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Biomedical subjects

R Zollinger

Publications and source records attributed to R Zollinger.

13 recordsLinked to original sources
PubMed1997

[Psychotherapy with a boy with depression following the death of his 2 brothers].

The author describes the psychotherapy of about 2 1/2 years duration of a 14-year old boy. This psychodynamically oriented psychotherapy dealt with the aftermath of two disasters in his family: The accidental deaths of two older brothers five and four years ago. These events had a lasting effect on the family which negatively interfered with the achievement of developmental tasks in adolescence in the patient. He had erected massive defenses against his own wishes and became withdrawn and depressed. The main issues dealt with in therapy were: (a) The boys fear to step out of his position as the families "child" in consideration of his grieving mother. (b) The boy's difficulty to tolerate and integrate aggressive fantasies and feelings because of his guilt feelings and fear of another loss due to these fantasies and feelings. The working through of conflictual issues in psychotherapy enabled the boy to gain awareness regarding his own needs and wishes, and to find ways to fulfill them. Subsequently, he succeeded in making an adequate professional choice and to go into training for it.

Accidents, Traffic↗
PubMed1993

Pharmacokinetics of epoetin (recombinant human erythropoietin) after long term therapy in patients undergoing haemodialysis and haemofiltration.

After long term therapy with epoetin (recombinant human erythropoietin) 17 patients with end-stage renal disease (ESRD) were studied in 3 groups to assess pharmacokinetics during the intertreatment interval and during haemofiltration and dialysis treatment. Epoetin was measured by radioimmunoassay. After an intravenous bolus of epoetin 150 U/kg bodyweight, the half-life was 7.7h, steady-state volume of distribution was 0.066 L/kg and total plasma clearance was 5.4 ml/min. The mean steady-state serum concentration during multiple-dose administration was 656 U/L. The drug was not eliminated by haemofiltration or dialysis. Long term treatment of ESRD patients with epoetin does not significantly alter the pharmacokinetic profile of the drug. Epoetin dosage adjustment or substitution after haemofiltration and dialysis is not necessary.

Adult↗
PubMed1991

Not all nonpalpable breast cancers are alike.

Clinical and mammographic data of 1009 consecutive patients were correlated with histopathologic data of 1144 biopsy specimens of nonpalpable breast lesions to better define the presentation and biologic behavior of early breast cancer. Patients with malignant neoplasms (269 [24%] of 1144 specimens) were older (mean age, 62.1 years) than patients with benign lesions (mean age, 54.9 years). Furthermore, patients with invasive disease were older (mean age, 63.3 years) than patients with noninvasive disease (mean age, 58.5 years) with an overall increased risk of invasive cancer per year of 1.035. A 58% incidence of invasive cancer was detected for lesions characterized by calcifications, while the incidence of invasive cancer was 84% for isolated mass lesions (relative risk, 4.31 for masses). Isolated mammographic calcifications associated with cancer appeared in a younger population and were significantly associated with noninvasive ductal cancer. Breast cancer presenting as a mammographic mass appeared in an older group and was highly associated with the presence of invasive disease.

Adult↗
PubMed1990

Breast biopsy for calcifications in nonpalpable breast lesions. A prospective study.

We prospectively studied 239 consecutive patients who underwent breast biopsy for 277 nonpalpable lesions characterized by mammographic microcalcifications. Clinical and mammographic characteristics were correlated with histologic findings in an attempt to identify patients more likely to have early breast cancer. The distribution of clinical risk factors was equal between patients with benign or malignant outcomes. The predominant Wolfe pattern on mammography was P2 (38%); however, no relationship was observed between the Wolfe pattern and malignancy. A marked correlation was observed between malignancy and small lesions, more than 15 calcifications, and calcifications in a linear or branching pattern. Twenty-four percent (n = 67) of the biopsy specimens contained either ductal or lobular breast cancer. This study highlights the necessity of an aggressive approach toward suspicious calcifications found by mammography.

Biopsy↗
PubMed1990

Biopsy of the breast for mammographically detected lesions.

We prospectively studied 718 women who underwent biopsy of the breast for suspicious, mammographically detected mammary lesions in an attempt to identify key clinical risk factors, as well as roentgenographic characteristics associated with the appearance of early carcinoma of the breast. Patients with a benign outcome had an average age of 55 years versus 63 years for patients with carcinoma of the breast. Seventy-six per cent of these patients had no previous history of mammary problems, 20 per cent had a positive family history for carcinoma of the breast, 58 per cent were premenopausal and 21 per cent had used birth control pills. Except for age (p less than 0.001), the distribution of clinical risk factors was equal among patients with benign or malignant outcomes. Suspicious mammographic findings included mass lesions (53 per cent), calcifications (36 per cent) and the association of both (11 per cent). The predominant Wolfe pattern on mammography was P1 (36 per cent). No relationship was observed between Wolfe pattern and malignant conditions. In this group of patients, mammography was poorly specific; however, the positive predictive value increased with age and is related to the age-specific prevalence of carcinoma of the breast. Eight hundred and twenty-five lesions were removed. Twenty-five per cent (n = 203) of the specimens taken at biopsy contained carcinoma. Stellate mass lesions were highly suggestive of a malignant growth (p less than 0.0001). No relationship between the size of the suspicious mammographic mass and the malignant lesion was observed. A marked correlation (chi-square test with Yate's correction) was observed between malignant tumor and lesions with a linear or branching pattern, more than 15 calcifications, or small sized calcifications. The presence of a mass with calcifications was associated with carcinoma in 34 per cent. The incidence of invasive carcinoma was much higher for mass lesions (81 per cent) than for suspicious calcifications (56 per cent) (p less than 0.0001).

