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Françon A, Behar-Cohen F, Torriglia A. Wavelength-dependency of the impact of light on proliferation and DNA damage of corneal cells in vitro. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2025; 264:113118. [PMID: 39922040 DOI: 10.1016/j.jphotobiol.2025.113118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Revised: 01/20/2025] [Accepted: 01/28/2025] [Indexed: 02/10/2025]
Abstract
The wavelength-dependent impact of light has been mainly studied focusing on retina. In particular, an opposite effect of the two ends of the visible spectrum was observed, with blue wavelengths being harmful and red wavelengths being protective. However, few studies on the cornea indicate that the increasing exposition to artificial light due to digital devices is linked to an increase in computer vision syndrome affecting the cornea. In this study, we aim at deciphering the impact of blue and red LED light on a primary culture of corneal endothelial cells, by looking at cell death and proliferation, and at DNA replication and DNA breaks. Our results show that exposure to blue light at 5.35 J/cm2 (455 nm) induces the inhibition of DNA replication and cell proliferation, and the formation of DNA breaks, highlighted by the formation of γH2AX foci and DNA fragmentation. Addition of red light at 0.3 J/cm2 (630 nm) to blue light mitigates the formation of DNA damage and delays the kinetics of formation and repair of the damage. Interestingly, exposure of the corneal cells to red light alone induces the formation of γH2AX foci that do not correspond to DNA breaks, but to DNA replication forks in proliferative cells. Our results highlight the wavelength-dependent effect of light on the cornea, and point out that the formation of γH2AX foci is not always representative of DNA breaks. This emphasizes the importance of light spectrum in eye health, an important issue in today's changing light environment.
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Affiliation(s)
- Anaïs Françon
- Centre de Recherche des Cordeliers, INSERM UMRS 1138, Université Paris Cité, Sorbonne Université, Team: Physiopathology of Ocular Diseases: Therapeutic Innovations, 15, rue de l'école de Médecine, 75006 Paris, France
| | - Francine Behar-Cohen
- Centre de Recherche des Cordeliers, INSERM UMRS 1138, Université Paris Cité, Sorbonne Université, Team: Physiopathology of Ocular Diseases: Therapeutic Innovations, 15, rue de l'école de Médecine, 75006 Paris, France; Assistance Publique, Hôpitaux de Paris, Hôpital Cochin, Ophtalmopole, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Alicia Torriglia
- Centre de Recherche des Cordeliers, INSERM UMRS 1138, Université Paris Cité, Sorbonne Université, Team: Physiopathology of Ocular Diseases: Therapeutic Innovations, 15, rue de l'école de Médecine, 75006 Paris, France.
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Françon A, Delaunay K, Jaworski T, Lebon C, Picard E, Youale J, Behar-Cohen F, Torriglia A. Phototoxicity of low doses of light and influence of the spectral composition on human RPE cells. Sci Rep 2024; 14:6839. [PMID: 38514646 PMCID: PMC10957882 DOI: 10.1038/s41598-024-56980-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/13/2024] [Indexed: 03/23/2024] Open
Abstract
Light is known to induce retinal damage affecting photoreceptors and retinal pigment epithelium. For polychromatic light, the blue part of the spectrum is thought to be the only responsible for photochemical damage, leading to the establishment of a phototoxicity threshold for blue light (445 nm). For humans it corresponds to a retinal dose of 22 J/cm2. Recent studies on rodents and non-human primates suggested that this value is overestimated. In this study, we aim at investigating the relevance of the current phototoxicity threshold and at providing new hints on the role of the different components of the white light spectrum on phototoxicity. We use an in vitro model of human induced pluripotent stem cells (hiPSC)-derived retinal pigment epithelial (iRPE) cells and exposed them to white, blue and red lights from LED devices at doses below 22 J/cm2. We show that exposure to white light at a dose of 3.6 J/cm2 induces an alteration of the global cellular structure, DNA damage and an activation of cellular stress pathways. The exposure to blue light triggers DNA damage and the activation of autophagy, while exposure to red light modulates the inflammatory response and inhibits autophagy.
