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1.
Free Radic Res ; 49(2): 113-21, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25363554

RESUMEN

Seven nitroxides of different structures were studied for the ability to prevent glycoxidation of bovine serum albumin incubated with three monosaccharides (glucose, fructose, and ribose). Glycoxidation was estimated by fluorimetric parameters of protein modifications (formation of advanced glycation end products [AGEs], dityrosine, N'-formylkynurenine, and kynurenine) and enzyme-linked immunosorbent assay for AGEs. From among the nitroxides tested, (2,2,6,6-tetramethylpiperidin-1-yl)oxyl (TEMPO), 4-carboxy-TEMPO, and 4-hydroxy-TEMPO offered significant protection against glycoxidation induced by glucose and fructose, while 3-carbamoyl-PROXYL was not protective, enhancing glycoxidation. Lower protection was observed for glycoxidation induced by ribose where only 3-carbamoyl-PROXYL and 4-amino-TEMPO showed some protection. Loss of electron spin resonance signal of the nitroxides was observed during glycoxidation indicating occurrence of free radical reactions in this process. These results suggest for the first time that nitroxides may be promising compounds for preventing glycoxidation.


Asunto(s)
Antioxidantes/farmacología , Óxidos N-Cíclicos/farmacología , Monosacáridos/química , Productos Finales de Degradación de Proteínas/análisis , Fructosa/química , Glucosa/química , Glicosilación/efectos de los fármacos , Oxidación-Reducción/efectos de los fármacos , Ribosa/química , Albúmina Sérica Bovina/química
2.
Biotechnol Appl Biochem ; 61(5): 593-602, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24433188

RESUMEN

Diamond nanoparticles find numerous applications in pharmacy, medicine, cosmetics, and biotechnology. However, possible adverse cellular effects of diamond nanoparticle cells have been reported, which may limit their use. The aim of this study was to compare the effect of nonmodified diamond nanoparticles (D) and diamond nanoparticles modified by the Fenton reaction (D+OH) on human umbilical cord endothelial cells (HUVEC-ST). We found that both D and D+OH show time- and concentration-dependent cytotoxicity, inducing apoptosis and necrosis of HUVEC-ST. Interaction with D and D+OH also induced changes in the production of reactive oxygen and nitrogen species and changes in the level of glutathione and activities of antioxidant enzymes in the cells. These data demonstrate that diamond nanoparticles may induce oxidative stress in human endothelial cells, which contributes to their cytotoxic effects seen at higher concentrations of D and D+OH.


Asunto(s)
Homeostasis/efectos de los fármacos , Células Endoteliales de la Vena Umbilical Humana/efectos de los fármacos , Nanodiamantes/toxicidad , Estrés Oxidativo/efectos de los fármacos , Materiales Biocompatibles/toxicidad , Línea Celular , Supervivencia Celular/efectos de los fármacos , Humanos , Especies de Nitrógeno Reactivo/análisis , Especies de Nitrógeno Reactivo/metabolismo , Especies Reactivas de Oxígeno/análisis , Especies Reactivas de Oxígeno/metabolismo
3.
Biotechnol Appl Biochem ; 60(2): 259-65, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23586587

RESUMEN

In recent years, the development of nanotechnology opens up new prospects for biomedical applications of unmodified and chemically modified diamond nanoparticles (DNPs). The problem of biocompatibility of DNPs is thus of primary importance. The first step in the modification of DNPs is usually the introduction of -OH groups, which can bind other functional groups. One of the basic methods to introduce -OH groups onto DNPs is the Fenton reaction. The aim of this study was to compare the effect of unmodified DNPs and nanoparticles modified by the Fenton reaction on human endothelial cells. Ultradisperse diamond (UDD) was modified by the Fenton reaction introducing surface -OH groups. Immortalized human umbilical cord endothelial cells (HUVEC-ST) were incubated with 2-100 µg/mL nanopowders in the opti-MEM medium. For comparison, graphite powder (GRAF and GRAF+OH) was also employed. UDD and GRAF augmented generation of reactive oxygen species in the cells after 24 H incubation, estimated by oxidation of 2',7'-dichlorofluorescin diacetate (H2DCF-DA). Cellular production of nitric oxide, estimated with DAF-FM-DA (3-amino-4-aminomethyl 2',7'-dichlorofluorescein diacetate), was also affected by UDD and GRAF after 24 H. Fenton-modified OH, in contrast to unmodified diamond, decreased NO production. Detonation nanoparticles also affected the cellular content of glutathione and activities of main antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, and glutathione S-transferase). This article was published online on 5 February 2013. Errors in the byline and affiliation line were subsequently identified. This notice is included in the online and print versions to indicate that both have been corrected 18 April 2013.


