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1.
Micro Total Anal Syst ; : 919-922, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-23989046

RESUMO

We present the concept of a general-purpose sample analysis platform (GSAP) based on dielectrophoretic methods. The platform architecture comprises integrated functional blocks that can be programmed to perform a diverse range of analysis steps, including the on-device preparation of real world samples.

2.
Curr Med Chem ; 8(12): 1513-33, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11562280

RESUMO

Polycyclic aromatic hydrocarbons (PAH) are considered potentially carcinogenic. Substituted PAH derivatives, in contrast, may serve as anticancer agents, and as chemotherapeutics. This article presents a review of their use. Particular emphasis is placed on the synthesis of these new compounds, electrophilic substitution reactions and novel synthetic methodologies developed in our laboratory. Based on numerous reports and the data available, we believe that DNA-intercalating and membrane-interacting sites are the target for their effects.


Assuntos
Antineoplásicos/química , Antineoplásicos/farmacologia , Hidrocarbonetos Policíclicos Aromáticos/química , Hidrocarbonetos Policíclicos Aromáticos/farmacologia , Antineoplásicos/síntese química , Humanos , Modelos Químicos , Estrutura Molecular , Hidrocarbonetos Policíclicos Aromáticos/síntese química , Relação Estrutura-Atividade
3.
Bioorg Med Chem ; 9(3): 593-605, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11310593

RESUMO

A large number of diamides and diamines were synthesized using 6-amino chrysene and 1-amino pyrene as starting materials. A structure activity study with cis-platinum as internal control against animal and human tumor lines was carried out in vitro. This study indicated that the in vitro cytotoxicity toward these lines depends on the functionality present in the molecules. The diamino compounds were found to be more potent than the diamides, and these were equally active irrespective of the end heterocyclic group, whereas the activity of the diamides was strongly dependent on the terminal unit. In general, the diamides containing chrysene as the chromophore were more active than those with a pyrene ring. The size of the end heterocyclic ring, along with the nature of the spacer connecting the polycyclic ring to the heterocyclic ring, seemed to affect the biological activity in certain cell lines. Hemolysis experiments on a lead compound established that it had activities similar to those described for membrane-stabilizing agents. This agent also demonstrated the capacity to produce differentiation in leukemia cell lines.


Assuntos
Antineoplásicos/síntese química , Antineoplásicos/farmacologia , Hidrocarbonetos Policíclicos Aromáticos/farmacologia , Animais , Antineoplásicos/toxicidade , Peso Corporal/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Crisenos/química , Crisenos/farmacologia , Crisenos/toxicidade , Feminino , Hemólise/efeitos dos fármacos , Humanos , Concentração Inibidora 50 , Injeções , Camundongos , Camundongos Nus , Hidrocarbonetos Policíclicos Aromáticos/síntese química , Hidrocarbonetos Policíclicos Aromáticos/toxicidade , Pirenos/química , Pirenos/farmacologia , Pirenos/toxicidade , Ratos , Ratos Sprague-Dawley , Relação Estrutura-Atividade , Taxa de Sobrevida , Células Tumorais Cultivadas
5.
Biophys J ; 78(5): 2680-9, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10777764

RESUMO

The differential analysis of human leukocytes has many important biological and medical applications. In this work, dielectrophoretic field-flow-fractionation (DEP-FFF), a cell-separation technique that exploits the differences in the density and dielectric properties of cells, was used to separate the mixtures of the major human leukocyte subpopulations (T- and B-lymphocytes, monocytes, and granulocytes). The separation was conducted in a thin chamber equipped with an array of microfabricated interdigitated electrodes on the bottom surface, and the separation performance was characterized by on-line flow cytometry. To investigate optimal separation conditions for different leukocyte mixtures, elution fractograms at various DEP field frequencies were obtained for each leukocyte subtype. With appropriately chosen conditions, high separation performance was achieved in separating T- (or B-) lymphocytes from monocytes, T- (or B-) lymphocytes from granulocytes, and monocytes from granulocytes. DEP-FFF does not involve cell-labeling or cell-modification step, and provides a new approach to hematological analysis.


