Purpose: We hypothesized that a radiomics approach could be employed to classify children with growth hormone deficiency (GHD) and idiopathic short stature (ISS) on sella magnetic resonance imaging (MRI). Accordingly, we aimed to develop a radiomics prediction model for differentiating GHD from ISS and to evaluate the diagnostic performance thereof. Materials and Methods: Short stature pediatric patients diagnosed with GHD or ISS from March 2011 to July 2020 at our institution were recruited. We enrolled 312 patients (GHD 210, ISS 102) with normal sella MRI and temporally split them into training and test sets (7:3). Pituitary glands were semi-automatically segmented, and 110 radiomic features were extracted from the coronal T2-weighted images. Feature selection and model development were conducted by applying mutual information (MI) and a light gradient boosting machine, respectively. After training, the model’s performance was validated in the test set. We calculated mean absolute Shapley values for each of the selected input features using the Shapley additive explanations (SHAP) algorithm. Volumetric comparison was performed for GHD and ISS groups. Results: Ten radiomic features were selected by MI. The receiver operating characteristics curve of the developed model in the test set was 0.705, with an accuracy of 70.6%. When analyzing SHAP plots, root mean squared values had the highest impact in the model, followed by various texture features. In volumetric analysis, sagittal height showed a significant difference between GHD and ISS groups. Conclusion Radiomic analysis of sella MRI may be able to differentiate between GHD and ISS in clinical practice for short-statured children.

Purpose: The purpose of this study is to identify that emotional labor has effect on depressive symptom, job satisfaction, and moderating effect of self-esteem and ego-resilience of nurses. Methods: Data were collected by questionnaires from 224 nurses university hospitals from May 8 to May 19, 2017, analyzing by hierarchical multiple regression. Results: There was a significant positive correlation with emotional labor and depressive symptom. Also emotional labor was significant negative correlation with job satisfaction, self-esteem, and ego-resilience. Ego-resilience had a moderating effect that emotional labor affected depressive symptom and job satisfaction. Conclusion In this study, Ego-resilience were found to have a significant moderating effect in relation to emotional labor, depressive symptom, and job satisfaction. Therefore, it's needed to consider the ego-resilience when developing emotional labor management program of nurses.

Purpose: The purpose of this study is to identify that emotional labor has effect on depressive symptom, job satisfaction, and moderating effect of self-esteem and ego-resilience of nurses. Methods: Data were collected by questionnaires from 224 nurses university hospitals from May 8 to May 19, 2017, analyzing by hierarchical multiple regression. Results: There was a significant positive correlation with emotional labor and depressive symptom. Also emotional labor was significant negative correlation with job satisfaction, self-esteem, and ego-resilience. Ego-resilience had a moderating effect that emotional labor affected depressive symptom and job satisfaction. Conclusion In this study, Ego-resilience were found to have a significant moderating effect in relation to emotional labor, depressive symptom, and job satisfaction. Therefore, it's needed to consider the ego-resilience when developing emotional labor management program of nurses.

PURPOSE: People with a family history of mood disorder are more likely to have depression. This study compared the characteristics of non-psychotic major depression disorder according to family history of depression. METHOD: Subjects were total of 817 persons recruited for the CRESCEND-K multicenter trial. Characteristics of depression and suicide history of patients with and without a family history of depression were assessed. Family history was determined through self-report. RESULTS: Of 817 participants, 12.4% had a positive family history of depression. Those with family history of depression reported an earlier age at onset of MDD, and more psychiatric comorbidity. Severity of depression and anxiety were not different according to family history of depression. There were no difference in attempted suicide history, number of attempted suicide and age at onset of 1st attempted suicide according to such a family history. CONCLUSION: Patients with family history of depression reported earlier onset of MDD and more history of psychiatric comorbidity.
Anxiety ; Comorbidity ; Depression ; Depressive Disorder, Major ; Humans ; Mood Disorders ; Suicide ; Suicide, Attempted

