Biomedical subjects

G Van Maele

Publications and source records attributed to G Van Maele.

At least 19 recordsLinked to original sources

PubMed2007

Free radical scavengers are more effective than indomethacin in the prevention of experimentally induced heterotopic ossification.

The pathogenesis of heterotopic ossification is still unclear and the preventive therapies are usually insufficient. The present study was designed to investigate the possible preventive effect of free radical scavengers on the development of experimentally induced heterotopic ossification in a rabbit model and to compare free radical scavengers with indomethacin to determine whether they act synergistically. A standard immobilization-manipulation model was used to induce heterotopic ossification in the hind legs of 40 1-year-old female New Zealand albino rabbits. The animals were divided into four groups and received daily either placebo, a free radical scavenger cocktail [allopurinol and N-acetylcysteine (A/A)], indomethacin or the combination of A/A and indomethacin in a randomized double-blind fashion. Every 4 days an X-ray was taken and the thickness and length of new bone formation was measured at the thigh. A marked statistically significant difference was found between the four groups. In the groups that received A/A, either alone or combined with indomethacin, an inhibition of bone growth, both in thickness and in length was demonstrated. In this experimental model free radical scavengers had a superior inhibitory effect on heterotopic ossification than indomethacin. Free radicals could play an important role in the pathogenesis of heterotopic ossification.

Acetylcysteine↗

PubMed2006

EEG findings after a cerebral territorial infarct in patients who develop early- and late-onset seizures.

BACKGROUND: EEG findings are generally not considered to be very helpful for the diagnosis of poststroke seizures. PURPOSE: This retrospective study investigates the EEG characteristics in patients who develop seizures after a cerebral territorial infarct. PATIENTS AND METHODS: The study population consisted of 110 patients with seizures after a cerebral territorial infarct (12 with early- and 98 with late-onset seizures) and 275 without. All 110 patients had an interictal EEG after their first seizure. The EEG patterns after the stroke were compared between those available from 69 patients who developed seizures and those from 275 who did not. Also the EEG patterns after the seizure (n = 110) were compared to those in the poststroke group without subsequent seizures. RESULTS: Periodic lateralized epileptic discharges (PLEDs) on the EEG after stroke were only found in 5.8% of the patients with early- and late-onset seizures. They were absent in the stroke group without seizures. Frontal intermittent rhythmic delta activities (FIRDAs) were observed in 24.6% of the seizure group, compared to 1.1% in the control group. Diffuse slowing occurred also significantly more often in the former (21.7%) compared to the latter group (5.1%). Normal EEG findings were seen in 53.8% of the stroke patients without seizures, compared to 8.5% in those with seizures. The incidence of focal slowing was the same in both groups. Similar findings were observed when comparing the EEG patterns of the patients after the first poststroke seizure to those of the stroke group without subsequent seizures. In patients with early-onset seizures, PLEDs or FIRDAs were present in 25% each. FIRDAs and diffuse slowing were significantly more frequently observed on the poststroke EEGs of patients who developed late-onset seizures. CONCLUSIONS: FIRDAs, PLEDs and diffuse slowing are the most frequent EEG findings in patients with early-onset seizures. Patients with FIRDAs and diffuse slowing on the poststroke EEG have a high risk to develop late-onset seizures, while the chance is reduced in those with normal EEG findings.

Adolescent↗

PubMed2006

Delayed transient worsening of neurological deficits after ischaemic stroke.

BACKGROUND: Although the causes of stroke recurrence are well known, no particular study deals with the specific issue of late-onset transient worsening of the neurological deficit (TWND) after an ischaemic stroke. PATIENTS AND METHODS: In this retrospective study the aetiology of the TWNDs in 101 patients was compared to the causes of transient ischaemic attacks (TIAs) in 115 patients. All patients had a full cardiovascular and neuroimaging examination according to current guidelines. An electroencephalogram (EEG) was performed when necessary. The diagnosis of inhibitory seizures was retained when the EEG showed periodic lateralized epileptiform discharges or intermittent rhythmic delta activities, or when the patient developed typical seizures afterwards. RESULTS: Arterial hypertension and diabetes were more prevalent vascular risk factors in TWND patients. Small-vessel disease and inhibitory seizures were a more frequent cause of TWNDs than of TIAs. Extracranial large-vessel disease predominates in TIA patients. The global prevalence of cardiac diseases as cause of TIAs and TWNDs was the same, although severe ulcerous plaques of the aortic arch and patent foramen ovale with atrial septum aneurysm occurred more frequently in TWND patients. CONCLUSIONS: The most frequent causes of late-onset TWNDs were different from those of TIAs. Apart from repeated neuroimaging of the brain, exhaustive cardiac investigations and EEG are mandatory in TWND patients.

