ISO IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. BME-27, NO.
3, MARCH 1980
Indirect Measurement of Instantaneous Arterial Blood
Pressure in the Human Finger by the
Vascular Unloading Technique
KEN-ICHI YAMAKOSHI, HIDEAKI SHIMAZU,
Abstract-For the indirect measurement of beat-to-beat systolic and
diastolic pressure in the human finger, a new hydraulic servocontrol
system was designed to maintain the vascular volume in the unloaded
state. The servocontrol system consists of a compression chamber
equipped with an occluding cuff and a photoelectric plethysmograph, an
electromagnetic shaker, and a volume servo circuit. The shaker con-
nected to a diaphragm actuator is used for controlling the cuff pressure.
The vascular volume change in the rmger is detected by the photoelectric
plethysmograph. The plethysmographic signal is fed into the servo cir-
cuit to control the cuff pressure, which is clamped at a proper value
corresponding to the unloaded vascular volume. At this state the con-
trolled cuff pressure follows the intraarterial pressure. The accuracy of
this method was evaluated using an in vitro vascular model of the fin-
ger. Comparisons with direct measurement were carried out success-
fully in four normotensive and six hypertensive subjects.
INTRODUCTION
A number of studies for the long-term and/or automated
indirect measurement of arterial pressure using sphyg-
momanometric techniques has been presented [1], [2]. In
most of these the systolic and diastolic pressure can be ob-
tained only intennittently, because some time is needed for
the measurement procedure. There is a need for an instrument
by which arterial pressure can be measured continuously and
noninvasively.
The present paper describes a new method for measuring both
beat-to-beat systolic and diastolic pressure and pressure wave-
form in the human fmger noninvasively. Using a hydraulic
servocontrol technique, an applied counterpressure is made to
equalize the intraarterial pressure. Thus, the instantaneous
arterial pressure can be indirectly recorded by measuring the
counterpressure.
METHODS
The Instrument
The method to be described is based on the indirect unload-
ing of the vascular wall [3], [4] . The vascular volume changes
associated with the intraarterial pressure are compensated by
an applied counterpressure to maintain a constant vascular
volume in the unloaded state (the unloaded vascular volume).
Manuscript received June 25, 1979; revised August 30, 1979, and
October 11, 1979.
The authors are with the Institute for Medical and Dental Engineer-
ing, Tokyo Medical and Dental University, Tokyo, Japan.
0018-9294/80/0300-0150$00.75
AND TATSUO TOGAWA
In the unloaded state the counterpressure is equal to the intra-
arterial pressure. This allows the indirect measurement of the
intraarterial pressure.
Fig. 1(a) shows a block diagram of the instrument. This is a
modification of the system used for the measurement in the
rat's tail [5] . The instrument can be divided into a mechanical-
sensing system and a servo system. The mechanical system
is shown in Fig. 1(b). It consists of a compression chamber
(CC) filled with water and a diaphragm actuator (DA) (effec-
tive diaphragm area = 11 cm2) connected with an electro-
magnetic shaker (SHAKER, G-002, Shinken Company). A
finger is placed in the chamber through an occluding cuff (OC),
so that the finger segment can be compressed or decompressed
by the hydraulic pressure in the chamber (cuff pressure Pa).
The cuff is a thin-walled (0.1 mm) translucent polyurethane
tube. It is formed so that during the finger compression no
cuff tension is developed. Both flanges of the cuff are firmly
fixed to both ends of the chamber by a pair of annular disks
[AD in Fig. 1(a)]. The effective width of the cuff is 28 mm
and its inner diameter is about 22 mm.
The diaphragm actuator which is used to control the cuff
pressure is connected with the chamber through a 10 mm-long
fluid passage of 20 mm inner diameter (compliance of its
diaphragm = 0.011 ml/100 mmHg). A retainer plate (RP)
firmly fixed to the diaphragm is connected with plunger (P) of
the shaker. The maximum displacement, the force, and nat-
ural frequency of the shaker are ±2 mm, 5 kg, and 80 Hz,
respectively. The position of the plunger is sensed by a photo-
electric linear displacement transducer (LT) (frequency re-
sponse = -3 dB at 100 Hz). The controlled volume (Se) can
be obtained from the output of this transducer. The chamber
has a side connection (SC) for a Statham P-37 pressure trans-
ducer and a vent (AV) to remove air bubbles.
A transmittance photoelectric plethysmograph is used to de-
tect the volume change in the finger. Series-connected light
emitting diodes (LED's) (TLN103, Toshiba Electric Company)
are used as a light source, while parallel-connected phototran-
sistors (PT) (TPS603, Toshiba Electric Company) are used as
photodetector [see Fig. 1(c)] . The light source (LED) is placed
in a cylindrical hole in the upper part of the chamber and in-
sulated from the water by a transparent acrylic plate. The
photodetector (PT) is fixed directly on the skin on the opposite
side of the light source using adhesive tape. The frequency re-
sponse of this plethysmograph is uniform up to about 200 Hz.
The servocontrol system consists of a differential amplifier
© 1980 IEEE
YAMAKOSHI et al.: INSTANTANEOUS ARTERIAL BLOOD PRESSURE
(a)
.PC
(b)
LED PT
(c)
