Abstract:
A high speed method is described for analyzing a plurality of individual blood samples to determine characteristics therein indicative of hemoglobin variant(s), while also quantifying the amounts of important A 2  and F hemoglobins therein. The method involves analysis of a respective blood sample by passing it through an HPLC column (preferably a polyaspartic acid cation exchange column), eluting hemoglobin species using an eluant stream passing through the column, and characterizing eluted species as a function of their respective adsorbance values and retention times; the characterizing step further includes quantification of the amounts of A 2  and F hemoglobins in the sample. The foregoing analysis is repeated for each of the plurality of blood samples, wherein the total time between successive analyses is up to about 7 minutes, and more preferably up to about 5.5 minutes.

Description:
MICROFICHE APPENDIX A microfiche appendix containing the source code of a computer program useful in the present invention is appended hereto as one sheet of microfiche containing 42 frames.  
     BACKGROUND OF THE INVENTION  
       [0001]     1. Field of the Invention  
         [0002]     The present invention is broadly concerned with improved HPLC methods usefull in identifying and characterizing hemoglobin variants in blood. More particularly, the present invention relates to methods in which a blood sample is injected into an HPLC unit and hemoglobin species from the blood sample are separated using high column temperatures and high eluant flow rates; chromatographic data regarding the separated hemoglobin species are analyzed manually or with the aid of a computer to determine if an eluted hemoglobin species has a characteristic indicative of a hemoglobin variant, and/or to determine if an eluted hemoglobin species corresponds to a known hemoglobin variant; hemoglobin abnormalities are thereby putatively identified. In particular, the present invention is directed to an improved HPLC assay which provides a relatively low resolution “quick scan” coupled with quantitation of two important hemoglobins, namely A 2  and F; the improved assay is capable of providing such information for respective plural samples with a maximum of seven minutes from injection-to-injection, and more preferably a maximum of 5.5 minutes injection-to-injection.  
         [0003]     2. Description of the Prior Art  
         [0004]     The hemoglobin molecule is composed of a prosthetic heme group attached to two pairs of unlike polypeptide chains. Normal adult hemoglobin (A) consists of two α and two β chains (α 2 β 2 ). A second normal adult hemoglobin (A 2 ) consists of two α and two δ chains (α 2 δ 2 ). The primary structure of the δ chain differs from that of the β chain at ten amino acid positions. The blood of normal adult humans contains both A as the major hemoglobin species and A 2  as a minor hemoglobin species. Human fetuses and newborn infants produce mainly fetal hemoglobin (F) which consists of two α chains and two γ chains. The β and γ chains differ at 39 amino acid positions. Additionally, the δ chain and the ε chain have been observed in early human embryos. Newborn infants have two types of γ chain, the  G γ chain which has a glycine residue at position  136 , and the  A γ chain which has an alanine residue at position  136 . Thus, seven types of hemoglobin chains exist in the human, namely α, β, γ,  A γ,  G γ, δ, and ε chains.  
         [0005]     The first abnormal hemoglobin discovered (S) is responsible for sickle cell anemia, S is the result of a substitution of a valine residue for the glutamate residue normally found at position  6  of the β chain. Another relatively common abnormal hemoglobin is C. Most of the hundreds of hemoglobin variants, discovered over the last 40 to 50 years, are the result of single base substitutions in the DNA of either the α, β,  A γ,  G γ, or δ globin genes, but other variants with hybrid chains, extended chains, and chains with deletions have been discovered. The detection of abnormal hemoglobin variants is the primary method of diagnosing hemoglobinopathies.  
         [0006]     Approximately 90% of total hemoglobin is nonglycosylated. The major fraction of nonglycosylated hemoglobin is nonglycosylated A, referred to as A 0 . The major fraction of glycosylated hemoglobin is glycosylated A, referred to as A 1c . A 1c  arises by reaction of a terminal valine amine group in the β chain with the aldehyde group of glucose to give an unstable aldimine. Amadori rearrangement of the aldimine gives A 1c , which is characterized by a β-ketoglycoside linked to the valine amine group. The determination of the concentration of A 1c  is useful in diagnosing diabetes mellitus and in monitoring the treatment of the disease. In nondiabetic individuals, the A 1c  level is generally between 4 to 8% of total hemoglobin. In diabetics, the A 1c  level is two- to three-fold higher and may range up to 20% of total hemoglobin.  
         [0007]     Numerous procedures have been used to identify and characterize normal and abnormal hemoglobins. Traditionally, these methods have included electrophoresis, isoelectric focusing, and macro-chromatography. During the past several years, high-performance liquid chromatography (HPLC) has been applied to the study of hemoglobinopathies and diabetes mellitus. Advantages of HPLC include relatively high sensitivity, specificity, and speed of analysis. However, HPLC methods generally lack the resolution necessary to differentiate some commonly encountered hemoglobin variants, and also lack the sensitivity required to detect hemoglobins at low concentrations. Additionally, most HPLC methods do not offer computer-assisted analysis of the resultant data, and therefore require time-consuming manual analysis.  
