• Journal of Chest Surgery
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• v.43 no.5
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• pp.557-561
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• 2010

In the treatment of myasthenia gravis, thymectomy is generally accepted as the standard of therapy. For thymectomy, there have been various conventional open approaches including sternal splitting, but recently minimally invasive approaches have been increasingly applied. A 28-year-old man presenting with weakness of both hands and fatigability was diagnosed as having myasthenia gravis with thymic hyperplasia. He underwent a robot-assisted thymectomy with the 'da Vinci' surgical system. Through the right thoracic cavity, two thirds of the thymic gland was dissected, and the remainder was resected through the left; these procedures took, respectively, 1 hour and 30 minutes. The patient was discharged on the 8th postoperative day without complications. The minimally invasive approach with the 'da Vinci' surgical system is emerging as a popular choice and various advantages have been reported. Here we report the first successful case of robot-assisted thymectomy.

• Journal of Chest Surgery
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• v.27 no.7
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• pp.610-616
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• 1994

Myasthenia gravis is a rare condition, affecting only 1/75000. It is characterized by weakness and fatigue of the voluntary muscles due to impaired neuromuscular transmission at the acetylcholine receptor site. It is probably caused by an autoimmune mechanism leading to reduction of the available nicotinic acetylcholine receptors at the neuromuscular junction. A relationship between the thymus and myasthenia gravis was suggested by Weigert in 1901, and Blalock was the first to report the efficiency of thymectomy in the treatment of myasthnia gravis in 1939. Since that time, thymectomy has become increasingly important in managing patients with myasthenia gravis. Fourteen patients with myasthenia gravis underwent thymectomy between September 1987 and March 1994 and got the following results; 1. The sex distribution was 10 females and 4 males with ages ranging from 15 to 51 years[mean, 34.8 years]. 2. Clinical manifestation of ocular symptoms were seen in all cases, dysphagia in 12[85.7%], extremity weakness in 11 [78.6 %], and dyspnea in 3 [21.4 %]. 3. According to the modified Osserman`s classification, 8 patients were in group IIb, 3 in IIa, 2 in I and 1 in IIc, respectively. 4. Histopathologic examination of the resected thymuses revealed hyperplasia in 8 patients, benign thymoma in 3, and malignant thymoma in 3. 5. There were no perioperative or immediate postoperative deaths but one patient died about two months after the thymectomy due to respiratory failure. 6. During the follow-up period, 11 patients [78.6 %] showed clinical improvement. Among them, 4 cases [28.6 %] showed complete remission, 3 [21.4 %] showed marked improvement, and 4 [28.6 %] showed subjective improvement. 7. Among the 8 patients with thymic hyperplasia, clinical improvement was noticed in 7 patients 5 %]. Among the 6 patients with thymoma, 4 patients [66.7 %] showed improvement.

• Annals of Clinical Neurophysiology
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• v.7 no.2
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• pp.93-96
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• 2005

Background: Myasthenia gravis (MG) and systemic lupus erythematosus (SLE) are well recognized to coexist and have some similarities in immunologic, clinical and serologic findings. Despite several reports of the association with autoantibodies and thymectomy in these disorders, the pathomechanism of coexistence remains to be elucidated. Objective: We aimed to investigate the relationship of MG and SLE through overall features of patients with both disorders;: clinical, laboratory, and electrophysiological findings. Materials and Methods: We reviewed the medical records of 6 consecutive patients with MG and SLE (2 men, 4 women, ages 17-51, mean 30.5 years, Seoul National University Hospital, from 1998 to 2005). Results: Three patients who developed SLE first, had ocular type of MG and 2 were children showing much severe and recurrent SLE features and only 1 patient had thymic hyperplasia. The other 3 developed MG first and they were generalized type and none underwent thymectomy. In addition, the development of MG or SLE was not coincident with remission or improvement of another disorder. Conclusion: The coexistence of SLE and MG may support the hypothesis of two different antibody populations modulated by thymus in the opposite extremesThis report suggests that the systemic and extensive autoimmune response in preceding MG or SLE may effect the development of the other disorder followed, while. the coexistence of two disorders cannot be explained by the hypothesis of two different antibody populations modulated by thymus in the opposite extremes The role of thymectomy and the theorectical subsequent effect on the development of SLE have been debated with controversy. However, SLE occurred without thymectomy in MG and these disorders did not develop in the quiescent period of another disorder. Therefore, the other pathomechanism for the coexistence of MG and SLE should be elucidated.

