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Topic: Thymectomy

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	Thymectomy
		A thymectomy is a type of surgery that removes the thymus gland, which is located in the upper portion of the chest behind the breastbone or sternum.
		Thymectomy is not a new treatment for MG.
		In the end, thymectomy may lessen the severity of the myasthenic symptoms; however, the degree to which the symptoms are lessened differs in each patient.
	www.mgawpa.org /thymectomy.htm (884 words)

	Thymectomy Questions
		Although it is not definitely established which patients should have a thymectomy or what type of operation should be performed, thymectomy is frequently recommended for patients under the age of 60 (occasionally older) with moderate to severe MG weakness.
		Thymectomy is usually not recommended for patients with weakness limited to the eye muscles, ocular myasthenia gravis.
		The neurological goals of thymectomy are significant improvement in the patient's weakness, reduction in the medications being employed, and ideally eventually a permanent remission (complete elimination of all weakness off all medications).
	www.myasthenia.org /information/thymectomy.htm (1770 words)

	Myasthenia Gravis (Site not responding. Last check: 2007-10-12)
		Thymectomy seemed to improve the course of the disease, mostly in patients operated on shortly after diagnosis and those with generalized mild-to-moderate disease and with a normally involuted thymus.
		Thymectomy is considered the most effective treatment for achieving sustained improvement as well as remission in patients with myasthenia gravis (MG), and most neurologists favor the use of this procedure.
		Therefore we advocate thymectomy for MG patients as early as possible in the course of disease because time elapsed from diagnosis to operation is the main determinant of the outcome.
	www.thedoctorsdoctor.com /diseases/myasthenia_gravis.htm (7943 words)

	What is the role of the thymus and a thymectomy in Myasthenia Gravis?
		Patients with immune MG tend to respond similarly to thymectomy whether they have antibodies to the acetylcholine receptors or not, but there is disagreement, with some experts thinking that patients without antibodies against the receptor do not benefit from thymectomy.
		Thymectomy is a major surgery and there are risks of bleeding, collapsed lung, and post-operative infections.
		Thymectomies are not common procedures and a surgeon would be considered experienced if he or she performs 3-4 thymectomies per year.
	www.netwellness.org /healthtopics/gravis/box5.cfm (1090 words)

	Thymectomy - Wikipedia, the free encyclopedia
		A thymectomy is an operation to remove the thymus gland.
		It usually results in remission of myasthenia gravis with the help of medication including steroids.
		A thymectomy prior to adolescence, results in no T-cell education, and therefore a servere compromise in cell mediated and humoral responses.
	en.wikipedia.org /wiki/Thymectomy (177 words)

	Indian Pediatrics - Editorial
		Thoracoscopic thymectomy is feasible in adolescents with myasthenia gravis.
		While thymectomy is a well-accepted and widely used treatment option in adult MG, its full potential has not been realized in the treatment of juvenile MG due to ignorance about the benefits of thymectomy in children and fears of possible ill effects of thymectomy at young age.
		Fears of post thymectomy sepsis and post thymectomy neoplasms have been proved to be unfounded on close scrutiny and long term follow up of the early-thymectomized children(1).
	www.indianpediatrics.net /dec2002/dec-1131-1137.htm (2001 words)

	Myasthenia Gravis
		The history of thymectomy dates back to 1901 when a thymoma in a patient with myasthenia gravis was described and the association between the thymus gland and myasthenia gravis was first suggested.
		The exact mechanism by which thymectomy improves the symptoms of myasthenia gravis is not completely understood.
		Various types of thymectomy procedures are performed at the University of Maryland Medical Center, a world-renowned teaching institution at the forefront of medical education and research.
	www.umm.edu /thoracic/myasthenia_gravis.html (1409 words)

	Mineo - Extended Vats Thymectomy for Myasthenia Gravis
		VATS thymectomy should be performed following adequate training with radical transsternal thymectomy to gain familiarity with an extended removal of perithymic adipose tissue in the anterior mediastinum and lower cervical area that must be always pursued to maximize probability of remission.
		Nerve injuries can also occur during VATS thymectomy; in particular, care must be paid to avoiding phrenic nerve injury during dissection of perithymic adipose tissue in the left pericardiophrenic angle, and injury to the left recurrent nerve in the aorto-pulmonary window.
		In another recent prospective study, VATS thymectomy resulted in less pronounced impairment and faster recovery of pulmonary function than the sternotomy approach, leading the authors to conclude that VATS thymectomy could become their preferred surgical treatment of MG provided that satisfactory long-term results are confirmed.
	www.ctsnet.org /doc/6699 (1858 words)

