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背景：在病人接受冠狀動脈介入治療術後，血腫是拔除橈動脈導管後最常見之合併症，一旦發生也對照護品質造成負面之影響，未改善前血腫發生率高達20.09%。 目的：本專案旨在應用臨床照護指引，來降低病人拔除橈動脈導管後的血腫發生率。 解決方案：參考經橈動脈路徑執行冠狀動脈介入治療的臨床照護指引，擬定解決方法有：（1）定期舉辦冠狀動脈介入治療術後之在職教育；（2）舉辦TR band止血照護的課程與案例討論；（3）制定TR band標準作業流程；（4）制定冠狀動脈介入治療術後照護稽核表與監測制度。 結果：經專案介入後，拔除橈動脈導管後的血腫發生率由20.09%下降至9.3%，不僅達到專案目的，對於護理人員拔除橈動脈導管的認知正確率，也由58.66%提升為96.66%；執行止血照護措施的正確率由57.64%提升至99.21%。 結論：經此專案執行後，不僅降低了拔除橈動脈導管後的血腫發生率，進而也增進了病人在止血過程中的舒適滿意度，結果顯示成效良好，未來將維持此成效以推廣至全院，造福更多心臟病患。 Background: After receiving percutaneous coronary interventions, hematoma is one of the most common vascular complications due to the removal of radial artery. Once happened, there will have a negative impact on the quality of care. The incidence rate of hematoma is up to 20.09% without proper treatment. Purposes: Applying evidence-based clinical care guidelines to effectively assist the medical team to reduce the oc­currence rate of hematoma after the removal of radial artery catheter. Methods and Materials: Designing an evidence-based clinical care guidelines based on empirical literature search­ing and the developed solutions include: regular on-the-job training course, regular TR band hemostasis care course and case study, formulating standard procedures of TR band, formulating a new check list and monitoring system for post-percutaneous coronary intervention. Results and Discussion: After applying the developed guidelines, the occurrence rate of hematoma decreased from 20.09% to 9.3%. As for after-removal of radial artery catheters knowledge, nurses’ cognitive correctness rate increased from 58.66% to 96.66%. The accuracy rate of hemostasis treatment increased from 57.64% to 99.21%. Conclusion: After implementing the project, not only the occurrence of hematoma after removal of radial artery catheter was reduced but also the satisfaction degree about the comfortability was significantly increased. The result indicates that this guideline can be applied in the future to benefit more patients with cardiovascular disease. &nbsp

This work presents the measurement of the complex permittivities of high density polyethylene (HDPE), linear low density polyethylene (LLDPE), low density polyethylene (LDPE), polypropylene (PP), Nylon, and thermoplastic vulcanizates (TPV) in irregular shapes at the microwave frequency. A Teflon sample holder was employed to pack irregularly shaped plastic materials with various volumetric percentages. The samples were put into a resonant cavity with an enhanced electric field in its center, which is known as the enhanced-field method (EFM). The resonant frequencies and the quality factors at different volumetric percentages were measured by a network analyzer and compared with simulated results using a full-wave simulator (high-frequency structure simulator (HFSS)). Three simulation models, layer, ring, and hybrid, are proposed and compared with the experimental results. It is found that the hybrid model (denoted as Z5R5) with five heights and five radii in the partition is the most suitable. The complex permittivities of six plastic materials were evaluated by the contour maps of the HFSS simulation using the hybrid model. The measured complex permittivities of the irregularly shaped polymers agree well with their counterparts in bulk form.

Rationale and Objectives This work aimed to study the effects of scanner model and study protocol on radiation dose received by breast tissues from 64-slice computed tomography (CT) studies. Materials and Methods Four scanner models and three study protocols were used in scanning an anthropomorphic phantom with breast modules. Each protocol follows recommendations or guidelines from the American Association of Physicists in Medicine and the American College of Radiology. Twenty thermoluminescent dosimeters were placed inside the breast modules to measure breast tissue doses. Both the absolute and the normalized breast tissue doses were analyzed. Results The mean glandular doses of a lung cancer screening CT, a chest/abdomen/pelvis CT, and a virtual colonoscopy CT are equivalent to less than 1, 5–7, and 1–3 two-view digital mammograms, respectively, for a standard-sized patient. The normalized breast dose differs significantly (P

A novel deposition technique, called 'neutral-beam enhanced atomic-layer deposition' (NB-EALD), was successfully used to form a high-quality SiO2 layer by using a precursor (BDEAS) and an oxygen neutral beam at room temperature (30 °C). The results demonstrate a typical ALD process and good thickness control at angstrom level. It was found that the properties of the NBEALD-formed SiO2 film (namely, chemical composition, surface roughness, uniformity, density, and wet etch rate) were almost equivalent to those of thermal SiO2. It is concluded from this result that NBEALD is a promising candidate for high-quality and low-temperature ALD instead of plasma-enhanced ALD and thermal ALD.

