Are pedicle screw perforation rates influenced by distance from the reference frame in multilevel registration using a computed tomography-based navigation system in the setting of scoliosis?

BACKGROUND CONTEXT

Pedicle screw fixation is commonly employed for the surgical correction of scoliosis but carries a risk of serious neurovascular or visceral structure events during screw insertion. To avoid these complications, we have been using a computed tomography (CT)-based navigation system during pedicle screw placement. As this could also prolong operation time, multilevel registration for pedicle screw insertion for posterior scoliosis surgery was developed to register three consecutive vertebrae in a single time with CT-based navigation. The reference frame was set either at the caudal end of three consecutive vertebrae or at one or two vertebrae inferior to the most caudal registered vertebra, and then pedicle screws were inserted into the three consecutive registered vertebrae and into the one or two adjacent vertebrae.

OBJECTIVES

This study investigated the perforation rates of vertebrae at zero, one, two, three, or four or more levels above or below the vertebra at which the reference frame was set.

STUDY DESIGN

This is a retrospective, single-center, single-surgeon study.

PATIENT SAMPLE

One hundred sixty-one scoliosis patients who had undergone pedicle screw fixation were reviewed.

OUTCOME MEASURES

Screw perforation rates were evaluated by postoperative CT.

MATERIALS AND METHODS

We evaluated 161 scoliosis patients (34 boys and 127 girls; mean±standard deviation age: 14.6±2.8 years) who underwent pedicle screw fixation guided by a CT-based navigation system between March 2006 and December 2015.

RESULTS

A total of 2,203 pedicle screws were inserted into T2-L5 using multilevel registration with CT-based navigation. The overall perforation rates for Grade 1, 2, or 3, Grade 2 or 3 (major perforations), and Grade 3 perforations (violations) were as follows: vertebrae at which the reference frame was set: 15.9%, 6.1%, and 2.5%; one vertebra above or below the reference frame vertebra: 16.5%, 4.0%, and 1.2%; two vertebrae above or below the reference frame vertebra: 20.7%, 8.7%, and 2.3%; three vertebrae above or below the reference frame vertebra: 23.8%, 7.9%, and 3.5%; and four vertebrae or more above/below the reference frame vertebra: 25.4%, 9.5%, and 4.1%, respectively. Fisher exact test was performed to detect significant differences among the above five groups. With regard to Grade 1, 2, or 3 perforations, the rates of screw perforation for three and four vertebrae or more above or below the reference frame vertebra were significantly larger than that for vertebrae at the reference frame (both p<.01). No significant differences were found for Grade 3 perforations (violations) among the groups.

CONCLUSIONS

In multilevel registration of three consecutive vertebrae, the accuracy of screw insertion into vertebrae at which the reference frame was not set was not significantly inferior to that in vertebrae at which the reference frame was set with regard to major perforation rate. Including minor perforations, however, a distance of three vertebrae or more above or below the reference frame vertebra produced significantly more frequent perforations.

Early diagnosis of hollow viscus injury using intestinal fatty acid-binding protein in blunt trauma patients

A delay in diagnosing hollow viscus injury (HVI) causes an increase in mortality and morbidity. HVI remains a challenge to diagnose, and there is no specific diagnostic biomarker for HVI. We evaluated the utility of intestinal fatty acid-binding protein (I-FABP) in diagnosing HVI in blunt trauma patients. Within a 5-year period, 93 consecutive patients with clinically suspected HVI at our trauma center were prospectively enrolled. The diagnostic performance of I-FABP for HVI was compared with that of other various parameters (physical, laboratory, and radiographic findings). HVI was diagnosed in 13 patients (14%), and non-HVI was diagnosed in 80 patients (86%). The level of I-FABP was significantly higher in patients with HVI than in those with non-HVI (P = 0.014; area under the curve, 0.71). The sensitivity, specificity, positive predictive value, and negative predictive value were 76.9%, 70.0%, 29.4%, and 94.9%, respectively (P = 0.003). However, all other biomarkers were not significantly different between the groups. Presence of extraluminal air, bowel wall thickening on computed tomography (CT), and peritonitis signs were significantly higher in patients with HVI (P < 0.05). Of 49 patients (52.7%) who had a negative I-FABP and negative peritonitis signs, none developed HVI (sensitivity, 100%; negative predictive value, 100%). This is the first study that demonstrated the diagnostic value of a biomarker for HVI. I-FABP has a higher negative predictive value compared to traditional diagnostic tests. Although the accuracy of I-FABP alone was insufficient, the combination of I-FABP and other findings can enhance diagnostic ability.