Asunto(s)
Diamante , Endotelio Vascular/metabolismo , Especies de Nitrógeno Reactivo/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Catalasa/metabolismo , Línea Celular Transformada , Endotelio Vascular/citología , Endotelio Vascular/enzimología , Glutatión Peroxidasa/metabolismo , Glutatión Reductasa/metabolismo , Glutatión Transferasa/metabolismo , Humanos , Óxido Nítrico/biosíntesis , Espectroscopía Infrarroja por Transformada de Fourier , Superóxido Dismutasa/metabolismo
4.
Food Addit Contam ; 24(6): 553-60, 2007 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-17487596

RESUMEN

The complexes of antioxidant ethoxyquin (1,2-dihydro-6-ethoxy-2,2,4-trimethylquinoline; EQ) with rutin or quercetin (EQ-R and EQ-Q, respectively) were studied in human lymphocytes for genotoxic and antioxidant activities with the use of the comet assay and micronucleus test. The study was undertaken to search for new potential antioxidants, and was motivated by reports of unfavourable side-effects observed in animals fed with feeds containing EQ, which is allowed up to 150 mg kg(-1) (0.015%) in complete animal feed. It was shown that EQ-R induced DNA damage in human lymphocytes when used at all the concentrations studied (1-25 microM), while after EQ-Q treatment, the genotoxic effect was observed mainly after higher doses (10 and 25 microM). An increase in the number of micronuclei was observed only for EQ-Q after a dose of 50 microM. The studied compounds decreased the degree of DNA damage induced by hydrogen peroxide (10 microM) in the comet assay. The results obtained in both tests showed that the antioxidant activity of EQ-Q was comparable with that of EQ, so further detailed studies are necessary to estimate its possible usefulness as a feed preservative.


Asunto(s)
Alimentación Animal/análisis , Antioxidantes/farmacología , Daño del ADN , Etoxiquina/toxicidad , Flavonoides/toxicidad , Células Cultivadas , Ensayo Cometa , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Peróxido de Hidrógeno/farmacología , Linfocitos/efectos de los fármacos , Pruebas de Micronúcleos , Quercetina/toxicidad , Rutina/toxicidad
5.
Mutat Res ; 542(1-2): 117-28, 2003 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-14644360

RESUMEN

The chromosomal aberration test was employed to investigate the effect in vitro of a known antioxidant and food preservative, ethoxyquin (EQ, 1,2-dihydro-6-ethoxy-2,2,4-trimethylquinoline) on human chromosomes. The studies were undertaken because there are no published in vitro data on genotoxicity of EQ in mammalian cells and there are many reports pointing out that it may be harmful to animals and human beings. Lymphocytes obtained from three healthy donors were incubated with EQ (0.01-0.5mM) both with and without metabolic activation. Stability studies performed by HPLC analysis showed that EQ was stable under the conditions of the lymphocyte cultures. The results of the chromosome aberration assay showed that EQ induces chromosome aberrations: gaps and breaks as well as dicentrics and atypical translocation chromosomes.


Asunto(s)
Aberraciones Cromosómicas/inducido químicamente , Etoxiquina/toxicidad , Conservantes de Alimentos/toxicidad , Linfocitos/efectos de los fármacos , Mutágenos/toxicidad , Células Cultivadas , Cromatografía Líquida de Alta Presión , Estabilidad de Medicamentos , Etoxiquina/química , Etoxiquina/metabolismo , Femenino , Conservantes de Alimentos/química , Conservantes de Alimentos/metabolismo , Humanos , Índice Mitótico , Mutágenos/química , Mutágenos/metabolismo , Análisis de Regresión
6.
Biometals ; 14(2): 159-70, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11508849

RESUMEN

The aim of this study was to evaluate the effect of piperidine nitroxides and their amine precursors on deoxyribose oxidation in the Fenton system. Protecting activity of nitroxides was found to be concentration-dependent and strongly influenced by ring substituents, while secondary amines did not provide any protection. The reported results suggest a mechanism of nitroxide action through iron oxidation rather than through direct scavenging of hydroxyl radicals. Moreover, presented data point to the danger of interference of nitroxides during the TBARS assay procedure.


