ABSTRACT OF INVITED LECTURES AND ORAL PRESENTATION

FP3-03RELATIONSHIP BETWEEN GALLBLADDERDISTENTION AND LIPID PROFILES INKAWASAKI DISEASEHae-Yong LEEProfessor, Department of Pediatrics and Adolescent Medicine, WonjuChristian Hospital, Yonsei University Wonju College of Medicine, Wonju,South KoreaFP3-04OVER-PRODUCTION OF PROTON DURINGMYOCARDIAL ISCHEMIA IS A MAJOR CAUSE OFMYOCARDIAL REPERFUSION INJURY- ANEXPERIENCE FROM THE STUDY OF DEPRESSEDYOUNGEST NEWBORN INFANTSChing-Tsuen Shen, Nan-Kung Wang, Lung-Huang LinDepartment of Pediatrics, Cathay General Hospital, Taipei, TaiwanBACKGROUND AND OBJECTIVES: While Kawasakidisease (KD) is an acute systemic vasculitis inchildren, which causes coronary arterial dilatation(CAD) and gallbladder distension (GBD). There is adearth of investigating the relationship between theseverity of KD and GBD with lipid profiles.SUBJECTS AND METHODS: A total of 80 patients with“complete KD” who were diagnosed from January2005 to May 2009 was enrolled in this study. Serumcholesterol (total, high density lipoprotein (HDL)and low density lipoprotein (LDL)), triglyceride,complete blood count (CBC), inflammation markers(erythrocyte sedimentation rate (ESR) and C-reactiveprotein (CRP) were measured at the time ofadmission during febrile period. Echocardiographyand abdominal sonogram were performed in allpatients to determine coronary arterial dilatation andgallbladder size. According to GBD, patients withKD were classified as patients with GBD andpatients without GBD. Between two groups,demographic data and clinical data were analyzed.RESULTS: The serum level of LDL cholesterol wassignificantly lower in patients with GBD (ρ=0.03)compared with patients without GBD or febrilecontrol. There was no significant difference ininflammatory indices between patients with GBDand patients without GBD. GBD was not significantrisk factor of CAD in this study (OR=2.0,95%CI=0.82-5.3, ρ=0.16).CONCLUSION: This is the first study that highlightsthe relationship between the GBD and lipidmetabolism in patients with KD. This study providesclinical insights about potential mechanismunderpinning the relationship between the GBD andlipid metabolism.[Kaywords]Kawasaki disease, Gallbladder distension; Lipidprofiles; Coronary arterial dilatation; ChildrenOBJECTIVE: Myocardial ischemia is a condition that myocardialsupply and demand of oxygen is imbalance. Under anaerobicmetabolism, mitochondria within the cardiomyocytes will producemore CO 2 , less ATP, and consequently, accumulate more protons[H+]. Re-circulation of blood to the tissue surrounding the ischemicarea will bring oxygen and neutrophils back to the penumbra area,generate interleukins, free radical, and turn on apoptosis signaling.In order to identify this relationship between the protonaccumulation and the myocardial reperfusion damage, we try to dothis study.METHODS: From 2003 to 2008, there were 118 newborn infantsdelivered at this hospital who had their one-minute Apgar score lessthan 7. Eighty-five of these 118 neonates had arterial blood gasanalysis. Fifty of these 85 neonates (58.8%) had their protonconcentration less than 10 -7.35 mol/L, (group A), the other 35neonates had their {H+} > 10 -7.36(group B). Cardiac enzymeevaluation included creatine phosphate kinase , theirMB-isoenzyme, troponin-I, lactate dehydrogenase, glutamateoxalate transaminase, and glutamate pyruvate transaminase.Twelve-lead surface electrocardiograms (EKG) were obtained in 25neonates; Seventeen of these 25 neonates were of group A, whilethe other 8 cases were of group B.RESULTS: We found that symmetric tall, inverted, or biphasic Twave, longer QRS duration, or longer QTc intervals weredemonstrated in 14 of 17 (82.35%) neonates of group A, while only2 of 8 (25%) neonates in group B. Fisher exact probability testshowed the p value was