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At least 613 records · Page 34Linked to original sources
PubMed1984

Myasthenia gravis: determinants for independent ventilation after transsternal thymectomy.

We evaluated the respiratory function of 32 patients with myasthenia gravis who had transsternal thymectomy. Preoperative clinical, pulmonary function, and respiratory muscle pressure data were submitted to stepwise logistic regression analysis to identify preoperative factors that correlated with duration of supported ventilation after surgery. Ten patients (31%) had postoperative supported ventilation for more than 3 days. The duration of ventilatory support correlated most closely with maximal static expiratory pressure (r = 0.714, p less than 0.001). Expiratory weakness, by reducing cough efficacy, seems to be the main determinant that predicts need for longer postoperative supported ventilation.

Adolescent↗
PubMed1985

Thymectomy in multiple sclerosis: a 3-year follow-up.

We studied 34 MS patients who were treated experimentally by thymectomy with or without 1 year of azathioprine therapy. After 3 years, there was no evidence of benefit. Relapsing-remitting patients had done as well or better clinically than controls, and the chronic progressive group did less well statistically than controls.

Follow-Up Studies↗
PubMed1993

A case report of post-thymectomy myasthenia gravis with residual thymoma.

A forty-nine-year-old female patient, complaining of swallowing difficulties and general fatigue, was admitted to the first hospital of Nippon Medical School. At the age of 32, she was operated on for the removal of a well encapsulated non-invasive thymoma. Since then, she had been well till the age of 46, when chest X-ray films showed a recurrent thymoma which was excised together with the complete thymic tissues. One year later, she developed myasthenia gravis (MG) with a ptotic right upper eyelid and general fatigue. Subsequently, she was placed on medication. After 21 months, however, she died of myasthenic crisis in spite of vigorous respiratory and nutritional support. The autopsy revealed a small residual thymoma on the left lung, and systemic atrophy of the skeletal muscles. In this paper, the mechanism of post-thymectomy MG and the recurrence of non-invasive thymoma are discussed.

Female↗
PubMed2005

Different effects on the inflammatory lesions in the lacrimal and salivary glands after neonatal thymectomy in IQI/Jic mice, a model for Sjögren's syndrome.

Thymectomy on day 3 after birth (D3Tx) is understood to eliminate CD4+CD25+ regulatory T cells (Treg) from the peripheral T cell repertoire in rodents, leading to the activation of autoreactive T cells. Herein, D3Tx was performed in IQI/Jic mice, a model for Sjögren's syndrome characterized by autoimmune infiltrations into the lacrimal and salivary glands. At the age of 16 weeks, very severe lesions were observed in lacrimal tissues from thymectomized mice, suggesting that Treg preserve their immunoregulatory function in young IQI/Jic mice. In contrast, salivary lesions were comparable in the D3Tx and control groups, raising the possibility that either salivary-specific Treg escaped elimination in thymectomized mice or spontaneous lesions in IQI/Jic mice developed independently of the tolerance through Treg.

Animals↗
PubMed1984

Postoperative respiratory care after transsternal thymectomy in myasthenia gravis. A 3-year experience in 53 patients.

During a three-year period, 53 patients with myasthenia gravis underwent transsternal thymectomy by a partial sternum-splitting technique at our institution. This procedure was carried out (1) because an x-ray film or a computed tomography scan had suggested the presence of a thymoma or (2) to manage symptoms of myasthenia gravis. In 41 patients the endotracheal tube was removed in the post-anesthesia recovery room. The remaining 12 patients were extubated in the Respiratory Care Unit--in five, after prolonged mechanical ventilation. From our experience, the only factor useful for predicting the probable need for prolonged postoperative mechanical ventilation is the degree of bulbar involvement. Patients in Osserman classification groups 3 and 4 have an extremely high incidence of postoperative respiratory failure. Consideration should be given to the use of preoperative plasmapheresis in myasthenia gravis patients who have significant bulbar symptoms.

Adolescent↗
PubMed1986

Recurrence of thymic hyperplasia after trans-sternal thymectomy in myasthenia gravis.

