WO2000071025A1 - Method and device for measuring the degree of organization of water in human and animal bodies - Google Patents

Method and device for measuring the degree of organization of water in human and animal bodies Download PDF

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Publication number
WO2000071025A1
WO2000071025A1 PCT/EP2000/004643 EP0004643W WO0071025A1 WO 2000071025 A1 WO2000071025 A1 WO 2000071025A1 EP 0004643 W EP0004643 W EP 0004643W WO 0071025 A1 WO0071025 A1 WO 0071025A1
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water
organization
skin
degree
spectral
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PCT/EP2000/004643
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German (de)
French (fr)
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Holger Freitag
Thomas Huth-Fehre
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Infralytic Gmbh
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Priority to EP00935095A priority Critical patent/EP1182968A1/en
Priority to AU50702/00A priority patent/AU5070200A/en
Publication of WO2000071025A1 publication Critical patent/WO2000071025A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence

Definitions

  • the invention relates to a method and a device for measuring the degree of organization of water in human and animal bodies.
  • the degree of organization of water molecules which is defined as the average number of hydrogen bonds in the water molecule, can be determined with the aid of vibration spectroscopy.
  • the degree of organization of the molecules can thus be determined directly from the red shift of the corresponding absorption bands. Suitable bands of the stretching vibration can be found at 2.8 ⁇ m, 1.9 ⁇ m, 1.4 ⁇ m, 1.2 ⁇ m and at 0.95 ⁇ m.
  • the association of water is strongly temperature-dependent, salts disturb it by blocking potential binding sites and suitable surfaces, eg the inner surface of clay or clay minerals, stimulate it.
  • the method of acupuncture which has been known and developed in East Asia for thousands of years, is based on a whole-body regulatory activity based on a balance of the different CHI flows, which are translated as "energy flows".
  • the "CHI” flows in channels, the meridians, along which the classic acupuncture points are arranged.
  • the CHI flow can be normalized by piercing it with a thin metal needle, applying pressure, heat or laser radiation.
  • the "high art” consists of knowing which route needs more CHI and which less. About this slide
  • the subcutaneous connective tissue approaches the classic acupuncture points particularly close to the skin surface. Since the basic system from Pischinger has reacted uniformly to all influences and stimuli, the normal state of a tissue region is a scalar variable, which up to now has been measured, among other things, by the electrical conductivity, the electromotive potential and the amount of the synthesized sugar polymers. The usefulness of acupuncture could be increased if the activity of the interconnects could be reliably recorded with a technical device.
  • Manfred Doepp describes a system that is supposed to fulfill this task by measuring resistance at the source or end points of the meridians in the publication Acta medica empirica 11/98, pp. 821-830, "Diagnostics with a new bio-physical measurement method" reported. Since over 90% of the skin's resistance is determined by the outermost dead corneal layer, the resistance measurement method is very susceptible to faults, especially against fluctuations in the moisture, salt and fat content of the epidermis.
  • the invention has for its object to provide an optical method and a device with which reactions of the human and animal body can be detected.
  • a method and a device for measuring the degree of organization of water in human and animal bodies ie also in mammalian bodies, in which the skin is proposed is irradiated with wavelengths between 900 and 1100 nm by a radiation source and the radiation scattered back into the underlying tissue is detected by a receiver arrangement and the spectral reflectance is measured and an evaluation device determines the spectral position of the water absorption of the 3rd harmonic of the stretching vibration, which is a measure of the degree of organization of the water.
  • the absorption from the water of the connective tissue is superimposed by the disturbance factors of the scatter on the epidermis and the absorption by structural proteins, fat stores and blood vessels.
  • the scattering m or on the epidermis is avoided in that the radiation source preferably radiates obliquely onto the skin and in that the receiver is directed at a point on the skin which is adjacent to the point of irradiation.
  • the disturbance factors with regard to the structural proteins, fat stores and blood vessels are lowest at the acupuncture points, since there the subcutaneous connective tissue comes particularly close to the skin surface. Measurements can thus be taken at an acupuncture point and at an adjacent point. At the adjacent point, the disturbances are present in a purer form and to suppress or compensate for the disturbances at the acupuncture point, a comparison is made between the spectral reflectances recorded at the two points. taken.
  • interference spectra of the structural proteins, fat stores and / or blood vessels, in particular outside the water absorption band are measured in the wavelength range from 800 to 1100 nm, which extrapolations and / or when determining the spectral position of the water absorption Extrapolation or the same mathematical procedure.
  • Spectra of storage substances are preferably stored in the evaluation device depending on the location of the measurement on the skin and / or the structure of the skin.
  • the device according to the invention allows, for example, the degree of organization of the connective tissue water of a person to be recorded at various acupuncture points of a person and used for later diagnosis of the overall constitution of this person, the correlation between typical combinations of measured values and clinical pictures being able to be evaluated in accordance with the different diagnostic teachings.
  • reflectance spectroscopy in the near infrared
  • chemome- fresh strategies for the non-invasive determination of blood glucose using near infrared reflection spectroscopy. copy "and other research attempts are being made for the purpose of diabetes treatment to determine the glucose content of the blood by irradiating the skin at wavelengths from approx. 800 nm to approx. 1100 nm and measuring the reflection.
  • the specific recording can also be taken into account when calibrating the glucose measurement.
  • the sensitivity of the non-invasive glucose measurement on the degree of organization of the tissue water Due to the temperature dependence, the sensitivity of the non-invasive glucose measurement on the degree of organization of the tissue water. However, as already explained above, this degree of organization depends not only on the temperature, but also on the regular state of the organism. Detecting the degree of organization of the tissue water thus brings with it additional information that plays a role in increasing the accuracy of the glucose measurement. In an advantageous manner, the degree of organization of the water in the tissue, which is a disturbance for the glucose measurement, is measured and taken into account for the glucose calibration.
  • a three-stage measurement can advantageously be carried out, namely the actual glucose measurement as the first stage, the measurement of the degree of organization at the acupuncture point m near the measurement location of the glucose, and m a third step the measurement of the spectral reflectance m near the acupuncture point and taking into account the disturbance factors determined there when evaluating the degree of organization.
