KR20230068857A - Self-olfaktometrie system - Google Patents

Abstract

The olfactory threshold and false positive self-test system according to the present invention includes an olfactory threshold and false positive self-test device that generates information for evaluating the patient's olfactory test performance based on the patient's olfactory test information and the actual number of effective training sessions. , A web server including a patient database that integrates and manages the patient's smell test information and the patient's smell test performance evaluation information generated by the olfactory threshold and false positive self-test device; and a medical staff terminal provided with the patient database, which is integrated and managed by the web server, to medical staff who provide feedback on olfactory examination results.

Description

Olfactory threshold and false positive self-test system {Self-olfaktometrie system}

The present invention relates to an olfactory threshold and false-positive self-test system, and more particularly, to a olfactory threshold and false-positive self-test system in which a patient performs a olfactory test himself, and a medical staff can confirm and feed back the olfactory test information of the patient.

The sense of smell plays a very important role in maintaining quality of life and leading a life in daily life. If the sense of smell is lost, appetite decreases, food intake decreases, and social life is restricted, leading to a decrease in quality of life and failure to cope immediately in dangerous situations such as fire or food poisoning.

Olfactory disorders are classified into conductive olfactory disorders and sensorineural olfactory disorders, and in the case of sensorineural olfactory disorders, if early treatment fails, it may become a permanent disorder.

Currently, there are sinus diseases, rhinitis, upper respiratory infections, trauma, drugs, and congenital causes for the mechanism of smell and the causes of olfactory disorders. The first thing they hear is that they have a problem with their sense of smell, so research results are coming out that they cannot distinguish the smells they have smelled on a daily basis. Since the function of the olfactory organ is closely related to dementia, Parkinson's disease, and depression, it is very important to train so that the function of the olfactory organ does not deteriorate.

On the other hand, there are various drugs as a treatment method for patients with loss of smell, but 'Olfactory training' is a practice of continuously and repeatedly smelling various smells in alternating ways for patients who have lost their sense of smell or complain of hyposmia. Since it was presented by the German huttenbrink group, it has been recognized as actually helping to restore the sense of smell. In addition, there is a study report that there was an improvement in olfactory function after olfactory rehabilitation training in Alzheimer's patients. In addition, as a result of a JAMA Network study by a German and British research team, in the case of loss of smell due to COVID-19, it was found that smell training therapy, which involves inhaling odorous substances such as lemon, rose, and eucalyptus for 20 seconds twice a day, improves the sense of smell loss patients. effect has been reported.

Currently, there is no standardized formal training device for olfactory rehabilitation training, and when a patient requests it, four kinds of fragrance substances are produced in a bottle, and the patient is prescribed to perform olfactory training at home. The olfactory training method uses 4 to 8 scent bottles twice a day in the morning and evening, identifies the type of scent written on the bottle, smells the scent for 10 seconds, takes a break for 10 seconds, and then smells another scent. Have them smell 4 scents for 10 seconds each.

However, currently, this olfactory training requires continuous training for at least 4 weeks rather than a short period of time, so patients' compliance with treatment is low. It is impossible to use it, and the patient has to select the scent himself, check the time, and train, so it is pointed out that it is cumbersome to use.

As such, self-olfactory training is not supported by professionalism and reliability, so most of the hospitals conduct olfactory training or olfactory function tests directly by professional personnel. However, professional manpower consumption is severe, olfactory function test equipment is large and expensive, and test execution and interpretation are complicated. As a result, the problem is pointed out that the patient can only perform the test only when he or she visits a hospital with a professional examiner.

Republic of Korea Patent Registration No. 10-20184533

According to the present invention, even if you do not visit the hospital directly, you can carry a patient's olfactory threshold and false-positive self-testing device to carry out a self-test, store the patient's olfactory test information in a web server, and based on this, the olfactory threshold and false-positive Its purpose is to provide a self-inspection system.

The olfactory threshold and false-positive self-test system according to an embodiment of the present invention for solving the above problems is information for evaluating the patient's olfactory test performance based on the actual number of effective training sessions compared to the patient's olfactory test information and training frequency A web server including a patient database that integrates and manages olfactory threshold and false-positive self-testing devices that generate olfactory threshold and false-positive self-testing devices, and the patient's olfactory test information generated by the olfactory threshold and false-positive self-testing device and the patient's olfactory test performance evaluation information. and a medical staff terminal providing the patient database, which is integrated and managed by the web server, to medical staff who communicate with the web server and provide feedback on the results of the patient's olfactory examination.

