The following tables show the contract or underlying principal amounts and fair values of derivative financial instruments analyzed by type of contract at December 31, 2005 and 2004. Contract or underlying principal amounts indicate the volume of business outstanding at the balance sheet date and do not represent amounts at risk. The fair values are determined by the markets or standard pricing models at December 31, 2005 and 2004.

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Ovulation induction involves the use of medication to stimulate development of one or more mature follicles where eggs develop ; in the ovaries of women who have anovulation and infertility. BACKGROUND This summary was put together from information submitted, as required by the Human Reproductive Technology Act 1991 Act ; , about six Storage Licences and five Practice Licences authorising artificial fertilisation procedures including in vitro fertilisation IVF ; under the Act. In addition, one other Practice licensee, and medical practitioners who are Exempt from the requirement to be licensed to carry out artificial inseminations reported as required ; , on their provision of intra-uterine insemination. Information about patients referred from the public fertility clinic at King Edward Memorial Hospital to the Concept Fertility Centre, has been provided by Concept. All information was submitted in a collated form and referred to the financial year which ended at 30 June 2003. While it is not possible to provide any data on outcomes of treatments undertaken during the financial year just ended because of the necessary lag time required for reporting, this summary shows the scale and type of activities carried out under the licences. The Practice and Storage licences held by Joondalup IVF terminated on 31 January 2003. Fertility North took over the clinic at Joondalup and Practice and Storage licences issued to Fertility North commenced on 1 February 2003. In Appendix 4 of this Report there is additional detailed information from the Reproductive Technology Register, including short-term outcomes of all treatments, for the calendar year 2001. SUMMARY Semen storage and donation From Table 1 it can be seen that semen was donated to WA Storage Licensees by 35 men during 2002 2003. Of these 25 were new donors. This is a substantial increase in both the total number of donors and the number of new donors when compared to the previous year 21 and 10 respectively ; . The age distribution of donors Table 2 ; , indicates that the majority 67.6% ; were 30 years of age or older. This continues the general trend seen over the last ten years, towards a greater number of older donors. Table 3 indicates there were substantially more single donors 74.3% ; than donors in a married de facto relationship 25.7% ; . Reporting by Exempt practitioners and the Sperm Banks indicated that during the year only one Exempt practitioner had been supplied with donor sperm. Additionally, one interstate medical practitioner was supplied with donor semen during the year, with the approval of the Council under Direction 6.2. This approval was based on an undertaking by that practitioner to ensure that all recipients were fully informed about requirements of the Act, and knew in particular that information about outcomes of treatments would be provided to the WA Reproductive Technology Register. Four, because dose of acyclovir.
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Department of Medicine & Microbiology, Prince of Wales Hospital, The Chinese University of Hong Kong; * Department of Medicine, Queen Elizabeth Hospital, Hong Kong Abstract We performed a retrospective study on the causes of acute viral encephalitis in Hong Kong and in particular we focused on the clinical, laboratory findings, imaging characteristics and outcome of Chinese patients with herpes simplex encephalitis. We identified 16 patients with herpes simplex encephalitis with age ranging from 24-74 years mean 51 years ; . The clinical presentation was diverse. Of these 16 patients, 2 13% ; died, 4 25% ; had a poor outcome, 10 62% ; made a full recovery. Herpes simplex encephalitis was the most commonly identified cause of acute viral encephalitis among adults in Hong Kong. INTRODUCTION Herpes simplex encephalitis HSE ; is a rare cause of sporadic encephalitis with an estimated annual incidence of 1-2 per million.1-3 The availability of polymerase chain