Visceral obesity, but not central obesity, is associated with cardiac remodeling in subjects with suspected metabolic syndrome.

BACKGROUND AND AIMS: Metabolic syndrome (MetS) is a cluster of multiple risk factors including central obesity that may lead to cardiac damage and cardiovascular events. We investigated whether visceral obesity induces cardiac structural and functional remodeling independently from central obesity and other risk factors in subjects with suspected MetS. METHODS AND RESULTS: We studied 229 participants with suspected MetS. Visceral fat area (VFA) was measured by bioelectrical impedance analysis. Left ventricular (LV) mass index, early diastolic velocity of mitral annulus (e'), and LV global longitudinal strain (GLS) were measured by echocardiography. Subjects were categorized into high and low VFA group (VFAh and VFAl). MetS was more prevalent in the VFAh than in the VFAl (p = 0.004). The VFAh had a higher waist circumference (WC) than the VFAl (p < 0.001). LV mass index was higher, but e' and GLS were lower in the VFAh than in VFAl (all p < 0.05). VFA was well correlated with blood pressure, fasting blood glucose, triglyceride, high-sensitivity C-reactive protein and adiponectin (all p < 0.05). VFA was correlated to LV mass index, e', and GLS (all p < 0.05) and was independently associated with GLS after adjustment for other risk factors, including WC (p = 0.005). CONCLUSIONS: Visceral obesity assessed by VFA was well correlated with parameters of MetS. Visceral obesity, but not central obesity measured by WC, was independently associated with structural and functional cardiac remodeling in subjects with suspected MetS. It suggests that visceral obesity should be considered as an important risk factor for cardiac damage in dysmetabolic subjects. TRIAL REGISTRATION: NCT02077530 (date of registration: November 1, 2013).

Environmental Impacts and Recovery After the Hebei Spirit Oil Spill in Korea.

The Hebei Spirit oil spill (HSOS) on December 7, 2007 was the worst oil spill recorded in Korea, with the release of approximately 10,900 tons of crude oil and 375 km of coastline polluted along the west coast of Korea. Cleanup operation was conducted by official and contract responders as well as volunteers for massive oil containment and removal of heavy accumulations of stranded oil. Together with the oil cleanup, a long-term environmental impact assessment (EIA) of the HSOS was initiated based on the Marine Environmental Management Act, which covers oil contamination in a multimedia environment, toxic effects on organisms, and ecosystem injury. This review summarizes the long-term monitoring results of HSOS EIA focused on (1) pollution status of seawater, sediment, and bivalves, (2) ecotoxicological effects, and (3) ecosystem recovery. Overall, concentrations of petroleum hydrocarbons in the environment indicated that their concentrations were well down to at or near background or pre-spill contamination levels at most sites after 1 year. The potential toxic effects of residual oils in sediments have decreased to background levels in most coastal areas of Taean. The entire ecosystem in the most affected area of the Taean coasts appear to be considerably, but not fully, recovered at present, namely after 8 years of the HSOS. The presence of lingering oil and elevated contamination levels at several sites still require continuous long-term monitoring.

Persistent organochlorine residues in estuarine and marine sediments from Ha Long Bay, Hai Phong Bay, and Ba Lat Estuary, Vietnam.

To assess the organochlorine contamination in the northeast coastal environment of Vietnam, a total of 41 surface sediments were collected from Ha Long Bay, Hai Phong Bay, and Ba Lat estuary, and analyzed for their organochlorine content. Organochlorine compounds (OCs) were widely distributed in the Vietnamese coastal environment. Among the OCs measured, DDT compounds predominated with concentrations ranging from 0.31 to 274 ng g(-1). The overall contamination level of DDTs in coastal sediments from northern Vietnam is comparable with those from other Asian countries. However, concentrations exceeding 100 ng g(-1) are comparable with high concentrations reported from India and China, the largest DDT consumers in the world. The overall concentrations of PCBs, HCHs, and chlordanes in surface sediments were in the ranges of 0.04-18.71 ng g(-1), not detected (n.d.) - 1.00 ng g(-1), and n.d. - 0.75 ng g(-1), respectively. Ha Long Bay and Hai Phong Bay were relatively more contaminated with DDTs and PCBs than other regions, respectively. In contrast, the distribution of HCHs was relatively homogeneous. OCs contamination in the coastal environment of Vietnam is closely related to shipping and industrial activities. The levels of DDT compounds in harbors and industrial areas exceeded their sediment quality guideline values suggested by Environment Canada [CCME (Canadian Council of Ministers of the Environment), 2002. Canadian sediment quality guidelines for the protection of aquatic life. In: Canadian Environmental Quality Guidelines. Canadian Council of Ministers of the Environment, Winnipeg, MB] and Australian and New Zealand [ANZECC and ARMCANZ, 2000. National water quality management strategy. Paper No. 4, Australian and New Zealand Guidelines for Fresh and Marine Water Quality, vol. 1, The Guidelines. Australia. Document: http://www.deh.gov.au/water/quality/nwqms/volume1.html], indicating that adverse effects may occur to marine species in that areas.

