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BM 402
ENGINEERING IN MEDICINE
LECTURE NOTES
Ata AKIN
Institute of Biomedical Engineering
Boğaziçi University
“Health care delivery team” that seeks new (innovative) solutions for the difficult problems
Innovation patent:
2. Non-(not) obvious
History of Medicine
They did not have any medication but they were interested in:
¾ Bone setting
¾ Midwifery
¾ Surgery
1
Greek Medicine (BC 500)
Dark Ages
¾ Anatomical investigations
1906 Æ Siemens & General Electric made the first X-ray machine
1914 Æ X-ray machine became mobile and it could work without electric.
Biomedical Engineering
- Biosensors
3
PHYSIOLOGY & ANATOMY (REVIEW)
Physiological Systems
Biochemical Biochemical
Physical Physiological Physical
System
Electrical Electrical
Environmental
OUTPUTS
INPUTS
HW 1
PART II: Find websites related to Biomedical Engineering and organize them under the
following headings:
1. Academic Websites
2. Industry
3. Professional Organizations
4
Circulatory (Cardiovascular) System
Lung
Aorta
Left Atrium
Left Ventricle
Body
Left Ventricle: Responsible for pumping oxygen rich blood to the body
SA node
AV node
5
SA node has a direct contact from central nervous system to control / modulate the rhythm of
the heart.
2. Hormonal stimulation
Coronary arteries supply oxygen, glucose, blood to the tissue of the heart.
6
Nervous System
- All the nerve tissue enclosed by the bone - Nerve tissue that is not enclosed by the bone
- Brain & spinal cord - Nerve fibers from the spinal cord, muscle
nerve fibers
Blood Vessels
7
Coagulant Æ fills where there’s an explosion
¾ Fibers cross over in brain stem, left side of the brain controls the right side of the body.
Temporal Æ auditory
Occipital Æ vision
8
Reflex Arch
Corpus Callosum
9
¾ Cerebrospinal fluid underneath and around the brain
10
Respiratory (Pulmonary) System
Pair Vair is constant Æ Plung decreases, Vlung increases Æ rush of fresh air through the lungs
As the red blood cell flows, oxygen is diffused through mucosa (secreted by the certain cells
that have hair) and the red blood cell fills with oxygen. CO2 is formed as HCO3- because it is
not desired in gas phase in the plasma. It is dissolved in acid form. The undissolved part is
11
Smoking: Smoke has tar in it. Tar sits on top of mucosal layer. Alveolar needs to secrete
more mucosa. The thickness has increased, diffusion takes longer. If you smoke more, the
distance that the oxygen should travel increases and there’s no more oxygen transfer.
Î Emphysema
Concerned with the ingestion and digestion of food, elimination of the residues of the
gastrointestinal system
12
Gastroesophageal reflux
1. Neoplasia
2. Dysplasia
3. Cancerous formation
o Immortality
o Uncontrolled growth
¾ Metastate
¾ Barnett’s Esophagus
Urogenital System
¾ Reproduction
Kidneys: Responsible for maintaining water equilibrium, balance of minerals, and removal of
13
Input: Blood Output: Blood
Bladder
Kidneys send hormones to blood vessels to relax the vessels Æ renin activates angiotensin
14
Central Nervous System
- Excitatory
Dialysis: A filtration system to remove toxins and urea from the blood.
Kidney Stone:
¾ Hypoglycemia
¾ Diabetes Mellitus
15
Musculoskeletal System
Amount of signals determine how many muscles should be recruited to carry the weight.
16
Force generated by muscles is a function of
¾ Available nutrients
¾ Hypertrophy
Endocrine System
¾ Secretes hormones via glands that control growth, metabolism and reproduction.
