Head Unit Research Articles

An audit of CT chest surveillance following oral cancer treatment

Computed tomography (CT) of the chest is an integral part of the staging of patients with oral cancer. It identifies metastases, synchronous pulmonary primaries, and detects small nodules of indeterminate character that require a follow-up scan. We aimed to find out how many patients with small nodules had had subsequent scans, and the outcome of those who did. Between 2010 and 2013, 413 patients with oral squamous cell carcinoma (SCC) were treated with curative intent or were actively monitored at the Merseyside and Cheshire Regional Surgical Head and Neck Unit. A total of 324 (78%) had CT at diagnosis. The scans of 246 were clear, metastases were detected in 4, and 51 showed abnormalities. Forty-nine of the patients with abnormalities were recommended for further interval scans but only 20 (41%) actually had them. Further pathological findings were found in 11 (increase in the size of the nodule n=2; metastatic disease n=5; and primary pulmonary tumour n=4). A substantial number of patients did not have the recommended follow-up scans and potentially serious disease was found in some who did. As a result of this audit we have changed the process regarding the booking of CT surveillance scans, and we now check periodically that they have been done. The audit will be repeated to include other sites in the head and neck.

Editorial introductions

Current Opinion in Otolaryngology & Head and Neck Surgery was launched in 1993. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of otolaryngology and head and neck surgery are divided into 11 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Piero NicolaiFigurePiero Nicolai was born in Mantua, Italy, on November 12, 1954. He is Professor and Chairman of the Otorhinolaryngology – Head and Neck Surgery Unit and Director of the Department of Surgical Specialties, Radiologic Sciences, and Public Health of the University of Brescia, Italy. He received his MD degree at the University of Padua, Italy, where he also completed his residency programme in otolaryngology and subsequently in medical oncology. His clinical and research activities are mainly focused on head and neck oncology and endoscopic sinus and skull base surgery. Prof. Nicolai is an active member of several medical societies: Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Società Italiana del Basicranio, European Skull Base Society, American Academy of Otolaryngology – Head and Neck Surgery, European Rhinologic Society, European Laryngological Society, American Head and Neck Society, American Rhinologic Society, American Laryngological Association, Cartesian Society, European Academy of Oto-Rhino-Laryngology, Head and Neck Surgery, Associazione Italiana Oncologia Cervico Cefalica, and Italian Academy of Rhinology. He is currently serving as Secretary of the European Academy of Oto-Rhino-Laryngology, Head and Neck Surgery and as Member of the Executive Committee of the European Skull Base Society. In 2009, he was awarded the American Academy of Otolaryngology-Head and Neck Surgery Honor Award in recognition of his volunteer contributions to the Academy and its Foundation. Prof. Nicolai has authored or co-authored 178 papers in peer-reviewed journals as well as 49 book chapters. He was co-Editor of a book on Imaging in Treatment Planning for Sinonasal Diseases, and Editor of 4 issues of Current Opinion in Otolaryngology & Head and Neck Surgery on Head and Neck Oncology. He is a member of the editorial board of 5 journals: Annals of Otology, Rhinology & Laryngology, Current Opinion in Otolaryngology & Head and Neck Surgery, Head & Neck, International Journal of Head and Neck Surgery, and The Laryngoscope. Cesare PiazzaFigureCesare Piazza is Assistant Professor of the Department of Otorhinolaryngology – Head and Neck Surgery at the University of Brescia, Italy. He received his MD degree at the University of Pavia, Italy and completed his residency programme in Otolaryngology in Brescia. His clinical and research activities are focused on head and neck oncology, with special emphasis to laryngeal, tracheal, oral (including laser and robotic surgery), and reconstructive microsurgery. Dr Piazza has been an active member of the European Laryngological Society since 2000 and part of its Scientific Council since September 2010. He has been a member of the European Board of Examination for Otorhinolaryngology – Head and Neck Surgery since November 2011. He has authored or co-authored 89 papers in peer-reviewed journals as well as 69 book chapters. He has delivered 605 papers and invited lectures in national and international congresses and courses. He has served as Section Editor of the Current Opinion in Otolaryngology & Head and Neck Surgery journal for the Head and Neck Oncology issue since 2010 and as a member of its Editorial Board since 2013.

