The association between community-level economic hardship and childhood obesity prevalence in Los Angeles.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: Neighbourhood social, economic and environmental factors are associated with childhood obesity. Childhood obesity disproportionately impacts those living in low-income neighbourhoods. WHAT THIS STUDY ADDS: Childhood obesity prevalence is strongly associated with community-level social and economic conditions as measured using a composite Economic Hardship Index. Childhood obesity prevalence among communities in the highest hardship quartile was more than double the prevalence among communities in the lowest hardship quartile (26.9 vs. 12.5%). The relationship between economic hardship and obesity differs by race/ethnicity. OBJECTIVE: The association between community-level economic hardship and childhood obesity prevalence was examined in Los Angeles County, one of the largest and most racially and ethnically diverse regions in the United States. METHODS: Data from the 2008-2009 California Department of Education's Physical Fitness Testing Program were analyzed to assess obesity prevalence among 5th, 7th and 9th grade students attending public schools (n = 298,485). Community-level socioeconomic conditions were compared using a census-tract-based Economic Hardship (EH) index. Mixed-effects modelling was used to examine the association between obesity prevalence and gender, grade, race/ethnicity and EH. RESULTS: Higher community-level EH was associated with higher childhood obesity prevalence (P < 0.001). The obesity prevalence among communities in the highest EH quartile (26.9%) was more than double the obesity prevalence among communities in the lowest EH quartile (12.5%). The slope of the association between EH and childhood obesity differed by racial/ethnic group. The slope was higher for non-Hispanic White students, Hispanics, and non-Hispanic Asians, and lower for non-Hispanic Black students. Racial/ethnic disparities were observed across the socioeconomic spectrum. CONCLUSIONS: Findings suggest that efforts to improve community socioeconomic conditions could reduce childhood obesity prevalence. Prevention efforts should target communities with high economic hardship and also focus on providing culturally relevant interventions that address disparities in obesity prevalence across communities.

Hodgkin lymphoma at the paediatric oncology unit of gabriel touré teaching hospital, bamako, mali: 5-year experience.

Introduction. The aim of this retrospective, unicentric study over 5 years is to describe the epidemiologic, pathologic, clinic and therapeutic aspects of children treated for Hodgkin lymphoma in our paediatric oncology unit. Patients and Methods. From January 2005 to December 2009, all children under 18 years of age, with Hodgkin lymphoma were included in this study. The treatment protocol was the GFAOP (Groupe Franco-Africain d'Oncologie Pédiatrique) Hodgkin lymphoma treatment protocol. Results. During the study period, 217 cancer cases were diagnosed in our centre. Of these cases, 7 were Hodgkin Lymphoma (LH) (0.04%). The mean age was 11.7 years. The sex-ratio was 6/1. 4% (5/7) of patients were stage IIB and 28.6% (2/7) stage IIIB of Ann-Arbor classification. There were 3 cases (42.8%) of sclero-nodular subtype, 2 cases (28.6%) of lymphocyte-rich classical HL subtype, 1 case (14.3%) of mixed cellularity and 1 case (14.3%) of lymphocyte depleted subtype. With a median followup of 37 months, 5 patients (71.4%) are alive, and 2 patients (28.6%) died. Conclusion. Broader multicentric studies are needed for more accurate data on this malignancy.

Nitric oxide stimulates adrenomedullin secretion and gene expression in endothelial cells.

Adrenomedullin, a peptide with vasorelaxant activity, stimulates nitric oxide (NO) synthesis. We tested whether or not NO regulates the function of the adrenomedullin system. Human umbilical vein endothelial cells (HUVEC) were incubated with the NO donors sodium nitroprusside (SNP), morpholinosydnonimine (SIN-1) and the phospodiesterase V inhibitor zaprinast. In HUVEC, adrenomedullin concentration in the supernatant was measured by radioimmunoassay and mRNA expression was studied by Northern blot and competitive quantitative PCR. SNP, SIN-1, and zaprinast (100 micromol/l each) significantly increased adrenomedullin concentration in the supernatant of HUVEC twofold. The same concentrations increased adrenomedullin mRNA expression four- to tenfold. Similar results were obtained by both quantitative PCR and Northern blot. Thus, NO donor exposure in vitro increases both adrenomedullin secretion and mRNA expression in a dose-dependent manner.

