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Mini Case Managing Technology at Genex Fuels4
4 Smith, H. A., and J. D. McKeen. “Managing Technology at
Genex Fuels.” #9-L05-1-004,
Queen’s School of Business, February 2005. Reproduced by
permission of Queen’s University,
School of Business, Kingston, Ontario.
“You have got yourselves into a terrible predicament,” said V.
R. “Sandy” Sandhuramen,
his soft Indian accent belying the gravity of his words. “You are
incredibly lucky you
have managed to do business as well as you have, but this
situation cannot be allowed
to carry on.” Sandy, a high-priced technology consultant, had
been hired by Genex
Fuel’s new CIO, Nick Devlin, to review the company’s
technology portfolio and help him
and his newly appointed IT architect, Chuck Yee, get a handle
on the firm’s technology
needs.
Genex, a major producer of crude oil and natural gas, is the
largest marketer of
petroleum and petroleum products in the region. It is structured
into three distinct
business divisions, each comprising a number of functional
segments. Until recently, IT
had been decentralized into the three divisions, each with its
own director of IT who
reported to the divisional executive vice presidents (EVPs).
Devlin, formerly the director
of the corporate division, had been appointed CIO and given the
specific mandate to
bring in SAP as the primary technology platform for all the
divisions.
“We have to start behaving like we’re one business,” said the
CEO when he appointed
Devlin. “I want a much more agile and responsive IT
organization than we’ve had in the
past. It seems to me that every time I ask IT to look into
something I’ve heard or read
about, they always come up with a thousand and one reasons
why it won’t work. We
need to be able to use technology competitively, and that won’t
happen unless you can
get ahead of the curve.”
Devlin’s excitement about his new mandate had lasted just
about a week, until the true
scope of the challenge became clear. He had asked each
divisional IT director for an
inventory of hardware and software currently in place and to
briefly outline the work that
was in their plans for the coming year. “We must have one of
every piece of hardware
and software ever produced,” Devlin marveled as he scanned
their reports. On the one
hand, there was a new customer management system called
COMC, which had been
implemented to improve real-time information exchange
between the company’s 135
bulk fuel sites and Genex headquarters. On the other hand, IT
was still running an
archaic DOS-based marketing system called MAAS to provide
customer service and
reports. “And they want to bring in SAP!” he groaned. “We
need a plan, and we need it
soon.”
That was when Devlin had engaged Sandy to work with Yee.
“First, I want a no-holds-
barred assessment of our current situation,” he had said, and
now they were in his
office, outlining the “terrible predicament.”
“The biggest problem you face at present,” said Sandy, “is the
fact that you have
absolutely no standards and no integration, as you discovered
for yourself, Nick.” There
was a lot of technology out there—both old and new—and it
was a political hot potato.
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Almost every system had its group of advocates, some very
senior in the company. All
the EVPs had invested their individual technology budgets in
the hardware and software
that they felt could best support their work. The problem was
that maintaining this
mishmash was now costing an arm and a leg. And it was highly
doubtful that the
company was getting true value for its technology investment.
“We should be able to leverage our existing investments so we
can invest in new
technology,” said Yee. “Instead, almost all our budget is taken
up with holding these
systems together with toothpicks and tape.”
“One of the most challenging situations,” Sandy went on, “is
Price One.”
Obsolete but absolutely essential, Price One is the fuel-pricing
system that stores the
pricing algorithms for all fuels marketing functions, including
aviation, marine, retail,
branded associates, and industrial and wholesale. Although
pricing is an integral part of
marketing, Price One cannot communicate with COMC and is
not easily adaptable to
changes in the business environment. Price One perfectly
reflected the business and
technology that existed ten years ago, but this has now become
a real drawback. To get
around these limitations while continuing to use Price One, staff
manually feed
information from pricing requests in COMC to Price One to get
approval because both
systems use different terminology in coding products for
different pricing methods.
Price One also lacks the ability to link information from
different systems to ensure data
integrity. As a result, Price One has accumulated some
irrelevant data groups under
pricing for products, and such corrupted data can be detected
only by an experienced
individual who has been dealing with that product group for
decades and who would
know at a glance the validity of the data. One of Price One’s
critical flaws is its inability
to link with other systems, such as COMC, and to pick up
competitive market
information in order to approve price. Previous plans to rewrite
this system have been
resisted strenuously by management because of the expense.
Now the system is on its
last legs.
“And like most oil and gas companies,” Sandy observed, “you
have automated very few
of your information assets as other types of organizations have
done.” Typically for the
industry, Genex had grown by acquiring other, smaller firms
and had inherited an
enormous amount of physical data. It now has more than two
million items of paper and
microfilm. It has one hundred twenty thousand tapes of data.
Some items date back to
the 1940s and came from numerous sources. The company’s
seismic assets, on which
it bases many of its decisions and which has a replacement cost
estimated at more than
two billion dollars, are stored on a wide variety of media from
analog tapes, magnetic
reels, and cartridges to optical discs to paper, film, and
microfilm. They are spread out
across five conventional physical warehouses.
This system of data management is problematic for two main
reasons. First, with land
sales occurring every two weeks, it is extremely difficult to
make timely decisions based
on all known information about a property. Clearly, the more
seismic information a
company can bring to bear on its decisions, the better it can
decide where it wants to do
further work. Second, the company’s data assets, on which its
future depends, are
extremely vulnerable. There is no backup. When needed, the
only copy of
the information requested is physically transported to Genex’s
offices. The tapes on
which the data reside deteriorate further with each reading.
Furthermore, much
information resides on obsolete forms of media and is getting
increasingly difficult to
access.
“Finally, IT is getting a lot of pressure from the executive
office,” reported Sandy. “These
guys have seen what’s going on in other companies, and they
want to see Genex move
into the twenty-first century. Staff at Genex cover vast territory
and must work from
home, from local facilities, or on the road. Not only does Genex
need to provide a virtual
working environment for these workers, but it also needs to
consider how they can work
together as a team without having physical colocation for
communication.”
