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https://www.readbyqxmd.com/read/28711822/extended-thymectomy-left-pneumonectomy-pericardiectomy-and-partial-pleurectomy-for-a-large-thymoma-using-only-a-median-sternotomy
#1
Jorge Cruz, André Sena, Catarina Carvalheiro, Ricardo Ferreira
We present a case of a large thymoma with invasion to the hilum of the lung and pleural dissemination. A 58-year-old woman was diagnosed with a type B2 thymoma, with suspected pericardium, pulmonary artery and left lung invasion and pleural metastasis (Masaoka-Koga stage IVb). A radical resection was planned after systemic chemotherapy. Through a median sternotomy, we resected the tumour, and after confirmation of pericardium and left lung invasion, we also performed resection of the pericardium, of the lung and of the pleural metastasis...
June 29, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28707128/thymectomy-is-a-beneficial-therapy-for-patients-with-non-thymomatous-ocular-myasthenia-gravis-a-systematic-review-and-meta-analysis
#2
Kai Zhu, Jiaoxing Li, Xin Huang, Wei Xu, Weibin Liu, Jiaxin Chen, Pei Chen, Huiyu Feng
Ocular myasthenia gravis, an autoimmune disease, is characterized by extraocular muscle weakness. Myasthenia gravis is closely associated with the functional status of the thymus gland. The efficacy of thymectomy for non-thymomatous ocular myasthenia gravis remains controversial. Here, we present the first systematic review and meta-analysis of studies assessing the outcome of thymectomy in patients with non-thymomatous ocular myasthenia gravis and found that the pooled rate of complete stable remission was 0...
July 13, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28699002/a-bilateral-approach-to-extended-thymectomy-using-the-da-vinci-surgical-system-for-patients-with-myasthenia-gravis
#3
Koji Kawaguchi, Takayuki Fukui, Shota Nakamura, Tetsuo Taniguchi, Kohei Yokoi
PURPOSE: We adopted a bilateral approach to complete robotic extended thymectomy with the excision of the pericardial fat tissue from both sides and analyzed the initial outcomes. METHODS: The patient cart was docked first from the left shoulder side. After dissection of the thymus and right pericardial fat tissue, the cart was temporarily rolled out, and the bed was rotated approximately 90° clockwise. The cart was then re-docked from the right-side shoulder, and extended thymectomy was performed via the left-side approach...
July 11, 2017: Surgery Today
https://www.readbyqxmd.com/read/28691750/human-neonatal-thymectomy-induces-altered-b-cell-responses-and-auto-reactivity
#4
Theo Broek, Asaf Madi, Eveline M Delemarre, Alvin W L Schadenberg, Kiki Tesselaar, José A M Borghans, Stefan Nierkens, Frank A Redegeld, Henny G Otten, Maura Rosetti, Salvatore Albani, Rachel Sorek, Irun R Cohen, Nicolaas J G Jansen, Femke van Wijk
An association between T-cell lymphopenia and autoimmunity has long been proposed, but it remains to be elucidated whether T-cell lymphopenia affects B-cell responses to auto-antigens. Human neonatal thymectomy results in a decrease in T-cell numbers and we used this model to study the development of auto-reactivity. Two cohorts of neonatally thymectomized individuals were examined, a cohort of young (1-5 years post-thymectomy, n = 10-27) and older children (>10years,n = 26), and compared to healthy age-matched controls...
July 10, 2017: European Journal of Immunology
https://www.readbyqxmd.com/read/28689684/-ectopic-thymus-a-rare-cause-of-neck-mass-in-children
#5
S Kallel, M Mnejja, M Kessentini, A Ben Said, I Charfeddine, B Hammami, A Ghorbel
INTRODUCTION: Ectopic cervical thymus (ECT) is a rare embryological abnormality in children. It can be revealed by a compressive neck mass mistaken for a malignant tumor. Through a new case of ECT, we review the embryopathogenesis, diagnostic difficulties and therapeutic features. CLINICAL OBSERVATION: A 19-month-old girl presented a right cervical mass that quickly increased in size, causing intermittent dyspnea. The physical examination objectified a 6-cm, soft and compressible, painless right cervical tumefaction, extending from the mastoid area to the ipsilateral supraclavicular fossa...
