Arbor Update

Ann Arbor Area Community News

‘Twas the Week Before the Election: Proposals 1 and 2

28. October 2008 • Juliew
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PROPOSAL 08-1
A LEGISLATIVE INITIATIVE TO PERMIT THE USE AND CULTIVATION OF MARIJUANA FOR SPECIFIED MEDICAL CONDITIONS
The proposed law would:

  • Permit physician approved use of marijuana by registered patients with debilitating medical conditions including cancer, glaucoma, HIV, AIDS, hepatitis C, MS and other conditions as may be approved by the Department of Community Health.
  • Permit registered individuals to grow limited amounts of marijuana for qualifying patients in an enclosed, locked facility.
  • Require Department of Community Health to establish an identification card system for patients qualified to use marijuana and individuals qualified to grow marijuana.
  • Permit registered and unregistered patients and primary caregivers to assert medical reasons for using marijuana as a defense to any prosecution involving marijuana.

PROPOSAL 08-2
A PROPOSAL TO AMEND THE STATE CONSTITUTION TO ADDRESS HUMAN EMBRYO AND HUMAN EMBRYONIC STEM CELL RESEARCH IN MICHIGAN
The proposed constitutional amendment would:

  • Expand use of human embryos for any research permitted under federal law subject to the following limits: the embryos are created for fertility treatment purposes; are not suitable for implantation or are in excess of clinical needs; would be discarded unless used for research; were donated by the person seeking fertility treatment.
  • Provide that stem cells cannot be taken from human embryos more than 14 days after cell division begins.
  • Prohibit any person from selling or purchasing human embryos for stem cell research.
  • Prohibit state and local laws that prevent, restrict or discourage stem cell research, future therapies and cures.

Information on the proposals can be found at the following web sites:
League of Women Voters Michigan’s Ballot Proposals
Ballotpedia Overview of Michigan’s Ballot Proposals
Citizen Research Council Analysis of Ballot Issues
National Institute of Health Resource for Stem Cell Research
University of Michigan’s Press Release on Stem Cell Science



  1. Michigan’s stem cell research policies are more restrictive than 45 other states in the country (matched only by North Dakota, South Dakota, Louisiana, and Arkansas). Not only do our restrictions make research harder and less effective here, it is one of the reasons mentioned for why labs are leaving Michigan and why we have a harder time attracting new talent. Michigan is doing so poorly economically, do we really need more reasons for people to stay away? These embryos are going to be dumped anyway, and the “owner” of the embryos can choose if they want to donate them for this purpose. Seems to me that using embryonic stem cells to perhaps cure, prevent, or lessen the severity of any number of terrible diseases is a far better legacy than just dumping them.


       —Juliew    Oct. 29 '08 - 02:24PM    #
  2. Well said, JulieW. Please vote “yes” on Prop 2 – to find cures for many diseases and conditions. If not for us, perhaps for our children and grandchildren.


       —Leah Gunn    Oct. 29 '08 - 04:19PM    #
  3. Am hoping prop 1 passes. My question is: will Ann Arbor City Council pass an ordinance to allow medicinal dispensaries to operate in this fine city? One city allows the dispensaries although they are allowed only to serve city residents.


       —sherry    Oct. 30 '08 - 02:04AM    #
  4. I agree with Juliew on Prop 2. I recognize the ethical questions around destruction of embryos. But since these studies are with embryos that would be destroyed anyway, if you want to address that ethical question the way to do it is to ban the fertility treatments that produce extra embryos, but I don’t see the anti-abortion movement trying to take on that issue.


       —Chuck Warpehoski    Oct. 30 '08 - 02:31PM    #
  5. Prop 2 is a constitutional amendment that prohibits any future state regulation of human embryonic stem cells. In a rapidly changing technological field, this would seriously impede oversight of yet to be discovered applications.

    Prop 2 says they will only use donated embryo’s that would be tossed anyway, however, less than 2% of patients who have extra embryo’s are willing to give them to research labs to use them for genetic experimentation. How comfortable would you be knowing that a sibling of your child is a human/animal chimera or being used to create a designer baby with a manipulated genome?

    Most stem cell experts now agree that the best prospects for future treatments are those that use adult stem cells. Why invest limited research dollars on embryonic stem cell research when adult stem cells are ubiquitous and are already being used to successfully treat over 73 human conditions?

