The Biomedical Engineering HandbookThird Edition
Medical Devicesand Systems
© 2006 by Taylor & Francis Group, LLC
The Electrical Engineering Handbook Series
Series Editor
Richard C. DorfUniversity of California, Davis
Titles Included in the Series
The Handbook of Ad Hoc Wireless Networks, Mohammad IlyasThe Avionics Handbook, Cary R. SpitzerThe Biomedical Engineering Handbook, Third Edition, Joseph D. BronzinoThe Circuits and Filters Handbook, Second Edition, Wai-Kai ChenThe Communications Handbook, Second Edition, Jerry GibsonThe Computer Engineering Handbook, Vojin G. OklobdzijaThe Control Handbook, William S. LevineThe CRC Handbook of Engineering Tables, Richard C. DorfThe Digital Signal Processing Handbook, Vijay K. Madisetti and Douglas WilliamsThe Electrical Engineering Handbook, Third Edition, Richard C. DorfThe Electric Power Engineering Handbook, Leo L. GrigsbyThe Electronics Handbook, Second Edition, Jerry C. WhitakerThe Engineering Handbook, Third Edition, Richard C. DorfThe Handbook of Formulas and Tables for Signal Processing, Alexander D. PoularikasThe Handbook of Nanoscience, Engineering, and Technology, William A. Goddard, III,
Donald W. Brenner, Sergey E. Lyshevski, and Gerald J. IafrateThe Handbook of Optical Communication Networks, Mohammad Ilyas and
Hussein T. MouftahThe Industrial Electronics Handbook, J. David IrwinThe Measurement, Instrumentation, and Sensors Handbook, John G. WebsterThe Mechanical Systems Design Handbook, Osita D.I. Nwokah and Yidirim HurmuzluThe Mechatronics Handbook, Robert H. BishopThe Mobile Communications Handbook, Second Edition, Jerry D. GibsonThe Ocean Engineering Handbook, Ferial El-HawaryThe RF and Microwave Handbook, Mike GolioThe Technology Management Handbook, Richard C. DorfThe Transforms and Applications Handbook, Second Edition, Alexander D. PoularikasThe VLSI Handbook, Wai-Kai Chen
© 2006 by Taylor & Francis Group, LLC
The Biomedical Engineering HandbookThird Edition
Edited byJoseph D. Bronzino
Biomedical Engineering Fundamentals
Medical Devices and Systems
Tissue Engineering and Artificial Organs
© 2006 by Taylor & Francis Group, LLC
The Biomedical Engineering HandbookThird Edition
Medical Devicesand Systems
Edited by
Joseph D. BronzinoTrinity College
Hartford, Connecticut, U.S.A.
A CRC title, part of the Taylor & Francis imprint, a member of theTaylor & Francis Group, the academic division of T&F Informa plc.
Boca Raton London New York
© 2006 by Taylor & Francis Group, LLC
Published in 2006 byCRC PressTaylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300Boca Raton, FL 33487-2742
© 2006 by Taylor & Francis Group, LLCCRC Press is an imprint of Taylor & Francis Group
No claim to original U.S. Government worksPrinted in the United States of America on acid-free paper10 9 8 7 6 5 4 3 2 1
International Standard Book Number-10: 0-8493-2122-0 (Hardcover) International Standard Book Number-13: 978-0-8493-2122-1 (Hardcover) Library of Congress Card Number 2005056892
This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted withpermission, and sources are indicated. A wide variety of references are listed. Reasonable efforts have been made to publishreliable data and information, but the author and the publisher cannot assume responsibility for the validity of all materialsor for the consequences of their use.
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Library of Congress Cataloging-in-Publication Data
Medical devices and systems / edited by Joseph D. Bronzino.p. cm. -- (The electrical engineering handbook series)
Includes bibliographical references and index.ISBN 0-8493-2122-01. Medical instruments and apparatus--Handbooks, manuals, etc. I. Bronzino, Joseph D., 1937- II.
Title. III. Series.
R856.15.B76 2006610.28--dc22 2005056892
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Introduction and Preface
During the past five years since the publication of the Second Edition — a two-volume set — of theBiomedical Engineering Handbook, the field of biomedical engineering has continued to evolve and expand.As a result, this Third Edition consists of a three volume set, which has been significantly modified toreflect the state-of-the-field knowledge and applications in this important discipline. More specifically,this Third Edition contains a number of completely new sections, including:
• Molecular Biology• Bionanotechnology• Bioinformatics• Neuroengineering• Infrared Imaging
as well as a new section on ethics.In addition, all of the sections that have appeared in the first and second editions have been significantly
revised. Therefore, this Third Edition presents an excellent summary of the status of knowledge andactivities of biomedical engineers in the beginning of the 21st century.
As such, it can serve as an excellent reference for individuals interested not only in a review of funda-mental physiology, but also in quickly being brought up to speed in certain areas of biomedical engineeringresearch. It can serve as an excellent textbook for students in areas where traditional textbooks have notyet been developed and as an excellent review of the major areas of activity in each biomedical engineeringsubdiscipline, such as biomechanics, biomaterials, bioinstrumentation, medical imaging, etc. Finally, itcan serve as the“bible” for practicing biomedical engineering professionals by covering such topics as a his-torical perspective of medical technology, the role of professional societies, the ethical issues associatedwith medical technology, and the FDA process.
Biomedical engineering is now an important vital interdisciplinary field. Biomedical engineers areinvolved in virtually all aspects of developing new medical technology. They are involved in the design,development, and utilization of materials, devices (such as pacemakers, lithotripsy, etc.) and techniques(such as signal processing, artificial intelligence, etc.) for clinical research and use; and serve as membersof the health care delivery team (clinical engineering, medical informatics, rehabilitation engineering,etc.) seeking new solutions for difficult health care problems confronting our society. To meet the needsof this diverse body of biomedical engineers, this handbook provides a central core of knowledge in thosefields encompassed by the discipline. However, before presenting this detailed information, it is importantto provide a sense of the evolution of the modern health care system and identify the diverse activitiesbiomedical engineers perform to assist in the diagnosis and treatment of patients.
