As modern medicine getting deeply to understand ever-detailed anatomy,structure and animal mechanics of the patellofemoral joint, excessive lateral pressure syndrome, a very common patellofemoral disorder, has been reacquainted by the clinicians. On account to the complexity and variety of the etiology and the mechanism of the pain, still, there are many difficulties and arguments on the exact description of the clinical symptoms and the establishment of a universally accepted diagnostic criteria. Accurately grasping different causes, pathomechanisms and developmental stages of the disease would be especially important. As a result, rational choice of the pertinent procedures become the clinical lynchpin. This paper reviews domestic and international pertinent literatures in the past 10 years, and provide an overview of the latest study of anatomy, biomechanic, pathomechanism and clinical experience, anticipating to offer help on standardizing the diagnosis and treatment of ELPS.
Humans ; Pain ; complications ; diagnosis ; Pain Management ; Patellofemoral Joint ; Pressure ; Syndrome

Abdominal Pain ; etiology ; Acute Pain ; etiology ; Child ; Humans ; Lymphoma ; complications

OBJECTIVETo investigate the states of chronic symptoms of other parts of the body concomitant with temporomandibular joint (TMJ) pain.

METHODSFifty-one patients with TMJ pain and thirty-one control subjects without TMJ symptoms were chosen randomly. The TMJ symptoms and chronic symptoms of other regions were investigated at the base line. The TMJ pain patients were investigated again half year after treatment. Between-symptom correlations were analyzed using linear regression and Chi-squared analysis method (alpha = 0.05).

RESULTSThe chronic symptoms related to the TMJ pain at the base line were headache, back pain, numbness of hand, neck and shoulder pain, insomnia, dizziness, reduced hearing ability, eye pain and fatigue (P < 0.05). The incidences of the symptoms of patients were higher than those of the control subjects (P < 0.01). Half year later, the headache, neck and shoulder pain and fatigue were the symptoms improved with the TMJ pain treatment (P < 0.05).

CONCLUSIONThe symptoms of adjacent regions of orofacial area such as neck and shoulder pain and headache are the main concomitant symptoms of the TMJ pain, and these symptoms may be improved by the treatment of TMJ.

Adolescent ; Adult ; Aged ; Facial Pain ; complications ; Female ; Headache ; complications ; Humans ; Male ; Middle Aged ; Neck Pain ; complications ; Shoulder Pain ; complications ; Temporomandibular Joint Disorders ; complications ; Young Adult

Objective: To explore the safety and feasibility of gasless submental approach endoscopic removal of thyroglossal cyst. Methods: This work prospectively included the clinical data of 13 patients who underwent the gasless submental approach endoscopic removal of thyroglossal cyst at the Department of Otolaryngology, the First Affiliated Hospital of Chongqing Medical University from August 2021 to February 2022. The operative time, bleeding volumes, postoperative complications, subjective pain levels, satisfaction with incisional scars, neck and facial deformities, and recurrences were prospectively evaluated by visual analogue scale(VAS) score. Results: All of 13 patients were successfully treated using this new technique. The patients had a median age of 38 years, ranging from 24 to 59 years, comprising of 3 males and 10 females. The length of the submental incision was about 3 cm and the median of operation time was 135 minutes. Postoperative complications were minimal. The median volume of blood loss was 10 ml. Surgical site swelling existed in 1 case and dysphagia for more than 1 week occurred in 2 cases. Patients were discharged from the hospital with a median of 3 days after surgery. On a VAS of 0-10 scores, the pain had a median of 2 on the first day after surgery, and the satisfaction with incision scars and neck and facial deformities showed a median of 8 at 6 months after surgery. There were no recurrences during the follow-up period of 9-15 months. Conclusion: Gasless submental approach endoscopic removal of thyroglossal cyst may be a reliable new surgical method that is safe and has cosmetic advantages.
Male ; Female ; Humans ; Adult ; Cicatrix/complications* ; Thyroglossal Cyst/complications* ; Endoscopy/methods* ; Postoperative Complications ; Pain/complications*

Uncontrolled or inadequately controlled postoperative pain may lead to delayed recovery from surgery, pulmonary complications, and restriction of mobility leading to increased risk of thromboembolism. Standardized regimens for pain management can lead to safer and better pain control. Of these regimens, patient-controlled analgesia, a delivery system with which patients self-administer small, predetermined analgesic doses, produced improved pain relief, greater patient satisfaction, less sedation, and fewer postoperative complications. Anesthesiologists have played an important role to make this pain management feasible. The introduction of acute pain services at hospitals prompted improvements in postoperative pain management in addition to the minimization of related complications.
Analgesia* ; Analgesia, Patient-Controlled ; Humans ; Pain Clinics ; Pain Management ; Pain, Postoperative ; Patient Satisfaction ; Postoperative Complications ; Thromboembolism

We experienced a case of chronic fibrosing pancreatitis in an 18/12-year-old girl, which was idiopathic because there were no familial back ground, no cystic fibrosis of pancrease, no ductal anomalies and obstruction. The patient presented intermittent colicky abdominal pain and progressive obstructive jaundice, but T-tube drainage and removal of the lymph nodes around the common bile duct relieved her symptoms and disease process. This seems to be the first case reported in a Korean child. Idiopathic fibrosing pancreatitis should be considered in the differential diagnosis of abdominal pain with obstructive jaundice in children.
Abdominal Pain/complications ; Female ; Fibrosis ; Humans ; Infant ; Jaundice, Chronic Idiopathic/complications ; Pancreatitis/complications/*pathology

