The Biomedical Engineering Handbook

Third Edition

Medical Devices
and Systems

© 2006 by Taylor & Francis Group, LLC

The Electrical Engineering Handbook Series
Series Editor
Richard C. Dorf
University of California, Davis

Titles Included in the Series

The Handbook of Ad Hoc Wireless Networks, Mohammad Ilyas
The Avionics Handbook, Cary R. Spitzer
The Biomedical Engineering Handbook, Third Edition, Joseph D. Bronzino
The Circuits and Filters Handbook, Second Edition, Wai-Kai Chen
The Communications Handbook, Second Edition, Jerry Gibson
The Computer Engineering Handbook, Vojin G. Oklobdzija
The Control Handbook, William S. Levine
The CRC Handbook of Engineering Tables, Richard C. Dorf
The Digital Signal Processing Handbook, Vijay K. Madisetti and Douglas Williams
The Electrical Engineering Handbook, Third Edition, Richard C. Dorf
The Electric Power Engineering Handbook, Leo L. Grigsby
The Electronics Handbook, Second Edition, Jerry C. Whitaker
The Engineering Handbook, Third Edition, Richard C. Dorf
The Handbook of Formulas and Tables for Signal Processing, Alexander D. Poularikas
The Handbook of Nanoscience, Engineering, and Technology, William A. Goddard, III,
Donald W. Brenner, Sergey E. Lyshevski, and Gerald J. Iafrate
The Handbook of Optical Communication Networks, Mohammad Ilyas and
Hussein T. Mouftah
The Industrial Electronics Handbook, J. David Irwin
The Measurement, Instrumentation, and Sensors Handbook, John G. Webster
The Mechanical Systems Design Handbook, Osita D.I. Nwokah and Yidirim Hurmuzlu
The Mechatronics Handbook, Robert H. Bishop
The Mobile Communications Handbook, Second Edition, Jerry D. Gibson
The Ocean Engineering Handbook, Ferial El-Hawary
The RF and Microwave Handbook, Mike Golio
The Technology Management Handbook, Richard C. Dorf
The Transforms and Applications Handbook, Second Edition, Alexander D. Poularikas
The VLSI Handbook, Wai-Kai Chen

© 2006 by Taylor & Francis Group, LLC

 The Biomedical Engineering Handbook
Third Edition
Edited by
Joseph D. Bronzino

Biomedical Engineering Fundamentals

Medical Devices and Systems

Tissue Engineering and Artificial Organs

© 2006 by Taylor & Francis Group, LLC

 The Biomedical Engineering Handbook
Third Edition

Medical Devices
and Systems

Edited by
Joseph D. Bronzino
Trinity College
Hartford, Connecticut, U.S.A.

Boca Raton London New York

A CRC title, part of the Taylor & Francis imprint, a member of the
Taylor & Francis Group, the academic division of T&F Informa plc.

© 2006 by Taylor & Francis Group, LLC

Published in 2006 by
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742

© 2006 by Taylor & Francis Group, LLC

CRC Press is an imprint of Taylor & Francis Group

No claim to original U.S. Government works

Printed in the United States of America on acid-free paper
10 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 with
permission, and sources are indicated. A wide variety of references are listed. Reasonable efforts have been made to publish
reliable data and information, but the author and the publisher cannot assume responsibility for the validity of all materials
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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 0-8493-2122-0
1. Medical instruments and apparatus--Handbooks, manuals, etc. I. Bronzino, Joseph D., 1937- II.
Title. III. Series.

R856.15.B76 2006
610.28--dc22 2005056892

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© 2006 by Taylor & Francis Group, LLC

 Introduction and Preface

During the past five years since the publication of the Second Edition — a two-volume set — of the
Biomedical 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 to
reflect 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 and
activities 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 engineering
research. It can serve as an excellent textbook for students in areas where traditional textbooks have not
yet been developed and as an excellent review of the major areas of activity in each biomedical engineering
subdiscipline, such as biomechanics, biomaterials, bioinstrumentation, medical imaging, etc. Finally, it
can 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 associated
with medical technology, and the FDA process.
Biomedical engineering is now an important vital interdisciplinary field. Biomedical engineers are
involved 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 members
of 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 needs
of this diverse body of biomedical engineers, this handbook provides a central core of knowledge in those
fields encompassed by the discipline. However, before presenting this detailed information, it is important
to provide a sense of the evolution of the modern health care system and identify the diverse activities
biomedical engineers perform to assist in the diagnosis and treatment of patients.

