The Mail-Journal, Volume 26, Number 7, Milford, Kosciusko County, 1 April 1987 — Page 15

L+fe after 2000: How we treat illness

uy BARBARA S. MOFFET | National Geographic News Service It looks like an ordinary microchip but it may have a life of its own. Someday it could end up inside somebody’s brain. Scientists from the National Institute of Mental Health are growing animal tissue on a silicon chip in hopes that the two eventually will connect and begin to interact. Sometime, probably well into the next century, microchips may be implanted in human brains, where they will link up with undamaged nerve cells and take over functions destroyed by injury or disease. Other medical scientists are wrestling with an age-old question: Can human life be significantly prolonged? Researchers on aging say that if cancer and heart ailments magically disappeared, the average American jifespan would increase only about seven years. These scientists are trying to retard the aging process itself, extending the years of robust health toward 100. One theory is that aging is causea by tne buildup of metabolism’s toxic byproducts and could be slowed by boosting the body’s protective enzymes. Rapidly Unlocking Secrets A formula for extended youth may never be found. But by 2000, many of the human body’s remaining secrets will have been unlocked. New discoveries are occurring almost daily, especially in molecular biology — the study of the body’s functions at the basic genetic level. The advances will make today’s medicine look primitive. Technology, some of it extremely costly to operate, will

Newfoundland and Labrador: a future in oil, not fish?

I By NATIONAL GEOGRAPHIC NEWS SERVICE — For nearly four centuries, Newfoundland's reason for being has been fish. When English explorer John Cabot reached its shore atthe end of the 15th century, he found the sea “swarming with fish, which can be taken not only with the net, but in baskets let down with a stone.” News of this discovery electrified Europe, and by the time Sir Humphrey Gilbert claimed Cabot’s “new found land” for England in 1583, European fishermen had long been harvesting cod from the Grand Banks, the greatest cod-fishing ground on edfcth. Fishing-wgnts were the heart of sovereignty disputes that lasted into the 20th century. In 1933, with the fishery in ruins during the Great Depression, local rule was withdrawn by London, and Newfoundlanders were governed by a commission composed of British and Newfoundland appointees. Not until 1949 did Newfoundland and Labrador become Canada’s 10th province. Troubled Fishing Industry Now change is coming to Newfoundland. Cod accounts for less than half of total fish landings; most fish is frozen for the US market. Mining products, chiefly iron ore from western Labrador, outstrip the export value of fish. Offshore oil, discovered in 1979, is expected to have a major impact on both the Newfoundland economy and its culture as oil companies gear up for production in the 19905. Today, as in the past, Newfoundland's “fields” are not on the land but in the sea. No wonder Newfoundlanders affectionately refer to their island as “the Rock.” “Battered by the Atlantic Ocean at Canada’s easternmost point, it is an elemental place, open to harsh weather, infertile, remote, and watery,” Canadian poet and journalist Harry Thurston writes in the May National Geographic. Newfoundland’s 581,000 proud residents, 95 percent of whom trace their ancestry to Britain, revere their land, but they pay a price to live there. Newfoundland and Labrador is Canada’s pooresfprovince, with the lowest per-capita income, $9,700 Canadian ($6,700 US) — two-thirds of the national average — and the highest unemployment rate, 21.9 percent. Despite the changes in the economy, the fishery still provides full-time work to 20,000

