Search

We examine whether delays in the expected release of annual earnings have implications for the future auditor-client relationship. Managers have strong incentives to release earnings on schedule, and auditors play an important role in helping their clients avoid costly earnings announcement delays. We find an increased likelihood of subsequent auditor-client realignments after earnings announcement delays. We further find that clients changing auditors realign with audit firms that better meet their earnings announcement timing demands, without finding evidence of a significant compromise in the reliability of the financial statement numbers in the earnings announcement. Our results help inform regulatory concerns about audit market concentration and how audit firm turnover has the potential to impact the auditor-client dynamic. While it is possible that auditor turnover could lead to a power imbalance where clients gain leverage in the relationship, our results suggest otherwise.

Early results using injectable autologous chondrocyte implantation (ACI) for the treatment of full thickness acetabular cartilage defects have been promising. However, so far there is no information on radiological results after injectable ACI using spheroids. The purpose of this sturdy was to (1) investigate the quality of tissue repair on MRI and (2) investigate the correlation between the MRI results and clinical results at a minimum follow-up of 24 months after third generation ACI in full thickness acetabular cartilage defects. It was hypothesized that ACI shows good MRI results in patients with large full thickness acetabular cartilage defects 24 months after surgery. It was also hypothesized that there is a correlation between postoperative clinical and MRI morphological results at a minimum follow-up of 24 months. Retrospective case series. Patients with ACI for full thickness acetabular cartilage defects > 2 cm2 were evaluated by preoperative and postoperative clinical scoring tools including the modified Harris Hip Score (mHHS), the International Hip Outcome Tool (iHOT-33), and the Subjective Hip Value (SHV) as well as a high resolution indirect arthro-MRI 24 months after surgery utilizing an identical imaging protocol for all patients. The magnetic resonance observation of cartilage repair tissue (MOCART) scoring system was used to classify the repair tissue on MRI. Demographic patient data was evaluated for influencing factors for pre- and postoperative clinical as well as radiological results. Thirty six consecutive patients (5 women/31 men, average age 32.9 years) had undergone two stage ACI procedure. The average size of the cartilage defect was 5.0 (2–6) cm2. The average follow-up was 29.9 (24–42) months. Four patients were not available for the final follow-up (follow-up rate 89%). The postoperative average MOCART score was 82.2 (± 14.2). MOCART score showed medium correlation of the item defect fill and the postoperative mHHS (r = 0.384, p = 0.043). There was no correlation of the other items or the total score with postoperative results. The patients showed significant improvement in the outcome measurements between preoperative and postoperative in the mHHS, the iHOT-33, and the SHV. Despite the large acetabular cartilage defects included in this study, ACI showed good MRI results with complete defect fill in 87.5% after a minimum 24-month follow-up. Statistically significant correlation of MRI and clinical results could only be seen with the item defect fill. Further research with longer follow-up is needed to evaluate the long-term results of ACI in acetabular cartilage defects.

Research suggests that greater earnings disaggregation in financial statements leads to favorable market outcomes. This perspective is based on a presumption that the disaggregation separates earnings components with heterogeneous characteristics. We hypothesize that the disaggregation of homogeneous earnings components is associated with greater investor disagreement and a less efficient market response to the earnings announcement. We estimate persistence regressions at the industry level and classify earnings components with persistence that differs significantly from the persistence of sales as heterogeneous and components with persistence that does not differ from the persistence of sales as homogeneous. Consistent with our hypothesis, we find a significant positive relation between the level of homogeneous earnings disaggregation and investor disagreement around earnings announcements. We also find significantly greater post-earnings announcement drift after earnings announcements with greater homogeneous earnings disaggregation. This evidence is consistent with homogeneous earnings disaggregation hindering investors’ ability to impound earnings information into price efficiently.

This study examines the relation between audit personnel salaries and office-level audit quality. We measure audit personnel salaries at the associate, senior, and manager ranks for Big 4 audit offices from 2004 to 2013, using unique individual-auditor-level data obtained from the U.S. Department of Labor. We find that offices that pay lower salaries have a higher percentage of clients that experience restatements. In related analyses, we also find lower levels of audit quality when audit employees are paid less, relative to other lines of service in accounting firms. Finally, we document positive and significant associations between salary and fees, suggesting that audit offices pass some of the cost of higher labor onto their clients. Overall, our findings provide important initial evidence on the role of audit salary and its relation to audit quality and audit fees.

A hypertrophic AIIS has been identified as a cause for extraarticular hip impingement and is classified according to Hetsroni using 3D-CT reconstructions. The role of the conventional AP pelvis X-ray, which is the first standard imaging step for the evaluation of hip pain, has not been investigated yet. AP pelvis X-rays and 3D-CT reconstructions of patients were evaluated regarding their morphology of the AIIS. The conventional X-rays were categorized into three groups according to the projection of the AIIS: above (A) or below (B) the acetabular sourcil or even exceeding the anterior acetabular rim (C). They were compared to the morphologic types in the 3D-CT reconstruction (Hetsroni type I-III). Ninety patients with an equal distribution of type A, B or C projection in the AP pelvis were evaluated and compared to the morphology in the 3D-CT reconstruction. The projection of the AIIS below the acetabular sourcil (B + C) showed only moderate sensitivity (0.76) and specificity (0.64) for a hypertrophic AIIS (Hetsroni type II + III), but if the AIIS exceeds the anterior rim, all cases showed a hypertrophic AIIS in the 3D-CT reconstructions (Hetsroni type II + III). Distinct differentiation of the AIIS morphology in the AP pelvis is not possible, but the projection of the AIIS below the anterior acetabular rim represented a hypertrophic AIIS in all cases and should, therefore, be critically investigated for a relevant AIIS impingement.

