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December 1958, Vol 96, No. 6 >
Article | December 1958

Plasma and Urine Pepsinogen (Uropepsin) Values in Normal Infants and Children FREE

HAROLD G. GRAYZEL, M.D.; BRUNO ELKAN, B.S.; LAWRENCE SCHNECK, M.D.; SANTIAGO L. GARZA, M.D.; ALENDRY P. CAVILES, M.D.
[+] Author Affiliations

Submitted for publication March 11, 1958.

Study supported by a grant from Desitin Chemical Company, Providence, R. I.

A preliminary report was presented at the International Pediatric Congress, Copenhagen, Denmark, July 22, 1956.


AMA Am J Dis Child. 1958;96(6):666-675. doi:10.1001/archpedi.1958.02060060668003.
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References
Comments

The present study is concerned with normal values of blood plasma pepsinogen and urine pepsinogen (uropepsin) excretion in infants and children. Recently there has been a revival of interest in this subject, but these investigations have been conducted in the main with normal adults and patients with gastric disturbances and diseases.

Method and Procedure  The study was divided into two parts. One pertained to the determination of blood plasma pepsinogen levels in normal infants and children; the other, to urine pepsinogen (uropepsin) excretion values. Only children free of acute or chronic disease, malignancy, or involvement of the nervous system, as well as allergic, dermatologic, hepatic, metabolic, endocrine, gastrointestinal, cardiopulmonary, hematologic, renal, emotional, or mental disturbance or disease were included in this series. The subjects were obtained at random, as the opportunity presented itself, from private practice, from the outpatient department, or from the inpatient service among those who were admitted