“Well, I guess we have it all,” said Devlin. “Integration
problems, outdated hardware and
software, inconsistent data, expensive workarounds, pressure to
modernize, and
substantial budget limitations.” Turning to Yee and Sandy, he
smiled. “Now what are we
going to do about it? Where do we start?”
Discussion Questions
1. What evidence is the CEO using to suggest that Genex is not
using technology
competitively?
2. Did Devlin need to hire Sandy, a “high-priced technology
consultant,” to tell him that
technology at Genex was a mess?
3. Devise a strategy to successfully implement enterprisewide
systems (such as SAP) at
Genex.
Page 1“A Pain in the Gut” by Ripple, Marcaccio, Shearman, &
Stephens
by
John T. Ripple, Stephen E. Marcaccio, Daniel R. Sherman, and
Philip J. Stephens
Department of Biology, Villanova University, Villanova, PA
NATIONAL CENTER FOR CASE STUDY TEACHING IN
SCIENCE
Part I – The Accident
Frank was driving home after a long day at work. It was late
and he was having problems driving in the dark with so
much traffic. He was forced to take a detour and felt tired, so he
took another sip of soda.
“What would I do without sugar and caffeine?” he mumbled to
himself.
Frank realized that he should probably stop the car as he noticed
his hands begin to shake, but he continued anyway.
Rounding a corner he realized that he was having trouble
focusing on the road. He tried to blink away the blurriness
and shook his head, but things did not change. In an instant, the
car slipped off the road and hit a tree.
“What was that?” exclaimed Frank to the night air.
He quickly got out of the car and checked himself out. Other
than the shock of the accident, Frank seemed to be okay.
He pulled out his cell phone and called his wife, Stacey, to
come pick him up. He then called to report the accident to
the police and his insurance agent.
His wife arrived about an hour later and looked very concerned
when she saw Frank sitting in the police car.
“Why aren’t you going to the hospital?” screamed Stacey.
“Were you drinking again?”
“I’m fine, and no I wasn’t drinking. Check with Sergeant
Eversman if you don’t believe me. I lost focus; it’s been a long
day and my vision’s a little off. This is too much stress. Please,
I just want to go home.”
They drove home, but Stacey continued to badger Frank about
going to the hospital.
Questions
1. List Frank’s physical problems.
2. What do you think is causing Frank’s blurred vision?
3. With the above physical problems in mind, what do you
speculate about Frank’s condition?
A Pain in the Gut:
A Case Study in Gastric Physiology
NATIONAL CENTER FOR CASE STUDY TEACHING IN
SCIENCE
Page 2“A Pain in the Gut” by Ripple, Marcaccio, Shearman, &
Stephens
Part II – The Checkup
“Good morning Frank, what can I do for you today?” asked
Doctor George.
“I was in a car accident last night. I’m fine, but I thought I
would see you before I leave for my business trip this
afternoon. I guess it’s better to be safe than sorry.”
“I’m glad you came to see me. I can always squeeze in my old
college roommate even though you dropped biology for
a business degree.” Both men smiled. “Your blood work should
be here soon. Have you managed to cut down on your
drinking and smoking?” asked the doctor.
“Old habits die hard, I’m afraid,” admitted Frank. “I still smoke
occasionally, but I have really cut down on the
drinking. In fact, I was drinking soda last night; the
breathalyzer test was negative for alcohol, as I knew it would
be. I
don’t know what came over me. I was tired after a long day. I
was driving home and ended up wrapped around a tree. I
can’t believe this happened,” Frank sighed.
“I believe you Frank, but our blood work isn’t looking for
alcohol,” the doctor responded. “Besides being tired, how did
you feel while you were driving? Was there anything abnormal
that you noticed?”
“Well, the thing that surprised me was my vision. I have had
great vision my whole life; it runs in my family. But
recently my vision has been blurry, and last night it got to the
point where I couldn’t see the lanes of the road—and,
well, you know the rest,” explained Frank.
“You mentioned it was a late night. Did you eat or drink
anything?” asked the doctor.
“Just the typical stuff I always have when I’m tired. I stopped
for a couple of candy bars and a refill of my large soda,
just to stay awake. I have been really stressed lately and I am
finding it very difficult to cope, so I usually stop at the
convenience store on the way home from work.”
“Was it diet soda?”
“No, I can’t drink that stuff,” responded Frank.
”So, how is your vision now?”
“My vision is okay now. After the accident, I went home and
went to bed. I woke up a little earlier than usual, but I
feel fine now,” mentioned Frank.
The nurse came in and gave the doctor the results of the blood
tests.
Table 1 – Frank’s (Fasting) Blood Test Results
Normal Frank
Blood glucose (mg/dL) 70–130 165
Blood insulin (IU/mL) 5–10 1
“Is there something wrong?” asked Frank.
“Your blood glucose levels are above normal. Are you sure you
didn’t eat or drink before the blood test this morning?”
Frank shook his head.
“I am concerned because it’s been more than 12 hours since the
accident and your blood glucose is elevated. I hate
to think what it was after you ate the candy bars and drank all
of that soda. Your body can convert excess glucose to
sorbitol; you may have heard it referred to as sugar alcohol.
Anyway, sorbitol accumulates in the lens of the eye, and
this could explain your blurred vision because it draws water
into the fibers of the lens and makes them swell. Since
this changes the shape of the lens, it can affect your vision and
in the long term it can even make the lens opaque and
form a cataract.”
NATIONAL CENTER FOR CASE STUDY TEACHING IN
SCIENCE
Page 3“A Pain in the Gut” by Ripple, Marcaccio, Shearman, &
Stephens
“But I didn’t do anything out of the ordinary. I always have
those snacks and soda when I’m driving late at night, and
it’s never been so bad that I had an accident!”
“That’s what worries me, Frank. How long have you been
feeling this high level of stress at work?”
“For about a year. They have been laying off people from work
and I feel it’s only a matter of time before it’s my turn.
Stacey says that we should buy stock in companies that make
candy bars and soda, and I admit that I am putting on a
little weight.”
