Mutagenesis vol.3 no.6 pp.455-458, 1988 DISCUSSION FORUM The role of mammalian cell mutation assays in mutagenicity and carcinogenicity testing C.F.Arlett and J.Cole MRC Cell Mutation Unit, University of Sussex, Falmer, Brighton, Sussex BN1 9RR, UK Recent debates (Ashby, 1986a,b, 1988; Gatehouse and Tweats, 1986, Gamer and Kirkland, 1986, Ennever et al., 1987; Ishidate and Harnois, 1987; Tweats and Gatehouse, 1988) in these columns have been concerned with a rational design for testing compounds for their genotoxic potential. Much of the debate is concerned with the relevance and efficiency of in vitro shortterm tests, in particular the mammalian cell gene mutation assay. This debate is particularly timely since the United Kingdom Department of Health and Social Security are at present reviewing the Committee on Mutagenicity (COM) guidelines, and their recommended strategy of testing. Both chromosomal and gene mutations may give rise to heritable genetic disease. Current knowledge indicates that carcinogenesis also involves both point mutation and chromosome changes. A direct role of mutagenesis is seen in the modulation of oncogenes (Sukumar et al., 1983; Marshall et al., 1984; Bos et al., 1985). The role of chromosome changes can be seen at two levels. First, in examples of reciprocal translocation whereby deregulation of normal levels of transcriptional control lead to malignancy, as with the myc proto-oncogene in Burkitt's lymphoma (Croce, 1986), or where an altered gene product may be involved as in chronic myelogenous leukaemia (Fainstein et al., 1987). Second, via non-reciprocal exchanges which may involve deletion or addition of chromosomal material. Deletions in 13q 14.11 in retinoblastoma (Strong et al., 1981) or Ilpl3 in Wilms tumour (Koufos et al., 1985) are now well documented. The involvement of both mutagenic and clastogenic events is emphasized in examples such as retinoblastoma (Cavenee et al., 1983) and perhaps bilateral acoustic neurofibromatosis (Rouleau et al., 1987) where the tumour is thought to arise when, following a primary mutation, the normal allele may be lost by deletion. In the case of multiple endocrine neoplasia type 2A, the primary defect maps to chromosome 10 (Simpson et al., 1987), and the 'tumour suppressing' sequences subject to deletion, to chromosome 1 (Mathew et al., 1987). We might then expect short-term tests which detect both end points to be most valuable. The Ames test only detects point mutations in DNA organized in a prokaryotic genome and thus it is generally considered that at least one mammalian in vitro test is also required. The question is, which one? Clastogenicity assay The clastogenicity assays have, in addition to their current legal status considerable justification for this role since: (i) they have been available for years (Evans, 1986) and have been used to monitor changes in lymphocyte cultures from individuals in hazardous occupations such as radiation workers (Evans et al., 1979). They thus assume authority through usage; © IRL Press Limited, Oxford, England (ii) the assays test chromosomal changes over the whole genome; (iii) it is believed thatrelativelyfew compounds exist which cause gene mutations and which are not also clastogenic. Negative points with respect to the clastogenicity assays are: (i) only chromosome changes are detected and the mechanisms by which these changes occur are poorly understood. At least 50% of chromosome changes are not viable and thus not relevant to carcinogenesis. In order to lead to a recognizable tumour any change must occur in a viable cell; (ii) they are expensive, the current cost in the UK being in the region of ~ 5K£ for a single unreplicated test, in addition they demand considerable skill in scoring and interpretation at the microscope; (iii) they are subject to deficiencies in experimental design. Any suggestion that the test should be expanded and replicated would make the assay even more expensive; (iv) A list of compounds (Table I) has recently been assembled which have been assessed as being positive in mammalian cell gene mutation assays but negative in both Ames and clastogenicity tests. Mammalian cell gene mutation assays The latter point suggests that mammalian cell gene mutation assays are a necessary component of the primary in vitro screen and we wish to make a number of comments about this and the assays themselves. Actual evidence for non-clastogenic mutagens