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Validation of the mobile wireless digital automatic blood pressure monitor using the cuff pressure oscillometric method, for clinical use and self-management, according to international protocols.

Sooyoung YOO ; Hyunyoung BAEK ; Kibbeum DOH ; Jiyeoun JEONG ; Soyeon AHN ; Il Young OH ; Kidong KIM

Biomedical Engineering Letters.2018;8(4):399-404. doi:10.1007/s13534-018-0085-0

The purpose of this study was to evaluate the accuracy of a mobile wireless digital automatic blood pressure monitor for clinical use and mobile health (mHealth). In this study, a manual sphygmomanometer and a digital blood pressure monitor were tested in 100 participants in a repetitive and sequential manner to measure blood pressure. The guidelines for measurement used the Korea Food & Drug Administration protocol, which reflects international standards, such as the American National Standard Institution/Association for the Advancement of Medical Instrumentation SP 10: 1992 and the British Hypertension Society protocol. Measurements were generally consistent across observers according to the measured mean ± SD, which ranged in 0.1 ± 2.6 mmHg for systolic blood pressure (SBP) and 0.5 ± 2.2 mmHg for diastolic blood pressure (DBP). For the device and the observer, the difference in average blood pressure (mean ± SD) was 2.3 ± 4.7 mmHg for SBP and 2.0 ± 4.2 mmHg for DBP. The SBP and DBP measured in this study showed accurate measurements that satisfied all criteria, including an average difference that did not exceed 5 mmHg and a standard deviation that did not exceed 8 mmHg. The mobile wireless digital blood pressure monitor has the potential for clinical use and managing one's own health.
Blood Pressure Monitors* ; Blood Pressure* ; Hypertension ; Korea ; Methods* ; Self Care* ; Sphygmomanometers ; Telemedicine

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Promotion of excisional wound repair by a menstrual blood-derived stem cell-seeded decellularized human amniotic membrane.

Saeed FARZAMFAR ; Majid SALEHI ; Arian EHTERAMI ; Mahdi NASERI-NOSAR ; Ahmad VAEZ ; Amir Hassan ZARNANI ; Hamed SAHRAPEYMA ; Mohammad Reza SHOKRI ; Mehdi ALEAHMAD

Biomedical Engineering Letters.2018;8(4):393-398. doi:10.1007/s13534-018-0084-1

This is the first study demonstrating the efficacy of menstrual blood-derived stem cell (MenSC) transplantation via decellularized human amniotic membrane (DAM), for the promotion of skin excisional wound repair. The DAM was seeded with MenSCs at the density of 3 × 10⁴ cells/cm² and implanted onto a rat's 1.50 × 1.50 cm² full-thickness excisional wound defect. The results of wound closure and histopathological examinations demonstrated that the MenSC-seeded DAM could significantly improve the wound healing compared with DAM-treatment. All in all, our data indicated that the MenSCs can be a potential source for cell-based therapies to regenerate skin injuries.
Amnion* ; Humans* ; Skin ; Stem Cells ; Wound Healing ; Wounds and Injuries*

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Analytic simulator and image generator of multiple-scattering Compton camera for prompt gamma ray imaging.

