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American Depositary Shares We incorporate by reference the disclosure regarding our ADS program included in the registration statement on Form 20-F A File No. I-15024 ; , as filed with the Commission on May 9, 2000, in the section entitled ``Part II--Item 14. Description of Securities to be Registered--American Depositary Receipts.'' On May 3, 2001, we filed an Amendment No. 2 to the Amended and Restated Deposit Agreement, dated as of May 7, 2001, pursuant to the Registration Statement on Form F-6 File No. 333-13446 ; . The Amendment No. 2 changed the ADS-to-share ratio from 40-to-1 to 1-to-1. On January 31, 2002, we filed a Restricted Issuance Agreement dated as of January 11, 2002, supplementing Amendment No. 2 to the Amended and Restated Deposit Agreement dated as of May 3, 2001, as an exhibit to the Registration Statement on Form F-3 File No. 333-81862 ; . The Restricted Issuance Agreement supplemented the Deposit Agreement to permit the deposit of restricted ADSs into a parallel facility to the ADR facility established in the Deposit Agreement. 7.B Related Party Transactions We have formed certain foundations for the purpose of advancing employee welfare, employee share participation, research and charitable contributions. The charitable foundations foster health care and social development in rural countries. The foundations are autonomous, and their boards are responsible for administering the foundations in accordance with the foundations' purpose and applicable law. The employee share participation foundation has not been included in our consolidated financial statements prepared under IAS, as the International Accounting Standards Committee, Standing Interpretations Committee No. 12, exempts post-employment and equity compensation plans from its scope. The total assets of this foundation, as of December 31, 2002, included 95.1 million of our shares with a market value of approximately CHF 4.8 billion. As of December 31, 2001, the assets included 101.3 million of our shares with a fair market value of CHF 6.1 billion. This foundation has been consolidated with our financial statements under US GAAP, and is included as a reconciling item in the US GAAP reconciliation. In 2002 we granted short-term loans totaling CHF 875 million to the employee welfare and other foundations and received short-term loans totaling CHF 3 million from them. In 2001, we granted short-term loans totaling CHF 1.2 billion to these foundations and received short-term loans totaling CHF 10 million from them. In 2000 we granted short-term loans totaling CHF 936 million to these foundations, received short-term loans totaling CHF 6 million from them and sold 1.4 million of our shares to them at market rates. 7.C Interests of Experts and Counsel Not applicable, for example, cholesterol.
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Only towards the latter half of the nineteenth century did the infectious nature of TB become apparent, as a result of the studies by Villemin 1865 ; and, particularly, Robert Koch 1843-1910 ; . Koch was the first to suggest the possibility of controlling this endemic disease, with the presentation of the results of his research in 1882 ; that showed that TB was a contagious disease. He not only isolated the bacterium, which was latter named after him Koch's bacillus ; , from the sputum of infected patients, but also proposed that the principal measure for controlling the disease in the community would be to isolate affected patients. This suggestion paved the way for the "sanatorium" era of TB, during which prolonged confinement of patients in sanatoriums was believed to be the only effective way to cure TB and control its transmission. Based on the above, and throughout the prolonged history of the disease, it can be seen that the human host defences were the only means to counter M. tuberculosis. In this confrontation between the microorganism and the immune defence system, the latter tended to prevail--as a result of which only a very small proportion of infected individuals eventually developed the disease. However, when the disease became more established, the prognosis became very bleak in most cases--with a mortality of more than 50% five years after the onset of the disease. In turn, 25% of infected patients died within 18 months. Cure was only achieved in 25% to 30% of cases; the rest remaining chronically ill while continuing to spread the disease throughout the community. This extremely poor prognosis led to the development of various treatment attempts, most of which were empirical in nature and which proved to be ineffective. For this reason, when reviewing the history of TB therapy, two major divisions should be established: treatment in the prepharmacotherapeutic era, and treatment in the period corresponding to the last 50 years during which effective cure became possible. In the eighteenth century, treatment recommendations included moving to the countryside and partaking in moderate activities. There was still special attention to diet, with medication reserved for the initial or "inflammatory" stage of the disease. Thus, during the initial phase, treatment involved bleeding, antiemetic agents, and a light diet, whereas treatment in the "ulcerative" phase of the disease involved balsamic products, expectorants, and opium. In the early part of the nineteenth century, the practice of bleeding became more common, after the "irritative" doctrine developed by Broussais, who introduced the use of leeches as therapy for TB in the first third of that century. Some were opposed to this practice, including 18 and biaxin.
