Pediatric kidney disease has a relatively lower prevalence than do other pediatric conditions and has a notably different etiology from kidney diseases observed in adults. Furthermore, the pediatric population is unique in that they experience ongoing growth and development, distinguishing them from adult patients. Consequently, pediatric patients with kidney disease require more specialized and meticulous nutritional management than do adults. To address this need and promote optimal dietary practices for pediatric patients with kidney disease, pediatric nephrologists from the Korean Society of Pediatric Nephrology and nutritionists from the Korean Society of Clinical Nutrition have collaborated to establish nutritional guidelines specifically tailored to Korean dietary patterns. These guidelines offer detailed, nutrient-specific recommendations covering energy, protein, calcium, phosphorus, and potassium consumption while providing practical, culturally relevant guidance intended to support both pediatric patients and their caregivers.

Pediatric kidney disease has a relatively lower prevalence than do other pediatric conditions and has a notably different etiology from kidney diseases observed in adults. Furthermore, the pediatric population is unique in that they experience ongoing growth and development, distinguishing them from adult patients. Consequently, pediatric patients with kidney disease require more specialized and meticulous nutritional management than do adults. To address this need and promote optimal dietary practices for pediatric patients with kidney disease, pediatric nephrologists from the Korean Society of Pediatric Nephrology and nutritionists from the Korean Society of Clinical Nutrition have collaborated to establish nutritional guidelines specifically tailored to Korean dietary patterns. These guidelines offer detailed, nutrient-specific recommendations covering energy, protein, calcium, phosphorus, and potassium consumption while providing practical, culturally relevant guidance intended to support both pediatric patients and their caregivers.

Purpose: This study evaluated the nutrition and food intake status among adults in Jeju, Republic of Korea, based on their sociodemographic characteristics and obesity. Methods: Nine hundred and forty-nine adults aged 19 years or older were included based on the 2022 Jeju Nutrition and Physical Activity Survey data. A dietary assessment was conducted using a one-day, 24-hour recall method, and the nutrition status was evaluated using the 2020 Dietary Reference Intakes for Koreans. The sociodemographic status included sex, age, education, and household income, and obesity was defined as a body mass index (BMI) of ≥ 25 kg/m 2 . Results: The mean age of the subjects was 49.8 years, and the overall prevalence of obesity was 48.4% (59.5% for males and 37.2% for females). The top three insufficient nutrients consumed at less than the estimated average requirement were calcium (77.7%), vitamin A (77.3%), and vitamin C (61.3%), while 40.9% of the subjects consumed fat as more than 30% of their total energy intake. The sodium intake was approximately 1.5 times higher than the chronic disease risk reduction intake level. In terms of food groups, the participants consumed more meat (148.2 g/day), seafood (69.0 g/day), potatoes, and starches (41.6 g/day) but consumed fewer vegetables (214.3 g/day) and less dairy (62.0 g/day) than Korean adults. The nutritional status and food intake patterns differed by the sociodemographic status. In addition, the obese group consumed more poultry and beverages than the non-obese group (p < 0.05 for all). Conclusion Adults in Jeju under-consume essential nutrients while over-consuming certain nutrients, such as fat and sodium. The nutritional status also varied according to the sociodemographic characteristics. These findings suggest that sociodemographic factors should be considered carefully when developing nutritional policies and programs to improve the nutritional status and address obesity among adults in Jeju.

Background: This study investigated the relationship between intraoperative requirement for an inhalational anesthetic (sevoflurane) or an opioid (remifentanil) and postoperative analgesic consumption. Methods: The study included 200 adult patients undergoing elective laparoscopic colectomy. In the sevoflurane group, the effect-site concentration of remifentanil was fixed at 1.0 ng/ml, while the inspiratory sevoflurane concentration was adjusted to maintain an appropriate anesthetic depth. In the remifentanil group, the end-expiratory sevoflurane concentration was fixed at 1.0 volume%, and the remifentanil concentration was adjusted. Pain scores and cumulative postoperative analgesic consumptions were evaluated at 2, 6, 24, and 48 h after surgery. Results: Average end-tidal concentration of sevoflurane and effect-site concentration of remifentanil were 2.0 ± 0.4 volume% and 3.9 ± 1.4 ng/ml in the sevoflurane and remifentanil groups, respectively. Cumulative postoperative analgesic consumption at 48 h postoperatively was 55 ± 26 ml in the sevoflurane group and 57 ± 33 ml in the remifentanil group. In the remifentanil group, the postoperative cumulative analgesic consumptions at 2 and 6 h were positively correlated with intraoperative remifentanil requirements (2 h: r = 0.36, P < 0.01; 6 h: r = 0.38, P < 0.01). However, there was no significant correlation in the sevoflurane group (r = 0.04, P = 0.69). Conclusions The amount of intraoperative requirement of short acting opioid, remifentanil, is correlated with postoperative analgesic consumption within postoperative 6 h. It may be contributed by the development of acute opioid tolerance. However, intraoperative sevoflurane requirement had no effect on postoperative analgesic consumption.