REFERENCES

1 +
Mirsky, I. A.; Futterman, P.; Kaplan, S., and Broh-Kahn, R. H.:  Blood Plasma Pepsinogen: I. Source, Properties and Assays of Proteolytic Activity of Plasma at Acid Reactions , J. Lab. & Clin. Med. 40:17, 1952;.
2 +
Hirschowitz, B. I.:  Pepsinogen in the Blood , J. Lab. & Clin. Med. 46:568, 1955;.
3 +
Spiro, H. M.; Reifenstein, R. W., and Gray, S. J.:  The Effect of Adrenocorticotrophic Hormone upon Uropepsin Excretion , J. Lab. & Clin. Med. 35:899, 1950;.
4 +
Gray, S. J.; Ramsey, C. G., and Reifenstein, R. W.:  Clinical Use of the Urinary Uropepsin Determination in Medicine and Surgery , New England J. Med. 251:835, 1954;.
5 +
Grayzel, H. G.; Warshall, H. B.; Elkan, B. S., and Sternberg, A.:  24-Hour Urinary Pepsinogen Excretion in Juvenile Diabetes , Diabetes 6:480, 1957;.
6 +
Mirsky, A.; Kaplan, S., and Broh-Kahn, R. H.:  Pepsinogen Excretion (Uropepsin) as an Index of the Influence of Various Life Situations on Gastric Secretion , A. Res. Nerv. & Ment. Dis., Proc. 29:628, 1950;.
7 +
Balfour, D. C., Jr.:  Uropepsin , Advances Int. Med. 6:13, 1954;.
8 +
Segal, H. L.; Miller, L. L.; Reichsman, F.; Plumb, E. J., and Glaser, G. L.:  Proteolytic Enzyme Activity: I. Urinary Proteolytic Activity at pH 1.5 in Adults , Gastroenterology 33:557, 1957;.
9 +
Fisher, A. A.: Statistical Methods for Research Workers , Ed. 10, Edinburgh, Oliver & Boyd, Ltd., 1948;.
10 +
Baldwin, E.: Dynamic Aspects of Biochemistry , London, Cambridge University Press, 1949;.
11 +
Babkin, B. P.: Secretory Mechanism of the Digestive Glands , Ed. 2, New York, Paul B. Hoeber, Inc. (medical book department of Harper & Brothers), 1950;.
12 +
Northrop, J. H.; Junitz, M., and Herriott, R. M.: Crystalline Enzymes , Ed. 2, New York, Columbia University Press, 1948;.
13 +
Hirschowitz, B. I.:  Pepsinogen: Its Origin, Secretion and Excretion , Physiol. Rev. 37:475, 1957;.
14 +
Frouin, A.:  Sur l'Origine et le lieu de résorption de la pepsin urinaire , Compt. rend. Soc. biol. 56:204, 1904;.
15 +
Bucher, G. R., and Ivy, A. C.:  Disappearance of Uropepsin from the Urine of Gastrectomized Cats , Am. J. Physiol. 150:415, 1947;.
16 +
Balfour, D. C., Jr.; Preston, F. W., and Bolman, J. L.:  The Disappearance of Uropepsin Following Total Gastrectomy , Gastroenterology 10:880, 1948;.
17 +
Farnsworth, E. B.; Speer, H., and Alt, H. L.:  The Quantitative Determinations of a Pepsin-Like Substance in the Urine of Normal Individuals and of Patients with Pernicious Anemia , J. Lab. & Clin. Med. 31:1025, 1946;.
18 +
Bucher, G. R.:  Uropepsin: A Review of the Literature and Report of Some Experimental Findings , Gastroenterology 8:627, 1947;.
19 +
Podore, C. J.; Broh-Kahn, R. H., and Mirsky, I. A.:  Uropepsin Excretion by Man: III. Uropepsin Excretion by Patients with Peptic Ulcer and Other Lesions of the Stomach , J. Clin. Invest. 27:834, 1948;.
20 +
Bucher, G. R., and Anderson, A.:  Uropepsin Output in Cats Treated with Caffeine and Histamine , Am. J. Physiol. 153:454, 1948;.
21 +
Matthes, M., cited by Bucher and Anderson.20
22 +
Mirsky, I. A.; Bach, S.; Osher, S., and Broh-Kahn, R. H.:  Uropepsin Excretion by Man: I. Source, Properties and Assay of Uropepsin , J. Clin. Invest. 27:818, 1948;.
23 +
Janowitz, H. D., and Hollander, F.:  Relation of Uropepsinogen Excretion to Gastric Pepsin Secretion in Man , J. Appl. Physiol. 4:53, 1951;.
24 +
