MATERIALS AND METHODS: A retrospective review of aclinical database was performed at our institution, a largetertiary care university hospital, from December 1 2006 toSeptember 30 2007. We performed 8 consecutive proce-dures on 8 patients aged 47 to 77 with a mean age of 63. Allpatients had optimally debulked stage III ovarian cancer.The first four procedures were performed in the operatingroom with surgical backup if necessary. The remainder ofthe procedures were performed in the interventional radiol-ogy suite. All procedures were performed with an 8 or 9.6Fr intravenous chemotherapy port.

RESULTS: Primary percutaneous intraperitoneal port place-ment using sonographic and fluoroscopic guidance was per-formed in all patients without the need for surgical conver-sion. No intraprocedural complications occurred. One portbecame infected within 31 days of implanation, and wassubsequently removed.

CONCLUSION: Percutaneous insertion of peritoneal infu-sion ports using sonographic and fluoroscopic guidance issafe and technically feasible in patients with optimallydebulked stage III ovarian cancer.

Abstract No. 365

Peritoneal/Pleural Ports for Refractory Ascites/Effu-sions, Quality of Life and Hospice Nurse Satisfaction.W.L. Monsky, L.-S. Deutsch, K. Yoneda, C. Duffield,J. Cernilia, D. Paul, T. Boak, H. Hourigan; University ofCalifornia, Davis, Sacramento, CA

PURPOSE: To evaluate quality of life, patient and nursingsatisfaction and clinical use of subcutaneously implantedperitoneal and pleural ports. A moderate number of patientswith end-stage thoracic and intra-abdominal malignancieshave refractory ascites or effusions requiring frequent tho-racenteses and paracenteses. Each minor procedure requiresa hospital visit and a small, but present risk. These portsallow for safe management by home or hospice nursing,with improved quality of life and palliation.

MATERIALS AND METHODS: Using seldinger techniqueand ultrasonographic guidance scilastic tubing with sideholes is placed within the fluid, tunneled subcutaneously,then attached to the reservoir within a SQ pocket. 28 portswere placed, 16 peritoneal and 12 pleural, in patients withmean age of 62 years, ranging from 19 to 93. Patients weresubsequently under hospice or home nursing care. 9 hadmalignant effusions, 12 had malignant ascites, 3 had CHF,4 had hepato-renal syndrome, and 2 had polycystic disease.Fluid was aspirated between one and three times a weekwith between 50 cc and 8 liters (mean 1.8 liters) aspirated.Retrospective chart review was conducted and interviewsheld with patients and hospice nursing during follow-up.Mean follow up was 59 days, range 7 to 302 days.

RESULTS: 6 of 16 pleural ports were removed with 2spontaneously pleurodesing, one pleurodesed with bleomy-cin and 3 surgically decorticated. Only minor complicationswere encountered with 3 having leaking, 2 bruising, 1bleeding, 2 discomfort, 1 cellulitis. All minor complicationsresolved. Four became occluded with patency restored usingTPA infusion. 12 patients stated that the port had signifi-cantly improved their quality of life. 2 wanted the portsremoved due to discomfort, which improved without re-moval. Interviewed hospice/home nursing staff thought theapproach benefited overall quality of life and advocatedearlier placement.

CONCLUSION: This approach offers a safe and convenientalternative to frequent paracentesis or thoracentesis for themanagement of refractory ascites and pleural effusions thatcan improve the quality of life for patients with end-stagedisease.

Basic Science: Animal Studies

Abstract No. 366

Improving Drug Delivery by Altering Cell Permeabilityin a Rat Model.D.H. Chu, L.A. Freeman, T.L. Brix, E.N.K. Cressman;University of Minnesota Medical School, Minneapolis, MN

PURPOSE: To study the effect of DMSO on cell perme-ability over time and evaluate compound distribution byfluorescence microscopy.

MATERIALS AND METHODS: Doxorubicin or fluoresceinwere injected either directly into liver parenchyma or intothe peritoneum of anesthetized Sprague-Dawley rats using0.5 mg of compound in 0.5 mL of saline varying theconcentration of dimethylsulfoxide (DMSO) from 0% con-trol to 100%. Animals were euthanized (n�3 in each of 15groups and 3 time points of 5, 15 and 60 minutes for eacharm of the study) and tissues were harvested and cryopre-served in OCT medium. Frozen sections with a slice thick-ness of 15 microns were then analyzed by fluorescencemicroscopy using excitation/emission wavelengths of 475/570nm for doxorubicin and 497/530 nm for fluorescein.

