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PubMed2001

Human immunodeficiency virus p24 antigen testing in cornea donors.

PURPOSE: Testing for the p24 antigen of the human immunodeficiency virus (HIV) may detect early HIV infection in the seronegative window; however, falsely reactive results may occur in cadaver specimens. Although neither the Food and Drug Administration (FDA) nor the Eye Bank Association of America requires p24 testing of cornea donors, many tissue banks using other organs from cornea donors do perform this assay, and the FDA requires that eye banks reject corneal tissue if a reactive p24 assay is reported. We investigated the impact of p24 testing on eye banking and corneal transplantation. METHODS: Two clinical cases and records from the Lions Eye Bank of Delaware Valley (LEBDV) were reviewed retrospectively. RESULTS: Two corneas from the LEBDV were transplanted before the reporting of p24 reactivity by other tissue banks. In one case, because of the young age of the recipient, the surgeon elected to replace the cornea with new tissue hours after the original transplant, and later polymerase chain reaction (PCR) testing was negative. In the other case, there was not enough specimen to perform Western blot or PCR confirmatory testing. The patient was followed with periodic serologic testing for HIV and has remained seronegative. To avoid such problems in the future, the LEBDV initiated testing of all donors with p24 and other nonrequired screening tests. Over a 2-month period, 22 corneas (from 11 donors) were discarded because of these tests: 4 donors had reactive p24 tests, 6 were reactive for antibody to hepatitis B core antigen, and 1 had a reactive syphilis test. CONCLUSIONS: Results from p24 assays by other tissue banks may cause difficult clinical situations when the results are received after transplantation of the tissue, but the use of the p24 assay in the screening of cornea donors may result in excessive waste of donor tissue. Further guidance is needed regarding the management of positive results from this and other nonrequired screening tests.

Adolescent↗
PubMed2001

The effect of state legislation on eye donation.

PURPOSE: Pennsylvania Act 102 implemented in March 1995 required all acute care hospitals in Pennsylvania to routinely refer all deaths to the Organ Procurement Organization for determination of suitability for organ/tissue donation. This study analyzed the effect of the law on eye donation. METHODS: Retrospective analysis of the total number of referrals and the actual number of eye donations from 62 hospitals in Pennsylvania to the Lions Eye Bank of Delaware Valley was performed for the years 1993 to 1998. Information gathered included donor's age, gender, race, cause of death, referring institution, and result of referral. RESULTS: From 1993 to 1998, the total numbers of referrals were 988, 1,647, 8,101, 21,123, 21,783, and 22,987, and the numbers of donors were 570, 574, 660, 644, 594, and 568, respectively. The increase in the number of donors after implementation of the law was not commensurate with the number of referrals. This was caused by a disproportionate increase in the number of referrals older than 70 years of age (from a mean of 33% to 52%), which exceeded the donor age limit of 69 years, and also to a lower family consent rate (from a mean of 48% to 24%). CONCLUSIONS: Well-designed state legislation with proper implementation greatly increased hospital referrals for eye donation. However, there was only a small increase in the number of eye donors because many of the referrals were beyond the acceptable upper age limit for eye donation. A small increase in the donor age limit would increase the number of eye donations without having to expand the potential donor pool. Education of the public may help to improve the family consent rate.

Adolescent↗
PubMed1975

Ocular lesions in the Earth Day, 1970, histoplasmosis epidemic.

The relationship between systemic histoplasmosis and this particular clinical picutre of a central choroiditis with peripheral atrophic lesions in the fundus was postulated by Woods in 1960 [19]. Since that time there have been many studies attempting to substantiate his hyptthesis [1, 3-5, 7-18]. In a large study performed in Walkersville, Maryland, which is an area endemic for histoplasmosis [14], the prevalence of the characteristic peripheral histoplasmic lesion in the fundus was 27 per 1000 population. The prevalence was 44 per 1000 population with positive histoplasmosis skin tests. In a similar study done in sothern Ohio, the prevalence of peripheral fundus lesions was 1.6 percent of 1417 patients examined [1]. Several generalizations can be made from the information obtained in studying the students involved in the Willis flu, and these can be compared with information from the control students from Bellingham. First, the acute infection at Willis School did not cause significant ocular abnormalities. This finding is supported by the fact that no significant differences occurred in the fundus lesions seen in the control group of students who lived in the same geographic area but were not clinically ill from histoplasmosis. Our evidence shows that the eyegrounds of the individuals living in this area were different from those of the students who lived outside the central Ohio area. How do we account for the similarity of ocular lesions in the affected students and the Delaware control group? Perhaps by the age of 11 or 12, a person living in the histoplasmosis belt will have already been exposed to histoplasmosis, resulting in the characteristic scars that are seen. If, in fact, histoplasmosis is the etiological agent in the patients who are diagnosed as having presumed ocular histoplasmosis, difficulty arises in understanding why those individuals involved in the epidemic did not have more scars than the control group. Perhaps the numbers of patients examined were not large enough to reflect the difference that really may exist. An interesting observation is that 4 (67 percent) of our control students with significant lesions had negative histoplasmosis skin tests. Of course, other organisms may have caused these lesions which have not yet been implicated as causative agents in the presumed ocular histoplasmosis syndrome.