  • the device according to the invention can also be used to determine whether an artery has burst in the event of a stroke or an edema has arisen.
  • stroke occurs
  • two basic cases must be distinguished, the blockage of an artery and the bursting of one.
  • the affected brain tissue suffocates and a short time later the dead areas form an edema through the storage of tissue water.
  • the second case blood flows out of tissue. Both, edema like blood, appear in the MRI as only in the normal X-ray image only as water accumulation.
  • the device according to the invention has at least one radiation source which radiates light with a wavelength between 900 and 1100 nm onto the skin.
  • At least one receiver arrangement measures the spectral reflectivity in the form of the reflected radiation and / or radiation scattered in the tissue under the skin. The interference caused by scattering or by reflection on the epidermis is minimized by directing the receiver arrangement at a location that is a few millimeters from the point of irradiation.
  • An evaluation device determines the exact spectral position of the water absorption, specifically the 3rd harmonic of the stretching vibration, the red shift of which is taken as a measure of the degree of organization of the water in the tissue.
  • the spectrum of the reflectivity may have disturbances due to structural proteins, fat stores and / or blood vessels that depend on the location of the measurement, these must be taken into account in the evaluation. This can be done in many different ways. For example, with the same radiation source or with an additional one, the spectra of the interfering substances at the same measuring location at several wavelengths between 800 and 1100 nm in the form of Sorptions measured outside the water band and these spectra can be extrapolated, extrapolated or determined by other mathematical methods in the evaluation device for the area of the water absorption band. The severity of the current disruption is then taken into account when evaluating the degree of organization.
  • a further possibility is that acupuncture points are preferably used for the measurement, in which the water-carrying connective tissue lies closer to the skin surface, since the disruptive cover tissue layers are thinner at these points than outside these points.
  • This measure can be used in addition to the one mentioned above.
  • a further possibility for taking disturbances into account is that, in addition to the acupuncture points, one or more measurements are carried out in an adjacent environment in relation to the spectral reflectance.
  • the evaluation device can then filter out the interference or suppress it in another way by spectrally comparing the spectral reflectance at the acupuncture points and the spectral reflectance in the directly adjacent tissue.
  • a corresponding procedure, as described above, is used to measure the degree of organization of the water in the tissue in order to calibrate the device for measuring the blood glucose content, but the degree of organization is carried out adjacent to the measuring point of the glucose content, preferably at adjacent acupuncture points.
  • the radiation source and the receiver arrangement are preferably arranged so that the radiation is more oblique and that the E radiation and detection points are further apart, for example 2 to 5 cm, possibly even more, the depth of penetration being relatively large st and may reach the brain stem.
  • the spectral data obtained on the basis of irradiation with different wavelengths allow the degree of organization of the irradiated water to be recorded. Since a brain breath is created by the strong absorption of water by the connective tissue, the water stored in it is highly organized, whereas the water in the blood is very poorly organized. Threshold values for the degree of organization are stored in the evaluation device, which prescribe a differentiation criterion. The evaluation device compares the organizational degrees determined from the spectra with the threshold value and makes the decision.

Abstract

The invention relates to a method and device for measuring the degree of organization of water in human and animal bodies, whereby the skin is irradiated by a radiation source with wavelengths ranging from 900 to 1100 nm. The radiation backscattered in the underlying tissue is detected by a receiver device and the spectral reflectivity is measured by the same. An evaluation device determines the spectral position of the water absorption of the third harmonic of the extended oscillation which is a measure for the degree of organization of water.

Description

Verfahren und Vorrichtung zur Messung des Method and device for measuring the
Organisationsgrades von Wasser in menschlichen und tierischen KörpernDegree of organization of water in human and animal bodies
Die Erfindung betrifft ein Verfahren und eine Vorrichtung zur Messung des Organisationsgrades von Wasser in menschlichen und tierischen Körpern.The invention relates to a method and a device for measuring the degree of organization of water in human and animal bodies.
Es ist bekannt, daß sich der Organisationsgrad von Wassermolekülen, der als durchschnittliche Anzahl der Wasserstoffbrückenbindungen im Wassermolekül definiert ist, mit Hilfe der Schwingungsspektroskopie ermitteln läßt. Je mehr Wasserstoffbrückenbindungen ein Molekül eingeht (maximal 4), desto stärker werden seine internen Bindungen gestreckt, womit sich ihre Schwingungsenergie vermindert. Aus der Rotverschiebung der entsprechenden Absorptionsbanden läßt sich somit der Organisationsgrad der Moleküle direkt ermitteln. Dafür geeignete Banden der Streckschwingung finden sich bei 2,8 μm, 1,9 μm, 1,4 μm, 1,2 μm und bei 0,95 μm. Die Assoziation des Wassers ist stark temperaturabhängig, Salze stören sie durch Blockade von potentiellen Bindungsstellen und geeignete Oberflächen, z.B. die innere Oberfläche von Ton- oder Lehmmineralen stimulieren sie.It is known that the degree of organization of water molecules, which is defined as the average number of hydrogen bonds in the water molecule, can be determined with the aid of vibration spectroscopy. The more hydrogen bonds a molecule forms (maximum 4), the more its internal bonds are stretched, which reduces their vibrational energy. The degree of organization of the molecules can thus be determined directly from the red shift of the corresponding absorption bands. Suitable bands of the stretching vibration can be found at 2.8 μm, 1.9 μm, 1.4 μm, 1.2 μm and at 0.95 μm. The association of water is strongly temperature-dependent, salts disturb it by blocking potential binding sites and suitable surfaces, eg the inner surface of clay or clay minerals, stimulate it.
