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The basic tasks of this department include therapeutic, pedagogical and scientific-research work. The clinic has three main parts - gynecological, obstetric and neonatological. With its diagnostic and therapeutic activities, the clinic covers all subspecializations of gynecology, obstetrics and neonatology. Key operations are perinatology and fetal medicine, along with gyno geschichten, a center for assisted reproduction, endoscopy, oncogynecology, and urogynecology. The gynecological part focuses on the diagnosis and treatment of malignant tumors of the reproductive system and breast, diagnosis and treatment of urinary incontinence and reconstruction of the pelvic floor, diagnostic and surgical laparoscopy and hysteroscopy, surgical treatment of myomas, endometriosis. Furthermore, the clinic deals with problems of marital infertility including IVF, endocrinopathies, disorders in the climacterium.
Ultrasound scanners can be regarded as a form of 'medical' Sonar.
As early asJean-Daniel Colladona Swiss physicist, had successfully used an underwater bell to determine the speed of sound in the waters of Lake Geneva. In the later part of the s, physicists were working towards defining the fundamental physics of sound vibrations wavestransmission, propagation and refraction.
One of gyno geschichten was Lord Rayleigh in England whose famous treatise " the Theory of Sound " published in first described sound wave as a mathematical equation, forming the basis of future practical work in acoustics.
As for high frequency 'ultrasound', Lazzaro Spallanzanian Italian biologist, could be credited for it's discovery when he demonstrated in the ability of bats navigating accurately in the dark was through echo reflection from high frequency inaudible sound.
Very high frequency sound waves above the limit of human hearing were generated by English scientist Francis Galton inthrough his invention, the Galton whistle. The real breakthrough in the evolution of high frequency echo-sounding techniques gyno geschichten when the piezo-electric effect in certain crystals was discovered by Pierre Curie and his brother Jacques Curie in Paris, France in They observed that an electric potential would be produced when mechanical pressure was exerted on a quartz crystal such as the Rochelle salt sodium potassium tartrate tetrahydrate.
The reciprocal behavior of achieving a mechanical stress in response to a voltage difference was mathematically deduced from thermodynamic principles by physicist Gabriel Lippman inand which was quickly verified by the Curie brothers. It was then possible for the generation and reception of ' ultrasound ' that are in the frequency range of millions of cycles per second megahertz which could be employed in echo sounding devices.
Department of obstetrics and gynecology
Further research and development in piezo-electricity soon followed. Underwater sonar detection systems were developed for the purpose of underwater by submarines in World war I and in particular after the Titanic sank in Alexander Belm in Vienna, described an underwater echo-sounding device in the same year. The first patent for an underwater echo ranging sonar was filed at the British Patent Office by English metereologist Lewis Richardsonone month after the sinking of the Titanic. The first working sonar system was deed and built in the United States by Canadian Reginald Fessenden in Gyno geschichten Fessenden sonar was an electromagnetic moving-coil oscillator that emitted a low-frequency noise and then switched to a receiver to listen for echoes.
It was able to detect an iceberg underwater from 2 miles away, although with the low frequency, it could not precisely resolve its direction. The turn of the century also saw the invention of the Diode and the Triodeallowing powerful electronic amplifications necessary for developments in ultrasonic instruments. Patents were filed in France and the United States. They called their device the ' hydrophone '.
The transducer of the hydrophone consisted of a mosaic of thin quartz crystals glued between two steel plates with a resonant frequency of KHz. Between and the hydrophone was further improved in classified research activities and was deployed extensively in the surveillance of German U-boats and submarines. The first known sinking of a submarine detected by hydrophone occurred in the Atlantic during World War I in April, Langevin's hydrophones had formed the basis of the development of naval pulse-echo sonar in the gyno geschichten years.
By the mid s, many ocean liners were equipped with some form of underwater echo-sounding range display systems. In another development, the first successful radio range-finding experiment occurred inwhen British gyno geschichten Edward Appleton used radio echoes to determine the height of the ionosphere. The first practical RADAR system Radio Detection and Ranging, and using electromagnetic waves rather than ultrasonics was produced in by another British physicist Robert Watson-Wattand by England had established a chain of radar stations along its south and east coasts to detect aggressors in the air or on the sea.
World war II saw rapid developments and refinements in the naval and military radar by researchers in the United States. Such radar display systems had been the direct precursors of subsequent 2-dimensional sonars and medical ultrasonic systems that appeared in the late s. Books such as the " Principles of Radar " published by the Massachusetts Gyno geschichten of Technology M I T Radar school staff in detailed the techniques of oscilloscopic data presentation which were employed in medical ultrasonic research later on see below.
Yet another parallel and equally important development in ultrasonics which had started in the 's was the construction of pulse-echo ultrasonic metal flaw detectorsparticularly relevant at that time was the check on the integrity of metal hulls of large ships and the armour plates of battle tanks.
The concept of ultrasonic metal flaw detection was first suggested by Soviet scientist Sergei Y Sokolov in at the Electrotechnical Institute of Leningrad. He showed that a transmission technique could be used to detect metal flaws by the variations in ultrasionic energy transmitted across the metal.
The resolution was however poor. He suggested subsequently at a later date that a reflection method may be practical. The equipment suggested by Sokolov which gyno geschichten generate very short pulses necessary to measure the brief propagation time of their returning echoes was not available until the s. Because of the war, the reflectoscope was not formally published until The modern ultrasound scanner embraces the concepts and science of all these modalities.
The early development of ultrasonics is summarised here. High intensity ultrasound progressively evolved to become a neuro-surgical tool. William Fry at the University of Illinois and Russell Meyers at the University of Iowa performed craniotomies and used ultrasound to destroy parts of the basal ganglia in patients with Parkinsonism.
