{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T03:09:45Z","timestamp":1764644985840},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[1995,1,1]],"date-time":"1995-01-01T00:00:00Z","timestamp":788918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1995,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Twenty\u2010six consecutive patients with ACTH\u2010dependent Cushing syndrome were subjected to simultaneous, bilateral inferior petrosal sinus sampling for ACTH assay before and after ACTH\u2010releasing hormone (CRH) stimulation. The baseline ACTH inferior petrosal sinus\/periphery (IPS\/P) ratio was \u22652\u00a0in 12 of 26 patients (46%), whereas the CRH\u2010stimulated IPS\/P ratio was \u2265 3\u00a0in 19 of 26 patients (73%). A pituitary adenoma, ACTH\u2010secreting at immunostaining, was surgically proved in all of the 19 patients who had an ACTH IPS\/P ratio \u2265 2 basally or \u2265 3 after the CRH test but also in three other patients who did not have such ratios. The value of the basal IPS\/P ratio and the complete lack of ACTH increase after CRH led to the diagnosis of an ectopic ACTH syndrome in four patients: a bronchial carcinoid was found in three patients, and the site of the tumor was still unknown in the other. In conclusion, the CRH test improved the diagnostic accuracy of inferior petrosal sinus sampling from 61.5% (12 pituitary, 4 ectopic) to 92.0% (19 pituitary, 4 ectopic). Thus it should be performed during the diagnostic process.<\/jats:p>","DOI":"10.1007\/bf00317003","type":"journal-article","created":{"date-parts":[[2004,12,10]],"date-time":"2004-12-10T04:25:59Z","timestamp":1102652759000},"page":"150-153","source":"Crossref","is-referenced-by-count":20,"title":["Corticotropin\u2010releasing hormone test: Improvement of the diagnostic accuracy of simultaneous and bilateral inferior petrosal sinus sampling in patients with cushing syndrome"],"prefix":"10.1002","volume":"19","author":[{"given":"Lucio","family":"Zarrilli","sequence":"first","affiliation":[{"name":"Department of Medical\u2010Surgical Endocrinology \u201cFederico II\u201d University School of Medicine via S. Pansini 5 80131 Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annamaria","family":"Colao","sequence":"additional","affiliation":[{"name":"Department of Medical\u2010Surgical Endocrinology \u201cFederico II\u201d University School of Medicine via S. Pansini 5 80131 Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bartolomeo","family":"Merola","sequence":"additional","affiliation":[{"name":"Department of Medical\u2010Surgical Endocrinology \u201cFederico II\u201d University School of Medicine via S. Pansini 5 80131 Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"La Tessa","sequence":"additional","affiliation":[{"name":"Institute of Radiology \u201cFederico II\u201d University School of Medicine via S. Pansini 5 80131 Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato","family":"Spaziante","sequence":"additional","affiliation":[{"name":"Institute of Neurosurgery \u201cFederico II\u201d University School of Medicine via S. 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