Roles
Professor of Medicine
ACOS/Research MVAHS
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Biography
Secondary School:
1966-1970 Somerset High School, Somerset, Massachusetts
College:
1973 A.B. Magna cum Laude
Boston University
(Combined 6-year program in liberal arts and medicine)
(See http://jama.ama-assn.org/content/235/24/2618.abstract)
Medical School:
1976 M.D., Boston University School of Medicine
Internship:
1976-1977 University of Miami Affiliated Hospitals
Straight Medicine
Residency:
1977-1979 University of Miami Affiliated Hospitals
Internal Medicine
Fellowship:
1979-1980 University of Miami Affiliated Hospitals
Pulmonary Fellowship
1980-1981 University of Miami School of Medicine
Pulmonary Research Fellowship, supported by NIH Training Fellowship HL 07283 and a Research Fellowship from the American Lung Association of Florida
1981-1983 Post-doctoral Research Associate
Institute for Environmental Medicine
University of Pennsylvania School of Medicine
Appointments:
1983-2003 Staff Physician, Pulmonary Section
Birmingham Veterans Administration
Medical Center, Birmingham, Alabama
1983-1989 Assistant Professor of Medicine
Division of Pulmonary and Critical Care Medicine
Department of Medicine and School of Medicine
University of Alabama at Birmingham
Birmingham, Alabama
1989-1998 Associate Professor of Medicine
Division of Pulmonary and Critical Care Medicine
Department of Medicine
University of Alabama at Birmingham
Birmingham, Alabama
1991-1992 Visiting Associate Professor (sabbatical leave)
Division of Allergy, Critical Care and Respiratory Medicine
Department of Medicine
Duke University
Durham, North Carolina
1996-2003 Associate Professor of Physiology and Biophysics
Department of Physiology and Biophysics
University of Alabama at Birmingham
Birmingham, Alabama
1998-2003 Professor of Medicine
Division of Pulmonary and Critical Care Medicine
Department of Medicine
University of Alabama at Birmingham
Birmingham, Alabama
2000-2003 Associate Professor of Environmental Health Sciences
University of Alabama at Birmingham
Birmingham, Alabama
1999-2003 Director, UAB-HSF IPF Clinical Program
University of Alabama at Birmingham and Kirklin Clinic
Birmingham, Alabama
Current Appointments:
2003-pres. Associate Chief of Staff for Research and Development
VAMC
Miami, Florida
2004- pres. Professor of Medicine
Division of Pulmonary and Critical Care Medicine
University of Miami School of Medicine
Miami, Florida -
Education & Training
Education
Post Graduate Training
Licensures and Certifications
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Honors & Awards
No result found
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Teaching Interests
Every month, I teach residents and pulmonary fellows during rounds and in clinics. Yearly, I present formal lectures on ILD to second year medical students and physiology lectures to pulmonary fellows. I have served on a number of Masters and Doctoral thesis committees and formally advised degree candidates. In addition, I am a NAUI certified SCUBA and Nitrox Instructor teaching skills useful in scientific diving. -
Research Interests
My early publications directly addressed the mechanisms by which organisms, cells and organelles adapted to oxidant stress and overcame oxidative injury. These studies used often overlooked models of adaptation to stress to understand underlying mechanisms that led to survival in ozone, hyperoxia and during reoxygenation after hypoxia. Specifically, we found that hypoxia often down regulated cellular antioxidant defense mechanisms, while adaptation to oxidative stress was attributable to an up regulation of cellular antioxidant defenses. These basic studies led directly to the mechanisms of lung hypoxia-reoxygenation injury in mammals. Evidence derived from these studies has led (in part through an associated NIH RFA) to recognition of the clinical importance of lung hypoxia-reoxygenation injury, especially after trauma or lung transplantation.
I worked extensively with collaborators to elucidate how lung metabolic functions responded to acute and chronic hypoxia, focusing on the renin-angiotensin-aldosterone system and modulation of atrial natriuretic peptide (ANP). These studies built on observations that the lung vascular endothelium was metabolically active (e.g., converting angiotensin 1 to angiotensin 2) and that hypoxia and/or oxidative stress might impair normal endothelial homeostasis. These studies emphasized lung vascular function in isolated, perfused lungs in which we could assess peptide and lipid metabolism and precisely identify the role of ANP in regulation of pulmonary vascular resistance in hypoxia. These studies have proved durably relevant to patients with IPF, in whom pulmonary artery hypertension is common and brain natriuretic peptide has been shown by us to be elevated and to increase with exercise and accompanying hypoxemia.
The subsequent phase of my preclinical investigations focused on cellular mechanisms that regulate antioxidant defenses during hypoxia and reoxygenation. These basic studies are directly related to the proposed experiments that would elucidate how muscle tissue hypoxia (resulting from exercise-induced hypoxemia) and resulting oxidative stress limit the ability of patients with IPF and other ILD to exercise. In vitro cellular models including primary isolates of alveolar type 2 epithelial cells and related cell lines showed clearly that both hypoxia and oxidative stress modulated mitochondrial superoxide dismutase (MnSOD) and further revealed mechanisms (e.g., oxidative inhibition of Complex I) that impaired mitochondrial respiration. -
Publications
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Copyrights & Patents