1.Dietary management of pediatric patients with kidney disease: recommendations by the Korean Society of Pediatric Nephrology and the Korean Society of Clinical Nutrition
Yo Han AHN ; Hee Gyung KANG ; Jiyoung SONG ; Sangmi HAN ; Eujin PARK ; Jin-Soon SUH ; Jeong Yeon KIM ; Min Ji PARK ; Keum Hwa LEE ; Seon Hee LIM ; Kyeong Hun SHIN ; Hyunji KO ; Hyun Joo LEE ; Eunyoung JEONG ; Jinsu KIM ; Sohyun PARK ; Eonju CHOI ; Yuri SEO ; Kyooyung OH ; Jin Kyoung KIM ; Hyun Kyung LEE
Childhood Kidney Diseases 2026;30(1):4-14
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.
2.Evaluating the Performance of Basic Local Government Initiatives in Suicide Prevention: Insights From Korea
Kyoung-Hoon KIM ; Minjae CHOI ; Yo Han LEE ; Sang Min LEE
Journal of Korean Medical Science 2026;41(1):e22-
Background:
Korea’s national suicide prevention strategies emphasize the role of local authorities. Evaluating local government performance helps determine whether suicide reduction goals are being met. This study assesses the performance of basic local government suicide prevention activities and explores their implications.
Methods:
Data were drawn from the 2023 Survey on Suicide Prevention Activities. Seventeen indicators, covering both process and outcome measures, were used to evaluate performance.A composite score (0–100) was calculated by weighting and summing the indicators, with weights based on average scores for each indicator. The 229 local governments were grouped into four categories by urbanization and population size: large Si (≥ 300,000 population), small Si (< 300,000), Gun, and Gu. The maximum–minimum (max–min) value ratio was used to examine composite score variation.
Results:
Among the 229 local governments, 29 were large Si areas, 49 small Si, 82 Gun, and 69 Gu. Significant disparities were found across several indicators, such as the operation of community suicide prevention centers, availability of mental health professionals, and allocated budgets. Composite scores were highest in large Si areas (59.8), followed by small Si (59.3), and Gu (57.9). The greatest variation was in Gun areas (max–min ratio: 2.6), suggesting inconsistent performance.
Conclusion
There are notable disparities in suicide prevention performance among Korea’s basic local governments. Customized strategies that reflect local capacities and contexts are essential to reduce these gaps and improve overall effectiveness.
3.Fasting is not always good: perioperative fasting leads to pronounced ketone body production in patients treated with SGLT2 inhibitors: a case report
Jae Chan CHOI ; Yo Nam JANG ; Jong Hoon LEE ; Sang Wook PARK ; Jeong A PARK ; Hye Sook KIM ; Jae Won CHOI ; Joo Hyung LEE ; Yong Jae LEE
Korean Journal of Family Medicine 2025;46(3):204-209
Ketone bodies produced by sodium-glucose cotransporter 2 (SGLT2) inhibitors can be advantageous, providing an efficient and stable energy source for the brain and muscles. However, in patients with diabetes, ketogenesis induced by SGLT2 inhibitors may be harmful, potentially resulting in severe diabetic ketoacidosis (DKA). During fasting, ketone body production serves as an alternative and efficient energy source for the brain by utilizing stored fat, promoting mental clarity, and reducing dependence on glucose. The concurrent use of SGLT2 inhibitors during perioperative fasting may further elevate the risk of euglycemic DKA. We describe a case of DKA that occurred during perioperative fasting in a patient receiving empagliflozin, an SGLT2 inhibitor. This case underscores the importance of recognizing the potential risk of DKA in patients with diabetes using SGLT2 inhibitors during perioperative fasting.
4.The Vaccine Cold Chain in North Korea:Assessing the Capacity to Store Routine Vaccines and Potential to Support Pandemic Vaccination Activities
Joshua Kirabo SEMPUNGU ; Minjae CHOI ; Eun Hae LEE ; Mi-Hyui KIM ; Joon Hee HAN ; Yo Han LEE
Journal of Korean Medical Science 2025;40(10):e36-
Background:
The health system's capacity to store vaccines in North Korea has been less studied. In this study, we aimed to investigate if the current vaccine cold chain in North Korea can store routine vaccines and if it has the storage capacity to handle pandemic vaccination activities (PVAs) without interrupting the country’s successful routine immunization program.
Methods:
We used tables extracted from an evaluation report of The Global Alliance for Vaccines and Immunization (GAVI)’ Health Systems Strengthening program in North Korea from 2007 to 2014. We then used the World Health Organization’s Immunization Supply Chain Sizing Tool to estimate gaps and the cost of scaling up cold chain storage.
