Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 19 de 19
Filter
Add more filters










Publication year range
1.
J Biotechnol ; 298: 45-56, 2019 Jun 10.
Article in English | MEDLINE | ID: mdl-30959136

ABSTRACT

In order to maximize cell growth and productivity for an inducible CHO cell line expressing rituximab, various fed-batch culture strategies were investigated. In each case, the performance was evaluated for cultures induced at moderate and high cell density conditions (4 × 106 and 10 × 106 cells/mL) to assess the impact of the timing of induction. We first demonstrate the importance of starting the feeding process during the growth phase, as this translated into significantly improved integral of viable cells and antibody concentration, when compared to post-induction feeding only. Secondly, we investigated the impact of the feed rate by maintaining different levels of glucose (25, 35 and 50 mM) via a dynamic feeding strategy. The highest antibody concentrations were achieved under a moderate feeding regime for both cell densities at induction, highlighting the risks of under- or over-feeding the cultures. We then evaluated the impact of performing a temperature shift at induction by testing different mild hypothermia conditions. At small-scale, the highest production yields (1.2 g/L) were achieved when the temperature was reduced from 37 to 30 °C during the production phase of a culture induced at high cell density. When the strategy was applied in bioreactor, the better controlled conditions led to even greater product concentrations (1.8 g/L). Furthermore, this production protocol was shown to promote a more galactosylated glycan profile than a bioreactor culture initiated at 34 °C during growth and downshifted to 30 °C during the production phase.


Subject(s)
Antibodies, Monoclonal/biosynthesis , Batch Cell Culture Techniques/methods , Cell Proliferation/genetics , Rituximab/biosynthesis , Animals , Antibodies, Monoclonal/chemistry , Antibodies, Monoclonal/genetics , CHO Cells , Cell Survival/genetics , Cricetulus , Glucose/metabolism , Humans , Rituximab/chemistry , Rituximab/genetics
2.
Bioprocess Biosyst Eng ; 42(5): 711-725, 2019 May.
Article in English | MEDLINE | ID: mdl-30673843

ABSTRACT

Mammalian-inducible expression systems are increasingly available and offer an attractive platform for the production of recombinant proteins. In this work, we have conducted process development for a cumate-inducible GS-CHO cell-line-expressing rituximab. To cope with the limitations encountered in batch when inducing at high cell densities, we have explored the use of fed-batch, sequential medium replacements, and continuous perfusion strategies applied during the pre-induction (growth) phase to enhance process performance in terms of product yield and quality. In shake flask, a fed-batch mode and a complete medium exchange at the time of induction were shown to significantly increase the integral of viable cell concentration and antibody titer compared to batch culture. Further enhancement of product yield was achieved by combining bolus concentrated feed additions with sequential medium replacement, but product galactosylation was reduced compared to fed-batch mode, as a result of the extended culture duration. In bioreactor, combining continuous perfusion of the basal medium with bolus daily feeding during the pre-induction period and harvesting earlier during the production phase is shown to provide a good trade-off between antibody titer and product galactosylation. Overall, our results demonstrate the importance of selecting a suitable operating mode and harvest time when carrying out high-cell-density induction to balance between culture productivity and product quality.


Subject(s)
Batch Cell Culture Techniques , Bioreactors , Rituximab/biosynthesis , Animals , CHO Cells , Cricetinae , Cricetulus , Recombinant Proteins/biosynthesis , Recombinant Proteins/isolation & purification , Rituximab/isolation & purification
3.
Biotechnol Prog ; 35(1): e2742, 2019 01.
Article in English | MEDLINE | ID: mdl-30414355

