NEW YORK: It would seem logical for patients who have had a heart attack to cut back on fast food.

Some devoted fast food eaters do. But six months later, more than half can still be found at their favorite fast food places at least once a week, according to a study in the American Journal of Cardiology.

Of nearly 2,500 heart attack patients studied by John Spertus, at the University of Missouri at Kansas City, 884 -- or 36 percent -- reported in a survey while still hospitalized that they had eaten fast food frequently in the month before their heart attack. "Frequently" was defined as once a week or more.

When Spertus and his colleagues checked back six months later, 503 were still eating fast food every week.

"Fast food consumption by patients with AMI (acute myocardial infarction) decreased 6 months after the index hospitalization, but certain populations -- including younger patients, men, those currently working, and less educated patients -- were more likely to consume fast food, at least weekly, during follow-up," he wrote.

"Novel interventions that go beyond traditional dietary counseling may be needed to address continued fast food consumption after AMI in these patients."

But the study showed that older patients and those who had bypass surgery were more likely to be avoiding fast food six months later.

The survey did not ask what menu items people ordered, and some in the restaurant business have pointed out that fast food isn't always limited just to burgers and fries.

But Spertus and his colleagues pointed out that the people in their study who kept eating fast food tended to have health profiles "consistent with selection of less healthy options."

Nine out of 10 patients in the study received dietary counseling before they left the hospital, but this didn't seem to affect that odds that frequent fast food eaters would improve their diets, and Spertus said this showed they needed more education after leaving the hospital.

"The problem is that patients are absorbing so much information at the time of their heart attack, that I just don't think they can capture and retain all the information they're getting," he told Reuters Health.

AHMEDABAD: Australia captain Ricky Ponting won the toss and elected to bat against Zimbabwe in their opening World Cup match here at the Sardar Patel Stadium, Motera on Monday.

This is the fourth match of the tournament and the third in Group A.

Australia, who are aiming to win the fifth title after emerging champions in 1987, 1999, 2003 and 2007, have not lost a match in the last two editions in South Africa and the West Indies under Ponting.

They have lost just one of their 27 one-day internationals against Zimbabwe, the defeat coming in the 1983 World Cup in England.

Teams:
Australia: Ricky Ponting (captain), Shane Watson, Brad Haddin, Michael Clarke, David Hussey, Cameron White, Steve Smith, Mitchell Johnson, Jason Krejza, Brett Lee, Shaun Tait.

Zimbabwe: Elton Chigumbura (captain), Charles Coventry, Regis Chakabva, Graeme
Cremer, Craig Ervine, Christopher Mpofu, Raymond Price, Tatenda Taibu, Brendan
Taylor, Prosper Utseya, Sean Williams.

SINGAPORE: Oil prices surged in Asian trade Monday, with Brent crude passing $103 as escalating tensions in Libya fuelled concerns over instability spreading across the oil-producing Arab states, analysts said.

Brent North Sea crude for April delivery jumped $1.13 to $103.65 per barrel, and New York's main contract, light sweet crude for delivery in March, gained $1.17 to $87.37 in the afternoon.

"Both benchmarks have really zoomed ahead this morning. The main driver is really the unrest in the Middle East," said Victor Shum, senior principal for Purvin and Gertz energy consultants in Singapore.

He added that fresh violence in Organisation of Petroleum Exporting Countries (OPEC) member state Libya was igniting fears of instability spreading throughout the key oil-supplying Middle Eastern and North African region.

"Libya is a member of OPEC and even though Libya's oil production isn't very significant on a global basis, it's really threatening close to the main suppliers of crude oil to the world, mainly Middle East and North Africa," Shum told AFP.

Intense gunfire was heard early Monday in the heart of the Libyan capital Tripoli and other quarters of the city as Saif al-Islam Kadhafi, the son of strongman Moamer Kadhafi, warned the nation was on the verge of civil war.

MUMBAI: The Bombay High Court Monday confirmed death sentence of Ajmal Kasab who watched the proceedings via a video link and did not react after the judges delivered the verdict.