Asunto(s)
Desoxirribosa/química , Óxidos de Nitrógeno/metabolismo , Sustancias Protectoras/metabolismo , Aminas/química , Aminas/metabolismo , Antioxidantes/química , Antioxidantes/metabolismo , Óxidos N-Cíclicos/química , Óxidos N-Cíclicos/metabolismo , Desoxirribosa/metabolismo , Radicales Libres/química , Radicales Libres/metabolismo , Peróxido de Hidrógeno , Hierro , Espectroscopía de Resonancia Magnética , Estructura Molecular , Óxidos de Nitrógeno/química , Oxidación-Reducción , Sustancias Protectoras/química , Marcadores de Spin , Relación Estructura-Actividad , Superóxido Dismutasa/metabolismo , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismo
7.
Anticancer Res ; 20(4): 2421-6, 2000.
Artículo en Inglés | MEDLINE | ID: mdl-10953305

RESUMEN

The results presented herein clearly indicate that nitroxide derivatives--free radicals are effective as substrates for one-electron oxidation in the peroxidase cycle involving hydrogen peroxide, which have been the subject of considerable controversy. This oxidation is catalyzed enzymatically and it might occur in tumor cells (in vivo) where the level of ROS (H2O2 and O2.-) is increased. The result of this reaction involving hydrogen peroxide is the obligative formation of the oxo-ammonium cation involved in the superoxide dismutase-mimic reaction of nitroxides with superoxide and/or in reaction with H2O2 leading to superoxide formation and regeneration of the parent nitroxide molecule. The efficiency of this enzymatically catalyzed oxidation of nitroxide(s) depends on the structure of the substituent in position 4 of nitroxide ring as follows: -OCH3 > -NHCOCH3 > -NHCOCH2CH3. Notably, the reduced nitroxide salt was not substrate for peroxidatic oxidation clearly indicating the importance of the free radical moiety of the nitroxide molecule. These findings may have some relevance in the recent investigations of antioxidant properties/mechanisms of nitroxides. Based on these considerations we hypothesize that the administration of oxidizable free radical nitroxide compounds--antioxidants may be a useful strategy in the treatment and investigations of cancer diseases. An in vivo study ("Screening test of chemicals employing Yoshida Sarcoma animals") was carried out to verify whether the structure and/or the chain length of substituent of oxidizable nitroxide derivatives--antioxidants could influence their apoptotic activity. The results reported in this study are encouraging as we found a limited correlation between the molecular oxidative properties of nitroxides under study, their structure and antitumor (apoptotic) action. In conclusion, this work demonstrates that investigation of the structure-dependent oxidation of antioxidatively acting nitroxides can become a very important step in their future screening and selection for applications in vivo and in vitro.


Asunto(s)
Antineoplásicos/farmacología , Apoptosis/efectos de los fármacos , Piperidinas/farmacología , Sarcoma de Yoshida/tratamiento farmacológico , Animales , Femenino , Oxidación-Reducción , Ratas , Ratas Wistar , Sarcoma de Yoshida/metabolismo , Sarcoma de Yoshida/patología , Relación Estructura-Actividad
8.
Anticancer Res ; 20(4): 2593-9, 2000.
Artículo en Inglés | MEDLINE | ID: mdl-10953331

