Purpose: The purpose of this study was to determine the characteristics of patients with failed initial Kasai portoenterostomy (KP) and to compare the long-term prognosis of redo-KP with that of liver transplantation (LT) in these patients. Methods: The medical records of patients with biliary atresia (BA) who failed initial KP from 2010 to 2021 at a single center were retrospectively analyzed. KP failure was defined as persistent jaundice (total bilirubin concentration, ≥2.0 mg/dL) after KP or the performance of LT. Results: During the study period, 32 patients experienced initial KP failure, with 10 undergoing redo-KP and 22 undergoing LT. Redo-KP was successful in a minority of patients with failed initial KP, but the complications, particularly cholangitis, were more frequent in the redo-KP group. The long-term prognosis of redo-KP compared to LT showed that while some patients benefited from native liver survival after redo-KP, LT remains the more definitive solution for sustained liver function and survival in patients with BA. Conclusion The only factor differing significantly between patients who underwent redo-KP and LT after failed initial KP was complications of cholangitis. Redo-KP was successful in 4 of 10 patients with failed initial KP, suggesting that redo-KP may be a treatment option in patients with BA and failed initial KP.

Purpose: The purpose of this study was to determine the characteristics of patients with failed initial Kasai portoenterostomy (KP) and to compare the long-term prognosis of redo-KP with that of liver transplantation (LT) in these patients. Methods: The medical records of patients with biliary atresia (BA) who failed initial KP from 2010 to 2021 at a single center were retrospectively analyzed. KP failure was defined as persistent jaundice (total bilirubin concentration, ≥2.0 mg/dL) after KP or the performance of LT. Results: During the study period, 32 patients experienced initial KP failure, with 10 undergoing redo-KP and 22 undergoing LT. Redo-KP was successful in a minority of patients with failed initial KP, but the complications, particularly cholangitis, were more frequent in the redo-KP group. The long-term prognosis of redo-KP compared to LT showed that while some patients benefited from native liver survival after redo-KP, LT remains the more definitive solution for sustained liver function and survival in patients with BA. Conclusion The only factor differing significantly between patients who underwent redo-KP and LT after failed initial KP was complications of cholangitis. Redo-KP was successful in 4 of 10 patients with failed initial KP, suggesting that redo-KP may be a treatment option in patients with BA and failed initial KP.

Purpose: The purpose of this study was to determine the characteristics of patients with failed initial Kasai portoenterostomy (KP) and to compare the long-term prognosis of redo-KP with that of liver transplantation (LT) in these patients. Methods: The medical records of patients with biliary atresia (BA) who failed initial KP from 2010 to 2021 at a single center were retrospectively analyzed. KP failure was defined as persistent jaundice (total bilirubin concentration, ≥2.0 mg/dL) after KP or the performance of LT. Results: During the study period, 32 patients experienced initial KP failure, with 10 undergoing redo-KP and 22 undergoing LT. Redo-KP was successful in a minority of patients with failed initial KP, but the complications, particularly cholangitis, were more frequent in the redo-KP group. The long-term prognosis of redo-KP compared to LT showed that while some patients benefited from native liver survival after redo-KP, LT remains the more definitive solution for sustained liver function and survival in patients with BA. Conclusion The only factor differing significantly between patients who underwent redo-KP and LT after failed initial KP was complications of cholangitis. Redo-KP was successful in 4 of 10 patients with failed initial KP, suggesting that redo-KP may be a treatment option in patients with BA and failed initial KP.

Background: Genetic alterations play a pivotal role in multiple myeloma (MM) development and therapeutic resistance. Traditionally, the genetic profiling of MM requires invasive bone marrow (BM) procedures; however, these procedures are associated with patient discomfort and cannot fully capture the spatial and temporal heterogeneity of the disease.Therefore, we investigated the clinical implications of liquid biopsy using targeted deep sequencing. Methods: We analyzed the genetic profiles of circulating tumor DNA (ctDNA) by targeted deep sequencing from 102 patients, including those with monoclonal gammopathy of undetermined significance (MGUS, N = 7), smoldering MM (N = 6), and symptomatic MM (N = 89). Results: The number of ctDNA mutations increased with disease progression from MGUS to MM, with averages of 1.0 mutations in MGUS, 1.8 mutations in smoldering MM, and 1.9 mutations in MM, respectively. Shared mutations between BM and ctDNA were more prevalent in MM (68.9%) than in MGUS (25.0%). RAS/RAF and TP53 mutations were significantly enriched in MM ctDNA. Specific mutations were associated with clinical features in patients with MM: hypercalcemia and TET2 (P = 0.006), renal insufficiency and NRAS (P = 0.012), paramedullary myeloma and TP53(P = 0.02), and extramedullary myeloma and NRAS (P = 0.007). TET2 mutations significantly affected 2-yr progression-free survival (hazard ratio = 7.11, P = 0.003). Serial ctDNA profiling accurately predicted treatment response in patients with MM. Conclusions Our findings highlight the potential of liquid biopsy for understanding MM progression and prognosis utilizing a minimally invasive approach, paving the way for its integration into personalized treatment strategies and real-time disease monitoring.

Objectives: ：This study aimed to investigate the monthly characteristics of suicide attempts among adolescents considering the impact of the COVID-19 pandemic. Methods: ：From 2018 to 2023, patients who arrived at Korea University Ansan Hospital’s emergency depart-ment following a suicide attempt were categorized by age, with adolescents defined as those aged 18 and below.These patients were then compared across three periods: pre COVID-19, COVID-19 period, and post COVID-19 periods. Results: ：From January 2018 to December 2023, a total of 3,008 patients who attempted suicide visited the emergency room. Among them, 333 (11.1%) were adolescents. In the overall sample, the proportion of suicide attempts in January increased during the COVID-19 period compared to the pre-COVID-19 period, while the proportion in September decreased. Among adolescents, the proportion of suicide attempts in August decreased after COVID-19 compared to before. Conclusions ：Our findings highlight a concerning increase in suicide attempts among teenagers, showing a cor-relation with the academic semester after COVID-19 pandemic. Understanding and addressing this trend are paramount for effective suicide risk management strategies moving forward.