“This is not good. Both your high sugar intake plus the work
related stress, which can cause excess cortisol secretion,
can raise your blood glucose levels. High blood glucose levels
like yours suggest diabetes mellitus and I know this
problem runs in your family. At this point I usually send my
patients to take a glucose tolerance test, but I know that
you are going out of town on business this afternoon. How
about we set you up for a glucose tolerance test after your
trip and in the meantime take it easy on the sugar and try to
relax.”
“I can do that.”
“Also, I think that it would be wise not to drive.”
Questions
1. What hormone is responsible for decreasing blood glucose
levels?
2. Which gland secretes this hormone?
3. There are two types of diabetes mellitus: Type 1 or insulin-
dependent diabetes mellitus (IDDM) and Type 2
or noninsulin-dependent diabetes mellitus (NIDDM). Fill in
Table 2 below to show the difference between
the two types of (untreated) diabetes in terms of high, normal,
or low for both blood insulin levels and insulin
receptor function.
Table 2 – Diabetes Mellitus
Variable Type 1 Type 2
Blood insulin level
Insulin receptor function
4. If Frank is suffering from untreated diabetes mellitus, based
on Tables 1 and 2 which type do you think he
suffers from?
5. Is this diagnosis reasonable considering that some members
of Frank’s family suffer from diabetes mellitus?
NATIONAL CENTER FOR CASE STUDY TEACHING IN
SCIENCE
Page 4“A Pain in the Gut” by Ripple, Marcaccio, Shearman, &
Stephens
Part III – Something's Not Right
“It’s good to have you home, honey. I missed you. How was the
flight?” Stacey had come to the airport to pick Frank
up and she leaned over to kiss him as he climbed into the car
with his luggage. “How were the meetings? You look
tired,” she added.
“The past week was intense and I am exhausted. I thought I
would manage some R & R during the trip, but no such
luck. John and Dan were fired and we were told that there
would be more layoffs in the future if business doesn’t pick
up. Everyone is feeling stressed. “
“You’re one of the hardest workers they have Frank, they can’t
let you go.”
“I hope you’re right. They gave us tomorrow off in lieu of
making us work for 7 days straight, but I can’t help but think
I should go in and get a jump on the week.”
“I know you don’t want to hear this, but you have an
appointment for that glucose tolerance test first thing in the
morning. We’ll need to eat soon because the instructions say
you are not allowed to eat for 8 hours before the test.”
Frank felt miserable. “I’m really not hungry. Maybe it was the
change in diet, but I’ve had a persistent stomach ache
and I didn’t eat much when I was away.
“Well, we need to take extra special care of you until we find
out what’s wrong. I am sure everything’s going to be okay.”
The next morning the alarm went off and Frank felt refreshed
after a good night’s sleep.
“What’s the matter Stacey? You look like you’ve seen a ghost.”
Stacey brought him her pocket mirror so that he could see for
himself. “Forget the glucose tolerance test. I think we
need to go to the Emergency Room right now.”
* * * * * * * * * * * * *
Doctor Smithers looked into Frank’s eyes. “It’s a good thing
you came in because even a first year medical student
could see that you are jaundiced.”
Stacey looked concerned. “What does that mean? Is he going to
be okay?”
“Well it could mean a few different things,” replied the doctor,
“so we are going to have to run some tests to be sure.”
Questions
1. What new physical signs or symptoms is Frank exhibiting?
2. What does the doctor see in Frank’s eyes that indicates
jaundice?
3. What molecule is responsible for Franks’ jaundiced
appearance?
4. On the following page, fill in Flow Chart 1 with the best
choices from the provided word list.
5. Use Flow Chart 1 to suggest possible reasons for Frank’s
jaundiced appearance.
6. Do you think that Frank’s jaundice is connected to the high
blood glucose levels seen on the morning before his
business trip? Why or why not?
7. Would you like to make a diagnosis to explain Frank’s
jaundiced appearance?
8. What tests would you run to determine or confirm any of
your diagnoses?
NATIONAL CENTER FOR CASE STUDY TEACHING IN
SCIENCE
Page 5“A Pain in the Gut” by Ripple, Marcaccio, Shearman, &
Stephens
In the spleen, ___________ from red blood cells is broken down
to form (unconjugated) bilirubin.
Unconjugated bilirubin is insoluble in blood plasma so binds to
albumens in the blood and is sent to the ______.
Bilirubin ___________ with glucuronic acid to form conjugated
bilirubin. It forms
part of the bile, which is ______ in the gall bladder.
Food in the gut stimulates gall bladder contraction and the bile
passes down the
____ ____ to the _____ _________, where it aids in the
digestion of ______.
Flow Chart 1
bile duct lipid
binds liver
carbohydrate pancreas
cell membrane pancreatic duct
cytoplasm protein
dissociates small intestine
globin (protein) stomach
hemoglobin stored
Word List
NATIONAL CENTER FOR CASE STUDY TEACHING IN
SCIENCE
Page 6“A Pain in the Gut” by Ripple, Marcaccio, Shearman, &
Stephens
Part IV – The Test Results
“What does it mean to be jaundiced, doctor? Why did the whites
of my eyes turn yellow?”
“It’s usually caused by a high level of a molecule called
bilirubin in your blood, Frank.”
“I was a biology major in college, but I don’t remember where
bilirubin comes from.”
“Your blood has cells called erythrocytes or red blood cells;
they contain hemoglobin which gives blood its red color.
Cells in the spleen break down red blood cells and the products
are reused by your body. The heme portion of
hemoglobin is converted to bilirubin, which is the molecule that
is responsible for your yellow color.”
“I remember now, isn’t bilirubin involved in digestion?”
“Yes. Bilirubin leaves the spleen in the blood and, because it’s
not soluble in water, it binds with blood proteins called
albumens to form unconjugated bilirubin. This bilirubin is taken
up by the cells in the liver, where it combines with
glucuronic acid to form conjugated bilirubin. It is one
component of the bile, which travels down the bile duct to the
gall bladder and the small intestine. When you eat, the gall
bladder contracts and pushes the stored bile into the small
intestine to aid in the digestion of fat.”