RESULTS: Direct injection in all cases provided higherfluorescence than intraperitoneal dosing. There was a defi-nite trend toward intracellular distribution of compoundsover time compared to controls that became more pro-nounced as the amount of DMSO was increased. Comparedto fluorescein, which distributed evenly throughout thecells, doxorubicin displayed a distinct tendency to accumu-late in the nucleus. At higher concentrations of DMSO thisoccurred almost immediately and completely.

CONCLUSION: Altering cell permeability shows great po-tential for increasing intracellular concentrations of chemo-therapeutic drugs and warrants further investigation in atumor model. Development of an index to quantify thechanges in cytoplasmic vs. nuclear fluorescence intensityover time is in progress.

Abstract No. 367

In Vitro Thermal Profile Suitability Assessment of Acidsand Bases for Thermochemical Ablation.L.A. Freeman, B. Anwer, R.P. Brady, B.C. Smith,T.L. Brix, E.N.K. Cressman; University of Minnesota Med-ical School, Minneapolis, MN

PURPOSE: To measure temperature changes in a gel phan-tom of thermochemical ablation as a function of reagentconcentration using readily available acids and bases.

MATERIALS AND METHODS: Small aliquots (0.5-1cc) ofeither HCl or Acetic Acid and an equivalent of a base, eitherNaOH or NH4OH, were injected over 5 sec into a hydro-phobic gel phantom previously described by our group. ApH indicator, Congo Red or Litmus, was added to ensureadequate mixing of reagents. Injections were either sequen-tial or simultaneous using a coaxial device designed specif-

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ically for this purpose. Stepwise molar increments in con-centration were used from dilute to concentrated solutionsto survey the temperature changes caused by these exother-mic reactions. Injections of each of the four combinationswere performed in triplicate, measured every 15 seconds for5 minutes using a thermocouple probe positioned in thereaction mixture, and plotted as a function of both reagentconcentration and time.

RESULTS: Maximum temperatures were reached almostimmediately in all cases, reaching 75-110 deg C at thehigher concentrations, dropping off rapidly but still elevated5 min after the injections were completed. The highesttemperatures were seen with HCl and NH4OH. More con-centrated, viscous solutions of NaOH tended to mix incom-pletely such that experiments at 11M and higher weredifficult to perform consistently. Temperature data werehighly dependent on accurate probe positioning within thereaction medium.

CONCLUSION: As anticipated there is a clear correlationbetween the concentration of the reagents and the maximumtemperature obtained. Indeed, in some instances we wereunable to obtain satisfactory readings at the higher concen-trations of HCl due to the vigorous reactions boiling out ofthe gel phantom. Not as clear, however, is the relationshipbetween the strength of the reagents and the maximumtemperature. This may reflect the viscosity of the basesolutions, particularly NaOH at higher molarities impairingthe mixing of reactants. All four reagent combinationstested appeared suitable for further investigation in thermo-chemical ablation but adequate mixing must addressed ifhigher concentrations are to be employed.

Abstract No. 368

In Vitro Transfection of Hepatoma Cells and Hepatocyteswith a Nonviral Vector Using Protamine and Ethiodol.L.J. Higgins, M. van den Bosch, G. Hwang, R. Paulmurugan,N. Kothary, W.T. Kuo, D.Y. Sze, R. Katzenberg, S.S. Gambhir,L.V. Hofmann; Stanford University, Palo Alto, CA

PURPOSE: Suicide gene therapy for cancer therapy hasshown promise in preclinical studies. We hypothesize that amixture of protamine (a DNA condensing agent), ethiodizedoil (an agent with affinity for hepatoma cells), and DNA canprovide a platform for efficient hepatoma transfection. Thismixture has the advantage that it uses FDA-approved agents[protamine (P), ethiodized oil (E)]. We investigated the invitro transfection efficiency of hepatoma cells (McA-RH7777) and of hepatocytes using these agents.