A retrospective review of Lip Squamous Cell Carcinoma characteristics as Predictors of Nodal Spread

Current staging of Squamous Cell Carcinoma originating from the lip focuses on tumor size. It was thought that this American Joint Committee on Cancer (tumor–node–metastasis) staging system, whilst practical, may have shortcomings in predicting the risk of loco-regional or metastatic spread of lip tumors. This is a research highlight of a recent study performed through a rural multidisciplinary head & neck cancer unit analyzing 68 patients with primary lip SCC’s [1] . Overall 12 patients developed metastasis with increased risk of spread in patients with tumors of increased thickness (U = 103.50; degrees of freedom = 68; p < 0.001), those with a larger overall tumor size (U = 163.50; degrees of freedom = 68; p = 0.005) and patients living further from the treatment center at time of disease diagnosis (U = 199.00; degrees of freedom = 68; p = 0.018).This suggests that factors other then overall tumor size/staging have an important prognostic & staging role in patients with SCC of the lip.

One‐year swallowing outcomes following transoral laser microsurgery +/− adjuvant therapy versus primary chemoradiotherapy for advanced stage oropharyngeal squamous cell carcinoma

To assess the between-group change in swallowing function from baseline to 12 months following treatment, for patients treated for resectable stage III and IVA oropharyngeal squamous cell carcinoma. To assess the within-group change in swallowing function between 3 and 12 months following treatment. Non-randomised cohort study. A single head and neck cancer unit with oncology services held at the nearby regional treatment centre. Twenty-five patients treated with Transoral Laser Microsurgery +/- adjuvant (chemo)radiotherapy (Transoral Laser Microsurgery) observed alongside an historic cohort of 33 patients treated with (chemo)radiotherapy. The patient reported MD Anderson Dysphagia Inventory (MDADI), an objective timed Water Swallow Test, and the clinician rated normalcy of diet subsection of the Performance of Swallowing Scale . Between baseline and 12 months, patients treated with primary (chemo)radiotherapy demonstrated greater deterioration in swallowing function compared to Transoral Laser Microsurgery for all 3 swallowing measures. Between 3 and 12 months, the only significant change was an improvement in Performance of Swallowing Scale scores in the (chemo)radiotherapy group. This is the first study to report the results of a complimentary set of swallowing measures for patients treated with Transoral Laser Microsurgery, observed alongside a cohort of (chemo)radiotherapy patients. The preliminary results suggest a benefit in swallowing function for Transoral Laser Microsurgery over (chemo)radiotherapy during the year following treatment.

천마 탐지레이더 Limit&STC 조립체 개선을 통한 탐지성능 향상

In this paper, we have described the performance improvement of surveillance radar to prevent damage or malfunction of surveillance radar RF head unit due to the strong reflections caused by artificial obstacles at close range. We have proposed a technique to improve the performance of the RF head unit as a solution to overcome the limitations of the operating system and improve radar performance. We have verified the effectiveness of the improvement by comparing the before and after results applied to actual system.