Optimal cervical screw insertion angle determined by means of computed tomography scans pre- and postoperatively

BACKGROUND CONTEXT

Cervical pedicle screw (CPS) insertion is technically demanding and carries a risk of serious neurovascular complications when screws perforate. To avoid such serious risks, we currently perform CPS insertion using a computed tomography (CT)-guided navigation system. However, there remains a low probability of screw perforation during CPS insertion that is affected by factors such as CPS insertion angle and anatomical pedicle transverse angle (PTA).

PURPOSE

This study aimed to understand the perforation tendencies of CPS insertion angles in relation to anatomical PTA.

STUDY DESIGN

This is a retrospective chart review.

PATIENT SAMPLE

The study enrolled 151 consecutive patients (95 men and 56 women, with a mean age of 64.6 years).

OUTCOME MEASURES

Anatomical PTA and CPS insertion angles were evaluated by axial CT images.

METHODS

The medical records of 151 consecutive patients who underwent CPS insertion using a CT-based navigation system were reviewed. We examined the relationships between PTA and CPS insertion angle on axial CT images according to vertebral level.

RESULTS

The average preoperative PTA at each vertebral level was 32.1° for C2, 41.5° for C3, 41.0° for C4, 39.4° for C5, 34.4° for C6, and 27.3° for C7. Corresponding CT-determined pedicle screw insertion angles were 24.9°, 31.3°, 28.7°, 27.8°, 28.0°, and 26.0°, respectively. The CPS insertion angles at C2-C6 were significantly smaller than those for PTA (p<.01). In evaluations of angle thresholds from C3 to C5 that predicted a higher risk of perforation, the receiver operating characteristic curve analysis determined CPS insertion angles of <24.5° and >36.5° for the identification of lateral and medial perforations, respectively.

CONCLUSION

For CPS insertion into the C3-C5 pedicles using CT, there is an increased likelihood of lateral or medial perforation for insertion angles of <24.5° or >36.5°, respectively.

The combined use of US and MR imaging for the diagnosis of masses in the parotid region

Purpose: To evaluate the usefulness of the combination of the two non-invasive modalities US and MR imaging to diagnose masses in the parotid region.

Material and Methods: The US and MR findings of 21 patients with parotid masses were analyzed retrospectively by two radiologists without any clinical or histopathological information. The specific points evaluated were location, shape, margin, internal architecture, and intensity level on both US and MR, posterior echo enhancement on US, and capsule-like lining of the tumor on MR.

Results: The findings concerning the shape and margin on US and MR were in fairly good agreement. Concerning the findings of the internal architecture, US could reveal the minute structures of the tumor while MR demonstrated differences in the signal intensities of histological tissue types of the various tumors. The posterior echo enhancement on US and the capsule-like lining on MR of the tumors were also useful for the diagnosis.

Conclusion: Our results suggest that the combination of US and MR is useful for examining soft tissue masses in the parotid region to make a more accurate diagnosis, and not just differentiate malignant lesions from those which are benign.

Influence of Nonenzymatic Glycation in Dentinal Collagen on Dental Caries

Advanced glycation end-products (AGEs) are generated via nonenzymatic glycation of dentinal collagen, resulting in accumulation of AGEs in dentin tissue. Since accumulated AGEs cause crosslinking between amino acid polypeptides in the collagen molecule and modify mechanical properties of dentinal collagen, the authors assumed that there would be a significant interaction between the generation of AGEs and progression of caries in dentin. To confirm such an interaction, spectroscopic imaging analyses (i.e., nanosecond fluorescence lifetime imaging and second harmonic generation light imaging) were performed in addition to biochemical and electron microscopic analyses in the present study. Seven carious human teeth were fixed in paraformaldehyde and cut longitudinally into 1-mm sections using a low-speed diamond saw for the following analyses. In transmission electron microscopy (TEM) analysis, nondecalcified specimens were embedded in epoxy resin and sliced into thin sections for observation. For the immunohistochemical analysis, the specimens were paraffin embedded after decalcification for 2 wk and sectioned with a microtome. Resultant sections were stained with anti-AGE and anticollagen antibodies. The demineralized specimens were used for spectroscopic analyses without additional treatment. For Western blotting analysis, specimens were separated into carious and sound dentin. Each specimen was homogenized with a bead crusher and an ultrasonic homogenizer and then treated with hydrochloric acid. In carious dentin, the collagen fibers showed an amorphous structure in the TEM image, and the AGEs were localized in the areas of bacterial invasion in the immunostaining image. The total amount of AGEs in carious dentin was higher than in sound dentin in Western blotting. The ultrastructure of type I collagen and total amount of AGEs varied markedly in the dentinal caries region. The fluorescence lifetime was shorter in the carious area than that in the sound areas, indicating an increase of AGEs in the carious area. The increase of AGEs could influence the progression of dentinal caries.

