Depot-specific differences in perilipin and hormone-sensitive lipase expression in lean and obese

<p>Abstract</p> <p>Background</p> <p>Mainly dependent on hormone-sensitive lipase, lipolysis is differently impaired between fat depots in human obesity. Perilipin A expression is a critical element in adipocyte lipolysis. The present study aimed at comparing expression and subcellular distribution of perilipin and hormone-sensitive lipase in two abdominal adipose tissues of lean and obese women. We examined whether regional differences in perilipin expression contribute to impaired lipolytic rates.</p> <p>Methods</p> <p>Abdominal subcutaneous and omental adipose tissues were obtained from six lean and ten obese women. We measured total protein content and relative distribution of hormone-sensitive lipase and perilipin proteins between lipid and non-lipid fractions in tissue homogenates. Hormone-sensitive lipase and perilipin mRNA levels, adipocyte size, basal (non-stimulated) and noradrenaline-stimulated lipolysis in isolated adipocytes were determined.</p> <p>Results</p> <p>Adipocytes were significantly larger in the obese versus the lean women and in subcutaneous versus omental fat. Expressed as a function of cell number, basal lipolysis and noradrenaline responsiveness were higher in subcutaneous versus omental adipocytes from the obese women (P < 0.05). Despite higher or identical mRNA levels in the lean and the obese subjects and in subcutaneous and omental tissues, perilipin protein expression was lower in both depots in the obese versus the lean women, and in subcutaneous versus omental in both lean and obese women (P < 0.05). Perilipin was mostly (above 80%) present in the lipid fraction in both depots from the obese patients and the value decreased to 60% in the lean subjects (P < 0.05). Perilipin protein expression was inversely correlated to adipocyte size and basal lipolysis in both depots. Despite higher mRNA levels, hormone-sensitive lipase protein expression decreased in both depots of the obese women. Regional difference for hormone-sensitive lipase was reported in lipid fraction of subcutaneous fat of the obese subjects: hormone-sensitive lipase content was twice as low as in omental adipose tissue.</p> <p>Conclusion</p> <p>In both fat depots, a reduced perilipin protein expression was observed in women obesity. Perilipin protein level may contribute to differences in basal lipolysis and in adipocyte size between fat depots and may regulate lipid accumulation in adipocytes. Differences in hormone-sensitive lipase subcellular distribution were reported between fat depots in the obese women.</p

Connected Surveillance for Detection of Complications After Early Discharge from Bariatric Surgery.

peer reviewedAs part of a bariatric enhanced recovery after surgery (ERAS) program, at-home follow-up using a novel Internet application was used to detect early complications. The study aimed to evaluate the safety and effectiveness of this "connected surveillance" protocol over a 10-day follow-up. Patients were monitored 24/7 by a trained nursing team with daily surgeon review of patient self-reports. Morbidly obese patients (n = 281) underwent OAGB (126, 47.70%) or sleeve gastrectomy (138, 52.3%). Of 264 who completed the study (mean age 40 years [20-66]), 3 (1.1%) underwent revision for early complications; there were 6 (2.1%) readmissions and 22 (8.3%) consultations. In a bariatric surgery ERAS program, "Internet-connected surveillance" proved safe and effective in detecting 100% of early complications, and most patients were satisfied with their care

Long-Term Outcomes After One-Anastomosis Gastric Bypass (OAGB) in Morbidly Obese Patients.

