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A 55-year-old man presented to the emergency department (ED) following 2 episodes of typical cardiac chest pain and nonspecific electrocardiogram findings. His serial cardiac marker assays revealed an elevated total creatine kinase (CK) and 2 negative cardiac troponin levels. Because of a high clinical suspicion of acute coronary syndrome, a total creatine kinase MB mass was obtained and found to be elevated. Subsequent cardiac angiography demonstrated a significantly flow-limiting coronary artery lesion, and stenting was performed. This case demonstrates that simultaneous CK and troponin measurements may have utility in selected ED patients with chest pain. The interpretation of discordant CK and troponin levels is discussed.
We demonstrate a highly strained InGaAs/GaAs VECSEL operating at 1173 nm with more than 8.5 W output power and tunable over 40 nm. High-efficiency yellow-orange emission is then achieved by intra-cavity frequency doubling. Over 5 W of CW output power in the 585-589 nm spectral regions is achieved. This compact low-cost high-power yellow-orange laser provides an innovative alternative for sodium guidestar lasers or other medical / communication applications.
In this issue of the Journal, Auer and colleagues conclude that serum levels of neuron-specific enolase (NSE), a biochemical marker of ischemic brain injury, may have clinical utility for the prediction of survival to hospital discharge in patients experiencing the return of spontaneous circulation following at least 5 minutes of cardiopulmonary resuscitation. The authors used a receiver operating characteristic (ROC) curve to illustrate and evaluate the diagnostic (prognostic) performance of NSE. We explain ROC curve analysis in the following paragraphs.