Diagnostic accuracy of oblique chest radiograph for occult pneumothorax: comparison with ultrasonography

Backgraound

An occult pneumothorax is a pneumothorax that is not seen on a supine chest X-ray but is detected by computed tomography scanning. However, critical patients are difficult to transport to the computed tomography suite. We previously reported a method to detect occult pneumothorax using oblique chest radiography (OXR). Several authors have also reported that ultrasonography is an effective technique for detecting occult pneumothorax. The aim of this study was to evaluate the usefulness of OXR in the diagnosis of the occult pneumothorax and to compare OXR with ultrasonography.

Methods

All consecutive blunt chest trauma patients with clinically suspected pneumothorax on arrival at the emergency department were prospectively included at our tertiary-care center. The patients underwent OXR and ultrasonography, and underwent computed tomography scans as the gold standard. Occult pneumothorax size on computed tomography was classified as minuscule, anterior, or anterolateral.

Results

One hundred and fifty-nine patients were enrolled. Of the 70 occult pneumothoraces found in the 318 thoraces, 19 were minuscule, 32 were anterior, and 19 were anterolateral. The sensitivity and specificity of OXR for detecting occult pneumothorax was 61.4 % and 99.2 %, respectively. The sensitivity and specificity of lung ultrasonography was 62.9 % and 98.8 %, respectively. Among 27 occult pneumothoraces that could not be detected by OXR, 16 were minuscule and 21 could be conservatively managed without thoracostomy.

Conclusion

OXR appears to be as good method as lung ultrasonography in the detection of large occult pneumothorax. In trauma patients who are difficult to transfer to computed tomography scan, OXR may be effective at detecting occult pneumothorax with a risk of progression.

Serum WFA(+) -M2BP is a non-invasive liver fibrosis marker that can predict the efficacy of direct-acting anti-viral-based triple therapy for chronic hepatitis C

BACKGROUND

The Wisteria floribunda agglutinin-positive human Mac-2-binding protein (WFA(+) -M2BP) is a new liver fibrosis glycobiomarker with unique fibrosis-related glyco-alteration. WFA(+) -M2BP is also a useful surrogate marker for the risk of developing hepatocellular carcinoma and for the liver functional reserve.

AIM

To evaluate the diagnostic ability of WFA(+) -M2BP for liver fibrosis in the clinical setting and the clinical utility of WFA(+) -M2BP for predicting the efficacy of direct-acting anti-viral (DAA) treatment for chronic hepatitis C patients.

METHODS

The study included 159 genotype 1 hepatitis C patients who received DAA-based treatment (telaprevir or simeprevir) combined with pegylated-interferon alpha plus ribavirin (108 telaprevir- and 51 simeprevir-based triple treatment). The relation between baseline serum WFA(+) -M2BP and treatment efficacy was evaluated.

RESULTS

The serum WFA(+) -M2BP level significantly increased with the progress of liver fibrosis. Area under the receiver operating characteristic curve analysis identified 2.17 as the cut-off index (COI) for WFA(+) -M2BP for diagnosing advanced fibrosis. The sustained virological response (SVR) rate was significantly, negatively correlated with the serum WFA(+) -M2BP level. Multiple logistic regression analysis found a low serum WFA(+) -M2BP level (<2.17 COI) to be independently associated with SVR (odds ratio, 4.35, P = 0.027). Even for prior nonresponders and patients with the interleukin-28B minor allele or histological advanced fibrosis, treatment outcome was favourable for patients with a low serum WFA(+) -M2BP level.

CONCLUSION

Serum WFA(+) -M2BP is a non-invasive liver fibrosis marker useful for predicting the efficacy of DAA-based triple therapy for chronic hepatitis C patients.

Osteoid osteoma presenting as thoracic scoliosis

BACKGROUND CONTEXT

Osteoid osteoma of the thoracic spine is relatively uncommon and is often difficult to diagnose, especially when patients do not complain of pain.

