Apparent ruminal synthesis of B vitamins in lactating dairy cows fed diets with different forage-to-concentrate ratios.

Effects of the forage-to-concentrate ratio on apparent ruminal synthesis of thiamine, riboflavin, niacin, vitamin B6, folates, and vitamin B12 were evaluated in an experiment using 14 ruminally and duodenally cannulated Holstein cows. The experiment was a crossover design with two 15-d treatment periods and a 14-d preliminary period in which cows were fed a diet intermediate in composition between the treatment diets. Treatments were diets containing low-forage (44.8% forage, 32.8% starch, 24.4% neutral detergent fiber) or high-forage (61.4% forage, 22.5% starch, 30.7% neutral detergent fiber) concentrations. Both diets were formulated with different proportions of the same ingredients. Concentrations of B vitamins were analyzed in feed and duodenal digesta. Apparent ruminal synthesis of each B vitamin was calculated as the duodenal flow minus the intake. The high-forage diet had the highest concentrations of riboflavin, niacin, vitamin B6, and folates, whereas the low-forage diet had the highest thiamine concentration. Vitamin B12 in the diets was under the level of detection. Consequently, despite a reduction in dry matter intake when the cows were fed the high-forage diet, increasing dietary forage concentration increased or tended to increase intakes of riboflavin, niacin, and vitamin B6 but reduced thiamine and folate intakes. Increasing dietary forage concentration reduced apparent ruminal degradation of thiamine and apparent ruminal synthesis of riboflavin, niacin, and folates and increased ruminal degradation of vitamin B6, but had no effect on ruminal synthesis of vitamin B12. As a consequence, increasing the forage-to-concentrate ratio had no effect on the amounts of thiamine, riboflavin, and vitamin B12 reaching the small intestine but decreased the amounts of niacin, vitamin B6, and folates available for absorption. Apparent ruminal syntheses of riboflavin, niacin, folates, and vitamin B12 were correlated positively with the amount of starch digested in the rumen and duodenal flow of microbial N, whereas these correlations were negative for thiamine. Apparent ruminal syntheses of thiamine and vitamin B6 were negatively correlated with their respective intakes, whereas folate intake was positively correlated with its synthesis in the rumen.

Association of alcohol consumption pattern with risk of hypertension in Korean adults based on the 2010-2012 KNHANES.

We examined the association between alcohol-drinking pattern and hypertension in Korean adults. This cross-sectional study included 15,052 participants (7054 men and 7998 women) who were included in the 2010-2012 Korean National Health and Nutrition Examination Survey (KNHANES). We categorized alcohol-drinking patterns into three groups based on the Alcohol Use Disorders Identification Test (AUDIT) score: low-risk (score: 0-7), intermediate-risk (score: 8-14), and high-risk (score: ≥15). Hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or current use of anti-hypertensive medications. In the study population, 25.2% of men and 4.6% of women were high-risk drinkers. Hypertension prevalence was 30.8% in men and 20.6% in women. Of the total population, 13.8% of men and 13.6% of women were using anti-hypertensive drugs. Age-adjusted hypertension prevalence was 30.8, 40.9, and 45.3% in men, and 24.6, 27.0, and 32.3% in women in the low-, intermediate-, and high-risk drinking group, respectively. Compared to the low-risk drinking group, the prevalence ratio (95% confidence interval [CI]) for hypertension was 1.664 (1.4331.933) and 2.070 (1.772-2.418) for men and 1.012 (0.774-1.323) and 1.650 (1.080-2.522) for women in the intermediate- and high-risk drinking group, respectively, after adjusting for age and other confounding factors. In conclusion, our study suggests high-risk drinking appears to be associated with a higher risk of hypertension in men and women.

Effects of forage family on apparent ruminal synthesis of B vitamins in lactating dairy cows.

