Failure to cure Mycobacterium gordonae peritonitis associated with continuous ambulatory peritoneal dialysis

Nontuberculous mycobacteria are increasingly recognized as important pathogens in peritonitis associated with continuous ambulatory peritoneal dialysis (CAPD). Mycobacterium gordonae rarely causes human infection and is the least likely mycobacterium to produce clinical infection in CAPD patients. We describe a patient with persistent M. gordonae peritonitis acquired while undergoing CAPD. During 18 months of treatment, clinical improvement occurred but a microbiological cure could not be achieved. Principles of therapy for mycobacterial peritonitis developing during CAPD are reviewed, and potential explanations for our patient's failure to respond to therapy are discussed.     

The ground water behaviour pattern and foundation stabilisation practice at hartebeestfontein

Hartebeestfontein Gold Mining Company Limited, which produces 100 kg of gold per working day, has a mining lease area situated mainly over dolomite. A major river nearby governs the regional drainage. The formation of sinkholes and dolines, caused by fluctuations in the water table and the flow of water underground, often accelerated as the result of unavoidable or inadvertent surface activities, is common in such terranes. To maintain production, meticlous ground investigations under new installations plus periodic re-examination and stabilisation under existing ones, particularly key installations, is necessary. The local ground water behaviour pattern is controlled by three impervious major dykes and two major fissure zones, the latter draining surface water into the mine workings. Monthly water table measurements over 25 years show a steady rise to a limit over the area of one fissure zone and a drastic lowering over the other. The value of gravity techniques and thermal infra-red line scanning for cavity detection in the Hartebeestfontein context, is discussed. The procedures followed, for stabilising ground and foundations, are illustrated by means of case histories. The extension of the techniques, learnt from the stabilisation experience, to limiting water seepage into shafts sunk through dolomite, is also discussed.     

System Operational Evaluation of Mine Monitoring Systems

In the testing of mine monitoring systems, a software package was developed for the mine monitoring test facility designed at West Virginia University. The software establishes delay times of sensor input to annunciation for single alarms and multiple simultaneous alarms. The alarm measurement techniques for the test fixture are described, as is the software developed to analyze and graph monitoring system response data. Also included is the analysis capability of the facility, the criteria for evaluating mine monitoring systems, and typical test data from a sample system.     

Genetic marking shows that Ph+ cells present in autologous transplants of chronic myelogenous leukemia (CML) contribute to relapse after autologous bone marrow in CML

Relapse after autologous bone marrow transplantation for chronic myelogenous leukemia (CML) can be due either to the persistence of leukemia cells in systemic tissues following preparative therapy, or due to the persistence of leukemia cells in the autologous marrow used to restore marrow function after intensive therapy. To help distinguish between these two possible causes of relapse, we used safety-modified retroviruses, which contain the bacterial resistance gene NEO, to mark autologous marrow cells that had been collected from patients early in the phase of hematopoietic recovery after in vivo chemotherapy. The cells were then subjected to ex vivo CD34 selection following collection and 30% of the bone marrow were exposed to a safety-modified virus. This marrow was infused after delivery of systemic therapy, which consisted of total body irradiation (1,020 cGy), cyclophosphamide (120 mg/kg), and VP-16 (750 mg/m2). RT PCR assays specific for the bacterial NEO mRNA, which was coded for by the virus, and the bcr-abl mRNA showed that in two evaluable CML patients transplanted with marked cells, sufficient numbers of leukemia cells remained in the infused marrow to contribute to systemic relapse. In addition, both normal and leukemic cells positive for the retroviral transgenome persisted in the systemic circulation of the patients for at least 280 days posttransplant showing that the infused marrow was responsible for the return of hematopoiesis following the preparative therapy. This observation shows that it is possible to use a replication-incompetent safety-modified retrovirus in order to introduce DNA sequences into the hematopoietic cells of patients undergoing autologous bone marrow transplantation. Moreover, this data suggested that additional fractionation procedures will be necessary to reduce the probability of relapse after bone marrow transplantation in at least the advanced stages of the disease in CML patients undergoing autologous bone marrow transplantation procedures.