Acetabular cartilage lesions are frequently seen in young patients with hip pain and have been identified as an important prognostic factor. New therapies have complemented abrasion and microfracture procedures. The aim of the study is to evaluate the early outcome of patients with arthroscopic injectable autologous chondrocyte transplantations (ACT) for full thickness acetabular cartilage defects.A two-step procedure ACT was performed in patients with full thickness acetabular cartilage defects measuring ≥2 cm(2). The patients were closely followed with clinical examination, pre- and postoperative scores until the latest available follow-up of 3, 6, 12, and 24 months.20 consecutive cases (4 female, 16 male, mean age 33 years) were included. No patients were lost at final follow-up. The average defect size was 5.05 (range 2-6) cm(2). The average follow-up was 12.05 (range 6-24) months. Three months postoperatively the preoperative scores improved significantly from a mean mHHS of 63-81 points (p = 0.009), iHOT33 of 44-66 % (p = 0.028) and subjective hip assessment (Subjective Hip Value, SHV) of 60-87 % (p = 0.007). After 12 months the results improved significantly to a mean mHHS of 93 points (p = 0.017), an iHOT33 of 79 % (p = 0.007) and an SHV of 82 % (p = 0.048) compared with the preoperative scores.The injectable matrix associated ACT is a reliable procedure, yielding promising early results with a significant increase of all scores evaluated in patients with full thickness acetabular cartilage defects.

Histopathological examination of synovial specimens can contribute to the diagnosis of chronic joint diseases. A so-called synovitis score has been introduced as a standardised grading system, based on the semi-quantitative evaluation of the three determining features of chronic synovitis: enlargement of synovial lining, density of synovial stroma and inflammatory infiltrate, giving a score between 0 and 9. The present study examines the reliability of this procedure by comparison with exact measurements using computer-assisted image analysis (CAIA). Seventy-one synovial specimens from patients with osteoarthritis (OA, n=22), psoriatic arthritis (PsA, n=7), rheumatoid arthritis (RA, n=35) and from a control group (Co, n=7) were evaluated using both the synovitis score and CAIA. The measurements were transformed to semi-quantitative values analogous to the synovitis score. The differences between the transformed CAIA scores and the pathologist's scores were 0 or +/-1 in 40 cases, whereas in 31 cases the difference was greater than 1 (correlation coefficient r=0.725). The CAIA scores differed significantly between Co and RA cases (p=0.000) as well as between OA and RA (p=0.000). We conclude that the synovitis score was validated by CAIA and can be regarded a reliable grading system that contributes to the diagnostic procedure of chronic joint inflammation.

Gas is stored in the Triassic Buntsandstein units above the salt-pillow structure of Spandau. Brines obtained collaterally when bringing the gas back to the surface are reinjected into the oomoldic limestone of the Lower Muschelkalk. Cores of the limestone were investigated with respect to microfacies, diagnetic development, porosity, and permeability to provide the input for modeling reservoir configuration and capacity of this unit. In the porous portions of this unit, six microfacies types were distinguished by varying proportions of ooids, peloids and biogenic (skeletal) particles. Microfacies types do not correlate with porosity and permeability. The rocks were altered by varying successions of dissolution and cementation stages; four diagenetic grades were defined on the basis of development of moldic pores and their fillings. The diagenetic grades correlate with porosity and permeability showing that kind and intensity of diagenetic alterations largely overprinted initial control of microfacies on fluid flow.

Die photoakustische Infrarotspektrometrie gilt als Goldstandard zur zeitgenauen Messung von Spurenkonzentrationen von Narkosegasen in der Raumluft. Zur Sicherstellung der Messprazision empfiehlt der Hersteller des Gasmonitors die vierteljahrliche bis jahrliche Kalibrierung. Wir untersuchten, ob zertifizierte Prufgase als Alternative zur kommerziell angebotenen Kalibrierung geeignet sind. Hierzu wurde ein Multigas-Monitor Typ 1302 (Bruel & Kjaer, Naerum, Danemark) an Druckflaschen angeschlossen, die Prufgase mit Analysenzertifikat enthielten. Uber ein T-Stuck mit Durchflussmessgerat war gewahrleistet, dass wahrend der Kalibrierungsphase keine Raumluft eindrang. Zur Nullpunktkalibrierung diente hochreiner Stickstoff, der kein Infrarotlicht absorbiert. Fur Des-, En-, Iso-, Sevofluran und Halothan betrugen die Referenzwerte 41,6–51,1 ml/m3 (ppm) in synthetischer Luft. Wegen Uberschneidung der Infrarotabsorptionsspektren halogenierter Kohlenwasserstoffe mit im Operationssaal gebrauchlichen Alkoholen wurde eine Querempfindlichkeitskompensation mit Isopropanol (107,0 ppm) vorgenommen. Fur N2O wurde eine 2-Punkt-Kalibrierung mit 96,2 und 979,0 ppm sowie Querempfindlichkeitskompensation mit CO2 mit Nafionschlauchen durchgefuhrt, die Fehlbestimmungen durch molekulare Relaxationsphanomene verhindern. Die Abweichung vom Sollwert betrug initial fur volatile Anasthetika 0–2,0% und stieg nach 18 Monaten auf bis zu 4,9% an. Fur N2O ergaben sich 4,2% bzw. 2,7% Abweichung. Somit erreichten wir durch unser Kalibrierungsverfahren prazise Messwerte mit geringer Anderung uber 18 Monate. Die Vorteile liegen u. a. in der Moglichkeit, die Genauigkeit des Gerates selbststandig uberprufen zu konnen, so dass individuell uber die Notwendigkeit der erneuten Kalibrierung entschieden werden kann. Die Kosten (Prufgase, Flaschenmiete, Arbeitszeit) und logistischen Aspekte (Lagerung und Gultigkeitsdauer der Prufgase) mussen im Einzelfall gegen die Kosten der kommerziellen Kalibrierung aufgewogen werden.

