Influence of bupivacaine and morphine on human umbilical arteries and veins in vitro

Strips from human umbilical arteries and veins were prepared by microdissection. The vessel strips were mounted in tissue baths for isometric recording of contractile activity. The local anesthetic drug bupivacaine induced a concentration-dependent increase of tone in both artery and vein, whereas morphine had no effect. Nor did morphine influence the increase in vessel tone induced by bupivacaine. If applicable in vivo, the results suggest that morphine has little influence on umbilical vessel tone, whereas bupivacaine may reduce the umbilical blood flow, at least when the local concentration of bupivacaine exceeds a certain critical level. The addition of morphine to local anesthetics did not increase any adverse effects on the umbilical vessels in this study.     

Definition of terms and concepts applicable to clinical preventive medicine

This article defines the terms and concepts applied to the teaching of clinical preventive medicine by the Curriculum Development Project—a joint venture of the Center for Educational Development in Health (CEDH) at Boston University and the Association of Teachers of Preventive Medicine Foundation (ATPMF).Dr. Stokes is Professor of Medicine (Section of Preventive Medicine and Epidemiology), Boston University, Boston, MA 02118; Dr. Noren is Director (Administrative Medicine), University of Wisconsin, Madison, WI 53706; and Dr. Shindell is Professor and Chairman (Department of Preventive Medicine), Medical College of Wisconsin, Milwaukee, WI 53233.Supported in part by grants from the National Fund for Medical Education and the Kellogg Foundation.     

Farm tractor fatalities: the failure of voluntary safety standards.

There are no governmental standards for operator protection which require compliance by farm tractor manufacturers. To see how the Wisconsin farming population fares under voluntary safety standards, death certificate data were used to determine rates of tractor-associated fatal injuries. The injury deathrate associated with tractors on farms increased from 10.9 per 100,000 male farm residents during 1961-1965 to 13.6/100,000 during 1971-1975 (p less than .05). Deaths associated with overturning tractors were most common; with death rates of 6/100,000 male farm residents for 1961-1975. The rise in tractor-associated death rates shows that voluntary safety standards are not protecting the farm population. Rollover protective structures (ROPS) are designed to protect operators when tractors overturn but under voluntary safety standards these ROPS are sold only as optional accessory devices. Current Occupational Safety and Health Administration regulations which require ROPS for employees operating tractors do not protect self-employed farmers and their families. It is recommended that the government require all tractors sold to be equipped with ROPS as is currently the case in England and Sweden.     

Trunk rotation in scoliosis the influence of curve type and direction in 150 children

We compared the angle of trunk rotation (ATR) from scoliometer readings with Cobb angle measurements of the lateral deviation of the spine in 150 children referred to hospital for evaluation of scoliosis. the mean Cobb angle in thoracic curves was 16 °, in thoracolumbar curves 17° and in lumbar curves 20°. in thoracic curves and in right convex curves no patient with a Cobb angle of 25° or more had an ATR below 9°. in thoracolumbar and lumbar and in left convex curves, 7° ATR was occasionally associated with scoliosis of 25° or more. the correlation coefficient between the ATR and Cobb angle in right convex curves was 0.65 compared to 0.57 in left convex curves. We conclude that a criterion of 7° ATR for thoracic or right convex curves and one of 6° ATR for thoracolumbar and lumbar or left convex curves seem adequate for identification of patients with Cobb angles of 25° or more, which reduces the need for spinal radiography and follow-up outside the school screening programs.     

Tobacco habits among teenagers in the city of G?teborg, Sweden, and possible association with dental caries

Frome nine dental clinics within the Public Dental Service in the City of G?teborg, 2145 patients aged 14 to 19 answered a questionnaire concerning their tobacco habits. Tobacco was used in some form by 27 per cent of the patients and use increased with age. Smoking was more common among girls than among boys: 24 and 12 per cent, respectively. The statistical analyses showed that smoking as a habit and an increased number of cigarettes smoked per day are positively correlated with increases in the number of decayed, missing and filled teeth and the number of initially decayed proximal surfaces. Further, all caries epidemiological data were significantly higher among patients with tobacco habits compared to non-users. It can be concluded that there is a correlation between the tobacco habit and increased caries prevalence. However, dietary and oral habits have to be further elucidated before any definite conclusions can be made regarding the effect of the tobacco habit per se on the development of caries.     

Expression pattern of adhesion molecules (E-cadherin, alpha-, beta-, gamma-catenin and claudin-7), their influence on survival in primary breast carcinoma, and their corresponding axillary lymph node metastasis

Reduced intercellular adhesion is implicated in the development of metastasis. This study investigates the expression of intercellular adhesion molecules (E-cadherin, alpha-, beta-, gamma-catenin and claudin-7) and their influence on survival in primary breast carcinomas and corresponding axillary lymph node metastases (ALNM), and evaluates associations between them and with clinicopathological factors. The expression of adhesion molecules was analyzed immunohistochemically in tissues from 196 patients with primary invasive breast carcinomas and their nodal metastases (174 ductal and 22 lobular types). The expression was evaluated using semi-quantitative scoring of the intensity and proportion of immunoreactivity. All five adhesion proteins showed significantly reduced expression in primary ductal carcinomas with re-expression in ALNM (p<0.001). In uni- and multivariate analyses, the expression of E-cadherin in the primary tumours was a significant predictor of disease-free survival and distant disease-free survival. Thus, abnormal E-cadherin expression in the primary invasive breast carcinoma seems to be an independent prognostic biomarker in predicting a shorter survival in node-positive breast cancer patients. The results indicate that abnormal expression of the adhesion molecules in the primary tumours with re-expression in corresponding nodal metastases is a common event in breast ductal carcinomas and may play a central role in establishing metastasis.