Adolescent↗
PubMed1978

The effects of mandatory quality assurance: a review of hospital medical audit processes.

A study of 17 hospitals in the Greater Delaware Valley region was undertaken in order to determine if those hospitals which had participated in an early voluntary effort to initiate medical audit differed qualitatively or quantitatively from a matched group of hospitals which had not participated in the previous project. The study also provided the opportunity to analyze the current status of medical audit in a group of hospitals which varied significantly in size, location, and educational responsibilities. Data regarding audit administrative organization, number of audits performed, type of system used, quality of audit criteria, and utilization of audit findings were gathered and analyzed. For these variables, no discernible differences were found between hospitals which had participated in the early voluntary project and those which had not. Wide variations were found among the hospitals in the extent to which medical audit processes were formalized and implemented. There were also variations in the quality of criteria formulated by the hospitals, but they generally did not receive a high rating. The implications of audit findings were generally not followed up in an organized and appropriate manner. Many hospitals which had received PSRO delegated status were given a low rating by the reviewers. The implications of these findings are discussed.

Education, Medical, Continuing↗
PubMed1989

Magnetic resonance imaging of acute cervical spine trauma. Correlation with severity of neurologic injury.

Prior to the advent of computer-assisted imaging techniques, conventional radiographic studies did not accurately depict the severity of soft tissue injury (spinal cord and paravertebral tissue) attending severe spinal trauma. Computed tomography scanning is clearly superior to plain radiography in the demonstration of osseous fractures and impactions, but this modality does not clearly depict ligamentous or disc injuries and does not image the spinal cord directly. The authors' preliminary experience indicates that magnetic resonance imaging (MRI) more accurately defines the extent of soft tissue damage in the zone of injury. In this study, the authors correlate these objective imaging techniques with findings on neurologic exam. Seventy-eight patients with cervical spine injuries admitted to the Regional Spinal Cord Injury Center of the Delaware Valley between August 1987 and January 1989 were evaluated with surface-coil MRI on a 1.5-Tesla unit. Fifty-nine patients were studied within 7 days of injury. Image sequences consisting of T1-, proton density, and T2-weighted images were obtained in saggital views. Axial gradient recalled acquisitions in the steady state (GRASS) images were obtained from most patients. We learned that certain patterns of MRI signal were associated with severe neurologic deficit. These include: 1) intramedullary hematoma and 2) spinal cord contusion associated with edema encompassing more than one spinal segment. Magnetic resonance imaging findings also correlated with less severe injury and include 1) normal spinal cord signal and 2) small focal contusions associated with edema encompassing one spinal segment or less.

Adult↗
PubMed1995

Occurrence of infection in anterior cervical fusion for spinal cord injury after tracheostomy.

