[Studies on the synthesis of cholecystokinin A receptor antagonists. I. synthesis and cholecystokinin A receptor inhibitory activities of malonamide derivatives]

2-Substituted malonamide derivatives were synthesized and tested for cholecystokinin A (CCK-A) receptor inhibitory activity. Significant CCK-A receptor inhibitory activities were found in only three compounds (4g-i) which have carboxyl group. In order to study structure-activity relationships, carboxyethyl group was selected for 2-substituent and a number of N-substituted malonamides were prepared. After these compounds were tested for CCK-A receptor inhibitory activity, 4-(3,4-dichlorophenylcarbamoyl)-N,N-dipentylglutaramic acid (4h) was selected as the most preferred compound.

[Effects of KSG-504, a new CCK-A receptor antagonist, on gallbladder and gastrointestinal functions]

We investigated the interaction of KSG-504 with CCK-8- or pentagastrin-induced gallbladder and gastrointestinal responses in vitro and in vivo. KSG-504 (10(-7)-10(-4) M) inhibited CCK-8-induced contractions of both isolated guinea pig gallbladder and rabbit terminal cavity of the bile duct in a concentration-dependent manner. Furthermore, intravenous administration of KSG-504 also dose-dependently inhibited CCK-8-induced gallbladder contraction in anesthetized guinea pigs with an IC50 value of 0.23 mg/kg. In conscious mice, KSG-504 inhibited both CCK-8- and egg yolk-stimulated gallbladder emptying in a dose-dependent manner (IC50: 13.3 and 9.6 mg/kg, respectively). The CCK-8-induced delay of gastric emptying in conscious rats was also antagonized by KSG-504 with an IC50 value of 3.78 mg/kg, i.v., whereas pentagastrin-stimulated gastric acid secretion in anesthetized rats was not affected by KSG-504 at all. KSG-504 (1 mg/kg, i.v.) also inhibited CCK-8-induced duodenal and jejunal contractions in anesthetized rabbits. These results indicate that KSG-504 exerts an antagonistic effect on CCK-A receptors in the gastrointestinal tract, but not on gastrin receptors in the stomach.

Application of a dicistronic mRNA expression vector to antisense RNA expression in mammalian cells

One important role of antisense RNA expression in mammalian cell biology is to partially suppress the functions of target genes of which the functions are unknown but which are indispensable for host cell growth. Therefore, we applied a dicistronic mRNA expression vector to express antisense p53 RNA in mouse fibrosarcoma MethA cells. We also established several clones in which the p53 gene functions were partially suppressed by the introduced antisense RNA. Compared with the control MethA clones, the contents of p53 protein in those expressing the antisense RNA were about halved, and their growth rates were remarkably decreased. These results proved that an antisense RNA in a dicistronic mRNA construct decreases the cellular content of a targeted gene product and that clones harboring the dicistronic mRNA construct can be established in which expression levels of the introduced antisense RNA are controlled by the stringency of drug selection.

Development and applications of new technology for two-dimensional space-time characterization and correlation analysis of ultraweak biophoton information

We describe the spatial distribution and temporal correlation analysis of ultraweak biophoton emission based on photoelectron pulse time series and position measurement techniques. Experimental results on the spatio-temporal variation of biophoton emission from soybean seedlings after physical and chemical stimulation to the root tip are analyzed. Our results suggest the potential usefulness of this technique to quantify the transmission mechanisms of biological signals in the living system by measuring the biophoton emission.

Clinical implication of the integration patterns of human T-cell lymphotropic virus type I proviral DNA in adult T-cell leukemia/lymphoma

In this review, we discuss the possible relationship between the clinical characteristics and the integration patterns of human T-cell lymphotropic virus type I (HTLV-I) proviral DNA in patients with adult T-cell leukemia/ lymphoma (ATL). Some ATL patients show unusual integration patterns such as multiple or defective HTLV-I and have clinical characteristics unlike those of most ATL patients who have the characteristic integration pattern of one complete provirus. Multiple HTLV-I integrations can be detected as two or more bands using the standard Southern blotting method when the tumor cellular DNA is digested with an endonuclease that does not cleave within the provirus. This includes cases of one tumor cell clone carrying two or more copies of the provirus, or alternatively two or more cell clones, each carrying one copy of the provirus. The former group of patients always manifest severe dyspnea and hypoxemia with unusual organ infiltrations including the retina and muscle and an extremely aggressive clinical course. On the other hand, the latter group of patients have an indolent course with skin lesions or small T lymphocytes with cleaved or lobulated nuclei. A solitary defective HTLV-I in some ATL patients can be detected as one smaller band after digestion of cellular DNA with an endonuclease that does not cleave within the provirus. These patients generally have a favourable clinical course with small cleaved or bilobulated T lymphocytes without lymphadenopathy or skin lesions. These findings suggest that there are clinical implications for the integration patterns of HTLV-I and this may be one of the explanations for the heterogeneous behaviour of the disease. Such studies may provide information on the relationship between virus integration and the clinical manifestations and also improve our understanding of the pathogenesis of ATL.

