• Journal of Chest Surgery
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• v.32 no.3
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• pp.326-329
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• 1999

Pulmonary lymphangioleiomyomatosis is a rare disease occurring almost exclusively in woman of reproductive age. It is characterized by rapid deterioration of respiratory functions and results in death within an average of 10 years. This disease is caused by a progressive proliferation of atypical smooth muscle in the pulmonary lymphatic vessels, blood vessels, and airways leading to the development of distal cystic changes which causes frequent recurrent pneumothoraces. We experienced a case of pulmonary lymphangioleiomyomatosis in a 30-year old woman who had a history of bilateral, recurrent pneumothoraces. The patient underwent lung biopsy through right thoracotomy which revealed the diagnosis of pulmonary lymphangioleiomyomatosis. We report a case with a review of the literature.

• Journal of Chest Surgery
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• v.48 no.6
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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.

• Tuberculosis and Respiratory Diseases
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• v.41 no.2
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• pp.152-157
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• 1994

Histiocytosis-X is a tenn used to define three diseases with similar morphologic characteristics : Letterer-Siwe diseae, Hand-Schuller-Christian disease and Eosinophilic granuloma. In general, they differ in terms of their age of onset, severity of clinical course and site of involvement. Eosinophilic granuloma typically is seen in young adults. Eosinophilic granuloma is diagnosed in the presense of diffuse pulmonary infiltrate, bony involvement. However, the pulmonary radiologic findings of eosinophilic granuloma are variable accordinary to stage of disease. therefore pathologic diagnosis of involving site is essential for confirmative diagnosis of eosinophilic grananuloma. Pathologically. the three disease are characterized by granulomatous infiltration of alveolar septa and bronchial walls and often involvement of bone. The hallmark of this disease is proliferation of the Langerhans' cell. The identifying feature is the X-body or Birbeck granule that is present in Langerhans' cells and histiocytic cells found in the lung of EG patient. We report a case of bilatera1, recurrent and spontaneous pneumothoraces in a 21 year old man with pulmonary histiocytosis-X, which is confirmed by eosinophilc granuloma in bone marrow biopsy and ultrastructural examination in cells obtained from BAL.

• Journal of Chest Surgery
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• v.52 no.2
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• pp.85-90
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• 2019

Background: Variation exists in the initial treatment for the first episode of primary spontaneous pneumothorax (PSP), and no definitive consensus exists due to a lack of high-quality evidence. This study examined the outcomes of needle aspiration and closed thoracostomy in first episodes of PSP requiring intervention. Methods: This study was a randomized, prospective, single-center trial conducted between December 2015 and August 2016. Patients of all ages with a documented first episode of PSP who were unilaterally affected, hemodynamically stable, and had a pneumothorax measuring over 25% in size were included. Patients with underlying lung disease, severe comorbidities, bilateral pneumothorax, tension pneumothorax, recurrent pneumothorax, traumatic pneumothorax, and pregnancy were excluded. Patients were randomly assigned to the needle aspiration or closed thoracostomy group using a random number table. Results: Forty patients with a first episode of PSP were recruited, and 21 and 19 patients were included in the needle aspiration group and the closed thoracostomy group, respectively. The hospital stay of each group was $2.1{\pm}1.8days$ and $5.4{\pm}3.6days$, respectively (p<0.01). However, no significant differences were found in the success rate of initial treatment or the 1-month and 1-year recurrence rates. Conclusion: Needle aspiration is a favorable initial treatment in patients experiencing a first episode of PSP.

• Journal of Chest Surgery
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• v.17 no.3
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• pp.511-515
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• 1984

In this study, 213 cases of the spontaneous pneumothorax experienced at the department of thoracic and cardiovascular surgery, Chungnam National University Hospital during from April, 1977, till Dec, 1983 were reviewed. 1.Sex ratio of the studied patients was 7.19;1 showing high incidence male patients. The incidence according to the age group showed that 20.2%, 18.3% of the patients belong to the age group 6th, 5th decade respectively. 2.The etiologic factors were as follows, tuberculous origin in 50.2%, unknown origin in 28.2%, COPD in 3.3%, bullae in 8.5%. The site was right in 47.9% and left in 44.1%, bilateral in 8%. 3.The clinical symptoms were frequently dyspnea in 35%, chest pain in 27.5%. 4.The employed method of treatment were as follow, bed rest with oxygen inhalation in 1.9%, closed thoracostomy in 95.8%, open thoracotomy in 7.98%, which bullectomy was performed in 12 cases and pneumonectomy in 3 cases and lobectomy in 1 case and decortication with simple closure of bleb was performed in remaining 1 case. 5.The duration of closed thoracostomy was longer in tuberculosis, which average duration was 11.28 days. 6.The overall recurrent rate was 12.3%.

