BACKGROUND: Cytokeratins are epithelial markers whose expressions are not lost during malignant transformation. The utility of cytokeratin fragment (Cyfra) 21-1, a new tumor marker, was investigated in 110 patients with lung cancer. The aims of this study were to confirm sensitivity of Cyfra 21-1 in detecting non-small cell cancer, to assess the potential relationship between Cyfra 21-1 and disease stage of the lung cancer. METHODS: We measured serum levels of four tumor marker (NSE, CEA, SCC Ag, Cyfra 21-1) in 110 patients with lung cancer. The measurement of serum level of Cyfra 21-1 was performed with a cut off value of 3.3 ng/mL. An immunoradiometric assay was used to detect a fragment of the cytokeratin 19. The patients were grouped according to the stage of the disease and tumor type. RESULTS: Overall sensitivity of Cyfra 21-1 was relatively high (51.8%) than others tumor markers. Sensitivity of this marker was especially high for adenocarcinoma (63.2%) and squamous cell carcinoma (54.1%). In contrast, sensitiviy of Cyfra 21-1 was relatively low for small cell lung carcinoma (40.0%). Serum levels of Cyfra 21-1 were higher in advanced nonsmall cell lung cancer than early stage disease. CONCLUSION: We conclude that Cyfra 21-1 is a sensitive tumor marker of nonsmall cell lung cancer, especially adenocarcinoma and also may be a useful adjunctive marker for disease monitoring.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Humans ; Immunoradiometric Assay ; Keratin-19 ; Keratins ; Lung Neoplasms* ; Lung* ; Small Cell Lung Carcinoma ; Biomarkers, Tumor

Stent thrombosis (ST) is one of the major complications that occur in percutaneous coronary interventions (PCIs) with stents. Various factors have been attributed to the development of ST, and several strategies have been recommended for its management. We report the case of a patient suffering from recurrent subacute STs after recurrent PCIs. The patient was treated by coronary artery bypass graft (CABG).
Coronary Artery Bypass ; Humans ; Percutaneous Coronary Intervention ; Stents ; Stress, Psychological ; Thrombosis ; Transplants

PURPOSE: Catheter directed thrombolytic dissolution (CDT) of deep vein thrombus (DVT) is in widespread use, yet the complications especially pulmonary embolism (PE), associated with the procedure remains ill defined. To assess the incidence of PE we reviewed the clinical course of acute DVT patients treated by CDT. METHOD: From January 2000 to September 2003, 25 patients were treated by CDT. To define the new development of PE, patients had a technetium 99m lung scan before and just after CDT-, and clinical symptoms were recorded. All patients underwent ascending venogram and CT scan initially to define DVT extension. CDT with urokinase was done by a the same intervention radiologist. RESULT: Proximal thrombus extension level was the femoral vein in 8 patients, iliac vein in 12-, and inferior vena cava (IVC) in 5. Complete thrombolysis was achieved in 16 patients, partial lysis in 2 and no lysis in 7. PE was detected in 7 patients with initial lung scan whose thrombus proximal level was IVC 2, iliac vein 4, femoral vein 1 in each, and no changes in lung scan after CDT. In 17 patients with normal findings at intial lung scan, there were also no changes after CDT. One patient with normal lung scan showed high probable scan defects in lung scan after CDT. Because he also complained of sudden onset dyspnea with cough, we diagnosed him as newly developed, PE-related CDT. CONCLUSION: Only one (4%) case of PE was developed in our study. No prediction factor of PE such as CDT results, or thrombus proximal extent could be defined. These findings suggest that routine usage of temporary IVC filter is unnecessary during CDT.
Catheters* ; Cough ; Dyspnea ; Femoral Vein ; Humans ; Iliac Vein ; Incidence ; Lung ; Pulmonary Embolism* ; Technetium ; Thrombosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator ; Veins ; Vena Cava, Inferior ; Venous Thrombosis*