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Radiomics Analysis of Gray-Scale Ultrasonographic Images of Papillary Thyroid Carcinoma > 1 cm: Potential Biomarker for the Prediction of Lymph Node Metastasis (Radiomics를 이용한 1 cm 이상의 갑상선 유두암의 초음파 영상 분석: 림프절 전이 예측을 위한 잠재적인 바이오마커)

  • Hyun Jung Chung;Kyunghwa Han;Eunjung Lee;Jung Hyun Yoon;Vivian Youngjean Park;Minah Lee;Eun Cho;Jin Young Kwak
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.185-196
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    • 2023
  • Purpose This study aimed to investigate radiomics analysis of ultrasonographic images to develop a potential biomarker for predicting lymph node metastasis in papillary thyroid carcinoma (PTC) patients. Materials and Methods This study included 431 PTC patients from August 2013 to May 2014 and classified them into the training and validation sets. A total of 730 radiomics features, including texture matrices of gray-level co-occurrence matrix and gray-level run-length matrix and single-level discrete two-dimensional wavelet transform and other functions, were obtained. The least absolute shrinkage and selection operator method was used for selecting the most predictive features in the training data set. Results Lymph node metastasis was associated with the radiomics score (p < 0.001). It was also associated with other clinical variables such as young age (p = 0.007) and large tumor size (p = 0.007). The area under the receiver operating characteristic curve was 0.687 (95% confidence interval: 0.616-0.759) for the training set and 0.650 (95% confidence interval: 0.575-0.726) for the validation set. Conclusion This study showed the potential of ultrasonography-based radiomics to predict cervical lymph node metastasis in patients with PTC; thus, ultrasonography-based radiomics can act as a biomarker for PTC.

The National Survey of Acute Respiratory Distress Syndrome in Korea (급성호흡곤란증후군의 전국 실태조사 보고)

  • Scientific Subcommittee for National Survey of Acute Respiratory Distress Syndrome in Korean Academy of Tuberculosis and Respiratory Disease
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.25-43
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    • 1997
  • Introduction : The outcome and incidence of acute respiratory distress syndrome (ARDS) could be variable related to the varied definitions used for ARDS by researchers. The purpose of the national survey was to define the risk factors of ARDS and investigate the prognostic indicies related to mortality of ARDS in Korea according to the definition of ARDS determined by the American-European Concensus Conference on 1992 year. Methods : A Multicenter registry of 48 University or University-affliated hospital and 18 general hospital s equipped with more than 400 patient's beds conducted over 13 months of patients with acute respiratory distress syndrome using the same registry protocol. Results : 1. In the 12 months of the registry, 167 patients were enrolled at the 24 hospitals. 2. The mean age was 56.5 years (${\pm}17.2$ years) and there was a 1.9:1 ratio of males to females. 3. Sepsis was the most common risk factors (78.1%), followed by aspiration (16.6%), trauma (11.6%), and shock (8.5%). 4 The overall mortality rate was 71.9%. The mean duration was 11 days (${\pm}13.1$ days) from the diagnosis of ARDS to the death. Respiratory insufficiency appeared to be a major cause in 43.7% of the deaths followed by sepsis (36.1%), heart failure (7.6%) and hepatic failure (6.7%). 5. There were no significant differences in mortality based on sex or age. No significant difference in mortality in infectious versus noninfectious causes of ARDS was found. 6. There were significant differences in the pulse rate, platelet numbers, serum albumin and glucose levels, the amounts of 24 hour urine, arterial pH, $Pa0_2$, $PaCO_2$, $Sa0_2$, alveolar-arterial oxygen differences, $PaO_2/FIO_2$, and PEEP/$FI0_2$ between the survivors and the deaths on study days 1 through 6 of the first week after enrollment. 7. The survivors had significantly less organ failure and lower APACHE III scores at the time of diagnosis of ARDS (P<0.05). 8. The numbers of organ failure (odd ratio 1.95, 95% confidence intervals:1.05-3.61, P=0.03) and the score of APACHE III (odd ratio 1.59, 95% confidence interval:1.01-2.50, P=0.04) appeared to be independent risk factors of the mortality in the patients with ARDS. Conclusions : The mortality was 71.9% of total 167 patients in this investigation using the definition of American-European Consensus Conference on 1992 year, and the respiratory insufficiency was the leading cause of the death. In addition, the numbers of organ failure and the score of APACHE III at the time of diagnosis of ARDS appeared to be independent risk factors of the mortality in the patients with ARDS.