Assuntos
Fracionamento Celular/métodos , Leucócitos/citologia , Linfócitos B/citologia , Fenômenos Biofísicos , Biofísica , Fracionamento Celular/instrumentação , Eletroforese/instrumentação , Eletroforese/métodos , Granulócitos/citologia , Humanos , Monócitos/citologia , Linfócitos T/citologia
6.
Anal Chem ; 72(4): 832-9, 2000 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-10701270

RESUMO

Dielectrophoretic field-flow-fractionation (DEP-FFF) was applied to several clinically relevant cell separation problems, including the purging of human breast cancer cells from normal T-lymphocytes and from CD34+ hematopoietic stem cells, the separation of the major leukocyte subpopulations, and the enrichment of leukocytes from blood. Cell separations were achieved in a thin chamber equipped with a microfabricated, interdigitated electrode array on its bottom wall that was energized with AC electric signals. Cells were levitated by the balance between DEP and sedimentation forces to different equilibrium heights and were transported at differing velocities and thereby separated when a velocity profile was established in the chamber. This bulk-separation technique adds cell intrinsic dielectric properties to the catalog of physical characteristics that can be applied to cell discrimination. The separation process and performance can be controlled through electronic means. Cell labeling is unnecessary, and separated cells may be cultured and further analyzed. It can be scaled up for routine laboratory cell separation or implemented on a miniaturized scale.


Assuntos
Neoplasias da Mama/patologia , Separação Celular/métodos , Eletroforese/métodos , Células-Tronco Hematopoéticas/citologia , Linfócitos T/citologia , Animais , Bovinos , Separação Celular/instrumentação , Fracionamento Químico/métodos , Eletroforese/instrumentação , Humanos , Células Tumorais Cultivadas
7.
Biophys J ; 76(6): 3307-14, 1999 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10354456

RESUMO

The separation and purification of human blood cell subpopulations is an essential step in many biomedical applications. New dielectrophoretic fractionation methods have great potential for cell discrimination and manipulation, both for microscale diagnostic applications and for much larger scale clinical problems. To discover whether human leukocyte subpopulations might be separable by such methods, the dielectric characteristics of the four main leukocyte subpopulations, namely, B- and T-lymphocytes, monocytes, and granulocytes, were measured by electrorotation over the frequency range 1 kHz to 120 MHz. The subpopulations were derived from human peripheral blood by magnetically activated cell sorting (MACS) and sheep erythrocyte rosetting methods, and the quality of cell fractions was checked by flow cytometry. Mean specific membrane capacitance values were calculated from the electrorotation data as 10.5 (+/- 3.1), 12.6 (+/- 3.5), 15.3 (+/- 4.3), and 11.0 (+/- 3.2) mF/m2 for T- and B-lymphocytes, monocytes, and granulocytes, respectively, according to a single-shell dielectric model. In agreement with earlier findings, these values correlated with the richness of the surface morphologies of the different cell types, as revealed by scanning electron microscopy (SEM). The data reveal that dielectrophoretic cell sorters should have the ability to discriminate between, and to separate, leukocyte subpopulations under appropriate conditions.


Assuntos
Separação Celular/métodos , Leucócitos/classificação , Leucócitos/citologia , Fenômenos Biofísicos , Biofísica , Membrana Celular/ultraestrutura , Eletroquímica , Citometria de Fluxo , Humanos , Leucócitos/imunologia , Microscopia Eletrônica de Varredura , Rotação
8.
Biochim Biophys Acta ; 1417(1): 51-62, 1999 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-10076035