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Table 11 Age-adjusted relative increase in risk of fracture with 95% confidence interval ; in women for each standard deviation decrease in BMD absorptiometry ; below the age-adjusted mean Site of measurement Distal radius Femoral neck Lumbar spine Forearm fracture 1.7 1.42.0 ; 1.4 1.41.6 ; 1.5 1.31.8 ; Hip fracture 1.8 1.42.2 ; 2.6 2.03.5 ; 1.6 1.22.2 ; Vertebral fracture 1.7 1.42.1 ; 1.8 1.12.7 ; 2.3 1.92.8 ; All fractures 1.4 1.31.6 ; 1.6 1.41.8 ; 1.5 1.41.7.
Jennifer M. MacRae1 , Ognjenka Djurdjev2 , Debbie Rosenbaum1 , Adeera Levin1 , Christopher R. Thompson3 , Mercedeh Kiaii1 . 1 Nephrology, University of British Columbia, Vancouver, BC, Canada; 2 Centre for Health Epidemiology and Outcomes, St Paul's Hospital and University of British Columbia, Vancouver, BC, Canada; 3 Cardiology, University of British Columbia, Vancouver, BC, Canada AVF creation is associated with cardiac sequelae. High flow AVF may have greater cardiac impact than normal flow and produce more hemodynamic changes over time. This study aimed to document pt and vascular access characteristics associated with high and normal flow AVF, to determine if there are differences in cardiac hemodynamics as a function of AVF flow and to determine if there are significant changes in cardiac hemodynamics in high flow AVF over time. A prospective observational trial in which 14 pts with normal flow and 16 pts with high flow AVF were followed over 6-12 months with serial hemodynamic and echocardiogpahic evaluations. Patients were selected from a large HD population based on flow measurements obtained during routine monitoring. High AVF was defined as access flow, Qa 1700 ml min, normal AVF as Qa 600 - 1500 ml min. Hemodynamic data including US dilution data was obtained within the first 60 minutes of HD on the mid-week run. Echocardiography was performed predialysis ion the mid-week HD run. Patients with high AVF were younger 55 vs 73y ; , non-diabetic, and had upper arm AVF 71 vs 40% ; , all p 0.05. There was a trend to higher PTH in high AVF p 0.009 ; There was no difference in HD duration or AVF age. High AVF pts had significantly higher CO and lower TPR than normal flow AVF. LVMI and LVEDD did not significantly increase in either group over time. We conclude that high flow AVF may alter cardiac hemodynamics in HD pts. Echocardiography shows a trend to increased LVMI in high flow AVF but we were unable to show any statistically significant changes in echo data over time.This may be due to short duration and small sample size. Our study suggests that there may be a hemodynamic impact on LVH of high flow AVF. Future studies should systematically evaluate the longer term cardiovascular consequences of high flow AVF and
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4. Fluid administration: the route of fluid therapy depends on the patient's status, cooperation, fluid type, and cost. A ; Intravenous: generally reserved for acute cardiovascular support and in critical patients. 1. Avian veins tend to be fragile and long-term IV therapy is difficult to maintain. Veins of choice are the jugular, basilic, and medial metatarsal. IV catheters can be secured with surgical glue and tape. 2. Ferret veins of choice are the lateral saphenous or cephalic. To facilitate the IV catheter placement, first puncture the skin with a 22 gauge needle adjacent to the vein. Secure the catheter to the skin with tissue glue or a tape butterfly sutured to the skin before bandaging the leg. Fractious or overactive ferrets may need to be masked down with gas anesthesia to facilitate the placement of the catheter. 3. Rabbit intravenous catheter placement is similar to ferrets. The lateral ear vein should be avoided due to the potential for sloughing the skin. 4 Small mammals are usually the most difficult for IV placement. In larger patients, the lateral saphenous, cephalic, or medial femoral veins are accessible. In smaller patients such as rats, the lateral tail veins can be used for short term use. Most other small patients will require an intraosseous catheter IO ; . 5. The choice of intravenous catheterization in reptiles is: A ; Chelonians, jugular, B ; Lizards, cephalic, C ; Snakes, the right jugular which requires anesthesia and a cut down just proximal to the heart. B ; Intraosseous: This technique is very effective and well tolerated and maintained by most patients including birds. A 20-22 gauge 1"-1 1 2" spinal needle is used and can be placed under anesthesia, local or general. 1. For birds, the Ulna or tibiotarsus are most commonly used. Avoid pneumatized bones and strict asepsis and bandaging are required. 2. For all small mammals the IO catheter can be placed in the femur through the trochanteric fossa or the tibia. 3. The choice of IO catheterization in lizards is normograded in the proximal, medial, tibial crest. C ; Subcutaneous: Primarily use with stable patients and mild dehydration. Sites include: A ; Birds- axilla, inguinal, mid back from the scapulae to the mid lumbar region. Be careful of the cervicocephalic air sacks that are associated with base of the neck, B ; Small mammals- over the dorsum, C ; ReptilesChelonians, under the thin skin on the limbs, Lizards, caudolateral body wall or lateral tail base, Snakes, small volumes can be given in multiple sites in the bilateral epaxial grooves keeping the needle parallel to the skin and slightly lifting the skin to avoid intrapulmonary injection. D ; Intraperitoneal, Epicoelomic and Intracoelomic: Reserved mostly for reptiles but can be given to small mammals for rapid, brief administration of fluids. In mammals the fluids are given in the lower left quadrant with the head of the patient held lower than and
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Table 4 presents the number of items likely to accumulate on one mile of each road type on a monthly basis. When compared on a mile-per-mile basis, the Interstate Highway system contributes the largest amount of litter 1, 881 items per mile of roadway per month ; . The US Highway ranks second at 1, 054, followed closely by State Highways and Farm-to-Market Roads, at 877 and 876 items, respectively, per month per mile, for example, atorvastatin.
