Акромегалія: настанови з клінічної практики ендокринологічного товариства (Частина 2)
DOI:
https://doi.org/10.1210/jc.2014-2700Анотація
Частина 1 і перша частина переліку літературних посилань надрукована в журналі «Клінічна ендокринологія та ендокринна хірургія» 1(53) 2016
Посилання
Murray RD, Melmed S. A critical analysis of clinically available somatostatin analog formulations for therapy of acromegaly. J Clin Endocrinol Metab. 2008;93:2957–2968. https://doi.org/10.1210/jc.2008-0027
Bevan JS, Newell-Price J, Wass JA, et al. Home administration of lanreotide autogel by patients with acromegaly, or their partners, is safe and effective. Clin Endocrinol (Oxf ). 2008;68:343–349. https://doi.org/10.1111/j.1365-2265.2007.03044.x
Salvatori R, Woodmansee WW, Molitch M, Gordon MB, Lomax KG. Lanreotide extended-release aqueous-gel formulation, injected by patient, partner or healthcare provider in patients with acromegaly in the United States: 1-year data from the SODA registry. Pituitary. 2014;17:13–21. https://doi.org/10.1007/s11102-012-0460-2
Schopohl J, Strasburger CJ, Caird D, et al. Efficacy and acceptability of lanreotide autogel 120 mg at different dose intervals in patients with acromegaly previously treated with octreotide LAR. Exp Clin Endocrinol Diabetes. 2011;119:156–162. https://doi.org/10.1055/s-0030-1267244
Ezzat S, Kontogeorgos G, Redelmeier DA, Horvath E, Harris AG, Kovacs K. In vivo responsiveness of morphological variants of growth hormoneproducing pituitary adenomas to octreotide. Eur J Endocrinol. 1995;133:686–690. https://doi.org/10.1530/eje.0.1330686
Bhayana S, Booth GL, Asa SL, Kovacs K, Ezzat S. The implication of somatotroph adenoma phenotype to somatostatin analog responsiveness in acromegaly. J Clin Endocrinol Metab. 2005;90:6290–6295. https://doi.org/10.1210/jc.2005-0998
Howlett TA, Willis D, Walker G, Wass JA, Trainer PJ. Control of growth hormone and IGF1 in patients with acromegaly in the UK: responses to medical treatment with somatostatin analogues and dopamine agonists. Clin Endocrinol (Oxf ). 2013;79:689–699. https://doi.org/10.1111/cen.12207
Plöckinger U, Bäder M, Hopfenmüller W, Saeger W, Quabbe HJ. Results of somatostatin receptor scintigraphy do not predict pituitary tumor volume- and hormone-response to ocreotide therapy and do not correlate with tumor histology. Eur J Endocrinol. 1997;136:369–376. https://doi.org/10.1530/eje.0.1360369
Caron P, Bex M, Cullen DR, et al. One-year followup of patients with acromegaly treated with fixed or titrated doses of lanreotide autogel. Clin Endocrinol (Oxf ). 2004;60:734–740. https://doi.org/10.1111/j.1365-2265.2004.02045.x
Levy MJ. The association of pituitary tumors and headache. Curr Neurol Neurosci Rep. 2011;11:164–170. https://doi.org/10.1007/s11910-010-0166-7
Caron PJ, Bevan JS, Petersenn S, et al. Tumor shrinkage with lanreotide autogel 120 mg as primary therapy in acromegaly: results of a prospective multicenter clinical trial. J Clin Endocrinol Metab. 2014;99:1282–1290. https://doi.org/10.1210/jc.2013-3318
Colao A, Bronstein MD, Freda P, et al. Pasireotide versus octreotide in acromegaly: a head-to-head superiority study. J Clin Endocrinol Metab. 2014;99:791–799. https://doi.org/10.1210/jc.2013-2480
Melmed S, Cook D, Schopohl J, Goth MI, Lam KS, Marek J. Rapid and sustained reduction of serum growth hormone and insulin-like growth factor-1 in patients with acromegaly receiving lanreotide autogel therapy: a randomized, placebo-controlled, multicenter study with a 52 week open extension. Pituitary. 2010;13:18–28. https://doi.org/10.1007/s11102-009-0191-1