“So what do my tests show?”
“Your hematocrit and your liver enzymes are at normal levels.”
“So, my liver’s okay?”
“These enzymes are normally confined to the liver cells and
would only be found in large amounts in the blood if your
liver was damaged. So these results indicate that there is no
liver damage; that’s good. But I am concerned that there
is tenderness in the upper left quadrant of your abdomen …
sorry, around your stomach,” the doctor smiled at Frank
and Stacey.
“As I explained before, a jaundiced appearance is often
produced by a buildup of bilirubin in the blood and your results
confirm this (Table 3).”
Table 3 – The Level of Bilirubin in Blood
Bilirubin Type Frank’s Blood Normal Blood
unconjugated 0.9 mg/dl 0.3 – 1.6 mg/dl
conjugated 0.6 mg/dl 0 – 0.3 mg/dl
“One more thing concerns me,” continued the doctor. “There is
almost no urobilinogen or urobilin in your urine.”
“What are they?” asked Frank.
“Bacteria in your intestines change bilirubin to urobilinogen.
This urobilinogen can be reabsorbed back into your body
and some is converted to urobilin. These two molecules
circulate in your blood and are excreted in your urine; it is the
urobilin that produces the straw color of urine. The low level of
these two molecules in your urine plus the high level
of bilirubin in your blood and the pale color of your stools
indicates to me that, for some reason, bilirubin is staying in
your body instead of going into your intestines.”
Questions
1. Where is unconjugated bilirubin formed?
2. Is the level of unconjugated bilirubin in Frank’s blood within
the normal range?
3. Where is conjugated bilirubin formed?
4. Is the level of conjugated bilirubin in Frank’s blood within
the normal range?
NATIONAL CENTER FOR CASE STUDY TEACHING IN
SCIENCE
Page 7“A Pain in the Gut” by Ripple, Marcaccio, Shearman, &
Stephens
7. Consider your diagnosis for Frank’s high blood glucose
levels. Which gland secretes insulin?
8. Which organs are involved in creating Frank’s jaundiced
appearance?
9. Look at Figure 1 and determine whether this gland and these
organs (answers to Questions 7 and 8) are
connected in any way.
10. Can you think of a reason that would explain the high levels
of glucose and conjugated bilirubin in Frank’s
blood?
11. Would you like to make any adjustments to your diagnoses?
5. Using Flow Chart 1, outline some possible reasons for the
high level of conjugated bilirubin; remember Frank’s
liver enzymes are normal.
6. Frank experienced tenderness in the upper left quadrant of his
abdomen. Use the word list in Figure 1 to label
the major organs in this area.
Image credit: Figure 1, licensed illustration © Alila Medical
Images – Fotolia.com
Word List
Bile duct
Gall bladder
Liver
Pancreas
Pancreatic duct
Small intestine
Figure 1. Diagram of the organs in the upper left quadrant of the
abdomen plus a word list for labeling.
NATIONAL CENTER FOR CASE STUDY TEACHING IN
SCIENCE
Page 8“A Pain in the Gut” by Ripple, Marcaccio, Shearman, &
Stephens
Part V – CT Scans
“Here is your CT scan, Frank. Just to orient you, it shows a
slice across your abdoment just
below your diaphragm (inset on right). This scan (Figure 2) is
taken from a healthy individual;
we use it in teaching and you can see labels on the various
organs. Now look at your scan
(Figure 3), which was taken at a similar plane. I have drawn
arrows to show your pancreas,”
explained the doctor.
“My pancreas looks larger; and what are those dark blobs?”
Figure 2. Healthy Patient’s CT Scan Figure 3. Frank’s CT Scan
Image credits:
Figure 2: University of Leeds,
http://www.bmb.leeds.ac.uk/teaching/visible/, used with
permission.
Figure 3: Thoeni R F. The revised Atlanta classification of
acute pancreatitis: Its importance for the radiologist and its
effect on
treatment. Radiology 2012;262:751–764. Used with pemission.
Questions
1. Speculate on the identity of the “dark blobs” Frank noticed in
Figure 3.
2. Do you think these “dark blobs” could affect the secretion of
insulin?
3. Do you think these “dark blobs” could inhibit the liver from
producing conjugated bilirubin?
4. Frank’s CT scan shows the “head” of the pancreas in the
vicinity of the small intestine and the stomach. What
do you think would be the effect of an enlarged pancreas on the
ability of the gall bladder to send bile down the
bile duct and into the small intestine?
5. Why does Frank have elevated levels of bilirubin in his
blood?
6. Would you like to modify your diagnosis?
NATIONAL CENTER FOR CASE STUDY TEACHING IN
SCIENCE
Page 9“A Pain in the Gut” by Ripple, Marcaccio, Shearman, &
Stephens
2
Image in title block by © Daniel Jędzura | Dreamstime.com, ID
25936227. Case copyright held by the National Center for Case
Study Teaching
in Science, University at Buffalo, State University of New
York. Originally published October 15, 2013. Please see our
usage guidelines, which
outline our policy concerning permissible reproduction of this
work.
Part VI – The Final Diagnosis
“So what’s the problem doctor?” asked Frank.
“Your CT scan shows that your pancreas contains some unusual
growths, what you called ‘dark blobs’,” replied the
doctor. “These growths may be interfering with your ability to
secrete insulin.”
“So does that mean I do not have diabetes?”
“We’ll need to do more tests to determine that, but I am very
concerned about the size of your pancreas, which seems
to be so big that it’s blocking the bile and pancreatic ducts.”
“So these growths are blocking the duct that takes bile from the
gall bladder into the small intestine and are the source
of my pain?”
“That seems possible,” replied the doctor. “With a blocked bile
duct, bilirubin cannot get into your small intestine and
will build up in your gall bladder, your liver, and ultimately in
your blood.”
“That would explain why I am jaundiced. Are those ‘dark blobs’
cancerous, doctor?”
