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>Background: Smoking trends among nurses are important to monitor as smoking negatively affects their health and decreases their likelihood of providing cessation interventions to patients. > Objectives: The objective of the study was to describe the changes in smoking trends in the participants in the Nurses' Health Study (NHS) cohorts over 27 years. > Methods: An analysis of biennial changes in smoking status and cigarette consumption within nine 5-year birth cohorts (1920 1924 to 1960-1964) and age-specific mortality rates by smoking status were examined in 237,648 female registered nurses (RNs): NHS (ages of 30- 55 years in 1976, followed through 2002) and NHS II (ages of 25 42 years in 1989, followed through 2003). > Results: Current smokers constituted 33.2% of NHS in 1976 and 13.5% of NHS II in 1989. Smoking rates declined in all birth cohorts; 8.4% were smoking in 2002/2003. Seventynine percent of nurses who ever smoked had quit. The mean cigarettes per day declined over time but still exceeded half a pack per day (15.1 cigarettes) at the end of follow-up. The mortality rate among current smokers was higher than that of former smokers and was approximately twice that of never smokers in all age categories; those who smoked were more likely to have comorbid conditions. > Discussion: This study provides the first report of smoking trends among RNs in the NHS. The decline in smoking rate among female nurses mirrors the decline in smoking rate among women in the United States over the past 25 years. Increased mortality and morbidity rates indicate the devastating cost of smoking to the profession and can provide support for the urgent need for further research to encourage continued smoking cessation efforts for nursing professionals.

Objectives. We examined the association between psychological abuse in a current relationship and current cigarette smoking among women, with and without the co-occurrence of physical or sexual abuse. Methods. Women’s experience of psychological abuse, experience of physical or sexual abuse, and smoking status were ascertained through a survey of female nurses. A score of 20 or more on the Women’s Experience With Battering scale defined psychological abuse. We used logistic regression to predict current smoking, adjusting for demographic and social covariates. Analyses included women in a current relationship (n=54200). Results. Adjusted analyses demonstrated that women experiencing only psychological abuse alone were 33% (95% confidence interval [CI]=13%, 57%) more likely to smoke than nonabused women. Compared with nonabused women, psychologically abused women’s risk of smoking was greater if they reported a single co-occurrence of physical or sexual abuse (odds ratio [OR]=1.5; 95% CI=1.3, 1.8) or multiple co-occurrences (OR=1.9; 95% CI=1.7, 2.3). Conclusions. Psychological abuse in a current relationship was associated with an increased risk of smoking in this cohort of largely White, well-educated, and employed women. The co-occurrence of physical or sexual abuse enhanced that risk. Further research is needed to see if these associations hold for other groups.

Few studies have examined the influence of marriage on health-related behavior in Asian populations. The present study examined the effect of marital status on smoking in Korea. Data from two rounds of a nationally representative survey (1999 and 2003) were analyzed (57,246 women and 52,769 men). Marital status-specific prevalence ratios for smoking were estimated using log binomial regression after adjusting for age, survey year, occupation and education level. Smoking prevalence declined with age for men, but rose for women. Smoking rates were higher for unmarried men and women compared to their married counterparts. However, the gap in smoking rates between unmarried and married women (especially younger women

Furan is a colorless, volatile compound that is found in heat-treated foods, such as canned and jarred foods, at levels up to 100 ppb. When animals ingest high doses, furan metabolites, such as cis-2-butene-1,4-dial, cause severe hepatotoxicity and carcinogenicity. However, the levels and effects of furan on humans are not known. Therefore, we measured urinary furan in 100 healthy individuals consumed normal diet (49 men, 51 women) using solid phase micro-extraction–gas chromatography–mass spectrometry (SPME–GCMS). Urinary furan was detected in 56 subjects (31 males, 25 females) and ranged up to 3.14 ppb. In individuals with detectable urinary furan, the level of c-glutamyltranspeptidase (c-GT), a marker for liver damage, was strongly correlated with the urinary furan concentration (r = 0.56, p < 0.0001). Linear regression analysis indicated that the urinary furan level was significantly associated with c-GT in both univariate (p < 0.0001) and multiple (p = 0.0001) models including age, sex, body weight, and blood pressure as covariates. To our knowledge, this is the first study to measure detectable levels of furan in human urine. These levels of urinary furan, which may be dietary origin, could be hepatotoxic in humans; therefore; the metabolic fates and potential toxicity of dietary furan in humans should be investigated further. 2008 Elsevier Ltd. All rights reserved.

