Human herpesvirus-6 and human herpesvirus-7 in the bone marrow from healthy subjects.

BACKGROUND: Human herpesviruses (HHVs) 6 and 7 are recently discovered betaherpesviruses. Although HHV-6 has been associated with disordered hematopoiesis in bone marrow transplant recipients, little information is available on the presence of both viruses in the bone marrow from healthy subjects. METHODS: We detected HHV-6 and HHV-7 DNA by means of polymerase chain reaction in bone marrow and peripheral blood samples from 18 healthy subjects who underwent total hip arthroplasty. RESULTS: Genomic HHV-6 and HHV-7 DNA were detected in 11% and 67% of the blood samples, respectively, and in 28% and 50% of the bone marrow samples, respectively. CONCLUSIONS: Both viruses may be present in the bone marrow without hematopoiesis disorder and can be transmitted through bone marrow infusion. Therefore, the causative role of these two viruses in some bone marrow diseases cannot be inferred simply from the detection of their genome in bone marrow by means of polymerase chain reaction.

[Embolization of the circumflex femoral artery for recurrent hemorrhage after total hip arthroplasty. Apropos of a case]. / Embolisation de l'artère circonflexe postérieure pour hémorragie récidivante après prothèse totale de hanche. A propos d'une observation.

Reoperation of an haemorrhagic complication after total hip arthroplasty may be not efficacious when, as in the case report, bleeding's origin is not found. The vital prognosis can be quickly set in action and then the arterial embolization be the swift and efficacious solution. The selective arteriography that precedes it allows to locate the bleeding's origin, to estimate gravity of leak and to set indication of embolization. So it is fitting to think of this therapeutic solution that may avoid new operation and new failure.

[Internal plantar flap. Apropos of 30 cases]. / Le lambeau plantaire interne. A propos de 30 cas.

Thirty medial plantar flaps were used in twenty seven patients with large defects in soft tissues of the lower extremity. We performed that flap described in 1981 by Harrison for ankle defects (9 cases) and heel defects (21 cases). The etiology of the defect was a traumatic avulsion in 14 cases, a sole pressure in 10 cases and neurologic ulcer in 6 cases. The surgical procedure was performed in 5 operative sequences: 1--excision of the receptor site 2--disection of the posterior tibial artery and plantaris medialis artery 3--raising of the flap including plantar skin and aponeurosis, respecting the flexor hallucis brevis muscle 4--rotation of the flap and suture on the receiptor site 5--skin graft on the donor site Antibiotics were used according to the per-operative swabs. Full weight bearing was authorized on the 45th day. We observed no failure for heel localization. But in dorsal part of the ankle, we deplore 4 failures (on 9 cases). The rotation for ankle defects was rather important and the risk was squeezing the artery. We used 3 times the medial plantar flap as a cross foot. We observed 1 failure; the possibility of long pedicled flap (parallel legs), the innocuity for the donor site, the quality of the transferred skin are arguments for using that flap in a cross leg of rather small dimension. We successfully performed two more cross legs using this technique since that study. We think that the medial plantar flap is the best technique for heel reconstruction. The quality of the skin transferred is very able to make a secondary thickening reproducing exactly the consistence of the heel. The fiability of that flap is very high for the heel localisations (no failures on 21 cases).

Prevention of heterotopic ossification in hip arthroplasty. The influence of the duration of treatment.

A retrospective study has been carried out to assess the effectiveness of indomethacin in preventing heterotopic ossification after total hip arthroplasty, and the effect of using it for different periods of time. One hundred and sixty-eight hips operated on in 1983 were not given indomethacin and acted as a control. One hundred and fifty hips operated on in 1988 were given indomethacin and divided into 3 groups: 42 received indomethacin for 5 days, 49 for 11 days and 59 for 45 days. The results indicate that ossification is significantly reduced in those patients receiving indomethacin for 5 and 11 days, but there was no additional reduction when it was given for 45 days. Treatment should begin on the night of operation and continued for 11 days while the patient remains in hospital.