Consumer behaviour in E-Commerce : Millennials in the USA, Washington D.C area

The target of this thesis was to understand consumer behaviour in e-commerce. The target area is the Washington DC area USA from amongst young adults between 21-34 years of age classified as millennials. The impact of technology changes and variables influencing the selection process of an e-retailer among the millennials was studied. A research with help of a survey to total 285 participants in four different shopping malls was performed in the Washington D.C. metropolitan area conducted between April 1st and May 31st 2015. The findings of the survey show that both the number of consumers who use the Internet for both assessing a product and retailers that are selling via Internet is growing in the area of this research. Consumers are also purchasing with more frequency on the Internet and as such the importance of the Internet is becoming a crucial aspect to understand consumer behaviour. The items purchased on the Internet range from small purchase items of iPhone cases to large purchase of vessels and work trucks with prices ranging on the thousands of dollars. Trust is imperative on the Internet and along increasing competition it is the all more important to have a strict control of what goes in the Internet and what goes out to the Internet in regards to ones business. On a personal note, I had an experience purchasing a truck replacement part from a farm ways out in Pennsylvania farmland. The seller at the conclusion of the transaction re-marked how without “this Internet” we would have never met or known we existed. I believe that simple remark summarizes all the importance of E-Commerce

Efficacy of intraoperative fluorescence imaging using indocyanine green‐containing gauze in identifying the appropriate dissection layer in laparoscopic intersphincteric resection: A case report

Abstract In laparoscopic intersphincteric resection, identifying the dissection layer near the anus is often difficult. We safely proceeded with it, using indocyanine green‐containing gauze on the anal side to remove the internal anal sphincter with indocyanine green fluorography

Renoportal Anastomosis in Left Lateral Lobe Living Donor Liver Transplantation: A Pediatric Case

In adult liver transplantation, renoportal anastomosis (RPA) has been introduced as a useful technique for patients with grade 4 portal vein thrombosis and a splenorenal shunt. Here, we report a pediatric case in which RPA allowed a left lateral lobe living donor liver transplantation (LDLT) despite portal vein thrombosis and a large splenorenal shunt. At 36 days old, the patient underwent a Kasai operation for biliary atresia. At 17 months old, she underwent LDLT because of repetitive cholangitis. Pretransplant examinations revealed a large splenorenal shunt and portal vein thrombosis. Simple end-to-end portal reconstruction and clamping of the collateral route after removing the thrombosis were unsuccessful. Thus, RPA was performed using a donor superficial femoral vein as an interpositional graft. The portal vein pressure was 20 mm Hg after arterial reperfusion. Ligation of the splenic artery reduced the portal vein pressure. Although she developed severe acute cellular rejection and chylous ascites, there were no signs of portal vein complications. She was discharged 73 days after transplantation without any signs of renal dysfunction. The patient’s condition was good at her last follow-up, 22 months after transplantation. To our knowledge, this is the youngest case of RPA in pediatric left lateral lobe LDLT. Additionally, this is the first case of RPA with splenic artery ligation and using the donor’s superficial femoral vein as the venous graft for RPA. Although long-term follow-up is necessary, RPA could be a salvage option in LDLT in infants if other methods are unsuccessful

Surgical strategy for an adult patient with a catecholamine-producing ganglioneuroblastoma and a cerebral aneurysm: a case report

Abstract Background Ganglioneuroblastomas, particularly those that produce catecholamine, are extremely rare in adults. Here, we report an interesting surgical case of an adult patient with a catecholamine-producing ganglioneuroblastomas in her adrenal gland, suspected to be a pheochromocytoma, and with a cerebral aneurysm. Case presentation The patient was a 73-year-old woman under treatment for hypertension. During a health check-up, a cystic retroperitoneal tumor was incidentally found in the superior pole of her right kidney. Her blood adrenaline level was slightly elevated, and her urinary adrenaline, noradrenaline, and dopamine levels were above the upper reference limits. In addition, 24-h urinary excretion of metanephrine, normetanephrine, and vanillylmandelic acid were all increased. 123I-Meta-iodobenzylguanidine scintigraphy showed an abnormal accumulation of the marker in the cyst wall. She was, therefore, diagnosed with a pheochromocytoma and scheduled for tumor resection. However, preoperatively, 8-mm-diameter cerebral aneurysm was incidentally found in her basilar artery. This required careful preoperative discussion. The aneurysm was difficult to approach and treat, and based on its position, shape, and size, the risk of rupture was low. Because hypertension is a major risk factor for aneurysmal rupture, we decided to proceed with the tumor resection. A lumbar catheter was placed to monitor the cerebral aneurysm for intraoperative rupture, and her transcranial motor-evoked potential and somatosensory-evoked potentials were monitored to track her intraoperative neurological function. During surgery, we carefully monitored fluctuations in blood pressure and resected the tumor with minimal mobilization. Postoperatively, head computed tomography confirmed that there was no sign of rupture. Histopathologically, the tumor was diagnosed as a catecholamine-producing ganglioneuroblastoma. The postoperative course was good, and the patient’s blood pressure improved. Conclusions Careful perioperative management is needed for a patient with both a catecholamine-producing tumor and cerebral aneurysm

