Treatment of waste incinerator air-pollution-control residues with FeSO4: concept and product characterisation.

This paper describes a new concept for treatment of air pollution-control (APC) residues from waste incineration and characterises the wastewater and stabilised residues generated by the process. The process involves mixing of APC-residues with a ferrous sulphate solution and subsequent oxidation of the suspension (Ferrox-process 1996). The process results in a significant reduction in the leaching of salts and heavy metals from the residue, by washing out most of the salts and by binding the heavy metals in the iron oxides formed. In the laboratory, a semidry gas-cleaning residue and a fly ash were treated by the process. The generated wastewater contained low concentrations of heavy metals (e.g. Pb: 27-39 microg l(-1) and Cd: 2.6-4.6 microg l(-1)), but high concentrations of salts (e.g. Cl, Na, K, and Ca). The treatment process redUced the leaching of Pb from the residues by more than two orders of magnitude at fixed pH as determined by pH-static leaching tests. Likewise, the leaching of Cd, Zn and Cu was significantly reduced. The effect on elements that form oxyanions (e.g. Cr) is marginal and in the current process there is no reduction in the release of Hg.

High temperature co-treatment of bottom ash and stabilized fly ashes from waste incineration.

Bottom ashes from two Danish municipal solid waste incineration plants were heated at 900 degrees C with iron oxide stabilized air pollution control residues at actual mass flow ratios (9:1), simulating a treating method for the residues. The two residues were co-treated, producing one combined stream that may be utilized as a secondary road construction material. Scanning electron microscope analysis and grain size distribution analysis indicated that sintering of the particles did not occur. Batch leaching tests at liquid/solid 10 l/kg at a range of pH-values (6-10) quantified with respect to Cd, Cr and Pb revealed significant positive effects of co-heating the ashes, although Pb showed slightly increased leaching. At a liquid/solid ratio of 10 l/kg the leachate concentrations were still low at pH 7-10 and the release of Pb was, thus, not expected to limit the utilization of the mixed ashes. The process, thus, fixates the metals in the solid residues without altering the leaching properties of the bottom ash too significantly.

Effect of long-term monitoring of glycosylated hemoglobin levels in insulin-dependent diabetes mellitus.

BACKGROUND: The value of routine measurements of glycosylated hemoglobin (hemoglobin A1c) in the care of patients with diabetes mellitus is uncertain. We undertook this study to determine whether knowledge of hemoglobin A1c values would result in improved metabolic control in a group of patients with insulin-dependent diabetes mellitus (IDDM). METHODS: We randomly assigned 240 patients with IDDM to one of two groups that were comparable in age, sex, duration of diabetes, and initial hemoglobin A1c levels. The patients were followed for a year, and the hemoglobin A1c concentration was measured at three-month intervals. The hemoglobin A1c values were used in assessing glycemic control and modifying therapy in one of the two groups. In the other, care givers were not aware of the hemoglobin A1c levels and relied on blood or urine glucose measurements to monitor treatment. RESULTS: Among the 222 patients still being followed after one year, the mean hemoglobin A1c value decreased significantly--from 10.1 to 9.5 percent (P less than 0.005)--in the group whose hemoglobin A1c level was monitored (n = 115), whereas the initial and one-year values in the control group (n = 107) were 10.0 and 10.1 percent, respectively. The proportion of patients with poor control, defined as those having a hemoglobin A1c value above 10.0 percent, decreased from 46 to 30 percent (P less than 0.01) in the group whose hemoglobin A1c level was monitored but did not change significantly (45 to 50 percent) in the control group. The patients in the group whose hemoglobin A1c level was monitored were seen and their insulin regimens changed more often, but they were hospitalized for acute care of their diabetes less often than those in the control group. A similar decrease in hemoglobin A1c values occurred in the control group in the following year, when their care givers knew their hemoglobin A1c values. CONCLUSIONS: Regular measurements of hemoglobin A1c lead to changes in diabetes treatment and improvement of metabolic control, indicated by a lowering of hemoglobin A1c values.

