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Biomedical subjects

M Borchert

Publications and source records attributed to M Borchert.

At least 37 records · Page 2Linked to original sources
PubMed1998

Performance of village pharmacies and patient compliance after implementation of essential drug programme in rural Burkina Faso.

After implementation of a nation-wide essential drug programme in Burkina Faso a prospective study was undertaken consisting of non-participant observation in the health centre and in the village pharmacy, and of household interviews with the patients. The study covered all general consultations in nine health centres in three districts over a two-week period as well as all client-vendor contacts in the corresponding village pharmacies; comprising 313 patients in consultations and 498 clients in eight village pharmacies with 12 vendors involved in dispensing 908 drugs. Additionally patients were interviewed in their households. Performance and utilization of the village pharmacy: 82.0% of the drugs prescribed in the health centres were actually dispensed at the village pharmacy, 5.9% of the drugs were not available at the village pharmacy. Wrong drugs were dispensed in 2.1% of cases. 41.3% of the drugs dispensed in the village pharmacy were bought without a prescription. Differences are seen between the district and are put in relation to different onset of the essential drug programme. Patient compliance: Patients could recall the correct dosage for 68.3% of the drugs. Drug taking compliance was 63.1%, derived from the pills remaining in the households. 11.5% of the drugs had obviously been taken incorrectly to such an extent that the occurrence of undesired drug effects was likely. The study demonstrates the success of the essential drug programme not only in performance but also in acceptability and utilization by the population.

Burkina Faso↗
PubMed1997

Etiology and prognosis of acute, late-onset esotropia.

OBJECTIVE: The purpose of the study is to review etiologies and outcomes of sudden, late-onset esotropia. DESIGN: The authors reviewed charts of patients in whom acute, comitant, constant esotropia developed after 5 years of age. MAIN OUTCOME MEASURES: The authors evaluated final ocular alignment, treatment, fusion, apparent etiologies, and associated neurologic conditions. RESULTS: Ten patients met entry criteria with documentation of previous orthotropia. Ages ranged from 5 to 35 years. Esotropia at near ranged from 16 to 70 prism diopters. In seven patients, the esotropia improved partially or completely with correction of hypermetropia. Eight patients required surgery. In only one patient were neuroimaging studies positive, associated ophthalmic and systemic findings identified, and underlying neurologic disease diagnosed. CONCLUSIONS: Sudden, late-onset esotropia may be caused by an uncorrected refractive error. If no other neurologic signs are present, underlying intracranial disease is unlikely.

Acute Disease↗
PubMed1997

Direct and indirect estimates of maternal mortality in rural Burkina Faso.

A retrospective study of maternal mortality was conducted in Nouna, a rural area of Burkina Faso in 1992. Strong evidence was found of a major mortality decline among children and young adults over the 50 years preceding the study: The estimated life expectancy of 36 years in around 1945 rose to 58 years in 1991. Direct and indirect (using the sisterhood method) estimates of the maternal mortality ratio (MMR) were compared. Overall, the direct estimate of the MMR (389 deaths per 100,000 live births) for women aged 15 and older was slightly lower than the indirect estimate (428 deaths per 100,000). Taking into account the biases involved in the use of information obtained from sisters, the direct estimates indicated a marked decline in maternal mortality over time from 569 deaths per 100,000 around 1941 to 305 deaths around 1987. The validity of both data and approach, as well as the discrepancies between the direct and indirect methods, are discussed.

Adolescent↗
PubMed1995

Clinical assessment, optic disk measurements, and visual-evoked potential in optic nerve hypoplasia.

