PubMed Health⌕ Search

Biomedical subjects

R H Baker

Publications and source records attributed to R H Baker.

At least 19 recordsLinked to original sources
PubMed1992

Aqueous dynamics in exfoliation syndrome.

Eighteen untreated patients with unilateral exfoliation syndrome without glaucoma were studied with regard to differences in aqueous dynamics between the affected and unaffected fellow eyes. Additionally, both eyes of the patients with exfoliation were compared to the eyes of 18 age-matched and gender-matched control subjects. Intraocular pressure was significantly higher (13.9 +/- 3.0 mm Hg [mean +/- standard deviation]) in the affected compared with the unaffected eyes (12.2 +/- 2.5 mm Hg), but no difference in aqueous humor flow was detected when eyes in the three groups were compared (affected eyes, 2.40 +/- 0.60 microliter/min; unaffected eyes, 2.40 +/- 0.65 microliter/min; control eyes, 2.61 +/- 0.60 microliter/min). Anterior chamber volumes were significantly smaller in affected (122 +/- 37 microliters) and unaffected eyes (121 +/- 37 microliters) of the patients with exfoliation compared with the eyes of the control subjects (145 +/- 30 microliters). Apparent resistance was higher in the eyes with exfoliation (6.5 +/- 1.9 min mm Hg/microliters) compared with both unaffected (5.4 +/- 1.2 min mm Hg/microliters) and control groups (5.2 +/- 1.8 min mm Hg/microliters), although these differences were not statistically significant.

Aged↗
PubMed1991

Familial polyposis coli: the spectrum of ocular and other extracolonic manifestations.

Familial polyposis coli (FPC) is hereditary condition that conveys a virtual 100% risk for the development of colon cancer in the untreated patient. A total of 56 patients with FPC underwent complete ophthalmic examination. Highly pleomorphic pigmented retinal lesions were identified bilaterally in 52% (n = 29) and unilaterally in 14% (n = 8) of our subjects. In all, 33 patients had one or more extracolonic expressions associated with FPC, including desmoids, osteomas, epidermoid cysts, lipomas, fibromas, and upper gastrointestinal tract polyps. In 15 patients, pigmented fundus lesions were the only extracolonic manifestations. No significant association between eye findings and other extracolonic manifestations could be established. The presence or absence of pigmented fundus lesions was found to cluster within families. Pigmented fundus lesions are probably a variably penetrant expression of the polyposis gene and do not appear to be specifically associated with subgroups of inherited polyposis syndromes such as Gardner's syndrome.

Adenomatous Polyposis Coli↗
PubMed1991

Extracellular deposition of eosinophil major basic protein in orbital histiocytosis X.

Although eosinophils are prominent in orbital lesions of patients with histiocytosis X (Langerhans' cell histiocytosis), little is known of their pathogenic significance in the disease. To determine whether eosinophils degranulate and deposit toxic proteins in orbital histiocytosis X, the authors examined lesions by indirect immunofluorescence for localization of the core granule protein (major basic protein) outside of eosinophils. Four patients with histiocytosis X were studied: three with eosinophilic granuloma and one with Hand-Schüller-Christian disease. Tissue eosinophilia was prominent in all specimens; striking extracellular deposition of eosinophil major basic protein was noted in three patients, and focal deposition was present in the fourth patient. Orbital specimens obtained at autopsy from patients without orbital disease were studied as control specimens; no tissue eosinophilia or deposition of eosinophil major basic protein was observed. These findings indicate that eosinophils likely degranulate in lesions of orbital histiocytosis X and may participate in the pathogenesis of the disease.

Adolescent↗
PubMed1990

Progress in controlling the reinvasion of windborne vectors into the western area of the Onchocerciasis Control Programme in West Africa.

