Search PubMed⌕ Search

Biomedical subjects

John T Moore

Publications and source records attributed to John T Moore.

21 records · Page 2Linked to original sources

Nuclear receptor regulation of genes involved in bile acid metabolism.

Over the past few decades, the nuclear receptor superfamily of transcription factors has provided many opportunities for therapeutic intervention in a variety of pathophysiological conditions. A major question now is how many additional drug targets can be identified within this class of proteins. Advances in differential gene expression (DGE) technologies allow powerful new approaches to answer this question. Although DGE analysis is but one of several modern approaches to target identification, it is especially pertinent for nuclear receptors because many of these proteins are ligand-regulated transcription factors that directly alter gene expression. This article will focus on recent DGE experiments that have elucidated the physiological role of nuclear receptors in regulation of the bile acid biosynthesis, transport, and metabolism in the liver. Of particular relevance is the role of nuclear receptors in regulating CYP7A1 because this gene encodes the enzyme controlling the first and rate-limiting step in cholesterol degradation to bile acids. Modulation of CYP7A1 expression could provide a therapeutic benefit for multiple disease conditions. This article will focus on the relative contributions of farnesoid X-activated receptor, liver receptor homologous protein-1, small heterodimer partner, pregnane X receptor, and liver X receptor to the regulation of this specific gene, and bile acid metabolism in general. These studies highlight the dynamic interplay between nuclear receptors in the regulation of specific metabolic pathways.

Bile Acids and Salts↗

Hand-assisted laparoscopic splenectomy: indications and technique.

INTRODUCTION: Laparoscopic splenectomy has become the procedure of choice for those patients who need to have a splenectomy. The skills required to perform a laparoscopic splenectomy are not easy to learn and therefore may limit the availability of this procedure to patients. METHODS: We present a hand-assisted technique that allows the performance of a laparoscopic splenectomy safely and rapidly by surgeons without a great deal of experience with this procedure. RESULTS: A laparoscopic hand-assisted splenectomy was performed by a chief resident who had not performed this procedure before. The operative time was comparable to that of a laparoscopic splenectomy performed by an experienced laparoscopic surgeon at our institution (65 vs 62 min). CONCLUSIONS: The hand-assisted technique is useful in a number of laparoscopic situations. We suggest that hand-assisted laparoscopic surgery might be used as an adjunct for surgeons with limited laparoscopic experience and for residents who are learning advanced laparoscopic skills.

Adult↗

Laparoscopic suturing and knot tying: a comparison of standard techniques to a mechanical assist device.

BACKGROUND: Suturing and knot tying are basic skills for surgeons. Performing these tasks laparoscopically can be a tedious, time-consuming endeavor associated with much frustration. We evaluated a mechanically assisted suture and pretied knot device (Quik-Stitch) for performing the basic tasks of suturing and knot tying. METHODS: We performed a time study using 1) intracorporeal suturing and knot tying, 2) intracorporeal suturing and extracorporeal knot tying, and 3) a mechanically assisted suture and pretied knot device (Quik-Stitch). From September 2000 through March 2001, time trials were conducted using each of the different techniques. Three attending surgeons, one with much experience and 2 with less experience, and 2 chief residents, with the least experience, participated in the study. RESULTS: For the experienced surgeon, the average times for intracorporeal knot tying, extracorporeal knot tying, and knot tying with Quik-Stitch were 97.3, 103.9, and 67.7 seconds, respectively. For the less experienced surgeons, the times were 237.2, 224.3, and 92.5 seconds, respectively. For the least experienced group, the times were 265.3, 263.0, and 128.7 seconds, respectively. CONCLUSIONS: The mechanically assisted suture device and pretied knot (Quik-Stitch by PARE Surgical, Inc, Englewood, CO, USA) provides significant time-saving to surgeons regardless of experience and thus reduces operating room costs. Less experienced surgeons and surgeons in training benefited the most by the use of this device.

Humans↗