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.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.