Book Reviews
In spite of these minor limitations, it is felt that the
main thrust of this work can provide useful insights
into the details of an architecture that seems very
appropriate for particular application classes. It
offers valid support for project managers in decision-
making, and suggests feasible verification strategies
to licensing bodies. A particular merit of this
publication is the presentation of several detailed
examples, demonstrating the applicability of the
techniques proposed.
Medical Instrumentation: Application and Design
(Second Edition), by John G. WEBSTER. John
Wiley & Sons; New York; 1995; 814 pp.; £75-00;
ISBN: 0-47 !- 12493-1
Reviewed by: Akif UNDAR, John H. CALHOON
The University of Texas Health Science Center, San
Antonio, TX, USA, and
Adson da ROCHA
The University of Texas at Austin, Austin, TX, USA
This text illustrates the principles, applications, and
design of the most commonly used clinical medical
instruments. It focuses on the fundamental principles
of clinical devices, rather than on detailed
descriptions of these instruments. The book explores
the most important features of medical
instrumentation:
• Basic concepts of medical instrumentation
• Basic sensors and principles
• Amplifiers and signal processing
• The origin of biopotentials
• Biopotentiai electrodes and amplifiers
• Blood pressure and sound
• Measurements of flow and volume of blood
• Measurements of the respiratory system
• Chemical biosensors
• Clinical laboratory instrumentation
• Medical imaging systems
• Therapeutic and prosthetic devices
• Electrical safety.
An excellent review of the biomedical
instrumentation field is presented at the beginning of
the book, including the basic concepts and the
terminology commonly used in this field. Chapter 1
also gives the reader a clear idea of what the field is,
what the problems are, who works in the field, and
which agencies regulate the profession.
A sufficient but not fully complete section on bio-
medical transducers presents the most commonly
used sensors for the measurement of displacement,
force, and temperature, and the magnitudes derived
from those. Chapter 4 explains the origin of the bio-
potential signals. A concise but clear description of
295
the intracellular bioelectric processes is given, and a
simple and intuitive explanation of how these pro-
cesses manifest themselves in electrical fields in the
body is also provided. Some of the most commonly
used biopotential measurements are discussed:
Electroneurograms (ENG), Electromyograms (EMG),
Electrocardiograms (ECG), Electroretinograms
(ERG), Electroencephalograms (EEG), and Magneto-
encephalograms (MEG).
The electrodes used for the measurement of
biopotential signals are very well described. The
physical behavior of the electrodes is discussed, as
well as the most common electrodes used for surface,
internal and intra-cellular biopotential measurements.
The different signal distortions measured by the
electrodes, and the methods of minimizing these
distortions, are well explained. A very short section
on electrodes for electric stimulation of the biologic
tissues is also included. The chapter on electrodes is
not the most comprehensive one. However, in
comparison with other medical instrumentation
resources, it gives an excellent introduction to the
topic, and will be suitable for introductory courses in
biomedical engineering.
A short review of the basic electronic circuits
traditionally used in medical instrumentation is also
presented. This section warms the reader up for the
next chapter on biopotential amplifiers. An excellent
chapter on biopotential amplifiers presents the
fundamentals of the amplification of low-level
bioelectric signals. The chapter explains how to
minimize the noise that corrupts low-level signals,
such as the electrocardiogram (EKG) signal, and
discusses the commonly used circuits. Even though
the chapter concentrates more on the EKG signals,
the applications to other types of biosignais such as
electromyogram and electroencephalogram are also
presented. The chapter focuses more on fundamental
principles, rather than on the latest technological
breakthroughs, and this strategy slows down the
outdating process of the topics covered. The
reviewers believe that monolithic instrumentation
amplifiers and isolation amplifiers deserve at least a
small section in the book, since their use is so
widespread today. The inclusion of these topics,
together with some examples, would satisfy the
readers, since they would be able to build more
realistic practical circuits.
Invasive (direct) and noninvasive (indirect) tech-
niques to measure blood pressure, with a detailed
description of extravascular, intravascular and dis-
posable pressure sensors, are discussed in Chapter 7.
Phonocardiography, cardiac catherization, and heart-
sound instrumentation systems are also examined.
Indicator-dilution methods, with continuous infusion
and rapid injection techniques to measure the blood
flow and volume, are also covered in Chapter 8.
Electromagnetic, ultrasonic, continuous-wave Dop-
296 Book Reviews

pier and laser Doppler flowmeters are included, and
are explained well. A completely new chapter,
Chemical Biosensors, has been added to the second
edition, with a comprehensive review of electro-
chemical sensors, chemical fibrosensors, ion-selective
field-effect transistors (ISFET) and immunologicaily
sensitive field-effect transistors (IMFET). Computed
radiography and tomography, magnetic resonance
imaging, single-photon emission computed tomogra-
phy (SPECT) and positron emission tomography
(PET), with their fundamental principles, are well
explained.
The last chapter discusses the issue of the electrical
safety of medical instruments. The physiological
effects of electric current in the body are discussed,
and an excellent section on quantitative methods for
evaluating the intensity of microshocks is also in-
cluded. The codes and standards for electrical safety
are discussed, and basic approaches to protection
against shock are presented.
Unfortunately, some of the material presented in the
book is already outdated. For instance, the film type
of oxygenators is no longer in use during cardiopul-
monary bypass surgery. Currently, hollow-fiber
membrane oxygenators, with blood paths inside or
outside the fibers, and flat sheet membrane oxy-
genators with centrifugal pumps are used.
There are a couple of excellent references on this
topic for interested readers: Techniques in
Extracorporeal Circulation, 3rd edition, by Philip H.
Kay, (Butterworth-Heinemann, Oxford, UK, 1992)
and Cardiopulmonary Bypass Principles and
Practice, by G.P. Gravlee, R.F. Davis and J.R. Utley,
(Williams & Wilkens, Baltimore, MD, 1993).
It is almost impossible to cover all the aspects of
medical instrumentation in a single-volume textbook.
However. there is a 4-volume set on this topic from
the same editor, John G. Webster: Encyclopedia of
Medical Devices and Instrumentation (John Wiley &
Sons, New York, 1988) which is the most compre-
hensive resource available for interested readers.
Principles of Applied Biomedical Instrumentation,
3rd edition, by L.A. Geddes and L.E. Baker, (John
Wiley & Sons, New York, 1989) is a complete refer-
ence source on transducers, electrodes, and stimula-
tors.
In summary, the material is well selected and organ-
ized. Its style, illustrations, and discussions are clear
and logically correct. It contains more than 300 ex-
amples and homework problems, given at the end of
each chapter, that make the book suitable for class
use. The reviewers strongly believe that this is the
most comprehensive textbook in the medical instru-
mentation area. It is highly recommended to stu-
dents, engineers, physicians, and technicians.

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