Thymectomy: Surgical removal of the thymus gland. (Dorland, 28th ed)Myasthenia Gravis: A disorder of neuromuscular transmission characterized by weakness of cranial and skeletal muscles. Autoantibodies directed against acetylcholine receptors damage the motor endplate portion of the NEUROMUSCULAR JUNCTION, impairing the transmission of impulses to skeletal muscles. Clinical manifestations may include diplopia, ptosis, and weakness of facial, bulbar, respiratory, and proximal limb muscles. The disease may remain limited to the ocular muscles. THYMOMA is commonly associated with this condition. (Adams et al., Principles of Neurology, 6th ed, p1459)Thymoma: A neoplasm originating from thymic tissue, usually benign, and frequently encapsulated. Although it is occasionally invasive, metastases are extremely rare. It consists of any type of thymic epithelial cell as well as lymphocytes that are usually abundant. Malignant lymphomas that involve the thymus, e.g., lymphosarcoma, Hodgkin's disease (previously termed granulomatous thymoma), should not be regarded as thymoma. (From Stedman, 25th ed)Thymus Neoplasms: Tumors or cancer of the THYMUS GLAND.Oophoritis: Inflammation of the OVARY, generally caused by an ascending infection of organisms from the endocervix.Thymus Hyperplasia: Enlargement of the thymus. A condition described in the late 1940's and 1950's as pathological thymic hypertrophy was status thymolymphaticus and was treated with radiotherapy. Unnecessary removal of the thymus was also practiced. It later became apparent that the thymus undergoes normal physiological hypertrophy, reaching a maximum at puberty and involuting thereafter. The concept of status thymolymphaticus has been abandoned. Thymus hyperplasia is present in two thirds of all patients with myasthenia gravis. (From Segen, Dictionary of Modern Medicine, 1992; Cecil Textbook of Medicine, 19th ed, p1486)Thymus Gland: A single, unpaired primary lymphoid organ situated in the MEDIASTINUM, extending superiorly into the neck to the lower edge of the THYROID GLAND and inferiorly to the fourth costal cartilage. It is necessary for normal development of immunologic function early in life. By puberty, it begins to involute and much of the tissue is replaced by fat.Pyridostigmine Bromide: A cholinesterase inhibitor with a slightly longer duration of action than NEOSTIGMINE. It is used in the treatment of myasthenia gravis and to reverse the actions of muscle relaxants.Autoimmune Diseases: Disorders that are characterized by the production of antibodies that react with host tissues or immune effector cells that are autoreactive to endogenous peptides.Thoracoscopy: Endoscopic examination, therapy or surgery of the pleural cavity.Sternotomy: Making an incision in the STERNUM.Thoracic Duct: The largest lymphatic vessel that passes through the chest and drains into the SUBCLAVIAN VEIN.Thoracic Surgery, Video-Assisted: Endoscopic surgery of the pleural cavity performed with visualization via video transmission.Picryl Chloride: A hapten that generates suppressor cells capable of down-regulating the efferent phase of trinitrophenol-specific contact hypersensitivity. (Arthritis Rheum 1991 Feb;34(2):180).Thyroiditis: Inflammatory diseases of the THYROID GLAND. Thyroiditis can be classified into acute (THYROIDITIS, SUPPURATIVE), subacute (granulomatous and lymphocytic), chronic fibrous (Riedel's), chronic lymphocytic (HASHIMOTO DISEASE), transient (POSTPARTUM THYROIDITIS), and other AUTOIMMUNE THYROIDITIS subtypes.Animals, Newborn: Refers to animals in the period of time just after birth.Alfaxalone Alfadolone Mixture: A 3:1 mixture of alfaxalone with alfadolone acetate that previously had been used as a general anesthetic. It is no longer actively marketed. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1445)T-Lymphocytes: Lymphocytes responsible for cell-mediated immunity. Two types have been identified - cytotoxic (T-LYMPHOCYTES, CYTOTOXIC) and helper T-lymphocytes (T-LYMPHOCYTES, HELPER-INDUCER). They are formed when lymphocytes circulate through the THYMUS GLAND and differentiate to thymocytes. When exposed to an antigen, they divide rapidly and produce large numbers of new T cells sensitized to that antigen.

