bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between gender and aspirations to senior management
Authors: Litzky Barrie , Greenhaus Jeffrey
Published: October 2007

Purpose

The purpose of this paper is to examine the relationship of gender, work factors, and non‐work factors with aspirations to positions in senior management. A process model of senior management aspirations was developed and tested.

Design/methodology/approach

Data were collected via an online survey that resulted in a sample of 368 working professionals. Hierarchical multiple regression analysis was used to analyze results.

Findings

Women were less likely than men to desire promotion into a senior management position. Moreover, women's lower desired aspirations for promotion to senior management were due in part to the smaller degree of congruence that women perceive between personal characteristics and senior management positions and in part to the less favorable prospects for career advancement that women perceive relative to men.

Research limitations/implications

The cross‐sectional, correlational research design does not permit strong inferences regarding the causal direction of observed relationships. In addition, the specific nature of the sample (working professionals enrolled in graduate study at one university in the USA) may limit the generalizability of the results.

Practical implications

Because women's career aspirations are affected by their perceived congruence with senior management positions and by their perceived opportunity to reach senior management, organizations should assure that senior management roles are not predominantly associated with masculine characteristics and should evaluate their promotion systems to eliminate artificial barriers to women's advancement into senior management.

Originality/value

This research distinguishes between desired and enacted aspirations as well as provides insights into some factors that explain why women hold weaker desired aspirations for senior management positions than men.
The German guideline for intellectual capital reporting: method and experiences
Authors: Bornemann Manfred , Alwert Kay
Published: October 2007

Purpose

This paper seeks to describe a methodology for intellectual capital reporting which was successfully tested in Germany. Special focus is on developing a short list of IC drivers for urgent management intervention.

Design/methodology/approach

Building on established self‐assessment methodologies from quality management and concepts of system dynamics, an action research design was applied to develop an intellectual capital reporting framework.

Findings

It is possible to identify and to assess intellectual capital drivers for corporate results and to prioritize them according to marginal economic contribution. Based on concepts from system dynamics, group learning processes and organizational learning processes are stimulated. Investing scarce resources in specific drivers of intellectual capital with high impact on the organization and additional high levels of managerial control supports long‐term performance.

Research limitations/implications

The research builds on self‐organizing principles; the quality of intellectual capital assessment thus depends massively on the rigour of the team involved. Comparability of assessments is limited, as the standard reference is the organization's strategy.

Practical implications

The suggested methodology builds heavily on methods already established in SMEs and is compatible with general management approaches. It is economical by design and delivers insight into the functioning of the organization as well as insights on future fields for management intervention.

Originality/value

This methodology combines two established concepts of self‐assessment and system analysis and applies them to intellectual capital in order to resolve the decision problem of allocating funds based on economic efficiency and impact.
Extended VAIC model: measuring intellectual capital components
Authors: Nazari Jamal A. , Herremans Irene M.
Published: October 2007

Purpose

In the intellectual capital (IC) literature, only a few studies have analyzed the relationships among the components of IC and organizational success. This study sets out to extend the current models to provide further insight into the role of IC in organizational performance.

Design/methodology/approach

The study provides a theoretical discussion designed to push the measurement of IC into a more rigorous and comprehensive domain.

Findings

As this is a theoretical paper, several hypotheses are presented for testing in the future.

Practical implications

Recognizing the most influential elements of IC on organizational performance would help organizations to understand better the organizational capabilities they possess. In addition, the suggested extension would enable researchers to use archival resources to do cross‐company comparisons.

Originality/value

The suggested extension to the VAIC model builds on several IC models that have not been well‐connected in the literature previously.
Making sense of knowledge productivity: beta testing the KP‐ enhancer
Authors: Stam Christiaan D.
Published: October 2007

Purpose

The purpose of this article is to report progress of the development of a method that makes sense of knowledge productivity, in order to be able to give direction to knowledge management initiatives.

Design/methodology/approach

The development and testing of the method are based on the paradigm of design science. In order to increase the objectivity of the research findings, and in order to test the transferability of the method, this article suggests a methodology for beta testing.

Findings

Based on experiences within this research, the concept of beta testing seems to fit design science research very well. Moreover, applying this concept within this research resulted in valuable findings for further development of the method.

Originality/value

This is the first article that explicitly applies the concept of beta testing to the process of developing solution concepts. This article contributes to the further operationalization of the relatively new concept of knowledge productivity. From a methodological point of view, this article aims to contribute to the paradigm of design sciences in general, and the concept of beta testing in particular.
How does human capital affect the performance of small and mid‐cap mutual funds?
Authors: Switzer Lorne N. , Huang Yanfen
Published: October 2007

Purpose

This study sets out to examine whether small and mid‐cap fund performance is related to fund manager human capital characteristics including tenure, investment experience, education (MBA designation), professional training (CFA), and gender.

Design/methodology/approach

Based on a sample of 1,004 small and mid‐cap equity funds identified on the Morningstar database as of 31 December 2005, several statistical tests were applied which consider fund performance, risk, expenses, and turnover simultaneously.

