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Intraoperative multiple-staged resection and tumor tissue identification using frozen sections provide the best result for the accurate localization and complete resection of tumors in Cushing's disease.

DC Field Value Language
dc.contributor.author이은직-
dc.contributor.author임정수-
dc.contributor.author김세훈-
dc.contributor.author이승구-
dc.contributor.author김선호-
dc.date.accessioned2014-12-20T17:28:32Z-
dc.date.available2014-12-20T17:28:32Z-
dc.date.issued2011-
dc.identifier.issn1355-008X-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/94671-
dc.description.abstractThe treatment of choice in Cushing's disease (CD) is surgical removal; however, most tumors are too small to be detected. The objective was to establish a method to achieve the complete removal of tumors on the basis of the results of high-resolution magnetic resonance imaging (MRI), inferior petrosal sinus sampling (IPSS), and a surgical resection technique using frozen biopsy. Eighteen patients who underwent transsphenoidal surgery from 2004 to 2010 were included. High-resolution MRI and IPSS, multiple-staged resection, and tumor tissue identification in frozen sections (surgical and histological identification, SHI) were performed. All patients achieved surgical remission, as confirmed by 24 h urinary free cortisol excretion tests. Visible microlesions were identified on the initial MRI in 11 patients (61%). The SHI findings agreed with the MRI findings in 10 of the 11 patients (90.9%) and with IPSS lateralization in 6 of the 11 patients (54.5%). In the 7 patients whose lesions were not visible on the initial MRI, only 1 (14.3%) showed an agreement between IPSS and SHI. In 3 of the 7 patients, the microlesions were identified by additional MRI. The rate of concordance with SHI was 77.8% for the overall MRI and 38.9% for IPSS. High-resolution MRI is better than IPSS for localizing corticotroph adenomas. In patients with lesions not visible on the initial MRI, additional MRI should be performed using a different protocol. Although high-resolution MRI is better for localizing tumors, SHI remains an important approach for removing the tumors completely.-
dc.description.statementOfResponsibilityopen-
dc.format.extent452~461-
dc.relation.isPartOfENDOCRINE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdolescent-
dc.subject.MESHAdult-
dc.subject.MESHCushing Syndrome/blood-
dc.subject.MESHCushing Syndrome/pathology-
dc.subject.MESHCushing Syndrome/surgery*-
dc.subject.MESHFemale-
dc.subject.MESHFrozen Sections-
dc.subject.MESHHumans-
dc.subject.MESHMagnetic Resonance Imaging/methods-
dc.subject.MESHMale-
dc.subject.MESHMicrosurgery/methods-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMonitoring, Intraoperative/methods-
dc.subject.MESHNeurosurgical Procedures/methods*-
dc.subject.MESHPetrosal Sinus Sampling/methods-
dc.subject.MESHPituitary Neoplasms/blood-
dc.subject.MESHPituitary Neoplasms/pathology-
dc.subject.MESHPituitary Neoplasms/surgery*-
dc.subject.MESHTreatment Outcome-
dc.subject.MESHYoung Adult-
dc.titleIntraoperative multiple-staged resection and tumor tissue identification using frozen sections provide the best result for the accurate localization and complete resection of tumors in Cushing's disease.-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Pathology (병리학)-
dc.contributor.googleauthorJung Soo Lim-
dc.contributor.googleauthorSeung Ku Lee-
dc.contributor.googleauthorSe Hoon Kim-
dc.contributor.googleauthorEun Jig Lee-
dc.contributor.googleauthorSun Ho Kim-
dc.identifier.doi10.1007/s12020-011-9499-5-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA03050-
dc.contributor.localIdA03401-
dc.contributor.localIdA00610-
dc.contributor.localIdA02912-
dc.contributor.localIdA00560-
dc.relation.journalcodeJ00768-
dc.identifier.eissn1559-0100-
dc.identifier.pmid21688179-
dc.identifier.urlhttp://link.springer.com/article/10.1007%2Fs12020-011-9499-5-
dc.subject.keywordCushing’s disease-
dc.subject.keywordLocalization-
dc.subject.keywordHigh-resolution MRI-
dc.subject.keywordInferior petrosal sinus sampling-
dc.subject.keywordSurgical and histological identification-
dc.contributor.alternativeNameLee, Eun Jig-
dc.contributor.alternativeNameLim, Jung Soo-
dc.contributor.alternativeNameKim, Se Hoon-
dc.contributor.alternativeNameLee, Seung Koo-
dc.contributor.alternativeNameKim, Sun Ho-
dc.contributor.affiliatedAuthorLee, Eun Jig-
dc.contributor.affiliatedAuthorLim, Jung Soo-
dc.contributor.affiliatedAuthorKim, Se Hoon-
dc.contributor.affiliatedAuthorLee, Seung Koo-
dc.contributor.affiliatedAuthorKim, Sun Ho-
dc.rights.accessRightsnot free-
dc.citation.volume40-
dc.citation.number3-
dc.citation.startPage452-
dc.citation.endPage461-
dc.identifier.bibliographicCitationENDOCRINE, Vol.40(3) : 452-461, 2011-
dc.identifier.rimsid27668-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers

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