RESUMO

Human peripheral blood T-lymphocytes, normally resting at the G0 phase, were stimulated with phytohemagglutinin (PHA) and interleukin-2 (IL-2) to induce the cell division cycle. The cells were examined at 24-h intervals for up to 96 h by flow cytometry to determine cell cycle distributions and by electrorotation to determine dielectric properties. The average membrane specific capacitance was found to vary from 12 (+/-1.5) mF/m2 prior to stimulation to 10 (+/-1.5) and 16 (+/-3.5) mF/m2 at 24 and 48 h after stimulation, respectively, and to remain unchanged up to 96 h after stimulation. Scanning electron microscopy studies of the cells revealed an increased complexity in cell membrane morphology following stimulation, suggesting that the observed change in the membrane capacitance was dominated by the alteration of cell surface structures. The average electrical conductivity of the cell interior decreased from approximately 1.1 S/m prior to stimulation to approximately 0.8 S/m at 24 h after stimulation and showed little change thereafter. The average dielectric permittivity of the cell interior remained almost unchanged throughout the course of the cell stimulation. The percentage of T-lymphocytes in the S and G2/M phases increased from approximately 4% prior to stimulation to approximately 11 and approximately 34% at 24 and 48 h after stimulation, respectively. The large change in membrane specific capacitance between the 24 and 48 h time period coincided with the large alteration in the cell cycle distribution where the S and G2/M populations increased by approximately 23%. These data, together with an analysis of the variation of the membrane capacitance during the cell cycle based on the cell cycle-dependent membrane lipid accumulation, show that there is a correlation between membrane capacitance and cell cycle phases that reflects alterations in the cell plasma membrane.


Assuntos
Membrana Celular/efeitos dos fármacos , Mitógenos/farmacologia , Linfócitos T/efeitos dos fármacos , Ciclo Celular , Membrana Celular/química , Membrana Celular/fisiologia , Tamanho Celular , Condutividade Elétrica , Humanos , Imunofenotipagem , Interleucina-2/farmacologia , Microscopia Eletrônica de Varredura , Fito-Hemaglutininas/farmacologia , Linfócitos T/fisiologia , Linfócitos T/ultraestrutura , Fatores de Tempo
9.
Anal Chem ; 71(5): 911-8, 1999 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-10079757

RESUMO

Dielectrophoretic/gravitational field-flow fractionation (DEP/G-FFF) was used to separate cultured human breast cancer MDA-435 cells from normal blood cells mixed together in a sucrose/dextrose medium. An array of microfabricated, interdigitated electrodes of 50 microns widths and spacings, and lining the bottom surface of a thin chamber (0.42 mm H x 25 mm W x 300 mm L), was used to generate DEP forces that levitated the cells. A 10-microL cell mixture sample containing approximately 50,000 cells was introduced into the chamber, and cancerous and normal blood cells were levitated to different heights according to the balance of DEP and gravitational forces. The cells at different heights were transported at different velocities under the influence of a parabolic flow profile that was established in the chamber and were thereby separated. Separation performance depended on the frequency and voltage of the applied DEP field and the fluid-flow rate. It took as little as 5 min to achieve cell separation. An analysis of the DEP/G-FFF results revealed that the separation exploited the difference in dielectric and density properties between cell populations. The DEP/G-FFF technique is potentially applicable to many biological and biomedical problems, especially those related to microfluidic systems.


Assuntos
Separação Celular/instrumentação , Microeletrodos , Algoritmos , Neoplasias da Mama/patologia , Fracionamento Químico , Eletrofisiologia , Humanos , Células Tumorais Cultivadas
10.
J Hematother Stem Cell Res ; 8(5): 481-90, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10791899

RESUMO

Dielectrophoretic field-flow-fractionation (DEP-FFF) was used to purge human breast cancer MDA-435 cells from hematopoietic CD34+ stem cells. An array of interdigitated microelectrodes lining the bottom surface of a thin chamber was used to generate dielectrophoretic forces that levitated the cell mixture in a fluid flow profile. CD34+ stem cells were levitated higher, were carried faster by the fluid flow, and exited the separation chamber earlier than the cancer cells. Using on-line flow cytometry, efficient separation of the cell mixture was observed in less than 12 min, and CD34+ stem cell fractions with a purity >99.2% were obtained. The method of DEP-FFF is potentially applicable to many biomedical cell separation problems, including microfluidic-scale diagnosis and preparative-scale purification of cell subpopulations.


