HISTORY AND PROGRESS OF BIOMEDICAL ENGINEERING

Grupo Coimbra de Universidades Brasileiras (GCUB)

Workshop Program Day 2: December 2nd, Wednesday, 2015

Sadık KARA

Institute of Biomedical Engineering

Fatih University

maiden’s towerFatih University

Bosphorus Bridge

Research and Development Process in BME

Biomedical Engineering Project Samples from Institue of BME

Outline

Global Technological Developments and Interdisciplinary Studies

Introduction to Institute of BME

Firm Border

Permeable Border

Single Discipline

Interdisciplinary SCIENCE

Medicine

Chemistry

Economics

Mathematics

Biology

EngineeringPolitics

Language

Physics Ethics

4

Academic Disciplines & Interdisciplinary Studies

Time!

Technological Development

EMD Radiation

+

Pollution

Urbanization

Media

Healthcare

Politics…

5

Global Technological DevelopmentsInteractions between Environment & Humans

Biomedical Engineering necessitates collaboration and requires the expertise

of professionals from the fields like Biology, Medicine, Engineering, and

Economics to solve problems.

INPUT OUTPUT

Speech

Behavior

Appearance

Exhaled air

Body gestures

Liquid waste

Solid waste

Vision

Audition

Olfactory

Gustation

Touch

Inhaled air

Fluid Intake

Food Intake

6

Human as a model organism in Biomedical Engineering

1665 - London

Mortality rate from infectious diseases: 93%

Average Life Span: 40 years

Campaigns for the eradication of infectious diseases

(Vaccine Development for Measles, Plague and etc.)

1930

21. century Mortality rate from communicable diseases: 4%

Average Life Span: 80 years

Drop in prices to affordable levels

High Drug Development Costs

Technological Developments

(Mass Production)

7

Earlier Times and Diseases

• The first USA hospital was built in 1751 called “The Pennsylvania Hospital

• The first one in Boston in 1821.

• Hospital death rate % 25, % 9 of hospital workers 1788

Early Hospitals

• Today, hospital is the focal point around new medical knowledge and technology.

Modern Hospitals

8

Early Medical Ward

1969 Haydarpaşa 1990 Haydarpaşa 9

1970 Istanbul Faculty of Medicine 2003 Istanbul Faculty of Medicine

Early Medical Ward

10

Surgical operations without anesthesia

1846 - First surgery under ether anesthesia was performed by John Collins.

Anesthesia was administered by William T.G. Morton.

Anesthesia

Modern Anesthesia

1880 1846 - Surgery under anesthesia (Boston)

Early Operating Room

1990 – Advanced technology in a sterile environment and remote surgery

Modern Operating Room

12

Drop in prices to affordable levels

(Vaccines developed for Measles, Plague and etc.)

Drugs with high developmental costs

Technology Development

(Mass Production)

13

1650’s Cancer has not been defined yet

Today Diagnosis + Stage Identification + Treatment

CANCER

Industrialization

Environmental

changes

Carcinogenic

Materials

Processed

Foods

14

ECG, Ultrasonic Doppler Early diagnosis

Liver/Lung pum, Angioplasty Operational procedures

Cardiovascular Diseases

ObesityLifestyle

Stress

15

Improvement of the living conditions of people with disabilities

Alternative communication platforms for the disabled

Wheelchairs and novel designs

Smart Prosthesis Rehabilitation

Biomedical Engineering - Rehabilitation

16

Artificial organ development – Bioactive products, smart prosthetics

Development of new instruments for histological analysis – Flow cytometry

Imaging technologies for disease diagnostics – CT, MRI, PET, Ultrasound

Remote Patient Monitoring – Biotelemetry systems

Instruments for Physiological status monitoring – Sensors, ECG, EEG, EMG

Novel treatment methods – stem cells, pacemaker, stent, Nanomedicine

Instrument design for sports medicine – Biomechanical devices

Device design for orthodontists – Digital Intraoral X-Ray System

Lifestyle improving technologies for the disabled people – Brain-machine interface,

Deep Brain Stimulator

Biomedical Engineering – Medical Instrument Design

17

Biomaterials are used in,

Artificial joints

Bone coating

Bone strengthening

Artificial tendons and ligaments

Dental implants

Vascular grafts

Heart valves

Artificial skin

Cochlear prosthesis

Cornea

Breast implants

Controlled drug delivery systems

Artificial skin

Biomedical Engineering – Biomaterial Design

18

Expedite adaptation of new medical devices by doctors and operators

Clinical Engineering – Hospital Management

19

Invasive procedures – Infection, organ rejection, cancer recurrence, and etc.