Exposure to Pseudomonas aeruginosa triggers the apoptotic cell death of Chang epithelial cells, and this depends on the expression of both the CD95 receptor and CD95 ligand. In lymphocytes CD95-mediated apoptosis is paralleled by the activation of outwardly rectifying Cl- channels. The present study was performed to explore whether P. aeruginosa-induced apoptosis of Chang epithelial cells is paralleled by activation of Cl- channels. According to whole-cell patch-clamp recordings, exposure of Chang epithelial cells to P. aeruginosa does lead to rapid activation of an outwardly rectifying Cl- -selective current. The current is inhibited by the Cl- channel blocker NPPB. Exposure of Chang epithelial cells to P. aeruginosa led to a significant decrease of cell membrane capacitance by 6%, pointing to a decrease in cell volume by 7%. Exposure to P. aeruginosa depolarized the mitochondrial membrane potential indicating apoptotic cell death. The decline of mitochondrial membrane potential was not significantly affected by NPPB. In conclusion, P. aeruginosa-induced apoptosis of Chang epithelial cells is paralleled by activation of Cl- channels. Activation of the channels participates in the alteration of cell volume but is not a prerequisite for P. aeruginosa-induced apoptosis.

In this study, a diffusion-type device for generating gaseous mercuric chloride (HgCl(2)) was systematically evaluated and applied to validate the annular denuder method for sampling gaseous HgCl(2) species in a synthetic gas stream. The results show that it takes at least 48 h for the system to reach a steady-state condition after the diffusion cell reaches the temperature set-point and the carrier gas is activated. The primary Hg species from the source was proven to be HgCl(2). In the temperature range from -5.00 to 11.80 degrees C, the Hg emission rates from the source vary from 1.8 to 14.2 pg min(-1). It is shown that, under the experimental conditions examined, KCl-coated annular quartz denuders designed for ambient reactive gaseous mercury (RGM) collection could quantitatively collect HgCl(2). It is also demonstrated that the impactors used to remove coarse airborne particulate matter could lead to a loss of up to one third of the HgCl(2) in the gas stream.

Der hohe Stellenwert der transosophagealen Echokardiographie (TEE) in der perioperativen Medizin ist unumstritten. Die TEE gestattet eine direkte bildgebende Darstellung von pathologischen Veranderungen des Herzens. Daher ist die TEE das Verfahren der Wahl zur Diagnose und Graduierung von Herzklappenerkrankungen. Uber die direkte bildliche Darstellung hinaus erlaubt die TEE eine objektivierbare hamodynamische Beurteilung der Klappen- und Ventrikelfunktion. Durch Messung von Blutflussgeschwindigkeiten werden Druckgradienten uber stenotischen Klappen ermittelt. Unter Anwendung der Kontinuitatsgleichung oder der Planimetrie lassen sich Klappenoffnungsflachen bestimmen. Bei einer Klappeninsuffizienz wird der Schweregrad mittels color flow, continuous oder pulsed-wave Doppler abgeschatzt. Chirurgische Patienten sind intraoperativ mitunter grosen Schwankungen von Blutdruck, Volumenstatus und Beatmungsdruck ausgesetzt. Mittels TEE werden die Auswirkungen dieser hamodynamisch wirksamen Parameter auf die Funktion von Herzklappen erkannt. Gegenstand aktueller klinischer Studien ist daher die Untersuchung der Interaktionen zwischen Hamodynamik und Klappenfunktion mit dem Ziel, eine Verbesserung des anasthesiologischen Managements und perioperativen Verlaufs bei Patienten mit Klappenerkrankungen herbeizufuhren.