STUDY DESIGN: This study retrospectively reviewed the outcomes of 11 patients treated for a cervical spine injury with a tracheostomy placed before anterior cervical spine surgery. OBJECTIVES: The primary goal was to show that anterior cervical spine surgery in the setting of spinal cord injury is a viable option in patients with previous tracheostomy. SUMMARY OF BACKGROUND DATA: Respiratory failure after cervical cord injury commonly requires tracheostomy, possibly increasing the risk of soft tissue or bony infection in patients at high risk for morbidity after surgery. Although numerous studies have explored the risk of infection after tracheostomy or anterior cervical spine surgery, no study has been performed to explore the risk of infection in patients with previous tracheostomy at the time of anterior cervical spine surgery. METHODS: A retrospective review of the clinical data of 1800 spinal cord injury patients seen from 1979 to the present at the Regional Spinal Cord Injury Center of the Delaware Valley of Thomas Jefferson University with affiliated institutions of Thomas Jefferson University Hospital and Magee Rehabilitation Hospital was performed. Eleven patients were found who had existing tracheostomy at the time of anterior cervical spine surgery. Clinical follow-up period averaged 28 months with a range of 6-51 months, and radiographic analysis averaged 7 months with a range of 1-51 months. Autogenous iliac crest graft was used in all patients, consisting of an intervertebral graft after a discectomy or a strut graft after a complete corpectomy. Anterior instrumentation was used in more than 50% of the patients. RESULTS: After all patient interviews and review of all radiographs for evidence of infection, no patient was noted to have evidence of a cervical soft tissue or bony infection after surgery. The tracheostomy complications were minor and resolved quickly. CONCLUSIONS: The authors concluded that in patients with cervical cord damage resulting from nonpenetrating trauma, tracheostomy was not found to increase the risk of infection in subsequent anterior cervical surgery. Careful preparation of the skin and placement of the second surgical incision lateral to the tracheostomy site is recommended. Anterior cervical spine surgery remains a viable treatment option in this severely injured patient population.

Adult↗
PubMed1998

Prosthesis jump graft: an unusual arterial reconstruction in liver transplantation.

The authors present a case of arterial jump graft using a number 9 Goretex prosthesis (FEP ringed vascular graft; W.I. Gore Associates Inc.-Delaware, Flagstaff, AZ) with an excellent outcome 3 years after the transplant. The prosthesis was necessary because of the impossibility of using the donor iliac arterial grafts due to the presence of widespread atherosclerotic damage.

Adult↗
PubMed1999

A pilot study of a headache program in the workplace. The effect of education.

Headache is a frequent problem in the workplace and contributes to absenteeism and productivity loss. Disease-management programs targeting headache may reduce its impact on employees, employers, and society. A pilot study was conducted in an employer setting (J.P. Morgan & Co., Incorporated; four locations in New York City and two in Delaware) to evaluate a multimedia computer-based (kiosk) headache program. Study objectives included assessing the effect of the program on participant outcomes and evaluating the educational component of the program. Through the kiosk, participants were questioned about the types, severity, and frequency of their headaches; the impact of headaches on their daily activities; and lost workdays as a result of headache. All participants received personalized reports about their headaches, and the participants in New York were given access to an on-site neurologist and additional educational information. A follow-up assessment was requested 3 months after the baseline screening to evaluate the effect of the program. A total of 185 participants completed both a baseline and follow-up session. Of 177 evaluable participants, 19% saw a physician for headache after their initial kiosk session. Fifty-six percent of evaluable participants reported overall improvement in headache symptoms at follow-up (P < 0.01), with decreased headache frequency and better understanding of headache most often selected as reasons for improvement. Participants also reported higher satisfaction with headache management after using the program and fewer urgent care/emergency room visits for headache (P < 0.01). For participants who reported lost workdays because of headache, the number of days missed had decreased by the follow-up. The results of this study indicate that the headache program improved outcomes. Because all participants received educational materials, it is likely that education played a role in the improvements observed. These results are encouraging and warrant further study in larger, controlled trials.

Adult↗
PubMed2004

Patterns of complementary and alternative medicine use in a population of pediatric patients with inflammatory bowel disease.

Complementary and alternative medicine use is prominent in the United States. The use of complementary and alternative therapies appears to be common in patients with inflammatory bowel disease, but few studies have been completed in children. We sought to examine the extent that children with inflammatory bowel disease in the Greater Philadelphia area (Philadelphia County and the surrounding counties in Delaware, New Jersey, and Pennsylvania) use alternative therapies. We paid particular attention to the specific types of therapies used and whether certain demographic and disease associated factors influence the degree of usage. In this study, we questioned the families of all children diagnosed with inflammatory bowel disease, aged 6 to 16 years and living within Philadelphia and its surrounding counties, who were followed at 1 of the 2 academic pediatric gastroenterology programs that served the area. More than 80% of surveys were returned. Fifty-one percent (95% C.I. 45% to 56%) of patients surveyed reported some form of alternative medicine use within the previous year. Univariate analysis revealed increased use among patients who had Crohn disease, who used the Internet for research on their disease, who reported poor quality of life and had increased school absences in the past year. Therapies associated with alternative medicine use included biological and immunomodulatory therapy. Regression analysis revealed positive associations between use of alternative therapies and expenditure on nonprescription treatments, poor quality of life, Internet research, and the need for calorie supplementation, whereas there was a negative association with history of prior surgery for inflammatory bowel disease.