PURPOSE

This study aims to describe an unusual case of scoliosis caused by osteoid osteoma of the thoracic spine that was challenging to diagnose.

STUDY DESIGN/SETTING

A case report of a 12-year-old girl who presented with scoliosis caused by osteoid osteoma of the thoracic spine without apparent pain was carried out.

METHODS

Diagnosis of the lesion was made using computed tomography (CT) and magnetic resonance imaging as well as the Scoliosis Research Society-22 (SRS-22) patient-based questionnaire.

RESULTS

A preoperative CT myelogram revealed a mass lesion in the lamina of the 10th thoracic vertebra that was considered to be osteoid osteoma. This diagnosis was histologically confirmed following tumor excision. The patient's spinal deformity and SRS-22 scores were both improved at 5 months postoperatively.

CONCLUSIONS

Osteoid osteoma of the thoracic spine may present as non-painful scoliosis. Tumor resection is effective. Clinicians should bear this uncommon lesion in mind during recommended CT examination before scoliosis surgery.

Hemolytic-uremic syndrome with acute encephalopathy in a pregnant woman infected with epidemic enterohemorrhagic Escherichia coli: characteristic brain images and cytokine profiles

A food-poisoning outbreak due to enterohemorrhagic Escherichia coli (EHEC) occurred in Toyama, Japan. The case of a 26-year-old pregnant woman with hemolytic-uremic syndrome who developed acute encephalopathy due to EHEC infection after eating raw meat is presented herein. On day 2 following admission, a cesarean section was performed because of a non-reassuring fetal status. Fecal bacterial culture confirmed an O111/O157 superinfection. Intensive care therapies including continuous hemodiafiltration and plasma exchange were performed. After the operation, the patient developed encephalopathy for which steroid pulse therapy was added. Her condition improved gradually and she was discharged 55 days after delivery.

Anisotropic multi-step etching for large-area fabrication of surface microstructures on stainless steel to control thermal radiation

Controlling the thermal radiation spectra of materials is one of the promising ways to advance energy system efficiency. It is well known that the thermal radiation spectrum can be controlled through the introduction of periodic surface microstructures. Herein, a method for the large-area fabrication of periodic microstructures based on multi-step wet etching is described. The method consists of three main steps, i.e., resist mask fabrication via photolithography, electrochemical wet etching, and side wall protection. Using this method, high-aspect micro-holes (0.82 aspect ratio) arrayed with hexagonal symmetry were fabricated on a stainless steel substrate. The conventional wet etching process method typically provides an aspect ratio of 0.3. The optical absorption peak attributed to the fabricated micro-hole array appeared at 0.8 μm, and the peak absorbance exceeded 0.8 for the micro-holes with a 0.82 aspect ratio. While argon plasma etching in a vacuum chamber was used in the present study for the formation of the protective layer, atmospheric plasma etching should be possible and will expand the applicability of this new method for the large-area fabrication of high-aspect materials.

Comparison of the NMIJ and the ARPANSA standards for absorbed dose to water in high-energy photon beams

The authors report the results of an indirect comparison of the standards of absorbed dose to water in high-energy photon beams from a clinical linac and (60)Co radiation beam performed between the National Metrology Institute of Japan (NMIJ) and the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA). Three ionisation chambers were calibrated by the NMIJ in April and June 2013 and by the ARPANSA in May 2013. The average ratios of the calibration coefficients for the three ionisation chambers obtained by the NMIJ to those obtained by the ARPANSA were 0.9994, 1.0040 and 1.0045 for 6-, 10- and 15-MV (18 MV at the ARPANSA) high-energy photon beams, respectively. The relative standard uncertainty of the value was 7.2 × 10(-3). The ratio for (60)Co radiation was 0.9986(66), which is consistent with the results published in the key comparison of BIPM.RI(I)-K4.