The olfactory threshold and false positive self-test device is operated according to a predetermined olfactory test protocol, and the patient's olfactory test information includes at least one of the type of fragrance substance and olfactory training intensity, cycle, frequency, and training time, The patient's olfactory test performance evaluation information consists of a process of comparing and analyzing the number of times the scent substance is discharged and the number of times the patient has actually trained in proximity to the olfactory threshold and false-positive self-test device within a predetermined radius, and the web server A feedback database for integrated management of feedback information may be included, and the olfactory threshold and false positive self-test device may receive feedback information from the feedback database integrated and managed by the web server.

The olfactory threshold and false positive self-test system may reset the olfactory test protocol based on feedback information from the medical staff.

Based on the data accumulated in the web server, a medical staff may make a decision on the olfactory examination protocol for each patient.

The olfactory threshold and false-positive self-test device of the present invention is portable and can be implemented at a reasonable and economical price so that it can be owned by an individual, so that the patient can perform the test by himself at a desired place, and the time spent visiting the hospital is reduced. It can save time, prevent the time consumption of professional personnel on the hospital side, and improve efficiency.

In addition, since the olfactory threshold and false positive self-test device of the present invention operates according to the olfactory test protocol preset according to the degree of the patient's symptoms, the patient himself can systematically train himself, has high compliance, and can further check the patient's compliance. there is.

In addition, according to the present invention, the patient can self-evaluate the degree of olfactory improvement according to olfactory training by performing training according to a predetermined protocol and integrating and managing the corresponding information in a web server.

In addition, since the present invention allows the medical staff to access the web server and check information directly, the medical staff makes a decision on the future treatment method according to whether the patient is actually training well, and the medical staff's feedback is also integrated through the web server. In addition, the protocol of the olfactory threshold and the false positive self-test device can be reset in response to the feedback of the medical staff. In other words, patients with low treatment compliance and slow treatment can increase the compliance rate, while patients with poor treatment effect despite good compliance may consider other treatments.

In addition, by resetting the protocol of the olfactory threshold and false positive self-test device according to the feedback of the medical staff of the present invention, it is possible to maximize the treatment effect by adjusting the type and concentration, cycle, number of times, etc. of the fragrance substance according to the patient's condition, enabling personalized treatment. possible.

In other words, the present invention establishes a Koreanized olfactory substance and develops an automated device so that patients can easily train at home, and through the convergence of olfactory threshold and false positive self-test devices and ICT and IOT technology, the patient directly faces the medical staff. It can significantly reduce the number of times and furthermore, it can be the foundation for building a non-face-to-face or remote medical service platform, and by establishing a system that can make information into a database, high-value medical data can be integrated and managed, and through this, big data, AI It is possible to build general-purpose data that leads the 4th industrial revolution, such as precision medicine, precision medicine, etc.

1 is a schematic diagram showing an olfactory threshold and false positive self-test system according to an embodiment of the present invention.
2 is a schematic diagram illustrating a process of olfactory test using an olfactory threshold and a false positive self-test device according to an embodiment of the present invention.
3 is a schematic diagram showing an example of database utilization of the olfactory threshold and false positive self-test system according to an embodiment of the present invention.
Figure 4a is an exploded perspective view of an olfactory threshold and false positive self-test device according to an embodiment of the present invention, Figure 4b is a schematic perspective view showing the inside of the upper housing shown in Figure 4a, Figure 4c is shown in Figure 4a It is a schematic diagram showing the arrangement of the fragrance discharge unit and the capsule member in a state in which the olfactory threshold and false positive self-test device are combined.
5A is an exploded perspective view of an olfactory threshold and false positive self-test device according to another embodiment of the present invention, FIG. 5B is a schematic perspective view showing the inside of the upper housing shown in FIG. 5A, and FIG. It is a schematic diagram showing the arrangement of the fragrance discharge unit and the capsule member in a state in which the olfactory threshold and false positive self-test device are combined.
6A is an exploded perspective view of an olfactory threshold and false positive self-test device according to another embodiment of the present invention, FIG. 6B is a schematic perspective view showing the inside of the upper housing shown in FIG. 6A, and FIG. 6C is the view shown in FIG. 6A It is a schematic diagram showing the arrangement of the fragrance discharge unit and the capsule member in the state in which the olfactory threshold and false positive self-test device are combined.
7 is a cross-sectional view according to an embodiment of the capsule included in the olfactory threshold and false positive self-test device of the present invention.
8a to 8c are an exploded perspective view showing a combined state of the bottom plate and a rotating shaft member in the moving unit included in the olfactory threshold and false positive self-test device of the present invention, an exploded perspective view showing a coupled state between the bottom plate and the connecting member, and moving A cross-sectional view of the assembled unit.
9 is a perspective view showing a state in which the movement guide unit is fixed to the rotating shaft member in FIG. 5A.
10 is a flowchart according to an embodiment of the olfactory threshold test method for performing the olfactory threshold test using the olfactory threshold and false positive self-test device of the present invention.
11 is a flowchart according to an embodiment of a false positive detection method for performing a false positive test using an olfactory threshold and a false positive self test device according to the present invention.

