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PubMed1994

Art and literature in the anatomy of Charles Bell.

The artistic gifts of Sir Charles Bell (1774-1842) directed the course of his life's work. There is a fairly extensive literature on the discoveries of Bell in neurology and myology but comparatively poorly documented are the ways in which Bell exploited his aesthetic talents and erudition to communicate his findings to others. This study attempted to answer the question; how did Bell use art and literature to teach anatomy? The problem is all the more interesting because, in keeping with the spirit of education and improvement of the day, Charles Bell did not limit himself to addressing the medical profession but spoke to a wider public, dwelling on artists in particular. Bell's oil paintings and drawings, and the early editions of his written works, as well as their reviews in the contemporary press formed the main source material of this study.

Anatomy↗

PubMed1994

Plasma concentration of atrial natriuretic peptide in relation to severity of mitral regurgitation in Cavalier King Charles Spaniels.

Plasma concentration of immunoreactive atrial natriuretic peptide (ir-ANP) was investigated in 83 Cavalier King Charles Spaniels with variable severity of mitral regurgitation caused by chronic valvular disease (CVD). Severity of mitral incompetence was assessed by echocardiography. Significant differences in plasma concentrations of ir-ANP were not found between clinically normal dogs (New York Heart Association functional class O), dogs with only cardiac murmur (class I), and dogs with echocardiographic evidence of slight to moderate left atrial and ventricular dilatation (class II). Dogs with severe left atrial and ventricular dilatation and clinical signs of congestion (classes III and IV) were found to have significantly (P < 0.001) increased plasma concentration of ir-ANP. Overall, moderate degree of association was found between plasma concentration of ir-ANP and left atrial and left ventricular diameters (Pearson's r = 0.65, 0.60, respectively, P < 0.001), as well as heart rate (r = 0.47, P < 0.01). However, left atrial enlargement was found to have the predominant effect on plasma ir-ANP concentration. It is concluded that the plasma concentration of ir-ANP did not become markedly increased before decompensation of chronic mitral regurgitation associated with severe enlargement of the left atrium and ventricle in Cavalier King Charles Spaniels.

Analysis of Variance↗

PubMed1994

Modified Charles operation for primary fibrosclerotic lymphedema.

Radical excision of lymphedematous tissue with skin grafting (Charles operation) may be required for patients with advanced fibrosclerotic lower extremity lymphedema. Complications of this procedure include papillomatosis, wart formation, intractable skin ulcerations and weeping of lymph and are often considered major drawbacks of the operation. We have largely circumvented these sequelae by burying a strip of shaved split-thickness skin graft into the deep subcutaneous tissue thereby modifying the Charles operation. The strip of deepithelialized skin seemingly connects the superficial dermal lymphatics with subfascial deep lymphatics thereby facilitating lymph drainage and minimizing lymphedema accumulation and the complications outlined above. We have now treated 4 patients with advanced primary fibrosclerotic lymphedema using this modified technique. Not only were the patients improved in appearance and function with less trophic changes, but lymphscintigraphy using 99mTc-dextran also suggested improved interstitial tracer transport.

Humans↗

PubMed1996

Relationship between parental cardiac status in Cavalier King Charles spaniels and prevalence and severity of chronic valvular disease in offspring.

OBJECTIVE: To study the relationship between parental cardiac status in Cavalier King Charles Spaniels and development of chronic valvular disease (CVD) in offspring. DESIGN: Historical cohort. ANIMALS: 54 female and 53 male Cavalier King Charles Spaniel offspring. PROCEDURE: 7 sires, selected on the basis of their liability to develop CVD, were screened for clinical signs of CVD and assigned to 1 of 3 groups (late, intermediate, and early onset of CVD). The mates of these sires (30 dams) were selected and classified likewise, and 107 offspring produced in 1988 from matings between these parents were screened for clinical signs of CVD at a mean age of 5.3 +/- 0.3 years. RESULTS: 55% of the offspring were free from clinical signs of CVD, whereas 45% had cardiac murmurs of low or moderate intensity. The proportion of offspring with heart murmurs and the intensity of murmurs were significantly greater with increased parental classification. More males than females had developed murmurs, and murmurs of moderate intensity also were more prevalent in males. Results of multiple-regression analysis indicated that mean parental classification and sex had significant effects on proportion of offspring with murmurs and their intensity. Additionally, age affected disease prevalence and severity, despite the narrow range in age of offspring examined. CLINICAL IMPLICATIONS: Parental CVD status is an important factor influencing the probability of heart murmurs and their intensity in offspring. The results of this study indicate that CVD development is a polygenic threshold trait and that sex of the offspring influences threshold levels.

