1.Unique TTR Variants D38A and M13dup Among Korean Patients with Hereditary Transthyretin Amyloidosis:A Retrospective Single-Center Cohort Study
Min-Seung PARK ; Jae Joon LEE ; Darae KIM ; Jin-Oh CHOI ; Seok Jin KIM ; Kihyun KIM ; Ju-Hong MIN ; Hyun-Young KIM ; Hee-Jin KIM
Annals of Laboratory Medicine 2026;46(3):309-318
Background:
Transthyretin amyloidosis, a protein-misfolding disorder characterized by systemic amyloid deposition, can be classified as wild-type transthyretin amyloidosis (ATTRwt) or hereditary transthyretin amyloidosis (ATTRv), depending on the presence of transthyretin (TTR) gene variants. We examined the genetic distribution of TTR variants in Korean patients diagnosed with ATTRv.
Methods:
We retrospectively reviewed 801 participants who underwent TTR analysis at Samsung Medical Center from 2012 to 2024. The participants were categorized into two groups: in-house probands or relatives, and externally referred probands or relatives.
Results:
Pathogenic or likely pathogenic TTR variants were detected in 36 of 165 in-house probands (21.8%), among which D38A was the most frequent variant (50.0%; 18/36), followed by M13dup and E89K (8.3% each). Among referred probands, D38A was predominant (54.5%; 12/22), followed by M13dup (22.7%; 5/22). Cardiac amyloid involvement was the most common manifestation, observed in 97.2% (35/36) of in-house probands with ATTRv, followed by peripheral nervous system (PNS; 94.4%) and autonomic nervous system (ANS; 88.9%) involvement. In contrast, ANS involvement was most prevalent among in-house relatives who underwent organ evaluation (61.5%; 24/39), followed by cardiac (52.1%; 25/48) and PNS (48.7%; 19/39) involvement. Five of the eight in-house relatives harboring M13dup (62.5%) showed organ involvement, primarily in the ANS, supporting the pathogenicity of this variant.
Conclusions
This study provides the largest single-institution dataset of Korean patients with ATTRv, incorporating systematic organ assessments. The predominance of the unique TTR variants D38A and M13dup delineates a distinct genetic landscape that may facilitate accurate and timely diagnosis of ATTRv in the Korean population.
2.Cost-Effectiveness Analysis of Daratumumab Monotherapy and Subsequent Therapies in Heavily Treated Relapsed/Refractory Multiple Myeloma: A Feasible Methodology using a Korean Nationwide Population Cohort
Sung-Soo PARK ; Suein CHOI ; Seungpil JUNG ; Seunghoon HAN ; Chaehyeon LEE ; Jinseon HAN ; Soyoung KIM ; Kihyun KIM ; Chang-Ki MIN
Cancer Research and Treatment 2026;58(1):300-310
Purpose:
High-cost novel therapies for multiple myeloma (MM) require evaluation of efficacy and cost-effectiveness.
Materials and Methods:
This study developed a methodology to assess cost-effectiveness using nationwide data from 11,450 newly diagnosed MM patients. A novel algorithm was applied to identify lines of therapy (LoT).
Results:
The number of newly diagnosed MM patients increased significantly, from 873 in 2010 to 1,464 in 2019 (p < 0.001). Advancing LoT was associated with shorter time to next treatment (TTNT) and overall survival (OS) (p < 0.001), while all-cause medical costs increased with each LoT (p < 0.001). Bortezomib-melphalan-prednisolone was the most common frontline regimen for transplant-ineligible patients (29.2%), while bortezomib-thalidomide-dexamethasone was most used for transplant-eligible patients (11.3%). Daratumumab monotherapy demonstrated superior second TTNT (7.8 vs. 5.2 months) and OS (8.5 vs. 5.3 months) compared to standard care in heavily treated MM patients, with statistical significance maintained after cost adjustment. For subsequent therapies following daratumumab, a methodology was developed to estimate required medical costs using the incremental cost-effectiveness ratio (ICER): Expected cost ($)=ICER×(Expected life expectancy–0.567)+35,601.
Conclusion
This study provides a novel cost-effectiveness framework linking treatment efficacy and real-world costs, supporting predictions of societal costs for future MM therapies.
3.Sexual Victimization and Psychological and Behavioral Outcomes Among Children and Adolescents in South Korea
Hyun Ji LEE ; Jungtae CHOI ; Jae-Won KIM ; Kihyun KIM
Psychiatry Investigation 2025;22(5):564-573
Objective:
By focusing on a person-centered approach using latent class analyses (LCA), this study examined the patterns of sexual victimization among children and adolescents in South Korea and compared the psycho-behavioral outcomes of these classes.