Osteoradionecrosis following treatment for head and neck cancer and the effect of radiotherapy dosimetry: the Guy's and St Thomas' Head and Neck Cancer Unit experience

To analyze clinical features, dosimetric parameters, and outcomes of osteoradionecrosis (ORN). Thirty-six patients with ORN who had been previously treated with radiotherapy (RT) were retrospectively identified between January 2009 and April 2014. ORN volumes were contoured on planning computed tomography (CT) scans. Near maximum dose (D2%), minimum dose (Dmin), mean dose (Dmean), and percentage of bone volume receiving 50Gy (V50) were examined. Clinical and dosimetric variables were considered to compare ORN resolution versus ORN persistence. Median interval time from end of RT to development of ORN was 6months. Of the ORN cases, 61% were located in the mandible. Dmean to affected bone was 57.6Gy, and 44% had a D2% 65Gy or greater. Smoking was associated with ORN persistence on univariate analysis, but no factors were found to impact ORN resolution or progression on logistic regression. Prevention strategies for ORN development should be prioritized. Dose-volume parameters could have a role in preventing ORN.

The role of gender on malaria preventive behaviour among rural households in Kenya.

BackgroundMalaria remains a major health and development challenge in the sub-Saharan African economies including Kenya, yet it can be prevented. Technologies to prevent malaria are available but are not universally adopted by male- and female-headed households. The study thus, examined the role of gender in malaria prevention, examining adoption behaviour between male- and female-headed households in Kenya.MethodsThe study uses a recent baseline cross-section survey data collected from 2718 households in parts of western and eastern Kenya. Two separate models were estimated for male- and female-headed households to determine if the drivers of adoption differ between the two categories of households.ResultsThe findings from the study show that: access to public health information, residing in villages with higher experience in malaria prevention, knowledge on the cause and transmission of malaria significantly increase the number of practices adopted in both male- and female-headed households. On the other hand, formal education of the household head and livestock units owned exhibited a positive and significant effect on adoption among male-headed households, but no effect among female-headed households.ConclusionsThe findings from thus study suggest that universal policy tools can be used to promote uptake of integrated malaria prevention practices, for female- and male-headed households.

Clinical Outcome of Parotidectomy with Reconstruction: Experience of a Regional Head and Neck Cancer Unit.

Background:Salivary gland pathologies represent a histologically diverse group of benign and malignant neoplasms. Currently, World Health Organization recognizes 13 benign and 24 malignant variants of all salivary gland neoplasms. Surgery continues to remain the main-stay for treatment of parotid gland neoplasms. The aim of this study was to document our experiences of the patients treated for parotid tumors and find out if any compelling variable predicted the relative clinical outcomes.Materials and Methods:This was a retrospective study, from records of parotidectomies performed at the operating theatre by the head and neck cancer division of the study institution between 2010 and 2013. Eligibility for study inclusion included cases with benign or malignant parotid neoplasms requiring surgical management with or without adjunct radiotherapy. The predictors of postoperative complications, overall survival (OS), and disease-free survival (DFS) were analyzed.Results:A total of 20 patients underwent parotidectomy. The mean age was 42 years. Tumors were located on the left parotid in 13 cases (65%) and the right parotid in 7 cases (35%). The surgical procedures comprised 16 superficial parotidectomies, 1 total parotidectomy, and 3 radical parotidectomy (inclusive of facial nerve sacrifice) and 2 neck dissections levels II–V. The reconstructive procedures were 2 facial nerve branch cable grafts, 1 end-to-end facial-facial nerve branch anastomoses, and 2 facial re-animation surgeries (temporalis muscle suspensions). A total of five cases (33.3%) had postoperative complications. 2 variables (length of surgery and neck dissection) were found to have an impact on postoperative complications that were statistically significant. Additionally, length of surgery was a significant predictor on the 2 years OS and DFS.Conclusion:The result of this study showed good clinical outcome, especially in the benign cases. The comprehensive clinical outcome of the malignant cases could not be objectively assessed, as the OS and DFS were 50% at 2-years follow-up. It is our submission that a larger sample size is utilized in subsequent studies and quality of life evaluation is included in the methodology.

