Category Archives: Number

Eco Doppler Investigation of Utero-placental Circulation in High-risk Pregnancies

Túrós J, Szabó B, Puşcaşiu L, Kiss Sz, Bereczky Lujza-Katalin, Rozsnyai F

Emergency Clinical Hospital of Tîrgu Mureș, Obstetrics and Gynecology Clinic I

Introduction: Inadequate trophoblastic invasion of spiral arteries is associated with intrauterine growth retardation, pregnancy induced hypertension, preeclampsia, and abruptio placentae. The ability to accurately identify pregnant women who will develop these complications is limited. Predictive tests are further challenged by difficulty in the timing of the measurements, because the structural and biochemical characteristics of the placenta change with increasing gestational age. Improvements in ultrasound technology provide potentially useful novel tools for evaluating placental structure.
Aim of our study: To develop methods for early screening of high-risk pregnancies (studying the circulation in the utero-placental arteries — impedance to flow).
Material and methods: We have followed-up pregnant women in their first and second trimesters, who presented for pregnancy care in our unit. Results were calculated using Student-test and Chi-test (for the presence or absence of prothodiastholic notch). Results: Impedance to flow and the frequency of the prothodiastholic notch decrease in the uterine arteries with the evolution of pregnancy. Changes in the resistance of uterine arteries during pregnancy show different patterns in certain obstetrical risk groups: obesity, smoking in pregnancy, uterus with previous interventions (scar from C-section) with the placenta on the anterior wall, pregnancies with „Vanishing Twin Syndrome”. In these groups we noticed a greater resistance in the uterine arteries.
Conclusions: These pregnancies should have an intensified follow-up.

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The Results of Allogeneic Stem Cell Transplantation in CML — the Experience of BMT Unit Tîrgu Mureş

Tunyogi Aliz-Beáta1, Benedek I2, Benedek Erzsébet1, Köpeczi Judit Beáta1, Kakucs Enikő1, Istrati Monica1

1 County Emergency Clinical Hospital Tîrgu Mureș, Clinical Hematology and BMT Unit
2 University of Medicine and Pharmacy of Tîrgu Mureș

Introduction: Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder the molecular hallmark of the disease is the BCR-ABL gene rearrangement which occurs as the result of a reciprocal translocation between chromosomes 9 and 22. Imatinib, a small molecule, tyrosine kinase inhibitor (TKI) was the first drug that targeted BCR-ABL. Since the introduction of the first and second generation of TKI the role of allogeneic stem cell transplantation in chronic myeloid leukemia is being reevaluated. With this retrospective analysis our aim was to define the role of allogeneic stem cell transplantation for CML in the tyrosine kinase inhibitor era. The following is a general overview of the role of ASCT in the management of CML.
Material and methods: At the BMT Unit Tîrgu Mureș between 2005–2009 we performed five allogeneic transplantations of high risk CML patients with identical sibling donors.
Results: Two of the patients are at present in complete hematologic and cytogenetic remission with no or minimal immunosuppressive therapy after 6 and respectively 3 years of follow up time. Two of the patients had disease free survival but died from infectious complications appeared in the 3rd and 6th month after the allogeneic stem cell transplantation. One patient had an early relapse with treatment refractory disease and died from the evolution of the disease.
Conclusions: We perform allogeneic stem cell transplantation only in the cases in which we have resistance to first and second generation of tyrosine kinase inhibitors (TKI), intolerance to TKI and if we have a suitable donor.

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A Study Upon the Dissolution Properties of Bifonazole Through Complexation with Cyclodextrins

Trandafirescu Cristina1, Gyéresi Á2, Szabadai Z3, Sbârcea Laura1, Pătruţescu Cristina1, Kata M4, Aigner Z4

1 Victor Babeş University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Chemistry, Timişoara
2 University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Chemistry, Tîrgu Mureș
3 Victor Babeş University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Drug Analysis, Timişoara
4 University of Szeged, Faculty of Pharmacy, Department of Pharmaceutical Technology, Szeged, Hungary

