Doctors Fear Losing Leukemia Drug Deemed Risky

People with fatal diseases may be willing to try risky treatments that have a chance of saving their lives. But when is the risk too high?

Brian Lee for The New York Times

Dr. Brian Druker, of the Knight Cancer Institute at Oregon Health and Science University, said, "My patients are panicked."

Iclusig was approved in December 2012 to treat patients who had chronic myeloid leukemia that did not respond to other drugs.

That question was at the heart of a decision announced Thursday by the Food and Drug Administration to suspend sales of a leukemia drug, Iclusig, that was keeping patients alive but also significantly raising their odds of heart attacks, strokes, blindness, death and amputations.

Despite the potential consequences, several doctors who treat people with the disease, chronic myeloid leukemia, said there were patients for whom nothing else works, and whose lives depend on the drug.

"My concern is that I have patients right now who are benefiting from this medication with very few side effects, and if they're on the end of a one-month prescription, what's going to happen when their medication runs out?" said Dr. Brian Druker, the director of the Knight Cancer Institute at Oregon Health and Science University. "Without this medication, they won't have long to live. My patients are panicked."

The drug agency has said that patients who need the drug will still be able to obtain it, but that doctors will have to file applications for each patient, a process that some say is cumbersome and might leave patients tangled up in red tape, with no pills.

Dr. Michael Mauro, a leukemia specialist at Memorial Sloan-Kettering Cancer Center in New York, said that 23 leukemia specialists and three patient advocacy groups had sent the drug agency a letter saying they were concerned that the sudden withdrawal of the drug would interrupt treatment for patients with no other good options.

Iclusig, also called ponatinib, was approved in December 2012 to treat patients who had chronic myeloid leukemia that did not respond to other drugs. The disease is a relatively uncommon form of leukemia, with about 5,000 cases a year and 600 deaths in the United States. The wholesale price of the drug was $115,000 a year.

Iclusig was given accelerated approval by the drug agency under a program that allows some important drugs to reach the market quickly, without the full evidence of safety and efficacy that the agency usually requires but subject to further studies to confirm the drug's benefit. 

Critics might say Iclusig's approval is a sign that accelerated approval can allow dangerous drugs on the market. But supporters of the program say the fact that marketing of Iclusig is being suspended is a sign that the system is working as intended.

Iclusig is part of a new generation of "targeted" drugs that act against specific biochemical defects that fuel the explosive growth of certain types of cancer. The first of these drugs for chronic myeloid leukemia was Gleevec. (Dr. Druker was one of its developers.) It revolutionized the treatment of the illness and transformed it from a death sentence into a chronic disease that people could live with for many years.

Iclusig is one of several drugs developed for patients who did not respond to Gleevec, or who became resistant to it.

But even though these powerful new drugs are specifically designed to fight cancer cells, they also find their way to other targets, including the cardiovascular system.

In a bulletin on Thursday, the drug agency said that 24 percent of patients taking Iclusig who were studied for a median of 1.3 years, and 48 percent studied for a median of 2.7 years, had suffered "serious adverse vascular events." Those figures are unusually high, and higher than what was reported from the initial studies done before the drug was approved.

The events included blockages in blood vessels that led to heart attacks, strokes, blindness and lack of blood flow to the extremities. Some of the patients were young, in their 20s, and some had no risk factors for heart or artery disease.

A spokeswoman for the drug agency, Stephanie Yao, said that in studies of the drug to date, which involved 530 patients, at least 14 had died from cardiovascular problems.

Dr. Frank Haluska, the chief medical officer of Ariad Pharmaceuticals, the Cambridge, Mass., company that makes the drug, said the company was working with the drug agency to analyze the problems and hoped to return the drug to the market. Over all, he said, about 2,000 people have taken the drug.

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Nets Hand Heat First 2-Game Skid Since January

NEW YORK — Before they can think about beating Miami in the playoffs, the Brooklyn Nets had to show they could do it in a game.

By the time they ended 4½ years of futility, the only losing streak belonged to Miami — for the first time in 10 months.

Paul Pierce and Joe Johnson scored 19 points each, and the Nets ended a 13-game skid against the Heat and sent the NBA champions to consecutive losses for the first time since January with a 101-100 victory Friday night.

"It was good that we got a taste of this type of atmosphere this early in the season to try to see where we're at," Pierce said. "Miami, whenever they come into town, they're a measuring stick for everybody, so it was good for us to come out and get the win."

Pierce and Johnson both hit two free throws in the final seconds as the Heat were trying to pull off a comeback. Instead, they fell to 1-2 and have dropped two in a row for the first time since Jan. 8 and 10.

The Heat got Dwyane Wade back after he missed Wednesday's loss in Philadelphia, and he scored 21 points. LeBron James led Miami with 26 points as the Heat again fell far behind and couldn't catch up.