3m'
Fig. 1. (a) Block diagram of the servocontrol system for the indirect
measurement of blood pressure in the fmger. (b) Schematic illustra-
tion of the mechanical system of the instrument. (c) The arrangement
and connection of the LED's and the PT's. PT is fixed directly on the
skin on the opposite side of LED. For symbols see text.
(D.AMP), a gain and phase lead-lag compensator (CMP) con-
structed by conventional PID-control circuits, and a power am-
plifier (PA) (output power = 50 W). Reference value [REF(I)]
for the servocontrol is obtained by performing an open-loop
operation (0-position). The photoelectric plethysmogram
(PG) is recorded via a dc amplifier (AMP) at cuff pressure con-
trolled by an external signal [REF (II)] The cuff pressure is
. transducer (S,) were simultaneously recorded on a multichan-
raised until the superimposed pulsating signal on the plethys-
mogram attains a maximum amplitude. At this cuff pressure
the arterial wall is relieved of tension [6] -[8], which corre-
sponds to the unloaded state of the vascular wall. The cuff
pressure which allows the maximum amplitude is used as a
preset value, while the mean value of the plethysmogram de-
tected at this point serves as the reference value for the servo-
control. It has been experimentally proved by several investi-
gators that this cuff pressure is almost equal to the mean
arterial pressure [7], [9] [10] .
,
The closed-loop operation (C-position) is made after deter-
mining the reference value. The plethysmographic signal is
subtracted from the reference value by means of D.AMP to
produce a servocontrol error. The error is fed to PA via CMP.
Frequency response of the whole system was uniform up to
more than 60 Hz by use of an appropriate transfer function
[F(s)] of CMP [F(s) (1 + 0.3s) (1 + 0.5s)/(1 + 0.05s) (1 +
O.Ols)]. The output signal of the PA drives the shaker which
actuates DA to control the cuff pressure. In this way,any van-
ation in vascular volume due to the change in arterial pressure
is instantaneously compensated by the servocontrol system, so
that the vascular volume is clamped at the reference value.
Thus the cuff pressure follows the intraarterial pressure.
151
Model Experiments
An in vitro vascular model of the finger was made for the
preliminary experiment. Four cm-long segments of the com-
mon carotid arteries, ranging from 1.5 to 2.5 mm inner diam-
eter, were excised from seven mongrel dogs. Acrylic pipes
(3 cm long and 1.6 mm inner diameter) were inserted in both
ends of the arterial segment and tied with a ligature. The
segment was then stretched to its original length using rubber
stoppers (18 mm external diameter and 5 mm thick) fixed
on the pipes. The segment was mounted on a plastic base
(6 mm wide, 50 mm long, and 2 mm thick). Both the segment
and the base were carefully wrapped with a soft alginate im-
pression material (Vericol, G-C Dental Industrial Corpor-
ation). This model was then covered with a 6 cm long Penrose
tube (19 mm inner diameter). After fixing the photodetector
on the middle part of the model by adhesive tape, the model
was placed in the compression chamber.
A sinusoidal pressure of constant amplitude was supplied to
the arterial segment from a pump which was connected to one
of the acrylic pipes used as an inlet via a stiffpolyethylene tube
(3 mm inner diameter). The amplitude and frequency of the
sinusoidal pressure were controlled from 0 to 150 mmHg and
0.1 to 40 Hz, respectively. The other pipe used as an outlet
was connected to a reservoir via a polyvinyl tube (5 mm inner
diameter). The perfusing flow rate was controlled by a screw
clamp on this tube. Fresh heparinized dog blood was used as
a perfusate. Supply pressure (Ps) at the inlet of the arterial
segment was measured with a Statham P-37 pressure transducer.
Initially, the open-loop operation was performed to deter-
mine the reference value for the servocontrol. After the cuff
pressure was set at the preset value, the closed-loop operation
was carried out to obtain the supply pressure indirectly.
The signals from the two pressure transducers (Ps and Pa),
the photoelectric plethysmograph (PG), and the displacement
nel recorder (Polygraph 142, San-Ei Instrument Company).
The model experiment was completed within 1-2 h after ex-
cising the arterial segments from the anesthetized dogs.
Experiments in Human Subjects
Arterial pressure measurement by this method was compared
with direct measurement in four normotensive (19-35 years
old; 3 males and 1 female) and six hypertensive (21-45 years
old; 4 males and 2 females) subjects, undergoing catheteriza-
tion. Under local anesthesia, an indwelling 18 gauge thinwall
needle was inserted into the left brachial artery at the elbow
and connected to a Statham P-37 pressure transducer. Either
the index, the middle, or the ring finger of the left hand was
placed in the cuff after fixing the photodetector. During the
measurement the subjects were supine on a bed with their
heads elevated about 100. The left arm was held horizontally
at the heart level.
The measuring procedure is the same as described previously.
Only a single setting of the preset value was necessary for
continuous measurement over a few hours. Abrupt or unex-
plained pressure changes which appeared in the indirect re-
cording were suggestive of displacement of the finger placed in
the chamber. Resetting was necessary in such cases.
152