Methods:
Participants were 546 females aged 6–17, including 117 sexual victimization survivors and 429 non-victims in South Korea. LCA, an analysis of covariance, and Bonferroni post-hoc tests were conducted. Psychological and behavioral outcomes were measured using the Korean version of the Child Behavior Checklist 6–18 and the Youth Self Report. Variables include internalizing (anxious/depressed, withdrawn/depressed, somatic complaints), externalizing (rule-breaking, aggressive behavior), social, thought, and attention problems.
Results:
Based on the fit statistics, proportion of each class, and interpretability, a three-class solution was selected as the best fitting model. Profile 1 mainly involved survivors of rape, which first occurred in adolescence through social relations involving alcohol, drugs, or filming. Profile 2 mainly comprised survivors of both rape and physical sexual harassment by close relations, such as family members or relatives, more than once. Profile 3 mainly comprised survivors of sexual harassment by strangers or social relations. Statistically significant differences were suggested in the psych-behavioral outcomes of the profiles compared with the non-victim group.
Conclusion
These findings highlight the importance of examining experiences of sexual violence in a multifaceted manner. This approach may provide more effective interventions for survivors and allow clinicians to gain an in-depth understanding of sexual victimization in children and adolescents while also increasing the understanding of potential psycho-behavioral consequences.
4.Sexual Victimization and Psychological and Behavioral Outcomes Among Children and Adolescents in South Korea
Hyun Ji LEE ; Jungtae CHOI ; Jae-Won KIM ; Kihyun KIM
Psychiatry Investigation 2025;22(5):564-573
Objective:
By focusing on a person-centered approach using latent class analyses (LCA), this study examined the patterns of sexual victimization among children and adolescents in South Korea and compared the psycho-behavioral outcomes of these classes.
Methods:
Participants were 546 females aged 6–17, including 117 sexual victimization survivors and 429 non-victims in South Korea. LCA, an analysis of covariance, and Bonferroni post-hoc tests were conducted. Psychological and behavioral outcomes were measured using the Korean version of the Child Behavior Checklist 6–18 and the Youth Self Report. Variables include internalizing (anxious/depressed, withdrawn/depressed, somatic complaints), externalizing (rule-breaking, aggressive behavior), social, thought, and attention problems.
Results:
Based on the fit statistics, proportion of each class, and interpretability, a three-class solution was selected as the best fitting model. Profile 1 mainly involved survivors of rape, which first occurred in adolescence through social relations involving alcohol, drugs, or filming. Profile 2 mainly comprised survivors of both rape and physical sexual harassment by close relations, such as family members or relatives, more than once. Profile 3 mainly comprised survivors of sexual harassment by strangers or social relations. Statistically significant differences were suggested in the psych-behavioral outcomes of the profiles compared with the non-victim group.
Conclusion
These findings highlight the importance of examining experiences of sexual violence in a multifaceted manner. This approach may provide more effective interventions for survivors and allow clinicians to gain an in-depth understanding of sexual victimization in children and adolescents while also increasing the understanding of potential psycho-behavioral consequences.
5.Sexual Victimization and Psychological and Behavioral Outcomes Among Children and Adolescents in South Korea
Hyun Ji LEE ; Jungtae CHOI ; Jae-Won KIM ; Kihyun KIM
Psychiatry Investigation 2025;22(5):564-573
Objective:
By focusing on a person-centered approach using latent class analyses (LCA), this study examined the patterns of sexual victimization among children and adolescents in South Korea and compared the psycho-behavioral outcomes of these classes.
Methods:
Participants were 546 females aged 6–17, including 117 sexual victimization survivors and 429 non-victims in South Korea. LCA, an analysis of covariance, and Bonferroni post-hoc tests were conducted. Psychological and behavioral outcomes were measured using the Korean version of the Child Behavior Checklist 6–18 and the Youth Self Report. Variables include internalizing (anxious/depressed, withdrawn/depressed, somatic complaints), externalizing (rule-breaking, aggressive behavior), social, thought, and attention problems.
Results:
Based on the fit statistics, proportion of each class, and interpretability, a three-class solution was selected as the best fitting model. Profile 1 mainly involved survivors of rape, which first occurred in adolescence through social relations involving alcohol, drugs, or filming. Profile 2 mainly comprised survivors of both rape and physical sexual harassment by close relations, such as family members or relatives, more than once. Profile 3 mainly comprised survivors of sexual harassment by strangers or social relations. Statistically significant differences were suggested in the psych-behavioral outcomes of the profiles compared with the non-victim group.
Conclusion
These findings highlight the importance of examining experiences of sexual violence in a multifaceted manner. This approach may provide more effective interventions for survivors and allow clinicians to gain an in-depth understanding of sexual victimization in children and adolescents while also increasing the understanding of potential psycho-behavioral consequences.
