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Dupuytren's disease is a fibroproliferative condition of the palm, with a predilection for men, which has affected Northern Europeans since the Viking conquests. Although strongly heritable, clear evidence exists for environmental factors that modify the underlying genetic risk, such as diabetes, heavy drinking, and smoking. Evidence also exists for epilepsy (probably due to treatment with certain anti-epileptic drugs), and Human Immunodeficiency Virus infection. Recent large studies have shown no relationship with manual labour or vibrating tools. Two theories have emerged regarding the pathogenic mechanism: the first attributes the aberrant healing process that characterises Dupuytren's to free radicals, generated as a result of microangiopathy, whereas the second cites a genetic tendency toward apoptosis-resistant myofibroblasts. Despite only one study demonstrating linkage, emerging data from genome-wide association studies highlight a series of single nucleotide polymorphisms near members of the Wnt signalling pathway, and transcriptional profiling studies have consistently identified certain components of the extracellular matrix.

Pathophysiology of cubital tunnel syndrome (CubTS) is still controversial. Ulnar nerve strain at the elbow was measured intraoperatively in 13 patients with CubTS before simple decompression. The patients were divided into three groups according to their accompanying conditions: compression/adhesion, idiopathic, and relaxation groups. The mean ulnar nerve strain was 43.5 ± 30.0%, 25.5 ± 14.8%, and 9.0 ± 5.0% in the compression/adhesion, idiopathic, and relaxation groups respectively. The mean ulnar nerve strains in patients with McGowan's classification grades I, II, and III were 18.0 ± 4.2%, 27.1 ± 22.7%, and 33.7 ± 24.7%, respectively. The Jonckheere-Terpstra test showed that there were significant reductions in the ulnar nerve strain among the first three groups, but not in the three groups according to McGowan's classification. Our results suggest that the pathophysiology, not disease severity, of CubTS may be explained at least in part by the presence of ulnar nerve strain.

Trigger finger is a mechanical problem with many etiological factors as possible causes, such as diabetes mellitus, carpal tunnel syndrome and repetitive finger movements. Although it can afflict anyone, it is much commoner in middle-aged women than men and the most commonly involved digit is reported to be the thumb. The diagnosis is mainly based on clinical symptoms during examination and first-line treatment is conservative with splinting and corticosteroid injections. Surgical open release is the “gold standard” of trigger finger treatment because it allows more careful inspection of the surgical area and is highly effective with low complication rates.

There are striking ethnic and geographical variations in risk of nasopharyngeal carcinoma (NPC). Males have a higher NPC risk than females in all populations, and high risk populations have a younger peak age at onset than low risk populations. Epstein-Barr virus infection has been consistently documented to be associated with an increased risk of NPC. Dietary factors, especially Cantonese salted fish and preserved foods, are important risk factors for NPC. Cigarette smoking, occupational exposures to wood dust, formaldehyde and chemical fumes, use of Chinese herbs are also associated with NPC. There is a strong familial tendency of NPC. Genetic polymorphisms of human leukocyte antigens and some enzymes involved in xenobiotic metabolism and DNA repair are associated with NPC. Both segregation and linkage analyses have implied the inheritance mode and location of susceptibility genes of NPC. NPC is the result of a multistage process with a multi-factorial etiology of gene-environment interactions.

The incidence of hepatocellular carcinoma varies widely in different countries in the Asia-Pacific region. Despite this, chronic viral hepatitis infection is the most important etiological association. The mechanism of viral-related carcinogenesis is discussed. We also review the epidemiology of hepatocellular carcinoma with special reference to viral hepatitis in three countries in the Asia-Pacific region with different rates (high, intermediate and low) of hepatocellular carcinoma. As the most significant cause of hepatocellular carcinoma in the Asia-Pacific region is related to viral hepatitis, there is hope that the incidence will decline in the future with the control and treatment of viral hepatitis.