American Journal of Clinical Medicine Research

The upper-middle tibia is the multiple growth section of benign and malignant neoplasm, which is easy to result in bone defect after tumorectomy and it is a serious problem in orthopaedics. We reported a case about a huge benign or potential malignant tumor( giant cell tumor of bone) in upper-middle tibia and contrasted the advantage between the jade prosthesis and the allograft. Initially, the tumor had been curetted and then the upper-middle tibia had been given iliac bone graft, but the tumor recurred one year later. Then orthopedists gave the tumor excision and jade prosthesis replacement by the fixation of intramedullary screw. However, twenty one years later, the intramedullary screw fatigue fractured, orthopedists advised the patient be unloaded the jade prosthesis and be given the operative knee prosthesis surface replacement before allogeneic tibial condyle replacement. While 6 months later, the allogeneic bone in vivo had immunologic rejection and the knee was swelling, pain and no function. Finally, orthopedists gave the knee arthrodesis. Hence, we discovered that jade prosthesis had more advantages than allograft in proximal tibia of neoplastic bone defect and jade prosthesis was secure, durable, long period length, low immunological rejection and should be popularized in clinic.

American Journal of Clinical Medicine Research. 2013, 1(3), 45-47. DOI: 10.12691/ajcmr-1-3-3
Pub. Date: June 09, 2013

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Delayed Hemolytic Transfusion Reaction in Sickle Cell Disease

by Narcisse Elenga

Review Article

Patients with sickle cell disease frequently require red blood cell transfusions. However, transfusions can cause delayed hemolytic transfusion reaction (DHTR), a serious and potentially life-threatening complication of alloimmunization that results in hemolysis of transfused as well as patients’ own red cells. Although we are beginning to understand some of the pathophysiology and risk factors associated with alloimmunization, optimal management of DHTR in this patient population is still under debate. Here, I will review the clinical features, pathophysiology, laboratory evaluation, current strategies for management and prevention of DHTRs. Given that DHTRs are associated with massive hemolysis, it is recommended that all patients with sickle cell disease receiving transfusions are carefully and systematically monitored after each transfusion.

American Journal of Clinical Medicine Research. 2013, 1(3), 40-44. DOI: 10.12691/ajcmr-1-3-2
Pub. Date: May 24, 2013

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The Correlation between Uric Acid Levels and Amyotrophic Lateral Sclerosis

by Yu-Wei Lin, Thy-Sheng Lin and Ming-Liang Lai

Original Research

Introduction Uric acid (UA) may act as an antioxidant in ALS pathophysiology. This study examined whether serum UA concentration correlates to clinical course in the ALS patients. Methods We measured serum UA levels in 51 sporadic ALS patients, and compared them to 51 age-and-gender-matched healthy subjects. We analyzed the correlation between serum UA levels, illness duration, and disease “course factors” (defined as “disease duration” over “terminal time”) in the ALS patients. Results The mean serum UA levels in the ALS groups were higher than the control groups in both genders. Serum UA levels were inversely correlated with the disease “course factors” in the ALS male patients. Discussion The elevation of serum UA concentration in ALS patients may be related to oxidative stress. The reasons that serum UA levels inversely correlated with ALS “course factors” include: muscle wasting, poor nutrition, reduced antioxidant reserve, or increased UA consumption in end-stage patients.

American Journal of Clinical Medicine Research. 2013, 1(3), 35-39. DOI: 10.12691/ajcmr-1-3-1
Pub. Date: May 23, 2013

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