JP3231357B2 - Oxygen metabolism measurement device - Google Patents

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 apparatus for measuring the metabolism of a body organ or a tissue in a living body, and more particularly to a near infrared ray reflected from a target intracardiac region by using a method of entering a blood vessel through skin. (NIR) The present invention relates to an oxygen metabolism measuring device for transmitting and receiving light.

[0002]

BACKGROUND OF THE INVENTION A feature of the treatment of coronary vein occlusion is the need for a non-invasive means of assessing regional oxidative metabolism in heart disease patients. Currently, there is no way in the art to accurately and quickly measure the uptake and utilization of regional tissue oxygen.

[0003] Standard clinical indicators are not sensitive to non-uniform dropouts of myocardial reflux metabolism due to lack of coronary vein. Also, by radionuclide and angiography,
Myocardial perfusion and ventricular wall motion can be evaluated,
With these methods, prediction of myocardial metabolic status, especially in patients with end-perfusion and / or abnormal ventricular wall movement, is not always reliable.

[0004] Other methods of measuring myocardial metabolism, such as nuclear magnetic resonance imaging and spectroscopy and positron emission tomography, are expensive and are not used in cardiac catheterization rooms in most hospitals and clinics. However, troublesome parts (for example, magnets and cyclotrons) are required.

[0005] In particular, in the abnormally contracting myocardium, the ability to quickly identify metabolic status of a person's heart rate is a critical need for therapeutics such as coagulants, balloon angioplasty, and coronary artery bypass grafts. Affects the above decision.

[0006] With respect to prior art spectrophotometry for measuring circulatory respiratory function, arterial oxygenation and blood samples, US Pat.
3,680 and 4,281,645. This patent details the application of blood dispersed body organs by differential spectroscopy using near infrared light.

[0007] In both patents, the near-infrared light must span a relatively long optical path (eg, several cm). This long optical path is important because the 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 U.S. Pat. No. 4,223,680, the backscatter from the outer surface structure does not include the metabolic information of interest, and the detection of any metabolic information is unclear. This method was sought by Jobis to minimize this biophysical effect. Therefore, in both patents of Jovsis, near-infrared light must be sent to the organ to be tested (the original place of interest) and the radiant intensity must be detected and measured at a distance from the point where the light entered. Teaches not to be. FIG. 1 of US Pat. No. 4,223,680
As shown in FIG. 2 and FIG. 2, the physical distance between the entrance and the exit of the near-infrared light is set to several cm.

Thus, the fiber bundle of the photodetector must be spaced from the source fiber bundle to minimize light scattering from the external tissue area. Further, as presented in US Pat. No. 4,513,751 to 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 Detector fiber bundle spacing is required. That is, as proposed by Abe for the wavelength of visible light, near-infrared light is sent to a first optical fiber,
Simply receiving the reflected light with a second optical fiber parallel to and adjacent to the second optical fiber cannot measure any accurate near-infrared oxygenated metabolism within a substantial tissue volume.

[0009]

In summary, an intravascular application of a device for transmitting and receiving red to near infrared light 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. The introduction of two separate transceived scopes into the heart by a transcutaneous endovascular technique is due to the instrument that taps the myocardial wall and the instability of optically aligning the two scopes in the tissue area of interest. Will be prevented.

Applicants have overcome the shortcomings of the prior art disclosed in the Jovsis and Abe patents and have developed a steerable optical fiber device as described below. The device consists of one small diameter scope (3.3 mm diameter) placed on the inner surface of the heart.
Below) through which the near-infrared light is transmitted and received by the transcutaneous intravascular approach used in standard clinical catheterization rooms, and can be performed as part of a routine diagnostic catheterization study and can be performed in a moving heart. This device 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 light from red to near-infrared, a single scope including optical fibers for both transmission and reception is used in a heart. The purpose is to provide an oxygen metabolism measuring device that measures the oxygen uptake and utilization of tissue in internal body organs or selected body tissues using the heart, brain, liver, kidney, etc. to obtain optical information from internal sites And

[0012]

Oxygen metabolism measuring apparatus of the present invention According to an aspect of the emission of a flexible insertion tube, emitting end face for emitting forward light from the insertion tube tip is provided on the insertion tube distal end surface and means, and a light receiving means for receiving the end face is provided on the insertion tube distal end surface for receiving the optical information of the specimen by the light emitted from the emitting means, before
At the tip of the insertion tube, the light emitted from the
At least one of the optical axis and the optical axis of the received light on the light receiving end face
Has an angle with respect to the center axis of the tip of the insertion tube.
The light receiving means is directed outward so that the outgoing light
Receives light that has traversed a portion of the observation object .

