Papers by Zoltan Zsigmond Major
Neurophysiology, 2017
At present, such a type of endoscopic surgery as robot-assisted transaxillary thyroidectomy has b... more At present, such a type of endoscopic surgery as robot-assisted transaxillary thyroidectomy has become available. In this case, traumatization of the brachial plexus is a rare but possible complication. For the control of the function of the brachial plexus during the above operation we used monitoring of somatosensory evoked potentials (SSEPs) induced by stimulation of the median nerve. Fifteen patients (14 women and one man) were included in this study. All interventions were robot-assisted transaxillary thyroidectomies using the daVinci SI Surgical System. We found that such surgery induced mild but significant increases in the latency of the cortical N20 potential, especially when the tissue was tensioned by the autostatic retractor. The latency prolongation was a valuable signal given to the surgeon, followed by repositioning or loosening of the retractor. In the examined group, no significant decreases in the amplitude of the N20 potential were observed. We conclude that SSEP monitoring during robotic thyroid surgery is an available and safe method providing valuable information on the functional integrity of somatosensory pathways during surgical maneuvers.
Journal of Evidence-Based Complementary & Alternative Medicine, 2016
Postpartum psychosis has long-lasting consequences for mother and child. Beside depression, sleep... more Postpartum psychosis has long-lasting consequences for mother and child. Beside depression, sleep and eating disturbances, exhaustion, social withdrawal, and anxiety, postpartum depression can also interfere with normal maternal-infant bonding and adversely affect child development. Recent reports show that most affected pregnant women are hesitant about taking antidepressant drugs, with a high percentage discontinuing their use. Some authors suggest that the reluctance of pregnant women to take antidepressant drugs should encourage clinicians to discuss with their patients the use of psychological interventions or alternative forms of treatment. In this article, a case of severe postpartum depression, treated successfully with homeopathic therapy, is presented. Considering the high noncompliance of women suffering from postpartum depression with conventional antidepressant medication, research in safe complementary medical methods is justified. One of these methods should be homeop...
Orvosi Hetilap, 2015
Stroke-like presentation of multiple sclerosis is a challenging diagnosis requiring quick and eff... more Stroke-like presentation of multiple sclerosis is a challenging diagnosis requiring quick and efficient decision in order to provide the best possible therapeutical option. This case presentation focuses on the difficulties of the differential diagnostic process. Even if signs were misleading, the stepwise and structured approach with the use of adequate diagnostic tools revealed the most likely diagnosis and, thus, assured the best clinical care. Orv. Hetil., 2015, 156(37), 1514–1518.
European Neuropsychopharmacology, 2011
Medicine and Pharmacy Reports
Background and aims. To emphasize the importance of laboratory dissections in perfecting surgical... more Background and aims. To emphasize the importance of laboratory dissections in perfecting surgical techniques. In this paper, we describe the technical details on rabbit dissection for practical applications. Methods. Four New Zealand rabbits were distributed into two groups and underwent anastomosis between the Facial Nerve and Ansa Cervicalis (group 1) and between the Facial Nerve and Hypoglossal Nerve (group 2). They were clinically and neurophysiologically evaluated after ten weeks. Electroneurography with skin electrodes were used to identify the motor activity of the involved muscles and nerves. Facial and ipsilateral tongue reinnervation was analyzed 40 weeks after anastomosis. Evoked electromyographic muscle tension was used to evaluate facial and tongue reinnervation. Results. Facial and ipsilateral tongue reinnervation was analyzed 40 weeks after anastomosis. Recorded evoked potentials showed improvement in facial reinnervation in all four rabbits. Rabbits undergoing FN-HN ...
Journal of Personalized Medicine
Background: For decades, patients with facial asymmetry have experienced social interaction diffi... more Background: For decades, patients with facial asymmetry have experienced social interaction difficulties, leading them to seek treatment in the hope of restoring facial symmetry and quality of life. Researchers evaluated numerous surgical techniques, but achieving results remains a significant hurdle. Specifically, anastomosis between the ansa cervicalis (AC) and facial nerve (FN) can hinder the patient’s physical appearance. Objective: Our study goal was to examine the efficiency of anastomosis between AC and FN for facial motor function recovery even in the presence of peripheral neuropathy. Materials and Methods: Four patients diagnosed with facial palsy grade VI on the House & Brackmann Scale (HB) after vestibular schwannoma (VS) resection (Koos grade IV) via the retrosigmoid approach underwent AC and FN anastomosis. Outcomes were related to tumor grade, previous therapy, and the time between postoperative facial palsy and anastomosis. Images and neurophysiological data were eva...
Journal of Personalized Medicine, 2021
The use of robotic systems in physical rehabilitation protocols has become increasingly attractiv... more The use of robotic systems in physical rehabilitation protocols has become increasingly attractive and has been given more focus in the last decade as a result of the high prevalence of motor deficits in the population, which is linked to an overburdened healthcare system. In accordance with current trends, three robotic devices have been designed, called ParReEx Elbow, ParReEx Wrist, and ASPIRE, which were designed to improve upper-limb medical recovery (shoulder, elbow, forearm, and wrist). The three automated systems were tested in a hospital setting with 23 patients (12 men and 11 women) suffering from motor deficits caused by various neurological diseases such as stroke, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS). The patients were divided into three groups based on their pathology (vascular, extrapyramidal, and neuromuscular). Objective clinical measures, such as the Medical Research Council (MRC) scale, goniometry, and dynamometry, were used to compare pre- ...
