In silico analysis of the use of solanine derivatives as a treatment for Alzheimer's disease.

Alzheimer's disease (AD) is a brain illness that causes cognitive impairment in the elderly, especially females, as a result of genetics, hormones, and life experiences. It becomes more severe with age and is associated with cardiovascular disease, hypertension, and diabetes. Beta-amyloid plaques and hyper phosphorylated Tau protein buildup are common clinical findings. Misfiling of amyloid precursor protein (APP) and Amyloid beta peptide (Aß) proteins contributes to Alzheimer's disease. Enzyme Acetylcholinesterase enzyme interacts with amyloid-beta, enhancing its accumulation in insoluble plaques, leading to successful treatment for Alzheimer's disease primarily based on lowering this enzyme. Treatments include using the Rivastigmine for mild, moderate, or severe Alzheimer's disease, which inhibits acetylcholinesterase, but may cause side effects; Solanine derivatives, nightshade toxin, it is cholinesterase inhibitory, may mitigate Alzheimer's illness is progressing. In this research utilized a molecular docking program, which is a computer's computational ability to determine the optimal position for a specific compound to bind to a protein or target, forming a target-ligand complex and displaying biological activity and aiding in the development of effective anti-AD treatments and understanding AD pathological mechanisms. The study examined complexes of 3LII (Acetylcholinesterase receptor) in the A and B chain with Solanine and Rivastigmine derivatives, using an in-silico approach. PyRx default sorter was used to improve docking accuracy. Four compounds were selected based on their higher binding affinities in chain A and B. The results showed that Solanine derivatives (alpha-Solanine, Beta1-Solanine and Beta2-Solanine) have higher binding strength (-9.0,-9.3 and -8.6) than Rivastigmine (-7.2) in chain A, and also the binding strength was high for the Solanine derivatives (alpha-Solanine, Beta1-Solanine, and Beta2-Solanine) (-9.0,-8.8 and -8.9) is higher than Rivastigmine (-6.0) in the chain B. Solanine derivatives showed higher binding strength with acetylcholinesterase, potentially for to reduce the progression of the disease.

Effects of root-derived organic acids on sorption of pharmaceutically active compounds in sandy topsoil.

The presence and fate of pharmaceutically active compounds (PhACs) in agricultural fields are rarely investigated. The present study highlights that root-derived low-molecular-weight organic acids (LMWOAs) affect the mobility of PhACs in cultivated humic Arenosol. Sorption experiments are conducted using three PhACs characterised by different physicochemical properties: carbamazepine (CBZ), 17α-ethinylestradiol (EE2), and diclofenac-sodium (DFC). The results suggest that the adsorption of EE2 is more intense than the other two PhACs, whereas DFC and CBZ are primarily dominated by desorption. LMWOAs mainly provide additional low-energy adsorption sites for the PhACs, and slight pH changes do not significantly affect the sorption mechanism. During competitive adsorption, the high-energy sites of the adsorbents are initially occupied by EE2 owing to its high adsorption energy (∼15 kJ/mol). The new low-energy binding sites enhance the adsorption of DFC (from 8.5 % to 72.0 %) and CBZ (from 31.0 % to 70.0 %) during multicomponent adsorption. LMWOAs not only affect adsorption by modifying the pH but also provide additional binding sites that allow the PhACs to remain in the root environment for a longer period. As the concentration of LMWOAs temporarily changes, so does the availability of PhACs in the root zone. Environmental changes in the humic horizon enhance the mobility of the adsorbed PhACs, which renders them continuously available for uptake by plants, thus increasing the possibility of PhACs entering the human food chain.

Evaluation of the failure effects of a screwing station using a new approached FMEA.

Recognizing the importance of risk assessment and the large-scale industrial spread of network research, we developed a new approach to risk assessment.•The risk assessment takes into account the chains of impact between each level and the frequency of effects and their causes.•In contrast to the traditional FMEA methodology, we evaluate the frequency of occurrence and detectability not only at the level of causes but also at the level of effects.•All this is complemented by a toolkit of network research methodology. The new methodology is validated through a real industry example, which is a risk assessment of a screwdriver station.

Distribution and impacts of contamination by natural and artificial radionuclides in attic dust and urban soil samples from a former industrial Hungarian city: A case study from Salgótarján.

