Purpose: This study aimed to summarize the impact of neck and head radiation treatment on maxillofacial structures detected on panoramic radiographs. Materials and Methods: In this systematic review, the authors searched PubMed Central, Embase, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar for original research studies up to February 2020 that included the following Medical Subject Headings keywords: words related to “radiotherapy” and synonyms combined with keywords related to “panoramic radiography” and “oral diagnosis” and synonyms. Only original studies in English that investigated the maxillofacial effects of radiotherapy via panoramic radiographs were included. The quality of the selected manuscripts was evaluated by assessing the risk of bias using Cochrane's ROBINS-I tool for non-randomized studies. Results: Thirty-three studies were eligible and included in this review. The main objectives pertained to the assessment of the effects of radiation on maxillofacial structures, including bone architecture alterations, periodontal space widening, teeth development abnormalities, osteoradionecrosis, and implant bone loss. The number of participants evaluated ranged from 8 to 176. Conclusion The interaction between ionizing radiation and maxillofacial structures results in hazard to the tissues involved, particularly the bone tissue, periosteum, connective tissue of the mucosa, and endothelium. Hard tissue changes due to radiation therapy can be detected on panoramic radiographs.

Objective: Folate receptor α (FRα) is a membrane protein expressed in various solid tumors but has limited expression in normal cells. Therefore, FRα is an attractive target for cancer treatment. This study aimed to investigate the relationship between FRα expression and the clinicopathological characteristics and survivals of cervical cancer. Methods: This retrospective study included patients with cervical cancer who underwent primary surgery between 2000 and 2020 at our institution. Immunohistochemical staining of FRα was performed using an anti-folate-binding protein/FBP antibody. FRα-positive staining was defined as ≥5% of tumor staining and FRα-high as ≥50% tumor staining with ≥2+ intensity. The association between FRα expression and survival was assessed using multivariate Cox regression analysis, adjusting for established prognostic factors. Results: Overall, 123 patients were identified, and 140 tumor samples, including 17 paired primary and metastatic samples, were evaluated. As histological types, 67 patients had squamous cell carcinoma (SCC), and 56 patients had non-SCC. All primary tumors were FRα-positive. High FRα expression was observed in 25% of the cases and differed according to histology (SCC vs. non-SCC, 14.9% vs. 37.5%, p=0.004). FRα expression was significantly higher in metastatic tumors than in primary (170 [IQR, 140–205] vs. 125 [IQR, 110–150], p=0.0006). High FRα expression was significantly associated with worse overall survival (hazard ratio, 6.73; 95% confidence interval, 2.21–20.53; p=0.001). Conclusion In cervical cancer, FRα expression was elevated in metastatic tumors and high expression was associated with a worse prognosis. Our study supports the development of FRα-targeted therapy for advanced cervical cancer.

[Objective] In Japan, pediatric acupuncture and moxibustion are practiced mainly in the Kansai region, and the influence of treatment experience by close relatives has been suggested to influence the treatment behavior. On the other hand, the rate of acupuncture and moxibustion treatment in Japan has been declining, and the nuclear family is also increasing.　Based on the above, we decided to conduct an awareness survey of parents regarding their expectations and concerns about pediatric acupuncture in order to understand the issues involved in receiving pediatric acupuncture treatment.[Subjects and Methods] The survey was conducted from May to December 2016 among 50 parents who participated in a self-care workshop for children and their parents held in Tokyo. The survey was a questionnaire, in which the parents' age, gender, relationship with their children, employment status and childcare support status, and age and gender of their children were ascertained.　Massage was also used as a control, and a five-item method was used with acupuncture and massage as independent variables and expectations and anxiety as dependent variables. Expectations consisted of eight items related to symptoms, such as 『childhood neurosis and asthma』, and five items related to general questions, such as 『disease prevention and relaxation』. Wilcoxon signed-rank test was used to compare acupuncture and massage.[Results] Respondents were 35.0 years old (median), 92% were women, 94% were mothers, 98% were nuclear families, 46% were working parents, 44% were housewives/househusbands, 68% had concerns about childcare, and 92% had someone to talk to about childcare.　The children were 1 year (median) and 50% were girls, 48% were boys, and 94% were singletons.　In expectation, the scores for each item were high for both acupuncture and massage (3.0-4.6 points: mean), and there was no significant difference between the two.　For anxiety, acupuncture and moxibustion scored significantly higher than massage in terms of worsening symptoms, hygiene, and effectiveness.[Discussion and Conclusion] The parents of health-conscious children attending the workshop had high expectations for pediatric acupuncture and massage, but were more concerned about worsening symptoms, hygiene, and effectiveness of acupuncture and moxibustion compared to massage.　Based on the above, we believe that acupuncture and moxibustion practitioners updating and complying with information on findings and safety measures and disseminating this information to the public at large will lead to further promotion of the behavior of receiving acupuncture and moxibustion treatment.

Aims: This study aimed at investigating the status of polypharmacy and the experience and perception of bereaved family members of patients with advanced cancer regarding the burden of oral medication. Methods: Self-administered questionnaires were mailed to 303 bereaved family members of patients with advanced cancer, and 102 valid responses were analyzed (response rate, 33.7%). Results: The number of patients in the polypharmacy group (patients taking six or more tablets at a time) was 65 and that in the non-polypharmacy group (patients taking less than six tablets at a time) was 37. The percentage of bereaved family members who felt that the oral administration burden of patients was significantly higher in the polypharmacy group (43.1% vs. 10.8%, p<0.01). The results of the analysis indicated that the bereaved families wanted to reduce the number of tablets taken at a time for alleviating the burden of polypharmacy. The bereaved families of patients in the polypharmacy group were greatly concerned that the number of oral medications was too large. They also expressed the need for medical staff from whom they could seek explanation and counseling regarding the oral medication of patients. Conclusion: It is suggested that medical staff need to be fully aware of the concerns of patients’ families regarding drugs besides checking the compliance status.