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We describe three cases in which vivid visual hallucinations were experienced by elderly female patients who suffered from ocular disorders. The experiences followed the death of the patients' spouses. We discuss the possible association between the Charles Bonnet syndrome and bereavement.
As can be seen from this quick analysis. Senator Charles Percy has certainly left his mark in the United States Senate and on the nation as well. His accomplishments have been many. He has used his truly incredible intellect and energy level for the benefit of all Americans. All American citizens owe Senator Percy a debt of gratitude for his years of public service. He is proof that the American system of government endures and that the best and the brightest still look to public service. It says a great deal about the man that he has spent so much of his time dealing with the problems of the aged, disabled, and infirm. He has been the voice of the voiceless and the conscience of the country demanding the recognition and redress of grievances, an end to the neglect, violence and discrimination perpetrated against the weakest members of society. CARING is proud to salute this truly great American.
On January 21, Richard Reece, MD, interviewed Charles E. Dwyer, PhD, to talk about solutions for changing the perceptions of today's beleaguered physicians. He discusses the state of affairs of physician executives in this turbulent industry and how they need to move beyond their thinking about organizations and their current responses to change. The key, Dwyer emphasizes, is influencing people to do what you want them to do. "If you want somebody to do something other than what they are doing now, then you must bring them to perceive that what you want them to do is better than what they are doing now in terms of what is important to them." He also explores how physicians can change their responses to the health care environment: "You can actually decide how you are going to respond conceptually, emotionally, and behaviorally to anything that happens in your life." Part 2 of this interview will appear in the upcoming May/June issue and will provide hands-on strategies for dealing with physician anger, fear, and resentment.
The authors summarize their experience with intoxicated patients who were treated between 1994 and 1997 at the metabolic unit of the Medical Clinic, Second Medical Faculty Charles University, Prague. The group of intoxicated patients comprises 165 subjects, incl. 76 men and 89 women. 107 intoxications were committed with suicidal intentions, in another 27 cases intoxication was accidental, in 14 toxicomania was involved and 17 patients were chronic alcohol addicts. From the total number 57 patients suffered from serious psychiatric disease of the type of psychosis, but only 22 patients had a psychiatric case-history. In 46 instances suicide was a demonstrative deed or hysterical reaction to partnership conflicts. In this group women predominate over men. The group comprises 14 toxicomaniacs, incl. 9 dependent on hard drugs. The patients were most frequently intoxicated with alcohol which they took either alone or combined with medicaments. 56 of the patients consumed ethyl alcohol. The next most frequently used intoxicating substance is flunitrazepam (Rohypnol), which was taken by 48 subjects. In 113 cases medium severe intoxications were involved, 31 were mild and 21 intoxications were severe.
A short review on the history of pigment cell research at Charles University (Ch.U.) in Prague is presented. The famous Czech physiologist and professor J.E. Purkyne started the pigment cell research at Ch.U. already in 1837. He discovered melanin granules in the cells of substantia nigra of the brain. Later, in 1858, a Czech professor of medicine at Ch.U., B. Eiselt, as the first, described melanogenuria in 3 patients with generalized melanoma. Also some German professors at Ch.U. contributed to the research of melanins and melanogenuria in the past, especially H. Waelsch (1932). After the World War II, a Czech professor of medical chemistry at Ch.U., A.F. Richter with his young assistant J. Duchon continued in the chemical exploration of melanins (1954) and J.D. with Z. Pechan, B. Matous and S. Pavel devoted their attention to melanogenuria in melanoma patients (1962-1980). In 1967 they identified 2 new metabolites in melanoma urine: 5-hydroxy-6-methoxy and 6-hydroxy-5-methoxy-indole-2-carboxylic acids. J. Duchon with J. Borovanský and P. Hach also studied morphology and chemical composition of different melanosomes (1972-1979) and brought the first evidence that melanosomes consist of several proteins (1972). In 1980's 4 groups devoted to the pigment cell research and originated from Ch.U. were formed. The groups of J.B., of B.M. and of J. Vachtenheim in Prague and the group of S.P. who moved to the Netherlands (Leiden). As for the clinical aspects of the pigment cell research, the s.c. Hermanský-Pudlák syndrome published in 1959 and the histopathological classification of malignant melanomas estimated by J. Trapl (1957), should be mentioned. Therefore it is not surprising that, as a result of the tradition of pigment cell research at Ch.U., the 3rd European Workshop on Melanin Pigmentation was held in Prague already in 1981 and that, in 1998 again, Ch.U. was entrusted with the arrangement of the 8th Meeting of the European Society for Pigment Cell Research at the occasion of the Ch.U. 650th anniversary.