• Journal of Chest Surgery
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• v.24 no.5
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• pp.451-458
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• 1991

We have observed 101 cases of recurrent spontaneous pneumothorax from Sep. 1979 to Dec. 1989 at the Department of Thoracic & Cardiovascular Surgery, College of Medicine, Inje University, Pusan Paik Hospital and the result obtained as follows. 1] Age range of patients was the first decade to seventh decade. Males outnumbered females by 6.7: l. One or two episodes of recurrent attack were noted in majority cases. 2] In distribution of the lesion sites, right side was 55 cases[55.4%], left 42 cases[41.9%], and bilateral 4 cases[3.0%]. 3] In clinical manifestations, abrupt onset of dyspnea was 78 cases[77.2%], chest pain 48 cases[47.5%], cough 9 cases[8.9%] and chest discomfort 8 cases[7.9%]. 4] Of 101 cases, 48 cases were associated with pulmonary tuberculosis and other cases were associated with subpleural bullae and blebs[26 cases], emphysema[7 cases], bronchiectasis[2 cases], lung cancer[1 case], and silicosis[1 case], 5] In 88 cases[87.2%] of patients, the magnitude of collapse was above 50% in plain chest film. 6] The interval of recurrence after last attack was frequently within 1 year. 7] In the management, closed thoracostomy with underwater-sealed drainage was applied in first recurrent 53 cases but 2nd recurrence was developed in 16 cases. In 52 cases, surgical management was applied. The pleurodesis with chemical agent[tetracycline] via chest tube was applied in 2 cases. Among 51 cases subjected to the open thoracotomy, pleural abrasion was performed in 3 cases, excision of bullae & blebs in 12 cases, wedge resection in 28 cases, lobectomy in 6 cases and wedge resection combined with lobectomy in 2 cases. In one case subjected to the median sternotomy, wedge resection on both lung apex was performed. 8] Postoperative complications were developed in 8 cases but not serious.

• Tuberculosis and Respiratory Diseases
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• v.57 no.5
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• pp.470-475
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• 2004

Idiopathic hypereosinophilic syndrome (HES) is a disorder characterized by prolonged eosinophilia without an identifiable cause and eosinophil related tissue damage in multiple organs including heart, lung, skin, gastrointestinal tract, liver, and the nervous systems. Pulmonary involvement occurs in about 40% of HES cases, but pleural effusion due to pleuritis and bilateral pneumothoraces are very rare manifestations. We report a case of hypereosinophilic syndrome presented with bilateral pleural effusions and recurrent bilateral pneumothoraces in a 44 year-old male with brief review of the literature.

• Journal of Chest Surgery
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• v.9 no.1
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• pp.98-101
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• 1976

Clinical observations were made on a total 104 cases of spontaneous pneumothorax during the period of 5 years from MAR. 1971 to MAR. 1976 at the Dept. of Chest Surgery, Korea University Medical College. The ratio of male to female cases was 7.4 : 1 in male predominance, and age distribution was 73% of the total cases within the 15-40 age range. There were 56 patients (53.8%) of right sided pneumothorax and 44 patients (42.3%) of left sided pneumothorax, 8 patients presented bilateral spontaneous pneumothorax. The etiologic factors were tuberculous origin in 42.3%, rupture of bullae or blebs in 15.4%, acute pulmonary infection in 3.8%, pulmonary paragonimiasis in 2.9%, cysticercosis 1%, Marfan's syndrome in 1.9%, unknown causes in 32.7%. In all 104 cases, closed chest tube thoracostomy were performed for reexpansion of collapsed lung. In 50 cases of 104 cases, intrapleural instillation of Quinacrine HCl (Atabrine, Winthrop Laboratories, New York, N.Y.) thru the chest tube was used to control of recurrent pneumothorax, and compared observation with 54 cases control group of closed chest tube thoracostomy only. In both groups, 1) cure rates were 63% in control group and 88% in Atabrine group. 2) average duration of inserted chest tube were 5.6 days in control group and 5.7 days in Atabrine group.

• Tuberculosis and Respiratory Diseases
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• v.62 no.6
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• pp.554-559
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• 2007

A 29-year-old female patient presented with exertional dyspnea that she had suffered with for 2 months. The chest X-ray displayed right pleural effusion that was diagnosed as chyle, according to the level of cholesterol and triglyceride in the pleural fluid. VATS (video assisted thoracic surgery) of the right lung was performed on the 7th day of hospitalization for obtaining a lung biopsy and to control the of pneumochylothorax. On the 11th hospitalization day, VATS of left lung was also performed to control the recurrent pneumothorax via pleurodesis. The lung biopsy showed moderate amounts of spindle-shaped and rounded cells (so-called LAM cells), which were reactive to actin and HMB45 (on immunohistochemical stains). We report here on a rare case of lymphangioleiomyomatosis combined with chylothorax and bilateral pneumothroraces.

• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.183-187
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• 2004

Bronchiolitis obliterans (BO) is a nonspecific inflammatory injury affecting primarily the small airways. Its inflammatory process is characterized by fibrotic obliteration of the lumen of bronchioles. BO can be idiopathic or associated with connective tissue disease, inhaled toxins, infections, drugs, and chronic graft-versus-host-disease (GVHD). Pulmonary complications occur in 40~60% of patients who undergo allogeneic bone marrow transplantation (BMT), causing 10~40% of transplant-related deaths. BO is a characteristic pulmonary complication which occurs usually within a few years after BMT. Documented complications of BO include air-leak syndromes such as pneumomediastinum, subcutaneous emphysema and pneumothorax. We report a case of a 30-year-old male patient with BO due to chronic GVHD after allogenic BMT who presented with recurrent bilateral pneumothoraces.