Extra-abdominal pneumodissection after laparoscopic antireflux surgery.

The presence of pneumoperitoneum during laparoscopic antireflux surgery can lead to the dissection of carbon dioxide into the mediastinum, retroperitoneum, subcutaneous tissues, and neck (pneumodissection). The purpose of this study is to describe the incidence, extent, duration and pathways of pneumodissection during laparoscopic antireflux surgery. Twenty patients who underwent laparoscopic antireflux surgery from August 1998 through May 1999 were studied. Physical examination and chest radiographs were performed in the recovery room and each day postoperatively. Noncontrast computerized tomography (CT) of the neck, chest, and upper abdomen was also performed on postoperative day one. Subcutaneous emphysema and radiologic evidence of pneumodissection occurred commonly and typically resolved within 4 days postoperatively. The incidence of pneumomediastinum (85%) seen on CT scan was similar to that of pneumodissection into the neck (80%). The most common pathway of dissection of gas was through the anterior mediastinum and into the neck through the carotid space. Other findings on CT scan revealed pneumoperitoneum in 70 per cent, pneumoretroperitoneum in 10 per cent, and pneumothorax in 0 per cent. The dissection of gas into the mediastinum, neck, and subcutaneous tissues is very common after laparoscopic antireflux surgery. Subcutaneous emphysema on physical examination and radiographic pneumodissection typically resolves within 3 to 4 days. After this time one should consider the presence of any substantial amount of gas as a potential complication related to the procedure.

Intracranial giant cell reparative granuloma arising from the temporal lobe area: MR findings.

SUMMARY: We present an unusual case of a giant cell reparative granuloma arising from the left temporal lobe area of a 38-year-old man and provide clinical and MR findings. Current diagnosis and treatment options are also discussed.

Hepatic adenomatosis: rapid sequence MR imaging following gadolinium enhancement: a case report.

Hepatic adenomas are primary liver tumors usually associated with underlying metabolic disease or with anabolic steroid or oral contraceptive use. Hepatic adenomatosis (HA) is defined as the presence of more than four adenomas. Only 13 cases of HA have been reported in patients without glycogen storage disease or steroid use. We report a case of HA imaged by postcontrast T1-weighted images obtained during a breath-holding series. The lesions were most conspicuous 3-4 min after contrast administration; 4 of the 5 tumors were not identified on T2-weighted images. Unlike previous reports of HA in which the lesions remained hyperintense during sequential postcontrast imaging, the smaller lesions in this case demonstrated contrast washout, thereby distinguishing them from hemangiomata.

Influence of water deficits on the abscisic Acid and indole-3-acetic Acid contents of cotton flower buds and flowers.

A field experiment was conducted during the summer of 1988 to test the hypothesis that water deficit affects the abscisic acid (ABA) and indole acetic acid (IAA) concentrations in cotton (Gossypium hirsutum L.) flower buds in ways that predispose young fruits (bolls) that subsequently develop from them to increased abscission rates. Water deficit had little effect on the ABA content of flower buds but increased the ABA content of flowers as much as 66%. Water deficit decreased the concentrations of free and conjugated IAA in flower buds during the first irrigation cycle but increased them during the second cycle. Flowers contained much less IAA than buds. Water deficit slightly increased the conjugated IAA content of flowers but had no effect on the concentration of free IAA in flowers. Because water deficit slightly increased the ABA content but did not decrease the IAA content of flowers, any carry-over effect of water deficit on young boll shedding might have been caused by changes in ABA but not from changes in IAA.

Changes in Amide-Linked and Ester Indole-3-Acetic Acid in Cotton Fruiting Forms during Their Development.

The concentration of free indoleacetic acid (IAA) is high in cotton (Gossypium hirsutum L.) fruiting forms before anthesis, but is low at and for a few days after anthesis. Amide-linked and ester IAA were measured in fruiting forms at 9, 6, and 3 days before anthesis; at anthesis; and at 2, 4, 7, and 9 days after anthesis to determine if free IAA decreased because it was converted to a conjugated form. That did not appear to be the case. While the major decrease in free IAA occurred during the 6 days before anthesis, ester IAA increased only a small amount and amide-linked IAA decreased even more than free IAA. During the 6 days before anthesis free IAA decreased from 0.62 to 0.12 micrograms per gram and amide-linked IAA decreased from 19.14 to 1.16 micrograms per gram dry weight. No evidence was found that a large amount of amide-linked IAA was converted to an insoluble form; flowers contained less than 1 microgram per gram of insoluble IAA. The free and amide-linked IAA must have been converted to other forms, perhaps by oxidation. Soluble amide-linked IAA remained low after anthesis. No ester IAA was detected 6 days before anthesis and only 0.08 microgram per gram dry weight was measured at anthesis. The concentration of ester IAA increased thereafter to 4.43 micrograms per gram at 9 days after anthesis. Therefore, amide-linked IAA was the major form of IAA in flower buds and ester IAA was the major form in young fruits (bolls). Minimum concentrations of free and total IAA occurred during the 4 days after anthesis, a stage when cotton fruiting forms are most likely to abscise. The large decreases in free and amide-linked IAA during the 6 days before anthesis may indicate a rapid turnover of IAA in flower buds. But, the decrease in free IAA was not accompanied by a comparable increase in ester or amide-linked IAA.