Terms used in the present invention are only used to describe specific embodiments, and are not intended to limit the present invention. Singular expressions include plural expressions unless the context clearly dictates otherwise. In this application, terms such as "comprise" or "having" are intended to indicate that there is a feature, number, step, operation, component, part, or combination thereof described in the description of the invention, but one or more other It should be understood that it does not preclude the possibility of addition or existence of features, numbers, steps, operations, components, parts, or combinations thereof.

Terms such as first and second may be used to describe various components, but the components should not be limited by the terms. These terms are only used for the purpose of distinguishing one component from another. For example, a first element may be termed a second element, and similarly, a second element may be termed a first element, without departing from the scope of the present invention.

Unless defined otherwise, all terms used herein, including technical or scientific terms, have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Terms such as those defined in commonly used dictionaries should be interpreted as having a meaning consistent with the meaning in the context of the related art, and unless explicitly defined in the present invention, they should not be interpreted in an ideal or excessively formal meaning. don't

In interpreting the components, even if there is no separate explicit description, it is interpreted as including the error range. In particular, when the terms "about", "substantially", etc. of degree are used, they may be construed as being used in a sense at or close to that number when manufacturing and material tolerances inherent in the stated meaning are given. .

In the case of a description of a temporal relationship, for example, when a temporal precedence relationship is described as 'after', 'continue to', 'after ~', 'before', etc., 'immediately' or 'directly' Including non-consecutive cases unless ' is used.

Hereinafter, the technical configuration of the present invention will be described in detail with reference to the accompanying drawings and preferred embodiments.

However, the present invention is not limited to the embodiments described herein and may be embodied in other forms. Like reference numbers used to describe the invention throughout the specification indicate like elements.

The technical feature of the present invention is that three types of odors composed of butanol and optional fragrance substances 1 and 2 required for the olfactory threshold test are adjusted to a certain concentration according to the protocol set for the olfactory threshold test, and emitted for a certain period of time. It is configured so that the pause process can be automatically repeated, so that the patient can easily perform the olfactory threshold test, and two types of fragrances consisting of coffee and ammonia can be discharged according to the protocol set for the olfactory false positive test. It consists of a olfactory threshold and false positive self-test device with a structure that can be performed by the patient himself, a olfactory threshold and false positive self-test system using the device, a olfactory threshold test method, and a olfactory false positive test method.

Therefore, the olfactory threshold and false positive self-test system of the present invention is a olfactory threshold and false positive self-test device that generates information for evaluating the patient's olfactory test performance based on the patient's olfactory test information and the actual number of effective training sessions and a web server including a patient database that integrates and manages the patient's sense of smell test information and the patient's sense of smell test performance evaluation information generated by the olfactory threshold and false positive self-test device, and the patient by communicating with the web server and a medical staff terminal provided with the patient database, which is integrated and managed by the web server, to medical staff who provide feedback on the results of the olfactory examination.

More specifically, the configuration of the olfactory threshold and false positive self-test system according to an embodiment of the present invention will be described with reference to FIGS. 1 to 3 . 1 is a schematic diagram showing a olfactory threshold and false positive self-test system according to an embodiment of the present invention, and FIG. 2 shows a olfactory test process using a olfactory threshold and false positive self-test device according to an embodiment of the present invention. FIG. 3 is a schematic diagram showing an example of database utilization of the olfactory threshold and false positive self-test system according to an embodiment of the present invention.

