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.

While South Korea’s National Health Insurance (NHI) was once disparaged as a rudimentary “discount program,” it has matured into the cornerstone of the nation’s medical safety net owing to sustained governmental initiatives. Nevertheless, the pursuit of expanded benefit coverage, exacerbated by demographic shifts toward low fertility and an aging society, has catalyzed a rapid escalation in aggregate national healthcare spending.Consequently, there is an urgent need for the NHI to implement benefit expansion policies that prioritize cost-efficiency and fiscal prudence. This perspective asserts that coverage enhancement should be strategically focused on high-cost catastrophic illnesses, specifically through the robust fortification of the annual out-of-pocket (OOP) maximum system. Furthermore, the reform of private health insurance is imperative, as its unbridled growth in non-reimbursable services has undermined the efficacy of public coverage efforts. This paper proposes concrete policy frameworks for both the enhancement of the OOP maximum system and the structural reform of private indemnity health insurance.

BACKGROUND/OBJECTIVES: Obesity is a complex metabolic disorder characterized by excessive adipose tissue accumulation, dysregulated lipid metabolism, and insulin resistance, leading to an increased risk of metabolic disease. While Withania somnifera (AS) and Chrysanthemum zawadskii Herbich var. latilobum (Maxim.) Kitamura (C) have traditionally been used for their metabolic regulatory properties, their combined effects on adipogenesis, lipogenesis, lipolysis, and insulin signaling remain unexplored. Therefore, this study aimed to evaluate the anti-obesity effects of AS, C, and their optimal combination (ASC) in 3T3-L1 adipocytes by investigating their impact on lipid metabolism and glucose homeostasis.MATERIALS/METHODS: Following adipogenic differentiation, 3T3-L1 adipocytes were treated with AS, C, and ASC at different concentrations. RESULTS: AS, C, and ASC significantly inhibited adipogenesis by downregulating cyclic adenosine monophosphate (cAMP) response element-binding protein, peroxisome proliferator-activated receptor gamma, CCAAT/enhancer-binding proteins alpha and beta phosphorylation, thereby reducing lipid accumulation in adipocytes. They also suppressed lipogenesis by downregulating the expression of dephosphorylated acetyl-CoA carboxylase, fatty acid synthase, and lipoprotein lipase. In contrast, they markedly enhanced lipolysis, as evidenced by increased hormone-sensitive lipase and protein kinase A expression, along with elevated glycerol release and cAMP levels. Furthermore, AS, C, and ASC activated energy metabolism pathways, as indicated by the upregulation of AMP-activated protein kinase, uncoupling protein 1, and carnitine palmitoyltransferase 1A, suggesting a transition toward enhanced mitochondrial fatty acid oxidation. Notably, AS, C, and ASC significantly improved insulin signaling by restoring insulin receptor substrate 1, phosphoinositide 3-kinase, and Akt phosphorylation, while upregulating glucose transporter type 4 expression, indicating enhanced glucose uptake. Among all treatments, ASC showed relatively greater efficacy compared to AS or C alone, suggesting a potential additive effect. CONCLUSION These findings demonstrate that ASC effectively modulates multiple metabolic pathways in adipocytes, including adipogenesis, lipogenesis, lipolysis, energy metabolism, and insulin signaling, to exert its anti-obesity effects.

Purpose: Arm wrestling is a common strength competition, particularly among young men, including military personnel.While previous studies have examined humeral shaft fractures from arm wrestling or in soldiers, no research has focused on both. This study evaluates the outcomes of dual plating fixation via the anterolateral approach for arm wrestling-induced fractures in soldiers. Methods: This retrospective study included 18 male patients (mean age, 21.7 years) treated at the Armed Forces Daejeon Hospital (May 2022–December 2023). Data on rank, radial nerve injury, fracture type (AO-OTA classification), and clinical outcomes (union time, radial nerve recovery, DASH score) were analyzed. Results: The cohort included 12 soldiers, two non-commissioned officers, and four officers. Common fracture types were A1 and B1, with four cases of radial nerve palsy. Union occurred at 12.5 weeks, and nerve recovery averaged 15 weeks. No cases of non-union or persistent nerve damage were observed. Conclusion Arm wrestling carries a high risk of humeral fractures in soldiers. Awareness and preventive measures should be emphasized. The dual plating fixation technique via the anterolateral approach is highly effective, demonstrating excellent union and recovery outcomes.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

Purpose: Arm wrestling is a common strength competition, particularly among young men, including military personnel.While previous studies have examined humeral shaft fractures from arm wrestling or in soldiers, no research has focused on both. This study evaluates the outcomes of dual plating fixation via the anterolateral approach for arm wrestling-induced fractures in soldiers. Methods: This retrospective study included 18 male patients (mean age, 21.7 years) treated at the Armed Forces Daejeon Hospital (May 2022–December 2023). Data on rank, radial nerve injury, fracture type (AO-OTA classification), and clinical outcomes (union time, radial nerve recovery, DASH score) were analyzed. Results: The cohort included 12 soldiers, two non-commissioned officers, and four officers. Common fracture types were A1 and B1, with four cases of radial nerve palsy. Union occurred at 12.5 weeks, and nerve recovery averaged 15 weeks. No cases of non-union or persistent nerve damage were observed. Conclusion Arm wrestling carries a high risk of humeral fractures in soldiers. Awareness and preventive measures should be emphasized. The dual plating fixation technique via the anterolateral approach is highly effective, demonstrating excellent union and recovery outcomes.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

Purpose: Arm wrestling is a common strength competition, particularly among young men, including military personnel.While previous studies have examined humeral shaft fractures from arm wrestling or in soldiers, no research has focused on both. This study evaluates the outcomes of dual plating fixation via the anterolateral approach for arm wrestling-induced fractures in soldiers. Methods: This retrospective study included 18 male patients (mean age, 21.7 years) treated at the Armed Forces Daejeon Hospital (May 2022–December 2023). Data on rank, radial nerve injury, fracture type (AO-OTA classification), and clinical outcomes (union time, radial nerve recovery, DASH score) were analyzed. Results: The cohort included 12 soldiers, two non-commissioned officers, and four officers. Common fracture types were A1 and B1, with four cases of radial nerve palsy. Union occurred at 12.5 weeks, and nerve recovery averaged 15 weeks. No cases of non-union or persistent nerve damage were observed. Conclusion Arm wrestling carries a high risk of humeral fractures in soldiers. Awareness and preventive measures should be emphasized. The dual plating fixation technique via the anterolateral approach is highly effective, demonstrating excellent union and recovery outcomes.

Purpose: Arm wrestling is a common strength competition, particularly among young men, including military personnel.While previous studies have examined humeral shaft fractures from arm wrestling or in soldiers, no research has focused on both. This study evaluates the outcomes of dual plating fixation via the anterolateral approach for arm wrestling-induced fractures in soldiers. Methods: This retrospective study included 18 male patients (mean age, 21.7 years) treated at the Armed Forces Daejeon Hospital (May 2022–December 2023). Data on rank, radial nerve injury, fracture type (AO-OTA classification), and clinical outcomes (union time, radial nerve recovery, DASH score) were analyzed. Results: The cohort included 12 soldiers, two non-commissioned officers, and four officers. Common fracture types were A1 and B1, with four cases of radial nerve palsy. Union occurred at 12.5 weeks, and nerve recovery averaged 15 weeks. No cases of non-union or persistent nerve damage were observed. Conclusion Arm wrestling carries a high risk of humeral fractures in soldiers. Awareness and preventive measures should be emphasized. The dual plating fixation technique via the anterolateral approach is highly effective, demonstrating excellent union and recovery outcomes.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.