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Development of smart education-based teaching and learning plans and a smart textbook for 'healthy diet and meal plans' unit in 「Technology·Home Economics」 (중학교 「기술·가정」의 '건강한 식생활과 식사 구성' 단원에 적용한 스마트 교수·학습 과정안과 교재 개발)

  • Choi, Song Eun;Chae, Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.26 no.4
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    • pp.85-114
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    • 2014
  • The main purpose of this study was to develop teaching and learning plans and a smart textbook for food and nutrition education in Home Economics focusing on 'healthy diet and meal plans' unit in "Technology home Economics" textbooks for 7th graders to evaluate the effectiveness of the instruction conducted with the smart textbook. The content of the study to achieve the purpose is as follows: First, design a smart education-based teaching and learning curriculum for food and nutrition education in Home Economics, focusing on 'healthy diet and meal plans' unit. Second, develop a smart textbook for food and nutrition education based on the teaching and learning curriculum, using a smart content authoring tool. Third, evaluate the effectiveness of the instruction after applying the curriculum in real classroom situations. The results of this study were as follows: First, teaching and learning plans and materials were developed for two units, 'issues regarding teenagers' diet' and 'implementation of a healthy and balanced diet', under 'teenagers' life'. The first unit, 'issues regarding teenagers' diet', dealt with topics such as teenagers' dietary behaviors, nutrition, and health. Learning objectives for this unit were to help students identify and evaluate their own dietary behaviors. The second unit, 'implementation of a healthy and balanced diet', encouraged students to diagnose problems with their diet and plan nutrient rich meals. The objectives for this unit were to help students implement a healthy and balanced diet by providing them with nutrition and dietary guidelines for Koreans, sample meal plans, and guidelines for developing healthy eating habits for teenagers. In order to develop a teaching and learning plans to achieve these objectives, teaching and learning materials including inquiry tasks, materials for group activities, multimedia, applications and various pop-up learning materials were developed. Second, a smart textbook using DocZoom, which was a smart content authoring tool was developed. The textbook dealt with issues regarding teenagers' diet and implementation of a healthy and balanced diet. Multimedia material used in the textbook come from the Ministry of Food and Drug Safety's food and nutrition education web sites and other sources. To develop student-oriented material, relevant video clips were added to the smart textbook to motivate students and enhance their interest in the course. Third, the outcome of this study indicated that the instruction using teaching and learning plans and learning materials with the smart textbook was effective for enhancing students' interest in Home Economics classes (t-value=-3.99, p<.001), creating enthusiasm for learning(t-value = -2.61, p<.05), encouraging self-directed and independent learning(t-value = -4.77, p<.001), and improving students' interest in food and nutrition courses(t-value = -3.83, p<.001). The students' evaluation of the instruction were as follows: the instruction using teaching and learning plans and learning materials with smart textbooks, instead of paper textbooks, helped them save time looking for learning materials; students evaluated that it was easier for them to see and understand video clips and charts. In addition, most students answered that instruction with smart textbooks were more fun and convenient, and they agreed that the courses enhanced their learning experience.

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Comparison of Family Support and Mental Health Between the Rural and Urban Elderly (농촌과 도시지역 노인의 가족지지와 정신건강에 관한 비교)

