Recently, the size of livestock farms in Japan has been expanding and the pollution from farm wastes has become a serious problem in rural areas. Therefore it is necessary to design treatment strategies and improve the recycling of livestock manure for sustainability of agriculture in Japan. The dairy cattle waste management systems were studied at dairy farms in Aomori prefecture and in Hokkaido, Japan. The four farms, typical for the respective regions in Japan, were investigated on the basis of the land and livestock size, housing, overall farm and waste management, type of machinery and a farm labour force. A statistical comparison was made for housing, milking and waste handling systems of dairy farms. One of the waste handling strategies was aerobic slurry treatment and land irrigation of the treated liquid fraction. Such methods began to solve some of waste management problems created since 1967 in grassland farming areas of Hokkaido. The irrigation system supplies water fertiliser and organic material to land as well as shortening the spreading times. It recycles livestock resources, increases the soil fertility and rationalizes the farm management.

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Aim: Fluorescence imaging (FI) using indocyanine green (ICG) is a noteworthy alternative technique for sentinel lymph node (SLN) detection without radiation exposure in oral cavity and oropharynx cancer. However, conventional FI is monochrome, so the visibility is limited. This study assessed whether color FI using the HyperEye Medical System (HEMS) is feasible as an alternative for SLN detection. Methods: Patients with previously untreated cT1-2N0 oral or oropharyngeal cancer who were to undergo primary tumor resection and elective neck dissection (END) in our hospital were enrolled from November 2012 to March 2016. The patients underwent SLN detection for biopsy via the HEMS following the injection of ICG solution around the primary lesion before neck dissection. The visibility and the diagnostic accuracy of the imaging were evaluated.Results: SLNs were visualized in all eight cases; however, transcutaneous fluorescence detection was not observed in all cases. Utilizing color mode imaging simplified harvest by clearly discriminating SLNs from surrounding structures, while the monochrome mode proved to be more sensitive for detection. Two cases showed occult metastases on both sentinel and regional nodes. The identification and false negative rates were 100% and 0%, respectively. There were no complications incurred due to this method. Conclusion:Our results suggest that color FI with the HEMS allows for the accurate and safe harvest of SLNs with a preparatory skin incision. Although there is room for improvement of sensitivity, this easy-to-handle procedure might provide the potential to expand the role of the ICG method for SLN detection in head and neck cancer.

Reconstruction with microvascular free tissue transfer is useful for healing, appearance, and the preservation of function after head and neck cancer resection. Flap elevation, suturing, and vascular anastomosis are generally performed under microscopy by plastic surgeons. Since April 2017, however, this has been performed in our department by head and neck surgeons, except for the elevation of free jejunum. Here, we retrospectively evaluate this practice in 40 patients(41 flaps)undergoing treatment up to September 2019, focusing mainly on the perioperative period. There were 16 cases of primary tumors in the tongue and 12 cases in the hypopharynx, and almost all were advanced cancer. Pharyngolaryngoesophagectomy was performed in 13 cases, followed by subtotal tongue removal in 7 cases. Reconstruction materials consisted mainly of free jejunum in 12 cases and anterolateral thigh flap in 11 cases. Anastomosis with the pedicle was mainly done using the superior thyroid artery and internal jugular vein. Median operation time and blood loss were 603.5 minutes and 517.5ml, respectively. Intraoperative complications arose in 5 cases. Further, 17 cases had postoperative complications and reoperation was performed in 3 cases. No vascular thrombosis or leakage due to suture failure occurred. Although some points warrant improvement, performance was not significantly inferior to that in previous large studies.

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