[The role of mass morphological study of placenta for prognosis of infectious processes in newborns]. / Rol' massovykh morfologicheskikh issledovanii posledov dlia prognozirovaniia proiavlenii infektsionnykh protsessov u novorozhdennykh.

The results of the long-term morphological study of a great number of placentas in the cities of St. Petersburg and Novgorod have been summarized. These results show frequent occurrence of infection of various etiology. The efficiency of revealing the risk groups among newborns is documented by a considerable decrease of infant mortality in Novgorod (from 20.6 in 1986 to 11.9 in 1996). The same phenomenon is demonstrated in St. Petersburg where a decrease in the incidence of intrauterine infections was noted at the autopsy material. A detailed study of catamnesis of children infected in utero showed an increase of minor neurological symptoms and higher incidence of acute respiratory viral infections.

[Intrauterine mycoplasmosis in late miscarriage]. / Vnutriutrobnyi mikoplazmoz u pozdnikh vykidyshei.

118 late abortions were investigated at week 18-28 of pregnancy with the use of light and immunofluorescent microscopy. Intrauterine infections were found in 86 cases including 44 observations of mycoplasmosis, 16-M. hominis, 18-M. pneumoniae, 10-U. urealyticum. Histologically similar changes were found in the form of vacuolar degeneration of the amnion, trophoblast of the basal lamina and foetal coats, inner foetal organs and neuroepithelial cells in the central nervous system. Apart from this, focal leucocytic-lymphocytic infiltration was observed. Marked myeloid hematopoiesis was found in the liver. Maximum changes were found in the placenta and foetal organs in chronic placental deficiency.

[Cytological examination of urethral and endocervical smears in the diagnosis of infections]. / Tsitologicheskoe issledovanie mazkov iz uretry i édotserviksa dlia diagnostiki infektsii.

Cytologic studies of smears from 130 women suffering from various diseases, including 61 pregnant patients with gestoses, have shown structural changes of the cells in the smears from the endocervix and urethra, that permitted the diagnosis of Mycoplasma infection in 43.8% of patients, Chlamydia infection, 52.3%, and herpes simplex in 72.3% of patients; in 63.9% of patients these infections were combined. Cytologic studies may be useful in the tentative diagnosis of urogenital infections, including cases when it is necessary to elucidate the causes of unfavorable course of a previous pregnancy or when preterm babies are born.

[Morphologic manifestations of intestinal lesions of bacterial and mycotic etiology developing in association with acute respiratory infections]. / Morfologicheskie proiavleniia porazhenii kishechnika bakterial'noi i mikoticheskoi étiologii, razvivshikhsia v sochetanii s ostrymi respiratornymi infektsiiami.

By means of light and immunofluorescent microscopy the intestines of 34 children were studied, whose bacterial or mycotic enterocolitis most often combined with acute respiratory infections. Intestinal lesions were caused either by virus (sometimes by Mycoplasma), or by bacteria and fungi. Such changes developed in the debilitated children and their course was more severe, than in monoinfections because of the impaired systemic and local immunity, and probably due to formation of viral-bacterial complexes. Viral intestinal lesions were most often caused by a single virus, but not by multiple ones, as in pulmonary infections, which is explained by interferon production and the intensive therapy used. The alternative component in a viral lesion is enhanced due to the presence of lactic acid in the intestine and therefore it is inhibited when acute viral respiratory infection develops against the background of bacterial or mycotic enterocolitis due to dysbacteriosis. Changes in mucosal stroma and intestinal lymphatic system in different infections depend on the duration of the intestinal lesion.

[Intestinal lesions in acute respiratory viral and mycoplasma infections]. / Porazhenie kishechnika pri ostrykh respiratornykh virusnykh i mikoplazmennoi infektsiiakh.

