bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing new frameworks for operations strategy and service system design in electronic commerce
Authors: Sung‐Eui Cho
Published: June 2005

Purpose

The purpose of this study is to develop new frameworks for operations strategy and service system design in electronic commerce (EC) to provide strategic insights to academics and practitioners.

Design/methodology/approach

Product/service process matrices for intangible and tangible products in EC operations are presented based on the classification of products and delivery channel options and three cases are investigated to illustrate the newly developed matrices.

Findings

The fit between two dimensions (characteristics of product/service, service delivery processes) in the matrices contributes to firm's competitiveness through market expansion and improvement of customer services. Through the case studies, it was confirmed that the conceptual framework developed in this study illustrates actual EC operations well.

Research limitations/implications

Further case or empirical research on more diverse products or services will be required to increase robustness of the matrices and to additionally confirm the results of this study including the effects of the “fit”.

Practical implications

The new frameworks have the potential to be useful as a planning tool in developing an operations strategy and service system design, as well as a diagnostic tool for examining the causes of poor service quality and low customer satisfaction resulting from a mismatch between two dimensions.

Originality/value

The development of new frameworks is an important first step in the gradual process of theory building and theory testing, as well as providing strategic insights for practitioners.
Community pharmacies under pressure – can branding help?
Authors: Schmidt Ruth Ä. , Pioch Elke A.
Published: June 2005

Purpose

Despite their essential role as providers of emergency medication, expert advice and specialist healthcare services UK community pharmacies are coming under increasing competitive pressure. Deregulation measures and heightened competition from supermarkets and multiples have led to increases in market concentration and forced many independents into closure. This paper aims to explore the potential of retail branding as a tool for independent pharmacists who wish to complement their role as therapeutic experts with a strong retail proposition and enhance their competitive positioning.

Design/methodology/approach

Based on a qualitative study using key informant interviews with independent pharmacists in the Greater Manchester area, this paper takes a grounded theory approach. NVivo qualitative analysis software was applied to develop theoretical categories, explore themes and offer a starting point for theory building.

Findings

The UK pharmacy market is polarized into the highly branded large scale multiples and an independent sector which still fails to make full use of the opportunities for retail marketing support available. A SWOT analysis for the community pharmacy sector illustrates pharmacists' key strengths as healthcare professionals and therapeutic expert advisors. However, often this is complemented by an inward looking, reactive and short‐termist approach. Overall respondents fail to embrace the opportunities marketing and retail branding might offer on the retail side fully, to the detriment of overall business success.

Research limitations/implications

The paper is based on a small scale qualitative study. Whilst the sample was carefully selected to be a fair representation of the different types of small retail pharmacies found in the Greater Manchester area, and within this context ecological validity is thought to be high, care must be taken with wider generalisations.

Practical implications

Possibilities of complementing pharmacists' professional ethos as therapeutic experts with lessons from the retail marketing and branding literature with the aim of achieving image congruence and business success are explored.

Originality/value

A contribution is made to the understanding of the UK retail pharmacy sector, as well as the complex interaction between professional healthcare provision and retail marketing in relation to the self‐concept and business practice of independent pharmacists.
Exploring the connections between visual merchandising and retail branding
Authors: Davies Barry J. , Ward Philippa
Published: June 2005

Purpose

TThe purpose of this paper is to review the literature on facet theory and present an approach to map the relationship between retail branding (particularly brand recognition) and visual merchandising.

Design/methodology/approach

Fact theory has been used in other areas of investigation, particularly for the examination of the built environment within psychology. However, it has received little attention in either the marketing or retailing literature. This is surprising as facet theory also provides a conceptually stable and fully formed approach to: the definition of an area of interest; the statement of the proposed relationships between areas of interest; the development of a research instrument that is fully cognisant of the possible relationships; and also utilizes a form of analysis that explores the actual presence of the hypothesized relationships (smallest space analysis – SSA).

Findings

The application of facet theory and SSA were found to be particularly appropriate for an investigation of the relationship between retail branding and visual merchandising. This stems from the clear and consistent approach that is derived by using this method to structure the research.

Originality/value

This paper demonstrates facet theory provides a validated and robust approach to investigate a complex but managerially significant area in retailing.
Dynamic vehicle routing by means of a genetic algorithm
Authors: Pankratz Giselher
Published: June 2005

Purpose

To propose and to evaluate a new genetic algorithm (GA) for solving the dynamic pickup and delivery problem with time windows (DPDPTW).

Design/methodology/approach

First, a grouping genetic algorithm (GGA) for the (static) PDPTW is described. In order to solve the dynamic problem, the GGA then is embedded in a rolling horizon framework. Special updating mechanisms are provided which assure that reusable solution knowledge is preserved over the plan revisions. The approach is evaluated using a large number of test instances with varying degrees of dynamism.

Findings

The experimental results have demonstrated that the proposed approach is able to find high‐quality solutions when compared with two comparative heuristics.

Research limitations/implications

Future research will be dedicated to the following issues: testing the proposed method using larger problem instances, using more sophisticated objective functions in order to further improve and evaluate the approach, integrating fast local search techniques into the genetic search, speeding up the algorithm by optimizing its implementation.