The atmospheric emission of mercury (Hg) from a contaminatedwetlands system was studied in the floodplains along the riverElbe (Northern Germany). Results suggest that wetlands can beimportant transformation and phase transfer regions, linking theterrestrial, aquatic and atmospheric compartments of regionalbiogeochemical Hg cycles. Fluxes determined by flux chambermeasurements averaged 43 ± 5 ng m-2 h-1. Additionally,soil gas probe sampling was introduced to determine mercuryconcentrations in soil air. This technique shows some promise fordetecting and confining mercury contamination in soils. We alsopropose that measurements of total gaseous mercury (TGM) in soilair and the near-surface atmosphere, in combination with simplesoil physical parameters, may be suitable for calculatingsemiquantitative estimates of Hg evaporation from contaminatedsoils, based on laminar diffusion considerations. The results arecompared to other Hg flux measurements, and the advantages anddisadvantages of different approaches to quantify Hg emissionsfrom soils are discussed, especially with regard to possiblesystematic bias.

The use of the online urea monitor has not been validated in children on hemodialysis. We compared online measured Kt/V(urea) and protein catabolic rate (PCR) with single- and double-pool Daugirdas formula (DF and eDF) based Kt/V(urea) and with protein intake derived from dietary records (DPI). In 8 children aged 8-18 years, 26 measurements were performed with the online urea monitor (UM 1000) with double-needle access. In 7 children, aged 4-14 years, 12 additional measurements were performed using single-needle dialysis. Pre-dialysis serum urea was determined by the monitor in equilibrated ultrafiltrate, obtained with ultrafiltration rates (UF) of 0.5 or 1.0 l/h, in 10 and 23 experiments respectively, and compared with the laboratory results. Urea determination in ultrafiltrate correlated well with blood sample urea: r=0.945 and 0.88 for UF rates of 0.5 l/h and 1.0 l/h, respectively. The correlation of online Kt/V with DF and eDF was 0.79 for double-needle and 0.21 for single-needle access. Bland-Altmann analysis showed a mean bias of 0.02 and 0.001, but levels of agreement of +0.3 and -0.3 for double-needle and +0.77 and -0.77 for single-needle dialysis respectively with DF. Maximum percentage error for double-needle access was 18% and 59% for single-needle access. The correlation of DPI with PCR was 0.5. A Bland-Altmann plot showed a mean bias of =0.22 with upper and lower limits of agreement of +0.55 and -0.1, respectively. Online urea kinetic modelling is feasible in children with double-needle hemodialysis only. Even with small dialyzers, an accurate serum urea measurement is obtained. PCR underestimates dietary protein intake.

Large-scale transport pathways for atmospheric gaseous mercury emitted from surrounding source regions to reach the Alert sampling site located at the Northwest Territories of Canada between August 1992 and August 1993 were investigated. The 12-month atmospheric mercury data set comprises blank-corrected total gaseous mercury (TGM) concentrations collected on gold-coated sand traps during one-week long sampling intervals. For TGM concentrations above the 12-month mean TGM level, the analysis reveals regions in Eastern Europe (close to East Germany and Poland), areas on Northeastern America in Canada (Northwest Territories), and central Siberia of the former U.S.S.R. Identification of the physical locations of the emission sources was limited by the temporal resolution of weekly averaged data; however, major atmospheric pathways of mercury transport to the Arctic were successfully resolved. The objective of this note is to demonstrate that the potential source contribution function could be applied to resolve the sources and recover transport pathways of atmospheric mercury over a large scale.

This study compares allogeneic BMT with conventional chemotherapy for childhood ALL in second remission. Seventy-five children were transplanted between July 1981 and December 1995. For each patient two control patients matching the following criteria were selected from the Nordic database of ALL: (1) time of diagnosis, (2) T vs. non-T ALL, (3) site of relapse, (4) initial risk group, (5) sex and (6) relapseoror =6 months after cessation of therapy. The minimal time of follow-up was 24 months. Mortality rate in CR2, leukemic relapse rate and the proportion in continued second remission were 16/75 (21%), 22/75 (29%) and 37/75 (50%), respectively. P2.-EFS for the BMT group was significantly better than that for the control group (0.40 vs. 0.23, P = 0.02). Children transplanted for bone marrow relapses in particular had a higher P2.-EFS (0.35 vs. 0.15 for the control group, P0.01). Also, children grafted for early BM relapses had a higher P2.-EFS (0.32 vs. 0.11 for the control group P = 0.01). The outcome was similar when children were transplanted after early or late relapse. Also, there was no difference in outcome between the BMT and the chemotherapy group for children with late relapses. We conclude that allogeneic BMT with an HLA-identical sibling donor or other family donor should be performed in children relapsing in bone marrow during therapy or within 6 months of discontinuing therapy.

Total particulate mercury (TPM) may constitute, in general, a small percentage by mass of total atmospheric mercury, but under certain conditions it can be a very significant form of atmospheric Hg, and play an important role in the deposition of mercury to terrestrial and aquatic cosystems. To understand the cycling and distribution of mercury in the environment, accurate determination of the total concentration and speciation of TPM are necessary. This article provides a review of scientific and technical literature published in the past 5 yr pertaining to sampling and analytical methodologies for the determination and chemical speciation of TPM in ambient air. Sampling methods discussed include the conventional filtration method and the diffusion denuder-based technique. Analytical techniques, such as gold-amalgamation/cold-vapor spectrometry, and nuclear methods, are summarized.

The alignement and size of the components of a knee-prosthesis is most important for a sucessful and durable total knee arthroplasty. The effect of positioning the components on the patellafemoral joint is described in detail.

