Pediatric Laryngotracheal Stenosis and Airway Reconstruction: A Review of Voice Outcomes, Assessment, and Treatment Issues

Laryngotracheal stenosis is defined as a congenital or acquired narrowing of the airway. Congenital causes may include subglottic membranous or cartilaginous narrowing. Acquired causes may include trauma due to prolonged endotracheal or tracheal intubation or laryngotracheal injury. Although advances have been made over the past 30 years in reconstructive surgeries to improve airway patency in these patients, long-term laryngeal function for voice production is not well defined in this population. This review examines causes, symptoms and signs, and methods for diagnosing laryngotracheal stenosis. Surgical management procedures are briefly summarized. The current literature on voice outcomes is summarized. The predominant voice characteristics in the population are presented, although results are challenged by the heterogeneity of voice presentation and paucity of data from instrumental measures. Considerations for subjective and instrumental assessment, measures of quality of life, instrumental methods, and treatment options specific to the needs of this population are discussed. Research strategies to identify long-term outcomes of surgical and behavioral treatments in this population are posed.     

An Asymmetric Edge-Sharing Bioctahedral Complex: (η2-DAniF)MoIII(μ-DAniF)2(μ-O,Cl)MoVCl2 (DAniF=N,N′-di-p-anisylformamidinate)

A novel asymmetric, edge-sharing bioctahedral complex with formamidinato ligands ( ²-DAniF)Mo(-DAniF)₂(-O,Cl)MoCl₂, 1, (DAniF=N,N-di-p-anisylformamidinate) has been isolated as a byproduct from the preparation of the dimolybdenum(II,III) compound Mo₂(DAniF)₃Cl₂. An X-ray crystallographic study shows that the structure consists of edge-sharing bioctahedra, with the shared edge defined by the vector joining the: -O and -Cl ligands. Compound 1 is best formulated as a mixed-valent Mo^IIIMo^V compound, the Mo(V) ion being that with the two terminal Cl^– ligands. The cyclic voltammogram of 1 shows a reversible reduction at –0.472 V and a reversible oxidation at 1.028 V vs. the Ag/AgCl reference electrode, while the absorption spectrum of 1 reveals an intense low energy absorption at 523 nm ( _max=12 500) which is attributed to an intervalence charge transfer transition. Crystallographic data for 1 are as follows: a=13.387(1) Å, b=15.500(2) Å, c=21.855(2) Å, =98.786(2)°, V=4481.8(8) ų, P2₁/c, R1 (wR2)=0.082 (0.177).     

Further studies of M3(μ3-O)(μ-X)3(μ-O2CCH3)3L3 (M=Mo,W) type clusters with nine core electrons

Four new compounds having nine cluster electrons and cores of the types Mo₃OCl₃, Mo₃OBr₃, and W₃OCl₃ are reported. Compound (1) prepared by reduction of [Bu₄N][Mo₃OCl₆(OAc)₃] in THF with metallic zinc, was shown by X-ray crystallography to be Mo₃OCl₄(OAc)₃ (THF)₂ (1). It forms crystals in space groupP2₁ with unit cell dimensionsa=9.472(2) Å,b=13.546(4) Å,c=9.652(2) Å, =101.70(2)°,V=1201(1) Å₃,Z=2. The [Mo₃(₃-O)(-Cl)₃]⁴⁺ core is surrounded by three -O₂CCH₃ anions, one Cl^–, and two THF and has Mo-Mo distances of 2.620(1) Å, 2.613(1) Å, and 2.530(1) Å, with the shortest bond between the two Mo atoms to which the THF molecules are coordinated. Compounds [Bu₄N]₂ [Mo₃OBr₆(O₂CCH₃)₃] · Me₂CO, (2) and [Mo₃OBr₃(O₂CCH₃)₃(PMe₃)₃]₃ · BF₄, (3) are the first two nine-electron Mo₃ species with a [Mo₃(₃-O) Br₃]⁴⁺ core. Both were obtained by zinc reduction of [Mo₃OBr₆(O₂CCH₃)₃]^– in the presence of (NBu₄) Br (2) or PMe₃ and NaBF₄ (3), and each was characterized crystallographically. Compound (2) crystallized in space group Cc with unit cell dimensionsa=25.037(5) Å,b=12.827(2) Å,c=21.484(4) Å, =122.96(1)⁰,V=5790(3) ų,Z=4. While the anion has no crystallographically required symmetry, its virtual symmetry is C_3v . The Mo-Mo distances are 2.619(2) Å, 2.610(3) Å, 2.644(2) Å, with a mean value of 2.624[14] Å. Compound (3) crystallized in space groupP2₁/c with unit cell dimensionsa=10.846(2) Å,b=25.033(5) Å,c=12.641(5) Å, =94.74(2)⁰,V=3420(2) ų,Z=4. The cation occupies a general position but has virtual C_3v symmetry, with Mo-Mo distances of 2.601(2) Å, 2.610(2) Å, 2.627(2) Å, with a mean value of 2.613[14] Å. Thus the anionic and cationic Mo₃ clusters in (2) and (3), respectively, have average Mo-Mo distances that are equal within experimental error. Compound (4), [NEt₄]₂ [W₃OCl₆(O₂CCH₃)₃] is the first 9-electron compound of this type containing tungsten. It was prepared by reduction of [Et₄N][W₃OCl₆(OAc)₃] in benzene with Na/Hg. It crystallized in space groupP2₁2₁2₁ with unit cell dimensionsa=11.076(2) Å,b=14.345(2) Å,c=21.026(3) Å,V=3574(1) ų,Z=4. The anion resides on a general position but has virtual C_3v symmetry, with W-W distances of 2.577(1) Å, 2.612(1) Å, 2.584(1) Å and a mean value of 2.591[15] Å.     

