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Christian health workers need a common code of Christian medical mortality equal to the complex challenges of a secular society. By example and through formal teaching, the Christian student must learn the ethics, theology, and philosophy necessary to understand and justify clinical decisions.
The orbital bone lesion of a patient with Hand-Schüller-Christian disease was examined by electron microscopy. Vacuoles in the cytoplasm of foam cells contained granules which were shown by histochemical examination to be cholesterin. Langerhans cell granules in the histiocytes of Hand-Schüller-Christian disease showed a close resemblance to those in Langerhans cell of the epidermis, eosinophilic granuloma and Letterer-Siwe disease. Charcot-Leyden crystals appeared to be formed in the lysosomes of histiocytes in Hand-Schüller-Christian disease. From histopathological and cytological points of view, eosinophilic granuloma, Hand-Schüller-Christian disease and Letterer-Siwe disease are classified as histiocytosis X. The simultaneous appearance of Langerhans cell granules and Charcot-Leyden crystals is specific in histiocytosis X.
783 blood samples for the study of distribution of ABO blood groups and sickle cell haemoglobin in relation to malaria, from both the sexes of Muslim and Christian populations of Kheda district were screened. 414 blood samples from male individuals were screened for G-6-PD deficiency. High frequency of G-6-PD deficiency was observed in Christians (5.9%) and low in Muslim (1.8%) population, whereas sickle cell haemoglobin in Muslim population was 1.5% and absent in Christians. Blood group B was dominant in both the communities. Significant association of ABO polymorphs with P. falciparum and total malaria cases was observed.
Weber-Christian disease has no known cause and is characterized by a febrile, recurrent, nonsuppurative panniculitis occurring preferentially in young, obese women. The present case is of interest in that it occurred in a young, obese woman after she lost 18.2 kg (40 lb) in eight weeks. It is only speculative as to whether the sudden weight loss precipitated the Weber-Christian disease. However, since Weber-Christian disease is an obscure disease with metabolic and autoimmune overtones, such a hypothesis is not unrealistic in a predisposed individual.
Hand-Schüller-Christian disease is a disease primarily affecting children, occasionally young adults, and rarely older adults. Very few cases have been reported in individuals past their fifth decade. A review of the English language literature indicates that the onset of Hand-Schüller-Christian disease occurs after the fifth decade in less than 4% of reported cases. A 75-year-old woman's symptoms of Hand-Schüller-Christian disease began in her 76th year, and her cutaneous symptoms were controlled with a topically applied nitrogen mustard.
The mortality rates of Moslems, Druze and Christians in Israel have decreased strikingly since the early 1950s, mainly because of a decline in mortality among children and younger women. There has been an increase in mortality among middle-aged and elderly men. Mortality from infective diseases had declined, but these remain important causes of death, particularly among Moslems and Druze. Mortality from external causes has increased in recent years. The mortality rate from ischemic heart disease has risen sharply; it is especially high among Christian men. Mortality due to congenital anomalies is relatively high among Moslems and Druze.
A review of Weber-Christian syndrome in infancy is presented along with the report of two cases. Both infants had low serum properdin levels, and one patient showed remissions of his disease when he was T-lymphocytopenic. This suggests that the T-lymphocyte may have an important role in the pathogenesis of Weber--Christian syndrome.
A case is described of Weber-Christian panniculitis accompanied by a gammaglobulin disturbance which preceded by five years the diagnosis of an autoimmune hepatitis and pancytopenia. Also associated was the onset of diabetes mellitus, found at necropsy to be related to pancreatic islet amyloid deposition. This case reinforces the view that Weber-Christian panniculitis may be an adipose response to a variety of immunological stimuli.
A case of a 21-year-old woman with Weber-Christian disease, associated with consumption coagulopathy and adequately controlled over the past year or more by corticosteroid and heparin therapy, has been described. Through the study on this case, it was concluded that a hemorrhagic diathesis complicating Weber-Christian disease, at least in advanced cases, was characterized by consumption coagulopathy associated with enhanced blood coagulability which arises from hyperlipemia due to abnormal lipid metabolism and further, that the consumption coagulopathy was modified by diminished synthesis of clotting factors and activation of the fibrinolytic system due to the secondary hepatic impairment. It might also be likely that systemic vascular changes contribute to the activation of the clotting system as a trigger of clotting factor consumption. The complex pathophysiology of a hemorrhagic diathesis in this disease seemed to be brought about by a complex combination of such a variety of factors. In addition, decreased erythrocyte sedimentation rate observed characteristically during hemorrhage might probably have a direct correlation with hypofibrinogenemia due to consumption coagulopathy in advanced cases.
Identifiers must be easy for access and discrimination. Usual identification by surname and christian name is convenient, for these two identifiers are almost always available. Their discrimination ability was studied in terms of the theory of information and the rate of homonymy. In the French language, the first five letters of the surname provide information equal to 12.11 bits and the rate of homonymy is about 0.659%. If one adds the first three letters of the first name, the gain in the quantity of information is 1.68 bits and the rate of homonymy becomes 0.087%. So the first five letters of a surname and the first three letters of a christian name ensure a relatively satisfactory identification and may constitute a significant way of reinforcing the discrimination power of another identification system.