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Affiliation(s)
- Anaïs Françon
- Centre de Recherche Des Cordeliers, INSERM UMRS 1138, Université Paris Cité, Sorbonne Université. Team: Physiopathology of Ocular Diseases: Therapeutic Innovations, 15, Rue de L'école de Médecine, 75006, Paris, France
| | - Kimberley Delaunay
- Centre de Recherche Des Cordeliers, INSERM UMRS 1138, Université Paris Cité, Sorbonne Université. Team: Physiopathology of Ocular Diseases: Therapeutic Innovations, 15, Rue de L'école de Médecine, 75006, Paris, France
| | - Thara Jaworski
- Centre de Recherche Des Cordeliers, INSERM UMRS 1138, Université Paris Cité, Sorbonne Université. Team: Physiopathology of Ocular Diseases: Therapeutic Innovations, 15, Rue de L'école de Médecine, 75006, Paris, France
| | - Cécile Lebon
- Centre de Recherche Des Cordeliers, INSERM UMRS 1138, Université Paris Cité, Sorbonne Université. Team: Physiopathology of Ocular Diseases: Therapeutic Innovations, 15, Rue de L'école de Médecine, 75006, Paris, France
| | - Emilie Picard
- Centre de Recherche Des Cordeliers, INSERM UMRS 1138, Université Paris Cité, Sorbonne Université. Team: Physiopathology of Ocular Diseases: Therapeutic Innovations, 15, Rue de L'école de Médecine, 75006, Paris, France
| | - Jenny Youale
- Centre de Recherche Des Cordeliers, INSERM UMRS 1138, Université Paris Cité, Sorbonne Université. Team: Physiopathology of Ocular Diseases: Therapeutic Innovations, 15, Rue de L'école de Médecine, 75006, Paris, France
| | - Francine Behar-Cohen
- Centre de Recherche Des Cordeliers, INSERM UMRS 1138, Université Paris Cité, Sorbonne Université. Team: Physiopathology of Ocular Diseases: Therapeutic Innovations, 15, Rue de L'école de Médecine, 75006, Paris, France
- Assistance Publique, Hôpitaux de Paris, Hôpital Cochin, Ophtalmopole, 27, Rue du Faubourg Saint-Jacques, 75014, Paris, France
- Department of Ophthalmology, Hôpital Foch, 40 Rue Worth, 92150, Suresnes, France
| | - Alicia Torriglia
- Centre de Recherche Des Cordeliers, INSERM UMRS 1138, Université Paris Cité, Sorbonne Université. Team: Physiopathology of Ocular Diseases: Therapeutic Innovations, 15, Rue de L'école de Médecine, 75006, Paris, France.
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Farias TG, Rodrigues JA, Dos Santos MS, Mencalha AL, de Souza da Fonseca A. Effects of low‑power red laser and blue LED on mRNA levels from DNA repair genes in human breast cancer cells. Lasers Med Sci 2024; 39:56. [PMID: 38329547 DOI: 10.1007/s10103-024-04001-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
Photobiomodulation (PBM) induced by non-ionizing radiations emitted from low-power lasers and light-emitting diodes (LEDs) has been used for various therapeutic purposes due to its molecular, cellular, and systemic effects. At the molecular level, experimental data have suggested that PBM modulates base excision repair (BER), which is responsible for restoring DNA damage. There is a relationship between the misfunction of the BER DNA repair pathway and the development of tumors, including breast cancer. However, the effects of PBM on cancer cells have been controversial. Breast cancer (BC) is the main public health problem in the world and is the most diagnosed type of cancer among women worldwide. Therefore, the evaluation of new strategies, such as PBM, could increase knowledge about BC and improve therapies against BC. Thus, this work aims to evaluate the effects of low-power red laser (658 nm) and blue LED (470 nm) on the mRNA levels from BER genes in human breast cancer cells. MCF-7 and MDA-MB-231 cells were irradiated with a low-power red laser (69 J cm-2, 0.77 W cm-2) and blue LED (482 J cm-2, 5.35 W cm-2), alone or in combination, and the relative mRNA levels of the APTX, PolB, and PCNA genes were assessed by reverse transcription-quantitative polymerase chain reaction. The results suggested that exposure to low-power red laser and blue LED decreased the mRNA levels from APTX, PolB, and PCNA genes in human breast cancer cells. Our research shows that photobiomodulation induced by low-power red laser and blue LED decreases the mRNA levels of repair genes from the base excision repair pathway in MCF-7 and MDA-MB-231 cells.