    Human life should not be toyed with in scientific labs. In order to treat a human using embryonic stem cells, scientists would have to destroy the nucleus of the stem cell and replace it with the nucleus and DNA of the patient. Using the best current techniques, they destroy 200 embryos in their attempt to get one cell that survives and grows. Of these cells that grow, 30% have enormous genetic abnormalities that require their immediate destruction. All of the animal clones to date are genetically abnormal, have abnormal aging characteristics and tumor formation, and many display auto-immune difficulties. Even Dolly the sheep, the “poster child” of cloning, aged prematurely and had multiple auto-immune diseases and was forced to be euthanized.

    Prop 2 goes 2 Far – Vote No on 2.


       —J. Meyers    Nov. 2 '08 - 02:42PM    #
  6. “human/animal chimera”? “designer baby”?

    The study being used to claim that adult stem cells offer the same medical potential as embryonic stem cells is shown to probably have been a fraud that used flipped images to produce false reports of success. Scientists have not been able to duplicate the results.

    There’s another discussion on Prop 2 over at markmaynard.com.

    Vote YES on Prop 2.


       —Michael Schils    Nov. 2 '08 - 07:30PM    #
  7. It should also be said that marijuana has been deemed to be therapeutic for those afflicted with motor neuron diseases such as multiple sclerosis. Users have said the relief exceeds that associated with te legally presribed Marinol.


       —John Dory    Nov. 2 '08 - 07:47PM    #
  8. I urge everyone to vote YES on PROPOSAL 2. Embryonic stem cell (ESC) research is our greatest hope of finding cures for many debilitating diseases in our lifetime. There are many people suffering today who may benefit from embryonic stem cell research

    I would like to clear up some misconceptions and lies stated by the opposition to prop2. This proposal legalizes embryonic stem cell research on embryos that are being thrown away from in vitro fertilization clinics only; it does not allow new embryos to be created for research. This proposal only allows embryonic research permitted by federal law to be legal in Michigan; it cannot be more lenient than federal law and must abide by NIH restrictions. There is no request for public funding in this proposal to fund the research; any stipulation to a tax increase is outright lie. This proposal will not permit cloning.

    This proposal as written should be passed. Those who oppose the proposal are arguing against things that they believe might happen with future legislation. They are in essence arguing “slippery slope”. If our legislators and voting public always worried about what future legislation is passed, nothing would ever get done in government. Everyone should actually read the proposal and take it for what it is. The opposition claims about higher taxes, and “monster” cloning companies are all lies. Spin is spin, but a lie is still a lie.

    Adult stem cells cannot be used in the same way as embryonic stem cells. ESCs are pluripotent, meaning that they have the capability of turning into ALL kinds of cells, while adult stem cells can only self-renewal into similar like cells. The same types of experiments cannot be done on these cells. Using adult stem cells will give us a different set of data that is not equivalent to the data obtained from using ESCs.

    Currently, no one can say how long it will take to cure any disease using embryonic stem cells. Just keep in mind this: Bone marrow transplants were first performed in the early 1950’s, but were rather unsuccessful. It took almost 20 years (until the late 1960’s) for bone marrow transplants to be performed successfully on non-twins. Bone marrow transplants are now considered routine and are used as a highly successful treatment for leukemia. There are many people alive today because we spent many years working out the details. Where would we be if after 5 years we gave up and said it was not possible?

    Research takes time. Patience will be needed.


       —Diane    Nov. 2 '08 - 11:59PM    #
  9. Official ballot language for Prop 2 is below:

    A Proposal to Amend the Constitution of the State of Michigan by adding a new Article I, Section 27 as follows:

    Article I, Section 27.

    (1) Nothing in this section shall alter Michigan’s current prohibition on human cloning.

    (2) To ensure that Michigan citizens have access to stem cell therapies and cures, and to ensure that physicians and researchers can conduct the most promising forms of medical research in this state, and that all such research is conducted safely and ethically, any research permitted under federal law on human embryos may be conducted in Michigan, subject to the requirements of federal law and only the following additional limitations and requirements:

    (a)No stem cells may be taken from a human embryo more than fourteen days after cell division begins; provided, however, that time during which an embryo is frozen does not count against this fourteen day limit.

