{"id":"https://openalex.org/W2018299169","doi":"https://doi.org/10.7326/0003-4819-109-6-487","title":"Transsphenoidal Microsurgery for Cushing Disease: A Report of 216 Cases","display_name":"Transsphenoidal Microsurgery for Cushing Disease: A Report of 216 Cases","publication_year":1988,"publication_date":"1988-09-15","ids":{"openalex":"https://openalex.org/W2018299169","doi":"https://doi.org/10.7326/0003-4819-109-6-487","mag":"2018299169","pmid":"https://pubmed.ncbi.nlm.nih.gov/2843068"},"language":"en","primary_location":{"id":"doi:10.7326/0003-4819-109-6-487","doi":"https://doi.org/10.7326/0003-4819-109-6-487","is_oa":false,"landing_page_url":"https://doi.org/10.7326/0003-4819-109-6-487","pdf_url":null,"source":{"id":"https://openalex.org/S119722071","display_name":"Annals of Internal Medicine","issn_l":"0003-4819","issn":["0003-4819","1539-3704"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310316812","host_organization_name":"American College of Physicians","host_organization_lineage":["https://openalex.org/P4310316812"],"host_organization_lineage_names":["American College of Physicians"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annals of Internal Medicine","raw_type":"journal-article"},"parent_works":[],"lineage":["https://openalex.org/W2018299169"],"child_works_count":0,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5064760172","display_name":"Thomas J. Mampalam","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Thomas J. Mampalam","raw_affiliation_strings":["School of Medicine, University of California, San Francisco"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Medicine, University of California, San Francisco","institution_ids":["https://openalex.org/I180670191"]}]},{"author_position":"middle","author":{"id":null,"display_name":"J. Blake Tyrrell","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"J. Blake Tyrrell","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5103119939","display_name":"Charles B. Wilson","orcid":"https://orcid.org/0000-0002-2597-5694","observed_orcids":["https://orcid.org/0000-0002-2597-5694"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Charles B. Wilson","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5064760172"],"corresponding_institution_ids":["https://openalex.org/I180670191"],"apc_list":null,"apc_paid":null,"fwci":6.2378,"has_fulltext":false,"cited_by_count":384,"citation_normalized_percentile":{"value":0.96953284,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":89,"max":99},"biblio":{"volume":"109","issue":"6","first_page":"487","last_page":"493"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10832","display_name":"Pituitary Gland Disorders and Treatments","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10832","display_name":"Pituitary Gland Disorders and Treatments","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11054","display_name":"Adrenal and Paraganglionic Tumors","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11669","display_name":"Head and Neck Surgical Oncology","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/cushing-disease","display_name":"Cushing's disease","score":0.9990000128746033},{"id":"https://openalex.org/keywords/transsphenoidal-microsurgery","display_name":"transsphenoidal microsurgery","score":0.9549999833106995},{"id":"https://openalex.org/keywords/pituitary-adenoma","display_name":"pituitary adenoma","score":0.9179999828338623},{"id":"https://openalex.org/keywords/selective-adenomectomy","display_name":"selective adenomectomy","score":0.9229999780654907},{"id":"https://openalex.org/keywords/selective-venous-sampling","display_name":"selective venous sampling","score":0.7549999952316284},{"id":"https://openalex.org/keywords/acth","display_name":"ACTH","score":0.9020000100135803},{"id":"https://openalex.org/keywords/pituitary-microadenoma","display_name":"pituitary microadenoma","score":0.7799999713897705},{"id":"https://openalex.org/keywords/macroadenoma","display_name":"macroadenoma","score":0.9120000004768372},{"id":"https://openalex.org/keywords/ectopic-acth-syndrome","display_name":"ectopic ACTH syndrome","score":0.7960000038146973},{"id":"https://openalex.org/keywords/surgical-complications","display_name":"surgical complications","score":0.675000011920929},{"id":"https://openalex.org/keywords/remission","display_name":"remission","score":0.6880000233650208}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9484384655952454},{"id":"https://openalex.org/C2780104272","wikidata":"https://www.wikidata.org/wiki/Q933496","display_name":"Hypophysectomy","level":3,"score":0.7126049399375916},{"id":"https://openalex.org/C2779653919","wikidata":"https://www.wikidata.org/wiki/Q7835364","display_name":"Transsphenoidal surgery","level":4,"score":0.6355812549591064},{"id":"https://openalex.org/C2780546910","wikidata":"https://www.wikidata.org/wiki/Q185690","display_name":"Adrenocorticotropic