Browsing by Author "Andersson, Mats"

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Impact from business environment and corporate strategy on financial structure
(2001) Tsagkalias, Leonidas; Andersson, Mats; Göteborgs universitet/Graduate Business School
For decades companies had focused their efforts only on quantitative results, rather than on the quality of profits generated. However, the need to readjust to a more volatile business environment and the new strategic directions followed by companies made financial structure an issue of primary importance. Therefore the research question how do business environment and corporate strategy impact financial structure is formulated and the case study of Electrolux, SCA, and Volvo is designed, in order to identify the effects during the last thirty years. In the first part of the thesis, a brief description of each of the three concepts is given and their interrelationship is shown. Referring to the business environment, two sets of factors are mentioned; macro environmental factors, which focus on economic, technological and political variables, and micro environmental factors, which refer to the industrial structure and globalisation. Then the concept of corporate strategy is discussed by presenting two different schools of thought, explicit and incremental strategic planning, and finally,the concept of financial structure is elaborated by analysing issues like the capital structure and the principal-agent theory. In continuation, the thesis is dedicated to the presentation of the business environment, corporate strategy and financial structure of Electrolux for the examined period, followed by another part, where the impacts on the financial structure are analysed. The same procedure is repeated for SCA and Volvo. In general, most of the findings indicate that business environment impacts financial structure mostly in economic terms, while the results from corporate strategy, usually linked to organic growth,acquisitions, related and unrelated diversification, and divestments,are different in the three companies. The determining factor is the existence or not of aggressiveness and opportunism, when implementing untested strategies.
Radiological evaluation of esophageal function in dysphagia with special emphasis on achalasia
(2008-10-03T08:24:42Z) Andersson, Mats
In idiopathic achalasia, degeneration of the inhibitory innervation of the esophageal smooth muscle results in absence of primary peristalsis and in incomplete relaxation of the lower esophageal sphincter (LES). All treatments for achalasia aim at reducing the pressure gradient across the LES, thus facilitating esophageal emptying by gravity. Objective evaluation of the response to treatment is important, since persistent poor emptying may lead to progressive deterioration of esophageal function. The timed barium esophagogram (TBE) has been introduced as a standardized technique for evaluating esophageal emptying in patients with achalasia and the aim of the present thesis was to validate this new diagnostic test. I. In order to investigate the reproducibility and observer variation of TBE, 21 patients with achalasia were examined by repeat TBE median 8 days apart. Radiographs of the esophagus were taken 1, 2 and 5 minutes after patients had ingested 250 ml of barium. The height and width of the barium column and the rate of change over time were recorded. The static parameters were reproducible between studies, but the dynamic data were not (correlation coefficient of only 0.50). There was excellent intra- and interobserver agreement for all measured variables. Control subjects (n= 8) uniformly achieved complete esophageal emptying within 2 minutes. II. To describe TBE characteristics in patients with newly diagnosed achalasia, and to correlate these to clinical and manometric variables, 46 patients were examined. All patients showed markedly delayed emptying of barium from the esophagus. Emptying, expressed as volume of barium, showed significant inverse correlation with the resting and the maximal relaxing pressure of the LES at manometry (r= -0.34 and r= -0.54, respectively) and with the duration of symptoms (r= -0.36). III. TBE was prospectively applied in a randomized trial comparing pneumatic dilatation (n= 26) and laparoscopic myotomy (n= 25) in patients with newly diagnosed achalasia. Following therapy, TBE parameters did not differ significantly between treatment groups. Significant correlations were found between the height of the barium column at 1 minute and the symptom scores for “dysphagia for liquids” (r= 0.47), “chest pain” (r= 0.42) and the “Watson dysphagia score” (r= 0.46) at the end of follow-up (median 18 months). Patients with less than 50% improvement in barium column height at 1 minute had a 40% risk of treatment failure during follow-up. IV. A modified TBE-technique was applied in a case series of 7 patients operated for hypopharyngeal or proximal esophageal cancer with radical resection and reconstruction with a free jejunal transplant. Radiographic signs of disturbed bolus transport through the jejunal transplant were found in all patients, but the patients only reported mild dysphagia symptoms on clinical assessment. One possible explanation for this discrepancy might be diminished visceral sensation in the denervated jejunal transplant. In conclusion, we found that TBE is an easily performed and reproducible technique for the objective evaluation of esophageal emptying before and after treatment for achalasia. However, the impact of routinely performing TBE on the long-term outcome of achalasia patients needs to be studied in further prospective trials.