ABSTRACT

Inducible mammalian expression systems are becoming increasingly available and are not only useful for the production of cytotoxic/cytostatic products, but also confer the unique ability to uncouple the growth and production phases. In this work, we have specifically investigated how the cell culture state at the time of induction influences the cumate-inducible expression of recombinant rituximab by a GS-CHO cell line. To this end, cells grown in batch and fed-batch cultures were induced at increasing cell densities (1 to 10 × 10 6 cells/mL). In batch, the cell specific productivity and the product yield were found to reduce with increasing cell density at induction. A dynamic feeding strategy using a concentrated nutrient solution applied prior and postinduction allowed to significantly increase the integral of viable cells and led to a 3-fold increase in the volumetric productivity (1.2 g/L). The highest product yields were achieved for intermediate cell densities at induction, as cultures induced during the late exponential phase (10 × 10 6 cells/mL) were associated with a shortened production phase. The final glycosylation patterns remained however similar, irrespective of the cell density at induction. The kinetics of growth and production in a 2 L bioreactor were largely comparable to shake flasks for a similar cell density at induction. The degree of galactosylation was found to decrease over time, but the final glycan distribution at harvest was consistent to that of the shake flasks cultures. Taken together, our results provide useful insights for the rational development of fed-batch cell culture processes involving inducible CHO cells. © 2018 American Institute of Chemical Engineers Biotechnol. Prog., 35: e2742, 2019.


Subject(s)
Rituximab/metabolism , Animals , Batch Cell Culture Techniques , Bioreactors , Biotechnology , CHO Cells , Cricetinae , Cricetulus , Glycosylation
4.
Bioprocess Biosyst Eng ; 39(2): 267-76, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26677137

ABSTRACT

Several recent studies demonstrated significant charge storage in electrochemical biofilms. Aiming to evaluate the impact of charge storage on microbial fuel cell (MFC) performance, this work presents a combined bioelectrochemical-electrical (CBE) model of an MFC. In addition to charge storage, the CBE model is able to describe fast (ms) and slow (days) nonlinear dynamics of MFCs by merging mass and electron balances with equations describing an equivalent electrical circuit. Parameter estimation was performed using results of MFC operation with intermittent (pulse-width modulated) connection of the external resistance. The model was used to compare different methods of selecting external resistance during MFC operation under varying operating conditions. Owing to the relatively simple structure and fast numerical solution of the model, its application for both reactor design and real-time model-based process control applications are envisioned.


Subject(s)
Bioelectric Energy Sources , Models, Theoretical
5.
Water Environ Res ; 82(4): 362-73, 2010 Apr.
Article in English | MEDLINE | ID: mdl-20432655

ABSTRACT

The Activated Sludge Model No. 1 was chosen as the basis for model development and was modified to take into account the specific characteristics of pulp and paper effluents. The model was incorporated to the GPS-X simulation environment (Hydromantis, Hamilton, Ontario, Canada) to study operating deficiencies and nutrient transformations, particularly in relation to bulking. The results show that the process of ammonification is not significant at the studied mill and that the process of phosphatification (transformation of soluble organic phosphorus into orthophosphates) seems to be related to settling problems, as indicated by the sludge volume index. The phosphatification rate and the standard oxygen-transfer efficiency were found to decrease as the system entered a bulking state. Understanding the behavior of pulp and paper activated sludge can be improved by the incorporation of industry-specific processes and components to comprehensive models. These models then can be used to gain insight to the causes of bulking.


Subject(s)
Hot Temperature , Mechanics , Models, Theoretical , Paper , Sewage , Waste Disposal, Fluid/methods , Industrial Waste , Waste Disposal, Fluid/instrumentation
6.
J Virol Methods ; 165(1): 83-9, 2010 Apr.
Article in English | MEDLINE | ID: mdl-20116403