Effects of forage family (legume vs. grass) on apparent ruminal synthesis (ARS) and postruminal supply of B vitamins were evaluated in 2 experiments. Diets containing either alfalfa (AL) or orchardgrass (OG) silages as the sole forage were offered to ruminally and duodenally cannulated lactating Holstein cows in crossover design experiments. Experiment 1 compared diets containing AL and OG [~23% forage neutral detergent fiber (NDF) and ~27% total NDF] offered to 8 cows in two 15-d treatment periods. Experiment 2 compared diets containing AL and OG (~25% forage NDF and ~30% total NDF) offered to 13 cows in two 18-d treatment periods. Thiamin, riboflavin, niacin, vitamin B6, folates, and vitamin B12 were analyzed in feeds and duodenal digesta. Apparent ruminal synthesis was calculated as the duodenal flow of each vitamin minus its intake. Forage family affected B vitamin intakes, duodenal flow, and ARS. In both experiments, AL diets increased vitamin B6 and decreased folate intakes. In experiment 1, riboflavin and niacin intakes were greater with the OG diet, whereas in experiment 2 thiamin intake was greater but riboflavin intake was smaller with the OG diet. In spite of the low contribution of either silage to the dietary folate content, folate intake was greater with OG diets than AL due to the difference in soybean meal contribution between diets. Niacin and folate ARS were not affected by the forage family. Duodenal microbial nitrogen flow was positively correlated with ARS of riboflavin, niacin, vitamin B6, folates, and vitamin B12, but tended to be negatively correlated with thiamin ARS. Apparent ruminal synthesis of folates and vitamin B12 appear to be related to microbial biomass activity. Changes in nutrient composition of the diets likely affected the microbial population in the rumen and their B vitamin metabolism.

Reading nutrition labels is associated with a lower risk of metabolic syndrome in Korean adults: the 2007-2008 Korean NHANES.

BACKGROUND AND AIMS: Several studies demonstrated that reading nutrition labels was associated with healthier food choices, despite some controversy. This study investigated the association between the use of nutrition labels and metabolic syndrome (MetS) in Korean adults. METHODS AND RESULTS: This cross-sectional study included 7756 individuals who participated in the 2007-2009 Korean National Health and Nutrition Examination Survey (KNHANES). A self-reported questionnaire was used to determine participant's awareness of nutrition labels. Modified Asian criteria based on a harmonizing definition of MetS were adopted. Individuals in the group that read nutrition labels (the Reading Group) were youngest and leanest, but their daily caloric intake fell between that of the group that did not read nutrition labels (the Non-Reading Group) and the group that did not know about them (the Not-Knowing Group). The prevalence of MetS was 16.8% in the Reading Group, 27.2% in the Non-Reading Group, and 47.3% in the Not-Knowing Group. In comparison to participants in the Reading Group, the odds ratios (95% confidence interval) for MetS in the participants in the Non-Reading Group and Not-Knowing Group were 1.85 (1.60-2.14) and 4.44 (3.79-5.20), respectively, when not adjusted. The relationship between the use of nutrition labels and MetS remained statistically significant even after adjusting for covariates such as age, sex and socioeconomic status including household income and education level [1.27 (1.05-1.53) in the Non-Reading Group and 1.34 (1.05-1.70) in the Not-Knowing Group]. CONCLUSION: Reading nutrition labels appeared to be associated with a lower prevalence of MetS in a nationally representative sample of Korean adults.

The association between the ratio of triglyceride to HDL-C and insulin resistance according to waist circumference in a rural Korean population.

BACKGROUND AND AIMS: This study aimed to examine the association between an increased ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) and insulin resistance as well as to investigate the interactive effect of TG/HDL-C and waist circumference on insulin resistance in a rural Korean population. METHODS AND RESULTS: This study, employing a cross-sectional design, included 8411 participants from the Korean Genomic Rural Cohort Study. Levels of fasting insulin, lipid profiles and anthropometric data were assessed for all participants. Insulin resistance was defined as a value greater than the 75th percentile on the homeostasis model assessment of insulin resistance (HOMA-IR). The TG/HDL-C ratio was positively correlated with waist circumference, total cholesterol, low-density lipoprotein cholesterol (LDL-C), TG and HOMA-IR, and negatively correlated with HDL-C when the calculations were controlled for gender. In comparison with the lowest quartile group of TG/HDL-C (≤1.92 in men, ≤1.63 in women), the odds ratios (ORs) (95% confidence interval) for insulin resistance in the highest quartile group of TG/HDL-C (>4.90 in men, >3.93 in women) were 2.33 (1.72-3.16) in men and 2.16 (1.73-2.71) in women, after adjusting for multiple covariates including waist circumference. Following stratification of waist circumference into quartiles, the effect of TG/HDL-C on insulin resistance remained significant irrespective of the waist circumference quartile. CONCLUSION: The TG/HDL-C ratio was linearly associated with insulin resistance in a rural Korean cohort independently of waist circumference in both genders, albeit not interactive.

