Affinity maturation of tacrolimus antibody for improved immunoassay performance.

Background: Organic solvents used for extraction of tacrolimus from whole blood samples lower the apparent affinity of the antibody used in a diagnostic immunoassay, thereby affecting the detection limit.

Methods: We used in vitro recombinant antibody engineering to screen and isolate clones from diverse libraries with mutagenic complementarity regions (CDRs) from tacrolimus 1-60-46 hybridoma cell line, with improved binding to tacrolimus in the presence of 10% methanol organic solvent solution.

Results: We isolated a number of clones with mutations in variable heavy (VH) CDR 2, variable light (VL) CDR 1, and VL CDR 3 with improved binding.

Primary evaluation and management of knee injuries.

In summary, knee injuries may be difficult to evaluate, but a systematic approach can lead one to an accurate, precise diagnosis. Certain injuries require higher priority management, and more expedient care and recognition of these is critical.

Immediate closed antegrade Ender nailing of femoral fractures in polytrauma patients.

Fifty-four trauma patients with 61 femoral fractures stabilized within the first 24 hours of admission by closed antegrade Ender nailing were included in this study. This technique involves the insertion of Ender nails from a portal at the proximal end of the femur through the piriformis fossa. The curved distal ends of the nails were distributed throughout the distal femur to achieve greater purchase in the enlarged medullary canal of the distal fragment.

Quadriceps atrophy in the anterior cruciate insufficient knee.

Atrophy of the quadriceps musculature is frequently associated with chronic knee instability. This atrophy may persist despite the patient's ability to return to athletic competition. When open biopsies of the quadriceps muscle from unstable knees were compared with those from normal acutely injured knees, it was found that clinical evidence of atrophy correlated with a relative decrease in the size of Type II or fast twitch muscle fibers.

Primary evaluation and management of knee injuries.

In summary, knee injuries may be difficult to evaluate, but a systematic approach can lead one to an accurate, precise diagnosis. Certain injuries require higher priority management, and more expedient care and recognition of these is critical (Table 1).

Peripheral nerve compression by brachial artery-basilic vein vascular access in long-term hemodialysis.

This report presents the first description of direct peripheral nerve compression as a complication of brachial artery-basilic vein vascular access in patients with uremia who are receiving long-term hemodialysis. Three patients are presented. An expanding basilic vein hematoma compressed the radial nerve in one patient.

Outpatient meniscectomy of the knee.

This paper reviews 218 patients who had outpatient meniscectomy at the University of Virginia between January 1974 and June 1977. Only one patient (0.46%) returned before his scheduled visit.

Early ischial weight-bearing cast brace for femoral fractures.

Three patients with middle or distal femoral fracture were treated with modified ischial weight-bearing cast incorporating only the thigh. The treatment provided adequate stabilization, allowed early ambulation, and promoted fracture healing.

Stability examination of the knee: a simple anatomic approach.

The knee is a complex joint and its stability depends upon many factors, but static stablizing structures are the most critical. The anatomic integrity of these structures correlates well with both their functional integrity and the instability observed during manual stress-testing of the knee. This makes accurate diagnosis possible.

Hand and wrist injuries in the athlete.

Injuries to the hand and wrist are probably among the most common injuries incurred by the athlete. Neglect of such injuries may result in irreparable damage to the hand or wrist. This summary of the more common injuries to these areas seen in the athlete, with a description of the recognition and treatment, gives the reader insight into the multiple considerations the athlete and coach must have.

Epiphyseal transplant in amputations. Effects on overgrowth in a rabbit model.

Bony overgrowth of the stump is a recognized complication of amputated limbs in children. Transplantation of an epiphysis inhibits bony overgrowth in rabbits. The mechanism of inhibition as well as its applicability to other species warrants further investigation.

Gossypol detoxication by fungi.

An unidentified Diplodia isolate representative of several fungi tested and grown for 13 days on gossypol-containing cottonseed reduced the amount of free gossypol by 90 percent and detoxified the cottonseed for weanling rats and chickens. Residual free gossypol was also less toxic than equivalent amounts of normal free gossypol.