The court was to give its verdict in the appeal of the sole surviving gunman from the 2008 Mumbai attacks against his conviction and death sentence.

Kasab, now 23, was convicted and sentenced to death last May for his part in the wave of attacks on India's financial capital by 10 militants which killed 166 people and injured more than 300 others.

State prosecutor Ujjwal Nikam said on Sunday that he was "very confident" that the death sentence would be upheld.

One of Kasab's lawyers, Farhana Shah, added: "Inshallah (God willing), we hope for the best but it's up to the discretion of the honourable court."

Kasab was found guilty of a string of offences including waging war against India, murder, attempted murder and terrorist acts after a high-profile trial at a maximum security prison court in Mumbai.

The appeal, which began last October, saw Kasab's legal team ask for a retrial, arguing that his trial lawyer was not given sufficient time to wade through the 11,000-page charge sheet before the case began.

They also claimed that prosecution evidence and witnesses were manipulated.

Under Indian law, death sentence cases have to be referred to the local state high court. The judges can uphold the sentence, reduce it, order a retrial or overturn the conviction.

If a death sentence is upheld in the high court, there is a further right of appeal to the Supreme Court in New Delhi and as a last resort to India's president for clemency.

The court upheld the acquittal of two Indians Fahim Ansari and Sabahuddin. The state had appealed against the acquittal of the pair who was accused of providing hand-drawn maps of potential targets to the gunmen.

The trial judge rejected the prosecution evidence against them as flimsy.

Kasab has been held in solitary confinement since his arrest in a shoot-out with police just hours after the attacks began. He has not attended the appeal for security reasons but has been able to follow proceedings via video link.

SYDNEY: Vancouver topped the list of the world's most liveable cities for the fifth straight year, while Melbourne claimed second place from Vienna and Australian and Canadian cities dominated the list's top 10 spots.

In the annual survey by the Economist Intelligence Unit, the Canadian west coast city and 2010 Winter Olympics host scored 98 percent on a combination of stability, health care, culture and environment, education, and infrastructure - a score unchanged from last year.

It has topped the list from 2007.

Although Melbourne pipped the Austrian capital for silver medal, there was no other major change near the top of the list of 140 cities worldwide. Auckland, New Zealand, came in 10th.

"Mid-sized cities in developed countries with relatively low population densities tend to score well by having all the cultural and infrastructural benefits on offer with fewer problems related to crime or congestion," said Jon Copestake, editor of the report, in a statement.

Pittsburgh was the top US city with 29th place - just ahead of Honolulu -- while Los Angeles moved up three places to 44th and New York held onto the 56th spot.

London moved up one place to 53rd while Paris came in at number 16.

The top Asian city was Osaka at number 12, tying Geneva, Switzerland and beating out the Japanese capital of Tokyo, which came in at 18.

Hong Kong came in at 31 but Beijing, capital of the world's most populous nation and No. 2 economy, straggled in at 72.

There was also little change at the bottom, with Harare, the capital of Zimbabwe, once again claiming the worst position with a rating of 37.5 percent, narrowing beating out the Bangladesh capital of Dhaka.

The Economist Intelligence Unit survey ranks cities based on 30 factors such as healthcare, culture and environment, and education and personal safety.

Following is a list of the top 10 most liveable cities as ranked by The Economist Intelligence Unit:
1. Vancouver, Canada
2. Melbourne, Australia
3. Vienna, Austria
4. Toronto, Canada
5. Calgary, Canada
6. Helsinki, Finland
7. Sydney, Australia
8. Perth, Australia
8. Adelaide, Australia
10. Auckland, New Zealand
The bottom 10 cities were:
1. Harare, Zimbabwe
2. Dhaka , Bangladesh
3. Port Moresby, Papua New Guinea
4. Lagos, Nigeria
5. Algiers , Algeria
6. Karachi, Pakistan
7. Douala, Cameroon
8. Tehran, Iran
9. Dakar, Senegal
10. Colombo, Sri Lanka

RAWALPINDI: Anti-Terrorism Court (ATC) Rawalpindi has issued non-bailable arrest warrant of former President Gen Pervaz Musharraf (retd) in Benazir Bhutto assassination case, Geo News reported on Saturday.

