Forty operated cases of myasthenia gravis correspond to 14 thymomas, 18 hyperplasias and 8 vestigial thymus : 3 stages, I, 28 stages, II, 6 stages III, 3 stages IV. For vestigial thymus and moderate hyperplasias, cervicotomy was used in 11 cases. Surgery allowed 15 remissions, 12 ameliorations, 11 failures, aggravations and late deaths, and 2 post-operative deaths (one of them avoidable). Apart from its oncologic interest in thymomas (1/3 of the patients), thymectomy is beneficial in 2/3 of the cases of myasthenia gravis in general.

Adult↗

PubMedDate not supplied

[Paravertebral ganglioneuroma in an adult. Discovery during a spinal attack revealing multiple sclerosis].

A paravertebral ganglioneuroma was discovered in a 25 year-old woman presenting a transverse spinal syndrome at the same level. Exeresis necessitated sacrifice of the ninth left intercostal artery, but paraplegia regressed completely under corticotherapy. Additional exploration and subsequent clinical evolution revealed multiple sclerosis, of which the pavaplegia had been a manifestation. The authors discuss ganglioneuroma in the adult, a rare tumour, and the possibility of a link with multiple sclerosis. The association seems fortuitous despite the fact that the tumour and the transverse myelitis occurred at the same level.

Adrenal Cortex Hormones↗

PubMedDate not supplied

[Surgical treatment of cancer of the cardia].

Adeno-carcinoma of the cardia corresponds to an accurate definition. During a period of 20 years we have operated on 114 such tumours, and resected 88 of them, 44 by esophageal and proximal gastric resection (group I), and 44 by esophageal and total gastric resection (group II). The resection rate was 77%. Hospital mortality was 20 p. cent in group I and 27 p. cent in group II. There were 1 T1, 8 T2 and 77 T3 (on 86 specimens); 14 p. cent of tumour invasions were observed on the esophageal section (18 p. cent in group I, 9 p. cent in group II); 90 p. cent had lymphatic nodes invasion. Five year's survival was nil in group I, 5 patients survived in group II. Five year's cure can be obtained only in stages I et II (NO MO or NI MO) with total gastrectomy associated with omentectomy, lymphatic curettage of the three coeliac chains, resection of 8 cm of esophagus, and mediastinal lymphatic curettage. When the condition of the patient is poor, or for more evolved stages, proximal gastric resection associated with terminal esophagectomy is the best palliative treatment.

Adenocarcinoma↗

PubMedDate not supplied

[Arteriovenous fistulae for chronic haemodialysis. Report on 400 patients].

The authors report their experience of 551 arteriovenous fistulae created in 400 patients undergoing haemodialysis for chronic renal failure. The mean follow-up period was 34 months. Eighteen cases of primary thrombosis (7%) and 11 cases of secondary thrombosis (4%) were observed. There were 7 cases of local sepsis, one of these fatal, and 7 cases of systemic infection, also with one death. The authors conclude that the Cimino-Brescia fistula is superior to any other type of vascular approach in patients with chronic renal failure. They reserve vascular grafts to those cases where no other procedure is possible.

Adolescent↗