  • Min, Kyung-Hwa;Kim, Sang-Soon
    • Journal of agricultural medicine and community health
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    • v.20 no.2
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    • pp.175-185
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    • 1995
  • This study is to compare family support and mental health between the rural and the urban elderly. In order to do that I collected the data through questioning 238 people in 3 urban areas in Busan and 201 people in 9 rural areas near Daegu. The degree of their family support is 36.70 on the average in the rural area and 40.77 in the urban area. The degree of family support of urban elderly is a little higher. According to general characters between the differences of family support in both areas, in the rural area there are differences in sex, age, whether they have a spouse or not, education level, financial state, number of children, number of co living, status of co living, subjective health status, amount of pocket money and how much they are participating in leisure activity. In the urban area there are differences in sex, whether they have a spouse or not, religion, financial state, number of co living, status of co living, subjective health status, amount of pocket money, how much they are participating in leisure activity and house pattern. In the stepwise multiple regression analysis the main variables that affect degree of family support in the rural area are age, whether they have a spouse or not and financial state which account for 33% of the total variance and in the urban area are subjective health status, financial state, whether they have a spouse or not and number of co-living which account for 35%. Health status is better in the urban area(average 36.87) than in the rural area(57.42). In each item the people whose mark was more than 75%(low) have Depression 8.4%, Somatization 8.0% in the urban area and Somatization 8.5%, Depression 8.5%, Anxiety 4.0%, Phobic anxiety 4.0%, Obsessive compulsive reaction 2.5%, Hostility 2.0%, Paranoid ideation 2.0%, Psychoticism 1.5% and Interpersonal sensitivity 1.5% in the rural area. In the mental health condition, on the basis of 4 points in both areas, the average is Somatization(rural : 1.69, urban : 1.51), Depression (rural : 1.64, urban : 1.37) and Obsessive compulsive reaction(rural : 1.33, urban : 0.99). According to the differences between mental health conditions by general characters, in the rural area the differences are presented in sex, age, whether they have a spouse or not, religion, education level, financial state, number of children, status of co living, subjective health status, amount of pocket money and how much they are participating in leisure activity, in the urban area the differences are presented in sex, whether they have a spouse or not, religion, financial state, number of co living, status of co living, subjective health status, house pattern, amount of pocket money and how much they are participating in leisure activity. In the stepwise multiple regression analysis the main variables that affect mental health condition in the rural are family support degree subjective health status, religion sex, age and financial state which account for 43% of the total and in the urban area are family support degree, subjective health status and financial state which account for 51%. In the matter of family support degree and mental health condition the rural area was -0.4555, of urban area was -0.6446. The rural area that has a high percentage in family support degree and mental health condition Depression was -0.5036, Psychoticism was -0.4265 in the urban area Psychoticism was -0.6452, Depression was -0.5955. Family support has a great influence on mental health of old people and family support and mental health condition can be different according to living area. So in their problems nursing intervention through family and nursing strategies according to living area should be established.

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Nutrition knowledge, eating attitudes, nutrition behavior, self-efficacy of childcare center foodservice employees by stages of behavioral change in reducing sodium intake (어린이집 조리종사자 대상의 나트륨 저감화 행동변화단계에 따른 영양지식, 식태도, 식행동, 자아효능감 비교)

  • Ahn, Yun;Kim, Kyung Won;Kim, Kyungmin;Pyun, Jinwon;Yeo, Ikhyun;Nam, Kisun
    • Journal of Nutrition and Health
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    • v.48 no.5
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    • pp.429-440
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    • 2015
  • Purpose: The purpose of this study was to examine sodium-related nutrition knowledge, eating attitudes, eating behaviors, and self-efficacy by stages of behavioral change in reducing sodium intake among childcare center foodservice employees. Methods: Subjects (n = 333) were categorized according to two groups based on the stages of change; Pre-action stage (PA group: precontemplation/contemplation/preparation stage), Action stage (A group: action/maintenance stage). Results: A major source of sodium-related nutrition information was TV/radio (56.6%) and only 166 people (49.8%) have experienced nutrition education specific to sodium. Although the A group showed slightly higher scores for nutrition knowledge than the PA group, the difference was not significant. The percentages of correct answers for 'daily goal of sodium intake for adults (27.0%)', 'calculation of sodium content in nutrition labeling (30.3%)' were low for both groups. The A group (total score: 40.3) had more desirable eating attitudes regarding reducing sodium intake than the PA group (36.6, p < 0.001). The total score for eating behaviors was slightly higher in the A group (49.6) than in the PA group (48.5), but without statistical significance. The A group (total score: 58.2) also received higher scores for self-efficacy regarding reducing sodium intake than the PA group (52.5, p < 0.001). Conclusion: This study suggests that nutrition education for childcare center foodservice employees should be expanded and customized education should be implemented according to the stages in reducing sodium intake. It is also suggested that food companies make efforts to develop low-sodium products.

