Full Endoscopic Ligamentum Flavum Sparing Unilateral Laminotomy for Bilateral Recess Decompression: Surgical Technique and Clinical Results

Objective Interlaminar endoscopic spine surgery has been introduced and utilized for lumbar lateral recess decompression. We modified this technique and utilized it for bilateral lateral recess stenoses without significant central stenosis. Here we present the surgical details and clinical outcome of ligamentum flavum sparing unilateral laminotomy for bilateral recess decompression (ULBRD). Methods Prospectively collected registry for full-endoscopic surgeries was reviewed retrospectively. One hundred eighty-two consecutive cases from a single center between September 2015 and March 2021 were reviewed and 57 of them whom underwent ULBRD were enrolled for analysis. Basic patient demographic data, perioperative details, surgeryrelated complications, and clinical outcome were reviewed. The detailed surgical technique is presented as well. Results Among the 57 patients enrolled, 37 were males while the other 20 were females. The mean age was 58.53 ± 14.51 years, and a bimodal age distribution at the age of mid-fifties and mid-sixties or older was noted. The later age-peak was related to coexistence of degenerative scoliosis. The average operative time per lamina was 70.34 ± 20.51 minutes and mean length of stay was 0.56 ± 0.85 days. Four perioperative complications were reported (7.0%) and the overall reoperation rate at the index level within 1 year was 8.8%. The preoperative back/leg visual analogue scale scores and functional outcome scales including EuroQol-5 dimension questionnaire, Oswestry Disability Index presented significant improvement immediately after surgery and were maintained until final follow-up. Conclusion ULBRD for bilateral lateral recess stenoses without significant central stenosis resulted in good clinical outcomes with acceptably low perioperative complications rates. Sufficient decompression was achieved with the central ligamentum flavum being preserved

Short-wave infrared imaging enables high-contrast fluorescence-guided surgery in neuroblastoma

Fluorescence-guided surgery is set to play a pivotal role in the intraoperative management of pediatric tumors. Short-wave infrared imaging (SWIR) has advantages over conventional near-infrared I (NIR-I) imaging with reduced tissue scattering and autofluorescence. Here, two NIR-I dyes (IRDye800CW and IR12), with long tails emitting in the SWIR range, were conjugated with a clinical-grade anti-GD2 monoclonal antibody (Dinutuximab-beta) to compare NIR-I and SWIR imaging for neuroblastoma surgery. A first-of-its-kind multispectral NIR-I/SWIR fluorescence imaging device was constructed to allow an objective comparison between the two imaging windows. Conjugates were first characterized in vitro. Tissue-mimicking phantoms, imaging specimens of known geometric and material composition, were used to assess the sensitivity and depth penetration of the NIR-I/SWIR device, showing a minimum detectable volume of ~0.9 mm3 and depth penetration up to 3 mm. In vivo, fluorescence imaging using the NIR-I/SWIR device showed a high tumor-to-background ratio (TBR) for both dyes, with anti-GD2-IR800 being significantly brighter than anti-GD2-IR12. Crucially, the system enabled higher TBR at SWIR wavelengths than at NIR-I wavelengths, verifying SWIR imaging enables high-contrast delineation of tumor margins. This work demonstrates that by combining the high-specificity of anti-GD2 antibodies with the availability and translatability of existing NIR-I dyes, along with the advantages of SWIR in terms of depth and tumor signal-to-background ratio, GD2-targeted NIR-I/SWIR-guided surgery could improve the treatment of neuroblastoma patients, warranting investigation in future clinical trials

Imagining an Imperial Modernity: Universities and the West African Roots of Colonial Development

© 2016 Informa UK Limited, trading as Taylor & Francis GroupThis article takes the formation and work of the ‘Elliot’ Commission on Higher Education in West Africa (1943–45) to reconsider the roots of British colonial development. Late colonial universities were major development projects, although they have rarely been considered as such. Focusing particularly on the Nigerian experience and the controversy over Yaba Higher College (founded 1934), the article contends that late colonial plans for universities were not produced in Britain and then exported to West African colonies. Rather, they were formed through interactions between agendas and ideas with roots in West Africa, Britain and elsewhere. These debates exhibited asymmetries of power but produced some consensus about university development. African and British actors conceptualised modern education by combining their local concerns with a variety of supra-local geographical frames for development, which included the British Empire and the individual colony. The British Empire did not in this case forestall development, but shaped the ways in which development was conceived

John Ogunlade, D.O.