6.Sexual Victimization and Psychological and Behavioral Outcomes Among Children and Adolescents in South Korea
Hyun Ji LEE ; Jungtae CHOI ; Jae-Won KIM ; Kihyun KIM
Psychiatry Investigation 2025;22(5):564-573
Objective:
By focusing on a person-centered approach using latent class analyses (LCA), this study examined the patterns of sexual victimization among children and adolescents in South Korea and compared the psycho-behavioral outcomes of these classes.
Methods:
Participants were 546 females aged 6–17, including 117 sexual victimization survivors and 429 non-victims in South Korea. LCA, an analysis of covariance, and Bonferroni post-hoc tests were conducted. Psychological and behavioral outcomes were measured using the Korean version of the Child Behavior Checklist 6–18 and the Youth Self Report. Variables include internalizing (anxious/depressed, withdrawn/depressed, somatic complaints), externalizing (rule-breaking, aggressive behavior), social, thought, and attention problems.
Results:
Based on the fit statistics, proportion of each class, and interpretability, a three-class solution was selected as the best fitting model. Profile 1 mainly involved survivors of rape, which first occurred in adolescence through social relations involving alcohol, drugs, or filming. Profile 2 mainly comprised survivors of both rape and physical sexual harassment by close relations, such as family members or relatives, more than once. Profile 3 mainly comprised survivors of sexual harassment by strangers or social relations. Statistically significant differences were suggested in the psych-behavioral outcomes of the profiles compared with the non-victim group.
Conclusion
These findings highlight the importance of examining experiences of sexual violence in a multifaceted manner. This approach may provide more effective interventions for survivors and allow clinicians to gain an in-depth understanding of sexual victimization in children and adolescents while also increasing the understanding of potential psycho-behavioral consequences.
7.Real‑world treatment patterns, outcomes, and economic costs by lines of therapy in patients with newly diagnosed multiple myeloma: a nationwide population‑based cohort study in South Korea
Sung‑Soo PARK ; YoungJu PARK ; Soomin YOON ; Doik LEE ; Jihyeon JEONG ; Kihyun KIM
Blood Research 2025;60():26-
Purpose:
Given the notable increase in the incidence of multiple myeloma (MM) in Asia and advent of innovative treatments, this study aims to provide a comprehensive understanding of the treatment patterns, outcomes, and eco‑ nomic burden of MM across the lines of therapy (LOTs) in South Korea.
Methods:
This retrospective cohort study was conducted using data from the National Health Insurance claims data provided by the Health Insurance Review and Assessment Database. An identification algorithm was developed to detect the regimens and LOTs. Treatment patterns and outcomes were assessed as real-world treatment sequence, treatment duration (rwTD), time to next-line treatment (rwTTNT), and overall survival (rwOS). Economic burden was assessed as healthcare resource utilization (HCRU) and the cost incurred per person per month.
Results:
This study included 11,450 patients who were newly diagnosed with MM between January 2010 and December 2019. The observed real-world LOT patterns reflect the changes in South Korea’s reimburse‑ ment scheme. Mean treatment-free intervals decreased from 11.59 months (SD 16.23) to 2.77 months (SD 6.14) from the first LOT (LOT 1) to LOT 5. Median rwTTNT decreased from 26.61 months (95% CI: 25.69-27.57) to 12.40 months (95% CI: 11.55-13.49), and median rwOS decreased from 61.88 months (95% CI: 59.11-65.46) to 13.65 months (95% CI: 11.88-16.22). The HCRU and associated costs increased substantially with the LOT advancement.
Conclusion
This large-scale observational study offers comprehensive insights into the real-world treatment of MM in South Korea. The study findings highlight the progressive nature of MM and increasing economic burden of advanced lines of treatment, underscoring the necessity for optimized treatment strategies.
8.Sexual Victimization and Psychological and Behavioral Outcomes Among Children and Adolescents in South Korea
Hyun Ji LEE ; Jungtae CHOI ; Jae-Won KIM ; Kihyun KIM
Psychiatry Investigation 2025;22(5):564-573
Objective:
By focusing on a person-centered approach using latent class analyses (LCA), this study examined the patterns of sexual victimization among children and adolescents in South Korea and compared the psycho-behavioral outcomes of these classes.
Methods:
Participants were 546 females aged 6–17, including 117 sexual victimization survivors and 429 non-victims in South Korea. LCA, an analysis of covariance, and Bonferroni post-hoc tests were conducted. Psychological and behavioral outcomes were measured using the Korean version of the Child Behavior Checklist 6–18 and the Youth Self Report. Variables include internalizing (anxious/depressed, withdrawn/depressed, somatic complaints), externalizing (rule-breaking, aggressive behavior), social, thought, and attention problems.
