On the viscoelastic properties of the anteromedial bundle of the anterior cruciate ligament

The nonlinear viscoelastic properties of the anteromedial (AM) bundle of porcine anterior cruciate ligament (ACL) were characterized by using a new analytical approach based on the quasi-linear viscoelastic theory. Stress relaxation and cyclic tensile tests were performed. Using the solution derived from this approach, we curve-fitted data from the stress relaxation test to determine the viscoelastic coefficients for the ligament bundles. The coefficients were verified by comparison of the predicted and the experimental results from the cyclic tensile test. The ACL AM bundle exhibited significant stress relaxation with time; a reduction of more than 50% of the peak value occurred during the 2-h experiment. Also, the reduced relaxation function for the ACL AM bundle was not a linear function of logarithmic time, as is commonly assumed for many soft tissues. The new approach, which takes into account the finite strain rate of the ramp function used in the stress relaxation test, provides an accurate description of this nonlinear stress relaxation behavior.

Hepatic gene therapy: adenovirus enhancement of receptor-mediated gene delivery and expression in primary hepatocytes

We have combined a receptor-mediated DNA delivery system with the endosomal lysis ability of adenovirus and shown that DNA can be delivered into primary hepatocytes, resulting in a high level of gene expression. When asialoorosomucoid conjugated with poly(L-lysine) was used to deliver the Escherichia coli beta-galactosidase gene into primary hepatocytes through binding with the hepatic asialoglycoprotein receptor, only a low level of beta-galactosidase was detectable, with less than 0.1% of the hepatocytes being transfected. This level of activity can be greatly enhanced by the cointernalization of the DNA.protein complex with a replication-defective adenovirus, resulting in 100% of the hepatocytes staining blue with 5-bromo-4-chloro-3-indolyl beta-D-galactoside. Quantitative analysis of beta-galactosidase expression also showed a 1000-fold enhancement of activity. To test the applicability of this DNA delivery system for the correction of phenylketonuria, a metabolic disorder that causes severe mental retardation in children, we have delivered the human phenylalanine hydroxylase (PAH) gene to hepatocytes derived from a PAH-deficient mouse strain and demonstrated complete reconstitution of enzymatic activity. This method shows great promise for efficient gene delivery to the liver for correction of hepatic disorders.

Hamstrings--an anterior cruciate ligament protagonist. An in vitro study

A cadaveric model that incorporated quadriceps and hamstrings muscle loads was developed to simulate the squat exercise. The addition of hamstrings load affected knee kinematics in two ways. First, anterior tibial translation during flexion ("femoral roll-back") was significantly reduced (P = 0.003) and second, internal tibial rotation during flexion was reduced (P = 0.008). However, quadriceps force was unaffected by the addition of hamstrings load. Thus, it seems likely that hamstrings muscle activity that has been observed in vivo during a squat probably functions synergistically with the anterior cruciate ligament to provide anterior knee stability. After the ACL was sectioned, anterior tibial translation was significantly increased during the squat (P = 0.04). The anterior cruciate ligament was then reconstructed using a graft instrumented with a load cell. During passive motion, maximal graft tension was at full extension. During simulated squat exercise, the addition of hamstrings caused a significant decrease in graft load (P = 0.006). During the squat, maximal graft tension was at full extension, and was equal to the graft tension at full passive extension. Thus, the squat exercise may be useful in the early stages of anterior cruciate ligament rehabilitation.

Methods for electrophoretic karyotyping of filamentous fungi in the genus Trichoderma

Methods for electrophoretic karyotyping of filamentous fungi in the genus Trichoderma were developed. These techniques permitted the separation and visualization of intact chromosomes from viable protoplasts. Three strains were analyzed: Trichoderma harzianum strains T12 his-2 and T95 lys-1, and a prototrophic strain (1295-22) produced by protoplast fusion of T12 his-2 with T95 lys-1. Four chromosome bands ranging in size from 2.2 Mb (megabase pairs) to 5.4 Mb were visualized with strain T95 lys-1, whereas two chromosome bands were visualized for strains T12 his-2 and 1295-22. The largest chromosome of all three strains seems to be similar in size and has been estimated to be approximately 5.4 Mb. All remaining chromosomes observed were dissimilar in size. Methods for protoplast isolation, protoplast embedding, and electrophoretic conditions useful for separation of intact chromosomes ranging in size from 50 kb (kilobase pairs) up to approximately 6.0 Mb utilizing transverse alternating field electrophoresis (TAFE) will be discussed. The techniques provided should be applicable to a variety of lower eukaryotic organisms when using the TAFE system.