Evolution of the Modern Health Care SystemBefore 1900, medicine had little to offer the average citizen, since its resources consisted mainly ofthe physician, his education, and his “little black bag.” In general, physicians seemed to be in short
© 2006 by Taylor & Francis Group, LLC
supply, but the shortage had rather different causes than the current crisis in the availability of healthcare professionals. Although the costs of obtaining medical training were relatively low, the demand fordoctors’ services also was very small, since many of the services provided by the physician also could beobtained from experienced amateurs in the community. The home was typically the site for treatmentand recuperation, and relatives and neighbors constituted an able and willing nursing staff. Babies weredelivered by midwives, and those illnesses not cured by home remedies were left to run their natural,albeit frequently fatal, course. The contrast with contemporary health care practices, in which specializedphysicians and nurses located within the hospital provide critical diagnostic and treatment services, isdramatic.
The changes that have occurred within medical science originated in the rapid developments that tookplace in the applied sciences (chemistry, physics, engineering, microbiology, physiology, pharmacology,etc.) at the turn of the century. This process of development was characterized by intense interdis-ciplinary cross-fertilization, which provided an environment in which medical research was able totake giant strides in developing techniques for the diagnosis and treatment of disease. For example,in 1903, Willem Einthoven, a Dutch physiologist, devised the first electrocardiograph to measure theelectrical activity of the heart. In applying discoveries in the physical sciences to the analysis of thebiologic process, he initiated a new age in both cardiovascular medicine and electrical measurementtechniques.
New discoveries in medical sciences followed one another like intermediates in a chain reaction. How-ever, the most significant innovation for clinical medicine was the development of x-rays. These “newkinds of rays,” as their discoverer W.K. Roentgen described them in 1895, opened the “inner man” tomedical inspection. Initially, x-rays were used to diagnose bone fractures and dislocations, and in the pro-cess, x-ray machines became commonplace in most urban hospitals. Separate departments of radiologywere established, and their influence spread to other departments throughout the hospital. By the 1930s,x-ray visualization of practically all organ systems of the body had been made possible through the use ofbarium salts and a wide variety of radiopaque materials.
X-ray technology gave physicians a powerful tool that, for the first time, permitted accurate diagnosisof a wide variety of diseases and injuries. Moreover, since x-ray machines were too cumbersome andexpensive for local doctors and clinics, they had to be placed in health care centers or hospitals. Oncethere, x-ray technology essentially triggered the transformation of the hospital from a passive receptaclefor the sick to an active curative institution for all members of society.
For economic reasons, the centralization of health care services became essential because of many otherimportant technological innovations appearing on the medical scene. However, hospitals remained insti-tutions to dread, and it was not until the introduction of sulfanilamide in the mid-1930s and penicillin inthe early 1940s that the main danger of hospitalization, that is, cross-infection among patients, was signi-ficantly reduced. With these new drugs in their arsenals, surgeons were able to perform their operationswithout prohibitive morbidity and mortality due to infection. Furthermore, even though the differentblood groups and their incompatibility were discovered in 1900 and sodium citrate was used in 1913 toprevent clotting, full development of blood banks was not practical until the 1930s, when technologyprovided adequate refrigeration. Until that time, “fresh” donors were bled and the blood transfused whileit was still warm.
Once these surgical suites were established, the employment of specifically designed pieces of med-ical technology assisted in further advancing the development of complex surgical procedures. Forexample, the Drinker respirator was introduced in 1927 and the first heart-lung bypass in 1939. Bythe 1940s, medical procedures heavily dependent on medical technology, such as cardiac catheterizationand angiography (the use of a cannula threaded through an arm vein and into the heart with the injectionof radiopaque dye) for the x-ray visualization of congenital and acquired heart disease (mainly valvedisorders due to rheumatic fever) became possible, and a new era of cardiac and vascular surgery wasestablished.
Following World War II, technological advances were spurred on by efforts to develop superior weaponsystems and establish habitats in space and on the ocean floor. As a by-product of these efforts, the
© 2006 by Taylor & Francis Group, LLC
development of medical devices accelerated and the medical profession benefited greatly from this rapidsurge of technological finds. Consider the following examples:
1. Advances in solid-state electronics made it possible to map the subtle behavior of the fundamentalunit of the central nervous system — the neuron — as well as to monitor the various physiologicalparameters, such as the electrocardiogram, of patients in intensive care units.
2. New prosthetic devices became a goal of engineers involved in providing the disabled with tools toimprove their quality of life.
3. Nuclear medicine — an outgrowth of the atomic age — emerged as a powerful and effectiveapproach in detecting and treating specific physiologic abnormalities.
4. Diagnostic ultrasound based on sonar technology became so widely accepted that ultrasonic studiesare now part of the routine diagnostic workup in many medical specialties.
5. “Spare parts” surgery also became commonplace. Technologists were encouraged to providecardiac assist devices, such as artificial heart valves and artificial blood vessels, and the artifi-cial heart program was launched to develop a replacement for a defective or diseased humanheart.
6. Advances in materials have made the development of disposable medical devices, such as needlesand thermometers, as well as implantable drug delivery systems, a reality.
7. Computers similar to those developed to control the flight plans of the Apollo capsule were usedto store, process, and cross-check medical records, to monitor patient status in intensive care units,and to provide sophisticated statistical diagnoses of potential diseases correlated with specific setsof patient symptoms.
8. Development of the first computer-based medical instrument, the computerized axial tomographyscanner, revolutionized clinical approaches to noninvasive diagnostic imaging procedures, whichnow include magnetic resonance imaging and positron emission tomography as well.
9. A wide variety of new cardiovascular technologies including implantable defibrillators andchemically treated stents were developed.
10. Neuronal pacing systems were used to detect and prevent epileptic seizures.11. Artificial organs and tissue have been created.12. The completion of the genome project has stimulated the search for new biological markers and
personalized medicine.
The impact of these discoveries and many others has been profound. The health care system of todayconsists of technologically sophisticated clinical staff operating primarily in modern hospitals designedto accommodate the new medical technology. This evolutionary process continues, with advances in thephysical sciences such as materials and nanotechnology, and in the life sciences such as molecular biology,the genome project and artificial organs. These advances have altered and will continue to alter the verynature of the health care delivery system itself.
Biomedical Engineering: A DefinitionBioengineering is usually defined as a basic research-oriented activity closely related to biotechnology andgenetic engineering, that is, the modification of animal or plant cells, or parts of cells, to improve plantsor animals or to develop new microorganisms for beneficial ends. In the food industry, for example, thishas meant the improvement of strains of yeast for fermentation. In agriculture, bioengineers may beconcerned with the improvement of crop yields by treatment of plants with organisms to reduce frostdamage. It is clear that bioengineers of the future will have a tremendous impact on the qualities ofhuman life. The potential of this specialty is difficult to imagine. Consider the following activities ofbioengineers:
• Development of improved species of plants and animals for food production• Invention of new medical diagnostic tests for diseases
© 2006 by Taylor & Francis Group, LLC
The world of biomedical engineering
Biomechanics
Medical &biological analysis
Biosensors
Clinicalengineering
Medical &bioinformatics
Rehabilitationengineering
Physiologicalmodeling
Bionanotechnology
Biomedicalinstrumentation
Neuralengineering
Tissue engineering
Biotechnology
Biomaterials
Medical imaging
Prosthetic devices& artificial organs
FIGURE 1 The World of Biomedical Engineering.