17
Pituitary gland: growth, reproduction
o Hyperthyroidism
o Hypothyroidism
¾ Responsible for maintaining calcium balance in the blood stream and tissues
18
Hematopoietic System & Lymphatic System
Integumental System
Skin Æ protection
HW 2
PART I: Pick a physiological system of your choice and describe its functions, organs in 2
pages
19
PART II: Find a major disease of this system. Explain its pathophysiology, progression,
20
BIOMEDICAL SENSORS
Sensors that are used to measure electrical, chemical, physical activities from human body
Biomedical Instruments
Diagnostic Therapeutic
Invasiveness
Invasive
Minimally invasive
Non-invasive
21
Biomedical Instruments
BIOMEDICAL SENSORS
Chemical Sensors
O2 measurement
Clark Electrode
V = IR Ohm' sLaw
ρL
R=
A
22
O2 + H 2 O + 4e − → 4OH −
Ag ↔ Ag + + e −
Ag + + Cl − → AgCl ↓
Pulse Oximetry
Detector
Hb
HbO2
Finger
λ1 λ2
(Near infrared)
⎡ OD(λ1 ) ⎤
S O2 = A − B ⎢ ⎥
⎣ OD(λ 2 ) ⎦
S O2: Saturation of O2
Offline Sensors
¾ O2 measurement: spirometer to measure O2 gas amount and CO2 gas in the air
23
Electrical Measurements
membrane
Action Potential
and gates
¾ Dipole
¾ Einthoven’s triangle
24
Electrocardiogram (ECG)
P: atrial contraction
¾ Heart Rate
¾ Pacemaker
Electrical Sensors
Non-invasive Invasive
Wire
Ag / AgCl
Electrolyte
Skin
25
¾ It allows the passage of electrical signals to the metal
Electromyogram (EMG)
+
_
Cable of electricity
Stimulus
Needle electrodes
Electroencelophalogram (EEG)
activity.
26
¾ 20 electrodes across the head (cap electrodes)
¾ Evoked Response
¾ Cortical electrodes
HW 3
1. ECG
2. EMG
PART II: What is functional electrical stimulation (FES)? What are its clinical applications?
(1 page)
Physical Measurements
Volume Measurement
Breath
Rubber strand
27
To measure the change in current:
V
R= ρ∝R
I
∆R ∝ ∆l
ρL
R=
A
I Æ limit of detection
I II III
II Æ linear range
∆V
¾ Transducer
T no of breaths
period
Breath Rate =
min
12-15 min-1 28
- Amplitude gives basic info about
the amount of air exchange
Force & Strain Measurement
I F
+
V
l Rubber
substrate
∆l
F ∝ ∆R ∝ ∆l
1. Intraesophageal balloon
Pump
2. Radiofloroscopy
29
o Ingest a liquid Æ absorber of X-ray
3. Strain Gage
Rubber
4. Piezoelectric Transducer
Metal
Voltmeter
F F
30
Q = kF
Temperature Measurement
2. Electrical Thermometer
3. Optical Thermometer
Electrical Thermometer
Thermistor
I
31
⎡ ⎛ 1 1 ⎞⎤
R (T ) = R0 exp ⎢ β ⎜⎜ − ⎟⎟ ⎥
⎣ ⎝ T T0 ⎠ ⎦
1
∆ I ∝ ∆ R ∝
Biosensors (≠ medical sensors)
T
Sensors that measure the concentration of chemical components of solution
Cholesterol Biological
compound
Glucose
Enzyme Transducer
Membrane
pH Glucose
HW 4
PART II: What is a molecular beacon? What is a quantum dot? Find their usage in biology.
32
BIOMEDICAL INSTRUMENTATION
Noise Removal
¾ Electromagnetic interference
33
1. Noise filter
Transfer Function
2. Data Filter
3. Gain
34
4. Differential Measurement
n(t)
V1(t)
+
Vo(t)
VR(t) _
VL(t)
V2(t)
V1 (t ) = VR (t ) + n(t )
− V2 (t ) = VL (t ) + n(t )
Vo (t ) = V1 − V2 = VR (t ) − VL (t )
y (t ) = G{[x1 (t ) − x 2 (t )] ∗ h N (t )}∗ hD (t )
Types of Signals
A / D Converter
Î Resolutions
1. Temporary Resolution
2. Dynamic Resolution
Ex: 12 bit A / D converter, Fs = 200 samples/sec records data for 10 min from 16 electrodes.
