KR20120082885A - 골수를 함유하는 골 시멘트 - Google Patents
골수를 함유하는 골 시멘트 Download PDFInfo
- Publication number
- KR20120082885A KR20120082885A KR1020127008302A KR20127008302A KR20120082885A KR 20120082885 A KR20120082885 A KR 20120082885A KR 1020127008302 A KR1020127008302 A KR 1020127008302A KR 20127008302 A KR20127008302 A KR 20127008302A KR 20120082885 A KR20120082885 A KR 20120082885A
- Authority
- KR
- South Korea
- Prior art keywords
- bone
- cement
- bone cement
- mpa
- mechanical properties
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
- 239000002639 bone cement Substances 0.000 title claims abstract description 130
- 210000001185 bone marrow Anatomy 0.000 title claims abstract description 57
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 64
- 239000000178 monomer Substances 0.000 claims abstract description 23
- 239000004568 cement Substances 0.000 claims description 48
- 239000004926 polymethyl methacrylate Substances 0.000 claims description 19
- 239000000843 powder Substances 0.000 claims description 19
- 238000000034 method Methods 0.000 claims description 18
- 229920000642 polymer Polymers 0.000 claims description 18
- 239000003505 polymerization initiator Substances 0.000 claims description 17
- 239000007787 solid Substances 0.000 claims description 12
- VVQNEPGJFQJSBK-UHFFFAOYSA-N Methyl methacrylate Chemical group COC(=O)C(C)=C VVQNEPGJFQJSBK-UHFFFAOYSA-N 0.000 claims description 10
- 239000012190 activator Substances 0.000 claims description 10
- QIGBRXMKCJKVMJ-UHFFFAOYSA-N Hydroquinone Chemical compound OC1=CC=C(O)C=C1 QIGBRXMKCJKVMJ-UHFFFAOYSA-N 0.000 claims description 8
- TZCXTZWJZNENPQ-UHFFFAOYSA-L barium sulfate Chemical group [Ba+2].[O-]S([O-])(=O)=O TZCXTZWJZNENPQ-UHFFFAOYSA-L 0.000 claims description 6
- 239000000203 mixture Substances 0.000 claims description 6
- 239000003795 chemical substances by application Substances 0.000 claims description 5
- GYVGXEWAOAAJEU-UHFFFAOYSA-N n,n,4-trimethylaniline Chemical compound CN(C)C1=CC=C(C)C=C1 GYVGXEWAOAAJEU-UHFFFAOYSA-N 0.000 claims description 5
- 239000003381 stabilizer Substances 0.000 claims description 5
- 239000004342 Benzoyl peroxide Substances 0.000 claims description 4
- OMPJBNCRMGITSC-UHFFFAOYSA-N Benzoylperoxide Chemical compound C=1C=CC=CC=1C(=O)OOC(=O)C1=CC=CC=C1 OMPJBNCRMGITSC-UHFFFAOYSA-N 0.000 claims description 4
- 235000019400 benzoyl peroxide Nutrition 0.000 claims description 4
- 229910052588 hydroxylapatite Inorganic materials 0.000 claims description 3
- XYJRXVWERLGGKC-UHFFFAOYSA-D pentacalcium;hydroxide;triphosphate Chemical compound [OH-].[Ca+2].[Ca+2].[Ca+2].[Ca+2].[Ca+2].[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O XYJRXVWERLGGKC-UHFFFAOYSA-D 0.000 claims description 3
- 229920003229 poly(methyl methacrylate) Polymers 0.000 claims description 3
- PPBRXRYQALVLMV-UHFFFAOYSA-N Styrene Chemical compound C=CC1=CC=CC=C1 PPBRXRYQALVLMV-UHFFFAOYSA-N 0.000 claims 2
- 229940102838 methylmethacrylate Drugs 0.000 claims 1
- 239000000463 material Substances 0.000 abstract description 7
- 238000006116 polymerization reaction Methods 0.000 description 9
- 238000002156 mixing Methods 0.000 description 8
- 206010017076 Fracture Diseases 0.000 description 6
- 238000004519 manufacturing process Methods 0.000 description 5
- 230000001009 osteoporotic effect Effects 0.000 description 5
- 238000001356 surgical procedure Methods 0.000 description 5
- 208000010392 Bone Fractures Diseases 0.000 description 4
- 238000007792 addition Methods 0.000 description 4
- 230000003247 decreasing effect Effects 0.000 description 4
- 239000007791 liquid phase Substances 0.000 description 4
- 238000005259 measurement Methods 0.000 description 4
- 239000007788 liquid Substances 0.000 description 3