1 to 3, the olfactory threshold and false positive self-test system according to an embodiment of the present invention includes a olfactory threshold and false positive self-test device 1, a web server 2, and a medical staff terminal (not shown). city), and configures a series of networks based on wired/wireless communication technology to enable mutual data transmission.

The olfactory threshold and false-positive self-test device 1 provides fragrance substances to the patient 4 for a olfactory test, and generates a series of olfactory test information according to the patient's individual test process and information to evaluate the performance of the olfactory test. Smell threshold and false-positive self-test information generated by the self-test device 1 and performance evaluation information are transmitted to the web server 3 through the communication unit 600 .

The olfactory threshold and false-positive self-test device 1 operates according to a olfactory test protocol previously set based on the prescription of the medical staff 3 so as to systematically test the olfactory test and increase the patient's compliance. The olfactory test protocol can be reset at any time based on feedback information from medical staff as treatment progresses, and therefore, personalized treatment for each patient can be made easier. The olfactory test protocol is directly entered by the patient (4) into the olfactory threshold and false positive test device (1), or controls the olfactory threshold and false positive test device (1) through the web server (2) based on the prescription of the medical staff (3). It can be received by unit 500 and automatically reset.

The olfactory test information of the patient 4 generates one or more of olfactory threshold test result information and false positive test result information. It includes at least one of period, frequency, and training time.

The patient 4's olfactory test performance evaluation information includes the actual number of discharges of fragrance substances from the olfactory threshold and false positive self-test device 1 and the proximity sensor unit (not shown) of the olfactory threshold and false positive self-test device 1 to be described later. Through the process, the patient 4 compares and analyzes the number of times the patient 4 has actually trained adjacent to the olfactory threshold and the false positive self-test device 1 within a predetermined radius. That is, if the actual number of training sessions confirmed through the proximity sensor unit compared to the number of actual fragrance discharges is more than a certain number, it is determined that the smell test has been completed accurately as prescribed by the medical staff 3, and if the number is less than a certain number, It may be determined that the patient 4 did not properly perform the olfactory test according to the prescription of the medical staff 3 .

The web server 2 includes a patient database that integrates and manages the olfactory test information of the patient 4 generated by the olfactory threshold and false positive self-test device 1 and the patient's olfactory test performance evaluation information. The patient database includes olfactory test information and performance evaluation information accumulated from several patients as shown in FIG. As shown in b), it can be quantitatively analyzed and provided.

In addition, the web server 2 may include a feedback database that integrates and manages feedback information of the medical staff 3 . Feedback information integrated and managed by the feedback database can be received by the olfactory threshold and false positive self-test device 1, and therefore, even if the patient 1 does not directly face the medical staff 3, the patient 1's own treatment results and It can be prescribed for future treatment, and the olfactory test protocol of the olfactory threshold and false positive self-test device (1) can be re-established.

The medical staff terminal is a computer, tablet, etc. that can be accessed by the medical staff (3), and is integrated in the web server (2) according to the request of the medical staff to communicate with the web server (2) and provide feedback on the patient's olfactory examination results. A patient database to manage is provided. Therefore, if necessary, the medical staff 3 can immediately check the individual treatment results of the patient 4 as data and provide feedback to the patient 4 regarding future treatment. At this time, the medical staff (3) receives accumulated decision-making data from multiple patients from the web server (2) and can be helped in making the best prescription for each individual patient (4). The olfactory test protocol can be set for each patient.

On the other hand, the feedback information of the medical staff 3 may be delivered orally when the patient 4 visits a hospital or the like face to face, or may be delivered in a non-face-to-face manner through the web server 2.

Hereinafter, the configuration of the olfactory threshold and false positive self-test device according to the first embodiment of the present invention will be described in more detail with reference to FIGS. 4A to 4C and FIGS. 7 to 8C. Figure 4a is an exploded perspective view of an olfactory threshold and false positive self-test device according to an embodiment of the present invention, Figure 4b is a schematic perspective view showing the inside of the upper housing shown in Figure 4a, Figure 4c is shown in Figure 4a It is a schematic diagram showing the arrangement of the fragrance discharge unit and the capsule member in a state in which the olfactory threshold and false positive self-test device are combined, and FIG. 4 is a cross-sectional view according to one embodiment of the capsule included in the olfactory threshold and false positive self-test device of the present invention. 5A to 5C are an exploded perspective view showing a combined state of the bottom plate and a rotating shaft member in the moving unit included in the olfactory threshold and false positive self-test device of the present invention, respectively, and an exploded perspective view showing a coupled state between the bottom plate and the connecting member. And a cross-sectional view of a state in which the moving unit is coupled.

