Structure of human apolipoprotein D: locations of the intermolecular and intramolecular disulfide links

We have determined the primary structure of human apolipoprotein D (apoD) by aligning peptides derived from digestions by cyanogen bromide, trypsin, and chymotrypsin. Our results confirm the primary structure derived from cDNA [Drayna et al. (1986) J. Biol. Chem. 261, 16535-16539]. ApoD consists of 169 amino acid residues, including 5 cysteines. Tryptic peptide analysis indicated that Cys41 and Cys16 are joined by a disulfide bridge. Using a combination of manual Edman degradations and mass spectrometric analysis on a purified cluster of chymotryptic fragments, we identified an intramolecular disulfide bridge between Cys8 and Cys114 and an intermolecular bridge between Cys116 of apoD and Cys6 of apoA-II. In addition, sites of N-glycosylation were found at Asn45 and Asn78. Because apoD contains two intramolecular disulfide linkages and has a high content of proline to disrupt alpha-helical structures, formation of the amphipathic helical regions that characterize the other soluble apolipoproteins is unlikely. We conclude that apoD binds to lipoprotein surfaces through structures other than alpha-helices, such as disulfide links.

Immunoreactivity of apolipoprotein B-100 in oxidatively modified low density lipoprotein

Thirteen monoclonal antibodies (MAbs) against apolipoprotein B-100 (apo B) were used to analyze changes in immunoreactivity of human LDL resulting from oxidation mediated by cupric ions and oxygen. Decrease in immunoreactivity of oxidized LDL was demonstrated by competitive ELISA with MAbs 5F8, BL3, Mb43, 2G8, B3, B5, and BL7 for which the epitopes are located within residues 1-1297, 4235-4355, 4027-4081, 3728-4306, 2239-2331, 1854-1878, and in the vicinity of residue 2331, respectively. Immunoreactivity of the epitope B6 (2239-2331) increased during first 4 hours of oxidation and then diminished gradually. Epitope B1 (405-539) had slightly reduced immunoreactivity during first 8 h of LDL oxidation and then its minor increase was observed. MAb 12G10, specific to the epitope within apo B thrombin-digest fragment T4 (1-1297), displayed either weak or strong binding to LDL. LDL with weak binding pattern demonstrated significant increase in immunoreactivity upon oxidation. In contrast, LDL with strong binding pattern showed little to no change. Epitopes Mb47 (3441-3569) and 8G4 (1-1297) remained unchanged in oxidized LDL. Immunoreactivity of apo B-100 epitope recognized by MAb 4C11 (residues 2377-2658) was shown to be a function of oxidation time: it increased progressively up to 16 h and was stabilized for another 24 h of LDL oxidation. This epitope may be unmasked by LDL oxidation and may provide a useful immunochemical marker to monitor the extent of LDL oxidation.

Double-stranded cyclic oligonucleotides with non-nucleotide bridges

A series of double-stranded, cyclic oligodeoxynucleotides with non-nucleotide bridges have been synthesized, and their physicochemical properties and susceptibility to enzymes have been investigated. These bridged duplexes are of potential interest for their binding properties to transcription factors and other DNA-binding proteins. Triethylene glycol has been employed as the bridge to alter the lipophilicity of the duplex and avoid the potential for enzymatic cleavage. The synthetic route involved the synthesis of a 3'-phosphorylated, nicked double-stranded precursor with the final internucleotide bond being formed chemically using a water soluble carbodiimide. These bridged duplexes have high thermal dissociation temperatures, and the Tm for a triethylene-bridged 20 base pair duplex was higher than that for the corresponding pentathymidylate-bridged duplex. EcoR I endonuclease cleaved a ligated, bridged duplex at a slower rate than the corresponding unmodified duplex, whereas the unligated, bridged duplex was cleaved more rapidly. Sufficient amounts of the bridged octamer and dodecamer were prepared for proton NMR spectroscopic studies, and 2D COSY and NOESY spectra were obtained. The results indicate that the ligated duplex has a B-form conformation.

A comparison of the growth patterns of Chinese infants in Chengdu and Hong Kong: 0-2 years

Factors affecting geographical differences in the growth of Chinese infants were examined by comparing data obtained from longitudinal growth studies on growth and feeding practices performed in two Chinese populations: Chengdu and Hong Kong infants from birth to 2 years. Their mean growth curves were fitted by the Reed model for the first year and the Count model for the second year. Chengdu mothers were significantly taller than Hong Kong mothers. Chengdu infants grew more rapidly than the Hong Kong infants during the first 6 months; it is likely that this is related to genetic differences in growth potential and earlier introduction of solids in Chengdu infants.

Contrasting actions of cocaine, local anaesthetic and tetrodotoxin on discharge properties of rat aortic baroreceptors

1. Effects of cocaine, lignocaine, benzocaine and tetrodotoxin (TTX) on the simultaneously measured pressure- and diameter-discharge frequency relations of single fibre baroreceptors were compared in rat in vitro aortic arch-aortic nerve preparations. 2. Between 1 and 10 microM, cocaine produced selective increases in the pressure threshold shifting the pressure-response curve without altering the gain or threshold frequency. At near-blocking concentrations, gain was depressed as well. Cocaine experiments were done in nitroprusside (NP, 1 microM). Neither NP or NP with cocaine altered diameter (P > 0.36). 3. Lignocaine (at > 10 microM) and benzocaine (at > 100 microM) shifted pressure-response curves to higher pressures and generally depressed discharge by increasing pressure threshold and decreasing maximum discharge frequency (P < 0.05). Gain decreased and threshold frequency increased at higher concentrations. Diameter was unaffected by lignocaine or benzocaine (P > 0.14). 4. TTX increased thresholds and discharge frequencies at threshold but did not shift pressure-discharge curve locations. This produced superimposable discharge curves with changes occurring as losses of discharge points in the threshold region. Diameter was unaffected by TTX (P > 0.80). 5. The contrasting patterns of effects between TTX and local anaesthetics suggest that blockade of TTX-sensitive sodium channels alone may not be responsible for the effects of cocaine, lignocaine and benzocaine.