RESUMEN

Here we show for the first time that the model nitroxide derivatives, free radical or its reduced piperidinium salt, suppressed cytotoxicity of ROS (O2 and H2O2) generated outside the cells (B14 line, model for neoplastic phenotype) in ***. The nitroxides prevented the decrease in the number of *** caused by exogenous O2- and H2O2 at concentrations which were not themselves cytotoxic. In the present study, we have also shown that a very substantial difference in the cell response occurred when the model rat tumor cells (Yoshida Sarcoma ascites) were treated in vivo with six novel synthesized nitroxide antioxidants. A number of tumor cells displayed morphological characteristics of apoptosis. This effect was comparable to those observed for other nitroxyls under similar experimental conditions. Since the increase in the ROS generation followed by apoptotic changes of nuclei is the consistent recent finding in various experimental models of apoptosis, one fundamental question was raised: why nitroxide antioxidants paradoxically act as apoptosis inducers in vivo? Taking together the results presented here and in our previous works, it seems reasonable to suggest that nitroxide-antioxidants improve the endogenous "antioxidants reserve" and action can induce a reductive stress as opposed to an oxidative stress, triggering a cascade of dose-dependent processes involving indirectly an antioxidant mechanism(s) and resulting in the apoptotic death of cancer cells in vivo. The SAR (structure activity relationship) revealed that either the substituent structure at 4-position of the nitroxide ring or its oxidation state are determinant for the degree of the observed differences in the apoptotic potency of nitroxide derivates in vivo.


Asunto(s)
Antioxidantes/farmacología , Apoptosis/efectos de los fármacos , Sarcoma de Yoshida/tratamiento farmacológico , Animales , Cricetinae , Relación Dosis-Respuesta a Droga , Masculino , Ratas , Especies Reactivas de Oxígeno/metabolismo , Sarcoma de Yoshida/metabolismo , Sarcoma de Yoshida/patología , Relación Estructura-Actividad
9.
Anticancer Res ; 19(2A): 1255-60, 1999.
Artículo en Inglés | MEDLINE | ID: mdl-10368685

RESUMEN

Since flavanone oximes derivatives (ethers) have been shown to modulate the growth of Yoshida Sarcoma cells in vivo and to induce apoptosis, the effects of these substances on immortalized cell lines growth were examined. Cell viability and sensitivity to investigated substances was measured by the modified tetrazolium salt (MTT) assay. The antiproliferative effects were expressed as IC50 and IC90, respectively. There were very substantial differences in the dose-dependency of the observed antiproliferative and cytotoxic effects. The structure-activity relationship was evident and revealed that the substitution at B-ring of molecule seems to be an important factor in flavanone oxime (ether) potency. Compared to anticancer drugs (doxorubicin, aclarubicin and mitoxantrone) flavanone oximes displayed cytotoxicity at considerably higher concentrations. The antiproliferative action of the investigated model nitroxides depended on the free radical part of the molecule. N-hydroxy derivative (reduced cation form) did not influence cells proliferation and nor display any cytotoxicity at the applied range about 60 times higher than those of flavanone derivatives. Taken together it seems reasonable to suggest that flavanone oxime(s) (ethers) as compared with antracycline(s), anthraquinone and nitroxides might be especially good candidates for in the future development of new therapeutic techniques.


Asunto(s)
Antraquinonas/farmacología , Antibióticos Antineoplásicos/farmacología , Antineoplásicos/farmacología , Óxidos N-Cíclicos/farmacología , Flavonoides/farmacología , Oximas/farmacología , Piperidinas/farmacología , Células 3T3 , Animales , División Celular/efectos de los fármacos , Cricetinae , Relación Dosis-Respuesta a Droga , Ratones , Relación Estructura-Actividad
10.
Anticancer Res ; 19(6B): 5259-64, 1999.
Artículo en Inglés | MEDLINE | ID: mdl-10697546

RESUMEN

A stable nitroxide radical named Metexyl (4-methoxy-2,2,6,6-tetramethylpiperidine-1-oxyl) was synthesized and its antioxidant and antitumor properties were investigated and compared with these of another nitroxide derivatives previously designed in our laboratories. Three experimental models were used: xanthine/xanthine oxidase system, pulse radiolysis and experimental rat cancer (Yoshida Sarcoma) in vivo. In this work we measured the rate constant of the reactions of Metexyl with enzymatically generated O2.- or radiolytically produced .OH. For comparison, the reactions of non radical derivative (4-acetamide-2,2,6,6-tetramethylpiperidinium acetate) or nitroxide Tempace (4-acetamide-2,2,6,6-tetramethylpiperidine-1-oxyl) with the above mentioned reactive oxygen radicals were also studied. The comparative ability of Metexyl to act as an inducer of apoptosis in vivo was also investigated in pharmacological test. The ring substituent (-OCH3) at position 4 of the Metexyl molecule had significant influence on its properties as antioxidant and apoptosis inducer. The results in this study suggest that Metexyl is a promising nitroxide antioxidant, which can induce apoptosis of tumor cells in vivo, thus providing a base for its further investigations in vitro and pharmacological applications.