Inhibitory effect of plasma FKBP12 on immunosuppressive activity of FK506

To evaluate the roles of extracellular FKBP12, we examined the effect of extracellular FKBP12 on the immunosuppressive activity of FK506 in vitro and clinically. The ability of FK506 to suppress phytohemagglutinin-induced proliferative response of human peripheral blood mononuclear cells was inhibited in the presence of recombinant FKBP12 dose-dependently. We measured plasma levels of FKBP12 using a newly developed enzyme-linked immunosorbent assay system in 34 patients receiving FK506 after liver transplantation. In 7 patients with acute cellular rejection, plasma FKBP12 increased significantly at the onset of rejection compared with 1 week before onset (P < 0.05) and further increased to or remained at more than 250 ng/ml 1 week after onset. In 22 of 27 patients without acute cellular rejection, plasma FKBP12 was less than 70 ng/ml during the 4 weeks after transplantation. In the other 5 of 27 patients without acute cellular rejection, plasma FKBP12 exceeded 250 ng/ml. Rapid increase of plasma FKBP12 was observed in only one of these 5 patients, at the onset of high fever due to a liver abscess. There was no significant difference in whole blood trough levels of FK506 between the patients with or without acute cellular rejection. These results suggest that the rapid increase in plasma levels of FKBP12 may contribute to the occurrence and progress of acute cellular rejection probably by inhibiting the immunosuppressive activity of FK506.

Human body textbook with three-dimensional illustrations

We made a toolkit for making education softwares using 3D computer graphics, and using the toolkit, we made an education software based on 3D illustrations for learning about the human body. The toolkit enables us to make such kind of education software based on 3D illustrations easy and systematic. In the education software, the human body structure is illustrated with 3D models. The user can see the 3D objects with real-time rotation and walk through the virtual space, and their functions are expressed in the 3D virtual space.

Immunoelectron microscopic localization of decorin in aged human corneal and scleral stroma

Decorin is one of the major proteoglycans in corneal and scleral stroma. Since the distribution of decorin in the normal human eye has not been fully investigated, we examined its immunoelectron microscopic localization in aged human corneal and scleral stroma using anti-decorin antiserum and gold particle-conjugated secondary antibody. In the corneal stroma, decorin was located on the surface of collagen fibrils, on interfibrillar type VI collagen filaments and on dark cross-bands of long-spacing collagen which occurred in the aged human corneal stroma. In the scleral stroma where the banding pattern of D-periodic collagen fibrils was clearly observed, decorin was located on the surface of D-periodic collagen fibrils, chiefly on the d (XI) and e (IX, X) bands, and also on interfibrillar amorphous materials of moderate density which were labeled with anti-type VI collagen antiserum.

Genotype, slow decrease in virus titer during interferon treatment and high degree of sequence variability of hypervariable region are indicative of poor response to interferon treatment in patients with chronic hepatitis type C

In a study assessing factors associated with a good or a poor response to interferon treatment in patients with chronic hepatitis type C, we analyzed serum samples taken from 26 interferon-treated patients and found further evidence that infection with genotype II is associated with a poor response. Whereas all seven patients with group III genotype tested showed a good response (normalization of alanine aminotransferase level for more than 6 months), only 10 of 19 (53%) patients infected with group II genotype showed a good response. We also observed that 16 of 17 (94%) patients who exhibited a rapid virus titer decrease during the first 2 weeks of treatment later showed a good response. In contrast, only three of nine (33%) patients with an initially slow viral decrease eventually showed a good response (p<0.04). None of the 26 control patients exhibited a marked virus decrease or normalization of serum alanine aminotransferase level. Interestingly, high degrees of sequence variability were seen in three patients with group II hepatitis C virus who responded poorly to the therapy. All three showed slow decreases in virus titer during the first 2 weeks of treatment. In contrast, patients with genotype II who showed a good response to treatment were seen to have very few mutations. In three patients with genotype III who had responded well to interferon treatment, all showed very little amino acid sequence variability in the hypervariable region compared with patients with genotype II who had responded poorly to interferon treatment. These data suggest that a slow decrease in virus titer during the beginning of interferon treatment and a high degree of sequence variability, both of which are often seen in patients with group II genotype, are associated with poor response to interferon treatment.

