Evaluation of the efficacy and safety of olopatadine and fexofenadine compared with placebo in Japanese cedar pollinosis using an environmental exposure unit.

BACKGROUND: Second-generation oral H1-antihistamines have become a mainstay of treatment for the symptoms of seasonal allergic rhinitis; however, the effect of olopatadine has not been widely reported to date. OBJECTIVES: To evaluate the efficacy of 2 oral H1-antihistamines, olopatadine and fexofenadine, in the treatment of the nasal symptoms of Japanese cedar pollinosis and their possible side effects. METHODS: This was a randomized, double-blind, placebo-controlled, crossover study conducted in an environmental exposure unit (EEU). Twenty volunteers suffering from Japanese cedar pollinosis were randomly divided into 3 groups and exposed to cedar pollen in the EEU with oral administration of olopatadine hydrochloride (5 mg), fexofenadine hydrochloride (60 mg), or placebo 1 hour prior to pollen exposure. Nasal symptoms, activity impairment, and subjective sleepiness were self-assessed during the study period. Attention was measured using the digit cancellation test. The trial was repeated after 4 and 7 weeks. RESULTS: Compared with placebo, olopatadine significantly improved nasal symptoms and activity impairment during pollen exposure (P < .05). There was no significant relief of nasal discharge or nasal congestion with fexofenadine throughout the 5-hour exposure to cedar pollen. Furthermore, olopatadine significantly reduced nasal congestion during the first 2 hours, as well as sneezing and nasal discharge 4 hours after admission to the EEU compared with fexofenadine (P < .05). There was no significant difference in the effect on subjective sleepiness among the 3 groups, and all 3 agents had little effect on attention. CONCLUSIONS: These findings suggest that olopatadine is more effective than placebo and fexofenadine in improving nasal symptoms of Japanese cedar pollinosis.

The association between high VEGF levels and multiple probable punctuate cavernous malformations.

Cerebral cavernous malformations (CCMs) are congenital abnormalities of the cerebral vessels. The de novo development of new lesions in this disease has been reported. However, the underlying mechanism of progressive CCMs in such patients remains unclear. This report documents two cases of multiple probable CCMs that showed a progressive behaviour. The plasma levels of vascular endothelial growth factor (VEGF), and transforming growth factor-beta1 (TGF-beta1) were measured using an enzyme-linked immunosorbent assay (ELISA). The concentration of both VEGF and TGF-beta1 in plasma was increased in these patients. A relationship was observed between high concentrations of growth factors and progressive CCMs. Even though a causal linkage between these conditions cannot be confirmed, a continuous high VEGF level in plasma could be a possible clinical indicator for subsequent intracerebral haemorrhages in the CCM patients.

Hypotension and reduced nitric oxide-elicited vasorelaxation in transgenic mice overexpressing endothelial nitric oxide synthase.

Nitric oxide (NO), constitutively produced by endothelial nitric oxide synthase (eNOS), plays a major role in the regulation of blood pressure and vascular tone. We generated transgenic mice overexpressing bovine eNOS in the vascular wall using murine preproendothelin-1 promoter. In transgenic lineages with three to eight transgene copies, bovine eNOS-specific mRNA, protein expression in the particulate fractions, and calcium-dependent NOS activity were confirmed by RNase protection assay, immunoblotting, and L-arginine/citrulline conversion. Immunohistochemical studies revealed that eNOS protein was predominantly localized in the endothelial cells of aorta, heart, and lung. Blood pressure was significantly lower in eNOS-overexpressing mice than in control littermates. In the transgenic aorta, basal NO release (estimated by Nomega-nitro-L-arginine-induced facilitation of the contraction by prostaglandin F2alpha) and basal cGMP levels (measured by enzyme immunoassay) were significantly increased. In contrast, relaxations of transgenic aorta in response to acetylcholine and sodium nitroprusside were significantly attenuated, and the reduced vascular reactivity was associated with reduced response of cGMP elevation to these agents as compared with control aortas. Thus, our novel mouse model of chronic eNOS overexpression demonstrates that, in addition to the essential role of eNOS in blood pressure regulation, tonic NO release by eNOS in the endothelium induces the reduced vascular reactivity to NO-mediated vasodilators, providing several insights into the pathogenesis of nitrate tolerance.

Rabphilin-3A, a putative target protein for smg p25A/rab3A p25 small GTP-binding protein related to synaptotagmin.

