{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T23:27:02Z","timestamp":1792279622349,"version":"4.4.0"},"reference-count":43,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1974,2]]},"abstract":"<jats:p>Serum acid phosphatase (AcPase) was measured by a colorimetric method utilizing adenosine 3\u2032 -monophosphate as substrate in 389 patients. In about half the cases blood was taken shortly after a rectal examination. The upper reference limit (mean + 2SD) for 116 cases with miscellaneous illness after eliminating outliers was 4\u00b71 International Units per litre (U\/I) at 37\u00b0C, and no correlation existed between AcPase activity and age in these subjects (r = 0\u00b7040). Eight of 18 patients with untreated carcinoma confined within the prostate gland had AcPase activities below 4\u00b71 U\/l, and all of 27 cases with extension to pelvic soft tissues or to bone exceeded this value. AcPase activities above 4\u00b71 U\/l were found in 6% of cases with benign hypertrophy of the prostate, in 5% of cases with non-prostatic cancer, and in none of 22 cases with other urological illness.<\/jats:p>\n                  <jats:p>Raised serum alkaline phosphatase (APase) activity was found in 60% of patients with untreated prostatic cancer and in only 6% of patients free of prostatic cancer, in most of whom there was a clinical explanation for the elevation. The correlation between the two phosphatase activities was not significant (r = 0\u00b7294). While APase activity does not reflect the stage of the disease as closely as AcPase activity, and is not so frequently elevated, it provided useful confirmation of the diagnosis in five patients of the present series whose AcPase levels were normal or only minimally elevated.<\/jats:p>","DOI":"10.1136\/jcp.27.2.140","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"140-147","source":"Crossref","is-referenced-by-count":14,"title":["An assessment of serum acid and alkaline phosphatase determinations in prostatic cancer with a clinical validation of an acid phosphatase assay utilizing adenosine 3\u2032 -monophosphate as substrate"],"prefix":"10.1136","volume":"27","author":[{"given":"David M.","family":"Goldberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Ellis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1974,2,1]]},"reference":[{"key":"ref_1","article-title":"Siullivan et","author":"al","year":"1942","unstructured":"Siullivan et al (1942)"},{"key":"ref_2","article-title":"change in serum AcPase levels after rectal examination (Marshall and Amador, 1969; Christensen and Nielsen","year":"1972","unstructured":"change in serum AcPase levels after rectal examination (Marshall and Amador, 1969; Christensen and Nielsen, 1972)."},{"key":"ref_3","article-title":"The value of 41 U\/l suggested as the reference limit for this AcPase assay appears to serve as a good discriminant, the overall incidence of 'falsepositive' elevations being lower than in almost all the major reports reviewed by Bodansky (1972). Failure to find an association between serum AcPase and age is in accord with previous results","volume-title":"In our hands the assay has given clinically useful results and appears to justify its inclusion in the routine investigtion of prostatic disease and even in males with non-specific 'backache'. Consideration of the curious circumstances surrounding cases","year":"1972","unstructured":"The value of 41 U\/l suggested as the reference limit for this AcPase assay appears to serve as a good discriminant, the overall incidence of 'falsepositive' elevations being lower than in almost all the major reports reviewed by Bodansky (1972). Failure to find an association between serum AcPase and age is in accord with previous results (Day, Ying, Schwartz, Whitmore, and Bodansky, 1956; Ericksson, Ginsburg, Hultberg, and Ockerman, 1972). In our hands the assay has given clinically useful results and appears to justify its inclusion in the routine investigtion of prostatic disease and even in males with non-specific 'backache'. Consideration of the curious circumstances surrounding cases 2 and 9 (table Ill) and of the fact that two of the stage D cases had been treated at a rheumatic clinic for some months before the diagnosis was made, suggests that those clinicians who ignore the value of AcPase determinations do so at the peril of some, at least, of their patients."