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At least 19 recordsLinked to original sources
PubMed1988

Inferior vena cava plethora with blunted respiratory response: a sensitive echocardiographic sign of cardiac tamponade.

To assess the diagnostic and prognostic value of the respiratory behavior of the inferior vena cava in pericardial effusions, clinical and two-dimensional echocardiographic data of 115 consecutive patients with a moderate or large effusion, including 33 who had cardiac tamponade, were reviewed. Echocardiograms were reviewed for effusion size, inferior vena cava diameter before and after deep inspiration and presence of right atrial and ventricular collapse. For the 83 patients (72%) with less than 50% decrease in inferior vena cava diameter after deep inspiration ("plethora"), inferior vena cava diameter decreased from 2.0 +/- 0.3 to 1.6 +/- 0.4 cm after inspiration (mean +/- SD) (mean decrease 18%). For the 32 patients (28%) without plethora, the diameter decreased from 1.6 +/- 0.5 to 0.6 +/- 0.3 cm (mean decrease 63%). Patients with plethora had significantly higher values for heart rate (111 +/- 21 versus 98 +/- 20 beats/min), pulsus paradoxus (24 +/- 15 versus 12 +/- 4 mm Hg), jugular venous distension (14 +/- 5 versus 8 +/- 3 cm H2O) and right atrial pressure (17 +/- 6 versus 12 +/- 6 mm Hg) and lower values for systolic blood pressure (109 +/- 22 versus 132 +/- 27 mm Hg) (all p less than 0.05) than did patients without plethora. Plethora was present in 58 (92%) of 63 patients who underwent a pericardial drainage procedure, 14 (88%) of 16 who developed constrictive physiology and 11 (92%) of 12 of those whose hospital death was related to pericardial effusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Tamponade↗
PubMedDate not supplied

Septal bounce, vena cava plethora, and pericardial adhesion: informative two-dimensional echocardiographic signs in the diagnosis of pericardial constriction.

To assess the diagnostic value of three different two-dimensional echocardiographic signs of pericardial constriction (early diastolic septal bounce, plethora of the inferior vena cava with blunted respiratory response, and pericardial adhesion), two independent observers retrospectively evaluated echocardiograms in 100 patients, 39 of whom had pericardial constriction, 15 had hemodynamically insignificant pericardial thickening, 16 had restrictive cardiomyopathy, and 30 had normal hearts. Causes of pericardial disease included cardiac surgery, malignancy, and uremia. Sensitivity and specificity of the three signs for constriction were 62% and 93% for septal bounce, 79% and 80% for vena cava plethora, and 79% and 90% for pericardial adhesion, respectively. The presence of either vena cava plethora or pericardial adhesion increased sensitivity, whereas the presence of both plethora and adhesion increased specificity. Between the two readers, septal bounce was the most consistent and pericardial adhesion the least consistent sign. False positive results included right ventricular pacing or left bundle branch block (septal bounce), postpericardiotomy (pericardial adhesion), and right heart failure (vena cava plethora). False negative results were often caused by technical problems with imaging. We conclude that these three two-dimensional echocardiographic signs are useful in differentiating pericardial constriction from hemodynamically insignificant pericardial thickening or restrictive cardiomyopathy.

Aged↗
PubMed1981

Red cell egress from bone marrow in state of transfusion plethora.

Marrow sinuses have been shown to undergo rhythmic dilatations and this has been suggested as a mechanism controlling cell egress from the marrow. Within the rigid frame of bone where the volume of the marrow is fixed, dilatation of sinuses can only lead to the displacement of cells into the lumen. The absence of tight junction between sinus endothelial cells is thought to permit the overlapping segments of these cells to slide over one another. To test this hypothesis, the length of overlapping segments between endothelial cells was measured before and after the induction of transfusion plethora and this was correlated with the magnitude of reticulocyte traffic across the sinus wall. Within one hour after the induction of plethora, marrow sinuses were dilated, packed with red cells, and the mean length of overlapping segments was reduced significantly from 0,75 micrometer to 0.41 micrometer. This was associated with a decline in the magnitude of reticulocyte transit across the wall (0.73 vs 0.13/mm). These observations are consistent with the theory that the overlapping segments of sinus endothelial cells can slide over each other to change the luminal caliber. Transfusion plethora results in a sustained maximal dilatation of sinuses, thus preventing their rhythmic changes necessary for cell delivery into the circulation.