	Thymectomy at weaning. An accelerated aging model for the mouse immune system. (Site not responding. Last check: 2007-10-12)
		Mouse thymectomy at weaning induces a long lasting immunodepression which can be measured by in vivo and in vitro experiments.
		The lack of effect of surgery on the in vitro T cytotoxic activity compared to the total abolition of in vivo graft versus host reaction shows that these two phenomena are under the control of different immunocompetent cell subsets.
		Thymectomy induces a stabilization of natural killer cell activity, while during normal aging, this parameter decreases regularly.
	www.arclab.org /medlineupdates/abstract_1717798.html (191 words)

	eMedicine - Surgery of the Thymus Gland : Article by Said Fadi Yassin, MD
		Patients usually are considered for thymectomy when they do not respond to treatment with cholinesterase inhibitors or when the adverse effects limit the benefit of this treatment.
		Transcervical thymectomy carries low morbidity, with remission and response rates that are comparable with those of the transsternal thymectomy.
		The complete remission rate after thymectomy is 33% in general and 17% in patients with isolated ocular symptoms, compared to 8% after medical treatment, with survival advantage after thymectomy.
	www.emedicine.com /med/topic3195.htm (6616 words)

	Thymectomy - a Form of Treatment for Myasthenia Gravis (Site not responding. Last check: 2007-10-12)
		When a thymectomy is being considered by the MG physician and Myasthenic, a referral is made to a surgeon who has experience of this type of surgery.
		Once it is decided that a thymectomy may be beneficial, hospital admission and surgical dates are arranged for the patient.
		Thymectomy may lessen the severity of the myasthenic symptoms; however, the degree to which the symptoms are lessened differs in each patient.
	www.mgauk.org /main/gil2.htm (1427 words)

	Transcervical Thymectomy for Myasthenia Gravis -- Experts -- CTSNet
		The practice parameter reported by the American Academy of Neurology (Gronseth, 2000) states that "for patients with nonthymomatous autoimmune myasthenia gravis, thymectomy is recommended as an option to increase the probability of remission or improvement." The strongest association between thymectomy and an improved clinical course has been seen in female myasthenics with systemic weakness.
		Other contraindications are relative and should be considered in light of a surgeon’s experience with thymectomy and with this exposure. Previous median sternotomy will make the substernal dissection more difficult and the suspension of the patient by the sternum hazardous.
		The consequence of such variability is the logic that a complete thymectomy would require resection of tissue beyond that which is normally detected on gross inspection of the thymus.
	www.ctsnet.org /doc/4989 (2413 words)

	Outpatient Thymectomy Can Reduce Myasthenia's Impact without Sternotomy - Washington, DC
		The outpatient procedure, known as a transcervical thymectomy, involves removal of the thymus, a gland located behind the breast bone, through a small incision in the neck.
		Thymectomy can lessen or eliminate myastheniaâs impact in many patients, particularly those in the early stages of the disease.
		For example, it is contraindicated for patients whose necks cannot be extended for the surgery and those with thymomas, or tumors of the thymus gland, that are greater than four centimeters in diameter.
	www.georgetownuniversityhospital.org /body.cfm?id=555711 (850 words)

	Myasthenia Gravis - Treatment - neurologychannel (Site not responding. Last check: 2007-10-12)
		It can be used to treat severe worsening of symptoms (exacerbations) or in preparation for surgery (thymectomy).
		In this procedure, blood is removed from the body and blood cells are separated from the liquid portion of the blood (plasma).
		Benefits of thymectomy develop gradually and most improvement occurs years after the procedure is performed.
	www.neurologychannel.com /myastheniagravis/treatment.shtml (535 words)

	Against Thymectomies (Site not responding. Last check: 2007-10-12)
		Thymectomies, along with prednisone are two of my pet peeves in the treatment of MG.
		Thymectomies remind me of the "accepted practice", when I was a child, of performing tonsillectomies, because the tonsils would often become swollen.
		I would NOT have a thymectomy as a preventative measure or as a 'maybe this will help' measure because the thymus gland is the master gland of immunity, and removing this gland severely weakens the body's ability to fight infections and cancer.
	myasthenia.puhs.org /moshe/thymectomy3.htm (625 words)