Evolution of the Modern Health Care System

Before 1900, medicine had little to offer the average citizen, since its resources consisted mainly of
the 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 health
care professionals. Although the costs of obtaining medical training were relatively low, the demand for
doctors’ services also was very small, since many of the services provided by the physician also could be
obtained from experienced amateurs in the community. The home was typically the site for treatment
and recuperation, and relatives and neighbors constituted an able and willing nursing staff. Babies were
delivered 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 specialized
physicians and nurses located within the hospital provide critical diagnostic and treatment services, is
dramatic.
The changes that have occurred within medical science originated in the rapid developments that took
place 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 to
take 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 the
electrical activity of the heart. In applying discoveries in the physical sciences to the analysis of the
biologic process, he initiated a new age in both cardiovascular medicine and electrical measurement
techniques.
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 “new
kinds of rays,” as their discoverer W.K. Roentgen described them in 1895, opened the “inner man” to
medical 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 radiology
were 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 of
barium salts and a wide variety of radiopaque materials.
X-ray technology gave physicians a powerful tool that, for the first time, permitted accurate diagnosis
of a wide variety of diseases and injuries. Moreover, since x-ray machines were too cumbersome and
expensive for local doctors and clinics, they had to be placed in health care centers or hospitals. Once
there, x-ray technology essentially triggered the transformation of the hospital from a passive receptacle
for 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 other
important 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 in
the 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 operations
without prohibitive morbidity and mortality due to infection. Furthermore, even though the different
blood groups and their incompatibility were discovered in 1900 and sodium citrate was used in 1913 to
prevent clotting, full development of blood banks was not practical until the 1930s, when technology
provided adequate refrigeration. Until that time, “fresh” donors were bled and the blood transfused while
it 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. For
example, the Drinker respirator was introduced in 1927 and the first heart-lung bypass in 1939. By
the 1940s, medical procedures heavily dependent on medical technology, such as cardiac catheterization
and angiography (the use of a cannula threaded through an arm vein and into the heart with the injection
of radiopaque dye) for the x-ray visualization of congenital and acquired heart disease (mainly valve
disorders due to rheumatic fever) became possible, and a new era of cardiac and vascular surgery was
established.
Following World War II, technological advances were spurred on by efforts to develop superior weapon
systems 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 rapid
surge of technological finds. Consider the following examples:
1. Advances in solid-state electronics made it possible to map the subtle behavior of the fundamental
unit of the central nervous system — the neuron — as well as to monitor the various physiological
parameters, 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 to
improve their quality of life.
3. Nuclear medicine — an outgrowth of the atomic age — emerged as a powerful and effective
approach in detecting and treating specific physiologic abnormalities.
4. Diagnostic ultrasound based on sonar technology became so widely accepted that ultrasonic studies
are now part of the routine diagnostic workup in many medical specialties.
5. “Spare parts” surgery also became commonplace. Technologists were encouraged to provide
cardiac 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 human
heart.
6. Advances in materials have made the development of disposable medical devices, such as needles
and 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 used
to 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 sets
of patient symptoms.
8. Development of the first computer-based medical instrument, the computerized axial tomography
scanner, revolutionized clinical approaches to noninvasive diagnostic imaging procedures, which
now include magnetic resonance imaging and positron emission tomography as well.
9. A wide variety of new cardiovascular technologies including implantable defibrillators and
chemically 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 today
consists of technologically sophisticated clinical staff operating primarily in modern hospitals designed
to accommodate the new medical technology. This evolutionary process continues, with advances in the
physical 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 very
nature of the health care delivery system itself.

Biomedical Engineering: A Definition

Bioengineering is usually defined as a basic research-oriented activity closely related to biotechnology and
genetic engineering, that is, the modification of animal or plant cells, or parts of cells, to improve plants
or animals or to develop new microorganisms for beneficial ends. In the food industry, for example, this
has meant the improvement of strains of yeast for fermentation. In agriculture, bioengineers may be
concerned with the improvement of crop yields by treatment of plants with organisms to reduce frost
damage. It is clear that bioengineers of the future will have a tremendous impact on the qualities of
human life. The potential of this specialty is difficult to imagine. Consider the following activities of
bioengineers:
• 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 & Prosthetic devices

biological analysis & artificial organs

Biosensors Medical imaging

Clinical Biomaterials
engineering

Biotechnology
Medical &
bioinformatics Tissue engineering

Rehabilitation Neural
engineering engineering

Physiological Biomedical
modeling instrumentation

Bionanotechnology

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 other
engineering principles to understand, modify, or control biologic (i.e., human and animal) systems, as
well as design and manufacture products that can monitor physiologic functions and assist in the diagnosis
and treatment of patients. When biomedical engineers work within a hospital or clinic, they are more
properly called clinical engineers.

Activities of Biomedical Engineers

The breadth of activity of biomedical engineers is now significant. The field has moved from being
concerned primarily with the development of medical instruments in the 1950s and 1960s to include a
more wide-ranging set of activities. As illustrated below, the field of biomedical engineering now includes
many 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) to

