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.     

Generalized inverse method for computation of molecular force field

The generalized inverse method is applied to the force constants calculation problem having a nearly singular Jacobian matrix, and by substituting it by one of lower rank which is near to it and well conditioned it is possible to eliminate the convergence difficulties of the least squares iteration process. A further significant advantage of the method is that certain matrix theoretical considerations give the possibility of deciding at the end of the iteration which force constants are determined by the available observations. Numerical results for the dimethylmercury molecule are given.     

Mamanine and pohakuline,two unprecedented quinolizidine alkaloids from sophorachrysophylla

From the bark of the endemic Hawaiian tree Sophora chrysophylla Seem. we have isolated two unprecedented quainolizidine alkaloids, mamanine (4) and pohakuline (5). Both bases are 1-hydroxymethylenequinolizidines which are linked at C-3 to α-pyridone or α-piperidone moieties. The alkaloids may be intermediates in a heretofore unknown biogenetic pathway of Sophora alkaloids.     

Determination of selenium in human tissues by atomic absorption spectrometry

A simple method is described for the determination of selenium in human tissues without the use of perchloric acid. Digestion with nitric and sulphuric acids is followed by hydride generation and atomic absorption spectrometry. Results for NBS bovine liver and IAEA horse kidney reference materials were in good agreement with assigned concentrations, as was also achieved with the perchloric acid digestion. Recovery of added selenium was >90%, and the relative standard deviation was 5.5% for within-batch and 6.9% for between-batch analyses. The values of selenium in heart tissue were 0.9–1.3 μg g^?1 dry weight.     

Distillation, on-line RP C18 preconcentration and HPLC-UV-PCO-CVAAS as a new combination for the determination of methylmercury in sediments and fish tissue

 Distillation as a way of sample digestion has been combined with on-line RP C18 preconcentration and HPLC-UV-PCO-CVAAS (high performance liquid chromatography – ultra violet – post column oxidation – cold vapour atomic absorption spectrometry) for the determination of methylmercury at background levels in sediments, soils and fish tissue. To prove the accuracy of this method, it was applied to sediment and fish tissue reference materials. The results correspond with the reference values within their error ranges. Excellent recoveries (92–95%) were obtained for the sediment samples by means of the standard addition method. The standard deviations of the sediment samples were within an acceptable range (7.2–12.5%), those of the fish samples were substantially lower (3.4–5.0%). The detection limit is 0.04 ng/g for 1 g sample weight. Received: 23 November 1995/Revised: 16 April 1996/Accepted: 20 April 1996     

Oxydative Kupplung von Indolinen und 1,2,3,4-Tetrahydrochinolinen mit Kaliumpermanganat. 153. Mitteilung über Alkaloide

It is shown that treatment of indolines like 4a-methyl-1,2,3,4,4a,9a-hexahydrocarbazole ( 1 ) and even indoline-alkaloids like 5 or 6 (cf. scheme 1) with KMnO₄ in boiling acetone solution leads to the indolenines 10, 29 and 33 , respectively, and, in relatively high yields, to N,N′- or C,N-coupling products (cf. schemes 2 and 5). The results of the oxidation of 6- or 8-methoxy-indolines are shown in schemes 3 and 4, respectively. Analogous ‘dimeric’ dehydrogenation products are observed when tetrahydroquinolines ( 8 and 9 , resp.) are treated with KMnO₄ (cf. schemes 7 and 8, resp.). The formation of the bis-compounds is almost certainly due to the coupling of two intermediate indolenyl or tetrahydroquinolyl radicals. The cleavage of the hydrazine derivatives 11 or 17 (scheme 9) also leads to ‘dimeric’ C,N-coupling products. By heating the hydrazine derivative 17 with aqueous HCl, a complete cleavage into indoline 2 and the indolenines 16 and 20 is observed. The reaction is rationalized in scheme 10. So far no naturally occurring alkaloids related to the above mentioned C,N-coupling products have been found.