FIRST AMENDMENT TO DISTRIBUTION AGREEMENT

Exhibit 4.39

FIRST AMENDMENT
TO
DISTRIBUTION AGREEMENT

This First Amendment to Distribution Agreement is made as of this 6 ^th day of August 2003 by and between Cardinal Health 414, Inc., a Delaware corporation formerly known as Syncor International Corporation (“Cardinal Health”), and Draximage, Inc., a Canadian corporation (“Draximage”), and amends that certain Distribution Agreement, dated July 12, 2000 (the “Agreement”), by and between Cardinal Health and Draximage. Initially capitalized terms used but not defined herein shall have the meanings ascribed thereto in the Agreement.

Cardinal Health and Draximage hereby agree to the following amendments to the Agreement:

1.              Section 2(A) of the Agreement is hereby amended to add the following second paragraph:

“Notwithstanding t