"What you've done in the past doesn't mean you can make it happen in the present, so we've just got to have a little more sense of urgency," James said. "It's not doomsday right now. We're good, but we understand what we need to fix and correct."

The Nets ended a 13-game skid against the Heat with their first victory since March 20, 2009, before Miami's Big Three got together and when the Nets were still playing in East Rutherford, N.J. — two homes ago.

Deron Williams, who came to the Nets two years later, said he wasn't aware of the skid until seeing it on TV earlier Friday.

"You don't want to have those types of losing streaks to any franchise," he said, "so it was definitely on our mind."

Brooklyn, bigger and deeper, opened an 11-point lead after three quarters and kept the lead right around there until the final 2 minutes. Then Miami ran off 10 straight, cutting it to 96-94 with 18 seconds left after consecutive 3-pointers by Wade and Mario Chalmers.

James later nailed a 3-pointer from the corner to cut it to 99-98 with 4.7 seconds remaining before Johnson hit two free throws. Chris Bosh was fouled and after making the first appeared to try and miss the second, but it went in and the Heat couldn't commit another foul in time.

The Nets bounced back from a season-opening loss in Cleveland by winning in their second and final game without first-year coach Jason Kidd, suspended two games by the NBA after pleading guilty in a drunken driving case.

James heated up late for his 21st straight 20-point game against the Nets. Only Michael Jordan had a longer streak, with 39 in a row from 1984-95.

Miami had bounced back with a win after every loss since following a Jan. 8 defeat to Indiana with another loss two nights later in Portland. But the Nets seized control in the third quarter behind 11 points from Pierce, holding the Heat without a basket for nearly 6 minutes and building just enough of a lead.

"This ain't nothing new. We've dealt with this before. This story line continues," Wade said. "At the end of the day, we want to play better. We would love to play better, obviously the start, the first and the third, but we had a chance to win the game. We have to find a way to pull it out."

The Heat swept three games against the Nets last season by an average of 21 points, the series appearing more lopsided than ever.

Getting Kevin Garnett and Pierce from Boston should change that, as well as whatever pleasantries might have existed between the teams. Garnett said James should worry about the Heat and stay out of Celtics business last month after James made some critical comments about their departure from Boston, and James refused to answer any questions about the Nets before the game Friday, saying Garnett told him not to talk about other teams.

Brooklyn got eight points in 12 minutes from Andrei Kirilenko after he missed the opener with back spasms. Fellow newcomer Alan Anderson also had eight points, while Andray Blatche led the reserves with nine.

NOTES: Miami's longest winning streak against an opponent is 12 in a row over Charlotte. ... The crowd included Magic Johnson, David Beckham, Allen Iverson and New York Mayor Michael Bloomberg.

___

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This Little LED of Mine

Nancy Finkelmeier tried to make the switch more than a year ago. After hearing that the long life of compact fluorescent bulbs would help her avoid changing the lights in her 15-foot ceilings so often, she got rid of her traditional incandescent bulbs in favor of the new ones.

Tony Cenicola/The New York Times

Comparing the light quality of, from left, a Sunlight compact fluorescent bulb, a Cree LED, and a GE incandescent.

But there was a problem. "I don't like that cool blue light that it emits," said Ms. Finkelmeier, a retired nurse from Cincinnati.

So she made another switch, to bulbs using a different technology called the light-emitting diode, or LED. It's a change that regulators and manufacturers, frustrated by consumer rejection of compact fluorescents, hope that others will make as well, especially the millions who have stuck with their energy-guzzling traditional incandescent bulbs, even hoarding them as stricter efficiency standards phase out most of them.

For several years, manufacturers have been making LED lights that increasingly mimic incandescents, while steadily bringing down their prices. Big-box retailers like Walmart are jumping into the market, offering their own brands of the bulbs, often for $10 or less.

Regulators are getting involved, too. The Environmental Protection Agency recently finished overhauling lighting standards for its Energy Star program, making it easier for more LEDs to qualify for generous discounts. And California, a leader in all things green, is going even further, with elaborate new requirements to control not just how much electricity the bulbs use but how the light feels.

"We want a lamp that people fall in love with," said Gary Flamm, supervisor of the building standards development unit at the California Energy Commission, adding that with compact fluorescents the push toward low prices and high efficiency had sacrificed light quality. "Once they fall in love with it, they can all save significant energy over the incandescent."

Nationwide, incandescent bulbs, including newer, more efficient halogen models, accounted for roughly 75 percent of general lighting sales this year, according to the National Electrical Manufacturers Association, a trade group, with compact fluorescents making up most of the balance. Manufacturers concede that early versions of the compact fluorescents did not meet expectations for light quality and longevity. Despite advances that have improved their performance, consumers still tick off a host of complaints about the squiggly bulbs: They take time to light up, they do not dim smoothly, they don't fit with clip-on shades and, worst of all, they cast a harsh and unflattering light. They also contain mercury, raising concerns about breakage and disposal.

