OBJECTIVETo investigate the effect of ultrasonic wave on extracting Konjac Glucomannan(KGM) in Konjac refined powder.

METHODFree reduced sugar in Konjac refined powder was removed and Konjac refined powder in the aqueous solution was processed by ultrasonic wave and KGM content was measured by spectrophotometry.

RESULTKGM content in the Konjac refined powder aqueous solution by ultrasonic process at fixed 40 kHz, 100 W, 30-45 min was equal to that by routine method at 4 h; whereas, by 1 h of ultrasonic process, KGM content was significantly enhanced than that by 4 h of routine method(P < 0.01), enhancement rate was 6.5%. Linearity of standard glucose was good (r = 0.9996) in range of 0.2-1.6 mg. The average recovery was 97.8%, RSD of repeatability was 1.27%.

CONCLUSIONUltrasonic extraction in aqueous solution is a reliable and rapid method that can enhance extraction efficiency of KGM in Konjac refined powder.

Amorphophallus ; chemistry ; Mannans ; analysis ; isolation & purification ; Powders ; Ultrasonics

OBJECTIVETo evaluate the clinical value of serum 1,3-beta-D-glucan (BG) and galactomannan (GM) detection for early diagnosis of invasive aspergillosis (IA) in patients after renal transplantation.

METHODSBlood samples collected from 69 renal transplant recipients were divided into diagnosis group, clinical diagnosis group, suspected diagnosis group, and non-infected group for detection of serum BG and GM.

RESULTSThe mean serum levels of BG in the diagnosis group, clinical diagnosis group, and suspected diagnosis group were significantly higher than that in non-infected group (P<0.05). The sensitivity, specificity, and positive and negative predictive values of BG was 69.49%, 70%, 93.18% and 35.71% for IA diagnosis, respectively. The serum levels of GM in the 3 diagnosis groups were also significantly higher than that in the non-infected group (P<0.05) with the sensitivity, specificity, and positive and negative predictive values of 84.75%, 90%, 96.15% and 52.63% for IA diagnosis, respectively.

CONCLUSIONIncreased serum BG and GM levels can serve as the evidence for early diagnosis of IA with a high diagnostic sensitivity and specificity in renal transplant recipients.

Aspergillosis ; diagnosis ; Early Diagnosis ; Humans ; Kidney Transplantation ; Mannans ; blood ; Sensitivity and Specificity ; beta-Glucans ; blood

BACKGROUND: Invasive aspergillosis (IA) is an important cause of morbidity and mortality among immunocompromised patients. However, IA is difficult to diagnose, especially in the aforementioned patient group. Recently, galactomannan assay (GMA) using enzyme immunoassay has been introduced in Korea. We evaluated its diagnostic usefulness in the diagnosis of IA and we analyzed the results according to the underlying diseases. MATERIALS AND METHODS: All patients who underwent GMA during the period from October 2007 to June 2008 were evaluated retrospectively. According to the criteria of European Organization for Research and Treatment of Cancer/Mycoses Study Group, IA was classified into four clinical categories: 'proven', 'probable', 'possible', and 'non' IA. Patients with 'proven' and 'probable' IA were used as the reference standards for IA. GMA was performed using Platelia Aspergillus EIA (Bio-Rad, Hercules, CA, USA). Optical density index > or =0.5 was considered positive. RESULTS: Of the 144 patients who underwent GMA, two patients were classificed as 'proven' IA and sixteen patients were 'probable' IA. Overall sensitivity, specificity, positive predictive value, and negative predictive value of the assay were 50% (95% confidence interval [CI95], 26-74%), 88% (CI95, 81-93%), 38% (CI95, 19-59%), and 93% (CI95, 86-97%), respectively. Among the 99 patients with underlying hematologic diseases, GMA showed 67% (CI95, 35-90%) sensitivity and 89% (CI95, 80-94%) specificity, whereas in 45 patients with underlying diseases other than hematologic diseases, sensitivity and specificity of the assay were 17% (CI95, 0-64%) and 87% (CI95, 73-96%), respectively. CONCLUSION: GMA showed high specificity, irrespective of the patient population. However, sensitivity of GMA was low and the assay was less sensitive in patients with underlying diseases other than hematologic diseases than in patients with hematologic diseases.
Aspergillosis ; Aspergillus ; Hematologic Diseases ; Humans ; Immunocompromised Host ; Immunoenzyme Techniques ; Korea ; Mannans ; Retrospective Studies ; Sensitivity and Specificity