         [0008]     A high-resolution cation-exchange HPLC method using a polyaspartic acid-containing column was described by Ou and Rognerud in  Clin. Chem.  39(5):820-824 (1993), the teachings of which are incorporated by reference herein. Although this method was capable of resolving more than 35 commonly encountered hemoglobin variants, at least 20 minutes were required for each sample run. Furthermore, this method was not coupled with an automated system of data analysis.  
         [0009]     The Primus Corporation of Kansas City, Mo. has heretofore commercialized a two-stage method for the identification of hemoglobin variants in blood samples, which is fully described in application for U.S. Letters Patent, Ser. No. 08/642,175 filed May 6, 1996. In the Primus assay, a blood sample may be analyzed in a two-step process. In the first step, a “quick scan” HPLC assay is performed at a relatively low resolution in order to identify characteristics indicative of a hemoglobin variant. If such a variant is indicated, the blood sample may be Her analyzed by passing a second aliquot thereof through the HPLC unit at a relatively high second resolution in order to provide more reliable quantitative data. As an alternative to a complete quantitative analysis, the Primus assay also permits quantitation of A 2  and F hemoglobins. While the Primus quick scan may be performed with an injection-to-injection time on the order of 2-4 minutes, the higher resolution quantitation step (either the full assay or the A 2 /F quantitation) normally takes approximately 10 minutes injection-to-injection.  
         [0010]     While the described Primus assay represents a decided breakthrough in the art, users have requested a relatively short-time assay which provides the indicative data of the quick scan together with quantitation of the important A 2  and F hemoglobins.  
       SUMMARY OF THE INVENTION  
       [0011]     The present invention overcomes the problems outlined above and provides a method for the high speed analysis of a plurality of individual blood samples to determine characteristics therein indicative of a hemoglobin variant, and for quantifying the amounts of A 2  and F hemoglobin in the samples. Broadly speaking, the method of the invention involves analysis of a respective blood sample by passing it through an HPLC column, eluting hemoglobin species with an eluant stream passing through the column, and characterizing the eluted species as a function of their respective adsorbance values and retention times. The characterizing step further includes the step of quantifying the amounts of A 2  and F in the respective blood samples. Importantly, the foregoing analysis of the respective blood sample is repeated in order to analyze each of the plurality of samples, wherein the total time between successive analysis steps is up to about 7 minutes, and more preferably up to about 5.5 minutes. The time between successive analysis steps is generally referred to as the injection-to-injection time at the HPLC column.  
         [0012]     In carrying out the method of the invention, it is preferred to maintain the HPLC column at a level of from about 30-45° C. and more preferably about 40° C. The HPLC column is preferably a cation exchange column and especially a polyaspartic acid column including a porous silica support. Column pressures in the method are dependent variables, i.e., the pressures result from factors such as column packing particle size, flow rates, and temperatures. Generally speaking, pressure drops across the column of from about 350-1500 psi are observed.  
         [0013]     In preferred forms, two mobile phases are employed in the analysis (i.e., mobile phase  1  and mobile phase  2 ). The flow rates of the eluants through the column are normally from about 2-5 ml/min., and more typically from about 2-3 ml/min. In order to obtain the desired short time high speed analyses of plural samples, it is desirable to establish a non-linear mobile phase gradient between mobile phase  1  and mobile phase  2 . That is to say, a non-linear mobile phase gradient covering a range of concentrations from about 70-95% mobile phase  1  and 5-30% mobile phase  2  up to 100% mobile phase  2  over a period of from about 2-6 minutes is employed to facilitate separation of hemoglobin components. The most preferred gradient covers a range of from about 90% mobile phase  1 /10% mobile phase  2  to 100% mobile phase  2  over a period of from about 4-5 minutes.  
         [0014]     Generally speaking, the mobile phase  1  has a relatively low total ionic strength and an approximately neutral pH. This phase should contain from about 5-50 meq of cation and a pH of from about 6.8-7.5. Mobile phase  2  should have a significantly higher total ionic strength and typically a somewhat lower pH. For example, this phase would normally have from about 100-300 meq of cation and a pH of from about 6-6.9. By appropriate manipulation of the relative pHs and ionic strengths of the mobile phases, it is possible to separate hemoglobin fractions with very similar physical properties.  