"I would, in a way, pay anything to avoid fluorescent," said Laura Stein, an artist who was picking up several different LEDs to try from a Manhattan Home Depot last week. "I can't stand them — I've always hated them and I will not use them."

Millions of consumers have come to the same conclusion, even though compact fluorescent bulbs use about 75 percent less electricity than standard incandescents.

LEDs offer a different proposition. Until recently, customers like Ms. Stein could pay about $30 for a bulb — a significant premium even though electricity savings and a life span that extends into the decades can make up the difference in the long run. But several manufacturers — including well-known brands like General Electric, Osram Sylvania and Philips and newcomers like Cree — began offering bulbs for around $10 or less this year.

The drop in price has helped increase demand for them, retailers and manufacturers say, although they still represent only about 1 percent of the bulbs in American homes, according to industry estimates. In the last few years, LED sales have doubled at retailers like Home Depot and Bulbs.com, executives there said, reaching roughly 20 percent of their lighting totals.

Ms. Finkelmeier, for instance, said she was very happy with the warmer light from her LEDs as well as with the savings on her electric bills.

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Gunman Kills T.S.A. Agent at Los Angeles Airport

LOS ANGELES — A 23-year-old man wielding an assault rifle and carrying 100 rounds of ammunition shot and killed a Transportation Security Administration officer at Los Angeles International Airport on Friday morning, sending travelers fleeing in panic and paralyzing one of the world's busiest airports for hours.

Two other people, one of them a security agent, were shot and at least four others were injured in the melee.

The gunman entered Terminal 3 just before 9:30 a.m., pulled a weapon from a bag and began firing as he forced his way through a security checkpoint, officials said. Airport police officers chased him through the bustling terminal as he continued to fire, before shooting him near a departure gate and arresting him.

The T.S.A. agent who was killed was the first to die in the line of duty since the agency was created in the aftermath of the Sept. 11 terrorist attacks, officials said.

Thousands of travelers throughout the airport were evacuated and flights were grounded for hours, with some incoming flights diverted to nearby airports and others held on the tarmac while the shooting unfolded. Passengers spent hours in waiting areas, parking lots and nearby hotels as they waited for flights to resume. Air traffic across the country was stalled in a ripple effect from the shutdown.

Federal officials identified the gunman as Paul Ciancia of Los Angeles, who had previously lived in New Jersey. A senior federal official said that he had a note with "antigovernment and anti-T.S.A. ramblings." Mr. Ciancia was being treated at a Los Angeles hospital, officials said. F.B.I. agents were searching his apartment on Friday night.

His family lives in Pennsville, N.J., and contacted the police chief there shortly after the shooting after the suspect's younger brother received a text message saying he might harm himself.

"The way it was written they had some concern about it," said the chief, Allen Cummings, speaking Friday night outside the family's home. He said the text message did not include the word "suicide."

Chief Cummings then contacted the Los Angeles police and asked them to check on Mr. Ciancia's well-being. He said the family was unaware that he owned weapons or had any antigovernment leanings.

Former classmates at the Salesianum School, a private boys' school in Wilmington, Del., said Mr. Ciancia was a quiet student. He played the tuba in the school band for all four years he attended, 2004 to 2008, said Jesse Sooy, 23.

"He was a really quiet kid," Mr. Sooy said, describing a slight young man, no taller than 5-foot-7, with dark brown hair, who rarely spoke unless spoken to. "His dream was to work in his dad's collision company," Mr. Sooy said, naming it as Salem County Collision, an auto repair shop in Pennsville, N.J. "I was so shocked that he was even at LAX."

In Pennsville, neighbors of the Ciancia family described them as hard-working people who had lived in the community for at least 20 years and kept to themselves.

"Paul, the father, has been a well-respected businessman here for many years, and has always taken care of people well," said Gary Hankins, who lives across the wooded street in the suburban South Jersey community of about 14,000.

Rich Garry, 68, of Fullerton, Calif., said he had been at Terminal 3 on Friday morning headed for a flight to New York to visit family members. He said that a security officer had just checked his boarding pass and that he was waiting in line at the security checkpoint when he heard two shots.

"I heard a 'pop-pop' and I looked down a floor below, and the T.S.A. guy was on the floor," he said. "He had been shot."

Mr. Garry said he believed it was the same security officer who had inspected his boarding pass.

As the gunman moved through the terminal, Mr. Garry said, "he was very calm. When he got to the top of the stairs where the security checkpoints are, he looked around. If he would have come up the ramp, he would have had a field day with all the people lying on the ground, like me."

