tients correlates weakly with ABIs, but exhibits a closer association with vascular symptoms. This suggests that sole reliance on ABIs may not accurately reflect the impact of PVD on HRQL, or the potential benefit of vascular surgery in improving HRQL. 3. Impact of a Teaching OSCE on RIME Skills. G. B. Nackman, M.D., C. S. Rettie, Ph.D., S. F. Lowry, M.D. Robert Wood Johnson Medical School, New Brunswick, NJ. Introduction: To improve skills of 4th yr students in the evalu- ation of patients in shock, a new case-based practice OSCE station was developed. We hypothesized that student skills would improve and identified factors affecting OSCE performance. Methods: A practice OSCE /teaching session, based on R-I-M-E, was introduced to the Class of 2003 as a teaching tool, a practice test, and provide an opportunity for feedback. On the final OSCE, students were in- structed to evaluate ICU flow sheets by identifying the abnormal data (Reporter), developing a problem list (Interpreter), and produc- ing management recommendations (Manager). Student performance on the practice OSCE were compared with the final OSCE, and to the prior Class of 2002 (n = 86). The variables assessed for impact on the final OSCE performance were clerkship site, block (time of year), prior performance on NBME subject exam and an OSCE during the 3 rd year clerkship, and the effect of the practice OSCE. Results: 107 of 108 students completed the practice OSCE session. Student skills improved significantly on the final OSCE as compared with the practice OSCE in the Reporter, Interpreter and Manager categories. The Reporter, Interpreter and Manager scores on practice and final OSCEs correlated (R = 0.5, 0.2 and 0.3; p  0.001 by regression). Student OSCE performance in the Reporter and Interpreter catego- ries improved after introduction of the OSCE teaching session in 2003 as compared with the Class of 2002. A stepwise regression analysis identified the new OSCE session as an independent factor affecting Reporter and Interpreter skills, P  0.01. Block signifi- cantly affected Reporter, Interpreter and Manager skills. Perfor- mance on a prior OSCE during the 3 rd year clerkship also affected Reporter skills. Clerkship site was not a significant factor. Conclu- sion: Student skills improved after introduction of a practice OSCE/ teaching session. Application of RIME principles in a teaching OSCE may help to improve learning in complex patient scenarios. 4. The Ataxia Telangiectasia Group D Associated Gene Con- fers A Cellular Survival Advantage In Pancreatic Adeno- carcinoma. C. E. Binkley, M.D., M. A. Davis, Ph.D., L. Zhang, M.D., T. S. Lawrence, M.D., Ph.D., C. D. Logsdon, Ph.D., D. M. Simeone, M.D. University of Michigan Medical Center, Ann Ar- bor, MI. Introduction: Recently we have determined that the gene Ataxia-Telangiectasia Group D Associated (ATDC) is significantly over- expressed in 90% of human pancreatic adenocarcinomas. The role of ATDC in tumorigenesis is unknown. We hypothesize that ATDC promotes growth and confers survival advantage after radia- tion exposure in pancreatic cancer. Methods: To examine the role of ATDC in pancreatic cancer, we designed an anti-ATDC small inhib- itory RNA (siRNA) as well as a mutated anti-ATDC siRNA (msiRNA) to serve as a control. Stable expression of both the anti-ATDC siRNA and the msiRNA was established in BxPC-3 cells, a pancreatic can- cer cell line with high endogenous ATDC expression. ATDC expres- sion was assessed by Western blotting. Cell growth was calculated by counting cell number. Following exposure to ionizing radiation (0-10 gy), the surviving fraction of cells after 2 weeks was analyzed by clonigenic assay. The effect of radiation exposure (5 gy) on cell cycle distribution was assessed by FACS analysis of propidium iodide stained cells. Results: Silencing