Histologic study using semiquantitative analysis and immunofluorescent microscopy of the intestine performed on 278 children of different age who died of acute respiratory, viral and Mycoplasma infections revealed intestinal changes in 168 cases. The incidence and degree of these changes depended on the duration of the disease and the type of the intensive therapy used. Beginning from day 2 of the disease specific changes in the enterocytes in the form of giant-cell metamorphosis were noted. These changes gradually increased reaching their maximum on day 7-9 when in all cases of acute viral respiratory infections microlysis of enterocytes was observed. It was maximal on day 5-6 and inhibited under the influence of intensive therapy. In addition some nonspecific changes were present: circulatory disorders and cellular reaction of the stroma, that changed depending on the duration of the disease being probably a manifestation of a local immune reaction.

Changes in the fetal organs and the placenta with intrauterine mycoplasma infection.

The effects of intrauterine mycoplasmal infections on the fetus (stillborn) and infant (mostly premature) are presented, based on 80 cases along with findings from 62 placentae with mycoplasmal placental infection. Morphometric, light and immunofluorescent microscopy findings are given. These data were correlated with clinical observations and laboratory parameters including serologic investigations. Damage to various organs including the placenta most frequently involved the epithelium. Mycoplasma multiply principally in the cytoplasm whereby the affected cells increase in size, and pale halos appear around the causative organism. Other microscopic changes have been described in the liver, lungs, kidneys, brain, lymphoid organs and placenta. Macroscopic changes in mycoplasmal and viral infections of the uterine cavity are minimal. Differential manifestations of the disease depending on the mycoplasma species (M. hominis, M. pneumoniae) have been described. Correlations between changes in the placenta and the outcome of pregnancy have been attempted.

[Mycoplasma placentitis]. / O mikoplazmennom platsentite.

The results of the study of 25 placentas are presented. The condition of placenta was evaluated by light and immunofluorescent microscopy using morphometry. The data obtained were compared with the content of antibodies in the blood of fetuses and their mothers, as well as with the results of clinical observations of pregnant women and babies, and, if the latter died, with morphological changes in their organs. The possibility of development of mycoplasmal affection of placenta with the development of typical changes analogous to those observed in this infection in other organs was established. Mycoplasma were found in the changed cells. Different variants of the influence of placenta involvement on the development of the fetus are discussed.

[Changes in the heart in various acute respiratory infections in children]. / Izmeneniia serdtsa pri nekotorykh ostrykh respiratornykh infektsiiakh u detei.

Hearts of 45 children dying with respiratory infections were studied by light and luminescent microscopy. Specific and nonspecific changes in tissues were found. Nonspecific changes consisted in disorders of microcirculation, degenerative, and necrotic processes in cardiomyocytes, and disorganization of the connective tissue of the endocardium and interstitial tissue of the myocardium, whereas specific changes included the presence of viral and mycoplasmal antigens in endotheliocytes and cardiomyocytes as well as metamorphosis of the latter detected mainly in adenovirus infection and mycoplasmosis. Analogous nonspecific and specific changes were also discovered in cytomegalovirus and Coxsackie virus infections which in some children were accompanied by acute respiratory infections.

[Viral appendicitis]. / Vurusnye porazheniia cherveobraznogo otrostka.

In order to study the appendix involvement with respiratory viruses in appendicitis, 44 cases of this disease in patients varying in ages from 14 to 71 years were investigated at random. Light microscopy and immunofluorescent examinations of the appendix were performed. The results were compared with those of serological blood tests done in the time course. In 20 patients the role of respiratory viruses and sometimes Mycoplasma pneumoniae proved to be doubtless by a significant rise in antibody titres (4-32-fold), as a rule, without any marked manifestations on the part of the respiratory organs. This was combined with detection of the antigen of the agent in enterocytes and with structural changes of the organ typical of these infections according to the results of previous examinations of the intestinal tract in generalized acute viral respiratory infections and mycoplasmosis. In 14 patients the role of respiratory viruses seemed to be likely. They showed positive results of immunofluorescent and light microscopy examinations without a significant rise in antibody titres, however. In 7 patients the role of respiratory viruses did not seem convincing: they had positive results of either immunofluorescence or serological tests alone. Three patients had no evidence of lesions caused by respiratory viruses or mycoplasma.

