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Cell electropermeabilisation is a new drug delivery approach as well as an efficient way to transfer DNA to cells in tissues. These two therapeutic approaches are based on the effects of the electric fields on cells and on molecules. The purpose of the Workshop is to provide the theoretical foundations of this approach and give the state of the art information with respect to drug and gene delivery in animal models and clinical situation. In addition, basic engineering concepts with respect to pulse generation and electric field distribution will be given.

Electrochemotherapy

Electrochemotherapy principle is the use of: (i) nonpermeant molecules possessing intracellular targets; (ii) short intense electric pulses that transiently permeabilise the cells in vivo.
The essential role of the electric pulses is to achieve the electropermeabilisation of the majority of the cells in the exposed tissue, and this can be achieved by means of the delivery of very short (100 microseconds) pulses.
Once into the cells, the drugs suitable to be used in combination with the electric pulses must exhibit a high intrinsic activity. Indeed, the time for drug uptake is essentially limited to the duration of cell electropermeabilisation, and a large accumulation of molecules inside the cells cannot be expected.
Bleomycin is still the best candidate for electrochemotherapy among the present anticancer drugs. When bleomycin molecules can diffuse into the cell inside, as few as 500 internalised molecules are sufficient to kill the cells. Moreover, due to the bleomycin mechanism of toxicity at low doses (i.e. when low amounts of bleomycin molecules are internalised into the cells), a differential effect can be expected between normal cells and tumour cells. Indeed, after bleomycin interaction with DNA (formation of DNA double strand breaks), cells die following a mitotic cell death pathway. Thus this drug affects essentially the dividing cells in the tissues, i.e. the tumour cells.
Unfortunately, without the electric pulses, bleomycin is an old drug that is not currently used in a lot of oncology protocols. However, since the increase of bleomycin efficacy can be augmented by a several thousands fold factor by cell electropermeabilisation, the use of this drug could be expanded to many oncological situations.
Cisplatinum has also shown interesting potentialities in combination with tumour cell electropermeabilisation. Cisplatinum is already a very active drug against a variety of tumours. Since the delivery of the electric pulses to the tumours allows to increase uptake and therefore to increase cisplatinum antitumour effects by a several fold factor, the combination of cisplatinum with in vivo cell electropermeabilisation is already clinically relevant.
Several clinical trials have shown the feasibility of electrochemotherapy on humans. Trials were performed in various oncological situations (head and neck carcinomas, melanomas, basal cell carcinomas, ... ) using either bleomycin or cisplatinum.

DNA electrotransfer

Keywords: stereology, morphometry, volume, surface area, number, length, unbiased estimator, variance prediction, second-order characteristics, spatial grid, Cavalieri principle, dissector, orientator, nucleator, rotator, vertical sections, fakir method, global spatial sampling.

Duration: 4 hours

Timetable: 

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Timetable with indicative session slots is shown below.

Within this context healthcare technology management (HTM) is being increasingly recognised for its contribution to health system performance and specifically in supporting proper assessment, planning, procurement and implementation/utilisation of appropriate and cost-effective healthcare technologies (defined broadly as including medical/surgical devices/equipment, drugs, information systems, health facilities, transport vehicles, etc.).

Many countries (and notably developing and emerging economies) are under-resourced in terms of the technology resources needed for accessible and equitable service delivery of acceptable quality, as well as the management-level skills needed to maximise the impact of healthcare technologies on service delivery.

Given the above there is an urgent need to (i) build HTM management capacity and (ii) develop effective HTM tools while at the same time (iii) developing indicators for HTM performance and sustainability.

This workshop uses the afore-mentioned as the foundation for exploring:

· Performance and sustainability indicators for HTM (including Clinical Engineering). 
· Models for HTM capacity building and HTM practitioner development. 
· The concept and methodology of an Essential Health Technology Package.

The format for the workshop will be largely informal with attendee participation encouraged.

*Students must provide an official letter confirming their student status

Faculty of Electrical Engineering and Computing
University of Zagreb
Unska 3, 10000 Zagreb, Croatia
Phone: +385 (1) 61 29 891
Fax: +385 (1) 61 29 652
E-mail: sven.loncaric@fer.hr

Faculty of Electrical Engineering and Computing
University of Zagreb
Unska 3, 10000 Zagreb, Croatia
Phone: +385 (1) 61 29 937
Fax: +385 (1) 61 29 652
E-mail: mario.cifrek@fer.hr