         [0015]     The improved method described herein is similar in some respects to the methods described in pending application for U.S. Letters Patent, Ser. No. 08/642,175 filed May 6, 1996, which is incorporated by reference herein.  
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0016]      FIG. 1  is an individual sample report generated using the quick scan/A 2  and F quantitation assay described in Example 1; and  
         [0017]      FIG. 2  is an individual sample report generated using the quick scan/A 2  and F quantitation assay described in Example 2. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT  
       [0018]     The present invention is directed to an HPLC chromatographic method for the identification and characterization of hemoglobin variants in blood samples from patients. In particular, the invention is directed to a combined assay giving “quick scan” hemoglobin variant indicative information together with quantitation of the important A 2  and F hemoglobins.  
         [0019]     The following examples set forth preferred techniques in accordance with the invention. It is to be understood however, that these examples are presented by way of illustration only and nothing therein should be taken as a limitation upon the overall scope of the invention.  
       EXAMPLE 1  
       [0020]     Instrumentation. The HPLC unit used in the chromatographic analysis of hemoglobin was the continuous, automated Hewlett Packard 1090 as modified by Primus Corporation and known as the Primus CLC330. This unit included a proportioning valve, a metering pump, a high pressure booster pump, an auto sampler, an auto injector, a photometric detector, dual disc drives, a recording integrator, a temperature-controlled oven, and an HP LUCI controller. However, the analysis can be conducted with any high-quality HPLC system using the appropriate parameters.  
         [0021]     Chemistry. Separation of hemoglobin components took place on a cation exchange column. Specifically, a polyaspartic acid column (3.5 cm×0.46 cm) including a porous silica support having a 5 um particle size and a pore size of 100 nm was used, although many other types of cation exchange columns can be employed. Two mobile phases were used in the HPLC unit. Mobile phase  1  was composed of 10 mM Bis-Tris and 1 mM KCN, and had a pH of 7.0; this phase therefore has a total ionic strength of 11 meq of cation. Mobile phase  2  was composed of 10 mM Bis-Tris, 1 mM KCN, and 200 mM NaCl, and had a pH of 6.6; this phase had a total ionic strength of 211 meq of cation. The amounts of mobile phase  1  and mobile phase  2  in a mixture thereof are represented below as volume percentages relative to the total volume of the mixture. The test samples contained whole blood hemolysate prepared by dilution of one part whole blood with from about 20 to 500 parts purified water (preferably from about 50 to 200 parts purified water, and ideally 100 parts purified water). Sodium azide (0.001%) was added as a preservative. The injection volume was from about 1 μl to 30 μl (preferably from about 2.5 μl to about 20 μl, and ideally 5 μl) of the diluted (i.e., hemolyzed) sample.  
         [0022]     During startup, the lamp and pumps for the unit were turned on. The flow rate of eluant was set to 2.5 ml/minute, and the column temperature was set to 40° C. Initially, 100% mobile phase  2  was pumped through the system for 4.9 minutes (i.e., from time 0 to time 4.9 minutes). From time 4.9 minutes to time 5.0 minutes, the composition of the eluant was changed in a linear fashion from 100% mobile phase  2  to 90% mobile phase  1  and 10% mobile phase  2 ; this condition was held constant from time 5.0 minutes to time 10.0 minutes. From time 10.0 minutes to time 13.0 minutes, the composition of the eluant was changed in a linear fashion from 90% mobile phase  1  and 10% mobile phase  2  to 60% mobile phase  1  and 40% mobile phase  2 . From time 13.0 minutes to time 16.0 minutes, the composition of the eluant was changed in a linear fashion from 60% mobile phase  1  and 40% mobile phase  2  to 100% mobile phase  2 . At time 16.0, the unit was ready for the quick scan/A 2  and F quantitation assay.  
         [0023]     The HPLC column was next equilibrated over a period of 1.4 minutes with a mixture of 85% mobile phase  1  and 15% mobile phase  2 , at a constant flow rate of 3.0 ml/minute for 0.4 minute followed by 1.4 minutes at a constant flow rate of 2.5 ml/minute. Throughout the analysis, i.e., during equilibration and thereafter, the column temperature was maintained at 40° C. and the eluant employed was passed through the column at a flow rate beginning at 2.5 ml/minute and increasing linearly to 3.0 ml/minute over a period of 2 minutes. The flow was then kept constant until 4.1 minutes, at which time it was reduced immediately to 2.5 ml/minute. A non-linear mobile phase gradient covering a range of concentrations from 90% mobile phase  1  and 10% mobile phase  2  to 100% mobile phase  2  was used to separate hemoglobin components. The gradient changes took place over 4 minutes. Thereafter, the conditions were returned to the starting conditions over a period of 0.1 minute. The non-linear mobile phase gradient included the following steps. At time of injection (i.e., time zero), the eluant consisted of 90% mobile phase  1  and 10% mobile phase  2 . Over the first minute (i.e., to time 1.0 minute), the composition of the eluant was changed in a linear fashion