Endoscopic transsphenoidal surgery for cushing\u27s disease: A review

Ever since the 1960s, transsphenoidal surgery has been the modality of choice for treating Cushing\u27s disease. Subsequent visualization of the pituitary fossa and sphenoid sinus may be done either with the operating microscope or with the relatively new endoscope. The endoscope due to its panoramic view allows greater visualization as compared to the operating microscope. It confers greater access to the cavernous sinus, sella, suprasellar, and parasellar regions and accommodates higher magnifications. It is bi-dimensional, however as opposed to the operating microscope that provides a three-dimensional view and allows greater depth perception. This article provides a comprehensive review of the advantages and disadvantages of the endoscope and compares it to the operating microscope. We hope this article will prove useful to both clinicians and academicians alike in their approach and management of Cushing\u27s disease

Perianal necrotizing fasciitis with retroperitoneal extension: A case report from Pakistan

Necrotizing fasciitis is a rare but potentially fatal condition. It is defined as a rapidly spreading infection of the subcutaneous soft tissue. Extension into the retroperitoneum may further complicate this deadly condition. We report a case of a 45-year-old gentleman who presented to our institute with perianal necrotizing fasciitis with extension into the retroperitoneum. He was managed with antibiotics and prompt surgical debridement. Our patient had a positive outcome which may be due to the fact that we had a high clinical suspicion, on the basis of which we opted for early operative management rather than delaying definitive treatment by obtaining imaging

Genetic analysis of pedigree.

<p>a) Pedigree examined in this study. Only individuals from generations III and IV were available for genetic analysis. b) Location of the mutation NM_020919.3:c.3512+1G>A at the boundary of the 21st intron of the <i>ALS2</i> gene and c) confirmation by Sanger sequencing. d) RT-PCR of total RNA isolated from patient (IV-4 labeled as ALS2) and two control fibroblast cells (labeled BJ and CV), visualized on a gel alongside an Invitrogen 1 kb+ ladder. Three splicing transcripts corresponding to the three bands (102 bp encoding p.Ser1116_Thr1170del [red], 200 bp encoding p.Pro1148fs [blue] and 267 bp encoding the normal protein [black]) were confirmed by Sanger sequencing and illustrated in the figure.</p