Charles Mingus was perhaps the foremost straight-ahead jazz upright bassist and composer of his generation, blending the inspirational influences of gospel, jazz improvisation, and art music leanings into a unique style all his own. His demise from amyotrophic lateral sclerosis (ALS) in his fifth decade robbed the world of one of the great creative voices of American music. Aspects of Mingus' life, his career as a bassist, bandleader, and composer, and his neuromuscular illness are discussed, emphasizing his legacy for the disparate fields of jazz and neurology.
In the medical community, bibliographic databases are widely accepted as a most important source of information both for theoretical and clinical disciplines. To improve access to medical bibliographic databases at Charles University, a database server (ERL by Silver Platter) was set up at the 2nd Faculty of Medicine in Prague. The server, accessible by Internet 24 hours/7 days, hosts now 14 years' MEDLINE and 10 years' EMBASE Paediatrics. Two different strategies are available for connecting to the server: a specialized client program that communicates over the Internet (suitable for professional searching) and a web-based access that requires no specialized software (except the WWW browser) on the client side. The server is now offered to academic community to host further databases, possibly subscribed by consortia whose individual members would not subscribe them by themselves.
Development of the internet network at the 2nd Faculty of Medicine, Charles University from one of the first nodes of Prague Academic Network up to a complicated infrastructure with many client computers is accompanied with a corresponding development of information services available in this network. For today's users, infrastructure of the network is hidden behind the services whose technical details are not significant. The paper deals with history, current state and possible perspectives of information services (both basic as e-mail, WWW and more advanced like specialized database server, proxy, etc.) available to users at the 2nd Faculty of Medicine--taking into account the development of information technologies, networking infrastructure and the possibilities and limitations of co-operation between the faculty and its teaching hospital.
A short review on the pigment cell research at Charles University in Prague is presented.
The author proceeds with his earlier 1990 contribution ou the complementary examination of the skull of the Czech king and Roman emperor Charles IV. Direct relationship between the injury to the cervical spine and the newly detected healed fractures of the mandible was established. A strong blow on the king's chin induced the four-fold dislocated fracture of the mandible. Based on our present knowledge of medieval medicine, and especially facial traumatology an attempt was made to clarify the treatment methods applied in management of the king's injury.
The "galenical" dissertation which was presented for disputation by Georgius Horcicka at Charles University in 1841 is discussed as far as its content is concerned. The dissertation studies a great number of pharmaceutical dosage forms, many of which are already obsolete, but a certain number of which are still in use in the present time. It is probably one of the first dissertations treating of the given subject.
The article reviews the current literature on Charles Bonnet syndrome (CBS), offers specific criteria to define this syndrome, evaluates its prevalence, analyses the possible associated ophthalmic and sociodemographic factors, suggests future work in this area. Despite the recent interest in CBS in contemporary medical literature, a universal definition of this entity has not been fully established yet. The syndrome is usually characterised by presence of vivid and complex visual hallucinations, which are recognised as unreal and occur in the absence of any other psychiatric symptoms. Therefore there are suggestions that the phenomena should be best described by the term 'pseudohallucinations' or 'parahallucinations'. Some researchers suggest that isolated visual hallucinations in older adults may be an indication of early stages of dementia. Contrary to what was considered for a long time, the syndrome seems to occur rather frequently. Recent findings support association of CBS with sensory deprivation and advanced age. CBS should be considered as a diagnosis in patients who complain of hallucinations and who meet the defined diagnostic criteria. There is no proven treatment, but many patients will benefit from reassurance that their hallucinations do not imply mental illness.