Processing of the LH/CG receptor and bound hormone in rat luteal cells after hCG-induced down-regulation as studied by a double immunofluorescence technique in conjunction with confocal laser scanning microscopy

We developed a double immunofluorescence technique for detection of the rat luteinizing hormone/choriogonadotropin (LH/CG) receptor and bound hCG in the same rat ovarian section and used it in conjunction with confocal laser scanning microscopy (CLSM) to study the fate of the receptor-hormone complex in luteal cells during the hCG-induced down-regulation. Pseudopregnant immature females rats were perfusion-fixed before (0 hr) and 2, 6, 12, 24, or 36 hr after a down-regulating dose of hCG (500 IU IV). The cryosections were stained for the LH/CG receptor and bound hormone by sequential incubations with a polyclonal rabbit antiserum to purified rat LH/CG receptor and a mouse monoclonal antibody (MAb) to hCG, followed by sequential incubation with TRITC- and FITC-conjugated secondary antibodies to rabbit and mouse immunoglobulins, respectively. The results were semiquantitatively analyzed by a pseudo-three-dimensional (3D) plotting of the intensities of the receptor and hormone-specific fluorescence in luteal cells by CLSM. The analysis suggested that the majority of the LH/CG receptors are located on the luteal cells before induction of the down-regulation and that their content seem to vary not only among cells but also on the surface of single cells, thus supporting the previous concept of the functional heterogeneity among the cells and their functional compartmentation. At 2 hr after injection of the down-regulating dose of hCG, the LH/CG receptor-specific and hCG-specific fluorescences clearly co-localized on the luteal cells. Both the LH/CG receptor- and hCG-specific fluorescences disappeared from the luteal cell surfaces in a parallel fashion within 36 hr without a detectable accumulation of either fluorescence deep in the cell interior. These results suggest that the LH/CG receptor and bound hCG do not differ in their manner of in vivo processing in luteal cells. Therefore, the disappearance of the receptor and bound hormone occurs in a parallel fashion and without detectable internalization.

Different mechanisms of regulation of the human stromelysin and collagenase genes. Analysis by a reverse-transcription-coupled-PCR assay

Tissue-remodeling processes are largely controlled by matrix metalloproteinases that degrade the extracellular components of connective tissues. In this study, gene regulation of two human matrix metalloproteinases, stromelysin and collagenase, was investigated by a reverse-transcription-coupled (RT)-PCR assay. Here, signals from both the heterogenous nuclear RNA (hnRNA) and mRNA are amplified, allowing the regulation of gene expression to be divided between transcriptional and/or post-transcriptional control. In confluent human lung fibroblast cultures, tumor-necrosis factor-alpha and 12-O-tetradecanoyl-phorbol 13-acetate induce stromelysin and collagenase genes transcriptionally. Interleukin-1 beta (IL-1 beta) induces stromelysin gene transcription but has little, if any, effect on the collagenase gene transcription in cells cultured in the presence of 10% serum. By a competitive RT-PCR assay, the IL-1 beta-reated cultures contain an average of 60 molecules of stromelysin mRNA/cell and the untreated cultures about 1.9 molecules/cell. In serum-starved cells, both IL-1 beta and serum induce transcription of the collagenase gene. Also, in serum-starved cells type II collagen can induce collagenase mRNA but not stromelysin mRNA. Inhibition of protein synthesis with cycloheximide induces stromelysin gene transcription but has no effect on the collagenase gene. These data indicate different mechanisms of regulation of the human stromelysin and collagenase genes in cultured cells.

A nonliner poroelastic model for the trabecular embryonic heart

A theoretical model is presented for the primitive right ventricle of the stage 21 chick embryo. At this stage of development, the wall of the heart is trabecular with direct intramyocardial blood flow. The model is a pressurized fluid-filled cylinder composed of a porous inner layer of isotropic myocardium and a relatively thin compact outer layer of transversely isotropic myocardium. The analysis is based on nonlinear poroelasticity theory, modified to include residual strain and muscle activation. Correlating theoretical and experimental pressure-volume loops and epicardial strains gives first-approximation constitutive relations for stage 21 embryonic myocardium. The results from the model suggest three primary conclusions: (1) Some muscle fibers likely are aligned in the compact layer, with a fiber angle approximately + 10 deg from the circumferential direction. (2) Blood is drawn into the wall of the ventricle during diastolic filling and isovolumic contraction and is squeezed out of the wall during systolic ejection, giving a primitive intramyocardial circulation before the coronary arteries form. As the heart rate increases, the transmural blood-flow velocity increases, but the volume of blood exchanged with the lumen per beat decreases. (3) Residual strain affects transmural stress distributions, producing nearly uniform stresses in the porous layer, where the peak end-systolic stress occurs. These results improve our understanding of the relation between form and function in the developing heart and provide directions for biological experiments to study cardiac morphogenesis.

Complete androgen insensitivity due to a splice-site mutation in the androgen receptor gene and genetic screening with single-stranded conformation polymorphism

OBJECTIVE

To characterize the genetic defect in a family with complete androgen insensitivity syndrome and to determine whether single-stranded conformation polymorphism (SSCP) can be used to detect subtle mutations in the androgen receptor (AR) gene.

DESIGN

Amplification, subcloning where appropriate, and sequencing of the AR gene in members of the affected family and to use SSCP to differentiate rapidly mutant from normal alleles.

SETTING

Reproductive endocrinology clinic and laboratory in a university hospital.

PATIENTS

A family of which two sisters (46XY) have complete androgen insensitivity syndrome.

RESULTS

A novel single base (G --> A) mutation in the exon G-intron 7 junction of the AR gene caused an abnormal donor splice site leading to complete androgen insensitivity in both affected siblings. Their mother was demonstrated to be the heterozygous carrier of this mutation while the other two males in the family carried the normal allele. Single-stranded conformation polymorphism proved useful for defining the normal, mutant, and heterozygous carrier status of each member of this family.

CONCLUSIONS

This new mutation of the human AR gene illustrates the importance of exon G in receptor function. Single-stranded conformation polymorphism is a simple and rapid screening technique that can be used to detect unknown subtle mutations in the AR gene.

Extreme evolutionary conservation of QM, a novel c-Jun associated transcription factor

QM is a 214 amino acid polypeptide, encoded by a gene (DXS648) in Xq28, that contains a high percentage of charged amino acids and has been found to bind c-Jun and DNA. Searches of the GenBank database revealed no matches between QM and any other known transcription factors. However, we and others have isolated QM homologs from a diverse array of eukaryotes. Alignment of these sequences indicated a high degree of conservation throughout the first 175 residues of the protein and revealed several interesting features. Most notable is the considerable conservation of charged amino acids within specific regions of the protein. Secondary structure analysis suggests that two of these regions form amphipathic alpha-helices, one basic and one acidic. A third conserved charged domain, comprising the N-terminal 30 amino acids, is both basic and proline rich. The rate of sequence divergence of the various homologs was found to be slow (of the order of 1% change every 22 million years), consistent with a critical role for QM in eukaryotic cells. A role for QM as a novel class of transcription regulatory protein is suggested.