This work aimed to study the effects of scanner model and study protocol on radiation dose received by breast tissues from 64-slice computed tomography (CT) studies.Four scanner models and three study protocols were used in scanning an anthropomorphic phantom with breast modules. Each protocol follows recommendations or guidelines from the American Association of Physicists in Medicine and the American College of Radiology. Twenty thermoluminescent dosimeters were placed inside the breast modules to measure breast tissue doses. Both the absolute and the normalized breast tissue doses were analyzed.The mean glandular doses of a lung cancer screening CT, a chest/abdomen/pelvis CT, and a virtual colonoscopy CT are equivalent to less than 1, 5-7, and 1-3 two-view digital mammograms, respectively, for a standard-sized patient. The normalized breast dose differs significantly (P 0.01) between lung cancer screening CT and chest/abdomen/pelvis CT; however, it shows less than ±10% variation among scanner models for the same protocol. In virtual colonoscopy CT, breast tissue dose decreases with the distance between local tissues to the edge of the x-ray field, although the decreasing trend varies for different scanner models and protocol settings.When breasts are entirely included in the primary x-ray field, breast dose by 64-slice CT is mainly protocol dependent, with the normalized breast dose about 15% lower for protocols with modulated mA than for those with constant mA; when breasts are only partially included in the primary beam field, breast dose by 64-slice CT is dependent on both the scanner model and the protocol settings.

Objective The few studies applying single-voxel 1 H spectroscopy in children and adolescents with bipolar disorder (BD) have reported low N -acetyl-aspartate (NAA) levels in the dorsolateral prefrontal cortex (DLPFC), and high myo-inositol / phosphocreatine plus creatine (PCr+Cr) ratios in the anterior cingulate. The aim of this study was to evaluate NAA, glycerophosphocholine plus phosphocholine (GPC+PC) and PCr+Cr in various frontal cortical areas in children and adolescents with BD. We hypothesized that NAA levels within the prefrontal cortex are lower in BD patients than in healthy controls, indicating neurodevelopmental alterations in the former. Method We studied 43 pediatric patients with DSM-IV BD (19 female, mean age 13.2 ± 2.9 years) and 38 healthy controls (19 female, mean age 13.9 ± 2.7 years). We conducted multivoxel in vivo 1 H spectroscopy measurements at 1.5 Tesla using a long echo time of 272 ms to obtain bilateral metabolite levels from the medial prefrontal cortex (MPFC), DLPFC (white and gray matter), cingulate (anterior and posterior), and occipital lobes. We used the nonparametric Mann–Whitney U test to compare neurochemical levels between groups. Results In pediatric BD patients, NAA and GPC+PC levels in the bilateral MPFC, and PCr+Cr levels in the left MPFC were lower than those seen in the controls. In the left DLPFC white matter, levels of NAA and PCr+Cr were also lower in BD patients than in controls. Conclusions Lower NAA and PCr+Cr levels in the PFC of children and adolescents with BD may be indicative of abnormal dendritic arborization and neuropil, suggesting neurodevelopmental abnormalities.

Few proton magnetic resonance spectroscopy ( 1 H spectroscopy) studies have investigated the dorsolateral prefrontal cortex (DLPFC), a key region in the pathophysiology of major depressive disorder (MDD). We used 1 H spectroscopy to verify whether MDD patients differ from healthy controls (HC) in metabolite levels in this brain area. Thirty-seven unmedicated DSM-IV MDD patients were compared with 40 HC. Subjects underwent a short echo-time 1 H spectroscopy examination at 1.5 T, with an 8-cm 3 single voxel placed in the left DLPFC. Reliable absolute metabolite levels of N -acetyl aspartate (NAA), phosphocreatine plus creatine (PCr+Cr), choline-containing compounds (GPC+PC), myo-inositol, glutamate plus glutamine (Glu + Gln), and glutamate were obtained using the unsuppressed water signal as an internal reference. Metabolite levels in the left DLPFC did not statistically differ between MDD patients and HC. We found an interaction between gender and diagnosis on PCr+Cr levels. Male MDD patients presented lower levels of PCr+Cr than male HC, and female MDD patients presented higher levels of PCr+Cr than female HC. Moreover, length of illness was inversely correlated with NAA levels. These findings suggest that there is not an effect of diagnosis on the left DLPFC neurochemistry. Possible effects of gender on PCr+Cr levels of MDD patients need to be further investigated.