Adolescent↗
PubMed2004

Elective cesarean delivery and long-term motor function or ambulation status in infants with meningomyelocele.

OBJECTIVE: To determine if elective cesarean delivery, when compared with trial of labor, is associated with better long-term motor function or ambulation status in infants with myelomeningocele. METHODS: This is a retrospective cohort study of patients with myelomeningocele followed at the Spinal Dysfunction Program at Alfred I. duPont Hospital for Children in Wilmington, Delaware. Medical records were reviewed for gestational age at delivery, birthweight, anatomical level of lesion, and initial (0-6 months) and long-term (10 years or longer) motor function. Ambulation status (independent ambulation, ambulant with assistance, or wheelchair-bound) at 2 and 10 years was compared with those delivered by elective cesarean versus those delivered after trial of labor. RESULTS: Of the 106 patients with myelomeningocele that were identified, 87 (82%) had all the data required for this review. There were 44 patients in the elective cesarean group and 43 in the trial of labor group. There was no significant difference in gestational age at delivery or birthweight between the groups. There was statistical difference between the 2 groups when anatomical, initial, and current motor levels were compared. Compared with the elective cesarean group, patients in the trial of labor group were more likely to be ambulatory at 2 years (independently ambulant 7% versus 28%, ambulant with assistance 63% versus 65%, or wheelchair-bound 30% versus 7%, P =.003) and at 10 years (independently ambulant 5% versus 21%, ambulant with assistance 30% versus 54%, or wheelchair-bound 65% versus 25%, P <.001). However, when logistic regression analysis was used to control for motor level of myelomeningocele, no significant association was observed in ambulatory status at ages 2 and 10 years between infants delivered by elective cesarean or after trial of labor. CONCLUSION: Elective cesarean delivery, when compared with delivery after trial of labor, was not associated with better motor function or ambulation status in myelomeningocele patients. LEVEL OF EVIDENCE: II-2

Adolescent↗
PubMed2004

Costs of occupational injury and illness across states.

The objective of this study was to estimate occupational injury and illness costs per worker across states. Analysis was conducted on injury data from the Bureau of Labor Statistics and costs data from workers' compensation records. The following states were at the top of the list for average cost (cost per worker): West Virginia, Alaska, Wyoming, Kentucky, and Mississippi. The following states were at the bottom: South Carolina, Delaware, Minnesota, Massachusetts, and New Hampshire. The following variables (and signs on regression coefficients comparing this industry with manufacturing) were important in explaining the variation across states: employment in farming (+), agricultural service, forestry, fishing (+), mining (+), transportation and public utilities (+), wholesale trade (-), and finance, insurance, real estate (-). Southern and especially Western states were disproportionately represented in the high cost per worker list. A significant amount of the variation in cost per worker across states was explained by the composition of industries.

Accidents, Occupational↗
PubMed2004

A new rapid point-of-care D-dimer enzyme-linked immunosorbent assay (Stratus CS D-dimer) for the exclusion of venous thromboembolism.

To evaluate the performances of a new D-dimer assay, Stratus CS D-dimer (Dade Behring, Newark, Delaware, USA), for the exclusion of venous thromboembolism and to determine the best cut-off values. This test relies on a sandwich enzyme-linked immunosorbent assay with a fluorogenic substrate in a radial partition immunoassay system in a dedicated device. It does not require laboratory staff and the results are available within 18 min. Two hundred and ninety-one frozen samples from patients suspected of either deep venous thrombosis (n = 137) or pulmonary embolism (n = 154) were measured and the results compared with the VIDAS D-dimer New assay. There were 37 deep venous thrombosis (27%) and 49 pulmonary embolism (32%) samples. Receiver-operating characteristic curve analysis indicated that the cut-off value could be set at either 300 or 400 ng/ml Fibrinogen Equivalent Units (FEU). The coefficient of variation determined with a lyophilized low-level control plasma (305 ng/ml FEU) was 6%. With a cut-off at 300 ng/ml FEU, the sensitivity, the specificity and the negative predictive value were 100% [95% confidence interval (CI), 95.8-100], 33.1% (95% CI, 26.8-40) and 100% (95% CI, 94.7-100), respectively. Raising the cut-off to 400 ng/ml FEU, the corresponding figures were 96.5% (95% CI, 90.1-99.3), 46.3% (95% CI, 39.4-53.2) and 96.9% (95% CI, 91.3-99.4), respectively. At 400 ng/ml, three results were false-negative, one with both devices and two with the Stratus D-dimer only. Stratus D-dimer appears to be suitable for the exclusion of venous thromboembolism in the emergency room setting.