Findings

Depending on the benchmark, an optimal size of managed mutual funds is determined that ranges between $US1.43 billion and $US3.89 billion.

Originality/value

The results suggest that there are some systematic cross‐sectional differences in fund performance that can be attributed to differences in managerial human capital characteristics.
A comparative analysis of mission statement content in secular and faith‐based hospitals
Authors: Bart Chris
Published: October 2007

Purpose

This paper seeks to determine whether significant differences exist between secular and faith‐based hospitals in terms of specific mission statement components and mission‐related performance variables.

Design/methodology/approach

A total of 130 top managers from a sample of 515 Canadian hospitals responded to a comprehensive questionnaire investigating 23 mission statement components and seven mission performance outcome measures. Data were analyzed using frequency analysis, one‐way analysis of variance, MANOVA, chi‐squared and Mann‐Whitney U tests.

Findings

The analysis showed that differences in mission content exist between different types of hospitals, and that these differences form a pattern of sorts within each type. It was also found that faith‐based hospitals out‐perform their secular counterparts in many ways.

Research limitations/implications

The research and its findings are limited in their application to relatively large Canadian health care organizations and the responses/opinions given by managers from a hospital's senior echelons.

Practical implications

The results have implications for all health care organizations interested in improving the results in their mission performance scorecard. The findings both confirm the impact that mission statements can have on selected hospital performance indicators and demonstrate that faith‐based hospitals have been more diligent in taking advantage of them.

Originality/value

This is the first paper to show that specific and significant differences exist between the mission statements of secular and faith‐based hospitals and that those differences are associated with hospital performance. These findings will be of special interest to senior hospital administrators and “directors of mission” within faith‐based institutions.
Intellectual capital management in Spanish universities
Authors: Ramírez Yolanda , Lorduy Carmen , Rojas José Antonio
Published: October 2007

Purpose

The purpose of this paper is to provide assistance to universities in the process of developing their ability to identify, measure, manage and value their intangible assets.

Design/methodology/approach

The paper takes the form of a review of the most important intellectual capital management initiatives at Spanish public universities.

Findings

The experience gained from the case studies provides a basis for understanding how Spanish universities are measuring and managing their intellectual capital.

Research limitations/implications

Despite its importance, intellectual capital at universities is scarcely dealt with in a specific manner. Up to now, only a few universities have taken the challenge of trying to measure, manage and report on intangible assets.

Practical implications

This study offers a perspective on how Spanish universities deal with their intellectual capital. In this sense, the first step would be the definition and diffusion of the organisation's strategic objectives. Then, critical intangibles related to these objectives should be identified and the causal network of relationships among them should be established. Afterwards, a set of indicators is defined and developed for each intangible.

Originality/value

This paper shows the importance of intellectual capital approaches as instruments to face the new challenges in Spanish universities. It offers practical help to universities to develop means to identify, measure, manage and value their intangible assets.
Acute medical assessment/admission units: clinical performance indicators
Authors: Thomas Peter , Makinde K. , Watkins A. , Gupta A.
Published: October 2007

Purpose

The purpose of this study is to explore the patterns of referral, reasons for admission or discharge from acute medical assessment/admission units (AMAUs) and the reasons for longer length of stay.

Design/methodology/approach

Details relating to consecutive patients were noted on a proforma by medical and nursing staff and were recorded over a three‐month period in 1638 patients. These included evidence of chronicity of disease, level of independence and recent contact with primary care services.

Findings

Age is an important factor in deciding admission or discharge. There is evidence that an opportunity for early intervention, to prevent admission, exists in a significant proportion of patients.

Practical implications

There is a need to develop a more integrated health care system to provide a more co‐ordinated approach to acute medical patients needs, keeping people in their own homes whenever possible.

Originality/value

The increasing number of acute medical admissions provides a challenge throughout the UK. This paper delineates the problem in a typical District General Hospital (DGH) and discusses approaches to decrease admission whilst improving patient care.
The cataract service satisfaction tool
Authors: Karthikeyan Mallika , Dahlmann‐Noor Annegret H. , Gupta Nitin , Vivian Anthony J.
Published: October 2007

Purpose

Client satisfaction is an important outcome measure of healthcare services. The aims of the present work are to develop a tool to assess client satisfaction with the components of streamlined cataract services and to conduct a pilot study to evaluate its reliability and validity.

Design/methodology/approach

A validated patient satisfaction questionnaire was modified for use in a cataract service and validated by expert panel and patient focus group approach. Two versions were used to evaluate pre‐operative assessment clinic and day surgical unit. The questionnaires comprised items covering individual domains of client satisfaction plus one global satisfaction item. Together with a visual analogue scale (VAS) the questionnaires were administered to 200 consecutive cataract patients.