Several reports of coccygodynia have been confined to the causes, the methods of treatment, and the methods of radiological examination. As far as we know, there has been no previous study about the objective measurement of the coccyx. The purpose of this study was to find the possible cause of idiopathic coccygodynia by comparing the clinical and radiological differences between traumatic and idiopathic coccygodynia by innovative objective clinical and radiological measurements. Thirty-two patients with coccygodynia were evaluated retrospectively. We divided the patients into two groups. Group 1 consisted of 19 patients with traumatic coccygodynia and group 2 consisted of 13 patients with idiopathic coccygodynia. We reviewed medical records and checked age, sex distribution, symptoms, and treatment outcome in each group. We also reviewed coccyx AP and lateral views of plain radiological film and measured the number of coccyx segments and the intercoccygeal angle in each group. The intercoccygeal angle devised by the authors was defined as the angle between the first and last segment of the coccyx. We also checked the intercoccygeal angle in a normal control group, which consisted of 18 women and 2 men, to observe the reference value of the intercoccygeal angle. The outcome of treatment was assessed by a visual analogue scale based on the pain score. Statistical analysis was done with Mann-Whitney U test and Chi-square test. Group 1 consisted of 1 male and 18 female patients, while group 2 consisted of 2 male and 11 female patients. There were no statistically significant differences between the traumatic and idiopathic coccygodynia groups in terms of age (38.7 years versus 36.5 years), male/female sex ratio (1/18 versus 2/11), and the number of coccyx segments (2.9 versus 2.7). There were significant differences between the traumatic and idiopathic coccygodynia groups in terms of the pain score (pain on sitting: 82 versus 47, pain on defecation: 39 versus 87), the intercoccygeal angle (47.9 degree versus 72.2 degrees), and the satisfactory outcome of conservative treatment (47.4% versus 92.3%). The reference value of the intercoccygeal angle in the normal control group was 52.3 degrees, which was significantly different from that of the idiopathic group. In conclusion, the intercoccygeal angle of the idiopathic coccygodynia group was greater than that of the traumatic group and normal control group. Based on the results of this study, the increased intercoccygeal angle can be considered a possible cause of idiopathic coccygodynia. The intercoccygeal angle was a useful radiological measurement to evaluate the forward angulation deformity of the coccyx.
Adult ; Coccyx/radiography* ; Coccyx/physiopathology* ; Female ; Human ; Male ; Pain/therapy ; Pain/surgery ; Pain/radiography* ; Pain/physiopathology* ; Pain/etiology ; Spinal Injuries/complications ; Treatment Outcome

PURPOSE: Recently, single incision laparoscopic surgery (SILS) has been studied for its being less invasive surgery and having cosmetic improvement. We investigated the application of SILS for an appendectomy (SILS-A) in cases of complicated appendicitis and compare it with a conventional laparoscopic appendectomy (C-LA). METHODS: This study involved a total of 40 patients who underwent C-LA or SILS-A in patients with complicated appendicitis; 25 patients received a C-LA, and the other 15 patients received a SILS-A. The clinical outcomes and cosmetic results were compared between the groups. RESULTS: The SILS-A procedures were performed successfully in patients with complicated appendicitis, but 6 patients who underwent SILS-A needed an additional port for dissection and drainage. Clinical outcomes and postoperative complications were similar in both study groups. The SILS-A group showed significantly higher numbers of pain control than the C-LA group, and the one port SLLS-A group showed significantly better cosmetic result than the C-LA group. CONCLUSION: SILS-A is technically feasible and safe in patients with complicated appendicitis. However, SILS-A has more postoperative pain than C-LA, and more active pain control should be considered for patients undergoing SILS-A.
Appendectomy ; Appendicitis ; Cosmetics ; Drainage ; Humans ; Laparoscopy ; Pain, Postoperative ; Postoperative Complications

PURPOSE: To determine the advantage and disadvantage of using tourniquet in the malleolar fracture treated with open reduction and internal fixation. MATERIAL AND METHOD: Randomized 12 patients were operated on with use of a tourniquet (Group T), and 12 patients without use of a tourniquet (Group NT). The operation time, the technical difficulty during operation, the incidence of postoperative complication and the intensity of postoperative pain were compared between the two groups. RESULT: The demographic of the two groups, including age, sex, fractire type, and delay after injury were similar. The average duration of the operation and the technical difficulty during operation were similar between the both group (76min. in Group T, 81min in Group NT, p=0.28) There were no severe complications, however, Four patients had local redness and oozing (3 in group T, 1 in group NT). The patients in group T had higher VAS (Visual Analogue Scale, p=0.014) and more frequencies of analgesic injection (p=0.03) than within 24 hours after operation than those in Group NT, which difference was more significant in male patients and the patient of more than 40-year old. CONCLUSION: Open reduction and internal fixation of the malleolar fracture without use of a tourniquet can be performed with little difficulty and the severity of postoperative pain and the incidence of postoperative complication can be reduced.
Adult ; Humans ; Incidence ; Male ; Pain, Postoperative ; Postoperative Complications ; Tourniquets*

The authors performed 19 cases of percutaneous automated discectomy using Nucleotome between Feb, 1988 and Jan, 1993. The mean age was 33 years ranging from 20 to 56 years. Eleven of the patients were men and eight were women. One level nucleotomy was done in 14 cases, two level in 4 cases and three level in 1 cases. Overall success rate was 63%. No intraoperative and postoperative complications occurred except transient back pain in 3 cases.
Back Pain ; Diskectomy* ; Female ; Humans ; Male ; Postoperative Complications