Objectives: Adults with major depressive disorder (MDD) are reported to have reduced orbitofrontal cortex (OFC) volumes, which could be related to decreased neuronal density. We conducted a study on medication naïve children with MDD to determine whether abnormalities of OFC are present early in the illness course. Methods: Twenty seven medication naïve pediatric Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition (DSM-IV) MDD patients (mean age ± SD = 14.4 ± 2.2 years; 10 males) and 26 healthy controls (mean age ± SD = 14.4 ± 2.4 years; 12 males) underwent a 1.5T magnetic resonance imaging (MRI) with 3D spoiled gradient recalled acquisition. The OFC volumes were compared using analysis of covariance with age, gender, and total brain volume as covariates. Results: There was no significant difference in either total OFC volume or total gray matter OFC volume between MDD patients and healthy controls. Exploratory analysis revealed that patients had unexpectedly larger total right lateral (F = 4.2, df = 1, 48, p = 0.05) and right lateral gray matter (F = 4.6, df = 1, 48, p = 0.04) OFC volumes compared to healthy controls, but this finding was not significant following statistical correction for multiple comparisons. No other OFC subregions showed a significant difference. Conclusions: The lack of OFC volume abnormalities in pediatric MDD patients suggests the abnormalities previously reported for adults may develop later in life as a result of neural cell loss.

Imaging studies indicate smaller orbitofrontal cortex (OFC) volume in mood disorder patients compared with healthy subjects. We sought to determine whether child and adolescent patients with bipolar disorder have smaller OFC volumes than healthy controls. Fourteen children and adolescents meeting DSM-IV criteria for bipolar disorder (six males and eight females with a mean age ± S.D. = 15.5 ± 3.2 years) and 20 healthy controls (11 males and nine females with mean age ± S.D. = 16.9 ± 3.8 years) were studied. Orbitofrontal cortex volume was measured using magnetic resonance imaging. Male bipolar patients had smaller gray matter volumes in medial (p = 0.044), right medial (0.037) and right (p = 0.032) lateral OFC subdivisions compared to male controls. In contrast, female patients had larger gray matter volumes in left (p = 0.03), lateral (p = 0.012), left lateral (p = 0.007), and trends for larger volumes in right lateral and left medial OFC subdivisions compared with female controls. Male patients exhibit smaller gray matter volumes, while female patients exhibit larger volumes in some OFC sub-regions. Gender differences in OFC abnormalities may be involved in illness pathophysiology among young bipolar patients.

Poor main magnetic field (B0) homogeneity (H(B)) leads to artifacts and signal losses in magnetic resonance imaging (MRI). The American College of Radiology's MRI quality control manual mandates annual checks of H(B), suggesting tests using spectral linewidth and phase-difference (delta phi) maps. A new method, the bandwidth-difference (deltaBW) method, which compares the distortion for small and large BW acquisitions to determine the HB, is proposed. The deltaBW method has the advantage that it can be used to measure multiple diameters of spherical volumes (DSV) in a single phantom. A phantom has been developed to exploit this method and results obtained with it are compared to those using three standard methods. Small receiver BW in the presence of poor H(B) leads to geometric distortions because gradients are reduced to the level of the B0 inhomogeneities. Data were acquired using seven MRI systems from different manufacturers, ranging in field strength from 0.2 to 3.0 T. Fast gradient echo pulse sequences were scanned twice using small and large BWs. H(B) was measured from the shift of landmarks between the two BW acquisitions. Results were compared with data from the full width at half maximum (FWHM) method, the delta phi method and one manufacturer's resonant frequency mapping data. The FWHM method was available on two systems and the detla phi method was available on one. The deltaBW method could be performed in all scanners investigated. The H(B) measured ranged 0.11-0.32 ppm to 6.7-12.9 ppm for DSV of 13-22.6 cm. Direct comparisons of the data obtained using the deltaBW method showed good agreement with data obtained using the FWHM method. Data obtained using the deltaBW method compared favorably with the manufacturer's resonant frequency map. The deltaBW method produces measurements of H(B) at various DSV values that can be obtained from a single set of phantom images. The accuracy of deltaBW B0 homogeneity measurements are comparable to the other methods tested.

