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1.
Enzyme Microb Technol ; 128: 1-8, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31186105

RESUMO

α2,3-Sialyltransferase from Pasteurella multocida (PmST1) is an enzyme that transfers a sialyl group of donor substrates to an acceptor substrate called N-acetyl-d-lactosamine (LacNAc). In this study PmST1 was expressed on the outer membrane of wildtype Escherichia coli (BL21) with lipopolysaccharide (LPS) and ClearColi with no LPS, and then the enzyme activity and expression level of PmST1 were compared. As the first step, the expression levels of PmST1 on the outer membranes of wildtype E. coli (BL21) and ClearColi were compared according to the IPTG induction time, and the absolute amount of surface-displayed PmST1 was calculated using densitometry of SDS-PAGE. As the next step, the influence of LPS on the PmST1 activity was estimated by analyzing Michaelis-Menten plot. The enzyme activity of PmST1 was analyzed by measuring the concentration of CMP, which was a by-product after the transfer of the sialyl group of donor compounds to the acceptor compounds. From a Michaelis-Menten plot, the enzyme activity of the surface-displayed PmST1 and the maximum rate (Vmax) of ClearColi were higher than those of wildtype E. coli (BL21). However, the KM value, which represented the concentration of substrate to reach half the maximum rate (Vmax), was similar for both enzymes. These results represented such a difference in enzyme activity was occurred from the interference of LPS on the mass transport of the donor and acceptor to PmST1 for the sialyl group transfer.


Assuntos
Proteínas da Membrana Bacteriana Externa/metabolismo , Técnicas de Visualização da Superfície Celular/métodos , Escherichia coli/enzimologia , Escherichia coli/metabolismo , Proteínas Recombinantes/metabolismo , Sialiltransferases/metabolismo , Proteínas da Membrana Bacteriana Externa/genética , Eletroforese em Gel de Poliacrilamida , Escherichia coli/genética , Perfilação da Expressão Gênica , Cinética , Pasteurella multocida/enzimologia , Pasteurella multocida/genética , Proteínas Recombinantes/genética , Sialiltransferases/genética
2.
Anal Chim Acta ; 1055: 106-114, 2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-30782361

RESUMO

The autoimmune diseases systemic lupus erythematosus (SLE) and Sjogren's syndrome (SS) are diagnosed by detection of autoantibodies against Ro and La protein autoantigens, respectively. In this work, the diagnosis of autoimmune diseases SLE and SS was demonstrated using thermophoresis of Escherichia coli with the autodisplayed autoantigens. Ro and La protein autoantigens were autodisplayed by constitutive expression together with a fluorescent protein called tdTomato in the cytosol. The binding affinity of the autodisplayed autoantigens was tested against positive and control sera by using FACS as a reference method. The factors influencing interactions between E. coli with autodisplayed autoantigens and autoantibodies in sera during thermophoresis were analyzed by measurement of cell surface charge and size before and after interaction. Finally, the thermophoretic diagnosis of autoimmune diseases SLE and SS was demonstrated using sera from patients afflicted with the respective diseases by estimating sensitivity and selectivity from ROC plots.


Assuntos
Autoantígenos/imunologia , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/imunologia , Escherichia coli/metabolismo , Animais , Autoanticorpos/química , Autoanticorpos/imunologia , Autoanticorpos/metabolismo , Autoantígenos/metabolismo , Modelos Moleculares , Conformação Proteica
3.
Enzyme Microb Technol ; 100: 1-10, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28284305