Drug therapy – Side affects

Paradoxes of classical medicine

Use of nanotechnology for diagnosis, treatment and prevention of diseases.

Production of Nanorobots

Rehabilitation of cells at the molecular level

Preventative interventions against viral infections

Monitoring and reporting of vital signs and disease indicating symptoms

Biomedical Engineering - Nanomedicine

20

Nanotechnologies and BME

Milestones in Device Development

and

History of Medical Device Development

1603 - Invented

1625 - Body temperature measurement

Classic Medical

Thermometer

Thermometer

Limitations:

Infection

Sterilization

Calibration

Disposable Medical Thermometers

22

Digital-infrared-medical-thermometers-non-contact

Ophthalmoscope

1666 - Newton carried out first studies about optic lenses

1850 - First blueprints of battery powered ophthalmoscope were designed

1860

19. century Modern

Stethoscope

1816 - Mechanic (Conventional) stethoscope used for differentiating various cardiac

sounds

1961 - Electronic stethoscope

Mechanic stethoscope – Transmission of internal sounds of the body to the ear of medical professional

Electronic stethoscope – Internal sounds are amplified by electronic circuits (Filtering+ADC+Bluetooth)

First Stethoscope,

Dr. Laennec’

(1816).

Dr. Laennec with a patient Mechanic

stethoscope

Digital stetoscope

24

X-Ray

1895 – Discovery of X-Ray Electromagnetic Radiation

1907

2007

.

Modern Radiotherapy Unit

Radiotherapy

First patient to be treated with

Radiotherapy (1957).

1903 - X –Rays were used for the treatment of skin cancer

1980 – Computer-aided modern radiotherapy

26

Electrocardiograph (ECG)

1887 – First ECG recording

1896 - Willem Einthoven creates the string galvanometer.

Einthoven

First ECG prototype machine

(1911) Handheld ECG machine

Augustus Waller

First ECG recording

(1887)

27

Modern ECG Monitor

Usage areas: Paralysis, Brain tumors, Epilepsy, brain damage

Electroencephalography (EEG)

Single channel EEG (1926) Modern - Multichannel EEG

1924 – Invention of EEG

28

Defibrillator

Prototype (1947)

First Portable

Defibrillator (1966)

Modern Defibrillator

1899 – First prototype (Initially used only for dogs)

1947 – AC defibrillators used for humans

1980 – Biphasic defibrillator

29

Pacemaker

First implantable

Pacemaker

240gr. (1958)

1958 – First portable pacemaker design (Karolinska Institute, Sweden)

Cardiac dysrhythmia rhythmic electrical signals

Modern pacemaker

25gr. (2005)

30

80.000 heart valve replacement surgeries every year in the U.S.

Mechanic Heart Valves

1960 – Caged ball heart valve that moves depending on the blood flow

What Causes Heart Valve Disease?

Heart conditions and other disorders, age-related changes, rheumatic fever, or infections can cause acquired heart valve disease. These factors change the shape or flexibility of once-normal valves.

Cardiac catheterization process

Balloon Angioplasty

1940 – Diagnostic cardiac catheter

1960 – Selective coronary angiography

Modern ultrasound machine

Ultrasound Imaging

Dussik’s ultrasound machine

1942 – First scientific article published about the use of ultrasound energy in Medicine

Hounsfield and his first CT

Modern CT

1972 – Developed by British engineer Godfrey Hounsfield. Awarded Nobel prize in Medicine.

