University of Medicine and Pharmacy of Targu Mures
Sfantu-Gheorghe, Romania

The University of Medicine and Pharmacy of Târgu Mureș or UMF Târgu Mureș is a public university in Târgu Mureș, Romania, founded in 1945 as Institute of Medicine and Pharmacy. The university is one of the 6 traditional medical schools in Romania beside Cluj, Bucharest, Timişoara, Iași and Craiova, all being founded before the 1989 Romanian revolution.The main building of the University was build in the period of dualism between 1908-1909 when it was a Hungarian military school. After World War II the Hungarian language branch of the Faculty of Medicine and Pharmacy of Babeș-Bolyai University was transferred here from Cluj-Napoca. Since 1962 the University of Medicine and Pharmacy has expanded as the number of students has doubled. Many of the doctors who graduated here have become known in the country and abroad. Wikipedia.

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Balasa R.,University Emergency County Hospital | Bajko Z.,University Emergency County Hospital | Hutanu A.,University Emergency County Hospital | Hutanu A.,University of Medicine and Pharmacy of Targu Mures
Multiple Sclerosis Journal | Year: 2013

Background: Interleukin-17 (IL-17), which is secreted by Th17 cells, is a proinflammatory cytokine that is implicated in the pathogenesis of multiple sclerosis (MS) and plays a role in nonresponse of MS patients to interferon-β (IFN-β) therapy. Objectives: The purpose of this study was to establish a correlation between nonresponders (NR) and IL-17A serum titers and binding antibodies (BAbs) to IFN-β, as well as to find a correlation between IL-17A serum levels and other features of MS patients. Methods: Our prospective study included 72 inactive relapsing-remitting multiple sclerosis (RRMS) patients that had been treated for at least 18 months with IFN-β and 15 healthy subjects. We determined the serum levels of IL-17A and of BAbs. IL-17A levels were considered elevated (IL-17A+) if the recorded value was greater than 1.6 pg/ml. Results: Twenty-seven patients (37.5%) were NR and had a significantly higher serum IL-17A level compared to the responders group. Nineteen patients (26.4%) were IL-17A+ and had had a significantly higher number of relapses in the previous year and a higher Expanded Disability Status Score. The majority of IL-17A+ patients were NR and had a shorter MS duration. Conclusions: RRMS patients with high serum IL-17A levels do not respond well to IFN-β therapy and have shorter MS duration compared to patients with low IL-17A levels. This response is not influenced by the presence of BAbs. © The Author(s) 2012.

Croitoru M.D.,University of Medicine and Pharmacy of Targu Mures
Journal of Chromatography B: Analytical Technologies in the Biomedical and Life Sciences | Year: 2012

Measurements of nitrite and nitrate are used in biomedical research to estimate the endogenous formation of nitric oxide (an important biomolecule). These anions are also toxins and their concentration is regulated in certain foodstuffs. There are many published methods for detecting nitrite and nitrate but most of them fail to detect nitrite in biological samples. A new HPLC-UV/VIS method was developed which easily detects low concentrations of nitrite and nitrate present in mammal blood, urine and in vegetal samples. The method is based on a pre-column derivatization of nitrite anion using the Griess reaction and direct determination of nitrate using its UV absorbance. A chromatographic process with detection at two wavelengths allows the determination of both anions in one run (23. min with column reequilibration included). The limits of quantification in mammal blood are 2. ng/ml and 200. ng/ml for nitrite and nitrate, respectively. As regards vegetables, due to the need of sample dilution in the preparation steps, these limits are 3 times higher. Concentrations measured in rabbit blood samples ranged from 1.09 to 42.65. μg/ml for nitrate and 15.8 to 384.6. ng/ml for nitrite. Concentrations in vegetables ranged from below the limit of detection to 4. g/kg for nitrate and from below the limit of detection to 369.2. μg/kg for nitrite. The specificity of Griess reaction toward nitrite is under discussion since substances able to mimic this reaction were found, leading to compounds with spectral properties in visible domain indistinguishable from that of nitrite related azo dye. © 2012 Elsevier B.V.