ABSTRACT

The preparation of large amount of purified helper-dependent adenoviral vector material is hampered by the lack of development of downstream processes with proven records on separation and recovery efficiencies. In order to facilitate the use of clinical-grade helper-dependent virus material for large-scale in vivo studies, a three-step purification scheme consisting of (1) an anion-exchange chromatography for initial capturing of virus, (2) a shallow iodixanol density gradient ultracentrifugation for the removal of helper virus from helper-dependent virus, and (3) a size-exclusion chromatography for the removal of iodixanol and residual protein contaminants as a polishing step was developed. The use of a fast iodixanol density ultracentrifugation step was highly effective in separating infectious helper-dependent virus from contaminating helper virus. The overall downstream processing scheme gave 80% infectious particle yield. The contamination ratio of helper virus in the helper-dependent virus preparation are reduced from 2.57 to 0.03% corresponding to a reduction of helper virus by factors of 85 by two iodixanol purification steps. It was also demonstrated that size-exclusion chromatography is an excellent step for the removal of iodixanol and polishing of the final helper-dependent virus preparation.


Subject(s)
Adenoviridae/isolation & purification , Genetic Vectors/isolation & purification , Helper Viruses/isolation & purification , Triiodobenzoic Acids , Ultracentrifugation/methods , Virology/methods , Chromatography, Gel/methods , Chromatography, Ion Exchange/methods , Humans
7.
Biotechnol Prog ; 26(2): 532-41, 2010.
Article in English | MEDLINE | ID: mdl-19938168

ABSTRACT

A perfusion small-scale bioreactor allowing on-line monitoring of the cell energetic state was developed for free-suspension mammalian cells. The bioreactor was designed to perform in vivo nuclear magnetic resonance (NMR) spectroscopy, which is a noninvasive and nondestructive method that permits the monitoring of intracellular nutrient concentrations, metabolic precursors and intermediates, as well as metabolites and energy shuttles, such as ATP, ADP, and NADPH. The bioreactor was made of a 10-mm NMR tube following a fluidized bed design. Perfusion flow rate allowing for adequate oxygen supply was found to be above 0.79 mL min(-1) for high-density cell suspensions (10(8) cells). Chinese hamster ovary (CHO) cells were studied here as model system. Hydrodynamic studies using coloration/decoloration and residence time distribution measurements were realized to perfect bioreactor design as well as to determine operating conditions bestowing adequate homogeneous mixing and cell retention in the NMR reading zone. In vivo (31)P NMR was performed and demonstrated the small-scale bioreactor platform ability to monitor the cell physiological behavior for 30-min experiments.


Subject(s)
Bioreactors , Cell Culture Techniques/methods , Magnetic Resonance Imaging/methods , Animals , CHO Cells , Cell Count , Cell Culture Techniques/instrumentation , Cricetinae , Cricetulus , Phosphorus Isotopes , Reproducibility of Results , Rheology , Suspensions
8.
Plant Biotechnol J ; 7(9): 939-51, 2009 Dec.
Article in English | MEDLINE | ID: mdl-19843248

ABSTRACT

A dynamic model for plant cell metabolism was used as a basis for a rational analysis of plant production potential in in vitro cultures. The model was calibrated with data from 3-L bioreactor cultures. A dynamic sensitivity analysis framework was developed to analyse the response curves of secondary metabolite production to metabolic and medium perturbations. Simulation results suggest that a straightforward engineering of cell metabolism or medium composition might only have a limited effect on productivity. To circumvent the problem of the dynamic allocation of resources between growth and production pathways, the sensitivity analysis framework was used to assess the effect of stabilizing intracellular nutrient concentrations. Simulations showed that a stabilization of intracellular glucose and nitrogen reserves could lead to a 116% increase in the specific production of secondary metabolites compared with standard culture protocol. This culture strategy was implemented experimentally using a perfusion bioreactor. To stabilize intracellular concentrations, adaptive medium feeding was performed using model mass balances and estimations. This allowed for a completely automated culture, with controlled conditions and pre-defined decision making algorithm. The proposed culture strategy leads to a 73% increase in specific production and a 129% increase in total production, as compared with a standard batch culture protocol. The sensitivity analysis on a mathematical model of plant metabolism thus allowed producing new insights on the links between intracellular nutritional management and cell productivity. The experimental implementation was also a significant improvement on current plant bioprocess strategies.