Objectives: ：This study aimed to investigate the monthly characteristics of suicide attempts among adolescents considering the impact of the COVID-19 pandemic. Methods: ：From 2018 to 2023, patients who arrived at Korea University Ansan Hospital’s emergency depart-ment following a suicide attempt were categorized by age, with adolescents defined as those aged 18 and below.These patients were then compared across three periods: pre COVID-19, COVID-19 period, and post COVID-19 periods. Results: ：From January 2018 to December 2023, a total of 3,008 patients who attempted suicide visited the emergency room. Among them, 333 (11.1%) were adolescents. In the overall sample, the proportion of suicide attempts in January increased during the COVID-19 period compared to the pre-COVID-19 period, while the proportion in September decreased. Among adolescents, the proportion of suicide attempts in August decreased after COVID-19 compared to before. Conclusions ：Our findings highlight a concerning increase in suicide attempts among teenagers, showing a cor-relation with the academic semester after COVID-19 pandemic. Understanding and addressing this trend are paramount for effective suicide risk management strategies moving forward.

Objectives: ：This study aimed to investigate the monthly characteristics of suicide attempts among adolescents considering the impact of the COVID-19 pandemic. Methods: ：From 2018 to 2023, patients who arrived at Korea University Ansan Hospital’s emergency depart-ment following a suicide attempt were categorized by age, with adolescents defined as those aged 18 and below.These patients were then compared across three periods: pre COVID-19, COVID-19 period, and post COVID-19 periods. Results: ：From January 2018 to December 2023, a total of 3,008 patients who attempted suicide visited the emergency room. Among them, 333 (11.1%) were adolescents. In the overall sample, the proportion of suicide attempts in January increased during the COVID-19 period compared to the pre-COVID-19 period, while the proportion in September decreased. Among adolescents, the proportion of suicide attempts in August decreased after COVID-19 compared to before. Conclusions ：Our findings highlight a concerning increase in suicide attempts among teenagers, showing a cor-relation with the academic semester after COVID-19 pandemic. Understanding and addressing this trend are paramount for effective suicide risk management strategies moving forward.

Purpose: This study aimed to assess the survival rate (SR) and death risk for associated pulmonary arterial hypertension (aPAH; 10th revision of the International Statistical Classification of Diseases [ICD-10], I27.2) in Koreans. Methods: The data were collected from the Korean National Health Insurance Service from 2006 through 2017 (n= 15,448). We analyzed the SR using the Kaplan-Meier method and carried out Cox proportional hazards analyses. Results: Patients’ mean age upon aPAH diagnosis was 60.1±24.0 years, and 60.7% of the patients were female. The 10-year SR of aPAH was 46.3% (95% confidence interval, 45.0 to 47.6). The factors associated with an increase in the adjusted death risk included age of 0 to 9 years, advancing age, male sex, lower income level, and comorbidities including diabetes mellitus, myocardial infarction, heart failure, hemorrhagic stroke, chronic kidney disease, malignant neoplasm, hereditary hemorrhagic telangiectasia, and systemic lupus erythematosus. Conclusion The 10-year SR of aPAH was over 46%. The risk of death from aPAH was significantly higher with advancing age, sex, lower income level, and comorbidities.

Objectives: ：This study aimed to investigate the monthly characteristics of suicide attempts among adolescents considering the impact of the COVID-19 pandemic. Methods: ：From 2018 to 2023, patients who arrived at Korea University Ansan Hospital’s emergency depart-ment following a suicide attempt were categorized by age, with adolescents defined as those aged 18 and below.These patients were then compared across three periods: pre COVID-19, COVID-19 period, and post COVID-19 periods. Results: ：From January 2018 to December 2023, a total of 3,008 patients who attempted suicide visited the emergency room. Among them, 333 (11.1%) were adolescents. In the overall sample, the proportion of suicide attempts in January increased during the COVID-19 period compared to the pre-COVID-19 period, while the proportion in September decreased. Among adolescents, the proportion of suicide attempts in August decreased after COVID-19 compared to before. Conclusions ：Our findings highlight a concerning increase in suicide attempts among teenagers, showing a cor-relation with the academic semester after COVID-19 pandemic. Understanding and addressing this trend are paramount for effective suicide risk management strategies moving forward.

Objectives: ：This study aimed to investigate the monthly characteristics of suicide attempts among adolescents considering the impact of the COVID-19 pandemic. Methods: ：From 2018 to 2023, patients who arrived at Korea University Ansan Hospital’s emergency depart-ment following a suicide attempt were categorized by age, with adolescents defined as those aged 18 and below.These patients were then compared across three periods: pre COVID-19, COVID-19 period, and post COVID-19 periods. Results: ：From January 2018 to December 2023, a total of 3,008 patients who attempted suicide visited the emergency room. Among them, 333 (11.1%) were adolescents. In the overall sample, the proportion of suicide attempts in January increased during the COVID-19 period compared to the pre-COVID-19 period, while the proportion in September decreased. Among adolescents, the proportion of suicide attempts in August decreased after COVID-19 compared to before. Conclusions ：Our findings highlight a concerning increase in suicide attempts among teenagers, showing a cor-relation with the academic semester after COVID-19 pandemic. Understanding and addressing this trend are paramount for effective suicide risk management strategies moving forward.