Discrepancies in assessment of metabolic regulation in insulin-dependent diabetes mellitus--can we do without measurements of glycated haemoglobin?

Our purpose was to compare physicians' assessment of metabolic control in insulin-dependent diabetes mellitus (IDDM) with measurements of glycated haemoglobin HbA1c. One hundred and twenty diabetics were evaluated by physicians without access to HbA1c. Simultaneously HbA1c was measured by a highly precise isoelectric focusing method (interval of non-diabetics 5.2-6.8%). A comparison between physicians' classification into good, acceptable or poor control, and a biochemical classification by HbA1c showed a considerable discrepancy. Identity between classifications was seen in 52%, but 30% of the diabetics were considered in good or acceptable control despite HbA1c values above 10.0%. Mean HbA1c was significantly higher in women than in men (p less than 0.01). Among patients, overrated by the physicians, were relatively more women, whereas no other differences could be demonstrated. Home blood glucose monitoring did not lead to better agreement between classifications. We conclude that measurements of HbA1c is presently the most accurate single assay of metabolic control in insulin-dependent diabetics.

Improved method for multisample evaluation of ligand binding to cells. Application to IL-2 receptor measurement.

A newly developed assay using microtitre plates with removable wells permits rapid measurements of IL-2 receptors. Triplicate or quadruplicate samples of several ligand dilutions are easily handled, thus giving more reliable results. In addition, measurement of binding parameters may be accomplished simultaneously on several cell lines. Results are presented which show that the binding assay may also be used for measuring binding constants of antibodies.

Urinary iodine excretion in a geographically stratified Danish population sample not affected by iodination programmes. A change towards higher values.

The excretion of urinary iodine was studied in a representative population sample from the county of Funen, Denmark, comprising 505 persons between 25-44 years of age, stratified according to geography, age, and sex. Urine samples were collected for 5 h during late afternoon and early evening. The 24-h iodine excretion was estimated on the basis of iodine and creatinine determinations using correlation equations determined in a pilot study of 50 men and women. The iodine excretion was significantly higher in men: 89 micrograms/24 h (median) than in women: 76 micrograms/24 h; the whole population: 85 micrograms/24 h. No significant differences were observed among the age groups studied. The iodine excretion was significantly higher in people living on small islands: 98 micrograms/24 h (median) compared with 84 micrograms/24 h in urban regions and 78 micrograms/24 h in rural districts. Median iodine excretion per gram of creatinine was 58.8 micrograms for the whole sample. The iodine excretion for men was 77% higher than reported in an earlier investigation performed in Funen, 1969, but still lower than internationally recommended (WHO).

Liver transplantation in a 48-year-old female with primary biliary cirrhosis.

In 1983, a Danish female with primary biliary cirrhosis underwent orthotopic liver transplantation (OLT). The transplantation took place in Groningen under a Danish-Dutch cooperation, at this writing, and more than four years after transplantation, the patient is still alive. The quality of her life has been dramatically improved, making possible her return to work. Liver tests, liver function, and biopsies are normal and without signs of development of primary biliary cirrhosis in the transplanted liver. Liver transplantation is now frequently performed at several centres throughout the world with an increasing success rate. In Scandinavia, centres have been established in Norway, Finland, and Sweden, whereas in Denmark the organisation of a programme for liver transplantation is still being discussed. Because of the extremely high costs, liver transplantation has to be approved medically and politically, and the brain death criteria have to be accepted before it can be considered as a generally accepted modality of treatment.

Comparison of overnight, morning and 24-hour urine collections in the assessment of diabetic microalbuminuria.