*  Myasthenia Gravis - Birmingham, AL - Thymectomy | St Vincents Robotics

Vincent's robotic surgery center in Birmingham, AL perform a da Vinci thymectomy as part of your recovery from myasthenia ... This process is called a thymectomy.. There are two widely used approaches for a thymectomy - the transcervical and the ... da VinciĀ® Thymectomy: A Less Invasive Procedure If your doctor recommends surgical repair, you may be a candidate for a new, ... For most patients, da Vinci Thymectomy offers numerous potential benefits over traditional open-chest surgery, including: ...
stvhs.com/roboticsurgery/myastheniagravis.asp

*  Thymectomy | Lake City Medical Center | Lake City, FL

Learn more about Thymectomy at Lake City Medical Center DefinitionReasons for ProcedurePossible ComplicationsWhat to ExpectCall ... A thymectomy is used to treat myasthenia gravis. A thymectomy may also be done if the thymus has a tumor, which is called ... A thymectomy is surgery to remove the thymus gland. This gland is located in the upper portion of the chest, behind the ... Extended transcervical thymectomy: the ultimate minimally invasive approach. Ann Thorac Surg. 2010;89(6):S2128-S2134. ...
https://lakecitymedical.com/hl/?/239516/

*  Subxiphoid VATS thymectomy for myasthenia gravis - Suda- Video-Assisted Thoracic Surgery

Subxiphoid VATS thymectomy for myasthenia gravis
vats.amegroups.com/article/view/3726/4458

*  Subxiphoid VATS thymectomy for myasthenia gravis - Suda - Video-Assisted Thoracic Surgery

Figure 2 Subxiphoid dual-port thymectomy. Compared with single-port thymectomy, dual-port thymectomy has an additional port in ... Subxiphoid dual-port thymectomy and subxiphoid robotic thymectomy are surgical approaches with improved operability through ... Video-assisted thoracoscopic thymectomy versus subxiphoid single-port thymectomy: initial resultsā€ . Eur J Cardiothorac Surg ... reported improvement in 20 MG patients following thymectomy (7). In 2016, Wolfe et al. reported the efficacy of thymectomy for ...
vats.amegroups.com/article/view/3726/4459

*  Bilateral VATS thymectomy in the treatment of myasthenia gravis - Bromberger- Video-Assisted Thoracic Surgery

Bilateral VATS thymectomy in the treatment of myasthenia gravis ...
vats.amegroups.com/article/view/3723/4452

*  Bilateral VATS thymectomy in the treatment of myasthenia gravis - Bromberger - Video-Assisted Thoracic Surgery

Bilateral VATS thymectomy in the treatment of myasthenia gravis ... The goal of thymectomy in MG is to remove as much thymic tissue ... Minimally invasive thymectomy and open thymectomy: outcome analysis of 263 patients. Ann Thorac Surg 2012;94:974-81; discussion ... Compared to extended transsternal thymectomy (T-3b), bilateral VATS thymectomy with transcervical dissection has been reported ... Bilateral video-assisted thoracoscopic thymectomy has a surgical extent similar to that of transsternal extended thymectomy ...
vats.amegroups.com/article/view/3723/4453

*  Dr. Arthur Grimball, MD - Jackson, TN - Cardiac Surgery & Thoracic Surgery & Cardiothoracic Surgery | Healthgrades.com

Open Thymectomy. *Pacemaker Insertion or Replacement. *Peripheral Artery Catheterization. *Port Placements or Replacements ...
https://healthgrades.com/physician/dr-arthur-grimball-2kymw

*  Dr. Marshall DeSantis, MD - Hudson, FL - Cardiothoracic Surgery & Thoracic Surgery & Cardiac Surgery & Vascular Surgery |...

Open Thymectomy. *Pacemaker Insertion or Replacement. *Peripheral Artery Bypass. *Peripheral Artery Catheterization ...
https://healthgrades.com/physician/dr-marshall-desantis-2l6rl

*  Research Faculty | Surgery | SUNY Upstate Medical University

General thoracic surgery, Multidisciplinary evaluation of lung cancer patients, Thymoma/thymectomy for myasthinia gravis, ...
upstate.edu/surgery/research/faculty.php?empID=kohmanl

*  da Vinci Surgery - Minimally Invasive Robotic Surgery with the da Vinci Surgical System

Mediastinal Mass Resection (chest tumor removal) including thymectomy (removal of thymus gland): lengthy time on a breathing ... Mediastinal Mass Resection (including thymectomy): prolonged ventilation ,48 hours, persistent air leak, pericardial effusion, ...
davincisurgery.com/safety/?utm_source=0&utm_medium=0&utm_campaign=Referral_HSmicro_HS


(1/762) Analysis of the adult thymus in reconstitution of T lymphocytes in HIV-1 infection.