In a previous study (H. Shirataki, K. Kaibuchi, T. Yamaguchi, K. Wada, H. Horiuchi, and Y. Takai, J. Biol. Chem. 267:10946-10949, 1992), we highly purified from bovine brain crude membranes the putative target protein for smg p25A/rab3A p25, a ras p21-related small GTP-binding protein implicated in neurotransmitter release. In this study, we have isolated and sequenced the cDNA of this protein from a bovine brain cDNA library. The cDNA had an open reading frame encoding a protein of 704 amino acids with a calculated M(r) of 77,976. We tentatively refer to this protein as rabphilin-3A. Structural analysis of rabphilin-3A revealed the existence of two copies of an internal repeat that were homologous to the C2 domain of protein kinase C as described for synaptotagmin, which is known to be localized in the membrane of the synaptic vesicle and to bind to membrane phospholipid in a Ca(2+)-dependent manner. The isolated cDNA was expressed in COS7 cells, and the encoded protein was recognized with an anti-rabphilin-3A polyclonal antibody and was identical in size with rabphilin-3A purified from bovine brain by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Moreover, both rabphilin-3A purified from bovine brain and recombinant rabphilin-3A made a complex with the GTP gamma S-bound form of rab3A p25 but not with the GDP-bound form of rab3A p25. Immunoblot and Northern (RNA) blot analyses showed that rabphilin-3A was highly expressed in bovine and rat brains. These results indicate that rabphilin-3A is a novel protein that has C2 domains and selectively interacts with the GTP-bound form of rab3A p25.

The functional domain of the stimulatory GDP/GTP exchange protein (smg GDS) which interacts with the C-terminal geranylgeranylated region of rap1/Krev-1/smg p21.

rap1/Krev-1/smg p21 (smg p21), a member of the small GTP-binding protein (G protein) superfamily, has a geranylgeranylated cysteine residue and clustered basic amino acids in the C-terminal region. The GDP/GTP exchange reaction of smg p21 is regulated by smg GDS, which is also active on Ki-ras p21 and rho p21. The C-terminal region of smg p21 is essential for its interaction with smg GDS. Moreover, smg p21 is phosphorylated by cyclic AMP- and cyclic GMP-dependent protein kinases at the serine residue between the polybasic region and the prenylated cysteine residue, and this phosphorylation initiates the smg GDS-induced smg p21 activation. Thus, the C-terminal cationic and hydrophobic region is important for the regulation of the smg p21 activity. In the present study, we attempted to determine the functional domain of smg GDS which interacts with the C-terminal region of smg p21 by use of a cross-link method and a site-directed mutagenesis method. The region of smg GDS cross-linked with the C-terminal region of smg p21B was residues 444-492, which is located at the C-terminal fifth of smg GDS. On deletion of these residues, smg GDS became inactive on smg p21B, Ki-ras p21 and rhoA p21. These results indicate that residues 444-492 of smg GDS are at least one of the domains which interact with the C-terminal region of its substrate small G proteins.

Molecular cloning of the human cDNA for a stimulatory GDP/GTP exchange protein for c-Ki-ras p21 and smg p21.

We have previously purified smg GDP dissociation stimulator (GDS) from bovine brain and isolated its cDNA from a bovine brain cDNA library. smg GDS stimulates the GDP/GTP exchange reaction of a group of small GTP-binding proteins (G proteins), including at least c-Ki-ras p21, smg p21A, smg p21B, rhoA p21 and rhoB p21, by stimulating the dissociation of GDP from and the subsequent binding of GTP to each small G protein. In this study, we have isolated and sequenced the cDNA of smg GDS from a human brain cDNA library using the cloned bovine smg GDS cDNA. The cDNA has an open reading frame encoding a protein of 558 amino acids with a calculated Mr value of 61,122. Human smg GDS shares 93% nucleotide and 96% amino acid sequence homologies with bovine smg GDS. The isolated cDNA is expressed in Escherichia coli, and the encoded protein shows the physical and functional properties similar to those of bovine smg GDS.

smg/rap1/Krev-1 p21s inhibit the signal pathway to the c-fos promoter/enhancer from c-Ki-ras p21 but not from c-raf-1 kinase in NIH3T3 cells.

