Paget-Schroetter syndrome, or 'effort' thrombosis of the axillary-subclavian vein, is an uncommon deep vein thrombosis usually caused by excessive upper limb activity. It may cause post-thrombotic syndrome, leading to significant disability if not treated appropriately. The optimal management for this syndrome is still controversial because the outcomes of different treatment strategies are based on case studies and series in small numbers. We report a case of Paget-Schroetter syndrome in a young male weight-lifter and discuss treatment strategies suggested by the current literature.

Erdheim-Chester disease is a rare, idiopathic, non-Langerhans' cell, histiocytic disorder. To our knowledge this is only the second case of Erdheim-Chester disease reported in the Chinese population. We describe a 45-year-old woman presenting with unilateral proptosis and periorbital xanthelasma. Histopathological examination revealed a xanthogranulomatous lesion expressing CD68, but negative for S100 protein, CD1a, CD3, or CD20. Systemic involvement was evident on bone scanning, and involvement of the thorax and abdominal aorta was seen on computed tomography. Despite treatment with systemic steroids, immunosuppressants, chemotherapy and interferon, progressive deterioration occurred. Our patient's clinical course was consistent with reports in the literature. Unfortunately, our patient developed neutropenic fever and died from septicaemic shock. Although Erdheim-Chester disease is a rare entity, especially in the Chinese population, an unusual presentation with orbital masses and bilateral xanthelasma, associated with systemic features, should raise the suspicion of this serious and potentially fatal disease.

We present two cases of postmaturity-related perinatal mortality with delivery at 42 weeks 6 days' and 44 weeks' gestation, respectively. No cause beyond postmaturity was found. Neither induction of labour nor foetal monitoring had been performed despite these gestations going post 41 weeks because of a current 'social obstetrics' phenomenon—non-local expectant mothers coming to Hong Kong from mainland China for delivery.

A 50-year-old woman developed rapidly progressive acute renal failure on the first day after the administration of intravenous acyclovir for acute left retinal necrosis. Intravenous acyclovir was stopped and replaced with intravitreal injections of ganciclovir sodium (2 mg/0.05 mL) and foscarnet (1.2 mg/0.05 mL) 3 times per week for 4 weeks. Acyclovir-induced renal impairment can be reversed if recognised early and treated with careful, timely body fluid replacement. The necrotising retinitis responded well to intravitreal antiviral agents. No complications were seen at the 6 months' follow-up. Constant vigilance is essential for avoiding acute renal failure when treating ophthalmic conditions with intravenous acyclovir. Systematic monitoring of renal function, urine output, and characteristic symptoms like loin pain is warranted.

A hydrothorax following ventriculoperitoneal shunt catheter insertion is very rare and usually reported in children. Only about 25 cases have been described in the literature and very few have been adults. We report a 51-year-old woman with a massive hydrothorax and respiratory distress following both supradiaphragmatic and transdiaphragmatic migration of a ventriculoperitoneal shunt catheter into the pleural space. To our knowledge this is the first report of the simultaneous occurrence of two types of such migration in one patient.