[Tonsils in diphtheria and the Corynebacterium diphtheriae carrier state]. / Mindaliny pri difterii i nositel'stve korinebakterii difterii.

Investigations of 16 archive autopsy observations of diphtheria of the fauces confirmed bacteriologically revealed that Corynebacteria diphtheriae multiplied mainly on the surface of the mucous membrane. Fibrinous inflammation on the tonsillar surface is most typical for this agent. In all cases with manifestations of acute inflammation the lesion was caused by C. diphtheriae in combination with other bacteria, most frequently streptococci. The latter were harboured deep in the tonsills and caused there an inflammatory process with characteristic lesions. Examinations of the tonsills removed from 72 C. diphtheriae carriers showed that longterm persistence of the bacteria in the tonsills was primarily due to the specific structure of the cryptae, particularly great branchiness and depth contributing to the retention of the content. Long-term carrier state leads to a statistically significant increase of the degree of their plasmatization as compared with the control group. This occurs in parallel with changes in the general responsiveness of the host.

[Morphology of the adrenal cortex in infants with generalized adenovirus infections]. / Morfologiia nadpochechnikov pri generalizovannoi adenovirusnoi infektsii u detei rannego vozrasta.

Morphometric, histological, and immunofluorescent studies were carried out with adrenal glands of 14 infants dying with generalized adenovirus infection sometimes concurrent with other acute viral respiratory diseases. Nonspecific changes were found: edema of the capsule and stroma, discomplexation of the trabeculae, circulatory disorders, delipoidization, an increase in the content of DNA and RNA in cells of the definitive cortex, resorption of the elements of the fetal cortex. The pattern of changes of morphometric values attests to increased functional activity of the adrenal cortex. The intensity of the observed changes was directly related to the duration of the disease. The results of clinico-morphological analysis confirm the importance of adrenal insufficiency in tanatogenesis in generalized adenovirus infection. In 10 cases epithelial and endothelial cells of the definitive cortex were found to have specific lesions, the so-called adenovirus cells.

[Intrauterine mycoplasmosis]. / Vnutriutrobnyi mikoplazmoz

Comparative studies of pathological anatomy of intrauterine mycoplasmosis of man and cattle were carried out. On the basis of investigations of 22 deceased newborns and of 3 stillborns with uterine infection caused by Mycoplasma pneumonia descriptions of lesions of various organs are presented. They most regularly were defected in the liver. In the respiratory organs in this infection, in contrast to respiratory mycoplasmosis, lesions of respiratory departments, not of the respiratory tract, were predominantly observed. The investigation of 18 liveborn and 5 stillborn calfs with intrauterine infection caused by Mycoplasma bovirhinis revealed the same regularities of the pathological process. The localisation of lesions and the presence of changes in the placenta justify the conclusion that the disease developed, as a rule, as a result of hematogenic transplacental infection.

[Role of viral-bacterial associations in meningitis in children]. / Rol'virusno-bakterial'nykh assotsiatsii pri meningitakh u detei

A total of 50 section cases of meningitis in children were investigated. All patients revealed acute viral respiratory infections with generalization, including lesions of the central nervous system (CNS). In 14 children moreover meningococcal infection was diagnosed. In 30 children lesions of the CNS were due to mixed bacterial microflora. In 6 children along with acute viral respiratory infections (AVRI) mycoplasmosis was also revealed. Etiology of the process was determined on the basis of characteristic structural changes in the CNS and other organs, findings of virological and bacteriological investigations. In the majority of children the intravascular blood coagulation was observed. Waterhouse-Friderichsen's syndrome was revealed mainly in meningococcal infection. In order to ascertain the data obtained case records of 120 children, who had undergone treatment in connection with meningococcal infection, were analysed. It turned out that all 42 children, who had developed this disease independently, recovered. Combination of the disease with AVRI led to fatal outcomes in 12 cases out of 72.