OBJECTIVE: Weight gain is a commonly encountered problem associated with atypical antipsychotics, especially olanzapine. To investigate the weight reducing effect of amantadine, we conducted an prospective open label study. METHODS: We started amantadine treatment in outpatients who had gained weight during olanzapine treatment (mean dose of 11.94 mg/day, mean weight gain of 6.33 kg). Data were collected at St. Mary's Hospital, College of Medicine, The Catholic University of Korea. The add-on treatment of amantadine was given at a mean dose of 161.9 mg/day with mean duration of administration for 110.2 day. Brief Psychiatric Rating Scale (BPRS), Extrapyramidal Symptom Scale were checked to evaluate the tolerability of amantadine. RESULTS: Before administration of amantadine, the mean dose of olanzapine was 11.94+/-4.58 mg and mean duration of administration was 123.1+/-174.6 days. Body weight and BMI during this period was significantly increased mean 6.33+/-4.45 kg (Z=-3.839, p<0.001), 4.94+/-0.75 (Z=-3.724, p<0.001) respectively. Amantadine was administered mean dose of 161.90+/-58.96 mg for mean 110.2+/-78.7 days. Body weight and BMI was decreased mean 0.96+/-3.44 kg, 0.71+/-2.7, respectively. There was no deterioration in psychiatric symptoms, as shown in BPRS score decrement and no adverse effects were reported. CONCLUSION: The present data suggests that amantadine does not significantly decrease weight gain experienced by some patients during olanzapine treatment and does not worse psychotic symptoms. Randomized placebo-controlled trial should be needed to confirm these findings.
Amantadine* ; Antipsychotic Agents ; Body Weight ; Brief Psychiatric Rating Scale ; Humans ; Korea ; Outpatients ; Prospective Studies ; Weight Gain*

OBJECTIVE: This retrospective naturalistic study was designed to compare the clinical characteristics including psychopathology of two groups of patients, long-term maintenance group and short-term drop-out group, who were taking risperidone. METHOD: Datas were collected for 210 schizophrenic patients with complete medical records among 580 patients who were enrolled with risperidone administration from January 1996 to December 1996 in 8 affiliated hospital of the Catholic University. The short-term drop-out patients group were assigned to whom treatment period was less than 6 month, and the long-term maintained patients group, treatment period was more than 2 years. We assessed demographics, psychopathology, and other variables related with medication based on past medical records. RESULTS: Among subjects of 210, short-term drop-out patients group were 67(31.9%) and long-term maintained patients group were 143(68.1%). Demographics and psychopathology were not significantly different between two groups. The starting and maximal dosage of risperidone was not significantly different between two groups but the maintenance dosage of risperidone was lower in long-term medicated patients group than short-term drop-out patients group(t=3.698, p<0.05). Additionally, the result of this study showed differences in experiences of past antipsychotic use as following. The number of no previous use of antipsychotic was 39(58.2%), the number of high potency antipsychotic use was 27(40.3%), and the number of low potency antipsychotic use was 1(1.5%) in short-term drop-out group. The number of no previous use of antipsychotic was 58(40.6%), the number of high potency antipsychotic use was 77(53.8%), the number of low potency antipsychotic use was 8(5.6%) in long-term maintained group(X 2=6.559, df=2, p<0.05). CONCLUSION: According to these results, administration of low therapeutic dosage should be recommended for long-term maintenance as if possible. Multi-center based retrospective naturalistic study like this would be useful for getting informations about efficacy and some other aspects of antipsychotic administration in practical field.
Demography ; Hospitals, University* ; Humans ; Medical Records ; Psychopathology ; Retrospective Studies ; Risperidone*

OBJECTIVES: Several novel and minimally invasive techniques to stimulate the brain have recently developed. Among these newer somatic interventions, vagus nerve stimulation(VNS) is regarded as a promising tool in the treatment of various neuropsychiatric disorders. This article reviews the history, methodology, and the future of VNS technique and its emerging research and therapeutic applications in the field of neuropsychiatry. METHODS: Wide ranged literature reviews and discussion with pioneering researchers were performed. RESULTS: VNS has been used in the treatment of refractory seizure disorder and depression. There are some reasons to hope that VNS might have other therapeutic applications in neuropsychiatric disorders, as well as advanced understanding about the pathophysiology of these disorders. CONCLUSION: Regardless of its clinical role as a new therapeutic technique, the capacity of VNS as a research tool to alter brain activity should lead to important advances in the understanding of brain-behavior relationships.
Brain ; Depression ; Epilepsy ; Hope ; Neuropsychiatry* ; Seizures ; Vagus Nerve Stimulation* ; Vagus Nerve*