ATC-III judge Rana Nisar issued the order while hearing in Adiala Jail.

FIA presented an interim charge of the case in which statements of former DG National Crisis Cell and IB Chief were recorded and Musharraf was declared nominated accused.

MADRID: The world's very first 3D smartphone will be unveiled by LG at Mobile World Congress (MWC) to be held on February 14 in Barcelona.

There will a live demo of LG’s 3D smartphone.

The LG Optimus 3D is aimed at addressing the lack of such a smartphone and the lack of 3D content issue.

Users will experience a full 3D experience right in the palm of their hands.

Concentrating on the 3D elements only the smartphone comes with a dual-lens camera offering 3D recording, the screen is a glasses-free LCD offering 3D viewing, HDMI and DNLA for 3D content sharing.

LONDON: Scientists have shown how an "artificial pancreas" can help pregnant women with type 1 diabetes and say their finding could significantly reduce cases of stillbirth and death among diabetic expectant mothers.

British researchers used a so-called "closed-loop insulin delivery system" or artificial pancreas, in 10 pregnant women with Type 1 diabetes and found it provided the right amount of insulin at the right time, maintained near normal blood sugar, and prevented dangerous drops in blood sugar levels at night.

"To discover an artificial pancreas can help maintain near-normal glucose levels in these women is very promising," said Helen Murphy of Cambridge University, who led the study.

The experimental artificial pancreas was created by combining a continuous glucose monitor, or CGM, with an insulin pump, both of which are already used separately by many people with type 1 diabetes.

Previous trials in children with the condition found that using an artificial pancreas system at night improved blood glucose control and reduced hypoglycaemia -- when the level of glucose in the blood falls too low.

The bodies of type 1 diabetes sufferers become unable to properly break down sugar and if untreated, bloodvessels and nerves are destroyed, organs fail and patients can die.

Pregnancy can be particularly risky for women with diabetes as hormonal changes make it very difficult to keep blood glucose levels within a safe range, especially at night.

As a result of high blood glucose levels, babies of women with diabetes are five times as likely to be stillborn, three times as likely to die in their first months of life and twice as likely to have a major deformity, the researchers said.

Data from previous studies suggest that pregnant women with type 1 diabetes spend an average of ten hours a day with glucose levels outside recommended targets, said Murphy, whose findings were published in thejournal Diabetes Care.

This increases the risk of birth defects, stillbirth, neonatal death, preterm delivery, oversized babies and other complications.

Type 1 diabetes, an autoimmune disease in which the body destroys its own ability to make insulin, accounts for around 10 percent of all people with diabetes. The more common type 2 diabetes is often linked to bad diet and lack of exercise.

Iain Frame, director of research at the charity Diabetes UK, which part-funded the study, said that although it was a small and early stage trial, the results were encouraging.

"It's a fantastic example of how existing technologies...can be adapted and developed to benefit as many people with diabetes as possible," he said in a statement.

The researchers said more studies were now needed on larger numbers of women to validate their findings, and to see if the system could be developed for use outside of a hospital.

NEW YORK: More research is suggesting that heavy smokers may benefit from screening for lung cancer, to detect tumors in their earliest stages.

A new study finds that regular smokers who received three-dimensional X-rays to look for the presence of early tumors had a significantly lower risk of dying over a 10-year period.

The results are in keeping with those of a much larger study published last month, which showed that these 3-D X-rays, or CT scans, reduced the death rate among 53,000 current and former heavy smokers by 20 percent compared with screening using regular chest X-rays. That previous finding was "very good news in the field," said Dr. Bruce Johnson of the Dana Farber Cancer Institute, who treats lung cancer patients and reviewed the results for the news agency.