reaction PCR ; to detect herpes simplex virus HSV ; DNA has revealed a wider clinical spectrum of CNS infection due to HSV, including milder forms and atypical presentations.4-10 Older studies have suffered from ascertainment bias as the diagnosis of HSE relied on autopsy or brain biopsy material.11-12 We studied the clinical, laboratory features and outcome of patients with HSE, and the proportion of acute viral encephalitis caused by HSV in Hong Kong, China. METHODS We conducted a multi-centre retrospective survey over a 6-year period from May 1998 to May 2004. Consecutive adults over the age of 15 years with a diagnosis of acute HSV encephalitis were included. The year 1998 was chosen as by this date improved diagnostic techniques such as PCR for the detection of viral DNA were widely available and a computerized system of archiving hospital episodes with International Classification of Disease diagnosis codes had been introduced in all public hospitals. Patients with a clinical suspicion of central nervous system infection who were admitted to public hospitals with a neurological service were ascertained from the computerized admission and discharge records of the hospital system. In order to establish the diagnosis of HSE, all three criteria had to be fulfilled: a ; confirmatory histology or positive PCR; b ; acute onset of focal or diffuse cerebral dysfunction such as alteration in conscious level, behavioural change, hemiparesis c ; the absence of alternative causes such as drug, toxic, metabolic, anoxic encephalopathy or acute disseminated encephalomyelitis. As part of standard management guidelines issued by the Hospital Authority, the organisation that runs government hospitals, brain CT scan, cerebrospinal fluid and viral analysis are part of the routine work-up in patients with suspected acute encephalitis. 13 In addition to PCR amplification of herpes DNA, viral serologies for cytomegalovirus, Epstein-Barr virus, Japaense B virus, measles virus, mumps virus, rubella virus, coxsackie A and B, echovirus and enterovirus are available. All patients received intravenous acyclovir as empirical therapy. The medical records were reviewed by a neurologist and the relevant clinical and laboratory details were recorded: age at onset and sex, history of coexisting medical diseases, presenting symptoms, Glasgow Coma Score, blood glucose and white cell count and neuroimaging results. Cerebrospinal fluid parameters included opening pressure, protein and glucose concentrations, total and differential white cell count and microbiological.

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Methods other than breast feeding should be considered if valacyclovir must be taken while nursing and aldara. We are extremely enthusiastic about this issue of the JAOCD. Even though this is only our third printing, we have made great strides. We now have an international presence and flare. We have gone from a black and white journal to a full color publication. The cover has been redesigned graphically and is even more aesthetically pleasing. We take great pride in all of these accomplishments that seem to have happened so quickly. As your editors, we continue to strive for improvement and growth. What is the next step? Without question, the next milestone is to be able to publish the JAOCD four times a year. When this happens, we will be able to have our journal listed in the Library of Congress as well as have it listed in Index Medicus. We therefore turn to the general, resident and student membership of the AOCD to assist us in making this happen as soon as possible. We solicit your contribution in the way of presenting an interesting case or even a pearl on office management. We require consistency. Become a consistent contributor, always looking out for what would be interesting to the readers of our journal. Also, our resident members are required to prepare and submit one paper each year to the AOCD that is suitable for publication. We have petitioned the education and evaluation committee to make it mandatory that each resident submit their yearly papers for consideration for publication. We need your support in these matters. We will continue to cover topics that will be academically challenging. We will include such areas as dermatologic therapeutic modalities, original presentation of research, brief opinions, a review of dermatology affiliated clinical studies, brief individual case reports of unusual interest, basic science as it relates to dermatology, articles emphasizing cutaneous surgery, dermatopathology, cosmetic dermatology, pharmaceutical dermatology, editorials, letters to the editors, and finally Pearls and anecdotes in dermatology. In 1999, the first cases of WNV infection occurred in New York City. Data from the 1999 West Nile Outbreak Response Working Group identified 59 patients hospitalized with WNV infection between August and September 1999. Overall attack rate of clinical WNV infection was 6.5 cases million population Nash, 2001 ; . 