Purpose: This study evaluated the nutrition and food intake status among adults in Jeju, Republic of Korea, based on their sociodemographic characteristics and obesity. Methods: Nine hundred and forty-nine adults aged 19 years or older were included based on the 2022 Jeju Nutrition and Physical Activity Survey data. A dietary assessment was conducted using a one-day, 24-hour recall method, and the nutrition status was evaluated using the 2020 Dietary Reference Intakes for Koreans. The sociodemographic status included sex, age, education, and household income, and obesity was defined as a body mass index (BMI) of ≥ 25 kg/m 2 . Results: The mean age of the subjects was 49.8 years, and the overall prevalence of obesity was 48.4% (59.5% for males and 37.2% for females). The top three insufficient nutrients consumed at less than the estimated average requirement were calcium (77.7%), vitamin A (77.3%), and vitamin C (61.3%), while 40.9% of the subjects consumed fat as more than 30% of their total energy intake. The sodium intake was approximately 1.5 times higher than the chronic disease risk reduction intake level. In terms of food groups, the participants consumed more meat (148.2 g/day), seafood (69.0 g/day), potatoes, and starches (41.6 g/day) but consumed fewer vegetables (214.3 g/day) and less dairy (62.0 g/day) than Korean adults. The nutritional status and food intake patterns differed by the sociodemographic status. In addition, the obese group consumed more poultry and beverages than the non-obese group (p < 0.05 for all). Conclusion Adults in Jeju under-consume essential nutrients while over-consuming certain nutrients, such as fat and sodium. The nutritional status also varied according to the sociodemographic characteristics. These findings suggest that sociodemographic factors should be considered carefully when developing nutritional policies and programs to improve the nutritional status and address obesity among adults in Jeju.

Purpose: This study evaluated the nutrition and food intake status among adults in Jeju, Republic of Korea, based on their sociodemographic characteristics and obesity. Methods: Nine hundred and forty-nine adults aged 19 years or older were included based on the 2022 Jeju Nutrition and Physical Activity Survey data. A dietary assessment was conducted using a one-day, 24-hour recall method, and the nutrition status was evaluated using the 2020 Dietary Reference Intakes for Koreans. The sociodemographic status included sex, age, education, and household income, and obesity was defined as a body mass index (BMI) of ≥ 25 kg/m 2 . Results: The mean age of the subjects was 49.8 years, and the overall prevalence of obesity was 48.4% (59.5% for males and 37.2% for females). The top three insufficient nutrients consumed at less than the estimated average requirement were calcium (77.7%), vitamin A (77.3%), and vitamin C (61.3%), while 40.9% of the subjects consumed fat as more than 30% of their total energy intake. The sodium intake was approximately 1.5 times higher than the chronic disease risk reduction intake level. In terms of food groups, the participants consumed more meat (148.2 g/day), seafood (69.0 g/day), potatoes, and starches (41.6 g/day) but consumed fewer vegetables (214.3 g/day) and less dairy (62.0 g/day) than Korean adults. The nutritional status and food intake patterns differed by the sociodemographic status. In addition, the obese group consumed more poultry and beverages than the non-obese group (p < 0.05 for all). Conclusion Adults in Jeju under-consume essential nutrients while over-consuming certain nutrients, such as fat and sodium. The nutritional status also varied according to the sociodemographic characteristics. These findings suggest that sociodemographic factors should be considered carefully when developing nutritional policies and programs to improve the nutritional status and address obesity among adults in Jeju.

Objectives: Recently, food insecurity has been a major public health issue along with the food crisis caused by COVID-19, climate change, and the polarization of food supply due to socioeconomic disparities. Food insecurity is known to be related to the food choices and environment of the consumer. Therefore, this study aimed to evaluate the food security statuses of adults in Jeju and investigate their food purchase patterns, food policy recognition, and food environment satisfaction. Methods: Based on data from the 2022 Jeju Food Survey, 346 adults aged ≥19 years in Jeju were classified into food security and insecurity groups (quantitatively and qualitatively) using the questionnaire. Food purchase patterns, including purchasing frequency, items, and reasons, were surveyed for local and eco-friendly foods. The recognition and necessity of several food policies and satisfaction with diet and food environment (availability, accessibility, affordability, accommodation, and acceptability) were measured using the Likert scale. Results: Among the total participants, 47.4% were in the food insecurity group. The frequency of purchasing local and eco-friendly foods did not significantly differ by food security status. The insecurity group exhibited a higher recognition rate of basic rights to food (36.0%) than the security group (24.7%, P = 0.023). The recognition and necessity of specific food policies did not significantly differ by food security status, except for the policy of promoting food communities, for which the food security group exhibited higher recognition than the food insecurity group did (P = 0.004). The food insecurity group exhibited significantly lower scores regarding satisfaction toward diet and food environment factors (P < 0.05 for all). Conclusions Overall, the food security group reported higher satisfaction with their diet and food environment than the food insecurity group. Further in-depth studies to investigate the determinants of food insecurity and effective promotional strategies for food policies are needed.

