Michael F Angel

University of Mississippi Medical Center, Jackson, MS, United States

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Publications (27)28.99 Total impact

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    ABSTRACT: In microsurgical flap procedures, creation of an arteriovenous fistula (AVF) is a technique of vein grafting where the vein graft is connected to recipient vessels as a flow-through loop prior to harvest and inset of the flap. Controversy exists whether this technique can be used as a 2-stage procedure with the loop and flap transfer accomplished in sequential operations or if the loop and flap transfer should be performed in a single operation. We performed 12 consecutive 1-stage AVF-flap procedures, with 1 flap failure. We combined this series with previously published reports to compare outcomes of 1-stage and 2-stage procedures. We found no significant difference in flap outcomes or complication rates between the 2 strategies. We conclude from our experience and this analysis that single-stage AVF-flap procedures are the optimum application of this technique.
    Annals of Plastic Surgery 02/2007; 58(1):61-3. · 1.38 Impact Factor
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    ABSTRACT: The radial forearm flap has been used for reconstruction of the cervical esophagus most often as a patch or for circumferential repair of short defects (less than 5 cm). In the following three cases, the radial forearm flap was used to reconstruct circumferential cervical esophageal defects ranging from 5 to 12 mm in length. These procedures were successfully carried out in three patients in whom the intraoperative defect was unexpectedly large or the intra-abdominal viscera harvest would have been difficult. These patients had reliable esophageal function 8 to 24 months after surgery. We conclude that the radial forearm flap can be used for reconstruction of large circumferential defects of the cervical esophagus.
    Journal of Craniofacial Surgery 04/2006; 17(2):382-7. · 0.69 Impact Factor
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    ABSTRACT: In cases of severe macromastia, the free nipple graft technique has been the traditional alternative to pedicle transposition. Distress over nipple survival in large reduction mammaplasty and long pedicle transposition is largely responsible for this.A retrospective investigation of the records of 142 reduction mammaplasty patients was carried out to determine whether nipple survival or overall complication rates were significantly different in patients undergoing larger (>1500 g per side) as compared with smaller reductions (< 1500 g per side). The 2 patient groups were compared with respect to mild or severe complications. Data were analyzed using Fisher exact test and 2-sample t tests. A P value of < 0.05 was considered statistically significant. No patient in either group had total nipple loss. There were no statistically significant differences in major or minor complications between the 2 groups. In our experience, the inferior pedicle, Wise pattern reduction is a reliable and predictable method of reduction, appropriate for all breast sizes and pedicle lengths.
    Annals of Plastic Surgery 10/2005; 55(3):245-9. · 1.38 Impact Factor
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    ABSTRACT: We investigated the changes in the properties of water when exposed to sunlight for 40 days. We hypothesize and prove that solar irradiation to water entraps electromagnetic radiation as potential energy, which becomes kinetic energy in various systems. It is postulated that photochemically-induced energy transfers, associated with individual spectral emission of visible spectrum of solar light, exert diverse influences on biological systems. Bottles of distilled water, individually wrapped in spectral-colored cellophane were exposed to sunlight and compared to an unwrapped bottle to determine chemical and physical changes as well as modifications of biological properties. Each bottle of water was named according to the color of cellophane paper with letter E (stands for exposed) as a prefix with (E-violet, E-indigo, E-blue, E-green, E-yellow, E-orange, and E-red). E-control (without wrap) was exposed to polychromatic sunlight. This study addresses two main issues viz., the chemical and physical changes in E-water and its effect on biological activities. Chemical and physical composition analysis using inductively coupled plasma atomic emission spectrometry; physical conductance by a Wheatstone Bridge type conductivity meter; osmolarity by a vapor pressure osmometer; and, salt solubility profile of 10% sodium bicarbonate were determined. Furthermore, testing the effect of E-waters on human lymphocyte proliferation, mosquito larvae hatching and seed germination determined the functional role of solar radiation through specific spectrum/s of visible light on various biological processes. We found that water exposed to visible spectral emissions of sunlight had an altered elemental composition, electrical conductance, osmolarity and salt-solubility, as well as differences in bio-modulatory effects. A gradual increase in leaching of Boron from E-violet to E-red was noted. E-indigo showed maximal increase in electrical conductance and maximal salt solubility of sodium bicarbonate. E-blue inhibited phyto-hemagglutinin-induced immune cell proliferation and mosquito larvae hatching. E-orange stimulated root elongation in seed germination. We conclude that 40-day exposure of water to specific solar spectrum changes chemical and physical properties and influences on biological activity.
