Abstract â–¡ 12

The most problem on the study of sudden infant death syndrome(SIDS) is regard to the personality of it's definition. If strictly speaking, there is no finding in SIDS, without normal. However, no cases have not been found out which is considered corresponding to the strict definition until today despite the detailed post mortem examinations of many sudden infant death cases. Then, it has been generally accepted the concept including the cases which have not been so significantly considered relating to the cause of death. It has been also widely studied on such findings by many researchers, too. By the way, isn't it so strange to definite such minor changes as not significant without enough investigation and explanation. No one had given enough explanations on the matter until today. The second problem is regard to it's variety of the cases. More than twenty varieties of the considerable cause of death in sudden infant death(SID) cases have been reported until today. It has been widely considered to include many varieties of disease and unnatural deaths among SID cases. Some of them had been excluded from SIDS, already. For example, Medium chain acyl CoA dehydrogenase defficiency(MCAD) is one of the diseases which is considered to cause sudden unexpected infant death. Some of the cases which had only minor pathological changes turned out to child abuse and neglect, or infanticide cases by the evidences of the assailants, too. The case of suffocation is still very difficult to distinguish from SIDS although the death scene shows sudden infant death. Among those situations, it must be very important to recognize the death mechanisms on the occurrence of minor medical findings, too. Japan SIDS Research Society organized a special committee on the investigation of sudden infant death cases in 1995. Twenty-four experts from seven specialities of neonatology, pediatrics, legal medicine, pathology, anesthesiology, emergency medicine, and medical examiners, were organized as members of the committee. Almost 300 sudden infant death cases had been registered to the committee from all over the nation and all of the cases were reviewed by the committee. Those sudden infant death cases included not only the cases of SIDS but also the cases of unnatural deaths or defined disease cases, too. All of the reviewed cases had been performed complete post mortem examinations by medical examiners, or pathologists. Conferences of the committee was performed twice a year from 1995 and we had eight regular conferences and two temporaries. At the conferences, personal informations, death scene reports, autopsy reports, pictures of the macro-findings at the autopsies, microscopic slides, and reports of biochemical analysis had been reviewed by the members and observers together. The major concept of the committee is reviewing with different specialists at the same time. After many debates, the committee reviewed a new criterion of classification on sudden infant death(SID) cases. The criterion shows a practical approach to clinical SID cases. We have to distinguish many varieties of SID cases into some defined groups to make a correct diagnosis. Our new suggestion of the criterion on SID cases will be showed at the congress. It must be one of the approachs to define the cause of death and death mechanisms of SID cases.