We conducted a retrospective study of all paediatric ocular injuries that were treated at the Prince of Wales Hospital between October 1991 and January 1997. Of the 60 injuries reviewed, eight (13.3%) resulted in some degree of visual deficit. The mean age was 5.5 years and the average male to female ratio was 2.75:1. The distribution of injuries was as follows: contusions, 29 (48.3%); non-penetrating lacerations, 14 (23.3%); penetrating lacerations, six (10.0%); chemical burns, six (10%) and superficial foreign bodies, five (8.3%). Thirteen (21.7%) ocular injuries were associated with common household items, seven (11.7%) injuries were due to toy gun pellets, and five (8.3%) injuries were sports-related. A total of 28 operations were performed on 21 patients, and the mean duration of hospital stay was 3.6 days. The visual outcome depended mainly on the type and severity of the injury. Some childhood eye injuries are preventable by means of more public education, improved safety measures, and closer adult supervision.

A questionnaire survey was conducted in late September 1996 to study the current practice in preventing blood-borne diseases during organ/tissue transplantation at local institutions. Twenty-five (83%) of 30 public transplantation institutions responded. Kidney and cornea/sclera transplantations were the most commonly practised procedures. Some institutions performed bone, skin, liver, heart and lung, and bone marrow transplantations. A variety of measures have been taken by most of the institutions to uphold safety during transplantation. Nevertheless, a lack of protocol standardisation and inadequate awareness to communicable diseases during transplantation are apparent. The establishment of local guidelines and the implementation of an effective monitoring mechanism might minimise the transmission risk of communicable diseases that are associated with transplantation.

Botulinum A toxin has been reported to provide excellent symptomatic relief for patients with dystonia. To analyse the treatment, complications, and outcome of patients receiving botulinum A toxin injection, the case records of 170 patients attending the Botox Clinic at the Kwong Wah Hospital from 1 December 1992 to 31 December 1996 were reviewed. Of these 170 patients, 130 (76.5%) had idiopathic hemifacial spasm, 18 (10.6%) had blepharospasm, 18 (10.6%) had spasmodic torticollis, and 4 (2.4%) had generalised or focal limb dystonia. One hundred and sixty-six (97.6%) patients were Chinese. The average dose of botulinum A toxin required for an optimal response was 14.54 U for those with hemifacial spasm, 49.64 U for those blepharospasm, and 137 U for those with spasmodic torticollis. Among patients with hemifacial spasm, 103 (81.7%) gave a good response, 21 (16.7%) gave a partial response, and there was no response in two (1.6%) patients. The corresponding figures for patients with blepharospasm were 7 (38.9%), 10 (55.6%), and 1 (5.6%), respectively, and for those with spasmodic torticollis, the figure were 6 (37.5%), 6 (37.5%), and 4 (2.5%), respectively. Complications from botulinum A toxin injection were rare (less than 10%), minor, transient, and usually dose-related. In conclusion, idiopathic hemifacial spasm was the most common type of movement disorder encountered in our Botox Clinic and botulinum A toxin injection was safe and effective in the majority of patients.

A prospective study of Chinese patients with megaloblastic anaemia was conducted at the Pamela Youde Nethersole Eastern Hospital from 1 May 1994 to 31 August 1997. Megaloblastic anaemia was diagnosed in 57 patients, 52 of whom were eligible for further evaluation. The median age of these 52 patients was 73.5 years and the male to female ratio was 1.08:1. The serum cobalamin level (median, 56 ng/L) was low in 46 (86.5%) patients. In five (9.6%) patients, both serum cobalamin and red blood cell folate concentrations were low. Isolated low red blood cell folate level was demonstrated in one (1.9%) patient. Serum antibodies against intrinsic factor and gastric parietal cells were detected in 32 (61.5%) and 26 (50.0%) patients, respectively; 19 (36.5%) patients had both types of antibody. The aetiology of megaloblastic anaemia included pernicious anaemia in 39 (75%) patients, postgastrectomy vitamin B12 deficiency in five (9.6%) patients, and nutritional deficiency in two (3.8%) patients; the cause was undetermined in six (11.5%) patients.

This study investigated the use of anti-ribosomal P antibodies in the diagnosis of cerebral complications of systemic lupus erythematosus using two different methods-western blotting and enzyme-linked immunosorbent assay. Anti-ribosomal P antibodies in patient serum were detected in both methods using a purified ribosomal P antigen substrate. Western blotting detected anti-ribosomal P antibodies with a 90% specificity for systemic lupus erythematosus in 56% of patients with the disease. The detection of anti-ribosomal P antibodies by western blotting in patients with systemic lupus erythematosus was significantly associated with psychosis and/or seizures; detection was positive in 90% of patients with these cerebral complications and in 41% of those without. Elevation of the level of anti-ribosomal P antibody, as measured by enzyme-linked immunosorbent assay, was 99% specific for systemic lupus erythematosus in 44% of patients with systemic lupus erythematosus that was not associated with cerebral involvement. We conclude that the measurement of anti-ribosomal P antibodies by western blotting is helpful in the diagnosis of cerebral lupus in selected patients.