Since vector control began in 1975, waves of Simulium sirbanum and S. damnosum s.str., the principal vectors of severe blinding onchocerciasis in the West African savannas, have reinvaded treated rivers inside the original boundaries of the Onchocerciasis Control Programme in West Africa. Larviciding of potential source breeding sites has shown that these 'savanna' species are capable of travelling and carrying Onchocerca infection for at least 500 km northeastwards with the monsoon winds in the early rainy season. Vector control has, therefore, been extended progressively westwards. In 1984 the Programme embarked on a major western extension into Guinea, Sierra Leone, western Mali, Senegal and Guinea-Bissau. The transmission resulting from the reinvasion of northern Côte d'Ivoire and Burkina Faso has been reduced by over 95%, but eastern Mali has proved more difficult to protect because of sources in both Guinea and Sierra Leone. Rivers in Sierra Leone were treated for the first time in 1989 and biting and transmission rates in Sierra Leone and Guinea fell by over 90%. Because of treatment problems in some complex rapids and mountainous areas, flies still reinvaded Mali, though biting rates were approximately 70% lower than those recorded before anti-reinvasion treatments started. It was concluded that transmission in eastern Mali has now been reduced to the levels required to control onchocerciasis.

Africa, Western↗
PubMed1990

Late juvenile-onset Krabbe's disease.

Krabbe's disease is an autosomal recessive leukodystrophy characterized by a lack of galactocerebroside beta-galactosidase activity. In contrast to the classic early infantile-onset form of Krabbe's disease, less recognized, late-onset variants exist. The authors present a case of late juvenile-onset Krabbe's disease, including the associated magnetic resonance imaging (MRI) findings. Most patients with late-onset Krabbe's disease present with visual loss due to optic atrophy. Associated gait abnormalities and parental consanguinity should increase the clinician's suspicion that a child may have late-onset Krabbe's disease. Because of the prolonged survival in late-onset Krabbe's disease, the recent development of bone marrow transplantation for these patient makes diagnosis of this disorder particularly important.

Adolescent↗
PubMed1990

Lacrimal gland ductule stones.

Chronic unilateral conjunctivitis may be caused by various infectious, inflammatory, neoplastic, or mechanical conditions. Two patients with persistent unilateral conjunctivitis were cured after removal of dacryoliths from the palpebral lobe of the ipsilateral lacrimal gland. Although lacrimal gland ductular dacryoliths are rare, this entity should be included in the differential diagnosis of chronic unilateral conjunctivitis.

Calculi↗
PubMed1990

Ocular onchocerciasis and intensity of infection in the community. III. West African rainforest foci of the vector Simulium sanctipauli.

The community pattern of ocular onchocerciasis is described for 11 villages from the forest area in Côte d'Ivoire where S. sanctipauli is the princial vector. An analytical method is applied which relates indices of ocular onchocerciasis with the Community Microfilarial Load (CMFL) and compares the results with the ocular onchocerciasis pattern found in the West African savanna. In spite of high transmission levels as estimated by entomological indices, the CMFLs were relatively low which complicated the characterization of the ocular disease pattern. Nevertheless, it could be shown that ocular onchocerciasis is less severe in the Sanctipauli forest than in the savanna, even after correction for differences in CMFL. The prevalence of onchocercal eye lesions and blindness were low and advanced sclerosing keratitis was completely absent. The differences are explained by presuming strain differences of the parasite Onchocerca volvulus. For given CMFLs the mean microfilarial loads in the eye were significantly lower than in the savanna which suggests that the parasite strain in the Sanctipauli forest is less invasive to the eye. Ocular microfilarial loads were too low to determine if the parasite is also less pathogenic to the eye, as has been concluded previously for foci of S. yahense, but this possibility cannot be excluded.

Animals↗
PubMed1990

Large scale ivermectin distribution and its epidemiological consequences.