• Production of synthetic vaccines from clone cells• Bioenvironmental engineering to protect human, animal, and plant life from toxicants and
pollutants• Study of protein–surface interactions• Modeling of the growth kinetics of yeast and hybridoma cells• Research in immobilized enzyme technology• Development of therapeutic proteins and monoclonal antibodies
Biomedical engineers, on the other hand, apply electrical, mechanical, chemical, optical, and otherengineering principles to understand, modify, or control biologic (i.e., human and animal) systems, aswell as design and manufacture products that can monitor physiologic functions and assist in the diagnosisand treatment of patients. When biomedical engineers work within a hospital or clinic, they are moreproperly called clinical engineers.
Activities of Biomedical EngineersThe breadth of activity of biomedical engineers is now significant. The field has moved from beingconcerned primarily with the development of medical instruments in the 1950s and 1960s to include amore wide-ranging set of activities. As illustrated below, the field of biomedical engineering now includesmany new career areas (see Figure 1), each of which is presented in this handbook. These areas include:
• Application of engineering system analysis (physiologic modeling, simulation, and control) tobiologic problems• Detection, measurement, and monitoring of physiologic signals (i.e., biosensors and biomedical
instrumentation)• Diagnostic interpretation via signal-processing techniques of bioelectric data• Therapeutic and rehabilitation procedures and devices (rehabilitation engineering)• Devices for replacement or augmentation of bodily functions (artificial organs)
© 2006 by Taylor & Francis Group, LLC
• Computer analysis of patient-related data and clinical decision making (i.e., medical informaticsand artificial intelligence)• Medical imaging, that is, the graphic display of anatomic detail or physiologic function• The creation of new biologic products (i.e., biotechnology and tissue engineering)• The development of new materials to be used within the body (biomaterials)
Typical pursuits of biomedical engineers, therefore, include:
• Research in new materials for implanted artificial organs• Development of new diagnostic instruments for blood analysis• Computer modeling of the function of the human heart• Writing software for analysis of medical research data• Analysis of medical device hazards for safety and efficacy• Development of new diagnostic imaging systems• Design of telemetry systems for patient monitoring• Design of biomedical sensors for measurement of human physiologic systems variables• Development of expert systems for diagnosis of disease• Design of closed-loop control systems for drug administration• Modeling of the physiological systems of the human body• Design of instrumentation for sports medicine• Development of new dental materials• Design of communication aids for the handicapped• Study of pulmonary fluid dynamics• Study of the biomechanics of the human body• Development of material to be used as replacement for human skin
Biomedical engineering, then, is an interdisciplinary branch of engineering that ranges from theoretical,nonexperimental undertakings to state-of-the-art applications. It can encompass research, development,implementation, and operation. Accordingly, like medical practice itself, it is unlikely that any singleperson can acquire expertise that encompasses the entire field. Yet, because of the interdisciplinary natureof this activity, there is considerable interplay and overlapping of interest and effort between them.For example, biomedical engineers engaged in the development of biosensors may interact with thoseinterested in prosthetic devices to develop a means to detect and use the same bioelectric signal to powera prosthetic device. Those engaged in automating the clinical chemistry laboratory may collaborate withthose developing expert systems to assist clinicians in making decisions based on specific laboratory data.The possibilities are endless.
Perhaps a greater potential benefit occurring from the use of biomedical engineering is identificationof the problems and needs of our present health care system that can be solved using existing engineeringtechnology and systems methodology. Consequently, the field of biomedical engineering offers hope inthe continuing battle to provide high-quality care at a reasonable cost. If properly directed toward solvingproblems related to preventive medical approaches, ambulatory care services, and the like, biomedicalengineers can provide the tools and techniques to make our health care system more effective and efficient;and in the process, improve the quality of life for all.
Joseph D. BronzinoEditor-in-Chief
© 2006 by Taylor & Francis Group, LLC
Editor-in-Chief
Joseph D. Bronzino received the B.S.E.E. degree from Worcester Polytechnic Institute, Worcester, MA,in 1959, the M.S.E.E. degree from the Naval Postgraduate School, Monterey, CA, in 1961, and the Ph.D.degree in electrical engineering from Worcester Polytechnic Institute in 1968. He is presently the VernonRoosa Professor of Applied Science, an endowed chair at Trinity College, Hartford, CT and Presidentof the Biomedical Engineering Alliance and Consortium (BEACON) which is a nonprofit organizationconsisting of academic and medical institutions as well as corporations dedicated to the development and
He is the author of over 200 articles and 11 books including the following: Technology for PatientCare (C.V. Mosby, 1977), Computer Applications for Patient Care (Addison-Wesley, 1982), BiomedicalEngineering: Basic Concepts and Instrumentation (PWS Publishing Co., 1986), Expert Systems: Basic Con-cepts (Research Foundation of State University of New York, 1989), Medical Technology and Society: AnInterdisciplinary Perspective (MIT Press and McGraw-Hill, 1990), Management of Medical Technology (But-terworth/Heinemann, 1992), The Biomedical Engineering Handbook (CRC Press, 1st ed., 1995; 2nd ed.,2000; Taylor & Francis, 3rd ed., 2005), Introduction to Biomedical Engineering (Academic Press, 1st ed.,1999; 2nd ed., 2005).
Dr. Bronzino is a fellow of IEEE and the American Institute of Medical and Biological Engineering(AIMBE), an honorary member of the Italian Society of Experimental Biology, past chairman of theBiomedical Engineering Division of the American Society for Engineering Education (ASEE), a chartermember and presently vice president of the Connecticut Academy of Science and Engineering (CASE),a charter member of the American College of Clinical Engineering (ACCE) and the Association for theAdvancement of Medical Instrumentation (AAMI), past president of the IEEE-Engineering in Medicineand Biology Society (EMBS), past chairman of the IEEE Health Care Engineering Policy Committee(HCEPC), past chairman of the IEEE Technical Policy Council in Washington, DC, and presently Editor-in-Chief of Elsevier’s BME Book Series and Taylor & Francis’ Biomedical Engineering Handbook.