	Transcervical-subxiphoid-VATS "maximal" thymectomy for myasthenia gravis -- Zielinski et al. 2005 (425): 836 -- ...
		the surrounding fatty tissue is described as an extended thymectomy.
		Thymectomy for myasthenia gravis: analysis of the controversies egarding technique and results.
		Transcervical thymectomy for myasthenia gravis achieves results comparable to thymectomy by sternotomy.
	mmcts.ctsnetjournals.org /cgi/content/full/2005/0425/mmcts.2004.000836 (2129 words)

	Thymectomy by partial sternotomy for the treatment of myasthenia gravis -- Pêgo-Fernandes et al. 74 (1): 204 -- ...
		Thymectomy by partial sternotomy for the treatment of myasthenia gravis -- Pêgo-Fernandes et al.
		Thymectomy by partial sternotomy for the treatment of myasthenia gravis
		Manubriotomy versus median sternotomy in thymectomy for myasthenia gravis.
	ats.ctsnetjournals.org /cgi/content/abstract/74/1/204 (377 words)

	Results in (Site not responding. Last check: 2007-10-12)
		We will show that early thymectomy relative to the onset of symptoms results in remission or improvement of symptoms of Myasthenia Gravis.
		While all patients underwent a median sternotomy, 2 patients had their thymectomies with a CABG and one patient was a redo.
		Performing a thymectomy early as possible will greatly increase the chances for complete remission of this disease.
	www.findarticles.com /p/articles/mi_m0984/is_4_128/ai_n15787381 (431 words)

	The immunologic role of thymectomy in the treatment of myasthenia gravis: implication of thymus-associated B-lymphocyte ... (Site not responding. Last check: 2007-10-12)
		The immunologic role of thymectomy in the treatment of myasthenia gravis: implication of thymus-associated B-lymphocyte subset in reduction of the anti-acetylcholine receptor antibody titer -- Okumura et al.
		The immunologic role of thymectomy in the treatment of myasthenia gravis: implication of thymus-associated B-lymphocyte subset in reduction of the anti-acetylcholine receptor antibody titer
		undergoing extended thymectomy were subjected to the study.
	jtcs.ctsnetjournals.org /cgi/content/abstract/126/6/1922 (351 words)

	MGnet Newsletter Fall 2005
		There is no question to the necessity of a thymectomy when a thymoma (a growth in or on the thymus) is present.
		The Executive Committee of the Thymectomy Clinical Trial, Drs John Newsom-Davis, Gil Wolfe, Henry Kaminski, Gary Cutter and Fred Jaretzki, are to be applauded for all their hard work.
		The Spring of 2005 may be the beginning of thymectomy trials, but there are other trials and research that relate directly to myasthenia gravis.
	www.mgfa-mgnet.org /html/newsletter.htm (5974 words)

	Positive Results After Transcervical Thymectomy Procedure: Presented at STS (Site not responding. Last check: 2007-10-12)
		Myasthenia gravis is a chronic autoimmune neuromuscular disease characterized by varying degrees of weakness of the skeletal muscles.
		The transcervical approach to thymectomy is the least invasive method, with only a small horizontal incision across the lower part of the neck.
		In this retrospective study, the researchers reviewed charts and interviewed 134 patients undergoing TCT for myasthenia gravis between 1992 and 2004.
	www.pslgroup.com /dg/2576c2.htm (550 words)

	Effect of Thymectomy on Human Peripheral Blood T Cell Pools in Myasthenia Gravis -- Sempowski et al. 166 (4): 2808 -- ...
		Effect of thymectomy on peripheral lymphocyte subsets in myasthenia gravis: selective effect on T-cells in patients with thymic atrophy.
		Long-term immunologic effects of thymectomy in patients with myasthenia gravis.
		Thymectomy for myasthenia gravis: analysis of the controversies regarding technique and results.
	www.jimmunol.org /cgi/content/full/166/4/2808 (5110 words)

	Results in (Site not responding. Last check: 2007-10-12)
		The purpose of this study is to analyze the results of thymectomy in patients with myasthenia gravis with or without the presence of a thymoma.
		It is well tolerated, has a low morbidity and results in high rates of remission for patients with or without a thymoma.
		CLINICAL IMPLICATIONS: Thymectomy may be used as a primary mode of therapy in patients with myasthenia gravis whether or not a thymoma is present.
	www.findarticles.com /p/articles/mi_m0984/is_4_118/ai_71127434 (399 words)

