Myasthenia in a patient with sarcoidosis and schizophrenia.

A 44-year-old male patient was hospitalised with paranoid schizophrenia in 1985. Depot neuroleptic treatment was started which successfully prevented further psychotic relapses for the next ten years. His myasthenia gravis started with bulbar signs in 1997 and the symptoms soon became generalized.

Decade-long experience with surgical therapy of myasthenia gravis: early complications of 324 transsternal thymectomies.

Background: We studied the incidences and evaluated the management of early postoperative complications after thymectomy for myasthenia gravis.

Methods: During the period between 1987 and 1996, 324 thymectomies were performed through median sternotomy access under general anesthesia. Postoperative management was administered according to a standardized protocol of anticholinesterase medication, which was withdrawn for the 48 hours of obligatory postoperative mechanical ventilation.

Dominantly inherited familial myasthenia gravis as a separate genetic entity without involvement of defined candidate gene loci.

Myasthenia gravis (MG) is a sporadic autoimmune disorder affecting neuromuscular transmission. Very rarely autoimmune myasthenia gravis may be inherited within a family. We present here the genetic analysis of a Hungarian family where nine members from two generations are affected by myasthenia gravis.

Altered polyamine levels in skeletal muscle of patients with myasthenia gravis.

Forty patients with myasthenia gravis were tested for polyamine content of the musculus sternothyreoideus removed during thymectomy. Cases with slight muscle alteration were found to show elevated values for all the three polyamines (putrescine, spermidine and spermine) examined with an increased spermidine/spermine ratio. In severe muscular atrophy, however, the high spermidine and spermine levels were accompanied by unchanged putrescine content and spermidine/spermine ratio.

[Tumor-associated myasthenia gravis and myasthenia syndrome].

Out of 700 patients operated on account of myasthenia gravis, 144 cases with tumours (20.57%) were evaluated. Classification took place in five groups: 1.

Myasthenia gravis: effect of immunoactive therapies.

New immunoactive therapies, plasmapheresis, intravenous steroid pulse infusion and intravenous immunoglobulins were examined for efficacy on the basis of large casuistics of myasthenia gravis. The best results were achieved with combination of these procedures. Indications of the new methods: (i) respiratory crisis of any character (myasthenic, cholinergic or mixed oscillating crisis); (ii) the patients' preparation for thymectomy; (iii) post-thymectomy therapy aimed at improving the patients condition, at avoiding relapses, at shortening the time of steroid therapy and at repressing cholinergic drug therapy; (iv) patients of old age in crisis-prone state.

Examinations of the relative fluidity in cerebrovascular disease patients.

Parallel with the increasing incidence of cerebrovascular diseases, and the limitations of possible surgical methods, the importance of drug therapy has significantly increased. Due to our knowledge of haemorheology the effectiveness of therapies may be measured by means of useful circulatory markers. In course of our research activities of one and a half decades the changes in blood viscosity were measured during vinpocetine therapy, and were compared to the changes of haematocrit and mean corpuscular volume (MCV) values.

Myasthenia gravis: prognostic significance of clinical data in the prediction of post-thymectomy respiratory crises.

Medical records of 170 patients who had undergone thymectomy for myasthenia gravis were reviewed from the point of view of respiratory disturbances. In the group of patients requiring mechanical ventilation for over 24 hours after operation the incidence of high preoperative cholinesterase inhibitor intake, severe bulbar symptoms and severe myasthenia gravis with anamnestic respiratory crisis and cardiorespiratory disease were much higher than in the group of patients who could have their trachea extubation within 24 hours. The presence of a thymic tumour, patients' age over 50 years and the so-called precrisis have revealed differences between the two groups, while the patient groups were identical in mean age, duration of myasthenia gravis and sex distribution.

Familial myasthenia gravis: nine patients in two generations.

In two generations of a family followed up for 15 years, nine patients suffering from myasthenia gravis were observed. The family, being of special genetic importance, is unique in the literature.

Myasthenia gravis: treatment with plasma exchange experiences over 10 years.

Evaluation of the results of plasmapheresis therapy is reviewed on 160 patients suffering from myasthenia gravis. This new therapeutical procedure is considered very valuable: improvement can be achieved in 63% of the patients during the therapy, a further improvement in 30% after it. Plasmapheresis is especially effective for patients in respiratory crisis-prone state, for drug-resistant cases and for preparation patients for surgery.

