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Biomedical subjects

J H Pearn

Publications and source records attributed to J H Pearn.

At least 19 recordsLinked to original sources
PubMed1992

Courage and curiosity: surgeon-explorers in Australia and New Zealand. Part II. The science of the outback. The Herbert Moran Lecture concluded.

After the broad brush of the topographical features of Australia and New Zealand had been mapped, the process of fine-tuning the geographic details of these countries continued. In parallel with this, a great wave of detailed scientific exploration proceeded and it was to these expeditions that medical men brought special skills. Surgeons played a special role because of the need of their practical skills in the field. Dozens of expeditions were commissioned throughout the nineteenth century. The aim of some was to search for minerals and document the fertility and water supply for pastoral and agricultural lands. Others had as their major raison d'etre the documentation of the many groups of animals and plants which populated these domains new to Western science. Surgeons and physicians were valued not only for their professional skills in the field, but for the pursuit of botany, zoology and geology, and in many cases for ethnological studies as well.

Anthropology↗
PubMed1991

Catfish trauma.

Explore the source record for details and available documents.

Adolescent↗
PubMed1990

The pivot: the First Australian Casualty Clearing Hospital at the Gallipoli beachhead--the first seven days.

In October 1914, a new type of medical unit was added to the order of battle of the Australian Army's casualty evacuation chain. Designated the casualty clearing hospital, it was called a Casualty Clearing Station on the beach at Anzac Cove in the Gallipoli campaign. This unit was established as the most forward unit to provide emergency surgery, freeing the forward field ambulances from the necessity of holding wounded soldiers, a task which compromised their mobility and prevented them from moving with the brigades they supported. The Casualty Clearing Station was to be the most forward unit where specialist surgeons, anaesthetists, nurses, radiologists and a dentist were to be found. The 1st Australian Casualty Clearing Station (1ACCS) was raised in Hobart and consisted of 93 men including 7 doctors. After some seven weeks of training in camp, the new unit embarked for Egypt and the Gallipoli offensive. They landed on the beach at Anzac Cove at 11 a.m. on 25th April 1915, and remained on a 20 metre stretch of beach through eight months of the Gallipoli campaign. This paper reviews the first seven days of the Station's role at Anzac Cove, during which time this essentially inexperienced medical unit treated and evacuated an estimated 2700 wounded Australian and New Zealand soldiers. This paper also reviews the Commanding Officer's hitherto unpublished war diary and other archival and family records which add to the medical story of Anzac. This frightful baptism of mass casualty evacuation, undergone by the Australian Army Medical Corps, brings a perspective to the problems of mass disasters today.

Australia↗
PubMed1989

Ciguatera and mannitol: experience with a new treatment regimen.

Ciguatera is a distressing, hitherto-untreatable and not rare disease which results from the eating of ciguatoxin-contaminated fish from tropical and subtropical waters. We report here the results of a pilot study to assess the efficacy of mannitol therapy in ciguatera poisoning. Twelve adult patients (six men) have been treated, five of whom--who were ill acutely--experienced a significant benefit from this therapy, in three cases, with a hitherto-unexperienced dramatic reversal of symptoms. We conclude that an intravenous infusion of 1.0 g/kg of mannitol which is given over 45 minutes, after rehydration if required, can be of significant benefit to at least some acutely intoxicated victims. We postulate either a reduction of axonal oedema, or a scavenger effect, or both, as the mechanism of the beneficial effects of mannitol. Ciguatoxin is rich in hydroxyl groups, and causes microscopic oedema of neural tissue. If our conclusion of the beneficial effects of mannitol therapy is confirmed, this will offer the first effective therapy for acute phases of this disease, and has promise of preventing much long-term morbidity.

Acute Disease↗
PubMed1989

Childhood deaths in Down's syndrome. Survival curves and causes of death from a total population study in Queensland, Australia, 1976 to 1985.

Data have been obtained from a total population study of diagnosed Down's syndrome cases born in Queensland between 1976 and 1985. Survival curves show a survival rate to one year of 87.4% and no significant differences in such patterns over the two five year periods of the study. Survival curves comparing maternal age at birth, sex of the infant, and locality of birth also indicate that early death is unrelated to any of these factors. Congenital heart disease and respiratory infection are the most common causes of infant death.

Australia↗
PubMed1988

The use of field-inversion gel electrophoresis for deletion detection in Duchenne muscular dystrophy.

Deletion is a common cause of Duchenne muscular dystrophy (DMD). Field-inversion gel electrophoresis, in conjunction with Southern blot hybridization, was used to detect large SfiI DNA fragments in the DMD locus. Two unrelated boys with DMD were found to have abnormal sized DNA fragments resulting from deletions. Some of the female relatives of these patients were also shown by this method to have deletions in the DMD locus.

Chromosome Deletion↗
PubMed1987

Prenatal cytogenetic diagnosis--a current audit. A review of 2000 cases of prenatal cytogenetic diagnoses after amniocentesis, and comparisons with early experience.

An audit of 2000 cases of prenatal cytogenetic diagnoses is presented. This comprises two consecutive series of 1000 cases (1974-1980 and 1980-1983). Chromosomal studies were performed after mid-trimester amniocentesis. For both series detailed results of the reasons for referral and the outcome of laboratory studies and pregnancy follow-up (in 95% of cases) are presented. In current practice 75% of prenatal cytogenetic diagnoses were for advanced maternal age. Ten per cent of tests were undertaken because of a family history of Down's syndrome. The detection rate of chromosomal abnormality in prenatal cytogenetic diagnoses was 2.06%. Two per cent of amniotic cell cultures failed to grow, necessitating a repeat amniocentesis. The rate of culture failure due to undefinable causes was 0.55%. Fetal loss after amniocentesis for prenatal cytogenetic diagnosis at 16 weeks' gestation has halved since 1980, with a current miscarriage rate of 0.6% within four weeks of the procedure. One maternal death (as a result of amniotic fluid embolism) and one case of amnionitis occurred in the first series of 1000 consecutive cases (up to 1980), but no such complication has occurred since. Secular trends in the indications for referral, laboratory complications, clinical outcome and diagnostic patterns are presented.

