Study: Fish in drug-tainted water suffer reaction


BOSTON (AP) — What happens to fish that swim in waters tainted by traces of drugs that people take? When it's an anti-anxiety drug, they become hyper, anti-social and aggressive, a study found. They even get the munchies.


It may sound funny, but it could threaten the fish population and upset the delicate dynamics of the marine environment, scientists say.


The findings, published online Thursday in the journal Science, add to the mounting evidence that minuscule amounts of medicines in rivers and streams can alter the biology and behavior of fish and other marine animals.


"I think people are starting to understand that pharmaceuticals are environmental contaminants," said Dana Kolpin, a researcher for the U.S. Geological Survey who is familiar with the study.


Calling their results alarming, the Swedish researchers who did the study suspect the little drugged fish could become easier targets for bigger fish because they are more likely to venture alone into unfamiliar places.


"We know that in a predator-prey relation, increased boldness and activity combined with decreased sociality ... means you're going to be somebody's lunch quite soon," said Gregory Moller, a toxicologist at the University of Idaho and Washington State University. "It removes the natural balance."


Researchers around the world have been taking a close look at the effects of pharmaceuticals in extremely low concentrations, measured in parts per billion. Such drugs have turned up in waterways in Europe, the U.S. and elsewhere over the past decade.


They come mostly from humans and farm animals; the drugs pass through their bodies in unmetabolized form. These drug traces are then piped to water treatment plants, which are not designed to remove them from the cleaned water that flows back into streams and rivers.


The Associated Press first reported in 2008 that the drinking water of at least 51 million Americans carries low concentrations of many common drugs. The findings were based on questionnaires sent to water utilities, which reported the presence of antibiotics, sedatives, sex hormones and other drugs.


The news reports led to congressional hearings and legislation, more water testing and more public disclosure. To this day, though, there are no mandatory U.S. limits on pharmaceuticals in waterways.


The research team at Sweden's Umea University used minute concentrations of 2 parts per billion of the anti-anxiety drug oxazepam, similar to concentrations found in real waters. The drug belongs to a widely used class of medicines known as benzodiazepines that includes Valium and Librium.


The team put young wild European perch into an aquarium, exposed them to these highly diluted drugs and then carefully measured feeding, schooling, movement and hiding behavior. They found that drug-exposed fish moved more, fed more aggressively, hid less and tended to school less than unexposed fish. On average, the drugged fish were more than twice as active as the others, researcher Micael Jonsson said. The effects were more pronounced at higher drug concentrations.


"Our first thought is, this is like a person diagnosed with ADHD," said Jonsson, referring to attention deficit-hyperactivity disorder. "They become asocial and more active than they should be."


Tomas Brodin, another member of the research team, called the drug's environmental impact a global problem. "We find these concentrations or close to them all over the world, and it's quite possible or even probable that these behavioral effects are taking place as we speak," he said Thursday in Boston at the annual meeting of the American Association for the Advancement of Science.


Most previous research on trace drugs and marine life has focused on biological changes, such as male fish that take on female characteristics. However, a 2009 study found that tiny concentrations of antidepressants made fathead minnows more vulnerable to predators.


It is not clear exactly how long-term drug exposure, beyond the seven days in this study, would affect real fish in real rivers and streams. The Swedish researchers argue that the drug-induced changes could jeopardize populations of this sport and commercial fish, which lives in both fresh and brackish water.


Water toxins specialist Anne McElroy of Stony Brook University in New York agreed: "These lower chronic exposures that may alter things like animals' mating behavior or its ability to catch food or its ability to avoid being eaten — over time, that could really affect a population."


Another possibility, the researchers said, is that more aggressive feeding by the perch on zooplankton could reduce the numbers of these tiny creatures. Since zooplankton feed on algae, a drop in their numbers could allow algae to grow unchecked. That, in turn, could choke other marine life.


The Swedish team said it is highly unlikely people would be harmed by eating such drug-exposed fish. Jonsson said a person would have to eat 4 tons of perch to consume the equivalent of a single pill.


Researchers said more work is needed to develop better ways of removing drugs from water at treatment plants. They also said unused drugs should be brought to take-back programs where they exist, instead of being flushed down the toilet. And they called on pharmaceutical companies to work on "greener" drugs that degrade more easily.


Sandoz, one of three companies approved to sell oxazepam in the U.S., "shares society's desire to protect the environment and takes steps to minimize the environmental impact of its products over their life cycle," spokeswoman Julie Masow said in an emailed statement. She provided no details.


