The South Korean healthcare system has achieved rapid quantitative growth; however, it continues to face critical challenges in ensuring the fundamental right to health of its citizens. From the perspective of healthcare consumers and civil society, this article identifies structural problems such as imbalances in medical accessibility, instability in essential and emergency care, and the limited participation of consumers in healthcare policy-making. Although the constitution stipulates the state’s responsibility to protect public health, current healthcare policies often prioritize administrative efficiency and provider-centered interests over patient experiences and health outcomes. In particular, this article argues that these challenges are closely related to the inadequate functioning of an accountable healthcare management framework. Structural failures in essential care, workforce shortages, and regional disparities are insufficiently monitored and addressed at the system level, resulting in responsibilities being blurred or shifted to individual healthcare providers. Consequently, the risks and burdens arising from systemic weaknesses are ultimately borne by citizens. To address these issues, this article emphasizes two major shifts. First, meaningful consumer participation must be institutionalized within healthcare governance to strengthen accountability, transparency, and responsiveness. Second, family medicine and primary care should be reinforced as the cornerstone of a sustainable, community-based healthcare system that ensures continuity of care, prevention, and chronic disease management. Re-establishing the healthcare system based on the right to health is not merely a technical adjustment, but a structural transformation toward a responsible and accountable system in which the state clearly assumes responsibility for monitoring, learning, and corrective action.

Functional hypoglycemia has not yet been clearly defined, however, it is generally understood as a condition in which hypoglycemic symptoms occur, predominantly postprandially, in the absence of glucose-related diseases or identifiable organic causes, such as diabetes mellitus, alcoholism, insulinoma, or insulin autoantibodies. The management for functional hypoglycemia is also not well established. Dietary modification, such as eating small, frequent meals, reducing carbohydrate intake, and increasing dietary fiber, is important, and regular physical activity is also useful. But other treatment options are limited and well not established. From a functional medicine perspective, functional hypoglycemia is thought to be associated with impaired insulin counter-regulatory response, particularly involving adrenal hormone function. A functional medical approach may be beneficial in managing patients with diminished adrenal capacity. In this context, we aim to explore the functional medicine-based diagnostic and therapeutic approach to functional hypoglycemia by presenting a case in which a suspected functional hypoglycemia was evaluated using continuous glucose monitoring and showed clinical improvement following dietary interventions and adrenal support therapy.

Purpose: Lidocaine, a type of local anesthetic, is used widely to suppress pain during intra-articular injections, but many studies have suggested that lidocaine is toxic to the articular cartilage. This study examined the biological changes that occur when chondrocytes are exposed to lidocaine to determine the protective effect of human placenta hydrolysate (HPH) on chondrocytes. Materials and Methods: SW1353 cells, human-derived chondrocytes, were treated with lidocaine and HPH to confirm the changes in cell viability, production of reactive oxygen species, and MMP13 and BNIP3 gene expression levels. In addition, the radical scavenging ability of HPH was evaluated using an ABTS assay. Results: After treating the cells with the test substance for 72 hours, the cell viability increased by up to 28% in the HPH/lidocaine-treated group compared to the lidocaine-treated group. The level of reactive oxygen species, which was increased by lidocaine, was lower in the group treated with HPH/lidocaine. In addition, the expression levels of the MMP13 gene, which damages cartilage tissue, and the BNIP3 gene, which is involved in mitophagy, were also 21% and 69% lower, respectively, in the HPH/lidocaine-treated group than in the lidocainetreated group. Conclusion HPH may alleviate the side effects of an intra-articular injection of lidocaine by suppressing cell death, suppressing free radicals, and alleviating intracellular mitochondrial damage.

Chronic migraine, affecting approximately 2% of the global population, markedly diminishes quality of life and imposes significant societal costs, surpassing the impacts of episodic migraine. Conventional medical treatments leave about 30% of patients with persistent chronic migraine, some of whom fluctuate between episodic and chronic migraine states. A holistic, functional medicine approach may provide supplementary benefits for these individuals. Clinical imbalances often identified in chronic migraine patients—such as mitochondrial dysfunction, oxidative stress, gut microbiota dysbiosis, leaky gut syndrome, food intolerance, histamine syndrome, vitamin D deficiency, and autonomic nervous system imbalances—can be detected through specific functional medical assessments, including urine organic acid profiles, hair tissue mineral analysis, hydrogen breath tests, comprehensive blood tests, and heart rate variability tests. Integrative functional medical interventions, encompassing lifestyle modifications, oral and intravenous nutrition therapies, and the comprehensive 5R program (remove, replace, reinoculate, repair, rebalance) for gut health, could offer therapeutic benefits. This review delves into the functional medicine paradigm and its potential role in managing chronic migraine.

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection or post-acute COVID-19 syndrome, refers to a range of symptoms and complications that persist more than four weeks after diagnosis. Typical symptoms include fatigue, headache, anosmia, ageusia, chronic cough, shortness of breath, impaired concentration and memory (brain fog), sleep disturbances, depression, anxiety, and hair loss. The incidence of long COVID varies according to the data, but it has been reported in approximately 20-60% of acute COVID-19 patients. However, despite its high incidence and significant medical and societal burden, there is currently no clear definition or objective diagnostic criteria for long COVID. Its diagnosis and treatment options are also limited and not established due to insufficient evidence. Nevertheless, a functional medicine approach, especially focused on adrenal functional and adrenal fatigue, can help long COVID patients. Relevant blood tests and urinary organic acid profile can be utilized, and lifestyle modification, oral or intravenous nutrition therapies can be implemented. In this article, we report a clinical case of long COVID with adrenal fatigue, demonstrating significant improvement after functional medical approach and management.