There are 7000 CTs in the US and 35,000 in the world )

Computed tomography (CT)

Modern MRI instrument

Magnetic Resonance Imaging

1946 – First nuclear magnetic resonance experiments on chemical materials

1952 – Engineering Physicist Dr. Bloch and Dr. Purcell won the Nobel prize in Physics

1980 – First MRI instrument for human use

First MRI instrument for medical use

and its designer, Raymond Damadian

Interface provides a

communication

pathway between the

brain and an external

device

Brain Machine Interface

1970 – Early research studies

BCI used to teach patient how to move muscles to which the brain has forgotten how to control

Microchip insertion to brain to

control prosthetic devices

Signal Amplification

Wireless communication

Optimal Signal Processing

Prosthesis

control

command

Feedback

36

Deep Brain Stimulator

2002 First approved by Food and Drug Administration (FDA) to prevent tremor in

Parkinson disease

Deep brain stimulation is used to treat a number of neurological conditions, such as: Essential tremor, Parkinson's disease and etc.

Insertion of elctrodes

during surgery

Photo taken during surgery

Electronic Oscillator

37http://www.medicalnewstoday.com/articles/265445.php

Introduction to Institute of BME

Biomaterials Research Laboratory

Biophotonics Research Laboratory

Biomedical Instrumentation Research Laboratory

PROJECTS

SAMPLES

Muscular Activity Analysis of Circumoral and Jaw-Closing Muscles

Response to the Trainer on Patients With Class II Malocclusion Using EMG

Twin BlockHerbst

Project Team: Sadık Kara, Şükrü Okkesim (Fatih University, Institute of Biomedical Eng.

Tancan Uysal, Aslı Baysal (Erciyes University, Faculty of Dentistry)

Funding: The Scientific and Technological Research Council of Turkey

Bacteria Classification using an Electronic Nose

Mikroorganizma türüne göre

sensörlerin direnç değişimleri

PC1’e göre 4 ayrı tür

mikroorganizmanın

sınıflandırılması

Schema of experimental setup

Project Team: Sadık Kara (Fatih University, Institute of Biomedical Eng.)

Musa Hakan Asyalı (Erciyes University, Biomedical Eng. Dept.)

Bekir Hakan Aksebzeci (Erciyes University, Biomedical Eng. Dept.)

Hatice Özbilge (Erciyes University, pharmacy Daculty)

Funding: T.R. Prime Ministry State Planning Organization

DESIGN OF AN ELECTRONIC SYSTEM FOR DIAGNOSIS AND

THERAPY OF CONSTIPATION

Sample of Test Screen

Main menu of Software Monochrome Graphic LCD Module EX8B Development Board

Project Team: Sadık Kara (Fatih University, Institute of Biomedical Eng.)

Eren Mert (Medron Med. Tech. Industry and Industry. Ltd. Com.)

Funding: The Scientific and Technological Reserach Council of Turkey

Analysis of Spectral Features of Mechanical Heart Valve

Sounds after Aortic and Mitral Valve Replacement

Kayıt sisteminin blok diyagramı

Kaçaklı hastanın replasman öncesi ve sonrası ve normal mekanik

kalp kapaklı bir hastanın mitral odaktan kayıt edilen kalp sesleri

0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 2-1

-0.5

0

0.5

1

1.5

time (sec.)

No

rmali

zed

EC

G

0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 2

-1

0

1

time (sec.)

No

rmali

zed

Heart

So

un

ds

0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 2-0.5

0

0.5

1

1.5

time (sec.)

No

rmali

zed

Sh

an

no

n E

nerg

y

RR Interval

T Peak+150ms

75 ms 75 ms

75 ms 75 ms

S1 Sound S2 Sound

EKG, Kalp sesleri ve Mitral kapak replasmanı

yapılmış bir hastaya ait Shannon enerji diyagramı

Project Team: Sadık Kara (Fatih University, Institute of Biomedical Engineering)

Sabri Altunkaya, Saadettin Herdem (Selçuk University Dept. of Elect. Eng.)

