Purpose: While TP53 mutations are well known to be associated with adverse prognosis in hematological diseases, their functional impact remains incompletely understood. This study examines the spectrum of TP53 mutations across various hematologic malignancies and evaluates their functional impact. Materials and Methods: Using targeted sequencing panels, we analyzed TP53 mutations in the bone marrow aspiration samples of a retrospective cohort of 856 patients diagnosed with hematologic malignancies. To assess the impact of TP53 mutations, we applied the evolutionary action (EAp53) score and the relative fitness score (RFS), previously proposed functional scoring methods. The effects of variant allele frequency (VAF), disruptive mutations, EAp53 score, and RFS on overall survival (OS) were evaluated. Results: TP53 mutations were associated with inferior OS compared with wildtype TP53 (median OS 10.0 months versus not estimable; hazard ratio (HR) 4.6; p<0.001). In the acute myeloid leukemia, multiple myeloma, and myelodysplastic syndrome subgroups, TP53 mutations had a significant adverse impact on OS. (HRs 3.8, 4.2, 6.0, respectively; p<0.001, p=0.005, p<0.001, respectively). Patients with VAF >50% had significantly poorer OS compared to those with VAF ≤50% (median OS 7.5 months versus 22.8 months; HR 2.2, p=0.016). Moreover, patients in the high-risk RFS group (RFS >0.22) had significantly worse OS compared to those in the low-risk RFS group (RFS ≤0.22) (median OS 5.6 months versus 16.3 months; HR 2.2, p=0.041). However, no significant survival difference was observed between the EAp53 high-risk (>75) and low-risk (≤75) groups, or between patients with disruptive and non-disruptive mutations. Conclusion Our findings highlight VAF and RFS as valuable tools for stratifying TP53-mutant patients into high-risk and low-risk groups.

Purpose: This study evaluates the Korean Cancer Study Group Geriatric Score-7 (KG-7) frailty screening tool’s effectiveness in elderly multiple myeloma (MM) patients to prevent under and overtreatment. Materials and Methods: This prospective pilot cohort study included 100 elderly patients aged 70 and older with newly diagnosed MM who had not undergone transplantation from August 2020 to January 2022. Results: The median age was 77 years, and 73.0% of patients were classified at International Staging System stages 2 or 3. Using a 5-point cutoff on the KG-7 index (non-frail, score ≥ 5; frail, score < 5), 31% were categorized as frail. After a median follow-up of 26.8 months, the 3-year overall survival rate was 73.0%. There was no statistically significant association between any frailty index and the risk of death. However, frail patients defined by the simplified frailty index (hazard ratio [HR], 2.49; 95% confidence interval [CI], 1.09 to 5.95; p=0.030) and by KG-7 (HR, 2.43; 95% CI, 1.03 to 5.86; p=0.043) had a significantly higher risk of grade 3-4 non-hematologic toxicity, whereas the International Myeloma Working Group definition did not. Over a 24-month tracking period, vulnerability as measured by KG-7 either improved or deteriorated. Conclusion The pilot study, which had a limited number of participants, did not demonstrate KG-7’s effectiveness in predicting survival; however, it successfully predicted severe non-hematologic toxicities. We plan to conduct larger studies in elderly MM patients to determine whether KG-7 can help tailor their treatment regimens.

Objective: This study compared the incidence of suicide cases among Korean students before and after the coronavirus disease-2019 (COVID-19) pandemic. Methods: Aggregated case reports of all known suicide victims attending elementary, middle, and high school in South Korea from 2017 to 2022 were analyzed. These reports, compiled by teachers under the directive of the South Korean Department of Education, surveyed the circumstances surrounding each suicide and identified associated risk factors posthumously. Results: The completed suicide rate was 2.37 per 100,000 students pre-COVID-19 (2017–2019), significantly increasing to 3.37 per 100,000 students post-COVID-19 (2020–2022; odds ratio [OR] 1.42, p<0.001). The rate began to rise approximately 6 months into the pandemic and continued to worsen throughout 2021 and 2022. Fair attendance significantly increased in 2020 (74.83%, p=0.003) during the initial stage of school closure measures compared to 2019 (58.27%) among students prior to suicide completion. However, as social distancing measures continued, “absence due to medical reasons” showed a significant increase in 2022 (23.56%) compared to 2019 (13.67%, p=0.025) and 2020 (9.52%, p<0.001) among these students. Among those who completed suicide, teachers reported increased signs of depression and anxiety posthumously compared to pre-COVID-19 periods. Conclusion The incidence of completed suicide among students was significantly higher in the post-COVID-19 years compared to pre-COVID-19. Attendance records and teachers’ reports indicated a deterioration in mental health among these students before suicide completion, highlighting the need to consider mental health impacts when implementing future quarantine policies.