smg/rap1A/Krev-1 p21 cDNA is known to inhibit v-Ki-ras p21-induced cell transformation in NIH3T3 cells, but the inhibitory mechanism is not clear at present. In the present study, we examined the effect of smg p21s on the c-fos promoter/enhancer linked to the luciferase reporter gene (c-fos-luciferase). After transfection of c-fos-luciferase into NIH3T3 cells constitutively expressing c-Ki-ras(val-12) p21 or activated c-raf-1 kinase, expression of c-fos-luciferase was much higher than after transfection into control NIH3T3 cells. Addition of platelet-derived growth factor (PDGF), 12-O-tetradecanoyl phorbol 13-acetate (TPA) or dibutyryl cyclic AMP (Bt2cAMP) to the control NIH3T3 cells stimulated c-fos-luciferase expression. Transfection of the smg p21 cDNAs inhibited the activated ras p21-, PDGF- or TPA-stimulated c-fos-luciferase expression, but did not inhibit the activated c-raf-1 kinase- or Bt2cAMP-stimulated reaction. These results indicate that smg p21s inhibit the signal pathways from the PDGF receptor, protein kinase C, and ras p21s to the c-fos promoter/enhancer, but not those from c-raf-1 kinase and cyclic AMP-dependent protein kinase to the c-fos promoter/enhancer.

Serotonin-induced hypercontraction through 5-hydroxytryptamine 1B receptors in atherosclerotic rabbit coronary arteries.

BACKGROUND: Augmented vasoconstriction to serotonin (5-hydroxytryptamine [5-HT]) in atherosclerotic vessels plays a crucial role in the development of myocardial ischemia. We investigated mechanisms for serotonin-evoked hypercontraction in atherosclerotic rabbit coronary arteries. METHODS AND RESULTS: Contractile responses to serotonergic agents of endothelium-denuded coronary arteries from control and Watanabe heritable hyperlipidemic rabbits (WHHL) were examined. WHHL coronary arteries exhibited hypercontraction to 5-HT(1)-receptor agonists; the constrictor threshold concentrations and E:D(50) to serotonin, 5-carboxamidotryptamine, and sumatriptan in WHHL were significantly lower, and the E:(max) in WHHL to these agents were increased 55% to 59% above those of the control. Serotonin-evoked contractions in both groups were inhibited by GR127935 (5-HT(1B/1D) antagonist; 0.1 to 1 nmol/L) and pertussis toxin but not by ketanserin (5-HT(2) antagonist; 0.01 to 1 micromol/L), suggesting that the hypercontraction is most likely mediated by 5-HT(1B/1D) receptors through a pertussis toxin-sensitive pathway. Furthermore, simultaneous measurements of [Ca(2+)](i) and isometric tension of fura-2-loaded arteries revealed that the hypercontraction was concomitant with the augmented elevation of [Ca(2+)](i) in the smooth muscle. The 5-HT(1B) mRNA levels in WHHL coronary arteries increased to 2.5-fold over those in control arteries, whereas neither 5-HT(1D) nor 5-HT(2A) mRNA was detected in either group. CONCLUSIONS: Atherosclerotic rabbit coronary arteries exhibited the enhancement in contraction and Ca(2+) mobilization in response to serotonin. The 5-HT(1B) receptor, which is upregulated by atherosclerosis, most likely mediates the augmenting effects of serotonin.

Identification of mRNA for 5-HT1 and 5-HT2 receptor subtypes in human coronary arteries.

OBJECTIVE: Although pharmacological studies have indicated that serotonin (5-HT)-evoked contraction of the human coronary artery is mediated by 5-HT1-like and 5-HT2 receptors, the gene expression of 5-HT receptors is still unclear. We examined mRNA expression of 5-HT1 and 5-HT2 receptor subtypes in human coronary arteries. METHODS: Total RNA was extracted from human coronary arteries of 14 patients at autopsy by the guanidine method. Reverse transcription-polymerase chain reaction (RT-PCR) and ribonuclease protection assays were performed to identify 5-HT1 and 5-HT2 receptor mRNA expression in human coronary artery. RESULTS: By RT-PCR, 5-HT1b, 5-HT2A and 5-HT2B mRNAs were detected in all of the 14 patients. 5-HT1A, 5-HT1D, and 5-HT1E mRNAs were detected in only some patients. However, neither 5-HT1F mRNA nor 5-HT2C mRNA was detected in any patient. By ribonuclease protection assay, 5-HT1B and 5-HT2A signals were detected in all patients examined, but neither 5-HT1A, 5-HT1D nor 5-HT2B signal was detected in any patient. CONCLUSIONS: Of 5-HT1/2 receptor subtypes, 5-HT1B and 5-HT2A receptor mRNAs were predominantly expressed in human coronary arteries. Our finding provides molecular evidence that the 5-HT1B receptor may be the 5-HT1-like receptor which mediates constriction of human coronary arteries.

