JPH07380A - Oxygen metabolism measuring device - Google Patents

Abstract

PURPOSE: To provide an oxygen metabolism measuring device by which intake and utilization of oxygen of a tissue can be measured by an internal body organ or a selected body tissue on a heart, a brain, a liver, a kidney or the like by using an independent scope containing an optical fiber of both transmission and reception to obtain optical information from a site in a heart. CONSTITUTION: An irradiating optical fiber 14 of an oxygen metabolism measuring device 10 is, for example, uniformly and optionally distributed to one or more optically coupling connectors 16. One 16 of the connectors is connected to a reference reflection detector 24b, and residual one or more than that of the optically coupling connectors 16 are used to send near infrared radiation from a near infrared radiation(NIR) light source 24a having one or more different wave lengths. A light receiving optical fiber 18 transmits the received light along the total length of the oxygen metabolism measuring device 10, and sends it to the optically coupling connectors 20 and a light detector 26.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an oxygen metabolism measuring device for measuring the metabolism of body organs or tissues in a living body, and more particularly to a reflection near-infrared region from a target intracardiac region using a method of entering a blood vessel through a skin. (NIR) The present invention relates to an oxygen metabolism measuring device that transmits and receives light.

[0002]

A feature of the treatment of coronary obstruction is the need for a non-invasive means for assessing regional oxidative metabolism in patients with heart disease. Currently, there is no method in the art to accurately and quickly measure oxygen uptake and utilization of regional tissues of the human body.

Standard clinical indicators are not sensitive to non-uniform dropouts of myocardial perfusion metabolism due to lack of coronary veins. Also, by radionuclide or angiography,
Although it is possible to evaluate myocardial perfusion and movement of the ventricular wall,
With these methods, the prediction of myocardial metabolic status, especially in patients with distal perfusion and / or abnormal ventricular wall movement, is not always reliable.

Other methods of measuring myocardial metabolism, such as nuclear magnetic resonance imaging and spectroscopy / positron emission tomography, are expensive and are not used in cardiac catheterization rooms in most hospitals and clinics. , Complicated parts (eg magnets and cyclotrons) are needed.

In particular, in the abnormally contracting myocardium, the ability to quickly identify the metabolic state of a person's heartbeat is a clinical requirement for treatments such as coagulants, balloon angioplasty, and coronary artery bypass grafts. Favorably influences the above decision.

Regarding prior art spectrophotometric methods for measuring circulatory respiratory function, arterial blood oxygenation and blood samples, US Pat. No. 4,22 to Jobsis, US Pat.
3,680 and 4,281,645. This patent details the application of blood-dispersed body organs by differential spectroscopy with near infrared light.

In both patents, near-infrared external light must span a relatively long optical path (eg, several cm). This long optical path is important because photons of light penetrate deeply into the tissue of interest and the received optical signal contains information from the substantial volume of the tissue. Also, the longer optical path reduces light scattering effects on the outer surface structure of the tissue region of interest. As can be seen in FIG. 2 of US Pat. No. 4,223,680, the backscatter from the external structure does not include metabolic information of interest, and the detection of any metabolic information is obscure. This method was sought by Mr. Jobis to minimize this biophysical effect. Therefore, in both Yovsis' patents, near infrared light must be sent to the organ to be tested (the original location of interest) and the radiant intensity must be detected and measured at points spaced from the point of light. It teaches you not to. FIG. 1 of US Pat. No. 4,223,680.
As shown in FIG. 2, the physical distance between the entrance and exit of the near infrared light is set to several cm.

Thus, the photodetector fiber bundle must be spaced from the source fiber bundle in order to minimize light scattering from the outer tissue region. Moreover, as presented in US Pat. No. 4,513,751 by Abe, even though the source fiber bundle and the photodetector fiber bundle are oriented parallel to each other, the source fiber bundle and the light The spacing of the detector fiber bundles is required. That is, as proposed by Abe for visible light wavelengths, near infrared light is placed in a first optical fiber,
It is not possible to measure any precise near-infrared oxygenated metabolism within a substantial tissue volume simply by receiving the reflected light at a second optical fiber that is parallel and adjacent to the second optical fiber.