Findings

The questionnaires were returned by 165 patients (82.5 per cent). Median individual item and global scores in the pre‐operative group were 87 and 100 per cent, respectively. In the day‐of‐surgery group median scores were 91 and 100 per cent, respectively. Mean VAS scores were 95.5 per cent (SD 5.6) and 94.5 per cent (SD 6.4), respectively. Cronbach's alpha was 0.768 for the pre‐operative and 0.636 for the day‐of‐surgery questionnaire. Spearman's correlation coefficient between individual item score and the VAS score was 0.350 (p=0.005) for the pre‐operative and 0.302 (p=0.028) for the day‐of‐surgery questionnaire. Spearman's correlation coefficient between individual item score and the global satisfaction score was 0.566 (p<0.001) for the pre‐operative and 0.317 (p=0.004) for the day‐of‐surgery questionnaire.

Originality/value

The questionnaire appears to be a useful tool for measuring client satisfaction with a one‐stop cataract pre‐assessment service where surgery is performed at a second visit, which other cataract service providers might adapt for local use.
Clinicians' and managers' responses to patients' complaints
Authors: Natangelo Roberto
Published: October 2007

Purpose

The purpose of this paper is to discuss the analysis of complaints lodged by patients and how the complainants' letters are handled by health boards and clinicians.

Design/methodology/approach

A retrospective analysis of patients' complaints lodged with an independent voluntary citizens' association in Milan and, at the same time, against the hospital administration offices or the consultants and responses returned by the hospitals in reply to the patients. The authors assessed: the reasons for the complaints according to the citizen; the nature of the complaint according to a medical expert revue; and the handling of the complaint process by managers.

Findings

For 83 of 151 people (55 per cent), the reason was compensation for injury or pain. According to the medical review, in 54 cases (35.7 per cent), the main themes emerging were mainly “perceived” poor quality of care. Together, or alone, were problems of “technical” quality of care. A total of 94 complaints (62.2 per cent) had been dealt with by the Health Boards, but 48 cases (31.7 per cent) were dealt with by the legal office or the insurance company who replied without showing evidence that they had discussed events with clinicians. Many times the managers did not undertake a systematic investigation, leaving complainants dissatisfied with the process and the outcome.

Originality/value

This paper is the first to report the results of an assessment process of complaints lodged via an independent citizens' association in Italy.
Why hedge? Rationales for corporate hedging and value implications
Authors: Aretz Kevin , Bartram Söhnke M. , Dufey Gunter
Published: October 2007

Purpose

In the presence of capital market imperfections, risk management at the enterprise level is apt to increase the firm's value to shareholders by reducing costs associated with agency conflicts, external financing, financial distress, and taxes. The purpose of this paper is to provide an accessible and comprehensive account of these rationales for corporate risk management and to give a short overview of the empirical support found in the literature.

Design/methodology/approach

The paper outlines the main theories suggesting that corporate risk management can enhance shareholder value and briefly reviews the empirical evidence on these theories.

Findings

When there are imperfections in capital markets, corporate hedging can enhance shareholder value through its impact on agency costs, costly external financing, direct and indirect costs of bankruptcy, as well as taxes. More specifically, corporate hedging can alleviate underinvestment and asset substitution problems by reducing the volatility of cash flows, and it can accommodate the risk aversion of undiversified managers and increase the effectiveness of managerial incentive structures through eliminating unsystematic risk. Lower volatility of cash flows also leads to lower bankruptcy costs. Moreover, corporate hedging can also align the availability of internal resources with the need for investment funds, helping firms to avoid costly external financing. Finally, corporate risk management can reduce the corporate tax burden in the presence of convex tax schedules. While there is empirical support for these rationales of hedging at the firm level, the evidence is only modestly supportive, suggesting alternative explanations.

Originality/value

The discussed theories and the empirical evidence are described in an accessible way, in part by using numerical examples.
Prediction of bank failures in emerging financial markets: an ANN approach
Authors: Nur Ozkan‐Gunay E. , Ozkan Mehmed
Published: October 2007

Purpose

The recent financial crises in the world have brought attention to the need for a new international financial architecture which rests on crisis prevention, crisis prediction and crisis management. It is therefore both desirable and vital to explore new predictive techniques for providing early warnings to regulatory agencies. The purpose of this study is to propose a new technique to prevent future crises, with reference to the last banking crises in Turkey.

Design/methodology/approach

ANN is utilized as an inductive algorithm in discovering predictive knowledge structures in financial data and used to explain previous bank failures in the Turkish banking sector as a special case of EFMs (emerging financial markets).

Findings

The empirical results indicate that ANN is proved to differentiate patterns or trends in financial data. Most of the bank failures could be predicted long before, with the utilization of an ANN classification approach, but more importantly it could be proposed to detect early warning signals of potential failures, as in the case of the Turkish banking sector.

Practical implications

The regulatory agencies could use ANN as an alternative method to predict and prevent future systemic banking crises in order to minimize the cost to the economy.

