Factors influencing the quality of life in children with atopic dermatitis in Korea: A multicenter cross-sectional study.

Background: There is a lack of studies about which factors affect the quality of life (QoL) in children with atopic dermatitis (AD), although it is well known that AD has considerably negative effects on their QoL. Objective: This study aimed to measure the QoL in children with AD and identify the factors that affect their QoL. Methods: A questionnaire derived from the Children's Dermatology Life Quality Index (CDLQI) was used to measure QoL. Family history, allergic comorbidities, exacerbation-related factors, time of exacerbation, and previous and current treatment were also evaluated. The total immunoglobulin E (IgE) level and specific IgE sensitization were determined by the multiple allergen simultaneous test, allergy test, or skin-prick test. AD severity was categorized into mild, moderate, and severe based on treatments. Results: In total, 254 children (46.4 months, 53% boys) from seven hospitals completed the survey. The mean CDLQI score was 7.2 ± 5.5 (total score range of 0-30). The respondents were divided into three groups according to their QoL score distribution, with 0 - 4 points (n = 84), 5 - 9 points (n = 90), and ≥10 points (n = 80) representing good, fair, and poor QoL, respectively. The more severe AD showed the higher CDLQI score significantly (p = 0.001). Compared with other groups, children with poor QoL were more sensitized to inhalant allergens (odds ratio [OR] 1.29 [95% confidence interval {CI}], 1.03 - 1.62) and had more exacerbating factors (OR 1.26 [95% CI, 1.04 - 1.54]), which included inhalation allergen-related exacerbating factors (OR 2.54 [95% CI, 1.23 - 5.23), even after adjusting for age, total IgE, body mass index, severity, and use of moisturizer. The concordance between animal sensitization and an exacerbating factor, including dog and cat, was fair, with 0.39 κ and 0.85 accuracy. Conclusion: This study showed that impaired QoL in children with AD is associated with inhalant allergen sensitization and inhalant allergen-related exacerbation factors. Especially, dog and cat sensitization was a significant exacerbating factor. The inhalation-related exacerbation factors, including animal allergens, might be addressed to improve AD management in children.

Analysis of national surveillance of respiratory pathogens for community-acquired pneumonia in children and adolescents.

BACKGROUND: Respiratory infections among children, particularly community-acquired pneumonia (CAP), is a major disease with a high frequency among outpatient and inpatient visits. The causes of CAP vary depending on individual susceptibility, the epidemiological characteristics of the community, and the season. We performed this study to establish a nationwide surveillance network system and identify the causative agents for CAP and antibiotic resistance in Korean children with CAP. METHODS: The monitoring network was composed of 28 secondary and tertiary medical institutions. Upper and lower respiratory samples were assayed using a culture or polymerase chain reaction (PCR) from August 2018 to May 2020. RESULTS: A total of 1023 cases were registered in patients with CAP, and PCR of atypical pneumonia pathogens revealed 422 cases of M. pneumoniae (41.3%). Respiratory viruses showed a positivity rate of 65.7% by multiplex PCR test, and human rhinovirus was the most common virus, with 312 cases (30.5%). Two hundred sixty four cases (25.8%) were isolated by culture, including 131 cases of S. aureus (12.8%), 92 cases of S. pneumoniae (9%), and 20 cases of H. influenzae (2%). The cultured, isolated bacteria may be colonized pathogen. The proportion of co-detection was 49.2%. The rate of antibiotic resistance showed similar results as previous reports. CONCLUSIONS: This study will identify the pathogens that cause respiratory infections and analyze the current status of antibiotic resistance to provide scientific evidence for management policies of domestic respiratory infections. Additionally, in preparation for new epidemics, including COVID-19, monitoring respiratory infections in children and adolescents has become more important, and research on this topic should be continuously conducted in the future.

Vaccine-related Anaphylaxis Cases Confirmed by KCDC from 2001-2016.

BACKGROUND: A national immunization program (NIP) to prevent disease and reduce mortality from vaccine preventable diseases (VPD) is very important. METHODS: We analyzed only the anaphylaxis cases that occurred between 2001 and 2016 that Korea Centers for Disease Control and Prevention (KCDC) determined had a definite causal relationship with a vaccine. The clinical symptoms were assessed according to the Brighton Collaboration case definition (BCCD) level. RESULTS: During the period, there were 13 cases of vaccine-related anaphylaxis. The median age was 9 years (range, 1 month to 59 years). The incidence of anaphylaxis per million doses was 0.090 in 2005, 0.079 in 2012, 0.071 in 2013, 0.188 in 2015, and 0.036 in 2016. Of those cases, 23.1% were influenza vaccines, and 76.9% were BCCD level 2. Epinephrine was used in 46.2%. CONCLUSION: Vaccine-related anaphylaxis seems to have been very rare in the past, but health care professionals must always be aware of anaphylaxis.

