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TORU AIZAWA, MD 4OBJECTIVE -The goal of this study was to know the fate of albuminuria in Japanese patients with type 2 diabetes under tight blood pressure and glycemic control.RESEARCH DESIGN AND METHODS -Patients having normoalbuminuria (urinary albumin excretion Ͻ30 mg/g creatinine, n ϭ 179) or microalbuminuria (albumin excretion 30 -299 mg/g creatinine, n ϭ 94) at baseline have been followed up for 8 years: ratio of men to women was 160/113, the mean age was 58 years, pretreatment HbA 1c (A1C) was 8.8%, and blood pressure was 136/76 mmHg. A1C Ͻ6.5% and blood pressure Ͻ130/80 mmHg were targeted, and the A1C of 6.5 Ϯ 0.7% (mean Ϯ SD) and blood pressure of 127 Ϯ 11/72 Ϯ 6 mmHg have been maintained during the 8 years. Development of microalbuminuria or macroalbuminuria (albumin excretion Ն300 mg/g creatinine) in initially normoalbuminuric patients and progression to macroalbuminuria or regression to normoalbuminuria in initially microalbuminuric patients were assessed at year 8.RESULTS -Development occurred in 27 (15%) of the normoalbuminuric patients and progression and regression in 16 (17%) and 20 (21%), respectively, of the microalbuminuric patients. Significant independent relationships existed between development and higher achieved mean systolic blood pressure (SBP) and regression and lower achieved mean SBP. In the patients with achieved mean SBP Ͻ120 mmHg, development was 3%, progression was 11%, and regression was 44% during 8 years. Prediction for nephropathy by blood pressure and glycemia alone was limited. Nevertheless, albumin excretion at year 8 was positively correlated with achieved mean SBP and baseline albuminuria.CONCLUSIONS -Development and progression were low and regression was high with SBP of 120 mmHg, provided A1C was maintained at 6.5%. Diabetes Care 28:2733-2738, 2005D iabetic nephropathy is now the leading cause of end-stage renal failure in Europe, the U.S., and Japan (1), and the establishment of an effective treatment strategy for diabetic nephropathy is of paramount importance. In particular, early intervention is hoped to bring about 1) the prevention of new development of nephropathy, 2) the prevention of progression of early-phase nephropathy, and 3) the regression of existing nephropathy (1-3). Urinary albumin excretion (UAE) is a marker of earlyphase diabetic nephropathy (1-3), and the amount of UAE correlates with renal pathologic changes in both type 1 and type 2 diabetes (4). Accordingly, many studies have been performed with UAE as a marker of diabetic nephropathy (5-7). The development and progression of nephropathy were improved by glycemic and blood pressure controls as expected (5-8). Antihypertensive therapy and improved glycemic control were independent predictors of the regression from micro-to normoalbuminuria (8). In this study, we analyzed the fate of early-phase diabetic nephropathy as indexed by the change in UAE in Japanese patients with type 2 diabetes over an 8-year period. In particular, the relationship between blood pressure and the state of albuminuria...

SUMMARYIn this paper, we present an accurate behavioral model for simulating single-photon avalanche diodes (SPADs). The device operation is described using the Verilog-A description language, which is an analog extension of the common digital hardware description language. The derived model is able to emulate the static, the dynamic behavior and the main statistical effects of an SPAD, such as the turn-off probability, the dark-count and the after-pulsing phenomena. Spectre simulations reveal the validity of the approach showing a good matching between the behavior of the proposed model and experimental results reported in the literature.

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In this brief, two simple semi-analytical models which allow the estimation of the propagation delay of an RC-chain with a linear input are presented. The closed-form models can be used to evaluate the propagation delay of wires in modern VLSI and ULSI processes. The two approximations, a continuous function and a piecewise function, exhibit a maximum error lower than 15% at the end of the chain. The models have been validated extensively through circuit simulations. In particular, 1000 different RC-chains have been considered and simulated demonstrating the accuracy of the proposed models with respect to the most widely used Elmore delay metric.

A methodology to design high-speed power-efficient MOS Current-Mode Logic (MCML) static frequency dividers is proposed. Analytical criteria to exploit the speed potential of MCML gates are first introduced. Then, an analytical strategy is formulated to progressively reduce the bias currents through the stages without affecting the divider operation speed, thereby reducing the overall power consumption.\ud The proposed design approach is general and independent of the process adopted. Thanks to its simplicity, it can be used in a pencil-and-paper approach, avoiding a tedious and time-consuming trial-and-error approach based on simulations. Moreover, the analytical approach allows for a deeper understanding on the power-delay trade-off involved in the design. As a design example, a 1/8 frequency divider is designed and simulated by using a 0.18-um CMOS process