Monocyte adhesion to vascular endothelium is an initial step in atherogenesis. To quantify this, we incubated monocytes with cultured endothelial cells, and quantified the adhered live monocytes using a colorimetric assay. Endothelium activated with lipopolysaccharide attracted monocytes in a dose-dependent manner and the adhesion was attenuated with post-treatments with L-ascorbic acid (53%), alpha- (40%) and gamma-tocopherol (39%), resveratrol (39%), and Lithospermum erythrorhizon root extract (45%). This non-radioactive, colorimetric assay may be useful for screening anti-atherogenic compounds in early atherogenesis.

Genistin has antioxidant activities; however, its insolubility in water often limits its biological availability in vivo. Using a novel transglycosylation process, the solubility of genistin glycosides was increased 1000 to 10000-fold, but it was not known whether these modified genistin glycosides maintained antioxidant activity. We found that both genistin and its glycosides similarly up-regulated the transcription of several metallothionein (MT) antioxidant genes (MT1A, MT2A, MT1E, and MT1X), as well as the glucose 6-phosphate dehydrogenase (G6PD) gene in HepG2 cells. This gene induction was mediated by the sequestration of zinc in the cytosol, which up-regulated the metal-responsive transcription factor-1 (MTF-1) that induced MT gene expression. Although not as effective as ascorbic acid, genistin glycosides possessed slightly greater reducing power than genistin. We concluded that genistin and genistin glycosides have a direct antioxidant effect and an indirect antioxidant effect, perhaps via induction of MT by activity of MTF-1.

We examined the association between parenting young children and smoking among US single women compared with married women, and whether this effect is moderated by socioeconomic status and race/ethnicity. Our main finding is that having children reduces smoking except among single white women, and women with low income. We used the Tobacco Use Supplement of the Current Population Survey, a nationally representative dataset (1995–96, n =70,019). Log-binomial regression analysis was used to estimate the association between parenting responsibility (i.e., presence of children aged 0–4 and 5–17) and daily smoking status, after taking into consideration marital status, income, and race/ethnicity. Single women faced a higher risk of smoking than married women. Parenting was protective against smoking among married women but not among single women. Additionally, among single women, the associations between parenting and smoking varied by income and race/ethnicity. Parenting increased the risk of smoking among single women in the lowest income quartile. Single black and Hispanic women with children had a risk of smoking similar to that of their childless counterparts. However, single white women with children were more likely to smoke than their childless counterparts. Smoking cessation interventions and programs to reduce environmental tobacco smoke should recognize that the co-occurrence of single motherhood, parenting responsibility and low-income may increase the risk of smoking. This is particularly significant given the rapid growth of the single women population, and their concentration in poverty in the USA. The finding that parenting is protective against smoking among single minority women, who presumably experience significant stressors, calls for a more thorough investigation of smoking behavior among minority women, and suggests the importance of stress buffers such as social support.

Wormwood ( Artemisia princeps ) due to the abundance of antioxidant in its essential oils (EO), has been used as a traditional drug and health food in Korea. Oxidative stress plays an important role in the etiology of atherosclerosis thus antioxidative chemicals improves hepatic lipid metabolism partly by reducing oxysterol formation. The antioxidant activity was assessed using two methods, human low-density lipoprotein (LDL) oxidation and the anti-DPPH free radical assays. It was found that the antioxidant activity of EO with vitamin E higher than EO alone. To study mechanisms accounting for the antiatherosclerotic properties of this wormwood EO, we examined the expression of key genes in cholesterol metabolism such as the LDL receptor, the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase and sterol regulatory element binding proteins. The induction was increased up to twofold at 0.05 mg/mL of EO treatment in HepG2 cells for 24 h. When EO (0.2 mg/mL) was co-incubated with vitamin E, interestingly, the LDL receptor was dramatically induced by 5–6-folds. HMG-CoA reductase did not change. However, treatment with the higher concentration resulted in cytotoxicity. Our data suggest that wormwood EO with vitamin E may be anti-atherogenic due to their inhibition of LDL oxidation and upregulation of the LDL receptor.