Practical implications

In order to meet the increasing demands on the flexibility and the promptness of transportation services, algorithms are needed for dispatching transportation requests that arrive dynamically during the planning period. The findings of this contribution justify the employment of GAs in such dynamic transportation planning environments.

Originality/value

Although the application of GAs in dynamic environments attracts growing attention, up to now no such algorithm has been published for the DPDPTW. To the best of the author's knowledge, this is the first time a GA has been applied to the DPDPTW.
Sales promotion effectiveness: the impact of consumer differences at an ethnic‐group level
Authors: Kwok Simon , Uncles Mark
Published: June 2005

Purpose

Aims to examine the proposition that consumer sales promotions are more effective when they provide benefits that are congruent with those of the promoted product. This proposition is considered at the ethnic‐group level (i.e. do differences in cultural values at this level have an impact on sales promotion effectiveness?).

Design/methodology/approach

A quasi‐experimental design is used to test a series of hypotheses based on a sample of Anglo‐Australians and Chinese‐Australians. The main experiment is informed by the results of two pretests.

Findings

First, there are significant differences in consumer cultural values at an ethnic‐group level. Second, despite these differences, ethnicity does not have a significant impact on responses to sales promotions. Third, the expected congruency effects between products and promotion types are not found.

Research limitations/implications

Some of the detailed results match those reported in previous studies, but there are important differences too.

Practical implications

There is a need to be aware of differing cultural values at an ethnic‐group level. Notwithstanding this inference, the second finding suggests that there continues to be scope for using standardised strategies when promoting to different ethnic groups. Finally, considerable caution should be exercised when planning promotion strategies around hoped‐for congruency effects.

Originality/value

New light is cast on the relationship between consumer differences at an ethnic‐group level and the effectiveness of various types of sales promotion for utilitarian and hedonic products.
Architecture and design of an internet‐enabled integrated workflow and groupware system
Authors: Dustdar Schahram
Published: June 2005

Purpose

In the last decade, bureaucratic organizational hierarchies have been increasingly replaced with flatter organizational forms, bringing together people from different disciplines to form project teams within and between organizations. Distributed project teams often are self‐configuring networks of mobile and “fixed” people, devices, and applications. They are the natural next step in the evolution of distributed computing, after client‐server, web‐based, and peer‐to‐peer computing. Seeks to show that a newly emerging requirement is to facilitate not just mobility of content (i.e. to support a multitude of devices and connectivity modes) to project members, but also mobility of context (i.e. to provide traceable and continuous support of dynamic relationships between people, artifacts, and business processes).

Design/methodology/approach

The contribution of this paper is to present the design goals, the architecture, and implementation of a system aiming at supporting internet‐enabled workflow and groupware for project teams, enabling traceable and continuous support of associations (relationships) between people, artifacts, and business processes.

Findings

The findings indicate that building internet‐enabled workflow and groupware systems is valuable for virtual teamwork, since they provide a foundation for context‐aware and process‐aware information systems.

Originality/value

This article outlines some foundations of process‐aware collaborative work. Provides an analysis of current workflow and groupware shortcomings in respect of virtual teamwork, outlines the design goals, architecture and an implementation of a system aiming at supporting virtual teams on the internet.
Indexing the invisible web: a survey
Authors: Ru Yanbo , Horowitz Ellis
Published: June 2005

Purpose

The existence and continued growth of the invisible web creates a major challenge for search engines that are attempting to organize all of the material on the web into a form that is easily retrieved by all users. The purpose of this paper is to identify the challenges and problems underlying existing work in this area.

Design/methodology/approach

A discussion based on a short survey of prior work, including automated discovery of invisible web site search interfaces, automated classification of invisible web sites, label assignment and form filling, information extraction from the resulting pages, learning the query language of the search interface, building content summary for an invisible web site, selecting proper databases, integrating invisible web‐search interfaces, and accessing the performance of an invisible web site.

Findings

Existing technologies and tools for indexing the invisible web follow one of two strategies: indexing the web site interface or examining a portion of the contents of an invisible web site and indexing the results.

Originality/value

The paper is of value to those involved with information management.
The Timber Trade in Southeastern Brazil, 1920–1960
Authors: Brannstrom Christian
Published: June 2005

Logging economies in Latin America have long supplied forest resources to international and domestic markets. One of Latin America's more significant timber regions supplied South America's largest industrial metropolis, São Paulo. However, relatively little is known about the historical geography of logging in Brazil, or elsewhere in Latin America, in part because of the bias of forest histories to the destruction, rather than utilisation, of forest resources. This study focuses on domestic demand for hardwood and its salient characteristics: transport, the distribution of sawmills, the use of contracts and dangerous working conditions.
El Ejercicio de Pensar: The Rise and Fall of Pensamiento Crítico
Authors: ARTARAZ KEPA
Published: June 2005