Introduction: The aim of this study is to characterize the interaction in solution between the antimycotic bifonazole and two cyclodextrins: random methyl-beta-cyclodextrin and beta-cyclodextrin.
Material and method: The interaction in solution between bifonazole and random methyl-beta-cyclodextrin/beta-cyclodextrin was characterized using dissolution studies and phase solubility studies. The dissolution of bifonazole was characterized through the index of the rate of dissolution and the dissolution efficiency, and from the phase solubility study we calculated the apparent stability constant of the complex.
Results: The bifonazole – random methyl beta-cyclodextrin binary systems revealed better dissolution properties as compared to bifonazole alone, and to the bifonazole – beta-cyclodextrin binary systems. The phase solubility studies revealed the formation of soluble complexes in the cyclodextrin concentration range, and an apparent stability constant of 17956 M-1 for bifonazole – random methyl-beta-cyclodextrin complex, and of 873 M-1 for bifonazole – beta-cyclodextrin complex.
Discussions: The dissolution studies and the phase solubility studies demonstrated an improvement of the wettability of the particles of bifonazole, due to a better contact between bifonazole and cyclodextrin, and the formation of soluble complexes in the dissolution medium.
Conclusions: The complexation with cyclodextrins determined the increase in the dissolution properties of bifonazole. The best results were obtained with random methyl-beta-cyclodextrin, which demonstrates a better interaction within the components in the liquid medium and the better solubilization properties of this cyclodextrin.

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Stem Cells Harvest from Volunteer Donors

Tănase Alina1, Berteanu Cristina2, Călugăroiu Carmen1, Marculescu Alexandra1, Copotoiu Sanda-Maria3, Brânzaniuc Klara3, Azamfirei L3, Cirstoiu C2, Stoica Maria4, Cernea Daniela4, Stoica GA4, Rosin A5

1 Fundeni Bone Marrow Transplant Center Fundeni
2 Bucharest Emergency University Hospital
3 University of Medicine and Pharmacy of Tîrgu Mureș
4 Craiova Emergency University Hospital
5 Bucharest Institute of Haematology

Background: Over the last several decades allogeneic hematopoietic cell transplantation (HCT) has emerged as an important therapeutic option for a number of malignant and non-malignant conditions. The collection of hematopoietic stem cells mobilized from the bone marrow into the bloodstream of healthy donors has now become a routine procedure throughout the world.
Materials and methods: A number of 86 procedures of hematopoietic stem cells (HSC) harvest and cryopreservation from 64 volunteer donors, 54 adults (28 women and 26 men) and 10 children (5 girls and 5 boys) with ages between 6–66 years (on ave-rage 30.5) were carried out in the Bone Marrow Transplant Center from Clinical Institute Fundeni, Bucharest.
Results and discussions: HSC mobilization was achieved for all the 64 volunteer donors by administration of Filgastrim, on an average 8.4 mcg/donor weight (limits: 5–16.64 mcg/donor weight), leukapheresis procedure being realized in day +5 of Filgastrim administration.
Conclusions: In conclusion, a healthy volunteer donor, will undergo in most cases 4 or 5 days of Filgastrim administration. The WBC and the number of CD34+ cells from the periphe-ral blood will be counted beginning with the 4th day. When the number of CD34+ cells from peripheral blood will reach a certain level (usually on the 4th or 5th day), the vo-lunteer donor will be sent to the apheresis unit for harvesting stem cells.

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Aspects of Suicide in Schizophrenia

Sălcudean Andreea1, Gaboș-Grecu I1,2, Buicu Gabriela2, Nireştean A1, Hădărean V2, Moica Th1, Pașca Maria1

1 Psychiatric Clinic 1, Tîrgu Mureș
2 University of Medicine and Pharmacy of Tîrgu Mureș

Introduction: In the literature, autolytic risk in patients with schizophrenia was estimated at 10–40%, and up to 50% in studies that also refer to patients with schizoaffective disorders.
Purpose: To find the risk factors of suicide in this specific group of patients with schizophrenia who comitted suicide.
Material and methods: A retrospective study made on 53 patients with typical history of schizophrenia, who committed suicide in the 2000–2009 period.
Results and discussions: Of the 794 investigated suicide cases, 53 were patients with schizophrenia (6.7%), 54.7% were between 15–30 years and 66% were male. Marital status seems to play a major role in suicide genesis, 72.7% of the subjects being either unmarried, divorced, separated or widowed. Alcohol consumption was present in 26.1% of cases and smoking in 32.2% of cases.
Conclusions: Although the number of studied cases is too small to draw relevant conclusions, our study indicates that male gender, young age, unmarried status and rural origin act as risk factors for committing suicide.