Classical Hodgkin lymphoma-type and monomorphic-type post-transplant lymphoproliferative disorder following liver transplantation: a case report

Abstract Background Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication that can be difficult to treat; moreover, determination of the pathophysiological type is difficult. We report a rare case of a patient who developed two types of Epstein–Barr virus (EBV)-negative PTLD following living donor liver transplantation (LDLT). Case presentation A 64-year-old man underwent LDLT for acute fulminant hepatitis B. Sixty-five months later, he developed EBV-negative monomorphic B cell PTLD. Reduction of immunosuppressive therapy and chemotherapy with rituximab resulted in a partial response. He received radioimmunotherapy with yttrium-90-ibritumomab tiuxetan, which was effective for all lesions, except for the splenic hilar lesion, which enlarged and seemed to penetrate the stomach. Therefore, he underwent resection of the pancreatic tail with splenectomy and partial gastrectomy. The pathological diagnosis was EBV-negative classical Hodgkin lymphoma (cHL)-type PTLD. Conclusions This patient showed an unexpected course of PTLD, from both a clinical and pathological perspective. There are no prior reports of an adult case of EBV-negative cHL-type PTLD coexisting with EBV-negative monomorphic B cell PTLD. When a strange and refractory lesion persists despite effective therapy for PTLD, we must consider the possibility of another type of PTLD within the residual lesion

The Induction of Cycloloxygenase-2(COX-2) Expression Responding to Ischemic Neuronal Injury and PET Imaging with Two Radio-labeled First-generation COX-2 Selective Inhibitors

Objectives: To clarify whether imaging for cyclooxygenase-2(COX-2) is potential for monitoring pathological advance in ischemic diseases, and labeled COX-2 selective inhibitors are available as positron emission tomography (PET) tracers for COX-2 imaging. Methods: We have investigated the expression of COX-2 in normal and ischemic mouse brain with an original anti-COX-2 antibody with high specificity against murine COX-2 molecule and performed in-vivo living imaging and in-vitro autoradiographic analysis with two radio-synthesized first-generation COX-2 selective inhibitors ([11C]celecoxib) and [11C]rofecoxib), in normal and ischemic mouse brains Results: The immunohistochemical analysis showed the expression of COX-2 was exclusively localized in neurons with the most abundant amount in cerebellum and brainstem in normal mouse brain, and such expression was detectable by in-vitro autoradiographic analysis with [11C]rofecoxib, not [11C]celecoxib. In-vivo imaging with both of these two PET tracers failed to detect COX-2 expression despite their excellent brain permeability. The hypoperfusion-induced ischemia caused overt necrotic neuron death accompanied with gliosis in hippocampus, where significant induction of COX-2 was detected exclusively in injured neuron soma and synapse-like structure. The binding of [11C]rofecoxib was also increased in injured hippocampus compared to uninjured corresponding region.Conclusions: COX-2 is suitable biomarker for monitoring progressive ischemic injury and developing PET tracers for COX-2 imaging with COX-2 selective inhibitors is feasible for this purpose, although in-vivo living imaging requires further development of PET tracer with higher affinity than [11C]celecoxib and [11C]rofecoxib.BRAIN\u2713 and BRAINPET\u271

Assessment of radioligands for PET imaging of cyclooxygenase-2 in an ischemic neuronal injury model.

Cyclooxygenase-2 (COX-2) plays crucial roles in progressive neuronal death in ischemic brain injury. In the present study, we evaluated two radiolabeled COX-2 selective inhibitors, [11C]celecoxib and [11C]rofecoxib, as positron emission tomography (PET) tracers for COX-2 imaging in normal and ischemic mouse brains. We also took advantage of our newly-generated antibody highly selective for mouse COX-2 to prove accumulation of the radioligands in regions enriched with COX-2. In vitro autoradiography demonstrated specific binding of high-concentration [11C]rofecoxib but not [11C]celecoxib to the cerebellum and brain stem of normal brains wherein COX-2 immunoreactivity in neurons was most abundantly observed. Meanwhile, both of these radioligands failed to detect COX-2 expression in PET assays despite their excellent brain permeability. Hypoperfusion-induced ischemia caused marked necrotic neuron death accompanied by gliosis and enhancement of neuronal COX-2 immunoreactivity in the hippocampus. Correspondingly, in vitro autoradiographic binding of [11C]rofecoxib was increased in the injured hippocampus compared to the uninjured contralateral region, but failed in living brains of ischemia model likewise. Our work provides the rationale for monitoring COX-2 as a biomarker reflecting ischemic brain injuries and demonstrates that [11C]rofecoxib, not [11C]celecoxib, is useful for in vitro assays of COX-2, but its affinity would be insufficient for in vivo PET visualization