MATERIALS AND METHODS: Firefly luciferase plasmidDNA (F-Luc) was used as a reporter gene and transfectionefficiency was measured using a luminometer (RLU/sec/mg_cell protein) in hepatoma cells and hepatocytes. In vitrotransfection experiments were performed using (1) E (1, 2,4, 8% v/v), (2) P:DNA complexes (2:1, 20:1, 200:1), (3)mixtures of E and P:DNA complexes.

RESULTS: For hepatoma cell transfection, the followingcombinations, performed in duplicate, produced only back-ground signal of 1.0 � 10^2 RLU/mg/sec: P:DNA 2:1,P:DNA 20:1, P:DNA 200:1, E:DNA 1%, E:DNA 2%,E:DNA 4%, E:DNA 8%, DNA alone. Combinations of thethree agents are depicted in the table. Hepatoma cells trans-fection (mean RLU/sec/mg Protein) Protamine variation:2%-E-P:DNA-(2:1) 1.6�10^2 (n�2) 2%-E-P:DNA-(20:1)

2.4�10^4 (n�7) 2%-E-P:DNA-(200:1) 2.6�10^5 (n�2)Ethiodized oil variation:

1%-E-P:DNA-(20:1) 4.3�10^4 (n�2)

4%-E-P:DNA-(20:1) 1.2�10^4 (n�2)

8%-E-P:DNA-(20:1) 3.9�10^4 (n�2)

8%-E-P:DNA-(200:1) 1.0�10^5 (n�4)

Hepatocytes transfection (mean RLU/sec/mg Protein):

2%-E -P:DNA-(200:1) 9.0�10^3 (n�2)

2%-E -P:DNA-(20:1) 3.1�10^4 (n�2)

The 2%-E-P:DNA-(200:1) transfected hepatoma cells at arate 1000� greater than any agent alone. Additionally, thismixture transfected hepatoma cells almost 30 times greaterthan hepatocytes. In contrast, the 2%-ethiodol-protamine:DNA-(2:1) mixture did not demonstrate any cellular selec-tivity.

CONCLUSION: Combinations of ethiodized oil, protamine,and DNA can be tailored for selective hepatoma cell trans-fection. This non-viral platform composed of FDA-ap-proved agents has the potential to facilitate safe and effec-tive gene therapy in patients with hepatocellular carcinoma.

Abstract No. 369

Technical Considerations for Reliable Vx-2 Liver Tu-mor Growth: Selection of Tumor Cells InoculationMethod.K.-H. Lee,1,2 E. Liapi,1 M. Buijs,1 J. Vossen,1 V.E. Prieto,1

C.S. Georgiades,1 K. Hong,1 J.-F.H. Geschwind;1 1JohnsHopkins University School of Medicine, Baltimore, MD;2Yonsei University College of Medicine, Seoul, Korea

PURPOSE: To evaluate and compare the cell preparationmethods favorable to subsequent experimental study whenimplanting Vx-2 carcinoma into rabbit liver.

MATERIALS AND METHODS: Forty adult NZ white rab-bits underwent Vx-2 carcinoma implantation into the leftlateral lobe of the liver by open laparotomy method. Basedon the cell preparation method, twenty rabbits underwentimplantation with using minced cells (Group I), and theother twenty rabbits underwent implantation with using achunk (3 mm3) of tumor (Group II). In Group I, mincedtumor cells were contained in a 16-G angiocath needle,punctured the liver, and then 0.035-inch guide wire pushedthe minced cells into the liver. In Group II, a chunk of tumorwas prepared in size of 3 mm3, liver capsule was lacerated,and then the chunk of tumor was inserted directly throughthe lacerated capsule and tract. The tumor growth and size,location, vascularity and peritoneal seeding were evaluatedby MR imaging, angiography and autopsy two weeks afterthe implantation.

RESULTS: Tumor implantation and tumor growing wassuccessful in all rabbits. Tumor size and vascularity werenot significantly different. Mean tumor size in both Group Iand II were 1.6 and 1.8 cm, respectively (p � 0.05). Alltumors showed hypervascular tumor staining with hypertro-phic feeder suitable for intervention. In Group I, all tumorswere confined near the center of the liver apart from thecapsule. In Group II, however, 15 of 20 (75%) tumors werelocated just beneath the capsule of liver which might affecthigher peritoneal seeding in Group II (10/20, 50%) thanGroup I (2/20, 10%) (p � 0.05).

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