4A to 4C, the olfactory threshold and false positive self-test device 1 of the present invention includes a capsule unit 100, a moving unit 200, a housing unit 300, a fragrance discharge unit 400, and a control unit (not shown). In addition, a communication unit (not shown) and a proximity sensor unit (not shown) may be further included.

The capsule unit 100 is a component for providing the patient with a scent determined for the olfactory test. In particular, for the olfactory threshold test, there are three capsule units 110 each storing butanol, optional fragrance material 1, and arbitrary fragrance material 2. Since two capsules 110 each storing coffee and ammonia are required for a false positive test, at least 11 capsules 110 may be included. Accordingly, the capsule unit 100 may be implemented with only five capsule units 110, but as an embodiment, it may be configured to include six capsule units 110 including one more capsule unit in which butanol is stored. This is to prevent, as much as possible, prediction of the discharged fragrance based on the realization state of the device rather than the patient's sense of smell during the olfactory threshold test.

The capsule unit 110 is not limited as long as it has a configuration capable of storing the fragrance material and then discharging it by adjusting the concentration of the fragrance discharged under certain conditions, but as an embodiment, as shown in FIG. 10, the cylindrical capsule member 111 ), it may be configured to include a heating member 112 and a fragrance material (113).

Referring to FIG. 4 , the tubular capsule member 111 is a container for storing a fragrance material 113 and may be formed in a test tube shape having a hollow shape having a predetermined diameter and a predetermined length and an open top. The heating member 112 is a component for adjusting the concentration of the fragrance material 113 discharged by applying heat to the fragrance material 113 stored in the capsule member 111, as shown in FIG. 10, the capsule member 111 ), but may be formed inside the walls constituting the lower surface portion and the side portion, or may be formed in such a way as to surround the outside of the capsule member 111. At this time, the heating member 112 operates only the heating member disposed on the upper portion of the capsule member 111 at first, and then only the heating member disposed in the middle portion operates as the fragrance material stored in the capsule member 111 is used. It can be implemented in such a way that only the heating members disposed on the lower and lower surfaces are operated. The fragrance material 113 generally includes butanol, arbitrary fragrance material 1 and arbitrary fragrance material 2 used in the olfactory threshold test, and coffee and ammonia used in the olfactory false positive test. Here, arbitrary fragrance material 1 and arbitrary fragrance material 2 are known fragrance materials used in the olfactory threshold test, such as rose, cinnamon, peach, orange, lemon, strawberry, pineapple, leather, grass, honey, vanilla, chocolate, peppermint fir, Onion, coconut, banana, walnut, cherry, apple, grapefruit, licorice, chewing gum, mustard, gum, mint, rosin, garlic, carrot, tobacco, wine, smoke, melon, pear, plum, green tea, sesame oil, rum, bread, Fish, chiju, ham, etc. may be used. The fragrance material 113 is stored in the capsule member 111 in a solid state so that the fragrance is not mixed, and the heating member 112 heats the heating member 112 by the control unit only at the time when the fragrance needs to be discharged through the fragrance discharge unit 400. It is configured to adjust the concentration of the fragrance discharged along the way.

The moving unit 200 is a component that fixes the capsule unit 100 and moves it to a certain position, that is, fixes a plurality of capsule parts 110 included in the capsule unit 100 to an appropriate position and performs an olfactory test selected by the patient. This is because the capsule unit 110, which is controlled by the control unit according to the protocol and stores the fragrance to be discharged through the fragrance dispensing unit 400, moves to a position consistent with the fragrance dispensing unit 400.

The moving unit 200 may include a bottom plate part 210 and a rotating part 220 as an example of implementation. As shown in FIGS. 8A to 8C, the bottom plate part 210 has six seating grooves in which the lower parts of the six capsule parts 110 included in the capsule unit 100 are inserted and fixed to the disk-shaped bottom plate member 211. 212 may be implemented in a form formed at regular intervals.