Objectives. We carried out analyses of smoking in relation to poverty and child care responsibility among women aged 18–54 years residing in the United States. Methods. With data from the Behavioral Risk Factor Surveillance System, we assessed the interaction effects of poverty and living with young children on maternal smoking behavior among 61 700 women aged 18–54 years in 4 different racial/ethnic groups. Results. For non-White racial/ethnic groups, the prevalence of smoking among women with small children in the household was lower than that among women without small children. However, White women were more likely to smoke if they were poor and living with small children (odds ratio=1.14, 95% confidence interval=1.03, 1.26). Conclusions. These results suggest that child care responsibility confers an increased risk of smoking among low-income White women.

We investigated associations between various dimensions of women's status and self-rated health. We hypothesized that women living in states with lower levels of women's status would be at greater risk of reporting poor health than women living in states with higher levels of women's status, even when controlling for individual and state characteristics.We used individual self-rated health and sociodemographic characteristics for 87 848 female respondents to the Behavioral Risk Factor Surveillance System (BRFSS) 2000. Women's status indices and indicators were obtained from the Status of Women in the States 2000. State median income and income inequality were included as state-level contextual variables. We examined data using a multilevel logistic regression method.Women living in states scoring in the lowest quintile on women's political and economic indices (political participation, employment and earnings, and economic autonomy) were more likely to report poor health, odds ratio (OR) 1.14 (95% confidence interval [CI] 1.01, 1.28), OR 1.29 (CI 1.08,1.55); OR 1.30 (CI 1.09, 1.56), respectively, after controlling for individual characteristics and other state-level variables than were women living in the highest-performing 20% of states.The status of women at the state level has an independent association with the risk of reporting poor health over and above women's individual characteristics. This finding suggests a contextual effect of women's societal status on health status.

Dear Editor: We report the case of a 3-year-old boy from Russia who presented to our department with reticulated erythematous brown patches involving the face and extremities. All patches were present at birth. The mother's pregnancy and delivery were uneventful. He had no remarkable familial history. Physical examination showed erythematous mottled marble-like lesions on the face and upper extremities. Brown reticulated patches were observed mainly on the lower extremities. In addition, poorly defined gray-bluish pigmented patches suggestive of Mongolian nevi were found on the trunk. Hypertrophy of the right side of the face and leg was observed. The right leg was 2 cm longer than the left (Fig. 1). He showed normal mental and physical development. All laboratory parameters were within normal limits. Brain magnetic resonance imaging revealed an old lacunar infarct in the right centrum semiovale. Multiple skin biopsies the erythematous patch of the face and a brown patch of the leg were taken. The histopathologic findings from the erythematous patch were generally normal, except for increased melanin pigment in the basal layer and dermal capillary dilatation (Fig. 2A). The brown patch exhibited increased melanin pigment in the basal layer and spindle-shaped melanocytes with abundant melanin in the dermis (Fig. 2B). Phacomatosis pigmentovascularis (PPV) is a rare genodermatosis characterized by the coexistence of pigmentary abnormalities and cutaneous vascular malformation. The "twin-spot phenomenon" is a possible cause of PPV, but the exact genetic and molecular bases of PPV are unclear. PPV is classified into five types according to distinguishing features; moreover, all types are subdivided into subtype "a" and "b", indicating PPV with oculocutaneous involvement only and extracutaneous involvement (e.g., neurologic and skeletal symptoms), respectively1,2. Type V PPV, described by Torrelo et al.1 in 2003, is characterized by cutis marmorata telangiectatica congenita (CMTC) associated with aberrant Mongolian nevi. The diagnosis of PPV is made clinically. To our knowledge, only seven patients with PPV type V have been reported in the literature3,4, none of which were in the Korean literature. Among patients with PPV type V, the most frequently associated extracutaneous features were ophthalmic abnormalities including ocular melanosis, glaucoma, leukocoria, and corneal opacity1,2,4. Body asymmetry and asymmetry of the brain hemispheres have also reported1,2. Although there were cases of cerebral ischemia patient associated with CMTC, there was no definite evidence of an association between cerebral ischemia and CMTC5. As observed in our patient, PPV is a congenital abnormality that can be associated with not only ophthalmic abnormality but also skeletal and neurological abnormalities. Considering extracutaneous abnormalities, it is important patients receive a full physical examination and proper management immediately after PPV diagnosis and undergo regular follow-up. Although CMTC and Mongolian spot, both tend to lighten over time, prominent lesions have remained in many cases1,2,3,4. Pulsed dye laser and Q-switched lasers for CMTC and pigmented nevi, respectively, can be helpful for improving aesthetics. In summary, we report a rare case of a 3-year-old boy diagnosed with PPV type Vb. Fig. 1 (A~C) Reticulated, mottled, marble-like erythema on the face and arms, reticulated brown patches on the legs. In addition, bluish-grey patches are seen on the trunk and thighs. (D) The full leg X-ray shows discrepancy in length between the right and left ... Fig. 2 (A) Increased melanin pigment in the basal layer and dilation of capillary in the dermis (H&E, ×100). (B) Increased melanin pigment in the basal layer and scattered spindle-shaped melanocytes with melanin pigment in the dermis (H&E, ...