hormone","level":3,"score":0.6293244361877441},{"id":"https://openalex.org/C2777428134","wikidata":"https://www.wikidata.org/wiki/Q272741","display_name":"Adenoma","level":2,"score":0.6117376685142517},{"id":"https://openalex.org/C2778356730","wikidata":"https://www.wikidata.org/wiki/Q1772886","display_name":"Sella turcica","level":2,"score":0.5780758261680603},{"id":"https://openalex.org/C2776810848","wikidata":"https://www.wikidata.org/wiki/Q1947304","display_name":"Cushing's disease","level":3,"score":0.5497666597366333},{"id":"https://openalex.org/C2779318953","wikidata":"https://www.wikidata.org/wiki/Q864296","display_name":"Pituitary adenoma","level":3,"score":0.5006999969482422},{"id":"https://openalex.org/C2778456384","wikidata":"https://www.wikidata.org/wiki/Q1508510","display_name":"Perforation","level":3,"score":0.4770618975162506},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.4628556966781616},{"id":"https://openalex.org/C2781437307","wikidata":"https://www.wikidata.org/wiki/Q977628","display_name":"Microsurgery","level":2,"score":0.4516713321208954},{"id":"https://openalex.org/C2910559741","wikidata":"https://www.wikidata.org/wiki/Q219102","display_name":"Cushing Disease","level":3,"score":0.45066016912460327},{"id":"https://openalex.org/C143409427","wikidata":"https://www.wikidata.org/wiki/Q161238","display_name":"Magnetic resonance imaging","level":2,"score":0.42438405752182007},{"id":"https://openalex.org/C2779435821","wikidata":"https://www.wikidata.org/wiki/Q219102","display_name":"Cushing syndrome","level":2,"score":0.39426904916763306},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.3268175721168518},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.2783565819263458},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.23481935262680054},{"id":"https://openalex.org/C71315377","wikidata":"https://www.wikidata.org/wiki/Q11364","display_name":"Hormone","level":2,"score":0.18827295303344727},{"id":"https://openalex.org/C192562407","wikidata":"https://www.wikidata.org/wiki/Q228736","display_name":"Materials science","level":0,"score":0.0},{"id":"https://openalex.org/C191897082","wikidata":"https://www.wikidata.org/wiki/Q11467","display_name":"Metallurgy","level":1,"score":0.0},{"id":"https://openalex.org/C2778527123","wikidata":"https://www.wikidata.org/wiki/Q11750728","display_name":"Punching","level":2,"score":0.0}],"mesh":[{"descriptor_ui":"D000236","descriptor_name":"Adenoma","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":false},{"descriptor_ui":"D000236","descriptor_name":"Adenoma","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":false},{"descriptor_ui":"D000236","descriptor_name":"Adenoma","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true},{"descriptor_ui":"D000293","descriptor_name":"Adolescent","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000324","descriptor_name":"Adrenocorticotropic Hormone","qualifier_ui":"Q000097","qualifier_name":"blood","is_major_topic":false},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000368","descriptor_name":"Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002648","descriptor_name":"Child","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003480","descriptor_name":"Cushing Syndrome","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":false},{"descriptor_ui":"D003480","descriptor_name":"Cushing Syndrome","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005500","descriptor_name":"Follow-Up Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006965","descriptor_name":"Hyperplasia","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":false},{"descriptor_ui":"D007016","descriptor_name":"Hypophysectomy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008279","descriptor_name":"Magnetic Resonance Imaging","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008866","descriptor_name":"Microsurgery","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010902","descriptor_name":"Pituitary Gland","qualifier_ui":"Q000473","qualifier_name":"pathology","is_major_topic":false},{"descriptor_ui":"D010911","descriptor_name":"Pituitary Neoplasms","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":false},{"descriptor_ui":"D010911","descriptor_name":"Pituitary Neoplasms","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":false},{"descriptor_ui":"D010911","descriptor_name":"Pituitary Neoplasms","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true},{"descriptor_ui":"D011183","descriptor_name":"Postoperative Complications","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":false},{"descriptor_ui":"D012074","descriptor_name":"Remission Induction","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012658","descriptor_name":"Sella