With the aim of comparing different urine collection periods in the assessment of micro-albuminuria, urinary albumin excretion rates (AERs) were measured in samples from 24 h, overnight, and morning urine collections in 54 patients aged 17 to 62 years with insulin-dependent diabetes mellitus with a mean duration of 15 years. The AER in overnight urine was found to be reduced by 25% compared to the rate in 24 h and morning urine. Assessing the ability to predict a 24 h AER within the microalbuminuric range (20-200 micrograms/min) we found a sensitivity of 90% and a specificity of 88% for both overnight and morning urine samples. These values were slightly improved by relating AER to the excretion of creatinine and it is concluded that overnight as well as morning urine collections can be used when diagnosing microalbuminuria in insulin-dependent diabetics. Furthermore the results show that the albumin to creatinine ratio in morning urine is a reliable estimate of 24 h AER and better than measurement of the albumin concentration alone.

Treatment of Graves' ophthalmopathy with cyclosporin A.

Six patients with Graves' ophthalmopathy (2 with acute and 4 with chronic alterations) were treated with cyclosporin A (10 mg/kg/day) for 5 weeks. This treatment had no effect on either the ocular manifestations (protrusion, eye muscle function) or subjective well-being of the patients. In contrast, creatinine clearance decreased from 83.5 to 55.5 ml/min during treatment, but normalized (94.9 ml/min) after cessation of the drug. A transient increase in serum 4-androstenedione was observed in 3 patients. We conclude that cyclosporin A has no convincing effect in the treatment of Graves' ophthalmopathy, but rather exerts serious renal effects.

Prediction of the course of Graves' disease after medical antithyroid treatment.

The course of thyrotoxicosis in 33 patients with Graves' disease was evaluated clinically and biochemically (free thyroxine index, serum triiodothyronine, thyroid stimulating antibodies, (TSAb), thyroid stimulating hormone binding inhibiting immunoglobulins (TBII)). Relapse of the disease was found to be correlated to anamnestic information of thyrotoxicosis among first degree relatives (predictive value 90%) and to concomitantly raised levels of TSAb and TBII at the start of treatment (predictive value 71%). Mean duration of treatment of patients with long-lasting remission was 16.8 months. When comparing various information used to predict relapse of Graves' disease, anamnestic information of familial predisposition to thyrotoxicosis carries the highest predictive value.

Autoradiographic demonstration of human 125I-interferon alpha in lysosomes of rabbit proximal tubule cells.

This investigation proves for the first time that by electron microscope autoradiography, 125I-interferon alpha can be located in the lysosomal system of the renal proximal tubule cells of the rabbit. The observation provides further evidence that the kidney has a major role in interferon catabolism.

A radioimmunoassay of human leukocyte interferon using protein A-containing Staphylococcus aureus.

We report the establishment of a radioimmune assay for human alpha-interferon using highly purified alpha-interferon labeled with iodine-125, a purified rabbit immunoglobulin directed against human interferon and the Cowan strain of Staphylococcus aureus. Radiolabeling conditions used do not change the antigenicity of interferon molecules. The regression of counts bound upon log. dose was found to be linear down to 10 units/ml of alpha-interferon (6-7 X10-12 M). This assay was specific for alpha-interferons derived from human peripheral blood leukocytes and from a continuous line of lymphoblastoid cells. No cross-reaction was found with either human beta-interferon or murine interferon. Neither human serum nor plasma interfered with the assay. Correlation between biological assay and radioimmune assay was found to be significant.

The epidemiology of thyrotoxicosis in Denmark. Incidence and geographical variation in the Funen region 1972-1974.

In a study based on a review of all thyroid function tests performed in the Funen region in Denmark over a three-year period, from Jan. 1, 1972 to Dec. 31, 1974, the annual incidence rates of thyrotoxicosis were found to be 46.5/100000 for women and 8.7/100 000 for men. In both sexes the age-specific rates rose with age. An analysis of the geographical distribution of the cases showed a significantly lower incidence rate among women from an urban than from rural areas. It is estimated that the life-time risk of developing thyrotoxicosis is 5% for women and 1% for men and that the prevalence rate of existing and previously diagnosed thyrotoxicosis is 1.4% for Danish women and 0.3% for Danish men.