Biochemical studies on glycoproteins secreted by the epithelium of the alimentary canal have been hampered to some extent because the mucosubstances in secretions are products of various cell types. The histochemical stainability of mucins within the same cell type also varies. Considerable differences can be seen when superficial and deep glandular epithelium are compared (Spicer and Sun, 1967). lmmunological techniques offer another way of identifying gastrointestinal glycoproteins. Using specific anti-A, -B or -H sera and the immunofluorescence technique, Glynn and Holborow (1 959), Szulman (1 960, 1962) and Davidsohn et al. (1966) studied the site of production of blood-group substances in gastrointestinal epithelium. The sequential order of sugars which determine the serological specificity of these macromolecules is we1 1 established (Watk ins, 1966). On the other hand, macromolecules having the same serological specificity can be structurally quite different. Examples of this are membrane glycolipids and water-soluble glycoproteins. Differences in molecular structure can also be postulated for water-soluble glycoproteins. Evidence for this comes from immunization experiments with an isolated gastric sulphoglycoprotein fraction possessing blood-group specificity (Hakkinen, 1966Hakkinen and Virtanen, 1967). The immunized rabbits apparently formed antibodies directed not against blood-group antigens, but against some other specific sites in these macromolecules. Molecular configuration in gastric sulphoglycoproteins may be altered in certain pathological conditions such as intestinalization of the gastric epithelium or gastric cancer. A preliminary attempt t o locate the sulphoglycoproteins possessing these antigenic configurations was made by the immunofluorescence technique using specific rabbit antisera . In the present study the same technique has been used to study also the

We compared the predictive value of determining group II phospholipase A2 (PLA2) in serum for diagnosing acute appendicitis with the predictive values of white blood cell count (WBC) and measurement of C-reactive protein (CRP). In this prospective study, we included 186 patients who were undergoing appendectomy after clinical diagnoses of acute appendicitis. The performance of each test was measured by receiver-operating characteristic curves. WBC was the test of choice in diagnosing uncomplicated acute appendicitis. However, in contrast to CRP and PLA2, which increased in patients with protracted inflammation, there was not a concomitant increase in WBC. Therefore, especially CRP, but also PLA2, were better indicators of appendiceal perforation or abscess formation than was WBC. Increased WBC, CRP, and PLA2 values did not unequivocally corroborate the clinical suspicion of appendicitis, but if all three values were within normal limits, acute appendicitis could be excluded with a 100% predictive value. PLA2 values showed a highly significant correlation with CRP but not with WBC values, which supports the view that PLA2 represents an acute-phase reactant.

The present study aimed to determine the role of leucocyte count and C‐reactive protein (CRP) measurements in the diagnosis of acute appendicitis in children. In particular, children with acute appendicitis but normal leucocyte count and CRP level were sought. The present study protocol was identical to those used in earlier studies on adult patients with suspected acute appendicitis. The mean preoperative leucocyte count and CRP value in 100 consecutive children with an uninflamed appendix at appendicectomy (group A) and in 100 consecutive patients with acute appendicitis (group B) were calculated. The numbers of patients with (i) both values normal, (ii) only leucocyte count raised, (iii) only CRP level raised, and (iv) both values raised were calculated in both groups A and B. Leucocyte count effectively (p < 0.001) separated children with uninflamed appendix (mean ± SEM 10.2 ± 0.4 ± 109 1−1) from those with acute appendicitis (15.0 ± 0.4 ± 109 1−1), but the CRP value was of no use in this respect (p= 0.866; 31 ± 4mg 1−1 and 30 ± 4mg 1−1). The most conspicuous finding was that in children with acute appendicitis, both values were normal in 7 out of 100 patients. Conclusion: Contrary to adult patients, normal leucocyte count and CRP value do not effectively exclude acute appendicitis in children.