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Results of Osteochondral Mosaic Grafting in a Sheep Model

Szántó A1, Gergely I2, Pop TS2, Russu O2, Zuh S2 Zazgyva Ancuţa2, Nagy Ö2

1 County Emergency Hospital, Miercurea Ciuc, Romania
2 University of Medicine and Pharmacy, Department of Orthopaedics and Traumatolog, Tîrgu Mureș, Romania

Objective: We present the results of an experimental study in sheep on using autogenous, cylindrical osteochondral grafts for treating cartilage defects in the knee. The aim was to produce hyaline or hyaline-like cartilage on weight-bearing surfaces through autogenous osteochondral transplantation using special instrumentation and the mosaicplasty technique.
Methods: We used a sheep model – cartilage defects were made in the knees of 16 young sheep from the Tigaia breed. At 4 and 8 weeks postoperatively macroscopic, radiologic and microscopic examinations were performed on the transplanted sites and the donor sites.
Results: We found that grafts incorporated well in the recipient sites, showing good survivorship. Joint congruency was maintained, with 75 to 80% hyaline cartilage at the transplanted site.
Conclusions: Our results lead us to conclude that mosaic-like osteochondral grafting is an excellent treatment method for repairing chondral defects in major joints.

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The Importance of Histo-pathological Factors in Setting the Long Term Prognosis for Non-small Cell Lung Cancer

Suciu B1, Bud V1, Copotoiu C1, Brânzaniuc Klara2, Copotoiu Ruxandra3, Fodor D1, Butiurcă V4

1 County Emergency Clinical Hospital Tîrgu Mureș, Surgical Clinic I
2 University of Medicine and Pharmacy of Tîrgu Mureș, Department of Anatomy and Embriology
3 County Emergency Clinical Hospital Tîrgu Mureș, Clinic of Anesthesia and Intensive Care
4 Student, University of Medicine and Pharmacy of Tîrgu Mureș

Introduction: In the last decades, the rate of pulmonary cancer has risen alarmingly. Pulmonary cancer represents the main cause of death in women and men in the United States of America, 100,000 new cases being registered annually in men and 50,000 new cases in women. The purpose of our study is to evaluate the importance of histo-pathological factors in the long term outcome of patients operated for lung cancer.
Material and methods: In order to write the present paper, we carried out a retrospective observational study on a period of 6 years. We used the casuistry of the Surgical Clinic I of the County Emergency Clinical Hospital Tîrgu Mureș. We studied all the patients’ papers who were admitted to Surgical Clinic I from the 1st of January 2005 till 31 December 2010. Further, we based our research on 197 patients that were admitted to Surgical Clinic I for bronchopulmonary tumors.
Results: We studied the importance of the T descriptor (tumor) from the TNM staging for establishing the long term prognosis. The value of p was 0.1676 so we didn’t obtain any value of statistical importance. We also took into consideration the value of N from the TNM staging as a prediction factor for long term survival in patients who underwent surgical intervention for pulmonary cancer. The p parameter was 0.0152 so we can say that we obtained a direct connection between the stages of lymph nodes metastasis and long term survival rate.
Conclusions: Long time survival rate of the patients depends on the histological type of the tumor. Long term survival prediction rate is better if the patients are over 60 years, compared with patients under 60 years. The N descriptor can be considered an important prediction factor, while the T descriptor’s value is useless. The existence of N’s descriptor in more stages of the TNM classification shows its limits and encourages for further improvements.