biologic 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 informatics
and 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 single
person can acquire expertise that encompasses the entire field. Yet, because of the interdisciplinary nature
of 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 those
interested in prosthetic devices to develop a means to detect and use the same bioelectric signal to power
a prosthetic device. Those engaged in automating the clinical chemistry laboratory may collaborate with
those 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 identification
of the problems and needs of our present health care system that can be solved using existing engineering
technology and systems methodology. Consequently, the field of biomedical engineering offers hope in
the continuing battle to provide high-quality care at a reasonable cost. If properly directed toward solving
problems related to preventive medical approaches, ambulatory care services, and the like, biomedical
engineers 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. Bronzino
Editor-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 Vernon
Roosa Professor of Applied Science, an endowed chair at Trinity College, Hartford, CT and President
of the Biomedical Engineering Alliance and Consortium (BEACON) which is a nonprofit organization
consisting of academic and medical institutions as well as corporations dedicated to the development and
commercialization of new medical technologies (for details visit www.beaconalliance.org).
He is the author of over 200 articles and 11 books including the following: Technology for Patient
Care (C.V. Mosby, 1977), Computer Applications for Patient Care (Addison-Wesley, 1982), Biomedical
Engineering: 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: An
Interdisciplinary 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 the
Biomedical Engineering Division of the American Society for Engineering Education (ASEE), a charter
member 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 the
Advancement of Medical Instrumentation (AAMI), past president of the IEEE-Engineering in Medicine
and 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 Goddard
Award from Worcester Polytechnic Institute for Professional Achievement in June 2004.

© 2006 by Taylor & Francis Group, LLC

 Contributors

Joseph Adam Raymond Balcerak G. Faye Boudreaux-Bartels

Premise Development Defense Advanced Research
Corporation Projects Agency
Hartford, Connecticut Arlington, Virginia
D.C. Barber
P.D. Ahlgren
University of Sheffield
Ville Marie Multidisciplinary
Sheffield, United Kingdom
Breast and Oncology Center
St. Mary’s Hospital Khosrow Behbehani
McGill University The University of Texas at
Montreal, Quebec, Canada Arlington
and Arlington, Texas
London Cancer Centre and
London, Ontario The University of Texas
Canada Southwestern Medical Center
Dallas, Texas
William C. Amalu
N. Belliveau
Pacific Chiropractic and
Ville Marie Multidisciplinary
Research Center
Breast and Oncology Center
Redwood City, California
St. Mary’s Hospital
McGill University
Kurt Ammer Montreal, Quebec, Canada
Ludwig Boltzmann Research and
Institute for Physical London Cancer Centre
Diagnostics London, Ontario, Canada
Vienna, Austria
and Anna M. Bianchi
Medical Imaging Research Group St. Raffaele Hospital
School of Computing Milan, Italy
University of Glamorgan
Carol J. Bickford
Pontypridd, Wales
American Nurses Association
United Kingdom
Washington, D.C.
Dennis D. Autio Jeffrey S. Blair
Dybonics, Inc. IBM Health Care Solutions
Portland, Oregon Atlanta, Georgia
University of Rhode Island
Kingston, Rhode Island
Bruce R. Bowman
EdenTec Corporation
Eden Prairie, Minnesota
Joseph D. Bronzino
Trinity College
Biomedical Engineering Alliance
and Consortium (BEACON)
Harford, Connecticut
Mark E. Bruley
ECRI
Plymouth Meeting, Pennsylvania
Richard P. Buck
University of North Carolina
Chapel Hill, North Carolina
P. Buddharaju
Department of Computer Science
University of Houston
Houston, Texas
Thomas F. Budinger
University of California-Berkeley
Berkeley, California
Robert D. Butterfield
IVAC Corporation
San Diego, California
Joseph P. Cammarota
Naval Air Warfare Center
Aircraft Division
Warminster, Pennsylvania

© 2006 by Taylor & Francis Group, LLC

Paul Campbell Steven Conolly Gary Drzewiecki
Institute of Medical Science Stanford University Rutgers University
and Technology Stanford, California Piscataway, New Jersey
Universities of St. Andrews
and Dundee Derek G. Cramp Edwin G. Duffin
and City University Medtronic, Inc.
Ninewells Hospital London, United Kingdom Minneapolis, Minnesota
Dundee, United Kingdom
Barbara Y. Croft Jeffrey L. Eggleston
Ewart R. Carson National Institutes of Health Valleylab, Inc.
City University Kensington, Maryland Boulder, Colorado
London, United Kingdom
David D. Cunningham Robert L. Elliott
Sergio Cerutti Abbott Diagnostics Elliott-Elliott-Head Breast Cancer
Polytechnic University Process Engineering Research and Treatment Center
Milan, Italy Abbott Park, Illinois Baton Rouge, Louisiana

