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This study was designed to investigate whether prophylactic immunotherapy for individuals sensitized to Japanese cedar pollen could prevent an outbreak of pollen-induced allergic rhinitis. A total of 13 non-atopic volunteers and 67 patients sensitized to Dermatophagoides farinae (D. farinae) and Japanese cedar pollen were enrolled in the study. Before enrollment in the study, all of the 67 patients had perennial nasal symptoms due to D. farinae, but no seasonal aggravation of nasal symptoms. 32 patients were treated with immunotherapy using standardized D. farinae extracts alone (control group), and the remaining 35 patients were treated with immunotherapy using the same D. farinae extracts and Japanese cedar pollen extracts (immunotherapy group). The following results were derived from the study:1. Prophylactic immunotherapy significantly decreased incidences of the outbreak of seasonal allergic rhinitis due to pollen.2. IL-4 synthesis during the pollen season by peripheral blood T cells stimulated with the cedar pollen allergen were enhanced in the control group, whereas IL-4 synthesis during the season was not enhanced in the immunotherapy group. In particular, IL-4 synthesis during the season did not differ between the non-atopic volunteers and the patients who were treated with prophylactic immunotherapy for more than 3 years.In conclusion, prophylactic immunotherapy could prevent the outbreak of seasonal allergic rhinitis in those who had been sensitized to the pollen. Therefore, it is likely that prophylactic immunotherapy is a new method of decreasing the incidence of seasonal allergic rhinitis in Japan.

Neural crest cells (NCCs) are an embryonic migratory cell population with the ability to differentiate into a wide variety of cell types that contribute to the craniofacial skeleton, cornea, peripheral nervous system, and skin pigmentation. This ability suggests the promising role of NCCs as a source for cell-based therapy. Although several methods have been used to induce human NCCs (hNCCs) from human pluripotent stem cells (hPSCs), such as embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs), further modifications are required to improve the robustness, efficacy, and simplicity of these methods. Chemically defined medium (CDM) was used as the basal medium in the induction and maintenance steps. By optimizing the culture conditions, the combination of the GSK3β inhibitor and TGFβ inhibitor with a minimum growth factor (insulin) very efficiently induced hNCCs (70-80%) from hPSCs. The induced hNCCs expressed cranial NCC-related genes and stably proliferated in CDM supplemented with EGF and FGF2 up to at least 10 passages without changes being observed in the major gene expression profiles. Differentiation properties were confirmed for peripheral neurons, glia, melanocytes, and corneal endothelial cells. In addition, cells with differentiation characteristics similar to multipotent mesenchymal stromal cells (MSCs) were induced from hNCCs using CDM specific for human MSCs. Our simple and robust induction protocol using small molecule compounds with defined media enabled the generation of hNCCs as an intermediate material producing terminally differentiated cells for cell-based innovative medicine.

There are few reports describing stroke due to the acute occlusion of the vertebral artery (VA) origin successfully treated by endovascularily. The authors report a case of 78-year-old man suffering from stroke owing to acute VA origin occlusion associated with contralateral hypoplastic VA leading to basilar artery (BA) thrombosis. Cerebral angiography demonstrated that the right VA was occluded at its origin, the left VA was hypoplastic, and BA was filled with thrombus. The occlusion of VA origin was initially passed through with a microcatheter and microwire. Hereafter, angioplasty was performed followed by stenting with a coronary stent. The VA origin was successfully recanalized. Next, a microcatheter was navigated intracranially through the stent and fibrinolysis was performed for BA thrombus. The patient's symptoms gradually improved postoperatively. Stroke due to acute VA origin occlusion leading to BA thrombosis was successfully treated by angioplasty and stenting followed by intracranial fibrinolysis.

Purpose To assess the histological integrity and cell viability in epithelial flaps prepared with epikeratomes. Setting Department of Ophthalmology, Kyoto Prefectural University of Medicine and The Baptist Eye Clinic, Kyoto, Japan. Methods Epithelial flaps were prepared by epi-LASIK surgery. After immediate fixation, they were examined by light and electron microscopy. To assess cell viability in fresh epithelial flaps, biostaining experiments were performed using propidium iodide (PI), calcein-AM, and Hoechst 33342 dye. In addition, some epithelial flaps were organ-cultured for 24 hours. Results Light and electron microscopy showed that most of the inspected areas showed nuclei and cytoplasm at significantly reduced density and discontinuity of the basement membrane. Biostaining experiments showed that approximately 90% of the basal cells in epithelial flaps were PI-positive dead cells; organ cultures showed detachment of basal cells from the epithelial flap after 24 hours of incubation. Conclusion Most basal cells in epithelial flaps prepared with different epikeratome devices were dead.