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This book describes measurement methods in medicine and biology. While many books on
medical instrumentation cover only hospital instrumentation, this book also encompasses
measurements in the growing fields of molecular biology and biotechnology.

As a first course in bioinstrumentation for undergraduate biomedical engineers, this
book describes measurement methods used in the growing fields of cell engineering, tissue
engineering, and biomaterials. It will also serve as a text for medical and biological personnel
who wish to learn measurement techniques.

Chapter 1 covers the basics of instrumentation systems, errors, and the statistics required to determine how many subjects are required in a research study. Because many biomedical engineers are not specialists in electronics, chapter 2 provides the necessary background in circuits, amplifiers, filters, converters, and signal processing.

Chapter 3 describes clinical measurements of molecules, such as oxygen and glucose,
to biotechnology measurements such as DNA sequencing. For the fields of biomaterials and
tissue engineering, chapter 4 covers measurements on polymers, using surface analysis,
protein adsorption and molecular size.

Measurements on blood components are the commonest measurements on cells, as
described in chapter 5. Cells are counted and identified using changes in impedance and light
scattering. Chapter 6 covers cellular measurements in biomaterials and tissue engineering,
such as cellular orientation, rolling velocity, pore size, deformation, shear stress, adhesion,
migration, uptake, protein secretion, proliferation, differentiation, signaling and regulation.

Chapter 7 describes measurements on the nervous system\u2014action potentials, EEG,
ERG, EOG, EMG and audiometry\u2014and brain imaging using X ray, CT, MRI, nuclear
imaging, SPECT, PET, and biomagnetism. Chapter 8 covers heart and circulation, with
measurements of cardiac biopotentials, pressures, output, sounds, viability\u2014as well as blood
flow and pressure in the periphery.

Measurements of pulmonary volume, flow, diffusion, and airway resistance are
described in chapter 9, which also includes kidney clearance, bone mineral, and skin water
loss. Chapter 10 covers measurements of body temperature, fat, and movement.

Each chapter has references for further study as well as homework problems to test
comprehension. A web site contains complete laboratory instructions for 12 laboratories,
examination questions, and quiz questions.

Suggested prerequisite courses are calculus, biology, chemistry, and physics. I would
welcome suggestions for improvement of subsequent editions.
John G. Webster
January 2002
1Measurement Systems
Kevin Hugo
1.1 Studying biomedical engineering

Edna Jones is a 67-year-old retired teacher who is having difficulty with her vision. She can't remember when it started, but her eyesight has increasingly blurred over the course of the last year. It has now become so poor that last week she drove her car off the road. She hasn\u2019t been to a doctor for many years, but now she\u2019s decided to see her family phy- sician.

The nurse measured and recorded Edna\u2019s vital signs. Although her weight, 90 kg (198 lb.), was measured with an electronic scale, her height, 173 cm (5 ft. 8 in.), was measured manually. She marveled at the device that took her blood pressure (118/76) and pulse (63 beats per minute) simultaneously. Another automated instrument took her body temperature (98.6 \u00b0F or 37 \u00b0C) from her ear in a few seconds, instead of having to place a thermometer under her tongue for a minute.

Edna related her vision problems and accident to the doctor. She is certain that she did not suffer any injuries. She finds it strange that the doctor asked about how much water she drinks, but she admitted that she has been rather thirsty lately and that she drinks and passes a lot of water. The doctor also noted that that Edna has gained a fair amount of weight.

The doctor began the physical examination by observing Edna\u2019s eyes with an ophthalmoscope. There were cotton-like blotches on the normally orange\u2013pink retina. The physician then felt her hands and feet; they were cold, and she has lost some of the sensation of touch in her feet. Finally, samples of urine and blood were taken.

It takes several minutes for the laboratory at the clinic to analyze the urine and blood samples; they use an automated instrument to measure the blood sugar (glucose) in each. The doctor is concerned about the results, and orders an electrocardiogram and fur- ther tests on the blood and urine samples before returning to Ms. Jones to discuss her condition.

Chapter 1 Measurement Systems
1.1.1 Scales of biological organization

The patient in the above story has noninsulin-dependent diabetes mellitus (NIDDM), a disease in which afflicted persons have high levels of blood glucose. Diabetes mellitus is a very common chronic disease with many complications, and is one of the most expen- sive diseases to treat in the United States. However, with early detection and diligent treatment, the risk of complications can be reduced (Diabetes, 1993).

In diagnosing the patient\u2019s disease and managing the future treatment, it is nec- essary to take measurements using biomedical instruments, which is the subject of this book. One way to classify the various types of bioinstrumentation is to consider the level of biological organization involved in taking the measurement. For example, it may in- volve molecules, cells, tissues, organ systems, or the entire body. The chapters of this book are presented in the order of these biological levels.

This chapter discusses how and why measurements are taken. For example, every patient has vital signs taken not only because they may be useful in analyzing the problem that the patient is concerned with, but also because they indicate that person\u2019s general health. We must also understand that the results of measurements will vary due to errors in taking the measurement as well as individual differences.

An automated thermometer measured Ms. Jones\u2019 temperature in just several seconds. This is accomplished by using a temperature-sensing element as well as elec- tronics to derive the temperature based on a mathematical algorithm. This type of elec- tronic signal processing is explained in Chapter 2.

Measurements of concentrations of glucose and other molecules are performed by spectrophotometry, as described in Chapter 3. Ms. Jones may have coronary artery disease and need an implanted graft vessel. Chapter 4 describes the electron microscopes used to test proposed biomaterials and the adhesion of protein molecules to them.

Methods used to analyze the blood sample that was drawn are described in Chapter 5. Diabetes causes a number of complications. In order to study the urinary casts (cylindrical protein molds) passed in the urine, Chapter 6 describes the optical micro- scopes used. Ms. Jones reported a loss of feeling in her legs. Chapter 7 describes the nervous system and the test used to diagnose nerve disease.

Chapter 8 describes the electrocardiogram, which is used to diagnose Ms. Jones\u2019 cardiac problems, as well as methods to obtain blood pressure measurements. Ms. Jones\u2019 kidney function is diagnosed by measuring creatinine clearance, as described in Chapter 9. NIDDM patients are frequently overweight. Chapter 10 describes measurements on the body, including measurements of body fat.

1.1.2 Fields of biomedical engineering

Biomedical engineering is a cross-disciplinary field that incorporates engineering, biol- ogy, chemistry, and medicine. This involves both the acquisition of new information and technology, but also of the development of new devices, processes, and algorithms in regards to biological systems.

Table 1.1 shows that instrumentation can be classified by the field of biomedical
engineering responsible for its design. Each of these fields is briefly described in the fol-

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