Soo Mee KIM

Biomedical Engineering Letters.2018;8(4):383-392. doi:10.1007/s13534-018-0083-2

For prompt gamma ray imaging for biomedical applications and environmental radiation monitoring, we propose herein a multiple-scattering Compton camera (MSCC). MSCC consists of three or more semiconductor layers with good energy resolution, and has potential for simultaneous detection and differentiation of multiple radio-isotopes based on the measured energies, as well as three-dimensional (3D) imaging of the radio-isotope distribution. In this study, we developed an analytic simulator and a 3D image generator for a MSCC, including the physical models of the radiation source emission and detection processes that can be utilized for geometry and performance prediction prior to the construction of a real system. The analytic simulator for a MSCC records coincidence detections of successive interactions in multiple detector layers. In the successive interaction processes, the emission direction of the incident gamma ray, the scattering angle, and the changed traveling path after the Compton scattering interaction in each detector, were determined by a conical surface uniform random number generator (RNG), and by a Klein-Nishina RNG. The 3D image generator has two functions: the recovery of the initial source energy spectrum and the 3D spatial distribution of the source. We evaluated the analytic simulator and image generator with two different energetic point radiation sources (Cs-137 and Co-60) and with an MSCC comprising three detector layers. The recovered initial energies of the incident radiations were well differentiated from the generated MSCC events. Correspondingly, we could obtain a multi-tracer image that combined the two differentiated images. The developed analytic simulator in this study emulated the randomness of the detection process of a multiple-scattering Compton camera, including the inherent degradation factors of the detectors, such as the limited spatial and energy resolutions. The Doppler-broadening effect owing to the momentum distribution of electrons in Compton scattering was not considered in the detection process because most interested isotopes for biomedical and environmental applications have high energies that are less sensitive to Doppler broadening. The analytic simulator and image generator for MSCC can be utilized to determine the optimal geometrical parameters, such as the distances between detectors and detector size, thus affecting the imaging performance of the Compton camera prior to the development of a real system.
Clothing ; Gamma Rays* ; Isotopes ; Radiation Monitoring ; Semiconductors

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The earth mover's distance and Bayesian linear discriminant analysis for epileptic seizure detection in scalp EEG.

Shasha YUAN ; Jinxing LIU ; Junliang SHANG ; Xiangzhen KONG ; Qi YUAN ; Zhen MA

Biomedical Engineering Letters.2018;8(4):373-382. doi:10.1007/s13534-018-0082-3

Since epileptic seizure is unpredictable and paroxysmal, an automatic system for seizure detecting could be of great significance and assistance to patients and medical staff. In this paper, a novel method is proposed for multichannel patient-specific seizure detection applying the earth mover's distance (EMD) in scalp EEG. Firstly, the wavelet decomposition is executed to the original EEGs with five scales, the scale 3, 4 and 5 are selected and transformed into histograms and afterwards the distances between histograms in pairs are computed applying the earth mover's distance as effective features. Then, the EMD features are sent to the classifier based on the Bayesian linear discriminant analysis (BLDA) for classification, and an efficient postprocessing procedure is applied to improve the detection system precision, finally. To evaluate the performance of the proposed method, the CHB-MIT scalp EEG database with 958 h EEG recordings from 23 epileptic patients is used and a relatively satisfactory detection rate is achieved with the average sensitivity of 95.65% and false detection rate of 0.68/h. The good performance of this algorithm indicates the potential application for seizure monitoring in clinical practice.
Classification ; Discriminant Analysis* ; Electroencephalography* ; Epilepsy* ; Humans ; Medical Staff ; Methods ; Scalp* ; Seizures ; Weights and Measures

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Simultaneous monitoring of motion ECG of two subjects using Bluetooth Piconet and baseline drift.

Tejal DAVE ; Utpal PANDYA

Biomedical Engineering Letters.2018;8(4):365-371. doi:10.1007/s13534-018-0081-4

Uninterrupted monitoring of multiple subjects is required for mass causality events, in hospital environment or for sports by medical technicians or physicians. Movement of subjects under monitoring requires such system to be wireless, sometimes demands multiple transmitters and a receiver as a base station and monitored parameter must not be corrupted by any noise before further diagnosis. A Bluetooth Piconet network is visualized, where each subject carries a Bluetooth transmitter module that acquires vital sign continuously and relays to Bluetooth enabled device where, further signal processing is done. In this paper, a wireless network is realized to capture ECG of two subjects performing different activities like cycling, jogging, staircase climbing at 100 Hz frequency using prototyped Bluetooth module. The paper demonstrates removal of baseline drift using Fast Fourier Transform and Inverse Fast Fourier Transform and removal of high frequency noise using moving average and S-Golay algorithm. Experimental results highlight the efficacy of the proposed work to monitor any vital sign parameters of multiple subjects simultaneously. The importance of removing baseline drift before high frequency noise removal is shown using experimental results. It is possible to use Bluetooth Piconet frame work to capture ECG simultaneously for more than two subjects. For the applications where there will be larger body movement, baseline drift removal is a major concern and hence along with wireless transmission issues, baseline drift removal before high frequency noise removal is necessary for further feature extraction.
Diagnosis ; Electrocardiography* ; Fourier Analysis ; Jogging ; Noise ; Sports ; Vital Signs

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Side lobe free medical ultrasonic imaging with application to assessing side lobe suppression filter.

