Hand Surgery in Hong Kong.

Hand surgery in Hong Kong was borne out of necessity. It has been changing with the social, economic, and political situations. The spectrum of hand surgeries evolves with time, from infection-related hand surgeries to microsurgical or non-microsurgical operations on the huge volume of industrial hand injuries, to a wider variety of reconstructions on rheumatological, congenital upper limbs, traumatic, neurological diseases, etc, to minimally invasive surgeries on hand, wrist, and elbow. Hand surgery was deeply-rooted in orthopaedics in Hong Kong and is inseparable from microsurgeries, which have built a strong foundation for any kind of its future development.

Arthroscopic Management of Scaphoid Nonunion.

Arthroscopic bone grafting (ABG) in difficult scaphoid delayed union and nonunion allows thorough assessment and comprehensive management for scaphoid fracture and its sequelae. It provides a favorable biological environment for bony healing and produces minimal trauma to the soft tissues, aiding in rehabilitation. With adequate training and experience, high union rates and satisfactory clinical outcomes can be achieved. Poor blood supply of the scaphoid is not a contraindication to bone grafting; union rates over 80% have been reported, comparable to other existing surgical methods. This article discusses the rationale, surgical techniques, and results of ABG.

Arthroscopic reconstruction of triangular fibrocartilage complex (TFCC) with tendon graft for chronic DRUJ instability.

PURPOSE: To report the 10-years' experience of a novel arthroscopic assisted anatomical TFCC reconstruction in treatment of chronic DRUJ instability resulting from irreparable TFCC injuries. MATERIALS AND METHODS: 15 patients (7 males, 8 females) with mean age of 37 (17-49) suffering from irreparable TFCC injuries received arthroscopic assisted reconstruction using palmaris longus graft. Three skin incisions were made with creation of one radial and one ulna tunnel for passage of graft following the path of dorsal and palmar radio-ulnar ligaments under fluoroscopic and arthroscopic guidance. The joint capsule was kept intact. Early mid-range forearm rotation was started since 4th week postoperatively. RESULTS: The mean follow-up was 85.53 months (32-138). Mayo wrist score improved from 62.5 to 88 (p<0.05). Comparing contralateral side, total prono-supination range increased from 76.6% to 92.1% and grip strength increased from 56.1% to 76.9%. Twelve patients resumed previous jobs. No evidence of DRUJ arthritis was noticed. Complications included 2 late graft ruptures and one unexplained dystonia. CONCLUSIONS: Our arthroscopic assisted approach on TFCC reconstruction is safe, produces comparable results as the standard technique and may achieve better range of motion with less soft tissue dissection and earlier mobilization.

A potential food-grade cloning vector for Streptococcus thermophilus that uses cadmium resistance as the selectable marker.

A potential food-grade cloning vector, pND919, was constructed and transformed into S. thermophilus ST3-1, a plasmid-free strain. The vector contains DNAs from two different food-approved organisms, Streptococcus thermophilus and Lactococcus lactis. The 5.0-kb pND919 is a derivative of the cloning vector pND918 (9.3 kb) and was constructed by deletion of the 4.3-kb region of pND918 which contained DNA from non-food-approved organisms. pND919 carries a heterologous native cadmium resistance selectable marker from L. lactis M71 and expresses the Cd(r) phenotype in S. thermophilus transformants. With the S. thermophilus replicon derived from the shuttle vector pND913, pND919 is able to replicate in the two S. thermophilus industrial strains tested, ST3-1 and ST4-1. Its relatively high retention rate in S. thermophilus further indicates its usefulness as a potential food-grade cloning vector. To our knowledge, this is the first report of a replicative potential food-grade vector for the industrially important organism S. thermophilus.

Cloning vectors for Streptococcus thermophilus derived from a native plasmid.

A 3.5-kb native plasmid (pND103) was identified in Streptococcus thermophilus ST2-1. Preliminary sequence analysis indicated that pND103 belongs to group I S. thermophilus plasmids. A region of approximately 2 kb appears to contain three components: a plus origin of replication (ori) typical of plasmids that replicate via rolling circle replication; a gene encoding a replication protein (rep); and a gene encoding a small heat shock protein (hsp). pND103 was then used to construct S. thermophilus/Escherichia coli hybrid cloning vectors by ligating different portions of pND103 to an origin-probe vector (pND330) composed of pUC19 and a Gram-positive erythromycin resistance gene. The shuttle vectors (pND913, pND914 and pND915) were successfully introduced back into plasmid-free S. thermophilus ST3-1 as well as to Lactococcus lactis LM0230 and E. coli JM109. Segregational and structural stability study indicated that these vectors can be maintained in these hosts. The results indicated that pND913, pND914 and pND915 are potential shuttle cloning vectors for S. thermophilus.