Aged↗

PubMed2006

Differentiation of chronic sinus diseases by measurement of inflammatory mediators.

BACKGROUND: Chronic rhinosinusitis (CRS) clinically is a heterogeneous group of sinus diseases, which may cover different disease entities, or may represent a disease continuum. Studying inflammatory cells and mediators in clearly defined disease subgroups may lead to a better differentiation of chronic sinus diseases. METHODS: Sinonasal mucosal tissue from 10 nasal polyp (NP) patients, 13 cystic fibrosis patients (CF-NP), eight CRS subjects without polyps, and nine control patients were stained for CD3, CD25, CD68, CD20, myeloperoxidase (MPO), CD138 and tissue homogenates were assayed for eotaxin, interleukin (IL)-1beta, IL-2sRalpha, IL-5, interferon (IFN)-gamma, IL-8, transforming growth factor (TGF)-beta1, tumor necrosis factor-alpha, and MPO by enzyme-linked immunosorbent assay or UNICAP system. RESULTS: Nasal polyp and CF-NP showed increased numbers and activation of T cells, while only NP displayed an increase in plasma cells. Nasal polyp had significantly higher levels of eosinophilic markers [eosinophils, eotaxin, and eosinophil cationic protein (ECP)] compared with CRS, controls and CF-NP. Chronic rhinosinusitis was characterized by a Th1 polarization with high levels of IFN-gamma and TGF-beta, while NP showed a Th2 polarization with high IL-5 and immunoglobulin (Ig) E concentrations. Nasal polyp and CF-NP were discriminated by edema from CRS and controls, with CF-NP displaying a very prominent neutrophilic inflammation. CONCLUSION: Based on cellular and mediator profiles, we suggest that CRS, NP, and CF-NP are distinct disease entities within the group of chronic sinus diseases.

Adult↗

PubMed2006

Computed tomographic changes of the brain and clinical outcome of patients with seizures and epilepsy after an ischaemic hemispheric stroke.

It is not well established whether seizures and epilepsy after an ischaemic stroke increase the disability of patients. Seventy-two patients with delayed seizures after a hemispheric infarct (37 with a single seizure and 35 with epilepsy) were included in the study. The modified Rankin scale was used to compare disability of the patients at 1 month after stroke and at 2 weeks after single or the last seizure, in case of epilepsy. The size of the X-ray hypoattenuation zone was compared on computed tomographic (CT) scans, performed in the weeks after the stroke and 1 week after single or repeated seizures. Lesion size was determined by superimposing the CT slices on digital cerebral vascular maps, on which the contours of the infarct area were delineated. The extent of the infarcts was expressed as the percentage fraction of the total surface area of the cerebral hemisphere. Groups with a single seizure and with epilepsy were mutually compared. Infarcts predominated in the parieto-temporal cortical regions. In the overall group the median Rankin score worsened significantly after seizures. The average size of the X-ray hypoattenuation zone was also significantly increased on the CT scans after the seizures, compared with those after stroke, without clear evidence of recent infarction. Mutual comparison of patients with a single seizure episode and of those with epilepsy showed only a trend of more severe disability and of increase in lesion size in the post-stroke epilepsy group. Delayed seizures and epilepsy after ischaemic stroke are accompanied by an increase in lesion size on CT and by worsening of the disability of the patients. This study does not allow to determine whether this is due to stroke recurrence or due to additional damage as a result of the seizures themselves.

Aged↗

PubMed2005

The influence of articular morphology on non-traumatic degenerative changes of the distal radioulnar joint. A radiographic study.

We examined 248 wrist X-rays of patients over 50 years of age to find out if ulnar variance, orientation of the sigmoid notch and ulnar head inclination play a role in the development of non-traumatic osteoarthritis of the distal radioulnar joint. Minor degenerative changes, viz. focal joint space narrowing and/or lipping, or small osteophytes at the inferior edge of the ulnar head, were present in 13% of the X-rays of these wrists. They were significantly more frequent in wrists with a more inclined ulnar head and significantly less present in wrists with an oblique, distally orientated sigmoid notch. There was no significant association with ulnar variance or age. This study suggests that articular morphology may play a role in the development of degenerative changes of the distal radioulnar joint.