Originality/value

This paper reveals that the ANN approach can be proposed as a promising method of evaluating financial conditions in terms of predictive accuracy, adaptability and robustness, and as an alternative early warning method that can be used along with the most common alternatives such as CAMEL, financial ratio and peer group analysis, comprehensive bank risk assessment, and econometric models.
A generalized ROC approach for the validation of credit rating systems and scorecards
Authors: Xanthopoulos Stylianos Z. , Nakas Christos T.
Published: October 2007

Purpose

The purpose of this article is to introduce Receiver Operating Characteristic (ROC) surfaces and hyper‐surfaces within a banking context as natural generalizations of the ROC curve.

Design/methodology/approach

Nonparametric ROC analysis using U‐statistics theory was used.

Findings

Application of the proposed methodology on data from a small size Greek bank illustrates the usefulness of ROC analysis for scoring systems assessment. The area under the ROC curve and the volume under the ROC surface and hyper‐surface are useful diagnostic indices for the assessment of credit rating systems and scorecards. The notion of statistical significance is not adequate for the evaluation of the loan granting strategy of a financial institution.

Originality/value

This article will be of value to financial institutions during the process of evaluation/validation of rating models.
Impacts of interval measurement on studies of economic variability
Authors: He Ling T. , Hu Chenyi
Published: October 2007

Purpose

The purpose of this study is to investigate the impacts of interval measured data, rather than traditional point data, on economic variability studies.

Design/methodology/approach

The study uses interval measured data to forecast the variability of future stock market changes. The variability (interval) forecasts are then compared with point data‐based confidence interval forecasts.

Findings

Using interval measured data in stock market variability forecasting can significantly increase forecasting accuracy, compared with using traditional point data.

Originality/value

An interval forecast for stock prices essentially consists of predicted levels and a predicted variability which can reduce perceived uncertainty or risk embedded in future investments, and therefore, may influence required returns and capital asset prices.
Outsourcing contracts as instruments of risk management
Authors: Ngwenyama Ojelanki K. , Sullivan William E.
Published: October 2007

Purpose

This paper aims to examine contracts in public jurisdictions to compare academic theories related to outsourcing risks and risk management strategies to current practice in order to extend and refine theory concerning what risk management strategies can, or should, be included in outsourcing contracts.

Design/methodology/approach

An automated content analysis tool is used to rigorously compare contract documents in two public jurisdictions to a comprehensive outsourcing risk framework from previous research.

Findings

The findings indicate that although IS outsourcing risk factors are widely acknowledged in the literature, they are not fully specified in the outsourcing contracts that are implemented in some public organizations. This research surfaces some of the differences in the techniques implemented through actual contracts to manage the risks inherent in IS outsourcing, including some strategies not previously identified in the literature. Also, not all risks need to be addressed in the contract to have a successful outsourcing engagement.

Practical implications

The improved framework for thinking about risk management strategies in the contracting process shown within the paper can provide important ideas and insights for managers contemplating or renewing outsourcing engagements.

Originality/value

This paper uses content analysis to rigorously compare academic theory to actual practice to extend theory. Specifically, it discovers several risk management strategies that have not been presented in previous research.
Modeling and analysis of mobile business processes
Authors: Gruhn V. , Köhler A. , Klawes R.
Published: October 2007

Purpose

The purpose of this paper is to present results from an analysis of service processes regarding their optimization potential through mobile technologies. The analysis was performed with a company of the housing industry.

Design/methodology/approach

The analysis was conducted with the aim of organizing business processes more efficiently in order to realize cost savings. Therefore, a method introduced in this paper was used.

Findings

It is shown how the initial situation of the company was analyzed, which alternative process models on the basis of mobile technologies were developed and how these alternatives were economically evaluated. Furthermore, first restrictions for the software and system design were identified on the basis of one process model. Finally, it is shown how the method can be used to verify whether the adoption of mobile technologies is suitable to obtain a defined goal, and which requirements such a solution needs to fulfill.

Originality/value

This paper shows practitioners how to conduct a systematic analysis of business processes regarding their optimization potential through mobile technologies.
An alternative excited‐state proton transfer pathway in green fluorescent protein variant S205V
Authors: Shu Xiaokun , Leiderman Pavel , Gepshtein Rinat , Smith Nicholas R. , Kallio Karen , Huppert Dan , Remington S. James
Published: October 2007

Wild‐type green fluorescent protein (wt‐GFP) has a prominent absorbance band centered at ∼395 nm, attributed to the neutral chromophore form. The green emission arising upon excitation of this band results from excited‐state proton transfer (ESPT) from the chromophore hydroxyl, through a hydrogen‐bond network proposed to consist of a water molecule and Ser205, to Glu222. Although evidence for Glu222 as a terminal proton acceptor has already been obtained, no evidence for the participation of Ser205 in the proton transfer process exists. To examine the role of Ser205 in the proton transfer, we mutated Ser205 to valine. However, the derived GFP variant S205V, upon excitation at 400 nm, still produces green fluorescence. Time‐resolved emission spectroscopy suggests that ESPT contributes to the green fluorescence, and that the proton transfer takes place ∼30 times more slowly than in wt‐GFP. The crystal structure of S205V reveals rearrangement of Glu222 and Thr203, forming a new hydrogen‐bonding network. We propose this network to be an alternative ESPT pathway with distinctive features that explain the significantly slowed rate of proton transfer. In support of this proposal, the double mutant S205V/T203V is shown to be a novel blue fluorescent protein containing a tyrosine‐based chromophore, yet is incapable of ESPT. The results have implications for the detailed mechanism of ESPT and the photocycle of wt‐GFP, in particular for the structures of spectroscopically identified intermediates in the cycle.
Efficacy of interferon‐γ in patients with refractory bullous pemphigoid
Authors: NAKAMA Takekuni , ISHII Norito , ONO Fumitake , HAMADA Takahiro , YASUMOTO Shinichiro , HASHIMOTO Takashi
Published: October 2007