International Journal of Environmental Research and Public Health, 2020
Motor disability is a key feature of many neurological diseases, influencing the social roles of ... more Motor disability is a key feature of many neurological diseases, influencing the social roles of affected patients and their ability to perform daily life activities. Current rehabilitation capacities are overwhelmed by the age-related increase of motor dysfunctions seen, for example, in stroke, extrapyramidal or neuromuscular diseases. As the patient to rehabilitation personnel ration increases, robotic solutions might establish the possibility to rapidly satisfy the increasing demand for rehabilitation. This paper presents an inaugural exploratory study which investigates the interchangeability of a novel experimental robotic rehabilitation device system with classical physical therapy, using a multimodal neurophysiological assessment of the motor system—quantitative electroencephalogram (EEG), motor conduction times and turn/amplitude analysis. Preliminary results show no significant difference between the two methods; however, a significant effect of the therapy was found on dif...
International Journal of Environmental Research and Public Health, 2020
A few decades ago, robotics started to be implemented in the medical field, especially in the reh... more A few decades ago, robotics started to be implemented in the medical field, especially in the rehabilitation of patients with different neurological diseases that have led to neuromuscular disorders. The main concern regarding medical robots is their safety assurance in the medical environment. The goal of this paper is to assess the risk of a medical robotic system for elbow and wrist rehabilitation in terms of robot and patient safety. The approached risk assessment follows the ISO12100:2010 risk management chart in order to determine, identify, estimate, and evaluate the possible risk that can occur during the use of the robotic system. The result of the risk assessment process is further analyzed using a fuzzy logic system in order to determine the safety degree conferred during the use of the robotic system. The innovative process concerning the risk assessment allows the achievement of a reliable medical robotic system both for the patient and the clinicians as well. The clini...
1Kinga A. Major, 2,3 Zoltán Z. Major, 4Giuseppe Carbone, 5Adrian Pîslă, 5Calin Vaida, 5Bogdan Ghe... more 1Kinga A. Major, 2,3 Zoltán Z. Major, 4Giuseppe Carbone, 5Adrian Pîslă, 5Calin Vaida, 5Bogdan Gherman, 5Doina L. Pîslă 1 Cluj County Emergency Clinical Hospital, IInd ICU, Neurosurgery Clinic, Cluj-Napoca, Romania; 2 “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania; 3 Municipal Clinical Hospital Cluj-Napoca, Neurology Department, Romania; 4 Laboratory of Robotics and Mechatronics, DiCEM, University of Cassino and South Latium, Italy; 5 Research Center for Industrial Robots Simulation and Testing, CESTER, Technical University of Cluj-Napoca, Romania All authors had equal contribution
Revista Romana de Medicina de Laborator, 2018
Aim: A possible molecular mechanism of clinically defined multidrug-resistant epilepsy involves d... more Aim: A possible molecular mechanism of clinically defined multidrug-resistant epilepsy involves drug efflux transporters such as P glycoprotein (P-gp), a member of the ATP-binding cassette subfamily B1 (ABCB1). We have investigated the prevalence of the C3435T, G 2677T/A, and T129C single-nucleotide polymorphisms in the promoter region of MDR1 gene, in Romanian epileptic patients. Methods: 70 epileptic patients evaluated in the Neurology Department of Cluj County Hospital were included in the study. The response to treatment was assessed by reviewing the seizure diaries and the patients were classified as responders or non-responders. Antiepileptic drug (AED) plasmatic concentrations were measured and the patients were divided into 2 groups: first group with AED concentrations in therapeutic range and the second one with sub-optimal AED concentrations. Genotyping the DNA samples, we investigated MDR1 gene polymorphism by polymerase chain reaction (PCR). Results were expressed as gen...
International Journal of Immunopathology and Pharmacology, 2012
Lymph node (LN) infiltration by neoplastic process involves important changes in lymph node immun... more Lymph node (LN) infiltration by neoplastic process involves important changes in lymph node immune microenvironment. In particular, regulatory T cells (Treg) seem to have a key role in altering the immunoediting function of the immune system which leads to the elusion of the tumor from immune surveillance. In this study, we evaluate the expression of T-cell markers in CD4+ and CD8+ subsets from tumor-positive and tumor-negative lymph nodes from the same, advanced stage breast cancer patient. The study was carried out on 3 patients and similar results were obtained. Flow cytometric analysis of CD8+ cells demonstrated a significant difference in the expression of CD25, CD45RA, CD45RO, and GITRL (Glucocorticoid-Induced TNF receptor-Related ligand). Flowcytometric analysis of CD4+ cells demonstrated a significant difference in the expression of GITR (Glucocorticoid-Induced TNF receptor-Related), CD25, FoxP3 (Forkhead box P3), CD28, and CD45RA. Multiple staining allowed the identificatio...