Assuntos
Purging da Medula Óssea/métodos , Neoplasias da Mama/patologia , Células-Tronco Hematopoéticas/citologia , Purging da Medula Óssea/instrumentação , Neoplasias da Mama/terapia , Eletroforese/instrumentação , Eletroforese/métodos , Desenho de Equipamento , Feminino , Células-Tronco Hematopoéticas/patologia , Humanos , Células Tumorais Cultivadas
11.
Arch Facial Plast Surg ; 1(1): 9-15, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10937068

RESUMO

This article reports our observations on, and modification of, the subunit principle with regard to reconstruction of nasal tip and dorsum defects. Forty-two patients who underwent reconstruction of a nasal tip and/or dorsum defect with a forehead flap were reviewed. These patients were categorized by how the subunit principle was used in their reconstruction and graded on the aesthetic outcome of the reconstruction. We found that the patients who had both the nasal tip and dorsum replaced obtained better results than those who had just 1 subunit replaced (P = .008). Review of postoperative photographs shows that the reason for this discrepancy in aesthetic outcomes is the line of transition between the forehead skin and remaining nasal skin if only 1 subunit is replaced. With this observation in mind, we feel that patients undergoing reconstruction of the nasal tip and/or dorsum should be evaluated for discrepancies in tissue type between the recipient nasal site and forehead donor site. If the tissues are noted to be significantly disparate, the reconstructive surgeon may consider replacing both subunits with a single forehead flap.


Assuntos
Rinoplastia/métodos , Retalhos Cirúrgicos , Estética , Feminino , Humanos , Masculino
13.
Biophys J ; 74(5): 2689-701, 1998 May.
Artigo em Inglês | MEDLINE | ID: mdl-9591693

RESUMO

The characterization of a dielectrophoretic/gravitational field-flow-fractionation (DEP/G-FFF) system using model polystyrene (PS) microbeads is presented. Separations of PS beads of different surface functionalization (COOH and none) and different sizes (6, 10, and 15 microm in diameter) are demonstrated. To investigate the factors influencing separation performance, particle elution times were determined as a function of particle suspension conductivity, fluid flow rate, and applied field frequency and voltage. Experimental data were analyzed using a previously reported theoretical model and good agreement between theory and experiment was found. It was shown that separation of PS beads was based on the differences in their effective dielectric properties. Particles possessing different dielectric properties were positioned at different heights in a fluid-flow profile in a thin chamber by the balance of DEP and gravitational forces, transported at different velocities under the influence of the fluid flow, and thereby separated. To explore hydrodynamic (HD) lift effects, velocities of PS beads were determined as a function of fluid flow rate in the separation chamber when no DEP field was applied. In this case, particle equilibrium height positions were governed solely by the balance of HD lift and gravitational forces. It was concluded that under the experimental conditions reported here, the DEP force was the dominant factor in controlling particle equilibrium height and that HD lift force played little role in DEP/G-FFF operation. Finally, the influence of various experimental parameters on separation performance was discussed for the optimization of DEP/G-FFF.


Assuntos
Eletroforese/instrumentação , Poliestirenos , Eletroforese/métodos , Desenho de Equipamento , Gravitação , Microesferas , Poliestirenos/isolamento & purificação , Eletricidade Estática
15.
Biophys J ; 73(2): 1118-29, 1997 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9251828

RESUMO

We present the principle of cell characterization and separation by dielectrophoretic field-flow fractionation and show preliminary experimental results. The operational device takes the form of a thin chamber in which the bottom wall supports an array of microelectrodes. By applying appropriate AC voltage signals to these electrodes, dielectrophoretic forces are generated to levitate cells suspended in the chamber and to affect their equilibrium heights. A laminar flow profile is established in the chamber so that fluid flows faster with increasing distance from the chamber walls. A cell carried in the flow stream will attain an equilibrium height, and a corresponding velocity, based on the balance of dielectrophoretic, gravitational, and hydrodynamic lift forces it experiences. We describe a theoretical model for this system and show that the cell velocity is a function of the mean fluid velocity, the voltage and frequency of the signals applied to the electrodes, and, most significantly, the cell dielectric properties. The validity of the model is demonstrated with human leukemia (HL-60) cells subjected to a parallel electrode array, and application of the device to separating HL-60 cells from peripheral blood mononuclear cells is shown.