This article reviews the current controversy of resurfacing the patella in total knee arthroplasty. Up-to-date knowledge of experimental and biomechanical studies as well as the different types of implants and specifics of the patella preparation are described in detail. The author furthermore discusses the relevant clinical studies dealing with patellar resurfacing and tries to guide the reader in evaluating the results. Finally is summarized why the indication for resurfacing the patella is so controversial and how a differentiated indication for resurfacing the patella could be specified.

We present the radiological results of 2286 total hip replacements (THR) from the multicenter study. Concerning the acetabular component the analysis showed that socket migration and radiolucent lines were much more dependent on the specific design of the socket than on the primary diagnosis. A similar results was found for the femoral stems: rheumatoid arthritis did not cause a higher percentage of stem subsidence, radiolucent lines or bone remodeling. Within a mid-term follow-up period the reduced bone quality in rheumatoid arthritis is not associated to premature failure of a cemented or cementless prosthesis. THR failure seems to be more dependent on specific construction features of the individual socket and stem.

The analysis of THR-failures showed that the acetabular component still is the main problem of total hip replacement. The acetabular cup fails more often than the stem. In the midterm analysis the failure rate is a little bit higher in cementless than in cement fixed cups. The known effect that the failure rate of cups fixed with cement increases exponentially 8 to 10 years after implantation, could of course not be seen in this study. The success of the cementless fixation was negatively influenced by the diagnosis rheumatoid arthritis, age over 70 and the fixation manner: the failure rate of threaded cups was higher than the one of press-fit cups although the Zweymüller-cup as well as the Link type V-cup showed good results. The midterm results of the stem were very good for the cementless as for the cemented technique. Some implants showed compared to others significantly worse results. The further implantation should be thought of, what partially has already happened. The results of cementless stem fixation in patients with rheumatoid arthritis, osteoarthrosis and dysplastic osteoarthritis is comparable, so that cementless fixation should be thought of in case of adequate conditions (ability of partial weight bearing for some weeks, age under 60).

The ARO multicenter study intended to show clinical and radiological differences with regard to different systems of fixation and designs of the prothesis in total hip replacement in patients with hip dysplasia, osteoarthritis and rheumatoid arthritis. In 1987 and 1988 5255 total hip prothesis were implanted by the 24 hospitals which took part in the study. 3133 prothesis (95,6 %) were clinically and radiologically examined. The follow-up period averaged 6.9 years. The results of the Aro multicenter-study showed that despite difficult preoperative conditions especially in cases of rheumatoid arthritis the satisfaction rate improved remarkably. During the operation less complications arose in comparison to patients with hip dysplasia and osteoarthritis. Regarding the rate of infection after operation there were no differences between the 3 groups. Only the rate of postoperative luxation concerning rheumatoid patients turned out to be twice the number of the others. In our opinion this is due to the fact that these rheumatics were operated by posterior approach. Patients with rheumatoid arthritis were satisfied most with their surgeries. Results of rheumatic patients according to Harris hip score were slightly worse than the results of the two other groups. This was due to systemic involvement and bad preoperative function of the hip. As a result of the study there were no differences in using cemented or cementless techniques for rheumatic hip replacement. The decision for the method of fixation should depend on the patient's ability to relief the prothesis after operation. The study has shown that cementless implantation can also be used for young rheumatics provided that a suitable design of prothesis will be selected.

Sampling of total gaseous mercury (TGM) in air was initiated at Alert, Northwest Territories, Canada (82.5°N;62.3°W) by Atmospheric Environment Service (AES) staff during August 1992 on an exploratory basis for a year. TGM was pre-concentrated onto traps (2 in series) containing Au-coated quartz sand for sampling periods of 1 (or more) week(s) at flow-rates of 30–50 mL/min. During the first winter cruise of the RV “POLARSTERN” from Germany (56°N) to the Nordic Seas, and at an ice-camp (81°N;5°E) in the Arctic, simultaneous samples of TGM and aerosol black carbon (“soot”) were collected, from February to April 1993, by the GKSS group. The analytical methods for TGM determinations (2-stage gold amalgamation/thermal desorption, followed by cold-vapor atomic fluorescence spectroscopy) were essentially the same for both studies. Experimental details, results, and conclusions are presented and discussed.

In order to elucidate the control of local, regional and global factors on occurrence, distribution and character of Jurassic reefs, reefal settings of Mid and Late Jurassic age from southwestern Germany, Iberia and Romania were compared in terms of their sedimentological (including diagenetic), palaeoecological, architectural, stratigraphic and sequential aspects. Upper Jurassic reefs of southern Germany are dominated by siliceous sponge—microbial crust automicritic to allomicritic mounds. During the Oxfordian these form small to large buildups, whereas during the Kimmeridgian they more frequently are but marginal parts of large grain-dominated massive buildups. Diagenesis of sponge facies is largely governed by the original composition and fabric of sediments. The latest Kimmeridgian and Tithonian spongiolite development is locally accompanied by coral facies, forming large reefs on spongiolitic topographic elevations or, more frequently, small meadows and patch reefs within bioclastic to oolitic shoal and apron sediments. New biostratigraphic results indicate a narrower time gap between Swabian and Franconian coral development than previously thought. Palynostratigraphy and mineralostratigraphy partly allow good stratigraphic resolution also in spongiolitic buildups, and even in dolomitised massive limestones.