to consist of 86% mobile phase  1  and 14% mobile phase  2 . From time 1.0 minute until time 2.2 minutes, the eluant was changed in a linear fashion to consist of 70% mobile phase  1  and 30% mobile phase  2 . From time 2.2 minutes to time 2.8, the eluant was changed in a linear fashion to consist of 50% mobile phase  1  and 50% mobile phase  2 . From time 2.8 minutes until time 3.2 minutes, the eluant was changed in a linear fashion to consist of 75% mobile phase  1  and 25% mobile phase  2 . From time 3.2 minutes until 3.21 minutes, the eluant was changed in a linear fashion to consist of 100% mobile phase  2 . This eluant condition was then maintained for an additional 0.79 minutes (i.e., until time 4.0 minutes). From time 4.0 minutes until time 4.1 minutes, the eluant was changed in a linear fashion to consist of 90% mobile phase  1  and 10% mobile phase  2 . This eluant condition was maintained for an additional 1.4 minutes (i.e., until time 5.5 minutes). Thus, a total of 5.5 minutes elapsed from injection to injection.  
         [0024]     The first two samples of the batch run were respective aliquots of a known marker sample containing F, A, A 2 , S, and C. However, any other hemoglobin sample could also be used in lieu of the marker sample. Results of this first injection were ignored. The second sample injected was deemed to be the marker sample. The sequential order of elution of the hemoglobin species in the marker sample is known to be F, A, A 2 , S, and C (the largest peak between the A and S peaks is known to be the A 2  peak). The resultant chromatograph was used to calculate the absolute retention time, area percent value, and peak width for each of F, A, A 2 , S, and C. Area percent value refers to the percentage of a particular species&#39; integrated peak area relative to the total integrated peak area of the entire chromatography Marker samples were used as described above to recalibrate the HPLC unit with respect to absolute retention times, area percent values, and peak width usually after 20 unknown sample runs. However, recalibration was necessary only after 100 sample runs.  
         [0025]      FIG. 1  illustrates a typical chromatograph report for a respective sample obtained using the described techniques, together with the computer-generated numerical data. As shown, each report includes a chromatograph of the sample and a table including the number of each peak, the absolute retention time of the species giving the peak, the closest marker peak (i.e., F, A, S or C), the relative retention time of the species giving the peak (i.e., the absolute retention time of the species giving the peak divided by the absolute retention time of the closest marker species), the width of the peak, the area percent value of the peak and comments. Code numbers are included in the comment section where appropriate. Also, peaks may be putatively identified in the comments section by determining which species had a relative retention time falling within an individual window (see Table 3). The illustrated chromatograph is one where significant F and A 2  peaks were observed. It will be understood however that many samples will not contain significant F peaks.  
         [0026]     The rules shown in Table 1 were used to identify abnormal hemoglobin species in blood samples.  
                         TABLE 1                           Rules used to identify abnormal hemoglobin patterns       in Quick Scan/A 2  and F quantitation chromatographs.            Rule   Description               1   Any peak (other than the A 0  or A 1c  peaks) having an area           percent value greater than 5% is flagged (code 3). 1         2   Any peak in the A 1c  window having an area percent value           greater than 10% is flagged (code 3). 2,3         3   Any peak in the A 0  window having an area percent value less           than 80% is flagged (code 2). 4         4   Any peak in the A 0  window having a width greater than 1.2           times the width of the marker A 0  peak is flagged (code 1). 5         5   Any peak in the degradation products window having an area           percent value greater than 10% is flagged (code 3). 6         6   Any peak eluting after the A 2  window is flagged (code 3).       7   Any peak in the hemoglobin Bart&#39;s window having an area           percent value greater than 1% is flagged (code 3).       8   If any peak in the A 2  window has an area percent value           greater than 10%, the result is printed as not valid for           A 2  quantitation and thus signals the presence of a variant           comigrating with A 2 .                   1 See Table 2 for Codes.              2 See Table 3 for windows for A 1c , A 0 , degradation products, A 2 , and hemoglobin Bart&#39;s.              3 The A 1c  peak has an area percent value greater than 10% of total hemoglobin only when an abnormal hemoglobin is present or in poorly controlled diabetes.              4 The A 0  peak has an area percent value always greater than 80% of total hemoglobin except in cases of thalassemia, abnormal hemoglobin, or in very poorly controlled diabetes.              5 When A 0  and hemoglobin variants eluting very close to A 0  were both present in the same sample, the two hemoglobins blended together as a single peak which was shorter and broader than a peak composed of a single substance.              6 Degradation products result from hemoglobin degradation in older samples.             
 