The Respiratory and Hemodynamic Effect of Prone Position in Patients with ARDS (급성호흡부전증후군에서 Prone Position의 호흡 및 혈류역학적 효과)

  • Lim, Chae-Man;Koh, Youn-Suck;Jung, Bok-Hyun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1105-1113
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    • 1997
  • Background : Prone position improves oxygenation in some patients with ARDS. According to some authors, prone position can also improve the deteriorated hemodynamics induced by PEEP. But these respiratory and hemodynamic effects of prone position has not yet been fully established. Methods : Twentythree consequtive patients with ARDS(M : F= 11 : 12, $62.1{\pm}20.8yrs$) were the subjects for this study. ABGA, static compliance of the respiratory system, mean arterial pressure and pulse rate were obtained in supine position and at 5min, 0.5h and 2h of prone position. Positive respiratory response was defined as 20mmHg or more increase in $PaO_2/FIO_2$ within 2h of prone position. Early of late respiratory responses were defined if the positive response was observed within of after 3 day of ARDS onset, respectively. Positive hemodynamic response was defined as 10mmHg or more increase in mean arterial pressure at 5min of prone position. Results : Fifteen patients (65%) showed positive respiratory response. In the respiratory responders, $PaO_2$ was $69.8{\pm}17.6mmHg$ in supine position, $83.2{\pm}22.6mmHg$ in prone position 0.5h, $96.8{\pm}22.7mmHg$ in prone position 2h(p<0.001), and $PaO_2/FIO_2$ was $108{\pm}41mmHg$, $137{\pm}57mmHg$, $158{\pm}50mmHg$, respectively(p=0.001). Age, sex, cause of ARDS, supine $PaO_2$ and $PaO_2/FIO_2$ were not different between the respiratory responders and the nonresponders. The respiratory responders, however, showed higher mean arterial pressure than the nonresponders($91.1{\pm}13.1mmHg$ vs. $76.0{\pm}18.7mmHg$, p=0.035), and tendency of higher survival rate(9/15 vs. 2/8, p=0.074). Static compliance of the respiratory system was decreased in prone position 0.5h($28.4{\pm}7.9ml/cm$ $H_2O$ vs. $23.8{\pm}7.6ml/cm$ $H_2O$, p=0.007). The overall rate of early response(n=23) and late response(n=11) were similar(14/23 vs. 7/11, p>0.05). But patient without early response showed late response only in 25%(1/4), while patient with early response showed late response in 85.7%(6/7)(p=0.072). Five patients(22%) showed positive hemodynamic response, two of them being respiratory nonresponders. There were no differences in the baseline mean arterial pressure or the level of PEEP applied in supine between the hemodynamic responders and the hemodynamic nonresponders. Conclusions : Prone position either improved oxygenation or increased arterial pressure in significant proportion of patients with ARDS. And the respiratory response to prone position was thought to be determined in the early stage of ARDS.

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Relationship between Broca Index of Late School-Aged Children and Their Mothers' Eating, Cooking, and Exercise Habit (어머니의 식습관, 요리습관 및 운동습관과 학령기 후기 아동의 Broca 체질량지수와의 상관관계 연구)

  • Lee, Hyerim;Lee, Kyoung-Eun;Ko, Kwang Suk;Hong, Eunah
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.10
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    • pp.1488-1496
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    • 2016
  • The purposes of this study were to analyze mothers' eating, cooking, and exercise habits based on their demographic characteristics and to examine the relationship between those habits and their late school-aged children's Broca index. A total of 393 questionnaires were mailed to the mothers of late school-aged children who registered at four elementary schools in the Seoul area, of which 159 participants (40.0%) completed questionnaires. Statistical data analyses were performed using SPSS/Win 21.0 for descriptive statistics, t-test ANOVA, and Pearson's regression coefficient. There was a statistically significant difference in mothers' cooking habit (F=3.920, P=0.022) and exercise habit (F=3.211, P=0.043) according to their educational level. Interestingly, 82.4% of mothers had a Broca index of less than 90% of normal body mass level. A significant positive correlation of Broca index between mothers and their late school-aged children (r=0.345, P<0.001) indicated that children whose mothers had a low body mass level also tended to have a low body mass level. In this study, late school-aged children's Broca index was not significantly related with mother's eating (r=-0.072, P=0.367) or exercise habits (r=-0.010, P=0.897) but was significantly related with their mother's cooking habits (r=-0.157, P=0.048). Considering there are few studies examining the impacts of mother's cooking habits on their children's appropriate body mass, the results suggest that developing an effective educational program to cultivate mothers' healthy cooking habits to improve school-aged children's health status is very important. The findings of this study provide important data that could be used when developing health education programs tailored to the multi-dimensional impacts of mothers' life habits on their last school-aged children's developmental health status.