    (b)The human embryos were created for the purpose of fertility treatment and, with voluntary and informed consent, documented in writing, the person seeking fertility treatment chose to donate the embryos for research; and

    (i)the embryos were in excess of the clinical need of the person seeking the fertility treatment and would otherwise be discarded unless they are used for research; or

    (ii)the embryos were not suitable for implantation and would otherwise be discarded unless they are used for research.

    ©No person may, for valuable consideration, purchase or sell human embryos for stem cell research or stem cell therapies and cures.

    (d)All stem cell research and all stem cell therapies and cures must be conducted and provided in accordance with state and local laws of general applicability, including but not limited to laws concerning scientific and medical practices and patient safety and privacy, to the extent that any such laws do not:

    (i)prevent, restrict, obstruct, or discourage any stem cell research or stem cell therapies and cures that are permitted by the provisions of this section; or

    (ii)create disincentives for any person to engage in or otherwise associate with such research or
    therapies or cures.

    (3) Any provision of this section held unconstitutional shall be severable from the remaining portions of this section.


       —Diane    Nov. 3 '08 - 12:16AM    #
  10. We do know how long it will take before stem cells are used to treat human conditions. Its already being done! Adult stem cells are now being used in over 1000 clinical trials. There are thousands of peer reviewed journal articles in a large number of medical journals – Michael doesn’t have a clue about what he’s talking about. They’ve been used to make paraplegics walk. They’ve been used with diabetes patients who no longer have to take daily insulin shots. They have improved the lives of Parkinsonism patients. They have been used in the treatment of over 70 diseases. If you’re talking about cures using stem cells, then you’re talking about adult stem cells. This is not a future hope – it is a present day reality. We don’t have to destroy millions of embryo’s.

    I’ve read the language of the ballot proposal. It prohibits any future laws that might restrict or discourage ANY stem cell research or therapies. Proposal 2 goes too far. Our legislature can pass laws to allow embryonic stem cell research. We don’t need a constitutional amendment that ties our hands and prevents us from acting in a timely manner if the scientist’s zeal crosses moral boundaries in the future.

    Vote No on 2!


       —J. Meyers    Nov. 3 '08 - 01:41PM    #
  11. The experiments that you are referring to using adult stem cells were based on findings from research conducted FIRST with embryonic stem cells. Those clinical trial experiments could not have been possible without first using the ESCs to show the way. ESCs can point us in new directions that adult stem cells (which are much more differentiated)cannot do. First we need to start with the ESCs and then can use adult stem cells later if applicable.

    The proposal does say we cannot limit stem cell research, but ALSO says that we are governed by federal law. All other types of research, from clinical trials to animal research is governed and restricted by federal law and the NIH. State and local governments do not add extra restrictions into those areas. The NIH and other federal restrictions and regulations will be quite adequate for this purpose. All this proposal does is put us on the same footing as 45 other states.

    This is not something new that will be unique to our state. 45 states are ahead of us already, including states down in the bible belt area.

    VOTE YES ON PROP 2!


       —Diane    Nov. 3 '08 - 03:04PM    #
  12. We don’t need to experiment on HUMAN ESCs at all. Animal ESCs are sufficient. Let’s not use human life as spare parts.

    We can get pluripotent stem cells from bone marrow that can be made to grow into any type of blood cell. These have been successfully used to treat Lymphomas. The fact that they are differentiated already to only make blood cells is what keeps them from forming tetromas, or large tumors of hair, teeth, and other tissues as what happens when scientists try to make ESCs differentiate into blood cells.

    Adult stem cell therapy is less costly, more likely to result in cures, and the moral choice.

    VOTE NO ON PROP 2!


       —J. Meyers    Nov. 3 '08 - 03:33PM    #
  13. Biologists have been working with hematopoietic (bone marrow) stem cells for more than 50 years. And yes they can be used to treat many hematological diseases. However, at this point they cannot be used to treat other dibilitating diseases such as Parkinsons, ALS or diabetes.

    Biologists do use hematopoietic stem cells in basic research to investigate cell signaling pathways, but each type of cell and/or tissue is different. Just because we learn about a pathway in one cell/tissue, it does not mean it is relevant for all tissues.

    As for your last line:

    “Adult stem cell therapy is less costly, more likely to result in cures, and the moral choice”

    Research on adult stem cells will cost exactly the same as research on ESCs. The cost of an experiment is the cost of an experiment, it will not increase because of the type of cell used. Also, if cures are found more expeditiously we will save money.

