Association between Nitrogen Stable Isotope Ratios in Human Hair and Serum Levels of Leptin.

Stable isotope ratios have been reported to be potential biomarkers of dietary intake and nutritional status. High serum levels of leptin, a hormone which regulates energy metabolism and food intake, are associated with insulin resistance and metabolic syndrome. However, little is known about the association between stable isotope ratios and the metabolic risk in humans. We investigated whether the carbon and nitrogen stable isotope ratios in hair are associated with serum leptin levels. Hair samples were collected from 399 healthy adults (233 men and 166 women) aged 40 to 70 years of a community-based cohort in Korea and the bulk stable isotope ratios of carbon (δ13C) and nitrogen (δ15N) were measured for all hair samples. Serum leptin levels were analyzed by radioimmunoassay. δ15N showed positive correlations with serum leptin levels. In multivariate models, increasing δ15N were associated with elevated serum leptin levels (defined as ≥ the median values), whereas δ13C were not significantly associated with serum leptin levels. The odds ratio (95% confidence interval) per 1‰ increase in δ15N for an elevated serum leptin level was 1.58 (1.11-2.26). In participants with high body mass index, δ15N showed positive associations with serum leptin levels, whereas these associations were not seen in participants with low body mass index. The nitrogen stable isotopic ratio in hair is positively associated with serum leptin levels. The hair δ15N could be used as a clinical marker to estimate metabolic risk.

Addition of N-terminal pro-B-type natriuretic peptide levels to electrocardiography criteria for detection of left ventricular hypertrophy: the ARIRANG study.

The utility of electrocardiography (ECG) in screening for left ventricular hypertrophy (LVH) in general populations is limited mainly because its low sensitivity. B-type natriuretic peptide (BNP) is released due to the remodeling processes of LVH and could improve the diagnostic accuracy for the ECG criteria for LVH. We hypothesized that addition of BNP levels to ECG criteria could aid LVH detection compared with ECG alone in a general population. We enrolled consecutive 343 subjects from a community-based cohort. LVH was defined as LV mass index > 95 g/m(2) for females and > 115 g/m(2) for males according to echocardiography. The area under the receiver operator characteristic (ROC) curve to detect LVH was 0.55 (95% confidence interval [CI], 0.50-0.61) in Sokolow-Lyon criteria and 0.53 (0.47-0.59) in the Cornell voltage criteria. After addition of N-terminal-proBNP levels to the model, the corresponding areas under the ROC were 0.63 (0.58-0.69) and 0.64 (0.59-0.69), respectively. P values for the comparison in areas under the ROC for models with and without N-terminal-proBNP levels were < 0.001. These data suggest that addition of N-terminal-proBNP levels to ECG criteria could significantly improve the diagnostic accuracy of LVH in general populations.

Preparation of monolithic cu(In0.7Ga0.3)Se2 nanopowders and subsequent fabrication of sintered CIGS films.

Cu(In,Ga)Se2 (CIGS) is a compound semiconductor and is one of the most attractive light-absorbing materials for use in thin film solar cells. Among the various approaches to prepare CIGS thin films, the powder process offers an extremely simple and materials-efficient method. Here, we report the mechano-chemical preparation of CIGS compound powders suitable for fabrication of CIGS films by a powder process. We found that the CIGS phase was formed from the elemental powders of Cu, In, and Se and liquid Ga using high energy milling process with a milling time as short as 40 min at 200 rpm due to a self-accelerating exothermic reaction. The morphology and size of the CIGS powders changed with a function of the milling speed (100-300 rpm), leading to an optimal condition of milling at 200 rpm for 120 min. We also found that it was difficult to obtain a monolithic phase of the CIGS powders without severe particle aggregation by mechano-chemical milling alone. Therefore, in combination with the milling, subsequent heat-treatment at 300 degrees C was performed, which successfully provided monolithic CIGS nanopowders suitable for powder process. When a thin film was fabricated from the monolithic CIGS nanopowders, a highly dense film with large crystalline grains was obtained. The CIGS film preserved its chemical composition of CuIn0.7Ga0.3Se2 after sintering as evidenced by Raman spectroscopy, EDS and SAED pattern of transmission electron microscopy. The film was also found suitable for a light absorbing layer of CIGS solar cells with its band gap energy of 1.14 eV evaluated by transmittance spectroscopy.

