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The actual layout of the fair will depend on what sort of exhibition s ; Montreal is awarded. Though the proposed site would be large enough for a registered exhibition, specific attention has been focused on arranging a recognised exhibition combined with a horticultural and or housing expo. This would not only increase potential attendance and exhibition area, it would be well suited to the geographical layout and environmental aspects of Expo 17. Montreal, with the 1980 Floralies, and Quebec City, with Qubec en Fleur, have already acquired considerable experience and recognition in horticultural events. And a housing exposition would go very well with the urban renewal aspects of the fair, most notably the Habitat 2017 community for Area 1.

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ABSTRACT RSUM Background: We present a retrospective evaluation of the clinical outcome and complications associated with intravitreal injection of unaltered triamcinolone acetonide in conjunction with pars plana vitrectomy and silicone oil injection for the treatment of complicated proliferative diabetic retinopathy with tractional retinal detachment and severe proliferative vitreoretinopathy. Methods: Thirteen eyes of 12 consecutive patients were identified from a computerized patient database. All eyes were operated on by the same surgeon and received 4 mg of unaltered, commercially available triamcinolone acetonide intravitreally, before silicone oil injection. The patients were followed for a mean of 4.7 months range 1-15 months ; , and demographic as well as pertinent preoperative and postoperative clinical information was gathered. Results: At the last follow-up visit, vision had improved in 4 eyes, remained stable in 5 eyes, and worsened in 4 eyes. The retina was attached at the end of follow-up in 10 of the 13 eyes. Eight of the 13 eyes did not show any clinical signs of reproliferation or redetachment during the course of follow-up. The mean intraocular pressure did not increase preoperative value was 10.8 6.22 mm Hg with a range of 0-22 mm Hg; at last follow-up, mean pressure was 9.6 3.86 mm Hg with a cumulative postoperative range of 0-26 mm Hg ; . Steroid crystals were visible at 1 month postoperatively in 3 eyes and did not hinder fundus examination significantly. Interpretation: The intravitreal injection of low-dose, unaltered triamcinolone acetonide in the setting of pars plana vitrectomy and silicone oil injection for the treatment of proliferative vitreoretinopathy and complicated proliferative diabetic retinopathy appears to be well tolerated. Further controlled study is needed to clearly define the potential beneficial effects of intravitreal steroids in these 2 disease processes. Contexte : Nous prsentons une tude rtrospective des rsultats cliniques et des complications associes l'injection intravitrenne d'actonide de triamcinolone non modifi conjointement avec la vitrectomie par la pars plana et l'injection d'huile and terbinafine.
Diagnostic Methods: For decades standard diagnostic tools for diagnosing pulmonary TB other than the chest Xray or other radiological imaging methods ; included AFB smears and cultures, and the tuberculin skin test TST ; . These remain important but in recent years these have been supplemented by several newer "high-tech" methods. For example, the DHEC mycobacteriology laboratory, which processes approximately 9500 specimens per year, uses fully automated liquid media incubators to culture mycobacteria from clinical specimens, and DNA geneprobes and High-Performance Liquid Chromotography HPLC ; to identify M. tuberculosis and to distinguish it from other pathogenic mycobacteria. As a result, turnaround time for positive culture results has been greatly reduced in most cases. A technical revolution also appears to be in the making regarding the venerable TST as there are now several FDA licensed methods to perform in-vitro lymphocyte-based immunological assays which, essentially, perform a tuberculin skin test in a test tube. These methods are not currently used by DHEC because of collection to processing time limitations, but are likely to be used in the future as their sensitivity, specificity, utility and cost-effectiveness in different settings is better evaluated 10-12 ; . Another exciting development in mycobacteriology has been the development of "TB Genotyping" commonly called "DNA fingerprinting" ; . Last year DHEC joined a national network under which all new SC isolates of M. tuberculosis will be genotyped. This new tool will allow for more refined analysis of patterns of transmission and evaluation of TB control efforts 13 ; . Treatment of TB: While many of the broad principles of TB treatment have remained unchanged for decades e.g. always treat TB with at least two drugs to which the patients organisms are likely to be susceptible; never add a single drug to a failing regimen ; , many of the details continue to evolve. DHEC follows the most recent official guidelines for treatment of TB in the United States that are the product of a collaborative effort among the American Thoracic Society, the Infectious Disease Society of America, and the CDC 14 ; . Aside from detailed information regarding treatment regimens, drug dosages, and more, the guidelines also enunciate a basic principle that had been widely accepted for some time in the world of TB control but had never been so explicitly stated, namely that: "The responsibility for successful treatment is clearly assigned to the public health program or private provider, not to the patient." This principle follows from the fact that an infectious TB patient who fails to take his medications properly may infect others with consequences which may be disastrous both from a personal and from a public health point of view, e.g. leading to fatal miliary or meningeal tuberculosis in infants, or leading to a community or institutional outbreak ; . This new guiding principle thus provides a formal rationale for the use of Directly Observed Therapy DOT ; which has been discussed in the TB literature for many years 15 ; and which has gradually emerged as the "standard of care" towards which TB programs should aim. Continued on page 5!

Arbs angiotensin ii receptor antagonist or blocker; lvef left ventricular ejection fraction * percentages refer to the portion of the patient population receiving a particular medication and tetracycline, for example, betnovate. DAVID CAMPESE'S boiling blood is still to cool since England wrestled the William Webb Ellis trophy from his homeland, and already the ruling powers of the southern hemisphere are hatching a plan to cash in on the World Cup. Sanzar, the governing body of the tri-nation heavyweights, propose a Super Nine tournament pitting the cream of rugby from the South against the elite six nations of Europe. John O'Neill, the chief executive of the Australian Rugby Union, envisages three pools of three teams battling on a biennial basis, tapping into audiences and sponsors with new-found interest in the game. This is the latest in many attempts by Sanzar to converge the two major factions of world rugby, but like those before, it is flawed. T h e romance of the World Cup lies in the creation of clashes that only occur years apart. Australia 2003 lacked a real upset, but the element of surprise from the likes of Samoa, Fiji and Japan shook the old guard of international rugby. This should be the springboard from which such secondary teams can develop, yet in a bid to generate money for the established nations, the less affluent will once again be treading water in the IRB pool of wealth. Likewise, the beauty of a global centrepiece every four years is seeing how Europe's finest fair against the tri-nations in competitive, cut-throat rugby. Trans-hemispheric battles take place every autumn, but their experimental nature devalue the matches as true `Tests'. The Super Nine cup would dim the aura of the World Cup, not to mention putting.
Haiden Huskamp is an assistant professor of health economics, Department of Health Care Policy, at the Harvard Medical School. Arnold Epstein is the John H. Foster Professor, Department of Health Policy and Management, at the Harvard School of Public Health. David Blumenthal is a professor of medicine and health care policy at the Harvard Medical School and topamax.
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