[0009]

In summary, for intravascular applications of devices transmitting and receiving red to near infrared light, it includes both transmitting and receiving optical fibers to obtain optical information from sites within the heart. It is highly desirable to use a single scope. Introducing two separate transceiving scopes into the heart by the transcutaneous endovascular technique is due to the instrument that strikes the myocardial wall and the instability of optically aligning the two scopes in the tissue area of interest. Will be prevented.

The Applicant has overcome the shortcomings of the prior art disclosed in the patents of Yovsis and Abe and has developed the steerable fiber optic device described below. The device consists of a small-diameter scope (diameter 3.3 mm) placed on the inner surface of the heart.
The following is used to send and receive near-infrared light through the intradermal approach through the skin used in standard clinical catheterization chambers, which can be performed as part of a routine diagnostic catheterization study and can be performed in a moving heart. It is a device that can measure regional myocardial oxygenation.

That is, the present invention has been made in view of the above circumstances, and as an intravascular application of a device for transmitting and receiving red to near infrared light, a single scope including both transmitting and receiving optical fibers is used as a heart. It is intended to provide an oxygen metabolism measuring device which is used to obtain optical information from internal sites and measures oxygen uptake and utilization of tissues such as heart, brain, liver and kidney in internal body organs or selected body tissues. I am trying.

[0012]

Means for Solving the Problems The oxygen metabolism measuring device of the present invention is a flexible insertion part and an emission end face for emitting light forward from the tip of the insertion part. Means and light receiving means for receiving the optical information of the observation object by the light emitted from the emitting means, the light receiving means being provided on the distal end surface of the insertion part, wherein the emitting end surface and the light receiving end surface are opposite to each other. It is inclined to the outside.

[0013]

[Operation] The present invention is intended to insert a tube containing a plurality of optical fibers into contact with an organ or tissue of a target through at least a part of a body conduit, such as a blood vessel. In the tube, at least one irradiation optical fiber that is the emitting means,
It comprises at least one light-receiving optical fiber which is the light-receiving means.

The light is directed so as to diverge as seen from the receiving optical fiber and pass through the illuminating optical fiber to reach the target organ or tissue. The reflected light that traverses a part of the target organ or tissue is received by the receiving optical fiber. The reflected light is analyzed to obtain tissue oxygen uptake and / or to obtain relevant data for the organ or tissue of interest. The illuminating optical fiber is optically connected to the multi-wavelength spectroscope, and the receiving optical fiber is optically connected to the photodetector. The divergence path of red and near-infrared light from the illuminating optical fiber through the target tissue back to the receiving optical fiber provides optical information from the substantial volume of tissue to provide unwanted backside of light from the outer surface tissue layer. To minimize scattering,
Increase the light path through the tissue of interest.

[0015]

Embodiments of the present invention will be described below with reference to the drawings.

1 to 11 relate to a first embodiment of the present invention, and FIG. 1 is a block diagram showing the configuration of an oxygen metabolism measuring apparatus,
FIG. 2 is a configuration diagram showing the configuration of the distal end portion of the extension tube,
FIG. 3 is a configuration diagram showing a configuration of a distal end portion modification of the extension tube, FIG. 4 is a configuration diagram showing a configuration of a first modification example having a predetermined optical axis angle at the tip end portion of the extension tube, and FIG. Second with a predetermined optical axis angle at the tip of the tube
6 is a configuration diagram showing a configuration of a modified example of FIG. 6, FIG. 6 is a configuration diagram showing a configuration of a third modified example having a predetermined optical axis angle at the distal end portion of the extension tube, and FIG. The block diagram which shows the structure of the 4th modification which has an axial angle,
8 is an explanatory diagram for explaining the LG ratio of the irradiation optical fiber and the light receiving optical fiber, FIG. 9 is an explanatory diagram for explaining the action of the oxygen metabolism measuring device, and FIG. 10 is an explanatory diagram for explaining the result of the action of FIG. 9. Is.

As shown in FIG. 1, an oxygen metabolism measuring apparatus 10 of the present invention comprises an irradiation optical fiber 1 comprising a number of fibers whose proximal ends are connected to a polished optical coupling connector 16.
4 and a light-receiving optical fiber 18 composed of a large number of fibers whose proximal ends are connected to a polished optical coupling connector 20,
It is composed of, for example, an extension tube 12 made of a flexible plastic sheath as a conduit or a casing through which the irradiation optical fiber 14 is inserted.