[Complicated course of rheumatoid arthritis with pulmonary involvement, myocardial fibrosis and sleep apnea syndrome]. / Komplizierter Verlauf einer rheumatoiden Arthritis mit pulmonaler Beteiligung, Myokardfibrose und Schlafapnoesyndrom.

We report on a 67 year old man in whom the chest x-ray revealed marked interstitial opacities in both lungs. The diagnosis of Rheumatoid Arthritis (RA) was established by the presence of five criteria of the American College of Rheumatology for diagnosing RA. High resolution computertomography of the chest confirmed the abnormalities seen in the conventional chest x-ray. A biopsy, taken by open lung surgery, showed the typical pattern of pulmonary involvement in RA and confirmed the association of RA and interstitial lung fibrosis. The histologic examination pointed out lymphocytic infiltration of the bronchies, thickened alveolar walls with lymphoplasmarcellular infiltration and an increase in fibrous connective tissue. A congestive heart failure with severe arrhythmias and an obstructive sleep apnea syndrome (OSAS) were diagnosed in addition. The rhythm disturbances were attributed to the participation of the myocardium in RA and/or by the OSAS. By the treatment with prednisolone, methotrexate, mexiletine and continuous positive airway pressure (CPAP) the rhythm disturbances were alleviated and the patient's condition improved.

Diffuse sclerosing variant of papillary thyroid carcinoma. S-100 protein immunocytochemistry and prognosis.

The recently published second edition of the WHO classification of thyroid tumours describes the diffuse sclerosing papillary carcinoma (DSPC) as a specific variant of papillary thyroid cancer (PC). Besides several histological hallmarks, this rare tumour is characterized by its occurrence in young individuals and is thought to have a less favourable prognosis than PC in general. The observations on two examples of this tumour presented herein, however, are at variance at this assumption. The neoplasms occurred in a 10 year old girl and a 34 year old woman. Each time, diffuse involvement of both thyroid lobes and bilateral cervical lymphadenopathy were seen. In one case, the carcinoma extended into the cervical soft tissue. Follow-up disclosed both patients to be without evidence of disease 2 and 13 years, respectively, after thyroid surgery. Immunocytochemically, both thyroid primaries as well as 7 other cases of DSPC reported in the literature showed dense accumulations of S-100 protein positive dendritic/Langerhans cells. Such infiltrations have been demonstrated to be correlated with a benign clinical course of PC. It is thus suggested that DSPC behaves similarly or even less aggressively than PC in general, at least if prominent Langerhans cell infiltration is present.

[Perforation of a stomach ulcer into the left heart ventricle. Case report and review of the literature]. / Magenulkusperforation in den linken Herzventrikel. Kasuistik und Literaturübersicht.

We present a case of peptic-ulcer perforation from the stomach into the left ventricle. The patient who had no prior cardiac or abdominal symptoms was admitted with gastrointestinal bleeding and the electrocardiographic signs of myocardial infarction of the posterior wall. After the bleeding had subsided for 5 hours the patient died suddenly from massive upper gastrointestinal bleeding. At autopsy a peptic ulcer was found 3 cm beneath the cardia in the anterior wall on the lesser curvature which had perforated dorsal from the papillar muscle into the left ventricle. In the literature 19 such ulcer perforations have been reported which are compared with the present case.

[Comparative studies of IgE content of the gastric mucosa in various forms of gastritis]. / Vergleichende Untersuchungen zum IgE-Gehalt der Magenschleimhaut bei verschiedenen Gastritisformen.

The problem of the pathogenetic significance of IgE-mediated inflammatory processes in simple unspecific gastritis was studied in mucosal biopsies of 396 cases with unequivocal histological classification. The results demonstrate that only in acute and erosive gastritis high IgE cell counts are found, thus, indicating a pathogenetic significance. Furthermore the statistical evaluation showed a parallel age distribution of IgE containing cells in the four biopsy groups. Mucosal biopsies from patients 40-65 years of age exhibited higher IgE cell counts than younger and older persons. These results suggest that there is a higher IgE-reactivity in the middle age.

