[One-stage bilateral vats-sympathectomy for the treatment of severe upper body hyperhidrosis]. / Egy ülésben végzett kétoldali VATS-sympathectomia súlyos fokú hyperhidrosis kezelésére.

Thoracoscopic sympathectomy (VATS) is routinely used to treat severe palmar and axillary hyperhydrosis. The authors present a novel method: one-stage bilateral VATS-sympathectomy. Special considerations also discussed regarding the anaesthesia and operative technique of the procedure. The history of surgical therapy of hyperhidrosis is reviewed briefly, too. The authors conclude that one-stage bilateral VATS-sympathectomy for palmar and axillary severe hyperhidrosis is a safe and effective method, patient satisfaction improves and cost is significantly decreased due to shorter hospital stay.

Expression of NTPDase1 and caveolins in human cardiovascular disease.

Pathological circumstances like inflammation or ischemic insult facilitate the release of adenine nucleotides from several types of cells. These extracellular nucleotides are rapidly converted to adenosine by ectonucleotidases, mainly ectonucleoside triphosphate diphosphohydrolase1 (NTPDase1/CD39) and CD73. NTPDase1/CD39 can interact with caveolins, structural proteins of signal-transducing microdomains termed caveolae. Caveolins are thought to have physiological roles in heart ageing and cardiac diseases. The aim of this study was to investigate the expression of NTPDase1 together with caveolins in chronic human cardiovascular diseases and elucidate their role in human heart. The HPLC analysis showed significant increase in ATPase activity in pathological samples from patients with ischemic heart disease. Immunostaining also showed alterations in the expression and distribution of NTPDase1. Caveolin-1 and caveolin-2 expression was much alike in control and pathological cases, while expression of caveolin-3 was lower in pathological samples. Changes in the expression of NTPDase1 and caveolins seem to be independent of human cardiovascular disease.

[Case of a young woman successfully operated on for acute pulmonary embolism and right ventricular thrombus after urogenital infection]. / Akut tüdoembolia és jobb kamrai thrombus sikeresen operált esete fiatal nobeteg urogenitalis infekciója után.

The authors report a case of a 22-year-old women operated on for pulmonary embolism with success. The venous embolism developed in two phases one week apart. The first clinical sign was a dyspnea of abrupt onset limiting physical activity even after a mild exertion. However, relevant diagnostic tests were performed after one week when the patient fainted, her dyspnea worsened. The results of ECG, echocardiography and pulmonary perfusion scintigraphy indicated the presence of a thrombus residing in the right ventricle and the embolism of the right pulmonary artery. Chest CT and pneumo-angiography findings show the embolus completely blocking the main right branch of the pulmonary artery and partially blocking the left lower lobe artery. On the basis of their experiences published earlier the patient was brought to a stable cardio-respiratory state prior to surgery. Both the adherent right ventricular thrombus and the fresh embolus residing in the right branch of the pulmonary artery were removed under the protection of extracorporeal circulation. After the elapse of an event-free 6-month postoperative period the patient continued to remain symptomless, while being on a long-term anticoagulant regimen. The long-term anticoncipient medication and the urogenital infection 3 months prior to surgery may have been involved in the etiology of the pulmonary embolism. The authors propose the implementation of an antithrombotic prophylaxis in young women after gynecological infections.