There is increasing evidence of a reciprocal fronto-limbic network in the pathogenesis of mood disorders. Prior in vivo proton ((1)H) spectroscopy studies provide evidence of abnormal neurochemical levels in the cingulate and dorsolateral prefrontal cortex (DLPFC) of adult subjects with major depressive disorder (MDD). We examined whether similar abnormalities occur in children and adolescents with MDD. We collected two-dimensional multi-voxel in vivo (1)H spectroscopy data at 1.5 Tesla to quantify levels of N-acetyl-aspartate (NAA), glycerolphosphocholine plus phosphocholine (GPC+PC), and phosphocreatine plus creatine (PCr+Cr) in the DLPFC, medial prefrontal cortex (MPFC), and anterior cingulate (AC) of children and adolescents aged 8-17 years with MDD (n=16) compared with healthy control subjects (n=38). Analysis of covariance with age and gender as covariates was performed. MDD subjects showed significantly lower levels of NAA in the right MPFC and right AC than controls. MDD subjects also had significantly lower levels of GPC+PC in the right AC than control subjects. There were no significant differences in other metabolites in the studied regions. Pediatric patients with MDD exhibit neurochemical alterations in prefrontal cortex regions that are important in the monitoring and regulation of emotional states.

The few studies applying single-voxel ¹H spectroscopy in children and adolescents with bipolar disorder (BD) have reported low N-acetyl-aspartate (NAA) levels in the dorsolateral prefrontal cortex (DLPFC), and high myo-inositol / phosphocreatine plus creatine (PCr+Cr) ratios in the anterior cingulate. The aim of this study was to evaluate NAA, glycerophosphocholine plus phosphocholine (GPC+PC) and PCr+Cr in various frontal cortical areas in children and adolescents with BD. We hypothesized that NAA levels within the prefrontal cortex are lower in BD patients than in healthy controls, indicating neurodevelopmental alterations in the former.We studied 43 pediatric patients with DSM-IV BD (19 female, mean age 13.2 ± 2.9 years) and 38 healthy controls (19 female, mean age 13.9 ± 2.7 years). We conducted multivoxel in vivo ¹H spectroscopy measurements at 1.5 Tesla using a long echo time of 272 ms to obtain bilateral metabolite levels from the medial prefrontal cortex (MPFC), DLPFC (white and gray matter), cingulate (anterior and posterior), and occipital lobes. We used the nonparametric Mann-Whitney U test to compare neurochemical levels between groups.In pediatric BD patients, NAA and GPC+PC levels in the bilateral MPFC, and PCr+Cr levels in the left MPFC were lower than those seen in the controls. In the left DLPFC white matter, levels of NAA and PCr+Cr were also lower in BD patients than in controls.Lower NAA and PCr+Cr levels in the PFC of children and adolescents with BD may be indicative of abnormal dendritic arborization and neuropil, suggesting neurodevelopmental abnormalities.

Alcoholism is highly prevalent among bipolar disorder (BD) patients, and its presence is associated with a worse outcome and refractoriness to treatment of the mood disorder. The neurobiological underpinnings that characterize this comorbidity are unknown. We sought to investigate the neurochemical profile of the dorsolateral prefrontal cortex (DLPFC) of BD patients with comorbid alcoholism. A short-TE, single-voxel 1H spectroscopy acquisition at 1.5 Tesla from the left DLFPC of 22 alcoholic BD patients, 26 non-alcoholic BD patients and 54 healthy comparison subjects (HC) were obtained. Absolute levels of N-acetyl aspartate, phosphocreatine plus creatine, choline-containing compounds, myo-inositol, glutamate plus glutamine (Glu+Gln) and glutamate were obtained using the water signal as an internal reference. Analysis of co-variance was used to compare metabolite levels among the three groups. In the primary comparison, non-alcoholic BD patients had higher glutamate concentrations compared to alcoholic BD patients. In secondary comparisons integrating interactions between gender and alcoholism, non-alcoholic BD patients presented significantly higher glutamate plus glutamine (Glu+Gln) than alcoholic BD patients and HC. These results appeared to be driven by differences in male subjects. Alcoholic BD patients with additional drug use disorders presented significantly lower myo-inositol than BD patients with alcoholism alone. The co-occurrence of BD and alcoholism may be characterized by neurochemical abnormalities related to the glutamatergic system and to the inositol second messenger system and/or in glial pathology. These abnormalities may be the neurochemical correlate of an increased risk to develop alcoholism in BD, or of a persistently worse clinical and functional status in BD patients in remission from alcoholism, supporting the clinical recommendation that efforts should be made to prevent or early diagnose and treat alcoholism in BD patients.