Mr. Garry said he and several others crawled to a nearby elevator and went to the ground floor. Once there, he saw police officers for the first time, and told them to go to the second floor.

Reporting was contributed by Timothy Williams and Ravi Somaiya from New York, Michael S. Schmidt and Matthew L. Wald from Washington, and Jon Hurdle from Pennsville, N.J.

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Nets Prevail, Showing Heat That Rivalry Has Two Sides

Michelle V. Agins/The New York Times

The Nets had lost to the Heat 13 straight times before Friday's game. "You've got to grow from someplace," Kevin Garnett said after the Nets' 101-100 victory.

It is too early, perhaps, to assess how the Nets will fare against the Miami Heat as this N.B.A. season progresses. But within a so-called rivalry that has been so one-sided, so punishing, in recent years, it is probably never too early to start the emotional buildup.

This was the takeaway at Barclays Center as the Nets, who carried a 13-game losing streak against the Heat into their home opener Friday night, dispatched the reigning champions, 101-100. The win was the Nets' first over the Heat since March 20, 2009, and it improved their record to 1-1.

"You've got to grow from someplace," said Kevin Garnett, who had 6 points and 7 rebounds. "We're trying to set a new creed here, a new culture, and I guess you start with getting bears and monkeys off your back."

Last season, the Nets went 0-3 against the Heat, never putting up a fight. On Friday, they showed all the characteristics they claimed to possess after assembling their savvy veteran squad, a group that showed a new boldness by proclaiming it was gunning for a championship.

Before a tense finish, a boisterous tone was set early. The Nets were unhappy about their ball movement Wednesday night, when they lost their opener to the Cleveland Cavaliers, but they looked crisp in jumping to a 27-18 lead after one quarter.

Just before the first quarter ended, Jason Terry sank consecutive 3-pointers and showed off his airplane celebration, spreading his arms and running. He cupped his hands around his mouth, joined in the "Brook-lyn" chant and then waved his hands, asking for more volume. It was a brash move, and the crowd loved it.

"Big up to Brooklyn, straight up," Garnett said. "It's going to be a pleasure playing here."

There was substance to the Nets' game, too. They harassed LeBron James (26 points, 7 rebounds, 6 assists). They built their lead to 16 during the third quarter. Then, as the Heat surged down the stretch, the Nets showed a spine.

The game's edgy finish made the final whistle more cathartic. James hit a 3-pointer with four seconds left to cut the Nets' lead to 1 point. But Joe Johnson (19 points) swaggered to the free-throw line on the other end and hit both attempts. The Nets fouled Chris Bosh on the ensuing inbound pass, and although he made both free throws, the Nets played keep-away on the subsequent inbound pass as the clock died out.

Paul Pierce was a particular menace, scoring 17 of his 19 points in the second half. Just as important, he hounded James to the final buzzer.

Garnett said Pierce's nickname was Picasso because "he's like a beautiful painting, man, a beautiful painting I get to watch every night."

The Nets, like every other team, entered the season with the Heat squarely in their cross hairs. But there remains an emotional gulf to overcome first, a ragged recent history to wash away. James, dating to his tenure with the Cleveland Cavaliers, carried a personal 17-game winning streak against the Nets.

The Nets' personnel changes this season have changed the rivalry's complexion, but it remains to be seen if they will make it more competitive on the court. Whatever the ultimate outcome, the rivalry has already been supplied some new extracurricular tinder.

James incited some headlines during the preseason when he lobbed some critical comments toward Pierce and Garnett, who responded that James should mind his own business. On Friday night, when a reporter tried to ask James before the game about the Nets, his response was pointed.

"I'm not answering any questions about the Nets," he said. "K. G. already told me to worry about my own team."

The Nets were as close to full strength as they had been since training camp. The medical staff loosened the reins a bit on Deron Williams, who was limited on Wednesday to 22 minutes — and no fourth-quarter playing time — as he continued his return from a sprained right ankle. He played just over 27 minutes Friday and had 8 points and 8 assists.

Andrei Kirilenko, who missed the Nets' last five preseason games and the season opener because of back spasms, returned to the team, galvanizing the Nets on both ends during an abbreviated night.

The atmosphere was boisterous throughout. Celebrities and boldface names — David Beckham, Magic Johnson, Allen Iverson and the rapper Fabolous, to name a few — were shown on the video board and received big ovations. But the players got the loudest cheers. With less than five minutes on the clock, Pierce stuffed James, bringing the fans to their feet.

"It was big because, one, you're playing against the best team in the N.B.A. and, two, we're trying to establish something, some home presence," Pierce said. "It was good that we got a taste of this type of atmosphere this early in the season to try to see where we're at."

