III.3. Hormones and Hormone Regulators

Progestins, estrogens and oral contraceptives

In the 1930s, two female hormones were isolated and produced from natural sources, the urine of pregnant mare, and the Mexican sweet root. Progestins (progesterone, luteal hormone) were discovered to maintain gestation, and estrogens (follicular hormones) were understood to affect menstrual cycles. In the 1950s, synthetic versions of these hormones were produced and their effects on human conception and pregnancy were studied. Their excellent contraceptive qualities led to the development of oral contraceptives (birth control pills) for women. Enovid, marketed in the USA in 1960, was the first birth control pill to contain a mixture of estrogens and progestins for maximum effectiveness.

III.4. Gastro-intestinal Agents

Evolution of ulcer therapy

In 1972, James Black, a Scottish pharmacologist, and his colleagues at Smith, Kline & French shed light on the basis of surplus acid secretion in the stomach. This type of pharmaceutical research is now called rational drug design. By 1975, they developed the drug cimetidine (Tagamet) inhibits gastric acid secretion with minimal side-effects, and its widespread use for gastric ulcers dramatically decreased the need for surgery. Tagamet soon became the most frequently prescribed drug. Subsequent anti-ulcer drugs include omeprazole (Prilosec) in 1988 and lansoprazole (Prevacid) in 1992.

III.5. Medical Testing and Disease DiagnosticsMedical imaging technologies

Devices like x-ray machines and MRI (magnetic resonance imaging) scanners, revolutionary at the time of their discovery, are now a routine part of diagnosis and medical care. Wilhelm Konrad Roentgen, the German physicist who discovered x-rays in 1895, first produced an image of the bones in his wife’s hand. By 1900, every large hospital had an x-ray machine. Nuclear magnetic resonance (NMR) technology was used to determine chemical structure in the 1970s, and Magnetic Resonance Imaging scanners were approved for human usein 1985. Chemical contrasting agents and special film emulsions also improve the diagnostic value of x-rays, CT scans (three-dimensional x-ray imaging, computer tomography), and MRI and ultra sound images.

The transilluminated

hand of Mrs. Roentgen

III.5. Medical Testing and Disease Diagnostics

Medical isotopes

Medical imaging has been much aided by the use of medical isotopes to determine the function of internal organs, following the pioneering work of Georg Hevesy, the Hungarian Nobel Laureate (1943). Hevesy determined the phosphor metabolism by radioactive nuclides. Compounds are labeled with radioactive isotopes (such as technetium-99m and thallium-201) or radio-opaques (such as barium and iodine compounds). The radio-labeled compounds can then be tracked through the body by gamma-detecting cameras to provide useful images of organs to which they are transported. The diagnostic applications of medical isotopes include tumor detection, diagnosis of liver disease, and the stress test for cardiac function.

III.5. Medical Testing and Disease Diagnostics

Development of chemical assays

Today, we determine medical conditions by studying disease markers or drugs residues that can be chemically detected in blood, urine, feces, saliva, and perspiration. Laboratory testing, sophisticated computer-assisted analytical instruments, and at-home testing all measure fundamental chemical reactions. In the early 19th century, diagnosis was based on observing clinical symptoms; if a patient responded positively to a disease-specific treatment, then he or she must have the disease. Diagnostic testing began in 1882 when Paul Ehrlich observed that only the presence of typhoid bacillus (as identified with a certain dye) could prove a diagnosis of typhoid fever. Before, the diagnosis was based on the color of the patient’s skin.

III.5. Medical Testing and Disease Diagnostics

Evolution of personal monitoring

Simplified at-home test kits facilitate the personal monitoring of human health. For example, diabetic patients once had to visit a laboratory to determine if sugar was present in their urine. In 1941, Miles Laboratories introduced the first convenient sugar-in-urine assay for home use. Although difficult to develop, dip-and-read urine tests were finally introduced in 1956. In the 1960s, the first portable, battery-operated blood glucose meter was introduced to work with chemical sticks to detect the glucose, considerably improving the quality of life for diabetic patients. In the 1970s and 1980s, home-use diagnostic kits for fecal occult blood, ovulation, pregnancy, and strep were introduced.