Effect of Mixed Sowing Ratios Between Whole Crop Barley with Hooded Type and Forage Pea on the Forage Yield and Quality (삼차망 청보리와 사료용 완두의 혼파재배가 수량 및 사료가치에 미치는 영향)

  • Ju, Jung-Il;Park, Jong-Min;Lee, Jung-Jun;Kim, Chang-Ho;Koo, Han-Mo;Oh, Tae-Seok;Lee, Hyo-Won
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.29 no.3
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    • pp.171-178
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    • 2009
  • The study was conducted to clarify the mixed seeding rate of whole crop barley with hood type and forage pea for using of forage crops and to compare the forage yield and quality. At a mixed seeding rate between the whole crop barley (WCB) and forage pea, The heading date and plant height of WCB were not a difference according to mixed seeding rate of forage pea. The tillers of the WCB were a decrease and plant of the forage pea were a increase according to increased seeding rate of forage pea. The lodging index of the WCB was a appearance with distribution of $0{\sim}3$, The lodging index of WCB with a 20kg/10a seeding rate of a only WCB without seeding of the forage pea was 3. The overwintering rate of forage pea was a appearance more than 90% at all treatment. The plant height of forage pea was a increase according to increased seeding rate of forage pea at 14 kg/10a and 20 kg/10a plots of WCB. At a mixed seeding between the WCB and forage pea, The fresh weight was a increase according to increased seeding rate of forage pea and was a appearance more than 3,000 kg at all treatment plot. But the dry matter weight was decrease according to increased seeding rates of forage pea. The dry matter weight of 20 kg/10a seeding rate of a only WCB without seeding of the forage pea showed the most amount with 1,266 kg. The crude protein (CP) content was a tendency to increase according to increased seeding rates of forage pea. But, the relative feed value (RFV) was a tendency to decrease according to increased seeding rate of forage pea. The highest RFV was 183.8 at 14 kg/10a seeding rate of a only WCB without seeding of the forage pea. The acid detergent fiber (ADF) and neutral detergent fiber (NDF) were a increase according to increased seeding rate of forage pea at 14 kg/10a and 20 kg/10a plots of WCB. The highest content of ADF and NDF were 23.9% and 46.3% at mixed seeding rate of 20 kg/10a of WCB with 10 kg/10a of forage pea, respectively. The highest sum of standardized score by fresh weight, dry matter weight, CP, ADF, NDF and RFV was 2.309 at mixed seeding rate of 20 kg/10a of WCB with 7.5 kg/10a of forage pea. The optimum mixed seeding rate was a considered judgment in the order of mixed seeding rate of 20 kg/10a of WCB with 7.5 kg/10a of forage pea, mixed seeding rate of 20 kg/10a of WCB with 5.0 kg/10a of forage pea.

The Health Behavior Patterns of Some Rural Residents in Korea and Their Association with Health Status and Health Management Practice (일부 농촌주민의 건강행위유형과 건강상태 및 건강관련실태와의 관련성)