先頭部の改良による蠕動運動型ロボットの曲管の通過性能の改善

To reduce the risk of serious accidents, such as road subsidence caused by damaged and aging sewer pipes, internal inspections of sewer pipes is required. However, it is difficult to inspect small diameter pipes using existing inspection devices. In order to solve this challenge, this paper focuses on the locomotion of an earthworm that is capable of moving stably in a narrow space. A peristaltic crawling robot was developed which was capable of traveling 100 m through a 100A specification pipe using a peristaltic movement. The robot consists of a seven unit section, six joints, and a head unit equipped with a camera. It is actuated with the use of an artificial muscle operated by air pressure. In this study, the authors proposed and validated a new reaf spring to increase the robot speed in 90° elbow pipes.

複雑な管路を考慮した圧送管検査用蠕動運動型ロボットの開発

To reduce the risk of serious accidents, such as road subsidence caused by damaged and aging sewer pipes, internal inspections of sewer pipes is required. However, it is difficult to inspect small diameter pipes using existing inspection devices. In order to solve this challenge, this paper focuses on the locomotion of an earthworm that is capable of moving stably in a narrow space. A peristaltic crawling robot was developed which was capable of traveling 100 m through a 100A specification pipe using a peristaltic movement. The robot consists of a seven unit section, six joints, and a head unit equipped with a camera. It is actuated with the use of an artificial muscle operated by air pressure. The effectiveness of the new robot was evaluated by conducting experiments in horizontal, vertical, and bent pipes. In addition, the authors proposed and validated a new movement pattern to increase the robot speed in 90° elbow pipes.

Attitude disturbance correction for binocular vision cameras in rendezvous and docking

Vision-based relative position and attitude measurement methods are widely used in rendezvous and docking (RVD). For example, a structured light vision-based sensor (the advanced video guidance sensor) was included as one of the primary proximity navigation sensors in the Orbital Express mission [1]. A monocular vision-based sensor (hand–eye camera mounted on the end effector and monitor camera mounted on the first joint of the robot arm) is used in Engineering Test Satellite No. 7 to locate cooperative targets [2]. In the Front-end Robotics Enabling Near-term Demonstration, a binocular vision-based sensor (camera head unit LIDAR) is used to locate noncooperative targets [3].

Analysis of deaths between 2007 and 2012 of patients with cancer of the head and neck on a surgical ward at a regional centre and in an independent hospice

Providing the best care for patients dying from cancer of the head and neck is crucial, and their complex, unpredictable needs, particularly at the end of life, mean that they are likely to die in institutional care. To evaluate the care given at the end of life we retrospectively reviewed the case notes of patients who died between 2007 and 2012 in a regional head and neck unit and a specialist palliative care unit (hospice). Deaths were categorised as sudden (rapid or unanticipated) or expected (gradual or anticipated). A total of 105 patients died, of whom 29 were excluded from analysis because records were missing. Of the remaining 76, 63 died in the head and neck unit and 13 in the hospice. Patients who died the hospice were younger (mean (SD) age 63.7 (11.0) years) than those who died in hospital (mean (SD) age 70.6 (11.9) years). Most had stage III or IV disease (head and neck unit 45/57, 79%, hospice 9/13, 69%). Death was sudden in 33 (43%) and expected in 43 (57%). Haemorrhage was the commonest cause of sudden death (n=13) and carcinomatosis (n=17) the commonest cause of expected death. Specialists in palliative care had been involved in the care of 13 patients who died suddenly (39%) and 34 whose deaths were expected (79%). The family was present at the time of death (or was aware of it) in 30 who died suddenly (91%) and in 40 (93%) whose deaths were expected. In patients with cancer of the head and neck death can be sudden because of unpredictable complications, and everyone should be aware of this.

MicroASC instrument onboard Juno spacecraft utilizing inertially controlled imaging

This contribution describes the post-processing of the raw image data acquired by the microASC instrument during the Earth-fly-by of the Juno spacecraft. The images show a unique view of the Earth and Moon system as seen from afar. The procedure utilizes attitude measurements and inter-calibration of the Camera Head Units of the microASC system to trigger the image capturing. The triggering is synchronized with the inertial attitude and rotational phase of the sensor acquiring the images. This is essentially works as inertially controlled imaging facilitating image acquisition from unexplored perspectives of moons, asteroids, icy rocks and planetary rings.

