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1.
Science ; 385(6715): 1327-1331, 2024 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-39298597

RESUMEN

Quantum state teleportation is commonly used in designs for large-scale quantum computers. Using Quantinuum's H2 trapped-ion quantum processor, we demonstrate fault-tolerant state teleportation circuits for a quantum error correction code-specifically the Steane code. The circuits use up to 30 qubits at the physical level and employ real-time quantum error correction. We conducted experiments on several variations of logical teleportation circuits using both transversal gates and lattice surgery. We measured the logical process fidelity to be 0.975 ± 0.002 for the transversal teleportation implementation and 0.851 ± 0.009 for the lattice surgery teleportation implementation as well as 0.989 ± 0.002 for an implementation of Knill-style quantum error correction.

2.
J Physiol Pharmacol ; 67(2): 205-16, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27226180

RESUMEN

The objective of the study was to determine the effects of a high fat (HF) diet alone or with high fructose (HF/F) on functional and structural changes in the basilar arteries and cardiovascular health parameters in rats. Male Sprague Dawley rats were fed either a HF (30%) or HF/F (30/40%) diet for 12 weeks. The basilar artery was cannulated in a pressurized system (90 cm H2O) and vascular responses to KCl (30 - 120 mM), endothelin (10(-11) - 10(-7) M), acetylcholine (ACh) (10(-10) - 10(-4) M), diethylamine (DEA)-NONO-ate (10(-10) - 10(-4) M), and papaverine (10(-10) - 10(-4) M) were evaluated. Rats were also monitored for food intake, body weight, blood lipids, blood pressure, and heart rate. At death, asymmetrical dimethyl arginine level (ADMA) and leptin were assayed in serum. Although there was no significant difference in weight gain and food intake, HF and HF/F diets increased body fat composition and decreased the lean mass. HF/F diet accelerated the development of dyslipidemia. Although resting blood pressure remained unchanged, stress caused a significant elevation in blood pressure and a modest increase in heart rate in HF fed rats. Both HF and HF/F diet resulted in decreased response to endothelium-dependent and -independent relaxation, whereas increased basilar artery wall thickness was observed only in HF group. Serum leptin levels positively correlated with wall thickness. Moreover serum ADMA was increased and eNOS immunofluorescence was significantly decreased with both diets. These data suggest that the presence of high fructose in a HF diet does not exacerbate the detrimental consequences of a HF diet on basilar artery function.


Asunto(s)
Arteria Basilar/efectos de los fármacos , Dieta Alta en Grasa , Fructosa/farmacología , Animales , Arteria Basilar/patología , Arteria Basilar/fisiología , Glucemia/análisis , Presión Sanguínea/efectos de los fármacos , Glutatión/metabolismo , Frecuencia Cardíaca/efectos de los fármacos , Leptina/sangre , Lípidos/sangre , Masculino , Malondialdehído/metabolismo , Miocardio/metabolismo , Ratas Sprague-Dawley , Vasoconstricción/efectos de los fármacos , Vasodilatación/efectos de los fármacos
3.
J Endocrinol ; 222(1): 27-41, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24920667

RESUMEN

The present investigation examined whether leptin stimulation of ventral tegmental area (VTA) or nucleus of the solitary tract (NTS) has a role in body weight homeostasis independent of the medial basal hypothalamus (MBH). To this end, recombinant adeno-associated viral techniques were employed to target leptin overexpression or overexpression of a dominant negative leptin mutant (leptin antagonist). Leptin antagonist overexpression in MBH or VTA increased food intake and body weight to similar extents over 14 days in rats. Simultaneous overexpression of leptin in VTA with antagonist in MBH resulted in food intake and body weight gain that were less than with control treatment but greater than with leptin alone in VTA. Notably, leptin overexpression in VTA increased P-STAT3 in MBH along with VTA, and leptin antagonist overexpression in the VTA partially attenuated P-STAT3 levels in MBH. Interestingly, leptin antagonist overexpression elevated body weight gain, but leptin overexpression in the NTS failed to modulate either food intake or body weight despite increased P-STAT3. These data suggest that leptin function in the VTA participates in the chronic regulation of food consumption and body weight in response to stimulation or blockade of VTA leptin receptors. Moreover, one component of VTA-leptin action appears to be independent of the MBH, and another component appears to be related to leptin receptor-mediated P-STAT3 activation in the MBH. Finally, leptin receptors in the NTS are necessary for normal energy homeostasis, but mostly they appear to have a permissive role. Direct leptin activation of NTS slightly increases UCP1 levels, but has little effect on food consumption or body weight.