Subject(s)
Bioreactors , Biotechnology/methods , Cell Culture Techniques/methods , Models, Biological , Plants/metabolism , Algorithms , Computer Simulation , Culture Media
9.
J Biosci Bioeng ; 108(2): 160-7, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19619865

ABSTRACT

The effects of Na-butyrate on the physiological behaviour and on the specific productivity of recombinant tissue plasminogen activator (t-PA) Chinese Hamster Ovary (CHO) cells were characterized. Batch cultures were performed in a 3.5-L bioreactor. Na-butyrate was added either at the mid-exponential growth phase (48 h) or at the end of the exponential growth phase (74 h). The cultures with Na-butyrate showed higher net specific productivity of t-PA and lower final cell density and viability. Maximum specific productivity of t-PA for all cultures coincided with the early plateau phase (84 h). The cell's specific oxygen uptake rate (qO2) increased after the Na-butyrate addition and remained higher than that of the controlled culture. Triphosphate nucleotides, ADP, AMP and UDP-sugars all increased after 84 h in the cultures with Na-butyrate, showing different behaviours when Na-butyrate was added at 48 h or 74 h. Na-butyrate did not affect the cell's adenylate energy charge until the cell's viability started to decrease (156-168 h). The controlled culture and the culture with Na-butyrate addition, showed at 74 h, similar time trends as for purine and nucleotide ratios ((ATP+GTP)/(UTP+CTP) and UTP/ATP) with clear shifts in behaviour at 84 h and 168 h. However, the addition of Na-butyrate at 48 h resulted in damped variations of purine and nucleotide ratios in comparison to both the control culture and the culture with Na-butyrate addition at 74 h.


Subject(s)
Butyrates/pharmacology , Energy Metabolism/drug effects , Recombinant Proteins/biosynthesis , Tissue Plasminogen Activator/biosynthesis , Animals , CHO Cells , Cell Culture Techniques , Cricetinae , Cricetulus , Humans , Nucleotides/metabolism , Time Factors
10.
Biotechnol Prog ; 25(3): 676-82, 2009.
Article in English | MEDLINE | ID: mdl-19496144

ABSTRACT

This study demonstrates real-time maximization of power production in a stack of two continuous flow microbial fuel cells (MFCs). To maximize power output, external resistances of two air-cathode membraneless MFCs were controlled by a multiunit optimization algorithm. Multiunit optimization is a recently proposed method that uses multiple similar units to optimize process performance. The experiment demonstrated fast convergence toward optimal external resistance and algorithm stability during external perturbations (e.g., temperature variations). Rate of the algorithm convergence was much faster than in traditional maximum power point tracking algorithms (MPPT), which are based on temporal perturbations. A power output of 81-84 mW/L(A) (A = anode volume) was achieved in each MFC.


Subject(s)
Bioelectric Energy Sources , Biotechnology/methods , Conservation of Energy Resources/methods , Algorithms , Microelectrodes , Models, Biological , Sewage/chemistry
11.
J Theor Biol ; 259(1): 118-31, 2009 Jul 07.
Article in English | MEDLINE | ID: mdl-19281825

ABSTRACT

A previously developed kinetic metabolic model for plant metabolism was used in a context of identification and control of intracellular phosphate (Pi) dynamics. Experimental data from batch flask cultures of Eschscholtiza californica cells was used to calibrate the model parameters for the slow dynamics (growth, nutrition, anabolic pathways, etc.). Perturbation experiments were performed using a perfusion small-scale bioreactor monitored by in vivo(31)P NMR. Parameter identification for Pi metabolism was done by measuring the cells dynamic response to different inputs for extracellular Pi (two pulse-response experiments and a step-response experiment). The calibrated model can describe Pi translocation between the cellular pools (vacuole and cytoplasm). The effect of intracellular Pi management on ATP/ADP and phosphomonoesters concentrations is also described by the model. The calibrated model is then used to develop a control strategy on the cytoplasmic Pi pool. From the identification of the systems dynamics, a proportional-integral controller was designed and tuned. The closed-loop control was implemented in the small-scale NMR bioreactor and experimental results were in accordance with model predictions. Thus, the calibrated model is able to predict cellular behaviour for phosphate metabolism and it was demonstrated that it is possible to control the intracellular level of cytoplasmic Pi in plant cells.