PURPOSE: Because there is a broad spectrum of visual dysfunction in eyes with optic nerve hypoplasia, we determined whether any clinical observations, including optic disk measurements, could predict visual outcome in eyes with hypoplastic optic nerves. METHODS: We prospectively studied the eyes of 19 children (eight consecutive and 11 randomly selected), ages 7 to 92 months, in whom a diagnosis of optic nerve hypoplasia was made by an ophthalmologist. Clinical assessment included visual acuity, pupillary responses, and nystagmus. The ratio of the horizontal disk diameter to the disk-macula distance was calculated from fundus photographs. The amplitude and latency of the flash visual-evoked potential as well as the threshold response to pattern reversal checks were recorded. RESULTS: Visual acuity was associated with pupil reactivity, nystagmus, the ratio of the horizontal disk diameter to the disk-macula distance, pattern visual-evoked potential threshold, and flash visual-evoked potential amplitude (P < .001 for all parameters). All eyes with a ratio of the horizontal disk diameter to the disk-macula distance greater than .30 had good visual acuity, and all eyes with a ratio of the horizontal disk diameter to the disk-macula distance less than .30 had poor visual acuity. No eye with a ratio of the horizontal disk diameter to the disk-macula distance less than or equal to .15 had visual acuity better than light perception. CONCLUSIONS: Visual-evoked potential and photogrammetric measurement of relative disk size can be used to approximate visual acuity in eyes with optic nerve hypoplasia. This finding could lead to a diagnostic criterion or a severity classification for optic nerve hypoplasia.

Child↗
PubMed1995

The economic costs of illness for rural households in Burkina Faso.

Analyses of the health costs in developing countries have mainly dealt with provider costs. This is in spite of the fact that the bulk of illness related costs is borne by households. Where studied, household time and financial costs have not been treated in a comprehensive way. However, an incomplete cost assessment will lead to an underestimation of household costs. Using data from a household interview survey in a rural area of Burkina Faso, the authors carried out an exhaustive assessment of the economic cost of illness that households incur. Financial costs included out-of-pocket expenditures for drugs, fees, transport to the treatment site, lodging and food for accompanying household members. Time costs, in turn, were comprised of production foregone both by the sick person and by healthy household members, who tended to the sick. Time costs amounted to by far the largest proportion (73%) of total household costs. Of the total amount of illness related time loss of the average household, 45% was due to the fact that healthy household members tended to or accompanied their sick kin. Of the financial cost items, expenditures for drugs or traditional products represented 62%. When Western type services were sought, expenditures for transport, food etc., exceeded those for treatment fees. Total cost of illness was 4,002 F CFA/month for the average household. This amounted to 3.7% of household income and to 6.2% of household expenditures in the reference month. The authors discuss policy measures aimed to reduce household time costs.(ABSTRACT TRUNCATED AT 250 WORDS)

Absenteeism↗
PubMed1994

Independence of optokinetic nystagmus asymmetry and binocularity in infantile esotropia.

OBJECTIVE: Children with congenital esotropia, amblyopia, or early visual deprivation have persistent asymmetric monocular pursuit, as measured by optokinetic nystagmus (OKN), and favor targets moving in a temporal to nasal direction. Previous studies suggest that binocular visual development is necessary for the development of symmetric monocular OKN. We recently treated patients with congenital esotropia with unconventionally early surgery to establish good binocularity. We wished to determine if mature symmetric OKN responses could develop in patients with congenital esotropia following the acquisition of good stereopsis. METHODS: Electro-oculographic recordings documented horizontal eye movements in response to an electronic OKN stimulus. PATIENTS: The recordings of three patients with congenital esotropia that had been surgically aligned before age 20 weeks and who had achieved high-grade stereopsis with random dot and Titmus stereographic testing were studied. We compared this group of children with groups of age-matched controls, including the following: (1) three patients with congenital esotropia who underwent surgical alignment after age 6 months and who had no amblyopia but poor stereopsis; (2) three children with accommodative esotropia, good ocular alignment when wearing spectacles, and good stereopsis; and (3) three normal children. RESULTS: The normal children and those with accommodative esotropia demonstrated normal symmetrical OKN. The patients with congenital esotropia showed poor nasal to temporal OKN regardless of the degree of stereopsis or timing of surgery. CONCLUSIONS: Our results indicate that good binocularity, as measured by stereopsis, is not sufficient for the development of symmetric OKN in patients with congenital esotropia.

Child↗
PubMed1993

Modulation of interleukin 2 high affinity binding to human T cells by a pyrimidodiazepine insect metabolite.