of ATDC was confirmed by Western blotting in BxPC-3 cells expressing anti-ATDC siRNA, while the control msiRNA had little effect. Cellular proliferation in ATDC silenced cells was significantly inhibited compared to msiRNA and WT cells (fold change compared to time 0: siRNA = 0.97  0.29 * , msiRNA = 2.92  0.43, WT = 4.19  0.79, *p  0.05 vs. WT and msiRNA at 96 hours). Clonigenic assays revealed that following exposure to ionizing radiation, BxPC-3 cells with silenced ATDC were more sensitive to the effects of ionizing radiation than control cells (radiation dose for 1% survival: WT = 11.60  0.06 gy; siRNA = 10.16  0.70 gy). Preliminary analysis of cell cycle distribution 12 hours after exposure to 5 gy ionizing radiation showed an increased S phase fraction in ATDC silenced cells compared to msiRNA and WT (siRNA = 37.2%, msiRNA = 3.2%, WT = 3.5%), suggesting a role for ATDC in repair of DNA damage. Conclusion: Silencing of ATDC expression in BxPC-3 cells leads to decreased growth rate and in- creased sensitivity to ionizing radiation. Our data indicate that ATDC may be a therapeutic target in pancreatic cancer by inhibiting tumor growth and increasing sensitivity to radiation therapy. 5. Angiopoietin-1 Mediated Effects on Re-epithelialization: In Vitro and In Vivo Analysis. S. G. Keswani, M.D., A. B. Katz, J. J. Karmacharya, M.D., F.-Y. Lim, M.D., P. W. Zoltick, M.D., A. P. Radu, D. Alaee, M.S., P. Awatramani, E. D. Kozin and T. M. Crombleholme, M.D. The Children’s Hospital of Philadelphia, Philadelphia, PA. Introduction: Adenoviral-mediated overexpression of Angiopoietin-1 (AdAng-1), surprisingly results in accelerated re- epithelialization. Because keratinocytes do not express Tie2, the Ang-1 receptor, we hypothesize that Ang-1 induces downstream growth factors. We employed an in vitro co-culture system and an excisional wound healing model in TGF knock out (KO) and normal mice to examine Ang-1 wound healing effects. Methods: Fibroblasts transduced with AdAng-1, AdLacZ (MOI 20) or PBS are placed into co-culture with keratinocytes. Neutralizing antibodies (NAbs) to Ang-1, KGF, EGF, PDGF-B, PDGF-A, IGF-1, TGF and TGF1 were added. Ki67 immunostaining of the keratinocytes was used to deter- mine a proliferation index (PI). 6 mm crown wounds treated with 1 x 10 8 PFU of AdAng-1 AdLacZ, or 20l PBS were made in TGF KO (n = 15) and control mice (n = 15). Wounds harvested at 5 days were analyzed for epithelial gap, granulation tissue formation, capillary density and KGF expression. Results: In co-culture, AdAng-1 re- sults in increased keratinocyte PI compared to controls (Ang1 38.5% vs. LacZ 19% or PBS 16.3%). This response was completely inhibited by NAbs to Ang1 (17.1%) or TGF (16%) and partially inhibited by NAbs to KGF (29.5%) or PDGF-B (25.6%). NAbs to PDGF-A, IGF-1, TGF or EGF had no effect. AdAng-1 treated wounds in TGF KO mice showed significantly larger epithelial gaps compared to Ad- Ang-1 treated control mice (3.3 mm  0.1 vs. 2.7 mm  0.2, p  0.01). However, in TGF KO mice AdAng-1 treated wounds show signifi- cantly reduced epithelial gaps (Ang-1 3.3 mm .1, LacZ 4.4.2, PBS 4.4.3, p.001) and increased vessel density compared to controls (Ang1 11.1 Caps/HPF, LacZ 4.1  0.3, PBS 4.4  0.3, p  0.0001). KGF immunostaining localized to the advancing epithelial margin, was markedly enhanced in AdAng-1 treated wounds in both TGF KO and control mice. Conclusions: The effects of Ang-1 on keratin- ocyte proliferation are mediated indirectly by TGF, and KGF. In TABLE—ABSTRACT 3 (Mean %  SEM) Reporter Interpreter Manager Class 2003: Practice OSCE 76.1  1.6 58.7  2.0 35.8  2.7 Class 2003: Final OSCE 84.4  0.8*† 79.1  1.0*† 59.9  1.3* Class 2002: Final OSCE 78.3  1.5 71.0  1.8 57.8  1.6 * P  .05 by ANOVA, Pre vs. Final; † P  .05 by ANOVA 2003 vs. 2002 240 ASSOCIATION FOR ACADEMIC SURGERY—ABSTRACTS