In ‘El ejercicio de pensar’(the exercise of thinking), Fernando Martínez Heredia (El Caimán Barbudo 1967: 2–5) made reference to the words of Enrique Varona to describe what, in his view, was the appropriate role of the intellectual in the Cuban Revolution. Varona had argued that thinking was a rare human trait as it went against basic desires that preferred dogmas to ideas. Martínez Heredia's position on the role of the intellectual would have a prophetic character, for, soon after, given responsibility for the direction of the newly created Department of Philosophy at the University of Havana, he led a young group of academics gathered around the journal Pensamiento Crítico. In their heyday, both the group and their publication came to be identified with the concept of the revolutionary (and the Revolution’s) intellectual. This article examines the formative process of this new, politically committed, intellectual in the Revolution and explores the role played by this group in the intervening years, including the special relationship it established with the European New Left.
Global analysis of endothelial cell line proliferation patterns based on nutrient‐depletion models: implications for a standardization of cell proliferation assays
Authors: Tracqui P. , Liu J. W. , Collin O. , Clement‐Lacroix J. , Planus E.
Published: June 2005

Abstract.   It is known that cell populations growing in different environmental conditions may exhibit different proliferation patterns. However, it is not clear if, despite the diversity of the so‐observed patterns, inherent cellular growth characteristics of the population can nevertheless be determined. This study quantifies the proliferative behaviour of the permanent endothelial human cell line, Eahy926, and establishes to which extent the estimation of the cell proliferation rate depends on variations of the experimental protocols. Cell proliferation curves were obtained for cells cultured over 16 days and the influences of cell seeding densities, foetal bovine serum content and frequency of culture medium changes were investigated. Quantitative dynamic modelling was conducted to evaluate the kinetic characteristics of this cell population. We proposed successive models and retained a nutrient‐depletion toxicity dependant model, which takes into account the progressive depletion of nutrients, as well as the increase of toxicity in the cell culture medium. This model is shown to provide a very good and robust prediction of the experimental proliferation curves, whatever are the considered frequency of culture medium changes and serum concentrations. Thus, the model enables an intrinsic quantification of the parameters driving in vitro EAhy926 proliferation, including proliferation, nutrient consumption and toxicity increase rates, rather independently of the experiments design. We therefore propose that such models could provide a basis for a standardized quantification of intrinsic cell proliferation kinetics.
“Hidradenitis suppurativa” is acne inversa! An appeal to (finally) abandon a misnomer
Authors: Sellheyer Klaus , Krahl Dieter
Published: June 2005

The term “hidradenitis suppurativa” is firmly entrenched in the dermatological literature although it refers to a false pathogenetic concept. The term was historically coined based merely on the characteristic distribution of the apocrine glands and the anatomical coincidence with the disease process. At center stage is not a suppurative inflammation of the apocrine sweat glands but an occlusion of the hair follicles, comparable to acne vulgaris. Reviewing the literature on this subject, we were astonished to find that even articles that concluded that the entity represents a form of follicular occlusion still referred to it as hidradenitis suppurativa. The disorder shares histopathological and clinical aspects with acne vulgaris modified under the special circumstances of anatomical regions rich in apocrine glands. It is acne inversa because, in contrast to acne vulgaris, the disease involves intertriginous localizations and not the regions classically affected by acne. We suggest that the term “hidradenitis suppurativa” for this disease should (finally) be abandoned in favour of “acne inversa”.
Lucio's phenomenon/erythema necroticans
Authors: Sehgal Virendra N.
Published: June 2005

Lucio's phenomenon/erythema necroticans is a peculiar reaction pattern that occurs in untreated pure primitive diffuse lepromatous leprosy (PPDL) and/or relapsing leprosy recognized as spotted leprosy of Lucio. The small number of reported cases in the world literature suggests that it is fairly uncommon. Its clinical features are fairly characteristic and consist of extensive, bizarre, painful ulcerations of the skin, with constitutional symptoms being conspicuous by their absence. The clinical diagnosis is confirmed by microscopic pathology marked by proliferation and mobilization of polyblasts and histiocytes, dilatation, endothelial proliferation, luminal occlusion, and thrombosis of the superficial and mid‐dermal blood vessels and demonstration of acid‐fast bacilli in the blood vessel walls. Its precise pathogenesis is still unclear, but is believed to occur either through the usual or the alternate pathway of complement activation in the natural history of erythema nodosum leprosum. The clinical and immunological features of reactions in leprosy, including erythema nodosum leprosum, are well known and have been critically evaluated elsewhere.
Long‐term remission of recurrent parvovirus‐B associated anemia in a renal transplant recipient induced by treatment with immunoglobulin and positive seroconversion
Authors: Kumar J. , Shaver M.J. , Abul‐Ezz S.
Published: June 2005

Abstract: Parvovirus B‐19 (PVB)‐related recurrent anemia is reported in a renal transplant recipient with long‐term remission induced by intravenous immunoglobulin and decreasing immunosuppression. Positive plasma polymerase chain reaction (PCR) and intense bone marrow infection were present at diagnosis, despite the absence of serum immunoglobulin IgG and IgM antibodies to the virus. Seroconversion against the virus was followed by long‐term remission while the plasma PCR for PVB remained positive. This case illustrates the absence of serum antibodies in an immunosuppressed host despite florid infection with the virus. Positive seroconversion in a naïve subject is associated with long‐term remission even in the presence of detectable viral DNA copies in the plasma.
Disseminated toxoplasmosis with pulmonary involvement after heart transplantation
Authors: Fricker‐Hidalgo H. , Brion J.P. , Durand M. , Chavanon O. , Brenier‐Pinchart M.P. , Pelloux H.
Published: June 2005