Notch Signaling Induces Root Resorption via RANKL and IL-6 from hPDL Cells

In this study, we first investigated the expressions of Jagged1, Notch2, the receptor activator of nuclear factor–kappa B ligand (RANKL), and interleukin (IL)-6 in areas of root resorption during experimental tooth movement in rats in vivo. We then assessed the effects of compression force (CF) with or without GSI (an inhibitor of Notch signaling) on Jagged1, RANKL, and IL-6 release from human periodontal ligament (hPDL) cells. Twelve male 6-wk-old Wistar rats were subjected to an orthodontic force of 50 g to induce mesially tipping movement of the upper first molars for 7 d. The expression levels of tartrate-resistant acid phosphatase, Jagged1, Notch2, IL-6, and RANKL proteins in the dental root were determined using an immunohistochemical analysis. Furthermore, the effects of the CF on Jagged1, IL-6, and RANKL production were investigated using hPDL cells in vitro. The effects of the cell-conditioned medium obtained from the hPDL cells subjected to CF (CFM) and Jagged 1 on osteoclastogenesis of human osteoclast precursor cells (hOCPs) were also investigated. Under the conditions of experimental tooth movement in vivo, resorption lacunae with multinucleated cells were observed in the 50 g group. In addition, immunoreactivity for Jagged1, Notch2, IL-6, and RANKL was detected on day 7 in the PDL tissue subjected to the orthodontic force. In the in vitro study, the compression force increased the production of Jagged1, IL-6, and RANKL from the hPDL cells, whereas treatment with GSI inhibited the production of these factors in vitro. The osteoclastogenesis increased with the CFM and rhJagged1, and the increase in the osteoclastogenesis was almost inhibited by GSI. These results suggest that the Notch signaling response to excessive orthodontic forces stimulates the process of root resorption via RANKL and IL-6 production from hPDL cells.

The Composition Pulling Effect in MOVPE Grown InGaN on GaN and AlGaN and its TEM Characterization

InGaN films have been grown on GaN and AlGaN epitaxial layers by metalorganic vapor phase epitaxy. The “composition pulling effect” during the initial InGaN growth stages has been studied as a function of the lattice mismatch between the InGaN and the underlying epitaxial layer. The crystalline quality of the InGaN is good near the InGaN/GaN interface and the composition is close to that of GaN. However, with increasing InGaN film thickness, the crystal quality deteriorates and the indium mole fraction increases. The composition pulling effect becomes stronger with increasing lattice mismatch. It is suggested that indium atoms are excluded from the InGaN lattice during the early growth stages to reduce the deformation energy from the lattice mismatch. TEM observations of the InGaN/GaN structure reveal that the degradation of the crystalline quality of InGaN films grown on GaN is caused by pit formation which arises from edge dislocations propagating through the InGaN film from the underlying GaN.

Molecular Stability of Chicken and Rabbit Immunoglobulin G

Molecular stability of chicken egg yolk immunoglobulin G (IgY) and that of rabbit IgG were compared by measuring antibody activities and conformational changes. Stability of rabbit IgG to acid denaturation was much higher than that of IgY. Conformation of the IgY molecule was readily changed in acidic conditions, resulting in a rapid loss of antibody activity. Much less stable natures of IgY to heat-treatment and guanidine-HCl denaturation than rabbit IgG were also observed. Differences in the structure between the two immunoglobulins that might participate in their different stability were inferred from their amino acid sequence data. Importance of the intramolecular disulfide linkage in the rabbit light chain and some other structural differences were suggested.

Insecticidal Activity and Processing in Larval Gut Juices of Genetically Engineered 130-kDa Proteins ofBacillus thuringiensissubsp.aizawai

The 130-kDa insecticidal protein (IP) of Bacillus thuringiensis subsp. aizawai is proteolytically processed in the gut juice of susceptible insect larvae to yield an insecticidally active 60-kDa fragment. Twenty-seven mutant IP genes with the replacement of codons for Arg and Lys with codons for Gln in the active fragment and its adjacent regions of the 130-kDa IP were constructed by site-directed mutagenesis and expressed in Escherichia coli cells. The produced mutant IPs at Arg87, Arg131, Arg198, Arg311, Arg368, Arg402, Arg458, Arg502, Arg512, Arg524, Arg526, Arg528, and Arg601 had reduced insecticidal activity against Spodoptera litura larvae. The mutant at Arg601 was sensitive to proteolytic digestion in the gut juice of S. litura larvae. Although the mutants at Arg619, Lys622, and Lys637 had nearly the same activity as that of the wild type, the mutant with the triple replacement at Arg619, Lys622, and Lys637 was 2.5 times more active against S. litura larvae than the wild type. This triple mutant showed a slightly different processing profile in the gut juice than that of the wild type.

A new formula for a mild body cleanser: sodium laureth sulphate supplemented with sodium laureth carboxylate and lauryl glucoside

OBJECTIVE

Sodium laureth sulphate (SLES) is an anionic detergent, which has been used globally for personal care products because of its mildness and good foaming ability. However, SLES is somewhat invasive and stimulatory to the skin, and many consumers with sensitive skin desire milder detergents for daily use skin cleansers. We enhanced the mildness of SLES by formulating it with sodium laureth carboxylate (AEC) and lauryl glucoside (LG).