Mercury is released into the atmosphere from natural and anthropogenic sources. Once in the air, Hg species will be dispersed, chemically and physically transformed, and transported over varying distances (regional, continental and global scales) while concurrently being subjected to removal processes. Modeling of the aerial transport and deposition of Hg to receptor sites offers an attractive approach for integrating existing experimental data and represents an important tool for advancing our understanding of environmental Hg pollution. Comprehensive modeling efforts of the atmospheric pathways and fate of this heavy metal require knowledge of its atmospheric chemistry. To update and consolidate available information relevant to the atmospheric chemistry of Hg, a computer-assisted search was undertaken of the primary scientific literature published during the last ten years. Selected results from this literature survey are presented in this paper.

Aerosol and total vapor-phase Hg concentrations in air have been measured at Walker Branch Watershed, Tennessee for ≈ 2 yr. Airborne Hg at this site is dominated by vapor forms which exhibit a strong seasonal cycle, with summer maxima that correspond to elevated air temperature. Concentrations in this forest are near background levels; however, concentrations at a site within 3 km are significantly elevated due to emissions from Hg-contaminated soils. The concentration data have been combined with a recently modified dry deposition model to estimate dry deposition fluxes to the deciduous forest at Walker Branch. Weekly mean modeled Vd values for Hg° ranged from 0.1 (summer) cm s1. Weekly dry deposition fluxes ranged from 1.0 µgg m−2 in the summer. Our dry deposition estimates plus limited measurements of wet deposition in this area indicate that dry deposition may be the dominant input process in this forest, at least during the summer.

Die jurassischen Spongiolithe der epi- bis perikontinentalen Randentwicklung der Tehys erreichen im Malm ihre maximale Entfaltung. Sie konnen in der Evolution von Riffassoziationen wahrend der Erdgeschichte als ein historisch einmaliges Phanomen gesehen werden. Der Beitrag diskutiert den derzeitigen, zum Teil kontrovers beurteilten Kenntinisstand uber Genese und Rahmenbedingen dieser autochthonen Kieselschwamm-Gesteine Suddeutschlands und seiner Nachbargebiete. Im Hinblick auf das Teilprojekt ‘Riffevolution’ des DFG-Schwerpunktprogrammes ‘Biogene Sedimentation’ beleuchtet er insbesondere folgende genetischen und prozesorientierten Aspekte

We report on heat-capacity measurements of liquid3He droplets in a Ag matrix at 15 mK≤T≤1 K. The samples have been prepared by implanting about 0.1 at.%3He in 42 µm thick Ag Foils. Annealing of the foils results in high-pressure3He gas bubbles of diameters between 50 A and 150 A; the3He in the bubbles liquefies when the metal foils are cooled to low temperatures. After each annealing step we measured the low-temperature thermal relaxation time of the foils and determined in this way the heat capacity of the3He droplets. The results differ from the specific heat of bulk liquid3He. We will discuss possible origins of this deviation.

A series of 55 randomly chosen radical prostatectomy specimens was analyzed for expression of prostate-specific antigen (PSA) by immunohistochemical techniques. Tissue sections were selected in such a manner that in addition to glandular benign prostatic hyperplasia (BPH), one or more different prostatic tumour growth patterns were present. Four monoclonal antibodies, directed against three different PSA epitopes, and one polyclonal anti-PSA antiserum were used. Expression of PSA was compared with that of prostate-specific acid phosphatase (PAP), recognized by two different polyclonal antisera. A critical dilution aimed at a maximum of staining intensity on BPH tissue sections was chosen for all antibodies. Anti-PSA and anti-PAP antisera stained essentially all BPH samples (over 90%). Irrespective of the nature of the antibodies used, PSA expression was found to be decreased in prostatic carcinoma. A clear cut relationship was found between immunoreactivity for PSA and the degree of differentiation of the tumour area. Under the experimental conditions used the PSA monoclonal antibodies stained only 1 out of 10 undifferentiated carcinomas, whereas 50% to 70% of the well- and moderately-differentiated carcinomas showed immunoreactivity. This correlation was less pronounced with the PAP staining pattern. If the PSA antibody titer was raised the percentage of clearly staining undifferentiated carcinomas could be considerably increased (up to 60%-100%), indicating that PSA expression is not absent, but lowered in most (if not all) undifferentiated carcinomas.

At present there are several grading systems for prostatic carcinoma. Most are difficult to reproduce. An objective method of grading seems to be necessary and could make comparisons between various groups of patients easier and grading more reliable. In the present study morphometrically estimated nuclear size and variation in nuclear size are matched with the survival rates of 207 patients who underwent total perineal prostatectomy for cancer. On the basis of morphometrically estimated variation in nuclear size the patients could be divided into two groups with significantly differing survival rates. In this way it was possible to split the group of patients with grade 2 carcinoma (Mostofi's grading system) into two groups of patients with significantly different survival rates. The survival rates in these two groups did not differ significantly from those in the patients with Grade 1 and Grade 3 tumors respectively. The results are discussed in the light of the recent literature on the subject. Morphometry seems to be a valuable tool in grading prostatic cancer.

