Isolation of filamentous fungi from sputum in asthma is associated with reduced post-bronchodilator FEV1

Background

Fungal sensitization is common in severe asthma, but the clinical relevance of this and the relationship with airway colonization by fungi remain unclear. The range of fungi that may colonize the airways in asthma is unknown.

Objective

To provide a comprehensive analysis on the range of filamentous fungi isolated in sputum from people with asthma and report the relationship with their clinico-immunological features of their disease.

Methods

We recruited 126 subjects with a diagnosis of asthma, 94% with moderate-severe disease, and 18 healthy volunteers. At a single stable visit, subjects underwent spirometry; sputum fungal culture and a sputum cell differential count; skin prick testing to both common aeroallergens and an extended fungal panel; specific IgE to Aspergillus fumigatus. Fungi were identified by morphology and species identity was confirmed by sequencing. Four patients had allergic bronchopulmonary aspergillosis.

Results

Forty-eight percent of asthma subjects were IgE-sensitized to one fungal allergen and 22% to ≥ 2. Twenty-seven different taxa of filamentous fungi were isolated from 54% of their sputa, more than one species being detected in 17%. This compared with 3 (17%) healthy controls culturing any fungus (P < 0.01). Aspergillus species were most frequently cultured in isolation followed by Penicillium species. Post-bronchodilator FEV₁ (% predicted) in the subjects with asthma was 71(± 25) in those with a positive fungal culture vs. 83 (± 25) in those culture-negative, (P < 0.01).

Conclusion and Clinical Relevance

Numerous thermotolerant fungi other than A. fumigatus can be cultured from sputum of people with moderate-to-severe asthma; a positive culture is associated with an impaired post-bronchodilator FEV₁, which might be partly responsible for the development of fixed airflow obstruction in asthma. Sensitization to these fungi is also common.

Influence of agro-waste amendment on soil microbial population in relation to plant growth response

Introductions of high yielding inorganic fertilizer are not cheap and leave behind a large amount of dry matter for disposal. Thus there is a need to utilize these plant residues to save fertilizers and maintain a satisfactory level of soil fertility. Hence, with the view of in-situ manuring as well as to recycle the agricultural residue, pot experiments were conducted to study the effect of wheat husk amendments on soil microbial population and seedling vigour index (SVI) of wheat. Results of pot experiment showed the improvement in soil fungal population followed by bacterial and actinomycetal counts. Statistical significant increase in plant growth was also recorded as compared to unamended control, which indicates the practical possibility in utilizing wheat husk for improvement is soil fertility

Epidemiological considerations and clinical features of ENT tuberculosis

Between 1 April 1996 and 30 June 1997, 1003 ear, nose and throat (ENT) outpatients and 340 inpatients diagnosed as having pulmonary tuberculosis were analysed for ENT manifestations of tuberculosis to determine the relationship to sputum positivity, whether any high risk factors exist for the ENT manifestations as compared to other pulmonary tuberculosis patients, and the response to anti-tubercular treatment. The commonest ENT manifestation was found to be laryngitis (seven cases), which was more common in pulmonary tuberculosis patients (five out of seven), all except one of whom were sputum negative. All of these patients were defaulters from anti-tuberculosis treatment or relapse cases, and vocal cords were the commonest site of involvement. One case of tuberculous tonsillitis and one case of tuberculous mastoiditis were also noted. The practical implications of an awareness of ENT tuberculosis is a benefit of anti-tubercular therapy and hence conservative management usually suffices.

Diffusion in Fe(II/III) radiation dosimetry gels measured by magnetic resonance imaging

We analyse the diffusion problem in the traditional Fe(II/III) agarose gel system employed in MRI studies of radiation dosimetry. The diffusion coefficient is measured using an inversion recovery null-point imaging method in a model gel/water phantom. The diffusion coefficient of Fe(III) in 1% agarose gel at pH 1.1 is D = 2.7 +/- 0.3 x 10(-6) cm2 s-1. The diffusion coefficient of Fe(II) is D = 3.3 +/- 0.5 x 10(-6) cm2 s-1. Measurement of the diffusion coefficients permits simulation of the MRI signal intensity from phantoms with model radiation dose distributions. We allow for diffusion of both Fe(II) and Fe(III) in our simulations as well as the effect of both relaxation agents on the local spin-lattice relaxation time T1. We also analyse the effects of the physical penumbra on the diffusion problem.

Homogeneous irradiation of the "short-necked" laryngeal cancer patient

A technique for homogeneous irradiation of the "short-necked" laryngeal cancer patient is presented. The method is similar to a previously described technique in that inferiorly angled opposed lateral beams are used with tissue compensators and beam wedges. The advantages of the technique presented here are that the patient is treated supine rather than sitting and therapy simulation is more easily carried out. Experimental verification of the calculated radiation distributions was carried out in a water phantom having the same shape as the patient. These results show the extent of dose homogeneity and in addition show that neglecting tissue inhomogeneity, the measured and calculated dose distributions agree within 2%.