Dr. Bronzino is also the recipient of the Millennium Award from IEEE/EMBS in 2000 and the GoddardAward from Worcester Polytechnic Institute for Professional Achievement in June 2004.
© 2006 by Taylor & Francis Group, LLC
commercialization of new medical technologies (for details visit www.beaconalliance.org).
Contributors
Joseph AdamPremise Development
CorporationHartford, Connecticut
P.D. AhlgrenVille Marie Multidisciplinary
Breast and Oncology CenterSt. Mary’s HospitalMcGill UniversityMontreal, Quebec, CanadaandLondon Cancer CentreLondon, OntarioCanada
William C. AmaluPacific Chiropractic and
Research CenterRedwood City, California
Kurt AmmerLudwig Boltzmann Research
Institute for PhysicalDiagnostics
Vienna, AustriaandMedical Imaging Research GroupSchool of ComputingUniversity of GlamorganPontypridd, WalesUnited Kingdom
Dennis D. AutioDybonics, Inc.Portland, Oregon
Raymond BalcerakDefense Advanced Research
Projects AgencyArlington, Virginia
D.C. BarberUniversity of SheffieldSheffield, United Kingdom
Khosrow BehbehaniThe University of Texas at
ArlingtonArlington, TexasandThe University of TexasSouthwestern Medical CenterDallas, Texas
N. BelliveauVille Marie Multidisciplinary
Breast and Oncology CenterSt. Mary’s HospitalMcGill UniversityMontreal, Quebec, CanadaandLondon Cancer CentreLondon, Ontario, Canada
Anna M. BianchiSt. Raffaele HospitalMilan, Italy
Carol J. BickfordAmerican Nurses AssociationWashington, D.C.
Jeffrey S. BlairIBM Health Care SolutionsAtlanta, Georgia
G. Faye Boudreaux-BartelsUniversity of Rhode Island
Kingston, Rhode Island
Bruce R. BowmanEdenTec Corporation
Eden Prairie, Minnesota
Joseph D. BronzinoTrinity CollegeBiomedical Engineering Alliance
and Consortium (BEACON)
Harford, Connecticut
Mark E. BruleyECRI
Plymouth Meeting, Pennsylvania
Richard P. BuckUniversity of North Carolina
Chapel Hill, North Carolina
P. BuddharajuDepartment of Computer Science
University of Houston
Houston, Texas
Thomas F. BudingerUniversity of California-Berkeley
Berkeley, California
Robert D. ButterfieldIVAC Corporation
San Diego, California
Joseph P. CammarotaNaval Air Warfare Center
Aircraft Division
Warminster, Pennsylvania
© 2006 by Taylor & Francis Group, LLC
Paul CampbellInstitute of Medical Science
and TechnologyUniversities of St. Andrews
and DundeeandNinewells HospitalDundee, United Kingdom
Ewart R. CarsonCity UniversityLondon, United Kingdom
Sergio CeruttiPolytechnic UniversityMilan, Italy
A. Enis ÇetinBilkent UniversityAnkara, Turkey
Christopher S. ChenDepartment of BioengineeringDepartment of PhysiologyUniversity of PennsylvaniaPhiladelphia, Pennsylvania
Wei ChenCenter for Magnetic Resonance
ResearchandThe University of Minnesota
Medical SchoolMinneapolis, Minnesota
Victor ChernomordikLaboratory of Integrative and
Medical BiophysicsNational Institute of Child Health
and Human DevelopmentBethesda, Maryland
David A. CheslerMassachusetts General HospitalHarvard University Medical
SchoolBoston, Massachusetts
Vivian H. CoatesECRIPlymouth Meeting, Pennsylvania
Arnon CohenBen-Gurion UniversityBe’er Sheva, Israel
Steven ConollyStanford University
Stanford, California
Derek G. CrampCity University
London, United Kingdom
Barbara Y. CroftNational Institutes of Health
Kensington, Maryland
David D. CunninghamAbbott Diagnostics
Process Engineering
Abbott Park, Illinois
Ian A. CunninghamVictoria HospitalThe John P. Roberts Research
Institute
and
The University of Western Ontario
London, Ontario, Canada
Yadin DavidTexas Children’s Hospital
Houston, Texas
Connie White DelaneySchool of Nursing and Medical
School
The University of Minnesota
Minneapolis, Minnesota
Mary DiakidesAdvanced Concepts Analysis, Inc.
Falls Church, Virginia
Nicholas A. DiakidesAdvanced Concepts Analysis, Inc.Falls Church, Virginia
C. Drews-PeszynskiTechnical University of Lodz
Lodz, Poland
Ronald G. DriggersU.S. Army Communications and
Electronics Research,Development and EngineeringCenter (CERDEC)
Night Vision and ElectronicSensors Directorate
Fort Belvoir, Virginia
Gary DrzewieckiRutgers UniversityPiscataway, New Jersey
Edwin G. DuffinMedtronic, Inc.Minneapolis, Minnesota
Jeffrey L. EgglestonValleylab, Inc.Boulder, Colorado
Robert L. ElliottElliott-Elliott-Head Breast Cancer
Research and Treatment CenterBaton Rouge, Louisiana
K. Whittaker FerraraRiverside Research InstituteNew York, New York
J. Michael FitzmauriceAgency for Healthcare Research
and QualityRockville, Maryland
Ross FlewellingNellcor IncorporationPleasant, California
Michael FordeMedtronic, Inc.Minneapolis, Minnesota
Amir H. GandjbakhcheLaboratory of Integrative and
Medical BiophysicsNational Institute of Child Health
and Human DevelopmentBethesda, Maryland
Israel GannotLaboratory of Integrative and
Medical BiophysicsNational Institute of Child Health
and Human DevelopmentBethesda, Maryland
Leslie A. GeddesPurdue UniversityWest Lafayette, Indiana
Richard L. GoldbergUniversity of North CarolinaChapel Hill, North Carolina
© 2006 by Taylor & Francis Group, LLC
Boris GramatikovJohns Hopkins School
of MedicineBaltimore, Maryland
Barton M. GrattSchool of DentistryUniversity of WashingtonSeattle, Washington
Walter GreenleafGreenleaf MedicalPalo Alto, California
Michael W. GrennU.S. Army Communications and
Electronics Research,Development and EngineeringCenter (CERDEC)
Night Vision and ElectronicSensors Directorate
Fort Belvoir, Virginia
Eliot B. GriggDepartment of Plastic SurgeryDartmouth-Hitchcock Medical
CenterLebanon, New Hampshire
Warren S. GrundfestDepartment of Bioengineering
and Electrical EngineeringHenry Samueli School of