Results:
Based on the fit statistics, proportion of each class, and interpretability, a three-class solution was selected as the best fitting model. Profile 1 mainly involved survivors of rape, which first occurred in adolescence through social relations involving alcohol, drugs, or filming. Profile 2 mainly comprised survivors of both rape and physical sexual harassment by close relations, such as family members or relatives, more than once. Profile 3 mainly comprised survivors of sexual harassment by strangers or social relations. Statistically significant differences were suggested in the psych-behavioral outcomes of the profiles compared with the non-victim group.
Conclusion
These findings highlight the importance of examining experiences of sexual violence in a multifaceted manner. This approach may provide more effective interventions for survivors and allow clinicians to gain an in-depth understanding of sexual victimization in children and adolescents while also increasing the understanding of potential psycho-behavioral consequences.
9.Real‑world treatment patterns, outcomes, and economic costs by lines of therapy in patients with newly diagnosed multiple myeloma: a nationwide population‑based cohort study in South Korea
Sung‑Soo PARK ; YoungJu PARK ; Soomin YOON ; Doik LEE ; Jihyeon JEONG ; Kihyun KIM
Blood Research 2025;60():26-
Purpose:
Given the notable increase in the incidence of multiple myeloma (MM) in Asia and advent of innovative treatments, this study aims to provide a comprehensive understanding of the treatment patterns, outcomes, and eco‑ nomic burden of MM across the lines of therapy (LOTs) in South Korea.
Methods:
This retrospective cohort study was conducted using data from the National Health Insurance claims data provided by the Health Insurance Review and Assessment Database. An identification algorithm was developed to detect the regimens and LOTs. Treatment patterns and outcomes were assessed as real-world treatment sequence, treatment duration (rwTD), time to next-line treatment (rwTTNT), and overall survival (rwOS). Economic burden was assessed as healthcare resource utilization (HCRU) and the cost incurred per person per month.
Results:
This study included 11,450 patients who were newly diagnosed with MM between January 2010 and December 2019. The observed real-world LOT patterns reflect the changes in South Korea’s reimburse‑ ment scheme. Mean treatment-free intervals decreased from 11.59 months (SD 16.23) to 2.77 months (SD 6.14) from the first LOT (LOT 1) to LOT 5. Median rwTTNT decreased from 26.61 months (95% CI: 25.69-27.57) to 12.40 months (95% CI: 11.55-13.49), and median rwOS decreased from 61.88 months (95% CI: 59.11-65.46) to 13.65 months (95% CI: 11.88-16.22). The HCRU and associated costs increased substantially with the LOT advancement.
Conclusion
This large-scale observational study offers comprehensive insights into the real-world treatment of MM in South Korea. The study findings highlight the progressive nature of MM and increasing economic burden of advanced lines of treatment, underscoring the necessity for optimized treatment strategies.
10.Real‑world treatment patterns, outcomes, and economic costs by lines of therapy in patients with newly diagnosed multiple myeloma: a nationwide population‑based cohort study in South Korea
Sung‑Soo PARK ; YoungJu PARK ; Soomin YOON ; Doik LEE ; Jihyeon JEONG ; Kihyun KIM
Blood Research 2025;60():26-
Purpose:
Given the notable increase in the incidence of multiple myeloma (MM) in Asia and advent of innovative treatments, this study aims to provide a comprehensive understanding of the treatment patterns, outcomes, and eco‑ nomic burden of MM across the lines of therapy (LOTs) in South Korea.
Methods:
This retrospective cohort study was conducted using data from the National Health Insurance claims data provided by the Health Insurance Review and Assessment Database. An identification algorithm was developed to detect the regimens and LOTs. Treatment patterns and outcomes were assessed as real-world treatment sequence, treatment duration (rwTD), time to next-line treatment (rwTTNT), and overall survival (rwOS). Economic burden was assessed as healthcare resource utilization (HCRU) and the cost incurred per person per month.
Results:
This study included 11,450 patients who were newly diagnosed with MM between January 2010 and December 2019. The observed real-world LOT patterns reflect the changes in South Korea’s reimburse‑ ment scheme. Mean treatment-free intervals decreased from 11.59 months (SD 16.23) to 2.77 months (SD 6.14) from the first LOT (LOT 1) to LOT 5. Median rwTTNT decreased from 26.61 months (95% CI: 25.69-27.57) to 12.40 months (95% CI: 11.55-13.49), and median rwOS decreased from 61.88 months (95% CI: 59.11-65.46) to 13.65 months (95% CI: 11.88-16.22). The HCRU and associated costs increased substantially with the LOT advancement.
Conclusion
This large-scale observational study offers comprehensive insights into the real-world treatment of MM in South Korea. The study findings highlight the progressive nature of MM and increasing economic burden of advanced lines of treatment, underscoring the necessity for optimized treatment strategies.

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