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Background. Maturity-onset diabetes of the young (MODY) is commonly misdiagnosed as type 1 or type 2 diabetes. Common reasons for misdiagnosis are related to limitations in genetic testing. A precise molecular diagnosis is essential for the optimal treatment of patients and allows for early diagnosis of their asymptomatic family members. Objective. The aim of this study was to identify rare monogenic variants of common MODY genes in Japanese pediatric patients. Methods. We investigated 45 Japanese pediatric patients based on the following clinical criteria: development of diabetes before 17 years of age, a family history of diabetes, testing negative for glutamate decarboxylase-65 (GAD 65) antibodies and insulinoma-2-associated autoantibodies (IA-2A), no significant obesity, and evidence of endogenous insulin production. Genetic screening for MODY1 (HNF4α), MODY2 (GCK), MODY3 (HNF1α), and MODY5 (HNF1β) was performed by direct sequencing followed by multiplex ligation amplification assays. Results. We identified 22 missense variants (3 novel variants) in 27 patients (60.0%) in the GCK, HNF4α, and HNF1α genes. We also detected a whole exon deletion in the HNF1β gene and an exon 5–6 aberration in the GCK gene, each in one proband (4.4%). There were a total of 29 variations (64.4%), giving a relative frequency of 53.3% (24/45) for GCK, 2.2% (1/45) for HNF4α, 6.7% (3/45) for HNF1α, and 2.2% (1/45) for HNF1β genes. Conclusions. Clinicians should consider collecting and assessing detailed clinical information, especially regarding GCK gene variants, in young antibody-negative patients with diabetes. Correct molecular diagnosis of MODY better predicts the clinical course of diabetes and facilitates individualized management.

A major complication of blood donation is vasovagal reaction (VVR) with or without syncope. VVR occurs not only in the early phase, but also in the late phase after blood donation. We previously reported the hemodynamic characteristics of blood donors susceptible to early phase VVR. In the present study, we investigated the hemodynamic characteristics of those who developed late VVR. Ninety-six healthy volunteers donating 400 ml of whole blood were studied. After asking about their physical condition or routine questions for blood donation, blood pressure (BP) and heart rate (HR) were recorded while the donors were kept standing up for 3 min before and after blood collection. Questionnaires were distributed to all donors for reporting late VVR symptoms within 24 h. Those with younger age and lower diastolic blood pressure were more susceptible to late VVR (both p

Novel nonvolatile programmable switch for low-power and high-speed field-programmable gate array (FPGA) where flash memory is adjacently integrated to CMOS logic is demonstrated. The flash memory and the high-speed switching transistor (SwTr) are fabricated close to each other without deteriorating their respective performance. Furthermore, programming schemes to write and erase the flash memory are optimized so that the memory is successfully programmed without any damage to the SwTrs. Flash-based configuration memory in the nonvolatile programmable switch has only half the area of the conventional static random-access memory-based one, and it can be placed in each block in FPGA, enabling efficient power gating that offers low-power FPGA operation.

BACKGROUND: One of the serious complications of blood donation is vasovagal reaction (VVR) with syncope. This study was performed to determine if the measurement of hemodynamic responses to standing before blood collection (BC) was useful to identify the high-risk donors for VVR and also examined the effect of 300 mL of water ingestion in the prevention of VVR. STUDY DESIGN AND METHODS: Blood pressure and heart rate (HR) during 5 minutes of standing were examined before and after BC in 93 donors. Because HR increase of 6 of 7 donors who developed syncopal VVR during standing after BC was 15 beats per minute (bpm) or greater, those with HR increase of 15 bpm or greater were determined as high-risk donors (n = 31). In another group (n = 117), 45 donors were identified as high risk based on the HR response before BC (≥15 bpm). The effect of 300 mL of water ingestion 15 minutes before BC on hemodynamic responses to standing and the rate of VVR after BC were analyzed. RESULTS: Water ingestion given to the high-risk donors of the second group reduced HR increase with standing before BC (−6.6 ± 13.6 bpm, p