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Affiliation(s)
- Thayssa Gomes Farias
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Vila Isabel, Boulevard 28 de Setembro, 87, Rio de Janeiro, 20551030, Brazil.
| | - Juliana Alves Rodrigues
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Vila Isabel, Boulevard 28 de Setembro, 87, Rio de Janeiro, 20551030, Brazil
| | - Márcia Soares Dos Santos
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Vila Isabel, Boulevard 28 de Setembro, 87, Rio de Janeiro, 20551030, Brazil
| | - Andre Luiz Mencalha
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Vila Isabel, Boulevard 28 de Setembro, 87, Rio de Janeiro, 20551030, Brazil
| | - Adenilson de Souza da Fonseca
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Vila Isabel, Boulevard 28 de Setembro, 87, Rio de Janeiro, 20551030, Brazil
- Departamento de Ciências Fisiológicas, Instituto Biomédico, Universidade Federal do Estado do Rio de Janeiro, Rua Frei Caneca, 94, Rio de Janeiro, 20211040, Brazil
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Low-power therapeutic lasers on mRNA levels. Lasers Med Sci 2022; 37:2353-2362. [PMID: 35288806 DOI: 10.1007/s10103-022-03541-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
Gene expression evaluation in cells and biological tissues has been crucial for research in biology, medicine, biotechnology, and diagnostic. Messenger ribonucleic acid (mRNA) levels show relationship with gene expression, and they can be measured by real-time quantitative polymerase chain reaction (RT-qPCR) for the quantification of steady-state mRNA levels in cells and biological tissues. Radiations emitted from low-power lasers induce photobiomodulation, which is the base of therapeutic protocols for disease treatment. Despite that the understanding on photobiomodulation has been improved by mRNA level evaluation, laser irradiation parameters and procedures are diversified among studies, harming the comparison of RT-qPCR data. In this systematic review, data from mRNA levels reported in photobiomodulation studies were summarized regarding the process, function, and gene. Literature search was conducted for the assessment of published reports on mRNA levels evaluated by RT-qPCR in cells and biological tissues exposed to low-power lasers. Data showed that mRNA levels have been evaluated by RT-qPCR for a variety of genes related to molecular, cellular, and systemic processes after low-power violet-orange, red, and infrared laser exposure. Results from gene expression have increased the understanding of the mechanisms involved in photobiomodulation, and they can be useful to increase the efficacy and safety of clinical applications based on low-power lasers.
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Faria LV, Andrade IN, dos Anjos LMJ, de Paula MVQ, de Souza da Fonseca A, de Paoli F. Photobiomodulation can prevent apoptosis in cells from mouse periodontal ligament. Lasers Med Sci 2020; 35:1841-1848. [DOI: 10.1007/s10103-020-03044-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 05/20/2020] [Indexed: 01/09/2023]
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da Silva Sergio LP, Mencalha AL, de Souza da Fonseca A, de Paoli F. DNA repair and genomic stability in lungs affected by acute injury. Biomed Pharmacother 2019; 119:109412. [PMID: 31514069 PMCID: PMC9170240 DOI: 10.1016/j.biopha.2019.109412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/26/2019] [Accepted: 08/28/2019] [Indexed: 12/28/2022] Open
Abstract
Acute pulmonary injury, or acute respiratory distress syndrome, has a high incidence in elderly individuals and high mortality in its most severe degree, becoming a challenge to public health due to pathophysiological complications and increased economic burden. Acute pulmonary injury can develop from sepsis, septic shock, and pancreatitis causing reduction of alveolar airspace due to hyperinflammatory response. Oxidative stress acts directly on the maintenance of inflammation, resulting in tissue injury, as well as inducing DNA damages. Once the DNA is damaged, enzymatic DNA repair mechanisms act on lesions in order to maintain genomic stability and, consequently, contribute to cell viability and homeostasis. Although palliative treatment based on mechanical ventilation and antibiotic using have a kind of efficacy, therapies based on modulation of DNA repair and genomic stability could be effective for improving repair and recovery of lung tissue in patients with acute pulmonary injury.
