BACKGROUND: Fasting has a profound impact on GH synthesis, and is released in all mammalian species that have been studied. The male rat has long been used as a model to determine the mechanism on how fasting mediates these changes. However, many aspects of GH synthesis, release and function are known to be gender-dependent. This study was conducted in order to determine if changes in the GH-axis, in response to fasting, differs between the sexes. METHODS: Male and female rats (8~9 weeks; n=5/group) were fasted for 72h, or supplied food ad libitum. The mean circulating serum GH and IGF-I concentrations were measured by radioimmunoassay. The levels of hypothalamic GH-releasing hormone (GHRH), somatostatin (SRIF), neuropeptide Y (NPY) and pituitary GH mRNA were measured using an RNase protection assay. The levels of pituitary GHRH receptor (GHRH-R), GH secretagogue (GHS) receptor (GHS-R) and SRIF receptor (sst1-5) mRNA were measured by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Fasting resulted in a comparable weight loss in both the males and the females, (18.0+/-0.9%) and (17.0 0.8%), respectively. In the fasted males, there was a characteristic decrease in the serum GH (98 60 vs. 7 4 ng/mL) and IGF-I (367 35 vs 152 12 ng/mL), associated with a decrease in the hypothalamic GHRH, and an increase in the NPY mRNA, levels of 52 6% and 138 6%, respectively, compared to those of the fed controls (p<0.05). In spite of the reduction in the GHRH, fasting did not alter the levels of the pituitary GH mRNA, and in fact increased the expression of the pituitary receptors, GHRH-R and GHS-R, to 185 15 and 169 25%, respectively, to those of the fed controls. In contrast to the positive impact of fasting on the GH-stimulatory receptors, fasting led to a dramatic decrease in the expressions of the somatostatin receptor subtypes, sst2 (29+/-5% of Fed) and sst4 (60+/-7% of Fed). Fasting had comparable effects on the GH-axis of the female rats, with two notable exceptions; first, fasting did not suppress the mean circulating GH levels (16 3 vs. 38 28 ng/mL) and second, did not alter the sst2 and sst4 expressions. CONCLUSION: These results corroborate the other reports regarding the effects of fasting on the expressions of hypothalamic neuropeptides, pituitary GHRH-R and sst2, in male rats. This is the first report demonstrating that fasting stimulates the expression of pituitary GHS-R in both sexes. This is of great interest given the fact that ghrelin, the putative GHS-R ligand, is also elevated by fasting. We propose that the upregulation of both ghrelin and GHS-R may play important roles in increasing the sensitivity of the pituitary to GHRH, in that these GH-stimulatory systems work synergistically. These changes may compensate for the fasting-induced suppression of hypothalamic GHRH input. We might speculate that such compensatory mechanisms are dominant in the female rat, in that circulating GH levels are not suppressed by fasting.
Animals ; Axis, Cervical Vertebra* ; Fasting* ; Female* ; Ghrelin ; Growth Hormone ; Humans ; Hypothalamus ; Insulin-Like Growth Factor I ; Male* ; Neuropeptide Y ; Neuropeptides ; Radioimmunoassay ; Rats* ; Receptors, Somatostatin ; Ribonucleases ; RNA, Messenger ; Somatostatin ; Up-Regulation ; Weight Loss

Purpose: Based on the logic that self-oriented perfectionism (SOP) is one of the most well-established predictors of academic procrastination (AP), we predicted that fear of failure (FF) would mediate the association between SOP and AP. The purpose of this study is to investigate the mediating effect of FF on the influence of SOP on AP in medical students. Methods: A total of 156 undergraduate medical students completed a battery of questionnaires. This study is an analysis of cross-sectional data obtained through an offline survey. The self-report questionnaires assessed demographics and psychological scales, including the Multidimensional Perfectionism Scale, Performance Failure Appraisal Inventory, and Aitken Procrastination Inventory. The data were analyzed by descriptive statistics, correlations analysis, and multiple regression analyses using IBM SPSS ver. 22.0 (IBM Corp., Armonk, USA). Results: SOP had a direct negative influence on AP (β=-0.420, p<0.001). Also, SOP had a significant indirect effect on AP through FF (β=0.0393; 95% confidence interval, 0.040–0.0936). These results indicated that the FF partially mediates the relationship between SOP and AP. Conclusion Although SOP among medical students might play an adaptive role to lessen AP, in cases FF gets higher, SOP could have opposing effects via the mediating effect of FF, leading to an actual increase in AP. Attempts to deal with the FF among medical students should be made for better academic achievements.