The aim of this study was to assess the effectiveness and tolerability of a long-acting methylphenidate (MPH) formulation, beaded MPH (B-MPH), for treatment of attention-deficit/hyperactivity disorder (ADHD) in 4- and 5-year-old children.Eleven children (9 boys and 2 girls) with ADHD received 4 weeks of B-MPH treatment in a single-site, open-label pilot study. Medication dosing was flexible, with titration to a maximum of 30 mg/day. A brief education session on behavior management was offered to parents at each treatment visit.Subjects experienced a mean decrease of 1.09 (standard deviation [SD]=0.73, p0.01) on the Swanson, Nolan, and Pelham Questionnaire (SNAP-IV) ADHD composite score to an end point of 1.18 (SD=0.64). Subjects demonstrated mean decreases in scores of inattention of 1.01 (SD=0.85, p0.01) and in hyperactivity/impulsivity of 1.17 (SD=0.74, p0.01), with end point scores of 1.10 (SD=0.61) and 1.26 (SD=0.77), respectively. The Clinical Global Impressions-Severity (CGI-S) scale showed a statistically significant improvement from a baseline mean of 5 to the final visit mean of 3.36 (p0.01). At the final visit, the mean daily B-MPH dose was 17.73 mg. Subjects did not experience any statistically significant changes in weight, blood pressure, or pulse during the study. The most common adverse event was decreased appetite.B-MPH was safe and effective for the treatment of ADHD in the 4- and 5-year-olds participating in this study.

The dorsolateral prefrontal cortex (DLPFC) has been implicated in the pathophysiology of mental disorders. Previous region-of-interest MRI studies that attempted to delineate this region adopted various landmarks and measurement techniques, with inconsistent results. We developed a new region-of-interest measurement method to obtain morphometric data of this region from structural MRI scans, taking into account knowledge from cytoarchitectonic postmortem studies and the large inter-individual variability of this region. MRI scans of 10 subjects were obtained, and DLPFC tracing was performed in the coronal plane by two independent raters using the semi-automated software Brains2. The intra-class correlation coefficients between two independent raters were 0.94 for the left DLPFC and 0.93 for the right DLPFC. The mean +/- S.D. DLPFC volumes were 9.23 +/- 2.35 ml for the left hemisphere and 8.20 +/- 2.08 ml for the right hemisphere. Our proposed method has high inter-rater reliability and is easy to implement, permitting the standardized measurement of this region for clinical research applications

The striatum, including the putamen and caudate, plays an important role in executive and emotional processing and may be involved in the pathophysiology of mood disorders. Few studies have examined structural abnormalities of the striatum in pediatric major depressive disorder (MDD) patients. We report striatal volume abnormalities in medication-naïve pediatric MDD compared to healthy comparison subjects.Twenty seven medication-naïve pediatric Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) MDD and 26 healthy comparison subjects underwent volumetric magnetic resonance imaging (MRI). The putamen and caudate volumes were traced manually by a blinded rater, and the patient and control groups were compared using analysis of covariance adjusting for age, sex, intelligence quotient, and total brain volumes.MDD patients had significantly smaller right striatum (6.0% smaller) and right caudate volumes (7.4% smaller) compared to the healthy subjects. Left caudate volumes were inversely correlated with severity of depression in MDD subjects. Age was inversely correlated with left and right putamen volumes in MDD patients but not in the healthy subjects.These findings provide fresh evidence for abnormalities in the striatum of medication-naïve pediatric MDD patients and suggest the possible involvement of the striatum in the pathophysiology of MDD.

