Exploiting nucleotidylyltransferases to prepare sugar nucleotides

[reaction: see text] Enzymatic approaches to prepare sugar nucleotides are gaining in importance and offer several advantages over chemical synthesis including high yields and stereospecificity. We report the cloning, expression, and purification of two new wild-type thymidylyltransferases and observed catalysis with a wide variety of substrates. Significant product inhibition was not observed with the enzymes studied over a 24 h period, enabling the efficient preparation of 15 sugar nucleotides, clearly demonstrating the synthetic utility of these biocatalysts.

The "Inconclusive--possible high grade epithelial abnormality" category in Papanicolaou smear reporting

BACKGROUND

The Australian Terminology for Cervical Cytology Reporting includes the category "Inconclusive-Possible high grade epithelial abnormality."

METHODS

The frequency of use of this category, the types of associated cell patterns, and the yield of high grade lesions at biopsy were studied.

RESULTS

One hundred and two cases categorized as "Inconclusive" were reported between January and June 1995, representing 0.24% of 41,712 Papanicolaou (Pap) smears screened. The abnormal cells were reported as squamous in 74.5% of cases, endocervical in 4.9% of cases, endometrial in 3.9% of cases, and indeterminate in 16.7% of cases. The main cellular patterns included disorganized groups of hyperchromatic squamous, glandular, or indeterminate cells (64.2% of cases) and atypical metaplastic squamous cells (28.4% of cases). Cell preservation was suboptimal. In 25.3% of cases the cells were highly degenerate or air-dried. Follow-up included biopsy (84.3% of cases), colposcopy alone (7.8% of cases), and repeat Pap smears without any detected abnormality (3.9% of cases). No follow-up was available in 3.9% of cases. High grade abnormalities were found in 66.3% of the biopsied cases and 55.9% of the total cases (48 cervical intraepithelial neoplasia [CIN] of Grade 2 or 3; 2 squamous cell carcinomas; 3 endocervical adenocarcinoma in situ [ACIS]; 3 adenocarcinomas of endocervical, ovarian, and endometrial origin; and 1 endometrial stromal sarcoma). In 16.2% of cases a low grade squamous lesion was present on biopsy (CIN, Grade 1 or human papillomavirus effect); and no lesion was found in 17.4% of cases.

CONCLUSIONS

The "Inconclusive" category was not overused, and gave a high yield of biopsy abnormalities. Accepting uncertainty in the diagnosis of some high grade lesions reduces their likelihood of being classified incorrectly as reactive changes, ignored because of poor cell preservation, or lost in the larger group of classifications such as atypical cells of undetermined significance, borderline nuclear abnormality, or non-specific minor changes.

Sudden death in childhood and adolescence

Sudden natural deaths of individuals between the ages of 2 and 20 years which occurred during a 20-year period were identified from mortuary records. Necropsy reports and histological sections were reviewed; 169 sudden natural deaths were identified amongst 1012 deaths in that age group. Ninety-two sudden deaths occurred to children with recognized disorders; congenital heart disease, asthma, and epilepsy were the commonest problems identified. Amongst the 77 deaths of apparently healthy children, infection was the most frequently recognized disease. Only 11 deaths were unexplained, comprising 1 per cent of the necropsy population or 6.5 per cent of sudden natural deaths, a much smaller proportion than pertains in infancy. Necropsy examination of children dying suddenly yields useful information.

Megacystis-microcolon-intestinal hypoperistalsis syndrome: confirmation of autosomal recessive inheritance

We report two female sibs with the megacystis-microcolon-intestinal hypoperistalsis syndrome. The parents are first cousins. These cases, together with three other published reports of affected sibs, confirm the autosomal recessive inheritance of the syndrome.

Lymphadenopathy as a primary presenting sign: a clinicopathological study of 228 cases

A total of 228 cases of lymphadenopathy as a primary presenting sign are reported. Tissue diagnoses were divided into: metastatic carcinoma (41 per cent), lymphoma (19 per cent), a specific non-neoplastic condition (10 per cent) and non-specific hyperplasia and inflammation (30 per cent); thus the overall yield of positive tissue diagnosis was 70 per cent. Just 5 primary sites: breast, lung, gastrointestinal and genito-urinary tracts and skin (mainly melanomas) accounted for all but one case. Hodgkin's and non-Hodgkin's lymphomas were evenly distributed. In those with generalized malignant lymphadenopathy a surprisingly even proportion of 1 to 1.5 was found between carcinoma and lymphoma. In those with localized malignant disease metastatic carcinoma predominated. The overall incidence of primary lymphadenopathy in increased with age, due to an increase in malignancy. Less than half of patients with carcinomatous lymphadenopathy had symptoms and these tended to be organ specific, whereas three-quarters of patients with lymphoma had symptoms which were usually non-specific. A haematological screen, liver function tests and chest X-ray were frequently abnormal but were not diagnostic.

Tumoral calcinosis

Tumoral calcinosis is an uncommon, usually solitary, tumour-like mass characterized by soft tissue calcification for no apparent reason. Nearly all cases have occurred in negroes, including 2 previously recorded in this country. We report 7 cases seen over a period of 3 years in English caucasian patients and suggest that the condition is not rare but goes unrecognized under a variety of guises. Three of these 7 patients, 2 of whom were on haemodialysis for renal failure, had isolated hyperphosphataemia, which is the only aetiological factor detected so far. Surgical excision appears to be the only effective treatment.