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  • Laryngeal reconstructive surgery  (2)
  • dynamics  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European archives of oto-rhino-laryngology and head & neck 254 (1997), S. 463-465 
    ISSN: 1434-4726
    Keywords: Laryngeal cartilage ; Laryngeal reconstructive surgery ; Chondrosynthesis ; Plate and screw fixation systems
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two patients treated for laryngeal tumors at the University of Lübeck are presented. Both underwent laryngeal reconstructions with plate and screw fixation systems immediately following partial laryngectomies. Recurrent disease was found at 14 and 55 months, respectively, and was subsequently managed by total laryngectomy. The laryngectomy specimens with the plate and screws in situ were evaluated histopathologically, paying special attention to the reaction of local tissue to the implants. Findings showed that the metallic plates were fixed with screws in the bony trabeculae of the laryngeal skeleton. The histological response showed primary wound healing without evidence of sequestration or implant loosening, as often associated with excess mechanical stress. Furthermore, there were no signs of tissue necrosis or widespread chronic inflammation. In both patients, a small discrete area of chronic inflammation and soft tissue fibrosis was noted adjacent to the screw heads. This study supports our previously documented clinical experience that the use of chondrosynthetic techniques is almost complication-free and is an ideal system for performing precise anatomical reconstruction of the laryngeal skeleton.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0006-3592
    Keywords: Klebsiella pneumoniae ; glycerol ; pyruvate kinase ; pyruvate:formate-lyase ; pyruvate dehydrogenase ; in vitro and in vivo activities ; dynamics ; Chemistry ; Biochemistry and Biotechnology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology , Process Engineering, Biotechnology, Nutrition Technology
    Notes: The activities of pyruvate kinase (PK), pyruvate: formate-lyase (PFL), pyruvate dehydrogenase (PDH), and citrate synthase (CS) involved in the anaerobic glycerol conversion by Klebsiella pneumoniae were studied in continuous culture under conditions of steady states and sustained oscillations. Both the in vitro and in vivo activities of PK, PFL, and PDH are strongly affected by the substrate concentration and its uptake rate, as is the in vitro activity of CS. The flux from phosphoenolpyruvate to pyruvate is found to be mainly regulated on a genetic level by the synthesis rate of PK, particularly at low substrate concentration and low growth rate. In contrast, the conversion of pyruvate to acetyl-CoA is mainly regulated on a metabolic level by the in vivo activities of PFL and PDH. The ratio of in vitro to in vivo activities is in the range of 1 to 1.5 for PK, 5 to 17 for PFL and 5 to 80 for PDH under the experimental conditions. The regulation of in vivo activity and synthesis of these enzymes is sensitive to fluctuations of culture conditions, leading to oscillations of both the in vitro and in vivo activities. In particular, PFL is strongly affected during oscillations; its average in vitro activity is only about half of its corresponding steady-state value under similar environmental conditions. The average in vitro activities of PDH and PK under oscillations are close to their corresponding steady-state values. In contrast to all other enzymes measured for the glycerol metabolism by K. pneumoniae PFL and PDH are more effectively in vivo utilized under oscillations than under steady state, underlining the peculiar role of pyruvate metabolism in the dynamic responses of the culture. © 1998 John Wiley & Sons, Inc. Biotechnol Bioeng 60: 617-626, 1998.
    Additional Material: 11 Ill.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 0006-3592
    Keywords: Klebsiella pneumoniae ; glycerol dissimilation ; 1,3-propanediol ; in vitro and in vivo enzyme activities ; dynamics ; Chemistry ; Biochemistry and Biotechnology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology , Process Engineering, Biotechnology, Nutrition Technology
    Notes: The initial steps of glycerol dissimilation and 1,3-propanediol (1,3-PD) formation by Klebsiella pneumoniae anaerobically grown on glycerol were studied by quantifying the in vitro and in vivo activities of enzymes in continuous culture under conditions of steady state and oscillation and during transient phases. The enzymes studied included glycerol dehydrogenase (GDH), glycerol dehydratase (GDHt), and 1,3-propanediol oxidoreductase (PDOR). Three conclusions can be drawn from the steady-state results. First, glycerol concentration in the culture is a key parameter that inversely affects the in vitro activities (concentrations) of all three enzymes, but has a positive effect on their in vivo activities. Growth rate significantly affects the ratio of in vitro and in vivo enzyme activities under low glycerol concentrations, but not under glycerol excess. Second, whereas the flux through the oxidative pathway of glycerol dissimilation is governed mainly by the regulation of in vivo enzyme activity on a metabolic level, the flux through the reductive pathway is largely controlled by the synthesis of enzymes. Third, GDHt is a major rate-liming enzyme for the consumption of glycerol and the formation of 1,3-PD in K. pneumoniae at high glycerol concentrations. Results from oscillating cultures revealed that both in vitro and in vivo activities of the enzymes oscillated. The average values of the in vitro activities during an oscillation cycle agreed well with their corresponding values for nonoscillating cultures under similar environmental conditions. Experiments with step changes in the feed concentration of glycerol demonstrated that growth and product formation are very sensitive to changes of substrate concentration in the culture. This sensitivity is due to the dynamic responses of the genetic and metabolic networks. They should be considered when modeling the dynamics of the culture and attempting to improve the formation of 1,3-PD. © 1998 John Wiley & Sons, Inc. Biotechnol Bioeng 59: 544-552, 1998.
    Additional Material: 11 Ill.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European archives of oto-rhino-laryngology and head & neck 253 (1996), S. 481-487 
    ISSN: 1434-4726
    Keywords: Bone plates ; Bone screws ; Laryngeal cartilage ; Laryngeal reconstructive surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to investigate and develop techniques for stabilization and reconstruction of laryngeal defects with a method similar to osteosynthesis. In an anatomical study, 400 extrusion forces of sutures and various screws (Howmedica) were measured in the thyroid cartilage of fresh cadavers. A new screw was then especially designed for cartilage and a new technique was developed for stabilizing cartilage, using a screw-nut made out of bone. To date, 30 patients have undergone chondrosynthetic reconstruction of the larynx. Measurements of extrusion forces were found to depend on the degree of calcification present in the area of the laryngeal skeleton examined and the type of fixation device used. Good clinical results were achieved in all 30 patients studied and depended on stabilization of the two sides of the thyroid cartilage after thyrotomies, bridging of laryngeal defects and splinting of laryngeal fractures. Besides the increased extrusion forces the advantages of chondrosynthesis lay within the possibilities of axial stabilization and exact bridging of defects with or without implants.
    Type of Medium: Electronic Resource
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