Primordial radionuclides can be found in all environmental compartments. Since coal-fired power plants (CFPP) can be a source of additional radionuclide contamination because coal contains natural radioactive isotopes such as 238U (226Ra) and 232Th. This study investigated the impact of such possible radionuclide contamination from former heavy industrial activities, namely a former local coal-fired power plant, in urban soils and attic dust in Salgótarján, Hungary. Even today, industrial by-products, e.g., coal ash, in this city represent significant threat to its residents. A total of 36 attic dust samples (family houses, kindergartens, churches and blockhouses) were collected and 19 urban soil samples (playgrounds, kindergartens, parks and others) were selected no further than 500 m from the corresponding attic dust sampling sites. Additionally, a coal ash and a brown forest soil sample were also collected to differentiate between the anthropogenic and geogenic sources in the residential area. The sampled houses, built between 1890 and 1990, are considered to be representative sampling sites for long-term accumulations of attic dust. The mean values of the total U, Th and Cs (mg kg-1) concentrations as well as those of K (m/m %) in attic dust and urban soil samples are 2.4, 3.6, 1.7 and 0.6 and 1.1, 4.4, 1.2 and 0.3, respectively, measured using ICP-MS. The mean activity concentrations of 226Ra, 232Th, 40K and 137Cs in attic dust and urban soil samples are 43.3, 34.0, 534.4 and 88.5 and 25.1, 32.8, 386.4 and 5.6 Bq kg-1, respectively, by using a low-background iron chamber with a well-type HPGe and a n-type coaxial HPGe detector. The elemental compositions (U, Th) and activity concentrations (226Ra, 232Th) along with their abundances in coal ash from the CFPP increase in both studied media as the distance of the sampling sites from the CFPP decreases. Two outlier attic dust samples in particular show significantly high activity concentrations of 226Ra: 145 and 143, of 232Th: 83 and 94 Bq kg-1, which can be considered as a proxy of unweathered coal ash. The calculated total absorbed gamma dose rate (D) and annual effective dose (E) received from urban soils indicate that the presence of the CFPP, coal ash cone and slag dumps does not cause an increase in the level of background radiation in Salgótarján. However, the concentrations of the studied radionuclides are much higher (except for 232Th) and exhibit higher degree of variability in the samples of attic dustthan in those of urban soils. The study suggests that attic dust preserves the undisturbed 'fingerprints' of long-term atmospheric deposition thanks to its chemical and physical properties unlike urban soil.

[Surgery of the colon cancer - Expected standards]. / A colondaganatok sebészete, az elvárható hazai és nemzetközi standardok.

The incidence of colon cancer in Hungary shows a continuous increase. Improvements in the chances of survival are mostly dependent on early diagnosis and prevention. The state of the art multidisciplinary treatment of colon cancer also needs focused attention. Next to the ever evolving oncology, surgical resection still remains the indispensable foundation in the treatment of colon cancer. In our article we put an emphasis on the modern principles of surgery. We aim to overview current standards and future initiatives. The lecture that this article is based on was held at the third national event of the Oncologic Section of the Hungarian Surgical Society.

Cellulose in Foliage and Changes during Seasonal Leaf Development of Broadleaf and Conifer Species.

Stable isotope approaches are widely applied in plant science and many improvements made in the field focus on the analysis of specific components of plant tissues. Although technical developments have been very beneficial, sample collection and preparation are still very time and labor-consuming. The main objective of this study was to create a qualitative dataset of alpha-cellulose content of leaf tissues of arboreal species. We extracted alpha-cellulose from twelve species: Abies alba Mill., Acer pseudoplatanus L., Fagus sylvatica L., Larix decidua Mill., Picea abies (L.) Karst., Pinus sylvestris L., Quercus cerris L., Quercus petrea (Matt.) Liebl., Quercus pubescens Wild., Quercus robur L., Tilia platyphyllos Scop. and Ulmus glabra Huds. While these species show an increase in cellulose yield from bud break to full leaf development, the rates of increase in cellulose content and the duration of the juvenile phase vary greatly. Moreover, the veins display significantly higher alpha-cellulose content (4 to 11%) compared to blade tissues, which reflects their different structural and biochemical functions. A guide for the mass of sample material required to yield sufficient alpha-cellulose for a standard stable isotope analysis is presented. The additional benefits of the assessment of the mass of required sample material are reduced sample preparation time and its usefulness in preparing samples of limited availability (e.g., herbarium material, fossil samples).