The objectives of this study were to compare the distribution of spectral power in a heteroge-neo... more The objectives of this study were to compare the distribution of spectral power in a heteroge-neous idiopathic epilepsy group, under antiepileptic treatment, versus healthy controls. Methods: Relative power values were calculated from EEGs obtained in wakefulness using Fast Fourier Transformation. The patient group was compared to an age-matched group of healthy controls, derivation by derivation, then regarding asymmetry, and considering the influence of epilepsy on the topographic distribution of the main frequency bands. Results: There are highly significant differences between the two groups: the spectral power of the slow frequencies is increased in epileptics versus controls, and for the fast domains there is a reduction of the relative power. No asymmetries were observed between the two hemispheres. Gross topography-dependent power changes did not interfere significantly with the epilepsy-induced power spectrum of the investigated domains, although a tendency was recorded for...
Immune response in inflammation has a wide complexity, involving APC-lymphocyte and lymphocyte-ly... more Immune response in inflammation has a wide complexity, involving APC-lymphocyte and lymphocyte-lymphocyte communication. Fine modulation of the immune response is delivered by the interaction between co-stimulatory molecules, on which the final outcome of the immune response depends. Evaluation of the expression profile of certain co-stimulatory genes and cytokines in inflammation may clear some of this complexity. Hence a PCR method is proposed in order to asses mRNA presence and quantity in some pathologies. We proposed to establish standard "yes or no" condition to the PCR in order to confer a semi-quantitative attribute to our PCR. We constructed primers for the following genes: GITR, GITRL, IL-2, CD25, CD28, CTLA-4, TGF-β1 and IL-18. The GAPDH gene was used as internal control. Samples were collected from patients with tonsillitis, rheumatoid polyarthritis, systemic lupus erythematosus and voluntary subjects as controls, isolating lymphocytes from blood and tissue, an...
Multiple sclerosis is a neurological disease with diverse treatment options, but one of the main ... more Multiple sclerosis is a neurological disease with diverse treatment options, but one of the main tools of maintaining a relatively acceptable life quality is the pharmacological approach through disease modifying therapies. The objective of this paper is to give a brief presentation of the main feasible drug options, a higher attention being offered to glatiramer acetate.
Thirty-seven subjects with relapsing-remitting multiple sclerosis were included. Informed consent... more Thirty-seven subjects with relapsing-remitting multiple sclerosis were included. Informed consent was signed by all participants,
Ideggyógyászati szemle, Jan 30, 2013
The co-occurrence of Hodgkin's lymphoma (HL) and myasthenia gravis (MG) is a rare phenomenon ... more The co-occurrence of Hodgkin's lymphoma (HL) and myasthenia gravis (MG) is a rare phenomenon that is sometimes considered a paraneoplastic manifestation. There are a few documented cases in which myasthenia symptoms manifested only after the surgical removal of the tumor. However, the biological basis of this association is unknown. One hypothesis is that it derives from the infiltration of the residual thymic tissue by the developing tumor. In our case, the myasthenic symptoms led to the HL diagnosis. Our objective was to investigate the T cell phenotype in a HL patient presenting myasthenia-like symptoms. In patients with autoimmune disease, Tregs are usually decreased, but in some diseases, they appear to be increased. It has been speculated that this phenomenon may occur due to a homeostatic attempt by the immune system to control the expansion of auto-reactive effector cells. In the described patient the proportion of lymphoma infiltrating Tregs was high (more than 10% of C...
Ideggyógyászati szemle, Jan 30, 2011
Evoked potentials, both stimulus related and event related, show disturbances in attention defici... more Evoked potentials, both stimulus related and event related, show disturbances in attention deficit-hyperactivity disorder and epilepsies, too. This study was designed to evaluate if these potentials are characteristically influenced by the presence of the two diseases, individually, and in the case of co-occurrence. Forty children were included, and four groups were formed, control group, ADHD group, epilepsy group and a group with the comorbidity of epilepsy and ADHD. Epilepsy patients were under proper antiepileptic treatment; ADHD patients were free of specific therapy. Brainstem auditory evoked potentials, visual evoked potentials and auditory P300 evaluation were performed. The latency of the P100 and N135 visual evoked potential components was significantly extended by the presence of epilepsy. If ADHD was concomitantly present, this effect was attenuated. Brainstem auditory evoked potential components were prolonged in the presence of the comorbidity, considering the waves el...
... Therapeutics, Pharmacology and Clinical Toxicology 228 Ioana Corina Bocşan et al. Refferences... more ... Therapeutics, Pharmacology and Clinical Toxicology 228 Ioana Corina Bocşan et al. Refferences ... Pharmacol Res 2004;50:195–200. 12. Buzoianu AD, Trifa AP, Popp RA, Militaru C, Bocsan C, Pop IV. Analysis of the CYP2C19*2 and *3 gene variants in a Romanian population. ...
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Papers by Zoltan Zsigmond Major