The rotation unit 220 is a component that rotates the bottom plate unit 210 and can move the specific capsule member 100 to a position consistent with the fragrance dispensing unit 400. This is because when is rotated, the position of the capsule member 100 seated in the seating groove 212 of the bottom plate portion 210 is moved. As an embodiment, the rotation unit 220 may include a rotation shaft member 221, a rotation connection member 222, and a rotation power member (not shown). As shown in FIG. 5C, the rotating shaft member 221 is formed perpendicular to the ground from the bottom of the housing unit 300 through the center of the bottom plate portion 210, and the rotation connecting member 222 is the bottom plate portion 210 As shown in FIG. 5B as a component connecting the rotary shaft member 221 and the bottom plate part 210 by being formed between the rotary shaft member 221 and the bottom plate part 210 so that the rotational power of the rotary shaft member 221 is transmitted. It may also be implemented in the form of a cog wheel, but is not limited thereto. The rotational power member may be built into and installed in the lower housing 310 of the housing unit 300, and all known power sources may be applied as long as the rotational shaft can be rotated. As one implementation, an electric motor may be used.

The housing unit 300 is a component including a closed space in which the capsule unit 100 and the moving unit 200 can be installed. As an embodiment, the housing unit 300 may include a lower housing 310 , a side housing 320 and an upper housing 330 .

As shown, the lower housing 310 is a component surrounding the bottom plate portion 210 of the moving unit 200 by forming the lower surface and the lower side of the closed space, and includes a cylindrical member 311 having a certain thickness and a cylindrical member ( 311) may include a protruding extension member 312 extending vertically to a predetermined height toward the inner upper portion of the outer periphery. Here, the cylindrical member 311 has a thickness capable of forming a space in which a control unit, a communication unit, a rotational power member, and the like can be embedded. As shown, the protruding extension member 312 is the side housing 320 so that the side housing 320 can be positioned on the same plane as the side surface of the cylindrical member 311 when the side housing 320 is fitted to the outside as shown. It is formed at a position inserted into the inside by the thickness of. The side housing 320 extends vertically from the lower housing 310 to form a side surface of the closed space and surrounds the capsule unit 100. It includes a through-type cylindrical member without upper and lower surfaces while forming a hollow inner space having a longer length than the capsule unit 100 . Here, the through-type cylindrical member may be formed transparently or opaquely, but it may be preferable to be formed opaquely so that the patient does not visually perceive the fragrance. The upper housing 330 is a component that covers the upper end of the side housing 320 and forms the upper surface of the closed space in which the capsule unit 100 is embedded, and is a disk member having an inner diameter fitted with the outer surface of the upper end of the side housing 320. 331 and a vertical lower extension member 332 vertically extending a certain length from the outer periphery of the disk member 331 to the lower portion thereof.

In the housing unit 300, as an embodiment, the lower housing 310, the side housing 320, and the upper housing 330 having the above-described configuration may be detachably attached to each other. That is, the lower part of the penetrating cylindrical member of the side housing 320 is fitted to the outside of the protruding extension member 312 of the lower housing 310, and the vertical extending member 332 of the upper housing 330 to the outside of the upper end of the penetrating cylindrical member. ) is inserted so that the housing unit 300 can form a cylindrical shape having a height longer than that of the capsule unit 100 as a whole and having a closed space formed therein.

The fragrance discharge unit 400 is installed to form a part of the upper surface of the closed space included in the housing unit 300 and discharges the fragrance contained in the specific capsule unit 110 moved to a predetermined position by the moving unit 200 for a predetermined period of time. It is a component that As an embodiment, the fragrance discharge unit 400 may include a through hole 410, a cover part 420 and a hollow protruding part 430.

The through hole 410 is a hole formed through the upper housing 330 of the housing unit forming the upper surface of the inner space of the housing unit 300, that is, the closed space, and releases the fragrance contained in the capsule unit 110 installed in the closed space. It is a component that discharges to the outside. Therefore, as shown in FIGS. 4A to 4C , the through hole 410 is any one of the areas opposite to any one of the plurality of capsule parts 110 installed in the closed space in the disc member 331 of the upper housing 330. It can be formed by penetrating one area. Since the scent contained in the capsule part 110 is discharged to the outside through the through hole 410, the size of the through hole 410 may be formed equal to the diameter of the capsule part 110 so that all the emitted fragrance is discharged to the outside. there is.

