We compared diagnostic values of three serum carbohydrate antigens, KL-6, CA19-9 and SLX to discriminate interstitial pneumonia (IP) from alveolar pneumonia and healthy volunteers. Subjects consisted of 13 patients with idiopathic pulmonary fibrosis and 10 associated with collagen vascular diseases, 12 patients with sarcoidosis and 70 controls (52 healthy volunteers and 18 patients with alveolar pneumonia). Cut-off values were determined at the level at which the diagnostic accuracy became the highest for each marker, 449 U/mL for KL-6, 26 U/mL for CA19-9 and 41 U/mL for SLX. The sensitivity, the specificity and the diagnostic accuracy were 74.3% (26/35), 98.6% (69/70) and 90.5% (95/105) in KL-6, 42.9% (15/35), 94.3% (66/70) and 77.1% (81/105) in CA19-9, and 20.0% (7/35) and 95.7% (67/70) and 70.5% (74/105) in SLX, respectively. Receiver operating characteristic curves revealed that KL-6 was far superior to both CA19-9 and SLX. These results suggest that KL-6 is the best marker for interstitial pneumonia among these carbohydrate antigens.
Percutaneous transhepatic gallbladder drainage (PTGBD) is an alternative to emergency laparoscopic cholecystectomy in high-risk patients with acute cholecystitis. Severe complications of this procedure are rare, except for drainage tube-related complications. A case of thoracic empyema, which is a rare complication of PTGBD, is reported; penetration of the pleural cavity seemed to be the cause of the thoracic empyema.
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