The varying faces of gall bladder carcinoma: pictorial essay

The objective of this review is to highlight the pertinent imaging features and potential pitfalls in the diagnosis and staging of gall bladder carcinoma. This condition is notoriously non-specific on imaging on many occasions, particularly in its early stages; gall bladder carcinoma shows numerous features that overlap with a large number of benign conditions, leading to delayed diagnosis and incurable disease. Radiologists should be familiar with its typical and atypical imaging features.     

Role of Caudate Lobectomy in Type III<Subscript>A</Subscript> and III<Subscript>B</Subscript> Hilar Cholangiocarcinoma: A 15-year Experience in a Tertiary Institution

Background  

Concomitant liver resection for type III hilar cholangiocarcinoma could improve the R0 resection rate and long-term outcome. In the present study, we examine the specific role of caudate lobectomy in liver resection for type III_A and III_B hilar cholangiocarcinoma and the prognostic factors for survival in this group of patients.     

Cholesterol efflux capacity of high‐density lipoprotein was not associated with cognitive decline and brain structures in older people with diabetes mellitus

Aims/IntroductionTo examine the association between cholesterol efflux capacity (CEC) of serum high‐density lipoprotein (HDL) and cognitive function and brain structures in older people with diabetes mellitus.Materials and MethodsParticipants of a randomized placebo‐controlled trial of 27‐month vitamin B₁₂ supplementation in older people with diabetes mellitus, which showed no effect on cognition, were further followed up at month 72. Cognitive tests included the Clinical Dementia Rating scale, Neuropsychological Test Battery in memory, executive function and psychomotor speed. Brain magnetic resonance imaging scans were carried out in a subset at baseline, month 27 and month 45. Fasting serum at baseline, month 9, month 27 and month 72 were analyzed for adenosine triphosphate‐binding cassette transporter A1‐mediated CEC of HDL and apolipoprotein A1 (ApoA1).ResultsSerum HDL cholesterol at baseline was associated with better executive and memory function at follow up. Serum ApoA1 was associated with a better memory Z‐score at month 18. Serum CEC and ApoA1 were not associated with Clinical Dementia Rating scale, Neuropsychological Test Battery, hippocampal volume and white matter disease on magnetic resonance imaging at baseline and whole brain atrophy rates. They were also not associated with cognitive function at month 27 and 72 on multilevel modeling. CEC and ApoA1 decreased significantly from baseline to month 27. Faster decliners in CEC had a greater increase in brain peak width of skeletonized mean diffusivity.ConclusionsHigher serum HDL cholesterol was associated with more favorable changes in memory and executive function in older people with diabetes mellitus. However, this was not due to CEC or ApoA1. A decline in CEC was associated with small vessel disease in the brain.     

交沙霉素在中国汉族、维吾尔族及哈萨克族中的药代动力学比较

交沙霉素在中国汉族、维吾尔族及哈萨克族中的药代动力学比较李国昌陈春雁杨明义（新疆石河子医学院第一附属医院药剂科，石河子８３２００８；石河子农学院医院，石河子８３２００３）为探讨交沙霉素（ｊｏｓａｍｙｃｉｎ）在不同民族正常人体内过程，我们用相同的受...     

Immunosuppression in renal transplantation: Long-term clinical trial of a double versus triple therapy regimen

Summary: Sixty-nine renal allograft recipients were randomized to two immunosuppressive regimens: 35 patients received cyclosporine A and prednisolone (PC) while 34 patients received low dose cyclosporine A, prednisolone and short term azathioprine (PCA). the data of 66 patients (34 in PC and 32 in PCA groups) were analysed. the median follow-up periods were 62 months for the PC group and 60 months for the PCA group. There was no difference in graft survival between the two groups but five patients died in the PC group compared to none in the PCA group (graft survival: 88 vs 90% at 1 year and 82 vs 82% at 5 years, P = not significant at any time point; patient survival: 90 vs 100% at 1 year and 88 vs 100% at 5 years, P = 0.05 at 5 years). There was a trend for patients in the PCA group to develop earlier and more frequent rejections (not significant; P = 0.106 and P = 0.062, respectively). There were also more episodes of acute cyclosporine A nephrotoxicity and cytomegalovirus (CMV) infection in the PC group. the mean serum creatinine at 5 years was significantly higher in the PCA group when compared to the PC group (179.8 ± 76.5 μmol/L vs 154.7 ± 41.0 μmol/L; P =0.05). We found that both therapeutic regimens were effective in preventing renal allograft rejections. However, double therapy was associated with higher patient mortality secondary to infection. Patients on triple therapy, on the other hand, were more prone to develop rejections in the early post-transplant period and were associated with less favourable renal function in the long run.     

Alimentation calcique et effet de l'entraînement physique sur l'os

Physical exercise is able to influence bone structure. In the principal part of cases, physical training results in an enhanced bone density when in any case overtraining could decrease bone density. Numerous factors are involved in the effect of physical training on bone, dietary calcium supply being one. Numerous epidemiological surveys have shown that the daily calcium supply in the French population is between 500 and 1,200 mg/24 hours. Thus part of the French population is under the recommended intake of 1,000 mg. It was proposed that physical training could improve calorie intake and consequently calcium supply. The main objective of this paper is the relationship between exercise and bone structure: second, literature is used to present the role of dietary calcium on bone structure. Finally, the data of a survey in a French population are used in order to define to what extent calcium dietary supply of different sports groups agree with the dietary recommended allowance. They report that calcium supply is influenced by the type of sport, strength trained atheletes enhance calcium intake while endurance trained atheletes present lower calcium intake.