    International journal of environmental research and public health 09/2005; 2(2):219-27. · 1.61 Impact Factor
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    ABSTRACT: In Eastern cultures, such as India, it is traditionally recommended that women but not men cover their heads while working in the scorching sun. The purpose of this pilot study was to determine whether there was any scientific basis for this cultural tradition. We examined the differential cytotoxic effects of ultraviolet A light (UVA) on an established T cell line treated with female and male sex hormones. CD4+ Jurkat T cells were plated in 96 well plates at 2 x 106 cells/ml and treated with 17beta-estradiol (EST) or testosterone (TE). These cells were irradiated by UVA light with an irradiance of 170 J/cm2 for 15min at a distance of 6 cm from the surface of the 96-well plate. Controls included cells not treated with hormones or UVA. The effects of EST and TE were investigated between 1 and 20 ng/mL. Cytotoxicity by fluorescein-diacetate staining and COMET assay generating single strand DNA cleavage, tail length and tail moment measurements were examined. The effect of estrogen (5ng/mL) on apoptosis and its mediators was further studied using DNA laddering and western blotting for bcl-2 and p53. We found that EST alone, without UVA, enhanced Jurkat T cell survival. However, EST exhibited a dose-related cytotoxicity in the presence of UVA; up to 28% at 20 ng/ml. TE did not alter UVA-induced cytotoxicity. Since TE did not alter cell viability in the presence of UVA further damaging studies were not performed. COMET assay demonstrated the harmful effects of EST in the presence of UVA while EST without UVA. had no significant effect on the nuclear damage. Apoptosis was not present as indicated by the absence of DNA laddering on agarose gel electrophoresis at 5ng/ml EST or TE +/- UVA. Western blot showed that estrogen down regulated bcl-2 independently of UVA radiation while p53 was down regulated in the presence of UVA treatment. EST and TE have differential effects on UVA-induced cytotoxicity in Jurkat T-lymphocyte which suggested that women may be more susceptible to the harmful effects of solar irradiation than men.
    International journal of environmental research and public health 05/2005; 2(1):156-63. · 1.61 Impact Factor
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    ABSTRACT: In Eastern cultures, such as India, it is traditionally recommended that women but not men cover their heads while working in the scorching sun. The purpose of this pilot study was to determine whether there was any scientific basis for this cultural tradition. We examined the differential cytotoxic effects of ultraviolet A light (UVA) on an established T cell line treated with female and male sex hormones. CD4+ Jurkat T cells were plated in 96 well plates at 2 x 106 cells/ml and treated with 17β-estradiol (EST) or testosterone (TE). These cells were irradiated by UVA light with an irradiance of 170 J/cm2 for 15min at a distance of 6 cm from the surface of the 96-well plate. Controls included cells not treated with hormones or UVA. The effects of EST and TE were investigated between 1 and 20 ng/mL. Cytotoxicity by fluorescein-diacetate staining and COMET assay generating single strand DNA cleavage, tail length and tail moment measurements were examined. The effect of estrogen (5ng/mL) on apoptosis and its mediators was further studied using DNA laddering and western blotting for bcl-2 and p53. We found that EST alone, without UVA, enhanced Jurkat T cell survival. However, EST exhibited a dose-related cytotoxicity in the presence of UVA; up to 28% at 20 ng/ml. TE did not alter UVA-induced cytotoxicity. Since TE did not alter cell viability in the presence of UVA further damaging studies were not performed. COMET assay demonstrated the harmful effects of EST in the presence of UVA while EST without UVA had no significant effect on the nuclear damage. Apoptosis was not present as indicated by the absence of DNA laddering on agarose gel electrophoresis at 5ng/ml EST or TE ± UVA. Western blot showed that estrogen down regulated bcl-2 independently of UVA radiation while p53 was down regulated in the presence of UVA treatment. EST and TE have differential effects on UVA-induced cytotoxicity in Jurkat T-lymphocyte which suggested that women may be more susceptible to the harmful effects of solar irradiation than men.
