{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T10:24:41Z","timestamp":1793701481549,"version":"4.5.1"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,1,28]],"date-time":"2018-01-28T00:00:00Z","timestamp":1517097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japanese Society for the Promotion of Science, KAKENHI","doi-asserted-by":"crossref","award":["JP17K09780"],"award-info":[{"award-number":["JP17K09780"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of the New York Academy of Sciences"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>According to the 2014 Japanese clinical guidelines for myasthenia gravis, the most important priority in treatment is maintaining patients\u2019 health\u2010related quality of life. Therefore, the initial treatment goal is defined as maintaining a postintervention status of minimal manifestations or better (according to the Myasthenia Gravis Foundation of America classification) with an oral prednisolone dose of 5 mg\/day or less. Every effort should be made to attain this level as rapidly as possible. To achieve this goal, the guidelines recommend minimizing the oral prednisolone dose, starting calcineurin inhibitors early in the course of treatment, using intravenous methylprednisolone infusion judiciously (often combined with plasma exchange\/plasmapheresis or intravenous immunoglobulin), and effectively treating patients with an early, fast\u2010acting treatment strategy. The early, fast\u2010acting treatment strategy enables more frequent and earlier attainment of the initial goal than other strategies. Thymectomy is considered an option for treating nonthymomatous early\u2010onset myasthenia gravis in patients with antiacetylcholine receptor antibodies and thymic hyperplasia in the early stages of the disease.<\/jats:p>","DOI":"10.1111\/nyas.13544","type":"journal-article","created":{"date-parts":[[2018,1,29]],"date-time":"2018-01-29T15:02:33Z","timestamp":1517238153000},"page":"35-40","source":"Crossref","is-referenced-by-count":53,"title":["Rationale for the clinical guidelines for myasthenia gravis in Japan"],"prefix":"10.1111","volume":"1413","author":[{"given":"Hiroyuki","family":"Murai","sequence":"first","affiliation":[{"name":"Department of Neurology, School of Medicine International University of Health and Welfare  Narita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimiaki","family":"Utsugisawa","sequence":"additional","affiliation":[{"name":"Department of Neurology Hanamaki General Hospital  Hanamaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuriko","family":"Nagane","sequence":"additional","affiliation":[{"name":"Department of Neurology Hanamaki General Hospital  Hanamaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeaki","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Neurology Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomihiro","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy Sapporo Medical University School of Health Sciences  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakatsu","family":"Motomura","sequence":"additional","affiliation":[{"name":"Medical Engineering Course, Department of Engineering, The Faculty of Engineering Nagasaki Institute of Applied Science  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,28]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406233302507"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880171208"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20341"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22312"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2011.03.004"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen3.12180"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24213"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.1.16"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20950"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21053"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2011-000313"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23398"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002790"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24438"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21462"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1998.tb05968.x"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000062987"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25397"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602489"}],"container-title":["Annals of the New York Academy of Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnyas.13544","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/nyaspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nyas.13544","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T10:44:37Z","timestamp":1694601877000},"score":1,"resource":{"primary":{"URL":"https:\/\/nyaspubs.onlinelibrary.wiley.com\/doi\/10.1111\/nyas.13544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,28]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1111\/nyas.13544"],"URL":"https:\/\/doi.org\/10.1111\/nyas.13544","archive":["Portico"],"relation":{},"ISSN":["0077-8923","1749-6632"],"issn-type":[{"value":"0077-8923","type":"print"},{"value":"1749-6632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,28]]}}}