Background: and Purpose Dietary therapy (DT), including the ketogenic diet (KD), is one of the nonpharmacological treatment options for patient with drug-resistant epilepsy. However, maintaining DT in patients without seizure reduction is very difficult, so it is critical for clinicians to decide when to stop this intervention. Methods: We retrospectively analyzed early clinical and laboratory findings and the clinical characteristics of children who received DT. The maintenance of DT and the clinical seizure frequency were assessed at 1, 3, 6, 12, and 24 months after KD initiation. Responders were defined as patients showing an overall reduction in seizure frequency of >50% relative to the baseline. Results: We included 67 patients who received DT, but only 23 (34.3%) of these patients remained on DT at 6 months. Only 1 (5%) of the 20 responders at 1 month became a nonresponder at 6 months. The response rate at 6 months was significantly higher among patients under 2 years of age (15/17, 88.2%) than older patients (2/6, 33.3%; p=0.021). Moreover, the 6-month responders were significantly younger (29.4±38.6 months, mean±SD) than the nonresponders (98.9±84.6 months, p=0.012) at the initiation of the diet. A high blood β-hydroxybutyrate (BHB) level at 1 month predicted a good DT response at 6 months. Conclusions Most 1-month responders maintained their response on DT for up to 6 months.The blood BHB level at 1 month was significantly correlated with the 6-month seizure outcome.Confirming clinical and laboratory biomarkers for the efficacy of DT requires further studies with larger cohorts.

Objective: The objective of this study was to assess the effectiveness and safety of atomoxetine in Korean children and adolescents with epilepsy. Methods: We retrospectively reviewed the electronic medical records of 105 children and adolescents with epilepsy treated with atomoxetine. Effectiveness was measured with the Clinical Global Impressions-Severity (CGI-S) and/or Clinical Global Impressions-Improvement (CGI-I) scales at baseline, and after 4 and 12 weeks. We defined response to atomoxetine as a CGI-I score less than three at week 12. Safety was evaluated at each visit, based on clinical assessment by a child and adolescent psychiatrist and reports from participants or their caregivers. Results: In total participants (n=105), 33 (31.4%) showed a response to treatment: a significant decrease in CGI-S scale score was observed over 12 weeks of atomoxetine treatment. The most common adverse event (AE) was decreased appetite (n=16, 15.2%), and life-threatening AEs were not observed. Seizure aggravation due to atomoxetine was observed in 7.6% (n=8) of total participants, and one of them discontinued atomoxetine. Conclusion Our results provide preliminary evidence of the effectiveness and safety of atomoxetine in children and adolescents with epilepsy.

PURPOSE: The aim of this study was to evaluate the efficacy and tolerability of perampanel as adjunctive therapy in childhood-onset refractory epilepsy. METHODS: We retrospectively reviewed the medical records of 110 patients who were treated with perampanel in Asan Medical Center children's hospital. Two patients with poor compliance were excluded and 108 patients were enrolled. The clinical characteristics were reviewed, and the total seizure frequency before and after the add-on of perampanel was analyzed. RESULTS: The mean age of the patients (64 males) was 20.2 years (range, 10.5 to 35.6). The mean maintenance dose was 4.8 mg/day (2 to 10 mg). Eight patients (7.4%) achieved seizure freedom and 35 (32.4%) achieved a seizure reduction of ≥50%. Among them, three patients achieved seizure freedom with only 2 mg/day of perampanel. There was no significant difference in sex, age at seizure onset, duration of epilepsy, use of concomitant enzyme-inducing antiepileptic drugs, number of concomitant antiepileptic drugs, and adverse events between responders and non-responders. The retention rate was up to 68.0% in the first year and 59.5% in the second year of the study. Thirty-four patients (31.5%) reported adverse events: violence, somnolence, dizziness, drooling, weight gain, insomnia, and vomiting. There was no contributing factor for the adverse events, including sex, age, and the number of concomitant antiepileptic drugs and enzyme-inducing antiepileptic drugs when comparing the adverse event present group with the adverse event absent group. CONCLUSION Low-dose perampanel showed reasonable efficacy and tolerability in patients with refractory childhood-onset epilepsy. Further validation with pharmacokinetic studies is needed.