Recent Advances in ROS-Responsive Cell Sheet Techniques for Tissue Engineering.

Cell sheet engineering has evolved rapidly in recent years as a new approach for cell-based therapy. Cell sheet harvest technology is important for producing viable, transplantable cell sheets and applying them to tissue engineering. To date, most cell sheet studies use thermo-responsive systems to detach cell sheets. However, other approaches have been reported. This review provides the progress in cell sheet detachment techniques, particularly reactive oxygen species (ROS)-responsive strategies. Therefore, we present a comprehensive introduction to ROS, their application in regenerative medicine, and considerations on how to use ROS in cell detachment. The review also discusses current limitations and challenges for clarifying the mechanism of the ROS-responsive cell sheet detachment.

Using fluorescence surrogates to track algogenic dissolved organic matter (AOM) during growth and coagulation/flocculation processes of green algae.

Tracking the variation of the algogenic organic matter (AOM) released during the proliferation of green algae and subsequent treatment processes is crucial for constructing and optimizing control strategies. In this study, the potential of the spectroscopic tool was fully explored as a surrogate of AOM upon the cultivation of green algae and subsequent coagulation/flocculation (C/F) treatment processes using ZrCl4 and Al2(SO4)3. Fluorescence excitation emission matrix coupled with parallel factor analysis (EEM-PARAFAC) identified the presence of three independent fluorescent components in AOM, including protein-like (C1), fulvic-like (C2) and humic-like components (C3). Size exclusion chromatography (SEC) revealed that C1 in AOM was composed of large-sized proteins and aromatic amino acids. The individual components exhibited their unique characteristics with respect to the dynamic changes. C1 showed the highest correlation with AOM concentrations (R2 = 0.843) upon the C/F processes. C1 could also be suggested as an optical predictor for the formation of trihalomethanes upon the C/F processes. This study sheds a light for the potential application of the protein-like component (C1) as a practical surrogate to track the evolution of AOM in water treatment or wastewater reclamation systems involving Chlorella vulgaris green algae.

Suppression of T24 human bladder cancer cells by ROS from locally delivered hematoporphyrin-containing polyurethane films.

Systemic injection of a photosensitizer is a general method in photodynamic therapy, but it has complications due to the unintended systemic distribution and remnants of photosensitizers. This study focused on the possibility of suppressing luminal proliferative cells by excessive reactive oxygen species from locally delivered photosensitizer with biocompatible polyurethane, instead of the systemic injection method. We used human bladder cancer cells, hematoporphyrin as the photosensitizer, and polyurethane film as the photosensitizer-delivering container. The light source was a self-made LED (510 nm, 5 mW cm-2) system. The cancer cells were cultured on different doses of hematoporphyrin-containing polyurethane film and irradiated with LED for 15 minutes and 30 minutes each. After irradiating with LED and incubating for 24 hours, cell viability analysis, cell cycle analysis, apoptosis assay, intracellular and extracellular ROS generation study and western blot were performed. The cancer cell suppression effects of different concentrations of the locally delivered hematoporphyrin with PDT were compared. Apoptosis dominant cancer cell suppressions were shown to be hematoporphyrin dose-dependent. However, after irradiation, intracellular ROS amounts were similar in all the groups having different doses of hematoporphyrin, but these values were definitely higher than those in the control group. Excessive extracellular ROS from the intended, locally delivered photosensitizer for photodynamic treatment application had an inhibitory effect on luminal proliferative cancer cells. This method can be another possibility for PDT application on contactable or attachable lesions.

Influence of Biomimetic Materials on Cell Migration.

In recent tissue engineering applications, the advance of biomaterials has focused on the devising of biomimetic materials that are directing new tissue formation and capable of causing specific cellular responses. These advances can be controlled by modifying the devising parameters of the materials. The biomimetic materials potentially mimic many roles of ECM in tissues. For the homogeneous distribution and biocompatibility of scaffolds by cell migration with biomimetic materials, cell migration is studied because it has a important role in physiological phenomenon and in pathologies; cancer metastasis, immune response or embryonic development. This review discusses the migration of cells with biomimetic materials for tissue engineering. It is also summarized that the recent advances of cell migration with biomimetic materials in 2-D and 3-D for tissue engineering.

