Background: s/Aims: Radiofrequency ablation (RFA) is widely employed for managing recurrent hepatocellular carcinoma (HCC) following transarterial chemoembolization (TACE). However, local tumor progression (LTP) after treatment remains a significant challenge. This study evaluates the efficacy of saline-perfused bipolar RFA using twin internally cooled-perfusion (TICP) electrodes in managing recurrent HCC post-TACE. Methods: Between September 2017 and January 2019, 100 patients with 105 nodules (mean diameter, 1.6±0.5 cm) were prospectively enrolled. Bipolar RFA with TICP electrodes was performed under ultrasound-computed tomography/magnetic resonance fusion guidance. The primary outcome was the 2-year cumulative incidence of LTP. Results: The technical success and technique efficacy rates were 100% and 97%, respectively. During a median follow-up period of 34.0 months (range, 3-41), the estimated LTP rates were 13.3% at 1 year and 17.7% at 2 years. Progression-free survival rates were 37.8% and 27.7% at 1 year and 2 years, respectively. Conclusions Saline-perfused bipolar RFA using TICP electrodes demonstrates promising results for recurrent HCC after TACE, achieving high technical success and effective local tumor control rates.

Background: s/Aims: Radiofrequency ablation (RFA) is widely employed for managing recurrent hepatocellular carcinoma (HCC) following transarterial chemoembolization (TACE). However, local tumor progression (LTP) after treatment remains a significant challenge. This study evaluates the efficacy of saline-perfused bipolar RFA using twin internally cooled-perfusion (TICP) electrodes in managing recurrent HCC post-TACE. Methods: Between September 2017 and January 2019, 100 patients with 105 nodules (mean diameter, 1.6±0.5 cm) were prospectively enrolled. Bipolar RFA with TICP electrodes was performed under ultrasound-computed tomography/magnetic resonance fusion guidance. The primary outcome was the 2-year cumulative incidence of LTP. Results: The technical success and technique efficacy rates were 100% and 97%, respectively. During a median follow-up period of 34.0 months (range, 3-41), the estimated LTP rates were 13.3% at 1 year and 17.7% at 2 years. Progression-free survival rates were 37.8% and 27.7% at 1 year and 2 years, respectively. Conclusions Saline-perfused bipolar RFA using TICP electrodes demonstrates promising results for recurrent HCC after TACE, achieving high technical success and effective local tumor control rates.

Background: s/Aims: Radiofrequency ablation (RFA) is widely employed for managing recurrent hepatocellular carcinoma (HCC) following transarterial chemoembolization (TACE). However, local tumor progression (LTP) after treatment remains a significant challenge. This study evaluates the efficacy of saline-perfused bipolar RFA using twin internally cooled-perfusion (TICP) electrodes in managing recurrent HCC post-TACE. Methods: Between September 2017 and January 2019, 100 patients with 105 nodules (mean diameter, 1.6±0.5 cm) were prospectively enrolled. Bipolar RFA with TICP electrodes was performed under ultrasound-computed tomography/magnetic resonance fusion guidance. The primary outcome was the 2-year cumulative incidence of LTP. Results: The technical success and technique efficacy rates were 100% and 97%, respectively. During a median follow-up period of 34.0 months (range, 3-41), the estimated LTP rates were 13.3% at 1 year and 17.7% at 2 years. Progression-free survival rates were 37.8% and 27.7% at 1 year and 2 years, respectively. Conclusions Saline-perfused bipolar RFA using TICP electrodes demonstrates promising results for recurrent HCC after TACE, achieving high technical success and effective local tumor control rates.

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland, often leads to significant postoperative bleeding. This study assesses the efficacy of using drains to prevent complications such as hematomas, seromas, and bleeding, and their impact on infection rates and hospitalization duration post-thyroidectomy. Following the PRISMA guidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Library, including randomized controlled trials and published prospective studies on patients undergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative complications and the length of hospital stay as primary outcomes. Thirty-five studies with 4283 participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed no significant reduction in hematomas, bleeding, or seroma formation in the drain group. However, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence interval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI 1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impact the prevention of typical surgical complications but is linked to increased infection risks and extended hospitalization. These findings challenge the conventional practice of utilizing drains in thyroidectomy, highlighting the necessity for a tailored approach based on individual patient assessments.

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland, often leads to significant postoperative bleeding. This study assesses the efficacy of using drains to prevent complications such as hematomas, seromas, and bleeding, and their impact on infection rates and hospitalization duration post-thyroidectomy. Following the PRISMA guidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Library, including randomized controlled trials and published prospective studies on patients undergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative complications and the length of hospital stay as primary outcomes. Thirty-five studies with 4283 participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed no significant reduction in hematomas, bleeding, or seroma formation in the drain group. However, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence interval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI 1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impact the prevention of typical surgical complications but is linked to increased infection risks and extended hospitalization. These findings challenge the conventional practice of utilizing drains in thyroidectomy, highlighting the necessity for a tailored approach based on individual patient assessments.

