This paper provides an overview of the conventional therapeutic stimulation methodologies and proposes a more effective stimulation approach based on a consideration of the inherently fractal nature of normal biologic...This paper provides an overview of the conventional therapeutic stimulation methodologies and proposes a more effective stimulation approach based on a consideration of the inherently fractal nature of normal biological dynamics. There are varying forms of physiological stimulations including the use of electrical currents, electromagnetic fields, temperature change, ultrasound, light and so forth. These stimulation therapies can be categorized into three main modalities: electrical stimulation modalities, thermal modalities, and non-thermal modalities. Electrical stimulation modalities include therapeutic techniques where electrical current is directly applied to the body of treated subject. Direct application of electrical current to the brain also falls under this category. Thermal modalities consist of stimulations that induce temperature change on the body for therapeutic effects without the direct transfer of electrical current. Non-thermal modalities functions through energy transfer without directly applying electrical current and without the effects of temperature change. A fourth miscellaneous category for stimulation techniques consists of the stimulation effects of music along with physical stimulation as in massage therapy. Common to most of these therapeutic strategies is that the stimulation is delivered at certain fixed periods or frequencies. We introduce some rudiments of fractal dynamics, and the notions of self-similarity, scale-invariance, and long-range correlation or memory in the dynamics of a system. We present evidence that fractal dynamics is commonly observed in healthy physiological systems while unhealthy systems are shown to veer away from fractal dynamics towards periodic or random motion. This difference in dynamics can be observed in many biological signals such as in neural activity, heart rate variations, and breathing patterns. We propose that an optimal stimulation technique should thus be one that encourages an unhealthy, non-fractal pathological system towards a healthy, fractal dynamic. Given the ubiquity of fractality in healthy biological dynamics, we argue that a fractal pattern of stimulation is a more optimal approach to functional restoration than the widely used conventional periodic stimulation, which may further consolidate the existing pathological dynamics.展开更多
The application of minimally invasive approaches to pancreatic resection for benign and malignant diseases has been growing in the last two decades. Studies have demonstrated that laparoscopic distal pancreatectomy (L...The application of minimally invasive approaches to pancreatic resection for benign and malignant diseases has been growing in the last two decades. Studies have demonstrated that laparoscopic distal pancreatectomy (LDP) is feasible and safe, and many of them show that compared to open distal pancreatectomy, LDP has decreased blood loss and length of hospital stay, and equivalent post-operative complication rates and short-term oncologic outcomes. LDP is becoming the procedure of choice for benign or small low-grade malignant lesions in the distal pancreas. Minimally invasive pancreaticoduodenectomy (MIPD) has not yet been widely adopted. There is no clear evidence in favor of MIPD over open pancreaticoduodenectomy in operative time, blood loss, length of stay or rate of complications. Robotic surgery has recently been applied to pancreatectomy, and many of the advantages of laparoscopy over open surgery have been observed in robotic surgery. Laparoscopic enucleation is considered safe for patients with small, benign or low-grade malignant lesions of the pancreas that is amenable to parenchyma-preserving procedure. As surgeons’ experience with advanced laparoscopic and robotic skills has been growing around the world, new innovations and breakthrough in minimally invasive pancreatic procedures will evolve.展开更多
Hypersensitivity is a phenomenon that has a dual role: adaptive (protective) and maladaptive (pathological) based on different aspects of the pain mechanism. The mechanism of hypersensitivity has not been fully define...Hypersensitivity is a phenomenon that has a dual role: adaptive (protective) and maladaptive (pathological) based on different aspects of the pain mechanism. The mechanism of hypersensitivity has not been fully defined. However, it is known that over-excitability (too much sensitivity) of neurons can arise in both peripheral and central components of the nervous system. Pain theories can be useful in helping to explain complex phenomenon like hypersensitivity. The Gate control theory and other more bio-psychological pain models may assist us to understand a mechanism of chronic musculoskeletal pain. This article discusses a mechanism based pain model.展开更多
文摘This paper provides an overview of the conventional therapeutic stimulation methodologies and proposes a more effective stimulation approach based on a consideration of the inherently fractal nature of normal biological dynamics. There are varying forms of physiological stimulations including the use of electrical currents, electromagnetic fields, temperature change, ultrasound, light and so forth. These stimulation therapies can be categorized into three main modalities: electrical stimulation modalities, thermal modalities, and non-thermal modalities. Electrical stimulation modalities include therapeutic techniques where electrical current is directly applied to the body of treated subject. Direct application of electrical current to the brain also falls under this category. Thermal modalities consist of stimulations that induce temperature change on the body for therapeutic effects without the direct transfer of electrical current. Non-thermal modalities functions through energy transfer without directly applying electrical current and without the effects of temperature change. A fourth miscellaneous category for stimulation techniques consists of the stimulation effects of music along with physical stimulation as in massage therapy. Common to most of these therapeutic strategies is that the stimulation is delivered at certain fixed periods or frequencies. We introduce some rudiments of fractal dynamics, and the notions of self-similarity, scale-invariance, and long-range correlation or memory in the dynamics of a system. We present evidence that fractal dynamics is commonly observed in healthy physiological systems while unhealthy systems are shown to veer away from fractal dynamics towards periodic or random motion. This difference in dynamics can be observed in many biological signals such as in neural activity, heart rate variations, and breathing patterns. We propose that an optimal stimulation technique should thus be one that encourages an unhealthy, non-fractal pathological system towards a healthy, fractal dynamic. Given the ubiquity of fractality in healthy biological dynamics, we argue that a fractal pattern of stimulation is a more optimal approach to functional restoration than the widely used conventional periodic stimulation, which may further consolidate the existing pathological dynamics.
文摘The application of minimally invasive approaches to pancreatic resection for benign and malignant diseases has been growing in the last two decades. Studies have demonstrated that laparoscopic distal pancreatectomy (LDP) is feasible and safe, and many of them show that compared to open distal pancreatectomy, LDP has decreased blood loss and length of hospital stay, and equivalent post-operative complication rates and short-term oncologic outcomes. LDP is becoming the procedure of choice for benign or small low-grade malignant lesions in the distal pancreas. Minimally invasive pancreaticoduodenectomy (MIPD) has not yet been widely adopted. There is no clear evidence in favor of MIPD over open pancreaticoduodenectomy in operative time, blood loss, length of stay or rate of complications. Robotic surgery has recently been applied to pancreatectomy, and many of the advantages of laparoscopy over open surgery have been observed in robotic surgery. Laparoscopic enucleation is considered safe for patients with small, benign or low-grade malignant lesions of the pancreas that is amenable to parenchyma-preserving procedure. As surgeons’ experience with advanced laparoscopic and robotic skills has been growing around the world, new innovations and breakthrough in minimally invasive pancreatic procedures will evolve.
文摘Hypersensitivity is a phenomenon that has a dual role: adaptive (protective) and maladaptive (pathological) based on different aspects of the pain mechanism. The mechanism of hypersensitivity has not been fully defined. However, it is known that over-excitability (too much sensitivity) of neurons can arise in both peripheral and central components of the nervous system. Pain theories can be useful in helping to explain complex phenomenon like hypersensitivity. The Gate control theory and other more bio-psychological pain models may assist us to understand a mechanism of chronic musculoskeletal pain. This article discusses a mechanism based pain model.
