F-18-2-Fluoro-2-deoxy-D-glucose (FDG) positiron emission tomography (PET) /CT scan, which simultaneously provides metabolic function and morphology on the same tomographic section, is being the key imaging modality for diagnosis and treatment strategy of makignancies in various organs. FDG PET/CT scanning of the whole body beneficially allows the assessment of primary tumor and regional lymph nodes, and distant metastases and co-existed benign/other malignant lesions, as "one stop shopping" fashion. This technique contributes to the selection of the optimal treatment in individual patients, and also can predict histopathologic response to treatment and postoperative/post chemo-radiation therapeutic prognosis. In this paper, we describe the fundamental knowledge required for accurate interpretation of FDG PET/CT scan, and review the utility of this technique for diagnosis and treatment strategy of makignancies in abdominal and pelvic regions.

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Thyroid hormones (T3, T4) play critical roles in development, growth, and metabolism. The action of thyroid hormone is mediated by thyroid hormone receptors (TRs), which are ligand-dependent transcription factors. TRs are encoded by two genes TRα and TRβ. There are four major isoforms produced by alternative splicing, TRα1, TRα2, TRβ1, and TRβ2. Resistance to thyroid hormone (RTH) is a syndrome of disorders of thyroid hormone functions caused by mutation of TRβ gene. To investigate the mechanism of RTH, mouse with a targeted mutation of TRβ gene was generated. The mutated TRβ, TRβPV, which was identified in a patient with RTH, lacks T3-binding activity and acts in a dominant negative manner. TRβ^PV/PV showed severe RTH, extremely high serum TSH levels in spite of highly elevated thyroid hormone. And they spontaneously developed TSH secreting pituitary tumors. We also analyzed mice lacking all functional TRs, TRα1^-/-, TRβ^-/- mice and found that they had normal pituitary in spite of highly elevated TSH levels as TRβ^PV/PV. These results indicate that the loss in negative regulation of TSH is not sufficient to induce TSHoma and unliganded mutant TRβ may play a critical role in the tumorigenesis of thyrotroph.

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Background: Off-pump onlay bypass grafting has shown to be beneficial in patient with multiply diseased left anterior descending coronary arteries from the aspect of complete revascularization. We would like to present our 6 experiences and valuate expediency of Off-pump onlay bypass grafting . On our method, internal thoracic arteries were bypassed to diseased LAD of all 6 patients. Result: There were five males and one female with mean age of 68. 8±6. 5 years. Four patients had developed stable angina pectoris. The other two patients had developed unstable angina pectoris with usage of intra-aortic balloon pump (IABP). None of the procedures were converted to on-pump coronary artery bypass grafting (CABG). Mean postoperative CPK-MB (max) was 32. 8±29. 8 IU/l, and no patient had perioperative myocardial infarction. Early patency of grafts was assessed by multi-detector CT (MDCT). Five of 6 patients were administered MDCT. One was not administered MDCT because of chronic renal failure. Early patency rate was 100%(5/5). There was no early death and angina symptom. Mean hospital stay was 33. 3±15. 3 days. Conclusion: Off-pump onlay bypass grafting for multiple diseased left anterior descending coronary arteries seems to be a very useful procedure.

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Careful introduction is needed for endoscopic submucosal dissection (ESD) for superficial esophageal cancer (SEC) because of potentially serious complication. We safely introduced ESD for 9 SEC lesions of 8 cases after experience of endoscopic mucosal resection (EMR) for 13 esophageal lesions, ESD for 39 gastric lesions and EMR for 86 gastric lesions under close communication with esophageal surgeons. Communication with surgeons and such experience of ESD and EMR are thought to be important for safe introduction of ESD for SEC.

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