In der Veröffentlichung von Alfred Pischinger, "Das System der Grundregulation. Grundlagen einer ganzheitsbiologischen Medizin" Haug Verlag, 9. überarbei- tete Auflage (1998) ist recht detailliert der Aufbau des subkutanen Bindegewebes beschrieben und es wird dort die Existenz eines informationstragenden Regulationssystems, der sogenannten Grundregulation, auch Grundsystem genannt, in diesem Bindegewebe postu- liert. In diesem System, das über die offenen Endigungen der vegetativen Nervenstränge an das Nervensystem und über die Blutbahn an das hormonelle Regelgeschehen geknüpft ist, spielen Zuckerpolymere, die "Glykokalix" eine zentrale Rolle. Im "weichen" Binde- gewebe setzt sich mehr Wasser ab. Dies liegt darin, daß sich um die polaren Stellen der Zuckerpolymere Hydrathüllen bilden, in denen die
Figure imgf000003_0001
hochorganisiert vorliegen.In the publication by Alfred Pischinger, "The System of Basic Regulation. Fundamentals of Holistic Biological Medicine", Haug Verlag, 9th revised edition (1998), the structure of the subcutaneous connective tissue is described in great detail and the existence of an information-carrying regulatory system is described there so-called basic regulation, also called basic system, postulated in this connective tissue. In this system, which is linked to the nervous system via the open endings of the vegetative nerve strands and via the bloodstream to the normal hormonal processes, sugar polymers, the "glycocalyx", play a central role. More water settles in the "soft" connective tissue. This is because hydration shells form around the polar sites of the sugar polymers, in which the
Figure imgf000003_0001
are highly organized.
Die in Ostasien seit Jahrtausenden bekannte und entwickelte Methode der Akupunktur geht von einer gesamtkörperlichen Regeltätigkeit aus, die auf einem Gleichgewicht der verschiedenen CHI-Flüsse, die mit "Energieflüsse" übersetzt werden, basiert. Das "CHI" fließt in Leitbahnen, den Meridianen, an denen entlang die klassischen Akupunkturpunkte angeordnet sind. Durch deren Anstechen mit dünnen Metallnadel, durch Druck auf sie, Hitze oder Laserbestrahlung läßt sich der CHI-Fluß normalisieren. Die "hohe Kunst" be- steht allerdings daraus, zu wissen, welche Leitbahn mehr CHI und welche weniger benötigt. Zu dieser Dia- gnostik verwenden die Chinesen die Anamnese, das Aussehen der Augen und der Zunge und die Härte des Pulsschlages. All diese Methoden setzen große Sensibilität und Erfahrung des diagnostizierenden Arztes voraus.The method of acupuncture, which has been known and developed in East Asia for thousands of years, is based on a whole-body regulatory activity based on a balance of the different CHI flows, which are translated as "energy flows". The "CHI" flows in channels, the meridians, along which the classic acupuncture points are arranged. The CHI flow can be normalized by piercing it with a thin metal needle, applying pressure, heat or laser radiation. The "high art", however, consists of knowing which route needs more CHI and which less. About this slide The Chinese use gnostic history, the appearance of the eyes and tongue and the hardness of the pulse. All of these methods require great sensitivity and experience of the diagnosing doctor.
Nach Untersuchungen des Anatomieprofessors Heine, Hartmut Heine, "Lehrbuch der biologischen Medizin", Hippokratesverlag, 1991, tritt das subkutane Bindege- webe an den klassischen Akupunkturpunkten besonders nah an die Hautoberfläche heran. Da das Grundsystem von Pischinger auf alle Einflüsse und Reize gleichförmig reagiert ist, der Regelzustand einer Gewebsre- gion ist eine skalare Größe, die unter anderem bisher an der elektrischen Leitfähigkeit, dem elektromotorischen Potential und der Menge der synthetisierten Zuckerpolymere gemessen wird. Die Nützlichkeit der Akupunktur ließe sich steigern, wenn die Aktivität der Leitbahnen zuverlässig mit einem technischen Ge- rät erfaßt werden könnte. Über ein System, das diese Aufgabe durch Widerstandsmessungen an den Quell- oder Endpunkten der Meridiane erfüllen soll, wird von Manfred Doepp in der Druckschrift Acta medica empirica 11/98, S. 821 - 830, "Diagnostik mit einem neuen bio- physikalischen Meßverfahren" berichtet. Da über 90% des Hautwiderstandes durch die äußersten toten Hornhautschicht bestimmt werden, ist die Widerstandsmeßmethode sehr störanfällig, insbesondere gegen Schwankungen des Feuchte-, Salz- und Fettgehalts der Ober- haut.According to studies by the anatomy professor Heine, Hartmut Heine, "Textbook of biological medicine", Hippokratesverlag, 1991, the subcutaneous connective tissue approaches the classic acupuncture points particularly close to the skin surface. Since the basic system from Pischinger has reacted uniformly to all influences and stimuli, the normal state of a tissue region is a scalar variable, which up to now has been measured, among other things, by the electrical conductivity, the electromotive potential and the amount of the synthesized sugar polymers. The usefulness of acupuncture could be increased if the activity of the interconnects could be reliably recorded with a technical device. Manfred Doepp describes a system that is supposed to fulfill this task by measuring resistance at the source or end points of the meridians in the publication Acta medica empirica 11/98, pp. 821-830, "Diagnostics with a new bio-physical measurement method" reported. Since over 90% of the skin's resistance is determined by the outermost dead corneal layer, the resistance measurement method is very susceptible to faults, especially against fluctuations in the moisture, salt and fat content of the epidermis.
Der Erfindung liegt die Aufgabe zugrunde, ein optisches Verfahren und eine Vorrichtung zu schaffen, mit denen Reaktionen des menschlichen und tierischen Kör- pers erfaßt werden können. Zur Losung der Aufgabe wurden die oben erwähnten Erkenntnisse von Pischmger, Heine usw. verwendet und es wird ein Verfahren und eine Vorrichtung zur Messung des Organisationsgrades von Wasser im menschli- chen und tierischen Korper, d.h. auch in Saugetier- korpern vorgeschlagen, bei der die Haut mit Wellenlangen zwischen 900 und 1100 nm durch eine Strahlungsquelle bestrahlt wird und die m dem darunterliegenden Gewebe ruckgestreute Strahlung durch eine Empfangeranordnung erfaßt wird und das spektrale Re- flexionsvermogen gemessen wird und eine Auswerteeinrichtung die spektrale Lage der Wasserabsorption der 3. Harmonischen der Streckschwingung ermittelt, die ein Maß für den Organisationsgrad des Wassers ist.The invention has for its object to provide an optical method and a device with which reactions of the human and animal body can be detected. To solve the problem, the above-mentioned findings from Pischmger, Heine, etc. were used and a method and a device for measuring the degree of organization of water in human and animal bodies, ie also in mammalian bodies, in which the skin is proposed is irradiated with wavelengths between 900 and 1100 nm by a radiation source and the radiation scattered back into the underlying tissue is detected by a receiver arrangement and the spectral reflectance is measured and an evaluation device determines the spectral position of the water absorption of the 3rd harmonic of the stretching vibration, which is a measure of the degree of organization of the water.
