Cardiovascular Surgery, Chosun University Hospital. Males occupied 266 cases[73.9%] and females 94 cases[26.1%], and its ratio was 2.8: l. The age of patients ranged from neonate[5 days] to 84 years old. The site of pneumothorax was right in 50.3%, left in 43.3% and bilateral in 6.4%a. The clinical symptoms were frequently dyspnea, chest pain and coughing. The associated pulmonary lesions were shown pulmonary tuberculosis in 199 cases[55.3%], bullae in 54, pulmonary emphysema in 31, COPD in 17, pneumonia in 6, lung cancer in 5, paragonimiasis in 5, catamenial pneumothorax in 3 and unknown underlying pathology in 39 cases. The results of surgical management of spontaneous pneumothorax are followings: 288 out of 360 cases[80.0%] were cured by closed thoracotomy, 53 cases[14.8%] were cured by open thoracotomy. Open thoracotomy was the most effective procedure in persistent air leakage, recurrent pneumothorax, visible bleb or bullae on the chest X-ray, associated lesion, bilateral simultaneous pneumothorax, parenchymal incomplete lung expansion and bleeding after closed thoracotomy. The incidence of complication was developed in 10. ado and recurrent rate was seen in 10.6%. There was no operative death.

• Clinical and Experimental Pediatrics
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• v.45 no.3
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• pp.401-405
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• 2002

Mycoplasma pneumoniae(M. pneumoniae) is the leading cause of pneumonia in school-age children and young adults. The clinical courses are usually mild but recently, severe cases were reported such as lung abscess, Swyer-James syndrome and adult respiratory distress syndrome. Spontaneous pneumothorax associated with M. pneumoniae infection is rare. Carlisle reported a 6-year-old patient with bilateral spontaneous pneumothorax associated with M. pneumoniae infection and Koura also reported a 18-year-old girl with repeated. M. pneumoniae pneumonia with recurrent pneumothorax. We experienced bilateral spontaneous tension pneumothorax and subcutaneous emphysema associated with M. pneumoniae infection in a 6-year-old boy who presented with dyspnea, chest pain, and neck swelling. We reported it as the first case in Korea.

• Journal of Chest Surgery
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• v.25 no.9
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• pp.955-961
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• 1992

In this study, 237 cases of spontaneous pneumothorax experienced at the department of Thoracic and Cardiovascular Surgery, Kosin Medical College during from January 1986 to December 1990 were analysed retrospectively. 1. The ratio of male to female was 4.6: 1, predominent in male. The incidence of age group was highest as 36% between 21 and 40 years old. 2. The associated diseases of pneumothorax were 27 cases, in which pyothorax were 8 cases, and hydrothorax were 19 cases. 3. The site of pneumothorax was as follows: right side was 53%, left side was 45%, and both side was 2%, so right side was slight high. 4. The empolyed managements were as follows: bed rest with oxygen inhalation in 13 cases, closed thoracostomy in 155 cases, open thoracotomy in 69 cases. 5. The operative procedures of thoracotomy were as follows; simple pleurodesis in 2 cases, blebectomy & bullectomy in 38 cases, parietal pleurecttnny in 4 cases, segmentectomy in 12 cases, lobectomy in 9 cases. 6. The indication of open thoracotomy were as follows, recurrent history in 35 cases, contralateral pneumothorax history in 2 cases, continuous air leakage in 24 cases, bilateral pneumothorax in 2 cases, and visible blebs & bullaes on the chest X-ray in 6 cases. 7. The hospital duration after management was as follow, open thoracotomy in 13.2 days, closed thoracostomy in 22.4 days. The recurrent pneumothorax after closed thoracostomy was 25 cases, about 15%.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.299-306
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• 1988

We have reviewed 330 cases of spontaneous pneumothorax from Jan. 1980 to Jul. 1987 at the department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University. The ratio of male to female was 8.4:1, predominant in male. The incidence according to the age group was highest as 32% in the adolescence between 21 and 30 years old. The site of pneumothorax was right in 48%, left in 45% and bilateral in 7%. The initial symptoms were frequently dyspnea in 85%, chest pain in 63%. The etiologic factors were as follows; bleb origin in 31%, tuberculous origin in 30%, COPD in 3.3%, lung cancer in 1.5%, unknown in 29%. There was no significant difference in seasonal incidence irrespective of tuberculous or sex. The employed managements were as follows; bed rest with oxygen inhalation in 4 cases, closed thoracostomy in 326 cases, open thoracotomy in 122 cases, median sternotomy in 23 cases. The operative procedures at thoracotomy were as follows; simple pleurodesis in 5 cases, bleb excision or wedge resection in 113 cases, segmentectomy or lobectomy in 17 cases, decortication in 42 cases. Recurrence rate of each treatment was as follow; 50% in conservative treatment, 19% in closed thoracostomy, 2% in open thoracotomy, 4% in median sternotomy. Therefore overall recurrence rate was 12%. Open thoracotomy was the most effective procedure in recurrent pneumothorax, previous contralateral pneumothorax, bilateral simultaneous pneumothorax, visible bleb or bullae on the chest x-ray and persistent air leakage. 23 cases of unilateral spontaneous pneumothorax was examined whether or not underlying pathology of pneumothorax at opposite lung. 18 cases[78%] were positive findings. Therefore, bilateral thoracotomy by median sternotomy was a good operative method preventing contralateral pneumothorax.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.582-588
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• 1985

