AMENDMENT TO EQUIPMENT LEASE AGREEMENT

Exhibit 10.23a

AMENDMENT TO EQUIPMENT LEASE AGREEMENT

     This AMENDMENT TO EQUIPMENT LEASE AGREEMENT (this “Amendment”) is made effective as of the 15th day of September, 2005, and is entered into by and between (i) the BOARD OF TRUSTEES OF THE UNIVERSITY OF ARKANSAS on behalf of THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES (“Hospital”), and (ii) GK FINANCING, LLC, a California limited liability company (“GKF”),

Recitals:

     WHEREAS, GKF and Hospital executed an Equipment Lease Agreement dated October 29th, 1998 (the “Lease”), and desire to amend the Lease as set forth herein.

     NOW THEREFORE, for valuable consideration received, the receipt and sufficiency of which are acknowledged, the parties agree as follows:

Ag