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Medicine by Design

The Practice and Promise of Biomedical Engineering

Fen Montaigne

Publication Year: 2006

A heart that once beat erratically has regained its natural rhythm. A woman paralyzed by an automobile accident is now able to resume her favorite hobby. Physicians using a robotic surgeon named da Vinci perform lifesaving operations. These are some of the feats of biomedical engineering, one of the fastest-moving areas in medicine. In this exhilarating book, award-winning writer Fen Montaigne journeys through this little-known world, sharing the stories of ordinary people who have been transformed by technology. From the almost commonplace pacemaker to the latest generation of artificial hearts, Montaigne tells the stories of pioneering patients, engineers, and surgeons. Taking the reader behind the scenes of a dozen of America's leading centers of biomedical engineering, Montaigne recounts the field's history while describing cutting-edge work in medical imaging, orthopedics, cardiovascular care, neurological therapies, and genetics. Through the stories of patients whose lives have been saved and improved by biomedical devices, Montaigne reveals the marriage of medicine and engineering to be one of society's greatest advances.

Published by: The Johns Hopkins University Press


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pp. vi-vii

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pp. ix-xi

... scientists, and students who met with me as I traveled around the country researching this book. Biomedical engineering is a new, sprawling, and complex field, and were it not for the hospitality and patience of the more than 200 people I interviewed, I would never have been able to pull off this project. I am especially indebted to the ...

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pp. 1-6

...medical engineering, or merely a very unhappy one, is open to debate. But one thing is certain. Were it not for the implantable cardiac defibrillator in his chest, Jay Joyce would lead a far different life, assuming he had one to live at all. A West Point graduate and former army officer who had completed Airborne Ranger training, Joyce was 46 years old when he discovered that ...

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CHAPTER 1. The Rise of a New Field

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pp. 7-17

...in an auditorium at Boston University’s Photonics Center, just a few blocks from the Charles River. They had assembled for what has be-come a rite of passage for biomedical engineering students at BU: the senior class presentation of the projects they had labored on during the academic year. Among those present were representatives from ...

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CHAPTER 2. The New Generation

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pp. 18-30

...best of a very good lot at Boston University. Both immigrated to the United States at a young age, both were drawn to BU because it offered one of the best biomedical engineering educations in the country, both were top students in the department, and both planned to go on to graduate studies in medicine or biomedical engineering. I ...

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CHAPTER 3. Beyond the Artificial Heart

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pp. 31-44

...sick. She only occasionally caught a cold, rarely had the flu. Other than when giving birth to her two children, she had managed to avoid hospitals. So it came as something of a shock when, in 2000, at age 47, she came down with a terrible, early-spring cold. Within a day she felt miserable. And by the second or third day she felt so lousy and was so out ...

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CHAPTER 4. The Pump and Its Pipes

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pp. 45-56

The research taking place at the University of Virginia’s Biomedi-cal Engineering Department is a testament to how far cardiovascular medicine has progressed in the past half century. Just before I was born, in 1952, physicians treated my ailing grandfather, who had high blood pressure and atherosclerosis, by placing him on a rice and ...

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CHAPTER 5. To Breathe Again

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pp. 57-61

The body can betray a person in myriad ways and at many speeds. Some illnesses—atherosclerosis, Parkinson’s, Alzheimer’s, numerous cancers—come on gradually, gathering force until a patient is firmly in their grip. But other afflictions hit with lightning speed, changing a person’s life in an instant. Of these conditions none is more ...

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CHAPTER 6. The Wires

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pp. 62-76

A cure for Laszlo Nagy’s underlying paralysis may still be a long way off. But using electricity to tackle a host of medical problems is their colleagues are taking the techniques they developed for spinal cord injury patients and applying them to other conditions, such as incontinence, stroke-related paralysis, and obstructive sleep apnea....