This latest study, published in the journal Lung Cancer, looked at death rates in a different, smaller population of heavy smokers, and estimated that those who received up to two CT scans would have between a 36 and 64 percent lower risk of dying, compared to those who went unscreened.

The data are "consistent" with earlier studies but there are still many issues to resolve regarding lung cancer screening, Johnson said.

For one, scientists haven't yet worked out how often to screen people, and when to start. It is not clear when or how guidelines for lung cancer screening could be drawn up, and until they are, insurers including government programs such as Medicare are unlikely to pay the average $300 cost of a scan.

Furthermore, an April study showed that 21 percent of a patient's initial lung CT scans show suspicious lesions that turn out not to be cancer, but lead to needless invasive follow-up procedures and radiation exposure, as well as stress and anxiety for patients and their families.

The high so-called "false positive" rate is an issue, said Dr. James Hanley of McGill University, who also reviewed the findings for the British news agency, but many mammograms also find lesions that turn out to be benign. And for lung cancer, doctors know there is a high false-positive rate and have a set protocol to follow in order to determine which lesions are dangerous, added Johnson.

Lung cancer kills 1.2 million people a year globally and it will kill 157,000 people in the United States alone this year, according to the American Cancer Society.

Tobacco use accounts for some 85 percent of lung cancer cases in the U.S., and one estimate puts a smoker's lifetime absolute risk of developing lung cancer between 12 percent and 17 percent. Five-year survival rates for lung cancer are low.

In recent years, CT scans, in particular, have been promoted by some hospitals and advocacy groups for lung cancer screening, even though studies had not yet shown definitively whether such screening saves lives.

In 2006, Dr. Claudia Henschke, currently based at Mount Sinai School of Medicine and Arizona State University, caused a stir when she published a study concluding that 80 percent of lung-cancer deaths could be prevented through widespread use of spiral CT.

Her ideas were controversial to start with, especially when other researchers found her work had been paid for by a tobacco company.

In the current study, funded in part by manufacturers of CT scanners (along with government and other sources), Henschke and her colleagues compared outcomes for nearly 8,000 smokers and former smokers who volunteered to undergo CT scans to outcomes in two sets of people with smoking histories who were not scanned.

The three groups of people had some important differences, such as in average age and how long and heavily they had smoked, so the researchers had to use mathematical tools to try to eliminate the influence of those differences, said Hanley. For instance, to compare death rates, the researchers tracked how many people died among those who were screened, then pulled out all the people with similar underlying characteristics in the other two groups and looked at their death rates, Hanley explained.

A total of 64 people died in the screened population, the authors report -- but applying the death rate among people with the same underlying characteristics in one of the unscreened populations, they estimated that the number of deaths would have been 100. This translates into a 36 percent lower risk of dying among the screened population.

Applying the same methods to the other unscreened population, the authors estimated that screening was associated with a 64 percent lower risk of dying.

Overall, research is suggesting that CT scans of people at risk of lung cancer might make a dent in cancer mortality, and it's possible that more frequent screening might make an even bigger dent, Hanley noted. "If screening is going to work, you've got to keep at it."

BAGHDAD: Two suicide car bombers targeting a government compound in the Iraqi town of Ramadi killed at least 17 people and wounded 47 on Monday, a police official said.

"The death toll has risen to 17, most of them police officers, and 47 people have been wounded," he said, speaking on condition of anonymity. He said most of the wounded were in serious condition. He said rescue operations were continuing.

Ramadi is 100 km (60 miles) west of Baghdad.

KARACHI: The government of Pakistan has paid off Pakistan State Oil (PSO) dues worth 26 billion rupees on sale of oil to other state departments on Friday, Geo News reported.

PSO officials told Geo News that government had paid off the company 26.30 billion rupees dues relating to oil sale to different government departments.

The officials further said that still many companies owe PSO Rs.154 billion dues out of which, Rs.141 billion have to be recovered from companies working in energy sector.

It is hoped that after the recovery of the aforementioned amount PSO would be relieved of the financial hardships in connection with sale of and all the same, it would help end oil import crisis the company is currently grappled in.

