On the distubance of gas exchange in the lung in SIDS.Pathological and ultrastructural observation.

Research Project

Project/Area Number	04670350
Research Category	Grant-in-Aid for General Scientific Research (C)
Allocation Type	Single-year Grants
Research Field	Legal medicine
Research Institution	GIFU UNIVERSITY
Principal Investigator	OHYA Isao Gifu University, School of Medicine, Professor, 医学部, 教授 (80021393)
Co-Investigator(Kenkyū-buntansha)	MATSUURA Kazuya Gifu University, School of Medicine, Research Associate, 医学部, 助手 (00229410) BUNAI Yasuo Gifu University, School of Medicine, Associate Professor, 医学部, 助教授 (50165510)
Project Period (FY)	1992 – 1994
Project Status	Completed(Fiscal Year 1994)
Budget Amount *help	¥2,100,000 (Direct Cost : ¥2,100,000) Fiscal Year 1994 : ¥400,000 (Direct Cost : ¥400,000) Fiscal Year 1993 : ¥600,000 (Direct Cost : ¥600,000) Fiscal Year 1992 : ¥1,100,000 (Direct Cost : ¥1,100,000)
Keywords	Sudden Infant Death Syndrome(SIDS) / Lung / Pulmonary edema / Microemboli / Ultrastructure / 乳幼児急死症候群 / 肺臓
Research Abstract	Histological observation was performed using 28 cases of SIDS (2 months to one and a half years old) , 12 cases of asphyxia ( 1 day to 64 years old) and 6 cases of drowning (4 months to 9 years old) .All SIDS cases showed pulmonary edema and some SIDS cases showed more severe pulmonary edema, compared with that of cases of asphyxia and drowning. But, because SIDS cases showing severe pulmonary edema had received transfusion in hospitals, it was not concluded that severity of pulmonary edema in SIDS cases was significantly higher than that of asphyxia or drowning. Occurrence of microemboli which were composed of plateletes, fibrin and/or white blood cells, and considered as a characteristic finding in asphyxia, were investigated. Occurrence of microemboli was determined by counting of a number of microemboli per 30 microscopic fields by obseving 200 folds. The average numbers of microemboli per 30 microscopic fields in SIDS, asphyxia and drowning were 5.67<plus-minus>6.65,5.78<plus-minus>3.42 and 4.8<plus-minus>1.77, respectivly. SIDS cases were divided into 2 groups ; cases showing acute aspiration of gastric content or milk into the lung and cases without acute aspiration. The average number of microemboli in the group with acute aspiration was 9.86<plus-minus>7.85. On the other hand, that of the group without aspiration was 2.02<plus-m Ultrastructural observation was performed using 5 cases of SIDS.Edema in the alveolar walls was observed in all cases. In order to measure severity of edema in the alveolar walls and make it clear if edema in the alveolar wall disturbs gas exchange, thickness of tissue barrier from the surface of the alveolar epithelium from that of endothelial cells, using 3 SIDS cases (3 months to 6 manths old) showing mild postmortem changes and one case of head trauma (one and 3 months old) as a control. The thickness of tissue barrier in SIDS cases were 0.61,0.62, and 0.65 mum, respectively and in the control case was 0.63mum.