Die vom Wasser des Bindegewebes stammenden Absorptionen werden durch die Storfaktoren der Streuung an der Oberhaut und der Absorptionen durch Strukturproteine, Fettspeicher und Blutgefäße überlagert. Die Streuung m bzw. an der Oberhaut wird dadurch vermieden, daß die Strahlungsquelle vorzugsweise schräg auf die Haut strahlt und daß der Empfanger auf eine Stelle der Haut gerichtet ist, d e benachbart zu der Einstrahlstelle liegt.The absorption from the water of the connective tissue is superimposed by the disturbance factors of the scatter on the epidermis and the absorption by structural proteins, fat stores and blood vessels. The scattering m or on the epidermis is avoided in that the radiation source preferably radiates obliquely onto the skin and in that the receiver is directed at a point on the skin which is adjacent to the point of irradiation.
Die Storfaktoren hinsichtlich der Strukturproteine, Fettspeicher und Blutgefäße sind an den Akupunkturpunkten am geringsten, da dort das subkutane Bindegewebe besonders nah an die Hautoberflache herantritt. Es können somit Messungen an einem Akupunkturpunkt und an einer daneben liegenden Stelle vorgenommen werden. An der daneben liegenden Stelle sind die Störungen in reinerer Form vorhanden und zur Unterdruk- kung bzw. Kompensation der Störungen am Akupunktur- punkt wird ein Vergleich zwischen den erfaßten spektralen Reflexionsvermogen an den beiden Stellen vor- genommen .The disturbance factors with regard to the structural proteins, fat stores and blood vessels are lowest at the acupuncture points, since there the subcutaneous connective tissue comes particularly close to the skin surface. Measurements can thus be taken at an acupuncture point and at an adjacent point. At the adjacent point, the disturbances are present in a purer form and to suppress or compensate for the disturbances at the acupuncture point, a comparison is made between the spectral reflectances recorded at the two points. taken.
E ne andere bzw. zusätzliche Möglichkeit liegt darin, daß in dem Wellenlangenbereich von 800 bis 1100 nm Storspektren der Strukturproteine, Fettspeicher und/oder Blutgefäße, insbesondere außerhalb der Wasserabsorptionsbande gemessen werden, die bei der Ermittlung der spektralen Lage der Wasserabsorption durch Hochrechnungen und/oder Extrapolation oder der- gleichen mathematische Verfahren berucksichtigr werden. Vorzugsweise sind m der Auswerteeinrichtung Spektren von Storstoffen abhangig vom Ort der Messung auf der Haut und/oder dem Aufbau der Haut gespeichert.Another or additional possibility lies in the fact that interference spectra of the structural proteins, fat stores and / or blood vessels, in particular outside the water absorption band, are measured in the wavelength range from 800 to 1100 nm, which extrapolations and / or when determining the spectral position of the water absorption Extrapolation or the same mathematical procedure. Spectra of storage substances are preferably stored in the evaluation device depending on the location of the measurement on the skin and / or the structure of the skin.
Durch die erfmdungsgemaße Vorrichtung kann beispielsweise an verschiedenen Akupunkturpunkten einer Person der Organisationsgrad des Bindegewebswassers einer Person erfaßt und zur spateren Diagnose der Ge- samtverfassung dieser Person benutzt, wobei die Korrelation zwischen typischen Meßwertkombinationen und Krankheitsbildern entsprechend den unterschiedlichen diagnostischen Lehren ausgewertet werden können.The device according to the invention allows, for example, the degree of organization of the connective tissue water of a person to be recorded at various acupuncture points of a person and used for later diagnosis of the overall constitution of this person, the correlation between typical combinations of measured values and clinical pictures being able to be evaluated in accordance with the different diagnostic teachings.