A Gln-281 to Arg substitution in alpha-L-fucosidase is responsible for a common polymorphism detected by isoelectric focusing

A common polymorphism of human alpha-L-fucosidase consists of three phenotypes (Fu 1, Fu 2, and Fu 2-1) assigned by isoelectric focusing. The phenotypes are determined by two codominant alleles (Fu1 and Fu2). Isozymes with the Fu 2 phenotype have more basic pI than Fu 1, while Fu 2-1 is a mixture of Fu 2 and Fu 1. Recently, a missense mutation (A860-->G) in the alpha-L-fucosidase gene was described that did not affect alpha-L-fucosidase activity. The mutation causes the substitution of Arg (pKaGuan = 12.5) for Gln-281, which has no ionizable side chain. Isoelectric focusing profiles of extracts of COS-1 cells transfected with wild-type or mutant alpha-L-fucosidase cDNAs had phenotypes of Fu 1 and Fu 2, respectively. Next, 20 human lymphoid cell lines were examined for the occurrence of the A860-->G mutation and expression of the Fu 1, Fu 2, and Fu 2-1 phenotypes. Eight lines with Fu 2 were homozygous for the A860-->G mutation; six lines with Fu 1 were homozygous for the normal nucleotide (A860); and six lines with Fu 2-1 were heterozygous. Thus, the A860-->G mutation is the molecular basis for the protein phenotypes and the Fu1 and Fu2 alleles. The normal nucleotide (A860) is responsible for Fu1 and the A860-->G mutation for Fu2.

Clinically relevant concentrations of bupivacaine inhibit rat aortic baroreceptors

Bupivacaine is clinically associated with cardiovascular toxicity. To examine the possible role of drug actions at arterial baroreceptors, we studied discharge properties of baroreceptors in an in vitro aortic nerve-aortic arch preparation from rats. We measured single fiber discharge, pressure, and aortic diameter simultaneously during perfusion of the aortic arch with bupivacaine. Perfusion mean arterial pressure was held at 80 mm Hg. Only regularly discharging, presumably myelinated, baroreceptors were studied. To assess pressure threshold, threshold frequency, and maximum discharge rate, nerve activity was evoked by slow ramps of increasing pressure (< 2 mm Hg/s) beginning at 20 mm Hg and ranging up to 150-170 mm Hg. Following replicate control measurements, test ramps were repeated in the presence of sodium nitroprusside (1 microM) and phentolamine (1 microM) to eliminate potential smooth muscle and alpha 1-adrenoceptor effects, respectively. Bupivacaine was then added to the perfusate in increasing concentrations from 0.1 to 50 microM for 15 min to construct a full concentration-response curve at each level. Individual baroreceptors showed substantial depression of maximum discharge frequency and/or increases in pressure threshold at 1-5 microM bupivacaine. In overall population averages (n = 7), 5-10 microM bupivacaine clearly reduced maximum discharge and shifted the pressure threshold to higher values (P < 0.01). The net result was a general depression of discharge. Concentrations as low as 10 microM bupivacaine completely blocked discharge in some baroreceptors. Inasmuch as the pressure-diameter relations were not changed, discharge relations plotted against diameter showed equivalent changes. Bupivacaine-free solution reversed the block in all cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Intrauterine pressure: comparison of extra vs intra amniotic methods using a transducer tipped catheter

Fourteen women admitted in early labor, with intact membranes, were studied. In each woman, two catheters were inserted transcervically; one catheter was inserted into the extraamniotic space before rupture of membranes, and the second catheter was inserted, after artificial rupture of membranes into the intraamniotic cavity. The contraction to contraction difference in active pressure (pressure above the baseline) recorded by the two catheters, as well as the cumulative total active pressure generated (calculated by adding the active pressure of all contractions) throughout labor by the two catheters were compared. Of the 606 contractions analysed, 43.2% showed pressure difference of 0-5 mmHg between the intra amniotic and extraamniotic catheter; 21.3% showed 6-10 mmHg difference, 12.2% showed a difference of 11-15 mmHg, and 23.3% showed a difference greater than 15 mmHg. When total active pressure generated by each catheter for individual patients was calculated, the percentage difference varied from 2.3% to 53.7%. Intrauterine pressure measurements in labour using transducer-tipped catheters inserted in the extraamniotic space may not provide comparable information to a similar catheter inserted intraamniotically when membranes are ruptured.

Alpha-domain of human metallothionein IA can bind to metals in transgenic tobacco plants

With a view to exploring its use as a metal-binding factor in transgenic plants we prepared the alpha-domain of metallothionein by reconstitution of rabbit apometallothionein and proteolysis of MT-1 and MT-2 with subtilisin. The isolated alpha-domains were characterised by UV and CD spectroscopy Double-Stranded. DNA encoding the alpha-domain (106 bp) of the human MT-IA was constructed from chemically synthesized oligomers by repair synthesis and enzymatic ligation, cloned into pUC19 and sequenced. A expression construct containing the cloned alpha-domain was introduced into tobacco cells on a disarmed Agrobacterium tumefaciens Ti-plasmid. Transformed tobacco cells were selected and regenerated on medium containing cadmium and kanamycin. The growth of roots and shoots of transformants was unaffected by up to 100 microM cadmium, whereas control plants showed severe inhibition of root and shoot growth, and chlorosis of leaves on medium containing only 10 microM cadmium. Southern hybridization confirmed the presence of the transgene in the transformed plant tissues. The concentration of human alpha-domain peptides in transgenic tobacco leaves was determined by the Cd/hemoglobin saturation assay and polarography using the rabbit alpha-domain as standard. The results indicate that the alpha-domain, one of two domains in MT molecules, is not only stable in vitro, but is also expressed efficiently and functions independently in transgenic plant cells.