___


Online:


Overview of the drug: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682050.html


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Deputy killed in Dorner standoff was 'fun,' 'boisterous' new dad









Jeremiah MacKay was a regular at Liam's Irish Pub in Colton.


He always had a pint of Guinness and a smile, said Yara Alves, the bar's owner. He had Irish roots, and he'd show up, guaranteed, every St. Patrick's Day wearing a kilt and bringing his bagpipe.


"He never had anything sad or negative to say," Alves said. "It was as if he never had a bad day."





Alves choked up as she spoke about MacKay, 35, a San Bernardino County sheriff's deputy who was killed in a firefight Tuesday in an isolated area near Big Bear. Police said the gunman was Christopher Dorner, a former Los Angeles Police Department officer bent on revenge over his dismissal from the agency in 2009.


A second deputy, Alex Collins, was wounded in the gunfight, San Bernardino County Sheriff John McMahon said. Collins has undergone multiple surgeries and is expected to make a full recovery.


McMahon said the deputies who responded to the cabin where Dorner barricaded himself are "absolutely true heroes."


"The rounds kept coming" from the cabin, he said, "but the deputies didn't give up."


Dorner also is believed to have killed three other people, including Riverside Police Officer Michael Crain, who was shot in his marked patrol vehicle. Crain was buried Wednesday. On Feb. 3, Monica Quan, daughter of a retired LAPD captain, and her fiance, Keith Lawrence, were found shot to death in an Irvine parking garage in what police believe were the first of Dorner's crimes.


On Thursday, authorities confirmed that the charred remains found in the burned-out cabin were Dorner's.


For days, MacKay, a 14-year veteran of the department, was involved in the massive manhunt for Dorner in the mountains around Big Bear.


"We knew he was up there," MacKay's cousin Jennifer Goehring said. "We were praying for his safety, but never in a million years would we have thought this would happen."


MacKay posted photos from the mountains on his Facebook page, joking about how he — who grew up in the San Bernardino Mountains — was one of the only officers wearing short-sleeved shirts in the snow.


On Saturday he told an Associated Press reporter that he knew the danger as he scoured the mountains for Dorner: "This one, you just never know if the guy's going to pop out or where he's going to pop out. We're hoping this comes to a close without any more casualties."


On Sunday he was pictured on the front page of The Times, his eyes squinted as he put on a hat. He posted a photo of the newspaper on Facebook, making fun of his facial expression, Alves said.


San Bernardino County Sheriff's Capt. Lee Hamblin said he was responding to the call of a gun battle when he heard "Officer down." He said his worst fear was soon confirmed when he learned MacKay had been killed.


"Although we're glad it's over," Hamblin said of the manhunt, "the price we paid was way too high."


MacKay joined the department in July 1998, Hamblin said. He worked in the jails, as a detective at the department's Big Bear station and most recently as a deputy in the department's Yucaipa station.


He was married to Lynette Quinata MacKay and had a 7-year-old stepdaughter and a 4-month-old son, Goehring said. He was thrilled to be a new father. His family, she said, made him the happiest man in the world.


On Thursday, a steady stream of people stopped by a makeshift memorial outside the Yucaipa station.


Janet Lopez, 55, placed flowers and a note at the memorial. MacKay, she said, had taken a liking to her father, who suffered from renal failure. MacKay would "go over and cheer him up, get him to walk," she said.


Family, friends and co-workers described the deputy as having a big personality, a big heart and a big, loud laugh. It was difficult to be sad around him, they said.


It was MacKay's laugh that first caught Edward Knuff's attention years ago in Liam's Irish Pub.


"He was a little boisterous, always fun," Knuff said.


Knuff, a commercial photographer, said he met MacKay at the pub for a meeting of the Inland Empire Emerald Society, a nonprofit that raises money for the families of fallen law enforcement officers.


Now the organization is raising money for MacKay's family.


hailey.branson@latimes.com


adolfo.flores@latimes.com


Times staff writer Joseph Serna contributed to this report.





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Woman Found Fatally Shot at Home of Pistorius


Emilio Morenatti/Associated Press


Oscar Pistorius, the South African Olympic and Paralympic track star, was involved in the fatal shooting of a 30-year-old woman, the police said.