A control device 22 is placed in the middle of the extension tube 12, and the control tip 22 'of the extension flexible tube 12 can be operated by the control device 22. Further, in the middle portion of the control device 22, the control device 22 and the control tip 12 'can be operated in a sterilized state. For example, a 2 cm long steering tip 12 'can be curved by a steering instrument 22 in a 120 degree arc (see FIG. 1).

The irradiation optical fibers 14 of the oxygen metabolism measuring apparatus 10 are, for example, evenly and arbitrarily distributed to one or more optical coupling connectors 16. One of the connectors 16 is connected to a reference reflected light detector 24b and the remaining one or more optical connectors 16 send near infrared light from one or more different wavelength near infrared (NIR) light sources 24a. It is used for The light receiving optical fiber 18 transmits the received light along the entire length of the oxygen metabolism measuring device 10 and sends it to the optical coupling connector 20 and the photodetector 26. The proximal ends of all the optical fibers 14 and 18 are polished at the respective optical connectors 16 and 20 for optimal optical coupling to the near infrared light source 24a, the reference reflected light detector 24b, and the photodetector 26. There is.

Here, for example, most preferably, the extension tube 1 of the device 10 extending from the steering device to the steering tip.
The outer diameter of 2 is 3.3 mm (10 Fre so that the oxygen metabolism measuring device 10 of the present invention can be used in the feces in the blood vessel passing through the skin).
nch) is not exceeded. Further, the length of the extension tube 12 in the section from the control device to the control tip is brought close to the ventricle by the intravascular approach method of the major artery or vein,
It should be at least 150 cm and the length of the extension tube 12 from each optical coupling connector to the steering instrument 22 should be at least 2 meters in order to operate the steering instrument under sterile conditions.

2A to 2C and 3A.
Figures 3 (C) schematically illustrate two separate embodiments of the distal tip of extension tube 12.

In FIGS. 2A to 2C,
It can be seen that the tip of the extension tube 12 forms a cone with a blunt tip. The bundle of irradiation optical fibers 14 is included in a portion 12A of the distal end of the extension tube 12, and the bundle of reception optical fibers 18 is included in a portion 12B of the end of the extension tube 12. Also, an opaque or non-light-transmitting divider 12C is placed between the illuminating and receiving optical fibers (preferably arranged in two optical fiber bundles).

FIGS. 3 (A) to 3 (C) show modified examples of the distal end portion of the extension tube 12, in which,
The illuminating optical fiber 14 is inside the concentric outside 12A, and the receiving optical fiber 18 is the central portion 12B of the extension tube 12.
The opaque divider 12C separates the light-transmitting and light-receiving optical fibers.

What is common to both tip embodiments is that the tip of the extension tube 12 is shown in FIG.
As can be seen by referring to the photon path depicted in FIG. 3 (A), the photon from the irradiation optical fiber 14 which is distant from the light receiving optical fiber 18 is diverged to have a conical shape. . The principle of light in the divergent and reflective shape is to obtain optical information from a more substantial volume of tissue and to reduce the backscatter of light from the outer tissue layer compared to a flat tube tip, Or to increase the optical path of photons through tissue. Here, the light-transmitting and light-receiving optical fiber bundles are adjacent to each other and in a parallel relationship. In addition, the extension tube 12
The angle of the cone defined by the extremities of the is adjusted to elicit preferential signals from the deep tissue layers of the endocardial surface.

An appropriate lens (not shown) may be used for the light-transmitting and light-receiving portions at the conical end of the extension tube 12 to make the same adjustment to optimize the volume of the sample tissue. By changing the optical path of photons by adjusting the angle or the lens shape, it is possible to obtain optical metabolism information from different tissue depths. Similarly, time domain multiplexing may be utilized to selectively accept photons that have traversed different tissue depths.

A modified example having a predetermined optical axis angle at the tip of the extension tube 12 will be described.