Aged↗

PubMed2005

Clinical predictors of late-onset seizures and epilepsy in patients with cerebrovascular disease.

BACKGROUND: Seizures and epilepsy are harmful and worsen the disability of stroke patients. There are currently no good clinical predictors of late-onset seizures and epilepsy in patients with cerebrovascular disease (CVD). PATIENTS AND METHODS: 110 patients with delayed seizures after an ischaemic or a haemorrhagic stroke, a transient ischaemic attack or a subarachnoid haemorrhage (60 with a single seizure and 50 with epilepsy) and 366 without seizures were included in this retrospective study. The clinical syndrome, the stroke aetiology and the vascular risk factors were compared. The groups with a single seizure and with epilepsy were also analysed separately. RESULTS: There were no differences in age, gender, aetiology and vascular risk factors between the groups with and without seizures. When comparing the incidence of the clinical syndromes, ischaemic partial anterior circulation syndrome (PACS) was significantly more and transient ischaemic attack less frequent in the group with seizures compared to the control group. The severity of the neurological impairment on admission and the degree of disability on discharge after a PACS was similar in those who developed late-onset seizures compared with those who did not. Also on the Cox proportional hazards analysis, PACS appeared to be the only clinical risk factor for development of seizures and epilepsy in patients with CVD. No differences were observed in clinical predictors between patients with a single seizure and those with epilepsy. CONCLUSION: PACS is the only independent predictor for the occurrence of late-onset seizures in patients with CVD.

Aged↗

PubMed2005

Comparison of age of onset and development of motor complications between smokers and non-smokers in Parkinson's disease.

BACKGROUND: There is growing evidence from case-control and from cohort studies that smoking is inversely related to the risk of developing Parkinson's disease (PD). However, it is still controversial if PD starts at an older age in ever-smoking patients compared to never-smoking ones. PATIENTS AND METHODS: The present retrospective study compares in a large series of 512 out-patients, collected over the last 24 years, the age of onset of the complaints, the age at which PD was diagnosed and the start of levodopa treatment between ever- and never-smokers. Also, the occurrence of long-term side-effects of the drug was evaluated. 184 PD patients with a history of smoking were compared with 328 who had never smoked. The subgroups with and without a family history of PD were analysed separately. RESULTS: In the overall ever-smoking group, as well as in the subgroup without a family history, the onset of the disease and the time of the diagnosis of PD and the time at which levodopa was started occurred at an older age than in the never-smoking group. This difference could not be demonstrated in the patients with a family history, due to the low number of cases and the lack of statistical power. Although the follow-up period was the same in both study groups, motor fluctuations and dyskinesia were more frequent and appeared earlier after levodopa treatment in the non-smoking compared to the ever-smoking PD patients. Only for cognitive impairment there was a non-significant trend in the smoking group. CONCLUSION: The present study confirms the protective action of smoking on PD and also suggests some modulating effect of smoking on the dopaminergic system.

Age of Onset↗

PubMed2005

Cerebral blood flow and oxygen metabolism in symptomatic internal carotid artery occlusion by (traumatic) cervical artery dissection.

The present study investigates whether cerebral infarction resulting from internal carotid artery occlusion by cervical dissection is due to emboli, released from a superimposed luminal thrombus, or is due to haemodynamic failure and hypoperfusion. Ten patients with a history of stroke and with a visible cerebral infarct on computed tomographic scan, due to cervical dissection and thrombosis of the internal carotid artery, were studied with positron emission tomography in order to assess the regional cerebral blood flow (rCBF), the regional cerebral metabolic rate of oxygen (rCMRO2) and the regional oxygen extraction fraction (rOEF) in different regions of the brain. rCBF and rCMRO2 were only decreased in the infarct area but not in the peri-infarct zone or elsewhere in the brain. As rOEF was not increased in the affected cerebral hemisphere, the present study suggests artery-to-artery embolism rather than a haemodynamic event as the cause of the stroke. Use of anticoagulants thus appears to be the appropriate treatment in the acute stage.