- 208000001132 Osteoporosis Diseases 0.000 description 2
- 239000004809 Teflon Substances 0.000 description 2
- 229920006362 Teflon® Polymers 0.000 description 2
- MCMNRKCIXSYSNV-UHFFFAOYSA-N ZrO2 Inorganic materials O=[Zr]=O MCMNRKCIXSYSNV-UHFFFAOYSA-N 0.000 description 2
- 230000037182 bone density Effects 0.000 description 2
- 238000002591 computed tomography Methods 0.000 description 2
- 230000001054 cortical effect Effects 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 239000012530 fluid Substances 0.000 description 2
- 239000011159 matrix material Substances 0.000 description 2
- RVTZCBVAJQQJTK-UHFFFAOYSA-N oxygen(2-);zirconium(4+) Chemical compound [O-2].[O-2].[Zr+4] RVTZCBVAJQQJTK-UHFFFAOYSA-N 0.000 description 2
- 239000012071 phase Substances 0.000 description 2
- 125000003011 styrenyl group Chemical group [H]\C(*)=C(/[H])C1=C([H])C([H])=C([H])C([H])=C1[H] 0.000 description 2
- 210000001519 tissue Anatomy 0.000 description 2
- 206010041541 Spinal compression fracture Diseases 0.000 description 1
- 239000006096 absorbing agent Substances 0.000 description 1
- 239000003522 acrylic cement Substances 0.000 description 1
- 239000000654 additive Substances 0.000 description 1
- 239000000556 agonist Substances 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
- 239000011324 bead Substances 0.000 description 1
- 239000012867 bioactive agent Substances 0.000 description 1
- 230000002051 biphasic effect Effects 0.000 description 1
- 239000000919 ceramic Substances 0.000 description 1
- 238000012669 compression test Methods 0.000 description 1
- 239000002872 contrast media Substances 0.000 description 1
- 238000001739 density measurement Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 239000000975 dye Substances 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 239000000945 filler Substances 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 239000008240 homogeneous mixture Substances 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 239000004615 ingredient Substances 0.000 description 1
- 238000002347 injection Methods 0.000 description 1
- 239000007924 injection Substances 0.000 description 1
- 238000007689 inspection Methods 0.000 description 1
- 239000012528 membrane Substances 0.000 description 1
- 210000004379 membrane Anatomy 0.000 description 1
- 230000017074 necrotic cell death Effects 0.000 description 1
- 230000010355 oscillation Effects 0.000 description 1
- 230000011164 ossification Effects 0.000 description 1
- 238000005191 phase separation Methods 0.000 description 1
- 230000002787 reinforcement Effects 0.000 description 1
- 230000003014 reinforcing effect Effects 0.000 description 1
- 238000005070 sampling Methods 0.000 description 1
- 210000003625 skull Anatomy 0.000 description 1
- 239000007790 solid phase Substances 0.000 description 1
- 239000002904 solvent Substances 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 238000003786 synthesis reaction Methods 0.000 description 1
- 238000010998 test method Methods 0.000 description 1
- 210000000689 upper leg Anatomy 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/14—Macromolecular materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3641—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the site of application in the body
- A61L27/3645—Connective tissue
- A61L27/365—Bones
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
- A61L24/0005—Ingredients of undetermined constitution or reaction products thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
- A61L24/04—Surgical adhesives or cements; Adhesives for colostomy devices containing macromolecular materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
