OBJECTIVE: We intented to evaluate six acromegalic patients having secondary diabetes mellitus, they have heen followed and treated by Internal Medicine and Neurosur­gery Clinics.
STUDY DESIGN: We treated 6 case during /995-1997. Clinical, biochemical results and surgical techniques and also following complications were evaluated. We compared the results with other studies in literature.
RESULTS: Acral enlargemeýýt of hands and feet, increased soft tissue thickness,muscle weakness, arthralgias, hirsutismus, weight gain were clinical symptoms found similar to the literature. In all patients, polidypsia, poliüria an poliphagia like symptoms of diabetes mellitus were present. Hypertension, visual field defects, pituatry enlargement were symptoms correlared to the literature. Patients were operated performing an endonasal transsplýenoidal hipophysectonýy. 2 patients had heen given sonýaýostatin during 30 days preoperatively. in post-op period; aýýe patient had developed permanenet diabetes insipidus where as an other one revealed transient diabetes insipidus. Having a control MR imaging af suprasellar area in a patient we vsualized a residual adenoma and a total tumoral excesion by a right pterional craniotamy was performed. in post-op period we obtained lower levels of GH comparing to the recent results (p<0.001).
CONCLUSION: it was interesting that the diagnosis of the patients were made in internal medicine our patients clinics or clinics during the investigation of tize causes of diabetes mellitus. Therefor we think that at all patients with possible secondary diabetes mellitus diagnosis acromegaly should­ also be investigated.

The primary goal of the repair for the pharyngoesophage­al defects is to maintain the continuity after the upper alimentary tract by re-establishing the relation between the oral cavity and the csophagus. We reviewed several techniques of reconstruction for pharyngoesophageal defects and evaluated our experience in two cases in which we performed reconstruction using gastric pull-up. We conclude that, despite poor prognosis of the disease and high rates on the part of gastric pull-up technique, it is a method of choice in cancers of the hypopharynx arýd cervical esophagus owing to oncologic and palliative grounds.

Treatment of infections caused by Pseudomonas aerugino­sa has emerged as a challenging prohlem because of its increasing resistance. This case report presents difficulties encountered during treatment of a patient who developed nosocomial meningitis caused by multiple resistance P. aeruginosa following surgery because of head trauma.

A 21 year old male presented with dysequilibrium, speech and walking disability and involuntary movements of both eyes. His computed tomographic scan revealed a large posterior fossa cyst. The case was operated to insert a cysto-peritoneal shunt. The view with operating microscope revealed no cerebellum and cerebellar tissue in the posterior fossa. The peroperative diagnosis was determined as cerehellar agenesis or aplasia and was discussed with other cystic malformations of posterior fossa.