Changes in activity of hepatic xenobiotic-metabolizing enzymes of tiger puffer (Takifugu rubripes) exposed to paralytic shellfish poisoning toxins.

Attempts were made to examine the effect of paralytic shellfish poisoning toxins (PSP) on hepatic xenobiotic-metabolizing enzymes (XMEs) of tiger puffer (Takifugu rubripes). Two groups of nontoxic tiger fish were analyzed, and one group was fed with a PSP-containing diet (PSP group), and another with a PSP-free diet (control group). After 60 days of feeding, they were compared to each other mainly in terms of the activity of XMEs. Both groups did not differ from each other significantly in body weight gain, hepatosomatic index, and condition factor Hepatic level of cytochrome P450 was lower in PSP group than control group. NADPH-cytochrome P450 reductase, NADH-cytochrome b5 reductase, and ethoxyresorufin-O-deethylase (EROD) exhibited a reduced activity in PSP group than control group. Statistical analysis found that the activity or concentration of those enzymes correlated with the hepatic level of PSR with r2=0.497-0.611.

Distribution and characteristics of PAHs in sediments from the marine environment of Korea.

To assess the contamination of polycyclic aromatic hydrocarbons (PAHs) in the marine environment of Korea, 117 sediment samples along the coast were collected and analyzed. This study provides perspectives on concentration ranges and on geographic distributions of PAHs. Sum of 16 PAHs concentrations are in the range of 8.80-18500 ng/g dry weight. Industrialized and urbanized region showed high level of PAHs contamination. When compared with nationwide monitoring results of USA and UK, concentration of total PAHs are in the order of UK>US>this study. Major PAHs sources inferred from diagnostic indices and statistical approach were both pyrogenic and petrogenic. In coastal and offshore sediments of Korea, 7.76% sites had a mean PAH ERL quotient >1.0, indicating the potential to cause adverse effects in sensitive species. Youngil Bay was recognized as highly contaminated with PAHs, and recommended to be managed with special plan.

Nationwide monitoring of polychlorinated biphenyls and organochlorine pesticides in sediments from coastal environment of Korea.

To assess the organochlorine contamination in the Korean marine environment, a nationwide monitoring study was conducted. A total of 138 surface sediments, covering the whole Korean coast, were collected and analyzed. Organochlorine compounds (OCs) were widely distributed in the Korean coastal environment, with PCB and DDT contamination being particularly prevalent. The overall concentrations of PCBs, DDTs, HCHs, CHLs, and HCB in surface sediments were in the range of 0.088-199ngg(-1) (median value: 1.56ngg(-1)), 0.006-135ngg(-1) (0.68ngg(-1)), not detected (ND)-5.46ngg(-1) (0.32ngg(-1)), ND-3.26ngg(-1) (0.14ngg(-1)), and ND-2.59ngg(-1) (0.05ngg(-1)), respectively. The southeastern coast was found to be highly contaminated. Overall contamination status of Korean coastal sediments with regard to OCs is lower than that of USA. With the exception of highly industrialized sites, Korean coastal areas in general showed similar OC concentrations to those of other Asian countries. There was a significant correlation between distributions of most organochlorine contaminants with each other. OC contamination is closely related to shipping and industrial activities. Of the 7 sites categorized as highly polluted, 4 are in a harbor zone. Adverse effects to benthic communities are expected at the levels of OC contamination observed from harbor and industrial areas.

Multiple predictors of coronary restenosis after drug-eluting stent implantation in patients with diabetes.