From C Fund Conf Repr Corre D An 18-day-old female presented to our department with a skin rash on her trunk, legs, and arms that had first appeared shortly after birth. The physical examination revealed reticulated erythema and vesicles in a linear distribution (Fig 1). The pregnancy was uncomplicated and the baby was born fullterm by normal spontaneous delivery. The baby had a normal newborn screen and her physical status was otherwise unremarkable. The laboratory examination revealed an eosinophil count of 33% (normal range, 0-3%). A punch biopsy specimen of the lesion was obtained and revealed spongiotic dermatitis with intraepidermal vesicles filled with eosinophils. Dyskeratotic cells were also observed within the epidermis (Fig 2).

Posttraumatic stress disorder (PTSD) indicates a chronic stress reaction in response to trauma. This prevalent condition has been identified as a possible risk factor for obesity. Whether PTSD symptoms alter the trajectory of weight gain or constitute a comorbid condition has not been established.To determine whether women who develop PTSD symptoms are subsequently more likely to gain weight and become obese relative to trauma-exposed women who do not develop PTSD symptoms or women with no trauma exposure or PTSD symptoms and whether the effects are independent of depression.The Nurses' Health Study II, a prospective observational study initiated in 1989 with follow-up to 2005, using a PTSD screener to measure PTSD symptoms and time of onset. We included the subsample of the Nurses' Health Study II (54 224 participants; ages 24-44 years in 1989) in whom trauma and PTSD symptoms were measured.Trauma and PTSD symptoms.Development of overweight and obesity using body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) cut points 25.0 and 30.0, respectively; change in BMI during follow-up among women reporting PTSD symptom onset before 1989; and BMI trajectory before and after PTSD symptom onset among women who developed PTSD symptoms in 1989 or during follow-up.Among women with at least 4 PTSD symptoms before 1989 (cohort initiation), BMI increased more steeply (b = 0.09 [SE = 0.01]; P .001) during the follow-up. Among women who developed PTSD symptoms in 1989 or later, BMI trajectory did not differ by PTSD status before PTSD onset. After PTSD symptom onset, women with at least 4 symptoms had a faster rise in BMI (b = 0.08 [SE = 0.02]; P .001). The onset of at least 4 PTSD symptoms in 1989 or later was also associated with an increased risk of becoming overweight or obese (odds ratio, 1.36 [95% CI, 1.19-1.56]) among women with a normal BMI in 1989. Effects were maintained after adjusting for depression.Experience of PTSD symptoms is associated with an increased risk of becoming overweight or obese, and PTSD symptom onset alters BMI trajectories over time. The presence of PTSD symptoms should raise clinician concerns about physical health problems that may develop and prompt closer attention to weight status.

von Kossa stain. Calcium deposits were also noted in the stratum corneum and the stratum spinosum, but there were no calcium deposits within the dermis. The calcification was not in continuum with the acrosyringium. Calcified sweat ducts were not observed. In the 4 months since the punch biopsy, no signs of recurrence or new lesions have appeared. Calcinosis cutis comprises several subtypes, including milia-like idiopathic calcinosis cutis. Milia-like idiopathic calcinosis cutis appear as smooth, round papules resembling milia, sometimes surrounded by erythema. Twothirds of patients with milia-like idiopathic calcinosis cutis have shown an association with Down syndrome 2 . Only 8

We investigated hypocholesterolemic mechanisms of linalool, an aromatic anti-oxidative monoterpene, which is abundant in teas and essential oils. Oral administration of linalool to mice for 6weeks significantly lowered total and low-density lipoprotein cholesterol concentrations, and HMG-CoA reductase protein expression (−46%; P