[Histologic and mucin histochemistry studies on the topic of so-called transitional mucosa in the vicinity of large intestine cancers]. / Histologische und muzinhistochemische Untersuchungen zur Frage der sog. Ubergangsschleimhaut ("transitional mucosa") in der Umgebung von Dickdarmkarzinomen.

Morphological analysis of the mucosal change of the large bowel called "transitional mucosa"; 38 resection specimens with colonic carcinoma and 14 specimens with non malignant changes for control were studied. The "transitional mucosa" is described as the sum of histological, cytological and mucin histochemical findings forming a characteristic mucosal pattern in the vicinity of the carcinomatous lesion in all cases but in one. However, the expression of the single morphological finding is variable and all characteristics of the mucosal alteration were also found frequently in the control group without malignant tumours. Therefore the diagnostic value of the "transitional mucosa" for early recognition of large bowel carcinoma is negligible. The pathogenesis of this lesion remains unclear but is discussed as a reactive hyperplasia of the mucosal crypts caused by a change of the large bowel contents initiated probably by a long-standing motility disturbance.

[Diagnostic problems of virus-induced atypical squamous cell proliferations in the area of the anus and genitalia. A case report on Bowenoid papulosis]. / Zur diagnostischen Problematik virusinduzierter atypischer Plattenepithelwucherungen im Anal- und Genitalbereich. Ein kasuistischer Beitrag zur Bowenoiden-Papulose.

Papillomatous proliferations of squamous epithelium of the genital and anal region termed Bowenoid Papulosis (BP) macroscopically resemble condylomata acuminata, whereas histologically they show in part severe dysplasias. Despite the similarity of these lesions to Bowen's disease they are - like condylomas - induced by papilloma viruses and may regress spontaneously. Condyloma-like but predominantly flat proliferations of squamous epithelium of the transitional zone between exocervix and endocervix, which are likewise caused by viruses and have a prognosis similar to that of BP, are even more problematic in differential diagnostic differentiation from cervical carcinoma in situ. Both these atypical proliferations of squamous epithelium of the exocervix referred to as "flat condylomas" and BP contain koilocytes as a sign of cell regression relatively typical of virus-induced cell change. In a reported case of a 38-year old woman with widespread BP of the ano-genital region intranuclear papilloma virus antigen could be demonstrated immunohistochemically in the papillomatous proliferations of squamous epithelium and furthermore in sections made from the filed paraffin blocks of a cone biopsy taken five years ago. In two of altogether seven cases of BP presented in tables papilloma virus antigen could be shown as well. In one woman of already 54 years of age widespread BP is described more comprehensively, because due to the feature of inverted papillomatosis carcinoma was suspected clinically. BP and flat condylomas have been defined as terms only in recent years and - as virus-induced lesions - been differentiated from carcinoma in situ on account of a more favourable prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative light and electron microscopic studies of cystic and papillary tumors of the peritoneum.

Using a cystic lymphangioma of the greater omentum and a benign cystic mesothelioma as examples, the distinguishing characteristics of cystic peritoneal tumors are shown, using light microscopic and ultrastructural findings. A benign papillary mesothelioma is used for comparison. The cellular structures and growth rate of the mesotheliomas are contrasted with the tissue reactions which are typical for irritated serosa. The diffusely growing papillary mesothelioma is a very rare tumor, the cells of which are similar to normal serosa cells, but also show characteristics of other benign or malignant mesothelial tumors and of reactive proliferated mesothelial cells. The diffusely growing benign cystic mesothelioma has only been described in isolated cases and is characterized by cysts grouped in acini with mainly flat, localized cuboidal cell lining. The histochemical properties and cytological findings correspond closely to those of the papillary tumor or normal peritoneal lining cells. In contrast, the cystic lymphangioma probably represents a congenital defect with a slow growth rate. The structure is characterized by a sponge-like arrangement of smooth-walled cysts, in the walls of which smooth muscle cells and lymph follicles are embedded. The endothelium is also flat and ultrastructurally resembles that of lymph vessels.