JOHANNESBURG — South African police and media reports said on Thursday that Oscar Pistorius, a Paralympic gold medal sprinter nicknamed Blade Runner, was being questioned after his girlfriend was fatally shot at his home in Pretoria, possibly mistaken for an intruder. Police said a man had been arrested, but did not identify him by name.


Mr. Pistorius, 26, who races using carbon fiber prosthetic blades, won two gold medals and a silver at last year’s Paralympic Games in London. He was the first double amputee to also run in the Olympics and reached the 400-meter semifinal the London games.


“We found a 9-millimeter pistol at the scene. A 26-year-old man was taken into custody,” a police spokeswoman, Katlego Mogale, told Reuters without giving further detail.


Capt. Sarah Mcira, another police spokeswoman, said: “There is a woman who was shot by Oscar Pretorius.”


Johannesburg’s Talk Radio 702 said the victim was thought to have been struck in the head and arm in circumstances that have not been fully explained. But the radio said she may have been mistaken for a burglar.


In the Paralympics last September, Mr. Pistorius won individual gold, when he successfully defended his Paralympic 400 meter title. He had lost his 100- and 200-meter titles, but was part of the gold medal-winning 4x100 meter relay team. He same second in the 200 meter race.


After that race, Mr. Pistorius damaged his reputation among his followers by criticizing the winner, Alan Oliveira of Brazil, raising questions about the length of the winner’s blades. Mr. Pistorius later apologized and praised the gold medalist in the 100 meter race, Jonnie Peacock of Britain. Mr. Pistorius, who was born without fibulas, had both legs amputated below the knee before his first birthday and he battled for many years to compete against able-bodied athletes. In 2008, he qualified for the Beijing Games but was ruled ineligible by track’s world governing body because his blades were deemed to give him a competitive advantage.


South African journalists said Mr. Pretorius lived in an upscale, walled complex near the South Africa capital of Pretoria and said his girlfriend was a well-known fashion model. South Africa has a high crime rate. and elaborate security precautions, as well as personal weapons, are not uncommon.


A reporter outside the complex on Thursday said it was protected by high walls and razor wire.


Lydia Polgreen reported from Johannesburg, and Alan Cowell from Paris.



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Lady Gaga Cancels Born This Way Ball Tour Due to Severe Injury















02/13/2013 at 08:50 PM EST



It's a somber week for Lady Gaga – and her Little Monsters.

Following Tuesday's Facebook announcement that she was "devastated and sad" because she couldn't walk and had to postpone several Born This Way Ball concerts, the pop star, 26, has officially canceled the remaining dates of her world tour.

"After additional tests this morning to review the severity of the issue, it has been determined that Lady Gaga has a labral tear of the right hip," the singer's rep told PEOPLE Wednesday in a statement. "She will need surgery to repair the problem, followed by strict down time to recover. This unfortunately, will force her to cancel the tour, so she can heal."

Refunds for the cancelled performances will be available at point of purchase starting on Thursday.

"I hope you can forgive me, as it is nearly impossible for me to forgive myself," she wrote the previous day of postponing the dates. "I hate this. I hate this so much. I love you and I'm sorry."

Get well, Gaga!

Reporting by CHUCK ARNOLD

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Morning-after pill use up to 1 in 9 younger women


NEW YORK (AP) — About 1 in 9 younger women have used the morning-after pill after sex, according to the first government report to focus on emergency contraception since its approval 15 years ago.


The results come from a survey of females ages 15 to 44. Eleven percent of those who'd had sex reported using a morning-after pill. That's up from 4 percent in 2002, only a few years after the pills went on the market and adults still needed a prescription.


The increased popularity is probably because it is easier to get now and because of media coverage of controversial efforts to lift the age limit for over-the-counter sales, experts said. A prescription is still required for those younger than 17 so it is still sold from behind pharmacy counters.


In the study, half the women who used the pills said they did it because they'd had unprotected sex. Most of the rest cited a broken condom or worries that the birth control method they used had failed.


White women and more educated women use it the most, the research showed. That's not surprising, said James Trussell, a Princeton University researcher who's studied the subject.


"I don't think you can go to college in the United States and not know about emergency contraception," said Trussell, who has promoted its use and started a hot line.


One Pennsylvania college even has a vending machine dispensing the pills.


The morning-after pill is basically a high-dose version of birth control pills. It prevents ovulation and needs to be taken within a few days after sex. The morning-after pill is different from the so-called abortion pill, which is designed to terminate a pregnancy.