Phenotypic and functional characteristics of in vivo-induced interleukin-12-activated killer cells

A single i.p. administration of IL-12 (2000 U/mouse) into the mice caused the elevation of serum IFN-gamma activity and the generation of killer cells which can lyse various kinds of tumor cells including both NK-sensitive and -resistant tumor cells. Such in vivo induced killer cells were not detected in the mice treated with the same dose of IL-2. The generation of IL-12-activated killer cells (IL-12AK) peaked at day 1 and sustained their cytotoxicity until day 3 after IL-12 administration. The generation of IL-12AK was inhibited by in vivo administration of anti-asialo GM1 (ASGM1) Ab but not anti-CD4 or anti-CD8 mAbs, suggesting that the precursor cells for IL-12AK were ASGM1+CD4-CD8- NK cells. The phenotypic characterization of in vivo induced effector cells with IL-12AK activity was carried out by separating the cells with FACStar. The IL-12AK activity was highly enriched in ASGM1+CD4-8- or NK1.1+CD4-8- NK cells, but not in CD8+ T cells and CD4+ T cells. The IL-12AK cells were also generated in tumor-inoculated mice. In parallel with the in vivo generation of IL-12AK generation, the growth of i.p. inoculated MBL-2 lymphoma cells was markedly inhibited by the administration with IL-12. The in vivo antitumor activity of IL-12 was blocked by the administration of anti-ASGM1 but not anti-CD4 or anti-CD8 mAbs in concomitant with the decrease of IL-12AK generation. From these results, it was indicated that ASGM1+NK1.1+CD4-8- NK type IL-12AK cells might play an important role in IL-12-induced local therapy of tumor in vivo.

[Synthesis of estimated metabolites of 9-amino-2,3,5,6,7,8-hexahydro-1H-cyclopenta[b]quinoline monohydrochloride monohydrate (NIK-247). II. Synthesis of dihydroxylated metabolites]

The two dihydroxylated metabolites of 9-amino-2,3,5,6,7,8-hexahydro-1H-cyclopenta[b]quinoline monohydrochloride monohydrate (NIK-247), which is a new drug for the treatment of dementia, were synthesized to determine their chemical structures. Reduction of the tricyclic diketone, 9-amino-2,3,6,7-tetrahydro-1H-cyclopenta[b]quinoline-1,8(5H)-dione, with equivalent molar of NaBH4, afforded the racemic two alcohols, (+/-)-9-amino-2,3,5,6,7,8-hexahydro-8-hydroxy-1H-cyclopenta[b]quinoli n-1-on e and (+/-)-9-amino-2,3,5,6,7,8-hexahydro-1-hydroxy-1H-cyclopenta[b]quinoli n-8- one. (+)-9-Amino-2,3,5,6,7,8-hexahydro-8-hydroxy-1H-cyclopenta[b]quinolin+ ++-1-one was obtained by optical resolution of the corresponding racemic hydroxyketone using (-)-di-p-toluoyl-L-tartaric acid. The optically active dihydroxylated metabolites were obtained by reduction of the (+)-8-hydroxy-1-one with NaBH4.

In vivo microdialysis evidence for transient dopamine release by benzazepines in rat striatum

The effects of benzazepine derivatives on extracellular levels of dopamine (DA) and L-3,4-dihydroxy-phenylacetic acid (DOPAC) in the dorsal striatum of freely moving rats were studied using in vivo microdialysis. Direct injection of SKF-38393 (0.5 or 1.5 micrograms/0.5 microliter), a selective D1 receptor agonist, into the striatum through a cannula secured alongside a microdialysis probe produced a rapid dose-dependent transient increase in striatal DA efflux and a more gradual reduction in efflux of DOPAC. The rapid increase in DA efflux was not affected by infusion of tetrodotoxin (TTX; 2 microM) or Ca(2+)-free Ringer's solution and occurred after either enantiomer of SKF-38393. A TTX-insensitive increase in DA level similar to that induced by SKF-38393 was also seen after other benzazepines acting as agonists (SKF-75670 and SKF-82958, each 1.5 micrograms in 0.5 microliter) and antagonists (SCH-23390, 1.5 micrograms in 0.5 microliter) at the D1 receptor and after (+)-amphetamine. These effects were inhibited by infusion of nomifensine (100 microM). It is concluded that the transient increases in striatal DA efflux seen after intrastriatal injection of SKF-38393 and other benzazepines are not mediated by presynaptic D1 receptors but by an amphetamine-like action on the dopamine transporter.