The cover part 420 is a component that acts as a lid that opens or closes a closed space by opening and closing the through-hole 410, and has a diameter capable of covering the through-hole 410 from the top thereof, and one side of the outer periphery of the through-hole 410 It may be formed integrally with the disc member 331 of the. As long as the cover part 420 can open and close the through-hole 410, all known methods can be applied without limitation in material and shape. As an embodiment, it has a diameter that can be inserted into the through-hole 410 A form in which the protrusion is formed may be installed and a method of manually opening and closing it may be proposed. Of course, if necessary, an automatic opening/closing type cover unit 420 may be installed. Through the cover part 420 of this configuration, when the patient does not use the olfactory threshold and false positive self-test device 1, the through-hole 410 is covered with the cover 420 to close the closed space, and the olfactory threshold and false positive self-test device 1 is closed. In the case of olfactory examination using the self-testing device 1, the cover part 420 is opened to open a closed space, and when the fragrance whose concentration is adjusted by the control unit is discharged from the capsule unit 110, the discharged fragrance is discharged from the closed space. It can be made to radiate out of space.

The hollow protruding part 430 is a component for assisting that the fragrance emitted from the capsule part 110 is almost discharged through the through hole 410 without being scattered to other places, and as shown in FIG. 4B, the through hole ( 410) may be formed so as to form a cylindrical hollow part having the same diameter as the through-hole 410 vertically from the outer periphery to its lower part. In particular, the hollow protruding part 430 may be formed to have a length maintaining an extremely close distance from the upper end of the capsule part 110, as shown in FIG. 4C. Hereinafter, the term "ultra-close distance" means that the distance between the lower end of the hollow protrusion 430 and the upper end of the capsule 110 is not 0, but friction does not occur when the capsule 110 is moved by the moving unit 200. It means the smallest ultra-fine distance. Therefore, in the case of having an "ultra-close distance", it may visually appear to be almost in contact, but in reality, it may be formed to have a distance of about several nanometers to hundreds of micrometers.

The control unit is built into the housing unit 300 and controls one or more of the capsule unit 100, the moving unit 200, and the fragrance dispensing unit 400, so that the patient passes through the fragrance dispensing unit 400 according to a preset smell test protocol. As a component that controls the operation of the olfactory threshold and false positive self-test device 1 as a whole so as to discharge a scent that can be smelled, all known control unit technologies can be used, but as an embodiment, memory, auxiliary circuits and A type in which a micro-processing unit (MPU) is assembled on a single printed circuit board may be embedded in the housing unit 300 and used. The control unit controls the capsule unit 100, the moving unit 200, and the fragrance discharge unit 400 according to a preset odor test protocol program when the olfactory threshold and false positive self-test device 1 is turned on. The concentration of the fragrance emitted from the fragrance material 113 stored in the capsule unit 110 is divided into at least 11 to 16 stages from the weakest concentration stage to the strongest concentration stage, and the fragrance dispensing unit has a concentration determined in the predetermined smell test sequence. In step 400, a fragrance that the patient can smell is discharged, and after the patient smells the discharged fragrance, one or more of olfactory threshold test result information and false positive test result information may be generated according to selected input information. On the other hand, if the proximity sensor unit is included, it may be evaluated whether the user performed the smell test more accurately by comparing the number of times the patient smelled the fragrance discharged through the fragrance discharge unit with the nth number determined in the selected smell test protocol. That is, since the number of times the patient smells the fragrance discharged through the fragrance discharge unit is the number of times the proximity sensor unit detects that the patient's face is adjacent to the fragrance discharge unit, in fact, the number of times the fragrance is actually discharged through the fragrance discharge unit Because there is no choice but to be below.

The communication unit (not shown) transmits the patient's olfactory test information, that is, olfactory threshold test result information and false-positive test result information to a hospital server accessible to the patient's doctor, and various information related to the smell test including the doctor's feedback information. As a component for receiving information, it is installed and built into the housing unit 300. The communication unit does not limit wired/wireless communication and all known components can be used. In the case of direct transmission to an external hospital server, a communication unit may be implemented to enable communication with an external system in a hypertext transfer protocol (HTTP)/representational state transfer (REST)/simple object access protocol (SOAP) method.

The proximity sensor unit (not shown) is a component for checking whether the patient actually performs a smell test using the olfactory threshold and false positive self-test device 1, and the fragrance discharge unit 400, in particular, the through-hole 410 It may be installed on the upper outer side of the upper housing unit 330 adjacent to. As long as the proximity sensor unit can sense that the patient's face is facing the penetration hole 410, all known sensing technologies can be applied, but as an embodiment, it may be a proximity sensor.