A. Enis Çetin Ian A. Cunningham K. Whittaker Ferrara

Bilkent University Victoria Hospital Riverside Research Institute
Ankara, Turkey The John P. Roberts Research New York, New York
Institute
Christopher S. Chen and J. Michael Fitzmaurice
Department of Bioengineering The University of Western Ontario Agency for Healthcare Research
Department of Physiology London, Ontario, Canada and Quality
University of Pennsylvania Rockville, Maryland
Philadelphia, Pennsylvania Yadin David
Texas Children’s Hospital Ross Flewelling
Wei Chen Houston, Texas Nellcor Incorporation
Center for Magnetic Resonance Pleasant, California
Research Connie White Delaney
and School of Nursing and Medical Michael Forde
The University of Minnesota School Medtronic, Inc.
Medical School The University of Minnesota Minneapolis, Minnesota
Minneapolis, Minnesota Minneapolis, Minnesota
Amir H. Gandjbakhche
Victor Chernomordik Mary Diakides Laboratory of Integrative and
Laboratory of Integrative and Advanced Concepts Analysis, Inc. Medical Biophysics
Medical Biophysics Falls Church, Virginia National Institute of Child Health
National Institute of Child Health and Human Development
and Human Development Nicholas A. Diakides Bethesda, Maryland
Bethesda, Maryland Advanced Concepts Analysis, Inc.
Falls Church, Virginia Israel Gannot
David A. Chesler Laboratory of Integrative and
Massachusetts General Hospital C. Drews-Peszynski Medical Biophysics
Harvard University Medical Technical University of Lodz National Institute of Child Health
School Lodz, Poland and Human Development
Boston, Massachusetts Bethesda, Maryland
Ronald G. Driggers
Vivian H. Coates U.S. Army Communications and Leslie A. Geddes
ECRI Electronics Research, Purdue University
Plymouth Meeting, Pennsylvania Development and Engineering West Lafayette, Indiana
Center (CERDEC)
Arnon Cohen Night Vision and Electronic Richard L. Goldberg
Ben-Gurion University Sensors Directorate University of North Carolina
Be’er Sheva, Israel Fort Belvoir, Virginia Chapel Hill, North Carolina

© 2006 by Taylor & Francis Group, LLC

Boris Gramatikov David Hattery Millard M. Judy
Johns Hopkins School Laboratory of Integrative and Baylor Research Institute and
of Medicine Medical Biophysics MicroBioMed Corp.
Baltimore, Maryland National Institute of Child Health Dallas, Texas
and Human Development
Barton M. Gratt Bethesda, Maryland Philip F. Judy
School of Dentistry Brigham and Women’s Hospital
University of Washington Jonathan F. Head Harvard University Medical
Seattle, Washington Elliott-Elliott-Head Breast Cancer School
Research and Treatment Center Boston, Massachusetts
Walter Greenleaf Baton Rouge, Louisiana
Greenleaf Medical G.J.L. Kaw
Palo Alto, California Department of Diagnostic
William B. Hobbins
Radiology
Women’s Breast Health Center
Tan Tock Seng Hospital
Michael W. Grenn Madison, Wisconsin
Singapore
U.S. Army Communications and
Electronics Research, Stuart Horn J.R. Keyserlingk
Development and Engineering U.S. Army Communications and Ville Marie Multidisciplinary
Center (CERDEC) Electronics Research, Breast and Oncology Center
Night Vision and Electronic Development and Engineering St. Mary’s Hospital
Sensors Directorate Center (CERDEC) McGill University
Fort Belvoir, Virginia Night Vision and Electronic Montreal, Quebec, Canada
Sensors Directorate and
Eliot B. Grigg Fort Belvoir, Virginia London Cancer Centre
Department of Plastic Surgery
London, Ontario
Dartmouth-Hitchcock Medical Xiaoping Hu Canada
Center Center for Magnetic Resonance
Lebanon, New Hampshire Research C. Everett Koop
and Department of Plastic Surgery
Warren S. Grundfest The University of Minnesota Dartmouth-Hitchcock Medical
Department of Bioengineering Medical School Center
and Electrical Engineering Lebanon, New Hampshire
Minneapolis, Minnesota
Henry Samueli School of
Engineering and Applied Hayrettin Köymen
T. Jakubowska
Science Bilkent University
Technical University of Lodz
and Ankara, Turkey
Lodz, Poland
Department of Surgery
David Geffen School Luis G. Kun
of Medicine
G. Allan Johnson
Duke University Medical Center IRMC/National Defense
University of California University
Los Angeles, California Durham, North Carolina
Washington, D.C.

Michael L. Gullikson Bryan F. Jones

Phani Teja Kuruganti
Texas Children’s Hospital Medical Imaging Research Group
RF and Microwave Systems Group
Houston, Texas School of Computing Oak Ridge National Laboratory
University of Glamorgan Oak Ridge, Tennessee
Moinuddin Hassan Pontypridd, Wales
Laboratory of Integrative and United Kingdom Kenneth K. Kwong
Medical Biophysics Massachusetts General Hospital
National Institute of Child Health Thomas M. Judd Harvard University Medical
and Human Development Kaiser Permanente School
Bethesda, Maryland Atlanta, Georgia Boston, Massachusetts