Cardiovascular effects of intracerebroventricularly administered growth hormone-releasing factor in spontaneously hypertensive rat

1. We investigated the cardiovascular effects of intracerebroventricularly administered (ICV) growth hormone-releasing factor (GRF) in both spontaneously hypertensive rats (SHR) and Wistar rats (WR) with reference to the involvement of adrenergic mechanisms and plasma AVP concentration. 2. The ICV GRF induced biphasic changes of mean arterial pressure (MAP) in SHR. In the first phase, maximum pressor response was observed 2-3 min after injection. In the second phase, maximum depressor response was observed 12-13 min after injection, and lasted up to 21-22 min. In WR, there were no significant changes in MAP. 3. ICV phentolamine attenuated the GRF-induced pressor response, but did not affect the depressor response. ICV bunazosine had no effect in both responses. ICV yohimbine attenuated the GRF-induced pressor response, but did not affect the depressor response. 4. In SHR, plasma AVP concentration was not affected by ICV GRF. 5. These data suggest that central GRF plays an important role in the maintenance of hypertension in SHR, since ICV GRF caused a significant depressor effect in SHR but not in WR. ICV GRF induced biphasic changes of MAP in SHR. The pressor response was mediated through central alpha2-adrenoceptors. The depressor response was not mediated through central alpha-adrenoceptors. The depressor effect of ICV GRF was not mediated by the changes of plasma AVP concentration.

Roles of prostaglandins D2 and E2 in interleukin-1-induced activation of norepinephrine turnover in the brain and peripheral organs of rats

Possible roles of prostaglandins (PGs) in interleukin-1 (IL-1)-induced activation of noradrenergic neurons were examined by assessing norepinephrine (NE) turnover in the brain and peripheral organs of rats. An intraperitoneal injection of human recombinant IL-1 beta accelerated NE turnover in the hypothalamus, spleen, lung, diaphragm, and pancreas. A similar increase in NE turnover was also observed after intracerebroventricular injection of corticotropin-releasing hormone (CRH). Pretreatment with indomethacin (cyclooxygenase inhibitor) abolished the IL-1-induced, but not the CRH-induced, increase in hypothalamic and splenic NE turnover. To elucidate which eicosanoid-cyclooxygenase product(s) is responsible for accelerating NE turnover, PGD2, PGE2, PGF2 alpha, U-46619 (stable thromboxane A2 analogue), or carbacyclin (stable prostacyclin analogue) was administered intracerebroventricularly. Among them, PGE2 was the only eicosanoid effective in increasing NE turnover in spleen, whereas PGD2 was effective in the hypothalamus. The stimulative effect of PGD2 was abolished by pretreatment with intracerebroventricular injection of a CRH antiserum. These results suggest that the action of IL-1 is mediated through PGD2 production to activate the noradrenergic neurons in the hypothalamus, and through PGE2 production to increase sympathetic nerve activity in spleen.

Intratumoral heterogeneity of hst-1 gene amplification in esophageal carcinoma with reference to DNA stem line heterogeneity

Amplification of the hst-1 gene was examined in 112 neoplastic lesions from 27 patients with esophageal carcinoma. Ninety specimens were separately obtained from two or more sections of each individual primary tumor with DNA stem line heterogeneity and 22 specimens were obtained from metastatic lymph node lesions. The assessment was that hst-1 gene amplification within each individual primary tumor was identical in all 27 cases (100%) and that the intensity of amplification in the primary tumor matched that in the metastatic lesion in 18 of 22 cases (82%). When we examined 33 endoscopic biopsy specimens from esophageal carcinoma in the same manner, the intensity of hst-1 gene amplification in the specimens was similar to that obtained in surgical specimens from 26 of the 33 patients (79%). These results suggest that hst-1 gene amplification might occur in a homogeneous manner as a relatively early genetic event prior to lymph node metastasis, and that therefore, prior to surgical treatment, it can be evaluated from a single biopsy specimen.