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Mucous membrane infections, eczema, clubbing, rales, rhonchi, petechiae, and purpura.164 The majority of immunodeficient patients with recurrent sinusitis have defects in humoral immunity; however, patients with other types of immune defects might present with recurrent sinusitis, such as patients with AIDS who have combined humoral and cellular impairments.165-168 The indications for pursuing an immunodeficiency evaluation depend on the age, medical history, physical examination, and lifestyle of the patient. For example, in an infant of less than 2 years of age with recurrent and lifethreatening infections of the sinuses and other organs, one should pursue this evaluation in an expeditious manner. In addition, infections with organisms of low pathogenicity should alert the physician to the probability of a congenital immune deficiency. Similar indications for evaluation of immune deficiency exist for AIDS in both children and adults. Appropriate screening laboratory studies for immunodeficiencies might include quantitative immunoglobulin measurement IgG, IgA, and IgM ; , specific antibody responses, and measurement of T-cell number and function delayed hypersensitivity skin tests and flow cytometric enumeration of T cells ; . Although the postimmunization response to any protein antigen can be measured, assessment of response to tetanus immunization is particularly advantageous because most patients have been immunized, and 90% to 100% of children should have protective antibody titers after completing primary immunization.168 The response to polysaccharide antigens can be determined by measuring preimmunization and postimmunization titers to unconjugated pneumococcal vaccine. The diagnosis of IgG subclass deficiency is controversial, and the clinical significance of abnormal IgG subclass levels in patients with recurrent infections is unclear see ``Practice parameters for the diagnosis and management of primary immunodeficiency'' ; . The most common primary immunodeficiency disorders with recurrent sinusitis as a clinical feature are humoral immunodeficiencies, such as selective IgA deficiency169 and common variable immunodeficiency.166 Other primary immunodeficiencies that might present with recurrent sinusitis among other features include WiskottAldrich syndrome, 170 ataxia telangiectasia, 171 warts, hypogammaglobulinemia, infections, myelokathexis syndrome, 172 and caspase-8 deficiency.173 When these syndromes are clinically suspected, referral to a boardcertified allergist-immunologist for evaluation and therapy is indicated. Sinusitis is a recurrent or chronic problem in 30% to 68% of patients with HIV infection.174, 175 There might be a direct correlation between CD4 deficiency and increased likelihood of sinus disease. Specific antibody responses are abnormal in these patients, even though total serum immunoglobulin levels are often increased. Although there are case reports of infections with atypical organisms, most sinus infections in patients with HIV are caused by the same organisms involved in immunocompetent patients.176 Accordingly, successful.
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The Journal of American Science, 2 1 ; , 2006, Ma, Cholesterol and Human Health Dizziness. 6 ; Abdominal pain, 7 ; Constipation, 8 ; Decreased sexual desire. One newer drug is Zetia. This drug works by inhibiting the absorption of cholesterol from the blood. Side effects include back pain, joint pain, diarrhea and abdominal pain. As of August 8, 2001, Bayer Pharmaceutical Division voluntarily withdrew the drug Baucol cerivastatin ; from the U.S. market because of reports of fatal muscle damage caused by the drug. 9.2 Bacteria on Cholesterol Some bacteria can change cholesterol in food to coprostanol that cannot be readily absorbed by the body. These kinds of bacteria are called friendly bacteria. This helps recycle cholesterol to make hormones. Bifidobacterium and Lactobacillus acidophilus may play an important role in cholesterol metabolism of their host. Intestinal bacteria convert cholesterol into a less absorbable form coprostanol thus hampering its absorption from the intestinal tract Lin, 2000 ; . Lactic acid bacteria in intestine have the cholesterol lowering effect Pereira, 2002 ; . Some oral bacteria such as Lactobacillus acidophilus have been commercial available for the cholesterol lowering. Feeding friendly bacteria can do: 1 ; reduce the growth of unfriendly bacteria, 2 ; maintain regular bowel movements, 3 ; maintain cholesterol and triglyceride levels, 4 ; maintain healthy blood sugar levels Ma, 2004 and
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