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In early gastric cancer (EGC) cases with lymphovascular invasion or positive vertical margins after endoscopic submucosal dissection (ESD), additional radical gastrectomy is performed on principle. However, an additional surgery is often difficult to consider if the surgical approach itself is challenging or the patient refuses surgery. In such cases, only close surveillance is performed without additional surgical procedures. This study aimed to examine the difference in clinical prognosis of EGC cases with lymphovascular invasion or positive vertical margins after ESD either with or without surgery.We retrospectively studied 83 patients with lymphovascular invasion or positive vertical margins after ESD from July 2005 to November 2013.Of the 83 patients, 45 (54.2%) underwent radical additional gastrectomy (surgical group) and 38 (45.8%) were under close surveillance without surgical or endoscopic treatments (close surveillance group.) The cancer-free survival period was 78.3 ± 3.4 months in the surgical group and 64.5 ± 4.6 months in the close surveillance group. The recurrence rates did not significantly differ between the 2 groups, at 7.9% in the surgical group and 6.7% in the non-surgical group.Close surveillance may be suggested as an option for EGC patients for whom a surgical approach is difficult, who exhibit a positive vertical margin after ESD, and who have no lymphovascular or deep submucosa invasion after ESD.

Ectopic adrenocorticotropic hormone (ACTH) syndrome is caused most frequently by a bronchial carcinoid tumor or by small cell lung cancer. Medullary thyroid carcinoma (MTC) is a rare etiology of ectopic ACTH syndrome. We describe a case of Cushing syndrome due to ectopic ACTH production from MTC in a 48-year-old male. He was diagnosed with MTC 14 years ago and underwent total thyroidectomy, cervical lymph node dissection and a series of metastasectomies. MTC was confirmed by the pathological examination of the thyroid and metastatic mediastinal lymph node tissues. Two years after his last surgery, he developed Cushingoid features, such as moon face and central obesity, accompanied by uncontrolled hypertension and new-onset diabetes. The laboratory results were compatible with ectopic ACTH syndrome. A bilateral adrenalectomy improved the clinical and laboratory findings that were associated with Cushing syndrome. This is the first confirmed case of ectopic ACTH syndrome caused by MTC in Korea.

This study evaluated the efficacy of periodontal tissue regeneration using guided tissue regeneration (GTR) with a mixture of tooth ash and plaster as a bone substitute material in the treatment of class II furcation defects in dogs. GTR was performed at the site of a surgically formed mandibular premolar bifurcation area in dogs. Four adult dogs were used in the animal study. The animals were in a good periodontal state without any systemic disease. A resorbable membrane (Bio-Gide®, Swiss) and bone graft material using a mixture of tooth ash and plaster were used to examine the biological activity. The defect in the control group was filled a Bio-Gide® only. For the experimental group, the defects were filled with a mixture of tooth ash and plaster and covered by a Bio-Gide®. Oral rinsing with 0.12% chlorhexidine was performed twice a day for 2 weeks. In control group, new bone formation was observed adjacent to the preexisting bone. Soft tissue ingrowth was also noted. In experimental group, new lamellar type trabecular bone formation as well as centum and PDL regeneration was observed in the base of the infrabony pocket. More bone regeneration would be expected when GTR is performed using a mixture of human tooth-ash and plaster of Paris as a bone graft material.