is hard to come by, and we are grateful to David Kirkland, Microtest, who has compiled the information in the Table from published sources. What is immediately obvious is that all mutation data in Table I are from the L5178Y T K + / - assay. However, this is not always the case, and John Asquith, Toxicol Laboratories (personal communication), has an example of a compound which was negative for chromosome aberrations in L5178Y cells but mutagenic in both L5178Y TK+/— and Chinese hamster ovary cells. Since this compound is subject to commercial security full details are not available to us. Note also that a number of rodent non-carcinogens are mutagenic to these mammalian cells, a point we will return to later. We regard the high incidence of positive results for sister-chromatid exchanges as being evidence for the interaction of the compounds listed in Table I with DNA. A further example known to us (Lee et al., in preparation) is l-methoxy-l,3,5-cycloheptatriene (MCHT) which was regarded as Ames negative and negative for both in vitro human lymphocyte chromosome aberrations and in vivo mouse bone marrow tests, but positive for gene mutation in the V79 HPRT assay (±S9) and for the L5178Y T K + / - assay (+S9 only). However, upon further testing (Arlett et at., in press) we have shown that in L5178Y cells, MCHT induced micronuclei and trifluorothymidine (TFT) resistant mutants mainly of the small colony class but did not induce a significant number of ouabain resistant mutants. Thus, in these cells (in the presence of Aroclorinduced rat S9) MCHT acts as a clastogenic mutagen. Our experience with MCHT reminds us of the possibility that what 455 C.F.Arlett and J.Cole TaWe I. Chemicals giving positive mammalian cell gene mutation results, but negative in Ames and in vitro chromosomal aberration tests Chemical Ref Carc(Q or non-Carc(N) Benzoin Benzyl acetate Chloroacetic acid Chlorobenzene Chlorodibromomethane CI acid yellow 73 Cinnamyl anthranilate 1,2-Dichlorobenzene Dtcyclohexylthiourea 1,2-Epoxybutane FD and C yellow no. 6 Geranyl acetate Isophorone Linthocholic acid Malaoxon Pentachloroethane Sulfisoxazole 1,1,1,2-Tetrachloroethane Trichloroethylene 3 3 2 3 3 3 3 3 2 2 3 3 3 1 3 3 3 3 3 N C SAL L5178Y (TK+/-) CA 9 c c c c N N •7 N N C N N C N C c • = positive in SCE. ** = equivocal result in SCE. SAL = Salmonella. CA = chromosome aberration. ? = not known. 1. Shelby and Stasiewicz, 1984. 2. McGregor el at., 1987a. 3. Tennant etal., 1987. appears a + or — in Table I may, in fact, be based upon insecure, perhaps poor, data or reflect species differences perhaps mediated through differences in metabolic activation. Each compound in Table I should be treated on its individual merits. For example, one of the listed compounds benzyl acetate, was negative in the Ames test (+ or — rat or Syrian hamster S9) and negative for sister chromatid exchanges and chromosome aberrations in Chinese hamster cells (+ or -S9). A dose related mutation response was recorded for the L5178Y T K + / - assay (+S9 only, NTP Technical Report Series no. 250, and positive in the absence of S9, C.Riach and W.Caspary, personal communication). However, to date we have been unable to detect either clastogenicity or mutagenicity in L5178Y TK+/— cells with this compound (J.Cole et al., unpublished results), using micronuclei and 6-thioguanine, trifluorothymidine and ouabain resistance as end points. This leads us to believe that a detailed examination of all the raw data for all end points which went into Table I is needed and, in addition, further testing of the compounds may also be required to clarify their mechanisms of action. For example Colin Riach (Inveresk Research International, Ltd) has already informed us that 1,2-epoxybutane is Ames positive when tested in the vapour phase. Here we would point out that any subsequent interpretation is bound to be biased by the assignment of + or — in any table made by the most authoritative assessor. In the absence of access to the raw data there is no way any fresh independent assessment may be made. Thus we perceive a real problem whereby unsubstantiated + or — scores may be repeatedly quoted in the literature. In this connection we would remind readers that Mutagenesis provides a valuable facility for computerized storage of data. The present situation is that until a case to the contrary is made we must accept the possibility that a number of non-clastogenic mutagens exist. 