36
Biomediccal Signal Processing
P
Bioelecctric Signalss
¾ Generated by
b nerve annd muscle tissues when
n they are electrically acctive.
Æ Result of
o electrocheemical channges across the cell mem
mbrane.
Biomaggnetic Signaals
¾ Magnetic fields
fi are generated duee to changess in electric field.
Î Maagnetoencepphalogram ((MEG)
Biochem
mical Signaals
¾ concentrations of ions (Ca2+, K+, Na+, Cl-…)), hormoness, chemical compounds, blood
gases
Biomecchanical Siggnals
Bioacusstic Signals
37
Characteristics of Signals
Periodic Aperiodic
x(t)
x(t)
A-
e −t / T
38
Random: characterized by statistical values (mean, standard deviation)
¾ EEG signals
Fourier Transform
1. x1 (t ) = A1 sin(ω1t )
T1
A1
1
- A1 ω 1 = 2π f 1 f1 = = 12 Hz
T1
1
ω 2 = 2π f 2 f2 = = 25Hz
T2
2. x 2 (t ) = A2 sin(ω 2 t )
f1 < f 2
T1 > T2
T2
A2 < A1
A2
-A2 ∞
∫ x(t )e
− jωt
x( f ) = dt
−∞
xT(t) ∞
1
∫ x ( f )e
− jωt
x(t ) = dω
2π −∞
39
x(f)
A1 Data Compression
A2
frequency
f1 f2
¾ EEG
40
Medical Imaging
Functionality Invasiveness
1. Spatial Resolution
2. Contrast Resolution
3. Temporal Resolution
41
Radiation Imaging
- Depends on the use of X-rays to image the absorption (attenuation) distribution of the
tissues
Object
I0
I
Photographic film
covered with
fluorescent material
I < I0
Source
Object
Visible light
Fluorescent material
1901 – The very first Nobel Prize was given to Wilhelm Conrad Roentgen
42
Principles of X-Ray Imaging
Attenuation of X-rays by tissues between body parts having minimally different density, fat,
e-
Photographic
film
Ω
A grid of photo
Pulse detector
generation
Florescent
cover
Holes
Pb
43
Physics of X-Ray Imaging
Ionizing radiation
E = hf
h: Planck’s constant
c
↑ f =
λ↓
- Vaporization of tissues
γ rays, X rays pass through tissues and give permanent damage to skin
I0
44
I ( z ) = I 0 e − ρmz
µ: attenuation coefficient
When light enters (I0), some of it is absorbed by the body not to eliminate X-ray
immediately.
Geometric Unsharpness
X-ray
source
Fan beam
s
f
Image plane
45
s: source to image plane distance
f ⋅t
d=
s−t
Source
Detector
The detector rotates and cross-section images are obtained at every 1-2o
46
2 + 4
1 2
1 + 2
ρ1 µ1 ρ2 µ2
3 4
ρ3 µ3 ρ4 µ4
1 + 3 1 + 4
α i = ρi µi
We have 4 unknowns
1st Generation CT
1 source, 1 detector
2nd Generation CT
1 source 30 detectors
All detectors are close to the source at equal distances to reduce geometrical sharpness
3rd Generation CT
47
300 detectors Æ 2 – 4 seconds
4th Generation CT
Fluoroscopy
Patient is given a radio opaque (X-ray absorber) material and the movement of this material
Angiography
Injection of radio opaque material into the veins for observation of occlusions
HW 5
48
Radionuclide Imaging
Nuclear particles
e-
n, p+
energy
n → p + e + υ + energy
+ − −
e
p + → n + e + + υ e− + energy
Through a
catheter
Pow der
radioactive mix in
solution
C6H12O6 Æ Isotopes C11, C15 Æ accumulates in the parts where glucose is consumed
49
Positron Emission Tomography (PET Scan)
An imaging technique that uses γ cameras ( cameras) to monitor the whereabouts and
time.
