Placental Pulsatility: Quantitative Assessment of Placental Bed Vasculature by 2-Dimensional Doppler Cine Imaging.

OBJECTIVES: Vascular resistance is known to be one of the determinants of pulsatile flow. This study aimed to investigate whether quantitative 2-dimensional Doppler ultrasound can capture and evaluate the pulsatility within the placental bed vasculature. METHODS: The placental bed vasculature was imaged by directional power Doppler ultrasound. Ten-second cine clips were recorded by using standardized machine settings. A region of interest with a prominent Doppler signal in the uteroplacental interface was analyzed for the percentage of vascularity to generate a time-vascularity waveform. A vascular pulsatility index representing variation over the cardiac cycle was calculated by the ratio of the systolic-diastolic difference in vascularity to the mean vascularity. The acquisitions were repeated with 6 different pulse repetition frequencies (PRFs) and 3 wall motion filter (WMF) settings to evaluate their impact on the Doppler measurements. RESULTS: Ten sets of cine clips were analyzed for this study. The pulsatile nature of the vascularity was readily apparent in each cine clip. The measured time-vascularity waveforms showed uniform cyclic variation in vascularity over the cardiac cycle, with systolic vascularity significantly higher than diastolic vascularity at each combination of PRF and WMF (P < .05). A gradual increase in the vascular pulsatility index was observed with an increasing PRF or WMF. Normalization of systolic-to-diastolic measurement provided a stable vascular assessment across the range of PRFs. CONCLUSIONS: Doppler cine clips provide a dynamic representation of the placental bed vasculature and a novel analytic approach to quantitatively evaluating the pulsatility of this critical vascular network. Further work is warranted to explore the reproducibility and clinical potential of this approach.

The development of substitute inks and controls for reducing workplace concentrations of organic solvent vapors in a vinyl shower curtain printing plant.

During the summer of 1994, football players at a practice field reported noxious odors in the area. Ohio Environmental Protection Agency (OEPA) investigations of industries surrounding the field included a printing facility producing vinyl shower curtains with screen-printed designs. Though not the source of the odor, they were discharging volatile organic compounds directly to the environs in violation of OEPA regulations. To achieve compliance they installed a catalytic oxidizer for treating discharged air. Due to high equipment costs, the capacity of the installed catalytic oxidizer resulted in a substantial reduction in discharged air flow rates and increased solvent vapor concentrations within the workplace. Vapor levels caused worker discomfort, prompting a request for assistance from the Ohio Bureau of Workers Compensation. The vapor concentrations were found to exceed NIOSH, OSHA, and ACGIH acceptable exposure levels. The workers were then required to wear organic vapor removing respirators full-time while printing as a temporary protective measure. The company requested NIOSH assistance in finding methods to reduce solvent vapor concentrations. NIOSH studies included the identification of the sources and relative magnitude of solvent emissions from the printing process, the design of controls for the emissions, and the development of substitute inks using non-photochemically reactive solvents. The new ink system and controls allowed OEPA removal of the requirement for the treatment of discharged air and substantial increases in dilution ventilation. Increased ventilation would permit reduction in worker exposures to less than 1/3 mixture TLV levels and removal of requirements for respirator usage. This solution was the result of a comprehensive review of all facets of the problem, including OEPA regulations. It also required cooperative work between the company and federal, state, and local governmental agencies.