A missense mutation, S349P, completely inactivates phenylalanine hydroxylase in north African Jews with phenylketonuria

The majority of hyperphenylalaninemias (HPAs) result from mutations at the gene for phenylalanine hydroxylase (PAH). The broad phenotypic variability of these conditions, ranging from phenylketonuria (PKU) to mild benign HPA, is underlain by a wide spectrum of mutations giving rise to various genotypic combinations. Mutant PAH alleles, labeled by specific polymorphic haplotypes and mutations, are becoming useful markers in human population genetics. We report here a mutant PAH allele found in Jews from Morocco and Tunisia, marked by haplotype 4 and a missense mutation, TCASer-->CCAPro, at codon 349 in exon 10 of the gene. In vitro expression of the mutation showed normal levels of mRNA with virtually no enzymatic activity or protein immunoreactivity, pointing to a highly unstable protein. A homozygote for this mutation showed the most severe ("classical") type of PKU, while compound heterozygotes showed two other types of HPA--"atypical" PKU and "high benign" HPA--illustrating the interplay between different mutations that gives rise to various HPAs.

Relation between genotype and phenotype in Swedish phenylketonuria and hyperphenylalaninemia patients

Phenylketonuria (PKU) and hyperphenylalaninemia (HPA) are caused mostly by an inherited (autosomal recessive) deficiency in hepatic phenylalanine hydroxylase (PAH) activity. More than 50 PAH mutations have ben reported. The goal of the present study was to examine the molecular basis for the clinical heterogeneity of Swedish PKU and HPA patients. Mutations were identified through allele-specific oligonucleotide hybridization or DNA sequencing on 128 of the 176 mutant alleles (73%). Three mutations (R408W, Y414C and IVS12) together accounted for 56% of all mutant alleles and ten relatively infrequent mutations were found on another 17% of all mutant alleles. Patients from 50 of the 88 families (57%) had identified mutations in both PAH genes and allowed use to compare the clinical effects of different combinations of PAH mutations. The in vitro activity of all of these mutations, including the newly identified G272X and delta L364, have been tested in a eukaryotic expression system. There was a strong relationship between the average in vitro PAH activity of the two mutant enzymes and both the phenylalanine tolerance and the neonatal pretreatment serum phenylalanine concentration. This confirms previous observations in Danish and German PKU patients that disease phenotype is a consequence of the nature of the mutations at the PAH locus and not significantly influenced by other loci. The sample population in the previous study did not, however, include mild HPA patients, and the observed correlation is thus restricted to severe and moderate mutant alleles. Since a comparatively high proportion of the Swedish patients were mildly affected, we have provided additional evidence that this correlation is valid throughout a continuous spectrum of clinical varieties.(ABSTRACT TRUNCATED AT 250 WORDS)

The mechanical properties of skeletally mature rabbit anterior cruciate ligament and patellar tendon over a range of strain rates

The effect of strain rate on the mechanical properties of the rabbit anterior cruciate ligament (ACL) and patellar tendon (PT) was evaluated. The medial portion of the ACL was loaded to tensile failure at rates of 0.003, 0.3, and 113 mm/s, and the middle third of the PT was loaded at rates of 0.008, 0.8, and 113 mm/s. The load was recorded with a high-speed measurement plotting system, and each test was videotaped for strain analysis. The nonlinear portion of the stress-strain curve was curve-fit to an exponential function having two nonlinear constants, representing the initial modulus and rate of change of the modulus. The modulus of the rabbit PT was found to be 89% higher than that of the ACL. The initial modulus and rate of change of the modulus also were greater for the PT than for the ACL. The modulus of the PT was shown to be more sensitive to strain rate than that of the ACL; a 94% increase was observed for the PT, and a 31% increase was observed for the ACL. There was no effect of strain rate on the mode of failure of either the ACL or the PT; all but three of the specimens failed at the insertion site.