A key question in understanding the status of the immune system in HIV-1 infection is whether the adult thymus contributes to reconstitution of peripheral T lymphocytes. We analyzed the thymus in adult patients who died of HIV-1 infection. In addition, we studied the clinical course of HIV-1 infection in three patients thymectomized for myasthenia gravis and determined the effect of antiretroviral therapy on CD4(+) T cells. We found that five of seven patients had thymus tissue at autopsy and that all thymuses identified had inflammatory infiltrates surrounding lymphodepleted thymic epithelium. Two of seven patients also had areas of thymopoiesis; one of these patients had peripheral blood CD4(+) T-cell levels of <50/mm3 for 51 months prior to death. Of three thymectomized patients, one rapidly progressed to AIDS, one progressed to AIDS over seven years (normal progressor), whereas the third remains asymptomatic at least seven years after seroconversion. Both latter patients had rises in peripheral blood CD4(+) T cells after antiretroviral therapy. Most patients who died of complications of HIV-1 infection did not have functional thymus tissue, and when present, thymopoiesis did not prevent prolonged lymphopenia. Thymectomy before HIV-1 infection did not preclude either peripheral CD4(+) T-cell rises or clinical responses after antiretroviral therapy.  (+info)

(2/762) Peripheral autoantigen induces regulatory T cells that prevent autoimmunity.

Previous studies have shown that autoimmune thyroiditis can be induced in normal laboratory rats after thymectomy and split dose gamma-irradiation. Development of disease can be prevented by reconstitution of PVG rats shortly after their final irradiation with either peripheral CD4(+)CD45RC- T cells or CD4(+)CD8(-) thymocytes from syngeneic donors. Although the activity of both populations is known to depend on the activities of endogenously produced interleukin 4 and transforming growth factor beta, implying a common mechanism, the issue of antigen specificity of the cells involved has not yet been addressed. In this study, we show that the regulatory T cells that prevent autoimmune thyroiditis are generated in vivo only when the relevant autoantigen is also present. Peripheral CD4(+) T cells, from rats whose thyroids were ablated in utero by treatment with 131I, were unable to prevent disease development upon adoptive transfer into thymectomized and irradiated recipients. This regulatory deficit is specific for thyroid autoimmunity, since CD4(+) T cells from 131I-treated PVG.RT1(u) rats were as effective as those from normal donors at preventing diabetes in thymectomized and irradiated PVG.RT1(u) rats. Significantly, in contrast to the peripheral CD4(+) T cells, CD4(+)CD8(-) thymocytes from 131I-treated PVG donors were still able to prevent thyroiditis upon adoptive transfer. Taken together, these data indicate that it is the peripheral autoantigen itself that stimulates the generation of the appropriate regulatory cells from thymic emigrant precursors.  (+info)

(3/762) Gonadotropin-releasing hormone analogue conjugates with strong selective antitumor activity.

Conjugation of gonadotropin-releasing hormone (GnRH) analogues GnRH-III, MI-1544, and MI-1892 through lysyl side chains and a tetrapeptide spacer, Gly-Phe-Leu-Gly (X) to a copolymer, poly(N-vinylpyrrolidone-co-maleic acid) (P) caused increased antiproliferative activity toward MCF-7 and MDA-MB-231 breast, PC3 and LNCaP prostate, and Ishikawa endometrial cancer cell lines in culture and against tumor development by xenografts of the breast cancer cells in immunodeficient mice. MCF-7 cells treated with P-X-1544 and P-X-1892 displayed characteristic signs of apoptosis, including vacuoles in the cytoplasm, rounding up, apoptotic bodies, bleb formation, and DNA fragmentation. Conjugates, but not free peptides, inhibited cdc25 phosphatase and caused accumulation of Ishikawa and PC3 cells in the G2/M phase of the cell cycle after 24 h at lower doses and in the G1 and G2 phases after 48 h. Since P-X-peptides appear to be internalized, the increased cytotoxicity of the conjugates is attributed to protection of peptides from proteolysis, enhanced interaction of the peptides with the GnRH receptors, and/or internalization of P-X-peptide receptor complexes so that P can exert toxic effects inside, possibly by inhibiting enzymes involved in the cell cycle. The additional specificity of P-X-peptides compared with free peptides for direct antiproliferative effects on the cancer cells but not for interactions in the pituitary indicates the therapeutic potential of the conjugates.  (+info)

(4/762) Congenital myasthenia gravis: clinical and HLA studies in two brothers.