At least five versions of the morning-after pills are sold in the United States. They cost around $35 to $60 a dose at a pharmacy, depending on the brand.


Since it is sold over-the-counter, insurers generally only pay for it with a doctor's prescription. The new Affordable Care Act promises to cover morning-after pills, meaning no co-pays, but again only with a prescription.


The results of the study were released Thursday by the Centers for Disease Control and Prevention. It's based on in-person interviews of more than 12,000 women in 2006 through 2010. It was the agency's first in-depth report on that issue, said Kimberly Daniels, the study's lead author.


The study also found:


—Among different age groups, women in their early 20s were more likely to have taken a morning-after pill. About 1 in 4 did.


—About 1 in 5 never-married women had taken a morning-after pill, compared to just 1 in 20 married women.


—Of the women who used the pill, 59 percent said they had done it only once, 24 percent said twice, and 17 percent said three or more times.


A woman who uses emergency contraception multiple times "needs to be thinking about a more regular form" of birth control, noted Lawrence Finer, director of domestic research for the Guttmacher Institute, a nonprofit group that does research on reproductive health.


Also on Thursday, the CDC released a report on overall contraception use. Among its many findings, 99 percent of women who've had sex used some sort of birth control. That includes 82 percent who used birth control pills and 93 percent whose partner had used a condom.


___


Online:


CDC report: http://www.cdc.gov/nchs/


Emergency contraception info: http://ec.princeton.edu/index.html


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Couple recounts harrowing Dorner ordeal









Fugitive former police officer Christopher Jordan Dorner was apparently holed up inside a Big Bear area condo for as many as five days before the husband and wife who own the property surprised him and then were tied up and gagged, the couple said Wednesday night.


Dorner bound the husband's and wife's hands with plastic zip ties, stuffed small towels in their mouths so they couldn't scream and covered their heads with pillowcases that he tied with electrical cords, they said.


"I really thought it could be the end," Karen Reynolds, 56, told reporters gathered outside her condominium.





She and husband Jim Reynolds, 66, provided new details on some of Dorner's movements in the apparent final hours of his life. He is believed to have died Tuesday in a cabin fire after a mountainside gun battle with officers.


Law enforcement authorities previously said Dorner had held two cleaning women hostage. The Reynoldses spoke to reporters to end the confusion.


The couple said Dorner had been at the condo in the 1200 block of Club View Drive since as early as Friday, when they arrived to do maintenance in the yard. He told them he watched them — and even said they were "hardworking, good people." The couple slept at another property nearby.


When they entered the condo about noon Tuesday, the couple said, they were surprised to find the fired Los Angeles police officer inside the home, which is near the command post where authorities provided media briefings. They said they were held captive for about 15 minutes by Dorner, whom they recognized immediately.


The Reynoldses stumbled on the suspected killer when they went upstairs. Once they saw him, they said, he brandished a "big gun" and yelled, "Stay calm!"


Karen Reynolds said she tried to run down the stairs, but Dorner chased after her and caught her. He then took the couple to a bedroom, where he tied them up.


Dorner was a menacing presence but at other times tried to reassure the couple that he did not want to harm them, they said.


"He tried to calm us down, saying very frequently, he would not kill us," said Jim Reynolds, who has owned the condo with his wife for 12 years. "He huddled down beside me and said, 'You're going to be quiet right? Not make a fuss and let me get away?' "


Dorner identified himself as the man wanted by law enforcement authorities. "I know you know who I am, I know you've been seeing the news," Karen Reynolds recalled him saying.


Karen Reynolds said Dorner left the condo and stole their purple Nissan. About two minutes after they heard the car leave, Karen Reynolds propped herself up and shuffled to her cellphone. She grabbed it with her bound hands and called 911, using the speaker function.


"Dorner tied us up and he's in Big Bear," she recalled telling the dispatcher.


The couple, who have been married for 36 years, said they were "happy to be alive." They said they had mixed feelings about Dorner, whom they described as calm, alert and methodical. Karen Reynolds said she wasn't expecting to see any of the $1-million-plus reward money offered in the Dorner case. "We heard nobody was getting that because he needed to be captured and convicted," she said.


They said they found evidence that someone had been staying in the cabin, including a gallon of milk in the fridge, but that they didn't know if a previous tenant had left it behind. The last guests were there on Jan. 29.


All of the units are equipped with cable television and Internet. There was no sign of a forced entry.


