Studies in myasthenia gravis: Early thymectomy: Electrophysiologic and pathologic correlations
Indications for thymectomy in myasthenia gravis have been recently expanded to include all cases with extraocular symptoms as a result of the minimal morbidity and negligible mortality of the transcervical approach. As increasing numbers of patients with myasthenia gravis, covering the entire spectr...
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Veröffentlicht in: | The American journal of medicine 1975-01, Vol.58 (4), p.517-524 |
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creator | Genkins, Gabriel Papatestas, Angelos E. Horowitz, Steven H. Kornfeld, Peter |
description | Indications for thymectomy in myasthenia gravis have been recently expanded to include all cases with extraocular symptoms as a result of the minimal morbidity and negligible mortality of the transcervical approach.
As increasing numbers of patients with myasthenia gravis, covering the entire spectrum of generalized disease, have been added to the thymectomy population, a more accurate evaluation of the effects of the operation is possible.
Our experience with 353 patients who have undergone thymectomy indicates that early thymectomy, particularly in patients who do not have thymic germinal centers, is followed by early remission of the disease. Delayed remission after thymectomy is related to the duration and severity of the disease, and to presence of thymic germinal centers. Germinal centers were found more frequently in patients with long duration of the disease and in patients in whom the disease had progressed to respiratory involvement. Marked improvement in electromyographic findings immediately after thymectomy was observed in the majority of patients who had had the disease for 1 year or less and where germinal centers were absent. The percentage of malignant thymomas was higher in patients who underwent thymectomy 1 year or more after the onset of symptoms of myasthenia gravis.
These data indicate the importance of early thymectomy while the disease is still in the mild stages. Transcervical thymectomy is the treatment of choice as it is followed by a higher percentage of remissions and by less morbidity than other forms of treatment. |
doi_str_mv | 10.1016/0002-9343(75)90125-4 |
format | Article |
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As increasing numbers of patients with myasthenia gravis, covering the entire spectrum of generalized disease, have been added to the thymectomy population, a more accurate evaluation of the effects of the operation is possible.
Our experience with 353 patients who have undergone thymectomy indicates that early thymectomy, particularly in patients who do not have thymic germinal centers, is followed by early remission of the disease. Delayed remission after thymectomy is related to the duration and severity of the disease, and to presence of thymic germinal centers. Germinal centers were found more frequently in patients with long duration of the disease and in patients in whom the disease had progressed to respiratory involvement. Marked improvement in electromyographic findings immediately after thymectomy was observed in the majority of patients who had had the disease for 1 year or less and where germinal centers were absent. The percentage of malignant thymomas was higher in patients who underwent thymectomy 1 year or more after the onset of symptoms of myasthenia gravis.
These data indicate the importance of early thymectomy while the disease is still in the mild stages. Transcervical thymectomy is the treatment of choice as it is followed by a higher percentage of remissions and by less morbidity than other forms of treatment.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/0002-9343(75)90125-4</identifier><identifier>PMID: 1124789</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Electromyography ; Electrophysiology ; Female ; Humans ; Infant ; Infant, Newborn ; Lymphoid Tissue - pathology ; Male ; Middle Aged ; Myasthenia Gravis - complications ; Myasthenia Gravis - physiopathology ; Myasthenia Gravis - surgery ; Remission, Spontaneous ; Thymectomy ; Thymoma - complications ; Time Factors</subject><ispartof>The American journal of medicine, 1975-01, Vol.58 (4), p.517-524</ispartof><rights>1975</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0002-9343(75)90125-4$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1124789$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Genkins, Gabriel</creatorcontrib><creatorcontrib>Papatestas, Angelos E.</creatorcontrib><creatorcontrib>Horowitz, Steven H.</creatorcontrib><creatorcontrib>Kornfeld, Peter</creatorcontrib><title>Studies in myasthenia gravis: Early thymectomy: Electrophysiologic and pathologic correlations</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>Indications for thymectomy in myasthenia gravis have been recently expanded to include all cases with extraocular symptoms as a result of the minimal morbidity and negligible mortality of the transcervical approach.
As increasing numbers of patients with myasthenia gravis, covering the entire spectrum of generalized disease, have been added to the thymectomy population, a more accurate evaluation of the effects of the operation is possible.
Our experience with 353 patients who have undergone thymectomy indicates that early thymectomy, particularly in patients who do not have thymic germinal centers, is followed by early remission of the disease. Delayed remission after thymectomy is related to the duration and severity of the disease, and to presence of thymic germinal centers. Germinal centers were found more frequently in patients with long duration of the disease and in patients in whom the disease had progressed to respiratory involvement. Marked improvement in electromyographic findings immediately after thymectomy was observed in the majority of patients who had had the disease for 1 year or less and where germinal centers were absent. The percentage of malignant thymomas was higher in patients who underwent thymectomy 1 year or more after the onset of symptoms of myasthenia gravis.