A prospective study of epicardial adipose tissue and incident metabolic syndrome: the ARIRANG study.

Increased epicardial adipose tissue (EAT) may be closely associated with the development of metabolic abnormalities. We investigated whether EAT predicts the incident metabolic syndrome in a community-based, middle-aged population. The study subjects were comprised of 354 adults (134 men and 220 women) aged 40 to 70 yr without metabolic syndrome. Baseline EAT thickness, measured by echocardiography, was compared between subjects who developed new-onset metabolic syndrome at follow-up survey and those who did not. After an average of 2.2 yr of follow-up, 32 men (23.9%) and 37 women (16.8%) developed metabolic syndrome. Median EAT thickness at baseline was significantly higher in male subjects who developed metabolic syndrome than those who did not (1.52 mm vs 2.37 mm, P<0.001). The highest quartile of EAT thickness (≥2.55 mm) was associated with increased risk of progression to metabolic syndrome (Odds ratio [OR], 3.09; 95% confidence interval [CI], 1.11-8.66) after adjustment for age, smoking, alcohol intake, regular exercise, total energy intake, high sensitive C-reactive protein and homeostasis model assessment of insulin resistance in men. A significant association of EAT with incident metabolic syndrome was not seen in women (OR, 1.25; 95% CI, 0.54-2.90). In conclusion, increased EAT thickness is an independent predictor for incident metabolic syndrome in men.

The association between carbon and nitrogen stable isotope ratios of human hair and hypertension.

BACKGROUND: The relationship between stable isotope ratios and dietary protein sources has been reported. However, few studies have examined the effect of stable isotope ratios on metabolic risk in humans. We investigated whether the stable isotope ratios of carbon and nitrogen in human hair are associated with blood pressure and hypertension. METHODS: We conducted a cross-sectional study of 392 subjects (228 men and 164 women). Hair samples of the subjects were used for the measurement of stable isotope ratios of carbon (δ13C) and nitrogen (δ15N). RESULTS: The δ13C and δ15N values showed positive correlations with diastolic blood pressure in the subjects without antihypertensive medication. In the subjects without antihypertensive medication, the multivariable-adjusted odds ratio (95% confidence interval) for hypertension was 1.55 (1.04-2.30) per 1‰ increase in δ15N and 1.22 (0.86-1.73) per 1‰ increase in δ13C, respectively. However, in the subjects with antihypertensive medication, neither δ13C nor δ15N values showed a significant association with hypertension. CONCLUSIONS: The stable isotopic ratio of nitrogen in scalp hair is independently associated with hypertension in subjects without antihypertensive medication. The hair δ15N value might be used as a surrogate marker to screen a high-risk population for hypertension.

Performance Enhancement in Powder-Fabricated Cu2(ZnSn)Se4 Solar Cell by Roll Compression.

Despite the improved conversion efficiency of Cu2(ZnSn)Se4 (CZTSe) solar cells, their roll-to-roll fabrication nonetheless leads to low performance. The selenization time and temperature are typically considered major parameters for a powder-based CZTSe film; meanwhile, the importance of the densification during the roll-to-roll process is often overlooked. The densification process is related to the porosity of the light-absorbing layer, where high porosity lowers cell performance. In this study, we fabricated a dense CZTSe absorber layer as a method of controlling the compression of a powder precursor (Cu1.7(Zn1.2Sn1.0)S4.0 (CZTS)) during the roll-press process. The increased particle packing density of the CZTS layer was crucial in sintering the powder layer into a dense film and preventing severe selenization of the Mo back electrode. The pressed absorber layer of the CZTSe solar cell exhibited a more uniform chemical composition determined using dynamic secondary ion mass spectrometry (SIMS). Under the AM 1.5G illumination condition, the power conversion efficiency of the pressed solar cell was 6.82%, while the unpressed one was 4.90%.