The age-related characteristics of adults with asthma who visited emergency departments in Korea from 2007 to 2012.

BACKGROUND: Understanding the patterns of emergency department (ED) visits of patients with asthma is important for disease control and prevention of exacerbations. OBJECTIVE: This study aimed to investigate the characteristics of adult patients who visited EDs because of their asthma. METHODS: Patients with asthma, ages ≥19 years old, who visited 117 EDs throughout Korea between January 2007 and December 2012 were identified in the National Emergency Department Information System (NEDIS) data base using the International Classification of Disease, 10th revision, codes J45 (asthma) and J46 (status asthmaticus). RESULTS: A total of 97,835 adult patients with asthma visited 117 EDs throughout Korea during the study period. There was a slight female preponderance (male-to-female ratio, 1:1.09). The number of patients aged 70-79-years-old was 28,031 (28.7%), the highest among the patients with asthma. ED visits showed a seasonal distribution, with most occurring in winter and spring, followed by autumn. The seasonal distribution varied by age; most patients ages 19-49 years presented in autumn (September), whereas those patients ages ≥50 years presented to the ED most often in winter. Overall, 65.5% of patients were admitted to the hospital, including 12.6% admitted to an intensive care unit (ICU). Overall, 209 patients (0.2%) died. The rates of hospital admission to general wards and ICUs were highest in those patients ≥70 years old; this group also had the highest mortality rate. CONCLUSION: In this nationwide study, which spanned 6 years, of adult patients with asthma, we observed an age-specific seasonal pattern of ED visits. Identifying the causes of age-related deterioration and seasonal visits to the ED will help prevent asthma symptoms and reduce medical costs.

High-Mobility Group Box 1 Mediates Fibroblast Activity via RAGE-MAPK and NF-κB Signaling in Keloid Scar Formation.

Emerging studies have revealed the involvement of high-mobility group box 1 (HMGB1) in systemic fibrotic diseases, yet its role in the cutaneous scarring process has not yet been investigated. We hypothesized that HMGB1 may promote fibroblast activity to cause abnormal cutaneous scarring. In vitro wound healing assay with normal and keloid fibroblasts demonstrated that HMGB1 administration promoted the migration of both fibroblasts with increased speed and a greater traveling distance. Treatment of the HMGB1 inhibitor glycyrrhizic acid (GA) showed an opposing effect on both activities. To analyze the downstream mechanism, the protein levels of extracellular signal-regulated kinase (ERK) 1/2, protein kinase B (AKT), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) were measured by western blot analysis. HMGB1 increased the expression levels of ERK1/2, AKT, and NF-κB compared to the control, which was suppressed by GA. HMGB1 promoted both normal and keloid fibroblasts migration to a degree equivalent to that achieved with TGF-ß. We concluded that HMGB1 activates fibroblasts via the receptor for advanced glycation end product (RAGE)-mitogen-activated protein kinases (MAPK) and NF-κB interaction signaling pathways. Further knowledge of the relationship of HMGB1 with skin fibrosis may lead to a promising clinical approach to manage abnormal scarring.

A comparative study on generating simulated Landsat NDVI images using data fusion and regression method-the case of the Korean Peninsula.

Landsat optical images have enough spatial and spectral resolution to analyze vegetation growth characteristics. But, the clouds and water vapor degrade the image quality quite often, which limits the availability of usable images for the time series vegetation vitality measurement. To overcome this shortcoming, simulated images are used as an alternative. In this study, weighted average method, spatial and temporal adaptive reflectance fusion model (STARFM) method, and multilinear regression analysis method have been tested to produce simulated Landsat normalized difference vegetation index (NDVI) images of the Korean Peninsula. The test results showed that the weighted average method produced the images most similar to the actual images, provided that the images were available within 1 month before and after the target date. The STARFM method gives good results when the input image date is close to the target date. Careful regional and seasonal consideration is required in selecting input images. During summer season, due to clouds, it is very difficult to get the images close enough to the target date. Multilinear regression analysis gives meaningful results even when the input image date is not so close to the target date. Average R 2 values for weighted average method, STARFM, and multilinear regression analysis were 0.741, 0.70, and 0.61, respectively.