Janowitz, H. D., and Hollander, F.:  Exocrine-Endocrine Partition of Enzymes in Digestive Tract , Gastroenterology 17:591, 1951;.
25 +
Hollander, F.:  Current Views on the Physiology of the Gastric Secretions , Am. J. Med. 13: 453, 1952;.
26 +
Kowalewski, K.; Nowell, S. T., Jr., and MacKenzie, W. C.:  The Gastric Endocrine and Exocrine Response to Histamine in Dogs and Effect of Passage of Blood Through the Gastric and Hepatic Vessels on its Pepsinogen Content , Canad. J. Biochem. & Physiol. 34:244, 1956;.
27 +
Tuerkischer, E., and Wertheimer, E.:  Adrenalectomy and Gastric Secretion , J. Endocrinol. 4:143, 1945;.
28 +
Haeger, K.; Jacobsohn, D., and Kahlson, G.:  Atrophy of the Gastrointestinal Mucosa Following Hypophysectomy or Adrenalectomy , Acta physiol. scandinav. 30 ( (Supp. 111) ):161, 1953;.
29 +
Abrams, G. D., and Baker, B. L.:  The Cytology and Secretory Activity of Gastric Zymogenic Cells After Ablation of Ductless Glands , Gastroenterology 27:462, 1954;.
30 +
Baker, B. L., and Abrams, G. D.:  Effect of Hypophysectomy on the Cytology of the Fundic Glands of the Stomach and on the Secretion of Pepsin , Am. J. Physiol. 177:409, 1954;.
31 +
Baker, B. L., and Bridgman, R. M.:  The Histology of the Gastro-Intestinal Mucosa (Rat) After Adrenalectomy or Administration of Adrenocortical Hormones , Am. J. Anat. 94:363, 1954;.
32 +
Baker, B. L.:  The Adrenal Steroids and the Secretion of Digestive Enzymes , Ann. New York Acad. Sc. 61:324, 1955;.
33 +
Levy, A. H., and Levine, S.:  Uropepsin Excretion Studies in Clinical Surgery , Gastroenterology 30:270, 1956;.
34 +
Woodward, E. R.; Schapior, H., and Armstrong, G.:  Relation Between Uropepsin Excretion and Secretion of Gastric Juice , J. Appl. Physiol. 8:643, 1955-1956;.
35 +
Rigler, S. P.; Oberhelman, H. A.; Hanke, M. M., and Dragstedt, L. R.:  Uropepsin as a Measure of Gastric Secretion , A. M. A. Arch. Surg. 71:63, 1955;.
36 +
Spiro, H. M.; Ryan, A. E., and Jones, C. M.:  The Relation of Blood Pepsin to Gastric Secretion with Particular Reference to Anacidity and Achylia , Gastroenterology 30:563, 1956;.
37 +
Forrest, A. P. M., and Code, C. F.:  Effect of Post-Ganglionic Sympathectomy on Canine Gastric Secretion , Am. J. Physiol. 177:425, 1954;.
38 +
Janowitz, H. D.:  Quantitative Test of Gastro-Intestinal Function , Am. J. Med. 13:467, 1952;.
39 +
Fornstein, S., and Eichen, S.:  Influence of Smoking on Urinary Pepsinogen Excretion , Proc. Soc. Exper. Biol. & Med. 86:619, 1954;.
40 +
Addison, T.: On the Constitutional and Local Effects of the Suprarenal Capsules, London, Highley, 1855.
41 +
Bavetta, L.; Hallman, L.; Deuel, H. J., Jr., and Greeley, P. O.:  The Effect of Adrenalectomy on Fat Absorption , Am. J. Physiol. 134:619, 1941;.
42 +
Althausen, T. L.; Anderson, E. M., and Stockholm, M.:  The Effect of Adrenalectomy and of Sodium Chloride on Intestinal Absorption of Dextrose , Proc. Soc. Exper. Biol. & Med. 40:342, 1939;.
43 +
Clark, W. G.:  Effect of Adrenalectomy upon Intestinal Absorption of Sodium Chloride , Proc. Soc. Exper. Biol. & Med. 40:468, 1939;.
44 +
Haroutinian, L. M., and Segal, H. L.:  The Shay Rat as an Assay Animal for Anti-Ulcer Factors: IV. The Effect of Adrenalectomy and Nephrectomy , Gastroenterology 21:556, 1952;.
45 +
Madden, R. J., and Ramsburg, H. H.:  Adrenalectomy in the Shay Rat , Gastroenterology 18:128, 1951;.
46 +