    International Journal of Environmental Research and Public Health. 01/2005;
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    ABSTRACT: The induction of endogenous vascular endothelial growth factor (VEGF) production in the skin flap with ischemic injury and the effect of exogenous VEGF on survival of the ischemic skin flap were studied in rats. A dorsal flap model (3x10 cm(2)) was used in this study. In Part I, biopsies were taken from the flap at 2.5, 5.5, and 8.5 cm distances from the distal edge at 0, 6, 12, and 24 h after the flaps were sutured. Malonyldialdehyde (MDA) and VEGF(165) protein level were measured. In Part II, exogenous VEGF (1 microg/ml) was injected subdermally into the flaps in 14 rats before the flaps were replaced. Flaps that received a saline injection were used as the controls. The skin paddle survival was measured on postoperative day five. The results showed that the MDA level in the distal part of the flap significantly increased at 24 h postoperatively when compared to MDA in other parts of the flap. However, VEGF levels in the distal part of the flap significantly decreased when compared to the middle part of the flap. Subdermal injection of exogenous VEGF to the distal area of the flap could significantly improve survival of the distal flap (89% of total skin paddle) when compared to the control, which had a 64% mean percent survival. We conclude that production of endogenous VEGF protein is significantly increased in the skin flap with mild ischemia, but decreased in the flap with severe ischemia. Administration of exogenous VEGF could significantly enhance survival of ischemic flaps.
    British Journal of Plastic Surgery 11/2003; 56(7):653-9. · 1.29 Impact Factor
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    ABSTRACT: The effects of static electromagnetic fields (SEFs) on MG-63, a human osteoblast cell-line, were investigated. We examined proliferation, proline uptake and gene expression in an SEF approximately 1/728th the intensity of those previously reported. Cells were placed within an SEF apparatus (average field intensity of 0.618mT) with appropriate controls. Proliferation was measured by 3H-thymidine incorporation and showed a 34% decrease in cells exposed to SEF (P = .0001; N = 3). Proline, a major component of collagen necessary for bone formation by osteoblasts, incorporation was reduced 37% (P = 0.006; N = 3). Reverse-transcription-polymerase chain reaction revealed that collagen I, alkaline phosphatase, parathyroid hormone-receptor, and osteocalcin mRNA's were down regulated with the low intensity SEF. Exposure to very low SEFs affects the MG-63 osteoblasts in a manner that may be detrimental to bone formation.
    Biomedical sciences instrumentation 02/2003; 39:454-9.
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    ABSTRACT: Abstract: Oxidative stress is implicated in HIV-infection. It has been suggested that plant antioxidants may offer protection from viral replication and cell death associated with oxidative stress in patients with HIV/AIDS. Because of inherent antioxidant properties of turmeric (T) and its derivatives, water-soluble extract turmerin (Tm) and lipid soluble curcumin (Cu), their potential efficacy as anti-HIV drugs were examined. Cell viability and p-24 antigen release by CEMss-T cells (1 x 105 cells/ml) infected with HIV-IIIB strain, used as an acute model of infection, were tested in the presence of 3’azido-3’deoxythmidine (AZT). Proliferative responses of human mononuclear cells derived from HIV patients (chronic model) stimulated with phyohemagglutinin (PHA), concanavalin A (ConA), and pokeweed mitogen (PWM) were also examined in the presence of AZT and Tm. In the infection assay, T, Tm and Cu individually did not reduce p-24 antigen release or improve cell viability. AZT (5μM) + Tm (800 ng/ml) inhibited infection by 37 % and increased cell numbers by 30%; whereas, Tm (80 ng/ml) inhibited infection by 26% and increased cell number by 60%. In the proliferation assay, lymphocytes from HIV-infected patients showed better inhibition of mitogen responsiveness to Tm (800 ng/ml) when compared to AZT at 5 μM or Tm at 80 ng/ml. Turmerin inhibited HIV-infected T-cell proliferation and, in combination with AZT, decreased T-cell infection and increased cell viability. These data provide evidence suggesting that efficacious anti-HIV therapy may be possible using lower, less toxic doses of AZT in the presence of turmerin.