Mercado M, Borges F, Bouterfa H, et al. A prospective, multicentre study to investigate the efficacy, safety and tolerability of octreotide LAR (long-acting repeatable octreotide) in the primary therapy of patients with acromegaly. Clin Endocrinol (Oxf ). 2007;66:859–868. https://doi.org/10.1111/j.1365-2265.2007.02825.x
Giustina A, Mazziotti G, Torri V, Spinello M, Floriani I, Melmed S. Meta-analysis on the effects of octreotide on tumor mass in acromegaly. PLoS One. 2012;7:e36411. https://doi.org/10.1371/journal.pone.0036411
Fleseriu M. Clinical efficacy and safety results for dose escalation of somatostatin receptor ligands in patients with acromegaly: a literature review. Pituitary. 2011;14:184–193. https://doi.org/10.1007/s11102-010-0282-z
Giustina A, Bonadonna S, Bugari G, et al. Highdose intramuscular octreotide in patients with acromegaly inadequately controlled on conventional somatostatin analogue therapy: a randomised controlled trial. Eur J Endocrinol. 2009;161:331–338. https://doi.org/10.1530/eje-09-0372
Cozzi R, Montini M, Attanasio R, et al. Primary treatment of acromegaly with octreotide LAR: a long-term (up to nine years) prospective study of its efficacy in the control of disease activity and tumor shrinkage. J Clin Endocrinol Metab. 2006;91:1397–1403. https://doi.org/10.1210/jc.2005-2347
Attanasio R, Mainolfi A, Grimaldi F, et al. Somatostatin analogs and gallstones: a retrospective survey on a large series of acromegalic patients. J Endocrinol Invest. 2008;31:704–710. https://doi.org/10.1007/bf03346419
Paisley AN, Roberts ME, Trainer PJ. Withdrawal of somatostatin analogue therapy in patients with acromegaly is associated with an increased risk of acute biliary problems. Clin Endocrinol (Oxf ). 2007;66:723–726. https://doi.org/10.1111/j.1365-2265.2007.02811.x
Tuvia S, Atsmon J, Teichman SL, et al. Oral octreotide absorption in human subjects: comparable pharmacokinetics to parenteral octreotide and effective growth hormone suppression. J Clin Endocrinol Metab. 2012;97:2362–2369. https://doi.org/10.1210/jc.2012-1179
Kopchick JJ, Parkinson C, Stevens EC, Trainer PJ. Growth hormone receptor antagonists: discovery, development, and use in patients with acromegaly. Endocr Rev. 2002;23:623–646. https://doi.org/10.1210/er.2001-0022
Chen WY, Wight DC, Wagner TE, Kopchick JJ. Expression of a mutated bovine growth hormone gene suppresses growth of transgenic mice. Proc Natl Acad Sci USA. 1990;87:5061–5065. https://doi.org/10.1073/pnas.87.13.5061
Muller AF, Kopchick JJ, Flyvbjerg A, van der Lely AJ. Clinical review 166: growth hormone receptor antagonists. J Clin Endocrinol Metab. 2004;89:1503–1511. https://doi.org/10.1210/jc.2002-022049
Katznelson L. Pegvisomant for the treatment of acromegaly-translation of clinical trails into clinical practice. Nat Clin Pract Endocrinol Metab. 2007;3:514–515. https://doi.org/10.1038/ncpendmet0533
Trainer PJ, Drake WM, Katznelson L, et al. Treatment of acromegaly with the growth hormone-receptor antagonist pegvisomant. N Engl J Med. 2000;342:1171–1177. https://doi.org/10.1056/nejm200004203421604
van der Lely AJ, Hutson RK, Trainer PJ, et al. Longterm treatment of acromegaly with pegvisomant, a growth hormone receptor antagonist. Lancet. 2001;358:1754–1759. https://doi.org/10.1016/s0140-6736(01)06844-1
van der Lely AJ, Biller BM, Brue T, et al. Long-term safety of pegvisomant in patients with acromegaly: comprehensive review of 1288 subjects in ACROSTUDY. J Clin Endocrinol Metab. 2012;97:1589–1597. https://doi.org/10.1210/jc.2011-2508
