No abstract available.
Thymectomy*

No abstract available.
Myasthenia Gravis* ; Thymectomy*

This study was performed to observe the effectiveness of thymectomy in the management of myasthenia gravis. Twenty-seven myasthenic patients were undergone thymectomy at Keimyung University Dongsan Hospital between January 1981 and December 1990. The most prevalent age group was the 3rd decade and the myasthenic syrnptom developed below thirty in most. Seven patients had remission and 10 patients fared better after thymectomy. There was no significant effect with age and duration of the disease in the result of thymectomy. Those with less severe group had better response than more severe group and non-thymoma group had higher remission rate without statistical significance than thymoma group. There were better response and more complications in the group with maximal thymectomy than simple thymectomy. This study demonstrated that the effect of thymectomy was better in less severe, nontymoma and maximal thymectomy group in myasthenia gravis.
Humans ; Myasthenia Gravis* ; Thymectomy* ; Thymoma

This study was performed to evaluate the titer of serum acetylcholine receptor antibody (AChR-Ab), the correlation between AChR-Ab titer and clinical state, clinical response to thymectomy and histopathologic finding of thymus in myasthenia gravis. Twenty-seven patients with various clinical grades of myasthenia gravis and twenty-three norrnal controls were included in this study. Mean AChR-Ab titers were 4.21+4.27nM in myasthenia gravis and 0.05+0.06nM in control group(p<0.05). Mean AChR-Ab titers of each clinical grade were 0.80+1.67nM in grade I, 5.05+3.42nN in grade Iia, 8.37+4.50nM in grade Iib, 6.67nM in grade m and 10.89nM in grade IV. There were significant correlation between clinical grade and level of AChR-AB titer. There were no correlation between degree of clinical improvement and changes of serum AChR-Ab titer after thymectomy in myasthenia gravis. There were also no correlation between level of AChR-Ab titers and histopathologic findings of thymus.
Acetylcholine ; Humans ; Myasthenia Gravis* ; Thymectomy ; Thymus Gland

This study was performed to evaluate the titer of serum acetylcholine receptor antibody (AChR-Ab), the correlation between AChR-Ab titer and clinical state, clinical response to thymectomy and histopathologic finding of thymus in myasthenia gravis. Twenty-seven patients with various clinical grades of myasthenia gravis and twenty-three norrnal controls were included in this study. Mean AChR-Ab titers were 4.21+4.27nM in myasthenia gravis and 0.05+0.06nM in control group(p<0.05). Mean AChR-Ab titers of each clinical grade were 0.80+1.67nM in grade I, 5.05+3.42nN in grade Iia, 8.37+4.50nM in grade Iib, 6.67nM in grade m and 10.89nM in grade IV. There were significant correlation between clinical grade and level of AChR-AB titer. There were no correlation between degree of clinical improvement and changes of serum AChR-Ab titer after thymectomy in myasthenia gravis. There were also no correlation between level of AChR-Ab titers and histopathologic findings of thymus.
Acetylcholine ; Humans ; Myasthenia Gravis* ; Thymectomy ; Thymus Gland

OBJECTIVE: To  report  a  case  of  tumoral  calcinosis  from  secondary hyperparathyroidism  and  to describe its surgical management.
METHODS:
 Design: Case Report
 Setting: Tertiary Public University Hospital
 Patient: One
RESULTS: A 34-year-old woman presented with progressively-enlarging bilateral upper extremity masses. Diagnostic tests revealed hyperfunctioning parathyroid glands. The patient underwent subtotal  parathyroidectomy,  right  thyroid  lobectomy  with  isthmusectomy,  and  transcervical thymectomy.    Follow-up  revealed  marked  decrease  in  parathyroid  hormone,  and  progressive resolution of the tumoral calcinosis.
CONCLUSION: Subtotal  parathyroidectomy  and  transcervical  thymectomy  have  a  role  in  the management  of  tumoral  calcinosis,  and  in  this  case  led  to  excellent  post-operative  results. The rare  presentation  of  secondary  hyperparathyroidism  and  intervention  in  this  patient  may  have potential lessons for future management of similar cases.