© 2006 by Taylor & Francis Group, LLC

Z.R. Li Susan McGrath Michael R. Neuman
South China Normal University Department of Plastic Surgery Michigan Technological
Guangzhou, China Dartmouth-Hitchcock Medical University
Center Houghton, Michigan
Richard F. Little Lebanon, New Hampshire
E.Y.K. Ng
National Institutes of Health College of Engineering
Bethesda, Maryland
Matthew F. McKnight
Department of Plastic Surgery School of Mechanical and
Dartmouth-Hitchcock Medical Production Engineering
Chung-Chiun Liu Nanyang Technological University
Center
Electronics Design Center and Singapore
Lebanon, New Hampshire
Edison Sensor Technology
Center Paul Norton
Yitzhak Mendelson
Case Western Reserve University U.S. Army Communications and
Worcester Polytechnic Institute
Cleveland, Ohio Electronics Research,
Worcester, Massachusetts Development and Engineering
Center (CERDEC)
Zhongqi Liu James B. Mercer
Night Vision and Electronic
TTM Management Group University of Tromsø
Sensors Directorate
Beijing, China Tromsø, Norway
Fort Belvoir, Virginia
Arcangelo Merla Antoni Nowakowski
Jasper Lupo
Department of Clinical Sciences Department of Biomedical
Applied Research Associates, Inc.
and Bioimaging Engineering,
Falls Church, Virginia
University “G.d’Annunzio” Gdansk University of Technology
and Narutowicza
Albert Macovski
Institute for Advanced Biomedical Gdansk, Poland
Stanford University
Technology
Stanford, California Banu Onaral
Foundation “G.d’Annunzio”
and Drexel University
Luca T. Mainardi Istituto Nazionale Fisica della Philadelphia, Pennsylvania
Polytechnic University Materia David D. Pascoe
Milan, Italy Coordinated Group of Chieti Auburn University
Chieti-Pescara, Italy Auburn, Alabama
C. Manohar
Department of Electrical & Evangelia Micheli-Tzanakou Maqbool Patel
Computer Engineering Rutgers Unversity Center for Magnetic Resonance
University of Houston Piscataway, New Jersey Research
Houston, Texas and
Robert L. Morris The University of Minnesota
Joseph P. McClain Dybonics, Inc. Medical School
Walter Reed Army Medical Center Portland, Oregon Minneapolis, Minnesota
Washington, D.C. Robert Patterson
Jack G. Mottley
University of Rochester The University of Minnesota
Kathleen A. McCormick Rochester, New York Minneapolis, Minnesota
SAIC
Falls Church, Virginia
Jeffrey L. Paul
Robin Murray Defense Advanced Research
University of Rhode Island Projects Agency
Dennis McGrath Kingston, Rhode Island Arlington, Virginia
Department of Plastic Surgery
Dartmouth-Hitchcock Medical Joachim H. Nagel A. William Paulsen
Center University of Stuttgart Emory University
Lebanon, New Hampshire Stuttgart, Germany Atlanta, Georgia