[0013]

[0014]

[0015]

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

FIGS. 1 to 11 relate to a first embodiment of the present invention, and FIG. 1 is a configuration diagram showing a configuration of an oxygen metabolism measuring apparatus.
FIG. 2 is a configuration diagram showing a configuration of a 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 having a predetermined optical axis angle at the distal end portion of the extension tube, and FIG. Second having a predetermined optical axis angle at the tip of the tube
FIG. 6 is a configuration diagram showing a configuration of a third modified example having a predetermined optical axis angle at a distal end portion of an extension tube, and FIG. 7 is a configuration diagram showing a configuration of a predetermined light beam at a distal end portion of an extension tube. FIG. 9 is a configuration diagram illustrating a configuration of a fourth modified example having an axis angle;
FIG. 8 is an explanatory diagram illustrating the LG ratio between the irradiation optical fiber and the light receiving optical fiber, FIG. 9 is an explanatory diagram illustrating the operation of the oxygen metabolism measuring device, and FIG. 10 is an explanatory diagram illustrating the result of the operation in FIG. It is.

As shown in FIG. 1, an oxygen metabolism measuring apparatus 10 according to the present invention comprises an irradiation optical fiber 1 comprising a large number of fibers having a base end connected to a polished optical coupling connector 16.
4, a light receiving optical fiber 18 composed of a large number of fibers having a base end connected to a polished optical coupling connector 20,
The irradiation optical fiber 14 is constituted by a conduit or a casing, for example, an elongate tube 12 made of a flexible plastic sheath.

A steering device 22 is provided in the middle of the extension tube 12, and the steering tip 12 'of the extension flexible tube 12 can be operated by the steering device 22. Furthermore, in the middle part of the steering device 22, the steering device 22 and the steering tip 12 'can be operated in a sterilized state. For example, a 2 cm long steering tip 12 'can be bent in an arc of 120 degrees by the steering instrument 22 (see FIG. 1).

The irradiating optical fibers 14 of the oxygen metabolism measuring apparatus 10 are, for example, uniformly 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 wavelengths of near infrared (NIR) light sources 24a. 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 the light to the optical coupling connector 20 and the photodetector 26. The base ends of all the optical fibers 14 and 18 are polished at their 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 light detector 26. I have.

Here, for example, most preferably, the extension tube 1 of the device 10 extending from the steering instrument to the steering tip.
2 is 3.3 mm (10 Fre) so that the oxygen metabolism measuring device 10 of the present invention can be used in a blood vessel passing through the skin.
nch). In addition, the length of the extension tube 12 in the section from the control device to the control tip is set closer to the ventricle by the intravascular approach of the major artery or vein.
The length of the extension tube 12 from each optical coupling connector to the steering device 22 is at least 150 cm and at least 2 meters for operating the steering device in a sterile state.

FIGS. 2A to 2C and FIG. 3A
3C schematically illustrates two separate embodiments of the distal tip of the extension tube 12. FIG.

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

FIGS. 3A to 3C illustrate modifications of the distal end portion of the extension tube 12, in which:
The irradiation optical fiber 14 is located inside the concentric outer part 12A, and the light receiving optical fiber 18 is located at the center 12B of the extension tube 12.
The opaque divider 12C separates the light transmitting and receiving optical fibers.

The common feature of both embodiments is that the distal end of the elongate tube 12 is similar to that of FIG.
As can be clearly understood from the photon path illustrated in FIG. 3A, the photon from the irradiation optical fiber 14 distant from the light receiving optical fiber 18 has a conical shape due to divergence. . The principle of light in a divergent reflective shape is to transmit and transmit light to obtain optical information from a more substantial volume of tissue.
And the receiving optical fiber bundle are adjacent and parallel.
Behind the outer tissue layer compared to the tip of the tube
To reduce the scatter, Ru der to increase the optical path of photons through an organ or tissue of a subject. In addition, the elongated tube 1
The angle of the cone defined by the two ends is adjusted to extract a priority signal from a deep tissue layer on the inner surface of the heart.

It should be noted that a suitable lens (not shown) may be used for the light transmitting and receiving portions of the conical end of the extension tube 12 to make the same adjustment to optimize the volume of the tissue to be sampled. angles properly is by changing the photon optical path by adjusting the lens shape, it is possible to obtain an optical metabolism information from different depths of tissue. Also,
Similarly, time domain multiplexing may be used to selectively receive photons that have traversed different tissue depths.