Two brothers with congenital myasthenia gravis are described. In both, ptosis and ophthalmoplegia responded poorly to oral anticholinesterase therapy and to thymectomy. The brothers had two different HLA haplotypes and neither had the HLA-A1-B8-DW3 haplotypes which are commonly associated with myathenia gravis in adult-onset cases.  (+info)

(5/762) The value of thymectomy in myasthenia gravis: a computer-assisted matched study.

In the absence of a prospective randomized study of patients treated conservatively or with thymectomy, a computer-assisted retrospective matches study was devised. Of 563 patients treated for myasthenia gravis without thymoma up to 1965, 104 had thymectomy. With computer assistance, each surgical patient was matched with a medical patient on the basis of age, sex, and severity and duration of disease. On this basis 80 of the 104 surgical patients could be matched satisfactorily. There were 16 males and 64 females in each of the matched surgically treated and medical control groups. A complete remission was experienced by 27 of the 78 patients in the surgical group as compared to 6 of the medical group. Improvement was noted by 26 of 78 surgically treated patients and 13 of 78 receiving medical treatment. Survival for patients having thymectomy. Thirty-four patients in the medical group had died as compared to 11 in the surgical group. Comparison of survival in relation to sex, duration of symptoms, or age (less than 30 or less than 30 years) did not show a significant difference. Until more effective treatment is available for myasthenia gravis, thymectomy deserves consideration for both sexes, and with increased age or long duration of symptoms.  (+info)

(6/762) Survival of naive CD4 T cells: roles of restricting versus selecting MHC class II and cytokine milieu.

The diversity of naive CD4 T cells plays an important role in the adaptive immune response by ensuring the capability of responding to novel pathogens. In the past, it has been generally accepted that naive CD4 T cells are intrinsically long-lived; however, there have been studies suggesting some CD4 T cells are short-lived. In this report, we identify two populations of naive CD4 T cells: a long-lived population as well as a short-lived population. In addition, we identify two factors that contribute to the establishment of long-lived naive CD4 T cells. We confirm earlier findings that MHC class II interaction with the TCR on CD4 T cells is important for survival. Furthermore, we find that MHC class II alleles with the correct restriction element for Ag presentation mediate the peripheral survival of naive CD4 T cells more efficiently than other positively selecting alleles, regardless of the selecting MHC in the thymus. The second component contributing to the survival of naive CD4 T cells is contact with the cytokines IL-4 and IL-7. We find that the physiological levels of IL-4 and IL-7 serve to enhance the MHC class II-mediated survival of naive CD4 T cells in vivo.  (+info)

(7/762) Invasive thymoma with long-term survival by extensive reoperation.

The recurrence of invasive thymoma is often observed; however, no accepted treatment of recurrent invasive thymoma has yet been established. We herein report a 41-year-old woman with invasive thymoma and pleural dissemination who demonstrated long-term survival after undergoing 4 operations. Based on our findings, reoperation is thus suggested in patients with intrathoracic recurrence and long-term survival can be expected.  (+info)

(8/762) The effect of graft-versus-host disease on T cell production and homeostasis.

The aim of this work was to decipher how graft-versus-host disease (GVHD) affects T cell production and homeostasis. In GVHD+ mice, thymic output was decreased fourfold relative to normal mice, but was sufficient to maintain a T cell repertoire with normal diversity in terms of Vbeta usage. Lymphoid hypoplasia in GVHD+ mice was caused mainly by a lessened expansion of the peripheral postthymic T cell compartment. In 5-bromo-2'-deoxyuridine pulse-chase experiments, resident T cells in the spleen of GVHD+ mice showed a normal turnover rate (proliferation and half-life). When transferred into thymectomized GVHD- secondary hosts, T cells from GVHD+ mice expanded normally. In contrast, normal T cells failed to expand when injected into GVHD+ mice. Thus, the reduced size of the postthymic compartment in GVHD+ mice was not due to an intrinsic lymphocyte defect, but to an extrinsic microenvironment abnormality. We suggest that this extrinsic anomaly is consistent with a reduced number of functional peripheral T cell niches. Therefore, our results show that GVHD-associated T cell hypoplasia is largely caused by a perturbed homeostasis of the peripheral compartment. Furthermore, they suggest that damage to the microenvironment of secondary lymphoid organs may represent an heretofore unrecognized cause of acquired T cell hypoplasia.  (+info)



