Development of a versatile sample preparation method and its application for rare-earth pattern and Nd isotope ratio analysis in nuclear forensics.

An improved sample preparation procedure for trace-levels of lanthanides in uranium-bearing samples was developed. The method involves a simple co-precipitation using Fe(III) carrier in ammonium carbonate medium to remove the uranium matrix. The procedure is an effective initial pre-concentration step for the subsequent extraction chromatographic separations. The applicability of the method was demonstrated by the measurement of REE pattern and 143Nd/144Nd isotope ratio in uranium ore concentrate samples.

Parity in patients with chronic inflammatory arthritides childless at time of diagnosis.

OBJECTIVE: To assess parity in women with chronic inflammatory arthritides (CIA) childless at time of diagnosis. METHODS: Patients were selected from the Norwegian Disease-Modifying Anti-Rheumatic Drug (NOR-DMARD) registry. Each patient was matched by year of birth with 100 reference women from the Norwegian Population Registry. Data linkage for patients and references with the Medical Birth Registry of Norway (MBRN) identified all offspring until time of linkage (October 2007). Patients and corresponding references childless at the time of diagnosis were included in the analyses. Kaplan-Meier curves visualized the proportion of childless women and were compared by a log rank test. RESULTS: In all, 156 rheumatoid arthritis (RA), 107 other chronic arthritides (OCA), and 75 juvenile idiopathic arthritis (JIA) patients were childless at time of diagnosis. At the time of data linkage, the proportions (%) of childless RA/OCA/JIA patients versus references were 61.5/62.6/57.3 versus 46.9/42.9/41.0, respectively, all differences statistically significant. The log rank test showed lower parity in all diagnostic groups compared with references (p < 0.001 for RA and OCA and p = 0.002 for JIA). No difference in parity was observed between RA and OCA patients, but both diagnostic groups had lower parity than JIA patients (p = 0.001). Disease characteristics were similar between childless and fertile patients. CONCLUSIONS: Reduced parity was observed in all diagnostic groups compared with references. RA and OCA patients had lower parity than JIA patients, indicating that having the disease as a young adult may influence parity more than having the disease in childhood.

Postpartum onset of rheumatoid arthritis and other chronic arthritides: results from a patient register linked to a medical birth registry.

BACKGROUND: It is known that onset of rheumatoid arthritis (RA) is increased post partum. OBJECTIVE: To compare incidence rates between RA and other chronic arthritides (OCA) 0-24 months after delivery, and to compare the incidence rates within each group 0-24 versus 25-48 months post partum. METHODS: Premenopausal women from a Norwegian patient register were linked with the Medical Birth Registry of Norway to study the interval between delivery and time of diagnosis. Cox regression analysis with adjustments for age at delivery and birth order was applied to compare proportions of incident cases of RA and OCA with onset 0-24 months post partum. Poisson regression analysis with adjustment for the population at risk was applied to estimate the incidence rate ratio (IRR) 0-24 versus 25-48 months post partum. RESULTS: Of 183 RA and 110 patients with OCA diagnosed after delivery, 69 (37.7%) had RA and 31 (28.2%) OCA during the first 24 months post partum (p = 0.09). The IRR (95% CI) for diagnosis during 0-24 months versus 25-48 months was 1.73 (1.11 to 2.70) (p = 0.01) for RA, 1.05 (0.59 to 1.84) (p = 0.86) for OCA. The IRR was 2.23 (1.06 to 4.70) and 1.87 (0.67 to 5.21), respectively, when only considering diagnoses after the first pregnancy. Clinical characteristics were similar within each diagnostic group. CONCLUSION: The proportions of incident cases with onset 0-24 months after delivery were not different between RA and OCA. A peak in incidence during 0-24 months was seen in the RA group, both when considering all pregnancies and only the first pregnancy.

Comparison of work disability and health-related quality of life between males and females with rheumatoid arthritis below the age of 45 years.