Asunto(s)
Apoptosis/efectos de los fármacos , Óxidos N-Cíclicos/farmacología , Depuradores de Radicales Libres/farmacología , Especies Reactivas de Oxígeno , Animales , Antineoplásicos/farmacología , Ratas , Sarcoma de Yoshida/patología
11.
Anticancer Res ; 19(4B): 3343-8, 1999.
Artículo en Inglés | MEDLINE | ID: mdl-10652631

RESUMEN

In light of our previous SAR studies on nitroxides acting as less toxic anticancer agents, antioxidants and radioprotectors, we designed and tested, in vivo an in vitro, a new triradical spin trap -N,N',N"-tris-(l-oxyl-2,2,6,6-tetramethylpiperidine-4-yl)-1,3, 5-tnazine-2,4,6-triamine (TTT). The ability of TTT to act as an antitumor agent in vivo was investigated in pharmacological tests. The administration of TTT to rats bearing 3 day-old Sarcoma Yoshida (promotion phase of the disease) led to induction of apoptotic cell(s) death. Our results clearly indicated the suggested involvement of the free radical moiety of piperidine ring(s), thus indicating that the anticancer activity of nitroxide(s) may involve its intracellular redox reactions. To assess the relationship between the apoptotic effects of TTT in vivo and its possible cytotoxicity, we determined the relative antiproliferative and cytostatic potential of TTT in vitro as compared with this of the anticancer drugs: doxorubicin, aclarubicin and mitoxantrone, currently used in clinical practice in Poland. We found that TTT inhibits the growth and proliferation of two immortalized cell types-hamster B14 cell line and mouse NIH 3T3 fibroblasts which we used as a model for neoplastic phenotype, in a dose-dependent manner.


Asunto(s)
Antineoplásicos/farmacología , Compuestos Azo/farmacología , Piperidinas/farmacología , Sarcoma de Yoshida/patología , Células 3T3 , Animales , División Celular/efectos de los fármacos , Línea Celular Transformada , Cricetinae , Ratones , Ratas , Marcadores de Spin
12.
Anticancer Res ; 18(1A): 369-77, 1998.
Artículo en Inglés | MEDLINE | ID: mdl-9568105

RESUMEN

As a part of our studies on the chemical, biochemical and pharmacological characteristics of the newly synthesized antioxidants, nitroxide derivatives, we designed a novel nitroxide, named Tempicol-2. Its capacity to act as antioxidant of potential pharmacological application was tested in three model systems: xanthine/xanthine oxidase, iron- and ascorbate Fenton reaction(s) and gamma-radiolysis. The antioxidant properties of Tempicol-2 as a function of concentration were compared with those previously characterized nitroxide derivatives Tempace and Rutoxyl which we had synthesized. The possibility of one-electron reduction of the novel substance by ascorbic acid was also examined and compared. The ability of Tempicol-2 to act as anticancer agent in vivo was also investigated in pharmacologic tests. The administration of Tempicol-2 to rats bearing 3 day-old Yoshida Sarcoma (promotion phase) led to both growth inhibition and the induction of apoptotic cells(s) death, comparable to the effects of Tempace and Rutoxyl under the same experimental conditions. Our results confirmed the suggested involvement of free radicals in the pathogenesis of model. Yoshida Sarcoma, thus indicating that anticancer activity of the investigated nitroxides may indirectly involve an antioxidant mechanism. The results reported here are encouraging as we find a limited correlation between the molecular redox properties, structure of nitroxides and their antitumor action. Tempicol-2, similarly to Tempace and Rutoxyl, is a promising antioxidant which can induce apoptosis, thus providing the basis for further investigations of the concentration and phase-dependent effects and the exact mechanisms of nitroxide(s) apoptotic action using cell line(s) model.