SUPPLY PRESSIE
( Ps)

CUFf PRESSUK
( Pc)
100
~~
--r
___ _
1S
-lI
IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. BME-27, NO. 3, MARCH 1980

illiltllllliiitlill
*z1IU~_

iNII411i IWO 111fil'm likiiTii 1V AfiJ

Cp L PRESET VALUE :
1;;;; ;limuimiloiillr II"C~isi
vP
i. ______ _ _,

-------PPR= --- --i b--

15 AP -v-- -!- -
-1

-- - X- IUSTI iiOl,l O 6 _I r -ll

.
~It ,.~:x:d~I il IICREASINO GAIN
- PUILSATILE CNPONENT Of PO NN
PLETHYSKUNAN
()PG .%
------0R=/,,
VA,&LUEi
1 --- -. 9i i ,, . . -I :-
1..-__ii._.1 _1 t,._
APSc APS-
CUTROLLED U.u
I ---
1 ---- -
0.31 77§7______-. lfilmsituiuAr-
-- F
T
I,
.-
I.
VoluE 10
F,
~-rn
\ -v- ;-- LL
I~~~~~~~~~~~~~~~~k ilbRalinL
mmomm_t_U---
L =_
mmum
(SY) r .-.
I
-,-
OPEN-LOOP CLOSED-LOOP
Fig. 2. An example of simultaneous recordings of sinusoidal supply pressure (Ps), cuff pressure (P.), photoelectric plethys-
mogram (PG), and controlled volume (Sv) in open- and closed-loop operation obtained from the finger model. An ac
record of the pulsatile component of PG is inserted between Pc and PG records. Pcp indicates the peak pressure value
corresponding to the appearance of the plethysmographic pulsations. The cuff pressure corresponding to the maximum
amplitude of the pulsations and the mean level of PG at this moment were used as the "preset value" and the "reference
value" for the servocontrol, respectively. Note that with the gradual increase in the closed4oop gain of the system
(closed-oop operation) the cuff pressure begins to follow the supply pressure. Conversely, the superimposed pulsations
disappear and the plethysmogram is clamped at the reference value. Asterisks indicate the sudden change in the supply
pressure.