[Myasthenia gravis: results of thymectomy in 550 patients].

Report is giving on 550 myasthenic patients who underwent thymectomy during the last 18 years. Results of thymectomy are analysed in separate groups and according to different aspects, including thymic tumours (13.63%), operations in childhood (9.

Myasthenia gravis: effect of thymectomy in 425 patients. A 15-year experience.

We report 425 myasthenic patients who underwent thymectomy during the last 15 years. The authors analyse the results of thymectomy in separate groups, including thymomas (12.7%), childhood myasthenia (9.

Myasthenia gravis: familial occurrence. A study of 1100 myasthenia gravis patients.

Eleven-hundred myasthenia gravis cases observed by the author in a period of 37 years are reviewed. The ratio of familial incidence was 4.23%.

Treatment of multiple sclerosis.

Data referring to the pathogenesis, pathomechanism, pathology, clinical symptoms and immunological changes which are important considering the treatment of multiple sclerosis have been reviewed. On the basis of published data and own experiences of 37 years of conventional drug therapy, steroid therapy required in acute forms and cytostatic, immunosuppressive therapy used in chronic forms have been discussed. A survey has been given on the theoretical basis and clinical use of the therapeutic methods still under investigation.

Myasthenia gravis in childhood and adolescence. Report on 209 patients and review of the literature.

Authors review the different theoretical and practical problems of childhood and adolescent myastenia gravis, including the heterogeneous group of congenital myasthenia and the big casuistics of the literature. There are reports on 113 cases with childhood myasthenia gravis and 96 cases of adolescent myasthenia. Ratio of these forms ranged 10.

Myasthenia gravis: demonstration of membrane attack complex in muscle end-plates.

The membrane attack complex (MAC) assembles from C5b-9 complement components and has neoantigenic properties. Antihuman-MAC rabbit immunserum was applied in order to localize the MAC in myasthenic muscles. Using the indirect immunoperoxidase method MAC was demonstrated at the motor end-plates in eleven myasthenic patients who underwent thymectomy.

Myasthenia gravis: 75seleno-methionine scanning of thymus gland.

The 75Se-seleno-methionine isotope thymus scanning was examined in a series of patients with myasthenia gravis. The method proved useful and informative in the diagnostics of myasthenia. Prior to thymectomy, the thymic tumour or a large gland could be observed and some hints could be gained concerning the biological activity of the gland.

Myasthenia gravis: influence of thymic changes on clinical parameters. A study on the basis of 364 thymectomies.

In 364 patients with myasthenia gravis the morphology of thymus glands, thymomas and muscle samples was studied and compared to different clinical, therapeutic and prognostic parameters of the disease. The role of active thymus as the most outstanding finding, was considered for the result of thymectomy and for the prognosis to be positive: The more active the thymus the better the outcome of thymectomy and the final and lasting prognosis of the disease.

Myasthenia gravis: long-term prognostic value of thymus lactate dehydrogenase isoenzyme pattern of hyperplastic thymus and thymoma.

Lactate dehydrogenase (LDH) isoenzyme pattern and the percent of H-subunit content were determined in the thymus of 62 patients (55 with hyperplasia, 7 with tumours) after thymectomy. An increase in LDH1 relative activity indicates that in the thymus of patients with myasthenia gravis the ratio of mature differentiated thymocytes was higher than in the thymus of control subjects. LDH isoenzyme profiles of thymus tumours were similar to those described in other neoplasms, except that thymomas with apparent predominance of epithelial cells and with minimal lymphocytic reaction exhibited a marked elevation only in LDH2 relative activity, presumably associated with the specific (secretory) function of epithelial cells.

Effect of thymectomy in immune diseases other than myasthenia.

In the course of thymectomy of patients with myasthenia gravis, surprising data concerning the recovery or considerable improvement of other immune disorders have been observed. Among these disorders rheumatoid arthritis figured in six instances, immune thrombocytopenia in two cases, polymyositis and psoriasis in one case each. Thymectomy as a powerful immunosuppressive procedure may have a role in the therapeutic management of some immune disorders other than myasthenia gravis.