Neggers SJ, de Herder WW, Feelders RA, van der Lely AJ. Conversion of daily pegvisomant to weekly pegvisomant combined with long-acting somatostatin analogs, in controlled acromegaly patients. Pituitary. 2011;14:253–258. https://doi.org/10.1007/s11102-010-0289-5
Barkan AL, Burman P, Clemmons DR, et al. Glucose homeostasis and safety in patients with acromegaly converted from long-acting octreotide to pegvisomant. J Clin Endocrinol Metab. 2005;90:5684–5691. https://doi.org/10.1210/jc.2005-0331
Castinetti F, Nagai M, Morange I, et al. Long-term results of stereotactic radiosurgery in secretory pituitary adenomas. J Clin Endocrinol Metab. 2009;94:3400–3407. https://doi.org/10.1210/jc.2008-2772
Frohman LA, Bonert V. Pituitary tumor enlargement in two patients with acromegaly during pegvisomant therapy. Pituitary. 2007;10:283–289. https://doi.org/10.1007/s11102-007-0042-x
Marazuela M, Paniagua AE, Gahete MD, et al. Somatotroph tumor progression during pegvisomant therapy: a clinical and molecular study. J Clin Endocrinol Metab. 2011;96:E251–E259. https://doi.org/10.1210/jc.2010-1742
Buhk JH, Jung S, Psychogios MN, et al. Tumor volume of growth hormone-secreting pituitary adenomas during treatment with pegvisomant: a prospective multicenter study. J Clin Endocrinol Metab. 2010;95:552–558. https://doi.org/10.1210/jc.2009-1239
Bonert VS, Kennedy L, Petersenn S, Barkan A, Carmichael J, Melmed S. Lipodystrophy in patients with acromegaly receiving pegvisomant. J Clin Endocrinol Metab. 2008;93:3515–3518. https://doi.org/10.1210/jc.2008-0833
Schreiber I, Buchfelder M, Droste M, et al. Treatment of acromegaly with the GH receptor antagonist pegvisomant in clinical practice: safety and efficacy evaluation from the German Pegvisomant Observational Study. Eur J Endocrinol. 2007;156:75–82. https://doi.org/10.1530/eje.1.02312
Bernabeu I, Marazuela M, Lucas T, et al. Pegvisomant-induced liver injury is related to the UGT1A1*28 polymorphism of Gilbert’s syndrome. J Clin Endocrinol Metab. 2010;95:2147–2154. https://doi.org/10.1210/jc.2009-2547
Filopanti M, Barbieri AM, Mantovani G, et al. Role of UGT1A1 and ADH gene polymorphisms in pegvisomant-induced liver toxicity in acromegalic patients. Eur J Endocrinol. 2014;170:247–254. https://doi.org/10.1530/eje-13-0657
Sandret L, Maison P, Chanson P. Place of cabergoline in acromegaly: a meta-analysis. J Clin Endocrinol Metab. 2011;96:1327–1335. https://doi.org/10.1210/jc.2010-2443
Abs R, Verhelst J, Maiter D, et al. Cabergoline in the treatment of acromegaly: a study in 64 patients. J Clin Endocrinol Metab. 1998;83:374–378. https://doi.org/10.1210/jcem.83.2.4556
Freda PU, Reyes CM, Nuruzzaman AT, Sundeen RE, Khandji AG, Post KD. Cabergoline therapy of growth hormone & growth hormone/prolactin secreting pituitary tumors. Pituitary. 2004;7:21–30. https://doi.org/10.1023/b:pitu.0000044630.83354.f0
Valassi E, Klibanski A, Biller BM. Clinical review#: potential cardiac valve effects of dopamine agonists in hyperprolactinemia. J Clin Endocrinol Metab. 2010;95:1025–1033. https://doi.org/10.1210/jc.2009-2095
Maione L, Garcia C, Bouchachi A, et al. No evidence of a detrimental effect of cabergoline therapy on cardiac valves in patients with acromegaly. J Clin Endocrinol Metab. 2012;97:E1714–E1719. https://doi.org/10.1210/jc.2012-1833
Neggers SJ, de Herder WW, Janssen JA, Feelders RA, van der Lely AJ. Combined treatment for acromegaly with long-acting somatostatin analogs and pegvisomant: long-term safety for up to 4.5 years (median 2.2 years) of follow-up in 86 patients. Eur J Endocrinol. 2009;160:529–533. https://doi.org/10.1530/eje-08-0843