The demand for random numbers for security applications is increasing. A conventional random number generator using thermal noise can generate unpredictable high-quality random numbers, but the circuit is extremely large because of large amplifier circuit for a small thermal signal. On the other hand, a pseudo-random number generator is small but the quality of randomness is bad. For a small circuit and a high quality of randomness, we purpose a non-stoichiometric SixN metal–oxide–semiconductor field-effect transistor (MOSFET) noise source device. This device generates a very large noise signal without an amplifier circuit. As a result, it is shown that, utilizing a SiN MOSFET, we can attain a compact random number generator with a high generation rate near 1 Mbit/s, which is suitable for almost all security applications.

本研究は，重症慢性閉塞性肺疾患（chronic obstructive pulmonary disease，以下COPD）患者の希望を脅かす要素を抽出，記述することを目的とした．10名の研究参加者に対し，半構造化面接を実施し，得られたデータを質的帰納的に分析した．その結果，重症COPD患者の希望を脅かす要素として，《七転八倒の息苦しさの持続》，《衰え・悪化を知る兆しや証拠》，《活動を妨げる感覚》，《個人としての価値や人格を無視した周囲の対応》の4つのカテゴリーが抽出された．COPD患者が絶望に苛まれることのないよう，このような体験にともなう重症COPD患者の苦痛や苦悩に関心を向け，寄り添う看護師の態度は重要である．看護師は希望を脅かす要素の可能な限りの除去や最小化，あるいは適切な対処へと導くこと，また，それが困難な場合に生じた苦痛や苦悩の緩和をはかることにより，重症COPD患者が絶望を回避，希望を維持できるよう助ける必要がある．

We present a case report of a 63-year-old male who underwent lung resections for metastases originating from gastric cancer 18-year after total gastrectomy with lymphadenectomy. The gastrectomy was performed in 1994; histological examination of the original tumor revealed stage II poorly differentiated adenocarcinoma [pT2 (MP), N0, M0]. Chest X-ray and computed tomography in 2012 showed a well-defined tumor, 9 mm in size, at the left S3 of the lung. Thoracoscopic partial resection was performed. The tumor was diagnosed as poorly differentiated carcinoma, most likely metastatic gastric adenocarcinoma. Although rarely performed, resection of pulmonary metastases from carcinoma of the stomach was done to improve the patient’s chances for long-term survival.

Novel nonvolatile programmable switch for low-power and high-speed FPGA where MONOS flash is adjacently integrated to CMOS logic is demonstrated. The MONOS transistors (MTrs.) and low-voltage switching transistors (SwTrs.) are fabricated close to each other without deteriorating each performance. Furthermore, memory programming scheme is optimized to realize selective writing with no damage in the SwTrs. MONOS-based configuration memory has a half area of conventional SRAM, and it can be placed in each block in FPGA. That enables efficient power gating (PG) that offers low-power FPGA operation.

In this work, because of the high-amplitude random noise at high frequency from the SiN MOSFET, we need only a single amplifier and A/D converter, and the amplifier area is decreased.

A novel nonvolatile memory tunnel layer structure is proposed in which a Si nanocrystalline layer lies between double tunnel oxides. By Si nanocrystal size downscaling to 2 nm, the new double junction tunnel attains a remarkable 3×106 times retention improvement while keeping high-speed write/erase compared to single tunnel oxide. Based on Si nanocrystal size confirmation by transmission electron microscope (TEM), we show quantitatively that the advantage is due to Coulomb blockade and quantum confinement, and smaller Si nanocrystal will lead to greater improvement. We clarify a characteristic effect in double junction tunnel, tunnel penetration disappearance, which is extremely advantageous for nonvolatile memory applications and never occurs in other multilayer dielectrics structures. The double tunnel junction using Si nanocrystalline layer is very promising for future memory.