Background: This study aimed to determine whether the levels of healthcare indicators vary according to the duration of diabetes in diabetic people. Methods: From the 2018 Korean Community Health Survey, a total of 20,113 diabetic people aged 40-79 years were analyzed. The distribution of people with diabetes and its corresponding diabetes duration were as follows: 34.9%, less than 4 years; 22.4%, 5-9 years; 18.9%, 10-14 years; 9.4%, 15-19 years; and 14.1%, more than 20 years. Outcome variables included eight health behavior indicators and seven diabetes management indicators. Results: After adjusting for the sociodemographic characteristics, the longer the duration of diabetes, the less alcohol drinking and the more influenza vaccination was availed, whereas the regular tooth brushing, perceived usual stress, and perceived depressive symptoms tended to be unhealthy. Smoking, regular walking, and utilizing food nutrition label did not differ based on the duration of diabetes. Moreover, blood glucose control was evaluated to be poorly controlled as the duration of diabetes lengthened; however, diabetes management education and medical institution services (glycated hemoglobin measurement, diabetic retinopathy screening, and diabetic nephropathy screening) tended to increase significantly. There was also no difference in relation to diabetes duration in the recognition of early symptoms of myocardial infarction and stroke, which are the major complications of diabetes. Conclusions People with long-lasting diabetes are at a higher risk of developing diabetes-related complications; therefore, more active community strategies are needed to improve their health behavior.

This study aimed to identify and assess the differences in psychological health problems between families living with stroke survivors (FwSS) and the general population without stroke families (GwoSF). A total of 4,514 cases of FwSS were selected for analysis from the 2013 Korea Community Health Survey. In order to determine control groups in GwoSF, propensity scores were generated based on the sociodemographic characteristics of age, gender, residential region, marital status, educational level, monthly household income, and employment status. Each FwSS was matched to 3 controls of GwoSF (13,542 controls) using a greedy matching algorithm with 8 to 1 digit matching. After propensity score-matching, the proportion of usual stress (30.2% vs 24.6%), depressive mood (7.1% vs 6.1%), and suicidal ideation (13.0% vs 11.1%) in FwSS were all significantly higher than those in GwoSF (Ps<0.05). Compared to GwoSF, the adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for psychological health problems in FwSS were calculated using multiple logistic regression analysis. The aORs for usual stress (aOR 1.32, 95% CI 1.21-1.42), depressive mood (aOR 1.14, 95% CI 0.99-1.31; borderline significance), and suicidal ideation (aOR 1.17, 95% CI 1.05-1.30) were significantly higher among FwSS than GwoSF. Moreover, the psychological health problems of FwSS were more evident in females than in males. This study shows that FwSS have poorer psychological health outcomes than GwoSF with similar sociodemographic characteristics. Community-based strategies and family support programs, especially for female family members of stroke survivors, are essential to improve the psychological health of stroke families.

Purpose: We aimed to examine the participants’ satisfaction and evaluation of the program’s appropriateness, outcomes and benefits from participants’ perspectives and gather suggestions from students to improve peer mentor programs. Methods: From 2016 to 2018, 67 mentees and mentors participated in the peer mentoring program. All program participants were asked to participate in the survey, and the respondents were invited to focus group interview (FGI). Quantitative data was collected from the survey questionnaire. Qualitative data was gathered from the open-end questions in the survey and supplemented from additional semi-structured FGIs. The interview data were analyzed using qualitative content analysis. Results: Nineteen responded to the survey, and six participated in the further FGI. Qualitative data contained outcomes and mutual benefits, factors for mentoring success, negative experiences, and suggestions for improvement. Especially factors for mentoring success consisted of various methods of studying assistance, motivation, autonomy, responsibility, emotional support, and relational bonding as important topics concerning mentor-mentee experiences. The satisfaction scores about the program appropriateness, others’ attitudes, program implementation, ranged from 3.5 to 3.9 (5-point Likert scores) without significant difference between mentors and mentees. The only negative experience reported by a mentee was feeling the pressure. Specific guidelines on program implementation, pre-education for mentees, appropriate matching, and mentees’ clear purpose and spontaneity were suggested to improve the program. Conclusion Participants were generally satisfied with the peer mentoring program, gaining academic and non-academic achievements, including emotional support and improved relationships. Furthermore, we expect that this program can be improved with participants’ suggestions in the future.

This study aimed to identify and assess the differences in psychological health problems between families living with stroke survivors (FwSS) and the general population without stroke families (GwoSF). A total of 4,514 cases of FwSS were selected for analysis from the 2013 Korea Community Health Survey. In order to determine control groups in GwoSF, propensity scores were generated based on the sociodemographic characteristics of age, gender, residential region, marital status, educational level, monthly household income, and employment status. Each FwSS was matched to 3 controls of GwoSF (13,542 controls) using a greedy matching algorithm with 8 to 1 digit matching. After propensity score-matching, the proportion of usual stress (30.2% vs 24.6%), depressive mood (7.1% vs 6.1%), and suicidal ideation (13.0% vs 11.1%) in FwSS were all significantly higher than those in GwoSF (Ps<0.05). Compared to GwoSF, the adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for psychological health problems in FwSS were calculated using multiple logistic regression analysis. The aORs for usual stress (aOR 1.32, 95% CI 1.21-1.42), depressive mood (aOR 1.14, 95% CI 0.99-1.31; borderline significance), and suicidal ideation (aOR 1.17, 95% CI 1.05-1.30) were significantly higher among FwSS than GwoSF. Moreover, the psychological health problems of FwSS were more evident in females than in males. This study shows that FwSS have poorer psychological health outcomes than GwoSF with similar sociodemographic characteristics. Community-based strategies and family support programs, especially for female family members of stroke survivors, are essential to improve the psychological health of stroke families.