Madden, R. J., and Ramsburg, H. H.:  Gastric Secretion in the Adrenalectomized Rat , Endocrinology 49:82, 1951;.
47 +
Gray, S. J.; Ramsey, C. G.; Villarreal, R., and Krakauer, L. J.: Adrenal Influences upon the Stomach and the Gastric Response to Stress: Fifth Annual Report on Stress (1955-1956) , edited by H. Selye and G. Heuser, New York, MD Publications, Inc., 1956;.
48 +
Gray, S. J.:  Relationships of the Adrenal Gland to Peptic Ulcer , M. Clin. North America , p. 1471, 1957;.
49 +
Spiro, H. M.; Reifenstein, R. W., and Gray, S. J.:  The Effect of Adrenocorticotrophic Hormone upon Uropepsin Excretion , J. Lab. & Clin. Med. 35:899, 1950;.
50 +
Gray, S. J.; Benson, J. A., Jr., and Reifenstein, R. W.:  The Effect of ACTH and Cortisone upon the Stomach: Its Significance in the Normal and in Peptic Ulcer , Gastroenterology 19:658, 1951;.
51 +
Gray, S. J.; Benson, J. A., Jr., and Reifenstein, R. W.:  Chronic Stress and Peptic Ulcer: I. The Effect of ACTH and Cortisone upon Gastric Secretion , J. A. M. A. 147:1529, 1951;.
52 +
Goodman, R. D.; Sandoval, E., and Halsted, J. A.:  Observations on Some Technical and Clinical Factors Influencing Determination of Uropepsin Excretion in Man , J. Lab. & Clin. Med. 40:872, 1952;.
53 +
Eastcott, H. H. G.; Fawcett, J. K., and Rob, C. G.:  Some Factors Affecting Uropepsinogen Excretion in Man , Lancet 1:541, 1951;.
54 +
Kirsner, J. B., and Palmer, W. L.:  Effect of Corticotropin (ACTH) in Chronic Ulcerative Colitis: Observations in 40 Patients , J. A. M. A. 147:541, 1951;.
55 +
West, P. M.; Ellis, F. W., and Scott, B. L.:  Simplified Method for Determining Excretion Rate of Uropepsin , J. Lab. & Clin. Med. 39:159, 1952;.
56 +
Westphal, O.; Luderitz, O., and Keiderling, W.:  Über Uropepsin , Ztschr. Naturforsch. 6:309, 1951;.
57 +
Geyer, G., and Keibl, E.:  Die Pepsinogenausscheidung im Harn und ihre tagesrhythmischen Schwankungen , Wein. med. Wchnschr. 103:748, 1953;.
58 +
Hirschowitz, B. I.; Streeten, D. H. P.; Pollard, H. M., and Boldt, H. A., Jr.:  Role of Gastric Secretion in Activation of Peptic Ulcers by Corticotropin (ACTH) , J. A. M. A. 158:27, 1955;.
59 +
Villarreal, R.; Ganong, W. F., and Gray, S. J.:  Effect of Adrenocorticotrophic Hormone upon the Gastric Secretion of Hydrochloric Acid, Pepsin and Electrolytes in the Dog , Am. J. Physiol. 183:485, 1955;.
60 +
Hirschowitz, B. I.:  Pepsinogen in the Blood , J. Lab. & Clin. Med. 46:568, 1955;.
61 +
Hoar, C. S., Jr., and Browning, J. R.:  Plasma Pepsinogen in Peptic Ulcer Disease and Other Gastric Disorders , New England J. Med. 255:153, 1956;.
62 +
Wolfson, W. Q., and Timmis, G. W.:  Human Corticosterone Metabolism: V. The Failure of Large Oral Doses of Corticosterone to Increase Urinary Uropepsin , J. Clin. Endocrinol. 15:991, 1955;.
63 +
Baker, B. L.:  The Influence of the Hypophysis and Adrenals on Digestive Function , Am. J. Clin. Nutrition 5:455, 1957;.
64 +
Sun, D. C. H.; Shay, H.; Siplet, H., and Gruenstein, M.:  The Effect of Experimental Athyroidism and Hypothyroidism upon Gastric Secretion in the Rat , Gastroenterology 27:189, 1954;.
65 +
Vario, V.; Faredin, I., and Novaszel, F.:  Plasma Pepsinogen Concentration and Adrenocortical Activity , Acta med. scandinav. 153:211, 1956;.
66 +
Broh-Kahn, R. H.; Podore, C. J., and Mirsky, I. A.:  Uropepsin Excretion by Man: II. Uropepsin Excretion by Healthy Men , J. Clin. Invest. 27:825, 1948;.