Engineering and AppliedScience
andDepartment of SurgeryDavid Geffen School
of MedicineUniversity of CaliforniaLos Angeles, California
Michael L. GulliksonTexas Children’s HospitalHouston, Texas
Moinuddin HassanLaboratory of Integrative and
Medical BiophysicsNational Institute of Child Health
and Human DevelopmentBethesda, Maryland
David HatteryLaboratory of Integrative and
Medical Biophysics
National Institute of Child Healthand Human Development
Bethesda, Maryland
Jonathan F. HeadElliott-Elliott-Head Breast Cancer
Research and Treatment Center
Baton Rouge, Louisiana
William B. HobbinsWomen’s Breast Health Center
Madison, Wisconsin
Stuart HornU.S. Army Communications and
Electronics Research,Development and EngineeringCenter (CERDEC)
Night Vision and ElectronicSensors Directorate
Fort Belvoir, Virginia
Xiaoping HuCenter for Magnetic Resonance
Research
and
The University of MinnesotaMedical School
Minneapolis, Minnesota
T. JakubowskaTechnical University of Lodz
Lodz, Poland
G. Allan JohnsonDuke University Medical Center
Durham, North Carolina
Bryan F. JonesMedical Imaging Research Group
School of Computing
University of Glamorgan
Pontypridd, Wales
United Kingdom
Thomas M. JuddKaiser Permanente
Atlanta, Georgia
Millard M. JudyBaylor Research Institute and
MicroBioMed Corp.Dallas, Texas
Philip F. JudyBrigham and Women’s HospitalHarvard University Medical
SchoolBoston, Massachusetts
G.J.L. KawDepartment of Diagnostic
RadiologyTan Tock Seng HospitalSingapore
J.R. KeyserlingkVille Marie Multidisciplinary
Breast and Oncology CenterSt. Mary’s HospitalMcGill UniversityMontreal, Quebec, CanadaandLondon Cancer CentreLondon, OntarioCanada
C. Everett KoopDepartment of Plastic SurgeryDartmouth-Hitchcock Medical
CenterLebanon, New Hampshire
Hayrettin KöymenBilkent UniversityAnkara, Turkey
Luis G. KunIRMC/National Defense
UniversityWashington, D.C.
Phani Teja KurugantiRF and Microwave Systems GroupOak Ridge National LaboratoryOak Ridge, Tennessee
Kenneth K. KwongMassachusetts General HospitalHarvard University Medical
SchoolBoston, Massachusetts
© 2006 by Taylor & Francis Group, LLC
Z.R. LiSouth China Normal University
Guangzhou, China
Richard F. LittleNational Institutes of Health
Bethesda, Maryland
Chung-Chiun LiuElectronics Design Center and
Edison Sensor TechnologyCenter
Case Western Reserve University
Cleveland, Ohio
Zhongqi LiuTTM Management Group
Beijing, China
Jasper LupoApplied Research Associates, Inc.
Falls Church, Virginia
Albert MacovskiStanford University
Stanford, California
Luca T. MainardiPolytechnic University
Milan, Italy
C. ManoharDepartment of Electrical &
Computer Engineering
University of Houston
Houston, Texas
Joseph P. McClainWalter Reed Army Medical Center
Washington, D.C.
Kathleen A. McCormickSAIC
Falls Church, Virginia
Dennis McGrathDepartment of Plastic Surgery
Dartmouth-Hitchcock MedicalCenter
Lebanon, New Hampshire
Susan McGrathDepartment of Plastic Surgery
Dartmouth-Hitchcock MedicalCenter
Lebanon, New Hampshire
Matthew F. McKnightDepartment of Plastic Surgery
Dartmouth-Hitchcock MedicalCenter
Lebanon, New Hampshire
Yitzhak MendelsonWorcester Polytechnic Institute
Worcester, Massachusetts
James B. MercerUniversity of Tromsø
Tromsø, Norway
Arcangelo MerlaDepartment of Clinical Sciences
and Bioimaging
University “G.d’Annunzio”
and
Institute for Advanced BiomedicalTechnology
Foundation “G.d’Annunzio”
and
Istituto Nazionale Fisica dellaMateria
Coordinated Group of Chieti
Chieti-Pescara, Italy
Evangelia Micheli-TzanakouRutgers Unversity
Piscataway, New Jersey
Robert L. MorrisDybonics, Inc.
Portland, Oregon
Jack G. MottleyUniversity of Rochester
Rochester, New York
Robin MurrayUniversity of Rhode Island
Kingston, Rhode Island
Joachim H. NagelUniversity of Stuttgart
Stuttgart, Germany
Michael R. NeumanMichigan Technological
University
Houghton, Michigan
E.Y.K. NgCollege of Engineering
School of Mechanical andProduction Engineering
Nanyang Technological University
Singapore
Paul NortonU.S. Army Communications and
Electronics Research,Development and EngineeringCenter (CERDEC)
Night Vision and ElectronicSensors Directorate
Fort Belvoir, Virginia
Antoni NowakowskiDepartment of Biomedical
Engineering,
Gdansk University of Technology
Narutowicza
Gdansk, Poland
Banu OnaralDrexel University
Philadelphia, Pennsylvania
David D. PascoeAuburn University
Auburn, Alabama
Maqbool PatelCenter for Magnetic Resonance
Research
and
The University of MinnesotaMedical School
Minneapolis, Minnesota
Robert PattersonThe University of Minnesota
Minneapolis, Minnesota
Jeffrey L. PaulDefense Advanced Research
Projects Agency
Arlington, Virginia
A. William PaulsenEmory University
Atlanta, Georgia
© 2006 by Taylor & Francis Group, LLC
John PaulyStanford University
Stanford, California
I. PavlidisDepartment of Computer Science
University of Houston
Houston, Texas
P. Hunter PeckhamCase Western Reserve University
Cleveland, Ohio
Joseph G. PellegrinoU.S. Army Communications and
Electronics Research,Development and EngineeringCenter (CERDEC)
Night Vision and ElectronicSensors Directorate
Fort Belvoir, Virginia
Philip PercontiU.S. Army Communications and
Electronics Research,Development and EngineeringCenter (CERDEC)
Night Vision and ElectronicSensors Directorate
Fort Belvoir, Virginia
Athina P. PetropuluDrexel University
Philadelphia, Pennsylvania
Tom PiantanidaGreenleaf Medical
Palo Alto, California
T. Allan PryorUniversity of Utah
Salt Lake City, Utah
Ram C. PurohitAuburn University
Auburn, Alabama
Hairong QiECE Department
The University of Tennessee
Knoxville, Tennessee
Pat RidgelyMedtronic, Inc.
