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  • 1
    Online Resource
    Online Resource
    How to Reduce the Potential Harmful Effects of Light on Blastocyst Development during IVF
    S. Karger AG ; 2020
    In:  Medical Principles and Practice Vol. 29, No. 6 ( 2020), p. 558-564
    Details
    In: Medical Principles and Practice, S. Karger AG, Vol. 29, No. 6 ( 2020), p. 558-564
    Abstract: 〈 b 〉 〈 i 〉 Purpose: 〈 /i 〉 〈 /b 〉 Earlier findings revealed the damaging effect of visible light on zygotes and gametes. The aim of our study is to eliminate or significantly reduce the potentially harmful effects of light exposure during in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) and to investigate the effect of light protection on embryo development and implantation. 〈 b 〉 〈 i 〉 Materials and Methods: 〈 /i 〉 〈 /b 〉 To protect sperm cells, oocytes, and embryos from the potential harmful effects of light exposure during laboratory procedures, we created a dark environment for the cells and applied red filters on laboratory lamps and UV or infrared filters in the microscopes in order to eliminate white light exposure of the cells throughout all work stages. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The fertilization rate was significantly ( 〈 i 〉 p 〈 /i 〉 = 0.011) higher in light-protected ICSI cycles. Blastocyst development rates (blastocyst/embryo) were significantly ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) higher in light-protected embryos than in those manipulated in conventional light conditions both in IVF (20.9% difference) and ICSI (38.6% difference). Numbers of clinical pregnancies/transfers of ICSI fertilized day 5 blastocysts were also significantly ( 〈 i 〉 p 〈 /i 〉 = 0.040) higher in light-protected conditions. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 These data show that light protection has a positive effect on fertilization rate and increases the blastocyst development as well as the number of clinical pregnancies/transfers. Implementation of this light protection method in IVF centers may improve the success rate while maintaining maximal embryo safety.
    Type of Medium: Online Resource
    ISSN: 1011-7571 , 1423-0151
    URL: Article
    DOI: 10.1159/000509016
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1482963-0
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  • 2
    Online Resource
    Online Resource
    Changes in Quality of Life in Parkinson's Disease: How Large Must They Be to Be Relevant?
    S. Karger AG ; 2017
    In:  Neuroepidemiology Vol. 48, No. 1-2 ( 2017), p. 1-8
    Details
    In: Neuroepidemiology, S. Karger AG, Vol. 48, No. 1-2 ( 2017), p. 1-8
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Minimal clinically important difference (MCID) is the smallest change in an outcome, which a patient identifies as meaningful. Although the 2 most frequently applied Parkinson's disease (PD) “quality of life” questionnaires (the PDQ-39 and PDQ-8) provide encouragingly similar results, their MCID thresholds appear to be vastly different. Our aim was to calculate the MCID estimates for both PDQ-39 and PDQ-8 Summary Indices (PDQ-39-SI and PDQ-8-SI) by the utilization of both anchor- and distribution-based techniques. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Nine hundred eighty-five paired investigations of 365 patients were included. Three different techniques were used simultaneously to calculate the MCID values. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 First, we replicated the previously published results demonstrating how both PDQ-39-SI and PDQ-8-SI provide similar values and respond in a similar way to changes. Subsequently, we calculated the MCID thresholds. The most optimal estimates for MCID thresholds for PDQ-39-SI were -4.72 and +4.22 for detecting minimal clinically important improvement and worsening. For PDQ-8-SI, these estimates were -5.94 and +4.91 points for detecting minimal clinically important improvement and worsening respectively. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Our study is the first one that directly compared the MCID estimates for both PDQ-39-SI and PDQ-8-SI on a large pool of patients including all disease severity stages. These MICD estimates varied across PD severity.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    URL: Article
    DOI: 10.1159/000455863
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1483032-2
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  • 3
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    Online Resource
    How Efficient Is Subthalamic Deep Brain Stimulation in Reducing Dyskinesia in Parkinson's Disease?