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

As shown in FIG. 4A, the extension tube 1
In the first modified example having a predetermined optical axis angle at the tip of No. 2, the tip has a conical shape as described above, and FIG.
As shown in (1), the irradiation optical fiber LG14a and the light receiving optical fiber LG18a are separated by an opaque or non-transmitting divider 15a and disposed in the extension tube 12. The divider 15a is formed in an inverted conical shape coaxially with the cone within the tip of the cone, and the LG14
The a and LG 18a are separated along the inverted conical divider 15a, and the end faces of the LG 14a and LG 18a are arranged in an arc shape on the side of the conical end portion with the central axis of the extension tube 12 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 No. 2. LG
The side faces of the extension tube 12 of the extension tube 12 of the LG 14a and the LG 18a are, as described above, the LG 14a and the LG 18a.
For example, the end face of 18a has an angle of 22 ° so as to be arcuate.

The near-infrared light emitted from the irradiation optical fiber LG14a at the distal end of the extension tube 12 having the above-described structure is positioned 3 ° away from the central axis of the extension tube 12.
The light is radiated outward at an angle of 0 °, is received at the symmetrical position, and is received by the light-receiving optical fiber LG18a at an angle of 30 ° to the outside with respect to the center axis of the elongate tube 12. Increases the optical path of photons through an organ or tissue, gains optical information from a more substantial volume of tissue, and reduces backscatter of light from the outer tissue layers compared to a flat tube tip At the same time, it is possible to prevent the near infrared light from the irradiation optical fiber LG14a from being directly received by the light receiving optical fiber LG18a.

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

As shown in FIG. 6A, the extension tube 1
In a third modified example having a predetermined optical axis angle at the distal end of No. 2, the distal end of the extension tube 12 has a cylindrical shape, and as shown in FIG. LG1
The optical fiber 4a and the light receiving optical fiber LG18a are separated by an opaque or non-transmitting divider 15b and disposed in the extension tube 12. The divider 15b is formed in the shape of a roof coaxially with the cylinder within the cylindrical distal end, and the LG14a and the LG18a are separated along the roof-shaped divider 15b. The end faces of the LG14a and the LG18a The central axis is symmetrically arranged on the distal end surface in an arc shape. 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, so that the LG 14a and the LG 1
The side surface on the central axis side of the extension tube 12 of FIG. 8 a also has an angle of 24 ° with respect to the central axis of the extension tube 12.
The side faces of the extension tubes 12 of the LG 14a and the LG 18a facing the central axis side are, for example, 16 ° so that the end faces of the LG 14a and the LG 18a are arcuate as described above.
Angle.

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

As shown in FIG. 7, in a fourth modified example having a predetermined optical axis angle at the distal end portion of the extension tube 12, the distal end portion of the extension tube 12 has a circular shape. The operation and effect are the same as those of the first modified example having a predetermined optical axis angle.

In the above-described first to fourth modified examples having a predetermined optical axis angle at the distal end portion of the extension tube 12, as shown in FIG.
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. 8 indicates that the light receiving optical fiber LG18a and the irradiation optical fiber LG14a have the same L
The case where the G ratio is provided is shown.

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

As can be seen from the data shown in FIG. 10, the optical fiber bundles are separated from each other at intervals of several centimeters .
Parallel or mutually convergent
Light response from heart tissue when
A very similar light response is obtained .

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

In use, the steering tip 12 'of the oxygen metabolism measuring device 10 is transported to the ventricle in a transcutaneous manner under the guidance of a fluorescent scope and brought into contact with the heart of a human or animal for optical coupling. Light in continuous or pulsed from the near-infrared light source 24 a is delivered to the heart and transmit the irradiation optical fiber 14. This light is traversed through the tissue of interest and received by the receiving optical fiber 18 and sent back through the extension tube 12 to the photodetector 26 for analysis. To properly analyze the data sent by the reflected light,
For example, a computer (not shown) in which an appropriate program is set is electrically connected to the photodetector 26.

With the oxygen metabolism measuring apparatus 10 utilizing the above-mentioned divergent reflection shape, important parameters of cardiac oxidation metabolism can be made possible by transmitting and receiving near-infrared light through a single fiber optic scope (catheter). . That is, the present invention has substantial advantages over the prior art in that a second catheter is not required to perform reflectance measurements. Its advantages include:

1. Only one site is required to pass through the skin (vessel access) to advance the scope into the intravascular space and advance to the target intracardiac site.

2. Since the light source and receiver are carried directly to one point in the subject's heart, there are no external structures (eg, skin, bone, skeletal muscle, etc.) through which near-infrared light must pass.

3. Since the light source and receiver are delivered directly to a point in the heart of the subject, the device of the present invention can provide metabolic information from diseased and normal sites, thus distinguishing such regions in vivo. There are benefits. Regional viability and the potential to identify metabolic effects of effective blood flow within the aberrantly contracting part of the heart will impact the clinical decisions needed to treat thrombolysis, balloon angioplasty, coronary artery bypass ties, etc. give.