Bullous pemphigoid (BP) usually responds well to conventional therapies, although some severe cases show less response to various therapies or develop side‐effects due to long‐term drug administration using high doses. Most BP patients are elderly and are thus prone to systemic deterioration or unfavorable outcome. In the present study, we investigated the efficacy of interferon‐γ on severe BP patients resistant to conventional therapies. Interferon‐γ was administered to 10 severe BP patients at a dose of 2 million Japan reference units (JRU) once a day for 7 consecutive days by i.v. infusion in addition to oral corticosteroids. The degree of improvement in the clinical symptoms, serum interleukin (IL)‐4, IL‐5, and plasma RANTES concentrations, as well as the results of indirect immunofluorescence and BP180 enzyme‐linked immunosorbent assay index values, were compared before and after the 7‐day drug administration. Among the nine patients whose clinical symptoms were evaluated, an improvement was observed in all patients. Except for one patient, the serum IL‐4 concentrations decreased and similar results were observed for the serum IL‐5 concentration. All five patients in whom the plasma RANTES concentration was measured showed decreased levels. The indirect immunofluorescence titers decreased in only four patients. However, in seven patients in whom index values of BP180 enzyme‐linked immunosorbent assay were evaluated, all patients showed significant decrease of the index values. These results suggest that, in severe BP patients refractory to conventional therapies, interferon‐γ in addition to oral corticosteroids is effective and thus should be considered for further clinical use.
IgG/IgA pemphigus with dyskeratotic acantholysis and intraepidermal neutrophilic microabscesses
Authors: NAKAJIMA Kimiko , HASHIMOTO Takashi , NAKAJIMA Hideki , YOKOGAWA Maki , IKEDA Mitsunori , KODAMA Hajime
Published: October 2007

Herpetiform vesicles and erythema with erosion developed on the trunk of a 48‐year‐old Japanese man. Acantholysis was observed in the spinous layer of the lesional epidermis and direct immunofluorescence revealed cell surface deposition of immunoglobulin IgG and C3. Indirect immunofluorescence could not detect circulating anti‐cell surface antibodies. Immunoblot analysis detected neither anti‐desmoglein (Dsg)1 antibody nor anti‐Dsg3 antibody. Enzyme‐linked immunosorbent assay could detect IgG and IgA anti‐Dsg1 antibodies and IgA anti‐Dsg3 antibody, in addition to a gray zone titer of IgG anti‐Dsg3 antibody. Intraepidermal neutrophilic infiltration with neutrophilic microabscesses and intense dyskeratotic cells were histopathologically characteristic in this case. Skin lesions improved within 1 month and remission has continued for 9 years under oral administration of dapsone.
Autopsy case of systemic sclerosis with severe pulmonary hypertension
Authors: NAGAI Yayoi , YAMANAKA Masayoshi , HASHIMOTO Chie , NAKANO Akihiko , HASEGAWA Akira , TANAKA Yuko , YOKOO Hideaki , NAKAZATO Yoichi , ISHIKAWA Osamu
Published: October 2007

We report an autopsy case of a 60‐year‐old Japanese woman who died 27 years after the onset of systemic sclerosis and 4 years after the diagnosis of pulmonary arterial hypertension. Oral administration of bosentan was effective in improving her dyspnea but had to be stopped because of drug eruption along with fever and eosinophilia. During hospitalization for the treatment of multiple skin ulcers and gangrene, she suddenly complained of severe respiratory difficulty, followed by bradycardia, unconsciousness and cardiopulmonary arrest. The autopsy revealed concentric intimal proliferation and marked luminal obstruction in many small‐ and medium‐sized vessels of the lungs. In addition to right ventricular hypertrophy and dilatation, similar vascular changes were also present in the myocardial tissue and the atrioventricular node. In our patient, these marked vascular changes caused pulmonary hypertension followed by the severe right heart failure. The vascular changes in the atrioventricular node were suspected as the cause of a fatal arrhythmia leading to sudden death.
Case of adult T‐cell leukemia/lymphoma manifesting marked purpura
Authors: OKADA Junna , IMAFUKU Shinichi , TSUJITA Jun , MOROI Yoichi , URABE Kazunori , FURUE Masutaka
Published: October 2007