It was Karen Reynolds' 12:20 p.m. 911 call that set in motion the chain of events that led to a shootout between Dorner and a state Fish and Wildlife warden, then to the standoff at another cabin where he is believed to have exchanged hundreds of rounds in the gun battle with officers before dying.


As the couple described their harrowing ordeal, they recalled that Dorner was insistent about what he wanted to do.


"I don't have a problem with you," he told them. "I just want to clear my name."


adolfo.flores@latimes.com


robert.lopez@latimes.com


Flores reported from Big Bear, Lopez from Los Angeles. Times staff writers Andrew Blankstein and Rong-Gong Lin II contributed to this report.





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Iran to Resume Nuclear Talks





PARIS — As it prepares for two sets of negotiations with outsiders on its disputed nuclear program starting on Wednesday, Iran said on that it was converting some of its enriched uranium into reactor fuel, the state news agency IRNA reported, potentially limiting the expansion of stockpiles that the West fears could be used for weapons.




Iranian officials are to meet on Wednesday in Tehran with Herman Nackaerts, the deputy director of the International Atomic Energy Agency, the United Nations nuclear watchdog, who has been pressing for months for access to a restricted military area at Parchin, 20 miles south of Tehran. International inspectors suspect that the site may have been used for testing bomb triggers.


“Differences remain but we will work hard to try to resolve these differences,” Mr. Nackaerts told reporters before leaving Vienna for Tehran, IRNA said.


On a separate negotiating track later this month, Iranian negotiators are to meet in Kazakhstan with representatives of six powers — the United States, China, Russia, Britain, France and Germany — for a further round in a series of long-running and inconclusive talks about curbing Tehran’s uranium enrichment program.


Faced with economic sanctions, suspected cyber attacks and threats of military action against its nuclear facilities, Iran came under fresh pressure from President Obama in his State of the Union address to settle its differences with the West.


"The leaders of Iran must recognize that now is the time for a diplomatic solution, because a coalition stands united in demanding that they meet their obligations and we will do what is necessary to prevent them from getting a nuclear weapon,” Mr. Obama said.


Western countries suspect that the Iranian government is seeking to acquire the technology to make nuclear weapons despite its assertion that the program is for peaceful purposes like the creation of reactor fuel for civilian use.


At a news conference on Tuesday in Tehran, Ramin Mehmanparast, the Foreign Ministry spokesman, was asked to comment on a news report that Iranian scientists had converted some uranium enriched to 20 percent purity into fuel for a research reactor in Tehran. The spokesman said that the “work is being done” and that details had been sent to the I.A.E.A., which is based in Vienna.


Iran’s nuclear program came under added scrutiny on Tuesday after North Korea conducted its third nuclear test, since many intelligence officials believe that the two countries share nuclear knowledge, though so far there is no hard evidence to substantiate that belief.


Reuters quoted Mr. Mehmanparast as saying, “We think we need to come to a point where no country will have any nuclear weapons.” While all countries should be allowed to use nuclear technology for peaceful purposes, he said, “all weapons of mass destruction and nuclear arms need to be destroyed.”


Iran’s stockpile of enriched uranium is believed by Western negotiators and international inspectors to be of far lower purity than is required to make nuclear weapons. Diplomats in Vienna said on Tuesday that enriched uranium converted into reactor fuel is hard to convert into fuel for weapons.


Some analysts argue that, by slowing the growth of its stockpile, Tehran could delay the moment when it acquires enough 20 percent enriched uranium to set off a response by Israel, which has signaled readiness to attack Iran’s nuclear sites.


The likely outcomes of the forthcoming sets of negotiations remain unclear.


Mr. Mehmanparast, the Iranian spokesman, said the talks with the I.A.E.A. team in Tehran on Wednesday had “bright” prospects if the I.A.E.A. negotiators recognized Iran’s rights, IRNA said.


But Yukiya Amano, the director general of the I.A.E.A., said Monday that “the outlook is not bright” for obtaining permission to visit the Parchin site. Mr. Amano’s remarks contrasted with a more optimistic tone from the agency less than a month ago, when his deputy, Mr. Nackaerts, expressed hope that the negotiations would lead to an agreement on an inspection plan.


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Westminster Names Affenpinscher Banana Joe Best in Show















02/12/2013 at 11:55 PM EST



Westminster has its top dog!

After two days of meticulous primping, prizes and the less-pretty realities of any spirited championship, the 137th Annual Westminster Kennel Club Dog Show came to its finale Tuesday night, declaring Affenpinscher Banana Joe the best in show.