Food and water intake have been measured during the dynamic phase of gold thioglucose-induced obesity in Charles River mice. Regressions of gain in weight with food and water consumption were calculated in young growing animals and in adults fed ad libitum. The influence of fat content in the diet (2.5 and 8% fat) and environmental temperature (68degrees or 79degrees F) was estimated on the regressions. Excessive gain in weight without hyperphagia was observed in growing animals, in adults fed on a fat-enriched diet or maintained within a thermoneutral environment (79degrees F). But a significant hyperphagia was observed in adults fed with a conventional diet and maintained at 68degrees F or in growing animals as a sequela of food deprivation.
The authors report the experience of ambulatory surgery at Charles Nicoll's hospital on ophthalmology and ORL surgery in which 90% and 60% of acts can be realized on ambulatory. The organisation by means of structures and hospital workers makes an important gain. The anesthetic consultation, very important in this organisation, enable to avoid to rescue a patient at the last time.
Vestibular research before Flourens typically involved vertigo and eye movements. In 1820 Purkinje integrated these in studies of postrotary vertigo and he is linked with Flourens as a founder of vestibular research. In the late eighteenth century Erasmus Darwin described vertigo in detail, but he did not accept that it involved an oculomotor component. Darwin reached this conclusion despite detailed experiments by William Charles Wells (1757-1817), who described the pattern of postrotary nystagmus and its dependence on head orientation during rotation. Wells generated afterimages prior to rotation and subsequently compared their motions with those of real images. He was able to distinguish between the slow and fast phases of nystagmus, its reducing amplitude following cessation of rotation, its suppression with fixation, and its torsional dimension. In many ways, Wells's experiments were more sophisticated than those of Purkinje, and he should be recognised as a founder of vestibular research. Possible reasons for the neglect of Wells's work are discussed.
The evolving systems approach (ESA) addresses the need for direct study of the creative process in recognized creators at work, in contrast to indirect methods, such as those used in psychometric studies. The ESA emerged from H. E. Gruber's prolonged study of Charles Darwin's manuscripts, especially the notebooks he kept after the Beagle voyage. Gruber's interviews with J. Piaget about the latter's creative processes, as well as many doctoral dissertations, also helped shape the authors' approach. Using Gruber's (1974/1981) study of Darwin, the authors describe some facets of creative work identified in the course of their work. Among these are networks of enterprise, ensembles of metaphors, insights, and evolving belief systems. Although the ESA emphasizes cognitive processes, social, affective, and esthetic aspects of the case are not neglected. Each creative case is unique, otherwise the individual would not meet the criterion of originality. Uniqueness does not mean isolation; people who differ must and do work together. The integration of all these facets into a plausible system for each creator remains the authors' central task.
The 1st percutaneous transluminal angioplasty marked a new era in the treatment of peripheral atherosclerotic lesions. The early techniques used in peripheral percutaneous transluminal angioplasty form the basis for subsequent percutaneous intervention both in the peripheral and coronary arteries and are largely the contribution of Charles Dotter. Dotter was the 1st to describe flow-directed balloon catheterization, the double-lumen balloon catheter, the safety guidewire, percutaneous arterial stenting, and more. This practical genius dedicated his considerable energy to the belief that there is always a better way to treat disease. His personal contributions to clinical medicine, research, and teaching have saved millions of limbs and lives all over the world.
Charles Bonnet syndrome is described as complex visual hallucinations that are known to occur in individuals with impaired vision whose emotional and intellectual functions are within normal range. This paper presents a case of a 82 years old woman who experienced an individual hallucinatory episode during three days: seeing, alert and with her eyes open, different figures and images, static and moving in lovely colors that disappeared with closing her eyes and appeared as new with opening it. The diagnostic procedure comprised EEG and ophthalmologic examination. Vitamins and hemorrheologically active therapy were administrated and accompanied with explaining the nature of her problem.