We have observed 165 cases of spontaneous pneumothorax from Aug. 1978 to May. 1985 at the department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University. The ratio of male to female cases were 8.2:1 in male predominance, and the incidence was highest in the adolescence between 21 to 30 year of age. There were 85 patients of primary spontaneous pneumothorax and 80 patients of secondary spontaneous pneumothorax. The etiologic factors of secondary spontaneous pneumothorax were tuberculous origin in 50 cases, chronic bronchitis with emphysematous bullae or blebs in 17 cases, asthma in 10 cases and lung cancer in 3 cases. Closed thoracotomy was performed for reexpansion of collapsed lung in 153 cases, bed rest in 3 cases, needle aspiration in 5 cases and open thoracotomy in 14 cases. Closed thoracotomy was the main therapeutic approach of choice in the great majority of spontaneous pneumothorax with recurrence rate of 21.6%. However, open thoracotomy was undertaken in patients with continuous air leakage, recurrent episodes, bilateral pneumothorax and large visible apical blebs or bullae.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.82-88
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• 1984

Total 310 cases of spontaneous pneumothorax in 281 patients were analyzed to review the results of surgical treatment for this condition. Clinical data on the age & sex distribution, recurrence, etiologic conditions and on the other aspects of spontaneous neumothorax were summarized. The results of surgical management of spontaneous pneumothorax are followings; 205 out of 310 cases[66.1%] were cured by closed thoracostomies. 82 cases[26.5%] were cured by thoracotomy. The indications of thoracotomy were 1] persistent air leakage, 2] history of recurrences, 3] blebs or bullae on thoracoscopy, 4] associated parenchymal lesion, 5] pneumothorax caused by paragonimiasis. Other reasons of thoracotomy were bilateral pneumothorax and inadequate expansion due to chronicity. Excision of blebs or wedge resection was performed in most cases with good result. Lobectomy [9 case] or pneumonectomy [3 cases] was carried out depending on the pathological involvement of the lung. There was no operative death and only one case showed recurrent pneumothorax during follow-up after thoracotomy.

• Journal of Chest Surgery
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• v.47 no.3
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• pp.310-312
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• 2014

When the juvenile worms of the genus Paragonimus migrate and cause defects on the surface of the visceral pleura, pneumothorax can develop. A 34-year-old woman was admitted for pneumothorax with which was developed after she ate raw fish and crab. A 21-year-old male soldier presented with recurrent bilateral pneumothorax without eosinophilia, caused after drinking stream water frequently. In both patients, paragonimiasis was suspected from the computed tomography scan and confirmed by an enzyme-linked immunosorbent assay test of the pleural fluid. When pneumothorax develops in patients who have ingested raw fresh-water crab or stream water, paragonimiasis should always be considered in the differential diagnosis.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.887-893
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• 1990

We have experienced 142 cases of spontaneous pneumothorax from January 1987 to June 1990 at the department of Thoracic and Cardiovascular Surgery, Inha General Hospital, Inha University College of Medicine. The age of patients ranged from 16 to 79 years \ulcornerold. The incidence was highest between late 2nd and 3rd decades in non tuberculous group. Males occupied 110 cases [77.6%] and females 32 cases [22. 5%], and its ratio was 3.4: l. The incidence of right side pneumothorax was 76 cases [53.5%] and left side was 65 cases [45.8%]. There was one case of bilateral pneumothorax. The most common chief complaints were chest pain and dyspnea. The associated pulmonary lesions were pulmonary tuberculosis, active or healed in 51 cases [35.9%], Subpleural bleb in 19 cases [13.4%], emphysematous bulla in 12 cases [13.4%], asthma in 3, bronchiectasis in 3, pneumonia in 1, cyst in 1. The unknown origin pneumothorax, so called "idiopathic spontaneous pneumothorax”, which seemed to be caused by the rupture of bleb or bulla most likely, were 52 cases [36. 6%] in our series. Generally, closed [tube] thoracotomy with underwater sealed drainage is the treatment of choice in spontaneous pneumothorax. We experienced 94 cases[66.2%] which were cured by closed thoracotomy. However, open thoracotomy and adequate surgical procedures were undertaken in patient with continuous air leakage or recurrent attacks of spontaneous pneumothorax in 48 cases [33.8%]. The minithoracotomy is a good procedure for the bullectomy of upper lobe.lobe.