The competition proved fur-rocious as the pint-sized, black-haired furball bested six other finalists (and 2,721 entries total) for the honor, including Old English Sheepdog Swagger, who was named the reserve best in show. It’s the first time the breed has ever taken home the top prize in Westminster history.

Earning top marks at Westminster is the latest accolade in Banana Joe's storied run. The paw-dorable pooch, who is 5 years old, has been named best in show 86 times in his career, and his Westminster win will go down as his last.

"It's all so indescribable. It's just a wonderful thing as a tribute for a small breed with such a big heart," handler Ernesto Lara said post-victory. "The plans for him now is for him to retire back home where he was born, and that's in the Netherlands."

Describing his little buddy, Lara praised the breed for its commendable qualities as a canine companion.

"An Affenpinscher is a very human-like dog," he said. "It's definitely a breed you don’t want to tame or train, in the proper sense."

"You want to befriend it," Lara continued. "Once you gain the friendship, they're loyal just like a human friend."

As for Banana Joe's big victory, "Nobody told him he's small," said Lara, "and I don't think he'll believe that."

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Study questions kidney cancer treatment in elderly


In a stunning example of when treatment might be worse than the disease, a large review of Medicare records finds that older people with small kidney tumors were much less likely to die over the next five years if doctors monitored them instead of operating right away.


Even though nearly all of these tumors turned out to be cancer, they rarely proved fatal. And surgery roughly doubled patients' risk of developing heart problems or dying of other causes, doctors found.


After five years, 24 percent of those who had surgery had died, compared to only 13 percent of those who chose monitoring. Just 3 percent of people in each group died of kidney cancer.


The study only involved people 66 and older, but half of all kidney cancers occur in this age group. Younger people with longer life expectancies should still be offered surgery, doctors stressed.


The study also was observational — not an experiment where some people were given surgery and others were monitored, so it cannot prove which approach is best. Yet it offers a real-world look at how more than 7,000 Medicare patients with kidney tumors fared. Surgery is the standard treatment now.


"I think it should change care" and that older patients should be told "that they don't necessarily need to have the kidney tumor removed," said Dr. William Huang of New York University Langone Medical Center. "If the treatment doesn't improve cancer outcomes, then we should consider leaving them alone."


He led the study and will give results at a medical meeting in Orlando, Fla., later this week. The research was discussed Tuesday in a telephone news conference sponsored by the American Society of Clinical Oncology and two other cancer groups.


In the United States, about 65,000 new cases of kidney cancer and 13,700 deaths from the disease are expected this year. Two-thirds of cases are diagnosed at the local stage, when five-year survival is more than 90 percent.


However, most kidney tumors these days are found not because they cause symptoms, but are spotted by accident when people are having an X-ray or other imaging test for something else, like back trouble or chest pain.


Cancer experts increasingly question the need to treat certain slow-growing cancers that are not causing symptoms — prostate cancer in particular. Researchers wanted to know how life-threatening small kidney tumors were, especially in older people most likely to suffer complications from surgery.


They used federal cancer registries and Medicare records from 2000 to 2007 to find 8,317 people 66 and older with kidney tumors less than 1.5 inches wide.


Cancer was confirmed in 7,148 of them. About three-quarters of them had surgery and the rest chose to be monitored with periodic imaging tests.


After five years, 1,536 had died, including 191 of kidney cancer. For every 100 patients who chose monitoring, 11 more were alive at the five-year mark compared to the surgery group. Only 6 percent of those who chose monitoring eventually had surgery.


Furthermore, 27 percent of the surgery group but only 13 percent of the monitoring group developed a cardiovascular problem such as a heart attack, heart disease or stroke. These problems were more likely if doctors removed the entire kidney instead of just a part of it.


The results may help doctors persuade more patients to give monitoring a chance, said a cancer specialist with no role in the research, Dr. Bruce Roth of Washington University in St. Louis.


Some patients with any abnormality "can't sleep at night until something's done about it," he said. Doctors need to say, "We're not sticking our head in the sand, we're going to follow this" and can operate if it gets worse.


One of Huang's patients — 81-year-old Rhona Landorf, who lives in New York City — needed little persuasion.


"I was very happy not to have to be operated on," she said. "He said it's very slow growing and that having an operation would be worse for me than the cancer."