Nutrient demand interacts with forage family to affect nitrogen digestion and utilization responses in dairy cows.

The effect of preliminary feed intake on responses to diets containing alfalfa silage or orchardgrass silage was evaluated using 8 ruminally and duodenally cannulated Holstein cows in a crossover design experiment with a 14-d preliminary period and two 15-d treatment periods. Responses measured were intake, digestion, and utilization of N. Cows were 139 +/- 83 (mean +/- standard deviation) days in milk at the beginning of the preliminary period. During the 14-d preliminary period, 3.5% fat-corrected milk yield ranged from 23.9 to 47.6 kg/d (mean = 36.9 kg/d) and preliminary voluntary dry matter intake (pVDMI) ranged from 14.2 to 21.3 kg/d (mean = 18.6 kg/d). Treatments were a diet with alfalfa silage as the sole forage (AL) and a diet with orchardgrass silage as the sole forage (OG). Alfalfa silage contained 20.5% crude protein (CP; dry matter basis) and orchardgrass silage contained 20.4% CP; AL contained 18.3% CP and 5.6% estimated rumen-undegraded CP, and OG contained 18.8% CP and 6.3% estimated rumen-undegraded CP. Mean N intake was similar between treatments, ruminal N digestibility was greater for AL (30.4%) than for OG (17.7%), and whole-tract N digestibility did not differ between treatments. Intake and duodenal flow of N depended on a treatment x pVDMI interaction; both N intake and duodenal flow increased more for AL than for OG as pVDMI increased. Duodenal flow of microbial N and the efficiency of microbial N production from OM also depended on a treatment x pVDMI interaction in a manner similar to N intake and duodenal flow. However, treatment x pVDMI interactions also indicate that as pVDMI increased and N intake increased for AL compared with OG, a decreasing proportion of the additional N consumed from AL was digested and used for increased milk protein production or body tissue gain. Therefore, when feeding less-filling diets, such as those containing large proportions of legume forage, to high-producing cows, reducing dietary N concentration could increase the efficiency of N utilization and reduce the extent to which greater DMI leads to greater N excretion.

Nutrient demand interacts with forage family to affect intake and digestion responses in dairy cows.

The effect of feed intake in the preliminary period on responses to diets containing alfalfa silage or orchardgrass silage was evaluated using 8 ruminally and duodenally cannulated Holstein cows in a crossover design experiment with a 14-d preliminary period and two 15-d treatment periods. Responses measured were DMI, rates of fiber digestion and passage, and milk production. Cows were 139 +/- 83 (mean +/- SD) d in milk at the beginning of the preliminary period. During the preliminary period, 3.5% fat-corrected milk yield ranged from 23.9 to 47.6 kg/d (mean = 36.9 kg/d) and preliminary voluntary DMI (pVDMI) ranged from 14.2 to 21.3 kg/d (mean = 18.6 kg/d). The 2 treatments were a diet containing alfalfa silage as the sole forage (AL) and a diet containing orchardgrass silage as the sole forage (OG). Alfalfa silage contained 43% neutral detergent fiber (NDF; dry-matter basis) and orchardgrass silage contained 48% NDF; diets contained approximately 23% forage NDF and 27% total NDF, so forage-to-concentrate ratio was 53:47 for AL and 48:52 for OG. Digestibility of NDF was lower for AL in the rumen and whole tract compared with OG, and milk fat concentration tended to be greater for OG than for AL. Mean 3.5% fat-corrected milk yield and DMI were not different between AL and OG. Response of DMI to forage family depended on pVDMI, as indicated by a significant interaction between treatment and pVDMI in predicting DMI. As pVDMI increased, DMI increased when cows were fed AL but not when they were fed OG. That is, as appetite increased, intake was more restricted for the more physically filling OG than for the less physically filling AL. This more positive DMI response to AL over OG among high-pVDMI cows is corroborated by interactions between treatments and pVDMI for both ruminal NDF turnover rate and indigestible NDF passage rate response. Therefore, the effects of alfalfa and orchardgrass forages on intake and fiber digestion depended on the extent to which fill limited feed intake of an individual cow.