Continuous recordings were made during such interventions pressure began to follow the supply pressure as the closed-loop
as deep breathing, Valsalva maneuver, amyl nitrite inhalation, gain was gradually increased. Conversely, the superimposed
cold pressor test, and carotid sinus compression test. Intra- sinusoidal pulsations disappeared. The instantaneous pressure
arterial pressure (Pb), cuff pressure (Pa), photoelectric plethys- can be indirectly measured from the cuff pressure thus con-
mogram (PG), and controlled volume (S,) were simultaneously trolled. The cuff pressure was found to be in good agreement
recorded on the multichannel recorder. The experiment on with the supply pressure even when the supply pressure was
the model as well as on the human subjects were carried out at changed (indicated by *).
a room temperature of about 220C. The accuracy of the pulsatile pressure value determined by
this method was evaluated using an index termed as the pulse
RESULTS disappearance ratio (PDR). This is defined as the ratio of the
Measurements in the Finger Model amplitude of the plethysmographic pulsation during the increas-
ing of the closed-loop gain (APGC) to the maximum amplitude
Fig. 2 shows an example of the simultaneous recordings in (APG) (PDR APG,/APG; in decibels). Fig. 3 shows the re-
the open- (left side) and the closed-loop (right side) operation lationship between PDR and the pulse pressure ratio (PPR),
obtained by the in vitro experiment. For explaining the opera- defined as the ratio of the amplitude of the pulsatile pres-
tion, an ac record of the pulsatile component of the plethys- sure in the cuff (APC) to that of the supply pressure (AP,)
mogram is inserted between PC and PG records.
(PPR -APCIAPs; in percent). Mean values ± standard error of
In the open-loop operation, the mean level of the plethysmo- the mean (SEM) of all the measurements are shown in this dia-
gram changed almost linearly with the change in the cuff pres-
gram. Ideally, when PDR becomes -c decibels by increasing
sure. When the cuff pressure was gradually decreased from the closed-loop gain, the cuff pressure would follow the supply
about 150 mmHg the sinusoidal plethysmographic pulsation pressure in perfect agreement. However, it was practically dif-
appeared. The cuff pressure at this point (Pcp) was equal to ficult to attain the complete disappearance of the pulsations,
the peak supply pressure. The amplitude of the pulsations be- because at the higher gain the system tends to be unstable. It
came larger and then began to decrease following a further de-
was found that less than 5 percent measurement error was at-
crease in the cuff pressure. The maximum amplitude was ob-
tainable when PDR was less than approximately - 15 dB.
served when the cuff pressure was almost the same as the mean
supply pressure (100 mmHg). This cuff pressure and the cor- Measurements in the Human Fingers
responding mean level of the plethysmogram were used as the Fig. 4 shows simultaneous recordings of direct brachial ar-
"preset value" and the "reference value" for the servocontrol, terial pressure (Pb), cuff pressure (Pc) photoelectric plethys-
respectively. mogram (PG), its pulsatile component, and controlled volume
After closing the control loop at the preset value, the cuff (Se) in the open-loop operation obtained from the index finger
 |;fiMgIWlh;S^ra.Xt
YAMAKOSHI et al.: INSTANTANEOUS ARTERIAL BLOOD PRESSURE 153

