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.     

Structural-acoustic coupling effect on the nonlinear natural frequency of a rectangular box with one flexible plate

The nonlinear natural frequency of a rectangular box, which consists of one flexible plate and five rigid plates, is studied in this paper. The flexible plate is assumed to vibrate like a simple piston. The behavior of the structural-acoustic coupling between the flexible plate and the air cavity is analyzed by using the proposed finite element modal method. The system finite element equation is reduced and expressed in terms of the modal coordinates with small degrees of freedom by using the proposed reduction method. The system nonlinear stiffness matrix representing the large amplitude vibration can be transformed to be a constant modal matrix. The natural frequencies are determined by using the harmonic balance method to solve the eigenvalue equations of the structural-acoustic system. The effect of the cavity depth on the natural frequencies and convergence studies are discussed in detail.     

Patterns and Symmetries in the Visual Cortex and in Natural Images

As borders between different entities, lines are an important element of natural images. Indeed, the neurons of the mammalian visual cortex are tuned to respond best to lines of a given orientation. This preferred orientation varies continuously across most of the cortex, but also has vortex-like singularities known as pinwheels. In attempting to describe such patterns of orientation preference, we are led to consider underlying rotation symmetries: Oriented segments in natural images tend to be collinear; neurons are more likely to be connected if their preferred orientations are aligned to their topographic separation. These are indications of a reduced symmetry requiring joint rotations of both orientation preference and the underlying topography. This is verified by direct statistical tests in both natural images and in cortical maps. Using the statistics of natural scenes we construct filters that are best suited to extracting information from such images, and find qualitative similarities to mammalian vision. PACS84.35+i 89.70.+c 87.57.Nk     

Timing and detuning studies of a synchronously pumped mode-locked dye laser

The timing relationship between a synchronously pumped mode-locked dye laser and its pump laser is explored experimentally and theoretically. The experimental data is in quantitative agreement with numerical solutions of a semiclassical model that includes no free parameters. The data also agrees qualitatively with an approximate, analytic distillation of this model which is presented here for the first time. Our study has a direct bearing on the jitter and the long term stability of these important ultrashort pulse lasers.     

Three New Polyoxygenated Steroids from Two Species of the South China Sea Gorgonian Muricella flexuosa and Menella verrucosa Brundin

Three new polyoxygenated steroids, muricesteroid ( 1 ), and menellsteroids A ( 2 ) and B ( 3 ), were isolated from two species of the South China Sea gorgonian Muricella flexuosa and Menella verrucosa Brundin , respectively. The structures of these new compounds were elucidated on the basis of extensive spectroscopic analysis, chemical methods and comparison with known related compounds.     

Asymmetric synthesis of homo-apioneplanocin A from d-ribose

Homo-apioneplanocin A was efficiently synthesized via stereoselective hydroxymethylation, regio- and chemoselective hydroboration, and chemoselective oxidation as key steps from d-ribose.     

A finite model property for RMImin

It is proved that the variety of relevant disjunction lattices has the finite embeddability property. It follows that Avron's relevance logic RMI _min has a strong form of the finite model property, so it has a solvable deducibility problem. This strengthens Avron's result that RMI _min is decidable. (© 2006 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Active long pulse shaping technique of pulsed CO2 laser using multi-pulse discharge control

We describe the pulse forming of pulsed CO₂ laser using multi-pulse superposition technique. Various pulse shapes, high duty cycle pulse forming network (PFN) are constructed by time sequence. This study shows a technology that makes it possible to make various long pulse shapes by activating SCRs of three PFN modules consecutively at a desirable delay time with the aid of a PIC one-chip microprocessor. The power supply for this experiment consists of three PFN modules. Each PFN module uses a capacitor, a pulse forming inductor, a SCR, a high voltage pulse transformer, and a bridge rectifier on each transformer secondary. The PFN modules operate at low voltage by driving the primary of HV pulse transformer. The secondary of the transformer has a full-wave rectifier, which passes the pulse energy to the load in a continuous sequence.We investigated various long pulse shapes as different trigger time intervals of SCRs among three PFN modules. As a result, we could obtain laser beam with various pulse shapes and durations from about 250 to 1000 μs.     

Efficient microwave induced direct α-halogenation of carbonyl compounds

A novel and direct method for the synthesis of α-halocarbonyl compounds using sequential treatment of carbonyl compounds with [hydroxy(tosyloxy)iodo]benzene followed by magnesium halides under solvent-free microwave irradiation conditions is described.