BACKGROUND: Invasive aspergillosis (IA) is an important cause of morbidity and mortality among immunocompromised patients. However, IA is difficult to diagnose, especially in the aforementioned patient group. Recently, galactomannan assay (GMA) using enzyme immunoassay has been introduced in Korea. We evaluated its diagnostic usefulness in the diagnosis of IA and we analyzed the results according to the underlying diseases. MATERIALS AND METHODS: All patients who underwent GMA during the period from October 2007 to June 2008 were evaluated retrospectively. According to the criteria of European Organization for Research and Treatment of Cancer/Mycoses Study Group, IA was classified into four clinical categories: 'proven', 'probable', 'possible', and 'non' IA. Patients with 'proven' and 'probable' IA were used as the reference standards for IA. GMA was performed using Platelia Aspergillus EIA (Bio-Rad, Hercules, CA, USA). Optical density index > or =0.5 was considered positive. RESULTS: Of the 144 patients who underwent GMA, two patients were classificed as 'proven' IA and sixteen patients were 'probable' IA. Overall sensitivity, specificity, positive predictive value, and negative predictive value of the assay were 50% (95% confidence interval [CI95], 26-74%), 88% (CI95, 81-93%), 38% (CI95, 19-59%), and 93% (CI95, 86-97%), respectively. Among the 99 patients with underlying hematologic diseases, GMA showed 67% (CI95, 35-90%) sensitivity and 89% (CI95, 80-94%) specificity, whereas in 45 patients with underlying diseases other than hematologic diseases, sensitivity and specificity of the assay were 17% (CI95, 0-64%) and 87% (CI95, 73-96%), respectively. CONCLUSION: GMA showed high specificity, irrespective of the patient population. However, sensitivity of GMA was low and the assay was less sensitive in patients with underlying diseases other than hematologic diseases than in patients with hematologic diseases.
Aspergillosis ; Aspergillus ; Hematologic Diseases ; Humans ; Immunocompromised Host ; Immunoenzyme Techniques ; Korea ; Mannans ; Retrospective Studies ; Sensitivity and Specificity

OBJECTIVE: To analyze the diagnostic value of (1, 3) -β-D-glucan and galactomannan (GM) tests in the patients with acute leukemia complicated by invasive fungal disease, and explore the application of serological detection (G/GM) and lung CT for early diagnosis of invasive fungal disease (IFD). METHODS: A total of 493 patients with acute leukemia complicated by high risk invasive fungal infection, also receival G and GM tests, in Department of hematology of our hospital from June 2016 to December 2016 were selected and were divided into IFD-confirmed group (62 cases) including confirmed and clinical diagnesed IFD, and IFD-unconfirmed group (431 cases) including suspected IFD and non-IFD according to the diagnostic criteria of IFD. The results of G and GM tests in patients of 2 groups were analyzed, then the diagnostic efficacy of G and GM done and combination evaluated. In addition, 26 patients whose lung CT negative at hospitalization, moreover, presentation of changes in lung by CT during hospitalization and serological G and GM test positive were selected, and the difference of time between serological that postive and presentation of changes in lung by CT were compared for the estimation of early diagnotic value. RESULTS: The positive rate of (1, 3) -β-D-glucan in IFD-confirmed group and IFD-unconfirmed group was 56.5% and 10.4%, respectively. Meanwhile, that of galactomannan test was 41.9% and 9.0%, respectively. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of (1, 3) -β-D-glucan was 56%, 90%, 44% and 92%, and that of galactomannan was 42%、91%、40% and 93%, respectively. Moreover, the combination of (1, 3) -β-D-glucan and galactomannan could raise the sensitivity to 69% and specificity to 98%. The positive results of serological detection (G/GM) come earlier about five days than CT changes. CONCLUSION Both (1, 3) -β-D-glucan and galactomannan test have high sensitivity and specificity, and the combination of them can improve the diagnostic efficacy, and make the clinical antifungal therapy more precisely. In the early clinical diagnosis of IFD, the positive results of serological detection coming earlier than lung CT.
Humans ; Invasive Fungal Infections ; diagnosis ; etiology ; Leukemia, Myeloid, Acute ; complications ; Mannans