Thymomas are rare tumours which generally account for only 0.2 – 1.5% of mediastinal tumours in adults. Around 40% of patients present with systemic symptoms such as motor weakness due to myasthenia gravis (MG), pure red cell aplasia, and hypogammaglobulinemia. Based on recent guidelines, management of advanced thymoma uses a multimodal approach, which is thymectomy followed by radiotherapy, but not all health care centers have radiotherapy facilities. A 52-year-old woman presented with nasal voice and had difficulty swallowing food. Patient was diagnosed with myasthenia gravis (MG). CT scan with contrast of the thorax showed a heterogenous solid mass in anterior mediastinum. Histopathological examination showed thymoma type B2. Thymectomy followed by seven cycles of platinum-based chemotherapy were done on the patient. Evaluation afterward showed complete remission of thymoma. The patient’s motor weakness improved after the chemotherapy. Post-chemotherapy period was uneventful at six months on follow-up visit. The dosage of acetylcholinesterase inhibitor drug is reduced periodically due to improvement in motor weakness. The case emphasizes how to manage an advanced thymoma with MG with limited therapeutic options, and the importance of multidisciplinary management involving oncologists, surgeons, and neurologists.
Thymoma ; Myasthenia Gravis ; Drug Therapy ; Thymectomy

Myasthenia gravis is relatively rare disease which is related autoimmune response. There are various methods of management for myasthenia gravis, but nowaday radical thymectomy is the treatment of choice in the aspect of bringing out complete remission and clinical improvement. Sixteen patient of myasthenia gravis underwent radical thymectomy during last eight years, and its result was analyed. Complete remission was achieved in five patients(31 %) and pharmacological or symptomatic improvement in seven patients(44 %), thus giving a total remission in 12 patients(75 %). Postoperative result was not correlated with age, sex, degree of preoperative symptom, surgical approach, pathologic diagnosis.
Autoimmunity ; Diagnosis ; Humans ; Myasthenia Gravis* ; Rare Diseases ; Thymectomy

PURPOSE: We studied 32 children with myasthenia gravis to evaluate clinical features and outcomes. Also, we tried to compare between seropositive and seronegative juvenile myasthenia gravis, and validate the clinical correlation between acetylcholine receptor antibody titers and clinical severity in childhood myasthenia gravis. METHODS: The childhood myasthenia gravis patients were diagnosed and treated in Samsung Medical Center from Oct. 1994 to Aug. 2004. RESULTS: The overall clinical features, responses to treatment and outcomes were nearly same as those of other previous reports in Korea as well as the other countries. The mean age at onset was 5.3+/-3.4 years, and the ratio of male to female was 1:1.3. Ocular types were 78.1%, and generalized types were 21.9%. There were significantly lower mean acetylcholine receptor antibody titers in the ocular groups. There were no significant differences in clinical features and outcomes between seropositive and seronegative groups. However, there was a significant correlation between clinical severity and acetylcholine receptor antibody titers. Steroid add-on treatment was required in 78.6% of the patients. Thymectomy was done in 4 patients, all of whom were in partial remission. Overall, the complete remission rate was 37.5%. CONCLUSION: There were no significant differences in clinical features between seropositve & seronegative groups. However, there was a significant correlation between clinical severity and acetylcholine receptor antibody titers.
Acetylcholine* ; Child ; Female ; Humans ; Korea ; Male ; Myasthenia Gravis* ; Thymectomy

Anesthesiologists have a particular interest in myasthenia gravis, since they may need to provide anesthesia for thymectomy or other surgery, or they may have to be involved in the treatment of respiratory failure which mar complicate this disease. We report a case of balanced anesthesia, using thalamonal-N2O-O2 for thymectomy in myasthenia gravis, which posed no postoperative respiratory problem.
Anesthesia ; Balanced Anesthesia* ; Myasthenia Gravis* ; Respiratory Insufficiency ; Thymectomy*