Radioactive Decay
N (t ) = N 0 e − λt
λ: decay constant
t: time
0.693
T1 / 2 =
λ
50
Biological Half-life
Time needed for the body to excrete half of the amount of radionuclide. Tb1/2
T 1 / 2 ×T1b/ 2
T eff
1/ 2 =
T 1 / 2 +T1b/ 2
¾ Molecular Beacon
¾ Quantum Dot
51
Magnetic Resonance Imaging (MRI)
Physics of MRI
- Creation of 2 poles
Non-magnetic
-
Because all moments facing different directions
Magnet
S N
All moments are at the same
direction
1. All spinning nuclei have a characteristic resonance frequency which depends on the
atomic composition
2. When atoms are combined to form larger molecules, their overall resonance frequency
52
Nuclear Magnetic Resistance Spectroscopy (NMRS)
Larmor Frequency
ω = γ β0
ω = 2π f
γ: gyromagnetic ratio
Each molecule starts to rotate according to gyromagnetic ratio, resulting in ωA, ωB, ωC, ωD.
IA
A% ∝ × 100
IT
IT = I A + I B + IC + I D
53
PG Re
Re: Receiver
B1
S N
B0
3. Off S1, on S2
FID
τ
A
54
Imaging Takes Place In MR
Min resolution: 1 mm x 1 mm x 1 mm
H + → γ H+
BT ↑=ωT ↑
Srec
Rec PC Display
SX SY
PGX PGY
S N
SZ
PGZ 55
PG require high current to operate
MRI
It uses hemoglobin molecule to trace the functional activity level of the brain.
HW 6
56
ULTRASOUND IMAGING
Uses sound waves to probe the mechanical properties of the tissues (pressure waves)
= 1500 m/sec
Some sound waves reflect from the boundary. Some continue their way.
−α f z f
Pfat ( z ) = P0 e
f = 0 f f: frequency of operation
57
Med
dical Ultrasound
Diaagnostic Therapeuttic
- Suurgical
Amplittude (A – mode)
m Ultraasound
Brightn
ness Mode (B Mode)
58
The echoes are turned into gray scale image
Array of US sensors
Non-invasive!
Doppler Ultrasound
Doppler Effect is the result of changing the wavelength of a source by its velocity.
US Beam
θ
P0
f0
P1 (fd) 59
2ϑ cos θ
fd = f0
C
: velocity of object
C: speed of sound
f0
: measure the change in blood velocity
fd
Kidney Imaging
Blood moving away
from the probe
60
Blood towards
the probe
B – Mode + Doppler US
Kidney stone
Echocardiogram
Doppler is less invasive than B – mode because the patient is exposed to less Ultrasound.
Ultrasound (transmitter)
Bathtub
62
Electro Shock Wave Lithotripsy
Biomedical Optics
Diagnostic Therapeutic
(<100µm) (>100µm)
63
Light and Matter Interaction
γ ray X ray UV vis Infrared
Æ Depends on the
- Endoscopy
- 4 holes, 5 mm in dimension
Fluorescence Imaging
64
Therapy
Æ Surgical inventions
Laser
Cornea
Pupil
Infrared Therapy
o Tissue Damage
Cosmetic applications
1. Plastic Surgery
2. Epilation
65
Rehabilitation Engineering
Application of technology to help (ease) the problems faced by people with disabilities
- Functional
- Biocompatible
66
Mic
Cochlea
Skull
Analog data
Sensors
data
information knowledge
67
Clinical Engineering
- An engineer who manages, maintains and improves the safe use of medical equipment in
hospitals
68
¾ Train medical personnel in safe and effective use of equipment
- Mechanical Hazards
- Radiation Hazards
Medical Ethics
- What is man?
Ethics
- Represents the codes of conduct of society, the study of right and wrong, good and evil in
human conduct
Questions
69
2. Should treatment be stopped to allow terminally ill patients to die?
Medical Dilemmas
3. Does an individual have the right to refuse treatment when refusing it may lead to
Kant’s theory: Humans are owed a special kind of respect simply because they are people
Experiments
70