Background: Primary spontaneous pneumothorax is commonly treated with chest tube insertion, which requires hospitalization. In this study, we evaluated the efficacy, costs, and benefits of a portable small-bore chest tube (Thoracic Egg; Sumitomo Bakelite Co. Ltd., Tokyo, Japan) compared with a conventional chest tube. Methods: We retrospectively analyzed all primary spontaneous pneumothorax patients who underwent treatment at Gangnam Severance Hospital between August 2014 and May 2018. Results: A total of 279 patients were divided into 2 groups: the conventional group (n=236) and the Thoracic Egg group (n=43). Of the 236 patients in the conventional group, 100 were excluded because they underwent surgery during the study period. The efficacy and cost were compared between the 2 groups. There was no statistically significant difference between the groups regarding recurrence (conventional group, 36 patients [26.5%]; Thoracic Egg group, 15 patients [29.4%]; p=0.287). However, the Egg group had statistically significantly lower mean medical expenses than the conventional group (433,413 Korean won and 522,146 Korean won, respectively; p<0.001). Conclusion Although portable small-bore chest tubes may not be significantly more efficacious than conventional chest tubes, their use is significantly less expensive. We believe that the Thoracic Egg catheter could be a less costly alternative to conventional chest tube insertion.

Bronchobiliary fistula is a rare disease defined as an abnormal connection between the biliary tract and the bronchial tree. We report the successful surgical repair of bronchobiliary fistula. A 78-year-old man underwent surgery and several rounds of transcatheter arterial chemoembolization and radiofrequency ablation as treatment for hepatocellular carcinoma. He presented with greenish sputum and chronic cough for several months, and his symptoms did not resolve after endoscopic treatment. We performed lobectomy of the right lower lobe and omentopexy for bronchobiliary fistula under laparotomy and thoracotomy. The bronchobiliary fistula was successfully closed, and the bilious sputum disappeared after surgery.

Although the incidence of epidemic encephalitis has decreased mardekly nowadays, sporadic cases are stillobserved in Korea. In this study, CT findings of 17 patients with clinically and serologically proven epidemicencephalitis were analized. In principle, CT scans were done at the acute and subacute stage, whithin 20 days fromonset. The results were follows; 1. Of all 17 patients with CT scan, normal scan were demonstrated in 3 cases andabnormal scans in 14 cases. 2. The abnormal CT findings were ; area of low density in 9 cases, brain edema in 7cases, nodular and gyral contrast enhancement in 3 cases, central brain atrophy in 3 cases and hemorrhagic highdensity in 2 cases in order of frequency. 3. The CT findings, according to date of CT scan from onset, were; brainedema and are of low density within 10 days from onset, normal or central brain atrophy between 11 days and 20days, are of hemorrhagic high density and contrast enhanced lesions at both stage. 4. The locational distributionswere; thalamus and cerebral white matter in 7 cases respectively, basal ganglia in 5 cases, cerebral cortex in 4cases and septum pellucidum in 1 case in order of frequency.
Atrophy ; Basal Ganglia ; Brain ; Brain Edema ; Cerebral Cortex ; Encephalitis, Arbovirus ; Humans ; Incidence ; Korea ; Septum Pellucidum ; Thalamus ; Tomography, X-Ray Computed ; White Matter