Inhibition of endothelial nitric oxide synthase activity by protein kinase C.

Nitric oxide (NO) is an important molecular messenger accounting for endothelium-derived relaxing factor. Recently, NO synthase (NOS) from cultured endothelial cells has been purified and molecularly cloned. To evaluate the effect of phosphorylation by protein kinase C (PKC) and cyclic AMP-dependent protein kinase (PKA) on endothelial constitutive NOS catalytic activity, we incubated purified endothelial NOS with PKC or PKA. Endothelial NOS was stoichiometrically phosphorylated by PKC and PKA. In intact bovine aortic endothelial cells (BAECs), NOS was phosphorylated by stimulation with 12-O-tetradecanoylphorbol-13-acetate (TPA). NOS activity measured by the conversion of [3H]arginine to [3H]citrulline in homogenates of BAECs treated with TPA or phorbol 12,13-dibutyrate was reduced by 30%, whereas dibutylyl cyclic AMP did not affect NOS activity. Moreover, we measured NO release from cultured BAECs by a chemiluminescence method to examine the effect of PKC and PKA on endothelial NOS activity. In cultured BAECs, ATP gamma S and A23187 induced NO release in time- and dose-dependent manners. Phorbol esters such as TPA and phorbol 12,13-dibutyrate dose dependently inhibited NO release stimulated by A23187 as well as ATP gamma S. Reduction of NO release by TPA was almost completely prevented by pretreatment with staurosporine, an inhibitor of PKC. NO release by A23187 was increased in PKC-downregulated BAECs. In contrast, dibutylyl cyclic AMP or 8-bromo cyclic GMP had no effect on NO release from BAECs induced by A23187 or ATP gamma S. These results indicate that phosphorylation of NOS by PKC is associated with a reduction of its catalytic activity in vascular endothelial cells.

Auditory thalamic nuclei projections to the temporal cortex in the rat.

Thalamocortical projections from the auditory thalamic nuclei were examined systematically in the rat, including those from the dorsal division (MGD) of the medial geniculate body (MG), which were less clearly determined in previous studies. Injections of biocytin confined in each thalamic nucleus revealed characteristic features of projections in terms of cortical areas and layers of termination. In contrast to exclusively selective projections to cortical area Te1 from the ventral division (MGV) of the MG, diffuse and selective terminations were observed in the projections from the dorsal (MGD) and medial divisions (MGM) of the MG and the suprageniculate nucleus (SG). Diffuse termination was continuous in layer I or VI of the temporal cortex, while selective termination was in layers III and IV of discrete cortical areas. In addition to diffuse termination in the upper half of layer I of cortical areas Te1, Te2d and Te3v, the MGD and SG projections formed plexuses of axons selectively in lower layer III and layer IV of Te2d and Te3v. The SG projections targeted further the dorsal bank of the perirhinal cortex (PRh), while the MGD projections targeted in part the ventral fringe of Te1. The MGM projections terminated diffusely in layer VI of Te1 and Te3v, and selectively in lower layer III and layer IV of the rostral part of Te3v. Diffuse projections to layers I and VI from the SG and MGM extended in cortical regions over the dorsal fringe of Te1. Selective dense projections to middle cortical layers of Te2d and Te3v (especially its rostral part) indicate the existence of auditory areas, which could be involved in cross-modal interaction with visual and somatosensory system, respectively. Diffuse projections are supposed to bind information processings in these areas and the primary auditory area (Te1).

Topography of corticothalamic projections from the auditory cortex of the rat.

Corticothalamic projections from cortical auditory field to the medial geniculate body (MG) in the rat were systematically examined by making small injections of biocytin in cortical area Te1. All injections, confined to 400 microm in diameter, resulted in two projections terminating in the ventral (MGV) and dorsal divisions (MGD) of the MG. The projections to the MGV were evidently topographic. The rostral and caudal portions of area Te1 projected to the ventromedial and dorsolateral parts of the MGV, respectively, forming narrow bands of terminal axons that extended in the mediolateral direction in the coronal plane of the MGV. The minimum dorsoventral width of the bands ranged approximately from 100 to 300 microm. Besides, the more rostral portion of area Te1 tended to project to the more rostral side of the MGV. The projections to the MGD consistently arborized in its ventral margin made up of the deep dorsal nucleus of the MGD. A similar weak topography along the rostrocaudal direction was observed in the projections to the MGD. Large terminals were occasionally found in the MGD after the injections involving cortical layer V. The distribution of large terminals also appeared topographic along with small terminals that were the major component of labeling. Collaterals of labeled axons produced slabs of terminal field in the thalamic reticular nucleus, which also exhibited a weak topography of distribution. These results provide insights into the structural basis of corticofugal modulations related to the tonotopic organizations in the cortex and MG.

