Biomedical subjects
H A Razek
Publications and source records attributed to H A Razek.
Serial troponin I measurements detect recurrent myocardial infarction after initial acute myocardial infarction.
UNLABELLED: Serial serum troponin I and CK-MB measurements were obtained for 36 patients presenting to the emergency department with a confirmed diagnosis of acute myocardial infarction (AMI). For each patient, the normalized percentage of maximum troponin I concentration (%max TropI) was plotted vs. the time from the maximum value to obtain a kinetic decay plot. The linear correlation plots of the--Log (%max TropI) vs. time were compared. Patients with uncomplicated AMI (n = 31) showed linear correlation coefficients (CC) above 0.97 (mean CC = 0.991). Patients with AMI complicated by recurrent myocardial infarction (n = 5) documented by corroborate clinical findings, electrocardiographic abnormalities and/or abnormal CK-MB results showed linear correlation coefficients (CC) less than 0.97 (mean CC = 0.763). Using a cutoff value of CC = 0.97, both patient groups were completely separated and re-infarction or extension of infarction was predicted with 100% accuracy, sensitivity and specificity. CONCLUSION: Kinetic modeling of troponin I decay in patients with AMI correctly differentiates patients with complicated vs. non-complicated courses.
The waves of the electrocardiogram: Part 3: The ST segment.
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Tubular carcinoma of the breast: an institutional review.
Tubular carcinoma of the breast is a rare, but distinct, well-differentiated histologic subtype of invasive carcinoma, known for its favorable prognosis. Review of the literature reveals controversy relative to the frequency of tubular carcinoma, the mammographic appearance, the incidence of lymph node metastases, and the need for axillary node dissection. In consideration of these variables and because of the concern that this type of breast cancer was being surgically over-treated, this review was undertaken. Through the use of our tumor registry, a retrospective review of patients with invasive breast cancer was carried out from January 1984 to September 1995. Of 1483 total cases of invasive breast carcinoma, 22 (1.5%) had a diagnosis of pure tubular carcinoma (> 90% tubular component). The mean age was 58 years (range, 37-80). In 14 patients, the lesion was detected solely by mammography with a mean size of 1.0 cm (range, 0.5-1.5 cm). The mean pathologic tumor size was 1.2 cm (range, 0.5-2.9 cm). The mean number of nodes, in 22 axillary specimens, was 19 (range, 8-30). In one patient, there was lymph node metastasis to a single node (4.5% incidence), which demonstrated tubular characteristics. Presently, 18 of the patients are alive and disease free, with a mean follow-up of 3.5 years (range, 4 months to 9 years). Our study confirms the low incidence of pure tubular carcinoma, 1.5 per cent, with the lesions being small, 1.2 cm in mean size. The mammographic lesions had no unique features that would distinguish tubular from other invasive carcinomas. With the small tumor size and the overall excellent prognosis, these patients are ideal candidates for breast preservation. Most importantly, the review did demonstrate that even in pure tubular breast carcinoma, lymph node metastases, though rare, can occur.
[New aspects of the differentiation of the presomite mouse embryo].
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