Community trials were started to address questions concerning the safety of ivermectin during large scale treatment, its potential for transmission control, its effect in preventing ocular onchocercal disease, its acceptability and the organization of large scale treatment. A summary is presented of the major, latest results on the short-term epidemiological impact of large scale ivermectin treatment, as observed in eight community trials undertaken in the Onchocerciasis Control Programme in West Africa (OCP). Ivermectin treatment resulted in a 96%-99% reduction in the mean load of microfilariae (mf) in the skin in treated patients. The subsequent mf-repopulation of the skin was faster than in the clinical trials and after 12 months the mean loads had returned to more than 40% of the pre-treatment load. Ocular mf loads were also greatly reduced and a post-treatment regression of early lesions of the anterior segment of the eye was observed. The transmission of Onchocerca volvulus was reduced by some 60% during the first year after treatment in one trial but no additional reduction was observed after the second treatment round. These results, and other recent research findings, have been used to quantify an epidemiological model for the transmission and control of onchocerciasis. Preliminary results of computer simulations of the predicted long-term epidemiological impact of large scale ivermectin treatment indicate that ivermectin treatment may play a very important role in disease control but that it is unlikely to become a practical tool for transmission control in endemic foci. Ivermectin treatment appears to be the most appropriate method for control of recrudescence of infection in an area where the parasite reservoir has been virtually eliminated by vector control, such as in the core area of the OCP.

Africa, Western↗
PubMed1989

The quality initiative of the Royal College of General Practitioners.

The Quality Initiative of the Royal College of General Practitioners was set up in 1983 to promote the methods of quality assurance to general practitioners, and to answer some of the concerns of Government about the quality of general practice. Many small projects have been carried out, and this paper describes several undertaken by one faculty of the College, including studies of paediatric surveillance, the care of the elderly, and peer review visits to some members practices. General practitioners are now more positive about quality assurance, but the political debate about the future of primary care in the United Kingdom continues.

Family Practice↗
PubMed1989

Experimental vertical transmission of Japanese encephalitis virus by Culex tritaeniorhynchus and other mosquitoes.

Vertical transmission of Japanese encephalitis virus to the F1 adult stage was demonstrated in Culex tritaeniorhynchus, Cx. annulus, Cx. quinquefasciatus, and Armigeres subalbatus. Transmission to the F1 larval stage was demonstrated in Cx. pipiens, Aedes vexans, Ae. alcasidi, and A. flavus. In Cx. tritaeniorhynchus, vertical transmission rates (the percentage of parent females transmitting to progeny) varied (12-100%). Filial infection rates (the percentage of progeny infected) for a given mosquito virus combination were markedly affected by the interval of time between parental infection and oviposition, suggesting that vertical infection was not transovarial in nature but occurred at oviposition. Filial infection rates for Cx. tritaeniorhynchus also varied widely by family and, as measured in F1 larvae, rates in excess of 20% were observed in a family. Filial infection rates in Cx. tritaeniorhynchus F1 adults were about 4 times lower than those in larvae. Japanese encephalitis virus was sexually transmitted from male to female Cx. tritaeniorhynchus.

Animals↗
PubMed1989

A community trial of ivermectin in the onchocerciasis focus of Asubende, Ghana. I. Effect on the microfilarial reservoir and the transmission of Onchocerca volvulus.

A community trial of the microfilaricide ivermectin was undertaken in an isolated focus of hyperendemic savanna onchocerciasis in Ghana. One of the objectives was to determine the effect of mass treatment on the microfilarial reservoir and on the transmission of Onchocerciasis volvulus. Since 1978 the focus has been under entomological surveillance. This was intensified from 1 September 1987 till 11 February 1988 with daily vector collection and dissection of over 30,000 flies. A total of 14,991 people were treated with ivermectin on 7-10 October 1987. Skin snip surveys were done pre-treatment, and at two and four months after treatment. The mean skin microfilarial load in treated persons had fallen by more than 96% two months after treatment. During the next two months there was an increase in microfilaria loads which appeared to be faster than reported in the clinical trials. The total reservoir of skin microfilariae available for transmission had been reduced by an estimated 68%-78% two months after treatment. This was consistent with the entomological results which indicated a reduction in transmission of 65%-85% during the first three post-treatment months. The present study has shown for the first time that mass chemotherapy can significantly reduce onchocerciasis transmission. However, the remaining level of transmission was still unacceptably high and further studies are required to predict the long term impact of repeated mass treatment.

