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NO reduction by CO over a c-ZrO(110) ultrathin film covering a Cu(110) surface (ZrO/Cu) has been examined by means of density-functional theory calculations. Spontaneous transfer of electronic charge from Cu to zirconia gives the latter an ability to reduce oxidants. Gaining this excess charge, NO adsorbs and activates on the cationic Zr site of the oxide surface. Thus activated, two NO on adjacent Zr sites can react to form ONNO with an activation energy of 0.39 eV (8.9 kcal/mol), which readily decomposes into NO and an O adatom. NO also decomposes into N and an O adatom with negligible activation energy of 0.06 eV (1.4 kcal/mol). CO reacts off the O adatoms left on the surface as CO with an activation energy of 0.36 eV (8.2 kcal/mol), completing a redox cycle. These results indicate high potentials of oxide-covered metal catalysts (metal@oxide) for NO abatement. Graphical Abstract: [ABSTRACT FROM AUTHOR]

Purpose: We aimed to evaluate the value of single-photon emission computed tomography (SPECT)/computed tomography (CT) for the diagnosis of sacroiliac joint (SIJ) dysfunction. Methods: SPECT/CT was performed in 32 patients with severe SIJ dysfunction, who did not respond to 1-year conservative treatment and had a score of >4 points on a 10-cm visual analog scale. We investigated the relationship between the presence of severe SIJ dysfunction and tracer accumulation, as confirmed by SPECT/CT. In cases of bilateral SIJ dysfunction, we also compared the intensity of tracer accumulation on each side. Moreover, we examined the relationship between the intensity of tracer accumulation and the different treatments the patients subsequently received. Results: All 32 patients with severe SIJ dysfunction had tracer accumulation with a standardized uptake value (SUV) of >2.2 (mean SUV 4.7). In the 19 patients with lateralized symptom intensity, mean SUVs of the dominant side were significantly higher than those of the nondominant side. In 10 patients with no lateralization, the difference in the SUVs between sides was <0.6. Patients exhibiting higher levels of tracer accumulation required more advanced treatment. Conclusion: Patients with higher levels of tracer accumulation had greater symptom severity and also required more advanced treatment. Thus, we believe that SPECT/CT may be a suitable supplementary diagnostic modality for SIJ dysfunction as well as a useful technique for predicting the prognosis of this condition. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine if the use of antibiotic-impregnated fibrin sealant (AFS) was effective in preventing surgical site infections (SSI) associated with spinal instrumentation. Methods: In a preliminary study, five pieces of vancomycin-impregnated fibrin sealant, five nuts that were not treated with the sealant, and five nuts that were treated with the sealant were subjected to agar diffusion testing. In a clinical study, the rates of deep SSI were compared between 188 patients who underwent procedures involving spinal instrumentation without AFS (group 1) and 196 patients who underwent procedures involving spinal instrumentation with AFS (group 2). Results: All five pieces of vancomycin-impregnated fibrin sealant and the five nuts treated with the sealant exhibited antimicrobial efficacy, while the five untreated nuts did not exhibit antimicrobial efficacy in the agar diffusion test. In the clinical study, 11 (5.8 %) of the 188 patients in group 1 acquired a deep SSI, while none (0 %) of the 196 patients in group 2 acquired a deep SSI. Conclusion: The present study demonstrated that the application of AFS to spinal instrumentation yielded good clinical outcomes in terms of the prevention of postoperative spinal infections. It is hoped that limiting AFS use to patients requiring spinal instrumentation and those with risk factors for SSI will reduce the overall costs while preventing SSIs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to describe a free-hand pedicle screw insertion technique and to evaluate the accuracy of pedicle screw placement and validity of pedicle screw fixation in patients with subaxial cervical spine injuries. Methods: We retrospectively reviewed 32 consecutive patients with subaxial cervical spine injuries who underwent posterior cervical fixation using our cervical pedicle screw (CPS) insertion technique. We also assessed the clinical and radiological outcomes and the accuracy of pedicle screw placement. Results: The mean preoperative kyphosis was 4.0°, which was corrected to −5.2° after the operation, and the mean kyphosis angle was −4.4° at the final follow-up. The mean preoperative disc height ratio was 81.9%, and it improved to 105.4% after the operation, which was maintained until the final follow-up measurement of 103.4%. Bony union was achieved, and there were no instrumentation failures in any patient. Overall, 127 pedicle screws were inserted, of which 112 (88.1%) were classified as grade 1 (exact intrapedicular screw positioning), 10 (7.8%) as grade 2 (perforation <50% of the screw diameter), and 5 (3.9%) as grade 3 (perforation more than 50% of the screw diameter). Conclusion: In our technique, a gutter is created using a high-speed burr at the transitional area between the lateral mass and lamina similar to the procedure in double-door laminoplasty to identify an entry point for CPS insertion. It is easy for general spine surgeons to identify a CPS insertion entry point using our technique. [ABSTRACT FROM AUTHOR]

A 49-year-old woman presented with severe swelling and pain of the left little finger, which had exacerbated rapidly, in October 2006. The patient had a history of hepatocellular carcinoma and metastatic lung cancer. She had undergone partial hepatectomy for the hepatocellular carcinoma in September 2001 and pulmonary resection for metastatic lung cancer in November 2005. Roentgenogram of the hand on admission showed complete destruction of the distal phalanx of the left little finger. The final pathological result of the tissue obtained by disarticulation was an extrahepatic metastasis of hepatocellular carcinoma. Extrahepatic metastasis from primary hepatocellular carcinoma to the hand is very rare and only four cases have been reported in the literature. All the patients with extrahepatic metastases from the primary hepatocellular carcinoma to the hand had poor prognoses, but the patient presented in this article exhibited an unusual clinical course. The patient is still alive 1 year after the diagnosis of extrahepatic bone metastasis of the distal phalanx. [ABSTRACT FROM AUTHOR]