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1042\/bj0450051","article-title":"Properties of the acid phosphatases of erythrocvtes and of the human prostate gland","volume":"45","author":"Abul-Fadi, M.A.M.; King, E.J.","year":"1949","unstructured":"Abul-Fadi, M. A. M., and King, E. J. (1949). Properties of the acid phosphatases of erythrocvtes and of the human prostate gland. Biochemn. 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Path"},{"key":"ref_7","first-page":"83","article-title":"The importance of the substrate in assays of acid phosphatase in serum. A4iier","volume":"32","author":"Babson, A.L.; Read, P.A.; Phillips, G.E.","year":"1959","unstructured":"Babson, A. L., Read, P. A., and Phillips, G. E. (1959). The importance of the substrate in assays of acid phosphatase in serum. A4iier. J. (lin. Put\/h., 32, 83-87.","journal-title":"J. (lin. Put\/h"},{"key":"ref_8","first-page":"135148","article-title":"Hydrolysis of adenosine monophosphates bs acid phosphatases as measured by a continuous spectrophotometric assas","volume":"4","author":"Belfield, A.; Goldberg, D.M.","year":"1971","unstructured":"Belfield, A., and Goldberg, D. M. (1971). Hydrolysis of adenosine monophosphates bs acid phosphatases as measured by a continuous spectrophotometric assas. Biochemi. Wed., 4, 135148.","journal-title":"Biochemi. Wed"},{"key":"ref_9","first-page":"1179","article-title":"Biochemistry of Disease","author":"Bodansky, M.; Bodansky, 0","year":"1952","unstructured":"Bodansky, M., and Bodansky, 0. (1952). Biochemistry of Disease, 2nd ed., p. 1179. Macmillan, New York.","edition":"2nd ed"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0065-2423(08)60159-6","article-title":"Acid phosphatase","volume":"15","author":"Bodansky, 0","year":"1972","unstructured":"Bodansky, 0. (1972). Acid phosphatase. Advanc. clin. Chem., 15, 43-147.","journal-title":"Advanc. clin. Chem"},{"key":"ref_11","first-page":"179183","article-title":"Some factors other than neoplasms altering the prostatic fraction of acid phosphatase in the serum","volume":"99","author":"Bonner, C.D.; Homburger, F.; Fishman, W.H.","year":"1954","unstructured":"Bonner, C. D., Homburger, F., and Fishman, W. H. (1954). Some factors other than neoplasms altering the prostatic fraction of acid phosphatase in the serum. Surg. Gynec. Obstet., 99, 179183.","journal-title":"Surg. Gynec. Obstet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"103","DOI":"10.3109\/00365597209133619","article-title":"Serum acid phosphatase: the influence of routine rectal examination with diagnostic palpation of the prostate","volume":"6","author":"Christensen, P.; Nielsen, M.L.","year":"1972","unstructured":"Christensen, P., and Nielsen, M. L. (1972). Serum acid phosphatase: the influence of routine rectal examination with diagnostic palpation of the prostate. Scand. J. Urol. Nephrol., 6, 103-106.","journal-title":"Scand. J. Urol. Nephrol"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1093\/clinchem\/18.2.131","article-title":"Determination of serum acid phosphatase activity: a performance evaluation for clinical laboratories of upstate New York","volume":"18","author":"Copeland, W.H.; Vanderlinde, R.E.","year":"1972","unstructured":"Copeland, W. H., and Vanderlinde, R. E. (1972). Determination of serum acid phosphatase activity: a performance evaluation for clinical laboratories of upstate New York. Clin. Chem., 18, 131-136.","journal-title":"Clin. Chem"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1016\/S0140-6736(52)90643-0","article-title":"Rise of serum-acid-phosphatase level following palpation of the prostate","volume":"1","author":"Daniel, O.; Van Zyl, J.J.","year":"1952","unstructured":"Daniel, O., and Van Zyl, J. J. (1952). Rise of serum-acid-phosphatase level following palpation of the prostate. Lancet, 1, 998-999.","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1002\/1097-0142(195603\/04)9:2<222::AID-CNCR2820090204>3.0.CO;2-4","article-title":"Serum prostatic acid-phosphatase levels in the male patients of a cancer-prevention clinic","volume":"9","year":"1956","unstructured":"Day, E., Ying, S. H., Schwartz, M. K., Whitmore, W. F., Jr., and Bodansky, 0. (1956). Serum prostatic acid-phosphatase levels in the male patients of a cancer-prevention clinic. Cancer (Philad.), 9, 222-227.","journal-title":"Cancer (Philad.)"