[Membrane induction and transposition of non-vascularized ipsilateral fibula in posttraumatic bone neoformation. Case report]. / Inducción de membrana y trasposición de peroné ipsolateral no vascularizado en neoformación ósea postraumática. Reporte de caso.

OBJECTIVE: To demonstrate the outcome of tibial bone neo formation, using induced-membrane technique and non-vascularized ipsolateral fibular graft transposition. CASE REPORT: A 25 years old male with a 2 years ago firearm injury in left leg, presenting an initial diagnosis of open fracture Gustilo IIIB AO 42C3 IO4NV1MT2 with a 7cm tibial diaphyseal bone defect. During his hospital evolution multiple interventions were made including surgical debridement and skin grafts placement, with unfavorable results. Therefore, we decided to use the induced-membrane technique and non-vascularized ipsolateral fibular graft transposition, resulting in a cane dependent ambulation, in 4 months evolution after last intervention. CONCLUSION: Induced-membrane technique and non-vascularized ipsolateral fibular graft transposition could be a successful alternative for the management of patients with severe bone loss.

OBJETIVO: Demostrar los resultados en la neoformación ósea de tibia utilizando la técnica de inducción de membrana más la transposición de peroné ipsolateral no vascularizado. CASO CLÍNICO: Masculino de 25 años, antecedente de sufrir impacto por arma de fuego en pierna izquierda dos años antes, presentó un diagnóstico inicial de fractura expuesta Gustilo IIIB AO 42C3 IO4NV1MT2 con pérdida ósea de 7 cm de diáfisis tibial. Durante su evolución se realizaron múltiples aseos quirúrgicos y colocación de injertos cutáneos con resultados no favorables, por lo que se emplea la técnica de membrana inducida más colocación de peroné ipsolateral no vascularizado, teniendo una evolución a los cuatro meses posterior a su última intervención con deambulación dependiente de bastón. CONCLUSIÓN: La técnica de inducción de membrana con transposición de peroné ipsolateral no vascularizado podría ser una alternativa adecuada para el manejo de pérdidas óseas en los pacientes.

Preclinical evaluation of alpha-1-proteinase inhibitor. Pharmacokinetics and safety studies.

To assess the pharmacodynamics and safety of alpha-1-proteinase inhibitor (human) (A1PI) isolated from pooled human plasma, a series of animal studies was conducted. Using both unlabeled and 125I-labeled A1PI (highly purified), plasma residence time and tissue distribution were determined in rabbits. A catabolic half-life of 48.5 hours was obtained for the labeled material, which agreed well with the antigenic decay (35.5 hours), measured with a specific enzyme-linked immunosorbent assay, and the functional activity decay (38.1 hours), measured antigenically by the ability of resident human A1PI to complex with human neutrophil elastase. No unusual tissue distribution was observed at the first, 24th, or 168th hour of sacrifice. Cynomolgous monkeys received infusions of labeled A1PI and a catabolic half-life of 55.45 hours was obtained; infusion of unlabeled material yielded anticipated plasma recovery and a significant increment in A1PI in bronchial-alveolar lavage fluid, both antigenically and functionally determined. Safety studies assessing acute physiologic response and both acute and subacute toxicity presented no significant adverse effects. We conclude that A1PI (human) presents normal pharmacodynamics and safety and is therefore associated with a wide margin of safety for the intended clinical applications.