Three polymorphisms but no disease-causing mutations in the proximal part of the promoter of the phenylalanine hydroxylase gene

The proximal promoter region of the human phenylalanine hydroxylase (PAH) gene was analyzed for the presence of mutations in 122 European phenylketonuria (PKU) and hyperphenylalaninemia patients having altogether 187 uncharacterized mutant PAH alleles. This promoter fragment, which contained the most 5' transcription start site and about 300 bp upstream, was sequenced directly from polymerase-chain-reaction-amplified genomic DNA. No disease-causing mutations but three neutral nucleotide substitutions were found. A -195 T-to-C transition was present on 1% of 441 normal and 0.3% of 653 mutant chromosomes. All chromosomes that carried this transition and to which a restriction fragment length polymorphism (RFLP) haplotype had been assigned were of haplotype 1. A -71 G-to-A change and a +7 C-to-T change were always observed together and were found on 1% of 425 normal and 4% of 681 mutant chromosomes. In addition, these two transitions were found in seven heterozygote samples where the phase could not be established due to incomplete family samples. In individuals where RFLP haplotypes were known and phase could be established, these linked substitutions were associated with RFLP haplotype 9. The relatively high frequency (10-20%) of these two polymorphisms on PKU chromosomes from Great Britain, Ireland and France may reflect a relative concentration of haplotype 9 alleles among PKU chromosomes from these countries compared to the rest of Europe. The absence of disease-causing mutations within a region of the PAH gene that possesses basal promoter activity suggests that transcriptional mutations are not likely causes of PKU in Caucasian populations.

Morphologic and biomechanical comparison of tendons used as free grafts

The palmaris longus (n = 10), plantaris (n = 11), and extensor digitorum longus (n = 10) tendons were harvested from cadaver limbs for morphologic and biomechanical comparisons. Eleven flexor digitorum profundus tendons from the index finger were also harvested for comparison of biomechanical properties of the free graft tendons with those of a typical digital flexor. Maximal tendon length, cross-sectional area, volume, stiffness, and modulus of elasticity were determined by measurement, laser micrometry, and tensile testing. The plantaris and extensor digitorum longus yielded the longest grafts, 334 and 325 mm, respectively, compared with the palmaris longus, which yielded only 161 mm of length. Cross-sectional areas were as follows: palmaris longus, 3.1 mm2; plantaris, 1.4 mm2; extensor digitorum longus, 3.3 mm2; and flexor digitorum profundus, 10.6 mm2. Mean volumes were as follows: palmaris longus, 529 mm3; plantaris, 557 mm3; and extensor digitorum longus, 1006 mm3. The palmaris longus and the extensor digitorum longus showed greater stiffness, 42.0 and 47.8 N/mm, respectively, than the plantaris, which had a stiffness of 25.5 N/mm. However, the flexor digitorum profundus showed significantly greater stiffness than all of the graft tendons. The modulus of elasticity ranged from 1161.6 to 1673.0 MPa, with no significant difference between tendons tested. The findings in this study provide data that may be useful in the selection of a specific donor for free tendon grafting.

Hepatic gene therapy: persistent expression of human alpha 1-antitrypsin in mice after direct gene delivery in vivo

The liver represents an excellent target organ for gene therapy. The current strategy for hepatic gene therapy involves the isolation of primary hepatocytes from a resected liver lobe, transduction of therapeutic genes in vitro followed by autologous hepatocellular transplantation. This ex vivo approach is a rather complex procedure in its entirety; thus, a simple method for direct gene delivery into hepatocytes in vivo has been developed. The procedure involves partial hepatectomy followed by the portal vein infusion of recombinant retroviral vectors. Histological analysis of hepatocytes after in vivo delivery of a recombinant retrovirus bearing the E. coli beta-galactosidase gene showed that 1-2% of the parenchymal cells were transduced. Direct hepatic transfer of human alpha 1-antitrypsin cDNA under the transcriptional direction of the albumin promoter-enhancer led to constitutive expression of the human protein in the sera of recipients at concentrations of 30-1,400 ng/ml for at least 6 months. The experimental animals showed no signs of illness and histologic analysis of the liver revealed no evidence of pathologic abnormalities. The results suggest that the in vivo approach is an attractive alternative for hepatic gene therapy.

