Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
1,621
result(s) for
"Leslie, D B"
Sort by:
Partitioning of adipose lipid metabolism by altered expression and function of PPAR isoforms after bariatric surgery
Background:Bariatric surgery remains the most effective treatment for reducing adiposity and eliminating type 2 diabetes; however, the mechanism(s) responsible have remained elusive. Peroxisome proliferator-activated receptors (PPAR) encompass a family of nuclear hormone receptors that upon activation exert control of lipid metabolism, glucose regulation and inflammation. Their role in adipose tissue following bariatric surgery remains undefined.Materials and Methods:Subcutaneous adipose tissue biopsies and serum were obtained and evaluated from time of surgery and on postoperative day 7 in patients randomized to Roux-en-Y gastric bypass (n=13) or matched caloric restriction (n=14), as well as patients undergoing vertical sleeve gastrectomy (n=33). Fat samples were evaluated for changes in gene expression, protein levels, β-oxidation, lipolysis and cysteine oxidation.Results:Within 7 days, bariatric surgery acutely drives a change in the activity and expression of PPARγ and PPARδ in subcutaneous adipose tissue thereby attenuating lipid storage, increasing lipolysis and potentiating lipid oxidation. This unique metabolic alteration leads to changes in downstream PPARγ/δ targets including decreased expression of fatty acid binding protein (FABP) 4 and stearoyl-CoA desaturase-1 (SCD1) with increased expression of carnitine palmitoyl transferase 1 (CPT1) and uncoupling protein 2 (UCP2). Increased expression of UCP2 not only facilitated fatty acid oxidation (increased 15-fold following surgery) but also regulated the subcutaneous adipose tissue redoxome by attenuating protein cysteine oxidation and reducing oxidative stress. The expression of UCP1, a mitochondrial protein responsible for the regulation of fatty acid oxidation and thermogenesis in beige and brown fat, was unaltered following surgery.Conclusions:These results suggest that bariatric surgery initiates a novel metabolic shift in subcutaneous adipose tissue to oxidize fatty acids independently from the beiging process through regulation of PPAR isoforms. Further studies are required to understand the contribution of this shift in expression of PPAR isoforms to weight loss following bariatric surgery.
Journal Article
Correction to: Partitioning of adipose lipid metabolism by altered expression and function of PPAR isoforms after bariatric surgery
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Journal Article
Laparoscopic conversion of vertical banded gastroplasty to a Roux-en-Y gastric bypass
The vertical banded gastroplasty was the mainstay of bariatric surgery for over a decade. Though this procedure is now rarely performed many of these patients will present with failure or maladaptive eating and its sequelae. Some of these patients who demonstrate the motivation for lifestyle modification as well as many of these with complications will be candidates for revisional surgery. This article reviews the technical challenges in performing these revisions using minimally invasive techniques. In addition it reviews outcomes of laparoscopic conversion and tips for patient selection and success.
Journal Article
Improving a Credit Recovery Program at the High School Level: An Action Research Study
The purpose of the study was to implement and examine an online credit recovery program as a possible route to expanding recovery options for students who fail mathematics classes at a high school to better address the dropout problem. The study compared the results of an online credit recovery program and a traditional credit recovery delivery method as measured by students' final scores and gathered information regarding how satisfied student and teacher participants were with the online credit recovery program at the high school level. Twelve students in Grades 9-12 at a high school in the Southern region of the United States were involved in this study. All students participated in an online Edgenuity credit recovery program in the area of mathematics for six weeks. The framework for this study was based on four perspectives of the learning environment: learner-, knowledge-, assessment-, and community-centered. The students in Grades 9 and10 enrolled in the online credit recovery program received a higher score than the students in Grades 9 and 10 enrolled in the traditional credit recovery course. The students in Grades 11 and 12 enrolled in the traditional credit recovery course received a higher score than the students in Grades 11 and 12 enrolled in the online credit recovery program. Based on the data compiled from the observations, it was evident that activities centered around learner, knowledge, assessment, and community took place. Teachers perceived the online credit recovery program as effective tool used to foster students' academic achievement. Overall, the perceptions of student and teacher participants of the online credit recovery program were favorable.
Dissertation
National Differences in Remission of Type 2 Diabetes Mellitus After Roux-en-Y Gastric Bypass Surgery-Subgroup Analysis of 2-Year Results of the Diabetes Surgery Study Comparing Taiwanese with Americans with Mild Obesity (BMI 30–35 kg/m2)
Background
The purpose of this study is to compare effects of different nations on Roux-en-Y gastric bypass (RYGB) vs. intensive medical management (IMM) in achieving remission of type 2 diabetes mellitus (T2DM).
Materials and Methods
Between April 2008 and December 2011, this randomized, controlled clinical trial was conducted at four teaching hospitals in the United States and Taiwan involving 71 participants with mild obesity (BMI 30–35 kg/m
2
). Thirty-six of 71 participants were randomly assigned to the RYGB group, and the others were in IMM group. Partial or complete remission of T2DM was defined as blood HbA1c < 6.5 % (48 mmol/mol) or <6 % (42 mmol/mol) without any antihyperglycemic medication for at least 1-year duration, respectively.
Results
At baseline, Taiwanese participants had a lower BMI, younger age, and shorter duration of T2DM than American participants. At 24 months, weight loss was greater in the RYGB group in both populations than in the IMM group. No IMM participant of either population had partial or complete remission of T2DM. In the RYGB group, a substantial proportion of the subjects achieved complete or partial remission (57 % in Taiwanese and 27 % in American participants,
P
= 0.08). Logistic regression revealed stimulated C-peptide (Odds ratio 2.22,
P
= 0.02) but not nationality as a significant predictor of diabetes remission.
Conclusion
Adding RYGB to lifestyle and medical management was associated with a greater likelihood of remission of T2DM in both Taiwanese and American subjects with mild obesity with type 2 diabetes. Residual beta-cell function at baseline appears to be the major factor predicting remission of T2DM.
Trial registry number:
clinicaltrials.gov
Identifier: NCT00641251
Journal Article