AIm: Pituitary abscess is a disorder characterized with central nervous system (CNS) infection, mass effect, and endocrine dysfunction. These abscesses generally occur due to hematogenous spread in conditions such as paranasal sinusitis, sepsis, and where the blood brain barrier breaks down. This paper aims to discuss four cases of preoperatively diagnosed pituitary abscess in the light of the literature. Results: All the patients showed fever, systemic signs of toxemia and endocrine dysfunction at the time of diagnosis. In these cases, a preoperative diagnosis of the disease was made thanks to characteristic MRI findings. The four cases were operated by the transnasal transsphenoidal approach and histopathological and microbiological studies were performed for surgical specimens.ConClusIon: Pituitary abscesses are rare disorders responsible for a high mortality risk. Mortality and morbidity can be reduced by early surgical drainage and appropriate antibiotic treatments. Additionally, these cases should be closely followed-up in terms of pituitary insufficiency, surgical complications and infection.

In this article, a 9-year-old male patient with a compound depressed skull fracture overlying the superior sagittal sinus and an intracranial stone foreign body is presented. A cerebral penetrating injury caused by a stone is rare. The computed tomography images obtained at standard window widths and window density levels may not reveal a retained stone, which has a chemical structure similar to bone and may not show any artifacts in the computed tomography scans.

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AIm:The deletion polymorphism of the angiotensin-converting enzyme (ACE) genome causes neoplastic development in several organs by increasing the angiotensin 2 (A2) formation. In this study, we aimed to identify the ACE genome insertion/deletion polymorphism in pituitary adenomas and to compare it with the control group. mAterIAl and methOds: Patients operated for pituitary adenomas were included in the study. Genomic DNA was extracted from tumoral tissues and peripheral blood samples of the patients by using the Miller method. Primary sequence was selected via targeting the polymorphic region of intron 16 of ACE genome 17q23. DNA samples were multiplied by PCR using HACE3s and HACE3as primers.results: Twenty-one operated cases were studied. In the study group; 44 % of the patients were identified as D/D, 33% of them as I/D and 23% of them as I/I. In 60%, D allele was identified. According to immunohistochemical investigation, we found that 100% of the patients with Cushing adenoma were D/D alleles. COnClusIOn:Presence of high rate of ACE genome deletion in patients with pituitary adenoma and grade 3-4 patients suggest that ACE genome polymorphism can be a risk factor for the development of pituitary adenomas. KeywOrds: Angiotensin-converting enzyme, Pituitary adenomas, Gene ÖZAmAÇ: Anjiotensin Converting Enzim (ACE) genindeki bir delesyon Anjiotensin 2 de bir artış sağlayarak çeşitli organlarda neoplastik gelişmelere neden olur. Biz bu çalışmada hipofiz adenomlu hastalarda ACE geninde insersiyon /delesyon polimorfizmini belirleyerek kontrol grubuyla karşılaştırmayı amaçladık. sOnuÇ: Kontrol grubuyla karşılaştırıldığında özellikle Grade 3-4 olan hipofiz adenomlu hastalarda yüksek oranda ACE geninde delesyon varlığı hipofiz adenomu gelişiminde ACE geninin bir risk faktörü olabileceğini düşündürmektedir.

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The closure of large skin defects is one of the challenging problems in plastic surgery and neurosurgery. Different reconstructive surgical techniques can be used for closing large skin defects. We report a technique for closing the large skin defects after the surgical repair of meningomyeloceles.

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