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CHAPTER 7. Moving into the Brain

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pp. 77-89

Kathleen Schuessler came to Dr. Ali Rezai in the spring of 2004. A 66-year-old widow and former computer programmer from Mountain Home, Arkansas, she had been having tremors for thirteen years. They began with her right leg bobbing rapidly up and down. The tremors then spread to her right arm and eventually to her left leg. By 2004, even her left arm had started to shake. Like all people with Parkinson’s, her symptoms arose after neurons in a portion of her ...

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CHAPTER 8. The da Vinci

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pp. 90-96

...form an operation while sitting 15 feet from the patient is impressive indeed. But if Yuh’s collaborators in the engineering school at the Johns Hopkins University have their way, the doctor’s robotic surgery wizardry will soon look antiquated. On a raw windy winter morning in 2005, Yuh took up his station in an operating room adjacent to the hospital's ...

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CHAPTER 9. The Virtual Surgeon

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pp. 97-106

Those inclined to employ a liberal definition of biomedical engineering might argue that its application in the realm of surgery and orthopedics began several thousand years ago when the ancient Egyptians invented a wooden finger prosthesis. The pirate’s peg leg and hook hand were another crude step in the ...

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CHAPTER 10. Bones

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pp. 107-120

...giant steel mills that once dominated the city’s landscape are giving way to low-slung, modern glass buildings that contain the offices and labs of the health care and high-tech industry. Not far from the river, on a warm September morning in 2004, orthopedic surgeon Patrick J. McMahon was in a satellite hospital of the University of Pittsburgh ...

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CHAPTER 11. The Pictures

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pp. 121-130

...to understand that fighting the disease was a running battle. The 48-year-old mother of two from northern California was first diagnosed with a marble-sized tumor in her right breast in 1997. Surgeons re-years later, the cancer returned and was surgically removed again. Powell also received a round of radiation treatments. But by the sum-...

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CHAPTER 12. Seeing the Unseen

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pp. 131-146

...the paradox of medical imaging: that invisible energy could make the unseen visible. His discovery came quite by accident. On November 8, 1895, Roentgen was studying electrons generated in a vacuum cathode ray tube. In a nearby room was a sheet of paper covered with barium platinocyanide, a substance used for coating some types of ...

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CHAPTER 13. The Business

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pp. 147-167

...medicine at Emory University in Atlanta, living a full life of teaching and treating patients. In 1980, however, at the height of his career, Hersh—a gastroenterologist—noticed that his night vision, which had been poor for years, was getting worse. He also was losing the peripheral vision in his right eye. Visiting his ophthalmologist, Hersh ...

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CHAPTER 14. Weng’s Wars

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pp. 168-177

In her struggle to find a treatment for debilitating eye diseases like retinitis pigmentosa, Weng Tao has faced innumerable woes. Fortunately for her and her colleagues at the biomedical start-up Neurotech, Tao also has possessed an equal measure of single-minded drive. As a result, the tiny Neurotech team has done what few small ...

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CHAPTER 15. Tissues

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pp. 178-192

...tolerable for Laura Cochran. Her four young children were a handful, chaos were it not for the illness that had attacked her body seventeen years before. At age 28, Cochran was stricken with Type 1 diabetes, the most serious form of the illness and one in which her body’s own immune system attacked her pancreas, preventing it from ...

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CHAPTER 16. Body Builders

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pp. 193-205

...for new organs in the United States. Two-thirds of them are waiting for kidneys, while 15,000 to 20,000 desperately need a liver. A few thousand more wait, mainly in vain, for a heart. And then there are the hundreds of thousands of additional people, who, for various medical reasons, are not eligible for organ transplants. Many of them ...

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CHAPTER 17. The Road Ahead

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pp. 206-222

The future of biomedical engineering is on display at the University of California, San Diego, and it is invisible. For more than half a century, the great achievements of biomedical engineering have been devices you could see and touch: heart pacemakers and defibrillators, artificial joints, ultrasound and CT scanners, implantable pumps to assist the heart, automated blood ...


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pp. 223-229

E-ISBN-13: 9780801889059
E-ISBN-10: 0801889057
Print-ISBN-13: 9780801883477
Print-ISBN-10: 0801883474

Page Count: 248
Illustrations: 25 color photographs
Publication Year: 2006