Jørgensen JO, Feldt-Rasmussen U, Frystyk J, et al. Cotreatment of acromegaly with a somatostatin analog and a growth hormone receptor antagonist. J Clin Endocrinol Metab. 2005;90:5627–5631. https://doi.org/10.1210/jc.2005-0531
Trainer PJ, Ezzat S, D’Souza GA, Layton G, Strasburger CJ. A randomized, controlled, multicentre trial comparing pegvisomant alone with combination therapy of pegvisomant and long-acting octreotide in patients with acromegaly. Clin Endocrinol (Oxf ). 2009;71:549–557. https://doi.org/10.1111/j.1365-2265.2009.03620.x
Neggers SJ, van Aken MO, de Herder WW, et al. Quality of life in acromegalic patients during longterm somatostatin analog treatment with and without pegvisomant. J Clin Endocrinol Metab. 2008;93:3853–3859. https://doi.org/10.1210/jc.2008-0669
Higham CE, Atkinson AB, Aylwin S, et al. Effective combination treatment with cabergoline and low-dose pegvisomant in active acromegaly: a prospective clinical trial. J Clin Endocrinol Metab. 2012;97:1187–1193. https://doi.org/10.1210/jc.2011-2603
Bernabeu I, Alvarez-Escolá C, Paniagua AE, et al. Pegvisomant and cabergoline combination therapy in acromegaly. Pituitary. 2013;16:101–108. https://doi.org/10.1007/s11102-012-0382-z
Colao A, Pivonello R, Auriemma RS, et al. Predictors of tumor shrinkage after primary therapy with somatostatin analogs in acromegaly: a prospective study in 99 patients. J Clin Endocrinol Metab. 2006;91:2112–2118. https://doi.org/10.1210/jc.2005-2110
Castinetti F, Morange I, Dufour H, Regis J, Brue T. Radiotherapy and radiosurgery in acromegaly. Pituitary. 2009;12:3–10. https://doi.org/10.1007/s11102-007-0078-y
Molitch ME, Grossman AB. Pituitary radiotherapy. Pituitary. 2009;12:1–2. https://doi.org/10.1007/s11102-008-0148-9
Jenkins PJ, Bates P, Carson MN, Stewart PM, Wass JA. Conventional pituitary irradiation is effective in lowering serum growth hormone and insulin-like growth factor-I in patients with acromegaly. J Clin Endocrinol Metab. 2006;91:1239–1245. https://doi.org/10.1210/jc.2005-1616
Minniti G, Jaffrain-Rea ML, Osti M, et al. The longterm efficacy of conventional radiotherapy in patients with GH-secreting pituitary adenomas. Clin Endocrinol (Oxf ). 2005;62:210–216. https://doi.org/10.1111/j.1365-2265.2005.02199.x
Castinetti F, Taieb D, Kuhn JM, et al. Outcome of gamma knife radiosurgery in 82 patients with acromegaly: correlation with initial hypersecretion. J Clin Endocrinol Metab. 2005;90:4483–4488. https://doi.org/10.1210/jc.2005-0311
Pollock BE, Kondziolka D, Lunsford LD, Flickinger JC. Stereotactic radiosurgery for pituitary adenomas: imaging, visual and endocrine results. Acta Neurochir Suppl. 1994;62:33–38. https://doi.org/10.1007/978-3-7091-9371-6_7
Pollock BE, Nippoldt TB, Stafford SL, Foote RL, Abboud CF. Results of stereotactic radiosurgery in patients with hormone-producing pituitary adenomas: factors associated with endocrine normalization. J Neurosurg. 2002;97:525–530. https://doi.org/10.3171/jns.2002.97.3.0525
Lee CC, Vance ML, Xu Z, et al. Stereotactic radiosurgery for acromegaly. J Clin Endocrinol Metab. 2014;99:1273–1281. https://doi.org/10.1210/jc.2013-3743
Ronchi CL, Attanasio R, Verrua E, et al. Efficacy and tolerability of gamma knife radiosurgery in acromegaly: a 10-year follow-up study. Clin Endocrinol (Oxf ). 2009;71:846–852. https://doi.org/10.1111/j.1365-2265.2009.03589.x