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Affiliation(s)
- Luiz Philippe da Silva Sergio
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Boulevard Vinte e Oito de Setembro, 87, Vila Isabel, Rio de Janeiro, 20551030, Brazil.
| | - Andre Luiz Mencalha
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Boulevard Vinte e Oito de Setembro, 87, Vila Isabel, Rio de Janeiro, 20551030, Brazil
| | - Adenilson de Souza da Fonseca
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Boulevard Vinte e Oito de Setembro, 87, Vila Isabel, Rio de Janeiro, 20551030, Brazil; Departamento de Ciências Fisiológicas, Instituto Biomédico, Universidade Federal do Estado do Rio de Janeiro, Rua Frei Caneca, 94, Rio de Janeiro, 20211040, Brazil; Centro de Ciências da Saúde, Centro Universitário Serra dos Órgãos, Avenida Alberto Torres, 111, Teresópolis, Rio de Janeiro, 25964004, Brazil
| | - Flavia de Paoli
- Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Rua José Lourenço Kelmer - s/n, Campus Universitário, São Pedro, Juiz de Fora, Minas Gerais, 36036900, Brazil
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da Silva PAV, Dos Anjos LMJ, Abduch TF, Pereira R, da Fonseca ADS, de Paoli F. Photobiomodulation can alter mRNA levels cell death-related. Lasers Med Sci 2019; 34:1373-1380. [DOI: 10.1007/s10103-019-02732-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 01/21/2019] [Indexed: 11/27/2022]
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Low-power laser alters mRNA levels from DNA repair genes in acute lung injury induced by sepsis in Wistar rats. Lasers Med Sci 2018; 34:157-168. [DOI: 10.1007/s10103-018-2656-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 09/30/2018] [Indexed: 01/08/2023]
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da Silva Neto Trajano LA, Trajano ETL, da Silva Sergio LP, Teixeira AF, Mencalha AL, Stumbo AC, de Souza da Fonseca A. Photobiomodulation effects on mRNA levels from genomic and chromosome stabilization genes in injured muscle. Lasers Med Sci 2018; 33:1513-1519. [DOI: 10.1007/s10103-018-2510-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 04/17/2018] [Indexed: 01/09/2023]
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Trajano LADSN, Sergio LPDS, Stumbo AC, Mencalha AL, Fonseca ADSD. Low power lasers on genomic stability. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2018; 180:186-197. [DOI: 10.1016/j.jphotobiol.2018.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/02/2018] [Accepted: 02/07/2018] [Indexed: 12/11/2022]
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Sergio LPS, Lucinda LMF, Reboredo MM, de Paoli F, Fonseca LMC, Pinheiro BV, Mencalha AL, Fonseca AS. Emphysema induced by elastase alters the mRNA relative levels from DNA repair genes in acute lung injury in response to sepsis induced by lipopolysaccharide administration in Wistar rats. Exp Lung Res 2018; 44:79-88. [DOI: 10.1080/01902148.2017.1422158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Luiz Philippe S. Sergio
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Vila Isabel, Rio de Janeiro, Brazil
| | - Leda M. F. Lucinda
- Laboratório de Pesquisa em Pneumologia, Universidade Federal de Juiz de Fora, Dom Bosco, Juiz de Fora, Minas Gerais, Brazil
- Centro de Biologia da Reprodução, Universidade Federal de Juiz de Fora, Campus Universitário, São Pedro, Juiz de Fora, Minas Gerais, Brazil
- Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Campus Universitário, São Pedro, Juiz de Fora, Minas Gerais, Brazil
| | - Maycon M. Reboredo
- Laboratório de Pesquisa em Pneumologia, Universidade Federal de Juiz de Fora, Dom Bosco, Juiz de Fora, Minas Gerais, Brazil
- Centro de Biologia da Reprodução, Universidade Federal de Juiz de Fora, Campus Universitário, São Pedro, Juiz de Fora, Minas Gerais, Brazil
| | - Flavia de Paoli