RESUMO

The objective of this study was to present an immunoassay for the diagnosis of Sjögren's syndrome based on the autodisplayed La/SSB protein on the outer membrane of intact E. coli (strain UT-5600) and LPS-free E. coli (ClearColi™). As the first step, an autodisplay vector (pCK002) was transfected into intact E. coli and LPS-free E. coli for comparison of efficiency of autdisplay of La/SSB. The maximal level of La/SSB expression was estimated to be similar for LPS-free E. coli and intact E. coli at different optimal induction periods. Intact E. coli was found to grow twofold faster than LPS-free E. coli, and the maximal level of expression for LPS-free E. coli was obtained with a longer induction period. When the zeta potential was measured, both intact E. coli and LPS-free E. coli showed negative values, and the autodisplay of negatively charged La/SSB protein (pI<7) on the outer membrane of intact E. coli and LPS-free E. coli resulted in a slight change in zeta potential values. E. coli with autodisplayed La/SSB protein was used for an immunoassay of anti-La/SSB antibodies for the diagnosis of Sjögren's syndrome. The surface of E. coli with the autodisplayed antigen was modified with rabbit serum and papain to prevent false positive signals because of nonspecific binding of unrelated antibodies from human serum. LPS-free E. coli with autodisplayed La/SSB protein yielded sensitivity and selectivity of 81.6% and 78.6%, respectively. The Bland-Altman test showed that the immunoassays based on LPS-free E. coli and intact E. coli with autodisplayed La/SSB protein were statistically equivalent to a clinical immunoassay for detection of anti-La/SSB antibodies (confidence coefficient 95%).


Assuntos
Anticorpos Antinucleares/sangue , Autoantígenos , Ribonucleoproteínas , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/imunologia , Animais , Autoantígenos/genética , Técnicas de Visualização da Superfície Celular/métodos , Escherichia coli/genética , Escherichia coli/imunologia , Humanos , Imunoensaio/métodos , Testes Imunológicos/métodos , Lipopolissacarídeos/imunologia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/imunologia , Coelhos , Ribonucleoproteínas/genética , Antígeno SS-B
4.
Enzyme Microb Technol ; 96: 85-95, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27871389

RESUMO

The autodisplay technology has been applied for expression of a desired protein on the outer membrane (OM) of Escherichia coli. In this work, the OM fractions of E. coli with two autodisplayed proteins were separately prepared and mixed to demonstrate the feasibility of control over the ratio of two autodisplayed proteins. As the first model, Z-domain and streptavidin were autodisplayed, and their activities were tested by means of the combined OM layer in a 96-well microplate and a surface plasmon resonance (SPR) biosensor. As the second model, lipase and foldase were autodisplayed which required an interaction between two proteins to obtain the activity of lipase. The OM fractions of E. coli with an autodisplayed lipase and foldase were separately prepared and mixed to demonstrate the feasibility of control over the ratio of two autodisplayed proteins when the interaction of two proteins is required within the same OM layer for the activity of the lipase.


Assuntos
Técnicas de Visualização da Superfície Celular/métodos , Escherichia coli/genética , Escherichia coli/metabolismo , Proteínas Recombinantes de Fusão/genética , Proteínas Recombinantes de Fusão/metabolismo , Membrana Celular/metabolismo , Lipase/genética , Lipase/metabolismo , Domínios Proteicos , Estreptavidina/genética , Estreptavidina/metabolismo
5.
Enzyme Microb Technol ; 92: 1-8, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27542738

RESUMO

Escherichia coli cells with autodisplayed Z-domains have been used for immunoassays of specific target analytes. In this study, a magnetite suspension was used for the washing step in immunoassays of E. coli cells with autodisplayed Z-domains. This approach enhanced the washing conditions for these immunoassays by determining (1) the optimal concentration of the magnetite suspension, (2) the capacity of the magnetite suspension-based washing method to recover E. coli cells, and (3) the level at which the activity of autodisplayed Z-domains is maintained. In immunoassays of C-reactive protein (CRP), the immunoassay incorporating the magnetite suspension-based washing method showed a sensitivity and limit of detection considerably higher than those of the conventional centrifugation-based washing method. The results indicated that immunoassays incorporating the magnetite suspension-based washing method are effective for medical diagnoses based on CRP assay.