2 ; A household-based seroepidemiological survey, conducted in New York City area estimated that 8200 WNV infections occurred there in 1999, with 1700 of these resulting in febrile infections. Less than 1% resulted in serious neurological disease Mostashari, 2001 ; . 3 ; Since that time, the WNV has been isolated in birds, mosquitoes, horses, and other animals in over 40 states and the District of Columbia. Human cases of WNV infection have been identified in over 30 states and the District of Columbia CDC, 2002d; Peterson, 2002a; McCarthy, 2002 ; . e. CANADA: In 2001, WNV was isolated from birds in southwestern Ontario, Canada CDC, 2002d ; . f. CARIBBEAN: Data suggest WNV has spread to the Caribbean region; a case of WNV encephalitis was reported in a resident of the Cayman Islands who had no recent travel history CDC, 2002d ; . 6. INCUBATION PERIOD: Ranges from 3 to 15 days Petersen, 2002a, 2002; Horga, 2001; Nash, 2001 ; . 7. AGE: According to CDC data from 2002, median age of 52 y reported in patients with WNV infection CDC, 2002a ; . Similar mean age 54 y ; reported in patients with WNV infection in Israel in 2000 Weinberger, 2001 ; . In patients with WNV meningoencephalitis, median age was 65 y CDC, 2002d; Weiss, 2001 ; . 8. GENDER: 55% to 60% of patients with WNV infection are men CDC, 2002a; Nash, 2001 ; . Equal gender distribution reported in patients with WNV infection in Israel in 2000 Weinberger, 2001 ; . 9. CLINICAL PRESENTATION: Headache, fever, altered mental status, myalgias, fatigue, malaise, gastrointestinal symptoms eg, anorexia, nausea, vomiting ; , arthralgia, eye pain, rash, and lymphadenopathy Petersen, 2002a, 2002; Meek, 2002 ; . 10. OUTCOME: a. Mortality is 5% to 15%. Advanced age over 50 y ; is significant risk factor for death or significant neurologic disease CDC, 2002d; Petersen, 2002; Hochberg, 2002; Meek, 2002; Hindiyeh, 2001; Nash, 2001; Weiss, 2001; Weinberger, 2001 ; . b. Substantial morbidity reported following WNV infection; frequent persistent deficits include fatigue, memory loss, difficulty walking, and muscle weakness Petersen, 2002; Weiss, 2001 ; . B. ENCEPHALITIS, HERPES SIMPLEX 1. INCIDENCE: Most common cause of nonepidemic, acute focal encephalitis in the US; estimated annual frequency is 1 250, 000 to 1 500, 000 population Whitley, 2002 ; . 2. SEASON: Occurs throughout the year Whitley, 2002 ; . 3. AGE: 30% of patients are under 20 y; 50% are over 50 y Whitley, 2002 ; . 4. CLINICAL PRESENTATION: Headache, fever, altered level of consciousness, focal neurologic findings, including hemiparesis, seizures Whitley, 2002 ; . 5. OUTCOME: Factors influencing outcome include patient age, level of consciousness at presentation, and duration of encephalitis. Despite cyclovir treatment, substantial morbidity and mortality remain at long-term follow-up Ito, 2000; McGrath, 1997 ; . FOR FURTHER INFORMATION, SEE CLINICAL REVIEW: HERPES SIMPLEX ; C. ENCEPHALITIS, JAPANESE 1. INCIDENCE: One of the most common causes of acute encephalopathy affecting children and adolescents in the tropics. Approximately 50, 000 cases occur annually worldwide Tiroumourougane, 2002; Whitley, 2002; Solomon, 2000 ; . Has an annual incidence of 10 to 100 000 population. Infection is often asymptomatic; symptomatic infection occurs in 1 of 1000 cases Tiroumourougane, 2002; Solomon, 2000 ; . 2. ORGANISM: Japanese encephalitis JE ; virus is a single positive strained RNA genome of the family Flaviviridae Tiroumourougane, 2002; Solomon, 2000 ; . 3. TRANSMISSION: Infected mosquitoes transmit virus to humans. a. ARTHROPOD VECTOR: JE virus is maintained in an enzootic cycle involving mosquitoes, wild and domestic birds, and pigs. The most important mosquito vector of JE in South East Asia is Culex tritaeniorhynchus; in India, Culex vishnui is implicated Tiroumourougane, 2002; Solomon, 2000 and alendronate.