- Centro de Biologia da Reprodução, Universidade Federal de Juiz de Fora, Campus Universitário, São Pedro, Juiz de Fora, Minas Gerais, Brazil
- Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Campus Universitário, São Pedro, Juiz de Fora, Minas Gerais, Brazil
| | - Lídia M. C. Fonseca
- Laboratório de Pesquisa em Pneumologia, Universidade Federal de Juiz de Fora, Dom Bosco, Juiz de Fora, Minas Gerais, Brazil
- Centro de Biologia da Reprodução, Universidade Federal de Juiz de Fora, Campus Universitário, São Pedro, Juiz de Fora, Minas Gerais, Brazil
| | - Bruno V. Pinheiro
- Laboratório de Pesquisa em Pneumologia, Universidade Federal de Juiz de Fora, Dom Bosco, Juiz de Fora, Minas Gerais, Brazil
- Centro de Biologia da Reprodução, Universidade Federal de Juiz de Fora, Campus Universitário, São Pedro, Juiz de Fora, Minas Gerais, Brazil
| | - Andre L. Mencalha
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Vila Isabel, Rio de Janeiro, Brazil
| | - Adenilson S. Fonseca
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Vila Isabel, Rio de Janeiro, Brazil
- Centro de Ciências da Saúde, Centro Universitário Serra dos Órgãos, Teresópolis, Rio de Janeiro, Brazil
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Alessi Pissulin CN, Henrique Fernandes AA, Sanchez Orellana AM, Rossi E Silva RC, Michelin Matheus SM. Low-level laser therapy (LLLT) accelerates the sternomastoid muscle regeneration process after myonecrosis due to bupivacaine. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 168:30-39. [PMID: 28161653 DOI: 10.1016/j.jphotobiol.2017.01.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 01/19/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Because of its long-lasting analgesic action, bupivacaine is an anesthetic used for peripheral nerve block and relief of postoperative pain. Muscle degeneration and neurotoxicity are its main limitations. There is strong evidence that low-level laser therapy (LLLT) assists in muscle and nerve repair. The authors evaluated the effects of a Gallium Arsenide laser (GaAs), on the regeneration of muscle fibers of the sternomastoid muscle and accessory nerve after injection of bupivacaine. METHODS In total, 30 Wistar adult rats were divided into 2 groups: control group (C: n=15) and laser group (L: n=15). The groups were subdivided by antimere, with 0.5% bupivacaine injected on the right and 0.9% sodium chloride on the left. LLLT (GaAs 904nm, 0,05W, 2.8J per point) was administered for 5 consecutive days, starting 24h after injection of the solutions. Seven days after the trial period, blood samples were collected for determination of creatine kinase (CK). The sternomastoid nerve was removed for morphological and morphometric analyses; the surface portion of the sternomastoid muscle was used for histopathological and ultrastructural analyses. Muscle CK and TNFα protein levels were measured. RESULTS The anesthetic promoted myonecrosis and increased muscle CK without neurotoxic effects. The LLLT reduced myonecrosis, characterized by a decrease in muscle CK levels, inflammation, necrosis, and atrophy, as well as the number of central nuclei in the muscle fibers and the percentage of collagen. TNFα values remained constant. CONCLUSIONS LLLT, at the dose used, reduced fibrosis and myonecrosis in the sternomastoid muscle triggered by bupivacaine, accelerating the muscle regeneration process.
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Affiliation(s)
- Cristiane Neves Alessi Pissulin
- Department of Anatomy, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, SP, Brazil; General Bases of Surgery, Botucatu Medical School, Unesp, Botucatu, SP, Brazil.
| | | | | | | | - Selma Maria Michelin Matheus
- Department of Anatomy, Institute of Bioscience, General Bases of Surgery, Botucatu Medical School, Unesp, Botucatu, SP, Brazil.
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