Activity concentration of 137Cs in undisturbed attic dust collected from Salgótarján and Ózd (northern Hungary).

Due to the Chernobyl nuclear power plant accident, contaminated air masses, containing 137Cs, were widely propagated across all of Europe. Cesium-137 is easily adsorbed on aerosol particles as it returns to the lithosphere/pedosphere/via wet and dry deposition in the form of a radioactive fallout component. Following the nuclear accident, primary attention was paid to agricultural areas and less to urban environments. Our 137Cs activity study using undisturbed attic dust samples has been carried out from two residential areas (city of Salgótarján and Ózd) in northern Hungary, approx. 1000 km away from Chernobyl. A total of 61 attic dust samples were collected in 2016 and 2018 from houses (>30 years) functioning as family house, kindergarten, blockhouse and church. Activity concentration of 137Cs was determined for 1-2 g homogenized (<125 µm) attic dust samples in a low background iron chamber with a well-type HPGe detector. The mean 137Cs activity concentrations in attic dust samples are 88.5 ± 5.1 Bq kg-1 and 87.8 ± 4.5 Bq kg-1 in Salgótarján and Ózd, respectively. The dependence between 137Cs activities and the age of the houses was found to be significant (p=0.02), which could be explained by Chernobyl nuclear accident-causing elevated activity concentrations in location built prior to the accident. Three outliers in Ózd (>223 Bq kg-1), are probably related to the first rainfall event after the Chernobyl accident. Isotopic landscapes (isoscapes) of 137Cs were derived for both cities by means of kriging interpolation. In Salgótarján the 137Cs activity concentrations were higher than in Ózd which might have been due to redistribution loadings and local topographical features. We concluded that components of attic dust are highly useful indicators of home exposure to pollution events and remain detectable after several decades.

Pharmaceuticals in water and sediment of small streams under the pressure of urbanization: Concentrations, interactions, and risks.

Small streams are crucial but vulnerable elements of ecological networks. To better understand the occurrence of pharmaceutically active compounds (PhACs) in streams, this study focused on the occurrence, distribution, and environmental risk of 111 PhACs and 7 trace elements based on a total of 141 water and sediment samples from small streams located in the urbanizing region of Budapest, Hungary. Eighty-one PhACs were detected in the aqueous phase, whereas sixty-two compounds were detected in the sediment. Carbamazepine (CBZ) was the most frequently identified PhAC in water, and was found in 91.5% of all samples. However, the highest concentrations were measured for lamotrigine (344.8 µg·L-1) and caffeine (221.4 µg·L-1). Lidocaine was the most frequently occurring PhAC in sediment (73.8%), but the maximum concentrations were detected for CBZ (395.9 ng·g-1) and tiapride (187.7 ng·g-1). In both water and sediment, more PhACs were found downstream of the wastewater treatment plants (WWTPs) than in the samples not affected by treated wastewater, even though no relationship was observed between the total amount of treated wastewater and the number of detected PhACs. The PhAC concentrations were also independent of the distance from the WWTP effluents. PhAC-polluted samples were detected upstream of the WWTPs, thereby suggesting the relevance of diffuse emissions in addition to WWTP outlets. The most frequently detected PhACs in the sediment were usually also present in the water samples collected at the same place and time. The varying concentrations of PhACs and the fluctuating water-sediment properties resulted in a lack of correlation between the general chemical properties and the concentrations of PhACs, which makes it difficult to predict PhAC contamination and risks in urbanized small streams. The environmental risk assessment indicated that diclofenac had the highest risk in the sampling area.

The Behavior of MMP-2, MMP-7, MMP-9, and Their Inhibitors TIMP-1 and TIMP-2 in Adenoma-Colorectal Cancer Sequence.

