Acquired immunodeficiency syndrome-related Kaposi's sarcoma has become an important disease entity, both in the field of human immunodeficiency virus/acquired immunodeficiency syndrome as well as neoplastic disorders. In the 10-year period from February 1984 to December 1994, 17 (13%) of the 130 acquired immunodeficiency syndrome patients who reported to the Department of Health, Hong Kong, had Kaposi's sarcoma as primary (11) or subsequent (6) acquired immunodeficiency syndrome-defining illnesses. All of these patients had acquired the virus through sexual transmission, with 88% via homo- orbi-sexual contacts. Nine patients were Chinese, and seven were diagnosed in or after 1992. Solitary or multifocal cutaneous lesions were the commonest presentations. Only one patient had visceral involvement. The median CD4+ T-lymphocyte count at diagnosis was 91 cells/microL (normal range, >290 cells/microL). Eleven patients had died, but no deaths were directly related to the Kaposi's sarcoma. The mean survival after diagnosis of Kaposi's sarcoma was 14.4 months.

Forty patients were evaluated using sleep studies for assessment of possible sleep apnoea/hypopnoea syndrome. Twenty-six patients had significant sleep apnoea based on polysomnography. Most of the patients with this syndrome had at least two of the three major symptoms of obstructive sleep apnoea-witnessed apnoeas, heavy snoring, and excessive daytime somnolence. The most common associated medical illnesses were hypertension (47%), chronic obstructive airways disease (16%), respiratory failure (15%), and allergic rhinitis (12%). All 26 patients with sleep apnoea/hypopnoea syndrome were treated with either continuous positive airways pressure or bilevel positive airways pressure with significant improvement. Minimum percentage arterial oxygen saturation increased significantly, with a median difference of 25.5 (interquartile range, 10 to 36; P<0.01) and the apnoea/hypopnoea index decreased significantly with a median difference of 23.0 (interquartile range, 15 to 44; P<0.01). The clinical features of this syndrome in Hong Kong are similar to those reported in the West.

A retrospective study of 72 second trimester pregnancy terminations using 16,16-dimethyl-trans-delta 2 prostaglandin E1 methyl ester (Gemeprost, CervagemTM) vaginal pessary is reported. The success rate with this method of induced abortion was 93%. The mean induction-abortion interval was 12.6 hours. Minor side-effects such as fever, vomiting and diarrhoea occurred in 46%, 10% and 18% of patients respectively. Major complications were uncommon. Only one patient had blood loss of more than 500 mls and one patient had genital tract trauma. It is our experience that gemeprost is a safe and efficient method for second trimester termination.

The Infirmary Assessment Clinic was established at the Tuen Mun Hospital to assess the elderly registered on the central waiting list for the infirmary. The main purpose of the clinic was to look for appropriate candidates for infirmary placement and to deliver support to those who could remain in the community. A multidisciplinary approach was adopted for the assessment. Sixty-seven candidates were assessed and 51 were found to be qualified, i.e. 24% required a lower level of institutional care. With this rectification of the list, the clinic could save HK$5.8 million in one year if all assessed candidates were placed in the appropriate level of institutional care for 12 months. Seventy-five per cent of eligible candidates had mental disabilities and 55% had physical disabilities. All mental disabilities could be categorised as dementia requiring support in activities of daily living. A dividing score (Mini Mental State Examination <151,2 and Barthel Index <603,4) was arbitrarily defined as a guiding score for the assessment. Although this was found to be sensitive (84%), it was not specific (62%). The decision was multifactorial and individualised.

Silicosis is the most common occupational disease notified in Hong Kong. Annually, up to 200 cases--mostly from the construction industry--are reported. To elucidate the personal and behavioural risk factors for silicosis, we studied 215 silicosis patients in the construction industry and 173 controls from 1990 to 1992. We investigated occupational exposure to dust, work practice, education, vocational and safety training, work experience and personal habits (cigarette smoking, alcohol intake). No formal education, no vocational and safety training, current and past smoking, and the use of dust masks were found to be significant risk factors. Because of selection bias in the choice of controls in this study, risk factors identified in the logistic regression model have to be interpreted with caution. In addition to dust suppression on construction sites, on-the-job safety, health training and health maintenance programmes should be provided to construction workers. Health education should be aimed at increasing worker awareness of the danger of fibrogenic dusts, encourage the proper use and maintenance of effective personal protective equipment, implement dust supression measures, and discourage smoking.