         [0027]    
       
         
               
             
               
               
             
           
               
                 TABLE 2 
               
             
             
               
                   
               
               
                   
               
               
                 Codes. 
               
             
          
           
               
                 Code 
                 Description 
               
               
                   
               
               
                 1 
                 The width of the A 0  peak is greater than 1.2 times the width 
               
               
                   
                 of the marker A 0  peak. 
               
               
                 2 
                 The area percent value of the A 0  peak is less than 80%. 
               
               
                 3 
                 The area percent value of any peak other than the A 0  peak is 
               
               
                   
                 greater than the expected area percent value for that peak. 
               
               
                   
               
             
          
         
       
     
         [0028]    
       
         
               
             
               
               
               
             
           
               
                 TABLE 3 
               
             
             
               
                   
               
               
                   
               
               
                 Windows for A 1c , A 0 , degradation products, A 2 , 
               
               
                 hemoglobin Bart&#39;s, and F. 
               
             
          
           
               
                   
                 Hemoglobin 
                 Window 1   
               
               
                   
                   
               
               
                   
                 A 1c   
                 0.6-0.9 2   
               
               
                   
                 A 0   
                 0.98-1.03 3   
               
               
                   
                 Degradation Products 
                 0.75-0.89 4   
               
               
                   
                 A 2   
                 1.05-1.20 5   
               
               
                   
                 Bart&#39;s 
                 &lt;0.18 6   
               
               
                   
                 F 
                 0.90-1.05 7   
               
               
                   
                 Acetylated F 
                 0.28-0.40 8   
               
               
                   
                   
               
               
                   
                     1 Windows are expressed either as a range of values for either absolute retention time or relative retention time; relative retention time is determined by dividing the absolute retention time of one species by the absolute retention time of another species; the window for each particular species noted in Table 3 was determined experimentally by running one or more samples known to contain that species.    
               
               
                   
                     2 Relative retention time (absolute retention time of known A 1c  divided by the absolute retention time of marker F).    
               
               
                   
                     3 Relative retention time (absolute retention time of known A 0  divided by the absolute retention time of marker A).    
               
               
                   
                     4 Relative retention time (absolute retention time of known degradation products divided by the absolute retention time of marker A).    
               
               
                   
                     5 Relative retention time (absolute retention time of known A 2  divided by the absolute retention time of marker A).    
               
               
                   
                     6 Absolute retention time in minutes.    
               
               
                   
                     7 Relative retention time (absolute retention time of known F divided by the absolute retention time of marker F, with known F and marker F being in different samples).    
               
               
                   
                     8 Relative retention time (absolute retention time of known Acetylated F divided by the absolute retention time of marker F).    
               