OBJECTIVES: To identify parameters influencing the likelihood of restenosis after implantation of drug-eluting stents (DES) in patients with diabetes. METHODS: Stented patients (n = 840) with DES were retrospectively reviewed for inclusion in the study from the Multicenter PCI Database Registry. From this database, 211 (25.1%) of 840 patients with six-month angiographic follow up had diabetes. Predictors of coronary restenosis were identified with univariate and multivariate logistic regression analyses. RESULTS: Restenosis occurred in 92 of 629 (14.6%) patients without diabetes and in 44 (20.9%) of 211 patients with diabetes (p < 0.001). Multivariate parameters for predicting restenosis in the diabetic group were current smoking (odds ratio (OR) 1.923, 95% confidence interval (CI) 1.055 to 4.725, p = 0.036), higher C reactive protein concentration (OR 1.031, 95% CI 1.011 to 1.075, p = 0.043), use of the paclitaxel-eluting stent (OR 2.638, 95% CI 1.338 to 5.200, p = 0.005), longer stent length (OR 1.065, 95% CI 1.021 to 1.119, p = 0.033), smaller reference diameter before DES implantation (OR 0.501, 95% CI 0.110 to 0.965, p = 0.040), smaller reference diameter (OR 0.455, 95% CI 0.120 to 0.814, p = 0.026) and minimum lumen diameter (OR 0.447, 95% CI 0.068 to 0.876, p = 0.039) after DES implantation. CONCLUSION: Even with the introduction of DES, diabetes remains a significant predictor of coronary restenosis, especially in cases of a small baseline vessel size, small vessel size after percutaneous coronary intervention, longer stent length, use of the paclitaxel-eluting stent, current smoking and high C reactive protein concentration.

Spatio-temporal distribution and characteristics of PAHs in sediments from Masan Bay, Korea.

The distribution of polycyclic aromatic hydrocarbons (PAHs) has been investigated in the surface and core sediments from Masan Bay, Korea. Total PAHs in the surface sediments ranged from 207 to 2670 ng/g dry weight with a mean value of 680 ng/g. Qualitative similarity and quantitative difference between inner and outer bay indicate that the main sources of PAHs are located in the inner bay and outer bay is also affected by the same sources. Vertical distribution of PAHs revealed that three distinctive stages could be differentiated with the help of PCA analysis. The highest concentration (industrialization stage) appeared between late 1950s and 1980, which was 10 years later than other developed countries. A strong pyrolytic source fingerprint has been detected with slight influence of petrogenic sources, and diagenetic PAH, perylene also contributed. Total organic carbon normalized PAHs (sum of 13 PAHs, 8.85-88.0 microg/g OC) were under the threshold effects concentration (TEC, 290 microg/g OC).

Levels of persistent organochlorine contaminants in fish from Korea and their potential health risk.

Organochlorine contaminants in the muscles of sport and market fish were determined to understand the potential risks to humans consuming fish originating in Korea's coastal waters. Polychlorinated biphenyls (PCBs; sum of 22 congeners) and DDTs were the dominant contaminants, and their concentrations were in the range of 2.96 to 96.6 and 0.84 to 27.0 ng/g (wet weight basis), respectively. The highest PCB concentrations were found in samples taken from an industrial complex. Hexachlorocyclohexanes, chlordane-related compounds, and hexachlorobenzene concentrations were relatively low and ranged from 0.64 to 5.6, 0.17 to 4.24, and 0.08 to 1.58, respectively. Sport fish had levels of PCBs and DDTs approximately two times higher than market fish, implying that sport fish posed high potential risk of contamination with OCs. Risk-based screening value (SV) based on U. S. Environmental Protection Agency (USEPA) method was calculated using the USEPA approach to identify the primary chemicals of concern. Total PCB concentrations in all sport and market fish exceeded the SV (5.04 ng/g based on total PCBs), but the other compounds were mostly below SV values. Based on the estimated SVs, PCB compounds were identified as potential chemicals of concern.

Accumulation of tributyltin in olive flounder, Paralichthys olivaceus: its effect on hepatic cytochrome P450.

Accumulation of tributyltin (TBT) was determined in liver of olive flounder exposed to TBT (3.65, 36.5, 365, 3,650, and 7,300 ng Sn/L) for 10 or 30 days, followed by 60 days depuration. Effect of TBT on hepatic cytochrome P450 content was also measured in liver of olive flounder. TBT was highly accumulated in liver of fish during the 10- to 30-day exposures, and hepatic cytochrome P450 content decreased with increasing TBT concentration. Hepatic cytochrome P450 contents were affected in olive flounder exposed to even environmentally relevant TBT concentrations, such as 3.65 ng Sn/L. In addition, the liver TBT levels demonstrated strong negative correlation to the hepatic cytochrome P450 content. The effects started to appear from 20 ng Sn/g dry weight of TBT in liver. Tributyltin concentrations and hepatic cytochrome P450 were also determined in feral fine-spotted flounder. The relationship between other organic pollutants known as cytochrome P450 inducers (e.g., polychlorinated biphenyls) as well as TBT and hepatic cytochrome P450 in the feral fish implied that TBT even at ppt level could impose antagonistic effects on hepatic cytochrome P450 induction.