Elevation of endothelin biosynthesis in human endothelial cells with mycoplasma infection

The effects of mycoplasma infection on the biosynthesis of endothelin-1 (ET-1) in cultured human vascular endothelial cell lines were examined to understand regulatory mechanisms of ET-1 biosynthesis and causes of angiopathy due to mycoplasma infection. The growth of normal endothelial cells from the umbilical cord vein and of an immortal endothelial cell line transfected with prepro ET-1 cDNA was decreased, while the secretion of ET-1 into the culture medium was enhanced by mycoplasma infection. However, the rate of ET-1 production in these cell cultures was much higher at the growing phase than at the stationary phase. Immunocytochemical studies with anti-ET-1 antibody and an autoradiographic examination of the labeled nuclei with 3H-TdR revealed that mycoplasma infection induced an elevation of ET-1 production in both S and non-S phase cells. The expression of prepro ET-1 mRNA as examined by in situ hybridization and by RNase protection assay was not altered by mycoplasma infection. Thus, the biosynthesis of ET-1 in vascular endothelial cells may be regulated at the posttranscriptional level.

[Cooperative multicentric study on posttraumatic epilepsy]

A multicenter cooperative study was conducted to investigate factors influencing posttraumatic epilepsy (PTE) and to evaluate the prophylactic effect of anticonvulsants. A retrospective study of 102 PTE patients revealed the following typical clinical features: occurrence in young males, traffic accidents, contusion and/or cerebral hematoma. The latent period after the injury was longer in children. The percentage of EEG paroxysmal activity gradually increased as the generalized abnormality diminished. A retrospective-prospective study of 1998 patients who suffered a head injury between 1984 and 1988 was conducted till 1994. During the follow-up period, 62 patients (3.1%) developed PTE. The drop-out cases were excluded, and the 154 cases followed at least two years were analyzed. Statistical analysis of differences between patients with and without PTE suggested following factors: young, immediate early epilepsy (within 24 hours after injury; IMEE) and early epilepsy (within one week after injury). The risk with the highest relative risk rate was early epilepsy. Multiple regression analysis revealed that three factors, IMEE, early epilepsy and young age, contributed to the prediction of PTE. There was no significant difference in the percentage of patients having PTE in the group treated with anticonvulsants and the untreated group. Anticonvulsant treatment after head injury was unlikely to have a prophylactic effect on the development of PTE.

Sequencing of an 18.8 kb fragment from Saccharomyces cerevisiae chromosome VI

The nucleotide sequence of lambda phage clone 4121, which contains the 18.8 kb fragment of Saccharomyces cerevisiae chromosome VI left arm, was determined. This sequence had seven open reading frames (ORFs), four of which were identical to known genes (ACT1, YPT1, TUB2 and RPO41). Another three ORFs (4121orfR003, 4121orfR004 and 4121orfRN001) were highly homologous to FET3 multi-copper oxidase, glucose transport protein, and hypothetical protein of YIL106w on chromosome IX, respectively. 4121orfRN01 is suggested to contain an intron.

Cholecystokinin-A specific antagonism of KSG-504 to cholecystokinin receptor binding and pancreatic secretion in mammals

The effects of KSG-504 ((S)-arginium (R)-4-[-N-(3-methoxypropyl)-N-pentylcarbamoyl]-5-(2- naphthylsulfonyl) pentanoate monohydrate), a new cholecystokinin (CCK)-receptor antagonist, on 125I-CCK-8 binding to rat pancreatic, canine gallbladder and guinea pig cerebrocortical membranes and the pancreatic amylase release from isolated rat acini stimulated by several kinds of secretagogues, including CCK, were investigated. The 125I-CCK-8 saturation experiment showed that pancreatic, gallbladder and cerebrocortical CCK receptors had a single high affinity binding component with dissociation constants (Kd) of 0.18, 0.31 and 0.88 nM, respectively. The maximum numbers of specific binding sites (Bmax) in these membranes were 1012, 52 and 20 fmol/mg protein, respectively. KSG-504 and CCK-8 displaced specific 125I-CCK-8 binding to CCK receptors in all membrane preparations in a competitive manner. The affinity of KSG-504 for pancreatic (Ki = 173 nM) and gallbladder (Ki = 283 nM) CCK receptors were > 3 orders of magnitude higher than its affinity for cerebrocortical CCK receptors. KSG-504 also inhibited 125I-gastrin-I binding to guinea pig gastric glands, but the IC50 value (18.2 microM) was apparently much higher. CCK-8-stimulated amylase release from isolated pancreatic acini of rats was antagonized by KSG-504 in a concentration-dependent manner. KSG-504 did not affect amylase release stimulated by secretagogues such as gastrin-releasing peptide, carbachol, vasoactive intestinal peptide and A23187. These results indicate that KSG-504 acts as a CCK-A-receptor-specific antagonist in the pancreas and gallbladder.

