Two cases of hepatobiliary tuberculosis are described. Case one, the macronodular type of hepatic tuberculosis, presented as pyrexia of unknown origin and was eventually diagnosed by sectional imaging when a mass lesion developed in the liver and aspiration revealed acid-fast bacilli. Case two presented with jaundice due to a hilar bile duct stricture. The patient was successfully treated by repeated bile duct stenting and later chemotherapy for tuberculosis. In both cases previous positive histology or culture would have expedited diagnosis and treatment. Acute hepatobiliary tuberculosis remains a rare disease. Suspicion of the disease and adequate biopsy are important to allow prompt appropriate treatment.

No abstract

A grey disc which exhibits a vertical gradient of shading usually appears convex if lighter above and concave if lighter below. This phenomenon was investigated by Howard et al (1990) who varied both the shading axis relative to gravity and the orientation of the head. Their results indicated that head-centric or retinocentric coordinates determined the depth effect rather than gravitational axes. However, several possible problems with their study were noted, not the least of which was the possible intrusion of response rather than perceptual factors in the task they used. Here, we attempted to use an indirect measure of the perception of depth from shading; rather than asking subjects whether discs looked convex or concave, we constructed ensembles of shaded discs which, in terms of depth from shading, were or were not bilaterally symmetrical about an horizontal axis. These stimulus displays were briefly flashed to prohibit the intrusion of conscious assumptions about direction of light sources. Subjects were never asked whether any discs looked concave or convex, merely whether the set of discs was or was not depth symmetrical. Results were generally consistent with those of Howard et al and supported the conclusion that depth from shading is largely a low-level and automatic mechanism.

No abstract

Gallbladder function is progressively impaired in Barrett's esophagus and adenocarcinoma. Gallbladder malfunction increases duodenogastric reflux, exposing the lower esophagus to an altered chemical milieu which, in turn, may have a role in promoting metaplasia-dysplasia-neoplasia sequence in the lower esophageal mucosa.