Asunto(s)
Peso Corporal/fisiología , Homeostasis/fisiología , Receptores de Leptina/antagonistas & inhibidores , Receptores de Leptina/fisiología , Núcleo Solitario/fisiología , Área Tegmental Ventral/fisiología , Adenoviridae/genética , Adenoviridae/fisiología , Adiposidad/fisiología , Animales , Ingestión de Alimentos/fisiología , Regulación de la Expresión Génica/fisiología , Canales Iónicos/fisiología , Masculino , Proteínas Mitocondriales/fisiología , Modelos Animales , Ratas , Ratas Endogámicas BN , Ratas Endogámicas F344 , Receptores de Leptina/genética , Factor de Transcripción STAT3/fisiología , Transducción de Señal/fisiología , Proteína Desacopladora 1
4.
Physiol Behav ; 105(4): 909-14, 2012 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-22115947

RESUMEN

Voluntary wheel running (WR) is a form of physical activity in rodents that influences ingestive behavior. The present report describes an anorexic behavior triggered by the simultaneous introduction of a novel diet and WR. This study examined the sequential, compared with the simultaneous, introduction of a novel high-fat (HF) diet and voluntary WR in rats of three different ages and revealed a surprising finding; the simultaneous introduction of HF food and voluntary WR induced a behavior in which the animals chose not to eat although food was available at all times. This phenomenon was apparently not due to an aversion to the novel HF diet because introduction of the running wheels plus the HF diet, while continuing the availability of the normal chow diet did not prevent the anorexia. Moreover, the anorexia was prevented with prior exposure to the HF diet. In addition, the anorexia was not related to extent of WR but dependent on the act of WR. The introduction a HF diet and locked running wheels did not induce the anorexia. This voluntary anorexia was accompanied by substantial weight loss, and the anorexia was rapidly reversed by removal of the running wheels. Moreover, the HF/WR-induced anorexia is preserved across the age span despite the intrinsic decrease in WR activity and increased consumption of HF food with advancing age. The described phenomenon provides a new model to investigate anorexia behavior in rodents.


Asunto(s)
Anorexia/inducido químicamente , Anorexia/psicología , Grasas de la Dieta/efectos adversos , Modelos Animales de Enfermedad , Actividad Motora/fisiología , Factores de Edad , Animales , Conducta Alimentaria/fisiología , Conducta Alimentaria/psicología , Masculino , Ratas , Ratas Endogámicas F344 , Factores de Tiempo
5.
Neuropharmacology ; 60(2-3): 480-7, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21059361

RESUMEN

Diet-induced obesity (DIO) results in region-specific cellular leptin resistance in the arcuate nucleus (ARC) of the hypothalamus in one strain of mice and in several medial basal hypothalamic regions in another. We hypothesized that the ventral tegmental area (VTA) is also likely susceptible to diet-induced and leptin-induced leptin resistance in parallel to that in hypothalamic areas. We examined two forms of leptin resistance in F344xBN rats, that induced by 6-months of high fat (HF) feeding and that induced by 15-months of central leptin overexpression by use of recombinant adeno-associated viral (rAAV)-mediated gene delivery of rat leptin. Cellular leptin resistance was assessed by leptin-stimulated phosphorylation of signal transducers and activators of transcription 3 (STAT3) in medial basal hypothalamic areas and the VTA. The regional pattern and degree of leptin resistance with HF was distinctly different than that with leptin overexpression. Chronic HF feeding induced a cellular leptin resistance that was identified in the ARC and VTA, but absent in the lateral hypothalamus (LH), ventromedial hypothalamus (VMH), and dorsomedial hypothalamus (DMH). In contrast, chronic central leptin overexpression induced cellular leptin resistance in all areas examined. The identification of leptin resistance in the VTA, in addition to the leptin resistance in the hypothalamus, provides one potential mechanism, underlying the increased susceptibility of leptin resistant rats to HF-induced obesity.