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A Colorful Food Lover’s Feast for the Eyes, Starring Flavors of the Bronx

"It's the real deal," said the man, Justin Fornal, who is known as the wacky culinary explorer Baron Ambrosia, as he dug into a plate of pan-fried sticky rice with his fingers. "It's Baron-approved."

If New York City's fine dining establishments live by Michelin stars and Zagat ratings, the myriad homegrown restaurants and shops of the Bronx have their own roving critic. Those that please the Baron's palate are recommended to his fans and featured in his ever-expanding portfolio of media projects, which includes podcasts and two culinary-themed shows on the Cooking Channel and BronxNet, a local cable television network.

Now Mr. Fornal has cast some of his favorite Bronx places in a movie, "Baron Ambrosia Is Dead," which will be shown free on Saturday at the Andrew Freedman Home, a landmark site on the Grand Concourse. The movie, which was produced by BronxNet and Sony Creative Software, sends the Baron on a madcap escapade through congestion-free streets and charming ethnic enclaves with cameos by his real-life friends, including the hip-hop musician known as Grandmaster Melle Mel.

Notably, there is not one shot of a burning building — and, unlike that other movie about the Bronx, no Fort Apache-like police station under siege, either.

Mr. Fornal is not a Bronx native, but his homage to his adopted borough has won him a following among its 1.4 million residents. The borough president, Ruben Diaz Jr., proclaimed him the Bronx's official culinary ambassador, and a giant photo of the Baron was splashed across a billboard near the Robert F. Kennedy Bridge (formerly the Triborough) last year as part of an advertising campaign for his show on the Cooking Channel.

"We've adopted him, too," said Marlene Cintron, who oversees economic development for the borough. "He's a wonderful ambassador not just for Bronx food, but for the Bronx experience."

Still, Ms. Cintron added, "The first time I saw him, I had to blink a couple times."

Mr. Fornal, 35, was a pop of color on a recent gray, overcast afternoon as he strode down the street in a vintage purple suit, an oversize bow tie with the Baron's initials, matching shoes and an umbrella. Purple was his color, he said, because "it's the color of celestial funkiness." In the movie, he drives a purple convertible, which he built with his father.

"It's not an act, it's not a character, it's what I like to do every day," he said. "So many people settle for what's safe and what doesn't raise eyebrows. They're living at a fraction of what they could be. Every time I step out of the house, I want to live 110 percent."

Mr. Fornal, who grew up in Killingworth, Conn., followed his then-girlfriend — now wife — to her family's home in the Bronx in 1999 after studying filmmaking and history at the University of Pittsburgh. Soon he was exploring every corner of the Bronx, "blown away," he said, by "the diversity and all the ethnic enclaves that were still intact instead of being homogenized and watered down."

In 2006, Mr. Fornal invented the Baron Ambrosia persona and started capturing his adventures in a series of podcasts called "Underbelly." Two years later, he developed and starred in "Bronx Flavor," a show on BronxNet, in which the Baron fought villains and ate his way across the borough. "He makes it kind of comical and then you actually learn about the Bronx," Melle Mel said.

Michael Max Knobbe, executive director of BronxNet, described Mr. Fornal as a gifted storyteller who is helping to define the present-day Bronx rather than dwelling on stereotypes of the past. "Many leaders and organizations have worked to make the Bronx a symbol of urban renewal," he said. "Baron illuminates that, and is a champion of small businesses and people striving and thriving."

Food often has a central role. Mr. Fornal, a self-taught cook, said he did not see himself as a chef or a food critic but as a culinary anthropologist. And, he said, "obviously, I have a very ravenous appetite."

Max Falkowitz, the New York editor at Serious Eats, a food blog and website, said that while he was not familiar with all of Mr. Fornal's culinary picks, some, like the Bangladeshi restaurant Neerob in Parkchester, were highly regarded. He praised Mr. Fornal for drawing attention to a borough that is not known for its food. "The Bronx needs someone who can get really excited about the quality of the food there and who can share it with others in an accessible and engaging way," Mr. Falkowitz said.

"Baron Ambrosia Is Dead," which was shot over the past few years, follows the Baron as he breaks out of jail (where he landed in the last episode of "Bronx Flavor") and returns to old haunts like the kitchen at Neerob, and Frank Bee, a family-owned costume store in Throgs Neck.

Mr. Fornal also took his film crew to Nano Billiard Cafe. Regulars playing billiards and dominoes were pressed into service for a fight scene. The cook behind the lunch counter, Anita Romero, 53, is shown mixing huge pots with a long wooden spoon.

Under Ms. Romero's watchful gaze recently, Mr. Fornal cleaned his plate, then he headed upstairs to hit the Bronx streets. "A lot of people ask me if I was born in the Bronx," he said. "My reply is, 'No, I chose the Bronx.' I want people to come here and appreciate our community for what it is."