    S. Karger AG ; 2017
    In:  European Neurology Vol. 77, No. 5-6 ( 2017), p. 281-287
    Details
    In: European Neurology, S. Karger AG, Vol. 77, No. 5-6 ( 2017), p. 281-287
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Dyskinesia is among the most troublesome symptoms of advanced Parkinson's disease (PD). The recently developed Unified Dyskinesia Rating Scale (UDysRS) can simultaneously measure several subjective and objective aspects of dyskinesia, irrespective of the other motor symptoms of PD. Despite the advantages of deep brain stimulation (DBS), previous studies on DBS have not used the UDysRS yet. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 In this prospective study, 71 consecutive patients undergoing DBS implantation were enrolled. Patients were examined twice: 1 week prior to the DBS implantation (baseline) and 12 months postoperatively. The severity of PD-related symptoms was assessed by the Movement Disorders Society Unified PD Rating Scale (MDS-UPDRS). The presence and severity of dyskinesia were specifically measured by the UDysRS and patient diaries. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 At baseline, all 71 patients had dyskinesia, but 1 year after DBS implantation, 25 patients were dyskinesia-free, and an additional 19 had only mild dyskinesia. The total score on the UDysRS decreased from 38.0 ± 17.8 to 10.8 ± 13.0 ( 〈 i 〉 p 〈 /i 〉 〈 0.001). Besides this, all parts of the UDysRS showed significant improvement after STN DBS treatment, and the magnitude of these changes had a large effect size. The total score of MDS-UPDRS improved from 76.5 ± 24.3 to 60.4 ± 21.4 points ( 〈 i 〉 p 〈 /i 〉 〈 0.001). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Based on our results, UDysRS can reliably detect improvements in dyskinesia after DBS implantation.
    Type of Medium: Online Resource
    ISSN: 0014-3022 , 1421-9913
    URL: Article
    DOI: 10.1159/000455208
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1482237-4
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  • 4
    Online Resource
    Online Resource
    High-Frequency Repetitive Transcranial Magnetic Stimulation Can Improve Depression in Parkinson's Disease: A Randomized, Double-Blind, Placebo-Controlled Study
    S. Karger AG ; 2016
    In:  Neuropsychobiology Vol. 73, No. 3 ( 2016), p. 169-177
    Details
    In: Neuropsychobiology, S. Karger AG, Vol. 73, No. 3 ( 2016), p. 169-177
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 A recent evidence-based guideline demonstrated that bilateral repetitive transcranial magnetic stimulation (rTMS) over the motor cortex (M1) can improve motor symptoms of Parkinson's disease (PD). We conducted a randomized, double-blind, placebo-controlled study to evaluate the impact of bilateral M1 rTMS on depression in PD. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Forty-six patients with PD and mild-to-moderate depression were randomly assigned to active (n = 23) and sham (n = 23) rTMS. Two patients in the sham group did not complete the protocol because of reasons unrelated to the study. High-frequency rTMS was applied over the primary motor cortex bilaterally for 10 days. An investigator blinded to the treatment performed three video-taped examinations on each patient: before stimulation (baseline), and 1 day (short-term effect) and 30 days after the treatment session ended (long-term effect). The primary end point was the changes in depression, while secondary end points included health-related quality of life scales and Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In the actively treated group, not only did the severity of depression improve (from 17 to 7 points, Montgomery-Åsberg Depression Rating Scale, median values, p 〈 0.001), but also the health-related quality of life (from 25.4 to 16.9 points, PDQ-39 summary index, median values, p 〈 0.001). Besides, we could also demonstrate an improvement in MDS-UPDRS Motor Examination (from 26 to 20 points, median values, p 〈 0.05). In the sham-treated group, none of the examined tests and scales improved significantly after treatment. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Our results demonstrate the beneficial effects of high-frequency bilateral M1 rTMS on depression and health-related quality of life in PD. However, this effect of rTMS should also be confirmed in patients with severe depression by further clinical trials.
    Type of Medium: Online Resource
    ISSN: 0302-282X , 1423-0224
    URL: Article
    DOI: 10.1159/000445296
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2016
    detail.hit.zdb_id: 1483094-2
    SSG: 5,2
    SSG: 15,3
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  • 5
    Online Resource
    Online Resource
    Glucocorticoid Implants around the Hypothalamic Paraventricular Nucleus Prevent the Increase of Corticotropin-Releasing Factor and Arginine Vasopressin Immunostaining Induced by Adrenalectomy
    S. Karger AG ; 1986
    In:  Neuroendocrinology Vol. 44, No. 2 ( 1986), p. 229-234
    Details
    In: Neuroendocrinology, S. Karger AG, Vol. 44, No. 2 ( 1986), p. 229-234
    Type of Medium: Online Resource
    ISSN: 0028-3835 , 1423-0194
    URL: Article
    DOI: 10.1159/000124650
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1986
    detail.hit.zdb_id: 1483028-0
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  • 6
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    Online Resource
    Growth Patterns and Final Height in Congenital Adrenal Hyperplasia due to Classical 21-Hydroxylase Deficiency
    S. Karger AG ; 2001
    In:  Hormone Research in Paediatrics Vol. 55, No. 4 ( 2001), p. 161-171
    Details
    In: Hormone Research in Paediatrics, S. Karger AG, Vol. 55, No. 4 ( 2001), p. 161-171