Results:
We found that the vaccine cold chain in North Korea has adequate storage capacity for routine vaccines. While we found a deficit of 7,172 L at the central medical warehouse (CMW) and 14,256 L at the provincial medical warehouses (PMWs), the storage at the county warehouses (CoMW) had a surplus. When assessed for PVA, we found an aggregated deficit of 115,574 L (CMW), 113,160 L (PMW), and 25,133 L (CoMW). To fill the gaps, investments of 229,917 USD, and 2,262,211 USD were estimated for routine and PVA vaccination programs, respectively.
Conclusion
As countries and the international community work to improve systems in preparation for future pandemics, there is a need to scale up the North Korean vaccine cold chain to a pandemic-ready state.
5.The Vaccine Cold Chain in North Korea:Assessing the Capacity to Store Routine Vaccines and Potential to Support Pandemic Vaccination Activities
Joshua Kirabo SEMPUNGU ; Minjae CHOI ; Eun Hae LEE ; Mi-Hyui KIM ; Joon Hee HAN ; Yo Han LEE
Journal of Korean Medical Science 2025;40(10):e36-
Background:
The health system's capacity to store vaccines in North Korea has been less studied. In this study, we aimed to investigate if the current vaccine cold chain in North Korea can store routine vaccines and if it has the storage capacity to handle pandemic vaccination activities (PVAs) without interrupting the country’s successful routine immunization program.
Methods:
We used tables extracted from an evaluation report of The Global Alliance for Vaccines and Immunization (GAVI)’ Health Systems Strengthening program in North Korea from 2007 to 2014. We then used the World Health Organization’s Immunization Supply Chain Sizing Tool to estimate gaps and the cost of scaling up cold chain storage.
Results:
We found that the vaccine cold chain in North Korea has adequate storage capacity for routine vaccines. While we found a deficit of 7,172 L at the central medical warehouse (CMW) and 14,256 L at the provincial medical warehouses (PMWs), the storage at the county warehouses (CoMW) had a surplus. When assessed for PVA, we found an aggregated deficit of 115,574 L (CMW), 113,160 L (PMW), and 25,133 L (CoMW). To fill the gaps, investments of 229,917 USD, and 2,262,211 USD were estimated for routine and PVA vaccination programs, respectively.
Conclusion
As countries and the international community work to improve systems in preparation for future pandemics, there is a need to scale up the North Korean vaccine cold chain to a pandemic-ready state.
6.Fasting is not always good: perioperative fasting leads to pronounced ketone body production in patients treated with SGLT2 inhibitors: a case report
Jae Chan CHOI ; Yo Nam JANG ; Jong Hoon LEE ; Sang Wook PARK ; Jeong A PARK ; Hye Sook KIM ; Jae Won CHOI ; Joo Hyung LEE ; Yong Jae LEE
Korean Journal of Family Medicine 2025;46(3):204-209
Ketone bodies produced by sodium-glucose cotransporter 2 (SGLT2) inhibitors can be advantageous, providing an efficient and stable energy source for the brain and muscles. However, in patients with diabetes, ketogenesis induced by SGLT2 inhibitors may be harmful, potentially resulting in severe diabetic ketoacidosis (DKA). During fasting, ketone body production serves as an alternative and efficient energy source for the brain by utilizing stored fat, promoting mental clarity, and reducing dependence on glucose. The concurrent use of SGLT2 inhibitors during perioperative fasting may further elevate the risk of euglycemic DKA. We describe a case of DKA that occurred during perioperative fasting in a patient receiving empagliflozin, an SGLT2 inhibitor. This case underscores the importance of recognizing the potential risk of DKA in patients with diabetes using SGLT2 inhibitors during perioperative fasting.
7.The Vaccine Cold Chain in North Korea:Assessing the Capacity to Store Routine Vaccines and Potential to Support Pandemic Vaccination Activities
Joshua Kirabo SEMPUNGU ; Minjae CHOI ; Eun Hae LEE ; Mi-Hyui KIM ; Joon Hee HAN ; Yo Han LEE
Journal of Korean Medical Science 2025;40(10):e36-
Background:
The health system's capacity to store vaccines in North Korea has been less studied. In this study, we aimed to investigate if the current vaccine cold chain in North Korea can store routine vaccines and if it has the storage capacity to handle pandemic vaccination activities (PVAs) without interrupting the country’s successful routine immunization program.
Methods:
We used tables extracted from an evaluation report of The Global Alliance for Vaccines and Immunization (GAVI)’ Health Systems Strengthening program in North Korea from 2007 to 2014. We then used the World Health Organization’s Immunization Supply Chain Sizing Tool to estimate gaps and the cost of scaling up cold chain storage.
