• Title/Summary/Keyword: Phase of illness

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Changes of Lipid and Lipoprotein Compositions in Kawasaki Disease and its Impact on Cardiac Complications (가와사끼병에서 혈중 지질과 지단백의 변화와 심장 합병증에 미치는 영향에 관한 연구)

  • Yun, Sin Weon;Lee, Ho Seok;Kim, Dong Woon;Rhee, Kang Won;Jung, Young Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1370-1377
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    • 2005
  • Purpose : Delineation of serum lipid and lipoprotein values in children after Kawasaki disease(KD) is important because of the predilection of this disease for the coronary arteries. Methods : The KD group was composed of 51 patients who were hospitalized from Jan. 2002 to Dec. 2003. Control was 25 patients with non-KD febrile illness. The levels of total lipid, phospholipid, triglyceride, HDL-cholesterol(HDL-C), LDL-cholesterol, total cholesterol, apolipoprotein A1(apo A1), apolipoprotein B, and Lipoprotein(a) were measured and compared with Echocardiographic findings. Measurements were obtained in four time periods: acute febrile, subacute, convalescent phase and 1 year after KD. Results : HDL-C($33.64{\pm}7.49mg/dL$ vs $50.43{\pm}14.41mg/dL$, P<0.01) and apo A1($99.75{\pm}6.39mg/dL$ vs $113.34{\pm}11.35mg/dL$, P<0.05) were decreased more in the acute febrile period of KD than in the control, but these changes were not correlated with cardiac complications. All lipid profiles were markedly elevated in the subacute stage and normalized in the convalescent stage; there were no changes until 1-year follow up. There were no significant differences in the changes of lipid profiles, including Lp(a) and coronary dilatation, in any time periods. Conclusion : KD is associated with important abnormalities in lipid metabolism, but these changes were transient and appear to be due to the disease itself. These data lead us to infer that KD dose not cause such permanent changes in lipid abnormalities as to be considered a risk factor for atherosclerosis, beyond that caused by the disease itself.

PSYCHOPATHOLOGY IN ADOLESCENTS WITH PARENT ABUSE (부모학대 청소년의 정신병리)

  • Kwak, Young-Sook;Bang, Hyun-Soog
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.13-25
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    • 1998
  • Aim:We think that the most important etiology in parent abuse is the psychodynamic and psychopathology in the family. So, we investigated the adolescents being admitted in SNMH, whose chief complaints were parent abuse. We were trying to explore families psychodynamic and psychopathology, especially mother-child interaction and to differentiate them in according to developmental psychopathology. Method:Our objects were the adolescent patients admitted in SNMH from 1987 to 1997 because they attacked parents verbally and physically. We examined 21 adolescents except those with psychosis, organic mental disorder, autism and mental retardation by means of interview or chart review. Result and Conclusion:The number of male patients was 14 and the number of female patients was 7. The most common diagnosis was conduct disorder and borderline personality disorder. The mean age was in the mid-teens. We observed 4 subgroups that were divided developmentally in object relation. 1) Symbiotic group with mother:(1) They did not separate and remain in symbiotic relationships with their mothers based on insecure attachment. Fathers were abscent emotionally and physically, and their mothers were prominent in close relationships with the patients in their family , where as the patients were the only man in the family. Adolescents entered the second separation-individuation. They expressed anger and internal tension involved with the close attachment with their mothers and also attempted separation from their mothers through physically attacking them. (2) These patients had suffered from physical illness and developmental delay since birth. Therefore the parents overprotected their children. The children had persistent infantile omnipotence and fantasies of power, so they could not deal with unrealistic states, adapt to reality, and depended on their parents overtly. They easily acted out unless their demands were fulfilled. 2) Borderline personality disorder:We observed deficiencies in care taking. Their parents had personality problems and immaturity. They coulden’t help their children to be separated in the rapproachment phase. Their conflict about dependence-independence was revived in the second separation-individuation adolescent period. We understand parent abuse as an attempt to overcome the conflict. 3) Conduct disorder:They did not build up basic attachment with their parents. They think of their parents as only a means of fulfilling their needs. When patients’ need were not fulfilled and remained in a conflicted state, they attacked their parents, unable to control their aggressions and impulses.

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