Background: This study analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic on acute appendicitis (AA) treatment in Korea, a country that did not implement lockdown measures. Methods: A retrospective analysis was conducted during two discretionary time periods: a pre COVID-19 period, and a COVID-19 period. This study included adult and pediatric patients diagnosed with AA who underwent surgical treatment. Clinical and laboratory parameters, changes in surgery timing, disease severity, and postoperative outcomes were compared between the pre and post pandemic periods. Results: The study included a total of 221 patients, with 139 receiving appendectomy in the COVID-19 cohort and 82 in the control cohort. In patients without fever, operative time was significantly longer during the COVID-19 period (p<0.01). Among patients presenting with fever, the rate of complicated AA was higher during the COVID-19 period than in the control period (p<0.01). During the COVID-19 period, the diagnostic and preoperative delay times, as well as postoperative hospital stays, were longer (p<0.05), and the incidence of postoperative complications and other hospital diagnoses was higher (p<0.01) during the COVID-19 period than in the control period. Multivariate analysis showed that age (p=0.03) and the presence of fever (p<0.01) were independent risk factors for complicated AA. Conclusions Older patients and those with fever were at greater risk of severe AA. During outbreaks of infectious diseases like COVID-19, careful consideration is needed regarding surgical interventions in older patients with fever. Understanding vulnerabilities is crucial for disease management in the future.

Objective: This study compared the incidence of suicide cases among Korean students before and after the coronavirus disease-2019 (COVID-19) pandemic. Methods: Aggregated case reports of all known suicide victims attending elementary, middle, and high school in South Korea from 2017 to 2022 were analyzed. These reports, compiled by teachers under the directive of the South Korean Department of Education, surveyed the circumstances surrounding each suicide and identified associated risk factors posthumously. Results: The completed suicide rate was 2.37 per 100,000 students pre-COVID-19 (2017–2019), significantly increasing to 3.37 per 100,000 students post-COVID-19 (2020–2022; odds ratio [OR] 1.42, p<0.001). The rate began to rise approximately 6 months into the pandemic and continued to worsen throughout 2021 and 2022. Fair attendance significantly increased in 2020 (74.83%, p=0.003) during the initial stage of school closure measures compared to 2019 (58.27%) among students prior to suicide completion. However, as social distancing measures continued, “absence due to medical reasons” showed a significant increase in 2022 (23.56%) compared to 2019 (13.67%, p=0.025) and 2020 (9.52%, p<0.001) among these students. Among those who completed suicide, teachers reported increased signs of depression and anxiety posthumously compared to pre-COVID-19 periods. Conclusion The incidence of completed suicide among students was significantly higher in the post-COVID-19 years compared to pre-COVID-19. Attendance records and teachers’ reports indicated a deterioration in mental health among these students before suicide completion, highlighting the need to consider mental health impacts when implementing future quarantine policies.

Background: This study analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic on acute appendicitis (AA) treatment in Korea, a country that did not implement lockdown measures. Methods: A retrospective analysis was conducted during two discretionary time periods: a pre COVID-19 period, and a COVID-19 period. This study included adult and pediatric patients diagnosed with AA who underwent surgical treatment. Clinical and laboratory parameters, changes in surgery timing, disease severity, and postoperative outcomes were compared between the pre and post pandemic periods. Results: The study included a total of 221 patients, with 139 receiving appendectomy in the COVID-19 cohort and 82 in the control cohort. In patients without fever, operative time was significantly longer during the COVID-19 period (p<0.01). Among patients presenting with fever, the rate of complicated AA was higher during the COVID-19 period than in the control period (p<0.01). During the COVID-19 period, the diagnostic and preoperative delay times, as well as postoperative hospital stays, were longer (p<0.05), and the incidence of postoperative complications and other hospital diagnoses was higher (p<0.01) during the COVID-19 period than in the control period. Multivariate analysis showed that age (p=0.03) and the presence of fever (p<0.01) were independent risk factors for complicated AA. Conclusions Older patients and those with fever were at greater risk of severe AA. During outbreaks of infectious diseases like COVID-19, careful consideration is needed regarding surgical interventions in older patients with fever. Understanding vulnerabilities is crucial for disease management in the future.

Background: This study analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic on acute appendicitis (AA) treatment in Korea, a country that did not implement lockdown measures. Methods: A retrospective analysis was conducted during two discretionary time periods: a pre COVID-19 period, and a COVID-19 period. This study included adult and pediatric patients diagnosed with AA who underwent surgical treatment. Clinical and laboratory parameters, changes in surgery timing, disease severity, and postoperative outcomes were compared between the pre and post pandemic periods. Results: The study included a total of 221 patients, with 139 receiving appendectomy in the COVID-19 cohort and 82 in the control cohort. In patients without fever, operative time was significantly longer during the COVID-19 period (p<0.01). Among patients presenting with fever, the rate of complicated AA was higher during the COVID-19 period than in the control period (p<0.01). During the COVID-19 period, the diagnostic and preoperative delay times, as well as postoperative hospital stays, were longer (p<0.05), and the incidence of postoperative complications and other hospital diagnoses was higher (p<0.01) during the COVID-19 period than in the control period. Multivariate analysis showed that age (p=0.03) and the presence of fever (p<0.01) were independent risk factors for complicated AA. Conclusions Older patients and those with fever were at greater risk of severe AA. During outbreaks of infectious diseases like COVID-19, careful consideration is needed regarding surgical interventions in older patients with fever. Understanding vulnerabilities is crucial for disease management in the future.