Eine weitere Möglichkeit, das erfmdungsgemaße Verfahren und die erfindungsgemaße Vorrichtung anzuwenden, liegt in der Glucosemessung, d.h. sie kann bei einer Vorrichtung zur Messung des Blutglucosegehaltes eingebaut werden. Es gibt Ansätze in der Blutglucose- gehaltmessung, die Reflexionsspektroskopie im Nahinfrarot anzuwenden und auf nichtmvasive Weise die notwendigen medizinischen Parameter zu bekommen. In der Dissertation an der Universität Jena von Christoph Fischbacher, 1996 "Untersuchungen und chemome- frische Strategien zur nichtmvasiven Bestimmung der Blutglucose mittels Nahinfrarot-Reflexionsspektros- kopie" und anderen Forschungen wird versucht, zum Zwecke der Diabetesbehandlung den Glucosegehalt des Blutes durch Bestrahlen der Haut bei Wellenlängen von ca. 800 nm bis zu ca. 1100 nm und Messen der Reflexi- on zu ermitteln. Die bisherigen Kalibrationsverfahren schaffen es nicht, die medizinisch notwendige Schwelle von ± 10 mg/dl Ungenauigkeit zu unterschreiten. Für Kompensationen wurde bereits versucht, das Verhältnis zwischen Kapillarblut und Gewebsflüssigkeit getrennt zu ermitteln, da der Glucosegehalt im Gewebe noch verbrauchsabhängig ist und sich somit von dem des Blutes unterscheidet. Des Weiteren wird die Temperatur des gemessenen Gewebes getrennt erfaßt, da durch sie der Kristallisationsgrad des Wassers stark beeinflußt wird. Diese Störung durch die unterschiedlichen Temperaturen ist stark, da die Glucose primär über das Spektrum der in ihr enthaltenen O-H Bindungen erfaßt wird. Diese Absorptionen bilden eine kleine Schulter auf der Flanke der sehr starken Absorpti- on der im Wasser enthaltenen O-H Bindungen und zwar auf der Seite zu längeren Wellenlängen hin, also genau dort, wohin sich der Wasserpeak verrchiebt, wenn der Organisationsgrad steigt. Selbst diese Temperaturkompensation hat bisher anscheinend nicht ausge- reicht, um die auftretenden Artefakte wegkalibrieren zu können, was allerdings auch besonders schwierig ist, da die temperaturabhängige Verschiebungsfunktion der Wasserresonanz gerade bei der Körpertemperatur der Säugetiere einen Sprung aufweist.A further possibility of using the method according to the invention and the device according to the invention lies in the glucose measurement, ie it can be installed in a device for measuring the blood glucose content. There are approaches in blood glucose content measurement, to use reflectance spectroscopy in the near infrared and to obtain the necessary medical parameters in a non-vasive manner. In the dissertation at the University of Jena by Christoph Fischbacher, 1996 "Investigations and chemome- fresh strategies for the non-invasive determination of blood glucose using near infrared reflection spectroscopy. copy "and other research attempts are being made for the purpose of diabetes treatment to determine the glucose content of the blood by irradiating the skin at wavelengths from approx. 800 nm to approx. 1100 nm and measuring the reflection. The previous calibration methods do not succeed medically necessary threshold of ± 10 mg / dl inaccuracy. To compensate, attempts have already been made to determine the relationship between capillary blood and tissue fluid separately, since the glucose content in the tissue is still consumption-dependent and thus differs from that of the blood The temperature of the measured tissue is measured separately, since it strongly influences the degree of crystallization of the water, and this disruption due to the different temperatures is severe, since the glucose is primarily determined via the spectrum of the OH bonds contained in it the flank of the very strong absorpti - on the OH bonds contained in the water and on the side towards longer wavelengths, i.e. exactly where the water peak moves when the level of organization increases. Even this temperature compensation has apparently not been sufficient so far to be able to calibrate away the artefacts that occur, but this is also particularly difficult since the temperature-dependent displacement function of the water resonance has a jump, particularly in the body temperature of the mammals.
Durch die Erkenntnis der Erfinder, den Organisationsgrad des Wassers im Gewebe gezielt zu erfassen, kann die gezielte Erfassung auch bei der Kalibration der Glucosemessung berücksichtigt werden.Based on the inventors' finding that the degree of organization of the water in the tissue can be specifically recorded, the specific recording can also be taken into account when calibrating the glucose measurement.
Durch die Temperaturabhängigkeit ist die Empfindlich- keit der nichtinvasiven Glucosemessung auf den Organisationsgrad des Gewebswassers bewiesen. Dieser Organisationsgrad hangt aber, wie oben schon ausgeführt wurde, nicht nur von der Temperatur ab, sondern auch vom Regelzustand des Organismus. Eine Erfassung des Organisationsgrades des Gewebswassers bringt somit eine zusätzliche Information mit sich, die für die Steigerung der Genauigkeit der Glucosemessung eine Rolle spielt. In vorteilhafter Weise wird somit er- fmdungsgemaß m der Nahe des Meßortes der Glucose der Organisationsgrad des Wassers im Gewebe, das eine Störung für die Glucosemessung darstellt, gemessen und für die Glucosekalibration berücksichtigt. Dabei kann m vorteilhafter Weise ein dreistufiges Messen vorgenommen werden, nämlich als erste Stufe die eigentliche Glucosemessung, als zweite Stufe die Messung des Organisationsgrades an Akupunkturpunkt m der Nahe des Meßortes der Glucose und m einem dritten Schritt die Messung des spektralen Reflexionsver- mogens m der Nahe des Akupunkturpunktes und Ber cksichtigung der dort bestimmten Storfaktoren bei der Auswertung des Organisationsgrades.Due to the temperature dependence, the sensitivity of the non-invasive glucose measurement on the degree of organization of the tissue water. However, as already explained above, this degree of organization depends not only on the temperature, but also on the regular state of the organism. Detecting the degree of organization of the tissue water thus brings with it additional information that plays a role in increasing the accuracy of the glucose measurement. In an advantageous manner, the degree of organization of the water in the tissue, which is a disturbance for the glucose measurement, is measured and taken into account for the glucose calibration. In this case, a three-stage measurement can advantageously be carried out, namely the actual glucose measurement as the first stage, the measurement of the degree of organization at the acupuncture point m near the measurement location of the glucose, and m a third step the measurement of the spectral reflectance m near the acupuncture point and taking into account the disturbance factors determined there when evaluating the degree of organization.
Vorteilhafterweise kann die erfmdungsgemaße Vorπch- tung auch zur Feststellung eingesetzt werden, ob bei einem Hirnschlag eine Arterie geplatzt ist oder ein Odem entstanden ist. Bei Auftreten eines Hirnschlags (Schlaganfall) sind zwei grundsätzliche Falle zu unterscheiden, die Verstopfung einer Arterie und das Platzen einer solchen. Im ersten Fall erstickt das betroffene Hirngewebe und schon kurze Zeit spater bildet sich durch Einlagerung von Gewebswasser die abgestorbenen Bereiche ein Odem. Im zweiten Fall findet e n Ausstromen von Blut ms Gewebe statt. Bei- des, Odem wie Blut, erscheint im Kernspmtomogramm wie im normalen Rontgenbild nur als Wasseransammlung. Diese beiden Fälle so früh wie möglich unterscheiden zu können, hat eminente Bedeutung, denn im ersten Fall ist die Verabreichung von durchblutungssteigern- den Medikamenten sehr hilfreich, was aber im Fall ei- ner Blutung katastrophale Folgen hätte. Eine möglichst schon dem Ersthelfer zur Verfügung stehende Vorrichtung mit deren Hilfe sich die beiden Fälle unterscheiden ließen, würde die Behandelbarkeit und die Folgenschwere von Hirnschlägen wesentlich beeinflus- sen.Advantageously, the device according to the invention can also be used to determine whether an artery has burst in the event of a stroke or an edema has arisen. When a stroke occurs (stroke), two basic cases must be distinguished, the blockage of an artery and the bursting of one. In the first case, the affected brain tissue suffocates and a short time later the dead areas form an edema through the storage of tissue water. In the second case, blood flows out of tissue. Both, edema like blood, appear in the MRI as only in the normal X-ray image only as water accumulation. It is extremely important to be able to distinguish between these two cases as early as possible, because in the first case the administration of medication to increase blood flow is very helpful, but in the case of bleeding this would have catastrophic consequences. A device that would be available to the first aider, if possible, with the help of which the two cases could be distinguished, would have a significant influence on the treatability and the seriousness of the consequences of a stroke.