456 What of the mammalian cell gene mutation assays themselves? Experience with these assays to date has given them a reputation for being (i) difficult to perform, (ii) expensive and (iii) over sensitive ( T K + / - ) or insensitive (V79). In response, we would like to make the following points: (i) While skill and care is required in setting up mammalian cell gene mutation assays scoring requires relatively little skill and training and may readily be automated. In 1986 a Third Health and Safety Executive sponsored UKEMS trial was set up in order to establish and test improved protocols (Cole, 1988). It was fortunate that at the same time two UKEMS guidelines groups had been charged with developing statistical packages appropriate to these assays. It has been possible to integrate the two enterprises such that we now believe that robust protocols are capable of generating statistically sound data although there are numerical problems with the V79 and CHO Chinese hamster tests. We anticipate full reports in these pages in due course. (ii) The cost of a repeated full mammalian cell gene mutation assay is approximately the same at 5K£ as a single clastogenicity assay. (iii) An oft-repeated complaint is that the L5178Y T K + / - test, which is the most frequently used mammalian cell gene mutation assay, is hyper-sensitive. As we pointed out in our earlier comments on the results in Table I it is clearly giving positive genotoxicity results for 'non-carcinogens'. Examples of the use of this assay are provided by Clive et al. (1979) and more recently by Wangenheim and Bolcsfoldi (1988). In the latter study a number of non-carcinogens such as dimethyl sulphoxide, glucose and urea were shown to be positive on purely statistical grounds. This led the authors to propose an arbitrary '4-fold rule' for judging the carcinogenic potential of chemicals tested in the assay. Inspection of the data indicate considerable variation in the control (spontaneous) mutant frequencies and the experimental design would not have satisfied the requirements of the proposed UKEMS recommendations for statistical analysis. Meeting these requirements would, we believe, remove the need for 'N-fold' arbitrary rules in the assessment of genotoxic classification. We suggest that given a proper experimental design and application of appropriate statistics many of the apparent 'positives' would have been excluded. In a recent study conducted in accordance with the up-to-date UKEMS protocol Leigh Henderson at Huntingdon Research Centre (personal communication) found that of 50 compounds examined in routine testing only two gave highly significant positive responses (one of which was a reference compound, and the other a related compound), two gave smaller positive responses (both also related compounds) and one was equivocal. Theremaining45 were all clear negatives. While this result might be fortuitous, since we have no details of the compounds under test, it does not seem to us to reflect 'super-sensitivity' of this assay. Thus we suggest that a properly designed and executed L5178Y TK+/— assay will generate sound results. One aspect of assays based on hprt is that they may be perceived as insensitive. There are several reasons why hprt-based assays might be less sensitive for routine screening than the tkbased L5178Y assay. (i) The spontaneous mutant frequency to 6-thioguanine resistance is generally about an order of magnitude lower than trifluorothymidine resistance. Thus, many more cells Mammalian cell mutation assays must be treated, maintained and plated to obtain a similar level of statistical precision. This is a practical problem which it is possible to overcome, although it is more difficult in attached cells such as V79. (ii) The long expression time required for the selection of 6-thioguanine-resistant mutants (6—9 days) may mean that a class of slow-growing mutants (which are detected in the tk-based assay, 2 - 3 day expression time) is lost. Potentially this could be overcome by the use of 8-azaguanine as selective agent for hprt mutants (expression time 2 - 3 days) although it cannot be used for mouse cells, (iii) the hprt gene may be less mutable than the tk gene, or the mutations may not be detected by current methodology. (iv) Some classes of chromosome events such as very large deletions, loss of the whole chromosome, recombination and gene conversion may be detected in systems