Reverse genetics of Drosophila brain structure and function

A set of molecular genetic technologies are described, which will have far reaching consequences for the study of brain structure, function and development in Drosophila melanogaster. Site selected mutagenesis (a PCR-based screen for P-element insertion events) allows insertion mutants to be isolated for any cloned gene, and is being used in this laboratory to ask questions about the rolls of particular cellular components in learning and memory. Transposants have been isolated in genes encoding a regulatory (RI) and a catalytic (DCO) subunit of cAMP-dependent protein kinase, and in a gene encoding a Gi-like alpha subunit. The alternative use of I factors is described. The PKA RI homozygous mutants display a significant decrement in initial learning ability. Enhancer-trap strategies, for which the GAL-4 P-element system is particularly convenient, allow the identification of genes expressed in the developing fly brain. Strategies for the efficient detection of such events are described.

Deletion of QCR6, the gene encoding subunit six of the mitochondrial cytochrome bc1 complex, blocks maturation of cytochrome c1, and causes temperature-sensitive petite growth in Saccharomyces cerevisiae

It was previously reported that disruption or deletion of QCR6, the nuclear gene encoding subunit 6 of the cytochrome bc1 complex, does not impair growth of yeast on non-fermentable carbon sources (Schoppink, P. J., Hemrika, W., Reyne, J. M., Grivell, L.A., and Berden, J. A. (1988) Eur. J. Biochem. 113, 115-122; Crivellone, M. D., Wu, M. M., and Tzagoloff, A. (1988) J. Biol. Chem. 262, 14323-14333; Schmitt, M. E., and Trumpower, B. L. (1990) J. Biol. Chem. 265, 17005-17011). We have discovered that deletion of QCR6 results in a temperature-sensitive petite phenotype, manifested at 37 degrees C, and that this phenotype can be masked by spontaneously arising suppressor mutations. Mitochondrial membranes from the deletion strain grown at 37 degrees C lack ubiquinol-cytochrome c reductase activity, and optical spectra reveal an extensive decrease in cytochrome b absorption, but little or no decrease in cytochrome c1 absorption. Immunoblots of mitochondrial membrane proteins from the deletion strain indicate that processing of cytochrome c1 from intermediate to mature size is blocked coincident with the loss of subunit 6. This is the first example where mutation of a subunit within the bc1 complex blocks maturation of cytochrome c1.

Expression of mouse metallothionein-I gene confers cadmium resistance in transgenic tobacco plants

Transgenic tobacco plants containing a mouse metallothionein-I (MT-I) gene fused to the cauliflower mosaic virus 35S (CaMV 35S) promoter and nopaline synthase (nos) polyadenylation site were obtained by transforming tobacco leaf discs with an Agrobacterium tumefaciens strain carrying the chimaeric gene. Transformants were directly selected and rooted on medium containing cadmium and kanamycin. A total of 49 individual transgenic tobacco plants were regenerated. Among them 20% showed a very high expression level and their growth was unaffected by up to 200 microM cadmium, whereas the growth of control plants was severely affected leaf chlorosis occurred on medium containing only 10 microM cadmium. The concentration of microM cadmium. The concentration of MT-I in leaves of control and transgenic tobacco was determined with Cd/haemoglobin saturation assay, a polarographic method and western blotting. In addition, seeds from self-fertilized transgenic plants were germinated on medium containing toxic levels of cadmium and scored for tolerance/susceptibility to this heavy metal. The ratio of tolerant to susceptible plants was 3:1 indicating that the metallothionein gene is inherited as a single locus.

Primary structure of apoB-100

Apolipoprotein B-100 (apoB-100) is the major protein in low-density lipoprotein (LDL) and contains the ligand for binding LDL to its cell surface receptor. Lipoprotein [a] (Lp[a]) is a lipoprotein that consists of LDL and apolipoprotein [a] (apo[a]). The primary structure of apoB-100 has been determined by a combination of recombinant DNA and protein sequencing methods. Using high-performance liquid chromatographic techniques, we have identified sulfhydryl and disulfide groups of apoB-100 from LDL. Sixteen of the 25 cysteine residues in apoB-100 exist in disulfide form. All 14 cysteine residues within the N terminal end of apoB-100 are linked in disulfide bridges. Using the fluorescent sulfhydryl probe, 5-iodoacetoamidofluoresceine, two free sulfhydryls of apoB-100 on LDL were identified at positions 3734 and 4190. Based on its differential susceptibility to trypsin, apoB-100 can be divided into five domains: domain 1 (residues 1-1000), largely trypsin-releasable (TR); domain 2 (residues 1001-1700), alternating TR and trypsin non-releasable (TN); domain 3 (residues 1701-3070), largely TN; domain 4 (residues 3071-4100), mainly TR and mixed; and domain 5 (residues 4101-4536), almost exclusively TN. Based on our data, we propose that the structure of apoB-100 in LDL is probably an elongated form that wraps around the LDL particle, and that Cys3734 of apoB-100 may be the cysteine residue linked to a cysteine of apo[a].

Molecular basis of cross-reactivity among allergen-specific human T cells: T-cell receptor V alpha gene usage and epitope structure

Cross-reactivities between the major grass pollen allergens, at the level of T-cell recognition was examined employing several Lolium perenne I (Lol p I)-specific human T-cell clones. Nine of these Lol p I-specific T-cell clones exhibited cross-recognition of the recombinant Poa pratensis IX (Poa p IX) allergen, rKBG7.2, indicating that these two major antigens of a grass pollen share T-cell epitopes. Furthermore, proliferative responses of two other T-cell clones demonstrated that individual allergens of diverse grass pollens also possess common T-cell epitopes. Examination of the T-cell receptor (TcR) V alpha genes of these T-cell clones indicated that these cloned cells utilized distinct J alpha genes and that nine out of 10 clones possessed V alpha 13 gene. Furthermore, sequence comparisons of several allergenic molecules indicated that this cross-reactivity may be due to the presence of epitope(s) with structure(s) similar to the major T-cell epitope of Poa p IX allergens. Taken together, these results suggest for the first time that the major grass pollen allergens share cross-reacting T-cell epitope(s), and that this cross-reactivity is due to the structural homologies among allergens and restricted usage of TcR V alpha genes.