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References

1 +
Mirsky, I. A.; Futterman, P.; Kaplan, S., and Broh-Kahn, R. H.:  Blood Plasma Pepsinogen: I. Source, Properties and Assays of Proteolytic Activity of Plasma at Acid Reactions , J. Lab. & Clin. Med. 40:17, 1952;.
2 +
Hirschowitz, B. I.:  Pepsinogen in the Blood , J. Lab. & Clin. Med. 46:568, 1955;.
3 +
Spiro, H. M.; Reifenstein, R. W., and Gray, S. J.:  The Effect of Adrenocorticotrophic Hormone upon Uropepsin Excretion , J. Lab. & Clin. Med. 35:899, 1950;.
4 +
Gray, S. J.; Ramsey, C. G., and Reifenstein, R. W.:  Clinical Use of the Urinary Uropepsin Determination in Medicine and Surgery , New England J. Med. 251:835, 1954;.
5 +
Grayzel, H. G.; Warshall, H. B.; Elkan, B. S., and Sternberg, A.:  24-Hour Urinary Pepsinogen Excretion in Juvenile Diabetes , Diabetes 6:480, 1957;.
6 +
Mirsky, A.; Kaplan, S., and Broh-Kahn, R. H.:  Pepsinogen Excretion (Uropepsin) as an Index of the Influence of Various Life Situations on Gastric Secretion , A. Res. Nerv. & Ment. Dis., Proc. 29:628, 1950;.
7 +
Balfour, D. C., Jr.:  Uropepsin , Advances Int. Med. 6:13, 1954;.
8 +
Segal, H. L.; Miller, L. L.; Reichsman, F.; Plumb, E. J., and Glaser, G. L.:  Proteolytic Enzyme Activity: I. Urinary Proteolytic Activity at pH 1.5 in Adults , Gastroenterology 33:557, 1957;.
9 +
Fisher, A. A.: Statistical Methods for Research Workers , Ed. 10, Edinburgh, Oliver & Boyd, Ltd., 1948;.
10 +
Baldwin, E.: Dynamic Aspects of Biochemistry , London, Cambridge University Press, 1949;.
11 +
Babkin, B. P.: Secretory Mechanism of the Digestive Glands , Ed. 2, New York, Paul B. Hoeber, Inc. (medical book department of Harper & Brothers), 1950;.
12 +
Northrop, J. H.; Junitz, M., and Herriott, R. M.: Crystalline Enzymes , Ed. 2, New York, Columbia University Press, 1948;.
13 +
Hirschowitz, B. I.:  Pepsinogen: Its Origin, Secretion and Excretion , Physiol. Rev. 37:475, 1957;.
14 +
Frouin, A.:  Sur l'Origine et le lieu de résorption de la pepsin urinaire , Compt. rend. Soc. biol. 56:204, 1904;.
15 +
Bucher, G. R., and Ivy, A. C.:  Disappearance of Uropepsin from the Urine of Gastrectomized Cats , Am. J. Physiol. 150:415, 1947;.
16 +
Balfour, D. C., Jr.; Preston, F. W., and Bolman, J. L.:  The Disappearance of Uropepsin Following Total Gastrectomy , Gastroenterology 10:880, 1948;.
17 +
Farnsworth, E. B.; Speer, H., and Alt, H. L.:  The Quantitative Determinations of a Pepsin-Like Substance in the Urine of Normal Individuals and of Patients with Pernicious Anemia , J. Lab. & Clin. Med. 31:1025, 1946;.
18 +
Bucher, G. R.:  Uropepsin: A Review of the Literature and Report of Some Experimental Findings , Gastroenterology 8:627, 1947;.
19 +
Podore, C. J.; Broh-Kahn, R. H., and Mirsky, I. A.:  Uropepsin Excretion by Man: III. Uropepsin Excretion by Patients with Peptic Ulcer and Other Lesions of the Stomach , J. Clin. Invest. 27:834, 1948;.
20 +
Bucher, G. R., and Anderson, A.:  Uropepsin Output in Cats Treated with Caffeine and Histamine , Am. J. Physiol. 153:454, 1948;.
21 +
Matthes, M., cited by Bucher and Anderson.20
22 +
Mirsky, I. A.; Bach, S.; Osher, S., and Broh-Kahn, R. H.:  Uropepsin Excretion by Man: I. Source, Properties and Assay of Uropepsin , J. Clin. Invest. 27:818, 1948;.
23 +
Janowitz, H. D., and Hollander, F.:  Relation of Uropepsinogen Excretion to Gastric Pepsin Secretion in Man , J. Appl. Physiol. 4:53, 1951;.
24 +
Janowitz, H. D., and Hollander, F.:  Exocrine-Endocrine Partition of Enzymes in Digestive Tract , Gastroenterology 17:591, 1951;.