Association between short sleep duration and high incidence of metabolic syndrome in midlife women.

Chronic sleep deprivation is increasingly common in industrialized societies. Short sleep duration has been associated with a number of negative health outcomes. The objectives of this study were to investigate the association between self-reported sleep duration and the presence of metabolic syndrome (combination of central obesity, triglyceride, high density lipoprotein, blood pressure, fasting plasma glucose) in adults during midlife. The Korean Genomic Rural Cohort (KGRC) is a cohort study of aged 40 to 70 years in rural Korea. This study focuses on the prevalence, incidence, and risk factors for chronic degenerative disorders, such as hypertension, diabetes, osteoporosis, respiratory diseases, and metabolic syndrome. The baseline sample of participants in the KGRC study was recruited in 2005-2006 (phase 1). Respondents were followed until 2008-2009 (phase 2). The final sample included 1,107 subjects: 386 males (34.9%) and 721 females (65.1%). The incidence rate of metabolic syndrome in our sample was 18.4% (21.2% for males and 16.9% for females). Subjects sleeping < 6 hours a day (HR: 1.798; 95% CI: 1.06-3.05) were significantly more likely to experience metabolic syndrome than participants sleeping 6 to 7.9 hours a day after controlling for potential covariates (age, body mass index, menopause, smoking, alcohol and physical activity). Shorter sleep duration was associated with the high incidence of metabolic syndrome among females only. In conclusion, shorter sleep duration may be a significant risk factor for the development of metabolic syndrome in women.

Normative values and correlates of mean common carotid intima-media thickness in the Korean rural middle-aged population: the Atherosclerosis RIsk of Rural Areas iN Korea General Population (ARIRANG) study.

Carotid intima-media thickness (CIMT) is considered as a surrogate marker for cardiovascular disease (CVD). We determined the normative value of CIMT and correlates of CVD risk factors and Framingham risk score (FRS) in Korean rural middle-aged population. We measured CIMT with a B-mode ultrasonography in 1,759 subjects, aged 40 to 70 yr, in a population-based cohort in Korea. A healthy reference sample (n = 433) without CVD, normal weight and normal metabolic parameters was selected to establish normative CIMT values. Correlates between CIMT and conventional CVD risk factors were assessed in the entire population. Mean values of CIMT (in mm) for healthy reference sample aged 40-49, 50-59, and 60-70 yr were 0.55, 0.59, and 0.66 for men and 0.48, 0.55, and 0.63 for women, respectively. In multivariate regression analysis, CIMT was correlated with older age, higher BMI, male gender, higher LDL-cholesterol level and history of diabetes mellitus. The mean CIMT was also correlated with FRS in both gender (r(2) = 0.043, P < 0.01 for men; r(2) = 0.142, P < 0.01 for women). We identified normative value of CIMT for the healthy Korean rural middle-aged population. The CIMT is associated with age, obesity, gender, LDL-cholesterol, diabetes mellitus and FRS.

The clustering patterns of metabolic risk factors and its association with sub-clinical atherosclerosis in Korean population.

BACKGROUND AND AIMS: Metabolic syndrome (MetS) is considered to be an insulin-resistance syndrome, but recent evidence suggests that MetS has multiple physiological origins which may be related to atherosclerosis. This study investigated clustering patterns of metabolic risk factors and its association with sub-clinical atherosclerosis. SUBJECTS AND METHODS: This study used factor analysis of 11 metabolic factors in 1374 individuals to define clustering patterns and determine their association with carotid intima-media thickness (CIMT). Eleven metabolic factors were used: body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), fasting blood insulin (FBI), serum triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), homeostasis model assessment-insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hsCRP) and adiponectin. Two regression analyses were done, the first using individual metabolic variables and the second using each factor from the factor analysis to evaluate their relationships with CIMT. RESULTS: Four clustering patterns, insulin-resistance factor (FBG, FBI, HOMA-IR), obesity-inflammatory factor (BMI, WC, hsCRP), blood pressure factor (SBP, DBP) and lipid metabolic factor (HDL-C, TG, adiponectin) were categorized. In a multivariate regression model after adjustment for age, sex, low-density lipoprotein cholesterol and smoking history (pack year), insulin resistance factor (B = 11.09, p = 0.026), obesity-inflammatory factor (B = 18.50, p < 0.001), blood pressure factor (B = 12.84, p = 0.010) and lipid metabolic factor (B = - 11.55, p = 0.023) were found to be significantly associated with CIMT. CONCLUSION: In conclusion, metabolic risk factors have four distinct clustering patterns that are independently associated with sub-clinical atherosclerosis.