A 23-year-old woman with myasthenia gravis underwent thymectomy in September, 1975 by a trans-sternal approach for the removal of an hyperplastic gland. Surgical intervention was followed by marked improvement of her symptoms. Five years later, symptoms recurred. In March, 1982 diagnostic pneumomediastinum disclosed an anterosuperior mediastinal mass which, on excision, proved to be an hyperplastic thymus. This report confirms previous findings of thymus regrowth after surgery. It also demonstrates that surgical techniques using the trans-sternal approach do not guarantee complete removal of the thymus.

Adult↗
PubMed1985

The effect of thymectomy on the development of hypertension in spontaneously hypertensive rats.

We studied the effect of thymectomy on the development of hypertension in spontaneously hypertensive rats (SHR). There were no significant differences between thymectomized and sham thymectomized SHR during either the initial or chronic phase of spontaneous hypertension. Similarly, administration of anti-Thyl. 1 or anti-T sera did not influence the blood pressure in SHR during the chronic phase. The results suggest that the thymus does not play a direct role in the development and maintenance of blood pressure in SHR.

Animals↗
PubMed1985

Immunosuppression with corticosteroids and thymectomy in myasthenia gravis: an evaluation of immediate and short term results in 20 patients.

A comparative study was conducted on two groups of patients with the generalized severe form of myasthenia gravis. The first group of 20 patients received oral daily doses of 60-100 mg of prednisone prior to thymectomy. The control group of 20 were submitted to surgery without prior corticosteroid treatment. The study included statistical analysis of the clinical results and surgical complications for both groups. The authors concluded that the use of steroids preoperatively is beneficial.

Adolescent↗
PubMed1989

[Myasthenia gravis: treatment with thymectomy, corticoids and plasmapheresis].

This paper reviews a 12 year experience with myasthenia gravis management (surgical and drug therapy). A total of 27 patients were submitted to thymectomy, and 12 out of 13 showed fairly good results with this only form of therapy (15.3% with complete remission, 46.15% with marked improvement and 30.7% with moderate improvement). The other 14 need either a combination of surgery and plasmapheresis or corticosteroids with the cummulative results of: 14.8% of remission (4 out of 27), 74% of improvement (20 out of 27), 7.4% of worsening (2 out of 27) and 3.7% without change (1 out of 27). Two other patients not submitted to surgery showed either a stable state of their symptoms or a mildly worsening. Another eight patients not submitted to surgery could not be bollowed up. The authors also conclude by the validity of the use of plasmapheresis in myasthenic crises leading to a transient relief of the symptoms and suggest the use of corticosteroids as a second choice, due to their undesirable side effects and difficulty in their reduction and elimination without worsening the symptoms. Other immunosuppressive drugs could be used in cases in which those above cited therapies showed unsuitable results.

Adrenal Cortex Hormones↗
PubMed1995

[Myasthenia gravis: results of thymectomy in 52 patients].

From 1971 to 1993, 52 myasthenics without thymomas (7 men and 45 women) were thymectomized. The results were categorized in remissions and non-remissions. The remission rate was 48%. In the remission group there were 5 men and 20 women and in the non-remission group 2 men and 25 women. The follow-up time was 5.5 years in both groups. There were 16 patients in Osserman category II A, 11 achieving remission; 36 patients were in categories IIB and III, and 14 achieved remission. The duration of disease was 1.8 years and 4.3 years in the remission and non-remission groups, respectively. All patients with remission had less than four years of disease but among the 43 patients with less than four years of symptoms, 42% did not achieve remission. Our data reinforce the need for early thymectomy in myasthenia gravis.

Adolescent↗
PubMedDate not supplied

Cellular immunity in myasthenia gravis after thymectomy and corticosteroid therapy.

Clinical and immunological changes in patients with myasthenia gravis (MG) who had extended thymectomy (Tx) and/or corticosteroid therapy were examined to elucidate the mechanisms of improvement following the treatments. The changes found were: 1) After Tx and steroid therapy, in patients with MG who showed clinical improvement, the CD4/CD8 ratio and B lymphocyte subpopulations were markedly decreased. 2) Linear correlations between two T-cell subsets were evident in CD3 against CD4 and CD4/CD8 against CD4 after both Tx and steroid therapy. 3) T lymphocytes-CD8 decreased immediately after Tx and returned to pre-treatment levels within three weeks. 4) Cellular sensitization against a nicotine acetylcholine receptor (AChR)-like protein isolated from fetal calf thymus decreased after steroid therapy. These results indicate that clinical improvement in MG after the treatments was accompanied by a decrease in helper/inducer T lymphocytes, B lymphocytes and specific lymphocyte sensitization against nicotinic AChR.