An insect metabolite containing the little known pyrimido[4,5-b][1,4]diazepine ring system has been found to act as an effective mimic of tetrahydrobiopterin in its ability to modulate the affinity of interleukin 2 (IL-2) for its receptors on human T cells. Semi-empirical molecular orbital calculations reveal that while tetrahydrobiopterin has considerable flexibility, the pyrimidodiazepine has rather few conformational options and offers a useful model for exploring the nature of the pterin binding site.

Animals↗
PubMed1992

Structural requirements for the modulatory effect of 6-substituted pterins on interleukin 2 receptor binding.

(6R)-5,6,7,8-Tetrahydrobiopterin is produced by stimulated human T lymphocytes, and is known to affect various aspects of interleukin-2-directed T cell proliferation. Using an increased apparent affinity of interleukin 2 receptor to interleukin 2 as a measure of activity, this study explores whether other 6-substituted pterins might have the same effect, and what structural features are necessary for activity. Of the compounds tested, only the T-lymphocyte-derived (6R)-5,6,7,8-tetrahydrobiopterin was active. The diastereomeric (6S)-5,6,7,8-tetrahydrobiopterin was inactive, as were 7,8-dihydrobiopterin, sepiapterin, 5,6,7,8-tetrahydroneopterin, 6,7-dimethyl-5,6,7,8-tetrahydropterin and 6-hydroxymethylpterin. 7,8-Dihydroneopterin and neopterin were also found to be inactive. It follows that neither of these compounds participates in the feedback modulation of IL-2 receptor affinity, although both of them can be detected upon IFN-gamma stimulation of human monocytes/macrophages. A computer-based molecular modelling study of (6R)-5,6,7,8-tetrahydrobiopterin and (6R)-5,6,7,8-tetrahydroneopterin revealed substantial differences in overall shape between the two molecules, with certain features figuring prominently in the low-energy conformers of (6R)-5,6,7,8-tetrahydrobiopterin.

Biopterins↗
PubMed1990

Anchorin CII, a collagen-binding chondrocyte surface protein of the calpactin family.

In an attempt to identify collagen-binding proteins on the chondrocyte surface, a protein of Mr 34KD, called Anchorin CII was isolated from chondrocyte membranes by affinity chromatography on type II collagen sepharose (Mollenhauer & von der Mark, 1983). The protein was localized on the chondrocyte surface by immunofluorescence labeling using a specific rabbit antibody (Mollenhauer et al., 1984), by immunogold labeling and by cell surface iodination (Pfäffle et al., 1988). Fab'fragments of anti anchorin CII reduced the binding of chondrocytes to type II collagen substrates (Mollenhauer et al., 1984). Analysis of the complete primary structure of anchorin CII revealed 4 repetitive domains of each 70-80 amino acid residues, and the absence of hydrophobic transmembrane sequences or signal peptides (Fernández et al., 1988). Thus, anchorin CII is another member of the calpactin/lipocortin/annexin family, although most other members of this family are located strictly intracellularly. Similar to lipocortin I, however, anchorin CII can be identified extracellularly, e.g. in the culture medium of chondrocytes and fibroblasts (Pfäffle et al., 1988). Here we report on further studies on sequence homologies to other annexins, and on the Ca(++)- and phospholipide binding of this protein.

Amino Acid Sequence↗
PubMed1988

Progressive and recurrent nonarteritic anterior ischemic optic neuropathy.

We examined ten patients with nonarteritic anterior ischemic optic neuropathy in whom the visual deficit progressed over a number of weeks or who suffered a recurrence in the same eye. The visual deficits progressed over a month or more in five patients, four patients suffered a recurrence in the same eye after a long interval, and one patient had bilateral progression and a recurrence.

Aged↗
PubMed1988

Chronic ocular ischemia and neovascular glaucoma: a result of extracranial carotid artery disease.

Severe occlusive disease of the carotid artery may produce a rare syndrome of chronic ocular ischemia. Prolonged retinal hypoxia is associated with characteristic funduscopic changes and neovascularization of the iris, with subsequent obstruction of aqueous humor resorption. A case of neovascular glaucoma as a result of severe bilateral carotid occlusive disease and the pathophysiology involved are discussed. Definitive treatment consisted of carotid endarterectomy and aggressive control of intraocular pressure, including operative placement of a drainage implant in the anterior chamber of the eye. Seizure activity and an exacerbation of glaucoma developed after successful revascularization, exemplifying the derangements in cerebral and ocular function that may result from chronic hypoperfusion.