Results:
We found that the vaccine cold chain in North Korea has adequate storage capacity for routine vaccines. While we found a deficit of 7,172 L at the central medical warehouse (CMW) and 14,256 L at the provincial medical warehouses (PMWs), the storage at the county warehouses (CoMW) had a surplus. When assessed for PVA, we found an aggregated deficit of 115,574 L (CMW), 113,160 L (PMW), and 25,133 L (CoMW). To fill the gaps, investments of 229,917 USD, and 2,262,211 USD were estimated for routine and PVA vaccination programs, respectively.
Conclusion
As countries and the international community work to improve systems in preparation for future pandemics, there is a need to scale up the North Korean vaccine cold chain to a pandemic-ready state.
8.Fasting is not always good: perioperative fasting leads to pronounced ketone body production in patients treated with SGLT2 inhibitors: a case report
Jae Chan CHOI ; Yo Nam JANG ; Jong Hoon LEE ; Sang Wook PARK ; Jeong A PARK ; Hye Sook KIM ; Jae Won CHOI ; Joo Hyung LEE ; Yong Jae LEE
Korean Journal of Family Medicine 2025;46(3):204-209
Ketone bodies produced by sodium-glucose cotransporter 2 (SGLT2) inhibitors can be advantageous, providing an efficient and stable energy source for the brain and muscles. However, in patients with diabetes, ketogenesis induced by SGLT2 inhibitors may be harmful, potentially resulting in severe diabetic ketoacidosis (DKA). During fasting, ketone body production serves as an alternative and efficient energy source for the brain by utilizing stored fat, promoting mental clarity, and reducing dependence on glucose. The concurrent use of SGLT2 inhibitors during perioperative fasting may further elevate the risk of euglycemic DKA. We describe a case of DKA that occurred during perioperative fasting in a patient receiving empagliflozin, an SGLT2 inhibitor. This case underscores the importance of recognizing the potential risk of DKA in patients with diabetes using SGLT2 inhibitors during perioperative fasting.
9.The Vaccine Cold Chain in North Korea:Assessing the Capacity to Store Routine Vaccines and Potential to Support Pandemic Vaccination Activities
Joshua Kirabo SEMPUNGU ; Minjae CHOI ; Eun Hae LEE ; Mi-Hyui KIM ; Joon Hee HAN ; Yo Han LEE
Journal of Korean Medical Science 2025;40(10):e36-
Background:
The health system's capacity to store vaccines in North Korea has been less studied. In this study, we aimed to investigate if the current vaccine cold chain in North Korea can store routine vaccines and if it has the storage capacity to handle pandemic vaccination activities (PVAs) without interrupting the country’s successful routine immunization program.
Methods:
We used tables extracted from an evaluation report of The Global Alliance for Vaccines and Immunization (GAVI)’ Health Systems Strengthening program in North Korea from 2007 to 2014. We then used the World Health Organization’s Immunization Supply Chain Sizing Tool to estimate gaps and the cost of scaling up cold chain storage.
Results:
We found that the vaccine cold chain in North Korea has adequate storage capacity for routine vaccines. While we found a deficit of 7,172 L at the central medical warehouse (CMW) and 14,256 L at the provincial medical warehouses (PMWs), the storage at the county warehouses (CoMW) had a surplus. When assessed for PVA, we found an aggregated deficit of 115,574 L (CMW), 113,160 L (PMW), and 25,133 L (CoMW). To fill the gaps, investments of 229,917 USD, and 2,262,211 USD were estimated for routine and PVA vaccination programs, respectively.
Conclusion
As countries and the international community work to improve systems in preparation for future pandemics, there is a need to scale up the North Korean vaccine cold chain to a pandemic-ready state.
10.Fasting is not always good: perioperative fasting leads to pronounced ketone body production in patients treated with SGLT2 inhibitors: a case report
Jae Chan CHOI ; Yo Nam JANG ; Jong Hoon LEE ; Sang Wook PARK ; Jeong A PARK ; Hye Sook KIM ; Jae Won CHOI ; Joo Hyung LEE ; Yong Jae LEE
Korean Journal of Family Medicine 2025;46(3):204-209
Ketone bodies produced by sodium-glucose cotransporter 2 (SGLT2) inhibitors can be advantageous, providing an efficient and stable energy source for the brain and muscles. However, in patients with diabetes, ketogenesis induced by SGLT2 inhibitors may be harmful, potentially resulting in severe diabetic ketoacidosis (DKA). During fasting, ketone body production serves as an alternative and efficient energy source for the brain by utilizing stored fat, promoting mental clarity, and reducing dependence on glucose. The concurrent use of SGLT2 inhibitors during perioperative fasting may further elevate the risk of euglycemic DKA. We describe a case of DKA that occurred during perioperative fasting in a patient receiving empagliflozin, an SGLT2 inhibitor. This case underscores the importance of recognizing the potential risk of DKA in patients with diabetes using SGLT2 inhibitors during perioperative fasting.

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