Enzyme-Linked Immunosorbent Assay↗
PubMedDate not supplied

Diagnostic and therapeutic arthroscopy of the hip in children and adolescents: evaluation of results.

Twenty-four arthroscopies of the hip performed at the Alfred I. duPont Institute, Wilmington, Delaware, in 21 patients between 1981 and 1991 were retrospectively studied. The average age of patients at the time of arthroscopy was 16 years (range, 11-21 years). The arthroscopies were diagnostic if the procedure was performed to visualize the hip or to perform a synovial biopsy and therapeutic if the procedure was performed to treat a suspected intra-articular abnormality. There were eight diagnostic arthroscopies and 16 therapeutic arthroscopies. The arthroscopy correlated with the presumptive causes of symptoms in 13 hips (54%) and failed to correlate in 11 hips (46%). Two patients had complications of transient pudendal nerve dysesthesia with full recovery. There were no infections or residual hip stiffness. A diagnostic arthroscopy is not helpful as a confirming diagnostic procedure. Arthroscopy of the hip is helpful in obtaining synovial biopsies and allows loose body removal, thus obviating the need for open surgery and intraoperative dislocation of the hip.

Adolescent↗
PubMed1992

Resistance to phloem transport of potato leafroll virus in potato plants.

A 'double-graft sandwich' technique in which sections of potato stem from different potato cultivars were grafted between a susceptible healthy stock plant and a potato leafroll virus (PLRV)-infected scion was used to study the rate of phloem transport of PLRV in cultivars differing in resistance to PLRV infection (IR) and accumulation (AR). Resistance to phloem transport (i.e. delayed PLRV systemic movement) was found in Bismark cultivar (IR A(S)). This was independent of IR and AR as the rate of movement in Bismark cultivar was markedly slower than that in Omega and Spunta (IR AR), Delaware (I(S) AR), and Desiree and Renova (I(S) A(S)) cultivars. It operated in Bismark cultivar stems of two different ages, but did not operate against potato virus X (PVX) and was not influenced by previous infection with this virus. Aphid vector (Myzus persicae) feeding preferences and colonization rates differed between cultivars, but the cultivar characteristics responsible were unrelated to IR, AR or resistance to phloem transport. Delayed systemic movement of PLRV out of leaves inoculated with viruliferous aphids was independent of AR and resistance to phloem transport, and remained unaffected by previous infection with PVX. It was also independent of cultivar factors causing different aphid feeding preferences and colonization rates, but may be linked to IR.

Biological Transport↗
PubMed1999

Transmission of Eurasian avian H2 influenza virus to shorebirds in North America.

Influenza A virus of the H2 subtype caused a serious pandemic in 1957 and may cause similar outbreaks in the future. To assess the evolution and the antigenic relationships of avian influenza H2 viruses, we sequenced the haemagglutinin (HA) genes of H2 isolates from shorebirds, ducks and poultry in North America and derived a phylogenetic tree to establish their interrelationships. This analysis confirmed the divergence of H2 HA into two geographical lineages, American and Eurasian. One group of viruses isolated from shorebirds in North America had HA belonging to the Eurasian lineage, indicating an interregional transmission of the H2 gene. Characterization of HA with a monoclonal antibody panel revealed that the antigenicity of the Delaware strains differed from the other avian strains analysed. The data emphasizes the importance of avian influenza surveillance.

Animals↗
PubMed2001

Comparative assessment of groundwater quality in the Tangshan region of the People's Republic of China and similar areas in the U.S.