- A61L24/04—Surgical adhesives or cements; Adhesives for colostomy devices containing macromolecular materials
- A61L24/06—Surgical adhesives or cements; Adhesives for colostomy devices containing macromolecular materials obtained by reactions only involving carbon-to-carbon unsaturated bonds
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/14—Macromolecular materials
- A61L27/16—Macromolecular materials obtained by reactions only involving carbon-to-carbon unsaturated bonds
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3604—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the human or animal origin of the biological material, e.g. hair, fascia, fish scales, silk, shellac, pericardium, pleura, renal tissue, amniotic membrane, parenchymal tissue, fetal tissue, muscle tissue, fat tissue, enamel
- A61L27/3608—Bone, e.g. demineralised bone matrix [DBM], bone powder
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/02—Materials or treatment for tissue regeneration for reconstruction of bones; weight-bearing implants
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Chemical & Material Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Epidemiology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Chemical Kinetics & Catalysis (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Medicinal Chemistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Dermatology (AREA)
- Surgery (AREA)
- Botany (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Molecular Biology (AREA)
- Urology & Nephrology (AREA)
- Zoology (AREA)
- Vascular Medicine (AREA)
- Materials For Medical Uses (AREA)
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US23887009P | 2009-09-01 | 2009-09-01 | |
| US61/238,870 | 2009-09-01 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| KR20120082885A true KR20120082885A (ko) | 2012-07-24 |
Family
ID=43446803
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| KR1020127008302A Withdrawn KR20120082885A (ko) | 2009-09-01 | 2010-08-25 | 골수를 함유하는 골 시멘트 |
Country Status (10)
| Country | Link |
|---|---|
| US (1) | US20110150762A1 (https=) |
| EP (1) | EP2473206A2 (https=) |
| JP (1) | JP2013503659A (https=) |
| KR (1) | KR20120082885A (https=) |
| CN (1) | CN102596272A (https=) |
| BR (1) | BR112012004038A2 (https=) |
| CA (1) | CA2772569A1 (https=) |
| CO (1) | CO6511205A2 (https=) |
| RU (1) | RU2012112460A (https=) |
| WO (1) | WO2011028572A2 (https=) |
Families Citing this family (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP5847097B2 (ja) * | 2010-03-05 | 2016-01-20 | ジンテス ゲゼルシャフト ミット ベシュレンクテル ハフツング | 骨造成のための骨セメント系 |
| CN106540324A (zh) * | 2017-01-10 | 2017-03-29 | 东莞市第三人民医院 | 一种防止骨质疏松压缩性骨折的组合物及其制备方法 |
| US20180327614A1 (en) * | 2017-05-09 | 2018-11-15 | Imam Abdulrahman Bin Faisal University | Method of repairing an acrylic denture base and zirconia autopolymerizable resins therof |
Family Cites Families (25)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE3245956A1 (de) * | 1982-12-11 | 1984-06-14 | Beiersdorf Ag, 2000 Hamburg | Chirurgisches material |
| DE3738422A1 (de) * | 1987-11-12 | 1989-05-24 | Beiersdorf Ag | Chirurgisches material |
| US4910259A (en) * | 1988-09-26 | 1990-03-20 | Wolff & Kaaber A/S | Bone cement |
| EP0439250B1 (en) * | 1990-01-25 | 1994-11-02 | Howmedica Inc. | Bone cement |
| DE4433201A1 (de) * | 1994-09-17 | 1996-03-21 | Merck Patent Gmbh | Verfahren zur Herstellung von wirkstoffhaltigen Knochenzementen |
| DE4435680A1 (de) * | 1994-10-06 | 1996-04-11 | Merck Patent Gmbh | Poröse Knochenersatzmaterialien |
| US6291547B1 (en) * | 1995-02-08 | 2001-09-18 | Materials Evolution And Development Usa Inc. | Bone cement compositions comprising fused fibrous compounds |