LONDON: The government insisted it is closing a loophole that could see Queen Elizabeth II's head removed from stamps if the Royal Mail national postal service is sold to a foreign firm.

The monarch's head, facing left, has appeared on adhesive postage stamps since their invention with the 1840 "Penny Black", featuring queen Victoria.

The current standard stamps, drawn up in 1967 by Alan Machin, are considered a design classic and a defining icon of Britain.

Her Majesty's Government is in talks with Buckingham Palace after realising that the legislation paving the way for the Royal Mail to be sold off failed explicitly to guarantee the Queen's head would remain on the stamps.

The bill gives Queen Elizabeth a veto over any use of her image but does not insist that her head is shown, as per tradition.

Postal services minister Ed Davey found the loophole but said he was sure a solution could be found before the law passes through parliament.

RAWALPINDI: Pakistan successfully test-fired ballistic missile Ghauri Hataf-V capable of carrying all kind of warheads, the military spokesman said.


According to Geo News, ISPR spokesman stated that the missile is capable of carrying all kind of warheads besides hitting its target at a range of 1300 kilometers.

The test of Ghauri Hataf-V is normal experiment to identify its capability.

Meanwhile, President Asif Ali Zardari and Prime Minister Yousuf Raza Gilani have f congratulated Pak Army and the whole nation on succesfull test of Ghori Hataf-V.

LONDON: Snow and freezing temperatures grounded flights across northern Europe on Tuesday, while retailers fretted they would struggle to make up sales lost due to bad weather with just four shopping days to Christmas.

Eurocontrol, the umbrella group for air-traffic control across 38 countries, said more services would likely operate on Tuesday after more than 22,000 flights across Europe were cancelled on Monday.

But cancellations remained widespread.

British Airways said it expected to make a "significant number of cancellations" to its shorthaul services from London's Heathrow airport.

"Severe weather continues to cause significant disruption to our operation and will do so in the run up to Christmas," the airline warned.

Analysts believe the freezing conditions will hit BA's profit by around 10 million pounds ($15.55 million) a day.

Shares in BA were 1 percent up at 268 pence by 1022 GMT, in line with the FTSE100 bluechip index, up 0.78 percent.

BAA, the company owned by Spain's Ferrovial which operates Heathrow, said its south runway would remain closed again on Tuesday, meaning the world's busiest international airport would operate at significantly reduced capacity.

Thousands of passengers have been stranded at Heathrow for days as flights have been delayed and cancelled.

The British government has relaxed regulations on night flights at Heathrow, allowing for arrivals until 0100 GMT each day until Christmas.

London's Gatwick Airport re-opened at 0600 GMT after closing overnight.

Flights to and from Frankfurt airport, continental Europe's biggest, also resumed after the airport had been shut for several hours in the morning, operator Fraport said.

"It is our goal to return to normal flight operations as quickly as possible," said a Fraport spokesman.

In Belgium, handling agents at its main airport managed to get hold of de-icing fluid after saying on Monday they might run out, allowing the departure of some planes on Tuesday.

Britain's Met Office has issued severe weather warnings for most of the country for the remainder of the week.

Eurostar said it was running a restricted service due to the bad weather. Big queues of Eurostar passengers were building up at King's Cross St Pancras station in central London.

"We are asking all customers booked to travel before Christmas to refund or exchange their tickets free of charge, if their travel is not essential," the cross-channel operator said.

With most festive shopping done in the two weeks before Christmas, European retailers are worried they are running out of time to make up lost ground.

"The snow across the country (UK) is having a dramatic impact, with sales running as much as down 50 percent in heavily affected areas," said Andrew Wade, analyst at Numis Securities.

With no let-up in the extreme weather in sight pre-Christmas profit warnings from retailers have already started.

Alexon, the womenswear retailer with 990 outlets in the UK and Europe, warned its sales had slumped 20 percent over the last three weeks, sending its shares down a fifth.