© 2006 by Taylor & Francis Group, LLC

John Pauly E. Francis Ring
Stanford University Medical Imaging Research Group
Stanford, California School of Computing
University of Glamorgan
I. Pavlidis
Pontypridd, Wales
Department of Computer Science
United Kingdom
University of Houston
Houston, Texas Richard L. Roa
Baylor University Medical Center
P. Hunter Peckham Dallas, Texas
Case Western Reserve University Peter Robbie
Cleveland, Ohio
Department of Plastic Surgery
Joseph G. Pellegrino Dartmouth-Hitchcock Medical
Center
U.S. Army Communications and
Electronics Research, Lebanon, New Hampshire
Development and Engineering Gian Luca Romani
Center (CERDEC) Department of Clinical Sciences
Night Vision and Electronic and Bioimaging
Sensors Directorate University “G. d’Annunzio”
Fort Belvoir, Virginia and
Institute for Advanced
Philip Perconti Biomedical Technology
U.S. Army Communications and Foundation “G.d’Annunzio”
Electronics Research, and
Development and Engineering Istituto Nazionale Fisica della
Center (CERDEC) Materia
Night Vision and Electronic Coordinated Group of Chieti
Sensors Directorate Chieti-Pescara, Italy
Fort Belvoir, Virginia
Joseph M. Rosen
Athina P. Petropulu Department of Plastic Surgery
Drexel University Dartmouth-Hitchcock Medical
Philadelphia, Pennsylvania Center
Lebanon, New Hampshire
Tom Piantanida
Greenleaf Medical Eric Rosow
Palo Alto, California Hartford Hospital
and
T. Allan Pryor Premise Development
University of Utah Corporation
Salt Lake City, Utah Hartford, Connecticut
Subrata Saha
Ram C. Purohit
Clemson University
Auburn University
Clemson, South Carolina
Auburn, Alabama
John Schenck
Hairong Qi General Electric Corporate
ECE Department Research and Development
The University of Tennessee Center
Knoxville, Tennessee Schenectady, New York
Pat Ridgely Edward Schuck
Medtronic, Inc. EdenTec Corporation
Minneapolis, Minnesota Eden Prairie, Minnesota
© 2006 by Taylor & Francis Group, LLC
Joyce Sensmeier
HIMSS
Chicago, Illinois
David Sherman
Johns Hopkins School of Medicine
Baltimore, Maryland
Robert E. Shroy, Jr.
Picker International
Highland Heights, Ohio
Stephen W. Smith
Duke University
Durham, North Carolina
Nathan J. Sniadecki
Department of Bioengineering
University of Pennsylvania
Philadelphia, Pennsylvania
Wesley E. Snyder
ECE Department
North Carolina State University
Raleigh, North Carolina
Orhan Soykan
Corporate Science and
Technology
Medtronic, Inc.
and
Department of Biomedical
Engineering
Michigan Technological
University
Houghton, Michigan
Primoz Strojnik
Case Western Reserve University
Cleveland, Ohio
M. Strzelecki
Technical University of Lodz
Lodz, Poland
Ron Summers
Loughborough University
Leicestershire, United Kingdom
Christopher Swift
Department of Plastic Surgery
Dartmouth-Hitchcock Medical
Center
Lebanon, New Hampshire
Willis A. Tacker
Purdue University
West Lafayette, Indiana
Nitish V. Thakor Wolf W. von Maltzahn Christopher M. Yip
Johns Hopkins School of Medicine Rensselaer Polytechnic Institute Departments of Chemical
Baltimore, Maryland Troy, New York Engineering and Applied
Chemistry
Roderick Thomas Gregory I. Voss Department of Biochemistry
Faculty of Applied Design and IVAC Corporation Institute of Biomaterials and
Engineering San Diego, California Biomedical Engineering
Swansea Institute of Technology
University of Toronto
Swansea, United Kingdom Alvin Wald
Columbia University Toronto, Ontario, Canada
P. Tsiamyrtzis New York, New York
Department of Statistics E. Yu
University of Economics and Chen Wang Ville Marie Multidisciplinary
Business Athens TTM International Breast and Oncology Center
Athens, Greece Houston, Texas St. Mary’s Hospital
McGill University
Benjamin M.W. Tsui Lois de Weerd
Montreal, Quebec, Canada
University of North Carolina University Hospital of
Chapel Hill, North Carolina and
North Norway
Tromsø, Norway London Cancer Centre
Tracy A. Turner London, Ontario, Canada
Private Practice Wang Wei
Minneapolis, Minnesota Radiology Department Wen Yu
Beijing You An Hospital Shanghai RuiJin Hospital
Kamil Ugurbil
Beijing, China Shanghai, China
Center for Magnetic Resonance
Research B. Wiecek
and Technical University of Lodz Yune Yuan
The University of Minnesota Lodz, Poland Institute of Basic Medical Science
Medical School China Army General Hospital
Minneapolis, Minnesota M. Wysocki Beijing, China
Technical University of Lodz
Michael S. Van Lysel
Lodz, Poland Jason Zeibel
University of Wisconsin
Madison, Wisconsin U.S. Army Communications and
Martin J. Yaffe Electronics Research,
Henry F. VanBrocklin University of Toronto Development and Engineering
University of California-Berkeley Toronto, Ontario, Canada Center (CERDEC)
Berkeley, California Night Vision and Electronic
Robert Yarchoan
Sensors Directorate
Jay Vizgaitis HIV and AIDS Malignancy
Fort Belvoir, Virginia
U.S. Army Communications and Branch
Electronics Research, Center for Cancer Research
Development and Engineering National Cancer Institute (NCI) Yi Zeng
Center (CERDEC) Bethesda, Maryland Central Disease Control of China
Night Vision and Electronic Beijing, China
Sensors Directorate M. Yassa
Fort Belvoir, Virginia Ville Marie Multidisciplinary Xiaohong Zhou
Breast and Oncology Center
Duke University Medical Center
Abby Vogel St. Mary’s Hospital
Durham, North Carolina
Laboratory of Integrative and McGill University
Medical Biophysics Montreal, Quebec, Canada
National Institute of Child Health and Yulin Zhou
and Human Development London Cancer Centre Shanghai RuiJin Hospital
Bethesda, Maryland London, Ontario, Canada 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 Analysis
Arnon Cohen . . . . . . . . . . . . . . . . . . . . . 1-1

2 Digital Biomedical Signal Acquisition and Processing

Luca T. Mainardi, Anna M. Bianchi, Sergio Cerutti . . . . 2-1

3 Compression of Digital Biomedical Signals

A. Enis Çetin, Hayrettin Köymen . . . . . . . . . . . . 3-1

4 Time-Frequency Signal Representations for

Biomedical Signals
G. Faye Boudreaux-Bartels, Robin Murray . . . . . . . . 4-1

5 Wavelet (Time-Scale) Analysis in Biomedical

Signal Processing
Nitish V. Thakor, Boris Gramatikov, David Sherman . . . 5-1

6 Higher-Order Spectral Analysis

Athina P. Petropulu . . . . . . . . . . . . . . . . . . 6-1

7 Neural Networks in Biomedical Signal Processing

Evangelia Micheli-Tzanakou . . . . . . . . . . . . . . 7-1

8 Complexity, Scaling, and Fractals in Biomedical Signals

Banu Onaral, Joseph P. Cammarota . . . . . . . . . . . 8-1

9 Future Directions: Biomedical Signal Processing and

Networked Multimedia Communications
Banu Onaral . . . . . . . . . . . . . . . . . . . . . 9-1

© 2006 by Taylor & Francis Group, LLC

SECTION II Imaging

Warren S. Grundfest
10 X-Ray
Robert E. Shroy, Jr., Michael S. Van Lysel,
Martin J. Yaffe . . . . . . . . . . . . . . . . . . . . 10-1

11 Computed Tomography
Ian A. Cunningham, Philip F. Judy . . . . . . . . . . . 11-1

12 Magnetic Resonance Imaging

Steven 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 Medicine
Barbara Y. Croft, Benjamin M.W. Tsui . . . . . . . . . . 13-1

14 Ultrasound
Richard L. Goldberg, Stephen W. Smith, Jack G. Mottley,
K. Whittaker Ferrara . . . . . . . . . . . . . . . . . 14-1

