Magnetic ordering in Sr2RuO4 induced by nonmagnetic impurities

We report unusual effects of nonmagnetic impurities on the spin-triplet superconductor Sr2RuO4. The substitution of nonmagnetic Ti4+ for Ru4+ induces localized-moment magnetism characterized by unexpected Ising anisotropy with the easy axis along the interlayer c direction. Furthermore, for x(Ti) > 0.03 magnetic ordering occurs in the metallic state with the remnant magnetization along the c-axis. We argue that the localized moments are induced in the Ru4+ and/or oxygen ions surrounding Ti4+ and that the ordering is due to their interaction mediated by itinerant Ru-4d electrons with strong spin fluctuations.Comment: 5 pages, 4figure

Scleral buckling procedure with chandelier illumination for pediatric rhegmatogenous retinal detachment

Toshiyuki Yokoyama, Koki Kanbayashi, Tamaki YamaguchiDepartment of Ophthalmology, Juntendo University Nerima Hospital, Tokyo, JapanPurpose: To assess the treatment of pediatric patients with rhegmatogenous retinal detachment (RRD) by scleral buckling with chandelier illumination.Methods: Three eyes were treated in three patients, healthy boys aged 7 years, 12 years, and 11 years, with RRD, macular involvement, and small retinal holes, of which two were preoperatively undetectable. Conventional scleral buckling with cryoretinopexy was performed under the contact lens for vitreous surgery or noncontact wide-angle viewing system using 27-gauge twin chandelier illumination.Results: The only known predisposing factor for retinal detachment was myopia stronger than 3 D with lattice retinal degeneration in two of the three patients. Retinal reattachment was achieved in all cases without intra- or postoperative complications. However, visual recovery was limited in one of the three patients.Conclusion: Scleral buckling with chandelier illumination is effective for pediatric RRD, especially if the retinal hole is difficult to detect preoperatively. However, visual recovery was sometimes limited because of macular involvement due to late diagnosis, which is one of the characteristic features of pediatric RRD.Keywords: pediatric rhegmatogenous retinal detachment, chandelier illumination, scleral bucklin

Inpatient phase-advance therapy for delayed sleep–wake phase disorder: a retrospective study

Masahiro Takeshima,1 Tetsuo Shimizu,2 Masaru Echizenya,3 Hiroyasu Ishikawa,1,4 Takashi Kanbayashi1 1Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan; 2Mental Health and Welfare Center, Akita, Japan; 3Echizenya Sleep and Mental Clinic, Akita, Japan; 4Department of Neuropsychiatry, Nakadori Rehabilitation Hospital, Akita, Japan Purpose: The efficacy of inpatient phase-advance therapy among patients with delayed sleep–wake phase disorder (DSWPD) has not been adequately investigated because response rates are considered low. We aimed to examine the efficacy of such treatment in this patient population.Patients and methods: The present retrospective study included data from 66 patients with DSWPD who had been admitted to Akita University Hospital for inpatient phase-advance therapy between September 1, 2005, and April 30, 2018. DSWPD was diagnosed based on the International Classification of Sleep Disorders, 3rd edition, criteria using electronic medical records. We examined remission rates during inpatient therapy as well as relapse rates at the time of the first outpatient examination following discharge. Univariate analysis was performed to investigate predictive factors for postinpatient therapy relapse.Results: The rate of DSWPD remission over the course of inpatient phase-advance therapy was 100% (95% CI: 95.6%–100%), with a median duration of 1 day (IQR: 1–2 days; range: 1–9 days) until remission. The rate of relapse following discharge was 45.8% (95% CI: 32.7%–59.2%). Univariate analysis indicated that the rate of relapse was significantly higher for minors (under 18) than adults (18 and over), for those whose age at onset was below 16 years than for those whose age at onset was 16 or above, and for those with relatively low motivation for their occupation (P=0.0339, P=0.0136, and P<0.001, respectively).Conclusion: The rate of DSWPD remission under inpatient phase-advance therapy was remarkably high (100%), while the rate of relapse after discharge was ~50%. Further studies are required to determine the long-term prognosis of inpatient therapy, risk factors for relapse, and the types of treatment most effective for preventing relapse. Keywords: delayed sleep–wake phase disorder, chronotherapy, sleep disorders, circadian rhythm sleep disorder

Incidence of venous thromboembolism in psychiatric inpatients: a chart review

Masahiro Takeshima,1,* Hiroyasu Ishikawa,1,2,* Kazumi Shimizu,3 Takashi Kanbayashi,1 Tetsuo Shimizu1 1Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan; 2Department of Neuropsychiatry, Nakadori Rehabilitation Hospital, Akita, Japan; 3Palliative Care Center, Akita University Hospital, Akita, Japan *These authors contributed equally to this work Purpose: Venous thromboembolism (VTE) is the combination of pulmonary embolism (PE) and deep vein thrombosis. In recent years, VTE has been gaining attention in the field of psychiatry as it can cause sudden deaths in patients hospitalized in psychiatric departments. The purpose of this study was to investigate the incidence of VTE in psychiatric inpatients using contrast-enhanced computed tomography (CT). Patients and methods: At the psychiatric department of the Akita University Hospital, NANOPIA® D-dimer was measured in patients with suspected symptomatic VTE or believed to be at risk for asymptomatic VTE. A follow-up contrast-enhanced CT was also performed in cases of D-dimer values over 1 µg/mL. Patients diagnosed with VTE based on contrast-enhanced CT during hospitalizations between May 1, 2009 and April 30, 2017 were analyzed. VTE incidence was compared in restrained and unrestrained catatonic and noncatatonic patients. We also investigated whether VTE was symptomatic or asymptomatic as well as its outcomes. Results: The overall incidence of VTE was 2.3% (39/1,681) in the 8-year period. VTE was observed in 61.1% (11/18) of catatonic patients, 4.1% (11/270) of noncatatonic restrained patients, and 1.2% (17/1,393) of noncatatonic unrestrained patients. PE was observed in 76.9% (30/39) of VTE patients and 97.4% (38/39) of VTE patients were asymptomatic. Recovery was achieved in all cases of VTE treated with anticoagulation therapy. Conclusion: These results indicate that the risk of VTE is high in psychiatric inpatients and that PE is common in these population. The data may also suggest that contrast-enhanced CT is important in surveying thrombus in suspected cases of VTE. In the psychiatric field, proper attention must be given to VTE, regardless of the presence or absence of catatonia or restraint, particularly given that PE was observed in more than 75% of cases of VTE. Keywords: computed tomography, deep vein thrombosis, D-dimer, psychiatric patients, catatonia, pulmonary embolis