The Dilemma of Old, Urban Neighborhoods

In his recounting of the suburban migration from America\u27s cities, journalist and broadcaster Ray Suarez laments the loss of the old neighborhood . He extols its virtues while explaining its decline. Suarez\u27s nostalgic examples recall the virtues of the extended family kinship, neighborliness, and other features of the urban village. These are often associated with those urban neighborhoods populated by recent immigratns. These urban villages were thought to have peaked in the decades between the American Civil War and the onset of the First World War, when many U.S. cities industrialized and grew very rapidly. However, a continuing movement of migrants from the southern United States, Puerto RIco, and during the past few decades from around the globe has meant the survival of the urban village in many cities. Like their earlier predecessors, these neighborhoods are often characterized by high rates of poverty and substandard social conditions. In contrast to the old urban neighborhoods populated by the new immigratns, many neighborhoods in the economically and socially distressed areas of U.S. cities have been largely depopulated and have abnormally high rates of abandonment and social problems. These neighborhoods are often highly segregated by race and ethnicity and have high concentrations of poverty. Old urban neighborhoods have been a focus of social policy for the past fifty years. The passage of the Housing Act of 1949 heralded a federal commitment, at least on a limited basis, to provide the public housing for the poor and decent neighborhoods for those living in the slums through urban redevelopment, later renamed urban renewal. In the ensuing five decades, various federal policies and programs have been inaugerated, some later to be either reformed or dismantled, to address the problems presented by these older, urban neighborhoods and their residents. The dilemna confronting policymakers has been that neglect promises even worse problems, the worst of which have been urban riots triggered by festering social ills. On the other hand, no past active approach has yet solved these problems. After briefly reviewing major federal initiatives, I will focus on the emergence, evolution, and experience of community deveopment coroporations (CDCs) based in these neighborhoods

Nephrotic syndrome in a patient with Glycogen Storage Disease Type IXb.

Introduction: Glycogen storage disorder (GSD) IXb is characterized by liver and muscle involvement. We present a GSD IXb patient with an incidental union of nephrotic syndrome. Case Report: A 4 year-old-patient was diagnosed with GSD IXb at 13 months of age with mildly elevated transaminases and hepatomegaly. During the follow-up period, there was no hypoglycemia. Development and growth were normal. In the last month, the onset of generalized edema was reported. Urinalysis showed a high protein level. He had low serum albumin, high serum triglycerides cholesterol. Complement levels were normal. The patient was diagnosed as minimal change disease with a renal biopsy. He was treated with oral prednisone. Discussion: Minimal Change Disease is the most common cause of idiopathic nephrotic syndrome cases in children and the first step for therapy is the usage of corticosteroids. This is the first report of nephrotic syndrome associated with GSD IXb disease

A Proposed Histopathologic Classification, Scoring, and Grading System for Renal Amyloidosis Reply

WOS: 00028743050000

Atypia and Differential Diagnosis in Cellular Blue Nevi: Clinicopathological Study of 21 Cases

WOS: 000367954000002PubMed ID: 25690862Objective: Cellular blue nevus differs from the classic blue nevus with characteristics such as large size, cellularity, intense pigmentation, and growing pattern with subcutaneous infiltration. It is a dermal melanocytic tumor that can be confused with melanoma due to the atypia it may contain. Material and Method: Hematoxylin-eosin and MIB-1 stained slides of 21 cases diagnosed between 2000-2014 were re-evaluated. In order to attract attention to this rare lesion, 21 cases are presented with the clinical and above-mentioned histopathological findings. Results: Thirteen (61.9%) cases were females and eight (38.1%) were male. The mean age was 25.4 (2-73). The most frequent localization was the sacral and gluteal region (11 cases). The mean diameter was 14.4 mm (4-60 mm). From the parameters defined to assess the atypia, ulceration was identified in four cases. Prominent cellularity and subcutaneous infiltration were seen in three and 16 cases, respectively. Mitosis was seen in six tumors. Immunohistochemically, MIB-1 was present in two cases as 3% and 2% respectively, while in others it was 1% or less. Although there is no precise definition for the "atypical cellular blue nevus", five patients were assessed as atypical cellular blue nevus (a case with infiltrative development of six cm tumor diameter, two cases with two mitosis and a MIB-1 index 3% and 2%, a case with one mitosis and confluent development and a case with one mitosis in addition to focal necrosis areas). No lymph node and/or distant metastasis was observed during follow-up. Conclusion: We think it is more important to rule out the possibility of conventional melanoma in cellular blue nevus with exaggerated morphological findings alongside low proliferative activity rather than to determine the atypia