25 +
Hollander, F.:  Current Views on the Physiology of the Gastric Secretions , Am. J. Med. 13: 453, 1952;.
26 +
Kowalewski, K.; Nowell, S. T., Jr., and MacKenzie, W. C.:  The Gastric Endocrine and Exocrine Response to Histamine in Dogs and Effect of Passage of Blood Through the Gastric and Hepatic Vessels on its Pepsinogen Content , Canad. J. Biochem. & Physiol. 34:244, 1956;.
27 +
Tuerkischer, E., and Wertheimer, E.:  Adrenalectomy and Gastric Secretion , J. Endocrinol. 4:143, 1945;.
28 +
Haeger, K.; Jacobsohn, D., and Kahlson, G.:  Atrophy of the Gastrointestinal Mucosa Following Hypophysectomy or Adrenalectomy , Acta physiol. scandinav. 30 ( (Supp. 111) ):161, 1953;.
29 +
Abrams, G. D., and Baker, B. L.:  The Cytology and Secretory Activity of Gastric Zymogenic Cells After Ablation of Ductless Glands , Gastroenterology 27:462, 1954;.
30 +
Baker, B. L., and Abrams, G. D.:  Effect of Hypophysectomy on the Cytology of the Fundic Glands of the Stomach and on the Secretion of Pepsin , Am. J. Physiol. 177:409, 1954;.
31 +
Baker, B. L., and Bridgman, R. M.:  The Histology of the Gastro-Intestinal Mucosa (Rat) After Adrenalectomy or Administration of Adrenocortical Hormones , Am. J. Anat. 94:363, 1954;.
32 +
Baker, B. L.:  The Adrenal Steroids and the Secretion of Digestive Enzymes , Ann. New York Acad. Sc. 61:324, 1955;.
33 +
Levy, A. H., and Levine, S.:  Uropepsin Excretion Studies in Clinical Surgery , Gastroenterology 30:270, 1956;.
34 +
Woodward, E. R.; Schapior, H., and Armstrong, G.:  Relation Between Uropepsin Excretion and Secretion of Gastric Juice , J. Appl. Physiol. 8:643, 1955-1956;.
35 +
Rigler, S. P.; Oberhelman, H. A.; Hanke, M. M., and Dragstedt, L. R.:  Uropepsin as a Measure of Gastric Secretion , A. M. A. Arch. Surg. 71:63, 1955;.
36 +
Spiro, H. M.; Ryan, A. E., and Jones, C. M.:  The Relation of Blood Pepsin to Gastric Secretion with Particular Reference to Anacidity and Achylia , Gastroenterology 30:563, 1956;.
37 +
Forrest, A. P. M., and Code, C. F.:  Effect of Post-Ganglionic Sympathectomy on Canine Gastric Secretion , Am. J. Physiol. 177:425, 1954;.
38 +
Janowitz, H. D.:  Quantitative Test of Gastro-Intestinal Function , Am. J. Med. 13:467, 1952;.
39 +
Fornstein, S., and Eichen, S.:  Influence of Smoking on Urinary Pepsinogen Excretion , Proc. Soc. Exper. Biol. & Med. 86:619, 1954;.
40 +
Addison, T.: On the Constitutional and Local Effects of the Suprarenal Capsules, London, Highley, 1855.
41 +
Bavetta, L.; Hallman, L.; Deuel, H. J., Jr., and Greeley, P. O.:  The Effect of Adrenalectomy on Fat Absorption , Am. J. Physiol. 134:619, 1941;.
42 +
Althausen, T. L.; Anderson, E. M., and Stockholm, M.:  The Effect of Adrenalectomy and of Sodium Chloride on Intestinal Absorption of Dextrose , Proc. Soc. Exper. Biol. & Med. 40:342, 1939;.
43 +
Clark, W. G.:  Effect of Adrenalectomy upon Intestinal Absorption of Sodium Chloride , Proc. Soc. Exper. Biol. & Med. 40:468, 1939;.
44 +
Haroutinian, L. M., and Segal, H. L.:  The Shay Rat as an Assay Animal for Anti-Ulcer Factors: IV. The Effect of Adrenalectomy and Nephrectomy , Gastroenterology 21:556, 1952;.
45 +
Madden, R. J., and Ramsburg, H. H.:  Adrenalectomy in the Shay Rat , Gastroenterology 18:128, 1951;.
46 +
Madden, R. J., and Ramsburg, H. H.:  Gastric Secretion in the Adrenalectomized Rat , Endocrinology 49:82, 1951;.
47 +