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Comparative and Morphological Analysis of Patellar Tendon with the Native Anterior Cruciate Ligament (ACL): an Electron, Microscopic and Morphological Study

Sólyom Á1, Zuh GyS2, Ivănescu A3, Nagy Ö2

1 University of Medicine and Pharmacy of Tîrgu Mureș, Department of Orthopaedics and Traumatology II
2 University of Medicine and Pharmacy of Tîrgu Mureș, Department of Orthopaedics and Traumatology I
3 University of Medicine and Pharmacy of Tîrgu Mureș, Department of Anatomy and Embriology

Background: Ligaments and tendons are similar in composition but differ in proportion and arrangement. Tendons are used as grafts for the ACL reconstruction. The microscopic structure of these tendons has not been sufficiently studied and compared to the native ACL.
Objective: To compare the structure of the patellar tendon graft with the structure of a normal anterior cruciate ligament.
Material and methods: A null hypothesis was declared stating that the anterior cruciate ligament should be histologically, morphologically and functionally different from the patellar tendon used for ACL reconstruction. We investigated similarities and dif-ferences of the structure of ACL and patellar tendon used as a graft tissue for ACL reconstruction. In this study, samples of patellar tendon, and the ACL were harvested from 18 patients during ACL reconstruction and analysed by light and electron microscopy, immunohistochemistry and morphometry.
Results: The thickness of the collagen fibrils, collagen organization and diameter, the fibril/interstitium ratio, density of fibroblasts and blood vessels, and distribution of the collagen type I, III and V fibrils were analyzed.
Discussions: The ACL had the highest concentration of type III and V collagen fibrils as well as elastic fibers.
Conclusion: The histological and ultrastructural appearance of the ACL differs from patellar tendon used as graft for ACL reconstruction.

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Development of a Separation Method of Four Penicillin Derivatives by Capillary Electrophoresis

Simon Brigitta1, Hancu G2, Gyéresi Á2

1 Martin Luther str. 79, Săcele, Brașov
2 University of Medicine and Pharmacy of Tîrgu Mureş, Faculty of Pharmacy, Department of Pharmaceutical Chemistry

Introduction: The objective of this paper is the development and optimization of a capillary electrophoresis method, which allows the separation of four frequently used penicillin derivatives (amoxicillin, ampicillin, benzilpenicillin and oxacillin), with possible application in the analysis of environmental samples.
Material and method: In our experiments we worked on water solutions of the studied penicillins. The analysis was performed on an Agilent Capillary Electrophoresis System with a diode array detector. The data were recorded and processed by Chemstation software.
Results: Different buffer solutions were tried out in order to reach the most efficient separation of the studied compounds. The influence of different analytical parameters was evaluated by varying the buffer concentration, buffer pH, voltage, temperature, injection time and pressure. The analytical performance of the method was verified, in order to estimate reproducibility and sensitivity.
Conclusions: A micellar electrokinetic capillary chromatography method has been developed for the separation of the four penicillins. We obtained the best results with a buffer solution containing 25 mM sodium tetraborate and 100 mM sodium dodecyl sulfate (pH = 9.3), the separation being achieved in approximately 5 minutes.

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Surgical Management of Deep Infiltrating Endometriosis and Impact on Quality of Life

Rozsnyai FF1, Szabó B1, Pușcașiu L1, Túrós J1, Bereczky Katalin1, Molnar CV1, Roman H2

1 County Emergency Clinical Hospital Tîrgu Mureș, Clinic of Obstetrics and Gynecology I, Tîrgu Mureș, Romania
2 Rouen University Hospital-Charles Nicolle, Department of Gynecology and Obstetrics, Rouen, France

Objective: The purpose of this retrospective review study was to assess the impact of surgery and quality of life for patients presenting painful deep infiltrating endometriosis (DIE).
Patients and methods: All patients with histologically proved infiltrating endometriosis who had surgery from 1.01.2006 to 31.12.2010 at the Clinic of Obstetrics and Gynecology I, Tîrgu Mureș, Romania and the Department of Gynecology and Obstetrics of the Rouen University Hospital-Charles Nicolle, Rouen, France were included in the study. Surgical exeresis of endometriosis for patients with deep infiltrating endometriosis with GnRha (Gonadotrophin-releasing hormone) analogues treatment before and after the surgery.
Results: One-hundred-fourteen subjects underwent operative laparoscopy for deep infiltrating endometriosis. Involvement of urinary tract was confirmed in thirty patients and the colorectal localization in eighty-four patients. Intra-operative finding according to American Fertility Society reviewed-classification (AFSr) score revealed stage I 6 (5.3%), stage II 9 (7.9%), stage III 18 (15.8%), and stage IV 81 (71.1%).
Conclusion: Resection for deep endometriosis appears to relieve some symptoms. However, patients should be informed that pain may persist and that there is a risk of urinary and digestive side effects.

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