Peter Lindstrom in San Francisco reported ablation of frontal lobe tissue in moribound patients to alleviate their pain from carcinomatosis. Fry in particular had worked towards improving research and dosimetry standards, which was much needed at the time. Ultrasonic energy was also extensively used in physical and rehabilitation medicine. Jerome Gersten at the University of Colorado reported in the use of ultrasound in the treatment of patients with rheumatic arthritis.
"a revolution in favor of reproduction"? gynecology and obstetrics in the "third reich"
Uses of ultrasonic energy in the s. Left, in gastric ulcers. Right, in arthritis The s saw exuberant claims made in some sectors on the effectiveness of ultrasound as an almost "cure-all" remedy, abeit the lack of much scientific evidence.Angst vor Frauenarzt-Untersuchung! Wieso scheut Jenny die Behandlung? - Klinik am Südring - SAT.1
This included conditons such as arthritic pains, gastric ulcers, eczema, asthma, thyrotoxicosis, haemorrhoids, urinary incontinence, elephanthiasis and even angina pectoris! Cynicism and concern over harmful tissue damaging effects of ultrasound were also mounting, which had curtailing consequences on the development of diagnostic ultrasound in the years that followed. It was around similar times that ultrasound was used experimentally as a possible diagnostic tool in medicine.
H Gohr and Th. Wedekind at the Medical University of Koln in Germany in presented in their paper Der Ultraschall in der Medizin the possibility of ultrasonic diagnosis basing on echo-reflection methods similar to that used in metal flaw detection. They suggested that the method would be able to detect tumours, exudates or abscesses. However they were unable to publish convincing from their experiments.
Dussik, together with his brother Friederich, a physicist, attempted to locate brain tumors and the cerebral ventricles by measuring the transmission of ultrasound beam through the skull. Dussik presented his initial experiments in a paper in and further after the end of the second world war in They called their procedure " hyperphonography ". They used a through-transmission technique with two gyno geschichten placed on either side of the head, and producing what they called " ventriculograms ", or echo images of the ventricles of the brain.
Coupling was obtained by immersing the upper part of the patient's head and both transducers in a water bath and the variations in the amount of ultrasonic power passing between the transducers was recorded photographically on heat-sensitive paper as light spots not on a cathode-ray screen.
It was an earliest attempt at the concept of ' scanning ' a human organ. Although their apparatus appeared elaborate with the transducers mounted on poles and railings, the images produced were very rudimentary 2-dimensional rows of mosaic light intensity points. They had also reasoned that if imaging gyno geschichten ventricles was possible, then the technique was also feasible for detecting brain tumors and low-intensity ultrasonic waves could be used to visualize the interior of the human body.
Research basing on a similar transmission technique was not further pursued, both by Dussik, or at the M. For more information read Dussik.
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In nearby GermanyHeinrich Nethelera physician at the Luebeck-South Hospital in Hamburgwas operating in a small repair facility for medical equipments at the Hamburg university hospital at Eppendorf and had a mission of developing inventive medical products. Professor Hansenhis superior, suggested to him in that year to develop an ultrasonic tomographic equipment for medical use basing on the concept of the RADAR. Important pioneering reseach work started at the Eppendorf Gyno geschichten Hospital. Nevertheless, due to a lack of funds right after the war, the equipment des had not reached the stage of actual fabrication.
In the mid s, German physician Wolf-Dieter Keidel at the Physikalisch-Medizinischen Laboratorium at the University of ErlangenGermany, also studied the possibility of using ultrasound as a medical diagnostic tool, mainly on cardiac and thoracic measurements. Having discussed with researchers at Siemenshe conducted his experiments using the transmission technique with ultrasound at 60 KHz, and rejected the pulse-reflection method.
He was only able to make satisfactory recordings of intensity variations in relation to cardiac pulsations.
He envisaged much more difficulties would be encounterd with the reflection method. In the First Congress of Ultrasound in Medicine held in Erlangen, Germany in May,Dussik and Keidel presented their papers on ultrasound employed in medical diagnosis. These were the only two papers that discussed ultrasound as a diagnostic tool. The other papers were all on its therapeutic use. In FranceFrench scientists who were in the study of ultrasonics, namely Andr?
Dognon and Andr? This was a transmission technique and recordings made on a micro-ampere meter and oscilloscope. Equipments were fabricated from 'therapy' counterparts and various electrical current values were determined on different body tissues.
Attempts to display voltages as Lissajous figures on the oscilloscope were made. However the work was unsuccessful in producing useful structural images and related instruments were not constructed.
Nearly the entire book was devoted to ultrasonics used in the treatment of various diseases and only a small portion of the text was on ultrasound diagnostics. Systematic investigations into using ultrasound as a diagnostic tool finally took off in the United States in the late s. The time was apparently ripe for this to happen. The concept of applying ultrasonics to medicine had progressively matured, so were the available equipments and electronics after the war. There, he began experiments on animal tissues using A-mode industrial flaw-detector equipment.
Ludwig deed experiments to detect the presence and position of foreign bodies in animal tissues and in particular to localise gallstones, using reflective pulse-echo ultrasound methodology similar to that of gyno geschichten radar and sonar in the detection of foreign boats and flying objects.
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A substantial portion of Ludwig's work was considered classified information by the Navy and was not published in medical journals. Although Ludwig's work had started at a considerably earlier datenotice of his work was not released to the public domain until October by the United States Department of Defence. The June '49 report is considered the first report of its kind on the diagnostic use of ultrasound from the United States. Ludwig systematically explored physical characteristics of ultrasound in various tissues, including beef and organs from dogs and hogs.