4. The oxygen metabolism measurement device of the present invention can be used in a standard clinical heart catheterization room 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 configuration diagram showing the configuration of the oxygen metabolism measuring apparatus according to the second embodiment.

[0045] The oxygen metabolism measuring apparatus 10 of the first embodiment, the near infrared light source 24 a, for example, although the light transmission of four different near-infrared light, as shown in FIG. 11, the present invention Second
In the oxygen metabolism measuring apparatus 10 ′ of the embodiment, the transmission of different near-infrared light is transmitted to the irradiation optical fiber 14 ′ in the extension tube 12 on a time division basis. Thereby, as can be seen with reference to FIG. 11 , the number of irradiation optical fibers 14 'can be greatly reduced as compared with the oxygen metabolism measuring device 10 of the first embodiment.

Here, the irradiation optical fiber 14 ′ is
Connected to one optical coupling connector 16 '. One optical coupling connector 16 ′ is optically coupled to the NIR light source 24 a ′ and transmits pulse light of different wavelength on a time division basis, while the other optical coupling connector 16 ′ is connected to the reference reflected light detector 24 a.
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 inside, and a base end of the light receiving optical fiber 18 is a light optically coupled to a light detector 26. It is connected to the coupling connector 20. The steering device 22 is used to operate the steering tip 12 ', similarly to the oxygen metabolism measurement 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 steering instrument to the steering tip is the same as 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 transcutaneous vessels. In addition, the length of the extension tube 12 in the section from the control device to the control tip should be at least 15 so as to approach the ventricle by the intravascular approach of the major artery or vein.
0 cm, and the length of the extension tube 12 from each optical coupling connector to the steering device 22 should be at least 2 meters to operate the steering device in a sterile condition.

As in the case of the first embodiment, an appropriate lens (not shown) is used for the light transmitting and receiving portions at the conical end of the extension tube, and the cone angle is adjusted to reduce the volume of the tissue to be a sample. Optimal metabolism information can be obtained from different tissue depths by changing the optical path of photons by adjusting the cone angle or lens shape. Similarly, time domain multiplexing may be used to selectively receive photons that have traversed different tissue depths.

Further, in the oxygen metabolism measuring apparatus according to the second embodiment, the second embodiment of the distal end portion of the extension tube described above and the first to fourth modified examples of the distal end portion of the extension tube having a predetermined optical axis angle. Needless to say, can be used.

The other structures, operations and effects are the same as those of the first embodiment.

As described above, the intravascular measurement of myocardial metabolism has been described in detail here. However, the oxygen metabolism measuring apparatus of the present invention can be used for other measurements, and is used only for the intravascular measurement of myocardial metabolism. It is not limited. For example, the oxygen metabolism measurement 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 oximeter can be advanced through a physiological conduit in a human body large enough to accommodate a tube or scope of the size described above. For something like this,
Measures oxidative metabolism and blood volume in target organs and tissues such as heart, brain, liver, kidney, and skeletal muscle, including blood vessels, ureters, bile trees, and gastrointestinal tracts. be able to.

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

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As described above, according to the present invention, the oxygen metabolism measuring apparatus of the present invention uses a single scope including both transmitting and receiving optical fibers to obtain optical information from sites in the heart. The effect is that the oxygen uptake and utilization of tissues such as brain, liver and kidney can be measured in internal body organs or selected body tissues.

[Brief description of the drawings]

FIG. 1 is a configuration diagram illustrating a configuration of an oxygen metabolism measurement 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 a distal end portion of the extension tube according to the first embodiment.

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 embodiment.

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 embodiment.

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 embodiment.

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

FIG. 9 is an explanatory diagram illustrating the 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 illustrating a configuration of an oxygen metabolism measurement device according to a second embodiment.

[Explanation of symbols]

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

────────────────────────────────────────────────── ─── Continuation of front page (72) Inventor Benjamin J Comfort United States 27712 North Carolina, Inc. Darhan Rivermont Drive 4720 (56) Reference JP-A-48-72990 (JP, A) JP-A-47-44882 (JP) , A) JP-A-49-15493 (JP, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 5/145 G01N 21/35

Claims (1)

(57) [Claims] 1. A a flexible insertion tube, said insertion Ju
The insert Ju is emitting end face for emitting light from over blanking tip forward
Emission means provided on the tip end face of the probe, and a light receiving means provided on the tip end face of the insertion tube, wherein a light receiving end face for receiving optical information of the observation body by light emitted from the emission means,
At the distal end of the insertion tube, the light emitted from the emission end face.
At least one of the optical axis of the light receiving end face and the optical axis of the light receiving end face
Has an angle with respect to the center axis of the tip of the insertion tube.
The light receiving means is directed outward so that the outgoing light
An oxygen metabolism measuring device, wherein the device receives light crossing a part of an observation body .