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S38 Surgical Forum Abstracts J Am Coll Surg

ediastinotomy, carotid sheath exploration, and major bone/muscleesections. Patients received 6.5 antibiotics (2-10) for 42 days (40-5). Median hospitalization was 37.5 days (16-55), with 11 days7-48) intensive care. Astoundingly, we achieved 100% survival (me-ian follow-up 10.1 months), with no major complications, readmis-ions, or reinfections.

ONCLUSIONS: The application of a systematic approach to NMreatment, emphasizing aggressive operative debridement enhancedy equally aggressive CT imaging strategies reduced mortality. Ouratients had excellent outcomes despite the widely known lethality ofhis condition, suggesting that such an approach decreases compli-ations and improves survival for this highly malignant disease.

icroRNA miR-146b decreases metastaticotential of A549 lung cancer cellsantosh Patnaik MBBS, PhD, Eric Kannisto MS, Reema Mallick BS,ai Yendamuri MBBSoswell Park Cancer Institute, Buffalo, NY

NTRODUCTION: We and others have recently shown that reducedxpression of microRNA miR-146b in non-small cell lung cancerumors is associated with recurrence of the disease after surgical re-ection of the tumors.

ETHODS: Effect of miR-146b over-expression on cell proliferation,dherent or soft agar colony formation, spheroid formation on culturelates coated with basement membrane extract, and cell migration andnvasiveness of A549 lung cancer cells was examined by comparing thehenotype of a stably-transduced population of the cell-line engineeredo over-express the microRNA with that of control cells.

ESULTS: An A549 cell-line over-expressing miR-146b eight-foldompared to control A549 cells was generated using a lentivirus-ased approach. The increase in miR-146b level did not alter therowth rate of the over-expressors. However, there was a significantecrease in their ability to form adherent colonies as well as colonies

n soft agar. Migration of the cells in scratch assays was significantlyeduced, as was their invasiveness in Transwell assays. The over-xpressing cells formed more spheroids on plates coated with base-ent membrane extract, indicating reduced metastatic potential.

ONCLUSIONS: Over-expression of miR-146b decreased colony for-ation, cell migration, and invasiveness, and increased spheroid forma-

ion in A549 lung cancer cells without affecting their proliferation. Thisuggests that miR-146b has an anti-metastatic effect, which has beenbserved in breast cancer and glioma cells by others, and provides anxplanation for the association of the microRNA’s expression levels withhe clinical phenotype seen in non-small cell lung cancer.

patial and temporal expression profiling in theeveloping rat lunginee C Simpson MD, Miao Lin MD, Grace S Lee MD,arry Gibney DO, Akira Tsuda PhD, Steven J Mentzer MDrigham and Women’s Hospital, Boston, MA

NTRODUCTION: Growing evidence indicates that gene transcrip-

ion regulating lung development and regeneration is anatomically i

estricted and may not be reflected in bulk mRNA analysis. To testhe spatial and temporal dependency of gene expression in the devel-ping rat lung, we performed differential transcriptional profiling ofhe alveoli and terminal airways using laser capture microdissectionLCM).

ETHODS: Lungs from newborn and adult rats were snap frozen,ectioned, stained and dehydrated for LCM. Using automated imagenalysis and ultraviolet/infrared laser processing, RNA was capturedn selected regions of the terminal airways and alveoli. The isolatedNA integrity was confirmed by capillary electrophoresis and pre-mplified using commercial kits. Gene expression was studied using4 gene growth-specific quantitative real-time polymerase chain re-ction (PCR) arrays.

ESULTS: Pathway-specific PCR arrays demonstrated signifi-antly different gene transcription in the alveoli and terminal airwayscross age groups. In neonatal rats, the terminal airways demon-trated enhanced expression of IFNa1 (40.25-fold), Fgf 1 (5.59-old) and F2 (112.84- fold), whereas alveoli demonstrated increasedxpression for integrin beta3 (5.03- fold) (p-value �/� 0.05). Inontrast, adult terminal airways demonstrated enhanced expressionf Fgf16 (31.23- fold) and Lect1 (13.24-fold), whereas adult alveoliemonstrated increased expression of Vegfa (4.42- fold) and Flt6.53- fold).

ONCLUSIONS: Spatial expression profiling of the lung demon-trated distinct transcriptional signatures in different anatomic re-ions of the lung; a consistent finding in the developing and matureung. The results indicate the importance of spatial profiling of generanscription in studies of lung development and regeneration.

paradigm shift in management of gastrointestinaleaks after minimally invasive esophagectomyinh Nguyen,, Xuan-mai Nguyen PhD, Christian Elliott BS,rian Reavis MDniversity of California Irvine Medical Center, Orange, CA

NTRODUCTION: Gastrointestinal leak is a dreaded complicationfter esophagectomy. Conventional treatments include neck or tho-acic drainage and even complete gastrointestinal (GI) diversion. Theim of this study was to evaluate the use of endoluminal stent inanagement of esophageal leaks after esophagectomy.

ETHODS: Data on 14 (9.7%) of 145 patients who developedostoperative leaks after minimally invasive esophagectomy were re-iewed. Main outcome measures include patient characteristics,reatment type, length of stay, morbidity, and mortality.

ESULTS: There were 13 males with a mean age of 66 years. Indi-ations for esophagectomy were carcinoma (n � 12) and benignisease (n � 2). Neoadjuvant therapy was used in 36% of patients.eaks in patients with a cervical anastomosis were treated with neckrainage (n�4) and thoracotomy for repair of tracheogastric fistulaith GI diversion (n�1). Early experience in treatment of intratho-

acic leaks included thoracoscopic drainage with T-tube placementn�2), drainage alone (n�1), and GI diversion (n�1). Recently,

ntrathoracic leaks were treated with endoscopic drainage followed