Myasthenia Gravis


  • A thymectomy is used to treat myasthenia gravis. (lakecitymedical.com)
  • Thymectomy via the subxiphoid approach for myasthenia gravis is an excellent technique for both surgeons and patients because the operative field in the neck region is secured, bilateral phrenic nerve identification is possible, cosmetic outcomes are superior, and pain is minimal. (amegroups.com)
  • Further studies on the long-term therapeutic outcomes of subxiphoid thymectomy for myasthenia gravis are required. (amegroups.com)
  • Though still a source of debate, thymectomy is indicated for patients with myasthenia gravis with a thymoma and in non-thymomatous MG associated with certain autoantibodies ( 2 , 3 ). (amegroups.com)
  • A number of issues regarding thymectomy in myasthenia gravis remain unresolved, including optimal surgical approach. (amegroups.com)
  • The purpose of this paper is to provide an overview of bilateral video-assisted thoracic surgery (VATS) thymectomy in patients with myasthenia gravis, including a review of anatomic considerations, surgical technique, and evaluation of operative risk and disease outcomes in comparison to alternative methods of resection. (amegroups.com)
  • Surgeons at UC San Diego Health excel in a broad spectrum of minimally invasive techniques for thoracic conditions including lung cancer [minimally invasive video-assisted thoracoscopic surgery (VATS)], hyperhidrosis (endoscopic thoracic sympathectomy), thymus tumors and Myasthenia gravis (robotic thymectomy). (ucsd.edu)

thymus gland


Thoracic Surgery


  • General thoracic surgery, Multidisciplinary evaluation of lung cancer patients, Thymoma/thymectomy for myasthinia gravis, Clinical trials in thoracic malignancy. (upstate.edu)

video-assisted thoracoscopic surgery


  • Endoscopic thymectomy includes the transcervical approach via the neck region, video-assisted thoracoscopic surgery via the lateral intercostal space (lateral thoracic intercostal approach), and the subxiphoid approach. (amegroups.com)

robotic thymectomy


  • Subxiphoid dual-port thymectomy and subxiphoid robotic thymectomy are surgical approaches with improved operability through additional intercostal ports on the anterior chest and were originally designed for cases when single-port thymectomy is difficult. (amegroups.com)
  • Figure 3 Subxiphoid robotic thymectomy. (amegroups.com)

endoscopic


  • In recent years, surgeons have come to use less invasive endoscopic surgical techniques than conventional median sternotomy to perform thymectomy. (amegroups.com)
  • The lateral thoracic intercostal approach is currently the most commonly employed technique at facilities that offer endoscopic thymectomy, including robot-assisted surgery. (amegroups.com)

surgery


  • However, the benefit of thymectomy for symptom remission is not immediate and may not be achieved until 5 to 10 years after surgery ( 4 ). (amegroups.com)

approaches


  • There are two widely used approaches for a thymectomy - the transcervical and the transsternal approach. (stvhs.com)
  • While there exist a number of different surgical approaches, the optimal thymectomy removes the most amount of thymic tissue in the least invasive manner, allowing for rapid recovery from the procedure and providing the best chance of remission of disease. (amegroups.com)
  • Bilateral video-assisted thoracoscopic thymectomy appears to have improved recovery time and comparable rates of remission to more invasive approaches, though more high-quality long-term outcomes studies are needed. (amegroups.com)

outcomes


  • The purpose of this paper is to review bilateral video-assisted thoracoscopic thymectomy with regard to both relevant anatomy and surgical technique, as well as in comparison to other existing methods of thymectomy in terms of safety, recovery and outcomes. (amegroups.com)

surgical procedure


  • If your doctor recommends surgical repair, you may be a candidate for a new, less invasive surgical procedure called da Vinci Thymectomy. (stvhs.com)

neck


  • Ectopic thymic tissue was found in the mediastinum and cervical neck in 98% and 32% of thymectomy specimens, respectively ( 6 ). (amegroups.com)

remove


  • The purpose of thymectomy is to remove as much thymic tissue as possible in order to achieve remission and prevent tumor invasion in the setting of thymomas. (amegroups.com)

done


single


  • An advantage of subxiphoid single-port thymectomy is that it does not cause intercostal nerve damage because it does not traverse the intercostal space. (amegroups.com)
  • Figure 1 Subxiphoid single-port thymectomy. (amegroups.com)
  • Compared with single-port thymectomy, dual-port thymectomy has an additional port in the right fifth intercostal space to improve operability. (amegroups.com)