Pedigree analysis of alpha-L-fucosidase gene mutations in a fucosidosis family

Fucosidosis is an autosomal recessive lysosomal storage disease resulting from absence of alpha-L-fucosidase activity. Lymphoid cell lines from two siblings with fucosidosis and a healthy individual (control) had alpha-L-fucosidase mRNA of normal size (2.3 kb) but the level of alpha-L-fucosidase mRNA in the patients' cells was reduced. cDNA was prepared and amplified from alpha-L-fucosidase mRNA of lymphoid cells of the patients, their carrier parents, and the control. Direct DNA sequencing demonstrated three mutations in the fucosidosis family. One mutation, C1282-->T, changed the codon (CAA) for Gln-422 to a stop codon (UAA). This mutation was heterozygous (C and T) in the patients and their father and independently confirms an earlier report (J. Mol. Neurosci. (1989) 1, 177). Another mutation, C247-->T, changed the codon (CAG) for Gln-77 to a stop codon (UAG) and was heterozygous (C and T) in the patients and their mother. The third mutation, A860-->G, changed the codon CAG for Gln-281 to the codon (CGG) for Arg and was heterozygous (A and G) in the patients but homozygous in their father. alpha-L-Fucosidase activity in cells of the father was 37% of controls indicating that homozygosity of the A860-->G mutation did not cause an absence of alpha-L-fucosidase activity and fucosidosis. This mutation probably results in a normal polymorphic variant of alpha-L-fucosidase. It is proposed that the combination of the C247-->T mutation on the maternal allele of the alpha-L-fucosidase gene and the C1282-->T mutation on the paternal allele caused fucosidosis in the patients.

Isolation of a DNA probe for identification of Mycobacterium kansasii, including the genetic subgroup

In order to develop a DNA-based assay to identify all Mycobacterium kansasii clinical isolates, a specific DNA probe was isolated in plasmid p6123. A total of 145 M. kansasii clinical isolates were collected from several countries and were examined with three probes by DNA hybridization. Of the 145 isolates, 115 (79%) were positive with the previously described probe pMK1-9 (Z. H. Huang, B. C. Ross, and B. Dwyer, J. Clin. Microbiol. 29:2125-2129, 1991), 129 (88%) were positive with the commercial Accu-probe assay (Gen-Probe), and 145 (100%) were positive with the p6123 probe. Southern blot analysis of EcoRI-digested M. kansasii chromosomal DNA with p6123 revealed that all Accu-probe-positive M. kansasii strains exhibited a 3-kb fragment, whereas all Accu-probe-negative M. kansasii strains displayed DNA fragments of variable molecular sizes. These results indicate that, unlike the previously described probes for M. kansasii, the fragment cloned into p6123 identified all 145 biochemically typical strains tested and provides an ideal target for future DNA-based speciation assays.

Cutaneous inflammatory pseudotumor: a case report with immunohistochemical and ultrastructural studies

An unusual case of inflammatory pseudotumor of the subcutaneous tissue in a 44-yr old black male who presented with a 4 cm soft tissue mass on the dorsum of right hand is described. The mass was sharply circumscribed and composed of a polymorphous infiltrate of plasma cells, eosinophils, lymphocytes and some giant cells mimicking Reed-Sternberg cells. The giant cells, corresponding ultrastructurally to primitive mesenchymal cells, were immunoreactive for vimentin and were negative for actin, desmin and histiocytic markers. The patient remained well with no sign of recurrence 8 mths postoperatively. The present case is compared with the (4) previously reported cases in literature. The histologic differentiation from other neoplastic and non-neoplastic lesions is discussed.

Primary structure of Beijing duck apolipoprotein A-1

The primary structure of Beijing duck apolipoprotein A-1 was determined by sequencing peptide fragments derived from tryptic and endoproteinase Asp-N digestion of the protein, and alignment with homologous chicken apo A-1. All of the peptide fragments were isolated by high-pressure liquid chromatography (HPLC) with a Vydac C18 column using a trifluoroacetic acid (TFA) buffer system. The N-terminus of the protein was determined to be aspartic acid by directly sequencing 52 residues of the intact protein. The C-terminus was alanine. The protein contains 240 amino acid residues. By analysis of the whole protein and its tryptic peptides, a six amino acid (Arg-Tyr-Phe-Trp-Gln-His) prosegment was determined. No cross-reactivity between duck and human apo A-1 with a goat antiserum against human apo A-1 was found. Sequence analysis of apo A-1 of other species indicates that amino acid substitutions in rat are more extensive than in other mammals. Isoleucine residues in apo A-1 are inversely correlated to the homology of human to other species, except dog.

Construction of multiple copy of alpha-domain gene fragment of human liver metallothionein IA in tandem arrays and its expression in transgenic tobacco plants

Metallothioneins (MT) are low molecular weight, cysteine-rich, metal-binding proteins. An MT molecule contains two domains which appear to act independently--an alpha-domain, which is characterized by cadmium-binding, and a beta-domain, which binds preferentially to copper. Based on this conception, DNA duplex encoding the alpha-domain (106 bp) of human MT-IA was constructed from a chemically-synthesized oligomer by repair synthesis and enzymatic ligation and cloned into pUC19. The genes cloned were sequenced and found to be in the correct order as designed. Synthetic directional adapters were attached to the terminals of the alpha-domain gene fragment of human MT-IA to establish complete control over fragment orientation during ligation. The use of these directional adapters thereby ensured the production of multiple copies of the alpha-domain in tandem arrays. The successive alpha-domains were linked by a peptide linker consisting of 10 residues. A chimeric gene containing 12 cloned tandemly repeated copies of the 106 bp alpha-domain DNA was introduced into tobacco cells on a disarmed Ti-plasmid of Agrobacterium tumefaciens. A total of 10 different transgenic tobacco plants were generated, of which two showed root and shoot growth unaffected by up to 200 mg/l kanamycin and 100 microM cadmium, whereas root growth of control plants was severely inhibited and leaf chlorosis developed on media containing only 10 microM cadmium.

[The distribution of normal oral flora in 49 healthy children and juvenile]

The frequencies and proportions of predominant cultiv ableoral bacteria associated with 49 healthy children and juvenile (6-25 yr old) were studied. A total of 72 bacterial species belonging to 28 genus were detected in 195 samples of saliva, fissure plaque, supragingival plaque, and subgingival plaque. The predominant bacteria were Oral streptococci, Neisseria, Actinomyces, Capnocytophaga, Bacteroides and Fusobacterium in the normal oral cavity of healthy children and juvenile. There were differences in the distribution of the predominant flora, e.g. Fusobacterium and Bacteroides had higher incidence and proportion in the subgingival plaque than in the fissure plaque.