Ion-permselective polyelectrolyte multilayer membrane installed with a pH-sensitive oxazine switch.

This paper describes a pH-responsive multilayer film composed of two layered components, namely poly(allylamine hydrochloride) (PAH) and a copolymer of acrylic acid and [1,3]oxazine-modified acrylate (POA). The oxazine ring is an acidochromic chromophore and opens to form either cationic 3H-indolium or anionic hemiaminal in a pH-dependent manner. This structural transition was used to generate a net positive or negative charge on the membrane for selective ion permeation. Interestingly, the reversible oxazine ring opening and closing proceeded smoothly without significant steric hindrance in the multilayer film comprising 10 PAH/POA bilayers. The pH-responsive permselectivity for cationic and anionic probe molecules was demonstrated using a POA monolayer film adsorbed electrostatically onto an amino-functionalized ITO electrode. The origin of the excellent ion-transport selectivity in the 1 nm ultrathin POA membrane is discussed in terms of alternating charges of the aromatic amphoteric group, oxazine, in the polyeletrolyte membrane.

Optimal waist circumference cutoff values for metabolic syndrome diagnostic criteria in a Korean rural population.

The Korean Society for the Study of Obesity (KSSO) has defined the waist circumference cutoff value of central obesity as 90 cm for men and 85 cm for women. The purpose of this investigation was to determine the corresponding waist circumference values. A total of 3,508 persons in the Korean Rural Genomic Cohort Study were enrolled in this survey. Receiver operating characteristic (ROC) curve analysis was used to find appropriate waist circumference cutoff values in relation to insulin resistance determined by homeostasis model assessment for insulin resistance (HOMA-IR), body mass index (BMI), and components of metabolic syndrome. The optimal waist circumference cutoff values were 87 cm for men and 83 cm for women by ROC analysis to HOMA-IR and 86 cm for men and 83 cm for women by ROC analysis to value with more than two components of metaobolic syndrome. By using a BMI > or =25 kg/m(2), 86 cm for men and 82 cm for women were optimal waist circumference cutoff values. In this study, we suggest that the most reasonable waist circumference cutoff values are 86-87 cm for men and 82-83 cm for women.

Cardiovascular parameters correlated with metabolic syndrome in a rural community cohort of Korea: the ARIRANG study.

Although metabolic syndrome (MetS) is associated with increased cardiovascular mortality and the development of atherosclerosis, consensus is still lacking on the status of cardiovascular function and geometry in MetS patients. We investigated the relation between MetS and left ventricle (LV) geometry and function, carotid intima-media thickness (IMT) and arterial stiffness in a community-based cohort of 702 adult subjects. Subjects were categorized into three groups according to the number of MetS components present, as defined by the Adult Treatment Panel III guidelines: 1) Absent (0 criteria), 2) Pre-MetS (1-2 criteria) or 3) MetS (> or =3 criteria). In female subjects, LV mass, LV mass/height(2.7), deceleration time, and aortic pulse wave velocity increased, and E/A ration decreased in a stepwise manner across the three groups. These changes were not observed in male subjects. The mean carotid IMT was higher in the MetS group than in the other two groups. The degree of MetS clustering is found to be strongly correlated with geometric eccentricity of LV hypertrophy, diastolic dysfunction and arterial changes irrespective of age and blood pressure status, particularly in females. Waist circumference is found to have the most powerful effect on cardiovascular parameters.

