We investigated IgG transport across the gut of suckling opossums to see whether it is likely to be Fc gamma R-mediated. Enterocytes isolated from the proximal and distal regions of the small intestine of suckling aged 12-52 days, and reacted with indicator SRBC at pH 6.0 or 7.2, bound opossum IgG in rosette assays. Considerable overall variation was observed in the numbers of enterocytes forming rosettes. No binding was seen with rabbit IgG at these ages, or with opossum and rabbit IgG when enterocytes were obtained from opossums aged 55-73 days. Opossum anti-SRBC antibody (IgG) fed to sucklings at 52 days and earlier (but not later) could subsequently be detected in the serum. However, rabbit anti-SRBC antibody (IgG) could not be detected in the blood serum when fed to sucklings of any age. Fluorescent tracing of FITC-labelled opossum and rabbit IgG fed to suckling opossums, and of endogenous opossum IgG, pointed to transport of the homologous IgG occurring across gut enterocytes of the proximal region. These results suggest that IgG is recognised and transcytosed by specific Fc gamma Rs present on opossum enterocytes prior to weaning.

Age Factors↗

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Blood for culture.

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Bacteremia↗

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Graft fixation in cruciate ligament reconstruction.

Cruciate ligament reconstruction has progressed dramatically in the last 20 years. Anatomic placement of ligament substitutes has fostered rehabilitation efforts that stress immediate and full range of motion, immediate weightbearing, neuromuscular strength and coordination, and early return to athletic competition (3 months). This has placed extreme importance on secure graft fixation at the time of ligament reconstruction. Current ligament substitutes require a bony or soft tissue component to be fixed within a bone tunnel or on the periosteum at a distance from the normal ligament attachment site. Fixation devices have progressed from metal to biodegradable and from far to near-normal native ligament attachment sites. Ideally, the biomechanical properties of the entire graft construct would approach those of the native ligament and facilitate biologic incorporation of the graft. Fixation should be done at the normal anatomic attachment site of the native ligament (aperture fixation) and, over time, allow the biologic return of the histologic transition zone from ligament to fibrocartilage, to calcified fibrocartilage, to bone. The purpose of this article is to review current fixation devices and techniques in cruciate ligament surgery.

Anterior Cruciate Ligament↗

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