Taking into account the data from the World Health Organization on the insufficient level of therapeutic success in the treatment of MDR and XDR pulmonary TB, surgical treatment is necessary in regions with a high frequency of drug-resistant cases.

The amygdala is one of the most discussed structures of the brain. Correlations between its level of activity, size, biochemical organization, and various pathologies are the subject of many studies, and can serve as a marker of existing or future disease. It is hypothesized that the amygdala is not just a structural unit, but includes many other regions in the brain. In this review, we present the updated neuroanatomical and physiological aspects of the amygdala, discussing its involvement in neurodegenerative and neurological diseases. The amygdala plays an important role in the processing of input signals and behavioral synthesis. Lesions in the amygdala have been shown to cause neurological disfunction of ranging severity. Abnormality in the amygdala leads to conditions such as depression, anxiety, autism, and also promotes biochemical and physiological imbalance. The amygdala collects pathological proteins, and this fact can be considered to play a big role in the progression and diagnosis of many degenerative diseases, such as Alzheimer’s disease, chronic traumatic encephalopathy, Lewy body diseases, and hippocampal sclerosis. The amygdala has shown to play a crucial role as a central communication system in the brain, therefore understanding its neuroanatomical and physiological features can open a channel for targeted therapy of neurodegenerative diseases.

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Background: The long history of the struggle against tuberculosis (TB) inspired us to develop a new minimally invasive technique of thoracoplasty with videothoracoscope control (VATP). The aim of this study was to determine its efficacy.Methods: We conducted a retrospective single-center study of a cohort of patients operated on between 1999 and 2017. Two hundred eight patients who were indicated for thoracoplasty with verified TB with cavities in the upper lobe/S6 were enrolled in this study. Treatment outcomes were assessed based on Laserson criteria and active TB absence verified with CT.Results: Intraoperative and postoperative complications were observed in 15 (7.2%) and 4 (2.0%) cases, respectively. There were no 30-day mortalities. VATP with curative intent succeeded in 88% of cases according to Laserson criteria and active TB absence verified with computed tomography (CT). Clinical improvement (sputum negativity, closure of caverna, and lack of reactivation for 3 years) was achieved in 81% of cases. Conclusions: Comparing the successful results of this technique in the cohort of multidrug-resistant (MDR) TB patients with the outcomes of treatment of MDR TB worldwide (77% vs. 55%, respectively), the VATP technique is shown to be efficacious and thus recommended.Clinical trial registry number: ISRCTN67743278.

Background: Volume reduction surgery is a routine treatment method for lung emphysema in chronic obstructive pulmonary disease (COPD) patients. The formation of giant bullous emphysema is an indication for surgical bullectomy. Bilateral giant bullae severely compromise lung function and complicate surgical treatment. Case presentation: We present the algorithm for surgical treatment and correction of complications in a 38-yearold male with bilateral giant bullae (vanishing lung syndrome), severe COPD. Primarily the patient was admitted with a mild cough, mucopurulent sputum and dyspnea. A CT scan revealed bilateral giant bullae, displacing up to 50% of lung volume. A two-stage surgical bullectomy was planned, yet postoperative complications due to secondary bullae rupture prompted urgent revision with contralateral bullae resection. After complete bullectomy, severely reduced lung volume was successfully managed throughout a long postoperative rehabilitation period. At 5 year follow-up, spirometry indicators and radiological examination show significantly improved and stable lung function. Conclusion: This clinical case demonstrates the technical difficulties and possible complications of extended bilateral lung resections in patients with severe vanishing lung syndrome. Single-stage treatment of bilateral giant bullous emphysema is recommended to minimize postoperative complications and reduce risk of bullae rupture. Positive long-term outcome outweighs possible complications of surgical treatment.