Many human tumors such as bladder carcinoma that are initially responsive to chemotherapy eventually fail to respond to treatment. For most drugs, dose escalation that may be required for a cure cannot be achieved because sensitive tissues such as bone marrow limit cytotoxic therapy. Approaches to prevent or circumvent myelosuppression are therefore a high priority of research on dose intensification protocols. One such strategy is to protect bone marrow cells by virtue of expression of the multidrug-resistance (MDR1) gene encoding for P-glycoprotein. In our first set of experiments, we transplanted bone marrow cells derived from transgenic mice that constitutively express MDR1 to lethally irradiated recipients (n=36). From 6 weeks to 10 months after the transplant, all animals contained MDR1 DNA in spleen and bone marrow specimens as indicated by Southern-blot analysis and expressed MDR1 RNA in bone marrow samples as detected by slot-blot analysis. In addition, these animals were resistant to the myelosuppressive effect of doxorubicin, daunomycin, taxol, vinblastine, vincristine, etoposide, and actinomycin D, whereas control animals that were reconstituted with normal bone marrow reacted with a significant decrease in their white blood counts. In a second set of experiments, we retrovirally transfected a construct consisting of a murine long-terminal repeat (LTR) promoter and the human MDR1 gene into CD34-positive bone marrow stem cells from rhesus monkeys using the same technique as in the ongoing clinical ADA gene-therapy protocol. Upon transplantation, high-level and long-lasting expression of the human MDR1 gene was observed in recipient monkeys. On the basis of this preclinical analysis, we have, in close cooperation with the Dutch Gene Therapy Group, submitted clinical protocols designed to test myeloprotection afforded by MDR1 gene transfer to intensify chemotherapy in otherwise incurable human cancer for institutional and state approval. The Department of Urology will investigate metastatic, refractory bladder carcinoma using the multidrug-resistance (MDR)-related drugs vinblastine and doxorubicin for myeloablative support of bone marrow transplantation, selection of MDR-positive clones, and dose escalation of chemotherapy in patients. The objectives of these phase I/II studies are to test the feasibility and toxicity of transplanting retrovirally transfected MDR-bone marrow stem cells and, eventually, to determine the efficacy of this innovative approach.

Heparin-induced thrombocytopenia type II is a serious complication during heparin therapy. Treatment with lepirudin is an alternative when anticoagulation is indispensable. However, lepirudin accumulates in patients with acute renal failure treated with renal replacement therapy. This might lead to an increase in bleeding complications, longer ICU length of stay, and more therapeutic interventions. We conducted a retrospective study of all patients after cardiothoracic surgery that developed acute renal failure, treated by continuous renal replacement therapy, during a 17-month study period. We grouped the patients according to anticoagulation with heparin or lepirudin, respectively, and analyzed the groups for differences in length of ICU stay, bleeding complications, scores (APACHE II, SAPS, TISS), and mortality.

Leukocyte adhesion contributes to perfusion abnormalities and tissue damage during trauma, shock or overwhelming infl ammation. This study was performed to determine whether the lipoxygenase inhibitor phenidone and derivatives decrease the expression of adhe- sion molecules on tumor necrosis factor-α (TNF-α) stimulated endothelial cells and attenuate leukocyte-endothelial interactions under fl ow in vitro. TNF-α stimulated human umbilical venous endothelial cells (HUVECs) were incubated with phenidone, 4-methyl-phenidone, 4-4-dimethyl-phenidone, 5-methyl-phenidone, 5-phenyl-phenidone, and 5-methyl-1,(2,5-di- chloro-phenyl)-3-pyrazolidone. We tested the inhibition of adhesion molecule expression at different inhibitor concentrations before, during, and after the stimulation of HUVECs. The inhibition of endothelial cell expression on HUVECs was measured by fl ow cytometry. Roll- ing and fi rm adhesion of leukocytes to pretreated endothelium was examined in a parallel plate fl ow chamber. Phenidone inhibited the expression of intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and endothelial-leukocyte adhesion molecule-1 on HUVECs when added prior to HUVEC stimulation. The inhibitory effect of phenidone was still observed when added simultaneously, but not when added after HUVEC stimulation. 4-4-dimethyl-phenidone and 5-phenyl-phenidone inhibited the expression of adhesion molecules more effectively than phenidone. The attenuation of leukocyte rolling under fl ow conditions was also signifi cantly more effective with 4-4-dimethyl-phenidone than with phenidone. Lipoxygenase inhibitors might be of therapeutically interest for the treatment of overwhelming systemic infl ammation during shock, trauma, and sepsis.

Intraoperative use of high dose opioid anesthesia is common practice for hemodynamic control in patients undergoing coronary artery bypass grafting (CABG). It is unclear whether postoperative pulmonary function is affected by this practice. Remifentanil is an ultra-short acting μ-agonistic opioid [1]. We hypothesized that remifentanil is associated with improved pulmonary function, compared with longer acting opioids. Therefore, we performed a controlled randomized trial to evaluate pulmonary function in patients undergoing CABG with high dose remifentanil versus sufentanil.

The mortality of patients with acute renal failure (ARF) remains high (50-60%). Predictive variables of outcome include, age, altered previous health status, severity of illness, multiorgan failure, oliguria, cause of ARF [1]. We retrospectively analyzed all patients without pre-existing renal insufficiency, admitted to the surgical ICU between 1993 and 2000, who developed ARF, that was treated with renal replacement therapy (RRT).