OBJECTIVE: To evaluate the accuracy and diagnostic value of bronchoalveolar lavage fluid galactomannan test (BALF-GM) combined with serum GM test on invasive pulmonary aspergillosis (IPA). METHODS: 190 cases of BALF-GM and 4 787 cases of serum GM specimens suspected of fungal infection in patients admitted to Affiliated Hospital of Jining Medical University from January 2016 to June 2018 were enrolled and analyzed. All patients were classified into clinically confirmed IPA, clinically diagnosed IPA, suspected IPA and excluded IPA according to the classification standard of Expert consensus on diagnosis and treatment of pulmonary mycosis. The coincidence rate of BALF and serum GM test results with clinical diagnosis was analyzed. Receiver operating characteristic (ROC) curve was performed, and the diagnostic value of BALF and serum GM test alone or in combination for IPA was evaluated. Subgroup analysis was performed in patients with normal or abnormal immune function, and the sensitivity and specificity of BALF and serum GM test were compared separately or jointly. RESULTS: The positive rate of BALF-GM was 46.8% (89/190), and 10.4% (497/4 787) on serum GM. Among them, 156 patients were both tested on BALF and serum GM. There were 44 cases with both positive in BALF and serum GM, the coincidence rate of clinical definite was 93.2% (41/44). There were 34 cases with positive BALF-GM and negative GM test in serum, and the coincidence rate of clinical definite was 64.7% (22/34). There were 56 cases positive in serum GM and negative in BALF-GM, and the coincidence rate of clinical definite was 48.2% (27/56). BALF and serum GM tests were both negative in 22 cases, and the coincidence rate of exclusion diagnosis was 90.9% (20/22). ROC curve analysis showed that the diagnostic value of BALF-GM test combined with serum GM test for IPA was better than that of BALF-GM test or serum GM test alone [area under ROC curve (AUC): 0.992 vs. 0.983, 0.976]. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 95.3%, 87.0%, 93.2% and 90.9%, respectively. Subgroup analysis showed that among 89 patients with positive BALF-GM test, 85 cases (95.5%) had normal immune function and 4 cases (4.5%) had unknown condition. Among 497 patients with positive serum GM test, 12 cases (2.4%) had normal immune function, 372 cases (74.9%) had abnormal immune function and 113 cases (22.7%) were uncertain. It was shown by ROC curve analysis that the sensitivity of positive BALF-GM test in diagnosis of IPA in patients with normal immune function was higher than that of positive serum GM test (95.6% vs. 88.9%), while the sensitivity of positive serum GM test in patients with abnormal immune function was higher than that of positive BALF-GM test (91.8% vs. 89.9%). CONCLUSIONS The results of BALF and serum GM tests are in good agreement with clinical diagnosis, and the combined detection of BALF and serum GM is more valuable for IPA diagnosis than single detection, especially for patients with unknown immune function.
Bronchoalveolar Lavage Fluid/chemistry* ; Galactose/analogs & derivatives* ; Humans ; Invasive Pulmonary Aspergillosis/diagnosis* ; Mannans/blood* ; Sensitivity and Specificity

OBJECTIVETo establish a quantitative method for the content determination and monosaccharide composition analysis of Konjac glucomannan (KGM) in Konjac refined powder by pre-column derivatization high performance liquid chromatographic method (HPLC).

METHODThe two derivatives combined reducing monosaccharides with 1-phenyl-3-methyl-5-pyrazolone (PMP) were separated by reverse-phase HPLC using a developed fragment gradient elution process, and monitored by ultraviolet detector at 250 nm. The broad reagent peak of PMP was separated very well from all the PMP-sugars, and good separation was achieved for derivatives of mannose and glucose. The quantitative methods of two reducing monosaccharides were studied by the method combined internal and external standard; while the KGM content in Konjac refined powder was determined.

RESULTLinearity of glucose was good (r = 0.9990) in range of 1.002-8.016 nmol; while mannose (r = 0.9994) in range of 1.001-8.008 nmol. The average recovery of this method was 98.1%, RSD of repeatability was 1.72%. KGM content in Konjac refined powder was 79.5%, ratio of glucose to mannose in KGM was 1:1.51.

CONCLUSIONThis method is a sample, convenient and rapid method that can determine KGM content and analyze monosaccharide compositions in KGM, which will be helpful to quality assessment of Konjac refined powder.