“We’ll need to take a biopsy to be certain, but I am afraid they
may well be. I’m sorry, Frank. Still, we’re very lucky that
we discovered these growths at such an early stage. If you had
waited we could be looking at more serious problems.”
“So, what’s the next step?”
“We’ll need to do more tests, but I think you’ll probably need
surgery to remove the growths. I know that this may
sound drastic, so I think you should see a specialist. We are
fortunate because we have a very good gastroenterologist
and an excellent abdominal surgeon on staff. I have scheduled
an appointment for you to see them this afternoon.
One advantage of having them in this hospital is that it will be
easy to get your test results and CT scans to them
before your meeting. They can refer you to other doctors if you
wish, but I think they will advise you to get this
treated as soon as possible.”
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Mini Case Managing Technology at Genex Fuels4 4 Smith, H. A..docx

  • 1. Mini Case Managing Technology at Genex Fuels4 4 Smith, H. A., and J. D. McKeen. “Managing Technology at Genex Fuels.” #9-L05-1-004, Queen’s School of Business, February 2005. Reproduced by permission of Queen’s University, School of Business, Kingston, Ontario. “You have got yourselves into a terrible predicament,” said V. R. “Sandy” Sandhuramen, his soft Indian accent belying the gravity of his words. “You are incredibly lucky you have managed to do business as well as you have, but this situation cannot be allowed to carry on.” Sandy, a high-priced technology consultant, had been hired by Genex Fuel’s new CIO, Nick Devlin, to review the company’s technology portfolio and help him and his newly appointed IT architect, Chuck Yee, get a handle on the firm’s technology needs. Genex, a major producer of crude oil and natural gas, is the largest marketer of petroleum and petroleum products in the region. It is structured into three distinct business divisions, each comprising a number of functional segments. Until recently, IT had been decentralized into the three divisions, each with its own director of IT who reported to the divisional executive vice presidents (EVPs).
  • 2. Devlin, formerly the director of the corporate division, had been appointed CIO and given the specific mandate to bring in SAP as the primary technology platform for all the divisions. “We have to start behaving like we’re one business,” said the CEO when he appointed Devlin. “I want a much more agile and responsive IT organization than we’ve had in the past. It seems to me that every time I ask IT to look into something I’ve heard or read about, they always come up with a thousand and one reasons why it won’t work. We need to be able to use technology competitively, and that won’t happen unless you can get ahead of the curve.” Devlin’s excitement about his new mandate had lasted just about a week, until the true scope of the challenge became clear. He had asked each divisional IT director for an inventory of hardware and software currently in place and to briefly outline the work that was in their plans for the coming year. “We must have one of every piece of hardware and software ever produced,” Devlin marveled as he scanned their reports. On the one hand, there was a new customer management system called COMC, which had been implemented to improve real-time information exchange between the company’s 135 bulk fuel sites and Genex headquarters. On the other hand, IT was still running an archaic DOS-based marketing system called MAAS to provide customer service and reports. “And they want to bring in SAP!” he groaned. “We
  • 3. need a plan, and we need it soon.” That was when Devlin had engaged Sandy to work with Yee. “First, I want a no-holds- barred assessment of our current situation,” he had said, and now they were in his office, outlining the “terrible predicament.” “The biggest problem you face at present,” said Sandy, “is the fact that you have absolutely no standards and no integration, as you discovered for yourself, Nick.” There was a lot of technology out there—both old and new—and it was a political hot potato. https://jigsaw.vitalsource.com/books/9780133777628/epub/OPS/ xhtml/fileP700049440600000000000000000224E.xhtml#P70004 944060000000000000000023CE https://jigsaw.vitalsource.com/books/9780133777628/epub/OPS/ xhtml/fileP700049440600000000000000000224E.xhtml#r__P70 004944060000000000000000023CE Almost every system had its group of advocates, some very senior in the company. All the EVPs had invested their individual technology budgets in the hardware and software that they felt could best support their work. The problem was that maintaining this mishmash was now costing an arm and a leg. And it was highly doubtful that the company was getting true value for its technology investment. “We should be able to leverage our existing investments so we can invest in new
  • 4. technology,” said Yee. “Instead, almost all our budget is taken up with holding these systems together with toothpicks and tape.” “One of the most challenging situations,” Sandy went on, “is Price One.” Obsolete but absolutely essential, Price One is the fuel-pricing system that stores the pricing algorithms for all fuels marketing functions, including aviation, marine, retail, branded associates, and industrial and wholesale. Although pricing is an integral part of marketing, Price One cannot communicate with COMC and is not easily adaptable to changes in the business environment. Price One perfectly reflected the business and technology that existed ten years ago, but this has now become a real drawback. To get around these limitations while continuing to use Price One, staff manually feed information from pricing requests in COMC to Price One to get approval because both systems use different terminology in coding products for different pricing methods. Price One also lacks the ability to link information from different systems to ensure data integrity. As a result, Price One has accumulated some irrelevant data groups under pricing for products, and such corrupted data can be detected only by an experienced individual who has been dealing with that product group for decades and who would know at a glance the validity of the data. One of Price One’s critical flaws is its inability
  • 5. to link with other systems, such as COMC, and to pick up competitive market information in order to approve price. Previous plans to rewrite this system have been resisted strenuously by management because of the expense. Now the system is on its last legs. “And like most oil and gas companies,” Sandy observed, “you have automated very few of your information assets as other types of organizations have done.” Typically for the industry, Genex had grown by acquiring other, smaller firms and had inherited an enormous amount of physical data. It now has more than two million items of paper and microfilm. It has one hundred twenty thousand tapes of data. Some items date back to the 1940s and came from numerous sources. The company’s seismic assets, on which it bases many of its decisions and which has a replacement cost estimated at more than two billion dollars, are stored on a wide variety of media from analog tapes, magnetic reels, and cartridges to optical discs to paper, film, and microfilm. They are spread out across five conventional physical warehouses. This system of data management is problematic for two main reasons. First, with land sales occurring every two weeks, it is extremely difficult to make timely decisions based on all known information about a property. Clearly, the more
  • 6. seismic information a company can bring to bear on its decisions, the better it can decide where it wants to do further work. Second, the company’s data assets, on which its future depends, are extremely vulnerable. There is no backup. When needed, the only copy of the information requested is physically transported to Genex’s offices. The tapes on which the data reside deteriorate further with each reading. Furthermore, much information resides on obsolete forms of media and is getting increasingly difficult to access. “Finally, IT is getting a lot of pressure from the executive office,” reported Sandy. “These guys have seen what’s going on in other companies, and they want to see Genex move into the twenty-first century. Staff at Genex cover vast territory and must work from home, from local facilities, or on the road. Not only does Genex need to provide a virtual working environment for these workers, but it also needs to consider how they can work together as a team without having physical colocation for communication.” “Well, I guess we have it all,” said Devlin. “Integration problems, outdated hardware and software, inconsistent data, expensive workarounds, pressure to modernize, and substantial budget limitations.” Turning to Yee and Sandy, he smiled. “Now what are we going to do about it? Where do we start?”