Assuntos
Separação Celular/métodos , Eletroforese/métodos , Eletroforese/instrumentação , Eletrofisiologia , Células HL-60 , Humanos , Cinética , Matemática , Microeletrodos , Modelos Teóricos
16.
Arch Otolaryngol Head Neck Surg ; 123(5): 529-34, 1997 May.
Artigo em Inglês | MEDLINE | ID: mdl-9158402

RESUMO

OBJECTIVE: To analyze the results of secondary healing of Mohs defects of the forehead, temple, and lower eyelid. DESIGN: Scars resulting from secondary healing in these 3 sites were rated by patient interviews and by analysis of postoperative photographs by 3 board-certified members of the American Academy of Facial Plastic and Reconstructive Surgery. SETTING: Private facial plastic and reconstructive surgery practice in Florida. PATIENTS: Patients with Mohs wounds of the forehead, temple, and lower eyelid that were allowed to heal by secondary intention between January 1, 1989, and December 31, 1993, who were available for follow-up. There were 10 wounds of the forehead, 6 of the temple, and 10 of the lower eyelid that were available for analysis. MAIN OUTCOME MEASURES: Wound color, contour, distortion of surrounding structures, presence of telangiectasias or paresthesias, pain or infection during healing, and overall cosmetic result. RESULTS: Color, contour, and overall scar cosmesis were rated using the following scale: poor (0), fair (1), good (2), and excellent (3). Telangiectasias, paresthesias, and pain or infection during healing were recorded as present or absent. The respective color and contour ratings for the 3 sites were 2.2 and 2.2 for the forehead, 2.5 and 2.7 for the temple, and 2.7 and 3 for the lower eyelid according to patient interview and 1 and 1.3 for the forehead, 1 and 1.4 for the temple, and 2.6 and 2.5 for the lower eyelid according to surgeon analysis. Pain, infection, paresthesias, and distortion of surrounding structures were rare, but 7 of 10 forehead and 4 of 6 temple wounds had telangiectasias. CONCLUSIONS: Many defects of the forehead and temple will heal with acceptable results. Partial-thickness or small full-thickness lower eyelid wounds heal with excellent cosmetic and functional results. Patient satisfaction is greater than might be predicted by surgeon analysis of wound healing.


Assuntos
Pálpebras/patologia , Face/patologia , Cirurgia de Mohs , Cicatrização , Adulto , Idoso , Cicatriz/patologia , Estética , Neoplasias Palpebrais/patologia , Neoplasias Palpebrais/cirurgia , Pálpebras/cirurgia , Face/cirurgia , Neoplasias Faciais/patologia , Neoplasias Faciais/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade
17.
Biophys J ; 72(4): 1887-99, 1997 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9083692

RESUMO

Electrokinetic responses of human breast cancer MDA-MB-231 cells were studied in suspensions of conductivities 18, 56, and 160 mS/m on a microelectrode array consisting of four parallel spiral electrode elements energized with phase-quadrature signals of frequencies between 100 Hz and 100 MHz. At low frequencies cells were levitated and transported toward or away from the center of the spiral array, whereas at high frequencies cells were trapped at electrode edges. The frequencies of transition between these characteristic cell behaviors increased with increasing suspension conductivity. Levitation heights and radial velocities were determined simultaneously for individual cells as a function of the applied field magnitude and frequency. Results were compared with theoretical predictions from generalized dielectrophoresis theory applied in conjunction with cell dielectric parameters and simulated electric field distributions corrected for electrode polarization effects. It was shown that the conventional and traveling-wave dielectrophoretic force components dominated cell levitation and radial motion, respectively. Both theoretical predictions and experimental data showed that the cell radial velocity was very sensitive to the field frequency when the in-phase component of the field-induced polarization was close to zero. Applications of spiral electrode arrays, including the isolation of cells of clinical relevance, are discussed.