Assuntos
Escherichia coli/metabolismo , Imunoensaio/métodos , Anticorpos Imobilizados , Proteína C-Reativa/análise , Técnicas de Visualização da Superfície Celular , Escherichia coli/ultraestrutura , Óxido Ferroso-Férrico , Citometria de Fluxo , Imunoensaio/estatística & dados numéricos , Separação Imunomagnética , Limite de Detecção , Domínios Proteicos , Suspensões
6.
Biochim Biophys Acta ; 1848(12): 3126-33, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26407724

RESUMO

In this work, two proteins, Z-domains and bovine casein, were auto-displayed on the outer membrane of the same Escherichia coli cells by co-transformation of two different auto-display vectors. On the basis of SDS-PAGE densitometry, Z-domains and bovine casein were expressed at 3.12 × 105 and 1.55 × 105 proteins/E. coli cell, respectively. The co-auto-displayed Z-domains had antibody-binding activity and the bovine casein had adhesive properties. E. coli with co-auto-displayed proteins were analyzed by fluorescence assisted cell sorting (FACS). E. coli with co-auto-displayed Z-domains and bovine casein aggregated due to hydrophobic interaction. For application to immunoassays, the Z-domain activity was estimated after (1) immobilizing the E. coli and (2) forming an OM layer. E. coli with co-auto-displayed two proteins that were immobilized on a polystyrene microplate had the same antibody-binding activity as did E. coli with auto-displayed Z-domains only. The OM layer from the co-transformed E. coli had Z-domains and bovine casein expressed at a 1:2 ratio from antibody-binding activity measurements.


Assuntos
Caseínas/genética , Escherichia coli/genética , Animais , Caseínas/metabolismo , Bovinos , Membrana Celular/metabolismo , Eletroforese em Gel de Poliacrilamida , Citometria de Fluxo , Imunoensaio
7.
Biochim Biophys Acta ; 1848(7): 1509-13, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25858110

RESUMO

In this work, adrenodoxin (Adx) was expressed on the outer membrane of E. coli by autodisplay and then the iron-sulfur cluster was incorporated into apo-Adx by an anaerobic reconstitution process. For the determination of the redox potentials of the iron-sulfur clusters of the autodisplayed Adx, E. coli cells with autodisplayed Adx were immobilized on a gold electrode modified with a self-assembled monolayer of mercaptoundecanoic acid (MUA). From the repeated cyclic voltammetry (CV) analysis, the E. coli (10mM HEPES buffer, pH7.0) with autodisplayed Adx showed significant changes in shape with an oxidation peak at +0.4V (vs. Ag/AgCl) and a reduction peak at -0.3V (vs. Ag/AgCl) after the reconstitution process for the incorporation of the iron-sulfur cluster. From the repeated CV analysis in the reduction and oxidation potential ranges, the iron-sulfur clusters of the autodisplayed Adx were observed to undergo reversible redox reactions via direct electron transfer to the MUA-modified gold electrode.


Assuntos
Adrenodoxina/metabolismo , Membrana Celular/metabolismo , Técnicas Eletroquímicas/métodos , Proteínas Recombinantes/metabolismo , Adrenodoxina/química , Adrenodoxina/genética , Animais , Western Blotting , Bovinos , Técnicas Eletroquímicas/instrumentação , Eletrodos , Transporte de Elétrons , Escherichia coli/genética , Ácidos Graxos/química , Ouro/química , Proteínas Imobilizadas/química , Proteínas Imobilizadas/metabolismo , Oxirredução , Proteínas Recombinantes/química , Compostos de Sulfidrila/química
8.
Biochim Biophys Acta ; 1848(3): 842-7, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25528472

RESUMO

"Autodisplay technology" is an expression technique used to display the various recombinant proteins on the outer membrane (OM) of Escherichia coli. The resulting autodisplayed Z-domain has been used to improve the sensitivity of immunoassays. In this work, a facile isolation method of the OM fraction of E. coli with autodisplayed Z-domains was presented using (1) an enzyme reaction for the hydrolysis of the peptidoglycan layer and (2) short centrifugation steps. The purity of the isolated OM fraction was analyzed. For the estimation of contamination with bacterial proteins from other parts of E. coli, Western blots of marker proteins for the OM (OmpA), periplasm (ß-lactamase), inner membrane (SecA), and cytoplasm (ß-galactosidase) were performed. Additionally, assays of marker components or enzymes from each part of E. coli were carried out including the OM (KDO), inner membrane (NADH oxidase), periplasm (ß-lactamase), and cytoplasm (ß-galactosidase). The yield of OM isolation using this new method was determined to be 80% of the total OM amount, with less than 1% being contaminants from other parts of E. coli.