The gut and skin health are closely related, defined as gut-skin axis. In particular, gut microbiome has been revealed as major factor of gut-skin axis (gut-microbiome-skin axis). Psoriasis, atopic dermatitis, acne vulgaris, rosacea, hidradenitis suppurativa, and alopecia areata are elucidated as skin disease related with gut microbiome. However, in most clinical situations, skin diseases did not show significant improvement with probiotics alone. Because, various factors are involved in gut-microbiome-skin axis, including intestinal permeability, detoxification, brain function, neurotransmitter, immune and inflammatory imbalance. Also, probiotics alone cannot induce significant changes in whole intestinal microbiome. Functional medicine suggests 5R program (or 5R treatment) as a method to restore overall intestinal health. 5R program consists of five steps: remove, replace, reinoculate, repair, and rebalance. In the remove stage, antibiotics such as rifaximin are used to reduce intestinal microorganisms. In the replace stage, digestive enzyme or supplements for gastric or bile acid secretion are used. In the reinoculate stage, probiotics and prebiotics are supplied. In the repair stage, the intestinal barrier is restored by glutamine, lactoferrin or zinc. In the rebalance stage, lifestyle modification is emphasized to maintain balance between gut and whole-body health. It is thought that 5R program is more effective than probiotics alone in skin diseases, but the evidence is still lacking. We present a case of alopecia areata who did not response to conventional treatment but cured after 5R program and nutrition therapy, to explore the effectiveness of 5R program on skin disease with literature review.

According to recent studies, it has become evident that there is diversity in how the individuals, from a metabolic point of view, are affected by obesity. Difference in pathophysiology for each phenotype of obesity, may confer need for tailored approaches for the phenotype to maximize treatment effects. This narrative review, based on functional medicine, try to elucidate distinct feature of each phenotype of obesity and suggests a new approach which integrates body metabolism, energy balance into obesity management, in order not just to reduce body weight but also dissolve body fat which is a center of obesity pathophysiology. This approach leads to personalized treatment that work best for each obesity phenotype in reducing the risk of non-communicable diseases in clinical practice.

The placenta, a tissue unique to mammals including humans, plays multiple essential roles during pregnancy, facilitating nutrient supply, metabolism, immune modulation, and hormone regulation between the fetus and mouther. Historically, medical use of the placenta dates back to antiquity, with Hippocrates reportedly using it as a therapeutic agent, and traditional Asian medical textbooks such as Bencao Gangmu in China and Donguibogam in Korea also documenting its medicinal properties. In modern medicine, Soviet ophthalmologist Vladimir Filatov utilized placenta in disease treatment in the 1930s, and in the 1950s, placental preparations began pharmaceutical production in Japan. Recently, two injectable placental products, human placental extracts and human placental hydrolysates (HPH), are approved for menopausal symptom relief and liver function improvement in South Korea (though in clinical practice or research area, HPH often described simply as placental extracts). Current interest in anti-aging, menopause, regeneration, and detoxification has increased utilization and research on these placental products, although well-designed studies and evidence remain limited. This article aims to review the current medical evidence and clinical application of placental extracts, especially with a focus on HPH drawing from the authors' extensive clinical experience.

Bovine spastic paresis (BSP) is a neuromuscular disorder characterized by hypertension and stiffness of hindlimb. Two Korean native cattle (Hanwoo) calves developed BSP or BSP-like symptoms, and a tenotomy of superficial tendon of medial head and deep tendon of lateral head of gastrocnemius muscle was performed for treatment. A cast was applied postoperatively to prevent muscle rupture and was removed three weeks later. The prognosis was evaluated at 3 weeks, 6 and 18 months postoperatively. Neither calf showed any other postoperative sequelae. This is the first case study to report the diagnosis, treatment, and prognosis of BSP in Hanwoo.

Background: The coronavirus disease 2019 pandemic has been challenging the healthcare service, i.e., the vitalization of the point of care accompanying self-testing in vitro diagnostic medical devices (IVDs). This study aims to suggest priority criteria to classify self-testing IVDs using the analytic hierarchy process technique. Methods: Two dimensions of the characteristics embedded in the IVDs and the diseases to be diagnosed with self-testing IVDs were parallelly considered and independently investigated. In addition, three expert panels consisting of laboratory medical doctors (n=11), clinicians (n=10), and citizens (n=11) who have an interest in the selection of self-testing IVDs were asked to answer to questionnaires. Priorities were derived and compared among each expert panel. Results: First of all, ease of specimen collection (0.241), urgency of the situation (0.224), and simplicity of device operation (0.214) were found to be the most important criteria in light of the functional characteristics of self-testing IVDs. Medical doctors valued the ease of specimen collection, but the citizen’s panel valued self-management of the disease more. Second, considering the characteristics of the diseases, the priority criteria were shown in the order of prevalence of diseases (0.421), fatality of disease (0.378), and disease with stigma (0.201). Third, medical doctors responded that self-testing IVDs were more than twice as suitable for non-communicable diseases as compared to communicable diseases (0.688 vs. 0.312), but the citizen’s group responded that self-testing IVDs were slightly more suitable for infectious diseases (0.511 vs. 0.489). Conclusion Our findings suggested that self-testing IVDs could be primarily classified as the items for diagnosis of non-communicable diseases for the purpose of self-management with easy specimen collection and simple operation of devices, taking into account the urgency of the situation as well as prevalence and fatality of the disease.