C4d as a Practical Marker for Cutaneous Amyloidosis

Cutaneous amyloidosis (CA) is defined by the accumulation of amyloid in the dermis; it might be primary or secondary. The diagnosis is based on histopathological findings with the demonstration of amyloid deposits, confirmed by Congo red stain under the polarized light. Studies on other diagnostic markers are ongoing in the literature. The aim of this study was to demonstrate the utility of C4d staining in the recognition of amyloid in CA and using it as an alternative or substitute marker for the diagnosis. In this retrospective study, 199 skin biopsies with a clinical provisional diagnosis of CA were analyzed, the Congo red stain was performed, and, in a subgroup (n = 97) with histopathological findings probably for CA, C4d immunohistochemistry was assessed. Forty-eight cases of CA were detected. Congo red birefringence was positive in all cases, whereas in 14 cases, it was faded. In these 14 cases, the diagnosis of CA was made by means of Congo red fluorescence and Thioflavin T because the histopathological findings were highly suggestive for CA. All CA cases were positive with C4d, and in 12 of the 49 inflammatory dermatoses, C4d was positive. The interpretation of C4d immunohistochemistry can be performed more easily and rapidly than Congo red evaluation. The sensitivity and specificity of C4d were 100% and 75.5%, respectively. In our experience, C4d staining was a useful method for detecting amyloid deposits in CA. Although Congo red staining is the gold standard for amyloid detection, we propose C4d immunohistochemistry as a routine screening method or hybrid transition while further investigations are completed

Is it possible to diagnose infectious oesophagitis without seeing the causative organism? A histopathological study

WOS: 000345023700003PubMed ID: 25417607Background/Aims: We investigated the utility of using histological changes to diagnose infectious oesophagitis when causative organisms cannot be seen. Materials and Methods: Sixty-seven endoscopic biopsy specimens (51 Candida, 9 herpes simplex virus, 4 tuberculosis, and 3 cytomegalovirus oesophagitis) collected from 2000-2010 that matched the investigative criteria were included in the study. Cases were re-evaluated for histological changes observed in oesophagitis, and the findings were statistically compared using nonparametric tests. Results: Thirty-nine cases occurred in male patients, and 28 occurred in female patients; the mean age of the patients was 51 +/- 20.1 years (range, 5-94 years). All cases showed lymphocytic and neutrophilic infiltration; while 27 (40.3%) showed eosinophilic infiltration. The density of lymphocytes and eosinophils were 8.43 +/- 6 and 1.07 +/- 1.62 per high power field, respectively, and these rates were higher in tuberculosis oesophagitis cases. Lamina propria infiltration was present in herpes simplex virus and Candida oesophagitis. Dense neutrophilic infiltration (>50/high power field) was noted in herpes simplex virus oesophagitis. Candida colonization was observed in 82% of cases with eosinophilic infiltration, and 80% of cases with erosion. Ulceration was present in all tuberculosis oesophagitis cases (p<0.001). Basal cell hyperplasia, papillary elongation, and dilated intercellular spaces were seen in all cases except for 2 Candida oesophagitis cases. Lamina propria fibrosis was especially noted in cytomegalovirus oesophagitis cases. Conclusion: It is not possible to distinguish infectious oesophagitis from other subtypes, especially reflux oesophagitis, if the causative organism is not detected. Clinicopathological correlation and control with repeat targeted biopsies are essential for diagnosis