Abstract: Purpose – Despite the increasing popularity of virtual communities of practice (VCoPs), our understanding of how to intentionally form, develop and sustain them is still at an embryonic stage. Aims to go some way to remedying this. Design/methodology/approach – Investigates the attempt by 14 organizations to implement 18 VCoPs. Using existing documents, detailed logs, and focus groups, a large quantity of qualitative data was gathered, coded, and analyzed. Findings – The study shows that the environment, the relevance of the VCoPs objectives to its members’ daily work, and the degree to which the VCoP is embedded in the organizational structure of an organization are the three structuring characteristics most likely to explain the success or failure of a VCoP at the launching stage. Research limitations/implications – The focus is limited to the launching phase; further research should investigate different stages of development Practical implications – The results may offer an indica

Abstract: The Japanese Society of Thyroid Surgery undertook a pilot study of treatment for anaplastic thyroid carcinoma in a cooperative setting. The treatment consisted of cisplatin 40 mg/m2 drip intravenous infusion (div), day 1, adriamycin 60 mg/m2 iv, day 1, etoposide 100 mg/m2/day div, days 1-3, peplomycin 5 mg/body/day sc, days 1-5 and granulocyte colony-stimulating factor (G-CSF) 2 micrograms/kg/day sc, days 6-14. This was scheduled to be repeated every 3 weeks. Local radiation therapy was added for patients in whom it was indicated. A total of 17 patients (mean age, 66 yr) were enrolled. Ten patients had advanced disease with measurable lesions and 2 patients experienced partial remission lasting 2 and 3 months, respectively. Six of 7 patients were treated with the same modality of treatment as an adjuvant. Three died of progressive disease after 3-7 months and three others have survived for 3-11 months. The toxicities of the chemotherapy were mainly bone marrow suppression, despite G-CSF support. Transient liver dysfunction was also noticed. These results indicate that this combined a treatment can be given to patients with acceptable toxicity. The degree of leukopenia was greater than expected, partly due to the advanced age of the patients and the low dose of G-CSF. In addition, 8 available thyroid specimens were examined for the mdr 1 gene and P-glycoprotein, but all were negative. Further study of anaplastic thyroid carcinoma by this cooperative group will be carried out.

Abstract: The Japanese Society of Thyroid Surgery undertook a pilot study of treatment for anaplastic thyroid carcinoma in a cooperative setting. The treatment consisted of cisplatin 40 mg/m2 drip intravenous infusion (div), day 1, adriamycin 60 mg/m2 iv, day 1, etoposide 100 mg/m2/day div, days 1-3, peplomycin 5 mg/body/day sc, days 1-5 and granulocyte colony-stimulating factor (G-CSF) 2 micrograms/kg/day sc, days 6-14. This was scheduled to be repeated every 3 weeks. Local radiation therapy was added for patients in whom it was indicated. A total of 17 patients (mean age, 66 yr) were enrolled. Ten patients had advanced disease with measurable lesions and 2 patients experienced partial remission lasting 2 and 3 months, respectively. Six of 7 patients were treated with the same modality of treatment as an adjuvant. Three died of progressive disease after 3-7 months and three others have survived for 3-11 months. The toxicities of the chemotherapy were mainly bone marrow suppression, despite G-CSF support. Transient liver dysfunction was also noticed. These results indicate that this combined a treatment can be given to patients with acceptable toxicity. The degree of leukopenia was greater than expected, partly due to the advanced age of the patients and the low dose of G-CSF. In addition, 8 available thyroid specimens were examined for the mdr 1 gene and P-glycoprotein, but all were negative. Further study of anaplastic thyroid carcinoma by this cooperative group will be carried out.