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produce unprecedented tools for diagnosing and treating disease. New body scanners, especially the magnetic resonance imager, will produce photograph-like pictures that reveal far more than today’s CAT scanners, without using radiation. * Tiny pumps implanted in the body will take over for ailing organs, shooting out insulin for a malfunctioning pancreas, for example. Lasers will take over most work now done by scalpels, perhaps even making coronary bypass surgery obsolete. Robots will work alongside some surgeons. “For certain functions, robots will be more accurate than people, and they’ll take care of repetitive tasks too, such as suction and retraction,” says Dr. Donlin Long, chairman of neurosurgery at the, Johns Hopkins University ''-Medical School. \ “Teleradiology” will convert future accident victims’ X-rays to digits and send them by telephoiie to specialists for instant analysis. Doctors will turn to computer terminals, not musty reference books, for guidance on symptoms, treatments, and prescriptions. One futurist predicts that within 50 years, many dolors will be replaced by technicians operating wellprogrammed computers. Prevention, Not Treatment Meanwhile, health specialists say, more physicians will cease being repairmen. By 2000, Americans may spend as much time and money on prevention of illness as on treatment and look to changes in lifestyle, not technology, for their well-being. “We have it within ourselves to control our cardiac destiny,” says Dr. Robert I. Levy of Columbia University. He believes that education about smoking and

fishermen and fish-plant employees. Though the government created high hopes of prosperity when it declared a 200-mile limit for its fishing waters in 1977, small-boat fishermen’s yearly incomes have remained low: $7,000 to SIO,OOO Canadian ($5,000 t 057,500 US). In addition, the traditional hunt for harp seals has been beleaguered by international protest, further endangering the tenuous livelihood of more than 5,000 fishermen, many of whom depend on the hunt for mature seals -- not pups — to provide working capital for fishing equipment each year. Depopulating The Outports So difficult is life in Newfoundland’s isolated outports, as all towns except St. John’s, the main port, are called, that the provincial and federal governments tried to depopulate hundreds of them in the 1950 s and 19605, saying government no longer could the cost of roads, electricity, schools, medical care and other services.

■■■■■ML M ■ ■ K ‘ , ■aWt & BRINGING CHANGES TO NEWFOUNDLAND — Stormbound by high seas and blowing snow, villagers in the outport of Francois head for cover on the south coast of the island of Newfoundland. Canada’s oldest English settlement, it malpfftip, with Labrador, the nation's newest province, a hard place that has bred tough people. For criituries, fish dominated Newfoundland’s economic life; now the discovery of offshore oil and the Advent of modern amenities are bringing changes. (Photo by Yva Momatiuk and John Eastcott-1986 National Geographic Society)

FFA basketball team wins tourney The Wawasee FFA basketball team won the Fairfield Invitational 4-Way basketball tournament which was held recently at Fairfield High School. The team eliminated North Wood in semi-final action, 43-40, and defeated Fairfield, 54-40, in the championship game. Team members were Todd Roberts, Steve Carson, Dale Grady, Jeff’ Stookey, Brian Richcreek, Brian Wuthrich, Kevin Grimm, Rich Fifer and Terry Templin.

diet, especially cholesterol, will help bring heart disease down as the nation’s number-one cause of death within 15 to 20 years. A new generation of drugs will aim at preventing and curing disease rather than treating symptoms. Made more by biologists and computer scientists than chemists, these drugs will be cloned from the body’s own genes, f hormones, and enzymes and will mimic nature to cure ills. The next century also will see a new wave of vaccines to prevent such illnesses as chickenpox, malaria, and hepatitis — and even tooth decay. Viruses, which cause a range of illnesses including the common cold, herpes, and AIDS, wdj remain a challenge. Although researchers recently described for the first time the complex architecture of a human cold virus, they’re a long way from developing a vaccine for virus-related diseases. Areas of medical research with great significance for the future include: The brain — “As heart disease and cancer become more treatable, the major American health problem over the next 50 years will be degenerative diseases of the brain,” says Dr. Richard Jed Wyatt, chitef of neuropsychiatry at the National Institute of Mental Health. Some experts expect cases of Alzheimer’s disease, a type of dementia, to triple in the next 75 years as the population ages. But an explosion of research on the brain, one of the last frontiers of medical science, will offer eventual cures for some of to day’s most feared disorders. For example, a recent discovery that the brain has at least 50 and perhaps hundreds of neurotransmitters — chemicals Jhat direct much of its function —

