HemaSpot, a Novel Blood Storage Device for HIV-1 Drug Resistance Testing.

HemaSpot, a novel dried-blood storage filter device, was used for HIV-1 pol resistance testing in 30 fresh United States blood samples and 54 previously frozen Kenyan blood samples. Genotyping succeeded in 79% and 58% of samples, respectively, improved with shorter storage and higher viral load, and had good (86%) resistance mutation concordance to plasma.

Virus entry via the alternative coreceptors CCR3 and FPRL1 differs by human immunodeficiency virus type 1 subtype.

Human immunodeficiency virus type 1 (HIV-1) infects target cells by binding to CD4 and a chemokine receptor, most commonly CCR5. CXCR4 is a frequent alternative coreceptor (CoR) in subtype B and D HIV-1 infection, but the importance of many other alternative CoRs remains elusive. We have analyzed HIV-1 envelope (Env) proteins from 66 individuals infected with the major subtypes of HIV-1 to determine if virus entry into highly permissive NP-2 cell lines expressing most known alternative CoRs differed by HIV-1 subtype. We also performed linear regression analysis to determine if virus entry via the major CoR CCR5 correlated with use of any alternative CoR and if this correlation differed by subtype. Virus pseudotyped with subtype B Env showed robust entry via CCR3 that was highly correlated with CCR5 entry efficiency. By contrast, viruses pseudotyped with subtype A and C Env proteins were able to use the recently described alternative CoR FPRL1 more efficiently than CCR3, and use of FPRL1 was correlated with CCR5 entry. Subtype D Env was unable to use either CCR3 or FPRL1 efficiently, a unique pattern of alternative CoR use. These results suggest that each subtype of circulating HIV-1 may be subject to somewhat different selective pressures for Env-mediated entry into target cells and suggest that CCR3 may be used as a surrogate CoR by subtype B while FPRL1 may be used as a surrogate CoR by subtypes A and C. These data may provide insight into development of resistance to CCR5-targeted entry inhibitors and alternative entry pathways for each HIV-1 subtype.

Phenotypic characterization of HIV type 1 isolates from Ghana.

Viral isolates from 27 HIV-1-infected patients in Ghana, most of whom were symptomatic, were characterized for coreceptor usage using MT-2 and U87.CD4 cells. Irrespective of clinical status, most infections were caused by CCR5-tropic viruses although three CXCR4-tropic viruses were also found. Genotyping was performed by sequencing the gp41 region. Seven viruses clustered with subtype G reference strains, while the remaining 20 viruses clustered within the subtype A reference viruses. Most subtype A isolates clustered loosely with the CRF02_AG viruses and are described as CRF02_AG-like. The V3 loop was sequenced in selected isolates including all isolates capable of using CXCR4. The V3 region of CXCR4-using viruses contained genetic traits characteristic of CXCR4-using subtype B and C viruses, such as increased charge, the presence of positively charged residues at positions 11 and 25, and loss of a predicted glycosylation site. This study supports previous work showing that CRF02_AG is responsible for most HIV-1 infections in Ghana at this time. The predominance of CCR5-using viruses, even in symptomatic patients, suggests that CCR5-blocking strategies may be useful for prevention and treatment of HIV-1 infections in Ghana.

Neutron radiography and other NDE tests of main rotor helicopter blades.

A few nondestructive examination (NDE) techniques are extensively being used worldwide to investigate aircraft structures for all types of defects. The detection of corrosion and delaminations, which are believed to be the major initiators of defects leading to aircraft structural failures, are addressed by various NDE techniques. In a combined investigation by means of visual inspection, X-ray radiography and shearography on helicopter main rotor blades, neutron radiography (NRad) at SAFARI-1 research reactor operated by Necsa, was performed to introduce this form of NDE testing to the South African aviation industry to be evaluated for applicability. The results of the shearography, visual inspection and NRad techniques are compared in this paper. The main features and advantages of neutron radiography, within the framework of these investigations, will be highlighted.

Laparoscopic versus open surgical exploration in premenopausal women with suspected acute appendicitis.

OBJECTIVES: To assess the utility of laparoscopic versus conventional surgical exploration in premenopausal women with suspected acute appendicitis. METHOD: Female patients aged 15-45 years in whom an independent decision to undertake surgical exploration had been made, were randomised to laparoscopic or open procedures. Comparison of patient groups was conducted on an intention-to-treat basis. RESULTS: Eighteen patients underwent laparoscopic exploration, with 1 procedure requiring conversion to lower midline laparotomy. Open surgical exploration was performed primarily in 16 patients. Postoperative complications (3 patients versus 1 patient) and diagnostic errors (5 patients versus 1 patient) were more frequent in patients undergoing open surgical procedures. Laparoscopic procedures tended to be of longer duration than open operations, but were generally associated with slightly more favourable indices of postoperative recovery (analgesic requirement, postoperative hospitalisation, return to normal activity, return to work). In patients found not to have acute appendicitis, the difference in mean postoperative hospitalisation following laparoscopic intervention (2.6 days) and conventional surgery (3.4 days) approached statistical significance (p < 0.1). CONCLUSIONS: Laparoscopy may carry some diagnostic advantage over open surgery in premenopausal women with suspected acute appendicitis. Patients found not to have acute appendicitis have a marginally shorter period of hospitalisation after laparoscopic intervention. The outcome following laparoscopic appendicectomy for confirmed acute appendicitis is at least equivalent to that achieved with conventional appendicectomy. Laparoscopic exploration is an acceptable option in premonopausal women requiring surgery for suspected acute appendicitis.

Toxic epidermal necrolysis in a burn patient complicated by acute pancreatitis.

This report concerns a previously healthy patient who presented with 8% total body surface area burn wounds to his face and neck. Even though his burn wounds healed quickly, his course was complicated by the development of toxic epidermal necrolysis affecting 60% total body surface area due to a drug reaction. During the recovery period he subsequently developed jaundice and pancreatitis -- a rare and interesting course that is not well described in the literature.

Parental response to their child's hearing impairment.

The differential patterns of behaviour of hearing parents (30 married couples) who cope with the reality of parenting a hearing-impaired child were studied. Responses on the Questionnaire on Resources and Stress indicated no significant differences between mothers and fathers for pessimism, child characteristics, and physical incapacitation. Mothers obtained a significantly higher stress-response on their perception of difficulties for themselves, other family members, and the family as a whole. Parents with more education reported less stress than those with less education. Mothers perceived the emotional support they received from their spouses as insufficient and the amount of free time they had for themselves as inadequate.