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Tunnel for Smuggling Found Under U.S.-Mexico Border; Tons of Drugs Seized

Immigration and Customs Enforcement, via Agence France-Presse — Getty Images

A tunnel under the United States-Mexico border equipped with electricity, ventilation and an electronic rail system was shut down by federal authorities in San Diego. Marijuana and cocaine were confiscated, and three people were taken into custody.

SAN DIEGO — A deep tunnel snaking nearly 600 yards from Mexico under the border and into a San Diego warehouse is one of the most sophisticated underground drug smuggling passageways ever discovered, complete with electricity, ventilation and an electronic rail system, federal authorities said Thursday.

Sandy Huffaker/Getty Images

Mexican security officials stood guard Thursday outside a factory in Tijuana where the tunnel's starting point was discovered.

The tunnel, which was shut down Wednesday night after several weeks of surveillance, took about a year to build, the authorities said. Three people were taken into custody, and federal agents seized eight tons of marijuana and 325 pounds of cocaine they said was connected to the investigation.

As security at the border — both at the ports of entry and between them — has heightened in recent years, drug cartels have increasingly sought other avenues, including tunnels, maritime smuggling and ultralight aircraft, to move drugs into the United States. This was the fifth large-scale drug smuggling tunnel discovered in the San Diego area since 2010, the authorities said, and the eighth since 2006, when the Sinaloa drug cartel took firm control of the smuggling corridor along this section of the border.

"These cartels have spent years and tens of millions of dollars trying to create a secret underworld of passages so they can move large quantities of drugs," said Laura Duffy, the United States attorney for the San Diego region.

Derek Benner, special agent in charge for Homeland Security Department investigations in San Diego, said sophisticated tunnels like the one found here — which required not only laborers to build but also architects and engineers, and could cost upwards of $1 million to construct — were an investment only a well-financed cartel could afford to make.

He said the tunnel — like the two most recent "supertunnels" in the region, which were discovered in late 2011 — was shut down before any narcotics reached the market in the United States, which he called a major blow to the cartel.

"This serves as yet another warning to these organizations that mistakenly believe that tunnels will be their ticket to success," Mr. Benner said.

It was the first time cocaine had been seized in connection with a tunnel operation, the authorities said.

"They're desperate," said William R. Sherman, special agent in charge for the Drug Enforcement Administration in San Diego. "We're starting to see them try to move cocaine through these tunnels, which we've never seen before. We're seeing them try to move cocaine through ultra-lights into the desert, which we've never seen before. And those are simply acts of desperation."

Tunnels have also been found around the Nogales area in Arizona, where cartels make use of underground drainage canals.

But the San Diego-Tijuana corridor has remained popular for tunnel construction because the clay-like soil is easy to dig and less susceptible to cave-ins, Mr. Benner said. In addition, the warehouse districts on both sides of the border offer cover for the drug smuggling operations.

The tunnel discovered on Wednesday was about four feet high and three feet wide, the authorities said, and zigzagged on its way across the border at about 35 feet underground, likely because the builders veered off course several times during construction.

The authorities insisted that no drug smuggling tunnels in the San Diego area were currently in operation.

"We have the border underground fairly well monitored," Mr. Sherman said. "If you're building a tunnel, we know about it. This is the third once since 2011. We've found them all before they could successfully get any drugs into the United States."

Liam Dillon reported from San Diego, and Ian Lovett from Los Angeles.

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Palestinians in Peace Talks With Israel Offer Resignations

JERUSALEM — The Palestinian negotiators engaged in peace talks with Israel offered their resignations on Thursday in protest over the continuing construction of Israeli settlements and what Palestinians say is a lack of strong American action on this issue, according to an official involved in the process.

But he and other officials said that the Palestinian president, Mahmoud Abbas, was not likely to accept the resignations and that the talks would go on uninterrupted. The officials spoke on the condition of anonymity because they were not authorized to discuss the matter publicly.

Asked about the resignation of the negotiators, Saeb Erekat and Muhammad Shtayyeh, a senior American official said, "We have been informed by the Palestinian side that they remain committed to the negotiations for the nine months agreed upon and that they fully intend to participate in the next round of negotiations."

The talks resumed three months ago after having been stalled for years. Secretary of State John Kerry helped get the sides back to the table, and his special envoy, Martin S. Indyk, is facilitating the talks.

With Mr. Kerry due back in the region next week, the offers of resignation appeared to be a message of frustration directed primarily at the Americans.

In order to resume the talks, Israel agreed to release 104 long-serving Palestinian prisoners in four groups and the Palestinian leadership pledged to hold off its efforts to seek action against Israel in the International Criminal Court and to elevate the Palestinian role in other international organizations.