Asunto(s)
Núcleo Arqueado del Hipotálamo/metabolismo , Grasas de la Dieta/metabolismo , Ingestión de Alimentos/fisiología , Leptina/administración & dosificación , Leptina/biosíntesis , Área Tegmental Ventral/metabolismo , Animales , Núcleo Arqueado del Hipotálamo/efectos de los fármacos , Membrana Celular/efectos de los fármacos , Membrana Celular/metabolismo , Grasas de la Dieta/administración & dosificación , Resistencia a Medicamentos/fisiología , Ingestión de Alimentos/efectos de los fármacos , Infusiones Intraventriculares , Masculino , Actividad Motora/efectos de los fármacos , Actividad Motora/fisiología , Ratas , Ratas Endogámicas BN , Ratas Endogámicas F344 , Factor de Transcripción STAT3/metabolismo , Área Tegmental Ventral/efectos de los fármacos
6.
Physiol Behav ; 100(2): 173-9, 2010 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-20193697

RESUMEN

Voluntary wheel running (WR) is a form of physical activity in rodents that influences ingestive behavior. This study examined the effects of WR on dietary preference and the potential role of leptin in mediating these effects. In a two-diet choice paradigm in which both palatable high-fat (HF) food and standard laboratory chow were provided ad libitum, rats displayed a strong preference for the former and chose to eat almost exclusively the HF diet over chow in sedentary conditions. With free access to running wheels, however, rats exhibited no preference for the HF food and consumed equal gram amounts of both chow and HF diets. The total daily caloric consumption during WR in the dietary choice protocol was equivalent to the amount of calories consumed daily by WR rats with only chow or only HF diet available, yet significantly less than sedentary chow caloric consumption. Two days after initiating WR, leptin signal transduction was examined in multiple selected brain sites following leptin injection into the third cerebral ventricle. The maximal leptin-stimulated STAT3 phosphorylation was enhanced only in the ventral tegmental area (VTA), but not in the arcuate nucleus, lateral hypothalamus, dorsal medial or ventral medial hypothalamus, or substantia nigra. In conclusion, wheel running appears to act either as an independent reinforcing factor or as a more favored activity to substitute for the consumption of a palatable HF diet, thus eliminating the preference for the HF food. Moreover, WR enhances leptin signaling specifically in the VTA, suggestive of a WR-evoked mechanism of heightened leptin function in the VTA to curb the drive to consume palatable HF foods.


Asunto(s)
Preferencias Alimentarias/fisiología , Leptina/metabolismo , Actividad Motora/fisiología , Transducción de Señal/fisiología , Área Tegmental Ventral/metabolismo , Análisis de Varianza , Animales , Conducta Animal , Grasas de la Dieta/administración & dosificación , Grasas de la Dieta/farmacología , Ingestión de Alimentos/fisiología , Conducta Alimentaria/efectos de los fármacos , Conducta Alimentaria/fisiología , Conducta Alimentaria/psicología , Conducta Alimentaria/efectos de la radiación , Leptina/administración & dosificación , Leptina/farmacología , Masculino , Actividad Motora/efectos de los fármacos , Fosforilación , Ratas , Ratas Endogámicas F344 , Factor de Transcripción STAT3/metabolismo , Transducción de Señal/efectos de los fármacos , Estadística como Asunto , Factores de Tiempo , Área Tegmental Ventral/efectos de los fármacos
7.
Diabetologia ; 48(6): 1075-83, 2005 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15864530