Purpose: We aimed to examine the participants’ satisfaction and evaluation of the program’s appropriateness, outcomes and benefits from participants’ perspectives and gather suggestions from students to improve peer mentor programs. Methods: From 2016 to 2018, 67 mentees and mentors participated in the peer mentoring program. All program participants were asked to participate in the survey, and the respondents were invited to focus group interview (FGI). Quantitative data was collected from the survey questionnaire. Qualitative data was gathered from the open-end questions in the survey and supplemented from additional semi-structured FGIs. The interview data were analyzed using qualitative content analysis. Results: Nineteen responded to the survey, and six participated in the further FGI. Qualitative data contained outcomes and mutual benefits, factors for mentoring success, negative experiences, and suggestions for improvement. Especially factors for mentoring success consisted of various methods of studying assistance, motivation, autonomy, responsibility, emotional support, and relational bonding as important topics concerning mentor-mentee experiences. The satisfaction scores about the program appropriateness, others’ attitudes, program implementation, ranged from 3.5 to 3.9 (5-point Likert scores) without significant difference between mentors and mentees. The only negative experience reported by a mentee was feeling the pressure. Specific guidelines on program implementation, pre-education for mentees, appropriate matching, and mentees’ clear purpose and spontaneity were suggested to improve the program. Conclusion Participants were generally satisfied with the peer mentoring program, gaining academic and non-academic achievements, including emotional support and improved relationships. Furthermore, we expect that this program can be improved with participants’ suggestions in the future.

This study examined the gender-specific association between stroke status and depression in South Korea. A total of 5,746 men and 7,608 women aged ≥30 years who participated in the 2014, 2016, and 2018 Korea National Health and Nutrition Examination Survey were included in the analysis. The cross-sectional surveys targeted the general population consisting of nationally representative adults (≥19 years) residing in Korea. A 9-item Patient Health Questionnaire score of 10 or more was regarded as depression. A higher risk of depression in stroke survivors compared to the non-stroke population was not observed in men (odds ratio [OR], 1.51; 95% confidence intervals [CI], 0.82-2.81), while it was observed in women (OR, 2.49; 95% CI, 1.64-3.77). Compared to non-stroke women, women stroke survivors with a younger age at diagnosis (＜60 years) (OR, 4.05; 95% CI, 2.28-7.20) and stroke with duration of ≥10 years (OR, 3.12; 95% CI, 1.63-5.97) had a higher risk for depression. Gender aspects should be more intensively considered in the association between stroke status and depression in community settings.

Recurrent meningitis is defined as more than one episode of meningitis that is separated by an entire recovery period. Causes of recurrent meningitis include anatomical defects, immune deficiency, and parameningeal infections. A thorough investigation of the underlying causes of recurrent meningitis is required for proper treatment. Herein we report a case of recurrent bacterial meningitis caused by osteomyelitis of the odontoid process.

Background: This study aimed to examine the difference of sleep quality between family members of dementia patients and general population in community. Methods: Participants (n=215,676) aged 19 years and over in the 2018 Korea Community Health Survey were classified into three groups; family members living at home with a person with dementia (FHD; n=2,445), family members living separately from a person with dementia (FSD; n=9,132), and family members without a person with dementia in the family (FwoD; n=204,099). The Pittsburgh Sleep Quality Index greater than 6 points was regarded as poor sleep quality (PSQ). Multiple logistic regression analysis was used to explore the associations between living with dementia patients and PSQ. Results: The prevalence of PSQ was 48.3% in FHD, 40.7% in FSD, and 38.8% in FwoD. After adjusting for potential confounders, compared to FwoD, the odds ratio for PSQ was 1.42 (95% confidence interval [CI], 1.31-1.54) in FHD and 1.22 (95% CI, 1.17-1.27) in FSD. Additionally, almost all age- and sex-stratified family of dementia patients, except for the youngest (<40 years) men of FHD and the youngest (<40 years) men of FSD, had a higher risk for PSQ than FwoD. Conclusions Both FHD and FSD have lower sleep quality than FwoD. Public psychological interventions and supports are needed to family members of dementia patients in the community.