Subject(s)
Computer Simulation , Cytoplasm/metabolism , Phosphates/metabolism , Plants/metabolism , Bioreactors , Kinetics , Magnetic Resonance Imaging
12.
Biotechnol Adv ; 26(1): 73-88, 2008.
Article in English | MEDLINE | ID: mdl-17964108

ABSTRACT

Adeno-associated viral vectors have emerged as one of the most studied vectors for gene therapy. Numerous production methods have been described, each with its advantages and disadvantages. A challenge in assessing the current state of the art exists in comparing yields from one production system to the next due to the wide variety of quantification techniques. In this review, AAV vector production methods are summarized and the yields of the different processes are standardized to the number of harvested cells. Titers are further streamlined into five categories: transduction units, enhanced transduction units, infectious particles, DNase-resistant particles and total particles, and the importance of each type of measure is discussed.


Subject(s)
Dependovirus/genetics , Gene Transfer Techniques , Genetic Vectors/analysis , Animals
13.
Environ Sci Technol ; 41(3): 978-83, 2007 Feb 01.
Article in English | MEDLINE | ID: mdl-17328212

ABSTRACT

This study presents a temperature-based control strategy for the stabilization of an anaerobic reactor during organic overloads. To prove feasibility of the proposed approach the rate of methane production was followed in batch activity tests and reactor runs during mesophilic-thermophilic transitions. Within the first 0.25-6 h of temperature augmentation, an increase in the rate of methane production was observed with higher rates measured under thermophilic (above 40 degrees C) conditions. However, 24 h after startup both in batch tests and reactor runs, the rate of methane production under thermophilic conditions was inferior to that under optimal mesophilic conditions (35 degrees C). Following these results, a control strategy based on short-term augmentation of the reactor temperature was proposed and tested in a 10 L UASB reactor. The control strategy employed a multi-model observer-based estimator to stabilize the effluent COD concentration during organic overloads. The temperature-based control resulted in an increased methanization rate and improved reactor stability overall.


Subject(s)
Bioreactors , Waste Disposal, Fluid/methods , Water Purification/methods , Anaerobiosis , Methane/chemistry , Methane/metabolism , Models, Biological , Oxygen/chemistry , Oxygen/metabolism , Temperature , Time Factors
14.
Biotechnol Bioeng ; 97(6): 1501-9, 2007 Aug 15.
Article in English | MEDLINE | ID: mdl-17274066

ABSTRACT

Vectors based on adeno-associated viruses (AAV) are sought for therapeutic gene delivery because of their ability to transduce a variety of tissues with no significant immunological response. Production using the baculovirus expression vector (BEV)/insect cell system has the potential to meet the needs for pre-clinical and clinical trials. In this co-infection system, three baculoviruses are used to produce the AAV vector. A strategy aimed at increasing encapsidation/maturation of the viral vector involved varying the temperature over the course of the process. Cultures were subjected to temperature changes at various times pre- and post-infection (up to 24 h post-infection). It was found that raising the culture temperature to 30 degrees C at the time of infection nearly tripled the infectious titer. In fact, increasing the temperature to 30 degrees C at any time in the process investigated resulted in an increase in titer. Also, raising the culture to 33 degrees C or lowering the temperature to 24 degrees or 21 degrees C resulted in lower titers. The rise in infectious titer was also confirmed by an increase in DNase resistant particles (DRPs). Varying the temperature, however, did not affect the total amount of capsids significantly. Therefore increasing the culture temperature resulted in better encapsidation as determined by the ratio of capsids to DRPs to infectious particles. It is believed that an increase in early proteins and possibly a quicker cascade of baculovirus infection events resulted in this increased packaging efficiency.


