Esophageal pH monitoring developed a dependable external reference electrode. Using this technique to monitor esophageal acid exposure patients for periods up to 24 hours, DeMeester and Johnson were able to identify the most important parameters of esophageal acid exposure, and they developed a composite pH score to quantify gastroesophageal reflux. The initial 24-hour pH studies required hospitalization until the introduction of microcircuits in the 1980s that allowed portable esophageal pH monitoring in an outpatient setting. Gastroesophageal reflux disease (GERD) is a common disease in western countries. In the United States, 7% of the population experiences heartburn daily and 44% at least once a
Amino acid acids is about 9.4). Because all amino acids contain amine and carboxylic acid functional groups, they share amphiprotic properties. Below pH 2.2, the predominant form will have a neutral carboxylic acid group and a positive α-ammonium ion (net charge +1), and above pH 9.4, a negative carboxylate and neutral α-amino group (net charge −1). But at pH between 2.2 and 9.4, an amino acid usually contains both a negative carboxylate and a positive α-ammonium group, as shown in structure (2) on the right, so has net zero charge. This molecular state is known as a zwitterion, from the German Zwitter