Botianu P.V.-H.,University of Medicine and Pharmacy of Targu Mures | Botianu A.M.,University of Medicine and Pharmacy of Targu Mures
Pulmonary Medicine | Year: 2012

Empyema remains a challenge for modern medicine. Cases not amenable to lung decortication are particularly difficult to treat, requiring prolonged hospitalizations and mutilating procedures. This paper presents the current role of thoracomyoplasty procedures, which allow complete and definitive obliteration of the infected pleural space by a combination of thoracoplasty and the use of neighbourhood muscle flaps (latissimus dorsi, serratus anterior, pectoralis, rectus abdominis, omentum, etc). Recent publications show an overall rate of success of 90%, with a quick and definitive healing. Although rarely indicated in our days, this kind of procedures remain in the armamentarium of modern thoracic surgery. The importance of thoracomyoplasty derives from the fact that it may be a simple and definitive solution for complicated cases of chronic empyema not amenable to standard decortication. Copyright © 2012 Petre Vlah-Horea Botianu and Alexandru Mihail Botianu.

Kovacs M.,University of Medicine and Pharmacy of Targu Mures
Oral health and dental management | Year: 2012

This retrospective study aimed to assess the prevalence of dental trauma in deciduous and permanent teeth among children and teenagers who attended two dental clinics in Targu Mures, Romania, between 2003 and 2011 and the correlation of their risk of dental trauma with factors, including gender, age, physical activities and extent of incisor overjet. The study population consisted of patients aged between 1 and 18 years who attended the Clinic of Paediatric Dentistry and Orthodontics and the Clinic of Oral and Maxillofacial Surgery, Targu Mures, in the period between January 2003 and August 2011. Their records were reviewed and the following factors, relevant to dental trauma, were recorded: gender, age, type of dentition, injury aetiology, lesion type and location, number of teeth affected, occlusion, and radiography. For patients who attended the orthodontics clinic, the degree of overjet was also determined. The overall prevalence of dental trauma was 24.5%. The frequency of traumatic injuries to deciduous teeth was approximately equal for boys and girls, and the most for those between 1 and 2 years. In the permanent dentition, a dental trauma was more frequently found boys, and the most affected age group was between 11 and 12 years, for both boys and girls. The most common causes were falls, in deciduous teeth especially during learning to walk, and in permanent teeth particularly during cycling or other sporting mishaps. The most frequent type of trauma found in the deciduous dentition was lateral luxation and in the permanent teeth it was fracture with the involvement of enamel and dentine, but without the exposure of the dental pulp. A positive relationship was noted between the presence of overjet associated with lip incompetence and the frequency of dental trauma. The prevalence of dental trauma in children and adolescents who attended the Clinic of Paediatric Dentistry and Orthodontics and the Clinic of Oral and Maxillofacial Surgery, Targu Mures, was broadly similar to that found in other studies. More epidemiologic studies are needed to gain a more comprehensive overview of the prevalence of dental trauma in Romania.

Marusteri M.,University of Medicine and Pharmacy of Targu Mures | Bacarea V.,University of Medicine and Pharmacy of Targu Mures
Biochemia Medica | Year: 2010

Choosing the right statistical test may at times, be a very challenging task for a beginner in the field of biostatistics. This article will present a step by step guide about the test selection process used to compare two or more groups for statistical differences. We will need to know, for example, the type (nominal, ordinal, interval/ratio) of data we have, how the data are organized, how many sample/groups we have to deal with and if they are paired or unpaired. Also, we have to ask ourselves if the data are drawn from a Gaussian on non Gaussian population. A key question is, if the proper conditions are met, should a one-tailed test or two-tailed test be used, the latter typically being the most powerful choice. The appropriate approach is presented in a Q/A (Question/Answer) manner to provide to the user an easier understanding of the basic concepts necessary to fulfill this task. Some of the necessary fundamental concepts are: Statistical inference, statistical hypothesis tests, the steps required to apply a statistical test, parametric versus nonparametric tests, one tailed versus two tailed tests etc. In the final part of the article, a test selection algorithm will be proposed, based on a proper statistical decision-tree for the statistical comparison of one, two or more groups, for the purpose of demonstrating the practical application of the fundamental concepts. Some much disputed concepts will remain to be discussed in other future articles, such as outliers and their influence in statistical analysis, the impact of missing data and so on.