Assuntos
Proteínas da Membrana Bacteriana Externa/metabolismo , Membrana Celular/metabolismo , Proteínas de Escherichia coli/metabolismo , Escherichia coli/metabolismo , Proteínas da Membrana Bacteriana Externa/química , Western Blotting , Membrana Celular/química , Proteínas de Escherichia coli/química , Bicamadas Lipídicas/química , Bicamadas Lipídicas/metabolismo , Modelos Moleculares , Complexos Multienzimáticos/química , Complexos Multienzimáticos/metabolismo , NADH NADPH Oxirredutases/química , NADH NADPH Oxirredutases/metabolismo , Estrutura Terciária de Proteína , beta-Galactosidase/química , beta-Galactosidase/metabolismo , beta-Lactamases/química , beta-Lactamases/metabolismo
9.
Enzyme Microb Technol ; 66: 42-7, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25248698

RESUMO

The outer membrane of Escherichia coli was previously isolated as a liposome-like outer membrane particle using an enzymatic treatment for lysozymes; for immunoassays, the particles were subsequently layered on solid supports via hydrophobic interactions. This work presents an enzyme-free isolation method for the E. coli outer membrane with autodisplayed Z-domains using ultrasonication. First, the properties of the outer membrane particle, such as the particle size, zeta potential, and total protein, were compared with the properties of particles obtained using the previous preparation methods. Compared with the conventional isolation method using an enzyme treatment, the ultrasonic method exhibited a higher efficiency at isolating the outer membrane and less contamination by cytosolic proteins. The isolated outer membrane particles were layered on a gold surface, and the roughness and thickness of the layered outer membrane layers were subsequently analyzed using AFM analysis. Finally, the antibody-binding activity of two outer membrane layers with autodisplayed Z-domains created from particles that were isolated using the enzymatic and ultrasonic isolation methods was measured using fluorescein-labeled antibody as a model analyte, and the activity of the outer membrane layer that was isolated from the ultrasonic method was estimated to be more than 20% higher than that from the conventional enzymatic method.


Assuntos
Fracionamento Celular/métodos , Escherichia coli/química , Proteínas da Membrana Bacteriana Externa/isolamento & purificação , Membrana Celular/química , Enzimas , Proteínas de Escherichia coli/isolamento & purificação , Microscopia de Força Atômica , Sonicação/métodos
10.
Biosens Bioelectron ; 57: 213-8, 2014 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-24583694

RESUMO

A microarray-based immunoassay for the detection of autoantibodies against Ro protein was developed using Escherichia coli with autodisplayed Ro proteins (Ro(+)-E. coli). Patient serum usually contains various antibodies against the outer membrane components of E. coli as well as autoantibodies against the Ro protein. Therefore, the conventional immunoassay based on Ro(+)-E. coli requires both wild type E. coli (blank test) and Ro(+)-E. coli, and both strains of E. coli must be prepared in situ for each individual test serum. In this study, we tested the feasibility of using several types of animal sera as a replacement for individual human sera. An immunoassay without the blank test was developed using Ro(+)-E. coli by (1) blocking with rabbit serum, and (2) cleaving the Fc region from antibodies using papain. Modified E. coli with autodisplayed Ro protein was immobilized to a surface-modified microplate and the applicability of the immunoassay without the blank test was demonstrated using sera from patients with systemic lupus erythematosus (SLE). Using this approach, a microarray-based fluorescence immunoassay with immobilized Ro(+)-E. coli was able to detect anti-Ro autoantibodies in SLE patient sera with high specificity and selectivity and improved efficiency.


