• Annals of Clinical Neurophysiology
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• 제6권1호
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• pp.43-47
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• 2004

We report a case of 36-year-old woman with myasthenia gravis (MG) combined with mediastinal leiomyosarcoma (LMS) and Stevens-Johnson syndrome (SJS). She was admitted to ICU with the symptoms of acute onset headache, diplopia, ptosis, dysphagia, general weakness, and respiratory difficulty for several days. Physical examination revealed tachypnea, decreased breath sounds and dullness to percussion in right lower chest. Neurologic examination showed ptosis, diplopia, decreased gag reflexes, and generalized proximal weakness. Laboratory studies revealed increased serum acetylcholine receptor antibodies and positive Tensilon test. Chest CT showed a huge mass in the right middle mediastium but no evidence of thymic enlargement. Mediastinal LMS was diagnosed by ultrasound-guided needle biopsy. The myasthenic symptoms were fluctuated in spite og intravenous immunoglobulin, plasmapheresis, and corticosteroid. During therapy, SJS developed. She died 4 months after the onset of the myasthenic symptoms despite the chemotherapy for LMS.

• Journal of Chest Surgery
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• 제24권11호
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• pp.1125-1132
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• 1991

Myasthenia gravis is a disorder of neuromuscular transmission which is characterized fatigue and weakness of the voluntary muscle. From 1985. 1 to 1991.6, 34 patients underwent managed including 12 patient thymectomy, at the kyunghee medical center. A clinical analysis was performed and following result was obtained. Among the 34 patients, male to female ratio was 11 : 23 and the age was ranged from 2 years to 63 years. Thymectomy was done in 12 case and 1 case of malignant thymoma was not resectable. There were 2 deaths after operation due to respiratory failure and 1 death dur to gradually progression. THe effect of thymectomy in mtasthenia graves was 66.7% (8cases). The prognostic factors were severity of the disease and histopathological findings. Others were not related to the prognosis of the mayasthenia gravis. The severity of the myasthenia gravis was classified by Osserman modified classification.

• Journal of Chest Surgery
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• 제17권2호
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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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• 제25권10호
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• pp.1035-1040
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• 1992

Myasthenia gravis is an autoimmune disease in which the thymus gland is thought to play a central role in the pathogenesis. Thymectomy is now standard therapy, and improvements in surgical techniques, anesthesia, and respiratory care and the use of plasmapheresis have markedly reduced the operative morbidity. We experienced 7 myasthenia gravis with maximal thymectomy from November 1989. As compared with the results of previous classic transsternal thymectomy group the 25 patients who were operated from June 1979 to December 1991[Group B], excellent surgical result was obtained in maximal thymectomy group[Group A]. During follow-up period that ranged from a month to 10.7 years[mean 2 years], the remission rate for the entire group was 15.6 percent and an additional 71.9 percent had improvement[87.5 percent benefited]. In Group A, the remission rate was 42.9 percent with 100 percent of the patients benefiting from operations. But in Group B, 8 percent had remission and a total of 80 percent benefited. In both Groups, there was no operative mortality but there was one case`s mortality in Group B during follow-up period.

• Annals of Clinical Neurophysiology
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• 제8권2호
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• pp.203-205
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• 2006

There have been several reports about coexistence of myasthenia and other autoimmune disease. Psoriasis is a papulosquamous disease defined by erythematous plaques with a silvery scale and a T-cell-mediated autoimmune disease. We report a case of a 49-year-old man with generalized myasthenia gravis (MG) superimposed by psoriasis. MG was diagnosed by clinical symptoms, increased acetylcholine receptor antibody titer and repetitive nerve stimulation test. Psoriasis was diagnosed by clinical manifestations and specific skin biopsy findings. MG and psoriasis are both autoimmune diseases. The coexistence of MG and psoriasis suggest a close connection of pathogenesis.

• Journal of Chest Surgery
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• 제25권8호
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• pp.844-849
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• 1992

Between 1979 and 1991 thymectomy was performed on 31 patients with myasthenia gravis at the department of thoracic and cardiovascular surgery, Keimyung University medical school. All patients were treated by transsternal thymectomy. During follow-up period that ranged from a month to 10.7 years[mean 2 years], the remission rate for the entire group was 16.1 percent and an additional 71.0 percent had improvement [87.1 percent benefited]. In those 8 patients with thymoma, the remission rate was 12.5 percent with 75.0 percent of the patients benefiting from operations The remainimg 23 patients fared better the operations: 17.4 percent had remission and a total of 91.4 percent benefited. There was no mortality, I concluded that most patients with myasthenia gravis will benefit from thymectomy, and that the improvement persists over an extended period of time in a high percentage of patients.

