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Lipomas are common, benign, soft tissue masses in adults. Sarcomatous change within a giant lipoma is a very rare event. We present a case of a woman presenting with a forearm lipoma that subsequently developed a central, well-differentiated, spindle-cell sarcoma within the lipoma. This case underlines the importance of identifying red flags for referral of soft tissue tumours., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Background  Scapholunate advanced collapse and scaphoid nonunion advanced collapse result in high morbidity and pose significant challenges for active patients. Multiple treatment options have been proposed to yield satisfactory results; however, restoration of physiological wrist motion remains an issue. Questions/Purposes  The objective of this study was to compare wrist mobility after four different treatment methods for grade III wrist collapse: (1) no treatment, (2) scaphoidectomy and lunate-capitate arthrodesis, (3) scaphoidectomy, lunate-capitate arthrodesis, and triquetrum-hamate arthrodesis, and (4) scaphoidectomy, lunate-capitate arthrodesis, and triquetrum excision. Methods  Four paired ( n  = 8) fresh-frozen human cadaveric upper limbs were used in this controlled laboratory study. Computed tomography scans were collected at all testing states and measurements were made to evaluate midcarpal joint mobility and alignment. Results  A significant decrease in wrist extension was observed for all treatments. Middle column and two-column arthrodesis demonstrated no significant differences for carpal alignment and mobility. No significant differences were observed for triquetrum-hamate mobility or wrist extension between the partial and two-column arthrodesis. Triquetrum excision significantly improved ulnar deviation. Conclusion  The most important finding of this study was that the one-column arthrodesis has comparable carpal alignment and range of motion to that of bi-column arthrodesis. Clinical Relevance  The results of this study suggest that a stage III advanced wrist collapse can be treated by isolated lunate-capitate arthrodesis with scaphoidectomy. Fusion between the remaining carpal bones may not be necessary because the carpal alignment and range of motion of the remaining joints were not significantly different in the present study.

Background/aim: The ageing population in Australia may contribute to an epidemic of stroke in coming years. We aimed to assess whether deaths and hospitalisations from stroke in Australia are increasing., Methods: Nationwide age- and sex-specific hospitalisation episode data from 1996 to 1997 were used to predict future hospitalisations from stroke. Age- and sex-specific mortality data from 1997 were used to predict future mortality from stroke. These predictions were based on an expected increase in the population's age and population growth. We compared these estimates to those observed in national figures for the following 9 years., Results: Based on 1996-1997 hospitalisation rates, we calculated that hospitalisations for stroke would be expected to rise from 27,399 to 35,041 in 2005-2006. Using 1997 mortality rates, deaths from stroke would be expected to rise from 9,126 to 12,726 in 2007. Observed hospitalisations (2005-2006) were 6,380 fewer than expected, while deaths (2007) were 4,103 fewer than expected. This represents a 2.21% annual reduction in hospitalisation rate, and a 4.0% annual reduction in mortality rate., Conclusion: Encouragingly, hospitalisation and mortality rates for stroke appear to be declining. If these figures reflect actual occurrences of stroke then it may be that primary and secondary prevention strategies are working., (Copyright © 2012 S. Karger AG, Basel.)

TiO2-catalyst suspensions work efficiently in photocatalysis for wastewater treatment. Nevertheless, once photocatalysis is complete, separation of the catalyst from solution becomes the main problem. Catalyst recovery has been enhanced through charge neutralisation and coagulation with electrolytes at lab and pilot-plant scale (40 L) to evaluate the potential for its separation after photocatalytic degradation of pollutants. Zeta-potential analysis showed that the isoelectric point (IEP) of TiO2 suspensions is near pH 7. Settling rates and hydrodynamic diameter of TiO2 particles are maximum at the IEP. However, suspensions are stable at different pH. TiO2 was reused in solar photocatalysis pilot-plant (40 L) for treatment of tetrachloroethylene (C2Cl4) comparing two procedures: reuse of the entire suspension after destruction of the organics without separation of the catalyst, and reuse of the catalyst after it had settled to the bottom and clear water had been removed. Photocatalytic efficiency worsens with successive runs when catalyst and water are reused without separation, whereas, when TiO2 is separated, the photocatalyst is not deactivated.