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Longitudinal growth and bone age (BA) development are the most important clinical parameters for monitoring adequate glucocorticoid replacement in children with congenital adrenal hyperplasia (CAH). 〈 i 〉 Aim of the Study: 〈 /i 〉 To analyze the growth pattern of patients treated for CAH of the salt wasting (SW) and simple virilizing (SV) clinical forms; to evaluate final height as compared to reference data and individual target height; to evaluate the course of BA development. 〈 i 〉 Patients and Methods: 〈 /i 〉 A large database of 598 patients with CAH was created in 5 Central European countries and growth data of 341 treated patients with 21-hydroxylase deficiency were analyzed retrospectively. The patients were of Caucasian origin. Centiles were constructed in a cross-sectional manner and an additional longitudinal analysis was performed in order to evaluate the pubertal growth spurt by applying particular statistical methods (Preece-Baines model). 〈 i 〉 Results: 〈 /i 〉 The growth of SW CAH patients was impaired in infancy and early childhood (0–3 years of age), but followed normal patterns in childhood until puberty. In contrast, children with SV CAH had normal patterns of growth in infancy and early childhood and were considerably taller than healthy references during childhood. In the longitudinal study, peak height velocity in both boys and girls was normal, but it occurred at an earlier age than in the standard population. The final height of patients with CAH was reduced in comparison to both the reference and the individual target height. No correlations were found between final height and age at the start of the therapy in SV patients or between final height and year of birth. BA was advanced in both types of CAH, but more accelerated in SV patients. 〈 i 〉 Conclusion: 〈 /i 〉 Characteristic growth patterns for treated SV and SW CAH children were identified, with a normal pubertal growth spurt and reduced final height being observed.
    Type of Medium: Online Resource
    ISSN: 1663-2818 , 1663-2826
    URL: Article
    DOI: 10.1159/000049990
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2001
    detail.hit.zdb_id: 2540224-9
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  • 7
    Online Resource
    Online Resource
    Circadian Blood Pressure Changes and Cardiac Abnormalities in IgA Nephropathy
    S. Karger AG ; 1999
    In:  American Journal of Nephrology Vol. 19, No. 5 ( 1999), p. 546-551
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 19, No. 5 ( 1999), p. 546-551
    Abstract: The absence of diurnal blood pressure rhythm is characteristic of patients with chronic glomerulonephritis already before they develop hypertension. The prognostic importance and possible target organ-damaging effect of the absence are unknown. Simultaneously, 24-hour ambulatory blood pressure monitoring and echocardiographic investigations were done in 12 normotensive and 38 hypertensive IgA nephropathy patients. The hypertensive patients were treated with either angiotensin-converting enzyme inhibitor (ACEI) alone or in combination with a non-dihydropyridine calcium channel blocker. The absence of a night-time blood pressure reduction was frequent in both groups (5/12 vs. 20/38). In the hypertensive patients, blood pressure and left ventricular mass index were higher (124.6 ± 23.3/81.2 ± 15.3 vs. 106.6 ± 33.4/67.4 ± 21.8 mm Hg, p 〈 0.001, and 124.1 ± 46.2 vs. 89.2 ± 45.6 g/m 〈 sup 〉 2 〈 /sup 〉 , p 〈 0.01). Diastolic left ventricular function was better in normotensive patients, in whom E wave/A wave ratio (E/A) and decelaration time values correlated closely with the diastolic diurnal index (E/A, r = 0.86, p 〈 0.01; DT, r = –0.70, p 〈 0.01). In the hypertensive patients, both the left ventricular wall thickness and diastolic function were significantly related to nighttime blood pressure and diurnal index values, but there was no relationship with daytime blood pressure. In conclusion, in IgA nephropathy patients there are mild cardiac abnormalities before they develop hypertension, the abnormalities bearing the closest correlation with the decrease in diurnal blood pressure rhythm. These data suggest the inefficacy of ACEI and calcium channel blockers in treating nighttime hypertension and in reestablishing diurnal rhythm. These phenomena are of great importance in the development of left ventricular hypertrophy and diastolic malfunction.
    Type of Medium: Online Resource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000013517
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1999
    detail.hit.zdb_id: 1468523-1
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  • 8
    Online Resource
    Online Resource
    Reorganization of Motor System in Parkinson’s Disease
    S. Karger AG ; 2011
    In:  European Neurology Vol. 66, No. 4 ( 2011), p. 220-226
    Details
    In: European Neurology, S. Karger AG, Vol. 66, No. 4 ( 2011), p. 220-226
    Abstract: 〈 i 〉 Background/Aims: 〈 /i 〉 We investigated adaptive reorganization in Parkinson’s disease (PD) by fMRI using a passive movement task and compared the brain activation patterns of 10 patients with left- versus right-sided dominant symptoms. Five healthy controls were also investigated with the same settings. 〈 i 〉 Methods: 〈 /i 〉 We grouped patients according to the predominant side of symptoms; thus, a right-sided dominant and a left-sided dominant group was formed. The paradigm consisted of a 4-finger passive movement task, which altered with resting states. For each subject, this examination was performed twice: on the left and on the right hand separately. 〈 i 〉 Results: 〈 /i 〉 In healthy controls, motor-related areas contralateral to the moving fingers showed activation on fMRI. Concerning PD patients, motor-related areas of the ipsilateral hemisphere – including the primary motor cortex, supplementary motor area, and basal ganglia – seemed to be involved in the motor reorganization in PD. However, we could only demonstrate this reorganization in patients with right-sided dominant symptoms. 〈 i 〉 Conclusions: 〈 /i 〉 We suggest that the human brain in PD tries to compensate for the failure of the basal ganglia motor loop by employing alternative (ipsilateral) motor pathways, indicating that a complex reorganization can also take place in disorders like PD which affect the whole motor-related network.