• Journal of Yeungnam Medical Science
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• 제13권1호
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• pp.86-96
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• 1996

1985년 8월부터 1996년 1월까지 중증 근무력증으로 진단받은 환자 52례에 대한 임상적 고찰을 통하여 다음과 같은 결론을 얻었다. 1. 전체 환자 중 남자가 19례(35.8%), 여자가 33례(64.2%)이었고 11세에서 20세 사이가 12례 (23%)로 가장 높은 빈도를 보였다. 2. 환자의 초기 증상으로는 안검하수, 복시 등의 안구증상이 37례(71.2%)로 가장 많았고 modified Osserman의 분류에 따라서도 가장 증상이 가볍고 약물치료에 잘 반응하는 I군이 36례(69.3%)로 가장 많았다. 3. 환자가 호소하는 중상의 비특이성과 회복과 재발을 거듭하는 질병의 특성으로 인해 발병 이후 진단될 때까지의 시간은 비교적 오래 걸렸고 1년이상 경과하며 진단된 경우도 16례(30.8%)나 되었다. 4. 자가면역질환이 7.6%에서 동반되었는데 갑상선기능 항진증이 2례(3.8%), 인슐린의존형 당뇨 2례(3.8%)였고 종격동 전산화 단층촬영소견에서 흉선의 비대가 의심되었던 환자는 6례(11.5%), 흉선종이 발견되었던 경우는 3례였다. 5. 환자의 치료는 대부분 항콜린에스테라제나 부선피질호르몬을 병용하는 내과적 치료를 하였으며 약물의 치료에 반응이 미비하거나 악화되는 경우 혹은 종격동 전산화 단층촬영 상에서 흉선의 이상 소견이 보인 경우에 2례(3.9%)에서는 흉선절제술이, 1례(1.9%)에서는 혈장여과요법이 추가되었고 흉선절제술과 혈장여과요법이 같이 병합 치료된 경우도 3례(5.9%) 있었다. 6. 전체 환자중 2명에서 자연치유의 경과를 보였으며 이들은 모두 I군이였다. 그리고 흉선절제술과 부신피질 호르몬 투여로 완치된 예가 1례였었다.

• Journal of Chest Surgery
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• 제23권1호
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• pp.146-151
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• 1990

Myasthenia gravis is a disorder of neuromuscular transmission characterized by weakness and fatigue of voluntary muscles. It is now reasonably established to be due to an autoimmune attack directed against the postsynaptic nicotinic acetylcholine receptors of voluntary muscles. Thymectomy has become increasingly important in the treatment of this disease after the successful case of Blalock in 1939. From January 1984 to December 1988, we performed total thymectomy in 25 cases of myasthenia gravis except one, and get the results as follows. l. Among 25 cases, male to female was 10:15 and the age was ranged from 16 years to 65 years. 2. Thymectomy was done in 24 cases and 1 case of malignant thymoma was not resectable. 3. There were 2 deaths after thymectomy due to myasthenic crisis. 4. There were 19 cases [76 %] of improvement after thymectomy as follows; complete remission was 6 cases [24 %], marked improvement was 9 cases [36 %] and subjective improvement was 4 cases [16 %]. 5. The effect of age, and duration of disease on operative result was not statistically significant, but that of thymic pathology was significant.

• Journal of Chest Surgery
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• 제28권9호
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• pp.851-856
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• 1995

Thymectomy has played a central role in the management of myasthenia gravis. Although both the etiology of myasthenia gravis and the reason for improvement after thymectomy remain incompletely explained, complete removal of the thymus is the logical goal of surgical treatment for this disease.From April 1989 to June 1994, maximal thymectomy was performed for 19 cases of myasthenia gravis at Chonnam National University Hospital. The results were as follows:1.Among the 19 cases, male-to-female ratio was 1:1.4, the age ranged 13 years to 71 years, and a diphasic presentation appeared with a peak in young females and a second peak in elderly males;2.Five cases were classified by modified Osserman`s classification as Group I and Group IIa and 14 cases as Group IIb and Group IIc; 3.Histologic examination of the excised thymus glands revealed normality in 5 cases [26% , thymic hyperplasia in 4 [21% , benign thymoma in 8 [42% , and malignant thymoma in 2 [11% ;4.There was no operative mortalities but two deaths occurred during the follow-up periods due to myasthenic crisis and other causes;5.The clinical improvement and the complete remission rates were 85% and 32%, respectively;6.The clinical improvement and the complete remission rates were not so good in patients with thymomas, beeing 70% and 20%, respectively; and 7.Young women with hyperplasia of the thymic tissue tended to show the best response to thymectomy.

• 한방안이비인후피부과학회지
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• 제34권1호
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• pp.56-65
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• 2021

Objectives : The purpose of this study is to report the effectiveness of Korean medical treatment on ptosis in myasthenia gravis. Methods : We treated the patient who had suffered from rt. ptosis and was diagnosed with myasthenia gravis with acupuncture, electropuncture, herbal acupuncture, cupping therapy, herbal medicines and western medicine such as corticosteroids and acetylcholinesterase inhibitors. The effectiveness of treatment was evaluated through Relative Interpalpebral Fissure(IPF) and photography. Results : After the treatments, relative Interpalpebral Fissure(IPF) was increased and improvement remained for three months after the treatment was finished. Conclusions : The result indicates that combination therapy of Korean medical treatment and western medicine had an effect on treatment of ptosis with myasthenia gravis.