Carbonate apatite (COAp) is an inorganic component of bone. This study aimed to compare the composition and tissue response to of COAp (COAp-DP) fabricated by the dissolution-precipitation reaction using calcite as a precursor and Bio-Oss®, which is widely used in orthopedic and dental fields as a synthetic bone substitute. X-ray diffraction and Fourier transform infrared results showed that COAp-DP and Bio-Oss® were both B-type carbonate apatite with low crystallinity. The average sizes of COAp-DP and Bio-Oss® granules were 450 ± 58 and 667 ± 168μ m, respectively, and their carbonate contents were 12.1 ± 0.6 and 5.6 ± 0.1 wt%, respectively. COAp-DP had a larger amount of CO than Bio-Oss® but higher crystallinity than Bio-Oss®. When a bone defect made at the femur of rabbits was reconstructed with COAp-DP and Bio-Oss®, COAp-DP granules were partially replaced with bone, whereas Bio-Oss® remained at 8 weeks after implantation. COAp-DP granules elicited a significantly larger amount of new bone formation at the cortical bone portion than Bio-Oss® at 4 weeks after the implantation. The results obtained in the present study demonstrated that COAp-DP and Bio-Oss® showed different behavior even though they were both classified as COAp. The CO content in COAp played a more important role than the crystallinity of COAp for replacement to bone and high osteoconductivity.

Since bone apatite is a carbonate apatite containing carbonate in an apatitic structure, carbonate content may be one of the factors governing the osteoconductivity of apatitic bone substitutes. The aim of this study was to evaluate the effects of carbonate content on the osteoconductivity of apatitic bone substitutes using three commercially available bone substitutes for the reconstruction of alveolar bone defects of a beagle mandible with simultaneous dental implant installation. NEOBONE, Bio‐Oss, and Cytrans that contain 0.1, 5.5, and 12.0 mass% of carbonate, respectively, were used in this study. The amount of newly formed bone in the upper portion of the alveolar bone defect of the beagle's mandible was 0.7, 6.6, and 39.4% at 4 weeks after surgery and 4.7, 39.5, and 75.2% at 12 weeks after surgery for NEOBONE, Bio‐Oss, and Cytrans, respectively. The results indicate that bone‐to‐implant contact ratio was the largest for Cytrans. Additionally, the continuity of the alveolar ridge was restored in the case of Cytrans, whereas the continuity of the alveolar ridge was not sufficient when using NEOBONE and Bio‐Oss. Both Cytrans and Bio‐Oss that have a relatively larger carbonate content in their apatitic structure was resorbed with time. We concluded that carbonate content is one of important factors governing the osteoconductivity of apatitic bone substitutes.

Carbonate apatite (CO 3 Ap) granules are known to show good osteoconductivity and replaced to new bone. On the other hand, it is well known that a porous structure allows bone tissue to penetrate its pores, and the optimal pore size for bone ingrowth is dependent on the composition and structure of the scaffold material. Therefore, the aim of this study was to fabricate various porous CO 3 Ap granules through a twostep dissolution-precipitation reaction using CaSO 4 as a precursor and 30-, 50-, 120-, and 205-μm diameter microfibers as porogen and to find the optimal pore size of CO 3 Ap. Porous CO 3 Ap granules were successfully fabricated with pore size 8.2-18.7% smaller than the size of the original fiber porogen. Two weeks after the reconstruction of rabbit calvarial bone defects using porous CO 3 Ap granules, the largest amount of mature bone was seen to be formed inside the pores of CO 3 Ap (120) [porous CO 3 Ap granules made using 120-μm microfiber] followed by CO 3 Ap (50) and CO 3 Ap (30). At 4 and 8 weeks, no statistically significant difference was observed based on the pore size, even though largest amount of mature bone was formed in case of CO 3 Ap (120). It is concluded, therefore, that the optimal pore size of the CO 3 Ap is that of CO 3 Ap (120), which is 85 μm. K E Y W O R D Sbone formation, bone substitute, carbonate apatite, hydroxyapatite, optimal pore size

The prevalence of NT and ET on CT was lower than that of palatine and lingual tonsilloliths. However, since they are encountered more frequently than clinically significant calcifying diseases such as retropharyngeal calcific tendinitis, clinicians should be able to correctly diagnose NT and ET based on their anatomical features.

Kakkonkajutsubuto belongs to the Ephedra herb drug group and has useful properties for stiff shoulders, scapular neuralgia, and rheumatoid arthritis of the upper body. In this study, we assessed the effectiveness of kakkonkajutsubuto in patients with neck, shoulder, and upper-extremity pain from the viewpoint of decrease in a Visual Analog Scale (VAS) and adverse reactions. One hundred and twenty-four patients who had no gastrointestinal disorder, hot flashes, excessive sweating or other select symptoms were treated with kakkonkajutsubuto (5.0-7.5 g/day). The VAS was used for the assessment of pain-relieving effect. Eighty-one patients improved dramatically (their pre/post administration VAS ratio was less than 50%), 21 improved (between 51 to 75%), and 22 did not improve (more than 76%). Eighty-two point three percent of patients improved in total. Five patients showed adverse reactions, such as general fatigue, stomachache, and edema, but these were not clinically significant. This study suggests that kakkonkajutsubuto can be used more widely for neck, shoulder, or upper-extremity pain.kakkonkajutsubuto, neck-shoulder pain, prospective multicenter study