Abstract:
OBJECTIVE:Though transsphenoidal surgery remains the first-line treatment of Cushing's disease, recurrence occurs frequently. Conventional radiotherapy and anticortisolic drugs both have adverse effects. Stereotactic radiosurgery needs to be evaluated more precisely. The aim of this study was to determine long-term hormonal effects and tolerance of gamma knife (GK) radiosurgery in Cushing's disease. DESIGN:Forty patients with Cushing's disease treated by GK were prospectively studied over a decade, with a mean follow-up of 54.7 months. Eleven of them were treated with GK as a primary treatment. METHODS:Radiosurgery was performed at the Department of Functional Neurosurgery of Marseille, France, using the Leksell Gamma Unit B and C models. Median margin dose was 29.5 Gy. Patients were considered in remission if they had normalized 24-h free urinary cortisol and suppression of plasma cortisol after low-dose dexamethasone suppression test. RESULTS:Seventeen patients (42.5%) were in remission after a mean of 22 months (range 12-48 months). The two groups did not differ in terms of initial hormonal levels. Target volume was significantly higher in uncured than in remission group (909.8 vs 443 mm(3), P = 0.038). We found a significant difference between patients who were on or off anticortisolic drugs at the time of GK (20 vs 48% patients in remission respectively, P = 0.02). CONCLUSION:With 42% of patients in remission after a median follow-up of 54 months, GK stereotactic radiosurgery, especially as an adjunctive treatment to surgery, may represent an alternative to other therapeutic options in view of their adverse effects.
journal_name
Eur J Endocrinoljournal_title
European journal of endocrinologyauthors
Castinetti F,Nagai M,Dufour H,Kuhn JM,Morange I,Jaquet P,Conte-Devolx B,Regis J,Brue Tdoi
10.1530/eje.1.02323subject
Has Abstractpub_date
2007-01-01 00:00:00pages
91-8issue
1eissn
0804-4643issn
1479-683Xpii
156/1/91journal_volume
156pub_type
杂志文章abstract::With the use of two central health registries in Sweden, the Hospital Discharge Registry and the Medical Birth Registry, we identified 100 infants born of women who had been hospitalized for diabetes insipidus. By checking the medical records of these women, 29 infants were identified whose mothers had diabetes insipi...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1320144
更新日期:1995-02-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1470835
更新日期:2002-12-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,多中心研究
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abstract:OBJECTIVE:Leptin secretion is reduced by low temperatures in experimental animals, and this effect has been explained as an adaptive mechanism to cold environments. This study investigated the in vitro effects of cold exposure on human white adipose tissue. DESIGN:To understand whether the low temperature action is a ...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1420195
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abstract:OBJECTIVE:Changes in many gastrointestinal peptides, including the anorexigenic peptide YY (PYY), which is produced by L cells, occur in both anorexia nervosa (AN) and obesity (OB). High PYY levels are present in AN, whereas in morbid OB fasting and postprandial PYY secretion is blunted. Somatostatin (somatotropin rele...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-11-0312
更新日期:2011-09-01 00:00:00
abstract::Several lines of evidence suggest that tumor necrosis factor-alpha (TNFalpha) may contribute to the pathogenesis of autoimmune thyroid disease. It is not known, however, whether increased thyroidal TNFalpha levels are associated with changes in thyroid function. The purpose of the present study was to utilize in situ ...
journal_title:European journal of endocrinology
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doi:10.1530/eje.0.1390539
更新日期:1998-11-01 00:00:00
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journal_title:European journal of endocrinology
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abstract:BACKGROUND:Previous studies have suggested that infections are an important cause of death in patients with Addison's disease, but epidemiological studies on the frequency of infections in this population are lacking. OBJECTIVE:To assess and compare the incidence risk of infections in patients with primary adrenal ins...
journal_title:European journal of endocrinology
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doi:10.1530/EJE-12-0879
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journal_title:European journal of endocrinology
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更新日期:2001-10-01 00:00:00
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journal_title:European journal of endocrinology
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doi:10.1530/EJE-11-0131
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:A polymorphism near the promoter region of the IGF-I gene has been associated with serum IGF-I levels, body height and birth weight. In this study, we investigated whether this polymorphism is associated with body composition in young healthy subjects in two cohorts of different generations. DESIGN:Observati...
journal_title:European journal of endocrinology
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更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:Chromosomal rearrangements of the RET proto-oncogene is one of the most common molecular events in papillary thyroid carcinoma (PTC). However, their pathogenic role and clinical significance are still debated. This study aimed to investigate the prevalence of RET/PTC rearrangement in a cohort of BRAF WT PTCs ...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-14-0930
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND AND AIM:Several basic science studies support the existence of non-genomic glucocorticoid signaling in pancreas, liver, and adipocytes, but its clinical relevance has not yet been elucidated. This study aimed at investigating the rapid effects of hydrocortisone on the human metabolic response to glucose. SU...
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pub_type: 杂志文章,随机对照试验
doi:10.1530/EJE-10-0282
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Ki-67 labeling index (LI) is currently regarded as a useful prognostic marker of pituitary adenoma (PA) clinical behavior, although its relevance as a reliable clinical indicator is far from being universally accepted, since both validations and criticisms are found in the literature. Minichromosome maintena...
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pub_type: 杂志文章
doi:10.1530/EJE-15-0586
更新日期:2016-03-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1480403
更新日期:2003-04-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1410521
更新日期:1999-11-01 00:00:00
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journal_title:European journal of endocrinology
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doi:10.1530/eje.0.1510167
更新日期:2004-08-01 00:00:00
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doi:10.1530/eje.0.1480301
更新日期:2003-03-01 00:00:00
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journal_title:European journal of endocrinology
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doi:10.1530/EJE-16-0109
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journal_title:European journal of endocrinology
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doi:10.1530/eje.0.1480597
更新日期:2003-06-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1360330
更新日期:1997-03-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
doi:10.1530/eje.0.1450155
更新日期:2001-08-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,随机对照试验
doi:10.1530/EJE-13-0072
更新日期:2013-05-02 00:00:00
abstract:OBJECTIVE AND DESIGN:Patients with type 2 diabetes mellitus (T2D) have an increased fracture risk despite a normal or elevated bone mineral density (BMD). The aim of this cross-sectional in vivo study was to assess parameters of peripheral bone microarchitecture, estimated bone strength and bone remodeling in T2D patie...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-15-0860
更新日期:2016-02-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-09-0043
更新日期:2009-08-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
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更新日期:2020-02-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,随机对照试验
doi:10.1530/EJE-08-0151
更新日期:2008-08-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 临床试验,杂志文章
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更新日期:2012-04-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
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更新日期:2014-06-01 00:00:00