https://nsuworks.nova.edu/cnso_alumni/1089/thumbnail.jp

EFFECT OF EXTRACTION METHODS ON YIELD AND QUALITY CHARACTERISTICS OF COCONUT (Cocos nucifera L) OIL

Oil extraction method has a direct influence on the quantity and quality of vegetable oil obtained from plant parts. This study aimed at evaluating the effect of three extraction methods (traditional, mechanical and chemical) on the quality characteristics (including some proximate composition, microbial content, physical and chemical properties) of the coconut oil. The experiment was laid out in a completely randomized design and data obtained were subjected to analysis of variance while the mean of each variable were compared using Duncan’s new multiple range test at 95% level of confidence. The highest average oil yield of 82.7% (±3.03) was obtained from chemical extraction method using n-hexane as solvent, mechanical extraction method gave 72.9% (± 1.49) while the lowest oil yield of 61.3% (± 2.73) was obtained from traditional extraction method. Extraction method had a significant impact on the crude protein of the coconut oil; highest crude protein content (2.39%) was obtained for mechanical extraction method while the lowest protein content 1.68 was obtained for chemical extraction method. The highest Total Titratable Acid (TTA) of 0.58±0.25 was obtained for traditional extraction method while the lowest value of 0.25±0.01 was obtained for mechanically extracted oil. The free fatty acid ranged from 1.73 to 2.21 mg KOH/g while saponification value ranged from 248.52 – 263.28 mg KOH/g for traditional and chemical extraction methods respectively. Chemical extraction method has the highest pH value of 5.1 while mechanical expression has the lowest pH value of 4.5. Also, the result shows that the extraction method has a significant difference on the Total Titratable Acid of the coconut oil. Traditional method has the highest fungal count and a higher bacterial infection was observed in mechanical method. The total microbial count of the oil samples ranged from 5.07 to 6.19 x 102 cfu/ml. The highest microbial load (6.19 x102 cfu/ml) was in the traditional oil extraction method while the least microbial count occurred in the solvent oil. Flash point ranged from 124 to 131 for traditional and chemical methods respectively, a constant specific gravity value of 0.94 was obtained for the three methods used; lowest boiling and melting point (196.33 and 41oC) was obtained for chemical method while highest values (204 and 45oC) were obtained for traditional and mechanical methods respectively. Extraction methods had significant influence on the yield and quality of coconut oil; the quality attributes of the oil were comparable to international standards

Examining racial disparities in colorectal cancer care.

African Americans are disproportionately burdened with colorectal cancer. Although incidence and mortality rates have declined in the past two decades, the disparity in health outcomes has progressively increased. This comprehensive review examines the existing literature regarding racial disparities in colorectal cancer screening, stage at diagnosis, and treatment to determine if differences exist in the quality of care delivered to African Americans. A comprehensive review of relevant literature was performed. Two databases (EBSCOHOST Academic Search Premier and Scopus) were searched from 2000 to 2007. Articles that assessed racial disparities in colorectal cancer screening, stage of disease at diagnosis, and treatment were selected. The majority of studies identified examined colorectal cancer screening outcomes. Although racial disparities in screening have diminished in recent years, African American men and women continue to have higher colorectal cancer incidence and mortality rates and are diagnosed at more advanced stages. Several studies regarding stage of disease at diagnosis identified socioeconomic status (SES) and health insurance status as major determinants of disparity. However, some studies found significant racial disparities even after controlling for these factors. Racial disparities in treatment were also found at various diagnostic stages. Many factors affecting disparities between African Americans and Whites in colorectal cancer incidence and mortality remain unexplained. Although the importance of tumor biology, genetics, and lifestyle risk factors have been established, prime sociodemographic factors need further examination to understand variances in the care of African Americans diagnosed with colorectal cancer

In vivo three-dimensional photoacoustic imaging of the renal vasculature in preclinical rodent models

In vivo three-dimensional photoacoustic imaging of the renal vasculature in preclinical rodent models. Am J Physiol Renal Physiol 314: F1145–F1153, 2018. First published December 20, 2017; doi:10.1152/ajprenal.00337.2017.—Noninvasive imaging of the kidney vasculature in preclinical murine models is important for the assessment of renal development, studying diseases and evaluating new therapies but is challenging to achieve using existing imaging modalities. Photoacoustic imaging is a promising new technique that is particularly well suited to visualizing the vasculature and could provide an alternative to existing preclinical imaging methods for studying renal vascular anatomy and function. To investigate this, an all-optical Fabry-Perot-based photoacoustic scanner was used to image the abdominal region of mice. High-resolution three-dimensional, noninvasive, label-free photoacoustic images of the mouse kidney and renal vasculature were acquired in vivo. The scanner was also used to visualize and quantify differences in the vascular architecture of the kidney in vivo due to polycystic kidney disease. This study suggests that photoacoustic imaging could be utilized as a novel preclinical imaging tool for studying the biology of renal disease

Spatial Computing for preoperative planning and postoperative evaluation of single-position lateral approaches in spinal revision surgery

Spatial computing (SC) in a surgical context offers reconstructed interactive four-dimensional models of radiological imaging. Preoperative and postoperative assessment with SC can offer more insight into personalized surgical approaches. Spine surgery has benefitted from the use of perioperative SC assessment. Herein, we describe the use of SC to perform a perioperative assessment of a revision spinal deformity surgery. A 79-year-old wheelchair-bound male presented to the neurosurgery clinic with a history of chronic lumbar pain associated with bilateral lower extremity weakness. His surgical history is significant for an L2-L5 lumbar decompression with posterior fixation 1 year prior. On examination, there were signs of thoracic myelopathy. Imaging revealed his previous instrumentation, pseudoarthrosis, and cord compression. We perform a two-staged operation to address the thoracic spinal cord compression and myelopathy, pseudoarthrosis, and malalignment with a lack of global spinal harmony. His imaging is driven by a spatial computing and SC environment and offers support for the diagnosis of his L2-3 and L4-5 pseudoarthrosis on the reconstructed SC-based computed tomography scan. SC enabled the assessment of the configuration of the psoas muscle and course of critical neurovascular structures in addition to graft sizing, trajectory and approach, evaluation of the configuration and durability of the anterior longitudinal ligament, and the overlying abdominal viscera. SC increases the familiarity of the patient's specific anatomy and enhances perioperative assessment. As such, SC can be used to preoperatively plan for spinal revision surgery