An ionic current model for neurons in the rat medial nucleus tractus solitarii receiving sensory afferent input

1. Neurons from a horizontal slice of adult rat brainstem were examined using intracellular recording techniques. Investigations were restricted to a region within the nucleus tractus solitarii, medial to the solitary tract and centred on the obex (mNTS). Previous work has shown this restricted area of the NTS to contain the greatest concentration of aortic afferent baroreceptor terminal fields. Electrical stimulation of the tract elicited short-latency excitatory postsynaptic potentials in all neurons. 2. mNTS neurons were spontaneously active with firing frequencies ranging between 1 and 10 Hz, at resting potentials of -65 to -45 mV. These neurons did not exhibit spontaneous bursting activity. 3. Depolarizing current injection immediately evoked a finite, high-frequency spike discharge which rapidly declined to a lower steady-state level (i.e. spike frequency adaptation, SFA). Increasing depolarizations produced a marked increase in the peak instantaneous frequency but a much smaller increase in the steady-state firing level. 4. Conditioning with a hyperpolarizing prepulse resulted in a prolonged delay of up to 600 ms before the first action potential (i.e. delayed excitation, DE) with an attendant decrease in peak discharge rates. DE was modulated by both the magnitude and duration of the prestimulus hyperpolarization, as well as the magnitude of the depolarizing stimulus. Tetrodotoxin (TTX) eliminated spike discharge but had little effect on the ramp-like membrane depolarization characteristic of DE. 5. We have developed a mathematical model for mNTS neurons to facilitate our understanding of the interplay between the underlying ionic currents. It consists of a comprehensive membrane model of the Hodgkin-Huxley type coupled with a fluid compartment model describing cytoplasmic [Ca2+]i homeostasis. 6. The model suggests that (a) SFA is caused by an increase in [Ca2+]i which activates the outward K+ current, IK,Ca, and (b) DE results from the competitive interaction between the injected depolarizing current and the hyperpolarization-activated transient outward K+ currents, IA and ID. 7. We conclude that our ionic current model is capable of providing biophysical explanations for a number of phenomena associated with brainstem neurons, either during spontaneous activity or in response to patterned injections of current. This model is a potentially useful adjunct for on-going research into the central mechanisms involved in the regulation of both blood pressure and ventilation.

Identification of an insertion sequence-like element in a subspecies of Mycobacterium kansasii

Analysis of a genomic DNA clone library of a strain from the genetic subspecies of Mycobacterium kansasii determined the existence of a repetitive insertion sequence-like element. The element is 947 bp long and is present in a minimum of 1 to 11 copies per genome. Similar to insertion sequences, it contains a 3-bp (TAG) direct repeat at its extremities and a transcription promoter-like sequence. In addition, for one of the clones sequenced, a potential cointegrate formation, a characteristic frequently observed with insertion sequences, was revealed. This insertion sequence does not contain short inverted repeats near the ends or a large open reading frame to code for a transposase enzyme. Its host range is restricted to a previously described genetic subspecies of M. kansasii and is not present in typical M. kansasii or other mycobacterial species. When used as a probe for Southern blot hybridization, significant heterogeneity between different isolates of the M. kansasii subspecies was observed. This repeated element will be useful in further studies on the characterization, diagnosis, and epidemiology of M. kansasii.

Human very low density lipoprotein structure: interaction of the C apolipoproteins with apolipoprotein B-100

Very low density lipoproteins (VLDL) are a heterogenous population of particles differing in size and composition. Heparin-Sepharose chromatography yields three VLDL subfractions. Two subfractions, VLDLNR-1 and VLDLNR-2, which are not retained by heparin, contain little or no detectable apolipoprotein (apo)E. According to negative stain electron microscopy, VLDLNR-1 is slightly larger than VLDLNR-2. The third fraction, VLDLR, is composed of smaller particles that are retained by the heparin-Sepharose and contain apoE. The C apolipoproteins of the respective VLDL subfractions transfer to 1-palmitoyl-2-oleoyl phosphatidylcholine (POPC) single bilayer vesicles giving three subfractions designated VLDLNR-1-C, VLDLNR-2-C, and VLDLR-C. The protein, phospholipid, and cholesterol (free + esterified) contents decrease in the order VLDLR > VLDLNR-2 > VLDLNR-1. Triglyceride content decreases in the opposite order. POPC treatment of each VLDL subfraction increases the phospholipid and decreases the protein, triglyceride, and cholesteryl ester contents, while free cholesterol remains unchanged. According to immunological analysis of each subfraction with well-characterized monoclonal antibodies, the accessibility of some epitopes of apoB-100 on VLDL is changed by POPC treatment. Electron-microscopic analysis of POPC-treated VLDL subfraction reveals vacancies on the surfaces of each particle. VLDLNR-1, VLDLNR-2, and VLDLR are resistant to thrombin cleavage, whereas the lipoproteins lacking C apolipoproteins are not. Thrombin cleavage (8 h) of apoB-100 of VLDLNR-2-C and VLDLR-C gives two fragments, T1 and T2, that are converted to smaller fragments only after prolonged treatment. In contrast, apoB-100 of VLDLNR-1-C is converted into small fragments after 8 h thrombin treatment. These results suggest that removal of apoCs affects the accessibility and conformation of apoB-100 in the individual VLDL subfractions in the region near residue 3249, which is the primary thrombin cleavage site and the epitope of monoclonal antibody 4C11.

Involvement of antioxidant enzymes in multiple-drug resistance in a human T-lymphoblastic leukemia-cell line which over-expresses p-glycoprotein

We have compared the specific activities of Cu/Zn superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) in a vinblastine sensitive human T-lymphoblastic cell line (CCRF-CEM) and its multiple drug resistant (MDR) counterpart cell line (CEM/VLB100), which over-expresses P-glycoprotein (PGP). We have found that the specific activity Cu/Zn SOD was consistently 38% increased in CEM/VLB100 cells compared with CCRF-CEM cells. In contrast, the activities of CAT and GSH-Px were similar in the two cell lines. These results suggest that MDR in CEM/VLB100 is a complicated phenotype which not only involves a PGP mechanism, but also a SOD protection mechanism against drug-mediated O2.- cytotoxicity.

