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논문 기본정보

쿠싱병에 대한 경접형동접근법의 내분비학적 결과

논문 개요

기관명, 저널명, ISSN, ISBN 으로 구성된 논문 개요 표입니다.
기관명 NDSL
저널명 대한신경외과학회지 = Journal of Korean Neurosurgical Society
ISSN 1225-8245,1598-7876
ISBN

논문저자 및 소속기관 정보

저자, 소속기관, 출판인, 간행물 번호, 발행연도, 초록, 원문UR, 첨부파일 순으로 구성된 논문저자 및 소속기관 정보표입니다
저자(한글) 김준수,김창진,하상수,김정훈,이정교,권병덕,홍성관,이기업,이봉재,김용재,최충곤,이호규,울산대학교 의과대학 서울중앙병원 신경외과학교실,울산대학교 의과대학 서울중앙병원 신경외과학교실,울산대학교 의과대학 서울중앙병원 신경외과학교실,울산대학교 의과대학 서울중앙병원 신경외과학교실,울산대학교 의과대학 서울중앙병원 신경외과학교실,울산대학교 의과대학 서울중앙병원 신경외과
저자(영문)
소속기관
소속기관(영문)
출판인
간행물 번호
발행연도 2001-01-01
초록 Objective : We analyzed the clinical and endocrinological results of the transsphenoidal microsurgery for ACTH secreting pituitary adenomas. Marerials and Methods : From October 1995 to August 2000, 18 patients underwent transsphenoidal microsurgery for Cushing's disease. We analyzed the surgical results of 17 patients, one patient who was previously operated from other hospital was excluded. Age of the patients were 18 to 61 years old(mean 37.7), male to female ratio was 1 : 3.3, and follow-up period was 3 to 50 months(mean 20.3). The selection of candidates for transsphenoidal exploration was based on endocrinologic criteria. Magnetic resonance imaging was the preferred radiologic test. Selective inferior petrosal sinus sampling of adrenocorticotropic hormone futher refined the diagnosis when endocrinologic and radiologic procedures were not definitive. Results : Results of the preoperative endocrinological test were : level of serum ACTH 29.4 to $225{ mu}g/dL$(mean $93.88{ mu}g/dL$) ; serum cortisol 11.9 to $47.5{ mu}g/dL$(mean $27.49{ mu}g/dL$) ; 24-hour urine free cortisol 235 to $1019{ mu}g/day$(mean $571.0{ mu}g/day$). Inferior petrosal sinus sampling for ACTH was performed in 11 patients and all were confirmed by Cushing's disease and we could predict the laterality of the tumor in 9 of 11 patients. We performed transsphenoidal selective adenomectomy in 5 patients, adenomectomy and subtotal hypophysectomy in 2 patients, adenomectomy and partial hypophysectomy in 9 patients, and in the remaining one patient, hemihypophysectomy followed by total hypophysectomy due to remission failure. Fifteen of 17 patients(88.2%) showed endocrinological remission. Glucocorticoid replacement therapy was performed in all the patients who showed remission for 1 to 24 months(mean 5.9 months), and 6 patients received steroid over 6 months. Conclusion : We conclude that the direct demonstration of a tumor in the pituitary gland by MRI is the most important and definitive diagnostic tool and the location of a mass should be confirmed with increased level of ACTH by the inferior petrosal sinus sampling. Transsphenoidal microsurgery is effective treatment modality for Cushing's disease and the immediate postoperative evaluation of the surgical resection of the tumor is very important. The patients should show hypocortisolism, decreased, subnormal serum ACTH and cortisol levels and 24-hours urine free cortisol. We performed 18 transsphenoidal microsurgery for Cushing's disease in 17 patients and 15 patients(88.2%) showed endocrinological remission.
원문URL http://click.ndsl.kr/servlet/OpenAPIDetailView?keyValue=03553784&target=NART&cn=JAKO200128066989639
첨부파일

추가정보

과학기술표준분류, ICT 기술분류,DDC 분류,주제어 (키워드) 순으로 구성된 추가정보표입니다
과학기술표준분류
ICT 기술분류
DDC 분류
주제어 (키워드) Cushing's disease,Transsphenoidal microsurgery,Endocrinological remission