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Summary Objective The primary aim of the study was to compare the efficacy of Oct-LAR and surgery in terms of controlling IGF-1 and GH levels and tumour volumes. The second aim was to compare two primary treatment modalities in terms of side effects such as pituitary insufficiency, cholelithiasis, metabolic parameters and the effect on quality of life (QoL). Design The study was a randomized, prospective study. Patients The 22 patients were consecutively randomized to Oct-LAR and surgical treatment groups. Results Baseline serum IGF-1 level, tumour volume and GH levels were comparable in the Oct-LAR and surgery groups. No significant differences were detected between the Oct-LAR and the surgery groups in terms of IGF-1 and GH levels at the 3rd and 6th months, but at 12th month, preglucose GH was found to be lower in the surgical treatment group. IGF-1 control and complete biochemical response rates were found to be 27% and 64%, in the Oct-LAR and surgical treatment groups, respectively. The mean percentage of tumour volume reduction was found to be 26%, 30% and 31% in the Oct-LAR group vs 64%, 74% and 79% in the surgery group at the 3rd, 6th and 12th months, respectively. Conclusion Primary surgical treatment seems to be slightly more effective than Oct-LAR in terms of biochemical response and IGF-1 control, besides tumour volume reduction, in patients with acromegaly with noninvasive tumours. Oct-LAR is associated with more side effects such as cholelithiasis and glucose metabolism disorders and is more expensive.

The primary aim of the study was to compare the efficacy of Oct-LAR and surgery in terms of controlling IGF-1 and GH levels and tumour volumes. The second aim was to compare two primary treatment modalities in terms of side effects such as pituitary insufficiency, cholelithiasis, metabolic parameters and the effect on quality of life (QoL).The study was a randomized, prospective study.The 22 patients were consecutively randomized to Oct-LAR and surgical treatment groups.Baseline serum IGF-1 level, tumour volume and GH levels were comparable in the Oct-LAR and surgery groups. No significant differences were detected between the Oct-LAR and the surgery groups in terms of IGF-1 and GH levels at the 3rd and 6th months, but at 12th month, preglucose GH was found to be lower in the surgical treatment group. IGF-1 control and complete biochemical response rates were found to be 27% and 64%, in the Oct-LAR and surgical treatment groups, respectively. The mean percentage of tumour volume reduction was found to be 26%, 30% and 31% in the Oct-LAR group vs 64%, 74% and 79% in the surgery group at the 3rd, 6th and 12th months, respectively.Primary surgical treatment seems to be slightly more effective than Oct-LAR in terms of biochemical response and IGF-1 control, besides tumour volume reduction, in patients with acromegaly with noninvasive tumours. Oct-LAR is associated with more side effects such as cholelithiasis and glucose metabolism disorders and is more expensive.

The case of a 24-year-old man with a juvenile-type spinal arteriovenous malformation is reported. Spinal angiography and magnetic resonance image revealed a juvenile (Type III) AVM at the cervical spine. This spinal malformation was successfully resected with a posterior and anterior surgical approach in two stages following partial embolization.

T ongue abscesses are extremely rare infections. In the last 25 years, to our knowledge. 28 cases of tongue abscess have been reported in the English literature, mostly single case reports [ 11. The rarity of lingual abscesses, despite frequent bite traumas to the tongue during mastication and seizure attacks, is attributed to the thickly keratinized squamous epithehum of the tongue; the high vascularity of its musculature; and the lubricating, cleansing, and immunologic functions of the saliva and the salivary flow [2]. A tongue abscess is difficult to diagnose in the absence of physical signs. MR imaging provides an excellent and invaluable adjunct to clinical examination. We present a case of tongue abscess diagnosed using MR imaging.

To report our experience in the management of mesenteric, omental, and retroperitoneal cysts.Retrospective study.University department of paediatric surgery, Turkey.10 children with mesenteric, omental, and retroperitoneal cysts.Laparotomy in all cases.Mode of presentation, imaging techniques, surgical intervention, histological examination, morbidity, and recurrence.The main presenting symptoms were abdominal distension and pain. A palpable abdominal mass was detected in 4 patients. Preoperative ultrasonography was done in 8 patients and showed a cystic mass in 7. All patients underwent laparotomy-6 as emergencies because of acute abdominal findings. The cysts were located in the small bowel mesentery in 6, in the retroperitoneum in 2, and in the omentum and the mesosigmoid in another 2. Operations included complete excision of the cyst in 5 and complete excision with intestinal resection in the other 5. There was only one recurrence of a retroperitoneal cyst that needed a second operation.Early recognition and appropriate treatment of these cysts are associated with a good prognosis, but long term follow-up is advisable because of the possibility of recurrence.

Clinical experience with toxicity induced by products containing gamma butyrolactone is limited. We report here 2 cases of gamma butyrolactone poisoning with a nail polish remover labelled "acetone-free". Rapid onset of coma, respiratory depression and bradycardia occurred in both patients. After supportive care, they fully recovered within a few hours.

OBJECTIVE We present our experience with the various sonographic and CT findings observed in patients with hydatid disease involving the kidney. The imaging characteristics of various echinococcal cysts were evaluated comparatively to offer a diagnostically better explanation for the radiologic images and to assist the urologist in defining the nature of the cyst and its content preoperatively. Renal involvement is extremely rare in patients with hydatid disease. METHODS The clinical and radiological features in 17 patients with renal hydatid disease are described. Two patients (4 and 28 years old) had renal colic with passage of debris in urine (hydatiduria). Five males and twelve females were 4-61 years old (mean 37 years). Their histories, physical findings and imaging procedures were evaluated. Plain abdominal radiographs were taken in 17 patients. RESULTS Plain film showed calcified mass compressing the pelvicalyceal system and/or ureter in 10 cases. Sonography showed typical features of echinococcal cysts in 14 cases, especially in the liver and spleen. CONCLUSIONS Sonography demonstrates the internal cystic content better. When daughter cysts are present, CT establishes the diagnosis. CT scan provides further information on the affected organ and involvement of other organs, calcification of the cyst wall and density. The diagnosis was suggested preoperatively in all patients, and confirmed surgically in 12 patients. Eight total nephrectomies and four partial nephrectomies were performed. The others are being followed up.