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AIMS: To compare leak-point intravesical pressure and cystometric capacity in complete and incomplete spinal cord injury (SCI) patients with neurogenic detrusor overactivity (NDO). METHODS: Retrospective study of filling cystometry at non-physiological filling rate in 80 SCI patients at rehabilitation or annual check-up using Dantec Etude urodynamic machine. RESULTS: Fifty neurologically complete (ASIA (American Spinal Injury Association) A) and 30 incomplete (ASIA B-E) were diagnosed with neurogenic detrusor overactivity, all with suprasacral level of injury. Mean Pves leak-point pressure (Pves LPP) at cystometric capacity for ASIA A group was 79 +/- 30 cmH(2)O (range 26-140) and mean Pves LPP for ASIA B-E group was 70 +/- 29 cmH(2)O (range 25-130). There was no significant difference between groups (P = 0.234). Mean CC (cystometric capacity) for ASIA A group was 239 +/- 107 ml (range 47-526) and mean CC for ASIA B-E group was 227 +/- 125 ml (range 42-500). Again, no significant difference was found (P = 0.655). CONCLUSIONS: No difference in cystometric capacity and intravesical leak point pressure at terminal detrusor overactivity was shown between complete and incomplete spinal cord injury patients in our survey, that is, represented findings are equally unfavorable for both groups. Incomplete SCI patients with NDO should be tested with cystometry and observed with same caution as we proceed in complete SCI patients.

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STUDY DESIGN: Case report. OBJECTIVES: To report a rare case of hemodialysis-associated amyloidosis of cervical spinal canal with incomplete tetraplegia in long-term hemodialysis patient. SETTINGS: Traumatology Clinic, Zagreb; Spinal Unit, Varazdinske Toplice, Croatia. METHODS: Forty-seven-year-old male patient at long-term hemodialysis treatment developed progressive limbs weakness, graded as C4 ASIA C. Cervical computed tomography myelography showed extreme narrowing of the spinal canal. Decompressive laminectomy with bilateral foraminotomies was performed and histological examination revealed amyloidal deposition. RESULTS: Rehabilitation program started immediately after surgery with physical and occupational therapy, along with psychological support aiming at restoring full activities of daily living. Three months after surgery, the patient returned to his community, neurologically improved to ASIA E. Hemodialysis program was regularly maintained perioperatively and during the rehabilitation. CONCLUSION: Vertebral involvement with neurological deterioration in hemodialysis-associated amyloidosis patients prompts for early diagnosis, surgical and rehabilitation management, in this instance with good outcome.Spinal

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AIM: To assess whether the 1991-1995 war has stimulated development of the medical rehabilitation system in Croatia. METHODS: Review of documents pertaining to the system, study of clinical reports describing rehabilitation activities as published in the Croatian medical literature, study of data obtained and their consideration in terms of effectiveness and quality of rehabilitation care, and comparison of data from 1991 with those from 1995. RESULTS: There has been no significant change in the number of rehabilitation facilities, beds, and rehabilitation professionals. However, elements of structure and process of rehabilitation care have improved in respect of 1) education and composition of rehabilitation professionals, 2) availability of specialized facilities for rehabilitation of patients with complex impairments (traumatic brain and spinal cord injuries), 3) interdisciplinary team approach, 4) use of functional status measurements, and 5) laying the foundations for community-based rehabilitation in the country. CONCLUSION: The 1991-1995 war has stimulated the development of medical rehabilitation system in Croatia. Other factors may have played a complementary role, too. This proves that medical rehabilitation is a field that develops in association with war.

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The increased number of young people with spinal cord injuries in Croatia led us to study their functional abilities after completing medical rehabilitation and extended hospitalisation, as due to destroyed homes, they had no place to return to. They were all wounded during war in Croatia (1990-1992) and their average age was 27 years. Our tetraplegic patients achieved a mean Modified Barthel Index (MBI) of 57.3 after completing medical rehabilitation and 6l.3, 3 years later, which is a significantly higher rate than is given in Yarkony's study (30.3-37.8) where American civilian patients were monitored. Patients with paraplegia showed similar results (74.5-76.8) relating to those published by Yarkony (72.0-75.6).

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We wanted to define the concept of extracranial exactly and to find out which level of cervical spine has the most essential influence on REG curve forming. 919 patients coming for treatment in Spine disease diagnostic centre of Orthopaedic clinic at Zagreb Faculty of Medicine have been elaborated. According to the results, it can be concluded that cervical segment C5-C6 is the most essential according to the influence on positiveness of REG and that reoencephalography shows us the influence of lower part of cervical spine on artery vertebralis while we don't get information about the influence of craniovertebral area on REG.

