• Journal of Chest Surgery
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• 제48권6호
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• pp.393-397
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• 2015

Background: The management of contralateral bullae incidentally found in radiological studies is controversial, largely due to the unpredictability of the natural course of incidentally found contralateral bullae. This study aimed to identify the factors associated with the contralateral occurrence of primary spontaneous pneumothorax (PSP), and to characterize the outcomes of contralateral bullae incidentally found in radiological studies. Methods: From January 2005 to December 2008, 285 patients were admitted to our institution for PSP, and the patients underwent follow-up until August 2012. The relationships between the following variables and contralateral pneumothorax occurrence were evaluated: age, sex, smoking history, body mass index, ipsilateral recurrence, ipsilateral bullae size, the number of ipsilateral bullae, contralateral bullae size, and the number of contralateral bullae. Results: The study group consisted of 233 males and 29 females. The mean age and mean body index of the patients were $23.85{\pm}9.50years$ and $19.63{\pm}2.50kg/m^2$. Contralateral PSP occurred in 26 patients. The five-year contralateral PSP occurrence-free survival rate was 64.3% in patients in whom contralateral bullae were found. Conclusion: The occurrence of contralateral PSP was associated with younger age, ipsilateral recurrence, and the presence of contralateral bullae. Contralateral PSP occurrence was more common in young patients and patients with recurrent PSP. Single-stage bilateral surgery should be considered if an operation is needed in young patients, patients with recurrent pneumothorax, and patients with contralateral bullae.

• 한국임상수의학회지
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• 제17권1호
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• pp.159-162
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• 2000

Pulmonary bullae were diagnosed in 2 dogs with respiratory distress at Veterinary Medical Teaching Hospital, Seoul National University. Radiographically, thin-walled, fluid-gas leveled bullae in standing lateral positioning and moderately thick-walled bullae in lateral positioning were identified in case 1 and 2, respectively.

• 한국임상수의학회지
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• 제26권1호
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• pp.72-75
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• 2009

Pulmonary bullae are air-filled spaces within the lung parenchyma that result from the destruction, dilatation and confluence of adjacent alveoli. Pulmonary bullae are found most often in healthy, middle aged, large breed or deep-chested dogs that have no previous history of lung disease and bulla may occur as a result of emphysema, inflammation or trauma. Clinical signs include respiratory distress, anorexia, depression and tachypnea. In this study, a dog with respiratory distress by traffic accident was diagnosed as pulmonary bullae with pneumothorax using radiography at Veterinary Medical Teaching Hospital, GNU. In radiographs, various sized, smooth margin, well defined, oval shaped, gas or fluid filled multiple bullae are shown in the left cranial, left caudal and right accessory lobes. At the initial stage of observation, there were indications of four bullae, two of which were not found in the following radiograph. At the same time, there were serious indications of lung consolidation that caused respiratory distress of patient. Ultimately, the patient was expired after ten hours.

• Journal of Chest Surgery
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• 제29권2호
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• pp.227-230
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• 1996

Air space disorders are usually considered medical diseases, although some patients with air space disorders can benefit from surgical intervention. Recently we experienced two cases of bullous emphysema. One case is large bilateral apical bullae and the other is infected large bulls of RUL with bullous emphysema. The patient with large bilateral apical bullae underwent simultaneous operation via bilateral thoracotomy and other patient underwent simultaneous bilateral operation via median sternotomy. Postoperatively, the patient with large bilateral apical bullae showed subjective as well as objective improvement and other patient is resulted subjective improvement.

• Journal of Chest Surgery
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• 제52권2호
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• pp.91-99
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• 2019

Background: The relationship between the size of bullae and pneumothorax recurrence is controversial. The aim of this study was to retrospectively evaluate the role of blebs or bullae in predicting ipsilateral recurrence in young patients experiencing their first episode of primary spontaneous pneumothorax (PSP) who underwent conservative treatment. Methods: A total of 299 cases of first-episode PSP were analyzed. The status of blebs or bullae was reviewed on high-resolution computed tomography (HRCT). The dystrophic severity score (DSS; range, 0 to 6 points) was calculated based on HRCT. Results: The 5-year recurrence rate was 38.2%. In univariate analysis, age (<20 years), body mass index (<$20kg/m^2$), a unilateral lesion, and intermediate risk (DSS 4 and 5) were associated with recurrence. Sex; smoking history; and the presence, number, and maximal size of blebs or bullae were not related to recurrence. In Cox regression, age and intermediate risk were independent risk factors for recurrence. High risk (DDS 6) was not an independent risk factor. Conclusion: The presence, number, and size of blebs or bullae did not affect ipsilateral recurrence. DSS failed to show a positive correlation between severity and recurrence. The decision to perform surgery in patients experiencing their first episode of PSP should not be determined by the severity of blebs and bullae.