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1495 The True Hemorrhage Rate of Stereotactic Biopsy in 461 Patients Timothy F. Witham, MD Melvin Field, MD John C. Flickinger, MD Douglas Kondziolka, MD L. Dade Lunsford, MD Pittsburgh, PA ; Key Words: hemorrhage, biopsy, stereotactic Introduction: The hemorrhage rate following stereotactic biopsy varies considerably in reported series. We sought to determine the true hemorrhage rate with routine imaging and to identify risk factors. Methods: Our prospective biopsy protocol includes immediate postoperative computed tomography CT ; . We reviewed records and postoperative CT from the last 8 years n 461 ; . CT-defined hemorrhage was stratified by diameter 5, 5-10, 10-30, or 30 mm ; and symptomatic versus asymptomatic presentation. Multivariate logistic regression analysis determined factors age, sex, diagnosis, location, specimen number, platelet count, coagulation profiles, anticoagulant or antiplatelet medications, hypertension ; to predict risk of hemorrhage. Results: Forty-one patients 9% ; experienced post-biopsy hemorrhage. Five were symptomatic 1% ; and three 0.6% ; required surger y. The number of hemorrhages 5, 5-10, 10-30, or 30 mm were 22, 10, 6, and 3, respectively. One patient developed symptomatic, because acyclovir eye drops. A decrease in the intensity of use held trend to 4.0% for this class. The class is dominated by erythropoietin EPO ; products, which stimulate the production of red blood cells. Late in 2006, results of a few studies suggested that hematocrit and hemoglobin levels were elevated too much with EPO therapies. Additional awareness may have lead to the overall drop in intensity. Mircera is a long-acting EPO expected to be approved in mid-2007 for the treatment of anemia associated with chronic kidney disease. Mircera is dosed once-monthly compared to more frequent dosing regimens for similar drugs Aranesp, Epogen and Procrit. If approved, Mircera is expected to compete in the market even though a trial concerning the EPO patent is not scheduled until September 2007. Leukine, which is already on the market for the treatment of neutropenia low white blood cells ; , may be approved in late 2007 for treating Crohn's disease. Clinical trials for this use, however, have not been promising. AMG-531 injection ; and PromactaTM oral ; are novel agents for idiopathic thrombocytopenia purpura ITP ; , a bleeding disorder related to low platelet counts. Blood Cell Deficiency Pipeline and amoxycillin. Acyclovir ointment by acyclovir topical acyclovir dosing of acyclovir elion gertrude.

HN N H CH3 ; CH C C Valacyclovir Afyclovir 54% 100% liver GI 23 h 0.71 h HSV V2V EBV and clavulanate. Benzodiazepines these drugs quickly relieve agitation or violence in dementia. Poster #155 SUBJECTIVE CHANGES IN NIGHT VISION AFTER LARGE OPTICAL ZONE LASIK. Brian Snyder, OD, David Hardten, MD, Richard L. Lindstrom, MD. PURPOSE: To assess post-op subjective changes in night vision in patients treated with a larger optical zone excimer laser ablation. METHODS: Patients were asked to complete a pre operative survey assessing night vision disturbances such as glare and halo, both without correction and with spectacle and or contact lens correction. LASIK was then performed using a 6.5mm optical zone and extending the overall treatment zone to 8.0mm. Patients were asked to complete similar night vision surveys at 1 month and 6 months postoperatively. Patient responses were scored on a 100 pt scale. RESULTS: 23 patients 46 eyes ; have been enrolled in the study to date. Average preoperative manifest refraction spherical equivalent was -3.34 range 1 to 7 ; with average manifest refraction cylinder correction of 0.35 range 0.00 to 1.25 ; . Glare with spectacle correction pre-op n 44 ; was rated as sometimes 40 100 ; and mild 31 100 ; , while halo occurred rarely 37 100 ; and was rated as mild 32 100 ; . Nineteen patients 38 eyes ; completed questionnaires at the onemonth postoperative visit. At this visit, glare was rated as occurring sometimes 45 100 ; with mild to moderate severity 34 100 ; . Halo was also rated as occurring sometimes 42 100 ; and being mild to moderate in severity 34 100 ; . None of the patients were wearing spectacle correction for distance vision postoperatively, so symptoms with spectacle correction were not reported, and none of these changes were statistically different from pre-op values p 0.05 ; . At six months postop, patients