  • Kim, Young-Gab;Kang, Myung-Guen;Ryu, So-Yeon;Kim, Ki-Soon;Kang, Sung-Deuk
    • Journal of agricultural medicine and community health
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    • v.29 no.1
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    • pp.43-63
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    • 2004
  • Objectives: The purpose of this study was to classify the patterns of health behaviors of some rural residents in Korea by sub-grouping them into populations with similar patterns of diet quality, physical activity, alcohol consumption and cigarette smoking, and then to investigate the relationship between these health behavior patterns and health status or health management of them. Methods: The study subjects were 722 rural residents above 20 years old on a typical rural district in Korea, and the data used in this study was from the survey data for health planning of a health center. Study questionnaire for this survey was developed from modifying the questionnaire for 'National Nutrition and Health Study' conducted in 1998. To classify health behavior patterns, cluster analysis was conducted. And to test the association of health behavior patterns with health status or health management, multiple logistic regression analysis were conducted. Results: The results and their implications of this study were as follows: 1. We identified six health behavior typologies : 67.8% of the sample had a good diet quality but showed sedentary activity level(good diet lifestyle) and 10.9% had heavy smoking behavior(smoking lifestyle). Individuals included in fitness lifestyle cluster(6.2%) had high physical activity level and those in drinking life style(2.6%) had had mainly large amount of alcohol. Zero point six percent of sample were included in hedonic lifestyle cluster, who showed poor health behaviors in all. Those included in passive lifestyle(11.9%) had no active health promoting activities but tended to avoid risk taking health behavior such as cigarette smoking and alcohol drinking. 2. As a result of logistic regression analysis, to compare with the individuals in good diet lifestyle, the prevalence of chronic diseases of those in fitness lifestyle showed higher and that of those in smoking lifestyle, drinking lifestyle, hedonic lifestyle, passive lifestyle showed lower than them, retrospectively. 3. Adjusting with general characteristics and health status, to compare with the individuals in good diet lifestyle, the proportion of those who had good health management practices in fitness lifestyle was higher, and the proportion of those who had health check in past 2 years was lower than them, retrospectively. Conclusions: There were some differences in health behavior patterns between rural population and national population, which influenced significantly on health status and health management practice of them. We suggested that the health promotion program for them be developed with considering these points.

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When do we use the Recycling Autograft in Limb Salvage Surgery? (사지구제술에서 언제 재활용 자가골 이식술이 유용한가?)

  • Kim, Jae-Do;Jang, Jae-Ho;Cho, Yool;Kim, Ji-Youn;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.95-105
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    • 2008
  • Purpose: To identify which is the best procedure in recycling autograft according to the resection & reconstruction type and recycling methods, and so when the recycling autograft is used in limb salvage surgery. Materials and Methods: We have treated fifty-eight patients (34 male, 24 female; age range 5 to 74 years, mean age 36.5 years), who had the malignant musculoskeletal tumors, with recycling autograft (47 patients with extracoporeal irradiation, 11 patients with pasteurization) from December 1995 to February 2006. The resection and reconstruction type was 3 cases with fragmentary, 8 intercalary, 23 rAPC (recycling-Autograft-Prosthesis composite), 18 osteoarticular, 5 total joint and 1 soft tissue (achilles tendon). The result was evaluated by the radiologic union at junctional site, the functional score by musculoskeletal tumor society score and complications according to the resection & reconstruction type and recycling methods. Results: The junctional union was obtained at 15.0 months in extracoporeal irradiation and 12.6 months in pasteurization. Also the mean radiologic union was shown at 6.0 months in fragmentary, 12.8 months in intercalary, 10 months in rAPC, 23.3 months in osteoarticular and 15.6 months in total joint. The functional score was 65.5% in fragmentary, 60.8% in intercalary, 62.8% in APC (except pelvis), 66.0% in osteoarticular and 66.6% in total joint. We have experienced 1 infection, 1 prutrusio acetabuli in pasteurization (18.1%) and other 22 complications (3 deep infections, 8 nonunions, 2 fractures, 2 epiphyseal problems, 5 joint instabilities, 2 local recurrence) in extracoporeal irradiation (46.8%). Also we have experienced 3 complications (3 nonunions) in intercalary (37.5%), 9 complications (4 nonunions, 1 deep infection, 1 periprosthetic fracture, 1 epiphyseal problem, 1 local recurrence, 1 protrusio acetabuli) in rAPC (50.0%), 6 complications (2 deep infections, 2 nonunions, 1 epiphyseal problem, 1 pathologic fracture) in osteoarticular (33.3%), 5 complications (5 joint instabilities) in total joint (100%) and 1 complication(1 local recurrence) in soft tissue (100%). Conclusion: In our experience, according to the resection & reconstruction type fragmentary and intercalary may have several advantages such as good radiologic and functional result and low rate of complication. And it seems that rAPC was available in case which have no sufficient residual bone stock. Also the pasteurization may have more advantages than that of the extracorporeal irradiation.

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