Effects of ginseng on peripheral blood mitochondrial DNA copy number and hormones in men with metabolic syndrome: A randomized clinical and pilot study.

BACKGROUND: It has been observed that mitochondrial dysfunction is associated with an increased risk of metabolic syndrome. There is growing evidence that hyperactivity of the hypothalamus-pituitary-adrenal (HPA) axis and hormone (testosterone and growth hormone) deficiency may lead to metabolic syndrome. Recent studies have reported that ginseng treatment improves mitochondrial and HPA-axis function and increases anabolic hormone secretion. OBJECTIVES: The objective of this study was to investigate the effect of red ginseng (RG) on metabolic syndrome, hormones, and mitochondrial function using leukocyte mitochondrial DNA copy number in men with metabolic syndrome. METHODS: We performed a randomized, double-blind, placebo-controlled study in 62 subjects who were not taking drugs that could affect their metabolic function. A total of 62 men with metabolic syndrome were randomly assigned to either an RG group (3.0g/day) or a placebo group for 4 weeks. We analyzed changes in metabolic syndrome components, leukocyte mitochondrial DNA copy number, hormones (total testosterone, IGF-1, cortisol, and DHEAS) and inflammatory markers (C-reactive protein, ferritin) from baseline to 4 weeks. RESULTS: Significant improvement in mitochondrial function (95% CI -44.9 to -1.3) and an increase in total testosterone (95% CI -70.1 to -1.0) and IGF-1(P=0.01) levels were observed in the RG group when compared with the placebo group. Diastolic blood pressure (95% CI 2.0-9.4) and serum cortisol (95% CI 1.1-5.5) significantly decreased in the RG group. CONCLUSIONS: We found evidence that RG had a favorable effect on mitochondrial function and hormones in men with metabolic syndrome.

Oxidative damage markers are significantly associated with the carotid artery intima-media thickness after controlling for conventional risk factors of atherosclerosis in men.

BACKGROUND: This study aimed to assess the association between oxidative damage markers and carotid artery intima-media thickness (CIMT) after controlling for conventional risk factors of atherosclerosis in multiple logistic regression models. METHODS AND FINDINGS: Fifty-one case male participants (CIMT ≥ 0.9 mm) were enrolled during their visits to Korean Genomic Rural Cohort Study of Wonju centers between May 1 and August 31, 2011, along with 51 control participants (CIMT < 0.9 mm) selected using frequency matching by age group. The levels of oxidative damage markers, 8-hydroxy-2'-deoxyquuanosine (8-OHdG), malondialdehyde (MDA), and 8-iso-prostaglandin F2α (Isoprostane), were measured. Conditional logistic regression models were used to evaluate relative relationships between the oxidative damage markers and the risk of high CIMT. RESULTS: The markers of oxidative lipid (Isoprostane and MDA) and DNA (8-OHdG) damage were associated with CIMT after controlling for the conventional risk factors, including age, low density lipoprotein, body mass index, smoking history, alcohol consumption, and metabolic syndrome (ORs [95% CI] for Isoprostane: 3rd tertile, 8.47 [2.59-27.67]; for MDA: 3rd tertile, 8.47 [2.59-27.67]; for 8-OHdG: 3rd tertile, 5.58 [1.79-17.33]). When all the oxidative damage markers were incorporated in the same logistic regression model, only Isoprostane was significantly related to CIMT (OR [95% CI]: 4.22 [1.31-13.53] in 2nd tertile and 14.21 [3.34-60.56] in 3rd tertile). CONCLUSIONS: In this nested case-control study, the oxidative damage markers of lipid and DNA were associated with CIMT even after controlling for the conventional risk factors of cardiovascular diseases.

Blood Lead Levels and Cause-Specific Mortality of Inorganic Lead-Exposed Workers in South Korea.