Mok Kun JEONG ; Sung Jae KWON

Biomedical Engineering Letters.2018;8(4):355-364. doi:10.1007/s13534-018-0079-y

When focusing using an ultrasonic transducer array, a main lobe is formed in the focal region of an ultrasound field, but side lobes also arise around the focal region due to the leakage. Since the side lobes cannot be completely eliminated in the focusing process, they are responsible for subsequent ultrasound image quality degradation. To improve ultrasound image quality, a signal processing strategy to reduce side lobes is definitely in demand. To this end, quantitative determination of main and side lobes is necessary. We propose a theoretically and actually error-free method of exactly discriminating and separately computing the main lobe and side lobe parts in ultrasound image by computer simulation. We refer to images constructed using the main and side lobe signals as the main and side lobe images, respectively. Since the main and side lobe images exactly represent their main and side lobe components, respectively, they can be used to evaluate ultrasound image quality. Defining the average brightness of the main and side lobe images, the conventional to side lobe image ratio, and the main to side lobe image ratio as image quality metrics, we can evaluate image characteristics in speckle images. The proposed method is also applied in assessing the performance of side lobe suppression filtering. We show that the proposed method may greatly aid in the evaluation of medical ultrasonic images using computer simulations, albeit lacking the use of actual experimental data.
Computer Simulation ; Methods ; Transducers ; Ultrasonics* ; Ultrasonography*

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Electromyography-signal-based muscle fatigue assessment for knee rehabilitation monitoring systems.

Hyeonseok KIM ; Jongho LEE ; Jaehyo KIM

Biomedical Engineering Letters.2018;8(4):345-353. doi:10.1007/s13534-018-0078-z

This study suggested a new EMG-signal-based evaluation method for knee rehabilitation that provides not only fragmentary information like muscle power but also in-depth information like muscle fatigue in the field of rehabilitation which it has not been applied to. In our experiment, nine healthy subjects performed straight leg raise exercises which are widely performed for knee rehabilitation. During the exercises, we recorded the joint angle of the leg andEMGsignals from four prime movers of the leg: rectus femoris (RFM), vastus lateralis, vastus medialis, and biceps femoris (BFLH). We extracted two parameters to estimate muscle fatigue from the EMG signals, the zero-crossing rate (ZCR) and amplitude of muscle tension (AMT) that can quantitatively assess muscle fatigue from EMG signals. We found a decrease in the ZCR for the RFM and the BFLH in the muscle fatigue condition for most of the subjects. Also, we found increases in theAMT for the RFM and the BFLH. Based on the results, we quantitatively confirmed that in the state of muscle fatigue, the ZCR shows a decreasing trend whereas theAMT shows an increasing trend. Our results show that both the ZCR and AMT are useful parameters for characterizing the EMG signals in the muscle fatigue condition. In addition, our proposed methods are expected to be useful for developing a navigation system for knee rehabilitation exercises by evaluating the two parameters in two-dimensional parameter space.
Exercise ; Healthy Volunteers ; Joints ; Knee* ; Leg ; Methods ; Muscle Fatigue* ; Muscle Tonus ; Quadriceps Muscle ; Rehabilitation*

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Design and 3D-printing of titanium bone implants: brief review of approach and clinical cases.