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1136\/bmj.4.5733.470","article-title":"Prostatic contribution to normal serum acid phosphatase","volume":"4","author":"Dow, D.; Whitaker, R.H.","year":"1970","unstructured":"Dow, D., and Whitaker, R. H. (1970). Prostatic contribution to normal serum acid phosphatase. Brit. med. J., 4, 470-472.","journal-title":"Brit. med. J"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1136\/jcp.24.6.493","article-title":"Colorimetric determination of serum acid phosphatase activity using adenosine 3'-monophosphate as substrate","volume":"24","author":"Ellis, G.; Belfield, A.; Goldberg, D.M.","year":"1971","unstructured":"Ellis, G., Belfield, A., and Goldberg, D. M. (1971). Colorimetric determination of serum acid phosphatase activity using adenosine 3'-monophosphate as substrate. J. clin. Path., 24, 493-500.","journal-title":"J. clin. Path"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/0009-8981(72)90268-9","article-title":"Influence of age and sex on plasma acid hydrolases","volume":"40","author":"Eriksson, O.; Ginsburg, B.E.; Hultberg, B.; Ockerman, P.A.","year":"1972","unstructured":"Eriksson, O., Ginsburg, B. E., Hultberg, B., and Ockerman, P. A. (1972). Influence of age and sex on plasma acid hydrolases. Clin. chim. Acta, 40, 181-185.","journal-title":"Clin. chim. Acta"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1056\/NEJM195611152552001","article-title":"Serum 'prostatic' acid phosphatase and cancer of the prostate","volume":"255","author":"Fishman, W.H.; Bonner, C.D.; Homburger, F.","year":"1956","unstructured":"Fishman, W. H., Bonner, C. D., and Homburger, F. (1956). Serum 'prostatic' acid phosphatase and cancer of the prostate. New Engl. J. Med., 255, 925-933.","journal-title":"New Engl. J. Med"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S0021-9258(18)38440-0","article-title":"A method for estimating serum acid phosphatase of prostatic origin","author":"Fishman, W.H.; Lerner, F.","year":"1953","unstructured":"Fishman, W. H., and Lerner, F. (1953). A method for estimating serum acid phosphatase of prostatic origin. J. biol. Chem., 200, 89-97.","journal-title":"J. biol. Chem"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1016\/0002-9343(59)90173-1","article-title":"Serum alkaline phosphatase activity in diseases of the skeletal and hepatobiliary systems: a consideration of the current status","volume":"27","author":"Gutman, A.B.","year":"1959","unstructured":"Gutman, A. B. (1959). Serum alkaline phosphatase activity in diseases of the skeletal and hepatobiliary systems: a consideration of the current status. Amer. J. Med., 27, 875-901.","journal-title":"Amer. J. Med"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1172\/JCI100974","article-title":"An 'acid' phosphatase occurring in the serum of patients with metastasizing carcinoma of the prostate gland","volume":"17","author":"Gutman, A.B.; Gutman, E.B.","year":"1938","unstructured":"Gutman, A. B., and Gutman, E. B. (1938). An 'acid' phosphatase occurring in the serum of patients with metastasizing carcinoma of the prostate gland. J. clin. Invest., 17, 473-478.","journal-title":"J. clin. Invest"},{"key":"ref_23","first-page":"103","article-title":"Determination of serum 'acid' phosphatase activity in differentiating skeletal metastases secondary to prostatic carcinoma from Paget's disease of bone","volume":"38","author":"Gutman, A.B.; Gutman, E.B.; Robinson, J.N.","year":"1940","unstructured":"Gutman, A. B., Gutman, E. B., and Robinson, J. N. (1940). Determination of serum 'acid' phosphatase activity in differentiating skeletal metastases secondary to prostatic carcinoma from Paget's disease of bone. Amer. J. Cancer, 38, 103-108.","journal-title":"Amer. J. Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1093\/qjmed\/15.59.221","article-title":"The estimation of prostatic phosphatase in serum and its use in the diagnosis of prostatic carcinoma","volume":"15","author":"Herbert, F.K.","year":"1946","unstructured":"Herbert, F. K. (1946). The estimation of prostatic phosphatase in serum and its use in the diagnosis of prostatic carcinoma. Quart. J. Med., 15, 221-241.","journal-title":"Quart. J. Med"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/S0022-5347(17)68960-2","article-title":"Elevation of serum acid phosphatase following prostatic massage","volume":"62","author":"Hock, E.; Tessier, R.N.","year":"1949","unstructured":"Hock, E., and