Asunto(s)
Antineoplásicos/farmacología , Antioxidantes/farmacología , Óxidos N-Cíclicos/farmacología , Radicales Libres , Piridinas/farmacología , Protectores contra Radiación , Animales , Ácido Ascórbico/química , Desoxirribosa/química , Femenino , Masculino , Nitroazul de Tetrazolio/química , Oxidación-Reducción , Ratas , Especies Reactivas de Oxígeno , Sarcoma Experimental , Superóxidos/química , Células Tumorales Cultivadas/efectos de los fármacos
13.
Biochem Mol Biol Int ; 42(6): 1261-70, 1997 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-9305544

RESUMEN

A novel complex, Rutoxyl [rutin/4-acetamide-1-hydroxy-2,2,6,6-tetramethylpiperidinium] was synthesized and its structure and anticancer activity were investigated. The results reported here are consistent with our idea, that the formation of such a complex of two biologically active molecules: polyphenolic flavonoid antioxidant (Rutin) and nitroxylamine of nitroxide antioxidant (Tempace), stabilized by hydrogen bond(s) can result in a supra-additive properties.


Asunto(s)
Antineoplásicos/química , Antineoplásicos/farmacología , Óxidos N-Cíclicos/química , Óxidos N-Cíclicos/farmacología , Piperidinas/química , Piperidinas/farmacología , Rutina/análogos & derivados , Rutina/química , Animales , Antineoplásicos/síntesis química , Antioxidantes/química , Antioxidantes/farmacología , Óxidos N-Cíclicos/síntesis química , Diseño de Fármacos , Ensayos de Selección de Medicamentos Antitumorales , Masculino , Modelos Moleculares , Estructura Molecular , Piperidinas/síntesis química , Ratas , Ratas Wistar , Rutina/síntesis química , Rutina/farmacología , Sarcoma Experimental/tratamiento farmacológico , Relación Estructura-Actividad
14.
Biochem Mol Biol Int ; 40(6): 1211-9, 1996 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-8988333

RESUMEN

Two novel 2,2,6,6-tetramethylpiperidine derivatives (Tempace and Troxyl) were synthesized and their capacity to act as scavengers of superoxide, inhibitors of iron and ascorbate-driven Fenton reaction and radioprotectors was tested. The possibility for one-electron oxidation of novel compounds by heme-ferryl species was also examined. The results clearly indicate that Tempace and Troxyl are acting as promising antioxidants and radioprotectors thus providing a base for further investigations and pharmacological applications.


Asunto(s)
Antioxidantes/farmacología , Óxidos N-Cíclicos/farmacología , Depuradores de Radicales Libres/farmacología , Piperidinas/farmacología , Protectores contra Radiación/farmacología , Antioxidantes/síntesis química , Antioxidantes/metabolismo , Radioisótopos de Cobalto , Óxidos N-Cíclicos/síntesis química , Desoxirribosa/metabolismo , Relación Dosis-Respuesta a Droga , Depuradores de Radicales Libres/síntesis química , Depuradores de Radicales Libres/metabolismo , Peróxido de Hidrógeno , Radical Hidroxilo/metabolismo , Hierro , Oxidación-Reducción , Piperidinas/síntesis química , Protectores contra Radiación/síntesis química , Protectores contra Radiación/metabolismo , Marcadores de Spin , Superóxido Dismutasa , Superóxidos/metabolismo , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismo , Xantina , Xantina Oxidasa/metabolismo , Xantinas/metabolismo
19.
Anaesth Resusc Intensive Ther ; 3(3): 273-6, 1975.
Artículo en Inglés | MEDLINE | ID: mdl-1217701

RESUMEN

The authors report a case of microgenia which made endotracheal intubation impossible in a patient with pharyngeal stenosis. It is suggested that laryngological examination should precede the operation and when endotracheal intubation is impossible tracheostomy should be performed.


Asunto(s)
Intubación Intratraqueal/métodos , Mandíbula/anomalías , Adulto , Femenino , Humanos , Laringe/anomalías , Micrognatismo , Faringe/anomalías , Síndrome de Pierre Robin , Traqueotomía
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