As shown in FIG. 4 (A), the extension tube 1
In the first modification having the predetermined optical axis angle of the tip of No. 2, the tip has a conical shape as described above, and FIG.
As shown in FIG. 5, the irradiation optical fiber LG14a and the light receiving optical fiber LG18a are separated by an opaque or non-light-transmitting divider 15a and are arranged in the extension tube 12. The divider 15a is formed into a conical shape in the tip of the conical shape so as to be coaxial with the conical shape.
The a and the LG 18a are separated along the inverted conical divider 15a, and the end surfaces of the LG 14a and the LG 18a are arranged arcuately on the conical side surface of the distal end portion with the central axis of the extension tube 12 being symmetrical. At this time, the angle of the side surface of the inverted conical divider 15a is, for example, 30 ° with respect to the central axis of the extension tube 12, and therefore the LG 14a and the LG 18a.
The side of the extension tube 12 on the central axis side is also the extension tube 1
It has an angle of 30 ° with respect to the central axis of 2. LG
The side surfaces of the extension tubes 12a and LG18a facing the side surfaces on the central axis side of the extension tube 12 are LG14a and LG as described above.
The end surface of 18a has an angle of, for example, 22 ° so that it has an arcuate shape.

At the tip of the extension tube 12 thus constructed, the near-infrared light emitted from the irradiation optical fiber LG14a is 3 with respect to the central axis of the extension tube 12.
The light is emitted to the outside with an angle of 0 °, and is received by the light receiving optical fiber LG18a that is at a symmetrical position and has an angle of 30 ° to the outside with respect to the central axis of the extension tube 12, and It can increase the optical path of photons through an organ or tissue, gaining optical information from a more substantial volume of tissue, reducing backscattering of light from the outer surface tissue layer relative to a flat tube tip, The near infrared light from the irradiation optical fiber LG14a is received by the light receiving optical fiber LG.
It is possible to prevent the light from being directly received by 18a.

As shown in FIGS. 5 (A) and 5 (B), the second modified example in which the tip end portion of the extension tube 12 has a predetermined optical axis angle, the tip end portion of the extension tube 12 has a wedge shape. In the first modification having a predetermined optical axis angle, the tip end shape of the divider 15a is a roof shape instead of the inverted conical shape. Other configurations, actions, and effects are the same as those of the first modification having a predetermined optical axis angle.

As shown in FIG. 6 (A), the extension tube 1
The third modified example in which the tip end portion of No. 2 has a predetermined optical axis angle is that the tip end portion of the extension tube 12 has a cylindrical shape, and as shown in FIG. LG1
4a and the light-receiving optical fiber LG18a are separated by a divider 15b that is opaque or does not transmit light, and is disposed in the extension tube 12. The divider 15b is formed into a roof shape coaxially with the cylinder in the tip end of the cylindrical shape, LG14a and LG18a are separated along the roof-shaped divider 15b, and the end surfaces of LG14a and LG18a are The central axis is symmetrical and the arc is arranged on the tip surface of the tip. At this time, the roof-shaped divider 15
The angle of the side surface of b is, for example, 24 ° with respect to the central axis of the extension tube 12, and therefore LG14a and LG1
The side surface of the extension tube 12 on the side of the central axis of the extension tube 12 also has an angle of 24 ° with respect to the center axis of the extension tube 12.
The side surfaces of the LG 14a and the LG 18a facing the side surface on the central axis side of the extension tube 12 are, for example, 16 ° so that the end surfaces of the LG 14a and the LG 18a are arcuate as described above.
Have an angle of.

By doing so, even with a flat tube tip, the optical path of photons passing through the target organ or tissue can be increased, and optical information from a tissue of a more substantial volume can be obtained, It is possible to reduce backscattering of light from the outer surface tissue layer and prevent the near-infrared light from the irradiation optical fiber LG14a from being directly received by the reception optical fiber LG18a.

As shown in FIG. 7, in the fourth modified example in which the tip of the extension tube 12 has a predetermined optical axis angle, the tip of the extension tube 12 has a circular shape, and other configurations are provided. The action and effect are the same as those of the first modification having a predetermined optical axis angle.

In the first to fourth modified examples in which the distal end portion of the extension tube 12 has a predetermined optical axis angle, as shown in FIG. 8, the light receiving optical fiber LG1 is used.
The LG ratio of 8a may be increased with respect to the irradiation optical fiber LG14a. By doing so, the S / N ratio can be improved. The broken line in FIG. 9 indicates that the light-receiving optical fiber LG18a and the irradiation optical fiber LG14a are the same L.
The case where the G ratio is included is shown.

The above-described oxygen metabolism measuring apparatus 10 of the present invention
Was experimentally tested by the means shown in FIG. Here, two parallel fiber bundles are in contact except at the tips which are oriented in a divergent relationship. The irradiation optical fiber bundle A is oriented away from the light receiving optical fiber bundle B toward the outside.