RESUMEN

AIMS/HYPOTHESIS: Leptin resistance is generally considered a consequence of obesity. We postulated that leptin resistance is associated with diminished hypothalamic leptin signalling capacity and that leptin resistance is causal to obesity. We assessed maximal leptin-mediated binding of the transcription factor signal transducer and activator of transcription 3 (STAT3), and the response to high-fat feeding in lean leptin-resistant rats. MATERIALS AND METHODS: Recombinant adeno-associated virus encoding rat leptin cDNA (rAAV-leptin) or control vector were administered by intracerebroventricular injection to lean F344 x BN rats for up to 150 days, and food consumption, body weight, serum leptin and glucose tolerance were measured. Leptin-mediated hypothalamic transcription factor binding was assessed at day 150 following an intracerebroventricular injection of 2 mug leptin. Rats pretreated with either control or rAAV-leptin vector for 94 days were given a high-fat diet, and energy intake, body weight gain and adiposity were examined. RESULTS: The rAAV-leptin-treated rats initially responded to leptin gene delivery then became leptin-resistant. They displayed persistent submaximal hypothalamic leptin signalling and enhanced insulin sensitivity, yet maximal hypothalamic signalling capacity was decreased by more than 50%. On a high-fat diet, the leptin-resistant rats consumed more energy, gained more weight and accumulated greater visceral fat mass than controls. CONCLUSIONS/INTERPRETATION: The maximal hypothalamic leptin signalling capacity was diminished in leptin-resistant rats receiving central rAAV-leptin gene therapy. Moreover, this leptin-invoked leptin resistance perturbs the regulation of energy homeostasis in response to high fat exposure, producing augmented energy consumption. This, coupled with potential hypersensitivity to insulin, creates a milieu favouring fat deposition. Our data suggest that leptin resistance is both a consequence and cause of obesity.


Asunto(s)
Leptina/farmacología , Obesidad/fisiopatología , Transducción de Señal/fisiología , Animales , Peso Corporal , ADN Complementario/genética , Dieta , Conducta Alimentaria , Prueba de Tolerancia a la Glucosa , Inyecciones Intraventriculares , Insulina/sangre , Leptina/administración & dosificación , Leptina/genética , Leptina/fisiología , Masculino , Ratas , Ratas Endogámicas BN , Ratas Endogámicas F344 , Aumento de Peso/efectos de los fármacos
8.
Neuroscience ; 115(3): 879-89, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12435426

RESUMEN

Interleukin-6 (IL-6) is a multifunctional cytokine that may have a role in energy regulation. Using a recombinant adeno-associated viral vector expressing murine interleukin-6 (rAAV-IL-6), we examined the chronic effects of centrally expressed IL-6 on food intake, body weight and adiposity in male Sprague-Dawley rats, and investigated the underlying mechanisms. Direct delivery of rAAV-IL-6 into rat hypothalamus suppressed weight gain and visceral adiposity without affecting food intake over a 5-week period. rAAV-IL-6 enhanced uncoupling protein 1 (UCP1) protein levels in interscapular brown adipose tissue (BAT). To investigate if the induction of UCP1 and the reduction in body weight are dependent on sympathetic innervation of BAT, we administered rAAV-IL-6 or a control vector into the hypothalamus of rats in which the interscapular BAT was unilaterally denervated. Over 21 days, there was no difference in food consumption or body weight between rAAV-IL-6- and control vector-treated rats. rAAV-IL-6 delivery increased UCP1 mRNA and protein levels in innervated BAT pads but not denervated BAT pads. Hypothalamic IL-6 signal transduction, indicated by phosphorylated signal transducer and activator of transcription 3 (P-STAT3) levels, was elevated by 2.6-fold at day 21, but returned to control levels by day 35. However, the suppressor of cytokine signaling-3 mRNA level was significantly elevated both at day 21 and day 35. These data demonstrate that chronic elevation of IL-6 in the CNS reduces body weight gain and visceral adiposity without affecting food intake. The mechanism involves sympathetic induction of UCP1 in BAT and, presumably, enhanced thermogenesis in BAT. Furthermore, chronic central IL-6 stimulation desensitizes IL-6 signal transduction characterized by reversal of elevated P-STAT3 levels.