Animals↗
PubMed1991

Pulmonary artery-bronchus ratios in patients with normal lungs, pulmonary vascular plethora, and congestive heart failure.

The pulmonary artery-bronchus ratio (ABR), defined as the external diameter of a pulmonary artery divided by the external diameter of its accompanying bronchus, was measured in the upper and lower lung zones on frontal chest radiographs in the following groups of subjects: erect healthy subjects, erect subjects with pulmonary vascular plethora, erect subjects with clinical evidence of decompensated left-sided congestive heart failure (CHF), supine normal subjects, and supine subjects with clinical evidence of decompensated CHF. Characteristic vascular patterns were found in each group. The positive predictive value of an abnormal vascular pattern determined by means of changes in the ABR on the erect chest radiograph was 100%, with the negative predictive value of a normal pattern being 97%. The erect chest radiograph was 93% accurate in distinguishing between plethora and CHF. The positive predictive value of an abnormal vascular pattern on the supine chest radiograph was 100%, with the negative predictive value of a normal vascular pattern being 97%. Measurements of ABR can be a helpful adjunct to the interpretation of supine and erect chest radiographs.

Adolescent↗
PubMed1995

A novel type of unstable homogeneously staining region with a head-to-tail arrangement: spontaneous decay and reintegration of DNA elements into a plethora of new chromosomal sites.

After transfection of amplification-promoting DNA elements into mammalian cells, homogeneously staining regions (HSRs) are formed by high copy numbers of transfected DNA arranged in head-to-tail polymers. Here, we wanted to evaluate the stability of this type of HSR during prolonged cultivation of transfected cells in selective medium. Thymidine kinase-deficient mouse L cells were transfected with pAPR4tk DNA harboring the amplification-promoting element 4 (APR4) linked to the gene for thymidine kinase (TK) or, alternatively, transfected with a DNA construct (pARP4t-PA) carrying, in addition, the expression cassette for human tissue-type plasminogen activator (t-PA). After transfection, one or two HSRs per cell were formed that disintegrated spontaneously after 25-40 wk of continuous cultivation in the presence of selective HAT (hypoxanthine-aminopterin-thymidine) medium. Unexpectedly, plasmid DNA reinserted into a plethora of new chromosomal sites, as revealed by in situ hybridization and Southern blot analysis. Coincidently, secretion of t-PA decreased to 10-20% of its original level. After transfection of pAPR4tk DNA lacking the t-PA expression cassette, HSR decay and reintegration of plasmid constructs into multiple chromosomal sites were also observed, whereas the ptk vector without an amplification-promoting DNA element did not form an HSR after transfection. We conclude that, in contrast to the pattern of known structures with head-to-tail arrangements, the HSR formed by amplification-promoting DNA elements represents a novel type of HSR that disintegrates by transposition into a plethora of new chromosomal integration sites. This process is mediated by the amplification-promoting DNA element itself and can be observed even when selective pressure is maintained.

Animals↗
PubMed1977

Symptomatic neonatal plethora.

Blood volume and clinical data are reported on 8 premature and 3 full-term infants who presented with symptoms apparently due to polycythemia or hypervolemia. These cases termed 'symptomatic neonatal plethora' were caused by large placental transfusions associated with delayed clamping of the umbilical cord. Tachypnea, mild cyanosis, plethoric skin color, and neurological depression persisted on average for 30 h after birth. Chest X-rays showed mild cardiomegaly, pulmonary congestion and edema, and pleural effusions. Although the course was in general benign, phlebotomy was considered to be indicated in three infants to treat progressive clinical deterioration. The symptomatology and blood volume on these infants were compared with infants in an ongoing study with controlled time of cord clamping. Neonatal plethora must be considered as one cause of 'transient tachypnea of the newborn'.

Blood Pressure↗
PubMed1993

Human monoclonal antibodies against a plethora of viral pathogens from single combinatorial libraries.