Abstract: We report a case of pulmonary toxoplasmosis after heart transplant despite the prophylactic anti‐toxoplasmic treatment that was given but was not sufficient to prevent toxoplasmosis. However, the patient survived thanks to early diagnosis confirmed by polymerase chain reaction on blood and by serological techniques, and early treatment.
Outcomes steering practice: When the ends determine the means
Authors: Carberry Clare
Published: June 2005

Carberry C. International Journal of Nursing Practice 1998; 4: 2–8

Outcomes steering practice: When the ends determine the means

A discussion of outcomes and outcomes measurement will be presented through an examination of achievements of a collaborative project awarded a federal best practice grant in 1995. The project, which established a new service for women of nonEnglish‐speaking background, was part of a national venture which sought to benchmark best practice in the primary health care field. The process of benchmarking demanded that the approach to outcomes and outcomes measurement adopted by the project participants be articulated. The approach adopted acknowledges that outcomes are affected by the processes involved in care, which in turn are dependent upon the organisational environment in which care is offered and experienced. Both these contributing factors to outcomes can be hard to measure and, therefore, could be at risk of being omitted from the outcome equation in these economically stringent times. This paper aims to contribute to debate on the topic by recommending an approach to outcomes measurement which is comprehensive, values quality and embraces the short, medium and longer term.
Bcl‐2 protein and DNA ploidy in renal cell carcinoma: Do they affect patient prognosis?
Authors: SKOLARIKOS ANDREAS , ALIVIZATOS GERASIMOS , BAMIAS ARISTOTELIS , MITROPOULOS DIONYSIOS , FERAKIS NIKOLAOS , DELIVELIOTIS CHARALAMPOS , DIMOPOULOS MELETIOS‐ATHANASIOS
Published: June 2005

Abstract  Aim:  The aim of the present study was to correlate bcl‐2 protein expression and DNA‐ploidy status with established prognostic parameters in renal cell carcinoma (RCC) and to examine their impact on disease progression and patient survival.

Methods:  Both parameters were prospectively measured in 50 consecutive radical nephrectomy specimens using flow cytometry. They were correlated with the tumor grade, stage and histological type. Kaplan‐Meier survival analysis for all parameters was performed.

Results:  Bcl‐2 protein expression was higher in RCC compared to normal renal tissue (P < 0.0001). Aneuploid tumors had higher bcl‐2 expression compared to diploid tumors (P = 0.015). Bcl‐2 expression and DNA content were not correlated with tumor histological types (P = 0.277/P = 0.419), grades (P = 0.690/P = 0.449), T categories (P = 0.637/P = 0.585) or stages (P = 0.726/P = 0.800). Median follow‐up time was 46 months (range, 5–84) with a mean overall survival of 61.8 months (95% confidence interval, 53.7–69.9). Tumor stage was the only statistically important prognostic factor (P = 0.0045).

Conclusion:  Although Bcl‐2 expression was correlated with tumor DNA content, the prognostic value of these two parameters following radical nephrectomy was not established.
Oxalate‐degrading Providencia rettgeri isolated from human stools
Authors: HOKAMA SANEHIRO , TOMA CLAUDIA , IWANAGA MASAAKI , MOROZUMI MAKOTO , SUGAYA KIMIO , OGAWA YOSHIHIDE
Published: June 2005

Abstract  Background:  Oxalate‐degrading bacteria are thought to metabolize intestinal oxalate and thus decrease the urinary excretion of oxalate by reducing its intestinal absorption.

Methods:  We have isolated several novel oxalate‐degrading bacteria from human stools. Oxalate degrading bacteria were investigated to characterize their protein profiles with antibodies against oxalyl‐coenzyme A decarboxylase (65 kDa) and formyl‐coenzyme A transferase (48 kDa) purified from Oxalobacter formigenes.

Results:  One of these isolates was identified as Providencia rettgeri, which showed two proteins (65 kDa and 48 kDa) on sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS‐PAGE) that were not found in non‐oxalate‐degrading P. rettgeri. Antibodies reacted with the 65 and 48 kDa proteins from the P. rettgeri strain on Western blotting. An Oxalobacter formigenes formyl‐coenzyme A transferase gene probe reacted with chromosomal DNA from P. rettgeri on Southern blotting under high stringency conditions, while an Oxalobacter formigenes oxalyl‐coenzyme A decarboxylase gene probe did not react under the same conditions.

Conclusions:  The mechamism of oxalate degradation by P. rettgeri appears to be similar to that of Oxalobacter formigenes. This is the first report of a facultative oxalate‐degrading organism that is one of the Enterobacteriaceae.
A comparison of holmium:YAG laser with Lithoclast lithotripsy in ureteral calculi fragmentation
Authors: JEON SEONG SOO , HYUN JI‐HWAN , LEE KYU‐SUNG
Published: June 2005

Abstract  Purpose:  Among various intracorporeal lithotriptors, Lithoclast (EMS, Switzerland) has become the widely used tool for the treatment of urinary stones. Recently, the holmium:YAG laser has been used with a wide range of potential urological applications, including intracorporeal lithotripsy of urinary calculi. The purpose of the present study is to compare Lithoclast with holmium:YAG laser lithotripsy in ureteral calculi fragmentation.

