An epidemiological survey was carried out to examine the present situation with respect to sudden infant death syndrome (SIDS) in Kanagawa Prefecture. Questionnaires on sudden unexpected death of infants aged < 1 year in 1990‐91 were sent to the hospitals and clinics in Kanagawa Prefecture which may take care of such infants. By analysing information from 10 485 replies, 48 out of 73 reported sudden infant deaths were confirmed to be SIDS, although autopsy was not performed in 13 cases (27%). The incidence of SIDS per 1000 live births in Kanagawa Prefecture was 0.29 in 1990 and 0.31 in 1991; and if limited to autopsy cases 0.19 and 0.25, respectively. Sudden infant death syndrome cases in Japan were found to occur more frequently when infants were < 6 months old, at home and sleeping alone, but less in the winter and between midnight and early morning. There was little difference between the numbers in prone and supine sleeping positions at discovery. It was not clear whether SIDS occurred more often to babies sleeping prone than supine, because there were no controls matched with the SIDS cases. In future, continuous epidemiological surveys of SIDS in Japan should be carried out.
To assess the clinical manifestation of kerosene pneumonia, we studied20cases with accidental ingestion of kerosene, admitted to the Department of Pediatrics, Kitasato University Hospital in these15years from1983to1998.All cases were divided into two groups by presence of the positive radiological findings on chest X-ray on admission. Eight patients showed some positive radiological findings, and the remaining cases (n=12) did not have abnormal findings on chest X-ray. We compared several points between these two groups as follows,(1) clinical symptoms on admission,(2) results of arterial blood gas analysis,(3) the time which took from ingestion to confirmation of positive radiological findings,(4) 133Xe ventilation scintigraphy and (5) treatment options.There were no significant differences on clinical symptoms on admission nor results of arterial blood gas analysis between these two groups. In5cases, secondary chemical pneumonia appeared over 12 hours after kerosene ingestion. In2cases, 133Xe ventilation scintigraphy revealed impaired lung function after resolution of clinical symptoms and chest X-ray findings.These results suggest that closed observation in the hospital and sequencial radiological evaluation are necessary in the cases of accidental ingestion of kerosene. And functional evaluation, e.g., 133Xe ventilation scintigraphy, is important after resolution of clinical symptoms and chest X-ray findings.
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