OBJECTIVES: To compare work disability (WD) and health status between males and females with rheumatoid arthritis (RA) in the age group 18-45 years, and to compare health status between patients with and without WD within each gender, and finally to identify factors independently associated with WD in this age group. METHODS: A cross-sectional study of RA patients at the time starting with disease-modifying antirheumatic drug (DMARD) therapy and/or biological treatment. Patients receiving a permanent, national WD pension corresponding to >or= 50% were defined as work disabled. We examined gender differences with regard to disease characteristics, health status and WD. The Mann-Whitney U-test and Pearson's chi(2)-test were applied for group comparisons. Multiple logistic regression analyses with adjustments for duration of education, disease duration, age, erosive disease, disability score [using the Modified Health Assessment Questionnaire (MHAQ)], Disease Activity Score-28 (DAS-28), the Short Form Health Survey (SF-36) mental health score and gender were used to identify variables associated with WD. RESULTS: Out of 474 (372 females) patients, the number (%) of work-disabled females/males was 91 (24.7)/8 (8.1) (p<0.001). WD was associated with worse health status in both genders. The odds ratio (95% confidence interval) [OR (95% CI)] for WD in females vs. males was 4.84 (1.85-12.65) in the multivariate analyses. Other factors independently associated with WD were worse mental health, disease duration and low level of education. CONCLUSION: Females with RA had a fourfold increased risk of WD compared to men. Low level of education, disease duration and worse mental health were also independently associated with WD.

Work disability and health-related quality of life in males and females with psoriatic arthritis.

OBJECTIVES: To compare health status, demographic variables and work disability (WD) between males and females with psoriatic arthritis (PsA) in the 18-45 age group, and further to compare health status between those with and without WD for each gender and to identify variables associated with WD. METHODS: A cross-sectional study was carried out of patients with PsA with peripheral arthritis at the time at which they started disease-modifying antirheumatic drug therapy (DMARD) and/or biological treatment. Patients receiving a permanent national WD pension corresponding to >or=50% were defined as work disabled. Gender differences were examined with regard to health status, demographic variables and WD. Mann-Whitney U test and Pearson chi(2) were applied for group comparisons between males and females and work disabled versus not work disabled for each gender. Multiple logistic regression analyses with adjustments for duration of education, disease duration, age, erosive disease, disability score (Modified Health Assessment Questionnaire; MHAQ), the short form-36 (SF-36) mental health score, and gender were used to identify variables associated with WD. RESULTS: Out of 271 (102 females) patients, the number (%) of work-disabled females/males was 33 (32.7%)/29 (17.4%) (p = 0.004). Work-disabled patients had generally worse health status than non-work-disabled patients, and these differences were generally more pronounced in males than in females. In the multiple logistic regression model, low educational level, increasing disability score (MHAQ), presence of erosive disease, female gender and disease duration were independently associated with WD. CONCLUSIONS: WD in patients with PsA below 45 years of age was independently associated with educational level, disability score, erosive disease, female gender and disease duration.

Nuclear forensic investigations: two case studies.

This paper describes the methodology and analytical methods used in nuclear forensic investigations. Two case studies are taken as examples to illustrate this. These examples represent typical cases that have been analysed at the Institute for Transuranium Elements (ITU) since last 10 years, i.e. the beginning of the illicit trafficking of nuclear materials. Results of the various analytical techniques are shown, which, together with other type of information, reveal the origin of the material.

Determination of the age of highly enriched uranium.

This paper describes the analytical methods (thermal ionization mass spectrometry, inductively coupled plasma mass spectrometry, and alpha spectrometry) that have been developed for determination of the age of uranium and discusses their advantages and limitations. With regard to potential application of the methods (e.g. Fissile Material Cut-off Treaty), the discussion focuses on highly enriched uranium, because this seems to be of highest strategic relevance. The different analytical methods were tested and validated by use of uranium reference materials of different (235)U isotope abundance and of known ages. The results show that thermal ionization mass spectrometry and alpha spectrometry are both very accurate and precise techniques for this application. Inductively coupled plasma mass spectrometry, on the other hand, although less precise, because of the different approach to the analytical problem, is still sufficiently accurate to be used as a rapid screening method.

[Takayasu's arteritis]. / Takayasus arteritt.

BACKGROUND: Takayasu's arteritis is a chronic, idiopathic, inflammatory disease that affects aorta and its main branches. The disease is rare; its etiology is unknown and shows race differences. The inflammation of the arteries may lead to stenosis, occlusions, dilatations or aneurysms. The clinical picture and angiographic findings are not previously reported in a Norwegian cohort. MATERIAL AND METHODS: We report a retrospective, hospital-based study describing the clinical picture, diagnostic findings, treatment and prognosis in a cohort of six patients in Central Norway with Takayasu's arteritis. The data was extracted through chart review. RESULTS: In the period 1988-2000, six patients with Takayasu's arteritis, five women and one man, were identified. All the patients were of Norwegian origin. Median age at diagnosis was 39 years, range 24-63 years, and median time from first symptoms to definite diagnosis was six months, range 1-36 months. The estimated minimum annual incidence was 0.8 per million. All patients had elevated erythrocyte sedimentation rate; five out of six patients had unilateral or bilateral subclavian stenosis; one patient had a thoracoabdominal aneurysm. All patients were treated with prednisolone. There were no deaths in the observation period of median 7.5 years, range 0-26 years. INTERPRETATION: Takayasu's arteritis is a rare disease in our region, with lower incidence than reported in the literature. The prognosis is excellent, but the morbidity was substantial. The clinical findings are similar to those reported in other studies. The location and appearance of the angiographic findings were characteristic for the disease.