Methods:  Out of 51 patients with ureteral calculi, 26 underwent Lithoclast lithotripsy and 25 holmium:YAG lithotripsy using a 8/9.8F rigid ureteroscope. There were no changes to the ureteroscopes, video monitors, baskets or irrigation devices during the study period.

Results:  There were no differences in patient age, sex, stone size and location of stones between these groups. The immediate stone‐free rates were 96.0% in the holmium:YAG group and 73.1% in the Lithoclast group (P < 0.05). The 3‐month stone‐free rates were 96.0% and 84.6%, respectively (P = 0.350). The mean operation time and mean period of postoperative hospitalization in the holmium:YAG group (49.8 min and 1.0 days, respectively) were shorter than those of the Lithoclast counterpart (76.9 min and 2.5 days, respectively). Post‐treatment complications, such as ureteral perforation, were encountered in only two patients who underwent Lithoclast.

Conclusions:  Holmium:YAG lithotripsy was associated with shorter operation time and postoperative hospitalization period. These data also suggest that holmium:YAG lithotripsy was safe and more effective than Lithoclast lithotripsy in the aspect of immediate stone free rate. We believe that holmium:YAG laser is an excellent treatment modality for managing ureteral calculi.
Erectile dysfunction following nerve‐sparing radical retropubic prostatectomy and its treatment with sildenafil
Authors: SHIMIZU TAKASHI , HISASUE SHIN‐ICHI , SATO YOSHIKAZU , KATO RYUICHI , KOBAYASHI KO , TSUKAMOTO TAIJI
Published: June 2005

Abstract  Background:  We retrospectively evaluated the erectile function after nerve‐sparing radical retropubic prostatectomy (RRP) and the efficacy of sildenafil for erectile dysfunction (ED) following RRP according to the preoperative erectile function.

Methods:  We evaluated 48 Japanese patients who underwent nerve‐sparing RRP at the Sapporo Medical University School of Medicine, Sapporo, Japan, between January 1996 and December 2001. Erectile function following nerve‐sparing RRP was assessed by a simple mailed questionnaire that was constructed for the study.

Results:  Of the 48 patients, 36 had normal erectile function preoperatively, but for 12, function was not sufficient to penetrate. The overall estimated recovery rates of any degree of erection were 50.6% at 36 months and 94.3% at 60 months. However, that of erection sufficient to penetrate was only 17.7% at 36 months and was only seen in bilateral nerve‐sparing patients. Sildenafil was effective in 9 of 13 ED patients (69.2%) in both nerve‐sparing groups. When patients were divided according to preoperative erectile function, no difference was found in the efficacy rate between patients with normal function and those with ED.

Conclusions:  Even bilateral nerve‐sparing RRP can not always guarantee a sufficient erection. However, sildenafil is effective for ED following nerve‐sparing RRP regardless of the nerve‐sparing procedure or preoperative erectile function. Thus, preoperative function alone, although depending on its severity, may not necessarily be a reason for exclusion from receiving nerve‐sparing RRP if patients want to have the operation.
Ten cases of congenital urethral stricture in childhood with enuresis
Authors: SUGIMOTO MIKIO , KAKEHI YOSHIYUKI , YAMASHITA MOTOKI , MATSUKI TAKAKAZU , INUI MASASHI , TAKETA SIGEO
Published: June 2005

Abstract  Background:  To report short‐term clinical outcomes of endoscopic correction of congenital urethral stricture in 10 boys who suffer from enuresis resistant to conservative therapy.

Methods:  Fifteen boys ranging between 5 and 15 years old consulted our clinics for nocturnal and diurnal enuresis which had not been improved by medication and behavioral therapy. Among them, voiding cystography revealed bulbar narrowing (Cobb's Collar) in 10 cases and vesico‐ureteral reflux was found in four cases (seven ureters). Endoscopically, this lesion was recognized as a ring‐form stenosis just distal to the urethral sphincter. It was incised with infantile urethrotome.

Results:  Vesico‐ureteral reflux was resolved in four ureters and improved in one. In all cases, daytime enuresis resolved dramatically and night enuresis became controllable.

Conclusions:  Boys who suffer from diurnal enuresis should immediately be explored for the existence of congenital urethral stenosis. Early resolution may bring about better urinary behavior.
Different transformation of mature teratoma in a patient with mixed germ cell tumor of the testis
Authors: FUJIMURA TESTUYA , YAMADA YUTA , NASU MICHIYO , HAMASAKI KIMIHISA , MINOWADA SHIGERU , KITAMURA TADAICHI
Published: June 2005

Abstract  A 44‐year‐old male was referred with a left supraclavicular lymphadenopathy. A biopsy of the lymph node showed metastatic embryonal carcinoma. Tumor markers were present at high levels: alpha‐fetoprotein 253.9 ng/mL, beta‐human chorionic gonadotrophin 62 ng/mL. Computed tomography (CT) showed retroperitoneal adenopathy. High orchiectomy was done. The patient was treated with three cycles of etoposide plus cisplatin, achieved normalization of the serum tumor markers and underwent retroperitoneal lymph node dissection. Pathological findings of multiple lymph nodes showed teratomatous glands without viable cells. At follow‐ups performed every 3 months, tumor markers remained within normal limits and no evidence of recurrence was observed.