BACKGROUND: We and others have previously shown that matrix metalloproteinases (MMPs) play a role in colorectal cancer (CRC) invasion and metastasis. However, the serum changes of various MMPs and their inhibitors (TIMPs) have scarcely been concomitantly investigated in identical blood samples in the normal colon-adenoma-CRC sequence. METHODS: The MMP-2, MMP-7, MMP-9, TIMP-1, and TIMP-2 serum antigen concentrations were determined concomitantly in 19 tumor-free control patients, 19 patients with high-risk colorectal adenoma, and 47 patients with CRC by ELISA technique. The analyzed parameters were also investigated in correlation with CRC stages. Statistical analysis with one-way ANOVA and Student's t test was performed. p values <0.05 were considered significant. RESULTS: Serum antigen levels of MMPs and TIMPs were significantly increased in patients with CRC and adenomas compared to controls (mean values, ng/mL) (MMP-7: 5.88, 4.44, and 2.89, respectively, p = 0.001; MMP-9: 1,075.81, 999.22, and 845.97, respectively, p = 0.01; TIMP-1: 241.80, 205.98, and 166.53, respectively, p = 0.001; TIMP-2: 83.40, 80.30, and 69.62, respectively, p = 0.01). The elevated serum MMP-7, MMP-9, TIMP-1, and TIMP-2 levels significantly correlated with advanced tumor stages (p < 0.05). No statistically significant differences were observed in MMP-2 levels. CONCLUSIONS: We demonstrate that serum antigen concentrations of MMP-7, MMP-9, TIMP-1, and TIMP-2 were significantly increased in patients with CRC and adenomas compared to controls. These results suggest that MMPs and their inhibitors TIMP-1 and TIMP-2 play an important role in CRC invasion; however, they are also activated in premalignant adenomas. Furthermore, MMP-7, MMP-9, TIMP-1, and TIMP-2 may have a potential prognostic impact in CRC.

Geostatistical evaluation of the design of the precipitation stable isotope monitoring network for Slovenia and Hungary.

A detailed knowledge of the stable isotope signature of precipitation is the basis of investigations in a variety of scientific fields and applications. To obtain robust and reliable results, the representativity of the currently operating (at least, as of 2018) precipitation stable isotope monitoring stations across Slovenia (n = 8) and Hungary (n = 9) was evaluated on the basis of amount-weighted annual averages with the aim of revealing any redundantly (i.e. over-) represented or un(der)represented areas. In the case of the latter, optimal locations for additional sites were suggested in Slovenia and Hungary. The networks of both countries are design-based systems that need to be fine-tuned for long-term optimized operation. The evaluation of the monitoring network was performed taking into consideration the stations operating in Slovenia and Hungary, as well as closely situated ones operating in neighboring countries. The evaluation was carried out in nine different combinations, using spatial simulated annealing, with regression kriging variance as a quality measure. The results showed that (i) there are over- and un(der)represented areas in the network, an issue requiring remedial action, (ii) the mutual information exchange of the precipitation stable isotope monitoring networks of Slovenia and Hungary increases the precision of precipitation δ18O estimation by ~0.3‰ in a 15-30 km wide zone near the borders, and (iii) by an even greater degree in the neighboring countries' stations. The current research may be termed pioneering in the matter of the detailed geostatistical assessment of spatial representativity of a precipitation stable isotope monitoring network, and as such, can serve as an example for future studies aiming for the spatial optimization of other regional precipitation stable isotope monitoring networks.

The application of Magnetic Resonance Imaging (mri) to the examination of plant tissues and water barriers.

The aim of the present study is to extend the applicability of MRI measurements similar to those used in human diagnostics to the examination of water barriers in living plants, thus broadening their use in natural sciences. The cucumber, Cucumis sativus, and Phillyrea angustifolia, or false olive, were chosen as test plants. The MRI measurements were carried out on three samples of each plant in the same position vis-a-vis the MRI apparatus using a Siemens Avanto MRI scanner. Two different relaxation times were employed, T1, capable of histological mapping, and T2, used for the examination of water content. In the course of the analysis, it was found that certain histological formations and branching cause modifications to the intensity detected with relaxation time T2. Furthermore, these positions can also be found in T1 measurements. A monotonic correlation (cucumber: ρ = 0.829; false olive: ρ = -0.84) was observed between the T1 and T2 measurements. In the course of the statistical analysis of the signal intensities of the xylems it was concluded that they cannot be regarded as independent in a statistical sense; these changes rather depend on the anatomic structure of the plant, as the intensity profile is modified by nodes, leaves and branches. This serves as a demonstration of the applicability of MRI to the measurement of well know plant physiological processes. The special parametrization required for this equipment, which is usually used in human diagnostics, is also documented in the present study.

[Colon reconstruction after the Hartmann procedure. Laparoscopy or laparotomy?] / Colonrekonstrukció Hartmann-mutét után. Laparoszkópia vagy laparotomia?