A 42-year-old man was admitted with dyspnea and abnormal shadows on chest roentgenogram, which showed bilateral reticulonodular shadows, multiple pulmonary cysts, and pleural effusion. A month after admission, he developed severe respiratory failure and chest X-ray revealed exacerbation of reticulonodular shadows. Steroid pulse therapy improved the symptoms and chest X-ray. He had atrophy of the mandible. Bone scintigram revealed multiple hot lesions. Bone biopsy of the right tibia showed lipogranuloma, and the diagnosis of Hand-Schüller-Christian disease (HSC) was made. The percentage of OKT6-positive cells (Langerhans cells) found by immunofluorescence was 16.1% of all cells in bronchoalveolar lavage fluid, indicating pulmonary involvement due to HSC. This is a rare case of Hand-Schüller-Christian disease with pulmonary fibrosis.
The 300th anniversary of the birthday of Christian Wolff gave the occasion to set his multilateral work in relation to the medical currents of his time and to analyse it from the standpoint of modern medicine. Especially in his early period at Halle University Christian Wolff develops a new research programme with essential accents for the future physician. His philosophical literature with the postulates containing in this are conformable to the aim of the predecessors of the French revolution and on the sector of the art of therapeutic forms the basis decisive improvements in organised public health.
Correlations of (christian) religiosity and religious thematization in functional psychoses with paranoid syndromes (60 pat.) were studied by an extensive questionnaire. In regard of the frequency of religious themes in the paranoid syndromes there was no difference between catholic and protestant confession. Probands with religious experiences in their psychoses had other religious socialization (a home with special interest in religious subjects). They are themselves more active in regard to religious practices, more interested in religious problems, refer more often to fear of devil and hell, feel themselves more frequently close bound to the church. The premorbid religious activity increased in the period of 6 months before hospitalisation. They judge their fathers retrospectively more often as permissive. Concerning psychopathology probands with religious thematization in their psychosis had higher values of "grandiosity" in the IMPS (LORR), had more often experiences of immediate inspiration, evidence and clearness. They were hospitalized for a longer period than probands without religious thematization.
While government involvement with hospitals complicates an administrator's operating environment, much of what government and consumer advocates want is at least philosophically good. In the midst of conflicts between a secular society and the goals of church-related hospitals, Christian administrators must demonstrate integrity and would do well to see adversity as a challenge promoting greater strenghts for themselves and for their hospitals.
A short biographical note about Friedrich-Christian Rosenthal, a German anatomist, disciple of Reil, born in Greifswald on the 3rd of June 1780, died prematurely in the same town on the 5th of December 1829, leaving unfinished an important work on the anatomy of the brain and cranial nerves. His name is still associated with the spiral canal of the inner ear and to the basal cerebral vein.
We have described an unusual case of multifocal eosinophilic granuloma ("Hand-Schueller-Christian disease") in a middle-aged woman. The case underscores the varied and subtle nature of the disease presentation and the extent to which many organ systems may become involved. Unusual features of her case include atypical bone roentgenograms, cutaneous anergy, panhypopituitarism and evidence of diffuse central nervous system dysfunction. Several features of multifocal eosinophilic granuloma present in the older age group are different from those presenting in children and young adults. Finally, multifocal eosinophilic granuloma may present all the clinical and laboratory features of a progressive, chronic disease.
A correlated light microscopical, histochemical and ultrastructural study was made on bone lesions repeatedly biopsied from three patients with Hand-Schüller-Christian disease. The histiocytic cells proliferating in the early lesions had a markedly indented nucleus and contained in their cytoplasm varying numbers of Langerhans cell granules and round or irregular-shaped lipid droplets. Histochemically, the lipid droplets were verified to the lipo-protein rich in fatty acids. Such histiocytic cells differ from highly phagocytic histiocytes or macrophages because of indistinct phagocytotic activity, and are regarded as a metabolic type of histiocytes. The late lesions were mostly dominated by a xanthogranulomatous tissue chiefly comprised of xanthoma cells and collagen fibers. The xanthoma cells were usually filled with numerous lipid vacuoles which were histochemically proved to mainly contain cholesterol. Almost all the xanthoma cells were closely attached to collagen fibers and often had well-developed rough endoplasmic reticula. Ultrastructurally, it is suggested that the xanthoma cells are originated from fibroblasts or fibrocytes. As an important factor to induce proliferation and xanthoma cell transformation of fibroblasts in the late phase, the presence of such a lipoprotein produced in the histiocytic cells of the early phase is emphasized.
A patient with Weber-Christian disease (syn. nodular nonsuppurative panniculitis) is reported. The generalized cellular destruction in this patient resulted in liberation of proteolytic enzymes into the circulation, which led to multiple haemostatic disturbances with haemorrhagic diathesis. The most prominent haemostatic defects were thrombocytopenia with a normal life span of isologous platelets, high levels of AHF-related antigen, hypofibronigenaemia with short fibrinogen survival, low levels of Factor XIII (fibrin stabilizing factor = FSF) and increased amounts of fibrin/fibrinogen degradation products (FDP). Proteolytic enzymes, other than thrombin and plasmin which especially degrade Factor XIII and fibrongen, derived from destroyed cells (probably leukocytes) seem to have been involved in the pathogenesis of the bleeding disorder in this patient.