5-HT1Dbeta receptor mediates the supersensitivity of isolated coronary artery to serotonin in variant angina.

Although serotonin (5-hydroxytryptamine; 5-HT) is used for provocation of coronary spasm, 5-HT receptor subtypes in spastic coronary arteries remain undetermined. We demonstrated the supersensitivity of isolated coronary artery to ergonovine, 5-HT, and sumatriptan, a 5-HT1D receptor agonist, in a patient with variant angina. Furthermore, we detected gene expression of 5-HT1Dbeta and 5-HT2A receptors in spastic coronary artery using RNase protection assay. These findings suggest that the leftward shift of the dose-response curve for 5-HT, which plays an important role in the pathogenesis of coronary spasm, is mediated by activation of 5-HT1Dbeta receptor.

Month of birth, atopic disease, and atopic sensitization.

BACKGROUND: Japanese cedar (Cryptmeria japonica; CJ) pollen and house dust mites are the two important aeroallergens in Japan. However, no epidemiological survey has been performed in Japan to investigate the relationship between month of birth and manifestations of allergic disease and sensitization. OBJECTIVE: This study evaluates the correlation between month of birth and sensitization to aeroallergens or the occurrence of allergic disease on 755 Japanese school children aged 12-13 years. METHODS: The personal history of atopic disease (bronchial asthma, allergic rhinitis, eczema, and allergic conjunctivitis) as recorded by questionnaires was investigated in relation to total serum IgE and specific IgE toward house dust mites and CJ pollen. RESULTS: Positive specific IgE toward house dust mites was significantly less prevalent in the children born between January and March than those born during the rest of the year (p < 0.01). Positive specific IgE toward CJ pollen was significantly more prevalent in the children born between December and January than those born during the rest of the year (p < 0.05). High total IgE was less prevalent in the children born between February and April than in children born during the rest of the year (p = 0.05). The prevalence of bronchial asthma was 26.2% among children born between November and December, compared with a ratio of 17.3% among children born during the rest of the year (p < 0.05). A significantly higher proportion of the children with allergic rhinitis was born between August and October than during the rest of the year (p < 0.05). The prevalence of allergic conjunctivitis was 15.8% among the children who were born between December and January, compared with 9.1% among children born during the rest of the year (p < 0.01). No relationship between prevalence of eczema and season of birth was found. CONCLUSION: Month of birth appears to influence the risk in the development of allergic sensitization and atopic diseases. The findings concerning higher CJ pollen sensitization in children born in the months that proceed the CJ pollen seasons are as evident as the house-dust-mite-related findings.

67Ga citrate and 99mTc(v)-DMSA scintigraphy in a case of maxillary sinus liposarcoma.

Scintigraphic images with 67Ga citrate and 99mTc(v)-dimercaptosuccinic acid and MR image of a 16-year-old male with maxillary sinus liposarcoma (predominantly myxoid type) are reported. The MR image clearly indicated the exact location, size and anatomical relationship of the tumor. Scintigraphic evaluation was useful in suggesting the malignant nature of the tumor and showed no distant metastasis. Both examinations were effective in treating this case.

Heparin and heparan sulfate inhibit extracellular signal-regulated kinase activation and myocardial cell hypertrophy induced by endothelin-1.

Heparan sulfate (HS) is one of the components of extracellular matrix and a potent anti-growth factor in various cells. Heparin has a similar structure to HS and is demonstrated to inhibit myocardial cell hypertrophy. We examined the intracellular signal mechanisms linking to the inhibitory effects of heparin and HS on endothelin-1 (ET-1)-induced hypertrophy in cultured rat neonatal myocardial cells (MCs). Heparin inhibited ET-1-induced c-fos mRNA expression. Heparin and HS inhibited ET-1-induced activation of c-fos promoter/enhancer in MCs. Although heparin and HS inhibited ET-1-induced activation of the wild-type c-fos serum response element (SRE), the activation of a mutated c-fos SRE that contains an intact binding site for the serum response factor (SRF) but lacks the ternary complex factor (TCF) binding site, was not inhibited. In addition, heparin and HS inhibited the activation of TPA response element (TRE). However, heparin did not inhibit the activation of cyclic AMP response element (CRE). Furthermore, heparin and HS inhibited ET-1-induced activation of extracellular signal-regulated kinase (ERK) and phosphorylation of Elk-1, which is one of the TCFs. These results indicate that heparin and HS inhibited ET-1-induced ERK activation, resulting in suppression of Elk-1 phosphorylation, and lead to inhibition of c-fos gene expression through SRF-independent manner. Moreover, heparin and HS inhibited ET-1-induced [3H] leucine incorporation. These results suggest that heparin and HS inhibit ET-1 induced myocardial cell hypertrophy through the inhibition of gene expression and protein synthesis.