Ethyl-2, 5-dihydroxybenzoate displays dual activity by promoting osteoblast differentiation and inhibiting osteoclast differentiation.

The interplay between bone-forming osteoblasts and bone-resorbing osteoclasts is essential for balanced bone remodeling. In this study, we evaluate the ability of ethyl-2, 5-dihyrdoxybenzoate (E-2, 5-DHB) to affect both osteoblast and osteoclast differentiation for bone regeneration. Osteogenic differentiation of human mesenchymal stem cells (hMSCs) was quantified by measuring alkaline phosphatase (ALP) activity and calcium deposition. To evaluate osteoclast differentiation, we investigated the effect of E-2, 5-DHB on RANKL-activated osteoclastogenesis in RAW 264.7 cells. E-2, 5-DHB enhanced ALP activity and inhibited RAW 264.7 cell osteoclastogenesis in vitro. To assess the in vivo activity of E-2, 5-DHB, hMSCs were delivered subcutaneosuly alone or in combination with E-2, 5-DHB in an alginate gel into the backs of nude-mice. Histological and immunohistochemical evaluation showed significantly higher calcium deposition in the E-2, 5-DHB group. Osteocalcin (OCN) was highly expressed in cells implanted in the gels containing E-2, 5-DHB. Our results suggest that E-2, 5-DHB can effectively enhance osteoblast differentiation and inhibit osteoclast differentiation both in vitro and in vivo. Understanding the dual function of E-2, 5-DHB on osteoblast and osteoclast differentiation will aid in future development of E-2, 5-DHB as a material for bone tissue engineering.

Enhancement of human mesenchymal stem cell infiltration into the electrospun poly(lactic-co-glycolic acid) scaffold by fluid shear stress.

The infiltration of the cells into the scaffolds is important phenomenon to give them good biocompatibility and even biodegradability. Fluid shear stress is one of the candidates for the infiltration of cells into scaffolds. Here we investigated the directional migration of human mesenchymal stem cells and infiltration into PLGA scaffold by fluid shear stress. The human mesenchymal stem cells showed directional migrations following the direction of the flow (8, 16 dyne/cm(2)). In the scaffold models, the fluid shear stress (8 dyne/cm(2)) enhanced the infiltration of cells but did not influence on the infiltration of Poly(lactic-co-glycolic acid) particles.

Golgi polarization plays a role in the directional migration of neonatal dermal fibroblasts induced by the direct current electric fields.

Directional cell migration requires cell polarization. The reorganization of the Golgi apparatus is an important phenomenon in the polarization and migration of many types of cells. Direct current electric fields (dc (EF) induced directional cell migration in a wide variety of cells. Here nHDFs migrated toward cathode under 1 V/cm dc EF, however 1 µM of brefeldin A (BFA) inhibited the dc EF induced directional migration. BFA (1 µM) did not cause the complete Golgi dispersal for 2 h. When the Golgi polarization maintained their direction of polarity, the direction of cell migration also kept toward the same direction of the Golgi polarization even though the dc EF was reversed. In this study, the importance of the Golgi polarization in the directional migration of nHDf under dc EF was identified.

Stimulated Osteogenic Differentiation of Human Mesenchymal Stem Cells by Reduced Graphene Oxide.

Osteoprogenitor cells play a significant role in the growth or repair of bones, and have great potential as cell sources for regenerative medicine and bone tissue engineering, but control of their specific differentiation into bone cells remains a challenge. Graphene-based nanomaterials are attractive candidates for biomedical applications as substrates for stem cell (SC) differentiation, scaffolds in tissue engineering, and components of implant devices owing to their biocompatible, transferable and implantable properties. This study examined the enhanced osteogenic differentiation of human mesenchymal stem cells (hMSCs) by reduced graphene oxide (rGO) nanoparticles (NPs), and rGO NPs was prepared by reducing graphene oxide (GO) with a hydrazine treatment followed by annealing in argon and hydrogen. The cytotoxicity profile of each particle was examined using a water-soluble tetrazolium-8 (WST-8) assay. At different time-points, a WST-8 assay, alkaline phosphatase (ALP) activity assay and alizarin red S (ARS) staining were used to determine the effects of rGO NPs on proliferation, differentiation and mineralization, respectively. The results suggest that graphene-based materials have potential as a platform for stem cells culture and biomedical applications.

Promotion of full-thickness wound healing using epigallocatechin-3-O-gallate/poly (lactic-co-glycolic acid) membrane as temporary wound dressing.