Structural characterization of the 5' regions of the human phenylalanine hydroxylase gene

Human phenylalanine hydroxylase (PAH) is expressed in a liver-specific manner and catalyzes the enzymatic conversion of phenylalanine to tyrosine. Genetic deficiency of PAH results in the autosomal-recessive disorder phenylketonuria (PKU). Through the application of genomic and cDNA cloning, primer extension studies, SI mapping experiments, and PCR methodologies, the transcription initiation (CAP) site has been identified and the 5'-flanking region determined. The most upstream CAP site for the human hepatic PAH gene transcript is located 154 nucleotides upstream of the first translation codon. The genomic and cDNA sequences analyzed demonstrated that the previously reported cDNA sequence, phPAH247 [Kwok et al. (1985) Biochemistry 24, 556-561], contained a 164-nucleotide cloning artifact at its 5'-end. The 319 base pair region immediately upstream of the CAP site is characterized by the lack of a proximal TATA box and the presence of sequences similar to GC boxes, CACCC boxes, CCAAT boxes, activator protein 2 (Ap-2) sites, partial glucocorticoid response elements (GREs), and partial cyclic AMP response elements (CREs). This suggests that the human PAH gene has a TATA-less promoter regulated by multiple transcription factors.

Associations between mutations and a VNTR in the human phenylalanine hydroxylase gene

The HindIII RFLP in the human phenylalanine hydroxylase (PAH) gene is caused by the presence of an AT-rich (70%) minisatellite region. This region contains various multiple of 30-bp tandem repeats and is located 3 kb downstream of the final exon of the gene. PCR-mediated amplification of this region from haplotyped PAH chromosomes indicates that the previously reported 4.0-kb HindIII allele contains three of these repeats, while the 4.4-kb HindIII allele contains 12 of these repeats. The 4.2-kb HindIII fragment can contain six, seven, eight, or nine copies of this repeat. These variations permit more detailed analysis of mutant haplotypes 1, 5, 6, and, possibly, others. Kindred analysis in phenylketonuria families demonstrates Mendelian segregation of these VNTR alleles, as well as associations between these alleles and certain PAH mutations. The R261Q mutation, associated with haplotype 1, is associated almost exclusively with an allele containing eight repeats; the R408W mutation, when occurring on a haplotype 1 background, may also be associated with the eight-repeat VNTR allele. Other PAH mutations associated with haplotype 1, R252W and P281L, do not appear to segregate with specific VNTR alleles. The IVS-10 mutation, when associated with haplotype 6, is associated exclusively with an allele containing seven repeats. The combined use of this VNTR system and the existing RFLP haplotype system will increase the performance of prenatal diagnostic tests based on haplotype analysis. In addition, this VNTR may prove useful in studies concerning the origins and distributions of PAH mutations in different human populations.

Molecular biology and genetics of alpha 1-antitrypsin deficiency

The use of advanced recombinant DNA technology has provided an improved understanding of the human AAT deficiency phenotype by providing the amino acid sequence of several variant proteins and by allowing for the production of various cell and animal models to study the molecular and biochemical components of the retention, degradation, and accumulation of these variants in the hepatic ER. Human AAT deficiency will continue to serve as an excellent model for enhancing our current understanding of mechanisms utilized in regulating protein "traffic" in the ER and in elucidating the pathophysiologic components of AAT-related liver disease.

Biomechanics of the human anterior cruciate ligament. Muscle stabilization and ACL reconstruction

Several topics of debate surround the surgical reconstruction of the anterior cruciate ligament (ACL), including graft selection, reconstructive technique, and postoperative rehabilitation. The tensile properties of the human ACL and the role of this ligament in the normal kinematics of the knee have been addressed in the first part of this two-part review. This portion of the review will focus on the effects of reconstruction technique, initial graft tension, and muscular stabilization on knee kinematics.

Tissue- and development-specific expression of the human phenylalanine hydroxylase/chloramphenicol acetyltransferase fusion gene in transgenic mice

Human phenylalanine hydroxylase (PAH) catalyzes the conversion of L-phenylalanine to L-tyrosine. Deficiency of this enzyme results in phenylketonuria, a common genetic disorder of amino acid metabolism that causes severe mental retardation. In primates, PAH is expressed specifically in the liver, while in rodents PAH activity is also present in kidney, although at a much lower level. A 9-kilobase genomic DNA fragment at the 5' end of the hPAH gene (hPAH) was fused to the bacterial chloramphenicol acetyltransferase (CAT) gene. The hPAH/CAT minigene was used to generate multiple transgenic mouse lines. In all expressing lines, CAT activity was detected predominantly in the liver and at much lower levels in the kidney. By immunohistochemical staining, CAT expression was localized to hepatocytes and renal epithelial cells, both of which also express the endogenous mouse PAH enzyme. Furthermore, both the transgene and the endogenous mouse PAH were activated at about the same stage of embryonic development in the mouse liver. These results suggest that the 9-kilobase DNA fragment flanking the 5' end of the human PAH gene contains all the necessary cis-acting elements to direct tissue- and developmental-specific expression in vivo.