OBJECTIVES: This study was conducted to evaluate the prescription patterns, overall efficacy, and safety of atypical antipsychotics for inpatients with bipolar I disorder. METHODS: Inpatients with bipolar I disorder, who had received adjunctive treatment with olanzapine or risperidone, beyond 1 month, along with mood stabilizers were selected for a retrospective study. The charts of those patients(N=56) were reviewed for the details of efficacy, safety, and other pharmacological variables of the two drugs. RESULTS: Olanzapine and risperidone showed equivalent efficacy by the evaluation in accordance with clinical global impression scale (CGI) and global assessment of functioning scale(GAF) score. Different side effect profiles were noted between two drugs. CONCLUSION: These limited results suggested that the efficacy and safety of risperidone and olanzapine were similar for the treatment of inpatients with bipolar I disorder. Prospective controlled study for efficacy and safety of risperidone and olanzapine in the treatment of bipolar I disorder should be conducted in future.
Antipsychotic Agents ; Humans ; Inpatients* ; Prescriptions ; Retrospective Studies ; Risperidone

OBJECTIVES: Recently, functional magnetic resonance imaging(fMRI) has been an important tool for mapping in various functional brain disorders. And it is known that soft neurologic signs are frequently found in schizophrenia. The purpose of this study was to investigate the pattern of cerebral activation to motor tasks examining soft neurologic signs in patients with schizophrenia, non-schizophrenic psychoses, and control subjects, using functional MRI. METHODS: Nine patients with schizophrenia, and six patients with non-schizophrenic psychoses, and six healthy control subjects were examined. A paradigm, in a resting condition followed by an activation state(finger-to-thumb opposition task and fistring task by right hand) was used for blood oxygen level dependent f-MRI. Activated voxels in both motor cortices and supplementary motor cortex were recorded and the lateralization index of cortical response was measured. RESULTS: Patients with schizophrenia showed typical increased activation in right motor cortex and reversed lateralization by finger-to-thumb opposition task compared with non-schizophrenic psychoses and contol subjects. CONCLUSION: The present study provides evidence for specific reversed lateralizaiton in fMRI brain activation by motor task in patients with schizophrenia. FMRI will be used as a powerful tool for elucidating the pathophysiology of schizophrenia.
Brain ; Brain Diseases ; Humans ; Magnetic Resonance Imaging* ; Motor Cortex ; Neurologic Manifestations ; Oxygen ; Psychotic Disorders ; Schizophrenia*

A 56 year-old female patient with major depressive disorder, single episode with unremarkable findings on past medical and psychiatric history visited due to various depressive symptoms. Mirtazapine of 15 mg/day at evening was administered for the control of her depressive symptoms along with alprazolam of 0.5 mg/day at morning and evening for the control of anxiety. On fifth hospitalized day, she complained of creeping and crawling sensation on both legs which was aggravated at night after about one hour of mirtazapine intake and improved with movement. She also had a difficulty in falling a sleep as well as onset of discomfort on both legs. We rendered her discomfort as restless legs syndrome (RLS) due to mirtazapine disposition. Therefore, we maintained mirtazapine of 15 mg/day at evening and added clonazepam of 1 mg/day at morning and evening for the control of RLS. After 7 days observation, the patient complained of aggravated natures of RLS and wanted to stop the drug. Though the effectiveness of mirtazapine for control of depressive symptoms, the drug was switched to paroxetine of 20 mg/day at 16th hospitalized day and 4 days later the RLS was completely terminated.
Alprazolam ; Anxiety ; Clonazepam ; Depression ; Depressive Disorder, Major ; Female ; Humans ; Leg ; Middle Aged ; Paroxetine ; Restless Legs Syndrome* ; Sensation