• Journal of Chest Surgery
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• 제6권2호
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• pp.165-170
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• 1973

The selection and treatment with resection and drainage for patients with emphysematous bullae is discussed with reference to two patients recently. One case with bilateral multiple bullous emphysema resulting tension pneumothorax due to rupture of the bullae on right, 47 year old man with pulmonary tuberculosis history for 16 years, was treated with resection of the bullae on right including upper lobectomy and c!osed rhoracostomy drainage on left for another spontaneous pneumothorax, and result was excellent for 6 month after discharge. Another 53 year old man with giant tension air cysts occupying right whole lung field and shifting mediastinum to the left was treated with right under water sealed closed thoracostomy drainage for 7 days in vain, and resection was not performed for his poor respiratory function and general condition. The most useful preoperarive information was obtained from a study of the plain chest radiogram and the surgical procedure of choice was obliteration of the bullae at thoracotomy.

• Tuberculosis and Respiratory Diseases
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• 제39권3호
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• pp.278-281
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• 1992

Air fluid level in a large ring shadow poses a diagnostic problem. But a new development of fluid level in preexisting bullous lesion is another problem. A 60 year old man with chronic obstructive lung disease was noticed to have multiple bullae. A few years later fluid level was newly developed in some of the bullae. Fluid level persisted for several months and later completely filled the space. Surgical exploration revealed pus collection in the bullae and epidermoid carcinoma in the nearby bronchi.

• Journal of Chest Surgery
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• 제26권3호
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• pp.209-213
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• 1993

The pathogenesis of the primary spontaneous pneumothorax is the rupture of subpleural bleb or bullae and subsequent sudden collapse of the affected lung. Mostly, the bullae or blebs are present bilaterally, but detecting the number, size, and location of the causating foci by plain chest film is quite difficult . We have performed chest CT scans for detecting the bullous lesions in 33 cases of primary spontaneous pneumothorax, and compared the results with surgical findings.1. Seventy-four blebs were identified in the chest CT scan, and 100 blebs or bullae were detected surgically [ Sensitivity was 0.74 ].2. Diagnosis rate was 80% [40/50] at right upper lobe, 75.7% [28/37] at left upper lobe, 55.6% at right lower lobe, and 25.0% at left lower lobe, respectively.3. Blebs or bullae smaller than 1 cm of its diameter were detected by 57.1% [24/42] of sensitivity, and in the cases of size larger than 1 cm, it revealed 86.2% [50/58] of sensitivity respectively.4. Of the 45 cases, 7 cases were false negative [15.6%], most of these were ruptured or small size [< 0.5 cm]. 5. One case was false positive, which was irregular adhesion at the apex of the lung.6. We could detect blebs or bullae with preoperative CT scans in 84.4% [38/45] of total patients. In conclusion, chest CT scan is a very advantageous diagnostic tool for proper management and preventing recurrence of primary spontaneous pneumothorax patient.

• Childhood Kidney Diseases
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• 제16권1호
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• pp.51-53
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• 2012

헤노흐-쇤라인 자반증(HSP)은 소아에서 가장 흔한 혈관염으로 피부 자반증, 관절염, 복통, 그리고 신염 등을 특징으로 한다. HSP 소아에서 물집을 동반하는 경우는 매우 드물다. 관절염을 동반한 HSP를 보인 9세 여아에서 경구용 스테로이드 치료를 시작했음에도 불구하고 피부 자반이 빠르게 출혈성 물집 병변으로 진행되었다. 치료 7일 후 몇몇 궤양성 병변은 경미한 흉터로 남았으나 관찰 6개월 후 흉터는 완전히 소멸되었다. 현미경적 혈뇨는 관찰 6개월간 지속되었으나 단백뇨는 관찰되지 않았다. HSP 소아에서 물집이 동반되었을 경우, 신장의 예후에는 직접적인 연관은 없었다. 임상적으로 HSP 진단기준을 만족한다면 HSP 진단을 위해 피부조직검사는 필요 없을 것으로 보이며, 더 많은 증례가 모이면 정확한 결론을 내릴 수 있을 것으로 사료된다. 관절염을 동반한 HSP 9세 여자 소아에서 경구용 스테로이드 치료를 시작했음에도 불구하고 피부 자반이 빠르게 출혈성 물집 병변으로 진행되는 HSP 증례를 경험하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1286-1291
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• 1992

We have experienced 456 cases of spontaneous pneumothorax from January, 1981 to December, 1991 at the department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital. Of these, 102 cases were recurrent pneumothorax. These 102 cases were based on the retrospective clinical analysis, and the results were as follows: The ratio of male to female was 6.2: 1 in male predominance and the old aged patients, over 50 years old, occupied 46.8%a of all patients. Primary spontaneous pneumothorax was 43 cases[42.6%] and secondary spontaneous pneumothorax was 59 cases. The underlying pathology in secondary spontaneous pneumothorax was tuberculosis: 31 cases[30.4%], emphysema and chronic obstructive pulmonary disease: 27 cases[26.1%], Most frequent operative and pathologic findings in the primary and the secondary spontaneous pneumothorax was bullae and blebs at apex. The employed managements were only closed thoracostomy in 41 cases, open thoracot-omy in 61 cases. The operative procedures at thoracotomy were bullectomy or bullae ligation in 37 cases, bullae resection with wedge resection in 8 cases, bullae resection with segmentectomy in 6 cases, bullae resection with decortication in 3 cases, lobectomy in 5 cases, decortication in 2 cases. Complications were subcutaneous emphysema[5 cases], wound infection[1 case], and temporary pulmonary insufficiency[1 cases]