We present a case of a 62‐year‐old woman with marked purpura, first appearing on both legs, then spreading over the whole body, including the face. At presentation, the patient was thought to have Henoch–Schonlein purpura. However, a skin biopsy from a purpuric lesion revealed prominent infiltrations of atypical lymphocytes into the papillary dermis and marked extravasation of erythrocytes through the epidermis and upper dermis. Antibody to human T‐lymphotropic virus type 1 (HTLV‐1) was present in the serum and samples from skin lesions revealed HTLV‐1 proviral DNA integration, as well as a clonal T‐cell receptor Cβ1 gene rearrangement. We therefore diagnosed this case as adult T‐cell leukemia/lymphoma (ATL), and the purpuric lesions as ATL‐specific. Soon after the initiation of chemotherapy, these purpuric lesions began to resolve with pigmentation.
Case of purpura fulminans due to septicemia after artificial abortion
Authors: ICHIMIYA Makoto , TAKITA Yuko , YAMAGUCHI Michiya , MUTO Masahiko
Published: October 2007

We describe a case of purpura fulminans due to septicemia after artificial abortion. Our patient suffered purpuric progressive skin necrosis on the back, extremities and buttock. Rhabdomyolysis involvement was confirmed by high level of creatinine phosphokinase and appearance of much brownish discharge from necrotic gluteal muscle and latissimus dorsi muscle. Amputation of both feet and second, third, fourth and fifth fingers of the right hand was performed. The buttock lesion was reconstructed with the posterolateral thigh V‐Y flap after debridement. Other lesions were covered with split‐thickness skin grafts.
Erythropoietic protoporphyria with eye complications
Authors: TSUBOI Hiromi , YONEMOTO Kohzoh , KATSUOKA Kensei
Published: October 2007

We herein report a case of erythropoietic protoporphyria (EPP) complicated by a decrease in eyesight that occurred in a Japanese male. An ophthalmologist initially thought that the eyesight loss might be the result of idiopathic optic nerve atrophy due to a vascular obstruction in the fundus. There are no previous reports of EPP cases with eye complications. However, an eye abnormality has been reported in an animal model of protoporphyria after long‐term, low‐level exposure to blue light. As a result, in our case, it is therefore possible that a relationship may have existed between EPP and the onset of eye complications.
Phase III study to evaluate the use of high‐dose chemotherapy as consolidation of treatment for high‐risk postoperative breast cancer: Japan Clinical Oncology Group study, JCOG 9208
Authors: Tokuda Yutaka , Tajima Tomoo , Narabayashi Masaru , Takeyama Kunihiko , Watanabe Toru , Fukutomi Takashi , Chou Takaaki , Sano Muneaki , Igarashi Tadahiko , Sasaki Yasutsuna , Ogura Michinori , Miura Shigeto , Okamoto Shin‐ichiro , Ogita Masami , Kasai Masaharu , Kobayashi Tadashi , Fukuda Haruhiko , Takashima Shigemitsu , Tobinai Kensei ,   the members of the Autologous Bone Marrow Transplantation Study Group,   the Breast Cancer Study Group of the Japan Clinical Oncology Group (JCOG)
Published: October 2007

A randomized controlled trial was conducted to evaluate the efficacy of high‐dose chemotherapy (HDC) as consolidation of the treatment of high‐risk postoperative breast cancer. Patients under 56 years of age with stage I to IIIB breast cancer involving 10 or more axillary lymph nodes were eligible. The primary endpoint was relapse‐free survival (RFS). Between May 1993 and March 1999, 97 patients were enrolled, and two patients became ineligible. The median age of the 97 patients was 46 years (range 27–55 years), and 72 (74%) were premenopausal. The median number of involved axillary nodes was 16 (range 10–49). All patients had undergone a radical mastectomy. Major characteristics were well balanced between the treatment arms. Forty‐eight patients in the standard‐dose (STD) arm received six courses of cyclophosphamide, doxorubicin, and 5‐fluorouracil followed by tamoxifen. Forty‐nine patients were assigned to undergo HDC with cyclophosphamide and thiotepa after six courses of cyclophosphamide, doxorubicin, and 5‐fluorouracil followed by tamoxifen; however, 15 of these patients (31%) did not undergo HDC. HDC was well tolerated without any treatment‐related mortality. At a median follow‐up of 63 months, the 5‐year RFS of 47 eligible patients in the STD arm and 48 eligible patients in the HDC arm was 37% and 52% on an intent‐to‐treat basis, respectively (P = 0.17). Five‐year overall survival of all randomized patients was 62% for the STD arm and 63% for the HDC arm (P = 0.78). Although the prespecified values of the two arms were not so accurate as to allow detection of the observed difference, no advantage of HDC was observed in terms of RFS or overall survival. (Cancer Sci 2008; 99: 145–151)
Short‐term survival and long‐term mortality of Acacia drepanolobium after a controlled burn
Authors: Okello B. D. , Young T. P. , Riginos C. , Kelly D. , O’Connor T. G.
Published: October 2007