Age determination of plutonium material in nuclear forensics by thermal ionisation mass spectrometry.

Age is a key parameter when deducing the history of plutonium material, i.e. the plutonium produced in the nuclear reactors. This is of vital importance, when a smuggled plutonium sample has been seized and the origin has to be determined. A methodology is described which allows accurately to determine the age of plutonium material by thermal ionisation mass spectrometry using independent parent/daughter relations. This has been demonstrated for Reference Materials of known ages as well as for real samples. The already established method using gamma spectrometry is compared to this.

Renal transplantation in polycystic renal disease--a joint Scandinavian report.

During the period 1965-1977, a total of 339 patients with polycystic renal disease received at least 1 renal transplant at one of 10 transplant centres in Scandinavia. Patient survival at one year was 67%. The one year graft survival of 319 cadaveric grafts was 40%. The average age of the patient was 56.7 years. Patients who were 60 years or older (93 patients) had a significantly poorer patient and graft survival at one year (50% and 29.5% respectively). Patients receiving kidneys with O incompatibilities did significantly better than other donor-recipient combinations. Previous blood transfusions were associated with better graft prognosis, though the difference was only significant for 2 years. The incidence of posttransplant urinary tract infection (present in 47% of all the patients) was twice as common in patients with a history of pretransplant urinary tract infection (seen in 41% of all the patients). There was no association between posttransplant septicaemia and either pre- or post-transplant urinary tract infection. Only 10.5% of the patients were nephrectomized at the time of transplantation, half of these had urinary tract infection. Twenty-four per cent of the patients were nephrectomized in the posttransplant period, half of these because of infection. There was no difference in the graft survival data of the patients with or without pretransplant urinary tract infection. These findings justify a restrictive practice with regard to pretransplant nephrectomy in patients with polycystic renal disease.

Plasma vasopressin in conscious goats after cerebroventricular infusions of angiotensins, sodium chloride, and fructose.

Using a sensitive RIA, the levels of plasma arginine vasopressin (pAVP) were determined from jugular venous blood of conscious goats given cerebroventricular (c.v.) infusions of angiotensins, saralasin, NaCl, and fructose. In hydrated goats, c.v. angiotensin II (0.1--1.0 microgram) caused a dose-dependent rise of pAVP, drinking, and antidiuresis. The same responses were obtained after angiotensin III (1.8 microgram) and hypertonic NaCl (0.5 M), but the effect on water intake was less striking. [des1,2]Angiotensin II hexapeptide and isotonic NaCl (0.15 M) failed to affect these variables. In nonhydrated goats, there were no changes in drinking, diuresis, or pAVP after c.v. infusions of saralasin (5.0 microgram) and isotonic NaCl (0.15 M). Fructose (0.3 M) infusions lowered the pAVP, apparently by reducing the cerebrospinal fluid (CSF) Na+ concentration, while the renal free water clearance turned positive. Angiotensin III thus carries the minimal structural requirements for pAVP release via central nervous receptors in the goat. Lack of a saralasin effect suggests that, in the nonhydrated goat, angiotensin II may not regulate pAVP via receptors accessible to the CSF. Sodium-sensitive cells monitoring the Na+ concentration of the CSF seem to control the pAVP.

Renal transplantation in amyloidosis.

During a three-year period renal transplantation was performed in 12 patients with amyloidosis. This disease was primary (or the cause unknown) in two cases and secondary in ten. In the latter cases the primary disease was rheumatoid arthritis in six, ankylosing spondylitis in one, osteomyelitis in two and tuberculosis in one. Five of the 12 patients were alive one year after transplantation. Two years after transplantation four out of seven were alive. Graft survival was the same. At the end of the three-year period five patients were alive. In two of these cases renal biopsy showed amyloid deposits in the transplant two and three years, respectively, after the transplantation.

Parathyroidectomy in chronic renal failure.