peer reviewed[en] BACKGROUND: One-anastomosis gastric bypass (OAGB) has gradually gained in popularity. Evidence of the validity of the technique and the quality of life in the longer term is scarce. The aim of this study was to retrospectively evaluate the longitudinal (≥ 5 years) safety, weight-loss efficacy, comorbid disease improvement, and quality of life of patients following OAGB. METHODS: Data from patients who underwent OAGB from January 2009 to December 2011 were retrospectively reviewed. Preoperative clinical characteristics and data through 8 years were analyzed. RESULTS: A total of 163 patients completed 5 to 8 years of follow-up with a mean age of 41 ± 11.4 years (22-65). Ninety-four patients (57.6%) had undergone prior bariatric surgery (gastric band). Mean body mass index (BMI, kg/m2) at the time of OAGB was 41.2 ± 6.5 (range 30.1-50.6). Twenty-one patients (13.0%) suffered from type 2 diabetes mellitus (T2DM), 59 (36.2%) hypertension, 31 osteoarthritis (19.0%), and 24 had obstructive sleep apnea (14.7%). At 5, 6, 7, and 8 years of follow-up, respective mean BMI reduction was 12.6 (n = 163), 11.8 (n = 100), 10.7 (n = 82), and 8.8 (n = 40). Respective mean excess weight loss was 81.8 ± 23.6%, 75.9 ± 20.8%, 69.1 ± 20.4%, and 62.3 ± 23.4%. All obesity-related comorbidities decreased significantly at follow-up time points. Five patients (3%) underwent laparoscopic reoperation within 90 days after surgery. Incidence of recurrent reflux was 14.0%. At a mean follow-up of 92 months (76-111), improved or greatly improved quality of life was reported by 86.0% of patients. CONCLUSION: OAGB provided very good weight loss, comorbidity improvement, and quality of life at follow-up of ≥ 5 years

Exploring the antimicrobial properties of dark-operating ceramic-based nanocomposite materials for the disinfection of indoor air

International audienceAs people spend more and more time inside, the quality of indoor air becomes crucial matter. This study explores the germicidal potential of two dark-operating germicidal composite materials designed to be applied for the indoor air disinfection under flow conditions. The first material, MnO 2 /AlPO 4 /γ-Al 2 O 3 beads, is a donor-acceptor interactive composite capable of creating hydroxyl radicals HO.. The second one is a ZnO/γ-Al 2 O 3 material with inter-cropped hexagons on its surface. To determine the antimicrobial efficiency of these materials in lifelike conditions, a pilot device was constructed that allows the test of the materials in dynamic conditions and agar diffusion inhibitory tests were also conducted. The results of the tests showed that the MnO 2 /AlPO 4 /γ-Al 2 O 3 material has a germicidal effect in static conditions whereas ZnO/γ-Al 2 O 3 does not. In dynamic conditions, the oxidizing MnO 2 / AlPO 4 /γ-Al 2 O 3 material is the most efficient when using low air speed whereas the ZnO/γ-Al 2 O 3 one becomes more efficient than the other materials when increasing the air linear speed. This ZnO/γ-Al 2 O 3 dark-operating germicidal material manifests the ability to proceed the mechanical destruction of bacterial cells. Actually, the antimicrobial efficiency of materials in dynamic conditions varies regarding the air speed through the materials and that static tests are not representative of the behavior of the material for air disinfection. Depending on the conditions, the best strategy to inactivate microorganisms changes and abrasive structures are a field that needs further exploration as they are in most of the conditions tested the best way to quickly decrease the number of microorganisms

