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Small update: I've been seeing more and more cases of infections by trojans that kill any antivirus or antispyware programs you try to use and remove them. For such cases, I created a standalone version of the 'Itty Bitty Process Manager' inside HijackThis. It should be a bit harder for trojans to detect, since it has no window caption. If they do start targeting it by filename, rename the executable before running it and you should be good to go.
So I'd recommend itty bitty process manager too. Download from the merijn site url'ed above.