Age Factors↗

PubMedDate not supplied

Charles Dickens' old people.

Charles Dickens, rare among authors of any period, presented a host of elderly and old characters in his novels and stories. More than 120 such characters were identified, distributed among four levels of involvement (protagonist to minor role) and six categories of behavior (warm and sympathetic to villainous and threatening). The two-thirds male, one-third female characters tended to be concentrated at the minor, rather than major, levels of involvement in plots, but they represented a great range of behavior. Dickens' old people were fully engaged in life and society and were not age-stereotyped.

Aged↗

PubMed2002

Pediatric phantom vision (Charles Bonnet) syndrome.

Visual symptomatology in childhood often presents diagnostic difficulties. Recurrent paroxysmal visual complaints, although typically associated with migraine, may also signal other disorders. We describe a 9-year-old partially sighted male with paroxysmal zoopsias resulting from Charles Bonnet syndrome. This condition is characterized by paroxysmal visual hallucinations occurring in patients with chronic visual impairment, akin to the phantom-limb phenomenon. This pediatric case is the fourth report of this condition. We have reviewed the other cases.

Atrophy↗

PubMed2026

Cardiometabolic Multimorbidity Increases the Risk of Hip Fracture: A Longitudinal Cohort Study Based on CHARLS.

BACKGROUND: Cardiometabolic Multimorbidity (CMM) is defined as the co-occurrence of two or more conditions among heart disease, diabetes mellitus, stroke, and hypertension. Previous studies have shown associations between cardiometabolic diseases and fragility fractures; however, the relationship between CMM and hip fractures remains unclear in the Chinese population. This study therefore aims to investigate this association in a Chinese cohort to inform fracture prevention strategies. METHODS: This prospective cohort study used data from the China Health and Retirement Longitudinal Study (CHARLS) collected from 2011 to 2020. Participants from the 2011 baseline survey cohort were initially included. Subsequently, individuals were sequentially excluded if they were under 45 years of age, had incomplete baseline CMM information, had a history of hip fracture, lost to follow-up, or had missing data on confounders. Kaplan-Meier survival analysis, Cox proportional hazards regression, subgroup analyses, and sensitivity analyses were performed to evaluate the association between CMM and the risk of hip fracture. RESULTS: A total of 6314 participants aged 45 years and older were included, of whom 544 had CMM. Over a 9-year follow-up period, 287 incident hip fractures (4.55%) were identified. Among these, 36 participants had been diagnosed with CMM at baseline, whereas 251 had not. The incidence of hip fracture was significantly higher in participants with CMM than in those without CMM (13% vs. 8%, p = 0.015). After full adjustment for confounders, multivariable Cox regression showed that CMM was associated with a 70% increased risk of hip fracture (HR = 1.70, 95% CI: 1.318-2.47; p = 0.005). Subgroup analyses indicated that age and history of falls were significant effect modifiers. The association between CMM and hip fracture was more pronounced in participants under 60 years old (P for interaction = 0.048) and those with a history of falls (P for interaction = 0.014). CONCLUSION: These findings suggest that CMM increases the risk of hip fracture, particularly among relatively younger individuals and those with a history of falls.

Humans↗

PubMed2004

Sir Stuart Threipland (1716-1805), physician-in-chief to Prince Charles Edward Stuart during the Jacobite uprising of 1745.

Stuart Threipland (1716-1805), the son of Sir David Threipland, second baronet of Fingask Castle, was an ardent Jacobite. He obtained the Edinburgh MD degree in 1742, was admitted a fellow of the Edinburgh College of Physicians in 1744 and was elected its President in 1766. He accompanied "Bonnie" Prince Charles Edward Stuart during the Jacobite uprising of 1745 and went into exile shortly after the battle of Culloden in April 1746. He returned to Edinburgh under an Act of Indemnity in 1747. While he succeeded to the baronetcy after the death of his father in 1746, he was not technically allowed to use this title during his lifetime because his father's title and ancestral estates had been confiscated after the Battle of Sheriffmuir in 1715. He practised in Edinburgh for the rest of his life and outlived all of the other great Jacobite figures involved in the 1745 uprising.