Niyazi Görümüş (Meram Medicine Sch. Dept. of Cardiology Surgery)

Analysis of Normal and Cancerous Nucleus through a

Different Approach

Hücre

Mikroskop Kamera Capture Kartı

PC

Block diagram of the system

Active windov

Filtering cycle

Project Team: Sadık Kara (Fatih University, Institute of Biomedical Engineering)

Fulya Şener, Mustafa Yıldırım (Erciyes University, Eng. Faculty)

Determination of Time Of Death Estimation Based On Signal And

Image Processing

Set up for recording Cornea photograph Some photographs taken photos 2 different time

from cornea

Histogram of the photograph belong to corneaSet up for recording electrical dermal activity

Project Team: Sadık Kara (Fatih University, Institute of Biomedical Engineering)

İsmail Cantürk, Fethullah Karabiber (YTÜ, Electrical Faculty)

Safa Çelik, Feyzi Şahin (Istanbul Forensic Science Company)

Fatih Yağmur (Medeniyet University, Medicine Faculty)

Sadık Kara, Saime Akdemir Akar (Fatih University, Institute of Biomedical Engineering)

Vedat Bilgiç (Bakırköy Mental and Nervous Diseases Training and Research Hospital)

Analysis of biological signals and physiological parameters

in patients of psychiatry

Purpose: To investigate physiological and electrophysiological parameters on schizophrenia patients and healthy control

subjects using signal processing techniques to reach reliable discriminating features between patients

and control subjects.

Sadık Kara, Halil İbrahim Çakar (Fatih University, Institute of Biomedical Engineering.)

Design of a portable Surface Electromyography device for collection of

SEMG biopotentials from Back Herniated patients

Sadık Kara, Halil İbrahim Çakar (Fatih University, Institute of Biomedical Engineering.)

Mesut Şahin, Ferhat Erdoğan (New Jersey Inst. of Technology, Dept. of Biomedical Eng.)

Fatih Yakar (Bezmialem University, Department of Chest Diseases)

Investigating the effect of Mechanical Vibrations on Genioglossus and

Masseter Muscular Activity During Treatment of Obstructive Sleep

Apnea

Sadık Kara, Halil İbrahim Çakar (Fatih University, Institute of Biomedical Engineering)

Jörn Rittweger, Jochen Zange (German Aerospace Center, Institute of Aerospace Medicine)

Assessment of Capillary Blood Volume and Oxygenation in Unloaded

Lower Leg Muscles During Whole Body Vibration

Two types of vibration: Orthogonal and Parallel to the lower leg.

Measurements:

NIRS

DOPPLER

EMG / Acceleration

Volume Change (Strain Gauge)

ORTHOGONAL VIBRATION PARALLEL VIBRATION

0 10 20 30 40 50 60 70 80 90 1000.2

0.25

0.3

0.35

0.4

0.45

0.5

0.55

diseased vs control

Analysis of Magnetic Resonance Images of Patients Having Spontaneous Spinal

Cerebrospinal Fluid Leaks and Intracranial Hypotension Using Computerized

Image Processing Methods

Mustafa Selman Yıldırım (Fatih University, Institute of Biomedical Engineering)

Sadık Kara (Fatih University, Institute of Biomedical Engineering)

Mehmet Sait Albayram (İstanbul Univ. Cerrahpaşa Medical Faculty, Neuroradiology Department)

Long diagnosis time (13 months average)

Misdiagnosis (94% - Migraine, meningitis, hypertension, malingering)

Problems about the disease

illnessRate = 0.1094

Design of a Smart Digital Ophthalmoscope Device

Mustafa Selman Yıldırım (Fatih University, Institute of Biomedical Engineering)

Sadık Kara (Fatih University, Institute of Biomedical Engineering)

Funded By: Science, Industry and Technology Ministry of Turkey

Image sensor

Light Source

Lens SystemEye

Aperture

Optical Design

CCD Camera Module

ASIC based Circuit

Data Storing

Computer Interface

( )

Retinal Image

Digital Oftalmoscope Flow Diagram

User Interface

Optical Hardware

Compact ECG With Graphic LCD and Phonocardiogram Design

Facial nerve stimulator Design

Block diagram of facial nerve stimulator

ECG signal on the LCD screen. System block diagram.

Other samples of medical devices

THANKS