Ian Donald School Book 09.indb - World Association of Perinatal ...

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Chapter 2. THE HISTORY OF IAN DONALD SCHOOLretroperitoneal, genitourinary and involving the abdominal wall— and also alltypes of ascites, benign as well as malignant. Naturally, pregnancy, as quite thecommonest cause of female abdominal distension, came under ultrasonicscrutiny as well, but not initially by us before 1956-57. This was mainly dueto the geographic separation at that time of my gynecological unit from myobstetric hospital.I do not deny that we had our full share of discouraging problems and ourearly apparatus was laughably crude. As I commented in our first article inThe Lancet, what surprised and delighted us was that we got any results at all.You must remember that we had no yardsticks by which to control the rate ormethod of scanning, or even the best frequencies to use, and it was only theready feedback of information such as one gets in gynecology, which made itpossible to standardize our scanning techniques. Even so, we had very serioustechnical difficulties 20 or more years ago, such as the unreliability of oursine/cosine potentiometers, poor transducers, no controllable persistence cathoderay tubes, let alone storage tubes and computer storage systems, whichtoday you all take for granted. We worked literally in the dark in more sensesthan one.Prof. IAN DONALD with the fi rst generation of the students at his School in Dubrovnik, 1982.Looking back over what has been a long story of trial and even more of error,I cannot help feel a sense of surprise at all the lucky strikes which have beenmade over the years and their associated spin-offs. Who, for example, wouldhave thought that our crude early work would have made possible the correctdiagnosis of hydatidiform mole within a matter of minutes or that we wouldultimately, subsequent to this, have refined the technique to demonstrate theplacenta, both its site and its nature. Here I must acknowledge our co-operationwith our friends in Denver, Colorado with whom we have maintaineda happy liaison over the years. Our experiments in 1961 in measuring the biparietaldiameter proved to be the start of all the present sophisticated formsof fetal biometry.25
Chapter 2. THE HISTORY OF IAN DONALD SCHOOLNewcomers to the field of ultrasound must be bewildered as to which sort ofapparatus to select. There are many manufacturers, but I have noticed a steadilyincreasing convergence as to quality of performance as well as price, sothat you get roughly what you pay for. Cheap apparatus, cheap results. Expensiveapparatus may yield results beyond your clinical needs, so you shouldthink well before choosing.Much will depend upon the sort of work you want to do, and the availableanatomical access. For example, if you want to look deeply into the pelvis atvery early pregnancy or for early tumor or even for ripening ovarian follicles,the keyhole approach provided by sector scanners through the full bladderwill, in my opinion, give the best results. The same remarks in favor of thesectorized view apply to subcostal studies in the upper abdomen and throughthe intercostals spaces and particularly in echocardiology, anywhere, in fact,where access is small and the window area requires a sectorized view. Theview can be improved considerably if a compound sector scan can be employedwhich provides an appreciation of the organ under study in its relationshipto the rest of the body, particularly the urinary bladder. Unfortunately, theuse of sector scanners calls for more skill than the linear array systems which,though providing a blinkered «mouth organ» type of view, are very much easierto handle, especially in the hands of the relative novice who is able, proprioceptively,to appreciate just how well he is lining up his linear array. Theirmost impressive use is in the middle trimester of pregnancy when the fetus islikely to be no longer than the array system and the abdominal wall will besoft enough to accommodate it throughout its entire length.The advent of real-time scanners, both linear and sector, has revolutionizedultrasonic diagnosis, chiefly because it not only allows the continuous movementpatterns of what is being studied to be graphically displayed and recordedbut, even more important, it speeds up the whole process of ultrasonicsearch. Added to this, various methods of frame-grabbing or framefreezing canbe employed which provide static records for later scrutiny. This facility enormouslyincreases the throughput of patients, since it speeds up the whole examination.The various storage, recording, and photographic systems are mainlyresponsible for the differences in price between one apparatus and another.A real-time scanner can be combined with a static compound sector scanner.There is a choice of sector scanners between the wholly electronic phasedarraysystems, which are expensive, though very compact, and particularlyuseful in cardiology, and the combined mechanical and electronic systemsemploying either spinning rotors with several transducers or rockers, eithertransducer crystals or mirrors. The linear-array systems are all electronic andwithout moving parts, as in the case of phasedarray scanners. As they say inEnglish slang, «You pays your money and takes your choice».It distresses me that there are sometimes arguments about who should be incontrol of ultrasound scanning —just like dogs squabbling over a bone. Naturally,I now expect you all to be so much better at the ultrasonic art than me, sothat I can safely withdraw into my old age. But I do recognize that there aremany disciplines involved. On the whole, in medical sonar, there has been a26
Page 1 and 2: Inter-University School of Medical
Page 3 and 4: General Coordinator:JOSÉ M. CARRER
Page 6: ForewordWe live in a troubled world
Page 10 and 11: Chapter 1. PROF. IAN DONALD (1910-1
Page 16: Chapter 2. THE HISTORY OF IAN DONAL
Page 19 and 20: Chapter 2. THE HISTORY OF IAN DONAL
Page 25: Chapter 2. THE HISTORY OF IAN DONAL
Page 34 and 35: Chapter 3. OBJECTIVES, RULES AND OR
Page 52: Chapter 4. WORLD IAN DONALD SCHOOL
Page 55 and 56: Chapter 4. WORLD IAN DONALD SCHOOL
Page 59 and 60: Bosnia and HerzegovinaBranchDirecto
Page 61 and 62: BrazilBranchDirector: Dr. Francisco
Page 63 and 64: ChinaBranchDirector: Dr. Tony Duan
Page 65 and 66: CroatiaBranchCo-Directors: Dr. Beri
Page 73 and 74: FranceBranchDirector: Dr. Yves Vill
Page 75 and 76: GeorgiaBranchDirector: Dr. Alexande
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GermanyBranchDirector: Dr. Eberhard
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GreeceBranchDirector: Dr. Aris Ants
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Hawaii/USABranchDirector: Dr. Ivica
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HondurasBranchDirector: Dr. Karl Er
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Chapter 4. WORLD IAN DONALD SCHOOL
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ItalyBranchDirector: Dr. Vincenzo D
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JapanBranchDirector: Dr. Kazuo Maed
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MontenegroBranchDirector: Dr. Snež
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NepalBranchDirector: Dr. Hari Kisho
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PakistanBranchDirector: Dr. Syed Am
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ParaguayBranchDirector: Dr. Miguel
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PolandBranchDirector: Dr. Miroslaw
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PortugalBranchDirector: Dr. Alexand
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QatarBranchDirector: Dr. Badreldeen
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Saudi ArabiaBranchDirector: Dr. Sam
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UkraineBranchDirector: Dr. Yuriy P.
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United Arab EmiratesBranchDirector:
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United Arab EmiratesBranchDirector:
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Chapter 5. DONALD SCHOOL JOURNALIan
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Chapter 6. BOOKS FROM IAN DONALD SC
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