based on the autosomal tk gene but not on the X-linked hprt gene. The relative contribution of these possibilities cannot be resolved at present. However, the expanded protocols developed by McGregor et al. (1987b) indicate that the insensitivity in V79 and CHO Chinese hamster cells is intrinsic rather than a consequence of the limitations of size of experiment practicable with cells growing attached to surfaces. The insensitivity may arise as a consequence of the location of the gene of interest close to a vital gene(s) on the X chromosome. Target size does not seem an appropriate explanation since the hprt gene is 40 kb in comparison with the tk gene at 10 kb. However, this dose not take into account the size of the transcribing sequence. We believe that the continued use of the Chinese hamster assays must surely be called into question in those situations where we seek to attempt an evaluation of the genotoxic potential of a compound which is as complete as possible. A point in favour of mammalian cell gene mutation assays, whether they function as a primary screen, as seems appropriate to us at this time, or in a confirmatory role, follows from the fact that some are able to detect both gene mutations and chromosomal events. For the hprt assays dependent upon 6-thioguanine or 8-azaguanine resistance, both translocations and small deletions can be recognised (Thacker, 1985). With the tk gene in mouse lymphoma cells large deletions and rearrangements involving the gene result in the generation of 'small colony' TFT resistant mutants (Hozier et al., 1985). 'Large colony' TFT resistant mutants may represent point mutations or small deletions within the tk gene itself (Moore et al., 1985). Good examples of the use of large and small colonies with the TFT selective system and a correlated response with 6-thioguanine selection is given by the response of L5178Y cells to procarbazine (Clive etal., 1988) or sodium fluoride (Cole etal, 1986). For particular compounds for which more extensive information could be justified (for example to resolve apparent mutagenicity positive/clastogenicity negative compounds) we should like to recommend the use of an integrated L5178Y assay system. This should be based upon UKEMS protocols and statistical designs, and should include an assessment of large and small TFT-resistant colonies, ouabain resistance and micronucleus induction combined within a 48-h expression time. There would also be the opportunity for evaluating 6-TG resistance (at a 7-day expression time) in the same populations of treated and control cells. The requirement for a clastogenicity assay would be met by TFT resistant small colony mutants and micronuclei and the assay would have the added bonus of detecting any nonclastogenic mutagens. Examples of where we have utilised this system are seen with MCHT and BA. A similar integrated system would be possible using the human lymphoblastoid cell line TK6 (Yandell et al., 1986). Recent studies suggests that it is possible to select large and small colony tk mutants although the system is as yet less well characterized than the L5178Y TK+/— assay and the cells have been shown to be repair defective (Dean and Fox, 1984). Chromosome aberrations, micronuclei, and hprt mutations are also readily scored in these cells. Finally, for us, the most compelling feature of mammalian cell gene mutation assays which should commend their continued use is the possibility of analysis of the nature of the genetic change which gives rise to the mutant phenotype in viable cells. The observation of viable mutants in vitro raises the possibility that such mutants might also have an in vivo existence. Studies such as those described by Meuth and Arrand (1982) on the nature of mutations in an endogenous gene (aprt) and the potential for mutant analysis in shuttle vector systems (Du Bridge and Calos, 1988) gives mammalian cell gene mutation assays a unique role in understanding the mechanisms of mutagenesis in mammalian and ultimately human cells. Conclusions Given that both chromosomal and gene mutational events are important in the generation of heritable disease and cancer, assays for genotoxic potential which test for both end points would appear most valuable. In this context assays for mammalian cell gene mutation must be the most relevant of the battery of short term tests which are available to us, and, in addition, changes are detected in viable cells