Management of Nonresectable Thymomas

Couraud, L; Martigne, C

doi:10.1159/000416363

Cited by 3 publications

(3 citation statements)

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“…The selective procedure of goiter resection differs from the classic subtotal or partial resections which leave remnants at the hilus, even with residual goiter, for protection of the recurrent nerve and the parathyroid glands. Selective resection is individualized according to the distribution of the pathologic tissue [20]. In our prospective study, this tactic often required mobilization of the lobes, excision of posterior nodules, dissection of the hilus, and extracapsular resection of a part of or a whole lobe, also depending on suspicion of malignancy.…”

Section: Discussionmentioning

confidence: 98%

Surgical aspects of thyroid autonomy in multinodular goiter

et al. 1983

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In a prospective study of 217 consecutive patients with multinodular goiter selected for surgical treatment, 43% had significant autonomous thyroid hormone secretion as evidenced by TRH unresponsiveness [TSH<1.0 ΜU/ml after intravenous (200 Μg) or oral (40 mg) TRH], with normal values of the FT4‐Index and FT3‐Index (preclinical hyperthyroidism) in 74%, and with hyperthyroidism in 26% of these cases. The amount of autonomous thyroid hormone secretion increased with the mean goiter weight and age of patients. Nodular goiter growth is considered a further manifestation of escape from normal TSH dependence, namely, with respect to follicular epithelium cell replication. Goiter recurrence may, therefore, not only be TSH dependent, but it may also evolve from autonomously growing goiter tissue left behind. This implies a selective nodular goiter resection instead of the uniform subtotal resection leaving remnants at the hilus. Prospective results of this operative tactic and technique are presented: (a) operative morbidity was low; (b) in TRH‐unresponsive patients, the postablative autonomous thyroid hormone secretion was usually low. The thyrotropic and TSH‐mediated thyroid function recovered within 2–4 months; (c) no hypothyroidism occurred, but slightly elevated TSH secretion resulted in 40% of the patients; and (d) follow‐up of 76 selected patients during a mean of 3.5 years revealed the occurrence of TSH‐dependent and of autonomous recurrences, developing in nonresected lobes. Selective goiter resection is advocated on the basis of newer pathophysiological concepts in benign multinodular goiter and on the basis of refinement of the thyroid surgical technique.

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Section: Discussionmentioning

confidence: 98%

Surgical aspects of thyroid autonomy in multinodular goiter

et al. 1983

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“…using four bioassays ( Table 2). All six of these toxins are derived from sea anemones belonging to a single taxonomic family, Actiniidue, and available data indicate that they affect the sodium channel in a similar fashion, through a common receptor site (16,17). The goal of our study was to: I .…”

Section: No Namementioning

confidence: 99%

Quantitative structure‐activity relationships for sea anemone polypeptide toxins

Hellberg

Kem

1990

International Journal of Peptide and Protein Research

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Sea anemone polypeptides vary considerably in their affinities for sodium channels occurring in different excitable cells. The amino acid sequence variation in a set of six sea anemone type I polypeptide toxins (4649 residues long), was parameterized using descriptor scales zl. 22. and 23, derived from a large number of amino acid physicochemical properties. The pharmacological properties of the toxins were represented by the results from four bioassays on crab, mouse, and rat brain and from rat heart. By means of the descriptor scales and the multivariate data analytical method PLS (partial least squares projections to latent structures), it was possible to develop quantitative structure-activity relationships (QSAR). Using the QSARs derived from the set of six polypeptide toxins the pharmacological properties of two homologous sea anemone polypeptide toxins were predicted. Thus it is shown that QSARs may be formulated for relatively long bioactive polypeptides. The QSARs indicate that 11 different amino acid positions may be of importance, but that positions no. 5 , 21, 28, 34, 37, and 40 were of main importance in modeling the relative toxicities of the six polypeptides.

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“…Couraud (31) reported five partial cricoidal resections and two total resections with this technique. This protected the integrity of the recurrent laryngeal nerves.…”

Section: Subglottic Laryngeal Arid Upper Trucheal Stenosismentioning

confidence: 99%

Tracheal Surgery

Grillo

1983

Scandinavian Journal of Thoracic and Cardiovascular Surgery

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In the last 20 years the techniques for resection of the trachea with primary reconstruction have evolved to a point where most lesions involving up to 50% of the trachea can be successfully and dependably managed. A notable exception is the lengthy infiltrating adenoidcystic carcinoma. Postintubation stenosis is largely correctible in an initial operative approach. The operation has such a high degree of success that it appears to be the treatment of choice. Primary tracheal tumors and selected secondary tracheal tumors are often amenable to surgical resection, with the addition of radiotherapy for certain histologic types. Results strongly support this aggressive approach. Three problems of current interest seem to be yielding to surgical correction although decisions about the time of surgery, the delicacy of surgical execution from the postoperative management all present difficult problems. These are the repair of the rare congenital tracheal stenosis in children, resection and reconstruction of the carina and correction of subglottic and upper tracheal stenosis.

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Management of Nonresectable Thymomas

Cited by 3 publications

References 0 publications

Surgical aspects of thyroid autonomy in multinodular goiter

Surgical aspects of thyroid autonomy in multinodular goiter

Quantitative structure‐activity relationships for sea anemone polypeptide toxins

Tracheal Surgery

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