Laszlo L.,University of Medicine and Pharmacy of Targu Mures
Magyar Onkologia | Year: 2010

Colon cancer is the second most prevalent lethal cancer. The main cause for high mortality rate is that the prognosis for progressed metastatic colon cancer is most unfavorable. Recent data suggest that disease outcome can be further improved by the addition of targeted biological agents to the first- or second-line treatment. As a result of molecularly targeted anti-EGFR therapies (cetuximab and panitumumab) complementing chemotherapy, liver metastases can reduce in size and become operable in certain patients, which can contribute to the complete recovery of the patient. The main problem, however, is the fact that a positive response only occurs in one third of the patients, even in the case of chemotherapy combined protocol, and the side effects are considerable. For the application of individually tailored treatments, it is an urgent need to develop a system of biomarkers that can predict the effect of treatment and provide information about the optimal selection of both chemotherapy and biological treatment. It should be clarified what the most important requirements of a good and reliable biomarker are. As currently there is no precise predictive molecular diagnostics at our disposal, oncologists have to make one of two choices: they treat a large number of patients with anti-EGFR agents which has negative effects on the quality of life and also reduces the patient's chances of getting appropriate treatment or, if the oncologists refuse to take risks, they omit the use of anti-EGFR treatment in which case those patients for whom this would have been the appropriate treatment are also denied the chance of short-term survival or recovery. Clinical data (response rate, time to progression (TTP) and overall survival (OS)) of 130 colorectal cancer patients have been retrospectively analyzed. Patients have received different chemotherapy protocols in combination with anti-VEGF antibody or with anti-EGFR antibody therapies. EGFR expression was evaluated with immunohistochemistry, KRAS, BRAF and PIK3CA mutations were evaluated by direct sequencing and high resolution melting analysis in the archived formalin-fixed, paraffin-embedded tissue samples. The study found similar efficacy of first-line therapeutic protocols. Protocols combining chemotherapy with biological therapies achieved better overall survival but this difference was not significant (OS: 35.9 versus 36.7 months). The frequency of KRAS mutations was 44% (n=100). None of the KRAS mutant tumors responded to the anti-EGFR monotherapy. TTP in the case of cetuximab monotherapy was twice longer (208 months) than in the KRAS mutant tumors (104 months). One BRAF mutant tumor was also identified (4%) This tumor was also resistant to cetuximab monotherapy. The KRAS and BRAF mutations excluded each other. Except one case, the KRAS status was identical in both the primary tumor and the metastasis. In contrast, PIK3CA mutations were heterogeneous in different tumor samples. In 5 out of 6 cases the mutation status of PIK3CA was different in the primary tumor and the metastasis. New biological therapies provide an additional clinical benefit only for a subset of patients. We need biomarkers to identify these patients. KRAS and most probably BRAF testing can double the efficacy of the anti-EGFR therapies, but we need additional molecular diagnostic tests. PIK3CA is an important candidate but we might need to take biopsy directly from the metastasis or we have to evaluate the circulating tumor cells to judge the molecular status of distant metastasis. © Akadémiai Kiadó.

Schiopu A.,Malmö University | Schiopu A.,Skåne University Hospital | Cotoi O.S.,University of Medicine and Pharmacy of Targu Mures
Mediators of Inflammation | Year: 2013

Amplification of innate immune responses by endogenous danger-associated molecular patterns (DAMPs) promotes inflammation. The involvement of S100A8 and S100A9, DAMPs belonging to the S100 calgranulin family, in the pathogenesis of cardiovascular disease is attracting an increasing amount of interest. S100A8 and S100A9 (also termed MRP8 and MRP14) preferentially form the S100A8/A9 heterodimer (MRP8/14 or calprotectin) and are constitutively expressed in myeloid cells. The levels of circulating S100A8/A9 in humans strongly correlate to blood neutrophil counts and are increased by traditional cardiovascular risk factors such as smoking, obesity, hyperglycemia, and dyslipidemia. S100A8/A9 is an endogenous ligand of toll-like receptor 4 (TLR4) and of the receptor for advanced glycation end products (RAGE) and has been shown to promote atherogenesis in mice. In humans, S100A8/A9 correlates with the extent of coronary and carotid atherosclerosis and with a vulnerable plaque phenotype. S100A8/A9 is locally released following myocardial infarction and amplifies the inflammatory responses associated with myocardial ischemia/reperfusion injury. Elevated plasma levels of S100A8/A9 are associated with increased risk of future coronary events in healthy individuals and in myocardial infarction survivors. Thus, S100A8/A9 might represent a useful biomarker and therapeutic target in cardiovascular disease. Importantly, S100A8/A9 blockers have been developed and are approved for clinical testing. © 2013 Alexandru Schiopu and Ovidiu S. Cotoi.