and the potential exists for analysis of the nature of any genetic change. At present consideration is being given to the possible exclusion of mammalian gene cell mutation assays from the basic package of screening tests recommended in the UK. Two arguments are put forward in support of this proposal. First, that clastogenicity assays, which are believed to be more reliable, serve to detect all mutagens. This supposes that no non-clastogenic mutagens exist. At present the evidence is that few such compounds do exist. Nevertheless, until a concrete case is made we must adopt a position of caution and accept the existence of genotoxic agents which will only be detected by the mammalian cell gene mutation assays. Such assays must, therefore, remain as a primary screen. The second argument is based upon a belief that these assays deserve a poor reputation as being difficult to perform and generate spurious results. Within the United Kingdom a new generation of protocols have been developed embodying experimental designs which should provide data suitable for a statistical evaluation of results. It is envisaged that the use of these new protocols will generate sound data overcoming the objection of poor performance. Whether or not the tests continue as a primary or supplementary package we strongly recommend use of the new protocols. We believe that until the problem of the non-clastogenic mutagens is resolved (which may take up to 5 years), it is premature to exclude the mammalian cell gene mutation assays from the primary screen. We hope that such a reprieve will give an opportunity to demonstrate the quality and relevance of data which can be obtained from these assays. It will also provide an opportunity to evaluate the strengths and weaknesses of the individual assays available to us. Acknowledgements We are indebted to Professor B.A.Bridges for much helpful comment and to the many 'interested parties' who have urged us to assemble these comments on the relevance and practice of mammalian cell gene mutation assays. The views expressed, however, are the responsibility of the authors alone. 457 C.F.Ariett and J.Cde References AshbyJ. (1986a) The prospects for a simplified and internationally harmonized approach to the detection of possible human carcinogens and mutagens. Mutagenesis, 1, 3-16. AshbyJ. (1986b) Letter to the Editor. Mutagenesis, 1, 309-317. AshbyJ. (1988) The continuing search for an in vivo mutagen which is nongenotoxic in vitro—response to Twcats and Gatehouse: Letter to the Editor. Mutagenesis, 3, 103-104. BosJ.L., Toksoz.D., Marshall.C.J., Veriaan-de Vries.M., Veeneman.G.H., Van Der Eb.A.J., Van BoomJ.H., Janssen.W.G. and Steenvoordcn.C.M. (1985) Amino-acid substitutions at codon 13 of the N-ras oncogene in human acute myeloid leukaemia. Nature, 315, 726-730. Cavenee.W., Dryja,T.P., Phillips.R.A., Benedict,W.F., GodbouU*., Gallie.B.L., Murphree.A.L., Strong,L.C. and White.R.L. (1983) Expression of recessive alleles by chromosomal mechanisms in retinoblastoma. Nature, 305. 779-784. Clive.D., Johnson J.F.S., Spector,A.G., Batson.A.G. and Brown,M.M. (1979) Validation and characterization of the L5178Y/TK mouse lymphoma mutagen assay system. Mutat. Res., 59, 61-108. Clive.D., Turner.N. and Krehl.R. (1988) Procarbazine is a potent mutagen at the heterozygous thymidine kinase (tk±) locus of mouse lymphoma assay. Mutagenesis, 3, 83-87. ColeJ. (1988) Third UKEMS Collaborative genotoxicity study: Definitive protocols for mutagenicity testing with cultured cells. Mutagenesis, 3, 74-75. CcAeJ., Muriel.WJ. and Bridges.B.A. (1986) The mutagenicity of sodium fluoride to L5178Y [Wild-type and T K + / - (3.7.2C)] mouse lymphoma cells. Mutagenesis, 1, 157-167. Croce.C.M. (1986) Chromosome translocation and human cancer. Cancer Res., 46, 6019-6023. Dean.S.W. and Fox.M. (1984) DNA repair, DNA synthesis and cell cycle delay in human lymphoblastokl cells differentially sensitive to the cytotoxic effect of nitrogen mustard. Mutat. Res., 132, 63-72. Du Bridge.R.B. and Calos.M.P. (1988) Recombinant shuttle vectors for the study of mutation in mammalian cells. Mutagenesis, 3, 1 - 9 . Ennever.F.K., Noonan.T.J. and Rosenkranz.H.S. (1987) The predictivity of animal bioassays and short-term genotoxicity tests for carcinogenicity and noncarcinogenkity to humans. Mutagenesis, 2, 73—78. Evans,H.J. (1986) The role of human cytogenetics in studies of mutagenesis and carcinogenesis. In Genetic