OTONOMI DAERAH DALAM PERSEPEKTIF PEMBAGIAN URUSAN PEMERINTAH-PEMERINTAH DAERAH DAN KEUANGAN DAERAH

Framework of the Unitary Republic of Indonesia of the concepts embodied in the provisions of Article 18 paragraph (1) of the Constitution of the Republic of Indonesia in 1945, the Republic of Indonesia is divided into provincial regions and districts are divided into, each province, district government gets, the regulated by law. Local authorities at provincial and district levels have different strengths according to the level. With patterns and delegation of authority given to the attributes of the local government is subject to the provisions of Law No. 32 of 2004 on local governments, to organize and manage themselves well with the pattern of decentralization of government policy. In carrying out regional autonomy, which is assisted by the head unit area of each region as part of the elements to run local autonomy. Financial management should be based on the concept of accountability and transparency to the public. Keywords: Local Government and Affairs Division of the Central Government and Local Government

Oxyethylene chain length affects the physicochemical properties of sugar-based anionic surfactants with phosphates groups

In this study we prepared a series of novel sugar based anionic-polyoxyethylene stearyl ether surfactants through reactions of propylene glycol dextrin with oxirane-containing polyoxyethylene stearyl ethers and phosphorus oxychloride. These surfactants, which contain polyoxyethylene chains and sodium phosphonate groups as hydrophilic moieties, exhibited surface activities superior to those of traditional surfactants containing only one nonpolar or hydrophobic moiety and one polar head unit. The critical micelle concentration (cmc), surface excess concentration at the surface (Γcmc) and standard free energy of micellization per mole (ΔGm°) of these surfactants decreased upon increasing the length of their polyoxyethylene chain. In addition, we used UV–vis spectroscopy to study the interactions of dyes with these sugar based anionic surfactants in solution, the results shows that the interaction of the dye and surfactant molecules and the type of dye–surfactant aggregate formed will depend upon chemical structure of dye and surfactant.

Vascularized tissue transfer in head and neck surgery: Is intensive care unit-based management necessary?

To study the impact of a non-intensive care unit (ICU)-based postoperative management strategy on patient outcomes following vascularized free tissue transfer for head and neck surgical defects. Retrospective cohort study. The patients consisted of two groups of adults who underwent vascularized free tissue transfer for head and neck reconstruction between July 2007 and June 2012, at an academic and a community-based hospital. By protocol, the first group of patients had a planned admission to the intensive care unit. After creation of a designated head and neck surgical unit, the second group was cared for in a protocol driven, non-ICU setting. Outcomes and costs were compared between the two patient groups. There was no adverse impact on flap survival, inpatient morbidity, or mortality with the implementation of postoperative care outside of an ICU. The patients who stayed in the ICU in the immediate postoperative period had a longer median length of hospital stay (ICU vs. non-ICU, 8 days [interquartile range {IQR}= 7-11 days] vs. 7 days [IQR = 6-9.5 days], P = .001). Median hospital charges and cost of care for patients who received ICU-based care (US$109,367 [IQR = US$88,112-US$130,833] and US$33,642 [IQR = US$28,143-US$43,196], respectively) were significantly higher than those for non-ICU-based care (US$86,195 [IQR = US$71,208-US$101,199] and US$28,524 [IQR = US$22,611-US$33,226], P < .0001). We demonstrate that care in a non-intensive care setting following vascularized free tissue transfer is safe, less costly, and decreases length of hospital stay compared to routine intensive care-based management.

Squamous cell carcinoma of the lip: depth of invasion, local recurrence and regional metastases. Experience of a rural multidisciplinary head and neck unit.

