We conducted a study using Twitter, one of the social networking services that is widely used to post daily messages in real time. Recently, the method of using big data to predict the prevalence of infectious diseases, such as influenza and COVID-19, has been attracting attention. Pollen dispersal is influenced by real-time weather conditions and complex external factors, such as temperature, humidity, and wind direction. The appearance of allergic symptoms to pollen exposure is immediate. Infectious disease outbreaks and the onset of hay fever are very similar in that they are influenced by complex external factors. Therefore, we conducted a study to investigate whether tweets related to hay fever posted on Twitter could be related to the amount of pollen dispersal. Using the Python programming language, we retrieved data through Twitter API (Application Programming Interface), obtaining a total of 316,505 daily tweets between February 3 and May 22, 2022. We examined the relationship between the number of tweets related to hay fever and the amount of cedar and cypress pollen dispersal in Tokyo and Matsumoto. Our analysis revealed that the number of tweets related to hay fever increased as the amount of cedar pollen dispersal increased in Tokyo, with a strong correlation (0.85; p<0.001), but not in Matsumoto. Next, we analyzed the contents of the tweets related to hay fever using morphological analysis. The most frequently used terms were “sneezing” and “runny nose,” while “stuffy nose” was used infrequently. On the other hand, “itch” and “itchiness” were frequently used to express the feeling of itchiness. Using Twitter, a typical SNS, we were able to grasp the real-time trends of hay fever, a medical condition.

　　Mucosal malignant melanoma accounts for about 10% of all cases of malignant melanoma, and in the head and neck region, these tumors most frequently arise in the sinonasal cavities. Radical resection + postoperative radiotherapy is considered as the standard treatment, but distant metastases are common and the prognosis is poor. In recent years, the efficacy of proton beam therapy and immune checkpoint inhibitor (ICI) therapy, as novel treatment options, has been reported. We reviewed the data of 14 cases of sinonasal mucosal malignant melanoma who received multidisciplinary treatment at Nagoya City University Hospital between January 2014 and April 2021. The median age of the patients, consisting of 6 men and 8 women, was 76 years. As the initial treatment, surgery was performed in 3 cases, proton beam therapy in 9 cases, and ICI therapy in 2 cases (distant metastases). The response rate to proton beam therapy was 55.6%. Including cases that developed recurrence, 12 cases received anti-PD-1 therapy, 1 received anti-CTLA4 therapy, and 3 received anti-PD-1 + anti-CTLA4 therapy. The median survival duration after ICI treatment was 17 months (range: 3-58 months). Although patients with recurrence in poor general condition did not show good responses to ICI therapy, even patients who were 80 years old or older who were in good general condition could receive ICI therapy for a long period. In the future, it is necessary to develop individualized treatment strategies that would take into account the timing of ICI therapy.

　　The EXIT (ex utero intrapartum treatment technique) is a technique used to remove tumors causing upper airway obstruction in the fetus and to secure the neonatal airway while maintaining oxygenation, without cutting the umbilical cord following delivery by caesarean section. Herein, we report performing tracheostomy using the EXIT technique for a suspected case of agnathia-otocephaly. Prenatal imaging revealed a defect of the mandible and deviation of the auricle, which was suspected as a manifestation of agnathia-otocephaly, and we selected the strategy of performing tracheostomy under EXIT. The EXIT procedure was discontinued 16 min after the start owing to fetal bradycardia; however, the tracheostomy to secure the airway was completed 4 min after umbilical cord amputation. As compared with normal tracheostomy, there were many restrictions for EXIT in this case, such as body position, surgical field, and inability to perform neck extension by mandibular elevation due to a defect of the mandible.