Barrande G, Pittino-Lungo M, Coste J, et al. Hormonal and metabolic effects of radiotherapy in acromegaly: long-term results in 128 patients followed in a single center. J Clin Endocrinol Metab. 2000;85:3779–3785. https://doi.org/10.1210/jcem.85.10.6870
Biermasz NR, Dulken HV, Roelfsema F. Postoperative radiotherapy in acromegaly is effective in reducing GH concentration to safe levels. Clin Endocrinol (Oxf ). 2000;53:321–327. https://doi.org/10.1046/j.1365-2265.2000.01095.x
Powell JS, Wardlaw SL, Post KD, Freda PU. Outcome of radiotherapy for acromegaly using normalization of insulin-like growth factor I to define cure. J Clin Endocrinol Metab. 2000;85:2068–2071. https://doi.org/10.1210/jcem.85.5.6586
Biermasz NR, van Dulken H, Roelfsema F. Long-term follow-up results of postoperative radiotherapy in 36 patients with acromegaly. J Clin Endocrinol Metab. 2000;85:2476–2482. https://doi.org/10.1210/jcem.85.7.6699
Jezková J, Marek J, Hána V, et al. Gamma knife radiosurgery for acromegaly–long-term experience. Clin Endocrinol (Oxf ). 2006;64:588–595. https://doi.org/10.1111/j.1365-2265.2006.02513.x
Erfurth EM, Bülow B, Mikoczy Z, Svahn-Tapper G, Hagmar L. Is there an increase in second brain tumours after surgery and irradiation for a pituitary tumour? Clin Endocrinol (Oxf ). 2001;55:613–616. https://doi.org/10.1046/j.1365-2265.2001.01385.x
Minniti G, Traish D, Ashley S, Gonsalves A, Brada M. Risk of second brain tumor after conservative surgery and radiotherapy for pituitary adenoma: update after an additional 10 years. J Clin Endocrinol Metab. 2005;90:800–804. https://doi.org/10.1210/jc.2004-1152
Noad R, Narayanan KR, Howlett T, Lincoln NB, Page RC. Evaluation of the effect of radiotherapy for pituitary tumours on cognitive function and quality of life. Clin Oncol (R Coll Radiol). 2004;16:233–237. https://doi.org/10.1016/j.clon.2004.01.012
Peace KA, Orme SM, Padayatty SJ, Godfrey HP, Belchetz PE. Cognitive dysfunction in patients with pituitary tumour who have been treated with transfrontal or transsphenoidal surgery or medication. Clin Endocrinol (Oxf ). 1998;49:391–396. https://doi.org/10.1046/j.1365-2265.1998.00543.x
Rowe J, Grainger A, Walton L, Silcocks P, Radatz M, Kemeny A. Risk of malignancy after gamma knife stereotactic radiosurgery. Neurosurgery. 2007;60:60–65; discussion 65–66. https://doi.org/10.1227/01.neu.0000255492.34063.32
Laws ER, Sheehan JP, Sheehan JM, Jagnathan J, Jane JA Jr, Oskouian R. Stereotactic radiosurgery for pituitary adenomas: a review of the literature. J Neurooncol. 2004;69:257–272. https://doi.org/10.1023/b:neon.0000041887.51906.b7
Landolt AM, Haller D, Lomax N, et al. Octreotide may act as a radioprotective agent in acromegaly. J Clin Endocrinol Metab. 2000;85:1287–1289. https://doi.org/10.1210/jcem.85.3.6464
Pollock BE, Jacob JT, Brown PD, Nippoldt TB. Radiosurgery of growth hormone-producing pituitary adenomas: factors associated with biochemical remission. J Neurosurg. 2007;106:833–838. https://doi.org/10.3171/jns.2007.106.5.833
Eugster EA, Pescovitz OH. Gigantism. J Clin Endocrinol Metab. 1999;84:4379–4384. https://doi.org/10.1210/jcem.84.12.6222
Maheshwari HG, Prezant TR, Herman-Bonert V, Shahinian H, Kovacs K, Melmed S. Long-acting peptidomimergic control of gigantism caused by pituitary acidophilic stem cell adenoma. J Clin Endocrinol Metab. 2000;85:3409–3416. https://doi.org/10.1210/jcem.85.9.6824
Rix M, Laurberg P, Hoejberg AS, Brock-Jacobsen B. Pegvisomant therapy in pituitary gigantism: successful treatment in a 12-year-old girl. Eur J Endocrinol. 2005;153:195–201. https://doi.org/10.1530/eje.1.01956