Gray, S. J.; Ramsey, C. G.; Villarreal, R., and Krakauer, L. J.: Adrenal Influences upon the Stomach and the Gastric Response to Stress: Fifth Annual Report on Stress (1955-1956) , edited by H. Selye and G. Heuser, New York, MD Publications, Inc., 1956;.
48 +
Gray, S. J.:  Relationships of the Adrenal Gland to Peptic Ulcer , M. Clin. North America , p. 1471, 1957;.
49 +
Spiro, H. M.; Reifenstein, R. W., and Gray, S. J.:  The Effect of Adrenocorticotrophic Hormone upon Uropepsin Excretion , J. Lab. & Clin. Med. 35:899, 1950;.
50 +
Gray, S. J.; Benson, J. A., Jr., and Reifenstein, R. W.:  The Effect of ACTH and Cortisone upon the Stomach: Its Significance in the Normal and in Peptic Ulcer , Gastroenterology 19:658, 1951;.
51 +
Gray, S. J.; Benson, J. A., Jr., and Reifenstein, R. W.:  Chronic Stress and Peptic Ulcer: I. The Effect of ACTH and Cortisone upon Gastric Secretion , J. A. M. A. 147:1529, 1951;.
52 +
Goodman, R. D.; Sandoval, E., and Halsted, J. A.:  Observations on Some Technical and Clinical Factors Influencing Determination of Uropepsin Excretion in Man , J. Lab. & Clin. Med. 40:872, 1952;.
53 +
Eastcott, H. H. G.; Fawcett, J. K., and Rob, C. G.:  Some Factors Affecting Uropepsinogen Excretion in Man , Lancet 1:541, 1951;.
54 +
Kirsner, J. B., and Palmer, W. L.:  Effect of Corticotropin (ACTH) in Chronic Ulcerative Colitis: Observations in 40 Patients , J. A. M. A. 147:541, 1951;.
55 +
West, P. M.; Ellis, F. W., and Scott, B. L.:  Simplified Method for Determining Excretion Rate of Uropepsin , J. Lab. & Clin. Med. 39:159, 1952;.
56 +
Westphal, O.; Luderitz, O., and Keiderling, W.:  Über Uropepsin , Ztschr. Naturforsch. 6:309, 1951;.
57 +
Geyer, G., and Keibl, E.:  Die Pepsinogenausscheidung im Harn und ihre tagesrhythmischen Schwankungen , Wein. med. Wchnschr. 103:748, 1953;.
58 +
Hirschowitz, B. I.; Streeten, D. H. P.; Pollard, H. M., and Boldt, H. A., Jr.:  Role of Gastric Secretion in Activation of Peptic Ulcers by Corticotropin (ACTH) , J. A. M. A. 158:27, 1955;.
59 +
Villarreal, R.; Ganong, W. F., and Gray, S. J.:  Effect of Adrenocorticotrophic Hormone upon the Gastric Secretion of Hydrochloric Acid, Pepsin and Electrolytes in the Dog , Am. J. Physiol. 183:485, 1955;.
60 +
Hirschowitz, B. I.:  Pepsinogen in the Blood , J. Lab. & Clin. Med. 46:568, 1955;.
61 +
Hoar, C. S., Jr., and Browning, J. R.:  Plasma Pepsinogen in Peptic Ulcer Disease and Other Gastric Disorders , New England J. Med. 255:153, 1956;.
62 +
Wolfson, W. Q., and Timmis, G. W.:  Human Corticosterone Metabolism: V. The Failure of Large Oral Doses of Corticosterone to Increase Urinary Uropepsin , J. Clin. Endocrinol. 15:991, 1955;.
63 +
Baker, B. L.:  The Influence of the Hypophysis and Adrenals on Digestive Function , Am. J. Clin. Nutrition 5:455, 1957;.
64 +
Sun, D. C. H.; Shay, H.; Siplet, H., and Gruenstein, M.:  The Effect of Experimental Athyroidism and Hypothyroidism upon Gastric Secretion in the Rat , Gastroenterology 27:189, 1954;.
65 +
Vario, V.; Faredin, I., and Novaszel, F.:  Plasma Pepsinogen Concentration and Adrenocortical Activity , Acta med. scandinav. 153:211, 1956;.
66 +
Broh-Kahn, R. H.; Podore, C. J., and Mirsky, I. A.:  Uropepsin Excretion by Man: II. Uropepsin Excretion by Healthy Men , J. Clin. Invest. 27:825, 1948;.

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Compression-Only CPR: Pushing the Science Forward
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AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
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