Animals↗
PubMed1988

Hyperpigmented lesions of the retinal pigment epithelium in familial adenomatous polyposis.

Ophthalmic examinations were performed on 56 patients with validated familial adenomatous polyposis (FAP) for hyperpigmented defects of the retinal pigment epithelium. Such lesions were seen bilaterally in 29 patients (52%) and unilaterally in 8 patients (14%). Of the 56 patients, 33 had one or more of the extracolonic expressions associated with Gardner syndrome. We found retinal lesions in 8 patients without any of the expressions of Gardner syndrome. No association was found between Gardner syndrome and the retinal lesions when these patients were compared to patients without any stigmata of Gardner syndrome, nor was any significant association found when each of the expressions was compared individually with the presence of the pigmented retinal lesions. The presence or absence of eye findings were seen to cluster within families. There was no association with sex. Fundus lesions are apparently a variable expression of the FAP gene and are not specifically associated with Gardner syndrome.

Adenomatous Polyposis Coli↗
PubMed1988

Stage-selective inhibition of rodent malaria by cyclosporine.

The relative susceptibility of different developmental stages of Plasmodium berghei to cyclosporine was investigated in vivo. Within 12 h of receiving a single 25-mg/kg (body weight) dose of cyclosporine, mice with patent P. berghei infections uniformly exhibited a rapid fall in asexual parasite stages. Initially, ring forms and mature schizonts disappeared. Subsequently, trophozoites disappeared between 21 and 24 h, whereas gametocytes persisted for 36 h. In contrast, when cyclosporine was administered to mice 1 day before inoculation (100 mg/kg) with P. berghei sporozoites and for 2 consecutive days after inoculation (25 mg/kg), infections developed normally. When mice with patent infections were placed on prolonged cyclosporine therapy (25 mg/kg per day), parasitemia initially disappeared but often recrudesced. Recrudescent parasites were frequently resistant to cyclosporine (Csr). The Csr phenotype remained stable after serial passage of parasites in mice and after transmission through Anopheles stephensi mosquitoes, in which the capacity to produce oocysts was reduced. When infections of untreated mice were initiated with equal numbers of Csr and cyclosporine-susceptible (Css) parasites and then carried through two serial cycles of mosquito-to-mouse transmission without cyclosporine treatment, the Csr phenotype was lost. The results indicate that cyclosporine selectively inhibits asexual blood stages of P. berghei and favors the emergence of Csr parasites with diminished infectivity for mosquitoes.

Animals↗
PubMed1987

Extraction of thromboxane B2 from urine using an immobilized antibody column for subsequent analysis by gas chromatography-mass spectrometry.

This paper describes an antibody affinity (immunoaffinity) column which, in one step, extracts and sufficiently purifies urinary thromboxane B2 (TXB2) for quantitative analysis by high resolution gas chromatography-negative ion chemical ionization-selected ion monitoring-mass spectrometry (HRGC-NICI-SIM-MS). Polyclonal TXB2 antibody from rabbit was partially purified using immobilized Staphylococcus aureus Protein A. The purified IgG fraction was then immobilized using an N-hydroxysuccimidyl silica gel. The resulting matrix bound 570 ng TXB2 per ml of gel. TXB2 was quantitatively eluted with acetonitrile-water (19:1). Columns constructed from the gel could be used repeatedly since binding capacity was reconstituted using 0.01 M phosphate buffer (pH 7.4) with no apparent loss of activity. Using these columns, urinary TXB2 was sufficiently purified in one step such that in subsequent analysis by HRGC-NICI-SIM-MS interference free chromatograms were observed.