 Eight years after first admission a CT scan revealed a cystic tumor 1 cm in diameter in the para‐aortic region. The cystic tumor continued to slowly grow, expanding by 1 cm in diameter per year without elevation of tumor markers. The para‐aortic tumor had grown to 4 cm in diameter and a left supraclavicular lymphadennopathy recurred. A resection of the supraclavicular cystic tumor showed mucinous cystadenocarcinoma, but a cystic tumor in the para‐aortic region revealed mature teratoma. Here we report a case of mature teratoma with metastases at supraclavicular and para‐aortic lymph nodes which had different transformations in spite of both regions consisting of cystic tumors.
Modified endoscopic live donor nephrectomy: Retroperitoneoscopy followed by hand‐assistance
Authors: FURUYA YASUHISA , ARAKI ISAO , ZAKOJI HIDENORI , TAKIHANA YOSHIO , TANABE NOBUAKI , TAKEDA MASAYUKI
Published: June 2005

Abstract  We have developed a novel modification of previous approaches to donor nephrectomy and herein review our original operative procedure. First, the posterior aspect of the kidney was dissected retroperitoneoscopically and dissection of the renal artery, ureter and gonadal vein was almost completed. Second, the anterior aspect of the kidney was dissected with transperitoneal hand‐assistance, and dissection of the renal pedicle from the anterior surface was accomplished easily and safely. This operative procedure was successfully performed for two donors with no intraoperative or postoperative complications. Our modified endoscopic donor nephrectomy is feasible as a minimally invasive procedure because of its safety, and its ability to preserve renal function and establish an excellent operative field for both posterior and anterior aspects of the kidney.
Impact of anatomical pielocaliceal topography in the treatment of renal lower calyces stones with extracorporeal shock wave lithotripsy
Authors: RUGGERA LORENZO , BELTRAMI PAOLO , BALLARIO RICCARDO , CAVALLERI STEFANO , CAZZOLETTI LUCIA , ARTIBANI WALTER
Published: June 2005

Abstract  Aim:  There is wide consensus that the lowest success rate of extracorporeal shock wave lithotripsy (ESWL) is in the complete clearance of renal stones located in the lower calyces. We assess the effectiveness of extracorporeal shock wave lithotripsy monotherapy for lower pole renal calculi to determine the relationship between the spatial anatomy of lower pole and the outcome of ESWL.

Methods:  We evaluated 107 patients who were treated for solitary lower pole renal stones less than 20 mm in diameter with ESWL. The spatial anatomy of the lower pole, as defined by the lower infundibulopelvic angle, infundibular length and infundibular width, was measured by preoperative intravenous pyelography, while the stone location and size were determined by using abdominal plain X‐ray. All patients were followed up at 1 and 3 months with abdominal plain X‐ray and ultrasonography.

Results:  Only 62 patients (58%) became stone free, while 45 (42%) retained residual fragments. A small lower infundibulopelvic angle, a long infundibular length and a tight infundibular width are unfavorable for stone clearance after ESWL.

Conclusions:  ESWL is the treatment of choice for most renal and ureteral stones. However, stone clearance from the lower pole following ESWL is poor and significantly affected by the inferior pole collecting system anatomy. Therefore, we believe it is important to evaluate these anatomical factors when deciding on the best treatment for lower pole renal calculi.
Splenogonadal fusion: Report of a case
Authors: HİZLİ FATIH , UYGUR M. CEMIL , IRKKAN ÇIĞDEM
Published: June 2005

Abstract  A 15‐year‐old male patient was admitted to our hospital with a left undescended testis. He also suffered from congenital limb defects. Ultrasonography revealed atrophic testicular tissue in the left groin, approximately 2‐cm in size. Upon left inguinal exploration, atrophic testicular tissue was found and an orchidectomy was performed. Histopathological examination revealed splenogonadal fusion, which has a known association with congenital limb defects.
Successful cure of dermatomyositis after treatment of nonseminomatous testicular cancer
Authors: YOSHINAGA ATSUSHI , HAYASHI TETSUO , ISHII NOBUYUKI , OHNO RENA , WATANABE TORU , YAMADA TAKUMI
Published: June 2005

Abstract  Although the association between dermatomyositis and cancer is well recognized, there have been a limited number of reports of dermatomyositis associated with testicular cancer. We report the case of a 31‐year‐old man who was diagnosed with dermatomyositis. Because the patient's serum levels of α−fetoprotein and human chorionic gonadotropin beta subunit were elevated, the patient was referred to our department. Physical examination revealed an induration (2 cm × 2 cm) in the left testis and the patient was diagnosed with stage IIIB left testicular cancer. A left high orchidectomy was then performed, and pathological examination revealed embryonal carcinoma. The patient was started on a systemic chemotherapeutic (etoposide, ifosfamide and cisplatin; VIP) regimen. After the third chemotherapy session, metastases had completely disappeared, the serum levels of α−fetoprotein and human chorionic gonadotropin beta subunit had normalized and the dermatomyositis symptoms had improved. Cancer is known to be a trigger of dermatomyositis. This case illustrates the importance of palpation of the testes in young patients with dermatomyositis.
Modified pluck method in en bloc nephroureterectomy with bladder cuff for upper urothelial cancer
Authors: HAYASHI MUTSUO , TANAKA GAKU , OKUTANI TAKUYA
Published: June 2005

Abstract  Aim:  To evaluate the surgical results of the en bloc removal of the kidney and ureter with a bladder cuff by using our modified pluck method.