The Hartmann procedure - primarily - was introduced for the treatment of cancerous diseases of sigmoid colon and rectum. In the last few years it was performed in cases with complicated inflammation of the left colon, colon cancers with bowel obstruction or perforation, or in the case of insufficiency of the anastomoses, or in urgent operations after traumatics bowel injuries, when making the anastomosis is at very high risk. Later on the restoration of the continuity of the GI tract can be done traditionally (by laparotomy) or laparoscopically. We present our experiences with the above technique, and also compare our results with traditional open surgeries in our patients.

[Investigation of laparoscopic bimanual technic education with laparoscopic training box]. / Kétkezes technika elsajátításának vizsgálata laparoszkópos training boxon.

INTRODUCTION: In some surgical wards residents start to do laparoscopic operations using both hands, while in other places they only use their dominant hand, and only start to use both hands later. There are no data at the moment about which method is more effective. METHODS: We divided 20 students with no laparoscopic experience into 2 groups: one group practised one hand at a time (1K), the other group used both hands (2K) during the 5 days. On the last day both groups had to do every exercise with one hand and two hands as well, then they had to do 3 new exercises, which needed both hands. We measured the time taken, and gave points for the videos taken inside the training box based on OSATS. For statistical analysis we used t-tests, p < 0.05 being significant. RESULTS: On the first day, there was no significant difference between the 1K and 2K groups considering the time taken (518/500 s) and the OSATS points (87/84; 54/55 points). Both groups improved in the mean time and points (1K: 52%, 77% 2K: 50%, 70%) as well, but there was no significant difference between them. In the case of new exercises on the last day, there was no difference between mean time (1K: 425 s, 2K: 411 s) and points (53/59 and 56/52), but there was a significant difference considering the points given for bimanuality. CONCLUSION: Based on our study, we cannot exactly state that the bimanuality needed for expert laparoscopic surgery would be easier to learn with immediately practising with both hands.

[Reconstruction of the inguinal ligament with fascia lata sling. First reported case in Hungary]. / Poupart-szalag rekonstrukciója autológ fascia lata lebennyel. Az elso ismertetett hazai eset.

INTRODUCTION: A technique of reconstructing the inguinal ligament using pedicled fascia lata flap is described. PRESENTATION OF CASE: A 66-year-old woman was referred with massive incarcerated left inguinal hernia, following acute surgery on a femoral vein leasion and numerous attempts at repair and subsequent recurrences. There was complete absence of the left inguinal ligament. The inguinal ligament was reconstructed using a strip of fascia lata, pedicled on the anterior superior iliac spine. This was transposed to cover the external iliac vessels, and sutured to the pubic tubercle. The musculoaponeurotic abdominal wall was reconstructed with 15×13 cm sheet of polypropylene mesh, placed preperitoneal and sutured to the remaining abdominal wall muscles and to the neo-Pouoart ligament. DISCUSSION: Complete destruction of the inguinal ligament is rare but can occur following multiple operative procedures or trauma. Published reports of inguinal ligament reconstruction have been performed using synthetic mesh. The use of autologous tissue should reduce the risk of erosion into the neurovascular bundle, seroma formation, and enhance integration into surrounding tissues. CONCLUSION: This new technique for autologous reconstruction of the inguinal ligament provides a safe alternative to the use of synthetic mesh in the operative armamentarium of plastic and general surgeons. This is the first reported case in Hungary.

[Breast reconstruction surgery with endoscopic assisted latissimus dorsi muscle flap]. / Azonnali emlorekonstrukció endoszkóposan asszisztált latissimus dorsi izomlebennyel.

The results obtaining with breast reconstruction surgery are not always satisfactory for the patients. Reconstruction with pure latissimus dorsi flap is useful option and due to endoscopic harvest large scar on the back can be avoided. The skin sparing mastectomy and even the sentinel lymph node biopsy or lymphadenectomy can be performed using a single incision in the axilla. Also the immediate reconstruction with endoscopically assisted harvest of the latissimus dorsi muscle flap in selective cases can be done using the same incision. The patient reported high satisfaction with the aesthetic and functional results due to preservation the breast shape and the absence of any scarring on the back.

Catalytic Difluorination of Olefins.

Molecular editing with fluorine is a validated strategy for modulating the structure and function of organic systems. In the current arsenal of catalytic dihalogenation technologies, the direct generation of the vicinal difluoride moiety from simple olefins without a prefunctionalization step remains conspicuously absent. Herein we report a catalytic, vicinal difluorination of olefins displaying broad functional group tolerance, using inexpensive p-iodotoluene as the catalyst. Preliminary efforts toward the development of an enantioselective variant are also disclosed.