METHODS

In skin soak tests, 5% detergent solutions were applied to the forearms of 10 Japanese healthy volunteers for 30 min followed by washing with tap water once a day for 4 days. Twenty-four hours after the last treatment, cutaneous capacitance measurements and visual analyses were performed. In a controlled usage study, 16 Japanese healthy volunteers used the test body cleanser for 4 weeks. Assessment of efficacy and mildness was conducted prior to the start of the study and at the end of week 4 by cutaneous conductance, dermoscopic evaluation of the stratum corneum and visual assessment by a dermatologist.

RESULTS

In soak tests, cutaneous capacitance was significantly decreased on the soap-treated region and on the SLES-treated region. No significant decrease was identified on the SLES/AEC/LG-treated region with less induction of erythema or dryness. In the controlled usage study, no significant changes in cutaneous conductance or texture or damage of corneocytes on the forearm and lower thigh were found. However, visual assessment revealed a significant decrease in scaling and erythema on the lower thigh after 4 weeks of usage with an improvement of the discomfort of the consumer. The favourability rating of this formulated detergent in several questionnaire items was very good.

CONCLUSION

The newly formulated skin cleanser with the combination of anionic surfactants SLES and AEC and the non-ionic surfactant LG provides a mild surfactant with a satisfactory cleansing activity for body washing.

Diagnostic performance of plasma biomarkers in patients with acute intestinal ischaemia

BACKGROUND

The aim of this study was to evaluate the use of intestinal fatty acid binding protein (I-FABP) and traditional biomarkers in the early diagnosis of acute intestinal ischaemia of different causes.

METHODS

I-FABP, white blood cell (WBC) count, C-reactive protein, base deficit, lactate, lactate dehydrogenase, aspartate aminotransferase, creatine kinase and D-dimer were measured prospectively in consecutive patients suspected of having acute intestinal ischaemia. Biomarker levels were compared in patients with vascular and non-vascular ischaemia.

RESULTS

Two hundred and eight patients with a clinical suspicion of acute intestinal ischaemia were enrolled. Vascular intestinal ischaemia was diagnosed in 24 patients (11·5 per cent), non-vascular ischaemia in 62 (29·8 per cent) and non-ischaemic disease in 122 (58·7 per cent). The levels of most biomarkers (except WBC count and creatine kinase) were significantly higher in the vascular ischaemia group than in the other groups (P < 0·010). However, none of the biomarker levels differed between patients with non-vascular intestinal ischaemia and those with non-ischaemic disease. Receiver operating characteristic (ROC) curve analysis suggested that I-FABP was best at diagnosing vascular intestinal ischaemia (area under the curve 0·88).

CONCLUSION

Serum biomarkers may be useful in the diagnosis of vascular, but not non-vascular, intestinal ischaemia. Among them, I-FABP shows promise for detecting vascular ischaemia.

Dissimilatory reduction and transformation of ferrihydrite-humic acid coprecipitates

Organic matter (OM) is present in most terrestrial environments and is often found coprecipitated with ferrihydrite (Fh). Sorption or coprecipitation of OM with Fe oxides has been proposed to be an important mechanism for long-term C preservation. However, little is known about the impact of coprecipitated OM on reductive dissolution and transformation of Fe(III) (oxyhydr)oxides. Thus, we study the effect of humic acid (HA) coprecipitation on Fh reduction and secondary mineral formation by the dissimilatory Fe(III)-reducing bacterium Shewanella putrefaciens strain CN32. Despite similar crystal structure for all coprecipitates investigated, resembling 2-line Fh, the presence of coprecipitated HA resulted in lower specific surface areas. In terms of reactivity, coprecipitated HA resulted in slower Fh bioreduction rates at low C/Fe ratios (i.e., C/Fe ≤ 0.8), while high C/Fe ratios (i.e., C/Fe ≥ 1.8) enhanced the extent of bioreduction compared to pure Fh. The coprecipitated HA also altered the secondary Fe mineralization pathway by inhibiting goethite formation, reducing the amount of magnetite formation, and increasing the formation of a green rust-like phase. This study indicates that coprecipitated OM may influence the rates, pathway, and mineralogy of biogeochemical Fe cycling and anaerobic Fe respiration within soils.