15 Magnetic Resonance Microscopy

Xiaohong Zhou, G. Allan Johnson . . . . . . . . . . . . 15-1

16 Positron-Emission Tomography (PET)

Thomas F. Budinger, Henry F. VanBrocklin . . . . . . . . 16-1

17 Electrical Impedance Tomography

D.C. Barber . . . . . . . . . . . . . . . . . . . . . 17-1

18 Medical Applications of Virtual Reality Technology

Walter Greenleaf, Tom Piantanida . . . . . . . . . . . 18-1

SECTION III Infrared Imaging

Nicholas A. Diakides
19 Advances in Medical Infrared Imaging
Nicholas Diakides, Mary Diakides, Jasper Lupo,
Jeffrey L. Paul, Raymond Balcerak . . . . . . . . . . . 19-1

20 The Historical Development of Thermometry

and Thermal Imaging in Medicine
E. Francis Ring, Bryan F. Jones . . . . . . . . . . . . . 20-1

© 2006 by Taylor & Francis Group, LLC

 21 Physiology of Thermal Signals
David D. Pascoe, James B. Mercer, Lois de Weerd . . . . . 21-1

22 Quantitative Active Dynamic Thermal IR-Imaging and

Thermal Tomography in Medical Diagnostics
Antoni Nowakowski . . . . . . . . . . . . . . . . . 22-1

23 Thermal Texture Maps (TTM): Concept, Theory, and

Applications
Zhongqi 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 Accuracy
E.Y.K. Ng, G.J.L. Kaw . . . . . . . . . . . . . . . . . 24-1

25 Infrared Imaging of the Breast — An Overview

William C. Amalu, William B. Hobbins, Jonathan F. Head,
Robert L. Elliott . . . . . . . . . . . . . . . . . . . 25-1

26 Functional Infrared Imaging of the Breast:

Historical Perspectives, Current Application, and
Future Considerations
J.R. Keyserlingk, P.D. Ahlgren, E. Yu, N. Belliveau,
M. Yassa . . . . . . . . . . . . . . . . . . . . . . . 26-1

27 Detecting Breast Cancer from Thermal Infrared Images by

Asymmetry Analysis
Hairong Qi, Phani Teja Kuruganti, Wesley E. Snyder . . . 27-1

28 Advanced Thermal Image Processing

B. Wiecek, M. Strzelecki, T. Jakubowska, M. Wysocki,
C. Drews-Peszynski . . . . . . . . . . . . . . . . . . 28-1

29 Biometrics: Face Recognition in Thermal Infrared

I. Pavlidis, P. Tsiamyrtzis, P. Buddharaju, C. Manohar . . . 29-1

30 Infrared Imaging for Tissue Characterization and Function

Moinuddin 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 and

Neuromuscular Systems
E. Francis Ring, Kurt Ammer . . . . . . . . . . . . . . 31-1

32 Functional Infrared Imaging in Clinical Applications

Arcangelo Merla, Gian Luca Romani . . . . . . . . . . 32-1

© 2006 by Taylor & Francis Group, LLC

 33 Thermal Imaging in Surgery
Paul Campbell, Roderick Thomas . . . . . . . . . . . . 33-1

34 Infrared Imaging Applied to Dentistry

Barton M. Gratt . . . . . . . . . . . . . . . . . . . 34-1

35 Use of Infrared Imaging in Veterinary Medicine

Ram C. Purohit, Tracy A. Turner, David D. Pascoe . . . . 35-1

36 Standard Procedures for Infrared Imaging in Medicine

Kurt Ammer, E. Francis Ring . . . . . . . . . . . . . . 36-1

37 Infrared Detectors and Detector Arrays

Paul Norton, Stuart Horn, Joseph G. Pellegrino,
Philip Perconti . . . . . . . . . . . . . . . . . . . . 37-1

38 Infrared Camera Characterization

Joseph G. Pellegrino, Jason Zeibel, Ronald G. Driggers,
Philip Perconti . . . . . . . . . . . . . . . . . . . . 38-1

39 Infrared Camera and Optics for Medical Applications

Michael 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 State
T. Allan Pryor . . . . . . . . . . . . . . . . . . . . 40-1

41 Computer-Based Patient Records

J. Michael Fitzmaurice . . . . . . . . . . . . . . . . . 41-1

42 Overview of Standards Related to the Emerging Health Care

Information Infrastructure
Jeffrey S. Blair . . . . . . . . . . . . . . . . . . . . 42-1

43 Introduction to Informatics and Nursing

Kathleen A. McCormick, Joyce Sensmeier,
Connie White Delaney, Carol J. Bickford . . . . . . . . . 43-1

44 Non-AI Decision Making

Ron Summers, Derek G. Cramp, Ewart R. Carson . . . . . 44-1

© 2006 by Taylor & Francis Group, LLC

 45 Medical Informatics and Biomedical Emergencies: New
Training and Simulation Technologies for First Responders
Joseph 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 Measurements
Michael R. Neuman . . . . . . . . . . . . . . . . . . 46-1