Objective: This study compared the incidence of suicide cases among Korean students before and after the coronavirus disease-2019 (COVID-19) pandemic. Methods: Aggregated case reports of all known suicide victims attending elementary, middle, and high school in South Korea from 2017 to 2022 were analyzed. These reports, compiled by teachers under the directive of the South Korean Department of Education, surveyed the circumstances surrounding each suicide and identified associated risk factors posthumously. Results: The completed suicide rate was 2.37 per 100,000 students pre-COVID-19 (2017–2019), significantly increasing to 3.37 per 100,000 students post-COVID-19 (2020–2022; odds ratio [OR] 1.42, p<0.001). The rate began to rise approximately 6 months into the pandemic and continued to worsen throughout 2021 and 2022. Fair attendance significantly increased in 2020 (74.83%, p=0.003) during the initial stage of school closure measures compared to 2019 (58.27%) among students prior to suicide completion. However, as social distancing measures continued, “absence due to medical reasons” showed a significant increase in 2022 (23.56%) compared to 2019 (13.67%, p=0.025) and 2020 (9.52%, p<0.001) among these students. Among those who completed suicide, teachers reported increased signs of depression and anxiety posthumously compared to pre-COVID-19 periods. Conclusion The incidence of completed suicide among students was significantly higher in the post-COVID-19 years compared to pre-COVID-19. Attendance records and teachers’ reports indicated a deterioration in mental health among these students before suicide completion, highlighting the need to consider mental health impacts when implementing future quarantine policies.

Background: This study analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic on acute appendicitis (AA) treatment in Korea, a country that did not implement lockdown measures. Methods: A retrospective analysis was conducted during two discretionary time periods: a pre COVID-19 period, and a COVID-19 period. This study included adult and pediatric patients diagnosed with AA who underwent surgical treatment. Clinical and laboratory parameters, changes in surgery timing, disease severity, and postoperative outcomes were compared between the pre and post pandemic periods. Results: The study included a total of 221 patients, with 139 receiving appendectomy in the COVID-19 cohort and 82 in the control cohort. In patients without fever, operative time was significantly longer during the COVID-19 period (p<0.01). Among patients presenting with fever, the rate of complicated AA was higher during the COVID-19 period than in the control period (p<0.01). During the COVID-19 period, the diagnostic and preoperative delay times, as well as postoperative hospital stays, were longer (p<0.05), and the incidence of postoperative complications and other hospital diagnoses was higher (p<0.01) during the COVID-19 period than in the control period. Multivariate analysis showed that age (p=0.03) and the presence of fever (p<0.01) were independent risk factors for complicated AA. Conclusions Older patients and those with fever were at greater risk of severe AA. During outbreaks of infectious diseases like COVID-19, careful consideration is needed regarding surgical interventions in older patients with fever. Understanding vulnerabilities is crucial for disease management in the future.

Background: This study analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic on acute appendicitis (AA) treatment in Korea, a country that did not implement lockdown measures. Methods: A retrospective analysis was conducted during two discretionary time periods: a pre COVID-19 period, and a COVID-19 period. This study included adult and pediatric patients diagnosed with AA who underwent surgical treatment. Clinical and laboratory parameters, changes in surgery timing, disease severity, and postoperative outcomes were compared between the pre and post pandemic periods. Results: The study included a total of 221 patients, with 139 receiving appendectomy in the COVID-19 cohort and 82 in the control cohort. In patients without fever, operative time was significantly longer during the COVID-19 period (p<0.01). Among patients presenting with fever, the rate of complicated AA was higher during the COVID-19 period than in the control period (p<0.01). During the COVID-19 period, the diagnostic and preoperative delay times, as well as postoperative hospital stays, were longer (p<0.05), and the incidence of postoperative complications and other hospital diagnoses was higher (p<0.01) during the COVID-19 period than in the control period. Multivariate analysis showed that age (p=0.03) and the presence of fever (p<0.01) were independent risk factors for complicated AA. Conclusions Older patients and those with fever were at greater risk of severe AA. During outbreaks of infectious diseases like COVID-19, careful consideration is needed regarding surgical interventions in older patients with fever. Understanding vulnerabilities is crucial for disease management in the future.