SUMMARY
BackgroundCoeliac disease affects up to 1% of the population and the British Society of Gastroenterology recommends long-term follow-up of these patients, although the absolute risk of complications is small.
An immunohistochemical study has been carried out to compare and contrast the cellular distribution of two different sialosylTn antigen binding monoclonal antibodies, MLS102 and B72.3, in the pancreas. MLS102 but not B72.3 monoclonal antibody binding increases with the content of the sialosyl-Tn epitopes. It was found that all 13 pancreatic cancer specimens bound both MLS102 and B72.3 monoclonal antibodies. Their cellular distribution in the cancer was virtually identical. Fifteen of 20 (75%) patients with chronic pancreatitis and five of 10 (50%) normal subjects were B72.3 positive, but MLS102 was completely negative in the latter group. Both monoclonal antibodies bound fetal pancreas diffusely. Thus, when pancreatic ductal cells have undergone malignant transformation, like the fetal pancreas, they express cell surface and secreted glycoconjugates with increased sialosyl-Tn epitopes suggesting enhanced 2-6 sialosyltransferase activity. This study shows that MLS102 is an extremely sensitive and specific tumour marker in the pancreas and that it is better than B72.3 in distinguishing pancreatic cancer from normal and chronic pancreatitis.
Summary:Rectal (both digital and rigid sigmoidoscopic) examination is an important part of the clinical examination. The aim of this study was to find out the opinions of the patients to this routine examination at the time of referral by their general practitioner and during their firt hospital interview.Assessment of the value for the rectal examination was also examined.We questioned 103 patients attending their second out-patient interview through a simple questionnaire. We discovered that patients considered awareness and explanation important: patients preferred to be told of the possibility of rectal examination prior to hospital consultation. Explanation of the method and reason was expected from hospital doctors. Formal consent was expected; informed verbal consent should be sufficient. Where logistically possible, a chaperone should always be present. Rectal examination would have facilitated the diagnosis in 47% of the patients examined. Thus, rectal examination should be performed on all patients where symptoms are referable to the lower gastrointestinal tract and where a possible diagnosis may be made or facilitated.
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