Assuntos
Autoanticorpos/análise , Técnicas Biossensoriais/métodos , Lúpus Eritematoso Sistêmico/diagnóstico , Análise Serial de Proteínas/métodos , Ribonucleoproteínas/imunologia , Animais , Células Imobilizadas/química , Escherichia coli/química , Fluorimunoensaio/métodos , Humanos , Coelhos , Sensibilidade e Especificidade
11.
Enzyme Microb Technol ; 53(3): 181-8, 2013 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-23830460

RESUMO

Recently, we reported a highly sensitive immunoassay using Escherichia coli cells with autodisplayed Z-domains. In this work, E. coli cells with autodisplayed Z-domains were applied to the flow-cytometry-based simultaneous detection of multiple analytes. The E. coli cells were doubly transfected to express a fluorescent protein (tdTomato) in the cytosol and the autodisplayed Z-domains on the outer membrane. By using E. coli cells with only the autodisplayed Z-domains, immunoassay of multiple analytes could be performed simultaneously on the same sample. Flow cytometry can be used to identify the immunoassay type by simultaneously detecting the fluorescence signal from the cytosol (tdTomato) and the fluorescence from the outer membrane, enabling the quantification of bound analytes after treatment with additional fluorescently labeled antibodies. To demonstrate the immunoassay of multiple analytes by using flow cytometry, human hepatitis B virus surface antigen (HBsAg) and C-reactive protein (CRP), a broad spectrum inflammation marker, were used as model analytes.


Assuntos
Escherichia coli/imunologia , Escherichia coli/metabolismo , Citometria de Fluxo/métodos , Imunoensaio/métodos , Animais , Anticorpos Imobilizados , Proteína C-Reativa/análise , Membrana Celular/imunologia , Membrana Celular/metabolismo , Escherichia coli/genética , Cabras , Antígenos de Superfície da Hepatite B/análise , Humanos , Proteínas Luminescentes/genética
12.
Biosens Bioelectron ; 50: 345-50, 2013 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-23891796

RESUMO

We have developed a carbon nanotube (CNT) film-based biosensor with a metal semiconductor field effect transistor structure (MESFET). A gold top gate was deposited on the middle of the CNT channel and probe antibodies were immobilized on the gold top gate with an antibody-binding protein, protein G or Escherichia coli outer membrane (OM) with autodisplayed Z-domains of protein A. These CNT-MESFET biosensors exhibited a higher sensitivity than the CNT-FET biosensor with probe antibodies immobilized using a chemical linker, since the orientation of immobilized antibodies was controlled by the antibody-binding proteins. In addition, nonspecific binding was effectively inhibited by E. coli OM. Using the CNT-MESFET biosensors with E. coli OM containing Z domain, we detected amyloid-ß (Aß) in human serum, one of the biomarkers for early diagnosis of Alzheimer's disease. Aß at the level of 1 pg/mL in human serum could be measured in real-time and without labeling, which was lower than a limit of detection for plasma Aß using an enzyme-linked immune sorbent assay. These results suggested that our CNT-MESFET biosensors might be applicable for an early diagnosis of Alzheimer's disease.


Assuntos
Peptídeos beta-Amiloides/sangue , Técnicas Biossensoriais/instrumentação , Nanotubos de Carbono/química , Semicondutores , Doença de Alzheimer/sangue , Proteínas da Membrana Bacteriana Externa/química , Desenho de Equipamento , Escherichia coli/química , Proteínas de Escherichia coli/química , Ouro/química , Humanos , Limite de Detecção
13.
Enzyme Microb Technol ; 53(2): 118-22, 2013 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-23769312

RESUMO

Escherichia coli cells with autodisplayed Z-domains could increase the sensitivity of immunoassays by immobilizing antibodies in a controlled orientation. In the work presented here, E. coli cells with autodisplayed Z-domains were immobilized to magnetic beads for subsequent immunoassay. In comparing conventional immunoassay using the E. coli cells with autodisplayed Z-domains, the magnetic-bead-based immunoassay improved immunoassay efficiency by minimizing the loss of E. coli cells during repeated centrifugation steps during washing. For the immobilization of E. coli cells to magnetic beads, the magnetic beads were modified with poly-l-lysine to bind to negatively charged E. coli cells. During the surface modification process, physical parameters such as the surface charge and size of the magnetic beads were analyzed to confirm the formation of E. coli-magnetic bead complexes. To test the feasibility of the magnetic-bead-based immunoassay, horseradish peroxidase (HRP) was used as a model analyte, and a biomarker for inflammatory diseases, C-reactive protein (CRP), was used for a demonstration of an application in medical diagnosis.


