Biomedical subjects

S Ramel

Publications and source records attributed to S Ramel.

22 records · Page 2Linked to original sources

PubMed1992

Evaluation of p53 protein expression in Barrett's esophagus by two-parameter flow cytometry.

Barrett's esophagus is a condition in which the normal stratified squamous epithelium is replaced by metaplastic columnar epithelium that predisposes to the development of esophageal adenocarcinoma. Neoplastic progression in Barrett's esophagus occurs by a multistep process associated with genomic instability and the development of aneuploid cell populations. p53 protein overexpression and allelic deletions on chromosome 17p have been shown to be present in some Barrett's adenocarcinomas, but the stage in neoplastic progression at which p53 protein overexpression develops has not been investigated. To determine the stages in neoplastic progression at which p53 protein overexpression could be detected, biopsy specimens from patients with Barrett's esophagus at all stages of histological progression from Barrett's metaplasia negative for dysplasia to esophageal adenocarcinoma were investigated using a multiparameter flow-cytometric assay. p53 protein overexpression was found in 1 of 21 patients (5%) with Barrett's metaplasia negative for dysplasia, 2 of 13 patients (15%) with Barrett's metaplasia with abnormalities in the indefinite/low-grade dysplasia range, 5 of 11 patients (45%) with high-grade dysplasia, and 8 of 15 patients (53%) with Barrett's adenocarcinoma (P less than 0.01). p53 protein overexpression was found in 9% of patients with Barrett's esophagus who had neither high-grade dysplasia nor adenocarcinoma. Whether or not patients whose biopsy specimens show p53 protein overexpression are at increased risk for progression to adenocarcinoma can be determined by prospective endoscopic surveillance.

Adenocarcinoma↗

PubMed1991

17p allelic deletions and p53 protein overexpression in Barrett's adenocarcinoma.

Barrett's esophagus is a condition in which the stratified squamous epithelium of the esophagus is replaced by metaplastic columnar epithelium that predisposes to the development of esophageal adenocarcinoma. Allelic deletions of 17p and alterations of p53 including elevated p53 protein levels have been observed in many different tumors. To investigate the presence of 17p allelic deletions and p53 protein overexpression in Barrett's adenocarcinomas, we have combined the use of restriction fragment length polymorphism analysis, multiparameter flow cytometry, and DNA content cell sorting. The combined use of these methodologies permits the purification of aneuploid tumor cells for restriction fragment length polymorphism analysis of 17p allelic deletions and the evaluation of p53 protein expression by multiparameter flow cytometry in the same aneuploid tumor cell populations. We analyzed 15 aneuploid populations and one tetraploid populations from 13 Barrett's adenocarcinomas for 17p allelic deletions and p53 protein overexpression to determine whether both of these alterations are involved in carcinogenesis in Barrett's esophagus. Twelve of 13 tumors (92%) had 17p allelic deletions, and 8 of 13 tumors (62%) had p53 protein overexpression. Eight of the 12 tumors (67%) with 17p allelic deletions also had p53 protein overexpression. These data indicate that both 17p allelic deletions and p53 protein overexpression are frequently involved in carcinogenesis in Barrett's esophagus.

Adenocarcinoma↗

PubMed1990

Antireflux surgery. A surgeon's look.

With a reassessment of the antireflux barrier, we are gaining a better appreciation of the components of the barrier and their importance in preventing reflux. The GE valve in particular appears to play a key role in preventing reflux. With better understanding of the anatomy and function of the GE barrier, we should do a better job, both medically and surgically. The knowledge and new technology that are available should allow the surgeon to perform antireflux surgery with 95% good to excellent results with a minimum of morbidity. As our 15 to 20 year follow-up with a mean of 17.8 years shows, these good results will last over the long term. These observations should give the gastroenterologist confidence that antireflux surgery is highly effective for those patients who fail medical management.

Barrett Esophagus↗

PubMed1987

A retrospective study of 91 cases with gastroschisis or omphalocele 1956-1985.

The experiences of treatment of 91 infants with abdominal wall defects during thirty years are presented. The occurrence of gastroschisis increased during the last ten years. The results of treatment have improved markedly during the period of study but there is still a high mortality rate in children with omphalocele and multiple concomitant malformations and in children with gastroschisis and coexisting intestinal atresia. In cases with large omphalocele defects, if primary closure is not possible, an implant is recommended instead of silastic silo, skin flap closure or mercurochrome application. The clinical course in thirty-six patients during the last ten years is reported.

Abdominal Muscles↗