Landorf said her father had been a doctor, and she trusts her doctors' advice. Does she think about her tumor? "Not at all," she said.


___


Online:


Kidney cancer info: http://www.cancer.net/cancer-types/kidney-cancer


and http://www.cancer.gov/cancertopics/types/kidney


Study: http://gucasym.org


___


Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP


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Dorner manhunt leads to deadly standoff









When authorities hemmed in the man they suspected of killing three people in a campaign of revenge that has gripped Southern California, he responded as they had feared: with smoke bombs and a barrage of gunfire.


The suspect, who police believe is fugitive ex-cop Christopher Dorner, shot to death one San Bernardino County sheriff's deputy and injured another Tuesday. He then barricaded himself in a wood cabin outside Big Bear in the snow-blanketed San Bernardino Mountains, police said.


Just before 5 p.m., authorities smashed the cabin's windows, pumped in tear gas and called for the suspect to surrender. They got no response. Then, using a demolition vehicle, they tore down the cabin's walls one by one. When they reached the last wall, they heard a gunshot.





Then the cabin burst into flames. By late Tuesday evening, the smoldering ruins remained too hot for police to enter, but authorities said they believed Dorner's body was inside.


The standoff appeared to end a weeklong hunt for the former L.A. police officer and Navy reserve lieutenant, who is also suspected of killing an Irvine couple and a Riverside police officer. But Los Angeles Police Chief Charlie Beck said he would not consider the manhunt over until a body was recovered and identified as Dorner.


"It is a bittersweet night," said Beck as he drove to the hospital where the injured deputy was undergoing surgery. "This could have ended much better, it could have ended worse. I feel for the family of the deputy who lost his life."


According to a manifesto Dorner allegedly posted on Facebook, he felt the LAPD unjustly fired him in 2009, when a disciplinary panel determined that he lied in accusing his training officer of kicking a mentally ill man during an arrest. Beck has promised to review the case.


Dorner, 33, vowed to wage "unconventional and asymmetrical warfare" against law enforcement officers and their families, the manifesto said. "Self-preservation is no longer important to me. do not fear death as I died long ago."


Last week, authorities had tracked Dorner to a wooded area near Big Bear Lake. They found his torched gray Nissan Titan with several weapons inside. The only trace of Dorner was a short trail of footprints in newly fallen snow.


On Tuesday morning two maids entered a cabin in the 1200 block of Club View Drive and ran into a man who they said resembled the fugitive, a law enforcement official said. The cabin was not far from where Dorner's singed truck had been found and where police had been holding press conferences about the manhunt.


The man tied up the maids, and he took off in a purple Nissan parked near the cabin. About 12:20 p.m., one of the maids broke free and called police.


Nearly half an hour later, officers with the California Department of Fish and Wildlife spotted the stolen vehicle and called for backup. The suspect turned down a side road in an attempt to elude the officers but crashed the vehicle, police said.


A short time later, authorities said the suspect carjacked a light-colored pickup truck. Allan Laframboise said the truck belonged to his friend Rick Heltebrake, who works at a nearby Boy Scout camp.


Heltebrake was driving on Glass Road with his Dalmatian, Suni, when a hulking African American man stepped into the road, Laframboise said. Heltebrake stopped. The man told him to get out of the truck.


"Can I take my dog?" Heltebrake asked, according to his friend.


"You can leave and you can take your dog," the man said. He then sped off in the Dodge extended-cab pickup — and quickly encountered two Department of Fish and Wildlife trucks.


As the suspect zoomed past the officers, he rolled down his window and fired about 15 to 20 rounds. One of the officers jumped out and shot a high-powered rifle at the fleeing pickup. The suspect abandoned the vehicle and took off on foot.


Police said he ended up at the Seven Oaks Mountain Cabins, a cluster of wood-frame buildings about halfway between Big Bear Lake and Yucaipa. The suspect exchanged gunfire with San Bernardino County sheriff's deputies as he fled into a cabin that locals described as a single-story, multi-room structure.


The suspect fired from the cabin, striking one deputy, law enforcement sources said. Then he ducked out the back of the cabin, deployed a smoke bomb and opened fire again, hitting a second deputy. Neither deputy was identified by authorities. The suspect retreated back into the cabin.


The gun battle was captured on TV by KCAL 9 reporter Carter Evans, who said he was about 200 feet from the cabin. As Evans described on air how deputies were approaching the structure, he was interrupted by 10 seconds of gunfire.





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