Conventional antibody generation usually requires active immunization with antigen immediately prior to the preparation procedure. Combinatorial antibody library technology offers the possibility of cloning a range of antibody specificities at a single point in time and then accessing these specificities at will. Here we show that human monoclonal antibody Fab fragments against a plethora of infectious agents can be readily derived from a single library. Further examination of a number of libraries shows that whenever antibody against a pathogen can be detected in the serum of the donor, then specific antibodies can be derived from the corresponding library. We describe the generation of human Fab fragments against herpes simplex virus types 1 and 2, human cytomegalovirus, varicella zoster virus, rubella, human immunodeficiency virus type 1, and respiratory syncytial virus. The antibodies are shown to be highly specific and a number are effective in neutralizing virus in vitro.

Amino Acid Sequence↗
PubMed1988

Adenoviruses from patients with AIDS: a plethora of serotypes and a description of five new serotypes of subgenus D (types 43-47).

We analyzed 67 adenovirus isolates from 48 patients with AIDS. The isolates included 5 of subgenus A (all Ad31), 23 of subgenus B, 4 of subgenus C (all Ad5), and 35 of subgenus D. The subgenus A and C strains were from liver, lung, blood, urine, and stool and were unremarkable in their antigenic characteristics. The subgenus B strains were mostly from urine and were serotyped by neutralization (SN) and hemagglutination-inhibition (HAI) tests as Ad11 (12 isolates), Ad16 (1), Ad35 (3), and Ad21/H21 + 35 (1) plus new intermediate strains 34/H11 (3), 35/H11 (1), and 11 + 35/H11 (2). The subgenus D serotypes from 24 patients were mostly from stool specimens and consisted of 8 isolates of known serotypes, 16 of antigenically intermediate strains, and 11 of five new adenovirus types with distinct antigenic and restriction enzyme characteristics. The new serotypes were described as candidate types 43-47 in accordance with currently accepted taxonomic criteria. Ad45, 46, and 47 showed a major relation by HAI with Ad29, 24, and 20, respectively. Four intermediate types were related to the new serotypes. The plethora of serotypes from patients with AIDS suggests that no epidemiological significance can be attached to any one serotype.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Risk to human health from a plethora of simian immunodeficiency viruses in primate bushmeat.

To assess human exposure to Simian immunodeficiency virus (SIV) in west central Africa, we looked for SIV infection in 788 monkeys that were hunted in the rainforests of Cameroon for bushmeat or kept as pets. Serologic reactivity suggesting SIV infection was found in 13 of 16 primate species, including 4 not previously known to harbor SIV. Overall, 131 sera (16.6%) reacted strongly and an additional 34 (4.3%) reacted weakly with HIV antigens. Molecular analysis identified five new phylogenetic SIV lineages. These data document for the first time that a substantial proportion of wild monkeys in Cameroon are SIV infected and that humans who hunt and handle bushmeat are exposed to a plethora of genetically highly divergent viruses.

Animals↗
PubMedDate not supplied

Unilateral vascular plethora--a sign in advanced unilateral basal bronchiectasis.

Unilateral basal bronchiectasis results in a regional high vascular pressure and the flow of blood is thereby diverted to the uninvolved portion of the lung through bronchopulmonary anastomoses. Unilateral plethora of the upper lobe vessels in significant basal bronchiectasis of the same lung constitutes an important additional sign in the recognition of bronchiectasis on the plain chest radiograph. Attention is drawn to the fact that this will not occur if the adjacent lung is compromised by a related or unrelated disease process.

Adolescent↗
PubMed1981

Influence of growth rate on the ability of hypertransfusion induced plethora to suppress erythropoiesis in the growing rat.

To induce different rates of growth male rats 23 days of age were places on diets containing no protein or 20% casein for 10 days. They were then divided into three subgroups which were placed on diets containing 5%, 10% or 20% casein until the end of the experimental period (day 17). Adult rats were used as controls. Rats were hypertransfused on days 8 and 9 and RBC-59Fe uptake determined on day 17. Body weight was directly correlated with the casein content of the diet in the growing rats. RBC-radioiron incorporation was also influenced by the protein content of the diet in the young rats in spite of the fact that hematocrits were over 60% in all the animals. On the contrary, 59Fe uptake by erythrocytes was not related to diet composition in the adult rats. When radioiron incorporation values were plotted against growth rate it became evident that a close direct correlation exists between erythropoiesis and growth rate in transfused-polycythemic rats, indicating that the degree of suppression of red cell production provoked by hypertransfusion-induced plethora is dependent on the rate of growth of the animal, keeping with it an inverse relationship.

Animals↗