Experimental myasthenia in mice. The role of the thymus and lymphoid cells

A possible function of the thymus gland with regard to developing neuromuscular block after immunization with thymus extract is discussed. Inbred female C57BL/6 mice were immunized with thymus extract from female C57BL/6 (syngeneic), male C57BL/6 mice, AKR mice (allogeneic) and guinea-pigs and calves (xenogeneic). Two weeks later, the waning phenomenon was observed from the electromyography (EMG) in xenogeneically, allogeneically and syngeneically immunized mice. The waning reverted to a normal pattern following an intraperitoneal injection of neostigmine methylsulphate. EMG tracings revealed a decrease in the incidence of the waning phenomenon in those mice which were immunized after adult thymectomy. The passive transfer of the waning phenomenon to non-thymectomized recipients could be achieved by the intravenous administration of lymph node cells obtained from the mice that had developed a myasthenic neuromuscular block after immunization. This finding was also observed in the recipients when the donors of lymph node cells had not developed the block. On the other hand, administration of sera from mice with the waning phenomenon after immunization resulted in a neuromuscular block in both normal and adult-thymectomized mice. However, sera obtained from mice without waning did not have this feature

Prediction of Nonadherence and Renal Prognosis by Pre-Transplantation Serum Phosphate Levels

BACKGROUND Identifying characteristics of patients at high risk of poor adherence before transplantation would be advantageous. However, the optimal approach for characterizing such patients remains unknown.We aimed to evaluate the association between factors for hemodialysis nonadherence and post-transplant renal prognosis. We hypothesized that these factors would influence post-transplantation adherence and worsen renal prognosis. MATERIAL AND METHODS We reviewed patients on hemodialysis who underwent kidney transplantation at our hospital between 2000 and 2017 to identify risk factors associated with poor prognosis. The patients\u27 background and pre-transplantation data, known hemodialysis nonadherence factors, serum phosphate and potassium levels, and interdialytic weight gains were evaluated. The primary endpoint was renal death. We also evaluated the fluctuation of calcineurin inhibitor concentration and weight gain after transplantation. RESULTS Seventy-seven patients were eligible, and the mean observational period was 83.2 months (standard deviation, 50.5). Thirteen patients reached the endpoint.Cox proportional hazards regression analysis showed that pre-transplantation serum phosphate level was a risk factor for renal death (p<0.05), while serum potassium levels and weight gain were not. In addition, fluctuation of calcineurin inhibitor concentration was observed in patients with higher phosphate levels before transplantation (p=0.03). Weight gain after transplantation was not associated with the hemodialysis nonadherence factors. CONCLUSIONS High pre-transplantation serum phosphate levels are considered to represent poor drug adherence and/or an unhealthy lifestyle. Patient education that conveys the importance of adhering to medications and provides nutritional guidance is crucial for improving post-transplantation renal prognosis