Subject(s)
Adenoviridae/physiology , Cell Culture Techniques/methods , Genetic Vectors/genetics , Spodoptera/genetics , Spodoptera/virology , Virus Cultivation/methods , Animals , Cell Line , Genetic Enhancement/methods , Spodoptera/cytology , Temperature
15.
Biotechnol Bioeng ; 95(6): 1081-92, 2006 Dec 20.
Article in English | MEDLINE | ID: mdl-16952153

ABSTRACT

The production of viral vectors or virus-like particles for gene therapy or vaccinations using the baculovirus expression system is gaining in popularity. Recently, reports of a viral vector based on adeno-associated virus (AAV) produced in insect cells using the baculovirus expression vector system have been published. This system requires the triple infection of cells with baculovirus vectors containing the AAV gene for replication proteins (BacRep), the AAV gene for structural proteins (BacCap), and the AAV vector genome (BacITR). A statistical approach was used to investigate the multiplicities of infection of the three baculoviruses and the results were extended to the production of AAVs containing various transgenes. Highest AAV yields were obtained when BacRep and BacCap, the baculovirus vectors containing genes that code for proteins necessary for the formation of the AAV vector, were added in equal amounts at high multiplicities of infection. These combinations also resulted in the closest ratios of infectious to total AAV particles produced. Overexpression of the AAV structural proteins led to the production of empty AAV capsids, which is believed to overload the cellular machinery, preventing proper encapsidation of the AAV vector transgene, and decreased the viability of the insect cells. Delaying the input of BacCap, to reduce the amount of capsids produced, resulted in lower infectious AAV titers then when all three baculoviruses were put into the system at the same time. The amount of BacITR added to the system can be less than the other two without loss of AAV yield.


Subject(s)
Baculoviridae/metabolism , Dependovirus/metabolism , Genetic Vectors/genetics , Animals , Biotechnology/methods , Capsid/chemistry , Cell Line , Gene Transfer Techniques , Genetic Techniques , Genetic Therapy/methods , Humans , Models, Statistical , Spodoptera , Time Factors , Transgenes
16.
Biotechnol Bioeng ; 86(7): 765-74, 2004 Jun 30.
Article in English | MEDLINE | ID: mdl-15162452

ABSTRACT

One of the major limitations in the production of adenoviral vectors is the reduction in cell-specific productivity observed for increasing cell density at infection in batch cultures. This observation strongly suggests some nutrient depletion and/or metabolite inhibition in the media. These limitations have been partially overcome through other feeding strategies, such as fed-batch and sequential batch operations. To improve these results, we evaluated perfusion as a strategy to increase the volumetric productivity of HEK-293 cell cultures, by allowing productive infection at higher cell densities. An acoustic cell separator was employed in consideration of the increased shear sensitivity of the cells during the infection phase. The effects of perfusion rate and cell density at infection on the production of a recombinant adenovirus expressing the GFP were investigated. The perfusion mode allowed successful infection at cell densities in the range of 2.4-3 x 10(6) cell/mL, while maintaining a similar cell specific productivity (17,900 +/- 2400 VP/cell) to that of a batch infected at a low cell density (5 x 10(5) cell/mL). The highest virus concentrations (4.1 +/- 0.6 x 10(10) VP/mL) were attained for a feed rate of 2 vol/d and constituted a fivefold increase compared to a batch with medium replacement. Rapid assessment of the infection status was achieved through the use of on-line monitoring of respiration, fluorescence, and biovolume. Analysis of the kinetics of nutrient consumption and metabolite production revealed that a reduction in specific productivity is correlated with reduced metabolic activity.