responded that glare occurred rarely 29 100 ; with mild 21 100 ; intensity p 0.001 ; , while halo remained stable within these subjects n 24, p 0.05 ; . CONCLUSIONS: A slight decrease in the frequency and severity of glare was found at six months postoperatively using a large optical zone setting during standard LASIK. No significant change was found in subjective ratings of halo between pre-op, one and six months post-op and ampicillin and acyclovir, for example, acyclovir hsv. Table 3. Relation Between Early Response to PSL and EFS by Risk Group. Chlamydia Occurs in 1% to 2% of sexually abused children; most chlamydia infections produce no symptoms; may see perinatally acquired infestations for up to 3 years Must use culture technique to obtain organism recovery 50% to 90% enzyme immunoassay Chlamydiazyme ; and direct fluorescent antibody Micro Trak ; tests are unreliable for children and should not be used for evaluation of sexually abused children for chlamydial infection; use culture only Must be reported; link to sexual abuse is probable Treatment Infants 6 months: erythromycin 50 mg kg day divided QID x 10 to days Child who weighs 45 kg: erythromycin 50 mg kg day divided QID x 10 to days Child 45 kg, but 8 years: azithromycin 1 g PO Child to 8 years: azithromycin 1 g PO doxycycline 100 mg PO BID x 7 days Syphilis Occurs in about 0.2% of cases of sexual abuse Nontreponemal tests VDRL, RPR ; used for screening but must be confirmed by treponema tests FTA-ABS or MHA-TP false-positive rate about 1% to 2% Must be reported; link to sexual abuse is certain Treatment: Acquired first and second degree ; : benzathine penicillin 50, 000 U kg IM maximum 2.4 million U ; Herpes genitalis HSV-2 or HSV-1 in the genital area ; Risk for acquiring it from sexual abuse is unknown HSV-1 or HSV-2 can be found in the oral or genital region; viral cultures should be done on all suspicious lesions Must be reported; link to sexual abuse is probable for HSV-2 and possible for HSV-1 Treatment Adolescents: acyclovir 400 mg PO TID for 7 to 10 days or acyclovir 200 mg PO 5 times a day for 7 to 10 days or famciclovir 250 mg PO TID x 7 to days or Valacyclovir 1 g PO BID x 7 to days Children: acyclovir 80 mg kg day divided QID x 7 to days Trichomoniasis Uncommon in prepubertal girls Diagnosis made on wet mount of vaginal discharge 50% to 75% detection rate ; Must be reported; link to sexual abuse is possible Treatment Adolescents: metronidazole 2 g PO metronidazole 500 mg PO BID x 7 days Children: metronidazole 15 mg kg day maximum 250 mg ; TID for 7 days Human papilloma virus HPV ; Condyloma acuminata anogenital warts transmitted via sexual contact or perinatally Must be reported; link to sexual abuse is probable if not perinatally acquired ; Refer to gynecologist or dermatologist for biopsy Treatment Podophyllin 10% to 25% topically followed in 1 to hours by bathing, every week for 4 weeks Tricholoracetic acid TCA ; applied topically to warts Imiquimod 5% cream Aldara ; applied by the patient at bedtime three times a week for up to 16 weeks May require laser surgery or cryotherapy and anastrozole. 292 Tab Co. 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Management of Patients With Osteonecrosis of the Jaws Consultation with an oral surgeon or dental oncologist A nonsurgical approach may prevent further osseous injury -- Minimal bony debridement only to reduce sharp edges so as to reduce trauma to surrounding or opposing tissues eg, lateral tongue where lingual mandibular bone is exposed ; -- A removable appliance may be used to cover and protect the exposed bone -- A protective stint may be of benefit for patients with exposed bone that causes trauma to adjacent tissues and in patients where the osteonecrotic site is repeatedly traumatized during normal oral function. A thin, vinyl, vacuformed mouth guard or thin acrylic stint may be used, provided that the device does not further traumatize the osteonecrotic site and that it can be kept free of bacterial plaque and debris -- Biopsy should be performed only if metastasis to the jaw is suspected. A portion of the biopsy should be submitted for microbial analysis as well as culture from the biopsy site Intermittent or continuous antibiotic therapy may be beneficial cultures should be collected to determine the appropriate antibiotic therapy ; . The goal of antibiotic therapy is to prevent secondary soft-tissue infection and, therefore, pain as well as