During the period 1971-1976, subtotal parathyroidectomy was performed on 34 patients with chronic renal failure, representing 8% of all uraemic patients treated on the Renal Ward. Preoperative treatment of renal failure was conservative therapy in 6, haemodialysis in 20 and renal transplantation in 8 patients. The operation was indicated by grave clinical symptoms (pruritus, bone pains and mental disturbances), gastric ulcer and radiological abnormalities (osteoporosis, fractures, subperiosteal resorption and metastatic calcifications). The serum immunoreactive parathyroid hormone was determined in 13 cases, and the value was elevated in all. The serum calcium level was elevated in 8 out of 34 cases. Less than 500 mg of parathyroid tissue was removed in 12 cases, between 500 and 6000 mg in 19 and over 6000 mg in 3. Nodular hyperplasia was present in 11 patients, diffuse hyperplasia in 23. Postoperatively marked falls in serum parathyroid hormone and serum calcium values were observed. The bone pains, pruritus and mental disturbances were alleviated, and the general condition was favourably influenced. The operation had a lesser and more retarded effect on the radiological changes. Complete recovery was only achieved with successful renal transplant. Parathyroidectomy often had a favourable effect on the grave symptoms and may, therefore, be considered in some cases of severe hyperparathyroidism secondary to chronic renal failure.

Plasma vasopressin in ethanol intoxication and hangover.

The effect of ethanol intoxication and hangover on immunoreactive plasma arginine vasopressin (AVP) concentration was studied in 7 healthy supine men in controlled clinical conditions. In 6 subjects plasma AVP increased above control values at the time of maximal blood ethanol concentration. The highest AVP values were observed in the subjects having nausea and vomiting and the worst hangover symptoms. During hangover plasma AVP values were higher than the controls and the response of plasma AVP to upright posture was exaggerated. The dissociation of plasma AVP concentration and ethanol diuresis suggested that the suppression of AVP release is not the sole determinant of ethanol diuresis. The study may indicate that the toxic effects of ethanol and the severity of hangover symptoms are associated with the state of hydration and individual sensitivity of AVP triggering mechanisms.

Renal transplantation in polycystic kidney disease.

Thirty-one renal transplantations were performed in 25 patients with end-stage polycystic disease of the kidneys. Of the 14 recipients transplanted with both polycystic kidneys in situ and followed for at least 6 months, 10 had a previous history of urinary tract infection. Four of these 14 recipients had relapsing urinary tract infection after transplantation, the other 10 have been at risk on immunosuppressive therapy for a total of 152 months and have had no trouble that could be attributed to the presence of the polycystic kidneys. Despite the potentiality of polycystic kidneys to be a source of post-transplant infection when left in situ, a good outcome of renal transplatation could be achieved without preparative bilateral nephrectomy. The one-year patient and graft survivals are comparable to those obtained in our total transplantation series and renal transplantation is considered to be an acceptable therapy in polycystic disease.

Inappropriate secretion of antiduretic hormone, hypertension, and hypoplastic corpus callosum.

The threshold of serum osmolality causing release of vasopressin (antidiuretic hormone) was shifted to an abnormally low level (262 mosmol/kg H2O) in a 14-year-old girl with hypertension and signs of hypoplastic corpus callosum. There was a physiologically meaningful control of vasopressin release in response to water restriction and water load. Plasma vasopressin concentrations (range 1.2--11.9 pg/ml) were of the same magnitude as those of healthy adults, being abnormally high only when related to the hypotonicity of serum observed. Plasma concentrations of angiotensin II were higher than expected from the suppressed levels of plasma renin activity. Blood-pressure response to angiotensin II infusion was increased. Resetting of the osmostat and hypertension may both be explained by lesions of the central nervous system.

Secondary hyperparathyroidism and parathyroidectomy in terminal chronic renal failure.

Subtotal parathyroidectomy was performed on 34 patients with severe renal insufficiency. The indications were grave clinical symptoms (pruritus, bone pains and mental disturbances), gastric ulcer and radiological abnormalities (metastatic calcifications, osteoporosis, fractures and subperiostal resorption). The serum calcium level was elevated in eight cases. The serum parathormone value was determined in 13 cases, it was elevated in all cases. Less than 500 mg tissue was removed in 12, between 500 and 6000 mg in 19 and over 6000 mg in 3 cases. Nodular hyperplasia was demonstrated in 11 and diffuse hyperplasia in 23 patients. The serum calcium and parathormone levels fell markedly after the operation, and pruritus, bone pains and mental disturbances were markedly alleviated. Complete recovery was achieved only by a successful renal transplantation, but the operation had often a favourable effect on the grave symptoms.