Adult↗

PubMed2004

The prognostic significance of changes in lesion size of established cerebral infarcts on computed tomography of the brain.

BACKGROUND: As a second part of our prospective study, we assessed the size of the infarct lesion on computed tomography (CT) of the brain at two fixed time points after stroke in order to investigate its influence on the clinical outcome. METHODS: From 220 consecutive stroke patients, admitted within 24 h after onset with symptoms lasting more than 24 h, we selected 150 displaying an anterior circulation infarct or syndrome. All included patients had CT scans without contrast enhancement on day 3 (+/- 8 h) and on day 10 (+/- 8 h) after stroke onset. The size of the X-ray hypoattenuation zone was determined by superimposing the CT slices on digital cerebral vascular maps, on which the contours of the infarct area were delineated. The lesion size was expressed as the fraction of the total surface area of these digital cerebral maps. The patients were divided into four groups according to their degree of disability at 3 months on the modified Rankin (R) scale as follows : R 0-1, R 2-3, R 4-5, R 6. RESULTS: There was a clear association between lesion size on CT, on day 3 and on day 10, and the clinical outcome. Lesion size decreased between day 3 and day 10 in the groups R 0-1 and R 2-3, remained unchanged in the group R 4-5 and further increased in group R 6. CONCLUSION: Lesion size on CT is a significant predictor of stroke outcome. It decreases from day 3 to day 10 in patients with no or low disability at 3 months, but increases in those who do not survive their stroke.

Brain↗

PubMed2004

Cerebral bloodflow and oxygen metabolism in borderzone and territorial infarcts due to symptomatic carotid artery occlusion.

It remains controversial whether borderzone infarcts are due to compromised cerebral perfusion and whether territorial infarcts are caused by artery-to-artery emboli in case of occlusion of the internal carotid artery. The present positron emission tomography study compares with normal controls, the average regional cerebral bloodflow (rCBF), regional oxygen extraction fraction (rOEF) and regional cerebral metabolic rate for oxygen (rCMRO(2)) in the infarct area, the peri-infarct zone, the remaining homolateral hemisphere and in the contralateral hemisphere of 10 patients with borderzone and 17 patients with territorial infarcts, due to internal carotid artery occlusion by atherosclerosis and by cervical dissection. The steady-state technique with oxygen-15 was used. A nearly significant increase of rOEF with lowered rCBF and rCMRO(2) was observed in the peri-infarct zone of patients with territorial infarcts. In patients with borderzone infarcts rCMRO(2) was decreased in the peri-infarct zone, in the remaining homolateral hemisphere and in the contralateral hemisphere without changes in rCBF and rOEF. The present study finds no arguments that impaired cerebral perfusion is a more frequent cause of borderzone than of territorial infarcts.

Adult↗

PubMed2003

The prognostic significance of changes in X-ray attenuation on CT in established cerebral infarcts.

BACKGROUND: X-ray hypoattenuation on computed tomography (CT) reflects the severity of ischaemic damage after stroke. However, the clinical syndrome and the effect of time influence the visibility of infarcts. This prospective study analyses whether the degree of hypoattenuation on CT at two time intervals after stroke has a predictive value for the clinical outcome. METHODS: 220 consecutive stroke patients were admitted within 24 h after onset with symptoms lasting more than 24 h. The study was restricted to 150 patients displaying an anterior circulation infarct or syndrome. All patients had CT scans without contrast enhancement on day 3 (+/-8 h) and day 10 (+/-8 h) after stroke onset. The degree of X-ray attenuation expressed in Hounsfield units was determined in the centre of the infarct area and compared to that in the corresponding zone of the contralateral hemisphere. The patients were divided into four groups according to their degree of disability at 3 months on the modified Rankin scale as follows: R 0-1, R 2-3, R 4-5 and R 6. RESULTS: Patients in groups R 4-5 and R 6 had the most severe impairment on admission. The average decrease of X-ray attenuation on CT on day 3 was less in patients in group R 0-1, but was not different between the three other groups, while it was significantly correlated with the severity of the disability on day 10. CT X-ray attenuation increased between days 3 and 10 in group R 0-1, was unchanged in group R 2-3 and further decreased in groups R 4-5 and R 6. CONCLUSION: The degree of X-ray attenuation on CT on day 3 allows us to distinguish those patients who will recover more or less completely from those with definite disability, while the CT findings on day 10 allow a more precise prediction of outcome. Increase of X-ray attenuation on day 10 is known as the fogging effect and appears to be a favourable prognostic factor. Fogging is generally considered to be due to macrophage invasion and proliferation of capillaries within the infarct area, but probably also represents partial restoration of some viable tissue.

