Background: Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. Methods: This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. Conclusion This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Background: Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. Methods: This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. Conclusion This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Background: Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. Methods: This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. Conclusion This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Background: Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. Methods: This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. Conclusion This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

This study investigated the effects of radioiodine (RAI) therapy on fertility-related hormones, particularly anti-Müllerian hormone (AMH), and menopause in women with differentiated thyroid cancer (DTC). Materials and Methods: We recruited 46 women with regular menstrual cycles who underwent total thyroidectomy for DTC. After excluding those who were menopausal before surgery, 35 patients in the RAI group and seven in the control group were analyzed. AMH levels were measured at baseline, 6 months, 9 months, and 1 year post-operation. Statistical analyses included Kruskal–Wallis tests and linear mixed model. Results: The Kruskal–Wallis test showed no significant difference in AMH changes between RAI doses (p=0.62). Age was significantly associated with AMH levels, with corresponding to a decrease of 0.18 ng/mL per year (p＜0.001).No significant difference in AMH levels was observed between the RAI and control groups after adjusting for age and baseline AMH (p=0.62). At 6 months after surgery or RAI, AMH declined in 57.1% (4/7), 60.0% (9/15), and 50.0% (9/18) in the control, 30 mCi, and 50 mCi groups, respectively. Among single RAI-treated patients with long-term follow-up, AMH levels recovered to baseline or higher in 50.0% (2/4), 0.0% (0/1), and 42.9% (9/19) in the control, 30 mCi, and 50 mCi groups, respectively. Conclusion: RAI therapy in patients with DTC showed no significant impact on AMH levels compared to controls. Larger studies with longer follow-ups are needed to assess its long-term effects on fertility.

Multiple myeloma (MM), a hematological malignancy, is characterized by malignant plasma cell proliferation in the bone marrow. Recent treatment advances have significantly improved patient outcomes associated with MM.In this study, we aimed to develop comprehensive, evidence-based guidelines for the diagnosis, prognosis, and treat‑ ment of MM. We identified 12 key clinical questions essential for MM management, guiding the extensive literature review and meta-analysis of the study. Our guidelines provide evidence-based recommendations by integrating patient preferences with survey data. These recommendations include current and emerging diagnostic tools, thera‑ peutic agents, and treatment strategies. By prioritizing a patient-centered approach and rigorous data analysis, these guidelines were developed to enhance MM management, both in Korea and globally.

Objectives: The objective of this study was to evaluate the long-term clinical outcomes of one-piece narrow-diameter implants (NDIs), with diameters of 2.5 mm and 3.0 mm, and to investigate the factors that affect marginal bone loss (MBL) around these implants. Materials and Methods: This study analyzed patients who were treated with 2.5 mm and 3.0 mm MS SA narrow ridge implants (Osstem Implant) at the Section of Dentistry in Seoul National University Bundang Hospital from 2007 to 2022 and had more than 6 years of follow-up data. MBL was measured using periapical radiographs. Age, sex, implant location, timing of implant placement and loading, placement depth, guided bone regeneration (GBR), fixture diameter, type of implant prosthesis, and opposing dentition type were investigated in relation to MBL. The implant survival rate was analyzed using Kaplan–Meier survival curves, and univariate and multivariate logistic regression models were used to identify factors associated with MBL. All analyses were conducted using R software (version 4.1.0 for Microsoft Windows; R Foundation). Results: Twenty-five patients with 40 NDIs were included in this study. The mean observation period after implant function was 10.5 years (range, 6.1 to 14.0 years), and the survival rate of the NDIs was 95.1% at the implant level and 96.0% at the patient level. The average amount of MBL was 0.44±0.57 mm. The only factor that showed a significant association with MBL was the presence of GBR (P=0.046). Conclusion Within the limitations of a retrospective evaluation, NDIs have demonstrated optimal clinical outcomes over a long period in areas in which anatomical structures are limited. MBL around the NDI also showed clinically acceptable results, and a correlation with MBL was observed in cases in which a bone graft was performed. Further studies with a larger number of implants over extended periods are needed in the future.

Purpose: This study aimed to examine general nurses' nursing leadership in patient care using focus group interviews. Methods: This study was conducted after obtaining approval from the ethics committee of a university.After completing a focus group interview with 13 general nurses working at a general hospital, we performed qualitative content analysis according to Kreuger's guidelines. Results: A total of 170 meaningful statement units of nursing leadership that appeared in the clinical experience of general nurses were extracted, and 10 final sub-themes and the three themes connecting them were derived. The themes derived were “leading patients into nursing,” “experiencing the power of growth,” and “facilitating situations that allow focus on patient care.” Conclusion This study helps in understanding the nursing leadership of general nurses in patient care. To encourage general nurses to exert their nursing leadership and grow as autonomous nurses, nursing educators must appropriately present the learning outcomes and content of nursing leadership. Additionally, in the clinical setting, organizational support is necessary to foster understanding and the demonstration of general nurses' nursing leadership.

Purpose: The aim was to develop guidelines for delegating nursing tasks among nurses in integrated nursing care wards. Methods: This was a methodological approach. Literature reviews were conducted on delegation policies and practices for nurses in Korea and other countries to explore the area of nursing delegation. Focus group interviews were performed with nurses to identify the strength and weakness of the delegation of nursing tasks in clinical practice, and qualitative content analysis was conducted based on the interview. Ten areas and 115 items were derived through these steps, and their validity was confirmed using the Delphi technique. Results: The delegation guidelines of nursing tasks consisted of nine domains, 21 sub-categories, and 101 items, including Nurses and nursing assistants' duties, the necessity of delegation, definition of terms, scope of delegation, considerations for delegation, procedure, characteristics, and principles of delegation, and educational content for delegation. Conclusion These guidelines can help nurses to make decisions about delegating nursing tasks according to the delegation procedure.Education on the delegation of nursing tasks is necessary for both nurses and nursing assistants. The guidelines developed in this study can serve as a standard for delegating nursing tasks to ensure patient safety.

Purpose: This study aimed to examine general nurses' nursing leadership in patient care using focus group interviews. Methods: This study was conducted after obtaining approval from the ethics committee of a university.After completing a focus group interview with 13 general nurses working at a general hospital, we performed qualitative content analysis according to Kreuger's guidelines. Results: A total of 170 meaningful statement units of nursing leadership that appeared in the clinical experience of general nurses were extracted, and 10 final sub-themes and the three themes connecting them were derived. The themes derived were “leading patients into nursing,” “experiencing the power of growth,” and “facilitating situations that allow focus on patient care.” Conclusion This study helps in understanding the nursing leadership of general nurses in patient care. To encourage general nurses to exert their nursing leadership and grow as autonomous nurses, nursing educators must appropriately present the learning outcomes and content of nursing leadership. Additionally, in the clinical setting, organizational support is necessary to foster understanding and the demonstration of general nurses' nursing leadership.