             
          
         
       
     
         [0029]     At the conclusion of each batch run, a batch summary report is printed. Each batch summary report lists every sample which has been flagged as abnormal. The batch sample report includes the following information: a) the sample number, b) the number of the peak which was abnormal, c) the absolute retention time of the species giving the peak, d) the relative retention time of the species giving the peak (i.e., the absolute retention time of the species giving the peak divided by the absolute retention time of the closest marker species), e) the width of the peak, f) the area percent value of the peak, g) the quantitative A 2  and F values, and h) one or more of the code numbers described above.  
         [0030]     The data generated in this example was highly reproducible and accurate. A statistical analysis of the data indicated that the correlation coefficient was greater than 0.99 when compared with the 10 minute high resolution method.  
       EXAMPLE 2  
       [0031]     In this example, a series of quick scan/A 2  and F quantitation assays were performed as described above using a different lot of HPLC columns, which were found to have significantly different properties. This necessitated a change in both reagent composition and the non-linear eluant gradients employed. In particular, mobile phase  1  was composed of 20 mM Bis-Tris and 2 mM KCN, and had a pH of 7.0. Mobile phase  2  was composed of 20 mM Bis-Tris, 2 mM KCN and 200 mM NaCl and had a pH of 6.6.  
         [0032]     After start-up was completed, the column was equilibrated over 2 minutes with a mixture of 85% mobile phase  1  and 15% mobile phase  2  at a constant flow rate of 3.0 ml/minute for 0.5 minutes followed by 1.5 minutes at 2.5 ml/minute. Throughout the analysis (i.e., during equilibration and thereafter), the column temperature was maintained at 40° C., and the eluant employed was passed through the column at a constant flow rate of 2.5 ml/minute for the first 2.3 minutes and increasing linearly to 3.0 ml/minute over a period of 0.5 minutes (i.e., from 2.3 minutes to 2.8 minutes). The flow was then kept constant until 4.0 minutes at which time it was reduced immediately to 2.5 ml/minute. A non-linear mobile-phase gradient covering a range of concentrations from 90% mobile phase I and 10% mobile phase  2  to 100% mobile phase  2  was used to separate hemoglobin components. The gradient changes took place over 3.5 minutes. Thereafter, the conditions were returned to the starting conditions over 0.1 minute.  
         [0033]     The non-linear mobile phase gradient included the following steps. At time of injection (i.e., time zero), the eluant consisted of 90% mobile phase  1  and 10% mobile phase  2 . Over the first 0.4 minutes (i.e., to time 0.4 minute), the composition of the eluant was changed in a linear fashion to consist of 86% mobile phase  1  and 14% mobile phase  2 . From time 0.4 minutes until time 1.0 minutes, the eluant was kept constant at 86% mobile phase  1  and 14% mobile phase  2 . From time 1.0 minutes to time 2.3 the eluant was changed in a linear fashion to consist of 70% mobile phase  1  and 30% mobile phase  2 . From time 2.3 minutes until time 2.8 minutes the eluant was changed in a linear fashion to consist of 50% mobile phase  1  and 50% mobile phase  2 . From time 2.8 minutes until 3.2 minutes the eluant was changed in a linear fashion to consist of 25% mobile phase  1  and 75% mobile phase  2 . From time 3.2 minutes until time 3.21 minutes the eluant was changed in a linear fashion to consist of 100% mobile phase  2 . This eluant condition was then maintained for an additional 0.39 minutes (i.e., until time 3.5 minutes). From time 3.5 minutes until time 3.51 minutes the eluant was changed in a linear fashion to consist of 85% mobile phase  1  and 15% mobile phase  2 . This eluant condition was maintained for an additional 1.99 minutes (i.e., until time 5.5 minutes). Thus, a total time of 5.5 minutes elapsed from injection to injection.  
         [0034]      FIG. 2  is a representative output report from one of the samples tested in this batch.  
         [0000]     Computer Assistance.  
         [0035]     The above-described steps and calculations may be performed manually. However, they are preferably performed with the aid of the computer program set forth in detail in the attached Microfiche Appendix. The computer program operates a conventional microcomputer, minicomputer, or mainframe computer and is stored on a conventional computer-readable memory device such as a floppy or optical disk of the hard drive of the computer.