Pain evoked unit discharges in the parafascicular nucleus could be inhibited by direct electrical stimulation of the centromedian nucleus of thalamus, with residual inhibitory effect lasting for several minutes after cessation of stimulation. The optimal frequency of stimulation for production of the inhibitory effect was found to be 4--8 pulses per second. The duration of inhibition following each stimulating pulse lasted for 100--170 msec. Analysis of oscillographic records shows that there exists before the onset of the inhibition of parafascicular discharges a latent period of 10--20 msec which far exceeds the time required for impulse conduction between the two closely related structures, suggesting that a long tortuous neuronal circuit is involved in elaboration and transmission of the inhibitory effect.

Acupuncture Therapy↗

PubMedDate not supplied

Surgical treatment of hepatocellular carcinoma with biliary tumor thrombi.

Treatment is always abandoned in those HCC with jaundice, because it is usually attributed to the underlying liver cirrhosis and extensive tumor. In this series, 7 cases (0.8%) of HCC with jaundice were caused by bile duct invasion and tumor thrombi (BTT). 57% of cases showed Charcot's triad. 57% of BTT were small HCC, significantly higher than the 1.7% of total cases (p<0.05). The growth pattern of BTT was all spreading type, significantly higher than the 42% of total operation cases (p<0.05). The DNA ploidy of BTT was all aneuploid. 57% of BTT had AFP level higher than 400 IU/ml, but it was 27% in total cases. The prognosis is poor in those treated with palliative tube drainage. Aggressive hepatic resection was proved to be safe and achieved the best results in our limited experience. Choledochotomy to remove tumor thrombi is contraindicated because it easily causes tumor seeding. It is advocated to search BTT for resection from the group of HCC with jaundice.

Adult↗

PubMedDate not supplied

Laparoscopic versus open preperitoneal prosthetic herniorrhaphy for recurrent inguinal hernia.

BACKGROUND: Laparoscopic herniorrhaphy (LH) shares the same repair principle as open preperitoneal prosthetic herniorrhaphy (PPH). Theoretically, the recurrence rate of LH for recurrent inguinal hernia will match the low recurrence rate of PPH (1.2-3%). METHODS: One-hundred forty-five cases of recurrent inguinal hernia were retrospectively studied between 1990 and 1994. Forty-two cases receiving LH were compared to 103 cases receiving PPH. RESULTS: There were no differences in operative time, hospital stay, morbidity rate, satisfaction scale and recurrence rate between the LH group and the PPH group. The LH group showed significantly less postoperative pain and 2 times shorter convalescence (p<0.01). Unsuspected asymptomatic contralateral hernia was found in 4.8% of patients receiving LH. 11.9% of patients had bilateral hernia repairing at the same time in the LH group. CONCLUSIONS: LH is suitable for recurrent inguinal hernia, but further investigation of this technique is required before its wide application.

Adult↗