The role of posterior aortopexy in the treatment of left mainstem bronchus compression

OBJECTIVES: We reviewed the role of posterior aortopexy for left mainstem bronchus compression in infants and children. METHODS: Eighteen children with respiratory symptoms were enrolled between 2005 and 2015 for surgical decompression of the left mainstem bronchus. The children were managed from diagnosis to follow-up by a dedicated tracheal team. Primary outcomes were the complete relief of symptoms or improvement with respect to preoperative clinical status. RESULTS: The median age was 4 years (0.3-15.4) and the median weight was 13.2 kg (3, 1-40). Symptoms or indications for bronchoscopy included difficult weaning from mechanical ventilation (n = 3, 17%), difficult weaning from tracheotomy (n = 4, 22%), recurrent pneumonia (n = 4, 22%), wheezing (n = 3, 17%), atelectasis (n = 1, 5.5%), bitonal cough (n = 1, 5.5%) and stridor (n = 2, 11%). Associated malformations were present in 88.7%. The diagnosis was made by bronchoscopy and computed tomography. Indication for surgery was the presence of pulsations and reduction in the diameter of the left mainstem bronchus compression of more than 70%. Surgery was performed by left posterolateral thoracotomy. Aortopexy was done under bronchoscopic control. No early or late deaths were observed, nor were reoperations necessary. Residual malacia was observed in 8 children (44%). Median follow-up was 4.1 years (0.1-7.1). At last follow-up, 17/18 (94.4%) children showed adequate airway patency. CONCLUSIONS: The intrathoracic location of the left mainstem bronchus predisposes it to compression. Vascular anomalies represent the most frequent causes. Aortopexy has been advocated as a safe and useful method to relieve the compression, and our results confirmed these findings. Management of these patients is challenging and requires a multidisciplinary team

Modeling of the angular tolerancing of an effective medium diffractive lens using combined finite difference time domain and radiation spectrum method algorithms

International audienceA new rigorous vector-based design and analysis approach of diffractive lenses is presented. It combines the use of two methods: the Finite-Difference Time-Domain for the study in the near field, and the Radiation Spectrum Method for the propagation in the far field. This approach is proposed to design and optimize effective medium cylindrical diffractive lenses for high efficiency structured light illumination systems. These lenses are realised with binary subwavelength features that cannot be designed using the standard scalar theory. Furthermore, because of their finite and high frequencies characteristics, such devices prevent the use of coupled wave theory. The proposed approach is presented to determine the angular tolerance in the cases of binary subwavelength cylindrical lenses by calculating the diffraction efficiency as a function of the incidence angle

Chemical Characterization and Cytotoxic and Antioxidant Activity Evaluation of the Ethanol Extract from the Bulbs of Pancratium maritimun Collected in Sicily

P. maritimum L., belonging to the Amaryllidaceae family, is a species that grows on beaches and coastal sand dunes mainly on both sides of the Mediterranean Sea and Black Sea, the Middle East, and up to the Caucasus region. It has been largely investigated due to its several interesting biological properties. With the aim of providing new insights into the phytochemistry and pharmacology of this species, the ethanolic extract of the bulbs from a local accession, not previously studied, growing in Sicily (Italy), was investigated. This chemical analysis, performed by mono- and bi-dimensional NMR spectroscopy, as well as LC-DAD-MSn, allowed to identify several alkaloids, three of which were never detected in the genus Pancratium. Furthermore, the cytotoxicity of the preparation was assessed in differentiated human Caco-2 intestinal cells by trypan blue exclusion assay, and its antioxidant potential was evaluated using the DCFH-DA radical scavenging method. The results obtained demonstrate that P. maritimum bulbs’ extract exerts no cytotoxic effect and is able to remove free radicals at all the concentrations tested

Characterization of monovarietal olive oils obtained from mills of Calabria region (Southern Italy)

AbstractThe qualitative characteristics of four monovarietal olive oils produced in Calabria region (Southern Italy) were evaluated. The aim of this work was to evidence the differences on chemical parameters due to variety and to growing environment. Results demonstrated a large variability in qualitative indexes according to the variety. Most of the Grossa di Gerace oils sampled in Ionian Southern coast revealed a high total acidity (percentage upper 0.8% of oleic acid). Fatty acid composition showed some varietal characters: in Grossa di Gerace oils possessed a low content of oleic acid and many Carolea oils showed a heptadecenoic acid level higher than 0.3% as European Rules requires for the extra virgin olive oil category. Carolea cultivar is widely grown in different sites of Calabria and so it is influenced by the different climatic conditions: the obtained oils strongly differed according to the production area