Subject(s)
Adenoviridae/growth & development , Adenoviridae/genetics , Genetic Vectors/genetics , Virology/methods , Acoustics , Bioreactors/virology , Cell Count , Cell Culture Techniques , Cell Line , Cell Survival , Humans , Kinetics , Perfusion/methods
17.
Article in English | MEDLINE | ID: mdl-14970776

ABSTRACT

OBJECTIVE: We sought to investigate the impact of head and neck cancer treatment on salivary function. STUDY DESIGN: The study was conducted on 54 patients with advanced squamous cell carcinoma with confirmed (n = 50) or suspected (n = 4) primary oropharyngeal localization who were treated with radiation alone or in combination with surgery or chemotherapy, or both. The following groups were considered in the evaluation: 1, the entire pool of patients; 2, those undergoing surgery and those not undergoing surgery before radiation; 3, those undergoing resection and those not undergoing resection of the submandibular gland. The flow rates, pH, and buffering capacity were determined before, during, and up to 12 months after the completion of radiation. RESULTS: Head and neck surgery, particularly when submandibular gland resection was performed, had a negative impact on salivary flow rates but did not influence pH or buffering capacity. Nonetheless, the effect of surgery on salivary flow rates decreased progressively and disappeared at 3 to 6 months after radiotherapy. More than two thirds of the salivary output was lost during radiation treatment. All patients were experiencing salivary dysfunction at 1 year after completion of radiotherapy, with average decreases of 93% (P < .0001) and 95% (P < .0001) for whole resting salivary flow and whole stimulated salivary flow, respectively, compared with the preradiotherapy values. The buffering capacity decreased to 67% of its preradiotherapy value, and whole stimulated saliva became acidic. CONCLUSIONS: The result of this study confirms that cancer treatment involving full-dose radiotherapy (RTH) to all major salivary glands for locally advanced squamous cell carcinoma of the oropharynx induces severe hyposalivation with alteration of salivary pH and buffering capacity. Head and neck surgery has a negative impact on salivary flow rates, especially when the submandibular gland is removed. However, surgery before irradiation is not a factor aggravating hyposalivation when postoperative radiotherapy includes all the major salivary glands.


Subject(s)
Carcinoma, Squamous Cell/radiotherapy , Oropharyngeal Neoplasms/radiotherapy , Salivary Glands/radiation effects , Adult , Aged , Analysis of Variance , Buffers , Carcinoma, Squamous Cell/surgery , Chemotherapy, Adjuvant , Female , Follow-Up Studies , Humans , Hydrogen-Ion Concentration , Male , Middle Aged , Oropharyngeal Neoplasms/surgery , Prospective Studies , Saliva/radiation effects , Salivary Glands/metabolism , Secretory Rate/radiation effects , Submandibular Gland/surgery , Xerostomia/etiology
19.
Rev Med Suisse Romande ; 122(10): 495-8, 2002 Oct.
Article in French | MEDLINE | ID: mdl-12494782

ABSTRACT

The objective of "oral medicine" is to integrate medical knowledge and dental knowledge. This article emphasizes the importance of such integration in the management of medically compromised patients by the dentist. The aging population and the increasing number of medically compromised patients result in a situation where the dentist must adapt the diagnosis ant the treatment of oral lesions to both the patient general history and the patient medication history. The main systemic diseases affecting oral health are reviewed, emphasizing the care required by this category of patients, the importance of links between medicine and dentistry and the requirements for graduate and postgraduate education in comprehensive medicine.


Subject(s)
Dental Care , Dentistry , Family Practice , Education, Dental , Education, Medical, Graduate , Humans , Interprofessional Relations , Medical History Taking , Oral Health , Patient Care Planning , Patient Care Team
SELECTION OF CITATIONS
SEARCH DETAIL
...