Bladder cancer, 1992.

Although the incidence of bladder cancer has not changed in the last 40 years, treatment has greatly decreased morbidity. Invasive disease, however, remains fatal. Bladder cancer is not common in the general population, and current laboratory tests of urine are not adequate for screening the population at large. However, bladder cancer is not uncommon in certain high-risk groups, and urine studies in these patients can be helpful. Hematuria and/or an irritative voiding pattern in an elderly man or a patient otherwise at high risk for bladder cancer should be evaluated carefully. Fortunately, most bladder cancers are superficial when discovered and can be treated with local therapy with or without intravesicular chemotherapy. Cystectomy is still the treatment of choice for invasive disease, but preliminary reports of new methods of radiation therapy and chemotherapy show promising results.

Battered wife syndrome: overview and presentation in the office setting.

Spouse abuse is an under diagnosed entity in primary care. It is common in all social classes of both men and women. It is a cyclic phenomenon that tends to increase in severity and frequency. This article reviews the psychological factors of the man and the woman; the signs and symptoms of abuse; the reasons abused women stay or leave, and treatment modalities. Also discussed are the results of two studies performed by the authors. The first study was an anonymous survey of 218 women to determine the rate of spouse abuse to female patients in two family practice clinics. In the second study 14 clinic patients who volunteered for an interview were asked what they expected from their family doctor in regards to spouse abuse.

Rates of domestic violence against adult women by men partners.

This study examines the rate of domestic violence against adult women by men partners. Two hundred eighteen women at two primary care clinics responded anonymously to a questionnaire. Forty-eight percent reported verbal abuse, 44 percent minor physical abuse, and 28 percent severe physical abuse. Abuse was common (16 percent) before marriage. Respondents whose partners were reported to be chemically dependent or sexually abusive were at greater risk for verbal and physical abuse. Respondents with lower socioeconomic status were at increased risk for verbal and physical abuse, as were women whose partners had less formal education. Ages of respondents and partners were not significant factors in abuse. Boyfriends not cohabitating were the least abusive, while couples together for 4 to 6 years had more domestic violence than other couples. Because spouse abuse is common and the consequences are devastating, it is important that family physicians become astute in making this diagnosis and initiate early treatment.

Insulin-ricin B hybrid molecules: receptor binding and biological activity in a minimal-deviation hepatoma cell line.

Hybrid molecules were produced by covalently coupling the hormone insulin to the binding chain B of the plant toxin ricin. Binding of the insulin-ricin B hybrid to minimal-deviation hepatoma cells occurred primarily through ricin-specified cell-surface carbohydrates (galactose, N-acetylgalactosamine) since 125I-insulin-ricin B binding to cells could be 90% displaced by 50 mM lactose. [14C]Glucose incorporation into glycogen was maximally stimulated approximately 80% by insulin, whereas maximum stimulation by insulin-ricin B hybrid was greater than 100%. Ricin B chain alone was non-stimulating at concentrations tested (10(-9)-10(-7) M). Furthermore, the stimulation of [14C]glycogen labeling mediated by the hybrid was markedly inhibited by 1 mM lactose, while this sugar had no effect on the stimulation mediated by native insulin. Additionally, a preparation of ricin B shown to actively displace up to 80% of the binding of 125I-hybrid to cells also inhibited hybrid-mediated [14C]glycogen production. These results indicate that insulin-ricin B hybrid molecules possess toxin-specified binding abilities while evoking the insulin-associated cellular response of stimulated incorporation of [14C]glucose into glycogen. Such results thus suggest the possibility that alternate cell-surface receptors may play a role in conveying insulin's intracellular metabolic-control signals.