CESAR ISAAC
Projetos de Pesquisa
Unidades Organizacionais
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina - Líder
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Treatment of extrinsic ectropion on burned face with facial suspension technique(2014) VANA, Luiz Philipe Molina; ISAAC, Cesar; ALONSO, NivaldoThe extrinsic ectropion is a condition with low prevalence characterized by an ectropion with normal eyelid and anatomy unchanged and the cause is found in tissues adjacent orbits. There are not many studies in the literature regarding their treatment, especially without addressing the eyelid respecting its anatomical integrity. Purpose: To evaluate the outcome of 8 extrinsic ectropions secondary to facial burns treated with facial suspension technique. Patients and methods: Five patients were evaluated with sequelae of facial burns and extrinsic unilateral or bilateral ectropion, a total of 8 ectropions. The technique used was the endoscopic facial suspension with or without release of the facial scar retraction. We evaluated the position of the lower lid over medium-pupillary line, symptoms, complications and patient satisfaction in a 24 months follow-up. Results: 6 Peri-orbital regions showed good results and two moderate results, all cases had clinical improvement of the ectropion, the symptoms and the esthetic aspect; there was not any complication or reoperation. There was a gain of 2.2-26.2% of the lower eyelid margin position in relation to the horizontal mid-pupillary line. Conclusion: The endoscopic facial suspension proved to be a surgical technique with low morbidity and efficient treatment in 8 facial extrinsic ectropion.
- Short-term effects of 7-ketocholesterol on human adipose tissue mesenchymal stem cells in vitro(2014) LEVY, Debora; RUIZ, Jorge Luis Maria; CELESTINO, Andrea Turbuck; SILVA, Suelen Feitoza; FERREIRA, Adilson Kleber; ISAAC, Cesar; BYDLOWSKI, Sergio PauloOxysterols comprise a very heterogeneous group derived from cholesterol through enzymatic and nonenzymatic oxidation. Among them, 7-ketocholesterol (7-KC) is one of the most important. It has potent effects in cell death processes, including cytoxicity and apoptosis induction. Mesenchymal stem cells (MSCs) are multipotent cells characterized by self-renewal and cellular differentiation capabilities. Very little is known about the effects of oxysterols in MSCs. Here, we describe the short-term cytotoxic effect of 7-ketocholesterol on MSCs derived from human adipose tissue. MSCs were isolated from adipose tissue obtained from two young, healthy women. After 24 h incubation with 7-KC, mitochondrial hyperpolarization was observed, followed by a slight increase in the level of apoptosis and changes in actin organization. Finally, the IC50 of 7-KC was higher in these cells than has been observed or described in other normal or cancer cell lines.
- Evaluation of Radiosterilized Glyercerolated Amniotic Membranes as a Substrate for Cultured Human Epithelial Cells(2020) PAGGIARO, Andre O.; MATHOR, Monica B.; TEODORO, Walcy R.; ISAAC, Cesar; CAPELOZZI, Vera L.; GEMPERLI, RolfHuman amniotic membrane (HAM) is a biomaterial with biological properties beneficial to tissue repair, serving as a substrate for cell cultivation. Irradiation is used for tissue sterilization, but can damage the HAM structure. The objective of this paper was to construct a skin substitute, composed of human keratinocytes cultured on glycerolated HAMs, and to evaluate the influence radiation on subsequent cell culture growth. Four batches of HAMs were glycerolated, and half of them were radio-sterilzed with 25 kGy. Non-irradiated glycerolated HAM (ni-HAM) and irradiated glycerolated HAM (i-HAM) samples were then de-epithelized and analyzed using optical microscopy (Picrossirius staining), immunofluorescence and electron microscopy. Subsequently, keratinocytes were cultured on ni- and i-HAMs, and either immersed or positioned at the air-liquid interface. The basement membranes of the ni-HAM group remained intact following de-epithelialization, whereas the i-HAM group displayed no evidence or remnant presence of these membranes. Concerning the keratinocyte cultures, the ni-HAM substrate promoted the growth of multi-layered and differentiated epithelia. Keratinocytes cultured on i-HAM formed epithelium composed of three layers of stratification and discrete cell differentiation. The glycerolated HAM was compatible with cultured epithelia, demonstrating its potential as a skin substitute. Irradiation at 25 kGy caused structural damage to the amnion.
