Medical service utilization by children with physical or brain disabilities in South Korea.

BACKGROUND: Children with physical or brain disabilities experience several functional impairments and declining health complications that must be considered for adequate medical support. This study investigated the current medical service utilization of children expressing physical or brain disabilities in South Korea by analyzing medical visits, expenses, and comorbidities. METHODS: We used a database linked to the National Rehabilitation Center of South Korea to extract information on medical services utilized by children with physical or brain disabilities, the number of children with a disability, medical visits for each child, medical expenses per visit, total medical treatment cost, copayments by age group, condition severity, and disability type. RESULTS: Brain disorder comorbidities significantly differed between those with mild and severe disabilities. Visits per child, total medical treatment cost, and copayments were higher in children with severe physical disabilities; however, medical expenses per visit were lower than those with mild disabilities. These parameters were higher in children with severe brain disabilities than in mild cases. Total medical expenses incurred by newborns to three-year-old children with physical disorders were highest due to increased visits per child. However, medical expenses per visit were highest for children aged 13-18. CONCLUSION: Medical service utilization varied by age, condition severity, and disability type. Severe cases and older children with potentially fatal comorbidities required additional economic support. Therefore, a healthcare delivery system for children with disabilities should be established to set affordable medical costs and provide comprehensive medical services based on disability type and severity.

Effect of culture temperature on follicle-stimulating hormone production by Chinese hamster ovary cells in a perfusion bioreactor.

Follicle-stimulating hormone (FSH) was produced in Chinese hamster ovary (CHO) cells using a perfusion bioreactor. Perfusion culture at 37 degrees C yielded a high cell density but a low FSH production. To investigate the effect of culture temperature in the range of 26-37 degrees C on cell growth and FSH production, batch cultures were performed. Lowering culture temperature below 32 degrees C resulted in growth suppression. However, specific productivity of FSH, q (FSH), increased as culture temperature decreased, and the maximum q (FSH) of 43.4 ng/10(6) cells/h was obtained at 28 degrees C, which is 13-fold higher than that at 37 degrees C. Based on the results obtained from batch cultures, we performed perfusion cultures with two consecutive temperatures. CHO cells were grown up to 3.2 x 10(7) cells/ml at 37 degrees C and culture temperature shifted down to 28 degrees C to obtain a high FSH titer. Soon after the maximum FSH titer of 21 mug/ml was achieved, a rapid loss of not only viable cell concentration but also cell viability was observed, probably due to the low activities of enzymes related to cell growth. Thus, the extension of production period at 28 degrees C is critical for the enhancement of FSH production, and the use of antiapoptotic genes seems to be promising.