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weave that permits both length and girth expansion of the cylinders However, the Ultrex prosthesis is not appropriate for patients with Peyronie s disease because these patients need greater stiffness than is provided by the Ultrex prosthesis Three-piece in atable implants manufactured by the Mentor Corporation share a similar design to the previously described models The main difference is that the Mentor implants are made based of an inert aromatic polyurethane polymer called Bio exTM Compared to silicone, Bio exTM has increased abrasion resistance and higher tensile strength An additional feature of the current Mentor Titan or three-piece in atable prostheses, is a lockout valve that reduces the common phenomenon of autoin ation of the prosthesis [16] The lockout valve is also used in the two-piece Excel Resist device The Titan prostheses are also available in a narrow-base version, which is best used in patients with severe brosis of the corpora cavernosa, as described above for the AMS CXR prosthesis As infection is the most feared complication of penile prosthetic surgery, two- and three-piece implants speci cally modi ed to reduce this risk have been recently introduced into clinical practice The InhibiZoneTM prostheses by AMS are coated with a combination of rifampicin and minocycline to inhibit bacterial growth In these prostheses, the surfaces of the prostheses, which come into contact with the adjacent tissue, are impregnated with quanti able doses of these antibiotics that elute into the area surrounding the prosthesis after surgery Both drugs elute initially at high rates, with a signi cant decrease in rifampicin after one and minocycline after seven days The inhibitory effect of the InhibiZoneTM treatment is greatest for Staphylococcus epidermidis and Staphylococcus aureus [17,8] Mentor has also developed a method to reduce penile prosthetic infection This method uses an intensely hydrophilic coating called ResistTM that is applied to the Titan and Excel prostheses Its increased lubrication has been shown to decrease bacterial adherence in vitro Furthermore this coating absorbs antibiotics that can elute into surrounding tissues over 24 to 72 hours to further decrease infection An antibiotic-soaking solution, which has been tested both in laboratory experi-.

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data with permission of AMS, Germany [22])

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FORENSIC ACCOUNTING AND LITIGATION CONSULTING SERVICES (c) Documentation (d) Engagement Letters 19 19 19 19 21 21 21 22 (v) Rule 202: Compliance with Standards (vi) Rule 203: Accounting Principles (vii) Rule 301: Con dential Client Information (b) Statement on Standards for Consulting Services (i) General Standards (ii) Consulting Standards (c) American Institute of Certi ed Public Accountants Consulting Services Practice Aids 469 22 22 23 23 24 FEDERAL RULES OF EVIDENCE

Year 1994 1995 1996 1997 1998 1999 2000 2001 2002 Overall 23280 23760 24360 20760 17640 24960 26600 28800 31100 USA 19400 19800 20300 17300 14700 20800 22000 23800 25700 Europe 3880 3960 4060 3460 2940 4160 4400 5000 5400

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TESTIMONY (a) Giving Deposition Testimony (b) Giving Trial Testimony (i) Direct Testimony (ii) Cross-Examination (iii) Redirect Examination

You add a dynamic text box for the date On the Date layer, use the Text tool to create a dynamic text box, by choosing Dynamic from the Text Type drop-down list of the Property inspector In the Var text box (expand the Property inspector if necessary), type myDate1 Place it low enough to leave room for the clock

ments and in clinical use, is composed of 2 g of gentamycin and 100 000 units of bacitracin in 1000 ml of saline [17,21] Reduced infection rates have been reported recently for the AMS InhibiZoneTM and the Mentor ResistTM products [18,19,20] The three-piece implants of AMS and Mentor can be seen with their coatings in Figure 122 The two-piece device of Mentor is also available with hydrophilic coating, while the AMS two-piece Ambicor device is not Notably, to avoid elution of the coating prior to implantation, the various components should not be soaked in saline or other solutions for a prolonged period However, conventional parenteral prophylactic antibiotic protocols should be maintained Penile prosthesis implantation is a frequent operation performed worldwide The implant statistics over the last years are summarized in Table 123 The introduction of PDE5 inhibitors into the market in 1998 initially caused a signi cant drop in implant rates worldwide, but in more recent years a constant increase of implants has been noted Seventy- ve percent of penile implant sales are in the United States, where 90% of implants are threepiece and two-piece devices Outside the United States 40% of all implants are non-hydraulic devices [55]

PROFESSIONAL STANDARDS RELEVANT TO LITIGATION CONSULTING (a) American Institute of Certi ed Public Accountants Code of Professional Conduct (i) Rule 101: Independence (ii) Rule 102: Integrity and Objectivity (iii) Con icts of Interest (iv) Rule 201: General Standards

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It is of critical importance to offer this treatment only to properly selected patients, and furthermore to

(a) Federal Rule of Evidence 702 26 (b) Effect of Daubert v Merrell Dow Pharmaceuticals 26 (c) Federal Rule of Civil Procedure 26 26 4610 SOURCES AND SUGGESTED REFERENCES

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