Tessier, R. N. (1949). Elevation of serum acid phosphatase following prostatic massage. J. Urol., 62, 488-491.","journal-title":"J. Urol"},{"key":"ref_26","first-page":"449","article-title":"Acid phosphatases","volume-title":"The Enzymes","volume":"4","author":"Hollander, V.P.","year":"1971","unstructured":"Hollander, V. P. (1971). Acid phosphatases. In The Enzymes, edited by P. D. Boyer, 3rd ed., vol. 4, pp. 449-498. Academic Press, New York.","edition":"3rd ed"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/S0022-5347(17)63701-7","article-title":"Elevation of the acid phosphatase in benign prostatic disease","volume":"94","author":"Howard, Jr., P.J.; Fraley, E.E.","year":"1965","unstructured":"Howard, P. J., Jr., and Fraley, E. E. (1965). Elevation of the acid phosphatase in benign prostatic disease. J. Urol., 94, 687-690.","journal-title":"J. Urol"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1136\/jcp.7.4.322","article-title":"Estimation of plasma phosphatase by determination of hydrolysed phenol with aminoantipyrine","volume":"7","author":"Kind, P.R.N.; King, E.J.","year":"1954","unstructured":"Kind, P. R. N., and King, E. J. (1954). Estimation of plasma phosphatase by determination of hydrolysed phenol with aminoantipyrine. J. clin. Path., 7, 322-326.","journal-title":"J. clin. Path"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1093\/ajcp\/51.5.551","article-title":"Diagnostic usefulness of serum acid $-glycerophosphatase activities in prostatic disease","volume":"51","author":"Marshall, G.; Amador, E.","year":"1969","unstructured":"Marshall, G., and Amador, E. (1969). Diagnostic usefulness of serum acid $-glycerophosphatase activities in prostatic disease. Amer. J. clin. Path., 51, 551-554.","journal-title":"Amer. J. clin. Path"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/S0022-5347(17)62701-0","article-title":"Influence of tumor grade on survival and on serum acid phosphatase levels in metastatic carcinoma of the prostate","volume":"99","author":"Mobley, T.L.; Frank, I.N.","year":"1968","unstructured":"Mobley, T. L., and Frank, I. N. (1968). Influence of tumor grade on survival and on serum acid phosphatase levels in metastatic carcinoma of the prostate. J. Urol., 99, 321-323.","journal-title":"J. Urol"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1002\/1097-0142(196906)23:6<1309::AID-CNCR2820230611>3.0.CO;2-M","article-title":"Comparison of total and prostatic fraction serum acid phosphatase levels in patients with differentiated and undifferentiated prostatic carcinoma","volume":"23","author":"Murphy, G.P.; Reynoso, G.; Kenny, G.M.; Gaeta, J.F.","year":"1969","unstructured":"Murphy, G. P., Reynoso, G., Kenny, G. M., and Gaeta, J. F. (1969). Comparison of total and prostatic fraction serum acid phosphatase levels in patients with differentiated and undifferentiated prostatic carcinoma. Cancer (Philad.), 23, 1309-1314.","journal-title":"Cancer (Philad.)"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1001\/jama.1951.02920350015003","article-title":"Serum phosphatase determinations in diagnosis of prostatic cancer; a review of 1150 cases","volume":"145","author":"Nesbit, R.M.; Baum, W.C.","year":"1951","unstructured":"Nesbit, R. M., and Baum, W. C. (1951). Serum phosphatase determinations in diagnosis of prostatic cancer; a review of 1150 cases. J. Amer. med. Ass., 145, 1321-1324.","journal-title":"J. Amer. med. Ass"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1001\/jama.1969.03160240055015","article-title":"Chemical tests in the diagnosis of prostatic carcinoma","volume":"209","author":"Prout, Jr, G.R.","year":"1969","unstructured":"Prout, G. R., Jr. (1969). Chemical tests in the diagnosis of prostatic carcinoma. J. Amer. med. Ass., 209, 1699-1670.","journal-title":"J. Amer. med. Ass"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1002\/1097-0142(196711)20:11<1871::AID-CNCR2820201112>3.0.CO;2-D","article-title":"Response of men with advanced prostatic carcinoma to exogenous administration of testosterone","volume":"20","author":"Prout, Jr., G.R.; Brewer, W.R.","year":"1967","unstructured":"Prout, G. R., Jr., and Brewer, W. R. (1967). Response of men with advanced prostatic carcinoma to exogenous administration of testosterone. Cancer (Philad.), 20, 1871-1878.","journal-title":"Cancer (Philad.)"