• Journal of Chest Surgery
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• v.46 no.3
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• pp.234-236
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• 2013

A 42-year-old woman with short-term memory loss visited Gangnam Severance Hospital, and her chest X-ray and computed tomography revealed a right anterior mediastinal mass. On hospital day two, she suddenly presented personality changes and a drowsy mental status, so she required ventilator care in the intensive care unit. She underwent thymectomy, and was pathologically diagnosed with thymoma, type B1. Her mental status eventually recovered by postoperative day 90. Paraneoplastic encephalopathy associated with thymoma is very rare, and symptoms can be improved by thymectomy. We report a case of paraneoplastic encephalopathy associated with a thymoma.

• Korean Journal of Animal Reproduction
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• v.23 no.2
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• pp.119-125
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• 1999

The concentration of serum proteins, lipoproteins, leukocytes and lymphocytes in bursectomy and thymectomy Ogol chickens were examined from 5 days to 150 days of age. Concentration of serum proteins and lipoproteins were measured by cellulose acetate electrophoresis. The results summarized as follows : 1. The gamma-globulin concentrations in growing Korean native chickens and Ogol chickens were increased 0.41$\pm$0.01~0.85$\pm$0.05 mg/㎗ and 0.50$\pm$0.01~0.98$\pm$0.08 mg/㎗ from 1 day after to 5 days of age and gradually decreased at 10 days of age, and thereafter increased 0.82$\pm$0.06 mg/㎗, 1.09$\pm$0.04 mg/㎗ at 100 days of age. 2. The serum apha-, beta-, gamma-lipoprotein concentrations of growing Ogol chickens were 74.1$\pm$6.8~240.2$\pm$9.7 mg/㎗, 89.7 5.7~225.8$\pm$11.3 mg/㎗ and 87.6$\pm$4.7-220.3$\pm$10 mg/㎗, respectively. The serum -lipoprotein concentrations from 5 days to 150 days of age Ogol chickens were significantly decreased. 3. The leukocyte and lymphocyte counts in bursectomy and thymectomy Ogol chickens slightly increased from 10 to 100 days of age. However the leukocyte and lymphocyte counts in thymectomy chickens were lower than in untreated chickens. 4. The Ig concentrations of 1 day to 50 days(0.30$\pm$0.03~0.58$\pm$0.04 g/㎗) in bursectomy chickens were similar to those found in untreated chickens and thereafer increased from 50 to 150 days of age(0.58$\pm$0.04~1.21$\pm$0.05 g/㎗). The Ig concentrations in thymectomy chickens increased significantly.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.152-157
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• 1990

A clinical study for thymectomy for 23 patients in Myasthenia Gravis was done between May, 1982 and July, 1989. at the department of Thoracic and Cardiovascular Surgery, College of Medicine, Han Yang University. Among Z3 patients, male to female ratio was 11: 12 and Age of onset was ranged from 15 years-old to 52 years-old. Previous symptom duration from diagnosis until operation was ranged from 2 months to 96 months, and Mean duration was 28.74 months. The severity of disease was classified by Osserman`s classification preoperatively. In histopathology of thymus, Thymic hyperplasia 7 cases, Thymoma 7 cases, Invasive thymoma 3 cases, Within Normal Limit 5 cases, and Thymic Atrophy 1 case. Correlation between preoperative symptom duration and postoperative clinical course was statistically significant. The shorter of preoperative symptom duration, The better of postoperative clinical course. Grading of postoperative course was classified by Papatestas in 1975. Follow-up for postoperative course was ranged from 3 months to 7 year and 4 months, Cases of complete remission 1 year postoperative period were 9 cases and cases of Improvement were 8 cases, So totally 17 cases among 23 cases[73.91%] found good results.

