We report a case of a successful pregnancy managed to term in a liver transplant recipient. With an increasing number of liver transplants being performed, and increasing five-year survival rates, it is expected that similar cases will be seen more often.

This paper reviews the pathophysiology, symptoms, and signs of haemorrhoidal disease. The indications that necessitate patients being sent for further investigation are highlighted. The various treatments available for haemorrhoids are explained and the optimal use of different ambulatory procedures is discussed.

This review traces the history of genital human papillomavirus infection and documents its discovery as a venereally transmitted infection. The strong links of human papillomavirus to ano-genital malignancies--particularly carcinoma of the uterine cervix--are outlined. DNA hybridization testing has enabled various subtypes to be identified, some of which are associated with certain malignancies. This new technology has also shown that male transmission of human papillomavirus is important and some men are vulnerable to cancer from the infection. Methods for treating human papillomavirus lesions are discussed. The role of cervical cytological screening in preventing cervical cancer is detailed and cervical cytology, despite the advent of DNA technology, is still the key to preventing cervical cancer. This should be encouraged in Hong Kong which, unfortunately, has an unacceptably low screening rate. Because of changing sexual behaviour, human papillomavirus infection is reaching epidemic proportions worldwide and the infection rate in Hong Kong is probably much higher than was previously thought. The medical profession and the public need to be aware of the consequences of this infection.

With the advent of the Brown-Roberts-Wells stereotactic frame to the Queen Elizabeth Hospital in 1987, an evaluation was made of criteria for the safety and selection of patients for CT-guided stereotaxy. Sixty-five stereotactic procedures were performed on 47 men and 18 women from October 1987 to December 1994, which included biopsy, drainage of abscesses, and craniotomies. Fifty-five patients were operated on under local anaesthesia and 10 received general anaesthesia. Pathology was established by frozen section at the time of operation in 64 cases (98.4%), with the exception of one lesion in the pons. Bleeding was the single cause of the 4.7% mortality encountered, all of which occured in the initial few procedures. A radio-opaque ventricular catheter threaded through the stereotactically-guided cannula was found to be useful for draining abscesses and irrigation. The careful planning and selection of patients is very important, especially when the lesions are located in the pons or hypothalamus.

Colorectal cancer is the third most common cause of death due to cancer in Hong Kong. Most of these cancers are diagnosed at a late stage, when they are not amenable to curative treatment. Clinical trials have shown that screening for colorectal cancer using the faecal occult blood test can reduce death from colorectal cancer, but this test misses many cancers due to its inherent limitations. Double-contrast barium enema, flexible sigmoidoscopy and colonoscopy produce increasingly accurate results, at increasing cost. Selected population screening by faecal occult blood test, and targeted screening ofpersons at high risk using the more invasive tests, deserve consideration in Hong Kong. Amongst those at high risk are persons who have had rectal bleeding or colorectal adenomas, and those with one or more first-degree relatives with colorectal cancer or adenoma. Early diagnosis would allow more effective treatment to be given, without the need for a colostomy, and give better odds for survival and quality of life.