Assuntos
Neoplasias da Mama/fisiopatologia , Microeletrodos , Neoplasias da Mama/patologia , Condutividade Elétrica , Eletroforese , Humanos , Matemática , Células Tumorais Cultivadas
18.
Biochim Biophys Acta ; 1323(2): 240-52, 1997 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-9042346

RESUMO

The dielectric properties of normal erythrocytes were compared to those of cells infected with the malarial parasite Plasmodium falciparum. Normal cells provided stable electrorotation spectra which, when analyzed by a single-shelled oblate spheroid dielectric model, gave a specific capacitance value of 12 +/- 1.2 mF/m2 for the plasma membrane, a cytoplasmic permittivity of 57 +/- 5.4 and a cytoplasmic conductivity of 0.52 +/- 0.05 S/m. By contrast, parasitized cells exhibited electrorotation spectra with a time-dependency that suggested significant net ion outflux via the plasma membrane and it was not possible to derive reliable cell parameter values in this case. To overcome this problem, cell membrane dielectric properties were instead determined from dielectrophoretic crossover frequency measurements made as a function of the cell suspending medium conductivity. The crossover frequency for normal cells depended linearly on the suspension conductivity above 20 mS/m and analysis according to the single-shelled oblate spheroid dielectric model yielded values of 11.8 mF/m2 and 271 S/m2, respectively, for the specific capacitance and conductance of the plasma membrane. Unexpectedly, the crossover frequency characteristics of parasitized cells at high suspending medium conductivities were non-linear. This effect was analyzed in terms of possible dependencies of the cell membrane capacitance, conductance or shape on the suspension medium conductivity, and we concluded that variations in the membrane conductance were most likely responsible for the observed non-linearity. According to this model, parasitized cells had a specific membrane capacitance of 9 +/- 2 mF/m2 and a specific membrane conductance of 1130 S/m2 that increased with increasing cell suspending medium conductivity. Such conductivity changes in parasitized cells are discussed in terms of previously observed parasite-associated membrane pores. Finally, we conclude that the large differences between the dielectrophoretic crossover characteristics of normal and parasitized cells should allow straightforward sorting of these cell types by dielectrophoretic methods.


Assuntos
Membrana Eritrocítica/fisiologia , Eritrócitos/parasitologia , Plasmodium falciparum/fisiologia , Animais , Células Cultivadas , Condutividade Elétrica , Eletroforese , Eletrofisiologia , Humanos , Microscopia de Vídeo
19.
Biochim Biophys Acta ; 1349(2): 182-96, 1997 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-9421190

RESUMO

The reliability of multi-shell dielectric models, used to describe the ac electrokinetic behaviour of cells, has been tested by performing electrorotation and dielectrophoretic measurements on unilamellar, oligolamellar, and multilamellar liposomes of diameters ranging from 5 to 24 microm. Fluorescence microscopy, flow cytometry and electron spin resonance were used to characterise the morphology and membranes of the liposomes. The dielectric properties of the various types of liposomes, based on appropriate dielectric shell models, were then analysed using a general purpose, recursive, algorithm. Through simulations, the confidence levels that can be assigned to parameters derived through application of simple shell models are estimated. From this, we confirm that electrorotation data enable accurate determinations to be made of the dielectric properties of the outermost membrane of liposomes, and provide good indications of the level of complexity of the shells and internal compartments. We also demonstrate that, used with sufficient additional information, such as that provided by dielectrophoresis, electrorotation data yields unique solutions for the dielectric parameters of liposome-like particles.


Assuntos
Lipossomos , Condutividade Elétrica , Fluorescência , Rotação , Temperatura
20.
Arch Otolaryngol Head Neck Surg ; 122(9): 997-9, 1996 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-8797566

RESUMO

We describe our experience using a deep-plane technique to create an inferiorly based musculocutaneous flap to decrease distal flap necrosis in reconstruction of large anterior cheek and lower eyelid defects. Our early experience with the use of the deep-plane cervicofacial flap has been encouraging. We believe that it deserves more study for use in the population at risk for flap necrosis.


Assuntos
Bochecha/cirurgia , Neoplasias Faciais/cirurgia , Retalhos Cirúrgicos/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Pálpebras/cirurgia , Feminino , Humanos , Masculino
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