Minneapolis, Minnesota
E. Francis RingMedical Imaging Research GroupSchool of ComputingUniversity of GlamorganPontypridd, WalesUnited Kingdom
Richard L. RoaBaylor University Medical CenterDallas, Texas
Peter RobbieDepartment of Plastic SurgeryDartmouth-Hitchcock Medical
CenterLebanon, New Hampshire
Gian Luca RomaniDepartment of Clinical Sciences
and BioimagingUniversity “G. d’Annunzio”andInstitute for Advanced
Biomedical TechnologyFoundation “G.d’Annunzio”andIstituto Nazionale Fisica della
MateriaCoordinated Group of ChietiChieti-Pescara, Italy
Joseph M. RosenDepartment of Plastic SurgeryDartmouth-Hitchcock Medical
CenterLebanon, New Hampshire
Eric RosowHartford HospitalandPremise Development
CorporationHartford, Connecticut
Subrata SahaClemson UniversityClemson, South Carolina
John SchenckGeneral Electric Corporate
Research and DevelopmentCenter
Schenectady, New York
Edward SchuckEdenTec CorporationEden Prairie, Minnesota
Joyce SensmeierHIMSS
Chicago, Illinois
David ShermanJohns Hopkins School of Medicine
Baltimore, Maryland
Robert E. Shroy, Jr.Picker International
Highland Heights, Ohio
Stephen W. SmithDuke University
Durham, North Carolina
Nathan J. SniadeckiDepartment of Bioengineering
University of Pennsylvania
Philadelphia, Pennsylvania
Wesley E. SnyderECE Department
North Carolina State University
Raleigh, North Carolina
Orhan SoykanCorporate Science and
Technology
Medtronic, Inc.
andDepartment of Biomedical
Engineering
Michigan TechnologicalUniversity
Houghton, Michigan
Primoz StrojnikCase Western Reserve University
Cleveland, Ohio
M. StrzeleckiTechnical University of Lodz
Lodz, Poland
Ron SummersLoughborough University
Leicestershire, United Kingdom
Christopher SwiftDepartment of Plastic Surgery
Dartmouth-Hitchcock MedicalCenter
Lebanon, New Hampshire
Willis A. TackerPurdue University
West Lafayette, Indiana
© 2006 by Taylor & Francis Group, LLC
Nitish V. ThakorJohns Hopkins School of MedicineBaltimore, Maryland
Roderick ThomasFaculty of Applied Design and
EngineeringSwansea Institute of TechnologySwansea, United Kingdom
P. TsiamyrtzisDepartment of StatisticsUniversity of Economics and
Business AthensAthens, Greece
Benjamin M.W. TsuiUniversity of North CarolinaChapel Hill, North Carolina
Tracy A. TurnerPrivate PracticeMinneapolis, Minnesota
Kamil UgurbilCenter for Magnetic Resonance
ResearchandThe University of Minnesota
Medical SchoolMinneapolis, Minnesota
Michael S. Van LyselUniversity of WisconsinMadison, Wisconsin
Henry F. VanBrocklinUniversity of California-BerkeleyBerkeley, California
Jay VizgaitisU.S. Army Communications and
Electronics Research,Development and EngineeringCenter (CERDEC)
Night Vision and ElectronicSensors Directorate
Fort Belvoir, Virginia
Abby VogelLaboratory of Integrative and
Medical BiophysicsNational Institute of Child Health
and Human DevelopmentBethesda, Maryland
Wolf W. von MaltzahnRensselaer Polytechnic InstituteTroy, New York
Gregory I. VossIVAC CorporationSan Diego, California
Alvin WaldColumbia UniversityNew York, New York
Chen WangTTM InternationalHouston, Texas
Lois de WeerdUniversity Hospital of
North NorwayTromsø, Norway
Wang WeiRadiology DepartmentBeijing You An HospitalBeijing, China
B. WiecekTechnical University of LodzLodz, Poland
M. WysockiTechnical University of LodzLodz, Poland
Martin J. YaffeUniversity of TorontoToronto, Ontario, Canada
Robert YarchoanHIV and AIDS Malignancy
BranchCenter for Cancer ResearchNational Cancer Institute (NCI)Bethesda, Maryland
M. YassaVille Marie Multidisciplinary
Breast and Oncology CenterSt. Mary’s HospitalMcGill UniversityMontreal, Quebec, CanadaandLondon Cancer CentreLondon, Ontario, Canada
Christopher M. YipDepartments of Chemical
Engineering and AppliedChemistry
Department of Biochemistry
Institute of Biomaterials andBiomedical Engineering
University of Toronto
Toronto, Ontario, Canada
E. YuVille Marie Multidisciplinary
Breast and Oncology Center
St. Mary’s Hospital
McGill University
Montreal, Quebec, Canada
and
London Cancer Centre
London, Ontario, Canada
Wen YuShanghai RuiJin Hospital
Shanghai, China
Yune YuanInstitute of Basic Medical Science
China Army General Hospital
Beijing, China
Jason ZeibelU.S. Army Communications and
Electronics Research,Development and EngineeringCenter (CERDEC)
Night Vision and ElectronicSensors Directorate
Fort Belvoir, Virginia
Yi ZengCentral Disease Control of China
Beijing, China
Xiaohong ZhouDuke University Medical Center
Durham, North Carolina
Yulin ZhouShanghai RuiJin Hospital
Shanghai, China
© 2006 by Taylor & Francis Group, LLC
Contents
SECTION I Biomedical Signal Analysis
Banu Onaral
1 Biomedical Signals: Origin and Dynamic Characteristics;Frequency-Domain AnalysisArnon Cohen . . . . . . . . . . . . . . . . . . . . . 1-1
2 Digital Biomedical Signal Acquisition and ProcessingLuca T. Mainardi, Anna M. Bianchi, Sergio Cerutti . . . . 2-1
3 Compression of Digital Biomedical SignalsA. Enis Çetin, Hayrettin Köymen . . . . . . . . . . . . 3-1