Healing of the medial collateral ligament following a triad injury: a biomechanical and histological study of the knee in rabbits

The effect of a partial medial meniscectomy and anterior cruciate ligament (ACL) transection on medial collateral ligament (MCL) healing was studied in skeletally mature rabbits. Two groups of animals, group I (isolated MCL rupture) and group II (MCL rupture with ACL transection and partial medial meniscectomy), were examined. At 6 and 12 weeks postoperatively, histological examination of the healing MCL and biomechanical evaluation of the varus-valgus (V-V) knee rotation and tensile properties of the femur-MCL-tibia complex (FMTC) were performed. Group II animals experienced substantial joint degeneration by 6 weeks. Progressive osteophyte formation was observed adjacent to the MCL insertions along with proximal migration of the MCL tibial insertion between 6 and 12 weeks. Histologic examination of the healing MCL substance from both groups showed disorganized collagen, inflammation, and fibroblast proliferation that decreased over time. For group II knees, the V-V knee rotation was found to be significantly elevated (4.7 to 5.2 times the contralateral control), and did not decrease with time. In contrast, the V-V knee rotations of the group I specimens were 1.8 times greater than control immediately following injury, and approached control values by 12 weeks. Tensile testing of the FMTCs revealed that the ultimate load increased with time for both groups, but group I had significantly higher values than group II. The linear stiffness in group I was not different than that group II and did not increase with time. For the mechanical (material) properties of the healed MCL substance, the modulus of the healing tissue for group II was only 40% that of group I. The structural properties of the FMTC and the mechanical properties of the MCL substance from both groups at 6 and 12 weeks were significantly different from the contralateral controls. We further demonstrated that immediately after ACL reconstruction, the V-V rotation of group II knees could be restored to group I levels. Recent clinical studies of MCL healing following isolated complete ligament tears have suggested that nonoperative management without immobilization leads to excellent treatment outcome. However, in more severe injuries involving additional tissues, poor quality of the healed ligament tissue and articular degeneration are observed. Our results demonstrate the deleterious effects of an untreated triad injury on the healing of the MCL substance and its insertions. Examination of the MCL substance suggests that a much larger healing mass is formed following a triad injury, which partially compensates for inferior ligament mechanical properties.(ABSTRACT TRUNCATED AT 400 WORDS)

Identification of three novel missense PKU mutations among Chinese

Three novel missense mutations have been identified in the phenylalanine hydroxylase (PAH) genes of Chinese individuals afflicted with various degrees of phenylketonuria (PKU). A T-to-C transition was observed in exon 5 of the gene, resulting in the substitution of Phe161 by Ser161. Two substitutions, G-to-T and T-to-G, were observed in exon 7, resulting in the substitution of Gly247 by Val247 and Leu255 by Val255, respectively. Expression analysis demonstrated that these mutant proteins produced between 0 and 15% of normal PAH enzyme activity. Population screening of a Chinese sample population indicates that these mutations are quite rare, together accounting for only about 4% of all PKU alleles among the Chinese. The P161S and G247V mutations were each present on a single PAH RFLP haplotype 4 chromosome in patients form Northern China, while the L255V mutation was present on chromosomes of both haplotypes 18 and 21 in patients from Southern China. These results suggest that the remaining 30% of uncharacterized PKU alleles in the Chinese population may bear a large number of relatively rare PAH mutations.

Biomechanics of the human anterior cruciate ligament. ACL structure and role in knee motion

Surgical reconstruction of the anterior cruciate ligament (ACL) to restore knee stability has introduced many subjects of debate, including graft selection, reconstructive technique, and postoperative rehabilitation. In the first part of this two-part review, the tensile properties of the human ACL and the role of the ACL in knee kinematics are discussed. Reconstructive techniques for ACL replacement with regard to the biomechanics of the ACL in normal and ACL-deficient knees will be addressed in Part II.

Molecular characterization of two galactosemia mutations and one polymorphism: implications for structure-function analysis of human galactose-1-phosphate uridyltransferase

We report here the molecular characterization of two galactosemia mutations, L74P and F171S, and one polymorphism, S135L, in human galactose-1-phosphate uridyltransferase (GALT). Both galactosemia mutations result in reduced enzymatic activity when reconstructed in the cDNA and overexpressed. The polymorphism, in contrast, has near normal activity. Both mutations affect evolutionarily conserved residues, suggesting that they are functionally important, while the polymorphism occurs in a nonconserved domain which is presumably not critical for enzymatic function. The F171S mutation is close to the putative active-site nucleophile. Our data further support the notion of molecular heterogeneity of galactosemia and suggest that galactosemia mutations and GALT polymorphisms may be useful tools in highlighting different functional domains in human GALT.