As can be seen with reference to the data shown in FIG. 10, when the fiber optic bundles are spaced apart by a few centimeters and oriented parallel, or diverging in relation to each other, they are obtained from heart tissue. It is possible to obtain an optical response that is quite similar to the optical response.

This test demonstrates the efficacy of the device of the present invention in transmitting and receiving reflected near-infrared light from the intracardiac region of the subject and revealing important information about the regional regional oxidative metabolism. . The important information on this endogenous regional oxidative metabolism includes, for example, cytochrome a, a.
3 Changes in the oxidation level of redox centers such as copper, oxygenation of tissue hemonglobin and myoglobin,
It is not limited to this. The tissue hemoglobin volume can be evaluated by adding a myoglobin signal to the hemoglobin, assuming that the myoglobin concentration is constant (that is, remains in the light field in either form of oxidation or reduction). All of these can be continuously observed in vivo by means of the transcutaneous intravascular device and method.

In use, the manipulating tip 12 'of the oxygen metabolism measuring device 10 is brought to the ventricle by the skin-passing method by the guide of the fluorescent scope and comes into contact with the inside of the heart of a human or animal for optical coupling. The continuous or pulsed light from the near infrared light source 24 is transmitted through the irradiation optical fiber 14 and distributed into the heart. This light traverses the tissue of interest and is received by the receiving optical fiber 18 and is sent back through the extension tube 12 to the photodetector 26 for analysis. In order to properly analyze the data sent by the reflected light, for example, a computer (not shown) with an appropriate program is electrically connected to the photodetector 26.

The oxygen metabolism measuring apparatus 10 utilizing the above-mentioned divergent reflection shape enables important parameters of cardiac oxidative metabolism to be transmitted and received through near infrared light through one fiber optical scope (catheter). . That is, the present invention has a substantial advantage over the prior art in that it does not require a second catheter to perform reflectance measurements. The advantages include:

1. There is only one site through the skin (vascular access) to advance the scope into the intravascular space and advance to the intracardiac site of interest.

2. Since the light source and the light receiver are delivered directly to a point in the subject's heart, there is no external surface structure (eg skin, bone, skeletal muscle, etc.) through which near infrared light must pass.

3. Since the light source and the light receiver are delivered directly to a point in the heart of the subject, the device of the present invention can provide metabolic information from disease and normal sites, thus distinguishing such areas in the living body. There are advantages. The potential to discriminate between regional viability and metabolic effects of effective blood flow within the abruptly contracting heart segment influences clinical decisions needed for treatments such as thrombolysis, balloon angioplasty, and coronary artery bypass tie. give.

4. The oxygen metabolism measurement device of the present invention can be used in a standard clinical cardiac catheterization chamber and can be used as part of a routine diagnostic catheterization study in the human body.

5. The oxygen metabolism measurement method of the present invention is substantially less expensive than non-optical methods for assessing regional cardiac metabolism in humans, such as PET (positron emission tomography) or NMR (nuclear magnetic resonance) spectroscopy. .

FIG. 11 is a block diagram showing the arrangement of the oxygen metabolism measuring apparatus according to the second embodiment.

The oxygen metabolism measuring apparatus 10 of the first embodiment sends, for example, four different near infrared light from the near infrared light source 24. However, as shown in FIG. In the oxygen metabolism measuring apparatus 10 'of the second embodiment, different near infrared light is transmitted on a time division basis to the irradiation optical fiber 14' in the extension tube 12. As a result, the number of the irradiation optical fibers 14 'can be greatly reduced as compared with the oxygen metabolism measuring device 10 of the first embodiment, as can be seen with reference to FIG.

Here, the irradiation optical fiber 14 'is 2
It is connected to two optical coupling connectors 16 '. One optical coupling connector 16 'is optically coupled to the NIR light source 24a' and transmits pulsed light of different wavelengths on a time division basis, and the other optical coupling connector 16 'is a reference reflection photodetector 24.
b'is connected and optically coupled. Further, the extension tube 12 of the oxygen metabolism measuring device 10 ′ includes a light receiving optical fiber 18 therein, and a proximal end portion of the light receiving optical fiber 18 is a light optically coupled to the photodetector 26. It is connected to the coupling connector 20. The control device 22 is used to operate the control tip 22 ', similar to the oxygen metabolism measuring device 10 shown in FIG.