47 Biopotential Electrodes
Michael R. Neuman . . . . . . . . . . . . . . . . . . 47-1

48 Electrochemical Sensors
Chung-Chiun Liu . . . . . . . . . . . . . . . . . . . 48-1

49 Optical Sensors
Yitzhak Mendelson . . . . . . . . . . . . . . . . . . 49-1

50 Bioanalytic Sensors
Richard P. Buck . . . . . . . . . . . . . . . . . . . 50-1

51 Biological Sensors for Diagnostics

Orhan Soykan . . . . . . . . . . . . . . . . . . . . 51-1

SECTION VI Medical Instruments and Devices

Wolf W. von Maltzahn

52 Biopotential Amplifiers
Joachim H. Nagel . . . . . . . . . . . . . . . . . . . 52-1

53 Bioelectric Impedance Measurements

Robert Patterson . . . . . . . . . . . . . . . . . . . 53-1

54 Implantable Cardiac Pacemakers

Michael Forde, Pat Ridgely . . . . . . . . . . . . . . . 54-1

55 Noninvasive Arterial Blood Pressure and Mechanics

Gary Drzewiecki . . . . . . . . . . . . . . . . . . . 55-1

© 2006 by Taylor & Francis Group, LLC

 56 Cardiac Output Measurement
Leslie A. Geddes . . . . . . . . . . . . . . . . . . . 56-1

57 External Defibrillators
Willis A. Tacker . . . . . . . . . . . . . . . . . . . 57-1

58 Implantable Defibrillators
Edwin G. Duffin . . . . . . . . . . . . . . . . . . . 58-1

59 Implantable Stimulators for Neuromuscular Control

Primoz Strojnik, P. Hunter Peckham . . . . . . . . . . 59-1

60 Respiration
Leslie A. Geddes . . . . . . . . . . . . . . . . . . . 60-1

61 Mechanical Ventilation
Khosrow Behbehani . . . . . . . . . . . . . . . . . . 61-1

62 Essentials of Anesthesia Delivery

A. William Paulsen . . . . . . . . . . . . . . . . . . 62-1

63 Electrosurgical Devices
Jeffrey L. Eggleston, Wolf W. von Maltzahn . . . . . . . . 63-1

64 Biomedical Lasers
Millard M. Judy . . . . . . . . . . . . . . . . . . . . 64-1

65 Instrumentation for Cell Mechanics

Nathan J. Sniadecki, Christopher S. Chen . . . . . . . . 65-1

66 Blood Glucose Monitoring

David D. Cunningham . . . . . . . . . . . . . . . . 66-1

67 Atomic Force Microscopy: Probing Biomolecular

Interactions
Christopher M. Yip . . . . . . . . . . . . . . . . . . 67-1

68 Parenteral Infusion Devices

Gregory I. Voss, Robert D. Butterfield . . . . . . . . . . 68-1

69 Clinical Laboratory: Separation and Spectral Methods

Richard L. Roa . . . . . . . . . . . . . . . . . . . . 69-1

70 Clinical Laboratory: Nonspectral Methods and Automation

Richard L. Roa . . . . . . . . . . . . . . . . . . . . 70-1

71 Noninvasive Optical Monitoring

Ross Flewelling . . . . . . . . . . . . . . . . . . . . 71-1

© 2006 by Taylor & Francis Group, LLC

 72 Medical Instruments and Devices Used in the Home
Bruce R. Bowman, Edward Schuck . . . . . . . . . . . 72-1

73 Virtual Instrumentation: Applications in Biomedical

Engineering
Eric Rosow, Joseph Adam . . . . . . . . . . . . . . . 73-1

SECTION VII Clinical Engineering

Yadin David
74 Clinical Engineering: Evolution of a Discipline
Joseph D. Bronzino . . . . . . . . . . . . . . . . . . 74-1

75 Management and Assessment of Medical Technology

Yadin David, Thomas M. Judd . . . . . . . . . . . . . 75-1

76 Risk Factors, Safety, and Management of Medical Equipment

Michael L. Gullikson . . . . . . . . . . . . . . . . . 76-1

77 Clinical Engineering Program Indicators

Dennis D. Autio, Robert L. Morris . . . . . . . . . . . . 77-1

78 Quality of Improvement and Team Building

Joseph P. McClain . . . . . . . . . . . . . . . . . . . 78-1

79 A Standards Primer for Clinical Engineers

Alvin Wald . . . . . . . . . . . . . . . . . . . . . 79-1

80 Regulatory and Assessment Agencies

Mark E. Bruley, Vivian H. Coates . . . . . . . . . . . . 80-1

81 Applications of Virtual Instruments in Health Care

Eric Rosow, Joseph Adam . . . . . . . . . . . . . . . 81-1

SECTION VIII Ethical Issues Associated with

the Use of Medical Technology

Subrata Saha and Joseph D. Bronzino

82 Beneficence, Nonmaleficence, and Medical Technology
Joseph D. Bronzino . . . . . . . . . . . . . . . . . . 82-1

83 Ethical Issues Related to Clinical Research

Joseph D. Bronzino . . . . . . . . . . . . . . . . . . 83-1

© 2006 by Taylor & Francis Group, LLC