Gurzu S.,University of Medicine and Pharmacy of Targu Mures | Jung I.,University of Medicine and Pharmacy of Targu Mures
Pathology Research and Practice | Year: 2012

Cytokeratin 7 (CK7) and 20 (CK20) are used for the differential diagnosis of metastases from colorectal carcinomas (CRC), which are usually CK7-/CK20+, and other tumors. In our study, we performed immunohistochemical staining with CK7 and CK20 in 52 randomly selected cases of CRC and analyzed microsatellite instability status and BRAF mutations to identify those factors that may determine the changing pattern of CK7/CK20 immunophenotype in these tumors. CK7 was negative in all microsatellite stable tumors (MSS), but all carcinomas presenting microsatellite instability (MSI) and BRAF mutations were diffusely positive for this marker. CK20 was diffusely expressed in 79.06% of MSS tumors. Regarding MSI, in case with no BRAF mutations, a progressive decrease in CK20 expression was noted, and in BRAF-mutated adenocarcinomas, no expression of CK20 was observed. It seems that in case of MSI located on the proximal colon, which also presents BRAF mutations, CK20/CK7 may present a changing immunophenotype pattern, which may complicate the differential diagnosis of metastatic tumors. This is the first reported study of the relationship between CK20/CK7 immunophenotype, BRAF mutations and microsatellite status in CRC. © 2012 Elsevier GmbH.

Botianu P.V.,University of Medicine and Pharmacy of Targu Mures
Chirurgia (Bucharest, Romania : 1990) | Year: 2012

The aim of the paper is to evaluate the results achieved after mobilization of the omentum outside the peritoneal cavity. Between 01.01.2006-01.01.2012, the main author has performed an extraperitoneal mobilization of the omentum in 12 patients. The indications for the use of this flap were: prophylactic filling of the remnant space after the Miles procedure - 4 cases, solving of some pelvisubperitoneal and perineal complications after rectal surgery - 3 cases, covering of vascular prosthesis - 3 cases (2 of them with active infection) and closure of a post-pneumonectomy bronchial fistula - 1 case. The mobilization of the flap was performed by laparotomy - 10 cases, by laparoscopy - 1 case and transdiaphragmatic (thoracotomy) - 1 case; all the procedures were performed by the same team, with no assistance on behalf of a plastic surgeon. We have encountered one immediate postoperative death through myocardial infarction on postoperative day 12 (vascular prosthesis infection in a 75 years old patient). Based on the clinical and imagistic evaluation, we have encountered no necrosis of the omental flap. At late follow-up (1-5 years) we have encountered no significant complications related to the use of this flap. The omentum is a solution for a great variety of defects located outside the peritoneal cavity; it's mobilization is relatively simple and does not involve a major morbidity. Knowledge of the omentum's anatomy and techniques of mobilization are mandatory in digestive, thoracic and vascular surgery. RevistaChirurgia.

Gurzu S.,University of Medicine and Pharmacy of Targu Mures
European journal of histochemistry : EJH | Year: 2012

Mena (mammalian Ena) is an actin regulatory protein involved in cell motility and adhesion. Based on its potential role in malignant transformation revealed in other organs, we analyzed the Mena expression in normal salivary glands (SG) and salivary tumors. Mena expression was determined in normal SG (n=10) and also benign (n=20) and malignant (n=35) lesions of SG. For the immunohistochemical staining we used the anti-Mena antibody. All normal SG and the benign lesions (10 pleomorphic adenomas, 10 Warthin's tumors) were Mena negative. Salivary duct carcinomas (n=5), carcinomas in pleomorphic adenoma (n=5), acinic cell carcinomas (n=5), squamous cell carcinomas (n=10) and high-grade mucoepidermoid carcinomas (n=2) were positive. The lymphomas (n=5) and low-grade mucoepidermoid carcinomas (n=1) were Mena negative. In one case the lymphoblastic cells stained positive for Mena. Some of the endothelial cells, in the peritumoral vessels, were Mena positive. To the best of our knowledge, this is the first study in the literature about Mena expression in salivary tumors. Our study suggests that Mena protein seems to play a role in malignant transformation and its intensity is correlated with the type and grade of tumor and also with vascular invasion. Its positivity in endothelial cells may suggest its potential role in tumor angiogenesis.

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