[Rupture of the Achilles tendon--case report of a rare form of Achilles tendon damage]. / Achillessehnenlösung--Kasuistik einer seltenen Form der Achillessehnenschädigung.

The great increase in the number of persons engaged in sports in the 30-50 years age group has led to a marked increase in injuries of the tendon of Achilles. In this case there is tearing loose of the Achilles tendon; the bone and the tendon come apart, as in a rupture of Sharpey's fibres. The tack was made in webbing the tendon of Achilles with polydioxanone ligaments to the tuberosity of calcaneus. The question about prophylactic webbing of the degenerated tendon of Achilles on the other side has to be discussed. Assessment of this injury from the viewpoint of the accident insurance company is explained.

[The effect of the small intestine on 3-methylhistidine metabolism in the human]. / Der Einfluss des Dünndarms auf den 3-Methylhistidin-Stoffwechsel des Menschen.

20 male adult Sprague-Dawley rats were fed exclusively parenterally. After achieving metabolic equilibrium they received a duodenoileostomy and subtotal resection leaving only 8-10% of the small gut. On the 1st postoperative day the urinary 3-MH excretion rose to 1.5-1.7 times the preoperative level, but on the 12th-14th postoperative day it fell again and was equal to the preoperative basal level. A control group of 10 rats undergoing a small gut anastomosis without resection yielded similar results. We conclude that the small gut source does not make a significant contribution to 24h-urinary 3-MH excretion in the adult rat. The transient postoperative increase in urinary 3-MH excretion is probably due to post-injury metabolism. In contrast to these are the measurements in two male patients with a short bowel syndrome because of an occlusion of the superior mesenteric artery. Both patients have a body weight of 60 kg, are aged 44 and 45 years respectively, and have a 24h-urinary 3-MH excretion of 120.7 +/- 28 mumol. More than 1 year after operation they are being nourished parenterally in metabolic equilibrium. The 24h-urinary 3-MH excretion in a similar control group of 8 healthy male volunteers is 229.4 +/- 25 mumol (measurements for 6 days after a 1-week meat-free diet). We conclude that the small gut source makes a significant contribution to 24h-urinary 3-MH excretion in the adult human. There is no evident correlation between the rat model and measurements in human.

The contribution of small gut to the 3-methylhistidine metabolism in the adult rat.

Twenty male adult Sprague-Dawley rats received parenteral nutrition following a duodenoileostomy which left only 8% to 10% of the small gut intact. On the first postoperative day, the urinary 3-methylhistidine (3-MH) excretion rose to 1.5 to 1.7 times the preoperative level but fell again within 12 to 14 days to the basal level. A control group of 10 rats with small gut anastomosis without resection yielded similar results. We conclude that, at least in rats, the small intestine does not make a significant contribution to 24-hour urinary excretion of 3-MH. The transient postoperative rise in 3-MH excretion is probably due to postinjury metabolism.

[The influence of the small intestine on the metabolism of 3-methylhistidine in the rat]. / Einfluss des Dünndarms auf den Stoffwechsel von 3-Methylhistidin der Ratte.

20 male adult Sprague-Dawley rats were fed exclusively parenterally. After achieving metabolic equilibrium they received a duodenoileostomy and subtotal resection leaving only 8-10% of the small gut. On the 1st pop. day the urinary 3-MH excretion rose to 1.5-1.7 of the preoperative level, but on the 12th-14th pop. day it fell again and was equal to the preoperative basal level. A control group of 10 rats undergoing a small gut anastomosis without resection yielded similar results. We conclude that the small gut source does not make a significant contribution to 24 h-urinary 3-MH excretion in the adult rat. The transient postoperative increase in urinary 3-MH excretion is probably due to post-injury metabolism.