Die erfindungsgemäße Vorrichtung weist mindestens eine Strahlungsquelle auf, die Licht mit einer Wellenlänge zwischen 900 und 1100 nm auf die Haut strahlt. Mindestens eine Empfängeranordnung mißt das spektrale Reflexionsvermögen in Form des reflektierten und/oder in dem Gewebe unter der Haut gestreuten Strahlung. Die Störung durch Streuung bzw. durch Reflexion an der Oberhaut wird minimiert, indem die Empfän- geranordnung auf eine Stelle gerichtet ist, die einige Millimeter neben der Einstrahlstelle liegt. Eine Auswerteeinrichtung ermittelt die genaue spektrale Lage der Wasserabsorption und zwar der 3. Harmonischen der Streckschwingung, wobei deren Rotverschie- bung als Maß des Organisationsgrades des Wassers im Gewebe genommen wird.The device according to the invention has at least one radiation source which radiates light with a wavelength between 900 and 1100 nm onto the skin. At least one receiver arrangement measures the spectral reflectivity in the form of the reflected radiation and / or radiation scattered in the tissue under the skin. The interference caused by scattering or by reflection on the epidermis is minimized by directing the receiver arrangement at a location that is a few millimeters from the point of irradiation. An evaluation device determines the exact spectral position of the water absorption, specifically the 3rd harmonic of the stretching vibration, the red shift of which is taken as a measure of the degree of organization of the water in the tissue.
Da das Spektrum des Reflexionsvermögens Störungen durch Strukturproteine, Fettspeicher und/oder Blutge- fäße aufweisen kann, die abhängig vom Ort der Messung sind, müssen diese bei der Auswertung berücksichtigt werden. Dies kann auf unterschiedlichste Weise geschehen. Beispielsweise können mit derselben Strahlungsquelle oder auch mit einer zusätzlichen die Spektren der Störstoffe am selben Meßort bei mehreren Wellenlängen zwischen 800 und 1100 nm in Form von Ab- Sorptionen außerhalb der Wasserbande gemessen und in der Auswerteeinrichtung können diese Spektren für den Bereich der Wasserabsorptionsbande hochgerechnet, extrapoliert oder durch sonstige mathematische Verfah- ren bestimmt werden. Die Starke der aktuellen Störung w rd dann bei der Auswertung des Organisationsgrades berücksichtigt .Since the spectrum of the reflectivity may have disturbances due to structural proteins, fat stores and / or blood vessels that depend on the location of the measurement, these must be taken into account in the evaluation. This can be done in many different ways. For example, with the same radiation source or with an additional one, the spectra of the interfering substances at the same measuring location at several wavelengths between 800 and 1100 nm in the form of Sorptions measured outside the water band and these spectra can be extrapolated, extrapolated or determined by other mathematical methods in the evaluation device for the area of the water absorption band. The severity of the current disruption is then taken into account when evaluating the degree of organization.
Eine weitere Möglichkeit ist, daß für die Messung be- vorzugt Akupunkturpunkte benutzt werden, bei denen das wassertragende Bindegewebe naher an der Hautoberflache liegt, da an diesen Punkten die störenden Deckgewebeschichten dunner sind als außerhalb dieser Punkte. Diese Maßnahme kann zusatzlich zu der zuvor erwähnten verwendet werden.A further possibility is that acupuncture points are preferably used for the measurement, in which the water-carrying connective tissue lies closer to the skin surface, since the disruptive cover tissue layers are thinner at these points than outside these points. This measure can be used in addition to the one mentioned above.
Eine weitere Möglichkeit zur Berücksichtigung von Störungen besteht darin, daß zusatzlich zu den Akupunkturpunkten eine oder mehrere Messungen in dazu benachbarter Umgebung in Bezug auf das spektrale Re- flexionsvermogen durchgeführt werden. Die Auswertevorrichtung kann dann durch einen spektralen Vergleich des spektralen Reflexionsvermogens an den Akupunkturpunkten und des spektralen Reflexionsvermogens m dem direkt benachbarten Gewebe die Störungen her- ausfiltern oder auf anderem Wege unterdrucken.A further possibility for taking disturbances into account is that, in addition to the acupuncture points, one or more measurements are carried out in an adjacent environment in relation to the spectral reflectance. The evaluation device can then filter out the interference or suppress it in another way by spectrally comparing the spectral reflectance at the acupuncture points and the spectral reflectance in the directly adjacent tissue.
In entsprechender Weise, wie oben beschrieben, wird für die Messung des Organisationsgrades des Wassers im Gewebe zur Kalibration der Vorrichtung zur Messung des Blutglucosegehaltes vorgegangen, wobei jedoch der Organisationsgrad benachbart zum Meßort des Glucose- gehaltes, vorzugsweise an benachbarten Akupunkturpunkten vorgenommen wird.A corresponding procedure, as described above, is used to measure the degree of organization of the water in the tissue in order to calibrate the device for measuring the blood glucose content, but the degree of organization is carried out adjacent to the measuring point of the glucose content, preferably at adjacent acupuncture points.