  • 7. Discussion Questions 1. What evidence is the CEO using to suggest that Genex is not using technology competitively? 2. Did Devlin need to hire Sandy, a “high-priced technology consultant,” to tell him that technology at Genex was a mess? 3. Devise a strategy to successfully implement enterprisewide systems (such as SAP) at Genex. Page 1“A Pain in the Gut” by Ripple, Marcaccio, Shearman, & Stephens by John T. Ripple, Stephen E. Marcaccio, Daniel R. Sherman, and Philip J. Stephens Department of Biology, Villanova University, Villanova, PA NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE Part I – The Accident Frank was driving home after a long day at work. It was late and he was having problems driving in the dark with so much traffic. He was forced to take a detour and felt tired, so he took another sip of soda.
  • 8. “What would I do without sugar and caffeine?” he mumbled to himself. Frank realized that he should probably stop the car as he noticed his hands begin to shake, but he continued anyway. Rounding a corner he realized that he was having trouble focusing on the road. He tried to blink away the blurriness and shook his head, but things did not change. In an instant, the car slipped off the road and hit a tree. “What was that?” exclaimed Frank to the night air. He quickly got out of the car and checked himself out. Other than the shock of the accident, Frank seemed to be okay. He pulled out his cell phone and called his wife, Stacey, to come pick him up. He then called to report the accident to the police and his insurance agent. His wife arrived about an hour later and looked very concerned when she saw Frank sitting in the police car. “Why aren’t you going to the hospital?” screamed Stacey. “Were you drinking again?” “I’m fine, and no I wasn’t drinking. Check with Sergeant Eversman if you don’t believe me. I lost focus; it’s been a long day and my vision’s a little off. This is too much stress. Please, I just want to go home.” They drove home, but Stacey continued to badger Frank about going to the hospital. Questions 1. List Frank’s physical problems. 2. What do you think is causing Frank’s blurred vision?
  • 9. 3. With the above physical problems in mind, what do you speculate about Frank’s condition? A Pain in the Gut: A Case Study in Gastric Physiology NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE Page 2“A Pain in the Gut” by Ripple, Marcaccio, Shearman, & Stephens Part II – The Checkup “Good morning Frank, what can I do for you today?” asked Doctor George. “I was in a car accident last night. I’m fine, but I thought I would see you before I leave for my business trip this afternoon. I guess it’s better to be safe than sorry.” “I’m glad you came to see me. I can always squeeze in my old college roommate even though you dropped biology for a business degree.” Both men smiled. “Your blood work should be here soon. Have you managed to cut down on your drinking and smoking?” asked the doctor. “Old habits die hard, I’m afraid,” admitted Frank. “I still smoke occasionally, but I have really cut down on the drinking. In fact, I was drinking soda last night; the breathalyzer test was negative for alcohol, as I knew it would be. I don’t know what came over me. I was tired after a long day. I was driving home and ended up wrapped around a tree. I
  • 10. can’t believe this happened,” Frank sighed. “I believe you Frank, but our blood work isn’t looking for alcohol,” the doctor responded. “Besides being tired, how did you feel while you were driving? Was there anything abnormal that you noticed?” “Well, the thing that surprised me was my vision. I have had great vision my whole life; it runs in my family. But recently my vision has been blurry, and last night it got to the point where I couldn’t see the lanes of the road—and, well, you know the rest,” explained Frank. “You mentioned it was a late night. Did you eat or drink anything?” asked the doctor. “Just the typical stuff I always have when I’m tired. I stopped for a couple of candy bars and a refill of my large soda, just to stay awake. I have been really stressed lately and I am finding it very difficult to cope, so I usually stop at the convenience store on the way home from work.” “Was it diet soda?” “No, I can’t drink that stuff,” responded Frank. ”So, how is your vision now?” “My vision is okay now. After the accident, I went home and went to bed. I woke up a little earlier than usual, but I feel fine now,” mentioned Frank. The nurse came in and gave the doctor the results of the blood tests. Table 1 – Frank’s (Fasting) Blood Test Results
  • 11. Normal Frank Blood glucose (mg/dL) 70–130 165 Blood insulin (IU/mL) 5–10 1 “Is there something wrong?” asked Frank. “Your blood glucose levels are above normal. Are you sure you didn’t eat or drink before the blood test this morning?” Frank shook his head. “I am concerned because it’s been more than 12 hours since the accident and your blood glucose is elevated. I hate to think what it was after you ate the candy bars and drank all of that soda. Your body can convert excess glucose to sorbitol; you may have heard it referred to as sugar alcohol. Anyway, sorbitol accumulates in the lens of the eye, and this could explain your blurred vision because it draws water into the fibers of the lens and makes them swell. Since this changes the shape of the lens, it can affect your vision and in the long term it can even make the lens opaque and form a cataract.” NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE Page 3“A Pain in the Gut” by Ripple, Marcaccio, Shearman, & Stephens “But I didn’t do anything out of the ordinary. I always have those snacks and soda when I’m driving late at night, and it’s never been so bad that I had an accident!”
