An historical review of rheumatoid arthritis treatment: 1948 to 1952.

OBJECTIVES: The early responses by practicing physicians to the discovery of the effect of cortisone (compound E) and adrenocorticotropic hormone (ACTH) on acute rheumatoid arthritis in 1948 and their reactions to the drugs' scarcity have been reviewed. METHODS: Review of the relevant literature in American, British, and European medical journals and some newspapers. RESULTS: Whereas the effect of the compound E and ACTH was stunning, their scarcity made them unavailable to most physicians. Nevertheless, practicing physicians took a lively interest in the new therapy, as witnessed by the large number of letters with comments and questions to professional journals from all over the world. As expected, most of these were about attempts to find a substitute for cortisone or a way to release it endogenously to a sufficient degree. A few alternative therapies were suggested too, some quite unorthodox. A lively interest was shown by the general public. CONCLUSIONS: No alternative therapy recommended to treat acute rheumatoid arthritis in lieu of cortisone proved to be effective. The era of scarcity was ended by the discovery of a more efficient method to manufacture cortisone.

Transfer of carbon atoms among circulating glucose, alanine, and lactate in pancreatectomized dogs.

The rates of transfer of carbon atoms (mg C . kg body wt-1 . min-1) among plasma glucose, alanine, and lactate have been calculated in pancreatectomized dogs from the tracer concentration versus time curves in the plasma after an intravenous injection of either [2,3-3H]- and [U-14C]alanine or [3-3H]- and [U-14C]glucose. The calculations were based on an integrated kinetic model derived earlier from experimental data. In comparison to normal dogs, in insulin-deprived pancreatectomized dogs, the rate of turnover of glucose (mg C . kg-1 . min-1) is increased about twofold, but the turnover rates of lactate and alanine are not changed significantly. About twice as much carbon is transferred from lactate to glucose, whereas the transfer of carbon from alanine is increased by 47%. Carbon transfer to glucose from unidentified sources is also doubled. In conclusion, in the pancreatectomized dog, gluconeogenesis is increased not by an increased production of alanine and lactate but by an increased diversion of their carbon atoms to glucose at the expense of other pathways.