Wenn die Vorrichtung für die Unterscheidung zwischen einer Hirnblutung und einem Hirnodem herangezogen werden soll, werden vorzugsweise die Strahlungsquelle und die Empfangeranordnung so angeordnet, daß schräger eingestrahlt wird und daß die E strahlungs- und Erfassungsstellen weiter auseinander, z.B. 2 bis 5 cm, gegebenenfalls auch mehr liegen, wobei die Eindringtiefe relativ groß st und unter Umstanden bis zum Stammhirn reicht. Die anhand einer Durchstrahlung mit verschiedenen Wellenlangen gewonnenen Spektralda- ten, erlauben es, den Organisationsgrad des durchstrahlten Wassers zu erfassen. Da ein Hirnodem durch starke Wasseraufnähme des Bindegewebes entsteht, ist das darin gespeicherte Wasser stark organisiert, wohingegen das Wasser im Blut sehr gering organisiert ist. In der Auswerteemrichtung sind Schwellenwerte für den Organisationsgrad gespeichert, die ein Unter- scheidungskriterium vorgeben. Die Auswerteemrichtung vergleicht die aus den Spektren bestimmten Organisationsgrade mit dem Schwellenwert und trifft die Ent- Scheidung. If the device for distinguishing between a hemorrhage and a brain modem should be used, the radiation source and the receiver arrangement are preferably arranged so that the radiation is more oblique and that the E radiation and detection points are further apart, for example 2 to 5 cm, possibly even more, the depth of penetration being relatively large st and may reach the brain stem. The spectral data obtained on the basis of irradiation with different wavelengths allow the degree of organization of the irradiated water to be recorded. Since a brain breath is created by the strong absorption of water by the connective tissue, the water stored in it is highly organized, whereas the water in the blood is very poorly organized. Threshold values for the degree of organization are stored in the evaluation device, which prescribe a differentiation criterion. The evaluation device compares the organizational degrees determined from the spectra with the threshold value and makes the decision.

Claims

Patentansprüche claims
1. Verfahren zur Messung des Organisationsgrades von Wasser in menschlichen und tierischen Körpern, wobei die Haut mit Wellenlängen zwischen 900 und 1100 nm bestrahlt wird und die in dem darunterliegenden Gewebe rückgestreute Strahlung erfaßt und das spektrale Reflexionsvermögen gemessen wird und wobei die spektrale Lage der Wasserabsorption der 3. Harmonischen der Streckschwingung ermittelt wird, die ein Maß für den Organisationsgrad des Wassers ist.1. A method for measuring the degree of organization of water in human and animal bodies, wherein the skin is irradiated with wavelengths between 900 and 1100 nm and detects the backscattered radiation in the underlying tissue and the spectral reflectance is measured and wherein the spectral location of the water absorption 3. Harmonics of the stretching vibration is determined, which is a measure of the degree of organization of the water.
2. Verfahren nach Anspruch 1, dadurch gekennzeichnet, daß die rückgestreute Strahlung an einer Stelle der Haut, die benachbart zur Einstrahlstelle liegt, erfaßt wird.2. The method according to claim 1, characterized in that the backscattered radiation is detected at a location on the skin which is adjacent to the irradiation location.
3. Verfahren nach Anspruch 1 oder 2, dadurch ge- kennzeichnet, daß in dem Wellenlängenbereich von3. The method according to claim 1 or 2, characterized in that in the wavelength range of
800 bis 1100 nm Störspektren von in der Haut vorhandenen Strukturproteinen, Fettspeichern und/oder Blutgefäßen, insbesondere außerhalb der Wasserabsorptionsbande gemessen werden, die bei der Ermittlung der spektralen Lage der Wasserabsorption berücksichtigt werden.800 to 1100 nm interference spectra of structural proteins, fat stores and / or blood vessels present in the skin, in particular outside the water absorption band, are measured, which are taken into account when determining the spectral position of the water absorption.
4. Verfahren nach Anspruch 3, dadurch gekennzeichnet, daß die Störspektren abhängig vom Ort der Messung auf der Haut und/oder dem Aufbau der Haut erfaßt und klassifiziert werden.4. The method according to claim 3, characterized in that the interference spectra are detected and classified depending on the location of the measurement on the skin and / or the structure of the skin.
5. Verfahren nach Anspruch 3 oder Anspruch 4, dadurch gekennzeichnet, daß aus den Störspektren durch Hochrechnungen und/oder Extrapolation die Stärke der Störung im Bereich der gemessenen spektralen Lage der Wasserabsorption bestimmt wird.5. The method according to claim 3 or claim 4, characterized in that from the interference spectra by extrapolation and / or extrapolation Strength of the disturbance in the range of the measured spectral position of water absorption is determined.
6. Verfahren nach einem der Ansprüche 1 bis 5, da- durch gekennzeichnet, daß das spektrale Reflexionsvermögen an Akupunkturpunkten gemessen wird.6. The method according to any one of claims 1 to 5, characterized in that the spectral reflectance is measured at acupuncture points.
7. Verfahren nach Anspruch 6, dadurch gekennzeichnet, daß das spektrale Reflexionsvermögen direkt benachbart von Akupunkturpunkten gemessen wird und zur Unterdrückung der Störungen im Bereich der Wasserabsorptionsbande am jeweiligen Akupunkturpunkt ein spektraler Vergleich zwischen den spektralen Reflexionsvermögen vorgenommen wird, dessen Ergebnis bei der Bestimmung des Organisationsgrades des Wassers am Akupunkturpunkt berücksichtigt wird.7. The method according to claim 6, characterized in that the spectral reflectance is measured directly adjacent to acupuncture points and to suppress the interference in the water absorption band at the respective acupuncture point, a spectral comparison is made between the spectral reflectance, the result of which in determining the degree of organization of the Water at the acupuncture point is taken into account.