  • 12. “That’s what worries me, Frank. How long have you been feeling this high level of stress at work?” “For about a year. They have been laying off people from work and I feel it’s only a matter of time before it’s my turn. Stacey says that we should buy stock in companies that make candy bars and soda, and I admit that I am putting on a little weight.” “This is not good. Both your high sugar intake plus the work related stress, which can cause excess cortisol secretion, can raise your blood glucose levels. High blood glucose levels like yours suggest diabetes mellitus and I know this problem runs in your family. At this point I usually send my patients to take a glucose tolerance test, but I know that you are going out of town on business this afternoon. How about we set you up for a glucose tolerance test after your trip and in the meantime take it easy on the sugar and try to relax.” “I can do that.” “Also, I think that it would be wise not to drive.” Questions 1. What hormone is responsible for decreasing blood glucose levels? 2. Which gland secretes this hormone? 3. There are two types of diabetes mellitus: Type 1 or insulin- dependent diabetes mellitus (IDDM) and Type 2 or noninsulin-dependent diabetes mellitus (NIDDM). Fill in Table 2 below to show the difference between the two types of (untreated) diabetes in terms of high, normal,
  • 13. or low for both blood insulin levels and insulin receptor function. Table 2 – Diabetes Mellitus Variable Type 1 Type 2 Blood insulin level Insulin receptor function 4. If Frank is suffering from untreated diabetes mellitus, based on Tables 1 and 2 which type do you think he suffers from? 5. Is this diagnosis reasonable considering that some members of Frank’s family suffer from diabetes mellitus? NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE Page 4“A Pain in the Gut” by Ripple, Marcaccio, Shearman, & Stephens Part III – Something's Not Right “It’s good to have you home, honey. I missed you. How was the flight?” Stacey had come to the airport to pick Frank up and she leaned over to kiss him as he climbed into the car with his luggage. “How were the meetings? You look tired,” she added. “The past week was intense and I am exhausted. I thought I would manage some R & R during the trip, but no such luck. John and Dan were fired and we were told that there
  • 14. would be more layoffs in the future if business doesn’t pick up. Everyone is feeling stressed. “ “You’re one of the hardest workers they have Frank, they can’t let you go.” “I hope you’re right. They gave us tomorrow off in lieu of making us work for 7 days straight, but I can’t help but think I should go in and get a jump on the week.” “I know you don’t want to hear this, but you have an appointment for that glucose tolerance test first thing in the morning. We’ll need to eat soon because the instructions say you are not allowed to eat for 8 hours before the test.” Frank felt miserable. “I’m really not hungry. Maybe it was the change in diet, but I’ve had a persistent stomach ache and I didn’t eat much when I was away. “Well, we need to take extra special care of you until we find out what’s wrong. I am sure everything’s going to be okay.” The next morning the alarm went off and Frank felt refreshed after a good night’s sleep. “What’s the matter Stacey? You look like you’ve seen a ghost.” Stacey brought him her pocket mirror so that he could see for himself. “Forget the glucose tolerance test. I think we need to go to the Emergency Room right now.” * * * * * * * * * * * * * Doctor Smithers looked into Frank’s eyes. “It’s a good thing you came in because even a first year medical student could see that you are jaundiced.”
  • 15. Stacey looked concerned. “What does that mean? Is he going to be okay?” “Well it could mean a few different things,” replied the doctor, “so we are going to have to run some tests to be sure.” Questions 1. What new physical signs or symptoms is Frank exhibiting? 2. What does the doctor see in Frank’s eyes that indicates jaundice? 3. What molecule is responsible for Franks’ jaundiced appearance? 4. On the following page, fill in Flow Chart 1 with the best choices from the provided word list. 5. Use Flow Chart 1 to suggest possible reasons for Frank’s jaundiced appearance. 6. Do you think that Frank’s jaundice is connected to the high blood glucose levels seen on the morning before his business trip? Why or why not? 7. Would you like to make a diagnosis to explain Frank’s jaundiced appearance? 8. What tests would you run to determine or confirm any of your diagnoses? NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE
  • 16. Page 5“A Pain in the Gut” by Ripple, Marcaccio, Shearman, & Stephens In the spleen, ___________ from red blood cells is broken down to form (unconjugated) bilirubin. Unconjugated bilirubin is insoluble in blood plasma so binds to albumens in the blood and is sent to the ______. Bilirubin ___________ with glucuronic acid to form conjugated bilirubin. It forms part of the bile, which is ______ in the gall bladder. Food in the gut stimulates gall bladder contraction and the bile passes down the ____ ____ to the _____ _________, where it aids in the digestion of ______. Flow Chart 1 bile duct lipid binds liver carbohydrate pancreas cell membrane pancreatic duct cytoplasm protein dissociates small intestine globin (protein) stomach hemoglobin stored Word List NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE
  • 17. Page 6“A Pain in the Gut” by Ripple, Marcaccio, Shearman, & Stephens Part IV – The Test Results “What does it mean to be jaundiced, doctor? Why did the whites of my eyes turn yellow?” “It’s usually caused by a high level of a molecule called bilirubin in your blood, Frank.” “I was a biology major in college, but I don’t remember where bilirubin comes from.” “Your blood has cells called erythrocytes or red blood cells; they contain hemoglobin which gives blood its red color. Cells in the spleen break down red blood cells and the products are reused by your body. The heme portion of hemoglobin is converted to bilirubin, which is the molecule that is responsible for your yellow color.” “I remember now, isn’t bilirubin involved in digestion?” “Yes. Bilirubin leaves the spleen in the blood and, because it’s not soluble in water, it binds with blood proteins called albumens to form unconjugated bilirubin. This bilirubin is taken up by the cells in the liver, where it combines with glucuronic acid to form conjugated bilirubin. It is one component of the bile, which travels down the bile duct to the gall bladder and the small intestine. When you eat, the gall bladder contracts and pushes the stored bile into the small intestine to aid in the digestion of fat.” “So what do my tests show?” “Your hematocrit and your liver enzymes are at normal levels.”