But with each prisoner release — there have been two so far — the Israeli government has tried to appease right-wing members of the coalition by advancing settlement construction plans in East Jerusalem and the West Bank, moves that have deeply embarrassed the Palestinians.

"This is a humiliation process, not a negotiation process," a Palestinian official said on Thursday.

In particular, the Palestinian leadership is furious over claims that were made this week in the Israeli news media and by internal enemies of Mr. Abbas that he had agreed to settlement building in return for the release of prisoners. The Palestinian official said that a plea for the Americans to issue a statement denying any such deal went unheeded.

Addressing the issue as he greeted the returning prisoners in the West Bank city of Ramallah early Wednesday, Mr. Abbas said that "unpatriotic" individuals had made claims about a quid pro quo regarding prisoners and settlement building but that such talk was nonsense and that the Palestinians would never agree to settlement construction.

Also Thursday, a Hamas militant was killed and several others were wounded when Israeli forces fired a tank shell at a group of Palestinian gunmen in Gaza, near the border with Israel, according to Gaza security officials and witnesses.

Israeli news media said that the Israeli forces had first come under mortar fire from Gaza. A spokeswoman for the military said only that forces had been carrying out "a pinpoint and defensive activity" near the border.

Fares Akram contributed reporting from Gaza.

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In Reversal, Court Allows Texas Law on Abortion

Only three days after a federal judge blocked a new Texas law that threatened to shut down many of the state's abortion clinics, the United States Court of Appeals for the Fifth Circuit, in New Orleans, reversed the decision, saying the rule should take effect while the case is argued in the months to come.

Abortion clinic owners and women's health advocates said the decision would have catastrophic effects because as many as 13 of the 36 clinics providing abortions in the state would have to stop doing so immediately, forcing women in large swaths of Texas to travel several hours on at least two days to obtain abortions.

The clinics forced to halt abortions have been unable to satisfy a new requirement, part of a broader anti-abortion law adopted in July, that doctors performing the procedure must have formal admitting privileges at a hospital within 30 miles of the clinic.

Greg Abbott, the state attorney general and a Republican candidate for governor next year, filed an emergency appeal to the three-judge circuit court on Monday asking it to overrule the lower court. He said in a statement Thursday, "This unanimous decision is a vindication of the careful deliberation by the Texas Legislature to craft a law to protect the health and safety of Texas women."

Gov. Rick Perry, who has said he hopes to abolish abortion in Texas, said in a statement, "Today's decision affirms our right to protect both the unborn and the health of the women of Texas."

In blocking the requirement on Monday, Judge Lee Yeakel of United States District Court in Austin accepted the argument of the clinics, and many doctors and national medical associations, that requiring admitting privileges had no bearing on safety because in the rare event of an emergency, patients will be rushed to the nearest hospital and treated the same way regardless.

The requirement is likely to be unconstitutional, he declared, because it is "without a rational basis and places a substantial obstacle in the path of a woman seeking an abortion."

But the appeals panel found just the opposite: that the rule is likely to be constitutional because it serves a legitimate state interest in regulating doctors and does not impose an "undue burden" on the right to abortion.

The appeals court said that the admitting privilege rule might "increase the cost of accessing an abortion provider and decrease the number of physicians available to perform abortions."

But it cited a Supreme Court statement in an earlier abortion case that if a regulation serves a valid purpose, the fact that it has "the incidental effect of making it more difficult or more expensive to procure an abortion cannot be enough to invalidate it."

In Texas and other states, especially in smaller cities and rural areas, abortion clinics often use visiting doctors who may be highly qualified but do not meet the rules of local hospitals for admitting privileges. Many hospitals, for example, grant privileges only to doctors who admit a certain number of patients a year, while emergency hospitalizations after abortions are rare.

Some hospitals are unwilling to make formal arrangements with abortion providers because of religious reasons or because they fear protests.

The challenge to the admitting privilege rule was brought by the American Civil Liberties Union, the Center for Reproductive Rights, Planned Parenthood and other abortion clinic owners in Texas. They were apparently surprised by the sudden turn and warned of dire consequences.

"We believe there are currently 36 health centers in Texas that provide abortions, and one-third will be forced to stop those services tomorrow," Amanda Harrington, a spokeswoman for the Planned Parenthood Federation of America, said on Thursday.

Four of 13 Planned Parenthood clinics in Texas have not been able to find doctors with local admitting privileges and will halt abortions immediately, but they will remain open to provide other women's services, Ms. Harrington said. Some other private clinics may shut down, mostly in West Texas.