The governments offered cash to residents who moved to “growth centres,” and the inhabitants of nearly 200 towns did resettle, lured by the inducements of electricity, running water, better education for their children, and wage security for themselves at a time when fish prices were low. Still, many outports stood fast and today are undergoing a revitalization, Thurston reports. The lure of the fishing grounds brought many early visitors to Newfoundland and Labrador. The Vikings established a shortlived settlement about AD 1000. Basques hunted whales from shore stations across the Strait of Belle Isle in southern Labrador from about 1540 to 1610. The first permanent settlers, Englishmen, put down roots in 1610 on the easternmost Avalon Peninsula. All of the early arrivals would be amazed to discover that the fishing grounds of the Grand Banks blanket an enormous offshore oil deposit. Tapping this

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piuuaoly will lead to new treatments or cures for Parkinson’s disease, epilepsy, schizophrenia, chronic pain, and even Alzheimer’s. The workings of the mind, once though intangible and invisible, will be traced with new scanners. “We’re in the process of demystifying the brain. By the year 2000 we may know exactly what is happening, say, in my brain while I’m talking to you,” says Dr. Katherine Bick, deputy director of the National Institute Os Neurological and Communicative Disorders and Stroke. Future drugs will literally refresh our memories. “Using certain drugs, we now can make animals remember better, and I believe that before long, we’ll help humans with jaemory problems,” forecasts Dr. James L. McGaugh, director of the Center for the Neurobiology of Learning at the University of California, Irvine. Several US drug manufacturers already are researching these “cognitive enhancers.” One of the most ambitious areas of brain research is an effort to make a damaged brain “whole” through special surgery. Wyatt has found that rats suffering symptoms of Parkinson’s disease —a deficiency of a neurotransmitter that afflicts 500,000 Americans — can recover ,if affected brain tissue is surgically replaced by new cells. If the process works in rhesus monkeys, Wyatt believes, it eventually should work in humans. One scientist predicts that such transplants will be routine for some brain diseases by 2000 if ethical questions are resolved. Genetics — Gene by gene, scientists are mapping the human body. The number of identified genes is roughly doubling every two years and although the

submarine petroleum won't be easy, Thurston notes. The oil lies in "iceberg alley,” where the Labrador Current sweeps icebergs southward from Greenland and the Canadian Arctic. Progress has been slower than expected, but the promise of oil holds heady attractions, both for the oil companies and for the people of the Rock; offshore oil could provide as many as 4,000 muchneeded jobs by 1990. Preserving Traditional Ways William Marshall, the province’s energy minister, told Thurston that his goal was to “preserve our own culture and at the same time bring Newfoundland’s per-capita income up to the average Canadian’s.” This concern that an oil boom could wipe out traditional ways was echoed by many residents of the province. “I think they want to be in on the changes in Labrador, and they know there are tradeoffs and costs associated with these

rate will slow, many of tife significant ones will have been located by the turn of the century. Last year, for example, scientists found the gene that corresponds to the fatal Huntington’s disease. About 3,500 illnesses have been linked to genetic defects, including many forms of mental retardation, and future scientists for the first time may be able to treat them. Beyond that, genetic mapping will help explain a broad range of biological functions, such as the process that causes chromosomes to rearrange themselves and trigger cancer, says one of the mappers, Dr, Frank Ruddle of Yale University. Although ethical questions loom, the new knowledge should yield advances for future health care, among them genetic vaccines and drugs, prenatal screening, and early warnings of predisposition to certain adult diseases, even those caused by a combination of hereditary traits. “Now, for instance, we have to tell the whole population to cut down on fats,” says Dr. Arno G. Motulsky, director of the Center for Inherited Diseases at the University of Washington, Seattle. “When we can detect genetic predisposition to heart disease, we’ll be able to target those people at risk, and the rest may be able to eat as much fat as they want.” Many future prescription drugs will be genetically based, creations of a “gene machine.” Now able to make a small gene in less than a day, the device can recreate genes already in existence or synthesize genes unknown to nature, says Dr. Leroy E. Hood of the California Institute of Technology. If current animal studies succeed, 21st-century doctors likely will practice “gene therapy,” inserting normal genes to correct