July 6, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28686710/autoimmunity-and-allergy-control-in-adults-submitted-to-complete-thymectomy-early-in-infancy
#6
Susana L Silva, Adriana Albuquerque, Andreia J Amaral, Quan-Zhen Li, Catarina Mota, Rémi Cheynier, Rui M M Victorino, M Conceição Pereira-Santos, Ana E Sousa
The contribution of the decline in thymic activity for the emergence of autoimmunity is still debatable. Immune-competent adults submitted to complete thymectomy early in life provide a unique model to address this question. We applied here strict criteria to identify adults lacking thymic activity based on sjTREC levels, to exclude thymic rebound and/or ectopic thymuses. In agreement, they featured severe naïve CD4 T-cell depletion and contraction of T-cell receptor diversity. Notwithstanding this, there was neither increased incidence of autoimmune disease in comparison with age-matched controls nor significant changes in their IgG/IgA/IgM/IgE autoreactivity profiles, as assessed through extensive arrays...
2017: PloS One
https://www.readbyqxmd.com/read/28674368/thymoma-associated-progressive-encephalomyelitis-with-rigidity-and-myoclonus-perm-with-myasthenia-gravis
#7
Satoshi Morise, Masataka Nakamura, Jun-Ichi Morita, Kousuke Miyake, Takenobu Kunieda, Satoshi Kaneko, Hirofumi Kusaka
We report a case of a 72-year-old woman who initially presented with symptoms of bulbar myasthenia and was positive for anti-acetylcholine receptor antibodies. She subsequently developed painful muscle spasms, myoclonus, and stiffness. Thymoma was detected, and both anti-glycine receptor and anti-glutamic acid decarboxylase antibodies were found. She was diagnosed with thymoma-associated progressive encephalomyelitis with rigidity and myoclonus (PERM). She experienced marked improvement after thymectomy followed by plasma exchange and intravenous immunoglobulin and prednisolone...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28670075/malignant-thymoma-with-metastasis-associated-with-paraneoplastic-myasthenia-gravis
#8
Hourossadat Hashemi Jazi, David M Harmon, Tuan Tran, Claude Denham
We describe a patient who initially presented with a mixed thymic tumor and developed myasthenia gravis 8 years following thymectomy with recurrence of metastatic disease. Metastasis to the pleura, mediastinum, and cervical spine was identified with a positron emission tomography scan when this patient presented with recurring pneumonias and atrial fibrillation. The presentation and diagnosis were clouded by multiple courses of prednisone and chemotherapy for respiratory complications and metastatic disease, respectively...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28668447/effect-of-cryopreservation-on-viability-and-growth-efficiency-of-stromal-epithelial-cells-derived-from-neonatal-human-thymus
#9
Valentin P Shichkin, Oleksandr I Gorbach, Olga A Zuieva, Nataliia I Grabchenko, Irina A Aksyonova, Boris M Todurov
The thymus is the major site of T lymphocyte generation and so is critical for a functional adaptive immune system. Since, thymectomy is a component of neonatal surgery for congenital heart diseases, it provides great potential for collection and storage of thymic tissue for autologous transplantation. However, specific investigation into the optimum parameters for thymic tissue cryopreservation have not been conducted. In this research, we evaluated the effect of different cryoprotective media compositions, which included penetrating (Me2SO, glycerol) and non-penetrating (dextran-40, sucrose, hydroxyethyl starch) components, on the viability and functionality of frozen-thawed human thymic samples to select an optimal cryoprotective medium suitable for long-term storage of thymic tissue and a stromal-epithelial enriched population...
June 28, 2017: Cryobiology
https://www.readbyqxmd.com/read/28666024/outcomes-after-major-surgery-in-patients-with-myasthenia-gravis-a-nationwide-matched-cohort-study
#10
Yi-Wen Chang, Yi-Chun Chou, Chun-Chieh Yeh, Chaur-Jong Hu, Chih-Jen Hung, Chao-Shun Lin, Ta-Liang Chen, Chien-Chang Liao
OBJECTIVE: To validate the comprehensive features of adverse outcomes after surgery for patients with myasthenia gravis. METHODS: Using reimbursement claims from Taiwan's National Health Insurance Research Database, we analyzed 2290 patients who received major surgery between 2004 and 2010 and were diagnosed with myasthenia gravis preoperatively. Surgical patients without myasthenia gravis (n = 22,900) were randomly selected by matching procedure with propensity score for comparison...