	Laparoscopic Thymectomy for Myasthenia Gravis (Site not responding. Last check: 2007-10-12)
		Damage to the receptor and impaired neuromuscular transmission leads to symptoms of weakness and fatigue.
		Treatment of this potentially debilitating disorder includes anticholinesterase drug therapy, steroids immunosuppressive agents, plasmapheresis, and surgical removal of the thymus (thymectomy).
		Thymectomy is now recommended for most patients with generalized symptoms.
	www.nyp.org /masc/thymectomy.htm (209 words)

	Mortality and survival in myasthenia gravis: a Danish population based study -- Christensen et al. 64 (1): 78 -- ...
		The variables (age at diagnosis, sex, thymectomy or not) which were significantly related to survival in the univariate analysis
		Thymectomy is usually advocated in patients with generalised myasthenia gravis, although no prospective case-control study
		Thymectomy in the treatment of myasthenia gravis: report of 247 patients.
	jnnp.bmjjournals.com /cgi/content/full/64/1/78 (2918 words)

	Sub-acute presentation of Morvan's syndrome after thymectomy -- Cottrell et al. 75 (10): 1504 -- Journal of Neurology, ...
		Sub-acute presentation of Morvan's syndrome after thymectomy -- Cottrell et al.
		Thymectomy has previously been a proposed treatment for Morvan’s
		a low risk of thymectomy, it is an important complication to
	jnnp.bmjjournals.com /cgi/content/full/75/10/1504 (931 words)

	Levels of Recent Thymic Emigrant Cells Decrease in Children Undergoing Partial Thymectomy during Cardiac Surgery -- ...
		thymectomy in pediatric cardiac surgery should be avoided.
		Mean TREC values/million PBMC pre- and post-partial thymectomy with standard deviation in group A patients (paired data).
		Thymic function and impaired maintenance of peripheral T-cell populations in children with congenital heart disease and surgical thymectomy.
	cdli.asm.org /cgi/content/full/12/5/563 (1562 words)

	Thymectomy and Radiation-Induced Type 1 Diabetes in Nonlymphopenic BB Rats -- Ramanathan et al. 51 (10): 2975 -- ... (Site not responding. Last check: 2007-10-12)
		Thymectomy, sham thymectomy, and whole-body irradiation of rats
		Thymectomy and sublethal irradiation induce diabetes in BBDR rats in an age-dependent manner.
		Stumbles PA, Penhale WJ: IDDM in rats induced by thymectomy and irradiation.
	diabetes.diabetesjournals.org /cgi/content/full/51/10/2975 (4190 words)

	Is thymectomy necessary? - BrainTalk Communities (Site not responding. Last check: 2007-10-12)
		I'm no expert on thymectomies, but if it was suggested for my son, who has juvenile MG, I would get a second and maybe a third opinion.
		I am by no means an expert on thymectomies, but I did have one almost a year ago.
		Before the thymectomy, I was told to quit my job and start applying for disability and to find a caregiver to help me with daily chores.
	brain.hastypastry.net /forums/showthread.php?t=11094 (985 words)

	Thymic Function and Impaired Maintenance of Peripheral T Cell Populations in Children with Congenital Heart Disease and ... (Site not responding. Last check: 2007-10-12)
		thymectomy in infancy in a cohort of subjects with congenital
		To investigate the effects of thymectomy on the populations
		Eysteinsdottir JH, Freysdottir J, Haraldsson A, Stefansdottir J, Skaftadottir I, Helgason H, Ogmundsdottir HM 2004 The influence of partial or total thymectomy during open heart surgery in infants on the immune function later in life.
	www.pedresearch.org /cgi/content/full/57/1/42 (3880 words)

	Practice parameter: Thymectomy for autoimmune myasthenia gravis (an evidence-based review): Report of the Quality ...
		Jaretzki III A. Thymectomy for myasthenia gravis: analysis of the controversies regarding technique and results.
		The role of thymectomy in the treatment of myasthenia gravis.
		Thymectomy Task Force formed by the Medical Advisory Board of the Myasthenia Gravis Foundation of America.
	www.neurology.org /cgi/content/full/55/1/7 (3554 words)

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