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland, often leads to significant postoperative bleeding. This study assesses the efficacy of using drains to prevent complications such as hematomas, seromas, and bleeding, and their impact on infection rates and hospitalization duration post-thyroidectomy. Following the PRISMA guidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Library, including randomized controlled trials and published prospective studies on patients undergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative complications and the length of hospital stay as primary outcomes. Thirty-five studies with 4283 participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed no significant reduction in hematomas, bleeding, or seroma formation in the drain group. However, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence interval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI 1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impact the prevention of typical surgical complications but is linked to increased infection risks and extended hospitalization. These findings challenge the conventional practice of utilizing drains in thyroidectomy, highlighting the necessity for a tailored approach based on individual patient assessments.

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland, often leads to significant postoperative bleeding. This study assesses the efficacy of using drains to prevent complications such as hematomas, seromas, and bleeding, and their impact on infection rates and hospitalization duration post-thyroidectomy. Following the PRISMA guidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Library, including randomized controlled trials and published prospective studies on patients undergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative complications and the length of hospital stay as primary outcomes. Thirty-five studies with 4283 participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed no significant reduction in hematomas, bleeding, or seroma formation in the drain group. However, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence interval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI 1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impact the prevention of typical surgical complications but is linked to increased infection risks and extended hospitalization. These findings challenge the conventional practice of utilizing drains in thyroidectomy, highlighting the necessity for a tailored approach based on individual patient assessments.

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland, often leads to significant postoperative bleeding. This study assesses the efficacy of using drains to prevent complications such as hematomas, seromas, and bleeding, and their impact on infection rates and hospitalization duration post-thyroidectomy. Following the PRISMA guidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Library, including randomized controlled trials and published prospective studies on patients undergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative complications and the length of hospital stay as primary outcomes. Thirty-five studies with 4283 participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed no significant reduction in hematomas, bleeding, or seroma formation in the drain group. However, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence interval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI 1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impact the prevention of typical surgical complications but is linked to increased infection risks and extended hospitalization. These findings challenge the conventional practice of utilizing drains in thyroidectomy, highlighting the necessity for a tailored approach based on individual patient assessments.

Purpose: The purpose of this study was to analyze the influence of self-directed learning ability and self-leadership on the learning satisfaction and academic achievement of nursing students who experienced blended learning. Methods: This research was conducted from June 29 to July 17, 2023, targeting nursing students from three universities in Seoul, Gyeonggi, and Incheon who had experienced blended learning. The collected data were analyzed using a independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression utilizing IBM SPSS 25.0. Results: Self-directed learning ability, self-leadership, learning satisfaction, and academic achievement were all found to have positive correlations. The research variables that showed a significant effect on learning satisfaction were self-directed learning ability (β=.34, p<.001) and self-leadership (β=.19, p=.041), and the explanatory power was 28.0%. The research variable that showed a significant effect on academic achievement was self-directed learning ability (β=.56, p<.001), with an explanatory power of 40.0%. Conclusion To effectively apply blended learning to nursing students in the rapidly changing field of nursing education, it is important to analyze learner factors such as self-directed learning ability and self-leadership. Continuing research is needed to explore the learner factors that influence learning satisfaction and academic achievement, and systematic educational programs that can improve these factors will have to be applied.

Background: s/Aims: This study explored the initial institutional experience of using gold fiducial markers for stereotactic body radiotherapy (SBRT) in treating malignant hepatic tumors using real-time ultrasound-computed tomography (CT)/magnetic resonance (MR) imaging fusion-guided percutaneous placement. Methods: From May 2021 to August 2023, 19 patients with 25 liver tumors that were invisible on pre-contrast CT received fiducial markers following these guidelines. Postprocedural scans were used to confirm their placement. We assessed technical and clinical success rates and monitored complications. The implantation of fiducial markers facilitating adequate treatment prior to SBRT, which was achieved in 96% of the cases (24 of 25 tumors), was considered technical success. Clinical success was the successful completion of SBRT without evidence of marker displacement and was achieved in 88% of cases (22 of 25 tumors). Complications included one major subcapsular hematoma and marker migration into the right atrium in two cases, which prevented SBRT. Results: Among the treated tumors, 20 of 24 (83.3%) showed a complete response, three of 24 (12.5%) remained stable, and one of 24 (4.2%) progressed during an average 11.7-month follow-up (range, 2-32 months). Conclusions This study confirms that percutaneous gold fiducial marker placement using real-time CT/MR guidance is effective and safe for SBRT in hepatic tumors, but warns of marker migration risks, especially near the hepatic veins and in subcapsular locations. Using fewer markers than traditionally recommended-typically two per patient, the outcomes were still satisfactory, particularly given the increased risk of migration when markers were placed near major hepatic veins.