Ex vivo study of the effects of dietary magnesium deficiency on the formation and release of NO from endothelial cells and the sensitivity to NO of smooth muscle cells of thoracic aortas isolated from rats.

We found that the contractile responses to phenylephrine (PE) of isolated endothelium-intact thoracic aortas were enhanced by a nitric oxide (NO) synthase inhibitor, nitro-L-arginine (LNAG). and the magnitude of this enhancement was significantly greater in Mg-deficient than control rats. In this study, we used a sandwich method to evaluate the effects of dietary Mg deficiency on the ability of vascular endothelial cells to form and/or release NO and on the sensitivity to NO of vascular smooth muscle cells. Male Wistar rats were fed a Mg-deficient (10 mg Mg/kg diet) or control (700 mg Mg/kg diet) diet for 30 days. With the sandwich method, when endothelium-denuded thoracic aortas from chow fed rats were used as the assay vessels, and endothelium-intact aortas from control or Mg-deficient rats were used as the NO-donor vessels, neither the aortic contractile responses to PE nor the enhancement by LNAG of these responses in control and Mg-deficient rats differed significantly. When endothelium-denuded thoracic aortas from control or Mg deficient rats were used as the assay vessels and endothelium-intact aortas from chow fed rats were used as NO-donor vessels, LNAG enhanced PE-induced contractions to a significantly greater extent in Mg-deficient than control rats. Furthermore, sodium nitroprusside (a NO donor) had a greater relaxant effect on endothelium-denuded thoracic aortas isolated from Mg-deficient than control rats. These ex vivo results suggest that dietary Mg deficiency in rats has little effect on the formation and/or release of NO by aortic endothelial cells. but it does appear to increase the sensitivity to NO of aortic smooth muscle cells.

[Environmental control for allergic diseases--avoiding and killing effect on housedust-mite by eastern red cedar].

Housedust-mite has been a trigger factor for allergic diseases such as asthma, rhinitis and eczema. Therefore, it is important to remove housedust-mite from the environment of an allergic patient. Eastern red cedar is one kind of cypress tree which grows naturally in Northern America. It is used for the material of pencils, and the essence of soap. Its oil is used for oily substance for microscope lens. Using original system, we examined eastern red cedar and its oil, and found that it is effective for killing and preventing housedust-mites. The result was very effective. In conclusion the eastern red cedar and its oil seems to be useful for controlling mites in the home environment of allergic patients.

[Japanese cedar pollen in house dust].

Caring for oneself against Japanese cedar pollinosis is important as well as receiving medical-care. Although the importance of avoiding pollen is described in the guideline for nasal allergy medical treatment, however, there is no information for effective dust cleaning for the home. This study examined how many cedar pollens were included in indoor dust in order to obtain basic data whether dust removal for cedar pollen is available for pollinosis suffers. As a result, the study found that there were many Japanese cedar pollens in indoor dust even before the pollen season. Cedar pollen increased with the increasing number of airborne pollen. The highest number of pollen found in one week was approximately 450 pollens in a square meter of a living room floor. The study concluded that cleaning is one of the best way to remove Japanese cedar pollens found in indoor dust.

[Cochlear implantation in a child with a "common cavity" cochlear malformation].

A nucleus multichannel 22-electrode cochlear prosthesis was successfully implanted into a 4-year-old girl with a cochlear "common cavity" deformity. Preoperative radiologic studies showed bilateral common cavity cochlear malformations but no narrow internal auditory canal. Because left common cavity was larger than the right common cavity, the patient underwent a left cochlear implant. The facial nerve was found on the promontrium and interfered with accessing the hypoplastic round window. The cochlear cavity was entered through the hypoplastic semicircular canal to prevent facial nerve injury. In the postoperative rehabilitation phase, the child was able to distinguish phonemes, and word identification had started.