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Background: Synovial chondromatosis is a condition that rarely occurs in the hand and wrist. Recurrence and malignant transformation are two potential complications of the disease. We set out to retrospectively review 35 years of practice within our sarcoma and tertiary hand unit and identify recurrence or malignant transformation.

Methods: This is a retrospective analysis of patients with synovial chondromatosis seen at our sarcoma and tertiary hand unit for the past 35 years. Incidence of recurrence or malignant transformation was noted. Where possible, patients were clinically and radiologically reviewed with range of motion, grip strength and patient evaluation measures obtained.

Results: Of 12 patients presenting to the practice, seven patients were followed up and, of these, two demonstrated recurrences. The recurrence was diagnosed based on patient-reported symptoms, clinical examination and the requisition of further imaging. Of the five who could not be followed up, two demonstrated recurrence and one had malignant transformation with a low-grade chondrosarcoma on histology.

Conclusions: While a rare disease, we demonstrated recurrence within our small case series. Fusion to obliterate the joint is an option in the management of recurrence. For the diagnostically challenging, genetic testing may be beneficial, though genetic rearrangements are not seen in all cases. All patients should be counselled on symptoms to watch for as a small proportion may experience recurrence and a small percentage may undergo malignant transformation.

Level of Evidence: Level IV (Therapeutic)

In this paper we describe and implement a numerical method which provides highly accurate solutions of a generic two-dimensional model for the formation of capillary networks as a partial process in tumour angiogenesis. The model includes effects due to diffusion, chemotaxis, haptotaxis and cell proliferation. The governing partial differential equation is a diffusion-advection-reaction equation of parabolic type. In order to achieve high accuracy in space, we use a semi-discretisation based on the spectral element method. The resulting system of stiff ordinary differential equations is advanced forward in time using one-step explicit higher order time integrators based on Taylor series expansions. The high accuracy in space is monitored by a residual based a posteriori error indicator while the high accuracy in time is guaranteed by the local and global truncation errors of the higher order Taylor series method.

We report a case of multiple schwannomas of the median nerve. Multiple schwannomas can be difficult to diagnose on clinical grounds and can be mistakenly diagnosed as carpal tunnel syndrome or ganglia as in our case. Nerve conduction studies helped locate non-visible tumours. Magnetic resonance imaging (MRI) is useful in the preoperative planning of these tumours. The appearances on scanning however can be sometimes confused for ganglia as in this case. Intraneural dissection of the schwannomas was carried out and the pathology is described.

In this paper, the authors offer a classification of benign fatty tumours of the upper limb. There are three histologically distinct types of fat cells: immature fat cells which give rise to lipoblastomas, mature brown fat cells which give rise to hibernomas and mature white fat cells which give rise to lipomas. Lipomas are the most common and they are sub-classified according to the anatomic site of fat cells into dermal, subcutaneous and sub-fascial lipomas; or tumours directly related to muscle, bone, synovium or nerve. Finally, the authors review 67 patients with benign fatty tumours of the upper limb and provide clinical examples of these tumours including their characteristic histological and radiological features.

The superficial radial nerve might be compressed or injured at various anatomical sites along its course in the forearm. Most of the superficial radial nerve neuropathy are caused by pathological lesions such as trauma, a mass or tight band at the distal third of the forearm. Wartenberg's syndrome is the most common cause of sensory radial entrapment at the distal forearm. Compression of superficial radial nerve occurring at the proximal third of forearm is unusual. We present a rare case of superficial radial nerve compression due to a parosteal lipoma of proximal radius. Results of complete physical and radiological examinations are also presented. Surgical intervention of the tumour mass was performed for nerve decompression. The patient reported total relief of the neurological symptom post-operatively. This rare case demonstrates the unique characteristics of parosteal lipoma with unusual superficial radial nerve neuropathy at the proximal radius. This report reminds us that there is the possibility of superficial nerve compression caused by tumour mass over the proximal third of forearm.

We present a rare case of a 72-year-old woman who had a metastatic bone tumour on the fifth metacarpal of the left hand from gastric cancer. It had occurred in the patient, two years after subtotal gastrectomy and partial resection of a liver for advances gastric cancer with metastasis to the liver. A number of investigations and the needle biopsy confirmed the diagnosis of the metastatic malignant tumour of fifth metacarpal bone and an amputation was performed. Although our patient died 12 months after hand surgery, amputation was effective in providing relief from pain in the affected hand for the remainder of her life.

It is necessary to consider rare acrometastasis to the hand if a patient complains of swelling and pain of the hand without a trigger if there is a history of malignancy, including gastric cancer.

An intraosseous xanthoma is a very rare condition. It has an aggressive appearance on radiographs mimicking primary or metastatic malignant bone tumors. We report a case of intraosseous xanthoma of the distal radius in a 51-year-old male with no history of hyperlipidaemia. To the best of our knowledge, this condition has not been reported so far in the wrist and forearm region. The lesion was successfully excised and at last follow-up, there were no signs of recurrence and patient has been symptom-free.