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By fixateur interna light for spine fractures introduced and used by Magerl and Dick, we wanted to estimate fixateur interna validity by Nankovic. We considered 37 patients with spine fracture, operated by method previously mentioned. With no patient there was no deformation or fixateur fracture during the rehabilitation. With 3 patients (8%) fixateur was removed according to documentation because of infection. Because of all the things mentioned we consider the fixateur to be good and applied in the case of any indication for it.

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Metastasis disease is often located at the spine, especially with solid tumors where frequency can reach 80%. Indications for metastasis operational approach are threatening or existing neurologic deficit, static dislocations or even unbearable pain. Operation treatment may be extensive, with radical metastasis removal or even partial one with decompressive laminectomy and tumor reduction and spine stabilization. Using various kinds of alenthesis, the authors have used their own vertebra artificial limb in 10 cases, which enables spine stabilization after radical vertebra removal. They report their experience in the essay.

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A comprehensive disposition and metabolism study of epichlorohydrin (ECH) has not been previously reported. In this study, male Fischer 344 rats were dosed (6 mg/kg) orally with [2-14C]ECH (98% radiochemically pure) as an aqueous solution and killed after 3 days. Approximately 38% of the radioactive dose was exhaled as CO2, 50% was excreted as metabolites in the urine, and 3% was present in the feces. Radioactivity in tissues accounted for the remainder of the administered dose. When expressed per gram of tissue, radioactivity was highest in liver, kidney, and forestomach. The half-life of initial elimination of radioactivity in both the urine and exhaled air was about 2 hr, indicating that ECH was rapidly absorbed and metabolized. The major metabolites in the urine were identified as N-acetyl-S-(3-chloro-2-hydroxypropyl)-L-cysteine and alpha-chlorohydrin, about 36 and 4% of the administered dose, respectively. Finding these metabolites, which have not been previously reported, is consistent with the initial metabolic reactions being conjugation of the epoxide with glutathione and hydration of the epoxide.

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The flame retardant, tris(2,3-dibromopropyl)phosphate (tris-BP), which is a mutagen and causes cancer and sterility in animals is absorbed from fabric by people. 2,3-Dibromopropanol, a metboloite of tris-BP and a mutagen itself, has been found in the urine samples of ten children who were wearing or who had worn tris-BP-treated sleepwear. Eight of these children were wearing well-washed sleepwear and the possibility of absorption of tris-BP from well-washed sleepwear discussed. 2,3-Dibromopropanol was not found in the urines of one child and one adult who had never worn tris-BP-treated garments.

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Contemporary analytical systems based on mass spectrometry include as components a gas chromatograph, a mass spectrometer, and a computer. The form of operation is usually in electron impact ionization mode for identification and structural studies, and in chemical ionization mode for quantitative analyses. Important stages in the development of these systems included the design of "molecule separators" for the concentration of solutes in the gas phase, the use of mass spectrometers as specific ion detectors, the introduction of chemical ionization techniques, and the development of computer-based operation, data acquisition, and data analysis capabilities. A current line of investigation is concerned with the design and use of systems based on atmospheric pressure ionization. Samples are ionized in a small reaction chamber external to the low-pressure region of a quadrupole mass analyzer. The primary source of electrons is a 63Ni foil or a corona discharge. The ionization process leading to positive ions involves a sequence of ion molecule reactions, usually electrons leads to carrier gas ions leads to reagent ions leads to sample component ions. Negative ions may be formed by direct electron attachment, or by ion molecule reactions that include new types of elimination reactions. The source will accept a variety of gases and solvents. The sample may be introduced in the gas phase without solvents, by probe injection, or in the effluent stream from a gas chromatograph. Samples may be introduced in the liquid phase in solvents by injection after the fashion of gas chromatography or in the effluent stream from a high-performance liquid chromatograph. The novel aspects of atmospheric pressure ionization mass spectrometry lie in its versatility and high sensitivity of detection. Few clinical chemistry laboratories now use these systems. Significant future uses are likely to be in analytical work involving therapeutic drug monitoring and studies of drug metabolism, and in analyses for environmental biohazards including pesticides, herbicides, polyhalobiphenyls, dibenzodioxins, and other toxic compounds.

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