Woman who questioned Obama’s handling of economy at town hall is laid off

Back in September, at a town hall meeting broadcast nationally by CNBC, Velma Hart became the face of Americans anxious for their future. Hart stood before the microphone and gave President Obama a dressing-down about the state of the economy.

"I am a chief financial officer for a veterans service organization, AmVets here in Washington. I'm also a mother, I'm a wife, I'm an American veteran, and I'm one of your middle-class Americans," Hart told the president. "And quite frankly, I'm exhausted. I'm exhausted of defending you, defending your administration, defending the mantle of change I voted for, and deeply disappointed with where we are right now. I've been told that I voted for a man who said he was going to change things in a meaningful way for the middle class. I'm one of those people and I'm waiting, sir, I'm waiting. I don't feel it yet."

[Rewind: 'Exhausted' Hart joins chorus in Obama's very bad week]

You can watch the video of Hart's remarks in the clip above.

Hart also noted that she and her husband were worried about reverting back to the "hot dogs and beans era" of their lives, and asked the president a pointed question: "Is this my new reality?"

[Opinion: A rebuttal to Velma Hart]

Sadly, it may be, at least for a little while, as Velma Hart has been laid off by AmVets.

"It's not anything she did," Jim King, the national executive director of AmVets, told the Washington Post's Michelle Singletary. "She got bit by the same snake that has bit a lot of people. It was a move to cut our bottom line. Most not-for-profits are seeing their money pinched."

[Related: Jobless claims rise, but bigger trend offers hope]

Saying that Hart had been a "good employee," King added that the move "was just a matter of looking at the bottom line and where could we make the best cuts and survive."

[Rewind: 'Rent is too damn high' candidate captures spotlight]

President Obama, in closing his lengthy response to Hart's "new reality" question at the town hall in September, assured Hart that the country is "moving in the right direction." That's probably an especially tough case to make to Hart today. (Hart told The Lookout through a friend that she's unavailable for comment Tuesday.)

Hart, did however, tell CNBC that her misfortune has again brought home the suffering of many other Americans struggling with the same circumstances. "What's in my heart is: Now -- even more than I did before -- I appreciate what millions of people who are in my condition now have been experiencing for the last two, three, four years," she said. "Of course I'm afraid. Everybody's a little afraid." She also stressed that she remains a supporter of President Obama.

North, South Korea exchange fire; 2 marines killed

INCHEON, South Korea – North and South Korea exchanged artillery fire Tuesday after the North shelled an island near their disputed sea border, killing at least two South Korean marines, setting dozens of buildings ablaze and sending civilians fleeing for shelter.

The clash, which put South Korea's military on high alert, was one of the rivals' most dramatic confrontations since the Korean War ended, and one of the few to put civilians at risk, though no nonmilitary deaths were immediately reported. Fifteen South Korean soldiers and three civilians were injured and the extent of casualties on the northern side was unknown.

The skirmish began when Pyongyang warned the South to halt military drills in the area, according to South Korean officials. When Seoul refused and began firing artillery into disputed waters, albeit away from the North Korean shore, the North retaliated by bombarding the small island of Yeonpyeong, which houses South Korean military installations and a small civilian population.

"I thought I would die," said Lee Chun-ok, 54, an islander who said she was watching TV in her home when the shelling began. Suddenly, a wall and door collapsed.

"I was really, really terrified," she told The Associated Press after being evacuated to the port city of Incheon, west of Seoul, "and I'm still terrified."

South Korea responded by firing K-9 155mm self-propelled howitzers and dispatching fighter jets. Officials in Seoul said there could be considerable North Korean casualties. The entire skirmish lasted about an hour.

Each side has threatened the other against another attack.

The escalating tensions focused global attention on the tiny island and sent stock prices down sharply worldwide. The dollar, U.S. Treasury prices and gold all rose as investors sought safe places to park money. Hong Kong's main stock index sank 2.7 percent, while European and U.S. stock indexes fell between 1 and 2 percent. The Dow Jones industrial average fell 165 points in afternoon trading, or 1.5 percent.