Here, similarly to the first embodiment, for example, most preferably, the outer diameter of the extension tube 12 of the oxygen metabolism measuring device 10 'extending from the control device to the control tip is the oxygen metabolism measurement of the present invention. It does not exceed 3.3 mm (10 French) so that the device 10 'can be used in the feces in the transcutaneous vessels. In addition, the length of the extension tube 12 in the section from the control device to the control tip is at least 15 so that it can be approached to the ventricle by the intravascular approach method of the major artery or vein.
The length of the extension tube 12 from each optical coupling connector to the control device 22 is at least 2 meters in order to operate the control device under sterile conditions.

As in the first embodiment, a suitable lens (not shown) is used for the light-transmitting and light-receiving portions of the conical end of the extension tube to adjust the cone angle to adjust the volume of the sample tissue. It may be optimized, and the optical metabolism information can be obtained from different tissue depths by changing the optical path of photons by adjusting the cone angle or the lens shape. Similarly, time domain multiplexing may be utilized to selectively accept photons that have traversed different tissue depths.

Further, also in the oxygen metabolism measuring apparatus of the second embodiment, the above-mentioned second embodiment of the extension tube tip and the first to fourth modified examples of the extension tube tip having a predetermined optical axis angle. Needless to say, can be used.

Other configurations, operations, and effects are the same as those in the first embodiment.

As described above, the intravascular measurement of the metabolism of the myocardium has been described in detail here. However, the oxygen metabolism measuring apparatus of the present invention can be used for other measurements, and only for the intravascular measurement of the metabolism of the myocardium. It is not limited. For example, the oxygen metabolism measuring device of the present invention is advanced to the esophagus and its conical tip is directed to the heart muscle adjacent to the esophageal wall. The oxygen metabolism measuring device can be advanced through a physiological conduit within a human body large enough to accommodate a tube or scope of the above dimensions. To something like this
Includes blood vessels, ureters, bile trees, gastrointestinal tracts, etc., to similarly measure oxidative metabolism and blood volume in target organs and tissues such as heart, brain, liver, kidney, and skeletal muscle. be able to.

Furthermore, although the oxygen metabolism measuring apparatus of the present invention has been described as using near infrared light to obtain metabolic information, the present invention is not limited to this, and the present invention is not limited to visible or near ultraviolet wavelengths. Light can also be used and their use is within the scope of the invention. Further, the oxygen metabolism measuring apparatus of the present invention describes the use of an optical fiber composed of a large number of fibers for the function of transmitting and receiving, but an optical fiber composed of a single fiber can be used.

Furthermore, the embodiment of the present invention is as follows.

1. Inserting a tube comprising at least one illuminating and receiving optical fiber of a plurality of optical fibers through at least a portion of the length of the body conduit to contact the target organ or tissue;
A step of directing light to the at least one illuminating optical fiber and sending the light to the target organ or tissue through the fiber in a direction diverging from the at least one receiving optical fiber; and the at least one receiving light A procedure for receiving reflected light that has traversed a portion of a target organ or tissue that is a fiber and returning the reflected light to the other near end through this fiber; and analyzing the reflected light for the target organ or tissue. Measurement of oxidative metabolism and
Alternatively, a procedure for obtaining relevant data, comprising measuring oxygen uptake and utilization in internal organs such as the heart, brain, liver, kidneys or selected tissues of the body.

2. The light of the near infrared (N
IR) What is light.

3. The method according to item 1, wherein the light is visible light.

4. The method according to item 1, wherein the light is near-ultraviolet light.

5. The method of item 1, wherein the tube is inserted into a point in the heart that is inside the heart through the route of entering the skin into the blood vessel.

6. In the size of item 5, the measurement of the above-mentioned oxidative metabolism and / or the related data, cytochrome a, a
3 Includes changes in copper oxidation level, oxygenation of tissue hemoglobin and myoglobin, and tissue blood volume.

7. The method of paragraph 1, wherein the tube comprises the at least one illuminating optical fiber and the at least one
An opaque barrier between two receiving optical fibers.

8. The method of item 1, wherein the at least one illuminating optical fiber comprises a plurality of optical fibers operatively associated with a plurality of connectors, the connector operating with a plurality of different wavelength light sources and a reference reflected light signal detector. Related to.