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/S0022-5347(17)71556-X","article-title":"Clinical significance of increased serum 'acid' phosphatase in patients with bone metastases secondary to prostatic carcinoma","volume":"42","author":"Robinson, J.N.; Gutman, E.B.; Gutman, A.B.","year":"1939","unstructured":"Robinson, J. N., Gutman, E. B., and Gutman, A. B. (1939). Clinical significance of increased serum 'acid' phosphatase in patients with bone metastases secondary to prostatic carcinoma. J. Urol., 42, 602-618.","journal-title":"J. Urol"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"111","DOI":"10.3109\/00365597109133588","article-title":"The effect of prostatic surgery on the acid phosphatase level","volume":"5","author":"Romslo, 1","year":"1971","unstructured":"Romslo, 1. (1971). The effect of prostatic surgery on the acid phosphatase level. Scand. J. Urol. Nephrol., 5, 111-115.","journal-title":"Scand. J. Urol. Nephrol"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1002\/1097-0142(196305)16:5<583::AID-CNCR2820160507>3.0.CO;2-L","article-title":"Comparative values of phosphatases and other serum enzymes in following patients with prostatic carcinoma: consideration of phosphohexose isomerase, glutamic oxalacetic transaminase, isocitric dehydrogenase, and acid and alkaline phosphatases","volume":"16","year":"1963","unstructured":"Schwartz, M. K., Greenberg, E., and Bodansky, 0. (1963). Comparative values of phosphatases and other serum enzymes in following patients with prostatic carcinoma: consideration of phosphohexose isomerase, glutamic oxalacetic transaminase, isocitric dehydrogenase, and acid and alkaline phosphatases. Cancer (Philad.), 16, 583-594.","journal-title":"Cancer (Philad.)"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/S0022-5347(17)70732-X","article-title":"Theory and application of the serum 'acid' phosphatase determination in metastasizing prostatic carcinoma; early effects of castration","volume":"48","author":"Sullivan, T.J.; Gutman, E.B.; Gutman, A.B.","year":"1942","unstructured":"Sullivan, T. J., Gutman, E. B., and Gutman, A. B. (1942). Theory and application of the serum 'acid' phosphatase determination in metastasizing prostatic carcinoma; early effects of castration. J. Urol., 48, 426-458.","journal-title":"J. Urol"},{"key":"ref_39","article-title":"Acid phosphatase","author":"Tsuboi, K.K.; Hudson, P.B.","year":"1953","unstructured":"Tsuboi, K. K., and Hudson, P. B. (1953). Acid phosphatase. I.","journal-title":"I"},{"key":"ref_40","first-page":"\"191","article-title":"Acid phosphatase. III. Specific kinetic properties of highly purified human prostatic phosphomonoesterase","volume":"55","author":"Tsjboi, K.K.; Hudson, P.B.","year":"1955","unstructured":"Tsjboi, K. K., and Hudson, P. B. (1955). Acid phosphatase. III. Specific kinetic properties of highly purified human prostatic phosphomonoesterase. Arch. Biochem., 55, 191-205. Veterans Administration Cooperative Urological Research Group (1968). Factors in the prognosis of carcinoma of the prostate: a cooperative study. J. Urol., 100, 59-65.","journal-title":"Arch. Biochem; Factors in the prognosis of carcinoma of the prostate: a cooperative study"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1002\/1097-0142(195203)5:2<236::AID-CNCR2820050206>3.0.CO;2-A","article-title":"Factors leading to elevations in serum acid glycerophosphatase","volume":"5","author":"Woodard, H.Q.","year":"1952","unstructured":"Woodard, H. Q. (1952). Factors leading to elevations in serum acid glycerophosphatase. Cancer (Philad.), 5, 236-241.","journal-title":"Cancer (Philad.)"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1002\/1097-0142(195311)6:6<1219::AID-CNCR2820060616>3.0.CO;2-B","article-title":"Changes in blood chemistry associated with carcinoma metastatic to bone","volume":"6","author":"Woodard, H.Q.","year":"1953","unstructured":"Woodard, H. Q. (1953). Changes in blood chemistry associated with carcinoma metastatic to bone. Cancer (Philad.), 6, 1219-1227.","journal-title":"Cancer (Philad.)"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1016\/0002-9343(59)90174-3","article-title":"The clinical significance of serum acid phosphatase","volume":"27","author":"Woodard, H.Q.","year":"1959","unstructured":"Woodard, H. Q. (1959). The clinical significance of serum acid phosphatase. Amer. J. Med., 27 902-910.","journal-title":"Amer. J. 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