Toxicology of Environmental Chemicals, Part A: Basic Principles and Mechanisms of Mutagenesis. Ramel.C, Lambert.B. and Magnusson.J. (eds), Alan R.Liss, NY, pp. 4 1 - 6 9 . Evans.H.J., Buckton.K.E., Hamilton.G.E. and Carothers.A. (1979) Radiationinduced chromosome aberrations in nuclear-dockyard workers. Nature, 227, 531-534. Fainstein.E., Marcelle.C., Rosner.A., Canaani.E., Gale.R.P., Dreazen.O., Smith,S.D. and Croce.C.M. (1987) A New fused transcript in Philadelphia chromosome positive acute lymphocytic leukaemia. Nature, 330, 386-391. Garner.R.C. and Kirkland.D.J. (1986) Reply. Mutagenesis, 1, 233-235. Gatehouse.D.G. and Tweats,D.J. (1986) Letter to the Editor. Mutagenesis, 1, 307-308. HozierJ., SawyerJ., Clive.D. and Moore,M.M. (1985) Chromosome 11 aberrations in small colony L5178 Y - / - mutants early in their clonal history. Ann. NY Acad Sci., 107, 423-425. Ishidate,M.,Jr. and Harnois.M.C. (1987) The clastogenkity of chemicals in cultured mammalian cells. Letter to the Editor. Mutagenesis, 2, 240-243. Koufos.A., Hansen.M.F., Copeland.N., Jenkins,N.A., Lampkin.B.C. and Cavenee.W.K. (1985) Loss of heterozygosity in three embryonal tumours suggests a common pathogenetic mechanism. Nature, 316, 330—334. Marshall.C J., VousdenJC.M. and Phillips.D.M. (1984) Activation of c-Ha-raj-1 proto-oncogene by in vitro modification with a chemical carcinogen, benzo(a)pyrcne diol-expoxide. Nature, 310, 586-589. Mathew.C.G.P., Smhh.B.A., Thorpe.K., Wong.K., Royle.N.J., Jeffreys.A.J. and Ponder.B.AJ. (1987) Deletion of genes on chromosome 1 in endrocrine neoplasia. Nature, 328, 524-526. McGregor.D., Riach.C, Cattanach.P. and Caspary.W. (1987b) Development and investigation of an expanded CHO Ihgprt locus assay. Mutagenesis, 2, 303. McGregor.D.B., Martin.R., Cattanach.P., Edwards.I., McBridge.D. and Caspary.W J . (1987a) Responses of the L5178Y T K + / - mouse lymphoma forward mutation assay to coded chemicals: Results for nine compounds. Environ. Mutagenesis, 9, 143-160. Meuth.M. and ArrandJ.E. (1982) Alterations of gene structures in EMS-induced mutants of mammalian cells. MoL Cell. Biol., 2, 1459-1462. Moore.M.M., Clive.D., Hozier^.C., Howard.B.E., Batson,A.G., Tumer.N.T. and Sawyer J. (1985) Analysis of trifluorothymidine-resistant (TFT') mutants of L5178Y/TK+/- mouse lymphoma cells. Mutat. Res., 151, 161-174. Rouleau.G.A., Wertelecki.W., Haines.J.L., Hobbs,WJ., TrofatterJ.A., Seizinger.B.R., Martuza.R.L., Supemeau.D.W., Conneally.P.M. and 458 GusellaJ.F. (1987) Genetic linkage of bilateral acoustic neurofibromatosis to a DNA marker on chromosome 22. Nature, 329, 246-248. Shelby,M.D. and Stasiewicz.S. (1984) Chemicals showing no evidence of carcinogenicity in long-term, two species rodent studies: The need for shortterm test data. Environ. Mutagenesis, 6, 871-878. Simpson.N.E., Kidd.K.K., Goodfellow.P.J., McDermid.H., Myers.S., KiddJ.R., Jackson.C.E., Duncan.A.M.V., Farrer.L.A., Brasch.K., Castiglione.C., Genel.M., GertnerJ., Greenberg.C.R., GusellaJ.F., HoldenJ.J.A. and White,B.N. (1987) Assignment of multiple endocrine neoplasia type 2A to chromosome 10 by linkage. Nature, 328, 528-530. Strong.L.C, Riccardi.V.M., Ferrell.R.E. and Sparkes.R.S. (1981) Familial retinoblastoma and chromosome 13 deletion transmitted via an insertional translocation. Science, 213, 1501-1503. Sukumar.S., Notario.V., Martin-Zanca.D. and Barbacid.M. (1983) Induction of mammary carcinomas in rats by nitrosomethylurea involves malignant activation of H-ras-l locus by single point mutations. Nature, 306, 658—661. Tennant.R.W., Margolin.B.H., Shelby.M.D., Zeiger.E., Haseman^.K., SpaldmgJ., Caspary.W., Resnick,M., Stasiewicz.S., Anderson,B. and Minor.R. (1987) Prediction of chemical carcinogenicity in rodents from in vitro genetic toxicity assays. Science, 236, 933-941. ThackerJ. (1985) The molecular nature of mutations in cultured mammalian cells: a review. Mutat. Res., 150, 431-442. Tweats.D.J. and Gatehouse.D.G. (1988) Further debate of testing strategies. Mutagenesis, 3, 95-102. Wangenheim,J. and Bolcsfoldi,G. (1988) Mouse lymphoma L5178Y thymidine kinase locus assay of 50 compounds. Mutagenesis, 3, 193-205. Yandell.D.W., Dryja.T.P. and LittleJ.B. (1986) Somatic mutations at a heterozygous autosomal locus in human cells occur more frequently by allele loss than by intragenic structural alterations. Somatic Cell Mol. Genet., 12, 255-263. Received on May 5, 1988; accepted on June 26, 1988
© Copyright 2026 Paperzz