The ARO multicenter study intended to show clinical and radiological differences with regard to different systems of fixation and designs of the prothesis in total hip replacement in patients with hip dysplasia, osteoarthritis and rheumatoid arthritis. In 1987 and 1988 5255 total hip prothesis were implanted by the 24 hospitals which took part in the study. 3133 prothesis (95.6%) were clinically and radiologically examined. The follow-up period averaged 6.9 years. The results of the Aro multicenter-study showed that despite difficult preoperative conditions especially in cases of rheumatoid arthritis the satisfaction rate improved remarkably. During the operation less complications arose in comparison to patients with hip dysplasia and osteoarthritis. Regarding the rate of infection after operation there were no differences between the 3 groups. Only the rate of post-operative luxation concerning rheumatoid patients turned out to be twice the number of the others. In our opinion this is due to the fact that these rheumatics were operated by posterior approach. Patients with rheumatoid arthritis were satisfied most with their surgeries. Results of rheumatic patients according to Harris hip score were slightly worse than the results of the two other groups. This was due to systemic involvement and bad preoperative function of the hip. As a result of the study there were no differences in using cemented or cementless techniques for rheumatic hip replacement. The decision for the method of fixation should depend on the patient's ability to relief the prothesis after operation. The study has shown that cementless implantation can also be used for young rheumatics provided that a suitable design of prothesis will be selected.

Wellbutrin in Volunteer Studies -- Kinetics and Dose Proportionality of Bupropion and its Metabolites

Serum acid phosphatase activity is known to be elevated in a number of patients with metastatic prostatic carcinoma. Prostatic acid phosphatase (PAP) can be specifically measured by immunological methods. In this study we evaluated an enzyme-immunoassay of the sandwich type utilizing monoclonal antibodies.

Diagenetic sequences of many stages are know from various carbonate rocks, but the diagenetic spatial variations within a given facies, outcrop, hand specimen or thin section are only gradually rediscovered and taken into account in porosity studies. The variations occur in various carbonate facies such as reefs, beachrocks, shallow-water deposits, hardgrounds, and concretions. Multiple, parallel diagenetic pathways, branching in time, are recognized in such cases. Diagenetic spatial variations are caused by individual characteristics of particles and cements (mineral and chemical compositions, ultra- and microstructure, surface properties); collective characteristics of sediments and sedimentary rocks (component mix due to ecological and transport selection, fabrics as determined by primary sedimentary and skeletal structures); synsedimentary to early diagenetic processes (internal sedimentation, bioturbation, bioerosion); early to late diagenetic processes (cementation, dissolution, fracturing, decomposition of organic matter); hydrology (wave and tide ranges, sea and ground water levels, mixing zones), as well as substrate mobility and solubility. Many of the causal factors are determined, directly or indirectly, by biologic, meteorologic, or oceanographic factors. Causal factors may combine and thus, as a given diagenetic stage, provide for considerable diagenetic complexity. In the course of diagenesis, i.e. in time, the spatial variations increase: The spatial heterogeneity of one stage provides the scene for cementation, dissolution and/or alteration to act in their respective ‘local’ or ‘micro-local’ environments, and thus to increase the heterogeneity for the next scene or diagenetic stage. Superposition of respective variations gradually increases the diagenetic diversity. Porosity development therefore progresses not only in time, but also in space, and thus is four-dimensional. The study of diagenetic spatial variations and the respective detailed analyses lead to a comprehensive understanding of porosity development and of the highly variable and complex diagenetic history of carbonate rocks. The complexity provides problems for the application of diagenetic information in cement stratigraphy and porosity assessment. Cement-stratigraphic correlation, when taking into account spatial variations, uses selected pore types and pore fillings in a defined space/time framework. Examining pores and pore fillings of different diagenetic stages, the respective paleo-hydrologic gradients, the sources of solutes, and thus the hydrologic history of depositional and diagenetic environments can be established. Porosity assessment, when coping with diagenetic complexities, either is based on quantification of diagenetic pathways/products encountered, or on selection of indicative pores or pore fillings. Differentiation according to diagenetic stages permits assessing the porosities at successive stages. Realization of spatial variations in porosity development spoils fast and simple correlations, assessments, or predictions. The synthesis of the detailed analytical information, however, provides a route toward application of diagenetic complexities.

The staging and grading results of 107 patients considered to be potential candidates for radical prostatectomy are described. In all patients lymph node status was proven histologically. Understaging of the local tumor was found in 51.4% of the patients. Local overstaging in clinical T3 patients was noted in 23%. Undergrading of the pre-operative biopsy specimen was noted in 42% of the patients, while overgrading occurred in 6% of the patients. False negative frozen sections of pelvic lymph nodes occurred in 7%. The percentage of false negative frozen sections was higher in higher T-categories and higher tumor grades. The presence of lymph node metastases is a function of T-category and tumor grade. In T3G3 patients positive nodes were found in 90% of the cases. Bipedal lymphangiography and CT-scanning were of no value in detecting lymph node metastases in patients not being T3 or G3. In clinical T3 patients total tumor removal, as defined by negative pelvic lymph nodes and negative margins of resection, could be achieved in 30% of the cases.