Vladimir V POPOV ; Gary MULLER-KAMSKII ; Aleksey KOVALEVSKY ; Georgy DZHENZHERA ; Evgeny STROKIN ; Anastasia KOLOMIETS ; Jean RAMON

Biomedical Engineering Letters.2018;8(4):337-344. doi:10.1007/s13534-018-0080-5

Additive manufacturing (AM) is an alternative metal fabrication technology. The outstanding advantage of AM (3D-printing, direct manufacturing), is the ability to form shapes that cannot be formed with any other traditional technology. 3D-printing began as a new method of prototyping in plastics. Nowadays, AM in metals allows to realize not only net-shape geometry, but also high fatigue strength and corrosion resistant parts. This success of AM in metals enables new applications of the technology in important fields, such as production of medical implants. The 3D-printing of medical implants is an extremely rapidly developing application. The success of this development lies in the fact that patient-specific implants can promote patient recovery, as often it is the only alternative to amputation. The production of AM implants provides a relatively fast and effective solution for complex surgical cases. However, there are still numerous challenging open issues in medical 3D-printing. The goal of the current research review is to explain the whole technological and design chain of bio-medical bone implant production from the computed tomography that is performed by the surgeon, to conversion to a computer aided drawing file, to production of implants, including the necessary post-processing procedures and certification. The current work presents examples that were produced by joint work of Polygon Medical Engineering, Russia and by TechMed, the AM Center of Israel Institute of Metals. Polygon provided 3D-planning and 3D-modelling specifically for the implants production. TechMed were in charge of the optimization of models and they manufactured the implants by Electron-Beam Melting (EBM®), using an Arcam EBM® A2X machine.
Amputation ; Certification ; Corrosion ; Fatigue ; Freezing ; Humans ; Israel ; Joints ; Metals ; Methods ; Plastics ; Russia ; Titanium*

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PID controller design to generate pulsatile flow rate for in vitro experimental studies of physiological flows.

Mohammad Reza NAJJARI ; Michael W. PLESNIAK

Biomedical Engineering Letters.2017;7(4):339-344. doi:10.1007/s13534-017-0049-9

Producing accurate pulsatile flow rates is essential for many in vitro experimental studies in biofluid dynamics research. A controller system was developed to control a flow loop to produce easily adjustable pulsatile flow rates with sufficient accuracy. An Arduino board is used as a micro-controller to control a pump to produce various pulsatile flow rates, and an open-source proportional-integral-derivative (PID) control algorithm is developed for this purpose. Four non-trivial pulsatile waveforms were produced by the PID controller, as well as an iterative controller, and the performance of both controllers was evaluated. Both the PID and iterative controllers were able to successfully produce slowly-varying signals (single and multi-harmonic low frequency sine waves), but for high frequency signals where the flow has strong acceleration/deceleration (e.g. for physiological waveforms) the iterative controller exhibited significant undershoot. The comparison of PID and iterative controllers suggests that if the desired flow rate is a low frequency, simple waveform then the iterative controller is preferred due to simplicity of implementation. However, if the desired signal is rapidly changing and more complicated then the PID controller achieves better results. This system can be implemented in many flow loops due to its simplicity and low cost, and does not require a mathematical model of the system.
Carotid Artery, Common ; In Vitro Techniques* ; Models, Theoretical ; Pulsatile Flow*

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Transscleral LED illumination pen.

Christian LINGENFELDER ; Frank KOCH ; Philipp KOELBL ; Pia KLANTE ; Martin HESSLING

Biomedical Engineering Letters.2017;7(4):311-315. doi:10.1007/s13534-017-0039-y

Existing light sources for intraocular illumination are often bulky and expensive and pose a risk for the patient, because light guides are inserted in the eye through incisions and if the tip of these light guides get too close to the retina, the retina can be damaged photochemically within minutes or even seconds. Therefore a new, safe and simple device for intraocular illumination is developed and evaluated for its thermal and photochemical risks to the patient. It consists of a white LED which is integrated into a pen like holder. This device is pressed against the sclera by the physician who seeks for illumination during surgery or for diagnostic purposes. The LED light is transmitted through the sclera without the need for an incision. Considering the relevant standards, the device poses no harm to the patient, and in tests with the authors' own eyes a sufficient intraocular illumination is reached. The proposed device is quite simple but easy to handle and very gentle for the patient.
Humans ; Lighting* ; Retina ; Sclera

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