Courts in Alabama, Mississippi, North Dakota and Wisconsin have temporarily blocked similar admitting-privilege requirements as unconstitutional obstacles. With Thursday's ruling by the Fifth Circuit, it appeared likely that the issue will eventually be decided by the Supreme Court, part of the continuing battles over how much states may restrict the right to abortion granted by Roe v. Wade in 1973.

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Bulls 82, Knicks 81: With Late Floater, Rose Sinks Knicks

CHICAGO — It was an impossible shot, or at least it looked that way to Carmelo Anthony.

Derrick Rose was searching for an angle to the basket as the final seconds evaporated Thursday night, and his options were limited. In fact, Rose, the Bulls' do-everything point guard, was left with only one as he took a final hard dribble along the baseline and elevated against Tyson Chandler, the Knicks' 7-foot-1 center.

With both arms extended, Chandler constructed a 10-foot wall, so Rose simply flicked the ball toward the rafters, into the haze that lingered from some pregame pyrotechnics. Over Chandler. Over the side of the backboard, from Anthony's vantage point. Over everyone and everything, before it finally fell through the hoop.

The shot lifted the Bulls to a dramatic 82-81 victory, Rose's game-winner coming with 5.7 seconds left in a tussle between two teams that have never been particularly fond of each other.

"Derrick Rose hit a phenomenal shot," Anthony said. "And we'll live with that."

Anthony, who labored his way to 22 points and 8-of-24 shooting, had one last opportunity of his own. After creating a bit of space between himself and the Bulls' Luol Deng, Anthony stepped back for a long jumper, but misfired. Chandler's tip-in attempt at the buzzer was also off the mark.

Chandler grabbed 19 rebounds, and Raymond Felton added 13 points in the loss. The Bulls outscored the Knicks by 46-24 in the paint.

"We competed," Coach Mike Woodson said. "It says a lot for our club. Now I just need to do a better job getting us through down the stretch."

Rose's theatrics spoiled a late surge by the Knicks (1-1), who scored 12 straight points in the fourth quarter, turning a 10-point deficit into a 2-point lead. Tim Hardaway Jr. and Felton connected on 3-pointers, and Anthony sank a pair of fadeaways, the second pushing the Knicks ahead by 78-76.

With the score tied at 80-80, Anthony misfired on a long field-goal attempt. In the scrum for the loose ball, the officials called a foul on the Bulls' Joakim Noah. With 10.8 seconds left, Chandler hit the second of two free-throw attempts to give the Knicks a lead — one that was short-lived, thanks to Rose.

"He showed a lot of toughness," said Tom Thibodeau, the Bulls' coach. "He had the courage to take and make that last play."

Rose's performance was a mixed bag in his first regular-season game at the United Center since he injured his left knee during the 2012 playoffs. Hindered after straining his neck in Tuesday's loss to the Miami Heat, Rose was 7 of 23 from the field and scored 18 points.

Thibodeau, whose larynx appeared to be in midseason form, was less than expansive about Rose's health about an hour before the game, acknowledging only that Rose's body was sore and that he had not determined whether Rose would play.

Rose missed 10 of his first 12 shots before hitting back-to-back 3-pointers early in the second half to give Chicago a 49-40 lead. He had a knack for big plays that maintained the Bulls' cushion for much of the second half, including a fast-break layup (61-51) and a double-clutch move under the basket (76-66).

Armed with red glow sticks, a capacity crowd serenaded Rose with M.V.P. chants before the game. The atmosphere was electric. The Bulls celebrated their home opener with an elaborate show that left some thick haze that hovered inside the arena throughout the first half.

As both teams struggled to piece together consistent stretches of offense, all that fog made for some easy metaphors. It was an ugly game, and perhaps neither team looked particularly proficient on offense because the players had trouble locating each other on the court.

The Bulls were clear in their intentions: get to the basket as often as possible, by any means necessary. Early on, that meant letting Deng use his length and quickness to maneuver past Iman Shumpert for three straight buckets inside.

The Knicks, meanwhile, could not find their rhythm. Each possession was more tortured than the last, and their shooting percentage dipped to 31.6 percent by the end of the first quarter. Even Amar'e Stoudemire's first appearance of the season failed to provide a jolt.

Still, the Knicks showed some resolve. As the third quarter turned into the fourth, they kept hanging around, jostling, competing.

The fog eventually lifted for them, but not soon enough.

REBOUNDS

Having declared his plan to opt out of his contract next summer and test free agency, Carmelo Anthony tried to clarify his position in an interview shown during TNT's broadcast, saying that he wants to stay in New York. "They pulled all the strings to get me here, and I wanted to be here," he said. "And I want to retire in New York." ... Andrea Bargnani, who was booed Wednesday by fans at Madison Square Garden in the Knicks' season-opening win over the Milwaukee Bucks, started Thursday and scored 9 points on 4-of-7 shooting.

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