Relapsing polychondritis with features of dementia with Lewy bodies

We describe a 72-year old man with clinical features suggestive of dementia with Lewy bodies (DLB) who proved neuropathologically to have degeneration induced by relapsing polychondritis (RP), an autoimmune inflammatory disorder of cartilaginous tissues. There was lymphocytic infiltration of the leptomeninges, perivascular cuffing, reactive astrocytosis, and activation of microglia in multiple brain areas all consistent with an immunologically mediated process. There was widespread neuronal loss within the hippocampus, entorhinal cortex, and amygdala as well as diffuse myelin pallor of cortical pathways. Elevated levels of complement proteins and endothelial markers of inflammation were observed, which are similar to previous reports in DLB. This study demonstrates that qualitatively similar inflammation-associated neurodegeneration is present in widespread regions of the brain in a RP case presenting clinically as DLB.

Carcinosarcoma of the gallbladder: report of a case

Carcinosarcomas of the gallbladder are rare tumors characterized by malignant epithelial and mesenchymal components that grow intermingled into each other. Herein we present a case that illustrates the difficulties in the diagnosis and the clinical management of this entity.

Regulation of brain temperature in pigeons: effects of corneal convection

The effect of direct ventilation of the eyes on cooling in the brain was investigated in domestic pigeons (Columba livia, mean mass 0.27 kg) with thermocouples chronically implanted in the hypothalamus and anterior eye chamber. During conductive heating in still air body-brain temperature difference (delta T) was 2.6 degrees C. During exclusive ventilation of ocular surfaces, with air flowing at about flight speed, delta T increased to 3.5 degrees C and returned to preventilation values on cessation of ventilation. When the eyes were sealed then ventilated, delta T was not different from that in still air. Administration of phenylephrine caused iridial vasoconstriction and a significant decrease in intraocular temperature, but no changes in brain temperature. This suggests that compensation may occur via other evaporating cranial surfaces. Our findings suggest that the eyes contribute to the control of brain temperature by dissipating heat. Blood cooled while flowing through the ocular vasculature apparently contributes to the venous flow through the ophthalmic rete, serving as a heat sink for arterial blood flowing to the brain.

Metachronous ovarian metastases from adenocarcinoma of the colon and rectum

Our observations indicate that the menopausal status of a patient, the anatomic location or the histologic differentiation of a primary adenocarcinoma of the colorectal area does not seem to affect the incidence of ovarian metastases. Tumors initially classified as Dukes' B2 and, later, associated with ovarian metastases have consistently poorer prognosis. The reason that ovarian metastases attain a relatively large size, while other metastatic foci remain small, is unknown. Regardless of the surgical findings, patients with ovarian metastases from a primary adenocarcinoma of the colorectal area tend to have short survival with widespread distribution of the tumors at death. This would suggest that these metastases occur primarily by the hematogenous route rather than by an orderly invasion to contiguous structures and draining lymph nodes. Patients with resectable solitary ovarian metastases and prospectives of cure must be a rare event in carcinoma of the colon and rectum.

Mesothelial cysts associated with metastases to ovary from primary colonic carcinoma

The three cases herein reported concern metachronous ovarian metastases from primary adenocarcinomas of the colon associated with mesothelial cysts. Although the etiology of these cysts remains obscure, the cases were of interest because the cysts did not contain tumor cells despite the intimate relationship to the tumor. Metastases were localized to the ovary and were resectable. All signs and symptoms disappeared, affording excellent palliation and an extended survival.

Malignant (androblastoma) Sertoli cell tumor of testes

A case of malignant testicular tumor which originated in the Sertoli cells is reported. Metastases were studied by aortography and computerized axial tomography. The tumor presented no clinical evidence of hormonal activity and a long recurrence-free survival.

Malignant pheochromocytoma (paraganglioma) of the organ of Zuckerkandl: a study of two cases

Ten percent of pheochromocytomas are found in extra-adrenal locations and are called paragangliomas. In recent years we have had the opportunity to study two patients with malignant paragangliomas of the organ of Zuckerlandl. Only 13 cases of such neoplasms have been reported previously. Our cases are of interest because of their features of recurrence, distant metastases, response to adjuvant therapy, and long survival.