  • 18. “So, my liver’s okay?” “These enzymes are normally confined to the liver cells and would only be found in large amounts in the blood if your liver was damaged. So these results indicate that there is no liver damage; that’s good. But I am concerned that there is tenderness in the upper left quadrant of your abdomen … sorry, around your stomach,” the doctor smiled at Frank and Stacey. “As I explained before, a jaundiced appearance is often produced by a buildup of bilirubin in the blood and your results confirm this (Table 3).” Table 3 – The Level of Bilirubin in Blood Bilirubin Type Frank’s Blood Normal Blood unconjugated 0.9 mg/dl 0.3 – 1.6 mg/dl conjugated 0.6 mg/dl 0 – 0.3 mg/dl “One more thing concerns me,” continued the doctor. “There is almost no urobilinogen or urobilin in your urine.” “What are they?” asked Frank. “Bacteria in your intestines change bilirubin to urobilinogen. This urobilinogen can be reabsorbed back into your body and some is converted to urobilin. These two molecules circulate in your blood and are excreted in your urine; it is the urobilin that produces the straw color of urine. The low level of these two molecules in your urine plus the high level of bilirubin in your blood and the pale color of your stools indicates to me that, for some reason, bilirubin is staying in your body instead of going into your intestines.”
  • 19. Questions 1. Where is unconjugated bilirubin formed? 2. Is the level of unconjugated bilirubin in Frank’s blood within the normal range? 3. Where is conjugated bilirubin formed? 4. Is the level of conjugated bilirubin in Frank’s blood within the normal range? NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE Page 7“A Pain in the Gut” by Ripple, Marcaccio, Shearman, & Stephens 7. Consider your diagnosis for Frank’s high blood glucose levels. Which gland secretes insulin? 8. Which organs are involved in creating Frank’s jaundiced appearance? 9. Look at Figure 1 and determine whether this gland and these organs (answers to Questions 7 and 8) are connected in any way. 10. Can you think of a reason that would explain the high levels of glucose and conjugated bilirubin in Frank’s blood? 11. Would you like to make any adjustments to your diagnoses?
  • 20. 5. Using Flow Chart 1, outline some possible reasons for the high level of conjugated bilirubin; remember Frank’s liver enzymes are normal. 6. Frank experienced tenderness in the upper left quadrant of his abdomen. Use the word list in Figure 1 to label the major organs in this area. Image credit: Figure 1, licensed illustration © Alila Medical Images – Fotolia.com Word List Bile duct Gall bladder Liver Pancreas Pancreatic duct Small intestine Figure 1. Diagram of the organs in the upper left quadrant of the abdomen plus a word list for labeling. NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE Page 8“A Pain in the Gut” by Ripple, Marcaccio, Shearman, & Stephens Part V – CT Scans “Here is your CT scan, Frank. Just to orient you, it shows a slice across your abdoment just below your diaphragm (inset on right). This scan (Figure 2) is
  • 21. taken from a healthy individual; we use it in teaching and you can see labels on the various organs. Now look at your scan (Figure 3), which was taken at a similar plane. I have drawn arrows to show your pancreas,” explained the doctor. “My pancreas looks larger; and what are those dark blobs?” Figure 2. Healthy Patient’s CT Scan Figure 3. Frank’s CT Scan Image credits: Figure 2: University of Leeds, http://www.bmb.leeds.ac.uk/teaching/visible/, used with permission. Figure 3: Thoeni R F. The revised Atlanta classification of acute pancreatitis: Its importance for the radiologist and its effect on treatment. Radiology 2012;262:751–764. Used with pemission. Questions 1. Speculate on the identity of the “dark blobs” Frank noticed in Figure 3. 2. Do you think these “dark blobs” could affect the secretion of insulin? 3. Do you think these “dark blobs” could inhibit the liver from producing conjugated bilirubin? 4. Frank’s CT scan shows the “head” of the pancreas in the vicinity of the small intestine and the stomach. What do you think would be the effect of an enlarged pancreas on the ability of the gall bladder to send bile down the bile duct and into the small intestine?
  • 22. 5. Why does Frank have elevated levels of bilirubin in his blood? 6. Would you like to modify your diagnosis? NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE Page 9“A Pain in the Gut” by Ripple, Marcaccio, Shearman, & Stephens 2 Image in title block by © Daniel Jędzura | Dreamstime.com, ID 25936227. Case copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Originally published October 15, 2013. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work. Part VI – The Final Diagnosis “So what’s the problem doctor?” asked Frank. “Your CT scan shows that your pancreas contains some unusual growths, what you called ‘dark blobs’,” replied the doctor. “These growths may be interfering with your ability to secrete insulin.” “So does that mean I do not have diabetes?” “We’ll need to do more tests to determine that, but I am very concerned about the size of your pancreas, which seems
  • 23. to be so big that it’s blocking the bile and pancreatic ducts.” “So these growths are blocking the duct that takes bile from the gall bladder into the small intestine and are the source of my pain?” “That seems possible,” replied the doctor. “With a blocked bile duct, bilirubin cannot get into your small intestine and will build up in your gall bladder, your liver, and ultimately in your blood.” “That would explain why I am jaundiced. Are those ‘dark blobs’ cancerous, doctor?” “We’ll need to take a biopsy to be certain, but I am afraid they may well be. I’m sorry, Frank. Still, we’re very lucky that we discovered these growths at such an early stage. If you had waited we could be looking at more serious problems.” “So, what’s the next step?” “We’ll need to do more tests, but I think you’ll probably need surgery to remove the growths. I know that this may sound drastic, so I think you should see a specialist. We are fortunate because we have a very good gastroenterologist and an excellent abdominal surgeon on staff. I have scheduled an appointment for you to see them this afternoon. One advantage of having them in this hospital is that it will be easy to get your test results and CT scans to them before your meeting. They can refer you to other doctors if you wish, but I think they will advise you to get this treated as soon as possible.” http://sciencecases.lib.buffalo.edu http://sciencecases.lib.buffalo.edu http://sciencecases.lib.buffalo.edu/cs/collection/uses/