Chromatography, Affinity↗
PubMed1986

Localized onchocerciasis vector control in the Bahr el Ghazal Region of South-Western Sudan. II. Control.

Onchocerciasis vector breeding along 41 km of the Bussere River in the Wau Area of South-Western Sudan was controlled with temephos (Abate) insecticide for one annual transmission period. Vector biting and transmission was compared to the two years of precontrol data. Up to 70% reductions in vector biting and 80% reductions in transmission were recorded at sites with the highest precontrol levels. The flies invading in the control year (principally those invading from the south-west in the main part of the rainy season) were found to be much less infective - 2390 fly bites would be needed to transmit 100 larvae in the control year, compared to 1490 in the precontrol years. It was concluded that localized vector control could have a major impact on onchocerciasis transmission and that in this, and many other foci in Sudan, permanent reductions could be achieved by causeway removal and selective vegetation clearance.

Animals↗
PubMed1986

Onchocerciasis in Sudan: the distribution of the disease and its vectors.

The distribution of onchocerciasis and its vectors in Sudan has been reviewed with special emphasis on the hyperendemic foci where there is serious visual handicap caused by the disease. These blinding foci lie primarily in the south-west of the country, along the rivers flowing north and east from the borders with Central African Republic and Zaire, though at least one such focus is known from the eastern part of the country close to the Ethiopian border. In the blinding foci, often small villages localized to short stretches of the rivers, ocular onchocerciasis is as severe as that found in any other African foci. Only the S. damnosum s.l. species complex has been implicated in disease transmission and only the two dangerous, morphologically similar, savanna cytospecies, S. damnosum s.s. and S. sirbanum, have been identified from breeding sites close to known onchocerciasis foci. Near to the Uganda and Zaire borders it is very likely that other, less anthropophilic, cytospecies occur. Different Onchocerca-Simulium complexes (different strains of parasite with different pathogenicities transmitted by different vector species) may be responsible for the different severities of disease found in the 3 main areas of onchocerciasis in North, East and South-West Sudan. The localized, focal distribution of the communities seriously blinded by onchocerciasis, suggests that a strategy of tackling the disease on a focus basis may prove optimal. A control scheme, planned to treat all the vector breeding sites with insecticide, as in West Africa, would receive extensive invasion from the Zaire/Congo River Basin and the headwaters of the White and Blue Niles in neighbouring countries. While some foci are situated beside major river rapids, with vector breeding only controllable by regular insecticide treatments, several foci have been identified as lying close to removable man-made objects which provide excellent breeding sites at certain water levels e.g. causeways. The destruction of such breeding sites should be considered since localized vector control may produce substantial reductions in onchocerciasis transmission.

Animals↗
PubMed1986

Localized onchocerciasis vector control in the Bahr el Ghazal Region of South-Western Sudan. I. Precontrol.

Over a two year period, onchocerciasis vector biting and transmission rates were recorded from 11 sites within a 40 km radius of Wau, in the Bahr El Ghazal Region of South-Western Sudan. These data provide the baseline on which the efficacy of localized vector control in the third year of the study, has been assessed (Baker and Abdelnur 1986). During 1018 collection days, 59,660 Simulium damnosum s.l. vectors were attracted to man, 41,548 of which were dissected. 2.8% of the dissected flies were infective with head L3 Onchocerca with a mean of 2.4 head L3s per fly and a maximum of 19. Larval collections revealed that only Simulium sirbanum and S. damnosum s.str. were breeding in the study area. The results were analyzed to show the hourly, seasonal and annual patterns of biting and transmission. These patterns were found to be remarkably similar in both years even though vector biting and transmission was 24-28% lower in the second year. The sites could be divided into two groups. Those with Annual Transmission Potentials (ATPs) over 1000 lay beside fast flowing, well wooded stretches of river and those with ATPs below 500 lay near rivers flowing slowly in a wide grassy plain. Blinding onchocerciasis had been recorded only from the first group.

Animals↗