South Korean President Lee Myung-bak, who convened an emergency security meeting shortly after the initial bombardment, said that an "indiscriminate attack on civilians can never be tolerated."

"Enormous retaliation should be made to the extent that (North Korea) cannot make provocations again," he said.

The United States, which has more than 28,000 troops stationed in South Korea, condemned the attack. In Washington, White House Press Secretary Robert Gibbs called on North Korea to "halt its belligerent action," and said the U.S. is committed to South Korea's defense.

U.N. Secretary-General Ban Ki-moon condemned North Korea's artillery attack, calling it "one of the gravest incidents since the end of the Korean War," his spokesman Martin Nesirky said. Ban called for "immediate restraint" and insisted "any differences should be resolved by peaceful means and dialogue," the spokesman said.

The supreme military command in Pyongyang threatened more strikes if the South crossed their maritime border by "even 0.001 millimeter," according to the North's official Korean Central News Agency.

South Korea holds military exercises like Tuesday's off the west coast about every three months.

A statement from the North said it was merely "reacting to the military provocation of the puppet group with a prompt powerful physical strike," and accused Seoul of starting the skirmish with its "reckless military provocation as firing dozens of shells inside the territorial waters of the" North.

Government officials in Seoul called North Korea's bombardments "inhumane atrocities" that violated the 1953 armistice halting the Korean War. The two sides technically remain at war because a peace treaty was never signed, and nearly 2 million troops — including tens of thousands from the U.S. — are positioned on both sides of the world's most heavily militarized border.

The exchange represents a sharp escalation of the skirmishes that flare up along the disputed border from time to time. It also comes amid high tensions over the North's apparent progress in its quest for nuclear weapons — Pyongyang claims it has a new uranium enrichment facility — and six weeks after North Korean leader Kim Jong Il anointed his youngest son, Kim Jong Un, as the heir apparent.

"It brings us one step closer to the brink of war," said Peter Beck, a research fellow with the Council on Foreign Relations, "because I don't think the North would seek war by intention, but war by accident, something spiraling out of control has always been my fear."

Columns of thick black smoke rose from homes on the island, video from YTN cable TV showed. Screams and shouts filled the air as shells rained down on the island just south of the disputed sea border.

Yeonpyeong lies a mere seven miles (11 kilometers) from — and within sight of — the North Korean mainland.

China, the North's economic and political benefactor, which also maintains close commercial ties to the South, appealed to both sides to remain calm and "to do more to contribute to peace and stability on the peninsula," Foreign Ministry spokesman Hong Lei said.

Stephen Bosworth, the Obama administration's special envoy to North Korea, said he discussed the clash with the Chinese foreign minister and that they agreed both sides should show restraint. He reiterated that the U.S. stands firmly with its ally, South Korea.

Gen. Walter Sharp, commander of U.S. forces in South Korea and the U.S.-led U.N. Command, said in a Facebook posting that the U.S. military is "closely monitoring the situation and exchanging information with our (South Korean) allies as we always do."

Yeonpyeong, famous for its crabbing industry and home to about 1,700 civilians as well as South Korean military installations. There are about 30 other small islands nearby.

North Korea fired dozens of rounds of artillery in three separate barrages that began in midafternoon, while South Korea returned fire with about 80 rounds, South Korea's Joint Chiefs of Staff said. Naval operations had been reinforced in the area, the JCS said early Wednesday, declining to elaborate.

Two South Korean marines were killed and 15 injured, it said. Island residents fled to some 20 shelters on the island and sporadic shelling ended after about an hour, according to the military.

The Koreas' 1950s war ended in a truce, but North Korea does not recognize the western maritime border drawn unilaterally by the United Nations at the close of the conflict, and the Koreas have fought three bloody skirmishes there in recent years.

South Korea holds military exercises like Tuesday's off the west coast about every three months.

In March, a South Korean warship went down in the waters while on a routine patrolling mission. Forty-six sailors were killed in what South Korea calls the worst military attack on the country since the war.

Seoul blamed a North Korean torpedo, but Pyongyang denied responsibility.

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