Reaction products of W(CO)(6) with formamidines; electronic structure of a W(2)(mu-CO)(2) core with unsymmetric bridging carbonyls

Reactions of W(CO)(6) with formamidines contrast with those of Mo(CO)(6) and Cr(CO)(6) in that the former do not yield quadruply bonded dimetal species. From the reaction of W(CO)(6) with HDAniF (HDAniF = N,N'-di-p-anisylformamidine), several new ditungsten carbonyl compounds (W(2)(mu-CO)(2)(mu-DAniF)(2)(eta(2)-DAniF)(2) (1), W(2)(mu-CO)(2)(mu-DAniF)(2)(eta(2)-DAniF)(eta(2)-CH(2)DAniF) (2), and W(2)(mu-CO)(mu-CNC(6)H(4)OCH(3))(mu-DAniF)(2)(eta(2)-DAniF)(2) (3)) have been isolated and fully characterized. In 2, CH(2)DAniF represents a DAniF ligand in which a methylene group has been added to one of the nitrogen atoms. This ligand binds to the tungsten atom using a nitrogen and a carbon atom. Compound 1 has a tungsten-tungsten bond distance of 2.476(1) A and a planar W(2)(mu-CO)(2) core structure which has C(2)(h)() symmetry with short and long W-C bond distances (1.99(1) and 2.28(1) A, respectively). DFT calculations on a model of 1 indicate that (a) the C(2)(h)() instead of D(2)(h)() symmetry of the ditungsten core may be attributed to W --> CO pi back-bonding interactions and (b) the bond between the tungsten atoms may be formulated as a double bond. The new tetragonal paddlewheel compound W(2)(DAniF)(4) (4) and the edge-sharing bioctahedron W(2)(mu-O)(mu-NC(6)H(3)Cl(2))(mu-D(Cl)PhF)(2)(eta(2)-D(Cl)PhF)(2) (5) (D(Cl)PhF = N,N'-di-(3,5-dichlorophenyl)formamidinate) have also been prepared.     

Theoretical Study of Electronic Structures and Spectra of Chalcogenido Complexes of Molybdenum, trans-Mo(Q)(2)(PH(3))(4) (Q = O, S, Se, Te)

Electronic structures of the title complexes have been studied using quantum chemical computations by different methods. It is shown that the results of Xalpha calculations agree well with expectations from classical ligand-field theory, but both are far from being in agreement with the results given by ab initio calculations. The HOMO in the ab initio Hartree-Fock molecular orbital diagrams of all these complexes is a chalcogen p(pi) lone pair orbital rather than the metal nonbonding d(xy)() orbital previously proposed. Electronic transition energies were calculated by CASSCF and CI methods. The results suggest that in the cases when Q = S, Se, and Te the lowest energy transitions should be those from the p(pi) lone pair orbitals to the metal-chalcogen pi orbitals. The calculated and observed electronic spectra of the oxo complex are in good agreement and very different from the spectra of the other complexes, and the lowest absorptions were accordingly assigned to transitions of different origins.     