    Most scientists and citizens agree ESCs are more likely to result in cures, not adult stem cells. If you want to believe that it is wrong to use ESC in research, fine, but understand that your stand on the issue implies that the cures for many dibilitating disease will be impeded and delayed for many living people. For me, the moral thing is to help suffering people by using embryos in research that are being THROWN AWAY.

    This proposal does NOT allow embryos to be created for the sole purpose of research. Only the embryos that are being thrown away are to be used.

    ****VOTE YES ON PROP 2****


       —Diane    Nov. 3 '08 - 04:02PM    #
  14. Diane,

    I’m going to give you the benefit of doubt; maybe you actually aren’t aware of the number and variety of successful adult stem cell treatments. Here’s a link to a listing of diseases successfully treated to date:

    http://www.stemcellresearch.org/facts/treatments.htm

    Here’s a list of peer reviewed articles that back up these claims. (not a complete listing, sample references)

    http://www.stemcellresearch.org/facts/asc-refs.pdf

    Embryonic stem cells are exorbitantly more expensive. Women have to be treated with fertility drugs and their eggs need to be retrieved. You can only get about 10 eggs per patient. If you wanted to treat the millions of patients with chronic conditions, you would need tens of millions of women in their childbearing years to undergo treatment and donate their eggs. It is not economically feasible.

    The leading stem cell scientists have already determined that adult stem cells are the more logical choice for research and treatment.

    http://www.stemcellresearch.org/pr/kerry.pdf

    ******!!!!!!VOTE NO ON PROP 2!!!!!!!***********


       —J. Meyers    Nov. 3 '08 - 05:08PM    #
  15. Adult stem cells are NOT identical to ESCs. One researcher I spoke with said that they were useful for research but not yet for therapeutics – we just don’t know enough how they behave. And one cannot forget that we learned how to create adult stem cells from studying ESCs. If we are to create therapies from adult stem cells, we need to have ESCs to understand the differences; ESCs are the model we are learning from.

    Meanwhile the first IND (Investigational New Drug application) for ESC derived therapy has been submitted to the FDA where it languishes for political reasons under the current administration. Thus confounding the claim that there will be “no therapies developed in the foreseeable future” from ESCs. This will result in clinical trials being run in Europe rather than here.

    This continues a pattern we’ve already seen that states (and countries) that block ESC research merely causes it to go elsewhere. I have worked with researchers who are actively working on ESCs even though they are in states where it is forbidden – by collaborating with scientists in California or in Europe.

    For these and the many other reasons stated above, we should all VOTE YES ON PROP 2 and not let outside political money influence what we do in Michigan based on ads that have no shred of truth to them!

    -Bill


       —Bill    Nov. 3 '08 - 05:21PM    #
  16. Bill – where do I start….

    1) Adult stem cells are not created by scientists, they are isolated from the patients, themselves.

    2) You talked to one scientist and suggest an emotional appeal, while I have thousands of published research papers that support my claims.

    3) Adult stem cells ARE NOT the same as embryonic stem cells. They are far better for therapeutic cures. Their growth is regulated and their supply is unlimited. Patients use their own cells and no human life is sacrificed for treatments.

    “Therapeutic cloning”—unlikely chance of clinical success

    •“[T]he poor availability of human oocytes, the low efficiency of the nuclear transfer procedure, and the long population-doubling time of human ES cells make it difficult to envision this [therapeutic cloning] becoming a routine clinical procedure…”
    Odorico JS, Kaufman DS, Thomson JA, “Multilineagedifferentiation from human
    embryonic stem cell lines,”Stem Cells19, 193-204; 2001

    •“However, it is unlikely that large numbers of mature human oocytes would be available for the production of ES cells, particularly if hundreds are required to produce each ES line. The technical capability for nuclear transfer would also need to be widely available and this is unlikely. In addition, epigenetic remnants of the
    somatic cell used as the nuclear donor can cause major functional problems in development, which must remain a concern for ES cells derived by nuclear transfer. …it would appear unlikely that these strategies will be used extensively for producing ES cells compatible for transplantation.”
    Alan O.Trounson, “The derivation and potential use of human embryonic stem cells”,
    Reproduction, Fertility, and Development13, 523-532; 2001