• Journal of Chest Surgery
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• v.17 no.2
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• pp.292-298
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• 1984

Myasthenia 8ravis is a disorder of neuromuscular function due to a reduction of available acetylcholine receptors at the neuromuscular junction. Typically, the muscle weakness is worse after effort and improved by rest. In 1939, Blalock and associated reported a case of patient with myasthenia gravis who was successfully treated by thymectomy. Since then, operation has become increasingly important in the management of this disease. From 1968 to 1983, 10 cases of myasthenia gravis were operated at the Department of Thoracic and Cardiovascular Surgery,College of Medicine, Seoul National University. 1.Among 10 cases, 4 were male and 6 were female. 2.Thymectomy was performed in 9 cases, and 1 case of malignant thymoma with deeply infiltration to adjacent structure was not resectable. 3.There was 1 operative mortality with respiratory failure. 4.During follow-up period, most of them showed symptomatic improvement, but complete remission was not noticed in any case.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.736-743
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• 1986

Thymus gland is a kind of endocrine organ which secretes thymosin and thymoprotein. There can be developed variable lesions like thymoma, thymic hyperplasia, thymic cyst, thymolipoma, and carcinoid tumor of the thymus gland. We have experienced 25 patients of thymic disease: thymoma 12, thymic hyperplasia 11, thymic cyst 1, carcinoid tumor 1. The age distribution were ranged from 3 to 66 years and the sex ratio was 1:1.8 [male to female]. Thymectomy was performed in all cases, but 3 cases with deep infiltration to the adjacent structures were not resectable completely. Malignancy [all thymoma] were 5 and the rest were benign. Two cases were died of recurrence after tumor resection. Myasthenia gravis occurred in 10 cases. Among them, 2 were thymoma and 8 were thymic hyperplasia. We could obtained the result that thymectomized cases reached 2 remission and 5 improvement. Myasthenia gravis treated medically [18 cases] had no remission and only 2 clinical improvement. In the light of these results, early radical thymectomy would be most favorable treatment in not only thymic tumor, but generalized myasthenia gravis.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.72-76
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• 1997

Myasthenia gravis is relatively rare disease which is related autoimmune response. There are various methods of management for myasthenia gravis, but nowaday radical thymectomy is the treatment of choice in the aspect of bringing out complete remission and clinical improvement. Sixteen patients of myasthenia gratis underwent radical thymectomy during last eight years, and its result was analysed. Complete rem ssion was achieved in five patients (31 %) and pharmacological or symptomatic improvement in seven patients (44%), thus giving a total remission in 12 patients (75%). Postoperative result was not correlated with age, sex, degree of preoperative symptom, surgical approach, pathologic diagnosis.

• Journal of Chest Surgery
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• v.50 no.1
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• pp.68-70
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• 2017

The actual incidence of multiple thymoma is unknown and rarely reported because it remains controversial whether the cases represent a disease of multicentric origin or a disease resulting from intrathymic metastasis. In this case, a patient underwent total thymectomy for multiple thymoma with myasthenia gravis via bilateral video-assisted thoracic surgery. A well-encapsulated multinodular cystic mass, measuring $57mm{\times}50mm{\times}22mm$ in the right lobe of the thymus, and a well-encapsulated mass, measuring $32mm{\times}15mm{\times}14mm$ in the left lobe, were found. Both tumors were type B2 thymoma. Few cases of multiple thymoma with myasthenia gravis have ever been reported in the literature. We report a case of synchronous multiple thymoma associated with myasthenia gravis.