of a normotensive subject. The mean level of the plethys-

mogram and the amplitude of its pulsatile component changed
in a characteristic manner following the gradual increase in the
cuff pressure.
The rapid downward shift of the mean level of the plethys-
mogram was first observed following the gradual increase in
the cuff pressure (stage B). As the cuff pressure was increased
further, the similar but slower downward shift in the plethys-
mogram was observed (stage C). During stage C an increase
followed by a decrease in the amplitude of the superimposed
pulsation was observed. The maximum amplitude was notice-
able in approximately the first two-thirds of stage C in all of
the cases. The mean level of the plethysmogram at the maxi-
mum amplitude was used as the reference value. After the end
-20 -10 of stage C, the pulsating signal disappeared (stage D). The dis-
appearance of the pulsating signal indicates the end point at
POR dB which the cuff pressure represents the systolic pressure (PCS).
Fig. 3. Relationship between PDR (in decibels) and PPR (in percent) in The characteristic change in the plethysmogram following
the in vitro experiments. Brackets represent SEM.
the change in the cuff pressure in Fig. 4 was not observed in
the in vitro experiment. It is suggestive that the difference
of the slope of the plethysmogram was caused by the differ-
ence of the elastic properties of the venous and the arterial
n1 nHg ,2Q - I. .... Is
vessels [4].
Fig. 5 is a part of the simultaneous recordings in the closed-
i.. .... I..
LUU

INTRA-ARTERIAL
l:I :I:i
P:
:zS;i:!l:::r1: l !4- !-

loop operation obtained from the same subject as described in

PRESSURE 100 k.lilfijll'.!lii i"Jtiliiiiiilillil}liblIl!6i i
*-- F il.j..b. .., ,1,:.;1.._,$:.;.1.'1. .,.;,.1.. ;,_ :.i.l....

Fig. 4. It was demonstrated that the waveform of the indirect

ai!. :ti :1 ..!i .i l.!'!l rjl l!!leii;i ilili}i .i'ili: (cuff) pressure measured by this method was similar to that re-
corded simultaneously by intraarterial catheterization. Both
Pi nnt beat-to-beat systolic and diastolic pressures can be determined
2UU
I
F;Xl
;!. !4. , ;t-it' t
:lui*"
r . I.;j* |1
'-,; -1 :[;._ from the indirect record. The transient changes in the pressure
CUFF PRESSURE 100- PCS~ produced by interventions such as deep breathing, Valsalva
PC
! PRESET VALUE: maneuver, and cold pressor test were recorded in good agree-
ment with those by the direct measurement. However, the in-
n
-l I-tisilsj4jsjitj>z Ljils44 lE! E
direct pressure (finger pressure) indicated pressure values ap-
proximately 8-13 mmHg lower than the directly recorded
brachial arterial pressure, which may be caused by the fact
PLETHYSMOGRAM that the recording sites were different.
Fig. 6 is a pair of scatter diagrams of the arbitrarily collected
PG values of systolic (A) and diastolic (B) pressure showing the re-
lationships between the simultaneous results obtained by the
indirect and direct method in a mixed group of four normo-
tensive (e) and six hypertensive (o) subjects. The linear regres-
PULSATILE sion equations (solid lines) between the systolic values of in-
COMPONENT OF PG direct pressure (PCS) and direct pressure (Pbs), and between
the diastolic values of indirect pressure (Pad) and direct pres-
sure (Pbd) were PCS = 1.06Pbs - 21.8 and Pcd = 0.97-Pbd
CONTROLLED O.5 , _4-l--l!-- ; !4J4J
1,. .
if |- **tI
,t -Li_ 9.16, respectively, with correlation coefficient (r) of 0.992 for
VOLUME *ii 7E..:!.|i;i'!!'
|I
1]
-,eJ¢.sf .l::l ,liHEM
..t.!-i
the former and 0.978 for the latter. The PcslPbs and Pcd/Pbd
sy ratios were 0.902 ± 0.046 (mean ± SD) and 0.851 ± 0.085,
respectively.
Fig. 4. An example of simultaneous recordings of direct brachial arte-
rial pressure (Pb), cuff pressure (Pc), photoelectric plethysmogram DISCUSSION AND CONCLUSION
(PG), pulsatile component of PG, and controlled volume (Sv) in open-
loop operation obtained from the index fimger of a normotensive The principle of the "indirect unloading technique" on which
subject. The arrow directed upward indicates the pressure value (PCS) this method is based, was just proposed by Marey [6] and more
corresponding to the systolic end point, while the dotted line indi-
cates the maximum point of the plethysmographic pulsating signal. recently by Shirer [3]. In the latter system the finger was
See text for further details. placed in a chamber filled with liquid and was properly com-
 |'. :"' . ti .li . . 7-. i§.*-^|lI.!, .
n
154 IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. BME-27, NO. 3, MARCH 1980