Groundwater quality with respect to nitrate, major inorganic constituents, stable isotopes, and tritium was assessed in the agricultural Tangshan region in the Hai He River Basin of the People's Republic of China and compared with three regions in the U.S.: the Delmarva Peninsula of Delaware, Maryland, and Virginia; the San Joaquin Valley of California; and the Sacramento Valley of California. The China and U.S. regions are similar in size and land use, but have different climatic conditions and patterns of water use for irrigation. The Tangshan region has been in agricultural production for a much longer time, probably several centuries, than the three U.S. regions; however, the widespread use of synthetic fertilizers and other soil amendments probably started at a similar time in all four regions. In all four regions, median nitrate concentrations were generally below the U.S. drinking water standard of 10 mg/l of nitrate as nitrogen. However, higher concentrations and a greater range were evident for the Tangshan region. In the water samples collected from a shallow aquifer in the Tangshan region (over 25% of all samples), nitrate concentrations exceeded the Chinese standard of 20 mg/l, whereas few comparative samples (2.6%) collected in the U.S. exceeded 20 mg/l. In Tangshan, relatively low nitrate, which is indicative of uncontaminated background concentrations, was measured in older water of deeper wells. Recently recharged water was detected in wells drilled as deep as 150 m. Nitrate concentrations above background levels were also measured in water samples from these wells. In addition to nitrate, the agricultural area of the Tangshan region has been affected by elevated total dissolved solids and iron, the latter attributed to widespread application of animal wastes and sewage deposited on the land surface, which lead to oxygen depletion in the subsurface environment and dissolution of iron. The elevated total dissolved solids of the Tangshan study area could not be attributed to any one process.

China↗
PubMed1978

Conversion of labeled substrates to sugars, cell wall polysaccharides, and tartaric Acid in grape berries.

[U-(14)C]Sucrose, myo-[U-(14)C]inositol, [6-(14)C]- and [U-(14)C]glucuronate, UDP-[U-(14)C]glucuronate, [U-(14)C]gluconate, and l-[1-(14)C]ascorbic acid were fed into grape berries, Vitis labrusca L. cv. Delaware, at intervals throughout the ripening process and incorporation of (14)C into several metabolites was studied.[U-(14)C]Sucrose was the most effective precursor of cellulose in young grape berries and of glucose and fructose in mature berries. On the other hand, UDP-[U-(14)C]glucuronate was the best precursor of pectic substance, followed by [(14)C]glucuronate and myo-[U-(14)C]inositol. l-[1-(14)C]Ascorbic acid was the most effective precursor of tartaric acid. In young berries, [U-(14)C]sucrose and [U-(14)C]gluconate also produced labeled tartaric acid, the latter a somewhat better precursor in the 3 weeks following flowering. The remaining test compounds were only poor sources of (14)C for tartaric acid although all three, glucuronate, UDP-glucuronate, and myo-inositol, were utilized by the grape berry for pectin biosynthesis.These results strongly indicate that tartaric acid is synthesized by a C-1 oxidation mechanism of hexose in young grape berries.

Journal Article↗
PubMed1984

Synthesis of l-(+)-Tartaric Acid from l-Ascorbic Acid via 5-Keto-d-Gluconic Acid in Grapes.

5-Keto-l-idionic acid ( identical with5-keto-d-gluconic acid, d-xylo-5-hexulosonic acid) was found as a metabolic product of l-ascorbic acid in slices of immature grapes, Vitis labrusca L. cv ;Delaware'. Specifically labeled compounds, recognized as metabolic products of l-ascorbic acid in grapes, were fed to young grape tissues to investigate the metabolic pathway from l-ascorbic acid to l-(+)-tartaric acid.Label from dehydro-l-[1-(14)C]ascorbic acid, 2-keto-l-[1-(14)C]idonic acid (l-xylo-2-hexulosonic acid), l-[1-(14)C]idonic acid, or 5-keto-l-[1-(14)C] idonic acid was incorporated into l-(+)-tartaric acid in high yields as it was in the l-[1-(14)C]ascorbic acid experiment. In a double label experiment involving a mixture of l-[1-(14)C]idonic acid and l-[2-(3)H]idonic acid, the (3)H/(14)C ratios of 5-keto-l-idonic acid and l-(+)-tartaric acid synthesized in young grape leaves were almost the same as the value of the l-idonic acid fed. Label from 5-keto-l-[6-(14)C]idonic acid was incorporated into sugars and insoluble residue in the same way as l-[6-(14)C]ascorbic acid was metabolized in grapes.These results provide strong evidence that in grapes l-(+)-tartaric acid is synthesized from the C(4) fragment that corresponds to the C1 to C4 group of the 5-keto-l-idonic acid derived from l-ascorbic acid via 2-keto-l-idonic acid and l-idonic acid.

Journal Article↗