Methods:  We employed this procedure in 28 patients with renal pelvic and ureteral cancer. The clinical stages of the 28 patients were T(1–3)N(0–1)M(0). These patients were operated on by nephrectomy with standard open or retroperitoneoscopic surgery, and then standard or blind dissection of the distal ureter. After simultaneously making a transurethral circular incision of the ureteral meatus with a J‐shaped electrode, the ureteral end was plucked out of the bladder, and en bloc removal of the kidney and ureter was performed from the wound.

Results:  The mean operating time for nephroureterectomy using the pluck method was 278 min in all cases. The mean time for the pluck procedure after nephrectomy was 24 min in 22 cases, and 73 min in six cases where the nephrectomy was carried out via a new lower pararectal wound. There were no intra‐ or postoperative complications associated with these procedures. Within the mean follow‐up period of 25 months, there was no recurrence of tumors in the perivesical retroperitoneal space; however, the usual rate of intravesical recurrence was observed. Three patients died, two of metastatic urothelial cancer and one of heart disease.

Conclusions:  En bloc nephroureterectomy using our modified pluck method is a useful procedure for patients with upper urothelial cancer because of the simplicity and ease of the procedure.
The origin of the endothelial cells: an evo‐devo approach for the invertebrate/vertebrate transition of the circulatory system
Authors: Muñoz‐Chápuli R. , Carmona R. , Guadix J. A. , Macías D. , Pérez‐Pomares J. M.
Published: June 2005

Summary Circulatory systems of vertebrate and invertebrate metazoans are very different. Large vessels of invertebrates are constituted of spaces and lacunae located between the basement membranes of endodermal and mesodermal epithelia, and they lack an endothelial lining. Myoepithelial differentation of the coelomic cells covering hemal spaces is a frequent event, and myoepithelial cells often form microvessels in some large invertebrates. There is no phylogenetic theory about the origin of the endothelial cells in vertebrates. We herein propose that endothelial cells originated from a type of specialized blood cells, called amoebocytes, that adhere to the vascular basement membrane. The transition between amoebocytes and endothelium involved the acquisition of an epithelial phenotype. We suggest that immunological cooperation was the earliest function of these protoendothelial cells. Furthermore, their ability to transiently recover the migratory, invasive phenotype of amoebocytes (i.e., the angiogenic phenotype) allowed for vascular growth from the original visceral areas to the well‐developed somatic areas of vertebrates (especially the tail, head, and neural tube). We also hypothesize that pericytes and smooth muscle cells derived from myoepithelial cells detached from the coelomic lining. As the origin of blood cells in invertebrates is probably coelomic, our hypothesis relates the origin of all the elements of the circulatory system with the coelomic wall. We have collected from the literature a number of comparative and developmental data supporting our hypothesis, for example the localization of the vascular endothelial growth factor receptor‐2 ortholog in hemocytes of Drosophila or the fact that circulating progenitors can differentiate into endothelial cells even in adult vertebrates.
Almotriptan in Migraine Patients Who Respond Poorly to Oral Sumatriptan: A Double‐Blind, Randomized Trial
Authors: Diener Hans‐Christoph , Gendolla Astrid , Gebert Irmingard , Beneke Manfred
Published: June 2005

Objective.—To investigate the efficacy and tolerability of almotriptan 12.5 mg in migraine patients who respond poorly to sumatriptan 50 mg.

Background.—Poor response to sumatriptan therapy for acute migraine attacks has been documented in the literature, but few controlled trials have investigated the efficacy of an alternative triptan in this subgroup of patients.

Methods.—Patients with an International Headache Society diagnosis of migraine who self‐described as experiencing at least two unsatisfactory responses to sumatriptan treated their first migraine attack with open‐label sumatriptan 50 mg. Patients who did not achieve 2‐hour pain relief (improvement of headache from moderate/severe to mild/no headache) were then randomized to treat their second attack with almotriptan 12.5 mg or placebo under double‐blind conditions.

Results.—In the first attack, 221 of 302 participants (73%) did not achieve 2‐hour pain relief with sumatriptan and were randomized to treatment of their second attack with almotriptan 12.5 mg or placebo. Of the 198 sumatriptan nonresponders who treated their second attack (99 almotriptan; 99 placebo), 70% had severe headache pain at baseline. Two‐hour pain‐relief rates were significantly higher with almotriptan compared to placebo (47.5% vs 23.2%; P < .001). A significant treatment effect for almotriptan was also seen in pain‐free rates at 2 hours (33.3% vs 14.1%; P < .005) and sustained freedom from pain (20.9% vs 9.0%; P < .05). In the second attack, 7.1% of patients in the almotriptan group experienced adverse events compared to 5.1% in the placebo group (P= .77).