Müssig K, Gallwitz B, Honegger J, et al. Pegvisomant treatment in gigantism caused by a growth hormone-secreting giant pituitary adenoma. Exp Clin Endocrinol Diabetes. 2007;115:198–202. https://doi.org/10.1055/s-2007-956172
Goldenberg N, Racine MS, Thomas P, Degnan B, Chandler W, Barkan A. Treatment of pituitary gigantism with the growth hormone receptor antagonist pegvisomant. J Clin Endocrinol Metab. 2008;93:2953–2956. https://doi.org/10.1210/jc.2007-2283
Beckers A, Stevenaert A, Foidart JM, Hennen G, Frankenne F. Placental and pituitary growth hormone secretion during pregnancy in acromegalic women. J Clin Endocrinol Metab. 1990;71:725–731. https://doi.org/10.1210/jcem-71-3-725
Frankenne F, Closset J, Gomez F. The physiology of growth hormones (GHs) in pregnant women and partial characterization of the placental GH variant. J Clin Endocrinol Metab. 1988;66:1171–1980. https://doi.org/10.1210/jcem-66-6-1171
Eriksson L, Frankenne F, Edèn S, Hennen G, Von Schoultz B. Growth hormone 24-h serum profiles during pregnancy–lack of pulsatility for the secretion of the placental variant. Br J Obstet Gynaecol. 1989;96:949–953. https://doi.org/10.1111/j.1471-0528.1989.tb03352.x
Cheng V, Faiman C, Kennedy L, et al. Pregnancy and acromegaly: a review. Pituitary. 2012;15:59–63. https://doi.org/10.1007/s11102-011-0330-3
Kupersmith MJ, Rosenberg C, Kleinberg D. Visual loss in pregnant women with pituitary adenomas. Ann Intern Med. 1994;121:473–477. https://doi.org/10.7326/0003-4819-121-7-199410010-00001
Okada Y, Morimoto I, Ejima K, et al. A case of active acromegalic woman with a marked increase in serum insulin-like growth factor-1 levels after delivery. Endocr J. 1997;44:117–120. https://doi.org/10.1507/endocrj.44.117
Kasuki L, Neto LV, Takiya CM, Gadelha MR. Growth of an aggressive tumor during pregnancy in an acromegalic patient. Endocr J. 2012;59:313–319. https://doi.org/10.1507/endocrj.ej11-0306
Cozzi R, Attanasio R, Barausse M. Pregnancy in acromegaly: a one-center experience. Eur J Endocrinol. 2006;155:279–284. https://doi.org/10.1530/eje.1.02215
Caron P, Broussaud S, Bertherat J, et al. Acromegaly and pregnancy: a retrospective multicenter study of 59 pregnancies in 46 women. J Clin Endocrinol Metab. 2010;95:4680–4687. https://doi.org/10.1210/jc.2009-2331
Cheng S, Grasso L, Martinez-Orozco JA, et al. Pregnancy in acromegaly: experience from two referral centers and systematic review of the literature. Clin Endocrinol (Oxf ). 2012;76:264–271. https://doi.org/10.1111/j.1365-2265.2011.04180.x
Herman-Bonert V, Seliverstov M, Melmed S. Pregnancy in acromegaly: successful therapeutic outcome. J Clin Endocrinol Metab. 1998;83:727–731. https://doi.org/10.1210/jcem.83.3.4635
Molitch ME. Prolactinoma in pregnancy. Best Pract Res Clin Endocrinol Metab. 2011;25:885–896. https://doi.org/10.1016/j.beem.2011.05.011
Maffei P, Tamagno G, Nardelli GB, et al. Effects of octreotide exposure during pregnancy in acromegaly. Clin Endocrinol (Oxf ). 2010;72:668–677. https://doi.org/10.1111/j.1365-2265.2009.03706.x
Brian SR, Bidlingmaier M, Wajnrajch MP, Weinzimer SA, Inzucchi SE. Treatment of acromegaly with pegvisomant during pregnancy: maternal and fetal effects. J Clin Endocrinol Metab. 2007;92:3374–3377. https://doi.org/10.1210/jc.2007-0997
##submission.downloads##
Опубліковано
Як цитувати
Номер
Розділ
Ліцензія
Авторське право (c) 2016 Клінічна ендокринологія та ендокринна хірургія
Ця робота ліцензується відповідно до Creative Commons Attribution-NonCommercial 4.0 International License.