Nutrient demand affects ruminal digestion responses to a change in dietary forage concentration.

Previous research in our laboratory has indicated that the physical filling effects of high-forage diets become increasingly dominant in determining feed intake and milk production as nutrient demand increases. This effect was tested further by using 14 ruminally and duodenally cannulated Holstein cows in a crossover design experiment with a 14-d preliminary period and two 15-d experimental periods. During the preliminary period, 3.5% fat-corrected milk yield was 15 to 60 kg/d (mean = 40 kg/d), and preliminary voluntary dry matter intake (pVDMI) was 20.6 to 30.5 kg/d (mean = 25.0 kg/ d). Treatments were a low-forage diet (LF), containing 20% (dry matter basis) forage neutral detergent fiber (NDF), and a high-forage diet (HF), containing 27% forage NDF. The ability of linear and quadratic factors of pVDMI to predict the difference in responses of individual cows to treatments (Y(LF) - Y(HF)) was tested by ANOVA, with treatment sequence as a covariate. In contrast to results of previous research, differences in dry matter intake and fat-corrected milk yield responses to LF and HF did not depend on pVDMI. This might be because of the combined physical fill and metabolic satiety effects of LF, especially in cows with the greatest pVDMI. Digestion or passage of NDF might have been inhibited on LF among high-pVDMI cows. As pVDMI increased, NDF turnover time increased more on LF than on HF. Among high-pVDMI cows, the NDF turnover time was unexpectedly greater on LF than on HF. With increasing pVDMI, the digestion rate of potentially digestible NDF decreased at a similar rate on both diets. Passage rates of potentially digestible NDF and indigestible NDF were not related to pVDMI, regardless of treatment. Greater starch fermentation (resulting from greater starch intake) for LF as pVDMI increased likely inhibited NDF digestion through pH-dependent and pH-independent effects. Inhibition of NDF digestion might cause LF and HF to have similar effects on dry matter intake, depending on the nutrient demand of individual cows.

Community-based public health interventions in North Korea: one non-governmental organization's experience with tuberculosis and hepatitis B.

BACKGROUND: The Democratic People's Republic of Korea, also known as North Korea, is the most isolated country in the world, and has been a source of interest, politically and socially, since the 1953 ceasefire of the Korean War. While in the past year, interest has focused on the nuclear dispute with the USA, over the past decade, most interest has revolved around the economic plight of the country, the lack of funds and resources for health care, and the subsequent public health declines. North Korea's present economic and public health problems began in the early 1990s due to the gradual loss of economic support from its communist allies (i.e. after the fall of the Soviet Union and the capitalization of China), combined with an inordinate number of natural disasters (floods, famine and drought) all occurring within the same time span. These simultaneous events initiated a 'snowball effect' of severe economic depression and a rapid deterioration of the overall public health infrastructure in the country. North Korea's continued isolation and reluctance to release health statistics has left the international community uncertain of the precise extent of the public health devastation. The uncertainty of the situation has been further complicated by disparate accounts of the public health declines. For instance, the North Korean Government has estimated that approximately 220,000 people died due to famine in the 1990s, while the World Health Organization (WHO) claims that this figure is closer to 2 million. In the past few years, the willingness of the North Korean Government to engage the outside world has increased. This is reflected by the growing number of foreign aid organizations or non-governmental organizations (NGOs) that have been permitted entry into the country. NGOs have not only served to improve various aspects of the public health system but also serve as a source of 'on-the-ground' information for the outside world. This role has proven critical not only for public health purposes but for facilitating improved international relations between countries.

Extraovarian granulosa cell tumor.