4 Time-Frequency Signal Representations forBiomedical SignalsG. Faye Boudreaux-Bartels, Robin Murray . . . . . . . . 4-1
5 Wavelet (Time-Scale) Analysis in BiomedicalSignal ProcessingNitish V. Thakor, Boris Gramatikov, David Sherman . . . 5-1
6 Higher-Order Spectral AnalysisAthina P. Petropulu . . . . . . . . . . . . . . . . . . 6-1
7 Neural Networks in Biomedical Signal ProcessingEvangelia Micheli-Tzanakou . . . . . . . . . . . . . . 7-1
8 Complexity, Scaling, and Fractals in Biomedical SignalsBanu Onaral, Joseph P. Cammarota . . . . . . . . . . . 8-1
9 Future Directions: Biomedical Signal Processing andNetworked Multimedia CommunicationsBanu Onaral . . . . . . . . . . . . . . . . . . . . . 9-1
© 2006 by Taylor & Francis Group, LLC
SECTION II Imaging
Warren S. Grundfest
10 X-RayRobert E. Shroy, Jr., Michael S. Van Lysel,Martin J. Yaffe . . . . . . . . . . . . . . . . . . . . 10-1
11 Computed TomographyIan A. Cunningham, Philip F. Judy . . . . . . . . . . . 11-1
12 Magnetic Resonance ImagingSteven Conolly, Albert Macovski, John Pauly, John Schenck,Kenneth K. Kwong, David A. Chesler, Xiaoping Hu,Wei Chen, Maqbool Patel, Kamil Ugurbil . . . . . . . . 12-1
13 Nuclear MedicineBarbara Y. Croft, Benjamin M.W. Tsui . . . . . . . . . . 13-1
14 UltrasoundRichard L. Goldberg, Stephen W. Smith, Jack G. Mottley,K. Whittaker Ferrara . . . . . . . . . . . . . . . . . 14-1
15 Magnetic Resonance MicroscopyXiaohong Zhou, G. Allan Johnson . . . . . . . . . . . . 15-1
16 Positron-Emission Tomography (PET)Thomas F. Budinger, Henry F. VanBrocklin . . . . . . . . 16-1
17 Electrical Impedance TomographyD.C. Barber . . . . . . . . . . . . . . . . . . . . . 17-1
18 Medical Applications of Virtual Reality TechnologyWalter Greenleaf, Tom Piantanida . . . . . . . . . . . 18-1
SECTION III Infrared Imaging
Nicholas A. Diakides
19 Advances in Medical Infrared ImagingNicholas Diakides, Mary Diakides, Jasper Lupo,Jeffrey L. Paul, Raymond Balcerak . . . . . . . . . . . 19-1
20 The Historical Development of Thermometryand Thermal Imaging in MedicineE. Francis Ring, Bryan F. Jones . . . . . . . . . . . . . 20-1
© 2006 by Taylor & Francis Group, LLC
21 Physiology of Thermal SignalsDavid D. Pascoe, James B. Mercer, Lois de Weerd . . . . . 21-1
22 Quantitative Active Dynamic Thermal IR-Imaging andThermal Tomography in Medical DiagnosticsAntoni Nowakowski . . . . . . . . . . . . . . . . . 22-1
23 Thermal Texture Maps (TTM): Concept, Theory, andApplicationsZhongqi Liu, Chen Wang, Hairong Qi, Yune Yuan, Yi Zeng,Z.R. Li, Yulin Zhou, Wen Yu, Wang Wei . . . . . . . . . 23-1
24 IR Imagers as Fever Monitoring Devices: Physics,Physiology, and Clinical AccuracyE.Y.K. Ng, G.J.L. Kaw . . . . . . . . . . . . . . . . . 24-1
25 Infrared Imaging of the Breast — An OverviewWilliam C. Amalu, William B. Hobbins, Jonathan F. Head,Robert L. Elliott . . . . . . . . . . . . . . . . . . . 25-1
26 Functional Infrared Imaging of the Breast:Historical Perspectives, Current Application, andFuture ConsiderationsJ.R. Keyserlingk, P.D. Ahlgren, E. Yu, N. Belliveau,M. Yassa . . . . . . . . . . . . . . . . . . . . . . . 26-1
27 Detecting Breast Cancer from Thermal Infrared Images byAsymmetry AnalysisHairong Qi, Phani Teja Kuruganti, Wesley E. Snyder . . . 27-1
28 Advanced Thermal Image ProcessingB. Wiecek, M. Strzelecki, T. Jakubowska, M. Wysocki,C. Drews-Peszynski . . . . . . . . . . . . . . . . . . 28-1
29 Biometrics: Face Recognition in Thermal InfraredI. Pavlidis, P. Tsiamyrtzis, P. Buddharaju, C. Manohar . . . 29-1
30 Infrared Imaging for Tissue Characterization and FunctionMoinuddin Hassan, Victor Chernomordik, Abby Vogel,David Hattery, Israel Gannot, Richard F. Little,Robert Yarchoan, Amir H. Gandjbakhche . . . . . . . . 30-1
31 Thermal Imaging in Diseases of the Skeletal andNeuromuscular SystemsE. Francis Ring, Kurt Ammer . . . . . . . . . . . . . . 31-1
32 Functional Infrared Imaging in Clinical ApplicationsArcangelo Merla, Gian Luca Romani . . . . . . . . . . 32-1
© 2006 by Taylor & Francis Group, LLC
33 Thermal Imaging in SurgeryPaul Campbell, Roderick Thomas . . . . . . . . . . . . 33-1
34 Infrared Imaging Applied to DentistryBarton M. Gratt . . . . . . . . . . . . . . . . . . . 34-1
35 Use of Infrared Imaging in Veterinary MedicineRam C. Purohit, Tracy A. Turner, David D. Pascoe . . . . 35-1
36 Standard Procedures for Infrared Imaging in MedicineKurt Ammer, E. Francis Ring . . . . . . . . . . . . . . 36-1
37 Infrared Detectors and Detector ArraysPaul Norton, Stuart Horn, Joseph G. Pellegrino,Philip Perconti . . . . . . . . . . . . . . . . . . . . 37-1
38 Infrared Camera CharacterizationJoseph G. Pellegrino, Jason Zeibel, Ronald G. Driggers,Philip Perconti . . . . . . . . . . . . . . . . . . . . 38-1
39 Infrared Camera and Optics for Medical ApplicationsMichael W. Grenn, Jay Vizgaitis, Joseph G. Pellegrino,Philip Perconti . . . . . . . . . . . . . . . . . . . . 39-1
SECTION IV Medical Informatics
Luis G. Kun
40 Hospital Information Systems: Their Function and StateT. Allan Pryor . . . . . . . . . . . . . . . . . . . . 40-1