| US5795922A (en) * | 1995-06-06 | 1998-08-18 | Clemson University | Bone cement composistion containing microencapsulated radiopacifier and method of making same |
| DE19641775A1 (de) * | 1996-08-22 | 1998-02-26 | Merck Patent Gmbh | Verfahren zur Herstellung von wirkstoffhaltigen Knochenzementen |
| US5902839A (en) * | 1996-12-02 | 1999-05-11 | Northwestern University | Bone cement and method of preparation |
| US6020396A (en) * | 1998-03-13 | 2000-02-01 | The Penn State Research Foundation | Bone cement compositions |
| WO2000007639A1 (en) * | 1998-08-07 | 2000-02-17 | Tissue Engineering, Inc. | Bone precursor compositions |
| US6696073B2 (en) * | 1999-02-23 | 2004-02-24 | Osteotech, Inc. | Shaped load-bearing osteoimplant and methods of making same |
| US7014633B2 (en) * | 2000-02-16 | 2006-03-21 | Trans1, Inc. | Methods of performing procedures in the spine |
| US6984063B2 (en) * | 2002-10-07 | 2006-01-10 | Advanced Biomaterial Systems, Inc. | Apparatus for mixing and dispensing components |
| US7138442B2 (en) * | 2002-08-30 | 2006-11-21 | Biomet, Inc. | Reduced exothermic bone replacement cement |
| DE10340800A1 (de) * | 2002-12-20 | 2004-07-01 | Merck Patent Gmbh | Funktionalisierung unreaktiver Substrate |
| ATE336270T1 (de) * | 2003-02-13 | 2006-09-15 | Synthes Ag | Injizierbare knochenersatzmischung |
| US7261718B2 (en) * | 2003-09-11 | 2007-08-28 | Skeletal Kinetics Llc | Use of vibration with polymeric bone cements |
| GB0514076D0 (en) * | 2005-07-08 | 2005-08-17 | Depuy Int Ltd | Bioactive bone cement composition |
| IL174347A0 (en) * | 2005-07-31 | 2006-08-20 | Disc O Tech Medical Tech Ltd | Bone cement and methods of use thereof |
| EP1976460A4 (en) * | 2006-01-19 | 2012-06-20 | Warsaw Orthopedic Inc | INJECTABLE AND FORMABLE BONE REPLACEMENT MATERIALS |
| CN1810300A (zh) * | 2006-02-23 | 2006-08-02 | 北京茵普兰科技发展有限公司 | 微孔骨水泥和骨膏 |
| BRPI0808383A2 (pt) * | 2007-03-02 | 2014-07-01 | Synthes Gmbh | Cemento ósseo, e, método para formar o mesmo. |
| ES2483996T3 (es) * | 2008-02-28 | 2014-08-08 | Dfine, Inc. | Sistemas y métodos de tratamiento de los huesos |
-
2010
- 2010-08-25 US US12/868,237 patent/US20110150762A1/en not_active Abandoned
- 2010-08-25 RU RU2012112460/15A patent/RU2012112460A/ru not_active Application Discontinuation
- 2010-08-25 CA CA2772569A patent/CA2772569A1/en not_active Abandoned
- 2010-08-25 JP JP2012526937A patent/JP2013503659A/ja active Pending
- 2010-08-25 KR KR1020127008302A patent/KR20120082885A/ko not_active Withdrawn
- 2010-08-25 EP EP10749563A patent/EP2473206A2/en not_active Withdrawn
- 2010-08-25 CN CN2010800391541A patent/CN102596272A/zh active Pending
- 2010-08-25 WO PCT/US2010/046628 patent/WO2011028572A2/en not_active Ceased
- 2010-08-25 BR BR112012004038A patent/BR112012004038A2/pt not_active IP Right Cessation
-
2012
- 2012-03-01 CO CO12036502A patent/CO6511205A2/es not_active Application Discontinuation
Also Published As
| Publication number | Publication date |
|---|---|
| RU2012112460A (ru) | 2013-10-10 |
| WO2011028572A2 (en) | 2011-03-10 |
| WO2011028572A3 (en) | 2011-07-07 |
| CO6511205A2 (es) | 2012-08-31 |
| EP2473206A2 (en) | 2012-07-11 |
| US20110150762A1 (en) | 2011-06-23 |
| CN102596272A (zh) | 2012-07-18 |
| CA2772569A1 (en) | 2011-03-10 |
| BR112012004038A2 (pt) | 2016-03-29 |
| JP2013503659A (ja) | 2013-02-04 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PA0105 | International application |
Patent event date: 20120330 Patent event code: PA01051R01D Comment text: International Patent Application |
|
| PG1501 | Laying open of application | ||
| PC1203 | Withdrawal of no request for examination | ||
| WITN | Application deemed withdrawn, e.g. because no request for examination was filed or no examination fee was paid |