The internationally recognised American Joint Committee on Cancer (tumour-node-metastasis) staging system utilises tumour size to determine stage. Other factors (i.e. tumour depth) may provide additional prognostic information. A thorough retrospective analysis was performed of 68 patients with primary lip squamous cell carcinoma operated on or discussed by the Darling Downs Health Service between 2005 and 2013. Twelve patients developed lymphatic spread. There was a statistically significant increased risk of nodal metastasis in: patients with tumours of increased thickness (U = 103.50; degrees of freedom = 68; p < 0.001), those with a larger overall tumour size (U = 163.50; degrees of freedom = 68; p = 0.005) and patients living further from the treatment centre (U = 199.00; degrees of freedom = 68; p = 0.018). It may be reasonable that other factors are considered for staging of lip squamous cell carcinomas, in combination with tumour-node-metastasis staging. Depth of invasion may have utility in prognosis and treatment; however, larger prospective analysis needs to be performed. Patients living in a more rural setting presented with more advanced disease, suggesting an ongoing rural-metropolitan gap in healthcare.

Editorial introductions

Current Opinion in Otolaryngology & Head and Neck Surgery was launched in 1993. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of otolaryngology and head and neck surgery are divided into 11 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Piero NicolaiPiero NicolaiPiero Nicolai was born in Mantua, Italy, on November 12, 1954. He is Professor and Chairman of the Otorhinolaryngology – Head and Neck Surgery Unit and Director of the Department of Surgical Specialties, Radiologic Sciences, and Public Health of the University of Brescia, Italy. He received his MD degree at the University of Padua, Italy, where he also completed his residency programme in otolaryngology and subsequently in medical oncology. His clinical and research activities are mainly focused on head and neck oncology and endoscopic sinus and skull base surgery. Prof. Nicolai is an active member of several medical societies: Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Società Italiana del Basicranio, European Skull Base Society, American Academy of Otolaryngology - Head and Neck Surgery, European Rhinologic Society, European Laryngological Society, American Head and Neck Society, American Rhinologic Society, American Laryngological Association, Cartesian Society, European Academy of Oto-Rhino-Laryngology, Head and Neck Surgery, Associazione Italiana Oncologia Cervico Cefalica, and Italian Academy of Rhinology. He is currently serving as Secretary of the European Academy of Oto-Rhino-Laryngology, Head and Neck Surgery and as Member of the Executive Committee of the European Skull Base Society. In 2009, he was awarded the American Academy of Otolaryngology - Head and Neck Surgery Honor Award in recognition of his volunteer contributions to the Academy and its Foundation. Prof. Nicolai has authored or co-authored 178 papers in peer-reviewed journals as well as 49 book chapters. He was co-Editor of a book on Imaging in Treatment Planning for Sinonasal Diseases, and Editor of 4 issues of Current Opinion in Otolaryngology & Head and Neck Surgery on Head and Neck Oncology. He is a member of the editorial board of 6 journals: Annals of Otology, Rhinology & Laryngology, Current Opinion in Otolaryngology & Head and Neck Surgery, Head & Neck, International Journal of Head and Neck Surgery, and The Laryngoscope. Cesare PiazzaCesare PiazzaCesare Piazza is Assistant Professor of the Department of Otorhinolaryngology – Head and Neck Surgery at the University of Brescia, Italy. He received his MD degree at the University of Pavia, Italy and completed his residency programme in otolaryngology in Brescia. His clinical and research activities are focused on head and neck oncology, with special emphasis to laryngeal, tracheal, oral (including laser and robotic surgery), and reconstructive microsurgery. Dr Piazza has been an active member of the European Laryngological Society since 2000 and part of its Scientific Council since September 2010. He has been a member of the European Board of Examination for Otorhinolaryngology – Head and Neck Surgery since November 2011. He has authored or co-authored 80 papers in peer-reviewed journals as well as 66 book chapters. He has delivered 524 proffered papers and invited lectures in national and international congresses and courses. He has served as Section Editor of the Current Opinion in Otolaryngology & Head and Neck Surgery journal for the Head and Neck Oncology issue since 2010 and as a member of its Editorial Board since 2013.