Expression of IGF-II/Man-6-P receptors on rat, rabbit, and human colon epithelial cells

Previous experiments from this laboratory have established the presence of receptors for insulin and insulin-like growth factor I (IGF-I) on apical membranes prepared from rabbit colon epithelial cells; however, no receptors for multiplication-stimulating activity (MSA), the rat peptide hormone equivalent of human IGF-II, were found in this tissue. In the current studies, radioligand binding assays, covalent cross-linking experiments, and immunoblot analyses using a polyclonal rabbit antiserum that recognizes the IGF-II/mannose 6-phosphate (Man-6-P) receptor, all confirmed the presence of IGF-II/Man-6-P receptors on membranes prepared from rat and human colon epithelial cells. Exposure of rat colon epithelial cell membrane fractions to 5 mM Man-6-P before incubation with 125I-labeled IGF-II increased radioligand binding. Immunoblot analysis indicated that IGF-II/Man-6-P receptors were present in both unfractionated rat colon membranes and fractions enriched with apical membranes. Rabbit and human colon epithelial cells displayed a different pattern of receptor distribution than rat colon epithelial cells, with more insulin receptors but relatively few IGF-II/Man-6-P receptors. Immunohistochemical studies using a rabbit polyclonal antiserum confirmed that IGF-II/Man-6-P receptors were present on both the apical and the basolateral surfaces of colon epithelial cells.

Effect of sulfhydryl reagents on spectrin states on the erythrocyte membrane

The unique properties of erythrocytes are largely determined by its fibrillar network under the plasma membrane. Spectrin, one major component of the membrane skeleton, has been suggested to play a central role in this process. To understand the mechanism underlying this process, the effect of the sulfhydryl groups of erythrocyte membrane on spectrin structure and function was studied. By using non-denaturing gel analysis, dithiothreitol was found to protect spectrin in its tetramer state. In contrast, iodoacetamide and N-ethylmaleimide enhanced conversion of the spectrin tetramer to dimer and decreased its binding to the membrane. Moreover, when the membrane was treated with cadmium, the tetramer was converted to the dimer on the membrane, while zinc had no effect. Hemolysis experiments showed that cadmium could lyse erythrocytes in vitro. These results indicated that preservation of the spectrin tetramer or even higher oligomer states, by the sulfhydryl groups may be important to the membrane integrity and the intact cell functions.

Effects of intermediate metabolites of 37 xenobiotics on the catalytic activities of reconstituted cytochrome P-450IIB1 and P-450IA1 enzyme systems

Direct effects of intermediate metabolites of 37 different xenobiotics on the catalytic activities of both reconstituted cytochrome P-450IIB1 and P-450IA1 enzyme systems were studied by determination of NADPH oxidation at various intervals after initiation of the reaction. The results showed that cytochrome P-450IIB1 isozyme was much more likely than cytochrome P-450IA1 isozyme to be attacked by the reactive intermediates formed by some xenobiotics with smaller molecular weight and lose its catalytic activities. These xenobiotics were carbon tetrachloride, chloroform, carbon disulfide, benzene, parathion, methylparathion, methyldursban and dimethylnitrosamine. In contrast, however, steadily increasing metabolic activities were observed towards benzo(a)pyrene, 3-methylcholanthrene and polychlorinated biphenyls in reconstituted cytochrome P-450IA1 enzyme system as the reaction time prolonged within 4 min. The method discussed in this paper could be used as a simple and convenient way to observe directly the autocatalytic destruction of P-450 enzymes by some chemical agents.

High field proton NMR investigations of the metabolic profiles of multidrug-sensitive and -resistant leukaemic cell lines: evidence for diminished taurine levels in multidrug-resistant cells

High field proton (1H) nuclear magnetic resonance (NMR) spectroscopy has for the first time been employed to investigate and compare the metabolic profiles of vinblastine-sensitive and -resistant T-lymphoid leukaemic cell lines (CCRF-CEM and CEM/VLB100 respectively) and evidence is presented for a significantly lower taurine content in the CEM/VLB100 resistant subline when expressed relative to that of its drug-sensitive parental counterpart. These data suggest differences in the nature and relative involvements of taurine biosynthetic pathways between the two cell lines, a phenomenon that may be related to their differing sensitivities towards chemotherapeutic agents such as adriamycin which promote the generation of cytotoxic reactive oxygen species (ROS) in vivo. However, the 1H NMR data obtained provided no evidence for an increased metabolic consumption of hypotaurine (a metabolic precursor of taurine with powerful .OH radical scavenging properties) in CCRF-CEM cells since differences observed in the hypotaurine: taurine concentration ratio between the drug-sensitive and -resistant cell lines were not statistically significant. Furthermore, hypotaurine is unlikely to compete with alternative endogenous .OH radical scavengers present such as lactate since its level in either of the two cell lines investigated (ca. 6.0 x 10(-8) mol./10(8) cells) is insufficient for it to act as an antioxidant in this context. The biochemical and therapeutic significance of these results are discussed.

A mutation generating a stop codon in the alpha-L-fucosidase gene of a fucosidosis patient

Fucosidosis is an autosomal recessive, lysosomal storage disease featured by deficient activity of alpha-L-fucosidase. Lymphoid cell lines from a fucosidosis patient (JT) and a healthy individual (control) contained alpha-L-fucosidase mRNA of the same size, 2.3 Kb, as determined by Northern blot analysis. cDNA was prepared from alpha-L-fucosidase mRNA of JT and control cells and each cDNA was amplified by the polymerase chain reaction. Direct DNA sequencing of the amplified products revealed a single mutation in JT, a G1141-->T transition. This changed the codon (GAA) for Glu-375 to a stop codon (UAA). Amplification and sequencing of the area containing the G1141-->T transition in genomic DNA of JT and control cells demonstrated that the mutation was homozygous in JT. Analysis of cDNA and genomic DNA derived from lymphoid cells of mother JT revealed her to be heterozygous (G and T) at position 1141. The G1141-->T mutation is probably responsible for disease in JT.

Identification of a genetically distinct subspecies of Mycobacterium kansasii

To assess the usefulness of a specific DNA probe for Mycobacterium kansasii, 105 isolates from Australia, Belgium, Japan, South Africa, and Switzerland were collected and analyzed. Twenty of these isolates were probe negative, of which 18 were from Belgium and Switzerland. Analysis of all isolates by Southern blot hybridization indicated a lack of variability among probe-positive isolates, while probe-negative isolates were clearly distinct and showed greater diversity. Sequence analysis of the 250 nucleotides at the 5' end of the 16S rRNA gene revealed that 19 of the 20 probe-negative isolates had a sequence different from that of M. kansasii. A total of five nucleotide differences were present in a cluster consisting of two nucleotide deletions and three nucleotide substitutions. These results suggest the existence of a genetic subspecies of M. kansasii.