    International Journal of Molecular Sciences. 01/2003;
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    ABSTRACT: Abstract: Ion transport enzymes may play an important role in T cell activation. This study investigates the role of turmeric and its individual components, turmerin-and curcumin-on Ca2+ and Na/K+ adenosine triphosphatases (ATPase) in the course of T cell activation. Concanavalin A (Con A) stimulated human blood mononuclear T cell proliferation paradigm was investigated for 3, 5 and 7 day periods with different concentrations of turmeric, curcumin and turmerin. Con A-stimulated cells treated with turmeric (250, 50, 5 μg/ml) for 3 and 5 days inhibited ATPase levels when compared to base levels obtained by cells in media alone. At day 7, there was a 3-fold increase for Ca2+ATPase levels and a 2-fold increase for Na/K+ATPase. Curcumin (250, 50, 5 μg/ml) showed the same pattern for ATPase activity as turmeric at 3 and 5 days with a 2-fold increase at day 7. Turmerin (2500, 1250, 250, 25 ng/ml) for Na/K+ ATPase activity showed an increase at day 3, a decrease on day 5, and a 2-fold increase on day 7. Ca2+ ATPase activity in the presence of turmerin showed an increase in ATPase levels at day 3 (except at 2500ng/ml where it decreased) and a decrease in day 5 (except at 25 ng/ml where it increased). Turmeric and curcumin generally inhibited Ca2+ATPase and Na/K+ATPases in early (day 3) and intermediate (day 5) stages of mitogen stimulation. However, the effect after 7 days incubation for turmeric, curcumin and turmerin showed a marked increase up to three fold.
    International Journal of Molecular Sciences. 01/2003;
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    ABSTRACT: Aeromonas hydrophila infection has been described as the cause of necrotizing fasciitis in patients with suppressed immune systems, burns, or trauma in an aquatic setting. We report a case in which severe necrotizing fasciitis involving hand, arm, chest, and lateral side of trunk, along with toxic shock, developed after the patient was bitten by a venomous snake. Mixed aerobic and anaerobic bacteria, including A hydrophila, were isolated from the wound culture. The patient was treated with antivenom, a diuretic regimen, broad spectrum antibiotics, and 18 separate surgical procedures. After the application of skin grafts, the wound completely healed. This case illustrates that a venomous snakebite may result in infection with A hydrophila and can cause severe necrotizing fasciitis. Early and aggressive surgical intervention should be implemented as soon as the necrotizing fasciitis is diagnosed.
    Southern Medical Journal 10/2002; 95(9):1090-4. · 0.92 Impact Factor
  • Jeffrey Caplan, Michael Angel, Andrew Parent
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    ABSTRACT: Encephalocele is a rare late complication of craniosynostosis repair. An undiagnosed nick to the dura is the etiology of this complication. It usually presents within a few months to years after repair. This case report describes a patient with Crouzon's Disease who had a craniosynostosis repair as an infant and presents 22 years later with an encephalocele. The patient had a thorough physical exam, 2D, and 3D CT Scans as a preoperative workup. Surgical intervention included repair of the encephalocele, cranialization of the frontal sinus with bone grafting, and Lefort III osteomies for mid face advancement. The patient benefited from a two-team simultaneous approach between Neurosurgery and Plastic Surgery. The patient also benefited from an aggressive one-stage repair of all her defects and deformities.
    Journal of Craniofacial Surgery 08/2002; 13(4):501-4. · 0.69 Impact Factor
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    ABSTRACT: It has been observed previously that a hematoma affects skin flap survival adversely through free radical action. The current study was undertaken to determine whether similar mechanisms are operative in skin grafts. The experiment was divided into two parts. During part I, 2 x 2 cm2 split-thickness skin grafts (STSGs) were harvested from 18 Fischer rats and were divided randomly into three groups (each consisted of six grafts), and incubated with plasma, blood, and blood plus 70 mg deferoxamine for 48 hours respectively. Tissue samples were assayed for lipoperoxidation (malondialdehyde [MDA]), superoxide dismutase (SOD), and nitric oxide synthase (NOS). During part II, 36 STSGs were harvested and were divided randomly into three groups. The grafts were incubated as in part I for 48 hours. The STSGs were then affixed to the same dimension recipient beds created on the back of 36 inbred rats. Survival was evaluated 7 days postoperatively. The results showed that there was no significant difference in MDA and NOS levels between each incubated graft group in part I. Only the SOD level in both grafts incubated with plasma and blood plus deferoxamine were significantly higher than the grafts over blood alone (p < 0.05). During part II, there was no significant difference of the average STSG survival percentage between the groups incubated with blood and blood plus deferoxamine (35.8 +/- 6.5% and 52.0 +/- 9.5%). The survival percentage of the group incubated with plasma was 81.8 +/- 7.3%, which was significantly higher than the other two groups (p < 0.01). The authors concluded that unlike a distal flap model, the pathological importance of free radicals in survival of the STSG over a hematoma is insignificant. A more likely hypothesis, as suggested by others, is that a hematoma serves as a barrier preventing angiogenesis.