Conclusions.—Almotriptan 12.5 mg is an effective and well‐tolerated alternative for patients who respond poorly to sumatriptan 50 mg. A poor response to one triptan does not predict a poor response to other agents in that class.
Effects on Productivity and Quality of Life of Rizatriptan for Acute Migraine: A Workplace Study
Authors: Láinez Miguel J.A. , López Arturo , Pascual Ana M.
Published: June 2005

Objective.—To evaluate the impact of treatment with rizatriptan 10 mg on jobs and quality of life of patients with migraine.

Methods.—Prospective, open‐label study at 27 work sites of 20 companies representing diverse labor sectors in Spain. Eligible patients according International Headache Society (IHS) criteria were recruited for the study by on‐site physicians and instructed to treat moderate or severe migraine attacks with one tablet of rizatriptan 10 mg. They were asked to complete the study questionnaires (ML‐96, SF‐36) at baseline, and then 3 months later.

Results.—A total of 259 patients (83 men and 176 women) of a mean age of 39 (range 18 to 61 years) completed the study. Only 7% had taken triptans before for treatment of their migraine attacks. After 3 months of rizatriptan therapy, the use of medical services was significantly lower and all tested domains of quality of life had improved (P < .001). Absenteeism and days worked during migraine attacks also fell significantly during 3 months of rizatriptan therapy as compared with the 3 months before the study (P < .001). The improvement in productivity was reflected in the significant decreases in lost workday equivalents (decrease from 3.32 to 1.21 days; P < .001) and also in the total number of workdays lost (decrease from 5.16 to 1.82 days; P < .001). Two‐thirds of patients described the efficacy of oral rizatriptan as excellent or very good (62%), and 89% preferred it over their usual medications for acute treatment of migraine attacks.

Conclusion.—For this employed population of patients with migraine, treatment with rizatriptan significantly improved parameters measuring direct medical costs, work and productivity, and health‐related quality of life. In accordance with these findings, direct and indirect costs related to migraine could be substantially reduced by gathering detailed information about the nature of headache, eliminating triggering factors, and instituting effective treatment of migraine attacks.
Predictors of a Negative Response to Topiramate Therapy in Patients With Chronic Migraine
Authors: Rothrock John F. , Parada Victoria A. , Drinkard Renay , Zweifler Richard M. , Key Kristin F.
Published: June 2005

Objective.—To identify variables predictive of a negative response to prophylactic therapy with topiramate in patients with chronic migraine.

Background.—While certain of the newer antiepileptic drugs (AEDs) have emerged as promising or definitely effective therapies for migraine prevention, we continue to lack biologic or clinical variables predictive of treatment response to these or other widely used prophylactic therapies.

Methods.—A consecutive series of 170 patients with IHS‐defined migraine who were experiencing 15 or more days of headache per month were treated with topiramate according to a uniform dosing protocol. Variables examined for their potential value in predicting treatment response included age, gender, prior experience with prophylactic therapy, prior experience with divalproex sodium specifically, headache frequency and, if present, duration of chronic daily headache (CDH). A positive treatment response was defined as a 50% or greater reduction in headache days during the second treatment month relative to the patient's pretopiramate baseline. Only patients who completed the treatment phase and achieved the 50 mg BID target dose were analyzed (efficacy analysis). Each variable prospectively selected was evaluated in regards to treatment outcome via a paired t‐test, and a multiple regression analysis of all variables subsequently was performed.

Results.—A total of 116 patients completed at least 60 days of treatment and consequently were available for analysis. In the efficacy analysis, 45 (38.8%) of the 116 responded positively to topiramate. Neither age nor gender influenced treatment response. Those patients with CDH of more than 6 months duration, patients who previously had tried and failed more than three prophylactic agents and patients who previously had failed to respond to divalproex sodium were more likely to be nonresponders, but after multiple regression analysis the only statistically significant predictor of a negative treatment response was CDH of more than 6 months duration (P < .001).

Conclusions.—Patients with chronic migraine who are treated with topiramate may respond positively at a rate approaching that reported from placebo‐controlled trials involving topiramate or other AEDs administered to less severely afflicted migraineurs. Our analysis suggests that patients with chronic migraine least likely to respond to topiramate would be those with extensive and negative previous experience with prophylactic therapy, previous failure to respond to divalproex sodium, CDH, and, most notably, CDH of more than 6 months duration.
A High Incidence of Migraine With Aura Among Morbidly Obese Women
Authors: Horev Anat , Wirguin Itzhak , Lantsberg Leonid , Ifergane Gal
Published: June 2005

Introduction.—Nearly two‐thirds of adults in the United States and an increasing percentage of the population worldwide are overweight or obese. The relationship of obesity to headache has received inadequate attention. We evaluated the incidence of headache in a sample of morbidly obese women.

Methods.—Morbidly obese women, attending the surgical preoperative clinic of Soroka University Medical Center for preoperative assessment for laparoscopic gastric banding were evaluated using a structured interview and their medical charts were reviewed.

Results.—During a 2‐month period, 27 morbidly obese women were interviewed, with a mean BMI of 41.07. Ten patients suffered from migraine with aura, three from migraine without aura, and four from tension headache.

Conclusion.—The unusually high incidence of migraine with aura can be attributed to extraovarian production of estrogen and estradiol in the adipose tissue. Further study is indicated to explore the therapeutic role of weight loss in headache care.