Adolescent↗
PubMed1993

IDDM in rats induced by thymectomy and irradiation.

A diabetic syndrome closely resembling human IDDM has been induced in rats of specific pathogen-free origin by a combination of thymectomy and irradiation, with an overall incidence (10 wk postirradiation) in female rats of 34% for acute disease and 47% for islet lesions. Males were slightly more susceptible than females. Clinical features of the syndrome included hyperglycemia, insulinopenia, ketosis, and lipidemia, and corresponding islet pathology ranged from diffuse atrophy to focal atrophy and insulitis. Onset was usually acute, and the disease fatal unless early insulin therapy was initiated. Lymphocytic thyroiditis also was observed in a proportion of thymectomized and irradiated rats (49% in females) over the same period but with no apparent correlation to the occurrence of diabetes. A significant decrease in the incidence of disease was found in thymectomized and irradiated rats of conventional origin when compared with genetically identical specific pathogen-free rats, implicating a role for environmental factors in disease susceptibility. Diabetes inducement also was found to be strain related but not RT1u dependent. Both clinical signs and islet lesions were inhibited by early reconstitution of thymectomized and irradiated animals with syngeneic lymphoid cells from normal donors. Islet lesions and glucose intolerance could be transferred to syngeneic recipients by concanavalin A-activated lymphoid cells from acute diabetic donors. The close similarities between this experimental syndrome induced by immunological manipulation and the clinical condition in humans provide further evidence for an immune-mediated pathogenesis for IDDM.

Animals↗
PubMed2002

Thymectomy and radiation-induced type 1 diabetes in nonlymphopenic BB rats.

Spontaneous type 1 diabetes in BB rats is dependent on the RT1(u) MHC haplotype and homozygosity for an allele at the Lyp locus, which is responsible for a peripheral T-lymphopenia. Genetic studies have shown that there are other, as yet unidentified, genetic loci contributing to diabetes susceptibility in this strain. BB rats carrying wild-type Lyp alleles are not lymphopenic and are resistant to spontaneous diabetes (DR). Here we show that thymectomy and exposure to one sublethal dose of gamma-irradiation (TX-R) at 4 weeks of age result in the rapid development of insulitis followed by diabetes in 100% of DR rats. Administration of CD4(+)45RC(-) T-cells from unmanipulated, syngeneic donors immediately after irradiation prevents the disease. Splenic T-cells from TX-R-induced diabetic animals adoptively transfer type 1 diabetes to T-deficient recipients. ACI, WF, WAG, BN, LEW, PVG, and PVG.RT1(u) strains are resistant to TX-R-induced insulitis/diabetes. Genetic analyses revealed linkage between regions on chromosomes 1, 3, 4, 6, 9, and 16, and TX-R-induced type 1 diabetes in a cohort of nonlymphopenic F(2) (Wistar Furth x BBDP) animals. This novel model of TX-R-induced diabetes in nonlymphopenic BB rats can be used to identify environmental and cellular factors that are responsible for the initiation of antipancreatic autoimmunity.

Adoptive Transfer↗
PubMed1999

Improvement of dysgeusia after thymectomy with thymoma.

We present a case of 39-year-old woman with thymoma complaining of dysgeusia. This patient had suffered from dysgeusia for the previous 6 months. Thymectomy with the thymoma was performed, and her dysgeusia was improved within 6 months after the operation. The anti-acetylcholine-receptor antibody was reduced from 0.9 nmol/l to 0.4 nmol/l (normal: below 0.6 nmol/l) by the surgical intervention. This case suggested that symptoms of dysgeusia can be associated with myasthenic status.

Adult↗
PubMed1984

Influence of 90Sr, adult thymectomy and antilymphocyte globulin on T-cells in mouse peripheral blood.