We investigated the short‐ and long‐term effects of a controlled burn in Acacia drepanolobium woodland in Laikipia, Kenya in 1998. Fire temperatures averaged 250°C at ground level, with a maximum of over 500°C, but were rarely >100°C at 1.5 m above the ground or more. Nine months after the fire, virtually all A. drepanolobium trees had survived the fire. Some smaller trees were burnt to ground level, but most were only ‘top‐killed’ and had coppiced. Taller trees suffered less damage than smaller trees. However, a 2003 satellite image suggested a dramatic reduction in A. drepanolobium canopy cover at the site. A survey of the site in 2006 revealed that the density of larger A. drepanolobium trees was nearly three times greater in adjacent control areas than in the old burn, with a lesser reduction in the density of smaller trees. These data suggest that short‐term measures of postburn survivorship may be deceptive, and that an additional source of tree mortality (perhaps elephants) was concentrated on trees in burned areas, even many months after the burn, with long‐term consequences for tree and ecosystem dynamics.
Analysis of polymorphisms in the insulin‐like growth factor 1 receptor (IGF1R) gene from Japanese quail selected for body weight
Authors: Moe H. H. , Shimogiri T. , Kamihiraguma W. , Isobe H. , Kawabe K. , Okamoto S. , Minvielle F. , Maeda Y.
Published: October 2007

Insulin‐like growth factor 1 receptor (IGF1R) is essential for the signalling of growth. In this study, we performed single nucleotide polymorphism (SNP) detection in the Japanese quail IGF1R coding region and an association study between SNPs and body weight in two lines (SS and LL) selected for large and small body weight. Of 21 SNPs obtained, a SNP at position AB292766:c.2293G>A led to the replacement of a valine with an isoleucine (V765I). The two lines were fixed for alternate alleles, with allele encoding valine fixed in the LL line. A significant effect of the SNP genotype was found on 10‐week body weight (P < 0.01) and on 4‐ to 10‐week and 6‐ to 10‐week average daily gain (P < 0.05) in the F2 family obtained from lines LL and SS. In six populations maintained in Japan or France, the frequency of allele encoding valine was higher than the allele encoding isoleucine.
Overview of the human pharmacokinetics of recombinant activated factor VII
Authors: Klitgaard Thomas , Nielsen Tina G.
Published: October 2007

AIMS

To review the pharmacokinetics of rFVIIa in various patient populations, and to discuss the differences observed between groups.

METHODS

Based on a registry of Novo Nordisk studies, 14 studies evaluating rFVIIa pharmacokinetics following single and multiple bolus administration in healthy volunteers, adult and paediatric patients with congenital haemophilia and inhibitors, patients undergoing liver surgery and in patients with cirrhosis, inherited FVII deficiency, upper gastrointestinal bleeding or severe trauma were identified. Data on rFVIIa PK, analyzed with noncompartmental and population pharmacokinetic methods, were extracted.

RESULTS

Plasma clearance was a more robust parameter than half‐life for comparing rFVIIa pharmacokinetics between groups. In healthy volunteers and patients with no or low‐level bleeding (e.g. adults with haemophilia, nonbleeding patients with cirrhosis), plasma clearance was relatively low (30–40 ml kg−1 h−1). In children with haemophilia and adults with high‐level bleeding (e.g. cirrhotic patients undergoing orthotopic liver transplantation or resection) and patients with congenital FVII deficiency, plasma clearance was relatively higher (60–90 ml kg−1 h−1).

CONCLUSIONS

Comparison of plasma clearance rates in different patient populations suggested that subjects fall into two distinct groups. These differences may have clinical implications in terms of how to adapt the rFVIIa dosing regimen, depending on the expected bleeding rate/blood loss and underlying disease.
The effect of age, gender, and body mass index on the pharmacokinetics and pharmacodynamics of vildagliptin in healthy volunteers
Authors: He Yan‐Ling , Sabo Ron , Campestrini Joelle , Wang Yibin , Riviere Gilles‐Jacques , Nielsen Jace C. , Rosenberg Mitchell , Ligueros‐Saylan Monica , Howard Dan , Dole William P.
Published: October 2007

What is already known about this subject

• Vildagliptin is a new, potent, and selective inhibitor of DPP‐4.

• The efficacy and safety of vildagliptin in type 2 diabetes has been intensively studied in diverse subject populations.

• There has been little information published about the pharmacokinetics and pharmacodynamics of vildagliptin.

What this study adds

• No clinically relevant changes in pharmacokinetics or pharmacodynamics were observed between young and elderly, male and female, or high body mass index (BMI) and low BMI subjects.

• The results suggest that no dose modification is necessary for vildagliptin based on the age, gender, or BMI of a subject.

Aims

To evaluate the effect of age, gender, and body mass index (BMI) on the pharmacokinetics and pharmacodynamics of vildagliptin.

Methods

Forty healthy subjects received a single oral dose of 100 mg vildagliptin to assess the effects of age, gender, and BMI on the pharmacokinetics and pharmacodynamics, reflected by the time course of inhibition of DPP‐4 activity, of vildagliptin.