Assuntos
Células Imobilizadas/metabolismo , Escherichia coli/metabolismo , Separação Imunomagnética/métodos , Proteína C-Reativa/metabolismo , Escherichia coli/química , Citometria de Fluxo/métodos , Peroxidase do Rábano Silvestre/metabolismo , Humanos , Lisina/química , Sensibilidade e Especificidade , Propriedades de Superfície
14.
Anal Chim Acta ; 707(1-2): 142-7, 2011 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-22027131

RESUMO

Escherichia coli with autodisplayed Z-domains was reported to improve the sensitivity of immunoassays by the orientation control of antibodies. In this work, a sensitive microplate-based immunoassay is presented by immobilizing E. coli cells to a surface-modified microplate. The microplate was prepared by coating parylene-H film with formyl groups, and then covalently coupling poly-L-lysine to the parylene-H film. The E. coli cells were bound to the microplate by charge interactions between the negatively charged E. coli outer membrane and the positively charged microplate surface. In this work, the preparation of the microplate coated with poly-L-lysine is presented. The immobilization efficiency of E. coli to the modified surface was estimated to be far higher than non-specific interaction by fluorescence microscope and the optical transmittance of the modified microplate was measured to be feasible for immunoassay. The microplate-based immunoassay is demonstrated to be feasible for medical diagnosis of inflammatory diseases by using C-reactive protein as a target analyte for the medical diagnosis of inflammatory diseases.


Assuntos
Anticorpos Antibacterianos/química , Anticorpos Antibacterianos/metabolismo , Escherichia coli/química , Escherichia coli/metabolismo , Imunoensaio/métodos , Células Imobilizadas/microbiologia , Ensaio de Imunoadsorção Enzimática/métodos , Ligação Proteica/fisiologia , Propriedades de Superfície
15.
Laryngoscope ; 113(3): 508-13, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12616205

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of a combined endoscopic and transconjunctival orbital decompression in patients with thyroid-related orbitopathy with orbital apex compression. STUDY DESIGN: Retrospective review. METHODS: A sequential series of patients with thyroid-related orbitopathy presenting with orbital apex compressive myopathy with and without optic neuropathy who were undergoing combined endoscopic and transconjunctival decompression by the same surgeons from 1992 to 2001 was reviewed. Patients were regularly evaluated preoperatively and postoperatively over a 3- to 55-month period to record the effects of this approach on visual acuity, Hertel exophthalmometry, and diplopia. Complications and secondary ophthalmological procedures were reviewed. RESULTS: Between 1992 and 2001, 72 combined endoscopic and transconjunctival decompressions were performed on 41 patients with orbital apex compression. Visual acuity improved in 89.3% of the patients with compressive optic neuropathy (P <.0005) and in 34.1% of those without neuropathy. Proptosis was reduced by 3.65 mm, on average. There was one case of transient intraoperative cerebrospinal fluid extravasation at the site of the optic nerve decompression, and one patient developed epistaxis. CONCLUSIONS: The study supports the treatment of thyroid-related orbital apex compression with and without compressive optic neuropathy by a combined transconjunctival and endoscopic approach. This approach offers short hospital stays, excellent visual recovery, and minimal complications in patients with thyroid-related orbital apex compressive myopathy and related compressive optic neuropathy. The beneficial effects observed in the patients with visual loss continued to improve over time and were significant (P <.001).


Assuntos
Túnica Conjuntiva/cirurgia , Descompressão Cirúrgica/métodos , Doença de Graves/cirurgia , Síndromes de Compressão Nervosa/cirurgia , Doenças do Nervo Óptico/cirurgia , Órbita/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Diplopia/etiologia , Diplopia/cirurgia , Endoscopia/métodos , Exoftalmia/etiologia , Exoftalmia/cirurgia , Feminino , Doença de Graves/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/complicações , Doenças do Nervo Óptico/complicações , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Estudos Prospectivos , Estudos Retrospectivos , Acuidade Visual/fisiologia
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