41 Computer-Based Patient RecordsJ. Michael Fitzmaurice . . . . . . . . . . . . . . . . . 41-1
42 Overview of Standards Related to the Emerging Health CareInformation InfrastructureJeffrey S. Blair . . . . . . . . . . . . . . . . . . . . 42-1
43 Introduction to Informatics and NursingKathleen A. McCormick, Joyce Sensmeier,Connie White Delaney, Carol J. Bickford . . . . . . . . . 43-1
44 Non-AI Decision MakingRon Summers, Derek G. Cramp, Ewart R. Carson . . . . . 44-1
© 2006 by Taylor & Francis Group, LLC
45 Medical Informatics and Biomedical Emergencies: NewTraining and Simulation Technologies for First RespondersJoseph M. Rosen, Christopher Swift, Eliot B. Grigg,Matthew F. McKnight, Susan McGrath, Dennis McGrath,Peter Robbie, C. Everett Koop . . . . . . . . . . . . . 45-1
SECTION V Biomedical Sensors
Michael R. Neuman
46 Physical MeasurementsMichael R. Neuman . . . . . . . . . . . . . . . . . . 46-1
47 Biopotential ElectrodesMichael R. Neuman . . . . . . . . . . . . . . . . . . 47-1
48 Electrochemical SensorsChung-Chiun Liu . . . . . . . . . . . . . . . . . . . 48-1
49 Optical SensorsYitzhak Mendelson . . . . . . . . . . . . . . . . . . 49-1
50 Bioanalytic SensorsRichard P. Buck . . . . . . . . . . . . . . . . . . . 50-1
51 Biological Sensors for DiagnosticsOrhan Soykan . . . . . . . . . . . . . . . . . . . . 51-1
SECTION VI Medical Instruments and Devices
Wolf W. von Maltzahn
52 Biopotential AmplifiersJoachim H. Nagel . . . . . . . . . . . . . . . . . . . 52-1
53 Bioelectric Impedance MeasurementsRobert Patterson . . . . . . . . . . . . . . . . . . . 53-1
54 Implantable Cardiac PacemakersMichael Forde, Pat Ridgely . . . . . . . . . . . . . . . 54-1
55 Noninvasive Arterial Blood Pressure and MechanicsGary Drzewiecki . . . . . . . . . . . . . . . . . . . 55-1
© 2006 by Taylor & Francis Group, LLC
56 Cardiac Output MeasurementLeslie A. Geddes . . . . . . . . . . . . . . . . . . . 56-1
57 External DefibrillatorsWillis A. Tacker . . . . . . . . . . . . . . . . . . . 57-1
58 Implantable DefibrillatorsEdwin G. Duffin . . . . . . . . . . . . . . . . . . . 58-1
59 Implantable Stimulators for Neuromuscular ControlPrimoz Strojnik, P. Hunter Peckham . . . . . . . . . . 59-1
60 RespirationLeslie A. Geddes . . . . . . . . . . . . . . . . . . . 60-1
61 Mechanical VentilationKhosrow Behbehani . . . . . . . . . . . . . . . . . . 61-1
62 Essentials of Anesthesia DeliveryA. William Paulsen . . . . . . . . . . . . . . . . . . 62-1
63 Electrosurgical DevicesJeffrey L. Eggleston, Wolf W. von Maltzahn . . . . . . . . 63-1
64 Biomedical LasersMillard M. Judy . . . . . . . . . . . . . . . . . . . . 64-1
65 Instrumentation for Cell MechanicsNathan J. Sniadecki, Christopher S. Chen . . . . . . . . 65-1
66 Blood Glucose MonitoringDavid D. Cunningham . . . . . . . . . . . . . . . . 66-1
67 Atomic Force Microscopy: Probing BiomolecularInteractionsChristopher M. Yip . . . . . . . . . . . . . . . . . . 67-1
68 Parenteral Infusion DevicesGregory I. Voss, Robert D. Butterfield . . . . . . . . . . 68-1
69 Clinical Laboratory: Separation and Spectral MethodsRichard L. Roa . . . . . . . . . . . . . . . . . . . . 69-1
70 Clinical Laboratory: Nonspectral Methods and AutomationRichard L. Roa . . . . . . . . . . . . . . . . . . . . 70-1
71 Noninvasive Optical MonitoringRoss Flewelling . . . . . . . . . . . . . . . . . . . . 71-1
© 2006 by Taylor & Francis Group, LLC
72 Medical Instruments and Devices Used in the HomeBruce R. Bowman, Edward Schuck . . . . . . . . . . . 72-1
73 Virtual Instrumentation: Applications in BiomedicalEngineeringEric Rosow, Joseph Adam . . . . . . . . . . . . . . . 73-1
SECTION VII Clinical Engineering
Yadin David
74 Clinical Engineering: Evolution of a DisciplineJoseph D. Bronzino . . . . . . . . . . . . . . . . . . 74-1
75 Management and Assessment of Medical TechnologyYadin David, Thomas M. Judd . . . . . . . . . . . . . 75-1
76 Risk Factors, Safety, and Management of Medical EquipmentMichael L. Gullikson . . . . . . . . . . . . . . . . . 76-1
77 Clinical Engineering Program IndicatorsDennis D. Autio, Robert L. Morris . . . . . . . . . . . . 77-1
78 Quality of Improvement and Team BuildingJoseph P. McClain . . . . . . . . . . . . . . . . . . . 78-1
79 A Standards Primer for Clinical EngineersAlvin Wald . . . . . . . . . . . . . . . . . . . . . 79-1
80 Regulatory and Assessment AgenciesMark E. Bruley, Vivian H. Coates . . . . . . . . . . . . 80-1
81 Applications of Virtual Instruments in Health CareEric Rosow, Joseph Adam . . . . . . . . . . . . . . . 81-1
SECTION VIII Ethical Issues Associated withthe Use of Medical Technology
Subrata Saha and Joseph D. Bronzino
82 Beneficence, Nonmaleficence, and Medical TechnologyJoseph D. Bronzino . . . . . . . . . . . . . . . . . . 82-1
83 Ethical Issues Related to Clinical ResearchJoseph D. Bronzino . . . . . . . . . . . . . . . . . . 83-1
© 2006 by Taylor & Francis Group, LLC
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