9. The method of item 1, wherein the at least one illuminating optical fiber comprises a plurality of optical fibers operatively associated with two connectors, wherein one connector provides a plurality of different wavelengths on a time division basis through the optical fibers. Operationally associated with the light source used to sequentially send the optical signal, and another with the reference reflected optical signal detector.

10. The method of items 8 and 9, wherein the connector is operably connected to a near infrared (NIR) multiwavelength spectrometer.

11. At least one of the above according to the method of item 1.
One receiving optical fiber consisting of multiple optical fibers operatively associated with a connector.

12. Item 11, wherein the connector is operably connected to the photodetector.

13. The method of paragraph 1, wherein the distal end of the tube is oriented in a diverging relationship with the at least one receiving optical fiber but forms a substantially conical shape at the end.

14. The method of item 3, wherein the distal end of the tube is used to selectively bend through an arc extending from the longitudinal axis of the tube.

15. The method of item 1, wherein the reflected light is analyzed by a computer programmed appropriately.

16. A tube comprising at least one illuminating and receiving optical fiber, comprising a plurality of optical fibers, the remote ends of which are divergently placed in relation to each other, at least over the length of the body conduit. A procedure of inserting through a portion and contacting with a target organ or tissue, and directing near-infrared (NIR) light to the irradiation optical fiber through the fiber to the target organ or tissue from the light receiving optical fiber. A diverging direction, and means for receiving reflected near infrared (NIR) light that has traversed a portion of the organ or tissue of interest in the receiving optical fiber and directing the reflected light through the fiber, and , A procedure for analyzing the reflected light to measure oxidative metabolism and / or obtaining related data for a target organ or tissue, comprising a heart, a brain and a liver. The method of measuring the oxidation metabolism in the body organs or selected body tissue, such as kidney.

17. The method of item 16, wherein the tube is inserted through the skin and into the blood vessel at a point within the heart that is within the heart.

18. Item 17. The method according to item 17, wherein the above-mentioned measurement of oxidative metabolism and / or related data include changes in the oxidation level of cytochrome a, a3 copper, oxygenation of tissue hemonglobin and myoglobin, and blood volume of tissue.

19. The method of item 16, wherein the tube comprises a light barrier between the illuminating optical fiber and the receiving optical fiber.

20. In the method of item 16, the illuminating optical fiber is operatively associated with a plurality of connectors, and the connector is operatively associated with a plurality of different near infrared (NIR) sources and reference reflected light signal detectors. What you have.

21. In the method of item 16, the illuminating optical fiber is operatively associated with two connectors, one connector sequentially transmitting a plurality of different near infrared (NIR) optical signals through the optical fiber on a time division basis. Operationally related to the near-infrared light source used for the other, and another operationally related to the reference reflected light signal detector.

22. The method of items 20 and 21, wherein the connector is operably connected to a near infrared NIR) multiple wavelength light source and a reference reflected light signal detector.

23. A method according to item 16, wherein the light receiving optical fiber is operably connected to a connector.

24. The method of item 23, wherein the connector is operably connected to a photodetector.

25. The method of item 16, wherein the end of the tube is oriented so that it is divergent with the illuminating optical fiber and the fiber, but forms a cone at the end.

26. The method of item 25, wherein the distal end of the tube is used to selectively bend through an arc extending from the longitudinal axis of the tube.

27. Item 16. The method of item 16, wherein the reflected near infrared (NIR) light is analyzed by a suitably programmed computer.

28. Means for selectively manipulating at least these distal ends of the extension tube having manipulator means operatively associated therewith at the proximal and distal ends; and at least one illuminating optical fiber and at least one receiving optical fiber An optical fiber, placed in the tube, such that the far end of these light paths is such that the light path of the light sent by the illuminating optical fiber is diverged from the part of the light path received by the receiving optical fiber. And the connector means are operatively connected to the respective near ends of the irradiation optical fiber and the light receiving optical fiber, and the irradiation optical fiber is operably connected to the light source to be different. Means for producing light emission of a wavelength, connecting the light receiving optical fiber to a detector and sensing the light sent along the light receiving optical fiber, heart, brain, liver Apparatus for measuring a single catheter placed oxidation metabolism within the body organ or selected body tissue, such as kidney in contact with the body organs or selected body tissue.

29. Item 28. The apparatus of item 28, wherein the distal end of the tube is oriented in a diverging relationship with the at least one illuminating optical fiber and the at least one receiving optical fiber to create a substantially conical shape at the end. .