Asunto(s)
Tejido Adiposo Pardo/metabolismo , Regulación del Apetito/genética , Peso Corporal/genética , Proteínas Portadoras/metabolismo , Hipotálamo/metabolismo , Interleucina-6/genética , Proteínas de la Membrana/metabolismo , Sistema Nervioso Simpático/fisiología , Tejido Adiposo Pardo/inervación , Animales , Regulación del Apetito/efectos de los fármacos , Proteínas Portadoras/genética , Células Cultivadas , Corticosterona/sangre , Proteínas de Unión al ADN/genética , Proteínas de Unión al ADN/metabolismo , Metabolismo Energético/genética , Regulación de la Expresión Génica/genética , Vectores Genéticos , Humanos , Hipotálamo/efectos de los fármacos , Inmunohistoquímica , Canales Iónicos , Leptina/sangre , Masculino , Proteínas de la Membrana/genética , Proteínas Mitocondriales , ARN Mensajero/metabolismo , Ratas , Ratas Sprague-Dawley , Factor de Transcripción STAT3 , Transducción de Señal/genética , Simpatectomía , Termogénesis/genética , Transactivadores/genética , Transactivadores/metabolismo , Transfección , Proteína Desacopladora 1
9.
Gene Ther ; 9(22): 1492-9, 2002 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-12407421

RESUMEN

Our purpose was to incorporate regulation into the recombinant adeno-associated virus encoding leptin by introducing a tet-inducible promotor. This system, TET-Ob, allows for control of leptin gene expression via doxycycline in drinking water. F344XBN rats (aged 4 months) were given a hypothalamic injection of TET-Ob or control virus. During 34 days of doxycycline (doxy) administration to all rats (STAGE 1), TET-Ob rats gained 50.7% less mass, ate 10.4% less food, and had a 77.5% reduction in serum leptin as compared with controls. Doxy was then withdrawn from half of the TET-Ob rats for 32 days (TET-Ob-OFF), while half continued to receive doxy (TET-Ob-ON) (stage 2). During stage 2, TET-Ob-ON rats gained 44.8% less mass than TET-Ob-OFF and ate significantly less food than both TET-Ob-OFF and controls. Serum leptin increased to 83.4% of control values in TET-Ob-OFF, but remained very low in the in TET-Ob-ON. At death, visceral adiposity was 14.5% of controls in TET-Ob-ON animals, but had risen to 76.9% of controls in TET-Ob-OFF. A reversible increase in both leptin signal transduction in the hypothalamus and uncoupling protein expression in brown adipose was recorded. This system allows for more precise regulation of gene therapy-mediated fat loss.


Asunto(s)
Doxiciclina/farmacología , Ingestión de Alimentos/fisiología , Hipotálamo/metabolismo , Leptina/genética , Transducción de Señal/fisiología , Tejido Adiposo Pardo/metabolismo , Animales , Proteínas Portadoras/genética , Proteínas Portadoras/metabolismo , Proteínas de Unión al ADN/genética , Expresión Génica/efectos de los fármacos , Ingeniería Genética , Vectores Genéticos/administración & dosificación , Vectores Genéticos/genética , Canales Iónicos , Leptina/sangre , Masculino , Proteínas de la Membrana/genética , Proteínas de la Membrana/metabolismo , Proteínas Mitocondriales , ARN Mensajero/análisis , Ratas , Ratas Endogámicas F344 , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factor de Transcripción STAT3 , Transactivadores/genética , Transfección/métodos , Transgenes , Proteína Desacopladora 1
10.
J Endocrinol ; 174(3): 455-61, 2002 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-12208666

RESUMEN

Leptin is a peripheral immunoenhancing reagent that directly activates splenic lymphocytes in mice. We found that a 48 h fast in rats resulted in a decrease in serum leptin that was accompanied by a lower delayed-type hypersensitivity (DTH) response. Peripheral leptin replacement completely restored this response in fasted animals. We employed a recombinant adeno-associated virus (rAAV) system to deliver leptin gene directly into rat brain to assess the effect of sustained long-term central expression of leptin on immune responses. The rAAV-leptin rats had elevated central leptin over the 60 day duration of the experiment, whereas body fat and circulating leptin fell to near zero levels. The DTH response was significantly reduced by 10-20% in rats receiving rAAV-leptin compared with the control rats, and the difference was maintained for over 50 h. When the rats undergoing rAAV-leptin gene therapy were given either murine recombinant leptin or PBS s.c., rats receiving leptin had a 17% higher DTH response than rats receiving PBS. The isolated splenocytes from the former group also proliferated 34% more in vitro in response to the mitogen concanavalin A as compared with the latter group. These results suggest that peripheral leptin has a dominant role in maintaining T-cell-mediated immune responses in rats, and central leptin is unable to compensate for the immunosuppression associated with peripheral hypoleptinemia. Furthermore, preservation of normal cell-mediated immune responses does not require fat tissue as along as serum leptin levels are maintained.