Arterial Occlusive Diseases↗
PubMed1987

Assessment of visual impairment in patients with Alzheimer's disease.

We examined five patients with Alzheimer's disease who complained of poor vision. Two patients had mild Alzheimer's disease; they complained of problems with reading and of "bumping into things," yet both had normal visual acuities. One patient with moderate Alzheimer's disease had abnormal eye movements, visual-evoked potentials, and contrast sensitivity. The other two patients had severe Alzheimer's disease. Despite difficulties in performing the examination, we were able to see moderate impairments in visual acuity and visual fields, as well as marked dyschromatopsia, severe deficits in contrast sensitivity, and markedly abnormal eye movements and visual-evoked potentials.

Aged↗
PubMed1986

Phorbol ester causes short term and transient accumulation of pteridines in T cells and in cell lines.

Upon exposure to 12-O-tetradecanoylphorbol 13-acetate, interleukin 2 receptor+ T cells transiently accumulate neopterin and biopterin as was determined by HPLC after iodine oxidation of acidic cell extracts. Pteridines peak at maximally 20 fold levels after 10-20 min and return to initial levels during the following 30-40 min. Resting human peripheral blood mononuclear cells do not react within this short period. TPA elicits similar neopterin and biopterin accumulation kinetics in cell lines such as HL-60, Reh, Jurkat JMN, HeLa and 293, whereby HL-60 and Reh release substantial amounts of these transiently formed pteridines into the medium.

Biopterins↗
PubMed1985

Phagocytosis and killing of Brucella by human polymorphonuclear leukocytes.

Although cellular immunity involving activated macrophages is important in resistance to Brucella, serum factors and polymorphonuclear leukocytes (PMNLs) play some role in the initial response to infection. The interaction between human PMNLs and virulent and attenuated strains of Brucella abortus and Brucella melitensis was studied by in vitro techniques. Virulent and attenuated strains of both species were rapidly phagocytosed after opsonization with normal human serum (NHS); nonopsonized bacteria were not phagocytosed. In contrast, NHS devoid of detectable antibodies was bactericidal for strains of B. abortus but not of B. melitensis. In addition, intracellular killing of ingested bacteria was shown for virulent B. abortus but not for B. melitensis. Ultrastructural studies revealed morphological alterations in about one-half of phagocytosed B. abortus and B. melitensis after incubation for 10 min; thereafter, nearly 100% of B. abortus showed some degree of degeneration, whereas B. melitensis remained intact during 120 min of observation.

Adult↗
PubMedDate not supplied

Drug-induced and genetic hypermelanism: effects on pigment cell differentiation.

Allopurinol, a drug that inhibits the enzyme xanthine dehydrogenase (XDH), is known to cause hypermelanism in the axolotl. The hypermelanistic condition that results from allopurinol treatment is similar in most respects to the phenotype that results from the action of the melanoid (m) gene in axolotls. On the basis of structural and biochemical studies, it now seems clear that genetic and drug-induced hypermelanism are the same in the following ways. 1) Both types of melanism result in the production of more than normal amounts of melanin and more melanin-containing cells (melanophores). 2) In both cases the amount of pteridine-associated yellow pigment declines during development, and this is associated directly with fine structural changes that occur within the pigment organelles (pterinosomes) of yellow pigment cells (xanthophores). 3) In both cases the hypermelanistic condition results in the suppression of reflecting pigment cell (iridophore) differentiation. 4) Both conditions have now been linked directly to depressed levels of XDH activity. Thus both genetic and drug-induced hypermelanism result in alterations in the normal differentiation of all three pigment cell types and the subsequent disruption of normal pigment pattern formation. The possible significance of these findings with regard to factors known or suspected to direct the migration and/or differentiation of neural crest-derived pigment cells is discussed.

Allopurinol↗