These data indicate the importance of early thymectomy while the disease is still in the mild stages. Transcervical thymectomy is the treatment of choice as it is followed by a higher percentage of remissions and by less morbidity than other forms of treatment.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Electromyography</subject><subject>Electrophysiology</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Lymphoid Tissue - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myasthenia Gravis - complications</subject><subject>Myasthenia Gravis - physiopathology</subject><subject>Myasthenia Gravis - surgery</subject><subject>Remission, Spontaneous</subject><subject>Thymectomy</subject><subject>Thymoma - complications</subject><subject>Time Factors</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1975</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9UU1LxDAQDaKs6-o_UOhJ9FCdpEnTeBBkWT9gwYN6NaRN1kbapibtQv-9Xbd4mnnzHsPMewidY7jBgNNbACCxSGhyxdm1AExYTA_QHDPGYo5Tcojm_5JjdBLC9whBsHSGZhgTyjMxR59vXa-tCZFtonpQoStNY1X05dXWhrtopXw1RF051KboXD2Mk2rsvGvLIVhXuS9bRKrRUau6coKF895UqrOuCafoaKOqYM6mukAfj6v35XO8fn16WT6sY0NS3MWUppoDZlprjkUCGjMDGCgFnSc8J4RwkQERuSYF55rkOBNEqQ3LeJJRoMkCXe73tt799CZ0srahMFWlGuP6IDOSMQ6pGIUXk7DPa6Nl622t_CAnQ0b-fs-b8dqtNV6GwpqmMNr68XGpnZUY5C4AuXNX7tyVnMm_ACRNfgHD7Hci</recordid><startdate>19750101</startdate><enddate>19750101</enddate><creator>Genkins, Gabriel</creator><creator>Papatestas, Angelos E.</creator><creator>Horowitz, Steven H.</creator><creator>Kornfeld, Peter</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>19750101</creationdate><title>Studies in myasthenia gravis: Early thymectomy: Electrophysiologic and pathologic correlations</title><author>Genkins, Gabriel ; Papatestas, Angelos E. ; Horowitz, Steven H. ; Kornfeld, Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e261t-446d7015ddd71930d15e010440db37b222798029bd2c77d2b1892aaf587384043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1975</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Electromyography</topic><topic>Electrophysiology</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Lymphoid Tissue - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myasthenia Gravis - complications</topic><topic>Myasthenia Gravis - physiopathology</topic><topic>Myasthenia Gravis - surgery</topic><topic>Remission, Spontaneous</topic><topic>Thymectomy</topic><topic>Thymoma - complications</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Genkins, Gabriel</creatorcontrib><creatorcontrib>Papatestas, Angelos E.</creatorcontrib><creatorcontrib>Horowitz, Steven H.</creatorcontrib><creatorcontrib>Kornfeld, Peter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Genkins, Gabriel</au><au>Papatestas, Angelos E.</au><au>Horowitz, Steven H.</au><au>Kornfeld, Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Studies in myasthenia gravis: Early thymectomy: Electrophysiologic and pathologic correlations</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>1975-01-01</date><risdate>1975</risdate><volume>58</volume><issue>4</issue><spage>517</spage><epage>524</epage><pages>517-524</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><abstract>Indications for thymectomy in myasthenia gravis have been recently expanded to include all cases with extraocular symptoms as a result of the minimal morbidity and negligible mortality of the transcervical approach.
As increasing numbers of patients with myasthenia gravis, covering the entire spectrum of generalized disease, have been added to the thymectomy population, a more accurate evaluation of the effects of the operation is possible.
Our experience with 353 patients who have undergone thymectomy indicates that early thymectomy, particularly in patients who do not have thymic germinal centers, is followed by early remission of the disease. Delayed remission after thymectomy is related to the duration and severity of the disease, and to presence of thymic germinal centers. Germinal centers were found more frequently in patients with long duration of the disease and in patients in whom the disease had progressed to respiratory involvement. Marked improvement in electromyographic findings immediately after thymectomy was observed in the majority of patients who had had the disease for 1 year or less and where germinal centers were absent. The percentage of malignant thymomas was higher in patients who underwent thymectomy 1 year or more after the onset of symptoms of myasthenia gravis.
These data indicate the importance of early thymectomy while the disease is still in the mild stages. Transcervical thymectomy is the treatment of choice as it is followed by a higher percentage of remissions and by less morbidity than other forms of treatment.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>1124789</pmid><doi>10.1016/0002-9343(75)90125-4</doi><tpages>8</tpages></addata></record> |
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source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
subjects | Adolescent Adult Aged Child Child, Preschool Electromyography Electrophysiology Female Humans Infant Infant, Newborn Lymphoid Tissue - pathology Male Middle Aged Myasthenia Gravis - complications Myasthenia Gravis - physiopathology Myasthenia Gravis - surgery Remission, Spontaneous Thymectomy Thymoma - complications Time Factors |
title | Studies in myasthenia gravis: Early thymectomy: Electrophysiologic and pathologic correlations |
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