    Type of Medium: Online Resource
    ISSN: 0014-3022 , 1421-9913
    URL: Article
    DOI: 10.1159/000330658
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1482237-4
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  • 9
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    Online Resource
    Elastase Given Intracisternally Opens Blood-Brain Barrier in Newborn Piglets
    S. Karger AG ; 1995
    In:  Neonatology Vol. 67, No. 1 ( 1995), p. 59-63
    Details
    In: Neonatology, S. Karger AG, Vol. 67, No. 1 ( 1995), p. 59-63
    Abstract: The effect of elastase on the blood-brain barrier (BBB) permeability was intravitally studied by fluorescence photomacroscope using the open cranial window technique in newborn piglets. Eleven animals (group 1) were given intracisternal injection of porcine elastase (1.0 μg), while 7 piglets served as controls (group 2). Elastase administration resulted in spotty sodium fluorescein (MW 376 daltons) extravasations in pial venules in all animals of group 1 78 ± 4 min (mean ± SEM) after the challenge, and in a 2-fold increase (p 〈 0.05) in brain sodium fluorescein uptake both in occipital cortex and white matter. The concentration of elastase-α 〈 sub 〉 1 〈 /sub 〉 -proteinase inhibitor complex increased significantly (p 〈 0.05) in cerebrospinal fluid samples in group 1 2 and 4 h after the inject; m, while it did not change in sera. A significant pleocytosis and leukocytosis was also seen in group 1 while there was no change in laboratory data and BBB remained tight in group 2. BBB permeability changes during neonatal meningitis may be caused, at least partially, by elastase.
    Type of Medium: Online Resource
    ISSN: 1661-7800 , 1661-7819
    URL: Article
    DOI: 10.1159/000244144
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1995
    detail.hit.zdb_id: 2403535-X
    SSG: 12
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  • 10
    Online Resource
    Online Resource
    Plasma and Cerebrospinal Fluid Hyperinsulinism in Asphyxiated Piglets
    S. Karger AG ; 1996
    In:  Neonatology Vol. 70, No. 5 ( 1996), p. 296-303
    Details
    In: Neonatology, S. Karger AG, Vol. 70, No. 5 ( 1996), p. 296-303
    Abstract: Insulin (I) plays a crucial role in the maturation of the perinatal brain, and it may also be involved in the pathogenesis of neonatal brain injuries. The aim of the present study was to reveal the effect of neonatal asphyxia on the regulation of I and glucose (G) metabolism in plasma and cerebrospinal fluid (CSF) in newborn piglets. The I concentrations were measured by radioimmunoassay, while the G levels were analyzed by the G oxidase method during three phases (basal, critical, recovery) of bilateral pneumothorax in newborn piglets. We observed a significant hyperinsulinism (p 〈 0.001) both in plasma and CSF and a mild hypoglycemia (p 〈 0.05) during the recovery period. Postasphyxial G infusion (1.1 M, 10 ml·kg 〈 sup 〉 –– 〈 /sup 〉 〈 sup 〉 1 〈 /sup 〉 ) amplified the hyperinsulinism. The IcsF/piasma ratio (mean ± SEM; n = 16) was decreasing during cardiovascular failure (0.09 ± 0.02; NS) as compared with the initial value (0.12 ± 0.04), then it returned to basal values by 60min (0.14 ± 0.04; NS), and increased significantly 180min (0.40 ± 0.14; p 〈 0.05) after resuscitation of the piglets. There was a similar increase in GcsF/piasma ratio in asphyxiated animals at the end of experiments (0.99 ± 0.15 vs. initial 0.76 ± 0.05; p 〈 0.05). In conclusion, neonatal asphyxia resulted in plasma and CSF hyperinsulinism which may alter hypoxic-ischemic cerebral damages.
    Type of Medium: Online Resource
    ISSN: 1661-7800 , 1661-7819
    URL: Article
    DOI: 10.1159/000244379
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1996
    detail.hit.zdb_id: 2403535-X
    SSG: 12
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