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.     

Structure of neutron-rich Be and C isotopes

The structure of neutron-rich beryllium isotopes has been investigated using different heavy-ion-induced transfer reactions. In neutron transfer reactions, the population of final states shows a strong sensitivity to the chosen core nucleus, i.e., the target nuclei ⁹Be or ¹⁰Be, respectively. Molecular rotational bands up to high excitation energies are observed with ⁹Be as the core due to its pronounced 2α-cluster structure, whereas only a few states at low excitation energies are populated with ¹⁰Be as the core. For ¹¹Be, a detailed investigation has been performed for the three states at 3.41, 3.89, and 3.96 MeV, which resulted in the most probable spin-parity assignments 3/2⁺, 5/2^?, and 3/2^?, respectively. Furthermore, we have studied particle-hole states of ¹⁶C using the ¹³C(¹²C, ⁹C)¹⁶C reaction and found 14 previously unknown states. Using the ¹²C(¹²C, ⁹C)¹⁵C reaction, five new states were observed for ¹⁵C.     

Palladium-catalyzed pseudo-domino cyclizations: An easy entry toward polycondensed pyrrolidone derivatives

A new type I palladium-catalyzed pseudo-domino process is developed, in which a single Pd-based catalytic system promotes two mechanistically unrelated, sequential catalytic cycles in chronologically distinct order. Suitable precursors undergo an allylic alkylation and a Heck coupling in sequence, affording polycondensed pyrrolidone derivatives. Depending on the starting precursors, intra/inter or doubly intramolecular processes can be obtained. The allylic alkylation process takes place always very smoothly. On the other hand, the Heck coupling turns out to be rather difficult either when the process is intermolecular, or when an intramolecular process generates polycondensed structures featuring three fused bonds connected to a common carbon atom. In such difficult cases, use of the Herrmann-Beller phosphapalladacycle allowed to catalyze the coupling. This study demonstrates also that allylic alkylations can be catalyzed by the Herrmann-Beller phosphapalladacycle.     

Oxygen-distribution imaging with a novel two-tracer laser-induced fluorescence technique

We introduce a new technique for imaging oxygen concentrations in fuel/air mixtures that takes advantage of the different responses of toluene and 3-pentanone to collisional quenching by molecular oxygen. Since laser-induced fluorescence signals from both tracers upon excitation at 248 nm are spectrally well separated, simultaneous detection is possible. The technique is first applied to instantaneous imaging in turbulent mixing processes of interacting seeded air and nitrogen flows. Received: 1 August 2001 / Revised version: 29 October 2001 / Published online: 29 November 2001