INTRA-ARTEIIAL
PRIIR 1001 j.''.': |i:l,:I,
:;':.."'
.... ...

-
a

CUff PRESURE i' ? ..'

.......... -::;: :: ', - ', ':': ' '- - l v ,-
Pc

v; r . - - s w:r.,. ~ ~ ~ ~ ~ .. ..!.!....... .. .................'

PLETNYSIOIAII
PI ... ......

CONTROLLED
"LREE ...............
$I * ~~~~~~P BRUTE
- : : : . . ! - -i .-
VILI*IIA
..
SKI P3[IIU liST~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~. . . . T..-
.j -i K!i-|:-:--:
. !

+ OEEI HERUM lSkWy CO M[SU lEST

START of liTENlM
Fig. 5. Simultaneous recording of brachial arterial pressure (Pb), cuff pressure (Pc),photoelectric plethysmogram (PG), and
controlled volume (Sv) in the closed4oop operation obtained from the same subject as in Fig. 4. The waveform of indi-
rectly measured arterial pressure is similar to that simultaneously recorded by the direct measurement. The values at the
marked points represent the systolic/diastolic pressure at respective times. Different stages of measurement are indicated
in the lower part of this figure.
150 -
-0
* 4 NORMOTENSIVES * 4 NORMOTENSIVES
-Ir o 6HYPERTENSIVES o 6 HYPERTENSIVES
aa

Ie 100
° 100
CZO
se
CL

2 150 I=154 Co* n=154

r=0.992 "*
VU t=0.978
PCs =1.06N,-21.8 Pcd=0.970X-9.16

0 50 100 150 200 50 100 150

DIRECT BRACHIAL SYSTOLIC PRESSURE ( Pbs ) MuHg DIRECT BRACHIAL DIASTOLIC PRESSURE( Phd ) MmH8
(a) (b)
Fig. 6. Comparison of direct and indirect simultaneous measurements of systolic pressures (a) and diastolic pressures (b)
in four normotensive (.) and six hypertensive (o) subjects. Indirect systolic (P..) and diastolic (Pcd) pressures measured
by tids method are plotted against the corresponding direct systolic (Pbs) and diastolic (Pbd) pressures recorded by intra-
arterial catheters. These data are randomly collected from simultaneous recordings at various levels of arterial pressure.
A solid line in each diagram indicates the regression line.

pressed to obtain the fmger blood pressure by measuring the tinct than the setting by him. Although the reference value set
chamber pressure. As pointed out by Shirer, however, his by Penaz is close to this value, the setting according to our
method did not give satisfactory results due to several limiting method is more practicable and reduces the measurement
factors including viscous resistance of the finger tissue and the error.
compliance of the chamber-finger sealing [3], [8]. To elimi- The change in vasoconstrictive tone during the measurement
nate the errors caused by these factors we proposed a servo- by this method may be another causative factor of measure-
control system [4] in this paper. ment error. This should be minimal, so far as the detected
The most important factor in measuring blood pressure by plethysmographic signal is produced mainly by the blood
this method is to set the proper "reference value" for the ser- volume variations in relatively large arteries of the finger.
vocontrol. Improper setting of this value will produce large But if the vasoconstrictive tone is too high to produce the
measurement error. Penaz [4] has suggested setting this value plethysmographic signal, it is difficult to determine the refer-
at "about" one-third of the arterial vascular volume. (He ence value. Therefore, the blood pressure measured by this
determined this point from one-third of the height of the method should be accurate when the ratio of the active to the
mean level of the plethysmogram following the gradual change passive tension of the arterial wall or the change in the active
in cuff pressure.) However, the reference value used in our tension during the measurement is relatively small.
system is obtained from the point showing a maximum ampli- Several investigators have tried to measure instantaneous arte-
tude in the plethysmographic pulsating signal which indicates rial pressure noninvasively by tonometric techniques [11] [ 1 4]. -