    •Thomas Okarma, CEO, GeronCorporation says: “The odds favoring success are vanishingly small, and the costs are daunting.” “It would take thousands of [human] eggs on an assembly line to produce a custom therapy for a single person. The process is a nonstarter, commercially.”
    Denise Gellene, “Clone Profit? Unlikely”, Los Angeles Times, 10 May 2002

    “Cloning Unnecessary and Obsolete”
    —leading embryonic stem cell expert
    •Alan Trounson, Australian embryonic stem cell expert and a leader
    in the field worldwide, says that stem cell research has advanced so rapidly in the past few months that therapeutic cloning is now unnecessary. “My view is there are at least three or four other alternatives that are more attractive already,”he said. Trounson abandoned his call for therapeutic cloning, saying scientific breakthroughs mean there is now no need for the controversial technique.
    Professor Trounson said therapeutic cloning faced logistical problems, and that other techniques were showing great promise and offered better options. “I can’t see why, then, you would argue for therapeutic cloning in the long term because it is so difficult to get eggs and you’ve got this issue of (destroying) embryos as well.”
    “Stem-cell cloning not needed, says scientist”, The Age (Melbourne), pg. 2, July 29, 2002;
    “Stem-cell research outpaces cloning”, The Australian, pg. 3, July 29, 2002;
    “Therapeutic cloning no longer necessary: expert”, AAP Newsfeed, July 29, 2002

    VOTE NO ON PROP 2


       —J. Meyers    Nov. 3 '08 - 06:01PM    #
  17. J.,

    Once again I will state that this proposal is only dealing with embryos that are being THROWN AWAY. there is no cost as you stated above to create more embryos. You are arguing “slippery slope” and not against what the voters will be voting on.

    I do agree that hematopoietic stem cells are useful, bu they are not the cure for many diseases. They cannot be used for everything. By studying ESCs we can learn more about the pathways that are used in cell biology and disease. We can then apply that knowledge to the adult stem cells. Adult stem cells do not contain the knowledge that we can get from the ESC.

    Mouse ESC have been used for years by scientists. However, mice cells do not have all the same markers on their cells as humans do. They are not equivalent. Although useful, mouse ESC are not a replacement for human ESCs.

    As for the cloning, everyone agrees that there should be no human cloning. It has always been illegal and will remain illegal if this proposal passes.

    *****VOTE YES ON PROP 2******


       —Diane    Nov. 3 '08 - 06:31PM    #
  18. Diane,

    Reproductive cloning is illegal, but therapeutic cloning is the only method by which embryonic stem cells could possibly cure any disease, and it is not illegal nor would any stem cell scientist deny that its the goal.

    VOTE NO ON 2 – 2 GOES 2 FAR!


       —J. Meyers    Nov. 3 '08 - 07:20PM    #
  19. J. Meyers,

    Where do I start!!

    1. You are being disingenuous (a fancy way of lying): while adult stem cells are not “created” by scientists, they do have to be forced to be pleuripotent. Not an easy process and one that uses plasmids as part of the reprogramming – which may well introduce undesirable side effects.

    2. I have talked to more than one scientist on this subject, but the one I talked with had just had extensive discussions with Dr. Thomson of the University of Wisconsin, the person most credited with forcing pleuripotentcy from adult stem cells, in planning an ongoing collaboration. BTW, Dr. Thomson also has stressed the fact that adult stem cells do not replace ESCs for research purposes.

    3. If we are talking pleuripotent stem cells, adult stem cells are still an unknown quantity. Relying on them would reset the clock back 10 years – about where we were when ECS research was seriously looking at therapeutic uses. Even if we halve the time to develop therapeutic uses of pleuripotent adult stem cells, if we stop development on therapies based on ESCs, we set the clock back on therapies for people who desperately need them! Why? Because we chose to destroy embryos already created rather than continue research on pleuripotency using them.

    Vote YES on Prop 2 for more cures!

    3. Scientists have repeatedly stated that pleuripotent ESCs offer great opportunity for therapeutic uses as well as fundamental research into cell differentiation. Saying someone says the will be no benefit is an ignorant way to approach science. It is a negative proof (“We don’t have any so there can’t be any.”) The fact that a therapeutic application has been submitted to the FDA indicates that there can be therapies. The fact that they have neither accepted the IND nor rejected it, indicates that they want to sit on it – probably to the next administration.