The objective of this study was to identify the association of blood lead level (BLL) with mortality in inorganic lead-exposed workers of South Korea. A cohort was compiled comprising 81,067 inorganic lead exposed workers working between January 1, 2000, and December 31, 2004. This cohort was merged with the Korean National Statistical Office to follow-up for mortality between 2000 and 2008. After adjusting for age and other carcinogenic metal exposure, all-cause mortality (Relative risk [RR] 1.36, 95% confidence interval [CI] 1.03-1.79), digestive disease (RR 3.23, 95% CI 1.33-7.86), and intentional self-harm (RR 2.92, 95% CI 1.07-7.81) were statistically significantly higher in males with BLL >20 µg/dl than of those with BLL ≤10µg/dl. The RR of males with BLL of 10-20 µg/dl was statistically higher than of those with BLL ≤10µg/dl in infection (RR 3.73. 95% CI, 1.06-13.06). The RRs of females with 10-20 µg/dl BLL was statistically significantly greater than those with BLL <10µg/dl in all-cause mortality (RR 1.93, 95% CI 1.16-3.20) and colon and rectal cancer (RR 13.42, 95% CI 1.21-149.4). The RRs of females with BLL 10-20 µg/dl (RR 10.45, 95% CI 1.74-62.93) and BLL ≥20 µg/dl (RR 12.68, 95% CI 1.69-147.86) was statistically significantly increased in bronchus and lung cancer. The increased suicide of males with ≥20 µg/dl BLLs, which might be caused by major depression, might be associated with higher lead exposure. Also, increased bronchus and lung cancer mortality in female workers with higher BLL might be related to lead exposure considering low smoking rate in females. The kinds of BLL-associated mortality differed by gender.

The association between carbon and nitrogen stable isotope ratios of human hair and metabolic syndrome.

BACKGROUND: It has been reported that stable isotope ratios can be used as biomarkers for animal protein intake. Meat consumption and high protein intake could be risk factors for metabolic disorders. We investigated whether the stable isotope ratios of carbon and nitrogen are associated with metabolic syndrome. METHODS: We conducted a cross-sectional study of 399 subjects (233 men and 166 women). Hair samples from 399 subjects were measured for stable isotope ratios of carbon (δ(13)C) and nitrogen (δ(15)N). RESULTS: The δ(15)N values progressively increased with the number of components of the metabolic syndrome present in study subjects (P for trend 0.047). In multivariable models, δ(15)N values were positively associated with the presence of metabolic syndrome (odds ratio, 1.53; 95% confidence interval, 1.09-2.14), whereas δ(13)C values were not (odds ratio, 0.97; 95% confidence interval, 0.72-1.30). The odds ratio (95% confidence interval) for metabolic syndrome comparing the highest to the lowest quartiles of δ(15)N values was 2.64 (1.17-5.92). CONCLUSIONS: The nitrogen, but not carbon, stable isotopic ratio of hair is independently associated with the presence of metabolic syndrome. The hair δ(15)N value might be a surrogate marker for clustering of risk factors in metabolic syndrome.

Job characteristics and blood coagulation factors in Korean male workers.

This study examined the possible relationship between Karasek's job strain model and blood coagulation factors VII and VIII as risk factors for cardiovascular disease in Korean male workers. Based on the postulation of the model, we invited 160 male workers (40 people each subgroup) using a stratified sampling from the base population (n = 1071). In univariate analyses, decision latitude was negatively related to blood coagulation factors VII and VIII. Work demand was positively related to coagulation factor VIII, but not to factor VII. Hierarchical multiple regression analyses showed that job strain was associated with blood coagulation factor VIII after controlling for smoking, blood pressure, total cholesterol, and HDL cholesterol. These results indicate that job characteristics may be related to blood coagulation, and contribute to the development of cardiovascular disease with other classical risk factors.

The metabolism and liver toxicity of N,N-dimethylformamide in the isolated perfused rat liver.

