Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
First described by the 19th-century British anatomist Sir Alfred Poland,
Poland syndrome is a unique pattern of one-sided malformations that are present
at birth (congenital malformations). Poland syndrome is noted for the
underdevelopment or absence of the chest (pectoralis) muscles on one side of the
body as well as webbing of the fingers (cutaneous syndactyly) on the hand of the
same side (ipsilateral side) of the body.
Can Poland syndrome affect either side of the body?
Yes. For reasons not understood, Poland syndrome is twice as likely to
involve the right side of the body.
How frequent is Poland syndrome?
The severity of Poland syndrome is variable, and it is possible for mild cases
not to be evident until puberty when breast tissue and chest muscle mass
development become more obvious. It is felt, therefore, that cases may be
misdiagnosed and underreported. Experts currently are reporting an incidence of
one in 10,000 to one in 100,000 live births. For reasons not appreciated, boys
are more likely than girls to have Poland syndrome.
What causes Poland syndrome?
The cause of Poland syndrome is not known. The disorder is currently
considered "a nonspecific developmental field defect" occurring at about the
sixth week of fetal development. Diminished blood flow through the subclavian
artery that supplies blood to the arm has been blamed, but final proof for this
idea is lacking. Speculation has involved two hypotheses. One proposes that the
underlying ribs on the affected side grow too quickly in a forward growth plane
and thus reduce the flow of blood in the arteries leading to the overlying
pectoralis muscle and arm on the affected side. Another proposal is that a
malformation of the embryonic blood vessel serving the pectoralis muscle and
arm/hand on that side of the body limits blood flow to these structures. To date
no animal research has provided conclusive support for these proposals.
The time when boys and girls begin the process of sexual maturation is called puberty. During this time, both sexes undergo a series of biological changes that include a rapid increase in height, bone growth, weight increase, the growth of pubic hair, breast development and the onset of menstruation in girls, and testicle, penis, and muscle enlargement in boys.
Birth defects have many causes and currently, are the leading cause of death for infants in the first year of life. Some of the causes of birth defects include genetic or chromosome problems. Exposure of the mother to rubella or German measles during pregnancy, or using drugs or alcohol during pregnancy. The treatment for birth defects depends upon the condition of the effected child.
A computerized axial tomography scan is an x-ray procedure that combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. Computerized axial tomography is more commonly known by its abbreviated names, CT scan or CAT scan. A CT scan is used to define normal and abnormal structures in the body and/or assist in procedures by helping to accurately guide the placement of instruments or treatments.
A large donut-shaped x-ray machine takes x-ray images at many different angles around the body. These images are processed by a computer to produce cross-sectional pictures of the body. In each of these pictures the body is seen as an x-ray "slice" of the body, which is recorded on a film. This recorded image is called a tomogram. "Computerized Axial Tomography" refers to the recorded tomogram "sections" at different levels of the bod...