[Proton-magnetic resonance spectroscopy (1H-MRS) of human plasma obtained from patients with various cancer--new detection method for common cancer]

1H-Magnetic Resonance (MR) Spectra of plasma obtained from patients with various cancer were measured. Clinical usefulness of 1H-MRS assay for detection of common cancer was examined. The following results were obtained. 1. High lactate peak was detected significantly with 1H-MR Spectra of plasma in every cancer patients. The patterns of 1H-MR spectra were very similar in each case, except for the lactate peak. 2. Lactate values (area ratio of lactate peak to TSP) of cancer patients showed high correlation with tumor marker of AFP, but not significant with CEA and CA19-9. 3. 1H-MRS assay has many advantages in the clinical examination. From these results, it was concluded that lactate peak in 1H-MRS might be useful to detect common cancer as a new tumor marker and 1H-MRS assay was equipped with enough characters as a new clinical laboratory assay for detection of specific metabolic deficiency.

Magnetic resonance imaging study of the brain in aged volunteers: T2 high intensity lesions and higher order cortical function

The aims of the present study were to clarify the findings of magnetic resonance imaging (MRI) in the aging brain, and to relate the MRI findings to higher order cortical function. A total of 118 healthy aged volunteers (41 men, 77 women) underwent cranial MRI electroencephalography (EEG), Benton visual retention test (BVRT) and interview. The subjects had no past history or clinical evidence of cerebrovascular disorder, head trauma or dementia and were living at home without any difficulty. The majority of the subjects have participated in this series of studies since 1982. Using a 1.5 T superconductive MR instrument, T1-weighted, proton density and T2-weighted images were obtained. The MRI data were rated visually by regarding 12 items according to fixed criteria. T2 high signal intensity (T2HSI) lesions were found in 69.5% of subjects, the prevalence of which increased with age. T2HSI lesions were most frequently found in the basal ganglia (61.9%), followed by the thalamus (39.0%), parietal lobe (37.0%), temporal lobe (12.7%) and pons (8.5%). Among these lesions, lacunar infarction showed low signal intensity in T1-weighted images and was found in 24.6% of subjects, the prevalence also increasing with age. These findings, including brain atrophy determined according to similar criteria, were correlated closely with the subjects' age. The results of BVRT showed a close relation with T2HSI, suggesting that T2HSI may influence cognitive function. When the subjects were classified according to the presence of T2HSI, lacunar infarction and EEG abnormalities, brain atrophy was significantly milder in a group of subjects with T2HSI(-), lacunar infarction(-) and normal EEG than in the other groups. This suggests that changes seemingly representing physiological aging may be promoted by another pathological which also exerts influences on higher order cerebral function.

The effect of thymectomy on myasthenia gravis, thrombocytopenia, and granulocytopenia associated with thymoma: report of a case

We report the case of a 47-year-old woman with thymoma who developed myasthenia gravis, thrombocytopenia, and granulocytopenia, simultaneously, the concurrent association of these four disorders being extremely rare. Thymectomy was performed, and, during the post-thymectomy course, there were surprising findings concerning the recovery of not only the myasthenia gravis but also of the hematologic disorders. Immediately after thymectomy, the myasthenic symptoms completely disappeared, and the granulocyte and platelet counts recovered to within the normal range within a few days. The laboratory data revealed no difference between pre- and post-thymectomy in the release of cytokines (tumor necrosis factor; TNF, interleukin; IL-2, and IL-6), anti-acetylcholine receptor antibody, or platelet-associated IgG. On the other hand, the serum level of anti-neutrophil cytoplasmic antibody (p-ANCA), against the myeloperoxidase of the granulocytes was dramatically decreased, after thymectomy, showing a significant correlation with the granulocyte count. According to our survey of the literature, this is the first report to show that the removal of a thymoma led to the dramatic resolution not only of myasthenia gravis but also of other associated diseases. It is possible that p-ANCA may be regulated by thymoma, thus causing severe granulocytopenia.