Amorphophallus ; chemistry ; Chromatography, High Pressure Liquid ; Glucose ; chemistry ; Mannans ; analysis ; chemistry ; Mannose ; chemistry ; Monosaccharides ; analysis ; Plants, Medicinal ; chemistry ; Powders ; chemistry

Degraded guar was prepared by acid with guar as the main material, which was then brought into reaction with chlorosulfonic acid under proper conditions, the sulfonated degraded guar was obtained successfully. The effects of sulfonation conditions on the SO4(2-) content were investigated, and the proper reaction conditions were determined. The results of infrared spectrometry showed that this sulfated derivative is a novel heparin-like polysaccharide. At the same time, the selective removal of low density lipoprotein (LDL) and fibrinogen (Fib) by degraded guar gum sulfate was studied. The experimental results showed that degraded guar gum sulfate is a novel LDL/ Fib purifying agent. When pH= 5.15 and the initial concentration of the degraded guar gum sulfate is 2500 mg/L, the reduction percentages were about 60%-66% for total cholesterol, about 76%-89% for LDL and very low-density lipoproteins (VLDL), and almost 100% for fibrinogen. There were no significant changes regarding the level of high-density lipoproteins and total proteins.
Fibrinogen ; analysis ; isolation & purification ; Galactans ; chemistry ; Hyperlipidemias ; blood ; Lipoproteins, LDL ; blood ; isolation & purification ; Mannans ; chemistry ; Plant Gums ; chemistry ; Sulfates ; chemistry

OBJECTIVETo develop a colon position pulsatile capsule drug delivery system of which the lag-time is controlled by a plug tablet mainly made of konjac glucomannan and evaluate its release profile in vitro.

METHODImpermeable capsule body was prepared by filling method, the plug tablet was pressed by direct compression, and the rapid-disintegrable drug tablets was made by wet granulation. The pulsatile capsules were prepared by putting the drug tablet into the impermeable body and sealed it with the plug tablet The factors affecting the lag-time were investigated by dissolution testing.

RESULTThe formulation of the rapid-disintegrable drug tablets influenced the pulsatile release of the drug, the composition of the plug tablet significantly influenced the lag-time; the lag-time was extended with the higher viscosity of HPMC and the increased proportion of konjac glucomannan.

CONCLUSIONThe pulsatile capsule with a suitable lag-time and colon position characteristics can be achieved by adjusting the composition of the plug tablet.

Capsules ; chemistry ; Colonic Diseases ; drug therapy ; Drug Delivery Systems ; instrumentation ; Humans ; Mannans ; chemistry ; Mesalamine ; pharmacokinetics ; therapeutic use ; Technology, Pharmaceutical

OBJECTIVETo investigate the diagnosis and treatment of invasive pulmonary aspergillosis (IPA) in children.

METHODThe clinical data of 16 cases of proven or probable IPA who had been in our Hospital from January 2006 to June 2014 were retrospectively analyzed.

RESULTAmong the 16 patients, 11 were males and 5 were females. One child had proven IPA and 15 children had probable IPA. Host risk included long duration use of multiple broad-spectrum antibiotics in 16 cases, neutropenia in 9 cases, invasive mechanical ventilation in 3 cases, primary immunodeficiency disease in 2 cases, long-term use of glucocorticoids in 2 cases, measles in 2 cases, and congenital pulmonary hypoplasia in 1 case. Fever, cough and expectoration were present in all the children with IPA. At the time of diagnosis, the halo sign and subpleural wedge consolidation shadows were more common in neutropenia group (5/9, 7/9) than those in non-neutropenia group(0/7, 1/7)(P<0.05). The cavities and"air-crescent sign"were more common after 15 days to 1 month when the children had been treated with anti-aspergillosis drugs than that at the onset of diagnosis of IPA (P<0.05). The positive rate of serum galactomannan (GM) test was higher than that of sputum culture and serum G test (P<0.05). Thirteen children received voriconazole, in 7 of the children the treatment was effective.

CONCLUSIONNeutropenia were the common host risk factors in children with IPA. Subpleural wedge consolidation shadows, the halo sign and the"air-crescent"sign were highly suggestive of the diagnosis of IPA in children. Subpleural wedge consolidation shadows and the halo sign were more common in neutropenia group than in non-neutropenia group in the early stage of the course. Serum GM test played an important role in the diagnosis of IPA in children. Voriconazole was effective in majority of the children with IPA.

Anti-Bacterial Agents ; Aspergillosis ; Child ; Cough ; Female ; Fever ; Glucocorticoids ; Humans ; Male ; Mannans ; Measles ; Neutropenia ; Retrospective Studies ; Risk Factors ; Sputum ; Voriconazole