Background: and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes. Methods: We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data. Results: Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4. Conclusion Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.

Objective: To assess the success rate and proximity of miniscrews to the root using surgical guides produced by integrating data obtained from conebeam computed tomography and intraoral scanned models. Methods: This retrospective study involved 113 patients (224 miniscrews) who underwent miniscrew placement as part of their orthodontic treatment. Two operators placed miniscrews between the buccal alveolar bone of each patient and assessed initial stability by measuring the Periotest value (PTV) and insertion torque (IT). Patients were divided into two groups based on the miniscrew insertion method: manual group (MG) and surgical guide group (SG). Root proximity was assessed using periapical radiography, and miniscrews that remained in place for over 6 months were considered successful. Results: There was a statistically significant difference in the Kaplan–Meier survival curves between the groups (P < 0.05). The success rates of the miniscrews were 79.1% and 90.5% for the MG and SG, respectively (P < 0.05). The root contact rate also differed significantly between the groups (MG, 17.5%; SG, 0.1%; P < 0.001). However, the PTV and IT did not show significant differences between the groups. Conclusions Proximity to the root and utilization of surgical guides have the most direct impact on the success rate of miniscrews. Root proximity can be effectively reduced using surgical guides. Therefore, the use of a miniscrew surgical guide is recommended to increase the success rate of miniscrews as stable anchorage devices, particularly in cases with narrow interradicular space.

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.

Objective: To assess the success rate and proximity of miniscrews to the root using surgical guides produced by integrating data obtained from conebeam computed tomography and intraoral scanned models. Methods: This retrospective study involved 113 patients (224 miniscrews) who underwent miniscrew placement as part of their orthodontic treatment. Two operators placed miniscrews between the buccal alveolar bone of each patient and assessed initial stability by measuring the Periotest value (PTV) and insertion torque (IT). Patients were divided into two groups based on the miniscrew insertion method: manual group (MG) and surgical guide group (SG). Root proximity was assessed using periapical radiography, and miniscrews that remained in place for over 6 months were considered successful. Results: There was a statistically significant difference in the Kaplan–Meier survival curves between the groups (P < 0.05). The success rates of the miniscrews were 79.1% and 90.5% for the MG and SG, respectively (P < 0.05). The root contact rate also differed significantly between the groups (MG, 17.5%; SG, 0.1%; P < 0.001). However, the PTV and IT did not show significant differences between the groups. Conclusions Proximity to the root and utilization of surgical guides have the most direct impact on the success rate of miniscrews. Root proximity can be effectively reduced using surgical guides. Therefore, the use of a miniscrew surgical guide is recommended to increase the success rate of miniscrews as stable anchorage devices, particularly in cases with narrow interradicular space.

Objective: To assess the success rate and proximity of miniscrews to the root using surgical guides produced by integrating data obtained from conebeam computed tomography and intraoral scanned models. Methods: This retrospective study involved 113 patients (224 miniscrews) who underwent miniscrew placement as part of their orthodontic treatment. Two operators placed miniscrews between the buccal alveolar bone of each patient and assessed initial stability by measuring the Periotest value (PTV) and insertion torque (IT). Patients were divided into two groups based on the miniscrew insertion method: manual group (MG) and surgical guide group (SG). Root proximity was assessed using periapical radiography, and miniscrews that remained in place for over 6 months were considered successful. Results: There was a statistically significant difference in the Kaplan–Meier survival curves between the groups (P < 0.05). The success rates of the miniscrews were 79.1% and 90.5% for the MG and SG, respectively (P < 0.05). The root contact rate also differed significantly between the groups (MG, 17.5%; SG, 0.1%; P < 0.001). However, the PTV and IT did not show significant differences between the groups. Conclusions Proximity to the root and utilization of surgical guides have the most direct impact on the success rate of miniscrews. Root proximity can be effectively reduced using surgical guides. Therefore, the use of a miniscrew surgical guide is recommended to increase the success rate of miniscrews as stable anchorage devices, particularly in cases with narrow interradicular space.

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: and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes. Methods: We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data. Results: Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4. Conclusion Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.