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About Medford mail tribune. (Medford, Or.) 1909-1989 | View Entire Issue (March 10, 1963)
J, tf By ORLANDO J. MILLER, M. D. Aulttant Prafmur of Obstetrics and Gynecology and Ucturar in Gc-nc-tki, Coliimbia-r'rMbrterian Medical Cantor, Nw York 1U with lack Ryan be able to reduce the chances of cellu lar growth getting off track during a baby's development Consider cleft palate again. Two New Jersey doctors, Lyon P. Strean and Lyndon A. Peer, made a study of mothers of cleft-palate children. Most had suffered some illness or emotional disturbance, and in each case at a stage of pregnancy when the palate forms. Could these stresses have caused the mothers' adrenal gland to produce extra hydrocorti sone which, in turn, retarded normal formation of the baby's palate? The doctors injected female mice with cortisone and other agents in heavy dosage. The mice produced off spring with cleft palates. In the next experiment, the same agents were in troduced into the female mice but while the offsprings' palates were forming, the mice also received vita mins B6, B12, and C. This time, no cleft palates. Had the vitamins coun tered the original agents? If so, would it be practical to give these vitamins to an expectant mother who suffers illness at a stage of pregnan cy when the palate forms? No preventive has come out of this experiment, but it shows the direction research is taking in try ing to learn what causes abnormali ties and how to reduce them. This is important because we are not sure how permanent corrective surgery is. The cleft-palate child probably will have no future trouble. But what of the baby whose heart did not develop properly? Until 20 years ago, he faced death or incapacitation. Then Dr. Rob ert Gross performed an - operation on an infant's heart, closing off a malformed duct that was shunting blood from its normal circulatory route. From that pioneering effort, surgeons have advanced until they now probe the heart itself, mending nature's mistakes while machines take over the job of circulating blood. But if the heart had developed cor rectly, there would be less question of its enduring in adolescence and adulthood. Was this an inherited de fect? Or did some agent thwart na ture a drug the mother took, some thing awry in her body chemistry, or a virus infection? In 60 percent of the cases, we don't know what caused the anomalies, although scientists believe most con genital defects result from a combin- ation of causes. Are parents largely to blame for the defects? Sometimes they think so, yet there is little scien tific basis for this feeling. Only. 20 percent of abnormalities have been traced to inherited factors. Ten per cent probably come from chromosome aberrations (a breakdown of the chromosome, which helps pass on parents' characteristics, by nongene tic causes radiation would be one example), and another 10 percent from virus infection. THE THALIDOMIDE tragedies illus trate how more than one factor is probably involved in a deformed birth. You recall headlines about de formed babies being born to many mothers who took the drug, but what we overlooked is that deformities occurred only among 20 percent of thalidomide mothers. Why did most of them bear normal children? One guess is that the drug alone did not cause the deformity. It was a com bination of the drug and other factors. While we grope toward those "other factors," initial research has provided young women with a guide for reducing the risk of bearing de formed children. Abnormalities de velop in the first three months of pregnancy, with the first six weeks most vital, so obviously a woman should be under a doctor's care as early in pregnancy as possible. She will be advised to avoid such anomaly risks as X rays of the pelvic region, certain drugs, and high alti tudes. Some doctors may suggest immunization against influenza be cause we know that at least one virus can adversely influence development of the embryo and may lead to abor tion. In 1941, Dr. N. M. Gregg of Australia first proved that German measles, contracted during the first three months of pregnancy, produced heart malformations, cataracts, deaf ness, and other defects in the child. Despite such evidence, doctors could do little but warn expectant mothers of the risk of infection. Per haps they will do more in the future. Just last year American scientists succeeded in isolating the elusive virus that causes German measles. Evidence indicates that 90 percent of those infected develop neutralizing antibodies to the virus. There is a tremendous amount of work to be done on this development, but some hope is offered for a vaccine which would immunize child-bearing women against German measles. Are there other anomaly-producing viruses? Last year Australian doctors found indications that mongolism, which results from the presence of an extra chromosome, may be caused by a virus. For 16 years they kept records of mongoloid births, and the pattern typified those associated with viral epidemics. Mongoloid births clustered more in urban areas where there is more personal contact, and they increased in number at certain times one Melbourne suburb aver aged one or two mongoloids a year, then in 1944 seven were born in seven months, four in the same week and living within a quarter-mile area. Fifteen years later, five mongoloids were born in the same suburb within a half-block area. This is no more than a beginning, of course, but if borne out by other studies, we could hope to isolate the harmful virus someday, then try to develop an "an timongoloid vaccine." MEANWHILE, other scientists con centrate on helping those al ready born with afflictions. Signifi cant successes, for example, have been achieved with metabolic dis orders. A Swedish mother with two healthy children loses her newborn, and nobody knows why. But she re calls an uncommon odor to the baby's diapers, and from that slim clue eventually evolves treatment for phenylketonuria (PKU). In PKU, the liver fails to produce an enzyme which acts on phenylala nine. When unconverted, this life building amino acid gets into the blood stream with poisonous effects. That clue in Sweden led to the first forward step, a "green diaper" test which alerted doctors to the defect Next came the development of a diet low in phenylalanine which saved the afflicted baby's life but, because the diaper test lost vital time, it was sometimes administered too late to prevent serious brain damage. Obviously, the next step was to find a quicker test One has recently been developed. It uses a few drops of blood from the baby's heel to di agnose the disorder. Last summer, the U.S. Children's Bureau began a screening of this test on 400,000 new borns, with expectations that It will permit earlier treatment of PKU and other metabolic disorders. 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