[Children with acute respiratory distress syndrome: anatomoclinical and radiologic correlation]. / Estudo de crianças com síndrome do desconforto respiratório agudo: correlação anatomoclínica radiológica.

This retrospective study reviews cases of ARDS (Adult Respiratory Distress Syndrome) treated and followed up from October 1988 to December 1990 in the Pediatric Intensive Care Unit of Instituto Fernandes Figueira/FIOCRUZ, Brazil. Clinical, radiological and histopathological features were analyzed and correlated with well defined stages of the disease process. Out of 459 cases, 49 (11%) were selected for further study. In 11 cases, histopathological examination (4 biopsies and 8 autopsies) was performed and then classified into one of the following phases: exsudative, cellular proliferative and late fibrotic. The work emphasizes the need for further clinical and experimental studies in order to define the mechanisms and the impact of this Syndrome in the pediatric population.

[Abdominal cystic lymphangioma in childhood: report of eight cases]. / Linfangioma abdominal na criança: apresentação de oito casos.

Lymphangioma is a common pathology in children, however intra-abdominal cystic lymphangioma is rare. Morphology and clinical symptoms are variable and can be mixed up with other etiology. Ultrasound can make the diagnosis in the majority of the cases. Surgery is the best choice of treatment and prognosis is in general good. Authors present eight cases in a period of fifteen years, all of them treated surgically. Results were good in seven cases. One late death was observed.

Acute and chronic human adenovirus pneumonia: cellular and extracellular matrix components.

We present a comparative histopathological study of both acute and chronic human adenovirus pneumonia, with reference to the cellular and extracellular matrix components. Seventeen lungs from autopsied patients whose ages ranged from 2 to 60 months were studied. Adenovirus types 1, 2, 3, 5, and 7 were isolated from 15 patients with acute lung disease, and types 2 and 7 were isolated from the other two patients with chronic pulmonary illness. The results indicated the occurrence of two basic patterns of adenovirus interstitial pneumonia (1) classic pattern (acute), characterized by necrosis and degeneration and many type II pneumocytes with intranuclear inclusion bodies, which were positive for adenovirus DNA by in situ hybridization, and (2) proliferative or proliferative-productive pattern (chronic), which presented with diffuse pulmonary fibrosis and the interstitial proliferation of fibroblast-like cells, compatible with myofibroblasts (positive for vimentin and alpha smooth muscle actin), and increase in collagen types I and III, elastic fibers, and proteoglycans. Alveolar collapse appears to be an important pathogenetic mechanism in the development of this pattern.

Congenital echo virus infection--morphological and virological study of fetal and placental tissue.

A prospective study of 78 pregnant women was undertaken to detect maternal enterovirus infection. Maternal faecal specimens and blood samples, placental and fetal tissue were taken for viral study, electron microscopy, histochemistry, and morphological examination. We present the post-mortem findings in three fetuses whose maternal infection was detected before delivery by isolation of ECHO virus type 33 and type 27 from faecal specimens and/or placental and fetal tissues. The morphological aspects were similar in all cases and included an acute infection of the placenta and hypoxic/hypotensive injury to fetal organs. In one case, viral particles were detected by electron microscopy of the fetal liver. This series of cases of intrauterine ECHO virus infection confirms the potential gravity of such infection during pregnancy and the need to prevent enteroviral disease.

Enterovirus isolation from foetal and placental tissues.

Four spontaneous abortions and two stillbirth occurred during a prospective survey following the teratogenicity of echoviruses in 80 pregnant women selected at random from the Antenatal Care Service. Echovirus types 19, 27, and 33. Coxsackie B2 and B6 were isolated from placental and foetal tissues (brain, liver, kidney, heart, and spleen). The mothers also excreted the virus by faeces at least twenty days before abortion and responded serologically, indicating active virus infection. Almost all aborted children were anomalous with signs of viral infection.