8. Verfahren nach einem der Ansprüche 1 bis 7, dadurch gekennzeichnet, daß für die nichtinvasive Messung des Blutglukosegehaltes, bei der eine8. The method according to any one of claims 1 to 7, characterized in that for the non-invasive measurement of the blood glucose content, in which one
Korrelation zwischen spektraler Verteilung der an bzw. in der Haut reflektierten Strahlung bei Wellenlängen von ca. 800 nm bis ca. 1100 nm und dem Glukosegehalt im Blut hergestellt wird, der Organisationsgrad des Wassers an einem dem Meßort des Glukosegehaltes benachbarten Akupunkturpunkt miterfaßt und in der Kalibration für die Messung des Glukosegehaltes berücksichtigt wird.Correlation between the spectral distribution of the radiation reflected on or in the skin at wavelengths of approx. 800 nm to approx. 1100 nm and the glucose content in the blood is established, the degree of organization of the water at an acupuncture point adjacent to the measuring point of the glucose content is also recorded and in the calibration is taken into account for the measurement of the glucose content.
9. Vorrichtung zum Messen des Organisationsgrades von Wasser in menschlichen und tierischen Körpern mit einer Strahlungsquelle, die Strahlung mit Wellenlängen zwischen 900 und 1100 nm auf und in die Haut des Körpers strahlt, mit einer Empfangeranordnung, die die in und unter der Haut ruckgestreute Strahlung erfaßt und das spektrale Reflexionsvermogen mißt und mit einer Auswerteeinrichtung, die die spektrale Lage der Wasserabsorption der 3. Harmonischen der Streckschwingung ermittelt, die ein Maß für den Organisationsgrad des Wassers ist.9. Device for measuring the degree of organization of water in human and animal bodies with a radiation source which emits radiation with wavelengths between 900 and 1100 nm on and into the skin of the body, with a Receiver arrangement which detects the radiation scattered in and under the skin and measures the spectral reflectance and with an evaluation device which determines the spectral position of the water absorption of the 3rd harmonic of the stretching vibration, which is a measure of the degree of organization of the water.
10. Vorrichtung nach Anspruch 9, dadurch gekennzeichnet, daß Strahlungsquelle und Empfangsan- Ordnung derart zueinander angeordnet sind, daß die Einstrahlstelle benachbart zur Erfassungsstelle der ruckgestreuten Strahlung ist.10. The device according to claim 9, characterized in that the radiation source and receiving arrangement are arranged such that the irradiation point is adjacent to the detection point of the scattered radiation.
11. Vorrichtung nach Anspruch 9 oder Anspruch 10, dadurch gekennzeichnet, daß die Auswerteeinrich- tung die typischen Absorptionsspektren von in der Haut vorhandenen Strukturproteinen, Fettspeichern und/oder Blutgefäßen als Storstof- fe aus dem von der Empfangeranordnung gemessenen spektralen Reflexionsvermogen ermittelt und bei der Bestimmung der spektralen Lage der Wasserab- sorption berücksichtigt.11. The device according to claim 9 or claim 10, characterized in that the evaluation device determines the typical absorption spectra of structural proteins, fat stores and / or blood vessels present in the skin as stored matter from the spectral reflectance measured by the receiver arrangement and during the determination the spectral position of the water absorption is taken into account.
12. Vorrichtung nach Anspruch 11, dadurch gekennzeichnet, daß in der Auswerteeinrichtung Spektren von Storstoffen abhangig vom Ort der Mes- sung auf der Haut und/oder dem Aufbau der Haut gespeichert sind.12. The apparatus according to claim 11, characterized in that spectra of storage substances are stored in the evaluation device depending on the location of the measurement on the skin and / or the structure of the skin.
13. Vorrichtung nach Anspruch 11 oder Anspruch 12, dadurch gekennzeichnet, daß die Auswerteeinrichtung aus den Spektren der Storstoffe durch Hoch- rechnungen und/oder Extrapolation die Starke der13. The apparatus according to claim 11 or claim 12, characterized in that the evaluation device from the spectra of the storages by extrapolation and / or extrapolation the strength of the
Störung im Bereich der gemessenen spektralen Lage der Wasserabsorption bestimmt und zur Ermittlung der spektralen Lage berücksichtigt. Disturbance in the range of the measured spectral position of the water absorption is determined and taken into account for determining the spectral position.
14. Vorrichtung nach einem der Ansprüche 9 bis 13, dadurch gekennzeichnet, daß sie Bestandteil einer an sich bekannten Vorrichtung zur nichtinva- siven Messung des Blutglukosegehaltes mittels Nahinfrarot-Reflexionsspektroskopie ist, bei der der an einem benachbart zum Meßort der Blutglu- cose gemessene Organisationsgrad des Wassers zur Kalibration verwendet wird.14. Device according to one of claims 9 to 13, characterized in that it is part of a device known per se for non-invasive measurement of the blood glucose content by means of near infrared reflection spectroscopy, in which the degree of organization of the blood glucose measured adjacent to the measurement site Water is used for calibration.
15. Vorrichtung nach einem der Ansprüche 9 bis 13 zur Bestimmung eines Hirnödems, bei der die Auswerteeinrichtung Werte des Organisationsgrades bei einer Hirnblutung und einem Hirnodem sowie mindestens einen Schwellenwert für die Unterscheidung zwischen Hirnodem und Hirnblutung ge- speichert hat. 15. Device according to one of claims 9 to 13 for determining a cerebral edema, in which the evaluation device has stored values of the degree of organization in a cerebral hemorrhage and a cerebral hemorrhage and at least one threshold value for the distinction between cerebral hemorrhage and cerebral hemorrhage.
PCT/EP2000/004643 1999-05-22 2000-05-22 Method and device for measuring the degree of organization of water in human and animal bodies WO2000071025A1 (en)

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US8690864B2 (en) 2007-03-09 2014-04-08 Covidien Lp System and method for controlling tissue treatment
US8346327B2 (en) 2007-03-09 2013-01-01 Covidien Lp Method for identification of sensor site by local skin spectrum data
US8357090B2 (en) 2007-03-09 2013-01-22 Covidien Lp Method and apparatus for estimating water reserves
US8280469B2 (en) 2007-03-09 2012-10-02 Nellcor Puritan Bennett Llc Method for detection of aberrant tissue spectra
US8109882B2 (en) 2007-03-09 2012-02-07 Nellcor Puritan Bennett Llc System and method for venous pulsation detection using near infrared wavelengths
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