New Hexazirconium Clusters Containing Hydrogen Atoms

Reduction of ZrBr₄ with HSnBu₃ yielded a blue solid. When this blue solid was treated with PMe₃, a hexanuelear cluster [Zr₆Br₁₄H₄( PMe₃)₄] (2) was isolated. Reaction of the blue solid with [PPh₄]Br in CH₂Cl₂ resulted in the formation of a paramagnetic and unstable cluster anion, [Zr₆Br₁₈H₅]^2– (3), which disproportionated to form a new cluster anion, [Zr₆Br₁₈H₅]^3– (4) and some Zr(IV) species. Compounds containing 4 can also be obtained from reaction of the blue solid with Br^– in MeCN. Reduction of ZrCl₄ with HsnBu₃ gave a red–brown solid, and [Zr₆Cl₁₄H₄(AsMe₃)₄] (9) and [Zr₅Cl₁₂H₄(AsMe₃)₅](8) were obtained by reaction of the red–brown solid with AsMe₃. No cluster compounds containing amine ligands were obtained in the reaction of the red–brown solid with amines; only compounds containing the [Zr₆Cl₁₈ H₅]^3– anion and ammonium cations were isolated. Altogether ten products were characterized by single crystal X-ray diffraction and where possible, by ¹H NMR studies.     

Influence of synthesis route on the properties of doped lanthanum cobaltite and its performance as an electrochemical reactor for the partial oxidation of natural gas

La(0.6)Sr(0.4)Co(0.2)Fe(0.8)O(3-delta)(LSCF) perovskite powders have been synthesised by solid-state reaction, co-precipitation, drip pyrolysis and citrate gel routes, and characterised using XRF, XRD, SEM and BET. Co-precipitation using oxalic acid or aqueous ammonia as precipitant failed to achieve the correct chemical composition. Perovskite structures were achieved in all other cases. Surface areas ranging from 0.6 to 17.4 m(2) g(-1) were obtained, which was reflected in the different microstructures observed. The citrate gel product exhibited a convoluted network morphology resulting in its large surface area. Thin-walled (approximately 200 microm) tubular membranes have been manufactured from the LSCF powders using viscous plastic processing. The tubes have been characterised using a custom-built gas analysis rig with on-line mass spectrometry. Porosity levels of the membranes were found to be very low (<0.1%). The spontaneous oxygen flux across the tubular membranes was determined as a function of temperature. Oxygen permeation rates ranged from 0.1 to 0.3 micromol cm(-2) s(-1) at 1273 K. The catalytic behaviour of the LSCF tubes towards methane oxidation has been studied using temperature programmed reaction and conventional catalytic measurements. The tubes favoured combustion reactions, with smaller amounts of partial oxidation and oxidative coupling products observed. Powder coatings have been incorporated to establish the effect of increasing surface area.     

Conformations of fused cycloalkanes in organometallic complexes : IV. The crystal and molecular structure of tricyclo-[6.4.0.02.7]dodeca-3,5-dienetricarbonyliron

The precise molecular structure of the title compound has been determined by single crystal X-ray diffractometry. It consists of a cyclohexadiene ring fused at the 5 and 6 positions to a cyclobutane ring which is in turn fused to a cyclohexane ring. The two six-membered rings are trans to each other with respect to the shared four-membered ring. The Fe(CO)₃ moiety is bound in the usual way to the conjugated diene portion of the cyclohexadiene ring. The feature of greatest interest is the mutual influence of the conformations of the two fused cycloalkane rings, whose intrinsically preferred conformations are mutually incompatible. Under the influence of the fused cyclohexadiene ring the C₄ ring would tend to be planar, while the cyclohexane ring would tend, of itself, to have a chair conformation. The actual result is a compromise, with the C₄ ring being folded by 15° along its diagonal and the C₆ ring having a conformation intermediate between planarity and a chair. Crystallographic data: space group, P2₁, Z = 2. Unit cell dimensions at 3°C are a = 6.176(1), b = 11.307(2), c = 9.781(2) Å and β = 92.89(2)°. A set of 1733 reflections having 2θ(Mo-K_α) < 63.7° and I > σ(I) was refined to convergence (R₁ = 0.055; R₂ = 0.034) with hydrogen atoms refined isotropically and all others anisotropically.