LANSING, Mich. >> The former sports doctor who admitted molesting some of the nation’s top gymnasts for years under the guise of medical treatment was sentenced today to 40 to 175 years in prison by a judge who proudly told him, “I just signed your death warrant.”

The sentence capped a remarkable seven-day hearing in which scores of Larry Nassar’s victims were able to confront him face to face in a Michigan courtroom.

“It is my honor and privilege to sentence you. You do not deserve to walk outside a prison ever again. You have done nothing to control those urges and anywhere you walk, destruction will occur to those most vulnerable,” Judge Rosemarie Aquilina said.

Nassar’s actions were “precise, calculated, manipulative, devious, despicable,” she said.

When the hearing ended, the courtroom broke into applause. Victims and prosecutors embraced at the conclusion of the grueling 16-month case.

It was the second long-term prison sentence for the 54-year-old physician. He has also been sentenced to 60 years in federal prison for child pornography crimes.

A prosecutor said Nassar found competitive gymnastics to be a “perfect place” for his crimes because victims saw him as a “god” in the sport.

“It takes some kind of sick perversion to not only assault a child but to do so with her parent in the room,” prosecutor Angela Povilaitis said. “To do so while a lineup of eager young gymnasts waited.”

She described the “breadth and ripple” of Nassar’s sexual abuse as “nearly infinite.”

“What does it say about our society that victims of sexual abuse have to hide their pain for years when they did nothing wrong? What does it say about our society when victims do come forward … and are treated as liars until proven true?” Povilaitis said.

Nassar turned to the courtroom gallery to make a brief statement, saying that the accounts of more than 150 victims had “shaken me to my core.” He said “no words” can describe how sorry he is for his crimes.

“I will carry your words with me for the rest of my days” he said as many of his accusers wept.

One of the first athletes to publicly accuse Nassar of sexual assault was the last victim to offer a statement at the hearing.

Rachael Denhollander is a Kentucky lawyer who stepped forward in 2016 after the sport’s governing body was accused of mishandling complaints of sexual assault. She said Nassar groped, fondled and penetrated her with his hands when she was a 15-year-old gymnast in Michigan.

Denhollander’s statements to Michigan State University police put the criminal investigation in high gear in 2016.

“You have become a man ruled by selfish and perverted desires,” she told Nassar, who worked at the university and USA Gymnastics, the governing body that also trains Olympians.

Nassar pleaded guilty to assaulting seven people in the Lansing area, but the sentencing hearing has been open to anyone who said they were a victim. His accusers said he would use his ungloved hands to penetrate them, often without explanation, while they were on a table seeking help for various injuries.

The accusers, many of whom were children, said they trusted Nassar to care for them properly and were in denial about what was happening or were afraid to speak up. He sometimes used a sheet or his body to block the view of any parent in the room.

“I’d been told during my entire gymnastics career to not question authority,” a former elite gymnast, Isabell Hutchins, said Tuesday.

Hutchins and Mattie Larson, a former national gymnast, talked about how Nassar won their allegiance with candy, Olympic trinkets and encouraging words while they were under constant scrutiny from demanding coaches.

The judge praised the victims who appeared in her court over the last week, calling them “sister survivors.” The women have included Olympians Aly Raisman, Jordyn Wieber and McKayla Maroney.

Brooke Hylek, a gymnast who plans to compete in college, heaped scorn on Nassar.

“I cannot believe I ever trusted you, and I will never forgive you,” she said Tuesday. “I’m happy you will be spending the rest of your life in prison. Enjoy hell by the way.”

Emily Morales had a softer message.

“I want you to apologize to me right here,” the 18-year-old told Nassar. “I want to forgive you, but I also want to hear you tell me that you regret all the hurting you caused.”

He did. She replied with, “Thank you.”

Nassar is scheduled to be sentenced next week on more assault convictions in Eaton County, Michigan.

Associated Press Writer Ed White in Detroit contributed to this report.