Technologies and health care in the 21st century.

The factors shaping the nature and scope of health care in the 21st century are examined. Included are the technically driven infusion of new and innovative research and clinical tools; the diversity and capability of modern imaging methods; the predominance of diagnostic capabilities over effective therapy in clinical medicine; the focus of basic research on engineering issues such as instrumentation, biomaterials, modeling, and physiological functions; the growing use of image-based therapy; and the quest for causation in chronic conditions.

Research directions in biomedical engineering.

The role of biomedical engineering and developments that affect it are outlined. Research areas that the authors believe will be of major importance at the beginning of the next century are discussed. They are: systems science and integrated biology; biomedical engineering in the cardiovascular system; biomaterials (metals, ceramics, and polymers); artificial organs; instrumentation and sensors; medical imaging (radiography, ultrasonic imaging, magnetic resonance imaging, and other techniques); biomedical computing; biomechanics; and rehabilitation. Some new areas for biomedical engineering research (molecular biology, minimally invasive surgery, home health care, and geriatric care) are examined.

Blood flow measurement: future applications and prospects.

Blood flow measurements have great potential value for evaluating ventricular performance in humans in terms of dynamic properties--peak velocity, acceleration, and instantaneous power development. Transcutaneous ultrasonic Doppler flow sensors provide new and exciting opportunities as simple, noninvasive techniques for ready access to this kind of information under many different circumstances. Recent developments in laser-Doppler technology provide promise of new methods for measuring blood flow in superficial vessels (i.e., skin or retina) without even contact with the surface of the body.

Home care: a biomedical engineering challenge.

The contributions of biomedical engineering to health care delivery have focused on techniques for acquiring and processing patient data, primarily in the high technology setting of modern hospitals. The increased sophistication of hospitals is responsible in large measure for the soaring costs of health care. The current trend toward both ambulatory and home care provides new and challenging opportunities for biomedical engineering to bear on problems of great social and economic consequence in facilitating safe and effective care of the chronically ill in the security and comfort of their own homes. Techniques which are refined for use by the expanding population of both aged and handicapped individuals are also of potential value for the home care of younger patients with broader life expectancy. Projections into the future prospects for home care elicit a wide diversity of opportunities of great significance to the future of the health professions and society as a whole.

Correlation of peak aortic and carotid flow acceleration during coronary occlusion in conscious baboons.

1. Peak blood flow acceleration measured in the common carotid artery was compared with peak flow acceleration measured in the ascending aorta of three baboons. 2. The response to occlusion for 60s of the circumflex branch or the anterior descending branch of the left coronary artery was investigated. 3. Both accelerations decreased approximately to the same extent. Peak aortic flow velocity, stroke volume and cardiac output also decreased but to a smaller extent. 4. It is concluded that peak aortic flow acceleration is a sensitive index of myocardial function during acute coronary occlusion in conscious primates and that peak carotid flow acceleration is an indirect measure of myocardial performance under the same conditions.