    Annals of Plastic Surgery 07/2002; 48(6):665-9. · 1.38 Impact Factor
  • Joel Beck, Andrew Parent, Michael F Angel
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    ABSTRACT: Rigid fixation has been used over the past 20 years for the long-lasting correction of traumatic and congenital craniofacial defects. It has been noted that the use of plates and screws can result in the migration of the hardware through the skull to the inner cerebral cortex where it embeds in the dura. In addition, there is controversy concerning the safety of using titanium plates in the pediatric population. We report here on an 8-year-old boy who presented to our clinic with a chronic headache after rigid craniofacial fixation using titanium plates 7 years before.
    Journal of Craniofacial Surgery 04/2002; 13(2):327-30. · 0.69 Impact Factor
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    ABSTRACT: The potential for hyperbaric oxygen therapy (HBO) to decrease the untoward effects of a secondary ischemic event was studied in the rat superficial epigastric flap model. The secondary venous ischemic flap was created by cross-clamping the vascular pedicles for 2 h. Twenty-four hours later, the flap was reelevated and the venous pedicle was occluded for 5 h. Thirty-two rats were divided into three groups. In experimental group 1, animals received HBO treatment immediately prior to the initial flap elevation and ischemia at 2 atmosphere pressures for 90 min. In experimental group 2, the rats underwent a similar course except for a second 90-min HBO course immediately prior to the secondary venous occlusion. The rats without HBO therapy were used as controls. The results showed that all control flaps were nonviable at 1 week by clinical inspection and fluorescein injection. Complete flap survival occurred in 20% of group 1 flaps and 30.8% of group 2 flaps. Partial flap survival occurred in the rest of the flaps in these two groups, with mean survival areas of 48% and 55%, respectively. In conclusion, HBO treatments significantly increase the survival of flaps subjected to a secondary ischemia, even if administered before the primary ischemia. Administering HBO prior to secondary venous ischemia was marginal, which may be due to the effect of O(2) given by HBO not lasting longer than 5 h.
    Microsurgery 02/2002; 22(2):49-52. · 1.62 Impact Factor
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    ABSTRACT: In total, 41 consecutive patients with "idiopathic carpal tunnel syndrome" and abnormal electrophysiologic findings who underwent carpal tunnel release were studied prospectively. The focus of this investigation was the evaluation of the levels of specific chemical mediators within the serum and flexor tenosynovium of these patients. Blood was collected from these patients within 1 week prior to carpal tunnel release, and flexor tenosynovium was obtained at time of surgery. Specimens were then analyzed to determine the levels of interleukins 1 and 6, prostaglandin E(2) (PGE(2)), and malondialdehyde bis diethyl acetal. These values were compared to those of controls who had no evidence of carpal tunnel syndrome. A significant increase was noted in the serum malondialdehyde and tenosynovial levels of malondialdehyde, interleukin 6, and prostaglandin PGE(2) compared to controls. The elevated levels of these biologic factors and the absence of interleukin 1 elevation support a noninflammatory ischemia-reperfusion etiology for so-called "idiopathic carpal tunnel syndrome" that causes progressive edema and fibrosis of the tissues within the carpal canal. These findings correlate with previous histopathology reports. We believe that "idiopathic carpal tunnel syndrome" is an "-osis" not an "-itis."
    Microsurgery 02/2002; 22(8):378-85. · 1.62 Impact Factor
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    ABSTRACT: The effect of exogenous vascular endothelium growth factor (VEGF) on the survival of the distal skin paddle with early pedicle division was studied in a rat tubed pedicle flap model. In part I, tubed pedicle skin flaps were created on the backs of 14 rats. The pedicle was divided after an interval of 3, 4, 5 or 7 days, and the survival area of each distal skin paddle was measured 5 days after the pedicle was divided. The percentages of survival were 0, 24.9%, 89.9% and 100%, respectively. In part II, tube flaps were created in 20 rats. In the experimental group, 2 ml of VEGF (50 microg ml(-1)) was injected into the recipient bed during tube flap creation in each rat. In the control group, 2 ml of saline was given. The tubed pedicle was divided 4 days after creation. The mean survival area of the distal skin paddle in the group treated with VEGF was 7.32 +/- 1.36 cm(2) (80.91%) at 5 days after pedicle division, which was of statistical significance when compared with the survival in the control group of 2.70 +/- 1.89 cm(2) (27.9%). The histology showed angiogenesis at the skin paddle-recipient bed interface following VEGF injection. These results demonstrate that the subcutaneous administration of VEGF into the recipient bed of the tube flap transfer can induce angiogenes is at the junction between the donor and the recipient bed, and improve skin paddle survival with early pedicle division.