Epigallocatechin-3-O-gallate (EGCG) is a major polyphenolic compound in green tea. It has been known that EGCG regulates the secretion of cytokines and the activation of skin cells during wound healing. In this study, various concentrations of EGCG were added to the electrospun membranes composed of poly (lactic-co-glycolic acid) (PLGA), and its healing effects on full-thickness wounds created in nude mice were investigated. The electrospun membranes containing 5 wt% EGCG (5EGCG/PLGA membrane) exhibited cytotoxicity in human dermal fibroblasts (HDFs) as HDF morphologies were transformed on them. In the animal study, cell infiltration of mice treated with electrospun membranes containing 1 wt% EGCG (1EGCG/PLGA membrane) significantly increased after 2 weeks. The immunoreactivity of Ki-67 (re-epithelialization at the wound site) and CD 31 (formation of blood vessels) also increased in the mice treated with 1EGCG/PLGA membranes in comparison with the mice treated with PLGA membranes. These results suggest that 1EGCG/PLGA can enhance wound healing in full thickness by accelerating cell infiltration, re-epithelialization, and angiogenesis.

CT findings of acute pelvic inflammatory disease.

PURPOSE: To determine the computed tomographic (CT) findings of acute pelvic inflammatory disease (PID). METHODS: This retrospective, single-institution case-control study was approved by our institutional review board, and the informed consent was waived owing to the retrospective nature of the study. CT images of 32 women with clinically proven acute PID and 32 control subjects with other conditions of similar presentation were retrospectively reviewed. Analysis of CT findings included hepatic capsular enhancement, pelvic fat haziness, complicated ascites, uterine serosal enhancement, tubal thickening, endometritis, and oophoritis. Comparison of CT findings was performed with the Chi square test or the Fisher exact test and logistic regression analysis was used to determine significant CT findings in predicting PID. RESULTS: The CT findings that showed a statistically significant difference were hepatic capsular enhancement on late arterial phase (p = 0.003), pelvic fat haziness (p = 0.045), and tubal thickening (p = 0.001). Subsequent multivariate logistic regression analysis revealed that the presence of hepatic capsular enhancement on late arterial phase and tubal thickening were significant predictors of PID (hepatic capsular enhancement on late arterial phase, p = 0.015, odds ratio [OR] = 4.8; tubal thickening, p = 0.005, OR = 10.5). CONCLUSION: Diagnostic morphological CT findings in women with clinically proven PID and acute abdominal pain include hepatic capsular enhancement on late arterial phase and tubal thickening.

Differentiation of an intrapancreatic accessory spleen from a small (<3-cm) solid pancreatic tumor: value of diffusion-weighted MR imaging.

PURPOSE: To evaluate the value of diffusion-weighted (DW) imaging in differentiation of an intrapancreatic accessory spleen (IPAS) from a small (<3 cm) solid pancreatic tumor. MATERIALS AND METHODS: This retrospective study was approved by the institutional review board, and informed consent was waived. Twenty patients with IPAS and 22 patients with small solid pancreatic tumors were included. All patients underwent abdominal magnetic resonance (MR) imaging with DW and gadoxetic acid-enhanced imaging. Qualitative (signal intensity) and quantitative (signal intensity and apparent diffusion coefficient [ADC]) evaluations were performed by two observers. Fisher exact test and Mann-Whitney U test were used for comparing groups. RESULTS: Compared with the spleen, the IPAS showed isointensity more frequently than did small pancreatic tumors on T2-weighted images (95% [19 of 20] vs 41% [nine of 22]), arterial phase images (100% [20 of 20] vs 18% [four of 22]), portal phase images (100% [20 of 20] vs 23% [five of 22]), late phase images (100% [20 of 20] vs 41% [nine of 22]), and DW images with b value of 0 sec/mm(2) (100% [20 of 20] vs 9% [two of 22]), b value of 100 sec/mm(2) (95% [19 of 20] vs 27% [six of 22]), and b value of 800 sec/mm(2) (100% [20 of 20] vs 27% [six of 22]), with significant differences (P < .01). The means of the absolute value of relative signal intensity and ADC ratio on DW images of IPAS were significantly lower and closer to zero than those of pancreatic tumors (P < .05). Visual assessment of the similarity between pancreatic lesion and spleen on DW images for diagnosis of IPAS yielded diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 95% (40 of 42), 100% (20 of 20), 91% (20 of 22), 91% (20 of 22), and 100% (20 of 20), respectively, for observer 1 and 90% (38 of 42), 95% (19 of 20), 86% (19 of 22), 86% (19 of 22), and 95% (19of 20), respectively, for observer 2. CONCLUSION: In addition to conventional morphologic MR imaging, DW imaging can be used as a tool for differentiating IPAS from solid pancreatic tumors. SUPPLEMENTAL MATERIAL: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12112765/-/DC1.