The Acknowledgement of Indebtedness

La reconnaissance de dette se présente de prime abord comme un acte du quotidien des plus banals : un père prête à son fils une somme d’argent pour l’aider dans un projet, et celui-ci souscrit une reconnaissance de dette ; une succession s’ouvre, et l’on découvre une reconnaissance de dette dressée par le défunt ; un dirigeant de société signe une reconnaissance de dette pour l’activité de la société. Cette banalité induit une certaine évidence dans l’appréhension juridique de cet acte, et justifie probablement qu’aucune étude d’ensemble ne lui ait jamais été consacrée en doctrine. Une telle simplicité n’est pourtant qu’apparente. Les diverses qualifications juridiques que lui prête la doctrine en témoignent : acte unilatéral, contrat unilatéral à titre onéreux, acte déclaratif, acte récognitif, aveu, etc. Loin de constituer un questionnement purement théorique, déconnecté de la pratique, la qualification retenue pour la reconnaissance de dette emporte d’importantes conséquences sur le régime juridique qui lui sera appliqué. Est-elle soumise aux règles relatives aux vices du consentement du droit commun, ou de l’aveu ? Faut-il lui appliquer certains principes relatifs à la preuve, tel que celui de la loyauté ? Quelle capacité exiger de son auteur ? La récente réforme du droit des contrats a ajouté son lot de questionnements en supprimant la cause, grâce à laquelle la jurisprudence contrôlait l’existence d’une dette en matière de reconnaissance. Quel fondement utiliser pour contrôler cette existence en présence d’une reconnaissance de dette souscrite après le 1er octobre 2016 ? Pour répondre à l’ensemble de ces interrogations, la thèse se propose d’abord d’identifier la nature juridique de la reconnaissance de dette, qui semble se trouver quelque part entre la preuve et l’acte juridique. L’opération de qualification requerra d’adopter un autre regard sur ces deux notions, traditionnellement opposées, afin d’envisager l’éventualité d’une catégorie d’acte juridique présentant une qualité probatoire. Le régime juridique de la reconnaissance de dette pourra ensuite être bâti sur le socle de la qualification retenue, dans l’optique d’épouser les singularités de cet acte. Cette construction commandera souvent de résoudre les contradictions apparentes entre preuve et acte juridique.An acknowledgement of indebtedness has become one the banalest actions of everyday life: a father loaning his son some money for him to undertake a project, for which he would write a certificate of indebtedness; heirs finding out that the deceased person had written a certificate of indebtedness; a CEO writing a certificate of indebtedness to save their company… This banality implies some kind of obviousness in the way that this act would be acted upon legally. It probably explains why the doctrine has never researched it extensively. The apparent simplicity of dealing with the outcomes of certificates of indebtedness hides an uncovered process. The numerous legal qualifications given by the doctrine prove it: unilateral act, unilateral contract concluded for pecuniary interest, declarative act, acknowledging act, avowal, etc. Far from constituting a purely theoretical questioning, disconnected from practice, the qualification used for the consequences of dealing with an acknowledgement of indebtedness has important consequences on the legal regime that will be applied to it. Should it be bound to the rules relating to the defects of consent, or the avowal? Should certain principles relating to proof be applied to it, such as loyalty? How liable should the author of a certificate of indebtedness be? The recent reform of contract law has added its share of questions by removing the cause, thanks to which the case law controlled the existence of a debt in terms of recognition. What basis should be used to control this existence in the presence of an acknowledgement of debt subscribed after October 1st, 2016? To answer all these questions, this thesis first offers to identify the legal nature of the acknowledgement of debt, which seems to be somewhere between the proof and the legal act. The qualification operation will require adopting another look at these two notions, traditionally opposed, to consider the possibility of a legal acts category having a probative quality. The legal regime for the acknowledgement of debt can then be built based on the retained qualification, aimed to embrace the singularities of this act. This construction will often require resolving the apparent contradictions between the proof and legal acts

Intégration de l acupuncture en médecine occidentale (exemple de l aide médicale à la procréation)

L acupuncture est une approche médicale qui, bien que venue de l orient, est de mieux en mieux connue dans ses mécanismes d actions et repose sur des bases scientifiques solides. Aussi cette médecine s intègre parfaitement dans le cadre d une prise en charge multidisciplinaire, et une approche complémentaire à la médecine générale. Ce travail présente d une part, les recherches sur l état des connaissances du mécanisme d action de l acupuncture. Les aspects électriques, histologiques, neurologiques et endocriniens, ainsi que les notions de transduction et mécanotransduction sont abordés. D autre part ce travail évalue la place de l acupuncture dans le cadre des Fécondations in Vitro, à la lumières des études récentes. Ainsi que l utilisation de ce protocole d acupuncture, lors d une prise en charge multidisciplinaire en procréation médicale assistée, à Lyon, de janvier 2006 à décembre 2009. Les résultats ne montrent pas de différence statistique du taux de grossesse. Cependant les patientes décrivent une amélioration des effets secondaires des traitements hormonaux, et se sentent également en meilleure conditions physique et psychologique pour le transfert. En conclusion, les effets de l acupuncture ne peuvent être imputés au seul effet placebo. Des études de grande échelle et de bonne qualité doivent être mises en place dans le cadre de la recherche universitaire. Elle apporte un bénéfice non négligeable, aux patients, ainsi qu aux équipes médicales multidisciplinaires qui l intègrent.GRENOBLE1-BU Médecine pharm. (385162101) / SudocSudocFranceF