    British Journal of Plastic Surgery 02/2002; 55(1):59-63. · 1.29 Impact Factor
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    ABSTRACT: Abstract: The objective of this study is to determine if arterial endothelial injury can be attenuated by local application of 80 μg/ml turmerin at the site of injury and by oral administration of the same dose. Anesthetized Lewis rats (n =12) weighing 200 ± 4.0 gms randomly were assigned to two groups. After 5 min of air drying a segment of right carotid artery, six rats were treated locally 80μg/ml with turmerin and the rest were treated with 0.9% NaCl. Turmerin was then administered by gavage (80 μg) every 24 hrs for 14 days. Animals were sacrificed on day 14 and the carotid artery removed from the injured site for histological analysis and serum collected for lipid peroxidation analysis by measuring malondialdehyde (MDA) and conjugated dienes. This study showed no proliferation in the intima of one rat out of six rats treated with turmerin while there was significant variation between the treated rats and the controls. MDA for control was 0.593±0.02 nanomoles/ml while turmerin was 0.187±0.04 (p≤0.01); conjugated diene for control was 0.402±0.03 nanomoles/ml while turmerin was 0.212±0.04 nanomoles/ml (p ≤0.05). Although there was significant reduction in serum peroxidation activity, the histological findings indicate that attenuation of carotid artery injury may involve other factors than decreased lipid peroxidation.
    International Journal of Molecular Sciences. 01/2002;
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    ABSTRACT: Abstract: Currently, serum is used more often than urine to detect prostate specific antigen (PSA). The need for a non-invasive test yielding similar results led us to develop a urine test that uses solar irradiated water as a reactant species. To develop this technology, seven reagents plus one control were produced by exposure of water for 40 days in sunlight to the colors of the visible spectrum through colored cellophane, control being an unwrapped bottle of sterile water. Patients (127) were examined for serum PSA and the urine was tested using the above reagents. A positive urine test was observed with yellow-filtered irradiated water which absorbed at 454nm. Twenty-five of the 45 patients with positive results for the urine test had PSA levels of 0.21-4.0 ng/ml. Thus, this pilot study describes a non-invasive urine test mainly positive in patients with PSA 0.21-4.0 ng/ml.
    International Journal of Molecular Sciences. 01/2002;
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    ABSTRACT: Abstract: This study investigated gene regulation and unique gene products in both keloid (KDF) and normal (NDF) dermal fibroblasts in established cell lines. For gene regulation, NDF versus KDF were compared using Clontech's Atlas™ Human cDNA Expression Array while unique gene products were studied using RNA Fingerprinting Kit. RNA from each sample was converted to cDNA using oligo-dT primers. Down-regulated genes using Atlas Array in KDF were 1) 60 S ribosomal protein, 2) Thioredoxin dependent peroxidase, 3) Nuclease sensitive element DNA binding protein, 4) c-myc purine-binding transcription factor, 5) c-AMP dependent protein kinase, and, 6) Heat Shock Protein 90 kDa. Genes that are up regulated in KDF were 1) Tubulin and 2) Heat Shock Protein 27 kDa. With the differential display, we found 17 bands unique to both KDF and NDF. The specific gene and the manner in which they were differentially regulated have direct implications to understanding keloid fibroblast proliferation.
    International Journal of Molecular Sciences. 01/2002;

Publication Stats

252 Citations
28.99 Total Impact Points

Institutions

  • 2001–2007
    • University of Mississippi Medical Center
      • • Division of Plastic Surgery
      • • Department of Surgery
      • • Division of Rheumatology and Molecular Immunology
      Jackson, MS, United States
  • 2002
    • University of Virginia
      • Oral and Maxillofacial Surgery Clinic
      Charlottesville, Virginia, United States