Three groups of male CBA mice were treated by (1) 90Sr injection (14.8 kBq/g body weight i.p.), (2) adult thymectomy (ATx) + antilymphocyte globulin (ALG), and (3) 90Sr + ATx + ALG, respectively, and one untreated group served as a control. The relative number of T-lymphocytes was determined in peripheral blood mononuclear cells of individual animals using a dye exclusion cytotoxicity assay with antisera against the T-cell surface membrane marker Thy 1.2 and complement. Total and differential leucocyte counts were also performed. 90Sr irradiation decreased the total number of leucocytes irrespective of type, and the combined treatment of ATx and ALG decreased mainly mononuclear cells and particularly T-cells. The most advanced T-cell depletion in peripheral blood was found in the 90Sr + ATx + ALG treated group with a 97 per cent reduction as compared with untreated controls. ATx + ALG thus proved to be useful for blood T-cell depletion in mice treated simultaneously with 90Sr, and might provide a valuable tool in investigations on the possible role of cell-mediated immune response in radiation-induced oncogenesis, with particular emphasis on selective depletion within the monomorphonuclear compartment.

Animals↗
PubMedDate not supplied

Influence of 90Sr, adult thymectomy and antilymphocyteglobulin on haematopoietic tissues and peripheral blood leucocytes in CBA mice.

The role of long-time immune suppression in carcinogenesis induced by the long-lived internal emitter 90Sr, is investigated in an ongoing study. The experimental design is based on the assumption that impaired immune responsiveness, by other means than 90Sr, might increase the neoplastic response in exposed individuals, and thus reflect a protective function, if existing. Intercomparison is made of the tumour yield in mice exposed to different single doses of 90Sr and simultaneously subjected or not to long-term immune suppression by adult thymectomy (ATx) and/or antilymphocyteglobulin (ALG) treatment. Information on the general condition and responsiveness of the immune system, in the respective models, during tumour expectancy time, is essential for a conclusive evaluation of the results. To meet these demands the present paper reports on histopathologic alterations in immune organs and changes in white blood cell counts, induced by the different combinations of 90Sr, ATx and ALG treatment. The results confirm the prediction, that ATx + ALG is an efficient and, with respect to the purpose of the study, suitable treatment for additive long-term depression of the immune system in 90Sr irradiated mice, evidenced in particular by increased depletion of monomorphonuclear cells (MNC) in lymphoid organs and peripheral blood. Subsequent reports will deal with functional immune parameters.

Animals↗
PubMed1989

Radiostrontium-induced oncogenesis and the role of immunosuppression. I. Influence of 90Sr dose, adult thymectomy and antilymphocyteglobulin treatment on the development of neoplastic and preneoplastic lesions in the skeleton of CBA mice.

Ionizing irradiation by incorporated strontium-90 exerts two major effects: it induces tumours (mainly osteosarcomas and lymphoreticular tumours) and depresses the immune system. The interrelation between these functions, i.e. the significance of decreased immunological responsiveness in the oncogenic process, remains unclear. The influence of the 90Sr dose and the role of immune modulation on the tumour yield, were investigated in young adult CBA mice. The animals were exposed to different single doses of 90Sr and, in addition, some groups were subjected to long-term unspecific immune suppression by adult thymectomy (ATx) and/or prolonged antilymphocyteglobulin (ALG) treatment. The present paper (part I) reports on the effects of the treatments on bone tumour responses as reflected by incidence, multiplicity, latency time, histologic characteristics and growth behaviour. The histogenesis of osteosarcomas, as evidenced morphologically by preneoplastic and early neoplastic growth, is illustrated and discussed. The results demonstrate a positive dose-response relationship for osteosarcomas, in which the relative incidences of the various osteosarcoma subtypes were differentially affected. Thus, well-differentiated tumours were gradually replaced by less differentiated types as the dose decreased. A correlation was also observed between the incidence of osteosarcomas and that of assumed preneoplastic lesions in the same bones and sites. Immune suppression by ATx and/or ALG did not distinctly alter the neoplastic or preneoplastic responses at any dose-level of 90Sr.

Animals↗