Large allograft bones are commonly used in limb salvage procedures for the reconstruction of bone defects after resection of a bone tumor. A V-shaped osteotomy may perform better than the traditional transverse osteotomy as it increases the stability of the docking site and increases the contact area between an allograft and the host cortex. The aim of this study is to investigate the biomechanical properties of a V-shaped docking site of different angles.

orcine femurs with 45°, 60° or 90° V-shaped osteotomy were first tested with 1000 N compression, followed by 2 and 5 Nm torque. The torsional stiffness of the 45° specimen group at 5 Nm torque was significantly higher (P<0.05) than the 90° group. Therefore, our results show that 45° V-shaped osteotomy is found to be the most stable docking angle.

Opportunity Often Knocks Twice- Drug diversity lends to a host of pharmaceutical oppurtunities: Canopus biopharma's approach to R&D.

Imagene Labs Introduces Region’s First Complete Genetics-Based Wellness Solutions.

ASLAN Pharmaceuticals and A*STAR Enter RON Antibody Licensing and Research Collaboration Agreement.

Hidden HIV Revealed: New Insights into Latent HIV Infections.

Agilent Technologies Introduces Transformational Technology for Gas Chromatography.

Merck Joins DiViNe Consortium to Address Low Yields, High Costs of Vaccine Purification Processes.

FEI Celebrates Shipment of 1,000th Helios DualBeam System.

China’s Healthcare Reforms: Who Will Survive?

Neovia Enrolls First Patient in Cancer Trial for Immunotherapy Enhancing Drug.

$5M Foundation Gift to Help Support US-China Energy Center at Berkeley Lab.

Scientists Make Breakthrough in 21st Century Killers Research.

Chinese Scientist Participates in Human Gene Editing Committee.

Monkeys Master a Key Sign of Self-awareness: Recognizing Their Reflections.

Poisonous Gas May Have Driven Prehistoric Mass Extinction.

Chinese Scientists in Rice Breakthrough.

The following topics are under this section:

• Officials in China make progress in development of new drugs
• China conducts its first 5G-streamed robot-assisted surgery in Shanghai, China
• First Asian Scientist to be awarded the IBRO-Kemali Prize: Dr Hu Hailan
• Wuhan Healthgen Biotechnology gains approval for OsrHSA by U.S. FDA
• B&R tumor prevention, control training base to be built in Chongqing
• China-Thailand Joint Research Institute on Medicine Launched in Bangkok
• Porous Fibres Graphene Developed for Highly Sensitive Wearable Sensors
• New Cotton Fertilization Method Developed by CAS Researchers

Background: The purpose of this study was to compare the diagnostic accuracy of a smartphone flashlight to a conventional penlight with regards to transillumination of simulated soft tissue masses of the hand and wrist.

Methods: Eight participants performed transillumination assessments in a fresh frozen cadaver upper extremity model. Spheres measuring 9.5 mm were used to simulate fluid-filled or solid soft tissue masses. Two spheres were placed on the volar aspect and two on the dorsal aspect of the wrist. These were then evaluated with either a smartphone flashlight or penlight. Participants noted whether each sphere did or did not transilluminate. Each participant performed two evaluations at an interval of 3 weeks.

Results: The overall sensitivity, specificity and accuracy of the smartphone were 100%, 44% and 72%, respectively. The overall sensitivity, specificity and accuracy of the penlight were 100%, 75% and 88%, respectively. The difference in accuracy between the smartphone group and penlight group was statistically significant (p = 0.029). The kappa value, indicating intra-observer agreement, for the smartphone group and penlight group was 0.76 and 0.76, respectively.

Conclusion: In conclusion, transillumination with a penlight is a viable adjunct to the examination of soft tissue masses of the hand and wrist. The use of a smartphone flashlight, while convenient, is less accurate than a penlight and can lead the examiners to misinterpret the composition of soft tissue masses.

Level of Evidence: Level IV (Diagnostic)

Retinoblastoma is an embryonic neoplasm of retinal origin. Tumour development in retinoblastoma is initiated by the somatic inactivation of both alleles of the RB1 gene. It is predicted that 40% of all cases of retinoblastoma are hereditary with all bilateral and 10-15% of unilateral cases being constitutional in origin. In this study, the incidence of somatic loss of heterozygosity (LOH) as a mutational event in retinoblastoma was studied using four intragenic DNA markers. These include a microsatellite polymorphism, RB1.20 and four restriction fragment length polymorphisms (RFLPs) namely, intron 1/BamHI, intron 17/XbaI, intron 24/Tth1 III and intron 25/DraI. LOH was found in 17 out of 27 (63%) tumours analysed. A higher frequency of maternal loss compared to paternal loss was observed in bilateral cases (75%) as compared to unilateral cases (54%). Direct exon-by-exon sequencing revealed mutations in 15 out of 17 (88%) tumours with LOH. In three out of ten tumours without LOH, one mutation was detected and two mutations were found in five tumours without LOH. Seven of the mutations were found to be constitutional (germline) in origin with three of these mutations occurring in unilateral cases of retinoblastoma. The presence of constitutional mutations did not correlate with early age of tumour development. Our results show that there was no association between the types of mutation and constitutional origin of the mutation.