[Thymomas and associated diseases. Apropos of a series of 255 surgically treated thymomas].

The authors report on a series of 255 thymomas and the associated diseases most often auto-immune, myasthenia is the disease most frequently encountered (61% of cases). Next, but with a much reduced frequency of around 2%, come other diseases such as hypogammaglobulinaemia, erythroblastopenic anaemia, and disseminated lupus erythematosis. The authors analyse the effect of ablating the thymoma on the associated disease; those with myasthenia are the principal beneficiaries of thymic ablation, 83% in this series experiencing a good response.

[Long-term survival of patients operated on for primary bronchial cancers (excluding anaplastic cancers)].

The results of a retrospective study of patients operated upon for primary bronchial carcinoma (small-cell type excluded) are reported. The survival rates of 1285 patients who underwent tumoral excision between 1960 and 1973 were calculated by the actuarial method after exclusion of post-operative deaths. The overall survivals at 5 years' intervals were 31%, 18%, 11% and 8%.

Anti-AChR antibodies, thymic histology, and T cell subsets in myasthenia gravis.

The relationship between the titers of antibody against acetylcholine receptor (AChR) and T helper/suppressor balance (assessed by the OKT4/OKT8 ratio) were investigated in 74 patients with myasthenia gravis (MG). All patients with elevated AChR antibody titers (greater than 100 nM) had hyperplastic thymuses, while most patients with low or negative antibody titers (less than 1 nM) had involuted thymuses. All patients with thymoma had positive, though not very high, antibody titers.

Depletion of helper/inducer T cells after thymectomy in myasthenic patients.

Using monoclonal anti-T-cell antibodies, we have studied peripheral blood T-cell subsets in 53 patients with myasthenia gravis before and after thymectomy (Tx). Before Tx, the mean OKT4/OKT8 ratio was higher in patients than in controls. Furthermore patients showed a high number of cells reacting simultaneously with the OKT4 and OKT8 antibodies.

Evolution of the indications and results of treatment of myasthenia by thymectomy.

Four-hundred and fifty thymectomies from myasthenia were carried out at the Marie Lannelongue Surgical Center up to October 1980. This report deals with 248 patients who were operated on up to October 1977 and who were followed up for periods of 18 months to over 20 years with a view to examining the indications and results of thymectomy. In our opinion patients with thymomas should be operated upon when their general and cardiorespiratory condition allows surgery, and if there is no tumoral spread which precludes eradication.

[Tracheal resection for tracheal tumors (excluding cancer)].

Tracheal resection was performed in 10 patients with non-malignant tracheal tumors. Clinical, histological, and technical features are discussed, particular emphasis being given to long-term results. These tumors, mostly cylindromas (7 out of 10 cases in this series) are amenable to very wide surgical resection of the resection-anastomosis type.

Evaluation of T cell subsets in myasthenia gravis using anti-T cell monoclonal antibodies.

Functional T cell subsets have been evaluated in the peripheral blood of patients with myasthenia gravis using monoclonal anti-T cell antibodies and a suppressor cell assay based on the suppression of the mixed-lymphocyte reaction by concanavalin A-activated lymphocytes. A significant decline of suppressor cells was found in a large proportion of patients, both by direct count using the anti-suppressor-cytotoxic T cell antibody (OKT8) and by the suppressor assay. Patients also showed an increase in immature T cells defined by their simultaneous reaction with the anti-helper cell (OKT4) and anti-suppressor cell (OKT8) antibody.

[Prevention of postoperative thrombo-embolic accidents following thoracic surgery by low-dose calcium heparinate: a comparative study (author's transl)].

A comparative clinical trial was undertaken in 2420 patients undergoing thoracic surgery during a 4-year period (1973-1977); 40% of the patients had bronchial cancer. Random allocation was not considered as being possible by the surgeons and was replaced by allocation according to the time of operation. There were three protocol groups: Protocol A: First morning operations (1007 patients): subcutaneous calcium heparin, 5000 units (Ul) 2 hours and 30 minutes before surgery then every 12 hours for 15 days.

[Combined cervical and thoracic approach to the removal of tumours responsible for the Pancoast and Tobias syndrome (author's transl)].

The authors review the various treatments of the Pancoast and Tobias syndrome and propose a new surgical approach in two stages. The first, cervical stage involves resection of the internal half of the clavicle and of the first rib and dissection of the vessels and nerves lying in the supraclavicular fossa, so that the tumour can be lowered in one piece and exposed. The second stage consists of posterolateral thoracotomy with exeresis of the lung.

[About double drainage empyema treatment with bronchial fistula afer pneumonectomy (author's transl)].

We have resumed the files concerning the twenty patients treated these last eight years at Medico-Surgical center of Villiers Saint Denis for empyema with bronchial fistula after pneumonectomy, out of more than five hundred patients treatment for empyema of all origins. On that occasion, we explained the principals and the technique of double drainage which enabled us to cure 10 patients, the other ten died of a progressive resumption of cancer in the process of being treated. The direct treatment of fistula through endoscope has completed the action of pleural baths seven times.

[Surgical treatment of myasthenia by thymectomy. A report on 248 cases (author's transl)].

Good results were obtained in 80 p. cent of 248 patients seen after more than 15 months following the operation. Results are grouped as a function of the different characteristic features of the patients and three groups can be defined: failures, improvement, remissions.

[Treatment of bronchial carcinoid tumors. 29 cases (author's transl)].

The authors study the modalities of the surgical treatment of bronchial carcinoid tumors with regard to personal series of 129 cases and to 595 observations of the literature.