Gadoxetic acid-enhanced fat suppressed three-dimensional T1-weighted MRI using a multiecho dixon technique at 3 tesla: emphasis on image quality and hepatocellular carcinoma detection.

PURPOSE: To compare the image quality between T1 high-resolution isotropic volume examination using the multi-echo Dixon technique (mDixon-eTHRIVE) and that using spectrally adiabatic inversion recovery (SPAIR-eTHRIVE) in gadoxetic acid-enhanced liver MRI, and to evaluate the detectability of hepatocellular carcinoma (HCC) on mDixon-eTHRIVE. MATERIALS AND METHODS: Seventy patients with 117 HCCs underwent gadoxetic acid-enhanced liver MRI using mDixon-eTHRIVE. All patients also underwent gadoxetic acid-enhanced MRI using SPAIR-eTHRIVE (mean interval of 96 days). Two radiologists performed a consensus review of MRIs for image quality, homogeneity of fat suppression, artifact, and anatomic sharpness using a four-point scale. The detectability for HCC with mDixon-eTHRIVE was assessed using alternative-free response receiver operating characteristic. RESULTS: All mDixon-eTHRIVE images received higher scores for homogeneity of fat suppression and image quality (P < 0.05) compared with those for SPAIR-eTHRIVE. With respect to artifact and anatomic sharpness, there was no significant difference between two MRIs (P > 0.05). Diagnostic accuracy (Az) and sensitivity for detecting HCCs with mDixon-eTHRIVE images were mean 0.954 and 93.2%, respectively. CONCLUSION: For gadoxetic acid-enhanced liver MRI, mDixon-eTHRIVE showed improved homogeneity of fat suppression and overall image quality compared with SPAIR-eTHRIVE.

Unenhanced magnetic resonance portography using repetitive arterial or vein labeling method at 3.0-T.

OBJECTIVE: The objective of this study was to determine whether unenhanced magnetic resonance (MR) angiography using repetitive arterial or vein labeling (RAVEL) is feasible to visualize effectively the intrahepatic portal vein (PV) at 3.0 T. METHODS: Forty patients underwent liver MR imaging (MRI) with unenhanced MR portography using RAVEL. Two radiologists performed a consensus review of unenhanced MR portography and portal-phase MRI with regard to anatomic type of PV, vessel conspicuity, and image quality. RESULTS: For determination of the anatomic type of PV, the 2 techniques were equivalent. There were tendencies toward increased conspicuity for right segmental PV and its branches with unenhanced MR portography and for left PV with conventional MRI, although significant differences were not found between MRIs (P > 0.05). Image quality for unenhanced MR portography was poor in 1, moderate in 8, and good in 31 patients. CONCLUSIONS: Unenhanced MR portography using RAVEL at 3.0 T is feasible and provides effective visualization of intrahepatic PV.

Biological advantages of porous hydroxyapatite scaffold made by solid freeform fabrication for bone tissue regeneration.

Presently, commercially available porous bone substitutes are manufactured by the sacrificial template method, direct foaming method, and polymer replication method (PRM). However, current manufacturing methods provide only the simplest form of the bone scaffold and cannot easily control pore size. Recent developments in medical imaging technology, computer-aided design, and solid freeform fabrication (SFF), have made it possible to accurately produce porous synthetic bone scaffolds to fit the defected bone shape. Porous scaffolds were fabricated by SFF and PRM for a comparison of physical and mechanical properties of scaffold. The suggested three-dimensional model has interconnected cubic pores of 500 µm and its calculated porosity is 25%. Whereas hydroxyapatite scaffolds fabricated by SFF had connective macropores, those by PRM formed a closed pore external surface with internally interconnected pores. SFF was supposed to be a proper method for fabricating an interconnected macroporous network. Biocompatibility was confirmed by testing the cytotoxicity, hemolysis, irritation, sensitization, and implantation. In summary, the aim was to verify the safety and efficacy of the scaffolds by biomechanical and biological tests with the hope that this research could promote the feasibility of using the scaffolds as a bone substitute.