Junction chamber at vortex drop shaft: case study of Cossonay

The drainage network of the city of Cossonay (Switzerland) is currently being adapted for future needs. In particular, it is required to drain increased storm discharges due to a population augmentation, and to provide an adequate concept to overcome unfavorable geotechnical conditions. Vortex drop shafts are sewer manholes commonly applied in steep urbanized topographies to connect conduits across large elevation differences. In Cossonay, the existing 48 m high vortex drop shaft, with a diameter of 1.5 m, allowed the storm discharge to flow from the city to a watercourse issued at half of the valley height. The discharge capacity was initially assumed as 4.1 m3/s, but frequent pulsations and choking phenomena implied a reduced effective capacity of around 3.0 m3/s. A new planned vortex drop shaft will collect the supercritical inflows of four collectors in the old City Centre and spill them through a shaft of roughly 120 m height, restituting the flow at the valley bottom. It was pre-designed using FLOW-3D simulations to estimate the hydraulic features of the incoming flows and to predict the hydraulic behavior of the upper elements (before the water enters the shaft). The simulation thus included a novel junction chamber type and the steep inlet channel before the spiral intake. The numerical simulations provided a first layout of the structure that was then validated by physical model tests. The physical model was built at the Laboratory of Hydraulic Constructions (LCH) of École Polytechnique Fédérale de Lausanne (EPFL)

Multiple inflow branches at supercritical-type vortex drop shaft

Vortex drop shafts serve to overcome important elevation differences in drainage systems. If well designed, they are performant in terms of energy dissipation and safety. However, the standard design requires well-defined approach flow conditions to ensure the reliability of the structure. In practice, these conditions are frequently ignored due to space restrictions and the fact that several inflow branches may arrive at various elevations with supercritical and/or subcritical flows. The literature provides preliminary concepts for such situations that were not adaptable to the case discussed herein. Nevertheless, in order to apply a standard vortex drop shaft, a novel concept was developed that comprises a junction chamber to merge the inflow branches followed by a very short and steep inlet channel. Extended physical model tests have proven its feasibility. The hydraulic aspects discussed herein allow, at least partially, the adoption of the presented concept in similar situations

Curative treatment can be an option for patients with metastatic squamous cell cancer of the head and neck

Clémence Guenne,1 Jérôme Fayette,2 Alain Cosmidis,1 Carine Fuchsmann,1 Sophie Tartas,3 Véronique Favrel,4 Philippe Céruse1 1Head and Neck Surgery Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France; 2Medicine Department, Lyon-I University, Centre Léon Bérard, Lyon, France; 3Medical Oncology Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, 4Radiotherapy Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France Background: No specific study has focused on patients with metastatic squamous cell carcinoma of the head and neck (SCCHN) at diagnosis. Due to high response rates of induction chemotherapy in chemo-naïve patients with localized disease, their prognosis should be better than patients with recurrent disease.Methods: From January 1, 2008 to July 1, 2012, we retrospectively collected all patients’ records with SCCHN diagnosed as metastatic. Patients, disease, treatment and its results were analyzed. Survival was calculated using the Kaplan–Meier method.Results: Of the 749 new patients treated for SCCHN in our institution, 16 (2.1%) were metastatic at diagnosis, of whom five had cytological results to prove it. Six patients died before treatment or had palliative care and ten received initial chemotherapy and then surgery and/or radiotherapy according to the primary response. Four patients treated with first-line chemotherapy with docetaxel-5FU-cisplatin (TPF) showed a complete response of metastatic lesions allowing locoregional treatment. The overall survival at 1 year and 3 years was 50% and 24%, respectively. The median survival was 7 months (1–72 months). Seven patients (43.7%) had a higher survival at 12 months, including five (31.5%) who are still alive without recurrence with a mean follow-up of 30 months. There was a significant difference in overall survival (P<0.01) between patients who had chemotherapy with TPF versus other therapeutic protocols. The median survival of patients with lung metastases only was 15 months (1–72 months), significantly higher than that of patients with liver and/or bone localizations, which was 2 months (1–9 months).Conclusion: Patients with metastatic SCCHN treated by TPF followed by multimodal treatment could achieve long survival. Keywords: squamous cell carcinoma, head and neck, metastases, TPF, cetuxima

Infantile Hemangiomas of the Head and Neck

Infantile hemangiomas (IHs) are benign vascular tumors. Clinical history and physical examination are the most important factors for diagnosis, with most IHs having a typical presentation. Treatment is required for some IHs that cause significant cosmetic deformity or functional compromise. Propranolol is the first-line treatment of most IHs. Ongoing research is increasing our understanding of the pathophysiology of these tumors and should help to identify future potential therapeutic targets