Regular monitoring of cyclosporin A CsA ; 1 in whole blood for dosage adjustment is considered mandatory. Despite the possible role of CsA metabolites in immunosuppression and toxicity 1, 2 ; , the consensus among clinicians and laboratorians is that specific methods for measuring the parent drug only should be used 3 6 ; . All assays utilizing monoclonal antibodies and designed for the selective measurement of CsA are usually labeled "specific". However, there is considerable debate about that specificity, its clinical relevance, and the comparability of results from different monoclonal immunoassays. A new pretreatment reagent for the Emit Emit-NPT ; 7 ; and two new automated monoclonal immunoassays are presently being introduced: a fluorescence polarization immunoassay on the AxSYM instrument from Abbott 8 ; and a cloned enzyme donor immunotechnique CEDIA ; from Boehringer Mannheim. Considerably different biases have been published and conflicting recommendations have been given concerning the replacement of HPLC by a certain assay, particularly for patients with hepatic dysfunction and those undergoing heart HTx ; or liver LTx ; transplantation 9 22 ; . Thus, it has remained difficult to achieve comparable results between transplantation centers. In the present study, therefore, I evaluated the performance and particularly the specificity of all major monoclonal assays for CsA. Metabolite-to-parent ratios were estimated in all clinical specimens, using the TDx poly.

Ear Nose and Throat Associates of Johnstown 101 W Main St Ste 301 Somerset, PA 15501 814 ; 443-4500 Kristin C. Brant, MD Allison C. Ford, MD.
NKCC2 Functional Expression in Xenopus Oocytes -- Xenopus laevis oocytes were injected with 50 nL cRNA per oocyte, and maintained at ~17C in media containing 96 mM NaCl, 2 mM KCl, 0.9 mM MgCl2, 1.8 mM CaCl2, 0.1 mM furosemide, and 10 mM HEPES pH 7.4 at room temperature ; . Three days after injection, NKCC2 activity was determined in 86Rb influx assays. Oocytes were preincubated for 20 min at room temperature in a low-chloride 3 mM ; hypotonic 160 mOsm ; solution to inhibit the activity of the Xenopus NKCC1 14 ; , and incubated for 40 minutes in an influx medium containing: 100 mM NaCl, 2 mM RbCl, 1 mM MgCl2, 1 mM CaCl2, 1 mM Na2HPO4, 2 mM Na2SO4, 0.1 mM ouabain, 3 Ci ml 86RbCl, 5 mM HEPES pH 7.4 at room temperature ; and optionally 0.25 mM bumetanide in 0.1% DMSO. The dependence of 86Rb influx on cotransported ions was determined by substitution of N-methyl glucamine for Na or K, and of gluconate for Cl. Influx was stopped by three rinses with an ice-cold solution containing: 100 mM K gluconate, 2 mM Na gluconate, 1 mM MgCl2, 1 mM CaCl2, 1 mM Na2HPO4, 2 mM Na2SO4, 5 mM HEPES, 0.25 mM Bumetanide and 0.1 mM Ouabain. All Agree to a sentence of life imprisonment without the possibility of parole, refuse to seek extradition and allow the fugitive to remain at large until such time as he or she returned to the United States, or seek an Article IV prosecution. The Mexican Supreme Court now requires that choice to be made regarding more than 40 different categories of "lifetop" crimes in many states. For example, unlike the Federal government, many state prosecutors cannot guarantee parole on a "life-top" offense without arbitrarily reducing the charged crime to one which carries a determinate sentence. Unlike the Federal system, there is no authority to request a "downward departure." The effect of these rulings is to absolutely preclude extradition from Mexico on in the most serious offenses committed in the state. To simply reduce the charges would not only run afoul of the equal protection clauses of the United States and state constitutions, but would send a powerful message to criminals that you can escape justice for the price of a bus ticket across the border. It also sends a powerful message to Mexico that the United States will tolerate such an egregious interference with our sovereign right to prosecute and punish according to our criminal justice system. Neither is an acceptable option. Neither serves the ends of justice for victims nor adequately protects our community. IV. Article IV Prosecution Mexican prosecutors have asserted that foreign prosecution under Article IV is sufficient compliance with the Extradition Treaty. Article IV allows Mexico to try fugitives for crimes committed in a foreign territory by or against a Mexican citizen. The trial is conducted in accordance with Mexican Federal Law. Such provisions apply if the accused is located in Mexico, has not been tried in the country where he committed the offense, and the charged offense is a crime in both the foreign country and Mexico. Mexican Federal law is based on the Napoleonic Code. There is no presumption of innocence, no jury trial, and traditional common law and statutory rules of evidence don't apply. All trials are conducted by affidavit or declaration and witnesses rarely, if ever, testify. Victims and their families have no practical ability to witness the trial or be heard at sentencing which is controlled by the Mexican Federal Penal Code. Although the maximum sentence in Mexico is a term of 60 years for murder, a sentence can, and frequently is, reduced through the appellate process or the "Amparo" which is the rough equivalent to our habeas proceedings. Continued on next page.