{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:16:43Z","timestamp":1783099003426,"version":"3.54.6"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T00:00:00Z","timestamp":1584403200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100002380","name":"Hanyang University","doi-asserted-by":"publisher","award":["HY-2018"],"award-info":[{"award-number":["HY-2018"]}],"id":[{"id":"10.13039\/501100002380","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>This retrospective cohort study aimed to analyse the impact of asymptomatic blebs\/bullae on the occurrence of primary spontaneous pneumothorax (PSP) by monitoring the natural course of contralateral blebs\/bullae in patients with ipsilateral pneumothorax.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>From January 2003 to December 2017, 1055 patients [age 19.6\u2009\u00b1\u20093.98\u2009years (mean \u00b1 standard deviation), 953 men] experiencing the first episode of unilateral PSP were enrolled in this study, excluding patients aged 30\u2009years or more. The presence, number and maximal size of the blebs\/bullae were investigated in contralateral asymptomatic lungs based on high-resolution computed tomography.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Multiple and single blebs\/bullae were noted in contralateral lungs in 425 (40.3%) and 88 (8.3%) patients, respectively. The median follow-up period was 44.0 (interquartile range 71.5) months. The 1-, 3- and 5-year cumulative occurrence rates of PSP in contralateral lungs were 7.9%, 13.7% and 16.7%, respectively. On multivariable analysis, younger age [hazard ratio (HR) 1.19, 95% confidence interval (CI) 1.12\u20131.27; P\u2009&amp;lt;\u20090.001) and multiple bullae (HR 4.42, 95% CI 3.06\u20136.38; P\u2009&amp;lt;\u20090.001) were independent risk factors for spontaneous pneumothorax in the contralateral lung. The 5-year cumulative occurrence rates of PSP were significantly higher in patients with multiple blebs\/bullae than in those with no or a single bleb\/bulla (28.2% vs 8.5%, respectively; P\u2009&amp;lt;\u20090.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Asymptomatic blebs\/bullae often lead to PSP. If the patient is eligible for surgery for pneumothorax, preemptive surgery for contralateral bullae could be considered, especially in patients with multiple blebs\/bullae.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa054","type":"journal-article","created":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T12:12:41Z","timestamp":1580818361000},"page":"365-370","source":"Crossref","is-referenced-by-count":12,"title":["Fate of contralateral asymptomatic bullae in patients with primary spontaneous pneumothorax"],"prefix":"10.1093","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8414-6274","authenticated-orcid":false,"given":"Hyo Jun","family":"Jang","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8237-2542","authenticated-orcid":false,"given":"Jun Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Hyuk","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1472-0845","authenticated-orcid":false,"given":"Sun Kyun","family":"Ro","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, 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