Aged↗

PubMed2002

Fast withdrawal from benzodiazepines in geriatric inpatients: a randomised double-blind, placebo-controlled trial.

OBJECTIVE: We have previously demonstrated that temporary substitution with a low-dose hypnosedative drug may lead to successful withdrawal from chronic benzodiazepine (BZD) use in the majority of patients admitted to a geriatric ward. In the present study, a withdrawal programme was evaluated in which the habitual treatment with BZDs was replaced by either 1 mg lormetazepam or placebo, defining withdrawal success rate, sleep quality and withdrawal symptoms as main outcomes. METHODS: The target population was geriatric inpatients who had been taking BZDs for at least 3 months. Subjects suffering from mental disorders were excluded. Lormetazepam or placebo were randomly assigned and given in a double-blind fashion. After 1 week, the replacement therapy was discontinued. Subjective estimations of sleep quality and withdrawal symptoms were registered at predefined intervals, four times in a period of 30 days, using standard questionnaires (the Pittsburgh Sleep Quality Index and the Benzodiazepine Withdrawal Symptom Questionnaire, respectively). RESULTS: The success rate was significantly higher in the lormetazepam substitution group (80% vs 50% in the placebo group, P < 0.05). Both the subjective quality of sleep and withdrawal symptoms were significantly better in the lormetazepam substitution group. Important withdrawal effects were observed in the control group in two patients with a history of chronic alcohol abuse. CONCLUSIONS: Initial replacement therapy with a low-dose BZD is preferred over placebo, since the latter alternative is associated with worse sleep quality and a lower success rate. Placebo must only be used under medical scrutiny, given the potential for unmasking delirious symptoms, especially in patients with concomitant alcoholism.

Aged↗

PubMed2002

The Dynamic Patient Simulator: learning process, first results and students' satisfaction.

The Dynamic Patient Simulator (DPS) is an interactive case-program. After solving the case, third year medical students filled in an anonymous questionnaire. In this study we tried to have insight in the students' learning process and satisfaction. First results are presented. It seems that the implementation of the case was experienced as positive. The time aspect should be scheduled better and students should have as much time as they want to solve the case.

Adult↗

PubMed2001

Comparative study of 2 electric and 2 manual toothbrushes in patients with fixed orthodontic appliances.

The objective of this prospective single-blind crossover clinical trial was to evaluate the efficacy of 4 toothbrushes in 33 children undergoing fixed appliance orthodontic therapy. The toothbrushes included in this study were the Braun Oral-B 3D Plaque Remover (Kronberg, Germany), the Philips-Jordan HP 510 (Philips Domestic Appliances, Groningen, The Netherlands), the Lactona orthodontic toothbrush (Bergen op Zoom, The Netherlands), and the Oral-B Advantage Control Grip (Braun); the first 2 are electric, and the last 2 are manual. Every patient tested each type of toothbrush in a randomly designed sequence. Plaque and gingival scores were recorded at baseline and after every 4-week test period. All patients received professional prophylaxis after each clinical evaluation. The data were analyzed with the Friedman test, which showed no significant differences among the 4 brushes for any of the parameters measured. The Wilcoxon signed rank test, comparing the plaque and the gingival scores between the upper and lower jaw for each brush, indicated that plaque removal was more efficient in the lower jaw than in the upper.

Adolescent↗

PubMed2001

Embolization as a first approach with endoscopically unmanageable acute nonvariceal gastrointestinal hemorrhage.