the unloaded state of the vascular wall. Thus, it is more dis- Although these are simpler and more convenient methods,
YAMAKOSHI et al.: INSTANTANEOUS ARTERIAL BLOOD PRESSURE
improper adjustment or even slight movement of the transducer [141 P. D. Stein and E. F. Blick, "Arterial tonometry for the atrau-
frequently causes a distortion in the pressure wave and pro-
duces artifacts. Calibration for the tonometric techniques is
also practically difficult, and thus the absolute value of arterial
pressure may not be obtained accurately. In this sense this
method seems to be more advantageous than the tonometric
techniques for recording arterial pressure.
ACKNOWLEDGMENT
The authors wish to thank Ueda Electronics Works Ltd.,
Tokyo, Japan, for their assistance in constructing the instru-
ment, Prof. H. Ito, Department of Physiology, Kyorin Univer-
sity School of Medicine, Kyorin, Japan, and Dr. A. R. Bukhari,
University of Engineering, Lahore, Pakistan, for their assistance
in preparing the manuscript, Dr. 0. Tochikubo, Department of
Internal Medicine, Yokohama City University School of Med- biocontrol systems. His current research interests include ambulatory
icine, Yokohama, Japan, for his clinical assistance, and T. monitoring,
engineering.
Shoji and H. Matsumoto for their technical assistance.
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[3] H. W. Shirer, "Blood pressure measuring methods," IRE Trans.
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[41 J. Penaz, "Photoelectric measurement of blood pressure, volume
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[51 K. Yamakoshi, H. Shimazu, and T. Togawa, "Indirect measure-
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tron. Contr. Instrum., vol. IECI-19, pp. 54-56, May 1972.
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matic measurement of arterial blood pressure," J. Appl. Physiol.,
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Ken-Ichi Yamakoshi was bom in Tokyo, Japan,
on May 7, 1947. He received the B.Sc. and
M.Sc. degrees in mechanical engineering from
Waseda University, Tokyo, Japan, in 1970 and
1972, respectively, and the M.D. degree from
Tokyo Medical and Dental University, Tokyo,
apan, in 1979.
. I E His research work has involved the design of
medical instrumentation, in which he developed
the electrical admittance plethysmograph, car-
diovascular analysis, and the development of
exercise and environmental physiology, and rehabilitation
Hideaki Shimazu was born in Kanagawa, Japan,
on January 5, 1952. He received the B.Sc. de-
gree in mechanical engineering from Waseda
University, Tokyo, Japan, in 1973. After grad-
uating, he studied biomedical engineering for 1
year at the Institute for Medical and Dental En-
gineering, Tokyo Medical and Dental University,
',Tokyo, Japan.
Since 1974, he has been employed by the
Tokyo Medical and Dental University as a Re-
search Engineer. His research interests include
bioinstrumentation systems, exercise physiology, and the design of bio-
medical data processing systems.
Tatsuo Togawa was born in Tokyo, Japan, on
October 17, 1937. He received the B.Sc. degree
in applied physics from Waseda University,
Tokyo, Japan, in 1960, and the Ph.D. degree
in applied physics from Tokyo University,
Tokyo, Japan, in 1965.
He was a Research Assistant at the Institute
for Medical Electronics, Tokyo University,
from 1965 to 1967, an Assistant Professor at
the Institute for Medical and Dental Engineer-
ing, Tokyo Medical and Dental University,
Tokyo, Japan, from 1968 to 1972, and currently is a Professor. Cur-
rently he is involved in several research projects including physiological
measurements and transducers.