Results

Peak concentration and exposure (AUC(0–∞)) of vildagliptin were 17% (90% CI 2, 35%) and 31% (90% CI 18, 45%) higher in elderly vs. young subjects. Renal clearance was reduced by 32% (90% CI 17, 45%) in elderly subjects. The pharmacokinetics of vildagliptin were not significantly influenced by gender or BMI. Inhibition of DPP‐4 activity was similar regardless of age, gender, or BMI.

Conclusions

The pharmacokinetics of a single oral 100 mg dose of vildagliptin were not affected by gender and BMI. Exposure to vildagliptin was higher in elderly patients, but this was not associated with any difference in the effect of DPP‐4 inhibition. Based on these results, no vildagliptin dose adjustment is necessary for age, gender, or BMI.
Monoclonal B‐cell lymphocytosis in blood donors
Authors: Rachel Jane M. , Zucker Marjorie L. , Fox Christopher M. , Plapp Fred V. , Menitove Jay E. , Abbasi Fatima , Marti Gerald E.
Published: October 2007

Monoclonal B‐cell populations have been detected in the peripheral blood of apparently healthy individuals by flow cytometry. In 2005, the term monoclonal B‐cell lymphocytosis (MBL) was proposed to describe these findings. MBL may be immunophenotypically similar to chronic lymphocytic leukaemia (CLL) and, like CLL, the prevalence is higher in males and older individuals. We studied the prevalence of MBL in blood donors from the Midwestern United States. Samples from 5141 donors were examined and seven (0·14%) were found to have immunophenotypic characteristics of MBL or CLL. Immunoglobulin heavy chain analysis yielded monoclonality or oligoclonality. Prior and subsequent to the study, an additional undetermined number of blood donors were screened and seven of these expressed immunophenotypic characteristics of MBL or CLL. We thus found a total of 14 healthy blood donors with monoclonal expansions of B‐lymphocyte populations. Of these, 12 were presumptively classified as MBL and two as CLL. All but two of the donors were male; the mean age was 59 years. The clinical importance of these findings with regard to transfusion medicine has not been established.
Chemical exposures and risk of chronic lymphocytic leukaemia
Authors: Blair Aaron , Purdue Mark P. , Weisenburger Dennis D. , Baris Dalsu
Published: October 2007

Literature on the role of chemicals in the development of chronic lymphocytic leukaemia (CLL) and monoclonal B‐cell lymphocytosis in humans is sparse. This research is complicated by the rarity of these outcomes and the different disease classifications used over time. Several studies have noted excesses of CLL among farmers and a few have pointed to specific chemicals. Reports suggesting elevated CLL rates in the rubber and petroleum industries point to a possible role for solvents and other chemicals. The few studies that focus on specific chemicals suggest that CLL should be more carefully evaluated in relation to possible exposure to chemicals and solvents, particularly for benzene and butadiene. Pooled analyses of CLL studies within consortia offer an opportunity to investigate the possible aetiological role of chemical exposures with improved statistical power.
Molecular profiling of chronic lymphocytic leukaemia: genetics meets epigenetics to identify predisposing genes
Authors: Plass Christoph , Byrd John C. , Raval Aparna , Tanner Stephan M. , De La Chapelle Albert
Published: October 2007

Molecular profiling may lead to a better understanding of a disease. This knowledge is especially important in malignancies, where multiple alterations are required during the progression from premalignant to malignant stages. Such information can be useful for the development of novel biomarkers that allow the prediction of a clinical course, response to treatment or early detection. Molecular data is also utilized to develop targeted therapies. Moreover, gene defects identified in profiling studies will help to understand the molecular pathways disrupted in the disease. This review provides an overview of molecular profiling approaches in chronic lymphocytic leukaemia (CLL). We will describe our current understanding of genetic alterations in CLL, the use of familial CLL for the identification of predisposing mutations, and the search for epigenetic alterations in CLL.
Emerging therapy for chronic lymphocytic leukaemia
Authors: Auer Rebecca L. , Gribben John , Cotter Finbarr E.
Published: October 2007

The presentation, clinical course and prognosis for chronic lymphocytic leukaemia (CLL) is diverse and strategies for therapy reflect this variability. Staging of the disease has assisted in deciding treatment options and more recently the cytogenetic, molecular and surrogate markers of the immunoglobulin heavy chain mutational status, CD38 and ZAP‐70, have assisted in further risk stratification. Chemotherapy has been the mainstay of interventional therapy when required and the two most important classes of agents in the treatment of CLL are nucleoside analogues and alkylating agents. Combining these two groups of agents has significantly improved prognosis in this disease. More recently a number of novel agents have been applied to patients with CLL to determine if they represent better therapy. However, allogeneic stem cell transplantation offers perhaps the only realistic chance of a cure in this disease. Clinical trials are still needed to determine the timing and role of this promising treatment modality in the treatment of CLL and, where possible, combined with the emerging awareness of the disease biology, related biological markers and prognostic indicators.