       —Bill    Nov. 3 '08 - 09:51PM    #
  20. I’m intrigued by the fact that the “2 Goes 2 Far” ads on television are so wildly dishonest — even claiming it will raise taxes!

    I think the dishonesty arises because the groups promoting the ads have an agenda they know would not win widespread agreement: the notion that a fertilized egg is a citizen with rights.


       —Larry Kestenbaum    Nov. 3 '08 - 10:10PM    #
  21. Larry’s point could explain J. Meyers’ deceptive argument: “Patients use their own cells and no human life is sacrificed for treatments.” Unless I’m confused, nothing under discussion involves the loss of human life.

    J., I think your best option for swaying readers’ opinions here would be to explain why you thing therapeutic cloning is bad (as opposed to just difficult, ineffective, or expensive.) Otherwise your argument will likely continue to be seen as disguised and disingenuous, or at best misinformed.


       —Steve Bean    Nov. 3 '08 - 11:50PM    #
  22. Larry,
    I don’t like most of the ads for 2 goes 2 far either, they are dumb, but it’s the supporters of Prop 2 that have the deceptive ads. They show children suffering from illness and ask why don’t opponents of Prop 2 want a cure??? Duh… adult stem cells are the cure. Embryonic stem cells are merely the cell lines that scientists want to manipulate genetically in the lab. It is far more exciting research for the inquisitive mind.

    The constitutional amendment will not raise taxes for Michigan residents. Our newly elected Democratic House and Senate will.

    Steve, there is absolutely no disagreement among scientists that human embryos are both human and alive. They are an early stage of human life. They contain a complete set of human chromosomes and the entire genome of a unique individual. To obtain human embryonic stem cells, these embryos that are stored in freezers are thawed, grown in petri dishes for a few days, then torn to shreds and destroyed in the process. If the couples who put them in the freezer no longer desire to use them and give birth to their children, they can be adopted as “snow children” and other infertile couples can experience the joy of childbirth and parenting. Whether you fertilize eggs in a lab and later throw them away or tear them to shreds to obtain ESCs, you are destroying life. Adoption is the only option that saves lives. The argument that the only option for these embryos is to throw them away is dishonest and deceptive.

    I am not arguing that therapeutic cloning is bad – it is just a pipe dream that was once considered but is now obsolete due to the proven treatments using adult stem cells. If they could perform years of experiments and discover the techniques necessary to bring therapeutic cloning to fruition, it would still be an insurmountable task to obtain sufficient numbers of embryos to provide treatments for all persons who have chronic diseases. Why waste the money doing research in an area where we know from the onset that only a few individuals might be helped at best. Why can’t you consider devoting our limited resources to an area of research that could benefit everyone?


       —J. Meyers    Nov. 4 '08 - 02:26AM    #
  23. Bill,

    While some adult stem cells have been “forced” to become pluripotent, which is an exciting new area of research, most adult stem cells have been isolated from human tissues intact.

    In the bone marrow, there exist stem cells that are able to differentiate into any type of blood cell. In the basal membrane of skin, there exist stem cells that can differentiate into keratinocytes, fibroblasts, or melanocytes. For every tissue in the human body that regenerates itself throughout a person’s life, there is inevitably an adult stem cell progenitor for all the cells found in that tissue. Why don’t you read some of the journal articles I cited in my previous posts? The scientists that want to use the parts of living human embryos for their experiments are not likely to inform you of the alternatives.


       —J. Meyers    Nov. 4 '08 - 02:54AM    #
  24. J., since no one’s being arrested for murder when those embryos are used, I think you’re overstating things. “They are an early stage of human life.” Maybe “they’re an early stage of human development” would be more accurate to say.

    “The argument that the only option for these embryos is to throw them away is dishonest and deceptive.”

    That’s a straw man. Rather than stand it back up, I’ll ask if you believe that adoption is a feasible outcome for all “snow embryos”. If so, why isn’t that happening? What do you propose to make it a reality?

    By the way, I don’t know anything about any of this apart from what I’m learning from reading this thread. I just have a preference for logical and supported arguments, especially if plain and simple information isn’t offered—some of which has been. Thanks to those who supplied it.


       —Steve Bean    Nov. 4 '08 - 06:00AM    #