22 April 2015

Ultrasound


The invention: 

A medically safe alternative to X-ray examination,
ultrasound uses sound waves to detect fetal problems in pregnant
women.

The people behind the invention:

Ian T. Donald (1910-1987), a British obstetrician

Paul Langévin (1872-1946), a French physicist

Marie Curie (1867-1946) and Pierre Curie (1859-1906), the French husband-and-wife team that researched and developed the field of radioactivity

Alice Stewart, a British researcher






An Underwater Beginning

In the early 1900’s, two major events made it essential to develop
an appropriate means for detecting unseen underwater objects. The
first event was the Titanic disaster in 1912, which involved a largely
submerged, unseen, and silent iceberg. This iceberg caused the sinking
of the Titanic and resulted in the loss of many lives as well as
valuable treasure. The second event was the threat to the Allied
Powers from German U-boats duringWorldWar I (1914-1918). This
threat persuaded the French and English Admiralties to form a joint
committee in 1917. The Anti-Submarine Detection and Investigation
Committee (ASDIC) found ways to counter the German naval
developments. Paul Langévin, a former colleague of Pierre Curie
and Marie Curie, applied techniques developed in the Curies’ laboratories
in 1880 to formulate a crude ultrasonic system to detect submarines.
These techniques used beams of sound waves of very high
frequency that were highly focused and directional.
The advent ofWorldWar II (1939-1945) made necessary the development
of faster electronic detection technology to improve the efforts
of ultrasound researchers. Langévin’s crude invention evolved
into the sophisticated system called “sonar” (sound navigation ranging),
which was important in the success of the Allied forces. Sonar
was based on pulse echo principles and, like the system called “ra-
dar” (radio detecting and ranging), had military implications. This vital
technology was classified as a military secret and was kept hidden
until after the war.


An Alternative to X Rays

Ian Donald’s interest in engineering and the principles of
sound waves began when he was a schoolboy. Later, while he was
in the British Royal Air Force, he continued and maintained his
enthusiasm by observing the development of the anti-U-boat
warfare efforts. He went to medical school afterWorldWar II and
began a career in obstetrics. By the early 1950’s, Donald had em-
barked on a study of how to apply sonar technology in medicine.
He moved to Glasgow, Scotland, a major engineering center in
Europe that presented a fertile environment for interdisciplinary
research. There Donald collaborated with engineers and technicians
in his medical ultrasound research. They used inanimate
and tissue materials in many trials. Donald hoped to apply ultrasound
technology to medicine, especially to gynecology and obstetrics,
his specialty.
His efforts led to new pathways and new discoveries. He was interested
in adapting a certain type of ultrasound technology method
(used to probe metal structures and welds for cracks and flaws) to
medicine. Kelvin Hughes, the engineering manufacturing company
that produced the flaw detector apparatus, gave advice, expertise,
and equipment to Donald and his associates, who were then able to
devise water tanks with flexible latex bottoms. These were coated
with a film of grease and placed into contact with the abdomens of
pregnant women.
The use of diagnostic radiography (such as X rays) became controversial
when it was evident that it caused potential leukemias and other injuries to the fetus. It was realized from the earliest days
of radiology that radiation could cause tumors, particularly of the
skin. The aftereffects of radiological studies were recognized much
later and confirmed by studies of atomic bomb survivors and of patients
receiving therapeutic irradiation. The use of radiation in obstetrics
posed several major threats to the developing fetus, most
notably the production of tumors later in life, genetic damage, and
developmental anomalies in the unborn fetus.
In 1958, bolstered by earlier clinical reports and animal research
findings, Alice Stewart and her colleagues presented a major case
study of more than thirteen hundred children in England andWales
who had died of cancer before the age of ten between 1953 and 1958.
There was a 91 percent increase in leukemias in children who were
exposed to intrauterine radiation, as well as a higher percentage of
fetal death. Although controversial, this report led to a reduction in
the exposure of pregnant women to X rays, with subsequent reductions
in fetal abnormalities and death.
These reports came at a very opportune time for Donald: The development
of ultrasonography would provide useful information
about the unborn fetus without the adverse effects of radiation.
Stewart’s findings and Donald’s experiments convinced others of
the need for ultrasonography in obstetrics.


Consequences

Diagnostic ultrasound first gained clinical acceptance in obstetrics,
and its major contributions have been in the assessment of fetal
size and growth. In combination with amniocentesis (the study of
fluid taken from the womb), ultrasound is an invaluable tool in operative
procedures necessary to improve the outcomes of pregnancies.
As can be expected, safety has been a concern, especially for a developing,
vulnerable fetus that is exposed to high-frequency sound.
Research has not been able to document any harmful effect of ultrasonography
on the developing fetus. The procedure produces neither
heat nor cold. It has not been shown to produce any toxic or destructive
effect on the auditory or balancing organs of the
developing fetus. Chromosomal abnormalities have not been reported
in any of the studies conducted.
Ultrasonography, because it is safe and does not require surgery,
has become the principal means for obtaining information about fetal
structures. With this procedure, the contents of the uterus—as
well as the internal structure of the placenta, fetus, and fetal organs—
can be evaluated at any time during pregnancy. The use of
ultrasonography remains a most valued tool in medicine, especially
obstetrics, because of Donald’s work.


Ian Donald













Ian Donald was born in Paisley, Scotland, in 1910 and educated
in Edinburgh until he was twenty, when he moved to
South Africa with his parents. He graduated with a bachelor of
arts degree from Diocesan College, Cape Town, and then moved
to London to study medicine, graduating from the University of
London in 1937. DuringWorldWar II he served as a medical officer
in the Royal Air Force and received a medal for rescuing flyers
from a burning airplane. After the war he began his long
teaching career in medicine, first at St. Thomas Hospital Medical
School and then as the Regius Professor of Midwifery at Glasgow
University. His specialties were obstetrics and gynecology.
While at Glasgow he accomplished his pioneering work
with diagnostic ultrasound technology, but he also championed
laparoscopy, breast feeding, and the preservation of membranes
during the delivery of babies. In addition to his teaching
duties and medical practice he wrote a widely used textbook,
oversaw the building of the Queen Mother’s Hospital in Glasgow,
and campaigned against England’s 1967 Abortion Act.
His expertise with ultrasound came to his own rescue after
he had cardiac surgery in the 1960’s. He diagnosed himself as
having internal bleeding from a broken blood vessel. The cardiologists
taking care of him were skeptical until an ultrasound
proved him right. Widely honored among physicians, he died
in England in 1987.



See also:

Amniocentesis; Birth control pill; CAT scanner; Electrocardiogram;
Electroencephalogram; Mammography; Nuclear magnetic resonance;
Pap test; Sonar; Syphilis test

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