Forensic Pathological Study on Sudden Infant Death- Particularly Its Relation to Viral Infection.

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The advance in pathological diagnosis of sudden infant death syndrome (SIDS) may mean how we can eliminate the diagnosable pathological cause of death from the broad SIDS with precise and careful autopsy and close up the feature of narrow SIDS. In these situations, one of the most important discases to be excluded from broad SIDS may be viral infection. To diagnose the viral infection in autopsy cases of sudden infant death, we have ananlysed and studied from the following points of view.1. Statistical analyses of perinatal risk factors in autopsy cases of sudden infant death.52 infant victims under 1-year-old of autopsied sudden death cases was devided into three groups : viral infection group, SIDS group and control group, and analysed the perinatal risk factors mainly according to Sheffield's birth scoring system. In the series of our analyses, it was revealed that viral infection modified the distribution of each perinatal risk factor, and that the application of Sheffield's birth … More scoring system to supplemental diagnosis of SIDS was not so adequate, because only one case was evaluate as SIDS in Sheffield's system in our SIDS group.2. Valuable histological findings for the diagnosis of viral pneumonia and myocarditis.In our series, viral antigens were detected by using immunofluorescence in 34.8% of sudden infant death cases. The virus strains detected were Influenza B, Coxsackie B and Cytomegalovirus. In these cases we analysed the valuable histological findings in the lung and the heart for diagnosis of viral infection. Subsequently, autopsy cases of sudden infant death of unknown etiology were observed with these histological criteria. As a result, 77.4% of these cases were diagnosed as suspected viral pneumonia or viral myocarditis, and the rest as SIDS.These histological criteria may be useful for screening of cases to be done more precise viral examinations.3. Application of DNA analysis to diagnosis of viral infection in sudden infant death cases.(1) In situ hybridization methodWe developed DNA-probe against some kinds of virus strains, ex. Influenza, Coxsakie B, Herpes, Parainfluenza etc., and applied these DNA probe to detection of specific virus genome in formalin-fixed and paraffin-embedded sections of the lung from sudden infant dath cases. As a result, it was indicated that in situ hybridization was enough to detect specifically virus genome on the pathological sections.(2) Development of new DNA probe for diagnosis of viral infection in sudden infant death cases.(3) Application of PCR method to diagnosis of viral infection in sudden infant death cases.For these purpose, we have to check the specificity for each virus strain, particularly in PCR method. We developed firstly how to indentify specifically virus strain, papilloma virus as a model, by using PCR method. On the other hand, we developed new DNA prode against Cytomegalovirus and Enterovirus, and applied these to the practical cases, We should more intensively continue the experiments in these field in the future. Less