N,N-dimethylformamide (DMF) is metabolized by the microsomal cytochrome p-450 into mainly N-hydroxymethyl- N-methylformamide (HMMF), which further breaks down to N-methyformamide (NMF). However, the detailed mechanism of its toxicity remains unclear. We investigated the metabolism and the toxicity of DMF using the isolated perfused liver model. DMF was added to the recirculating perfusate of the isolated perfused rat liver at concentrations of 0, 10 and 25 mM. Samples were collected from the inferior vena cava at 0, 30, 45, 60, 75, and 90 minutes following addition of the DMF. The metabolites of DMF were analyzed using Gas-chromatography (GC). The changes in the rate of oxygen consumption by the DMF were monitored during perfusion. The enzyme activities (aspartic aminotransferase:AST, alanine aminotransferase:ALT, and lactic dehydrogenase:LDH)) in the perfusate were monitored to see if DMF caused hepatotoxicity. As the perfusion progressed, the DMF concentration in the perfusate decreased, but the level of NMF increased to a maximum of 1.16 mM. The rate of oxygen consumption increased at DMF concentrations of 10 mM and 25 mM. However, when a known inhibitor of cytochrome p-450, SKF 525A (300 micro M), was used to pretreat the perfusate prior to the addition of the DMF, the rate of oxygen consumption was significantly inhibited, indicating the cytochrome p-450 system was responsible for the conversion of DMF to NMF. On addition of the DMF, the activities of the enzymes AST, ALT and LDH were significantly increased a time and dose dependent manner. However, following pretreatment with SKF 525A, their releases were inhibited.

Association between job stress on heart rate variability and metabolic syndrome in shipyard male workers.

A growing body of literature has documented that job stress is associated with the development of cardiovascular disease. Nevertheless, the pathophysiological mechanism of this association remains unclear. The purpose of this study is to elucidate the relationship between job stress, heart rate variability, and metabolic syndrome. The study design was cross-sectional, and a total of 169 industrial workers were recruited. A structured-questionnaire was used to assess the general characteristics and job characteristics (work demand, decision latitude). Heart rate variability (HRV) was recorded using SA-2000 (medi-core), and was assessed by time-domain and by frequency-domain analyses. Time domain analysis was performed using SDNN (Standard Deviation of normal to normal interval), and spectral analysis using low-frequency (LF), high-frequency (HF), and total frequency power. Metabolic syndrome was defined on the basis of risk factors being clustered when three or more of the following cardiovascular risk factors were included in the fifth quintile: glucose, systolic blood pressure, high-density lipoprotein cholesterol (bottom quintile), triglyceride, and waist-hip ratio. The results showed that job characteristics were not associated with cardiovascular risk factors. Compared to the lower strain group (low strain+passive+active group), the high strain group had a less favorable cardiovascular risk profile with higher levels of blood pressure, glucose, homocysteine, and clotting factor, but the difference was not statistically significant. The SDNN of HRV was significantly lower in the high strain group than in the low strain group. The prevalence of metabolic syndrome in the lower strain group and high strain group was 13.2% and 23.8%, respectively. In the high strain group, the metabolic syndrome was significantly related to a decreased SDNN. However, we could not find a significant association in LF/HF ratio. This result suggests that decreased HRV found in the high-strain group are not a direct indicator of disease. However, it can induce cardiovascular abnormalities or dysfunctions related to the onset of heart disease among high risk groups.

Salmonella enterica serovar London infections associated with consumption of infant formula.

Epidemiologic studies were conducted on 31 cases of Salmonella group E infection detected in 2000 through a laboratory-based pathogen surveillance in Gangwon Province, Korea. Data were collected on the environmental exposures and the patients' foods, including the brand(s) of milk consumed before the onset of diarrhea. The patients' medical records were also reviewed. All of the patients were infants under 10 months of age except one 7-year old child. Surprisingly, all of the infants were fed with infant formulas from Company A, although two infants were fed with infant formulas from both Company A and Company B. Antimicrobial susceptibility test and pulsed-field gel electrophoresis (PFGE) were performed in 25 out of 31 isolates from the patients and in 1 isolate from an opened packet of infant formula collected from the home of an infected infant. All of the 26 isolates were Salmonella enterica serovar London. They showed a single PFGE pattern, and all of the isolates were susceptible to the 18 antibiotics tested. The causative agent of the salmonella outbreaks in the Gangwon Province and its surrounding areas was Salmonella London, and the highly likely source of the infection was infant formula from Company A.