- Clinical Trial Comparing 3 Different Wound Dressings for the Management of Partial-Thickness Skin Graft Donor Sites(2011) CARVALHO, Viviane Fernandes de; PAGGIARO, Andre Oliveira; ISAAC, Cesar; GRINGLAS, Julio; FERREIRA, Marcus CastroPURPOSE: A review of the literature reveals a lack of consensus regarding local management of skin graft donor sites. This study was undertaken to determine the effects of 3 different dressings on healing of donor sites and patient discomfort related to donor sites. DESIGN: This study is a comparison cohort study. SUBJECTS AND SETTING: We recruited 34 burn patients scheduled for partial-thickness skin grafts; their mean age was 36 +/- 18 years (mean +/- SD, range 20 to 54 years), and 63% were male. All subjects were managed at Burn Unity Care, located in Sao Paulo, Brazil. MATERIALS AND METHODS: Subjects were randomly allocated to 1 of 3 groups: (1) a study group (group A) whose donor sites were dressed with a bovine collagen calcium-alginate dressing covered with transparent polyurethane film; (2) a second intervention group (group B), whose donor sites were dressed only with transparent polyurethane film dressing; and (3) a control group whose donor sites were dressed with rayon soaked in 0.9% saline (group C). Two independent observers assessed donor site wounds for epithelialization, scabbing, quantity and characteristics of exudate, and complications. Pain was measured using the visual analog scale, the brief pain inventory, and Index of Pain Management. RESULTS: Subjects managed with the bovine collagen calcium-alginate dressing covered with transparent polyurethane film (group A) achieved the greatest epithelialization (6.3 vs 8.2 for thin film dressing only P < .02 and 6.3 vs 11.7 days for control group P < .01). Patients managed with the bovine collagen calcium-alginate dressing covered with transparent polyurethane film also reported less pain that subjects allocated to the control (group C) or thin film only group (group B), (P < .05). Ninety percent of subjects allocated to the calcium alginate covered with thin film dressing reported mild pain intensity on the Visual Analog Scale, 85% of did not report pain localized to the donor site on the brief pain inventory, and scores on the Index of Pain Management ranged from 23 to 11. CONCLUSION: Study findings suggest that use of a collagen calcium-alginate dressing with a transparent film covering reduces the time for complete epithelialization and may reduce pain related to skin graft donor sites.
- COMPARISONS OF THE RESULTS OF PERIPHERAL NERVE DEFECT REPAIR WITH FIBRIN CONDUIT AND AUTOLOGOUS NERVE GRAFT: AN EXPERIMENTAL STUDY IN RATS(2016) LONGO, Marco Vinicius Losso; FARIA, Jose Carlos Marques De; ISAAC, Cesar; NEPOMUCENO, Andre Coelho; TEIXEIRA, Nuberto Hopfgartner; GEMPERLI, RolfIntroduction: The standard treatment for nerve defects is nerve autograft. There is no conduit available that provides the same regenerative capacity of nerve autograft. This study evaluated the histological and functional recovery of nerve defects treated with fibrin conduit in comparison to the nerve autograft, in a rat model. Method: A sciatic nerve injury model (10-mm defect) was performed in 20 Wistar rats, nerve defect was reconstructed using a fibrin conduit (n=10). A nerve autograft was used as control (n=10). The walking behavior was measured by footprint analysis at 4, 8, and 12 weeks and sciatic function index was determined. After 12 weeks, histological analysis was performed to evaluate the regenerated nerve and measured axonal density. The triceps surae muscle weight was also evaluated. Results: The fibrin conduit group showed less improvement in walking behavior compared to nerve autograft (-53 +/- 2 vs. -36 +/- 2; P<0.001 at 12 weeks). The fibrin conduit group presented axonal density of 40.0 axons/10.995 mu m2 and the nerve autograft group had 67.2 axons/10.995 mu m2 (P<0.001). The triceps surae muscle weight ratio of the fibrin conduit group was 41 +/- 3% versus 71 +/- 4% of the nerve autograft group (P<0.001). Conclusion: The fibrin conduit could be used for nerve reconstruction following peripheral nerve injury in the rat model. However, the functional recovery in the fibrin conduit repair group was worse than that in nerve autograft group and the nerve repair with the fibrin conduit has less myelinated fibers when compared to the repair with nerve autograft. (C) 2015 Wiley Periodicals, Inc.