Geographical distribution and accumulation features of organochlorine residues in bivalves from coastal areas of South Korea.

As a part of Mussel Watch Program in Korea, the contamination levels and accumulation features of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) were assessed for 82 bivalve samples collected from 66 sites along the entire coast of Korea. The dry weight based sigmaPCBs and sigmaOCPs ranged from 4.4 ng g(-1) to 422.0 ng g(-1) (geometric mean = 36.9 ng g(-1)) and from 9.95 ng g(-1) to 131.37 (34.88) ng g(-1), respectively. PCB was predominant in Korean coast, followed by DDTs, HCHs, and Chlordanes. From the observed log normal distribution of PCB and each OCP, low- and high-levels were defined as geometric mean +/- 1 S.D., respectively. The levels at the sites near urban and/or industrial areas often exceeded the high-levels and the spatial distributions of sigmaDDTs and sigmaCHLs were correlated with that of sigmaPCBs, indicating terrestrial input pathways. Even distribution of sigmaHCHs suggested a possibility of atmospheric input pathway of HCHs. The observed isomer ratios of DDTs, HCHs, and CHLs indicated that aging has occurred.

Horizontal and vertical distribution of butyltin compounds in sediments from shipyards in Korea.

Butyltin compounds were quantitatively determined in surface sediment and sediment core samples near shipyards in the south coast of Korea, which is one of the major ship building industries in the world. Tributyltin (TBT) concentrations reached up to 46100 ng Sn/g on a dry-weight basis at the front of the shipyard. Horizontal distribution of butyltin compounds was closely related to dry-docking activities. Butyltin concentrations were relatively low where remote from the sources. The vertical distribution of TBT in sediment cores showed active use of TBT in Korean peninsula for the past decades. The increase of TBT concentrations in sediment core according to estimated sediment age demonstrated a positive correlation with the increase of gross tonnage of ships built in the shipyard for 20 years. High TBT residue levels in sediment core samples raise concerns over persistence of the compound in the marine environment.

The prevalence and awareness of hypertension and the relationship between hypertension and snoring in the Korean population.

BACKGROUND: Hypertension is the most important, and yet modifiable, risk factor for cardiovascular diseases. But in many countries, hypertension remains poorly controlled. Moreover, sleep apnea syndrome has shown that it is correlated with hypertension. The purpose of this study was to investigate the prevalence, awareness and control of hypertension among the Korean people and to evaluate the relationship between hypertension and snoring. METHODS: A total of 640 subjects living in Ansan, a regional city in Korea, were selected randomly, and trained nursing students investigated their age, sex, medical history, blood pressure, body mass index (BMI) and snoring score. Blood pressures were measured three times with a 10-minute interval and then averaged. The degree of snoring was estimated using a questionnaire. We divided the subjects into hypertensive (BP > or = 140/90 mmHg) versus normotensive group and snorer versus non-snorer group, and correlated hypertension with snoring. RESULTS: Of 640 subjects, 311 were male. The mean age was 39.7 +/- 14.6 years (18-77 years), the mean BMI (body mass index) was 22.4 +/- 3.0 kg/m2. The mean systolic and diastolic blood pressure was 121 +/- 15.7 mmHg and 79.5 +/- 11.6 mmHg. The prevalence and awareness of hypertension were 22.2% and 16.9%, respectively, and the prevalence of snoring was 35.2%. With the increment of age, in the male, the prevalence of hypertension and snoring were higher, and the snorer group showed a higher risk of hypertension than the non-snorer group (Odds ratio 2.32, CI = 1.56-3.39, p = 0.0001). CONCLUSION: In Korea, the prevalence of hypertension was similar to that in the western countries, but the awareness of hypertension was much lower compared with western countries. The prevalence of hypertension was higher in the snorer group, so more research on the correlation between the two conditions should be advanced in the future.

Coronary flow reserve is reflective of myocardial perfusion status in acute anterior myocardial infarction.