[Cytological observation on culture of embryo in vitro of Tripterygium hypoglaucum (level.) Hutch]

This paper for the first time reports the embryo culture in vitro of Tripterygium hypoglaucum. Callus, adventitious roots and adventitious protuberances were induced from the cultured embryos in vitro. Multi-buds at the excised embryo tip were also observed at the same time. Cytohistological examination showed (1) callus was histologically easy to be induced to form adventitious roots; (2) callus on the cotyledons was originated from the epidemical and subepidemical cells of the cotyledons, and the adventitious roots were originated from the disperse meristematic tissue or vascular tissue in the callus obtained from cultured excised embryos.

Identification of the promoter region of the Escherichia coli major cold shock gene, cspA

The major cold shock protein of Escherichia coli, CS7.4, is produced at a level of 13% of total protein synthesis upon a temperature shift from 37 to 10 degrees C. The transcription of its gene (cspA) was found to be tightly regulated and induced only at low temperature. In addition, the cspA mRNA was extremely unstable at 37 degrees C, so that CS7.4 production was hardly detected when the culture temperature was shifted from 15 degrees C to 37 degrees C. The transcription initiation site (+1) was identified. In vivo footprinting demonstrated that the region from bases -35 to -73 was protected from chemical modification, and gel mobility shift analysis showed that a cold-shocked cell extract contained a factor(s) specifically bound to the fragment containing the sequence between bases -63 and -92. This factor was synthesized de novo only at low temperature, and its synthesis was inhibited by chloramphenicol. Possible functions of this factor are discussed.

Localization and retention in vitro of fluorescently labeled aortic baroreceptor terminals on neurons from the nucleus tractus solitarius

The anterograde fluorescent tracer DiA was used to visualize baroreceptor fibers and synaptic terminals both in living and fixed tissue. Baroreceptor fibers labeled with DiA terminated as a dense synaptic field in the medial nucleus tractus solitarius (NTS), making synaptic contact on the soma, as well as processes of neurons that they innervated. A similar distribution and morphology was observed in baroreceptor fibers and terminals labeled with horseradish peroxidase. DiA also identified baroreceptor terminals and the neurons receiving these synaptic contacts in vitro. NTS neurons were dissociated from their surrounding tissue and identified by attached baroreceptor terminals that retained the fluorescent dye. These results will enable us to study the electrophysiological properties of dispersed neurons that receive identified baroreceptor synaptic terminals.

Gadolinium and mechanotransduction of rat aortic baroreceptors

The cellular mechanisms enabling baroreceptors to transduce wall distortion into axonal discharge are unknown but might involve stretch-activated ion channels. Gadolinium (Gd3+, 10 microM) blocks stretch-activated channels in several preparations. Here we tested Gd3+ effects on discharge responses of 15 single-fiber baroreceptors in vitro. We simultaneously measured discharge, pressure, and aortic diameter at Gd3+ concentrations from 0.001 to 400 microM. High levels of Gd3+ added to a bicarbonate-buffered perfusate (Krebs) slightly shifted the pressure-discharge relation (less than 4 mmHg, n = 3, P = 0.01) without affecting slope or discharge frequency at threshold. Gd3+ in Krebs variably altered the pressure-diameter relation. Because 500 microM Gd3+ produced visible precipitate in Krebs, we tested Gd3+ in a simpler perfusate using N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid (HEPES). Gd3+ in HEPES (n = 10) induced minor, but statistically significant, average increases in threshold (less than +5-7%) and no changes in gain. However, prolonged HEPES exposure alone (n = 2) produced similar shifts. Electron microscopy verified that Gd3+ diffused from the lumen to reach extracellular locations near baroreceptor endings. We conclude that 1) HEPES perfusate alone reversibly depresses baroreceptor discharge and 2) Gd3+ has no direct effects on baroreceptors. Thus it appears that aortic baroreceptor mechanotransduction must utilize a different class of stretch-activated ion channels.

The accuracy of catheter-tip pressure transducers for the measurement of intrauterine pressure in labour

OBJECTIVE

To assess the reliability of intrauterine pressure measurements in labour with transducer tipped catheters.

DESIGN

Prospective clinical study.

SETTING

Delivery ward, National University Hospital, Singapore.

SUBJECTS

20 women admitted in early labour were randomly allocated to two groups.

INTERVENTIONS

Women in the first group had two catheters that had been tied together introduced transcervically into the same amniotic fluid pocket. The second group had two catheters introduced in different directions so that each catheter tip was in a different pocket of amniotic fluid.

MAIN OUTCOME MEASURE

The contraction to contraction pressure difference recorded by the two catheters in the same uterus. In addition, the cumulative uterine active pressure generated by one catheter was compared with that of the other.

RESULTS

There were differences in peak pressure of up to 4-5.3 kPa (30-40 mmHg) during some contractions. The difference in pressure recordings between the two catheters could not be explained by effects of loculation of amniotic fluid. However, the pressures recorded were not systematically higher in one catheter than in the other. Cumulative uterine activity was very similar when assessed by each catheter in the same uterus.

CONCLUSION

Intrauterine pressure measurements using transducer tipped catheters provide reliable information on the cumulative pressure wherever the catheter tip was sited in the uterus, but there are variations in pressures recorded during individual contractions.

Comparative study of 99mTc-HM-PAO SPECT brain imaging, EEG and CT scanning in epileptic patients during the interictal period

Forty patients with epilepsy in the interictal period were studied with 99mTc (HM-PAO) SPECT brain imaging, EEG and CT scanning. Four cases of generalized epilepsy had normal findings on EEG, SPECT imaging and CT scanning. Two cases of childhood benign partial seizures had abnormal EEG, but the SPECT brain imagings were normal. Regional hypoperfusions of various extents were found in 20 of the 34 patients with complex partial seizures. Among the 34 patients, 17 had abnormal EEG and 8 had abnormal CT scans. A good topographic concordance between regional HM-PAO hypofixation and EEG foci was found (39.1%). Localization of the lesion by SPECT imaging and CT scan was coincident in 5 cases (27.8%). The correlation between these three examination methods is discussed.