Adult↗
PubMed1983

[Pheochromocytoma and sympathetic paraganglioma. 2. Combination with typical associated diseases. Familial occurrence].

Of 48 patients with chromaffin tumors observed at the Institute of Pathology of the University of Zurich between 1971 and 1982, 10 (20.9%) had a typical associated disease: 6 patients (12.5%) had Sipple's syndrome, 2 von Recklinghausen's neurofibromatosis, and 2 others von Hippel-Lindau's disease. The origin common to all these disorders involves the neuroectoderm. In the presence of one of these diseases the possibility of an occult chromaffin tumor must be considered. Familial occurrence of chromaffin tumors was observed in 5 patients (10.5%): 3 (of two families) had Sipple's syndrome, while the other 2 (of one family) had neoplasms without associated diseases.

Adrenal Gland Neoplasms↗
PubMed1983

[Pheochromocytoma and sympathetic paragangliomas].

Between 1971 and 1982, pheochromocytomas and sympathetic paragangliomas from 48 patients were examined at the Institute of Pathology of the University of Zurich. Thirty-four specimens had been resected surgically while 14 were discovered at autopsy, i.e. in 0.072% of the 19610 autopsies performed during that period. There were 42 cases (87.5%) of pheochromocytoma, of which 14.6% were bilateral, and 6 cases (12.5%) of sympathetic paragangliomas. The average age of our patients was 37.8% years, but the first clinical signs of the sympathetic paragangliomas preceded those of the pheochromocytomas by 20 years. Of all chromaffin tumors, 12.5% were obviously malignant and were metastasizing. In the assessment of biologic behavior it is noted that a histologically malignant tumor need not follow a malignant course and that, conversely, a tumor of benign appearance may develop metastases. Hence, long-term clinical follow-up is indicated as well as careful histologic diagnosis. The second part of this study will deal with associated diseases such as Sipple's disease and various neurocutaneous syndromes, which were present in 20.9% of our cases, and also with familial chromaffin tumors without associated diseases.

Adrenal Gland Neoplasms↗
PubMed1982

The distribution of the glycosaminoglycans in the anatomic components of the lung and the changes in concentration of these macromolecules during development and aging.

The glycosaminoglycans of the normal human and bovine lungs and of the major structural components of these organs (pleura, 'alveoli', peripheral and central bronchi, arteries and veins) were investigated. To carry out this study, a micromethod for the separation and quantitative determination of these macromolecules, namely two-dimensional electrophoresis on cellulose acetate plates, was employed. This procedure made it possible to measure the content of each glycosaminoglycan present in the mentioned anatomic components. In the human lung the distribution of the glycosaminoglycans varies considerably from one component to another: dermatan sulfate was the predominant mucopolysaccharide of the pleura, chondroitin 6-sulfate that of the central bronchi, and heparan sulfate and chondroitin sulfate those of the alveoli. Heparin and keratan sulfate were not detected in any of the structural components. Significant changes in the mucopolysaccharide levels were found during maturation and aging. Further age-related changes were noted between 22 and 39 years. In the bovine lung significant changes in the glycosaminoglycan levels were also observed during growth and aging. Heparin appeared in the lung at an age between 1 and 16 months. Similarities and differences in the total contents and compositions of the glycosaminoglycans between the human and bovine lung were noted.

Adolescent↗
PubMed1982

Kaposi's sarcoma: endoscopic observations of gastric and colon involvement.

Kaposi's sarcoma is a multisystem neoplastic disease in which skin manifestations are usually seen first. Visceral involvement is frequent and the gastrointestinal tract is the most common location. We report a patient with Kaposi's sarcoma in whom the typical violaceous skin lesions were the sarcoma in whom the typical violaceous skin lesions were the only overt clinical manifestations, but the patient had multiple macular angiodysplastic-like lesions on colonoscopy. In contrast to the uniform appearance of the colonic lesions, polypoid, volcano, and maculopapular lesions were seen in the stomach on endoscopy. This report provides probably the first endoscopic description of the colonic lesions of Kaposi's sarcoma and contrasts them with the typical upper gastrointestinal lesions. A thorough gastrointestinal survey should be performed in all patients with Kaposi's sarcoma to delineate involvement, since appropriate treatment will be dictated by the presence or absence of visceral involvement.

Aged↗