Turcica","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013100","descriptor_name":"Sphenoid Bone","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014057","descriptor_name":"Tomography, X-Ray Computed","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.7326/0003-4819-109-6-487","doi":"https://doi.org/10.7326/0003-4819-109-6-487","is_oa":false,"landing_page_url":"https://doi.org/10.7326/0003-4819-109-6-487","pdf_url":null,"source":{"id":"https://openalex.org/S119722071","display_name":"Annals of Internal Medicine","issn_l":"0003-4819","issn":["0003-4819","1539-3704"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310316812","host_organization_name":"American College of Physicians","host_organization_lineage":["https://openalex.org/P4310316812"],"host_organization_lineage_names":["American College of Physicians"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annals of Internal Medicine","raw_type":"journal-article"},{"id":"pmid:2843068","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/2843068","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annals of internal medicine","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":14,"referenced_works":["https://openalex.org/W102056867","https://openalex.org/W1964198576","https://openalex.org/W1966184376","https://openalex.org/W1971848065","https://openalex.org/W1987610912","https://openalex.org/W2004796013","https://openalex.org/W2018932366","https://openalex.org/W2025784270","https://openalex.org/W2126963766","https://openalex.org/W2149864622","https://openalex.org/W2157221423","https://openalex.org/W2418892212","https://openalex.org/W2419590232","https://openalex.org/W2615509544"],"related_works":["https://openalex.org/W2051239979","https://openalex.org/W2018932366","https://openalex.org/W2177354678","https://openalex.org/W108685443","https://openalex.org/W2157221423","https://openalex.org/W3032510770","https://openalex.org/W263636106","https://openalex.org/W2375201390","https://openalex.org/W2800417514"],"abstract_inverted_index":{"We":[0],"report":[1],"cumulative":[2],"results":[3,195],"of":[4,9,45,51,72,88,94,109,143,148,164,178],"the":[5,46,65,77,111,149,179,201],"transsphenoidal":[6,54,198],"microsurgical":[7],"treatment":[8,203],"Cushing":[10,208],"disease":[11,89],"in":[12,92,122,127,132,138,176],"221":[13],"patients:":[14],"173":[15],"patients":[16,34,97,105,123,128,133,139,159,169,206],"had":[17,21,25,30,160,170],"selective":[18],"adenomectomy,":[19],"25":[20],"total":[22],"hypophysectomy,":[23,27],"6":[24],"partial":[26],"and":[28,81,131],"12":[29],"exploration":[31,55],"only.":[32],"Five":[33,158],"were":[35,84,185],"excluded":[36],"from":[37],"analysis":[38],"because":[39],"intraoperative":[40],"technical":[41],"difficulties":[42],"precluded":[43],"exposure":[44],"pituitary":[47,172],"gland.":[48],"The":[49,194],"selection":[50],"candidates":[52],"for":[53,204],"was":[56,64,90,115],"based":[57],"on":[58],"endocrinologic":[59,80],"criteria.":[60],"Magnetic":[61],"resonance":[62],"imaging":[63],"preferred":[66,202],"radiologic":[67,82],"test.":[68],"Selective":[69],"venous":[70],"sampling":[71],"adrenocorticotropic":[73,165],"hormone":[74,166],"further":[75],"refined":[76],"diagnosis":[78],"when":[79],"procedures":[83],"not":[85],"definitive.":[86],"Remission":[87],"achieved":[91],"164":[93],"216":[95],"(76%)":[96],"analyzed":[98],"(95%":[99],"CI,":[100],"69":[101],"to":[102,188,192],"81).":[103],"Among":[104],"with":[106,124,129,134,140,207],"histologic":[107],"confirmation":[108],"adenomas,":[110],"percentage":[112],"having":[113],"remission":[114],"significantly":[116],"higher":[117],"(P":[118,154],"less":[119,155],"than":[120,126,137,156],"0.001)":[121],"microadenomas":[125],"macroadenomas":[130],"intrasellar":[135],"adenomas":[136],"extrasellar":[141],"extension":[142],"their":[144],"adenoma":[145,153],"or":[146],"perforation":[147],"sellar":[150],"floor":[151],"by":[152],"0.001).":[157],"an":[161],"ectopic":[162],"source":[163],"secretion.":[167],"Two":[168],"diffuse":[171],"hyperplasia.":[173],"Complications":[174],"occurred":[175],"9.3%":[177],"patients,":[180],"including":[181],"two":[182],"deaths":[183],"that":[184,197],"apparently":[186],"unrelated":[187],"surgery":[189,199],"(CI,":[190],"5.4":[191],"13).":[193],"indicate":[196],"is":[200],"most":[205],"disease.":[209]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2025,"cited_by_count":1},{"year":2024,"cited_by_count":2},{"year":2022,"cited_by_count":6},{"year":2021,"cited_by_count":7},{"year":2020,"cited_by_count":2},{"year":2019,"cited_by_count":2},{"year":2018,"cited_by_count":6},{"year":2017,"cited_by_count":9},{"year":2016,"cited_by_count":2},{"year":2015,"cited_by_count":11},{"year":2014,"cited_by_count":7},{"year":2013,"cited_by_count":7},{"year":2012,"cited_by_count":3}],"updated_date":"2026-11-14T11:04:58.165337","created_date":"2016-06-24T00:00:00"}