Our objective was to determine whether coronary vasodilatory reserve (CVR) correlates with the perfusion state of infarct zone in early recovery phase of acute anterior myocardial infarction (AMI). We studied 14 patients (11 males; mean age, 46 years) who had AMI and 6 control subjects who had chest pain but normal coronary angiograms. All patients underwent successful percutaneous revascularization of left anterior descending (LAD) coronary artery. Coronary flow velocity was measured using intracoronary (IC) Doppler at baseline and following IC injection of 18 microg of adenosine. Myocardial perfusion was evaluated by myocardial contrast echocardiography (MCE). CVR was higher in patients without a perfusion defect on MCE than in those with (2.48 +/- 0.21 vs. 1.66 +/- 0.13, P = 0.001). Subjects with a perfusion defect had a lower CVR than controls (1.66 +/- 0.13 vs.2.40 +/- 0.18, P < 0.05). CVR was > 2.0 in all subjects without a perfusion defect. There was a strong correlation between the magnitude of myocardial opacification in the LAD territory and CVR (r = 0.80, P < 0.01). Increase in peak diastolic flow velocity after adenosine infusion, but not systolic flow velocity, correlated with myocardial opacification index (r = 0.63, P = 0.016). CVR of infarct-related artery correlated closely with the perfusion status of the myocardium in infarct zone and those with a CVR > 2.0 had normal myocardial perfusion. These data suggest that CVR may be used to determine the perfusion state of the myocardium in the infarct zone, which is a known predictor of myocardial viability. Cathet. Cardiovasc. Intervent. 51:281-286, 2000.

Assessment of coronary flow reserve with transthoracic Doppler echocardiography: comparison with intracoronary Doppler method.

To evaluate the feasibility and usefulness of transthoracic Doppler echocardiography (TTDE) as a non-invasive method in recording distal anterior descending (LAD) coronary flow velocity, we compared coronary flow reserve (CFR) measured by TTDE with measurements by intracoronary Doppler wire (ICDW). Twenty-one patients without LAD stenosis were studied. ICDW performed at baseline and after intracoronary injection of 18 microg adenosine. TTDE was performed at baseline and after intravenous adenosine (140 microg/kgmin for 2 min). Adequate Doppler recordings of coronary flow velocities during systole were obtained in 14 of 21 study patients (67%) and during diastole in 17 (81%) patients. Baseline and hyperemic peak diastolic flow velocities measured by TTDE were significantly smaller than those obtained by ICDW (p<0.05). However, diminishing trends of diastolic and systolic velocity ratio after hyperemia were similarly observed in both methods. CFR obtained by TTDE (3.0+/-0.5), was higher than the value calculated by ICDW (2.5+/-0.4). There were significant correlations between the values obtained by the two methods (r=0.72, p<0.01). It is concluded that TTDE is a feasible method in measuring coronary flow velocity and appears to be a promising non-invasive method in evaluating CFR.

Assessment of coronary flow reserve with transthoracic Doppler echocardiography: comparison among adenosine, standard-dose dipyridamole, and high-dose dipyridamole.

Coronary flow reserve (CFR), defined as a ratio of hyperemic-to-basal coronary flow velocity, provides important information about the functional aspect of coronary circulation. However, it usually is determined by invasive methods during catheterization. Recent studies have shown that transthoracic Doppler echocardiography (TTDE) may be useful in the measurement of coronary flow velocity in the distal portion of the left anterior descending coronary artery (LAD). The vasodilators used for hyperemia are adenosine and dipyridamole. However, the coronary vasodilative response and systemic hemodynamic effects of the two agents have not been directly compared with TTDE. We assessed blood flow velocity and vascular resistance in the distal LAD by TTDE during an intravenous 2-minute adenosine infusion (140 microg/kg/min) and low- (0.56 mg/kg) and high-dose dipyridamole (0. 84 mg/kg) infusion in 25 patients with patent LAD. Coronary flow velocity was successfully recorded in 20 patients (80%) during baseline and the consecutive vasodilator-infusion period. Compared with low-dose dipyridamole, adenosine infusion induced a higher CFR (3.7 +/- 0.87 vs 2.73 +/- 0.65; P <.05) and a lower coronary resistance index (0.31 +/- 0.04 vs 0.35 +/- 0.08; P <.05). But by increasing the dipyridamole dose to 0.84 mg/kg, the values of the CFR and coronary resistance index became comparable to those of adenosine infusion (2.85 +/- 0.78 vs 3.03 +/- 0.7, P = not significant [NS]; 0.33 +/- 0.04 vs 0.32 +/- 0.09, P = NS; respectively). We conclude that adenosine seems to be a favorable vasodilator for the measurement of CFR with TTDE.