Optimization of the monitoring network on the River Tisza (Central Europe, Hungary) using combined cluster and discriminant analysis, taking seasonality into account.

The most essential requirement for water management is efficient and informative monitoring. Operating water quality monitoring networks is a challenge from both the scientific and economic points of view, especially in the case of river sections ranging over hundreds of kilometers. Therefore, spatio-temporal optimization is vital. In the present study, the optimization of the monitoring system of the River Tisza, the second largest river in Central Europe, is presented using a generally applicable and novel method, combined cluster and discriminant analysis (CCDA). This area for the study was chosen because, spatial inhomogeneity of a river's monitoring network can more easily be studied in a mostly natural watershed - as in the case of the River Tisza - since the effects of man-made obstacles: e.g water barrage systems, hydroelectric power plants, artificial lakes, etc. are more pronounced. Furthermore, since the temporal sampling frequency was bi-weekly, the opportunity of optimizing the monitoring system on a temporal (monthly) scale arose. In the research, 15 water quality parameters measured at 14 sampling sites in the Hungarian section of the River Tisza were assessed for the time period 1975-2005. First, four within-year sections ("hydrochemical seasons") were determined, characterized with unequal lengths, namely 2, 4, 2, and 4 months long starting with spring. Homogeneous groups of sampling sites were determined in space for every season, with the main separating factors being the tributaries and man-made obstacles. Similarly, an overall pattern of homogeneity was determined. As an overall result, the 14 sampling sites could be grouped into 11 homogeneous groups leading to the possibility of reducing the number of sampling locations and thus making the monitoring system more cost-efficient.

Impact of proteolytic enzymes in colorectal cancer development and progression.

Tumor invasion and metastasis is a highly complicated, multi-step phenomenon. In the complex event of tumor progression, tumor cells interact with basement membrane and extracellular matrix components. Proteolytic enzymes (proteinases) are involved in the degradation of extracellular matrix, but also in cancer invasion and metastasis. The four categories of proteinases (cysteine-, serine-, aspartic-, and metalloproteinases) are named and classified according to the essential catalytic component in their active site. We and others have shown that proteolytic enzymes play a major role not only in colorectal cancer (CRC) invasion and metastasis, but also in malignant transformation of precancerous lesions into cancer. Tissue and serum-plasma antigen concentrations of proteinases might be of great value in identifying patients with poor prognosis in CRC. Our results, in concordance with others indicate the potential tumor marker impact of proteinases for the early diagnosis of CRC. In addition, proteinases may also serve as potential target molecules for therapeutic agents.

[Massive localized lymphoedema (MLL) in the mons pubis]. / Masszív lokalizált lymphoedema a mons pubison.

Massive localized lymphoedema (MLL) is a relatively frequent complication in obesity. MLL is present as a giant swelling and associated with characteristic skin changes. Due to the pathologic and morphologic similarity to sarcoma, MLL is also called "pseudosarcoma". MLL can degenerate into angiosarcoma without surgery. We present a case of MLL of the mons pubis in a 54-year-old man with a BMI of 48.6.

[Urgent laparoscopic adrenalectomy in acute crisis caused by pheochromocytoma]. / Phaeochromocytomás krízisben végzett acut laparoscopos adrenalectomia.

CASE REPORT: Authors present the case of a 30-year-old female patient, who was admitted to the ICU because of hypertensive crisis accompanied by chest complains, cardiac decompensation, progrediating short of breath and unconsciousness. Despite the quick examinations and the prompt treatment multi-organ failure developed 3 days after admission. Investigations revealed the underlying cause, which was a left-sided suprarenal neoplasm. Hence, multidisciplinary decision was made to carry out a laparoscopic adrenalectomy urgently. The histology examination of the removed neoplasm was pheochromocytoma. In the postoperative period the condition of the patient gradually improved, her symptoms and complains settled, and finally she was discharged in a healthy condition. DISCUSSION: The diagnosis of a pheochromocytoma is a difficult task, the symptoms and complains caused by it can simulate many other illnesses. The acute crisis caused by pheochromocytoma usually can be treated conservatively, but in more severe cases with impending multi-organ failure an urgent operative treatment can be unavoidable. Though the operative risk is relatively high, the correct intra- and postoperative treatment with a quick laparoscopic procedure can be effective.