changes,” one resident said of his fellow Labradoreans. “But they also want some grip on the pace with which this all happens and the manner in which it happens.” Thurston writes that his odyssey through the province left him feeling that many of its traditions would be eroded by oil development or unforeseen things in the decades ahead. “But Newfoundlanders would stand like the Rock itself before the winds of change,” he concludes.

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mistakes m patients’ genetic makeup. In the next year or two, the first trial of human gene therapy will be conducted on ADA deficiency, a lifethreatening enzyme shortage. “If gene therapy works with ADA, any hereditary disease could theoretically be treated with gene therapy,” says Dr. W. French Anderson, chief of the National Heart, Lung, and Blood Institute’s molecular hematology laboratory. Eventuawy-the treatment could be simple: “A visiting nurse could cure sickle-cell anemia in a population with injections into the bloodstream,” Anderson says. Like tuberculosis and polio, most genetic disorders could be virtually banished. Ethical concerns envelop gene therapy, especially the question of using it to change future offspring and “enhancement gene engineering” — insertion of a gene to improve a trait such as intelligence. But such tampering is unlikely, even in the distant future. “Personality and intelligence are the products of dozens of genes, along with environmental influences,” Anderson says. “Changing them is just too complicated.” Cancer — This complex disease will continue to kill and cripple us in the next century, but it will be more curable. The National Cancer Institute foresees that if current research strategies succeed, cure rates should rise to an average of 75 percent by the year

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Wed., April 1,1987 —THE MAIL-JOURNAL,

2000, up from about 50 percent today. "Research is progressing in dozens of directions. Scientists now know that some cancers are triggered by oncogenes, normal genes that turn malignant. They’re starting to attack cancer with cells called monoclonal antibodies; these single-purpose molecules, armed with radioactive isotopes or drugs, can seek out and destroy a tumor. Other pioneer treatments seek to exploit the body’s natural defenses against malignancies. Research on immune substances known as tumor necrosis factor, which destroys cancerous cells while leaving normal cells intact, may lead to radical new approaches to cancer therapy. Combinations of surgery, radiation, and chemotherapy, commonly used today, will continue to be stapes of future cancer treatment, the specialists say, but they will be more refined and humane. “One of the main advances over the next 15 years will be a better way to determine who will respond to chemotherapy and who won’t,” predicts Dr. Bruce A. Chabner of the National Cancer Institute. By 2000, some cancers, especially breast and ovarian cancers, should be highly curable, but lung cancer will remain a major killer. And the AIDS virus, which can lead to a worrisome question mark in future cancer rates, Chabner says.

“We’ll go abuu. COiittviuu* cancer one disease at a time,” he says. But there probably will be no general cure. Artificial organs — Like a repaired car, the human body of 2000 will be made up of replaceable parts. “There is no organ which won’t be replaced in < the future,” says Dr. Pierre Galletti, who has developed artificial organs at Brown University- ’ Parts that will commonly be replaced in the future include heart, lungs, kidney, pancreas, blood vessels, ears, and maybe; eyes. Eventually, Galletti says, = man-made parts will replace the liver and even sections of the brain and nervous system. Tomorrow’s artificial organs will be made of more sophisticated materials than today’s. “Bioartificial organs,” hybrids of natural transplants and artificial parts, may help stop tissue rejection by encapsulating donor material in plastic. Mainly because of a donor shortage, natural-heart transplants will wane, says Dr. Willem J. Kolff on the University of Utah. Soon after 2000, he believes, thousands of Americans will live with miniaturized artificial hearts. Room temperature To get maximum volume when beating egg whites, be sure they are room temperature, and beat in a glass or metal bowl.

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