Famous Persons↗

PubMed2006

Sleep deficit: the performance killer. A conversation with Harvard Medical School Professor Charles A. Czeisler.

Companies today glorify the executive who logs 100-hour workweeks, the road warrior who lives out of a suitcase in multiple time zones, and the negotiator who takes a red-eye to make an 8 A.M. meeting. But to Dr. Charles A. Czeisler, the Baldino Professor of Sleep Medicine at Harvard Medical School, this kind of corporate behavior is the antithesis of high performance. In fact, he says, it endangers employees and puts their companies at risk. In this interview, Czeisler describes four neurobiological functions that affect sleep duration and quality as well as individual performance. When these functions fall out of alignment because of sleep deprivation, people operate at a far lower level of performance than they would if they were well rested. Czeisler goes on to observe that corporations have all kinds of policies designed to protect employees- rules against smoking, sexual harassment, and so on-but they push people to the brink of self-destruction by expecting them to work too hard, too long, and with too little sleep. The negative effects on cognitive performance, Czeisler says, can be similar to those that occur after drinking too much alcohol: "We now know that 24 hours without sleep or a week of sleeping four or five hours a night induces an impairment equivalent to a blood alcohol level of .1%. We would never say, 'This person is a great worker! He's drunk all the time!' yet we continue to celebrate people who sacrifice sleep for work." Czeisler recommends that companies institute corporate sleep policies that discourage scheduled work beyond 16 consecutive hours as well as working or driving immediately after late-night or overnight flights. A sidebar to this article summarizes the latest developments in sleep research.

Administrative Personnel↗

PubMed1992

Visual symptoms associated with choroidal neovascularization. Photopsias and the Charles Bonnet syndrome.

One hundred consecutive patients with macular choroidal neovascularization were studied in a cross-sectional fashion. Evidence of bilateral choroidal neovascularization was present in 31 patients. Among the 100 subjects, 59% related a history of seeing flickering or flashing lights (photopsias) in the affected eye or eyes. The colors varied, but in 59% of instances the lights were white. Twelve subjects experienced formed hallucinations (Charles Bonnet syndrome); in nine (75%) of these patients, the sequelae of choroidal neovascularization were bilateral. Symptoms that are commonly attributed to vitreoretinal tractional phenomena as well as neurologic and/or psychiatric disease are also frequently encountered in patients with macular degeneration associated with choroidal neovascularization.

Adult↗

PubMed1979

Charles Dickens and the ear, nose, and throat.

Charles Dickens is known as a novelist, humorist, humanist, and a social reformist. One of his many abilities was an astute power of observation, and some of his writings included descriptions considered as original medical knowledge. Among the hundreds of characters portrayed by Dickens, many had depictions or diseases of interest to the otolaryngologist. Dickens described deaf children and was interested in the methods used in their teaching. He had a keen interest in children and their welfare and described his visits to the Childrens Hospital in London and to Parkins Institute at Boston. He described both temporary and permanent deafness following exposure to loud noise. Dickens was a medical critic and most of his writings on the subject were humorous, though mixed at times with a spicy element of satire.

Adolescent↗

PubMed1998

The pancreas: a symposium in honor of Charles Frederick Frey, MD.

On October 3, 1997, the University of California, Davis, under the leadership of James E. Goodnight, Jr, MD, chair of the Department of Surgery, gathered together 5 distinguished authorities in surgical pancreatic disease to present a symposium in honor of the retiring professor of 21 years, Charles F. Frey, MD. The atmosphere was one of informality and "give and take," and the result was not only a thorough and up-to-date review of many aspects of pancreatic disease but a wonderful tribute to a colleague who has spent a lifetime in this area of endeavor. Dr Frey has been a leader in this field, both scientifically in refining and extending our treatment of severe acute pancreatitis and administratively in organizing the Pancreas Club and promoting the concept that one could manage the pancreas, not in fear, but with confidence of success.

Animals↗

PubMed1997

Charles Darwin as primatologist: a literature guide.

Charles Darwin made numerous references to the nonhuman primates in support of his evolutionary thesis. Most such references are found in The Descent of Man [1871] and The Expression of the Emotions in Man and Animals [1872], but other illuminating statements are scattered throughout Darwin's notebooks, letters, and lesser-known publications. As a research aid to modern primatologists, this paper presents a very nearly complete listing of Darwin's comments on primates, indexed by topic and primate type.

