This article, which is partly biographical and partly scientific, summarizes a life in academic medicine. It relates my progress from benchside to bedside and then to academic and research administration, and concludes with the teaching of human biology to college undergraduates. My experience as an intern (anno 1953) treating a youngster in diabetic ketoacidosis underscored our ignorance of the controls in human fuel metabolism. Circulating free fatty acids were then unknown, insulin could not be measured in biologic fluids, and beta-hydroxybutyric acid, which was difficult to measure, was considered by many a metabolic poison. The central role of insulin and the metabolism of free fatty acids, glycerol, glucose, lactate, and pyruvate, combined with indirect calorimetry, needed characterization in a near-steady state, namely prolonged starvation. This is the main topic of this chapter. Due to its use by brain, D-beta-hydroxybutyric acid not only has permitted man to survive prolonged starvation, but also may have therapeutic potential owing to its greater efficiency in providing cellular energy in ischemic states such as stroke, myocardial insufficiency, neonatal stress, genetic mitochondrial problems, and physical fatigue.

中文翻译：

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饥饿中的燃料代谢。

本文部分是传记式的，部分是科学的，总结了学术医学的生活。它涉及到我从实验室工作到床边学习，再到学术研究管理的进步，并以对大学生为对象的生物学教学作为结束。我作为一名实习生（1953年，安诺）在糖尿病酮症酸中毒中治疗年轻人的经历突显了我们对人体燃料代谢控制的无知。当时未知循环中的游离脂肪酸，无法在生物体液中测定胰岛素，许多代谢毒物都认为很难测定的β-羟基丁酸。胰岛素的主要作用以及游离脂肪酸，甘油，葡萄糖，乳酸和丙酮酸的代谢，以及间接量热法，都需要在接近稳定的状态下进行表征，即长期饥饿。这是本章的主题。由于其被大脑使用，D-β-羟基丁酸不仅可以使人长期处于饥饿状态，而且由于其在缺血性状态（例如中风，心肌供血不足，新生儿应激）中提供细胞能量的效率更高而具有治疗潜力。 ，线粒体遗传问题和身体疲劳。