2017: PloS One
https://www.readbyqxmd.com/read/28660682/robotic-versus-thoracoscopic-thymectomy-the-current-evidence
#11
Judith Buentzel, Judith Heinz, Marc Hinterthaner, Friedrich A Schöndube, Carmen Straube, Christian Roever, Alexander Emmert
BACKGROUND: The purpose of this study was to analyze all relevant comparative studies comparing robot-assisted minimally invasive thymectomy (RATS) and video-assisted thoracic surgery thymectomy (VATS) in terms of surgical and short-term outcomes. METHODS: A systematic search for articles describing robot-assisted and video-assisted thymectomy and addressing surgical outcomes, operation time, length of hospitalization, intra-operative blood loss, conversion to sternotomy and post-operative complications was performed using the medical databases...
June 29, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28660639/the-role-of-regulatory-t-cells-in-thymectomy-induced-autoimmune-ovarian-disease
#12
Yajun Dong, Hongmei Li, Yuyan Li, Yonggang Liu, Huiling Chen, Pingping Xu, Tingting Zhao, Wei He
PROBLEM: To evaluate the role of regulatory T (Treg) cells in autoimmune ovarian disease (AOD). METHOD OF STUDY: AOD model was set up by thymectomy of BALB/C mice on day 3 (d3tx). The variation of T lymphocyte subsets, especially the Treg cells were analyzed in the peripheral blood, spleen, para-aortic, and inguinal lymph nodes in d3tx mice. The effect of Treg cells on AOD was further evaluated by adoptive transfer of Treg cells into d3tx mice (d3tx+Treg). RESULTS: In d3tx mice, the ratio of Treg/CD4(+) was significantly increased rapidly from 1st to 2nd week, rapidly declined in 3rd week, then decreased slowly until the 9th week...
June 29, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28654435/myasthenia-gravis-new-developments-in-research-and-treatment
#13
Amelia Evoli
PURPOSE OF REVIEW: Myasthenia gravis, a rare disorder of the neuromuscular transmission, is increasingly acknowledged as a syndrome more than as a single disease. This review summarizes recent advances in pathophysiology which confirm the disease heterogeneity, and may help find disease-targeted and patient-targeted therapies. RECENT FINDINGS: Antibodies to the acetylcholine receptor, the muscle-specific tyrosine kinase and the lipoprotein receptor protein 4, characterize disease subtypes with distinct clinical traits and immune-pathogenic mechanisms...
June 24, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28647799/a-case-of-atypical-type-a-thymoma-with-vascular-invasion-and-lung-metastasis
#14
Naoya Kawakita, Kazuya Kondo, Hiroaki Toba, Akiko Yoneda, Hiromitsu Takizawa, Akira Tangoku
We present a case of type A thymoma with invasion of the left brachiocephalic vein and lung metastases. An 84-year-old man underwent extended thymectomy combined with left brachiocephalic vein reconstruction and resection of a lung metastasis. Histological examination showed vascular invasion by the tumor. The lung metastasis had high mitotic activity and slight nuclear enlargement, the so-called "atypical" features, but the main part of the primary tumor did not. However, the intravascular portion of the tumor had "atypical" histological features like the lung metastasis...
June 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28637940/thoracoscopic-thymectomy-with-tangential-partial-resection-of-the-innominate-vein
#15
Motoki Yano, Katsuhiro Okuda, Osamu Kawano, Ayumi Suzuki, Risa Oda, Ryoichi Nakanishi, Masayuki Haniuda
We herein report a case in which thoracoscopic thymectomy with partial resection of the brachiocephalic vein was performed using a subxiphoid approach. We suggest the usefulness of the subxiphoid approach in thymectomy. We could extend the indications of thoracoscopic thymectomy for invasive tumors. Thoracoscopic thymectomy with the combined resection of part of the brachiocephalic vein was possible. The pathological diagnosis of the tumor was diffuse large cell B-cell lymphoma. Since the postoperative complications were minimal, postoperative adjuvant chemotherapy could be initiated without delay...