Animal Communication↗

PubMed2026

A Combination of Alleles in LMOD2 and a lncRNA is Strongly Associated With Myxomatous Mitral Valve Disease in Cavalier King Charles Spaniels.

A previous genome-wide association study identified regions on canine chromosome (cfa) 13 and 14 associated with early onset myxomatous mitral valve disease (MMVD) in Cavalier King Charles Spaniels (CKCS). In the present study, whole genome sequencing (WGS) of 9 CKCS cases (mitral regurgitation (MR) before 4.5 years or congestive heart failure (CHF) at any age due to MMVD) and 10 CKCS controls (no or mild MR after 8 years of age) identified > 2000 genetic variants in the MMVD associated cfa13 and cfa14 regions. Ensembl Variant Effect Predictor (VEP) identified a possible functional impact of 18 variants. These were genotyped in 250 CKCS; 117 cases and 133 controls. The most significantly associated variants were a splice-site variant in a long noncoding RNA (lncRNA) on cfa13, a nonsynonymous variant in HYAL4, a 39 base-pair insertion in LMOD2 and a synonymous variant in ENSCAFG00000024436 (p-values from 2.03E-08 to 4.20E-06). Concomitant homozygosity for risk alleles in LMOD2 and the lncRNA gave an odds-ratio for MMVD of 52.5 compared to homozygosity for the nonrisk alleles (p = 0.00034, 95% CI: 8.8-1023.8). Upon validation of our results in an independent cohort, this gene variant combination in CKCS is expected to enable targeted breeding programs to reduce MMVD prevalence in CKCS.

Animals↗

PubMed2006

Charles Manning Child (1869-1954): the past, present, and future of metabolic signaling.

Charles Manning Child's work focused on metabolic gradients and their influence on organismal development. Early in the 20th century, his work had considerable currency, but by the second half of the century he had become little more than a historical footnote. Yet today Child's ideas are once again topical. While there were issues of cause and effect that Child and his students were never able to address adequately, in hindsight the extent of his eclipse hardly seems warranted. In fact, the demise of Child's theories may have resulted from larger changes in the nature of biology in the early 20th century. Child frequently studied planarians, hydroids, and other animals that are capable of asexual, agametic reproduction, and his theories most clearly apply to such organisms. In contrast, Thomas Hunt Morgan, initially one of Child's competitors in studies of regeneration, later developed the field of transmission genetics based on fruit flies, which can only reproduce via gametes. Child's theories and model systems were largely casualties of the success of Morgan's mechanistic paradigm. Nevertheless, in modern biology metabolic gradients, recast in terms of redox signaling, have become central to understanding both normal and pathological development.

Animals↗

PubMed2002

Did Charles Dickens describe progressive supranuclear palsy in 1857?

A character from one of Charles Dickens's lesser known works is presented, whose attributes suggest a possible diagnosis of progressive supranuclear palsy.

Famous Persons↗

PubMed2002

[Charles Bonnet syndrome in an elderly patient with bilateral vision loss, hyperthyroidism and relative digitalis overdose].

Charles Bonnet syndrome (CBS) is characterized by the presence of visual hallucinations in elderly, mentally healthy people. We report a visually impaired 90-year-old woman suddenly complaining of visual hallucinations, suffering from hyperthyroidism and a relative digitalis overdose. The diagnosis of CBS could be made after the exclusion of an intoxication and other neurological and psychiatric syndromes. In this case, visual hallucinations ceased without specific psychopharmacological therapy. A brief review of this organic hallucinosis, differential diagnosis, especially hyperthyroidism-induced psychosis, and digitoxin-induced psychosis is given and current therapeutic strategies are suggested.

Aged↗

PubMed1998

Charles B.G. de Nancrede: academic surgeon at the fin de siècle.

At the last turn of the century American surgery was in the midst of a number of paradigm shifts, involving transitions in technology, surgical practice, surgical specialization, patient care, surgical training, and medical economics. Charles B. G. de Nancrede was a leader during this formative period. A key figure in the transition from antiseptic to sterile technique in American medicine, he was also a prolific writer, a bold surgeon, and a great surgical educator. De Nancrede created one of the earliest prototypes of the modern multispecialty surgical departments. The coming turn of the century promises new transitions comparable to those of the past.

General Surgery↗