The prospective development of Climate and Environmental Research Laboratory of AARI, Roshydromet, after gaining the grant of Russian Science Foundation

In November 2010 a new research unit was inaugurated in Arctic and Antarctic Research Institute (St. Petersburg) – Climate and Environmental Research Laboratory (CERL) – that became the first lab in Russia dedicated to the complex studies of ice cores, paleoclimate and subglacial environments in Antarctica. The total investments to construct the laboratory were 28.8 million rubles, provided by Roshydromet and AARI in frames of implementing the program of International Polar Year. The total area of the laboratory is about 300 m² that includes mass-spectrometric and gas analyses labs, cold chambers and utility rooms. The CERL’s equipment comprises laser stable water isotope analyzer Picarro L2120-i, IR mass-spectrometer Delta V Plus, system of gas extraction from ice, facilities for ice petrographic observations, for ice core treatment and storage. Before 2014 CERL was the head unit in the project “Complex studies of Lake Vostok and glaciological investigations of Antarctica” of the sub-program “Antarctica” of the FTP “World Ocean”. Now CERL is the leading organization in International Associated Laboratory “Ice archives of climatic and environmental data” that combines 4 French and 5 Russian scientific research groups. In 2014 the specialists of CERL won a grant of Russian Science Foundation for fundamental scientific works implemented by operating research laboratories. Project 14-27-00030 “Evolution of climate, glaciation and subglacial environments of Antarctica from the deep ice core and Lake Vostok water sample studies” (2014–2016) is intended to refine the reconstruction of Antarctic climate history over the past 400,000 years using the newly developed geochemical methods of ice core studies. Another goal is to develop the approaches to study the hydrological parameters of subglacial Lake Vostok using the samples of lake ice and water. The funding to be received through the grant (58.5 million rubles) will be mainly spent to develop the analytical infrastructure of the laboratory. In particular, we plan to equip the “Delta” with the dual inlet system and “Gas Bench II” device, as well as to purchase the new generation of laser isotope analyzer, Picarro L2140-i. This will allow us to measure precisely the concentrations of deuterium, oxygen 18 and 17 in water, snow and ice samples, to define the О₂/N₂ ratio in the gas probes, as well as to develop new methods of ice core analyses.

Regional Myocutaneous Flaps for Head and Neck Reconstruction: Experience of a Head and Neck Cancer Unit.

Background:Pectoralis major myocutaneous pedicle flap and other regional myocutaneous pedicle flaps (RMF), despite the superiority shown by free flaps, have remained relevant in the reconstruction of major head and neck oncologic defects. It has continued to find relevance as the preferred reconstruction of choice in some general head and neck reconstructive applications. While its role has been defined in developed environment, the same cannot be said for developing environment. The aim thus, was to review our experiences with RMFs in head and neck reconstructions, with a view to evaluating the indications and outcomes in a limited opportunity environment with some free flaps expertise.Materials and Methods:This was a retrospective cohort study from records of RMF cases performed for head and neck reconstruction, at the study institution. Eligibility for study inclusion comprised case cohorts with advanced head and neck diseases requiring ablative surgery and reconstruction with pectoralis major flaps and other RMFs.Results:A total of 17 cases were treated with RMFs. 10 were pectoralis major flaps while 7 were other RMFs. The main indications were failed free flaps and financial constraints. No regional pedicle flap failure was recorded; however, complication rate was 35.5% (6/17).Conclusion:Pectoralis major flaps and other RMFs were very reliable option for head and neck reconstruction. Free flap failure and financial constraints were the main indications for RMF reconstruction indications in head and neck reconstruction in a developing environment with some free flap expertise.