[Contribution to the morphology and pathogenesis of eosinophilic colitis (author's transl)]. / Beitrag zur Morphologie und Pathogenese der eosinophilen Kolitis.

A 40 year old woman suffered from acute diarrhea and convulsive abdominal pains. Because of a palpable tumor of the right lower abdomen, which was thought to be localized in the deeper layers of the colon ascendens, a hemicolectomy on the right side was performed. Histologically there was a severe phlegmonous eosinophilic inflammation of the bowel wall and the surrounding fatty tissue. A parasite was found within the strongly oedematous submucosal layer. The different forms of eosinophilic inflammatory processes are referred to, with special emphasis on Anisakiasis. The so called "herring-worm-disease" proceeds under the same clinical and morphological features as the above mentioned disease and is caused by a larval nematode. This worm lives as an immature parasite in different saltwater fishes. Most often the stomach and the small intestine are involved; only in a few cases an eosinophilic phlegmon of the large bowel has been observed.

[Familial occurence of congenital short bowel (author's transl)]. / Familiäres Vorkommen des angeborenen Kurzdarmes.

We report the clinical and post-mortem findings of an infant with inborn short bowel. One sibling died because of the same malformation. The parents are cousins. This malformation is combined with malrotation, often with pylorus-stenosis too, and can cause an intestinal obstruction syndrome. All presently known cases in the pertinent literature are summarized. The occurence of familial cases suggest a rezessive autosomal disease.

[A case of congenital double pyloric canal (author's transl)]. / Uber eine Duplikatur des Pyloruskanals als kongenitale Anomalie (Pylorusband).

In the case of 47-year-old patient who had been suffering for several months from a duodenal ulcer disease, a so called double pylorus was traced by applying fiberoptic gastroscopy. At the same time proof was found for the ulcera duodeni. Owing to the fiberoptic result of two regularly pyloric canals it was already doubted, that this was only a question of a secondary pyloro duodenal fistula caused by peptic ulcer. A particular and differentiating pathological anatomical examination of the surgical specimen showed as a result, that the patient was suffering from a congenital duplication of the pyloric canal by a pyloric ligament. The duodenal ulcers, proofed by x-ray examination and gastroscopy, were recognised as a secondary disease of a locus minoris resistentiae.

[Morphological changes of the female urinary bladder in the elderly. Chronic infections of the urinary tract; the importance of their intensive treatment as preparatory measure for rehabilitation (author's transl)]. / Die weibliche Harnblase, ihre Sanierung als vorbereitende Massnahme für die Rehabilitation unter besonderer Berücksichtigung morphologischer Befunde.

The urinary bladder of the elderly is showing a reduced adaptability on account of morphological changes; it is therefore more prone to infections. The morphological changes consist in a reduction of muscle fibres and in an increase of collagen fibres and in elastosis, furthermore in a sklerosis of the intramural arteries. 58% of our chronically - ill patients prove to have a chronic infection of the urinary tract.

[Morphometric studies on epithelial cells of the rat stomach under chronic effect of alcohol]. / Morphometrische Untersuchungen an Belegzellen des Rattenmagens unter chronischem Alkoholeinfluss

In studying the effect of ethanol on the size of parietal cells 60 Wistar rats received 15% ethanol ad libitum and were killed after 8 days, 2, 4, 8, and 12 weeks. For the control group 24 untreated animals were used. The parietal cells were stained with Kongo-red for the histological preparations and with a Papanicolaou modification for the cytological smear. With two measuring-methods -- the Integration-disc and the Mikrovideomat -- the cell and nucleus surface were determined and the nucleus-plasma-relation was calculated. After 8 days of alcohol administration a significant increase of parietal cell surface appeared in the histological and cytological preparation. The cytoplasma surface area increased continuously until the 8th week. With further application of alcohol until the 12th week the zytoplasma surface area decreased again but remained above the starting size. The calculation of the cell surface areas produced nonuniform results. Further the sizes of parietal cells (cytoplasma and nucleus surface areas) in the cytological smear and after being embedded in the histological preparation were compared. In the applied measuring methods a comparison was also made.