Abortion, Induced↗
PubMed1987

Prenatal cytogenetic diagnosis. Amniotic cell culture versus chorionic villus sampling.

Chorionic villus sampling is under evaluation throughout the world. Amniocentesis with amniotic cell culture is reliable for the diagnosis of certain types of genetic disease in the second trimester, and has been the subject of extensive clinical and laboratory audit. Chorionic villus sampling has the advantage of the early diagnosis (for example, at 10 weeks) of chromosomal abnormalities, a shorter delay with results after the diagnostic procedure, and is, for some couples, a more socially and morally acceptable method of antenatal diagnosis. In current experience, the disadvantages of chorionic villus sampling include an increased fetal loss and an increased diagnostic error rate. Another factor is the early diagnosis of fetuses with chromosomal abnormalities--a proportion of whom would have miscarried spontaneously before being detected at an amniocentesis at 16 weeks. This has implications for an increased rate of therapeutic terminations of pregnancy. Chorionic villus sampling and amniotic cell culture are discussed and comparisons are drawn that concern the clinical advantages and diagnostic issues which are inherent in each method of prenatal diagnosis.

Abortion, Induced↗
PubMed1987

A corneal abnormality associated with trisomy 8 mosaicism syndrome.

Eye abnormalities are a significant feature of trisomy 8 mosaicism syndrome. This paper gives the first account of the specific histopathology of a corneal opacity which is characteristic of this syndrome. The importance of early recognition is stressed because of potential therapeutic visual improvement. The necessity of including mosaic trisomy 8 in the differential diagnosis of such corneal opacities is illustrated by this case.

Chromosomes, Human, Pair 8↗
PubMed1987

Diagnostic trends in childhood chromosome abnormalities and their implications--a total population eight-year survey from Queensland, Australia.

The data from an ongoing total population survey of all diagnosed chromosome anomalies in Queensland, Australia have been presented for an 8-year period (1976-83). A total of 760 patients was diagnosed, principally autosomal trisomies (431) and sex chromosome abnormalities (126). Nearly half of total childhood diagnoses (up to 14 years) were made in the first week. Virtually all expected cases of autosomal trisomies were detected in the first month. The largest component of the pool of unrecognized childhood disorders in this study was the sex chromosome group. This failure of detection has implications in terms of potentially beneficial hormone treatment and predisposition to neoplasia.

Adolescent↗
PubMed1986

Cerebral astrocytoma as a complication of acute lymphoblastic leukaemia.

A boy who developed acute lymphoblastic leukaemia at the age of two years and 10 months had several central nervous system relapses, and received two courses of cranial irradiation, each of 24 Gy, in addition to systemic and intrathecal chemotherapy. Nearly 10 years after the onset of his leukaemia he developed a brain stem astrocytoma from which he died. This appears to be a rare occurrence, and the role of the treatment in the induction of his second tumour is discussed. The need for the long-term follow-up of cancer patients after apparent cure is emphasized.

Astrocytoma↗
PubMed1985

Prenatal cytogenetic diagnosis: medical and social implications. Indications, acceptance by doctors and patients, impact and cost: a 10-year review.

Prenatal cytogenetic diagnosis has been in widespread use for a decade, and access to it has been determined by medical attitudes towards what constitutes "high risk", and by pragmatic questions about the logistics of delivering a new diagnostic test to as many couples as costs will allow. The most common indication - advanced maternal age - has led to different access criteria in various parts of Australia. Factors such as socioeconomic status, education, and religion affect the acceptance of prenatal cytogenetic diagnosis from the point of view both of patients and of the doctors who care for them. Cost-benefit analyses conducted elsewhere indicate that, in purely monetary terms, it is probable that prenatal cytogenetic diagnosis is cost-effective if offered to all couples in which the woman is over the age of 32 years. An assessment of the impact of prenatal cytogenetic diagnosis on the birth incidence of major chromosomal abnormalities, particularly Down's syndrome, indicates that the maximum reduction which might be achieved in current practice is 30%.

Abortion, Induced↗
PubMed1985

Prolonged intensive therapy after snake bite. A probable case of envenomation by the rough-scaled snake.

A case of snake-bite envenomation, probably by the rough-scaled snake (Tropidechis carinatus), in a 9-year-old boy is reported which we believe to represent the most severe and prolonged case yet of non-fatal snake-bite envenomation in a human. The initial clinical features included loss of consciousness within minutes of the bite, followed by a period of partial recovery. The child subsequently developed total body paralysis, acute renal failure, and gross rhabdomyolysis. Artificial ventilation was maintained for 10 weeks; muscle paralysis and paresis persisted for 18 weeks before neuromuscular function returned to normal. Recovery occurred in centripetal fashion, the respiratory muscles and the palatal muscles being the last to recover. Acute renal failure persisted for 18 days and was treated by peritoneal dialysis. Some beneficial effects were seen even when antivenom was given 90 hours after the bite, but gross rhabdomyolysis caused by this species is not prevented by the administration of antivenom after 60 hours. It is concluded that if life can be sustained for 10 weeks by artificial ventilation, normal intellectual and neuromuscular recovery is possible in such cases.

Acute Kidney Injury↗