A 54-year-old woman was admitted to our hospital complaining of postcoital bleeding. Sonography of the abdomen showed a 8.2 x 8.9 cm-sized solid heterogeneous mass occupying the cul-de-sac, which appeared to be in no way connected with the ovary. On exploratory laparotomy, the tumor mass protruded from the posterolateral retroperitoneum of the pelvic cavity and severely replaced the uterus and adnexa with the outer surface being grossly intact. It grossly measured 10 cm in maximal diameter. The histologic features closely resembled those of ovarian granulosa cell tumor. The primary extraovarian granulosa cell tumor is extremely rare such that in the English literature only 7 cases have been reported to date. Of those granulosa cell tumors are especially rare and only two cases have been reported to arise from retroperitoneum. We herein present a case of retroperitoneal granulosa cell tumor with special regard to differential diagnosis from other solid tumors with similar histology.

Clinicopathologic study of Wegener's granulomatosis with special emphasis on early lesions in 10 Korean patients.

We reviewed ten cases of Wegener's granulomatosis with special emphasis on the characteristics of the early stage of Wegener's granulomatosis. All patients presented with nonspecific symptoms and signs, so that Wegener's granulomatosis was not initially considered. However, half of the patients had clinical or radiologic disease in the nose/or paranasal sinuses as the primary presenting problems and showed neutrophil microabscess surrounded by palisading epithelioid cells and irregularly arranged giant cells in the nasal biopsy as the most characteristic feature. Five of ten patients were believed to have a protracted superficial phenomenon before involvement of other organs, specifically the lung or kidney. Four of ten patients showed nonreactivity to ANCA test at the time of presentation. Although the number of cases reviewed in this study was small, the rate of nonreactivity to ANCA was higher than those of the larger series. The importance of early diagnosis of Wegener's granulomatosis can not be overemphasized in view of the fact that cases unrecognized clinicopathologically finally progress to full-blown systemic form of Wegener's granulomatosis with poor prognosis. The diagnosis of Wegener's granulomatosis should be based on a thorough and meticulous examination of its characteristic histologic changes in biopsied tissue particularly extravascular foci.

Retroperitoneal multilocular bronchogenic cyst adjacent to adrenal gland.

Bronchogenic cysts are generally found in the mediastinum, particularly posterior to the carina, but they rarely occur in such unusual sites as the skin, subcutaneous tissue, pericardium, and even the retroperitoneum. A 30-year-old Korean man underwent surgery to remove a cystic adrenal mass incidentally discovered during routine physical checkup. At surgery, it proved to be a multilocular cyst located in the retroperitoneum adjacent to the left adrenal gland. Microscopically, the cyst was lined by respiratory epithelium over connective tissue with submucous glands, cartilage and smooth muscle, thereby histologically confirming bronchogenic cyst. This is the first reported case of retroperitoneal bronchogenic cyst in an adult without other congenital anomalies in Korea.

Effects of TNF-alpha and IL-1 beta on mucin, lysozyme, IL-6 and IL-8 in passage-2 normal human nasal epithelial cells.

Little is known about the regulatory effects of cytokines on various nasal secretions in normal human nasal epithelial cells. The aim of this study was to examine whether TNF-alpha, IL-1beta or their combination can increase the secretion of mucin as an indicator of mucous secretion, the secretion of lysozyme as an indicator of serous secretion and the secretion of IL-6 and IL-8 as important cytokines. In addition, we wanted to examine their message levels in normal human nasal epithelium. On day 12 of culture, passage-2 normal human nasal epithelial cells were treated with 10 ng/ml TNF-alpha, 10 ng/ml IL-1beta and combinations of both. Twenty-four hours later, the apical secretions were collected. A mixture of TNF-alpha and IL-1beta synergistically increased secretion of mucin, IL-6 and IL-8, but did not increase secretion of lysozyme. A combination of TNF-alpha and IL-1beta showed a questionable increase of MUC2 mRNA levels. TNF-alpha, IL-1beta and a combination of both all significantly increased MUC8 mRNA levels. Neither TNF-alpha, IL-1beta nor a combination of both increased MUC5AC, MUC5B and lysozyme mRNA levels. IL-1beta alone or a combination of TNF-alpha and IL-1beta comparably increased IL-6 and IL-8 mRNA levels slightly. In conclusion, a mixture of inflammatory mediators can synergistically increase secretion of mucin, IL-6 and IL-8 in human nasal epithelium. Accordingly, nasal secretions may be under the control of an inflammatory mediator network.