Asunto(s)
Ayuno/fisiología , Hipersensibilidad Tardía/inmunología , Leptina/administración & dosificación , Animales , Concanavalina A , Dependovirus/genética , Vectores Genéticos/administración & dosificación , Hipersensibilidad Tardía/sangre , Bombas de Infusión , Inyecciones Intraventriculares , Leptina/sangre , Leptina/genética , Activación de Linfocitos , Masculino , Ratas , Ratas Endogámicas BN , Ratas Endogámicas F344 , Pruebas Cutáneas
11.
Neuropharmacology ; 42(4): 548-61, 2002 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-11955525

RESUMEN

The purpose of this study was to determine if long-term leptin treatment desensitizes leptin signal transduction and the subsequent downstream anorexic and thermogenic responses in normal and leptin-resistant age-related obese rats. To this end, we administered, i.c.v., recombinant adeno-associated virus encoding rat leptin cDNA (rAAV-leptin) or control virus into young and aged-obese rats and after 9 or 46 days, examined food intake, oxygen consumption, body weight, serum leptin, STAT3 phosphorylation, hypothalamic NPY and POMC mRNAs, and UCP1 expression and protein level in brown adipose tissue (BAT). In young rats, rAAV-leptin depleted body fat and both anorexic and thermogenic mechanisms contributed to this effect. Moreover, leptin signal transduction was not desensitized, and there were persistent physiological responses. Similarly, in the aged-obese rats, there was unabated leptin signal transduction, however, both the anorexic and thermogenic responses completely attenuated sometime after day 9. This attenuation, downstream of the leptin receptor, may be contributing to the leptin-resistance and age-related weight gain in these aged-obese rats. Finally, in young rats, although the initial responses to rAAV-leptin were dominated by anorexic responses, by 46 days, the predominant response was thermogenic rather than anorexic, suggesting that energy expenditure may be an important component of long-term weight maintenance.


Asunto(s)
Envejecimiento/genética , Terapia Genética/métodos , Leptina/administración & dosificación , Leptina/genética , Obesidad/genética , Obesidad/terapia , Transducción de Señal/genética , Tejido Adiposo Pardo/metabolismo , Animales , Peso Corporal/genética , ADN Complementario/administración & dosificación , Sistemas de Liberación de Medicamentos/métodos , Sistemas de Liberación de Medicamentos/estadística & datos numéricos , Ingestión de Alimentos/genética , Vectores Genéticos/administración & dosificación , Inyecciones Intraventriculares , Leptina/biosíntesis , Leptina/líquido cefalorraquídeo , Masculino , Obesidad/fisiopatología , Consumo de Oxígeno/genética , Ratas , Ratas Endogámicas BN , Ratas Endogámicas F344
12.
Int J Pediatr Otorhinolaryngol ; 53(1): 39-44, 2000 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-10862923

RESUMEN

The oral-facial-digital (OFD) syndromes are a heterogeneous group of hereditary disorders which have in common the findings of oral abnormalities, facial dysmorphism, and hand/feet malformations. We report the case history of an 18-month-old male with cerebellar cysts, hydrocephalus, tongue hamartomas, and polydactyly. These findings are most consistent with OFD VI. The clinical features of eight different types of OFD are discussed, with particular attention to the characteristics of the most interest to the otolaryngologist.


Asunto(s)
Anomalías Múltiples/diagnóstico , Hamartoma/diagnóstico , Deformidades Congénitas de la Mano/diagnóstico , Hidrocefalia/diagnóstico , Polidactilia/diagnóstico , Enfermedades de la Lengua/diagnóstico , Anomalías Múltiples/cirugía , Estudios de Seguimiento , Hamartoma/cirugía , Deformidades Congénitas de la Mano/cirugía , Humanos , Lactante , Masculino , Otolaringología/métodos , Polidactilia/cirugía , Síndrome , Enfermedades de la Lengua/cirugía
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