Changes in Abscisic Acid and Indoleacetic Acid before and after Anthesis Relative to Changes in Abscission Rates of Cotton Fruiting Forms.

Cotton (Gossypium hirsutum L.) fruiting forms exhibit pronounced changes, with age, in their probability of abscission. Large floral buds rarely abscise, but after anthesis the young fruits (bolls) have a high probability of abscising. Abscission rate reaches a peak about 5 to 6 days after anthesis and then gradually decreases. An experiment was conducted to try to determine the reason for the rapid and pronounced increase in probability of abscission just after anthesis. Cotton was grown in the field and fruiting forms of various ages from 9 days before to 9 days after anthesis were all harvested the same day and subsequently analyzed for ABA and IAA. The concentration of ABA decreased slightly at anthesis and increased gradually thereafter. In contrast, the concentration of IAA was high before anthesis and then decreased at anthesis to about one-fifth the previous concentration. IAA remained low for at least 4 days after anthesis and then increased rapidly between 7 and 9 days after anthesis. The high concentration of IAA in floral buds before anthesis is probably a major factor in their resistance to abscission. Likewise, the low concentration of IAA at anthesis and for about 4 days thereafter may promote fruit abscission during the young boll stage.

Changes in Free and Conjugated Indole 3-Acetic Acid and Abscisic Acid in Young Cotton Fruits and Their Abscission Zones in Relation to Fruit Retention during and after Moisture Stress.

Experiments were conducted with field-grown cotton (Gossypium hirsutum L.) in 1985 and 1986 to determine effects of water deficit on levels of conjugated indole 3-acetic acid (IAA) and abscisic acid (ABA) in young fruits (bolls) and their abscission zones in relation to boll retention. Tissues were harvested three times during an irrigation cycle in 1985. They were harvested twice during an irrigation cycle and once after irrigation in 1986 to determine extent of recoveries of measured parameters. As reported earlier, the free IAA content of abscission zones decreased with moisture stress. Irrigation caused a partial recovery in free IAA content of abscission zones and caused a partial recovery in rate of boll retention. In contrast to free IAA, conjugated IAA increased with water deficit, both in 3-day-old bolls and in their abscission zones. Bolls contained much more ester IAA than their abscission zones. Some, but not all, of the increase in ester IAA in bolls during moisture stress could have come from a conversion of amide-linked IAA. Amide IAA decreased slightly during stress and increased after irrigation, but the concentration was low relative to ester IAA. Free and conjugated ABA both increased during stress and decreased after irrigation. However, the concentration of conjugated ABA remained relatively high in abscission zones. Ester IAA, being more resistant than free IAA to enzymic destruction during stress, may hasten recovery of fruit retention after relief of stress by providing a source of free IAA in abscission zones to inhibit continued abscission.

Concentrations of abscisic Acid and indoleacetic Acid in cotton fruits and their abscission zones in relation to fruit retention.

An experiment was conducted with field-grown cotton (Gossypium hirsutum L.) to determine the effects of drought and an increase in available photosynthate on the abscisic acid (ABA) and indoleacetic acid (IAA) contents of 3-day-old bolls and their abscission zones. Photosynthate availability was manipulated by removing about two-thirds of the plants to permit increased irradiance, and thus photosynthesis, in the plant canopy. The demand for photosynthate was decreased by removing all bolls from the remaining plants. The thinning and defruiting operations were performed about 3 weeks after first flower. Control plants were neither thinned nor defruited. Effects of water deficit were observed by making three harvests at different times during a 2-week irrigation cycle. Increasing the availability of photosynthate increased boll retention, but had relatively little effect on the concentrations of ABA and IAA in bolls. However, it did increase the concentration of IAA in abscission zones. Water deficit increased the ABA content of bolls and abscission zones and decreased the IAA content of bolls and abscission zones. Across all treatments, the IAA content of abscission zones was positively correlated, and the ABA content of bolls was negatively correlated, with boll retention. The results indicate that stresses change the hormonal balance in ways that are consistent with observed increases in fruit abscission.

Purification and measurement of abscisic Acid and indoleacetic Acid by high performance liquid chromatography.

A procedure was selected for the simultaneous extraction and purification of abscisic acid (ABA) and indoleacetic acid (IAA). Unnecessary steps were eliminated and an accumulation of aqueous phase was avoided. The superior performance of diethyl ether (compared to ethyl acetate) for bulk purification and the superior resolution provided by 250 millimeter columns packed with 5-micrometer spherical particles of strong anion exchanger and octadecylsilane (C18) greatly facilitated the purification of samples. A fixed-wavelength (254 nanometer) ultraviolet detector and a fluorescence detector connected in series on a high performance liquid chromatograph permitted nondestructive monitoring and measurement of ABA and IAA. Derivatization was not necessary for chromatography or for detection. Isocratic elution with simple mobile phases gave sharp peaks. A few simple precautions minimized losses. Recoveries through the entire procedure averaged about 75% for ABA and about 50% for IAA. Purified ABA and IAA fractions were usually free of interfering contaminants. Identities were confirmed by gas chromatography-mass spectrometry.