June 22, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28628938/outcome-after-robotic-assisted-thymectomy-in-children-and-adolescents-with-acetylcholine-receptor-antibody-positive-juvenile-myasthenia-gravis
#16
Adela Della Marina, Heike Kölbel, Maximilian Müllers, Olaf Kaiser, Mahmoud Ismail, Marc Swierzy, Jens-Carsten Rueckert, Ulrike Schara
No abstract text is available yet for this article.
June 19, 2017: Neuropediatrics
https://www.readbyqxmd.com/read/28624025/quantitative-computed-tomography-texture-analysis-for-estimating-histological-subtypes-of-thymic-epithelial-tumors
#17
Koichiro Yasaka, Hiroyuki Akai, Masanori Nojima, Aya Shinozaki-Ushiku, Masashi Fukayama, Jun Nakajima, Kuni Ohtomo, Shigeru Kiryu
OBJECTIVES: To investigate whether high-risk thymic epithelial tumor (TET) (HTET) can be differentiated from low-risk TET (LTET) using computed tomography (CT) quantitative texture analysis. MATERIALS AND METHODS: The data of 39 patients (mean age, 58.6±14.1 years) (39 unenhanced CT (UECT) and 33 contrast-enhanced CT (CECT)) who underwent thymectomy for TET were retrospectively analyzed. A region of interest was placed to include the entire TET within the slice at its maximum diameter...
July 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28619540/video-assisted-thoracic-surgery-thymectomy-versus-sternotomy-thymectomy-in-patients-with-thymoma
#18
Hiroyuki Agatsuma, Kazuo Yoshida, Ichiro Yoshino, Meinoshin Okumura, Masahiko Higashiyama, Kenji Suzuki, Masanori Tsuchida, Jitsuo Usuda, Hiroshi Niwa
BACKGROUND: This study was designed to evaluate the feasibility of video-assisted thoracoscopic surgery (VATS) and to compare the oncologic outcomes of VATS with those of sternotomy in patients with thymoma. METHODS: The clinical outcomes of 2,835 patients with thymic epithelial tumors treated between 1991 and 2010 in 32 Japanese institutions were collected retrospectively. The study compared postoperative complications, positive surgical margins, location of recurrence, and survival in 140 of 142 VATS-treated patients (VATS group) matched with 140 of 1,294 sternotomy-treated patients (ST group) by using propensity scores...
June 13, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28616293/video-assisted-thoracoscopic-completion-thymectomy-based-on-mediastinal-pleura-guidance
#19
Kai Guo, Liping Tong, Xiaofei Li, Xiaolong Yan
We describe a practical video-assisted thoracoscopic surgery (VATS) technique for the en bloc resection of the thymoma, thymus, and bilateral mediastinum lipid based on mediastinal pleura guidance. By taking advantage of single-lumen endotracheal tube (SLET) anesthesia and artificial pneumothorax, we acquired excellent exposure of the anterior mediastinum operative field. In addition, our limited data showed that this surgical approach might have a potential tendency on reducing the blood loss and the operative times...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28614249/thymectomy-via-open-surgery-or-robotic-video-assisted-thoracic-surgery-can-a-recommendation-already-be-made
#20
REVIEW
Judith Buentzel, Carmen Straube, Judith Heinz, Christian Roever, Alexander Beham, Andreas Emmert, Marc Hinterthaner, Bernhard C Danner, Alexander Emmert
BACKGROUND: Robot-assisted minimally invasive surgery (RVATS) is a relatively new technique applied for thymectomies. Only few studies directly compare RVATS to the mainstay therapy, open surgery (sternotomy). METHODS: A systematic search of the literature was performed in October 2016. The meta-analysis includes studies comparing robotassisted and open thymectomy regarding operation time, length of hospitalization, intraoperative blood loss, and chest-in-tube days, postoperative complications, reoperation, arrhythmic events, pleural effusion, and postoperative bleeding...
June 2017: Medicine (Baltimore)
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