PURPOSE: To determine technical and clinical results of embolization of endoscopically unmanageable nonvariceal gastrointestinal hemorrhage (GIH). MATERIALS AND METHODS: Results of 40 embolizations in 91 patients who underwent arteriography for acute nonvariceal GIH were retrospectively studied. GIH was upper, lower, or transpapillar (hemobilia, pancreatic duct bleeding). Clinical parameters and embolization data were assessed for clinical success and in-hospital survival. RESULTS: Technical success (bleeding target devascularization) was achieved in all patients except one with upper GIH (39 [98%] of 40 patients). No bowel complications occurred. One partial liver lobe and one partial spleen infarction were noted. Five (13%) of 39 patients bled again within 3 days; all had upper GIH (P =.049). Clinical success (no rebleeding after 30 days) was achieved in 32 (82%) of 39 patients. Clinical success occurred in 13 (68%) of 19 patients with upper GIH, in 10 (91%) of 11 with lower GIH, and in all with transpapillar GIH (P =.084). Mortality rate was 28% (11 of 40 patients), equally spread over upper, lower, and transpapillar GIH (P =.87). Blood loss (hemoglobin level < 80 g/L, P =.041), use of packed cells (P =.049) and fresh frozen plasma (P =.006); shock (P =.047); and corticosteroid use (P =.036) were related to rebleeding. Shock (P =.039) and use of fresh frozen plasma (P =.003) before embolization and rebleeding (P =.012), coagulopathy (P =.007), and need for surgery (P =.03) after embolization were strongly correlated with mortality. CONCLUSION: Embolization is an effective first approach with lower and transpapillar GIH after endoscopy; it was less effective with upper GIH.

Acute Disease↗

PubMed2000

Antisaccades and remembered saccades in mild traumatic brain injury.

The most common site of focal lesions after mild traumatic brain injury (MTBI) is the frontal lobe. This lobe, however, is difficult to examine clinically. Neuroimaging is not performed routinely and usually shows normal results in uncomplicated trauma. Antisaccades (AS) and remembered saccades (RS) are neuro-ophthalmological tests of frontal function. This study examined whether there are disturbances of latency time or error rate of AS and RS in patients within 24 h after MTBI. Eye movements were studied with infrared-oculography. Data were obtained prospectively from 25 patients. An additional group of 6 patients with MTBI and alcohol intoxication were also examined. No statistical differences in AS or RS, either for errors or for latency time, were found between a group of age-matched controls and the patients, except in the group of alcohol-intoxicated MTBI patients. Our findings indicate that visual reflex inhibition and initiation of voluntary saccades were not disturbed in the nonintoxicated patients. It is hypothesized that the responsible frontal area was not affected. It is concluded that error rate and latency time of AS and RS are inappropriate measures for evaluating acute MTBI.

Adolescent↗

PubMed2000

Cryopreservation of human germinal vesicle stage and in vitro matured M II oocytes: influence of cryopreservation media on the survival, fertilization, and early cleavage divisions.

OBJECTIVE: To study the influence of low-sodium cryopreservation media (CPM) on the survival and development of frozen-thawed germinal vesicle (GV) stage and in vitro matured human oocytes. DESIGN: Prospective experimental study. SETTING: Academic hospital-based fertility center. PATIENT(S): Experimental groups: Oocytes cryopreserved at the GV (group A, n = 63 and group B, n = 64) or M II stage (group C, n = 62) with use of conventional (group A) or low-sodium CPM (groups B and C). Control groups: Sibling GV stage oocytes subjected to in vitro maturation (IVM; control group A, n = 64; control group B, n = 64). INTERVENTION(S): IVM, intracytoplasmic sperm injection and subsequent culture. MAIN OUTCOME MEASURE(S): Rates of survival, maturation, fertilization, and cleavage. RESULT(S): The postthaw survival was significantly lower in groups A (57.1%) and B (48.4%) compared to C (84.4%). In group A, maturation and cleavage rates were significantly lower, and fertilization rate was similar to controls (GVBD: 72.2% vs. 90.6%; progression to M II: 33.3% vs. 76.6%; cleavage: 42.9% vs. 88.2%; and fertilization: 58.3% vs. 69.4% in group A vs. control group A, respectively). There was no such difference in group B. In group C, despite a slight but significant lowering of the rate of 2 PN and an increase in that of 3 PN (2 PN: 47.4% vs. 70.2% and 3 PN: 15.8% vs. 3.2% in group C vs. total controls, respectively), embryonic cleavage per GV oocyte was significantly higher (25.8%) compared to group A (4.8%) but not to group B (15.6%). The rate of maturation and cleavage per surviving GV oocyte was significantly higher in group B than group A. CONCLUSION(S): Low-sodium-based CPM is beneficial for in vitro matured M II stage oocytes and is significantly better than the conventional sodium-based media for the GV stage oocytes.

Cell Survival↗