Screw fixation in the human sacrum. An in vitro study of the biomechanics of fixation

A load-to-failure test was used to study the biomechanical properties of sacral screw fixation in human cadaveric specimens. The goals of this study were 1) to determine the effects of the two commonly chosen sacral screw orientations of fixation characteristics; 2) to determine the effects of selected screw-instrumentation linkages on the biomechanics of sacral screw fixation; 3) to correlate the biomechanical properties with a noninvasive assessment of sacral bone density; and 4) to correlate the torque during screw insertion with these biomechanical properties. The bone density of each specimen was measured with quantitative computed tomography. A screw was inserted from the dorsal surface either anteromedially or anterolaterally into the body of S1, and the torque needed to insert each screw was measured. The screw head was attached to a constrained or semiconstrained loading linkage. Force was applied to the screw in an inferior direction until the maximum load was achieved. The maximum load, screw translation, rotation at maximum load, and initial compliance of the bone-screw interface were determined. It was found that the anteromedial screw orientation, combined with a rigidly constrained loading linkage, resulted in the greatest maximum load to failure, the least screw rotation, and the least initial compliance of the four groups studied. The maximum load and the initial stiffness of bone-screw fixation increased significantly with bone density. Torque measurements correlated significantly with maximum load to failure, initial interface stiffness, and bone density. It was therefore concluded that bone density and torque measurements can be useful in assessing sacral screw fixation.

Human gene therapy: present and future

The hematopoietic system and the liver are two primary target organs for attempting somatic gene therapy of hereditary deficiencies. Several leading laboratories have recently been able to demonstrate that bone marrow cells from rodents and non-human primates can be successfully transduced with foreign genes, resulting in the functional expression of these genes in culture. The genetically reconstituted cells can subsequently be transplanted into X-irradiated recipients, and expression of the transduced genes is observed in the recipients for more than 6 months. Subsequently, gene transfer into peripheral T-lymphocytes in humans has been attempted, and the clinical trials are currently in progress. The liver is the other major organ under intensive investigation. Primary hepatocytes can be isolated from rodents, rabbits, and dogs, and successfully transduced with recombinant retroviruses. After autologous transplantation, long term survival of the engrafted cells in vivo has been observed. More recently, it has been shown that human hepatocytes can also be efficiently transduced with recombinant retroviruses. These experimental results have laid the foundation for somatic gene therapy of hereditary deficiencies in humans in the future.

DNA sequencing with dye-labeled terminators and T7 DNA polymerase: effect of dyes and dNTPs on incorporation of dye-terminators and probability analysis of termination fragments

The incorporation of fluorescently labeled dideoxynucleotides by T7 DNA polymerase is optimized by the use of Mn2+, fluorescein analogs and four 2'-deoxyribonucleoside 5'-O-(1-thiotriphosphates) (dNTP alpha S's). The one-tube extension protocol was tested on single-stranded templates, as well as PCR fragments which were made single-stranded by digestion with T7 gene 6 exonuclease. Dye primer sequencing using four dNTP alpha S's was shown to give uniform termination patterns which were comparable to four dNTPs. Efficiency of the polymerase also appeared to improve with the dNTP alpha S's. A mathematical model was developed to predict the pattern of termination based on enzyme activity and ratios of ddNTP/dNTPs. This method can be used to optimize sequencing reactions and to estimate enzyme discrimination constants of chain terminators.

Identification of three novel PKU mutations among Chinese: Evidence for recombination or recurrent mutation at the PAH locus

Three novel mutations have been identified in the phenylalanine hydroxylase (PAH) genes of Chinese classical phenylketonuria (PKU) patients. Two of these substitutions (W326X and Y356X) result in the generation of a premature stop codon, while the third (IVS-7nt2) alters an invariant dinucleotide splicing signal. These mutations together account for about 10% of all PKU alleles in the Chinese population. The W326X mutation is associated with PAH RFLP haplotype 4, the most common haplotype in Orientals, while the IVS-7nt2 mutation occurs once on a haplotype 7 chromosome. The Y356X mutation is associated with multiple haplotypes, possibly due to crossover, gene conversion, or recurrent mutation.