30. Item 28. The instrument of item 28, wherein the distal end of the tube is used such that the emission is selectively directed from the receiving optical fiber of the tube by lens means secured thereto.

31. Item 28. The instrument of item 28, wherein the extension tube comprises a flexible shaft having a protective plastic sheath around it.

32. Item 31. The flexible shaft whose outer diameter is not larger than 3.3 mm.

33. Item 28. The instrument of item 28, wherein the manipulator means is located substantially midway along the length of the extension tube.

34. Item 33. An instrument according to item 33, wherein the manipulator means selectively bends the distal end of the tube until about 120 degrees away from its longitudinal axis.

35. Item 33. The device of item 33, wherein the length of the tube between the manipulator means and the proximal end of the tube and the length between the manipulator means and the distal end is about 1 to 2 m.

36. Item 28. The apparatus of item 28, wherein said at least one illuminating optical fiber comprises a plurality of optical fibers optically connected to said light source.

37. Item 36. An apparatus according to item 36, wherein the light emission of different wavelengths from the light source is either simultaneous or continuous light emission.

38. Item 28. The apparatus of item 28, wherein said at least one receiving optical fiber comprises a plurality of optical fibers optically connected to said detector means.

39. Item 28. An apparatus according to item 28, wherein the light source emits near infrared (NIR) light.

40. Item 28. The instrument of item 28, wherein the light source comprises a near infrared (NIR) multiwavelength spectrometer.

41. Item 28. An apparatus according to item 28, wherein the light source emits visible light.

42. Item 28. An apparatus according to item 28, wherein the light source emits near-ultraviolet light.

43. Item 28. The instrument of item 28, wherein said detector means comprises a photodetector.

[0097]

As described above, according to the present invention, the oxygen metabolism measuring apparatus of the present invention uses a single scope including optical fibers for both transmission and reception to obtain optical information from a site in the heart. , The brain, liver, kidney, etc. can effectively measure the oxygen uptake and utilization of tissues in internal body organs or selected body tissues.

[Brief description of drawings]

FIG. 1 is a configuration diagram showing a configuration of an oxygen metabolism measuring device according to a first embodiment.

FIG. 2 is a configuration diagram showing a configuration of a distal end portion of the extension tube according to the first embodiment.

FIG. 3 is a configuration diagram showing a configuration of a modification of a distal end portion of the extension tube according to the first embodiment.

FIG. 4 is a configuration diagram showing a configuration of a first modified example having a predetermined optical axis angle at the distal end portion of the extension tube according to the first example.

FIG. 5 is a configuration diagram showing a configuration of a second modified example having a predetermined optical axis angle at the distal end portion of the extension tube according to the first example.

FIG. 6 is a configuration diagram showing a configuration of a third modified example having a predetermined optical axis angle at the distal end portion of the extension tube according to the first example.

FIG. 7 is a configuration diagram showing a configuration of a fourth modified example having a predetermined optical axis angle at the distal end portion of the extension tube according to the first example.

FIG. 8 is an explanatory diagram illustrating the LG ratio of the irradiation optical fiber and the light reception optical fiber according to the first example.

FIG. 9 is an explanatory diagram illustrating an operation of the oxygen metabolism measuring device according to the first embodiment.

FIG. 10 is an explanatory diagram illustrating a result of the operation of FIG. 9 according to the first embodiment.

FIG. 11 is a configuration diagram showing a configuration of an oxygen metabolism measuring device according to a second embodiment.

[Explanation of symbols]

 10 ... Oxygen metabolism measuring device 12 ... Extension tube 14 ... Irradiation optical fiber 16 ... Optical coupling connector 18 ... Receiving optical fiber 20 ... Optical coupling connector 24a ... Near infrared (NIR) light source 24b ... Reference reflection detector 26 ... Optical Detector

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Claude Apiantadosi United States 27710 Durhan Kildramy Drive, North Carolina 3808 (72) Inventor Benjamin Jay Comfort United States 27712 Durhan Rivermont Drive, North Carolina 4720

Claims (1)

[Claims] 1. A flexible insertion part, an emission means having an emission end face for emitting light forward from the tip of the insertion part, and an observation by the light emitted from the emission means. A light-receiving end surface for receiving optical information of the body, the light-receiving means being provided on the distal end surface of the insertion portion; Oxygen metabolism measuring device.