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Surgical management of Cushing's disease: a personal perspective. 库欣病的外科治疗:个人观点。
Clinical neurosurgery
Pub Date : 2011-01-01 DOI: 10.1227/neu.0b013e3182269d3f
Edward H Oldfield

One of the rewards of studying Cushing's disease is that the understanding of the stages of these tumors provides insight into what happens during the evolution of all types of pituitary tumors. The evolution of the development of the pseudocapsule at the margin of small adenomas begins to occur at about 2 to 3 mm in diameter, the minimum size at which we can identify them during surgical exploration. Certain advantages derive from removal of pituitary adenomas using the histological pseudocapsule as a surgical capsule and as a defined tissue plane. Other unresolved issues need our focus over the next few years. Surgical success would be enhanced if we had more accurate ways of localizing the very smallest tumors, either before or during surgery, in patients with Cushing's disease and negative MRI. We also need better therapies for tumors that invade the cavernous sinus, and we need to understand the biological basis of invasion in patients who have truly invasive tumors. Finally, it would be rewarding to understand the molecular basis of the relative resistance to negative cortisol feedback characterizing these tumors and why it is linked to tumor formation. We still have much to do.

研究库欣氏病的一个好处是，了解这些肿瘤的各个阶段，可以让我们深入了解所有类型的垂体肿瘤在进化过程中发生了什么。小腺瘤边缘的假包膜在直径约2至3mm时开始演变，这是我们在手术探查时可以识别的最小尺寸。使用组织学假包膜作为手术包膜和确定的组织平面切除垂体腺瘤具有一定的优势。其他尚未解决的问题需要我们在未来几年集中精力解决。如果我们在手术前或手术中，对患有库欣氏病且MRI呈阴性的患者，有更准确的方法定位最小的肿瘤，手术成功率将会提高。我们还需要更好的治疗方法来治疗侵入海绵窦的肿瘤，我们需要了解真正侵袭性肿瘤患者的侵袭生物学基础。最后，了解这些肿瘤特征对负皮质醇反馈的相对抵抗的分子基础以及为什么它与肿瘤形成有关，将是有益的。我们还有很多事要做。
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引用次数: 8
Assessment of the extent of surgical resection as a predictor of survival in patients with primary osseous spinal neoplasms. 评估手术切除程度作为原发性骨性脊柱肿瘤患者生存的预测因子。
Clinical neurosurgery
Pub Date : 2011-01-01 DOI: 10.1227/neu.0b013e318226fff7
Kaisorn L Chaichana, Scott L Parker, Debraj Mukherjee, Joseph S Cheng, Ziya L Gokaslan, Matthew J McGirt
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引用次数: 12
Excellence in neurosurgery program building: enhancing the academic mission. 卓越的神经外科项目建设:加强学术使命。
Clinical neurosurgery
Pub Date : 2010-01-01
James T Rutka, Christopher Wallace
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引用次数: 0
Mechanisms of evasion to antiangiogenic therapy in glioblastoma. 胶质母细胞瘤抗血管生成治疗的逃避机制。
Clinical neurosurgery
Pub Date : 2010-01-01
Samuel D Rose, Manish K Aghi
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引用次数: 0
Pursuing excellence in neurosurgical innovation. 在神经外科创新中追求卓越。
Clinical neurosurgery
Pub Date : 2010-01-01
Mandy J Binning, Adnan H Siddiqui, Elad I Levy, L Nelson Hopkins
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引用次数: 0
Neurological Society of India Guest Lecture: optimally invasive skull base surgery. 印度神经学会客座讲座：最佳侵入性颅底手术。
Clinical neurosurgery
Pub Date : 2010-01-01
Basant Kumar Misra
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引用次数: 0
The measurement of pain in patients with trigeminal neuralgia. 三叉神经痛患者疼痛的测量。
Clinical neurosurgery
Pub Date : 2010-01-01
H Isaac Chen, John Y K Lee
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引用次数: 0
Excellence in spinal neurosurgery. 擅长脊柱神经外科。
Clinical neurosurgery
Pub Date : 2010-01-01
Volker K H Sonntag
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引用次数: 0
Defining excellence in vascular neurosurgery. 定义血管神经外科的卓越。
Clinical neurosurgery
Pub Date : 2010-01-01
Nader Sanai, Robert F Spetzler

Success as a vascular neurosurgeon almost always begins with passion, an inherent love for the work that drives an insatiable desire for personal improvement. A personal definition of excellence in vascular neurosurgery includes several fundamental qualities: mastery of the basics, refinement of technique, advancement of technology, investigative study, advanced decision making, microsurgical innovation, a well-rounded surgical armamentarium, and a lifelong commitment to teaching. Ultimately, the reward for these efforts is the ability to influence generations to come, particularly as one follows the rising careers of former trainees, each redefining the term "excellence" in vascular neurosurgery.

作为一名血管神经外科医生，成功几乎总是始于激情，一种与生俱来的对工作的热爱，这种热爱驱使着对个人进步的永不满足的渴望。个人对血管神经外科卓越的定义包括几个基本素质:掌握基础知识，技术改进，技术进步，调查研究，先进决策，显微外科创新，全面的手术设备，终身致力于教学。最终，这些努力的回报是影响后代的能力，特别是当一个人跟随前受训人员的职业生涯上升时，每个人都重新定义了血管神经外科的“卓越”一词。
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引用次数: 0
Differentiating radiation effect from tumor progression after stereotactic radiosurgery: T1/T2 matching. 立体定向放射手术后肿瘤进展的放射效果鉴别:T1/T2匹配。
Clinical neurosurgery
Pub Date : 2010-01-01
Hideyuki Kano, Douglas Kondziolka, Javier Lobato-Polo, Oscar Zorro, John C Flickinger, L Dade Lunsford
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引用次数: 0
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