to prevent osteomyelitis. At this time, the duration of antibiotic therapy and the benefit of oral antiseptic rinses have not been defined, but pain control and disease control have been observed with this management strategy. The decision to treat with an antibiotic is a clinical judgment that should be made by an oral maxillofacial surgeon or other dental specialist in consultation with the treating physician oncologist. Cultures, including those for aerobic, anaerobic, viral, and fungal species, may be collected to determine the appropriate antimicrobial intervention Antibiotics that have been found useful for osteonecrosis include -- Penicillin VK 500 mg or amoxicillin 500 mg; both 4 times daily QID ; initially and twice daily BID ; for maintenance -- If penicillin allergic: Clindamycin 150 to 300 mg QID Vibramycin 100 mg once daily QD ; Erythromycin ethylsuccinate 400 mg 3 times daily TID ; -- Antifungals when required: Nystatin oral suspension 5 to 15 QID or 100, 000 IU mL Mycelex troches clotrimazole 10 mg ; 5 day Fluconazole 200 mg initially, then 100 mg QD Other potential systemic antifungals include itraconazole or ketoconazole -- Antivirals, if required: Acycovir 400 mg BID Valacyclovir hydrochloride 500 mg to 2 g BID 0.12% chlorhexidine gluconate Peridex ; oral rinses or minocycline hydrochloride Arestin ; periodontal pockets can be used Dentures can be worn, but should be adjusted to minimize soft-tissue trauma or irritation, especially in light of ongoing antibiotic therapy, and should be removed at night All patients should be monitored every 3 months or sooner if symptoms continue or worsen Cessation or interruption of bisphosphonate therapy may be considered in severe cases. However, close coordination between the dental specialist and the medical oncologist is recommended, taking into consideration the risk of skeletal complications including hypercalcemia of malignancy ; versus the risk of osteonecrosis. To date, cessation of bisphosphonate therapy appears to have no effect on established osteonecrosis. However, further study is needed. Stefan Weber has been the Company's Chief Financial Officer since April 2005. He holds a master's degree in business management from Fernuniversitaet Hagen Diplom-Kaufmann ; . He has 20 years of industry experience in finance, including nine years in senior management, of which seven years were spent as the chief financial officer of public and private biotechnology companies. From 1987 to 1999, he worked at the Lohmann group, a worldwide producer of pharmaceutical, medical, technical and consumer products. From 1997 to 1999, he was the head of finance, reporting to the chief financial officer of the Lohmann group. After joining Girindus, a fine chemistry process development and scale-up provider in 1999, he was appointed chief financial officer in 2000. From 2001 to 2005, he was the chief financial officer of Biofrontera, a company active in drug discovery and development. In his senior management positions at these companies, he was responsible for executing numerous substantial financing transactions, including debt, equity and mezzanine financing as well as national and European grants. As chief financial officer of Girindus, he managed the company's initial public offering and post-initial public offering investor and adapalene. The Kaiser Permanente Drug Formulary is developed by Kaiser Permanente doctors and pharmacists and includes drugs that are both effective and safe. Drugs on the formulary are routinely covered under a member's drug benefit. The formulary is subject to change at any time at the discretion of the Regional Pharmacy and Therapeutics Committee. Generally, if a drug is available generically, the generic is on the formulary and the brand is not. Because all drug product strengths and package sizes of a formulary drug are not necessarily included on the formulary, check with a Kaiser Permanente pharmacist for clarification if needed. In order to ensure safe use of the formulary drugs, certain drugs are restricted to specialists as indicated in italics below. For additional information regarding the Kaiser Permanente Drug Formulary, please contact Member Services or a Kaiser Permanente pharmacist. 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For reasons that are still unknown, certain herpes infections in certain cancer patients do not respond to acyclovir.

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