Poor main magnetic field (B0) homogeneity (H(B)) leads to artifacts and signal losses in magnetic resonance imaging (MRI). The American College of Radiology's MRI quality control manual mandates annual checks of H(B), suggesting tests using spectral linewidth and phase-difference (delta phi) maps. A new method, the bandwidth-difference (deltaBW) method, which compares the distortion for small and large BW acquisitions to determine the HB, is proposed. The deltaBW method has the advantage that it can be used to measure multiple diameters of spherical volumes (DSV) in a single phantom. A phantom has been developed to exploit this method and results obtained with it are compared to those using three standard methods. Small receiver BW in the presence of poor H(B) leads to geometric distortions because gradients are reduced to the level of the B0 inhomogeneities. Data were acquired using seven MRI systems from different manufacturers, ranging in field strength from 0.2 to 3.0 T. Fast gradient echo pulse sequences were scanned twice using small and large BWs. H(B) was measured from the shift of landmarks between the two BW acquisitions. Results were compared with data from the full width at half maximum (FWHM) method, the delta phi method and one manufacturer's resonant frequency mapping data. The FWHM method was available on two systems and the detla phi method was available on one. The deltaBW method could be performed in all scanners investigated. The H(B) measured ranged 0.11-0.32 ppm to 6.7-12.9 ppm for DSV of 13-22.6 cm. Direct comparisons of the data obtained using the deltaBW method showed good agreement with data obtained using the FWHM method. Data obtained using the deltaBW method compared favorably with the manufacturer's resonant frequency map. The deltaBW method produces measurements of H(B) at various DSV values that can be obtained from a single set of phantom images. The accuracy of deltaBW B0 homogeneity measurements are comparable to the other methods tested.

The volume of the pituitary gland in adults with bipolar disorder has previously been reported to be smaller than that of healthy controls. Such abnormalities would be consistent with the HPA dysfunction reported in this illness. We conducted a study of children and adolescents with bipolar disorder to determine whether size abnormalities in the pituitary gland are already present early in illness course. Magnetic resonance imaging (MRI) morphometric analysis of the pituitary gland was carried out in 16 DSM-IV children and adolescents with bipolar disorder (mean age±sd=15.5±3.4 years) and 21 healthy controls (mean age±sd=16.9±3.8 years). Subjects underwent a 1.5 T MRI, with 3-D Spoiled Gradient Recalled (SPGR) acquisition. There was no statistically significant difference between pituitary gland volumes of bipolar patients compared to healthy controls (ANCOVA, age, gender, and ICV as covariates; F=1.77, df=1,32, P=.19). There was a statistically significant direct relationship between age and pituitary gland volume in both groups (r=.59, df=17, P=.007 for healthy controls; r=.61, df=12, P=.008 for bipolar patients). No evidence of size abnormalities in the pituitary gland was found in child and adolescent bipolar patients, contrary to reports involving adult bipolar patients. This suggests that anatomical abnormalities in this structure may develop later in illness course as a result of continued HPA dysfunction. Depression and Anxiety 20:182–186, 2004. © 2005 Wiley-Liss, Inc.

Functional and postmortem studies suggest that the orbitofrontal cortex (OFC) is involved in the pathophysiology of bipolar disorder (BD). This anatomical magnetic resonance imaging (MRI) study examined whether BD patients have smaller OFC gray matter volumes compared to healthy comparison subjects (HC).Twenty-eight BD patients were compared to 28 age- and gender-matched HC. Subjects underwent a 1.5T MRI with 3D spoiled gradient recalled acquisition. Total OFC and medial and lateral subdivisions were manually traced by a blinded examiner. Images were segmented and gray matter volumes were calculated using an automated method.Analysis of covariance, with intracranial volume as covariate, showed that BD patients and HC did not differ in gray matter volumes of total OFC or its subdivisions. However, total OFC gray matter volume was significantly smaller in depressed patients (n = 10) compared to euthymic patients (n = 18). Moreover, total OFC gray matter volumes were inversely correlated with depressive symptom intensity, as assessed by the Hamilton Depression Rating Scale. OFC gray matter volumes were not related to lithium treatment, age at disease onset, number of episodes, or family history of mood disorders.Our results suggest that abnormal OFC gray matter volumes are not a pervasive characteristic of BD, but may be associated with specific clinical features of the disorder.