Next, the configuration of the olfactory threshold and false positive self-test device according to the second embodiment of the present invention will be reviewed with reference to FIGS. 5A to 5C and FIGS. 7 to 9 . 5A is an exploded perspective view of an olfactory threshold and false positive self-test device according to another embodiment of the present invention, FIG. 5B is a schematic perspective view showing the inside of the upper housing shown in FIG. 5A, and FIG. It is a schematic diagram showing the arrangement of the fragrance discharge unit and the capsule member in a state in which the olfactory threshold and false positive self-test device are combined. On the other hand, the configuration of the olfactory threshold and false positive self-test device according to the second embodiment of the present invention is different from the configuration of the first embodiment described above only in the configuration of the fragrance discharge unit 400, but the other components are the same, so the fragrance discharge Only the configuration of the unit 400 will be described.

The fragrance discharge unit 400 is installed to form a part of the upper surface of the closed space included in the housing unit 300 and discharges the fragrance contained in the specific capsule unit 110 moved to a predetermined position by the moving unit 200 for a predetermined period of time. It is a component that As another embodiment, the fragrance discharge unit 400 may include a through hole 410, a cover part 420 and a movement guide part 440. Here, since the configuration of the through hole 410 and the cover portion 420 of the fragrance dispensing unit 400 is also the same as that of the first embodiment described above, only the movement guide portion 440 will be described in detail.

The movement guide part 440 is also a component for assisting the scent emitted from the capsule part 110 to be discharged through the through hole 410 without scattering to other places, like the hollow protrusion part 430, FIG. As shown in 5b, a fixing member having a disk-shaped plate-like structure 441 inserted into the lower part of the upper surface of the closed space and fixed to the upper part of the rotating shaft member 221 of the moving unit 200 at the center of the plate-like structure 441 ( 442) is formed and has a structure in which a plurality of through insertion holes 443 are formed penetrating the plate-like structure 441 so that the upper end of the capsule unit 110 is inserted at a position facing each of the installed plurality of capsule units 110. can

Here, the diameter of the plate-shaped structure 441 is smaller than the diameter of the upper housing 330, but may have a diameter capable of covering an area where all the capsule units 110 included in the capsule unit 100 are installed. If necessary, the diameter of the plate-like structure 441 may be formed to a diameter capable of maintaining a very close distance to the upper housing 330 . The thickness of the plate-like structure 441 can be adjusted in consideration of the height of the rotating shaft member 221. In a state where the plate-shaped structure 441 is fixed to the rotating shaft member 221 through the fixing member 442, the upper housing 330 ) may be formed to a thickness capable of maintaining a very close distance to the inner surface of the disc member 331.

The fixing member 442 is not limited as long as it is formed at the center of the plate-like structure 441 and can be fixed with the rotary shaft member 221, but as an embodiment, the diameter in which the upper part of the rotary shaft member 221 can be fitted with an interference fit It can be implemented as a fixed groove of.

The through-insertion hole 443 is a through-hole formed at a position opposite to the seating groove 211 formed in the bottom plate part 210 towards the edge of the plate-shaped structure 441, and its diameter is such that the capsule part 110 can be inserted. is the diameter

As shown in FIG. 9, the movement guide unit 440 configured as described above is fixed to the upper portion of the rotating shaft member 221 by the fixing member 442, so that it is installed in a state spaced apart from the upper housing 330 at a very close distance. Movement without friction may be guided by the moving unit 200 so that the upper portion of the capsule unit 110 is located under the through hole 410 of the fragrance dispensing unit 400 .

Next, the configuration of the olfactory threshold and false positive self-test device according to the third embodiment of the present invention will be described with reference to FIGS. 6A to 6C and 7 to 8C. 6A is an exploded perspective view of an olfactory threshold and false positive self-test device according to another embodiment of the present invention, FIG. 6B is a schematic perspective view showing the inside of the upper housing shown in FIG. 6A, and FIG. 6C is a view shown in FIG. 6A It is a schematic diagram showing the arrangement of the fragrance discharge unit and the capsule member in the state in which the olfactory threshold and false positive self-test device are combined. Meanwhile, the configuration of the olfactory threshold and false positive self-test device according to the third embodiment of the present invention is the same as the above-described second embodiment, except that only the configuration of the first embodiment and the configuration of the fragrance discharge unit 400 are different. Since the components are the same, only the configuration of the fragrance discharge unit 400 will be described.

The fragrance discharge unit 400 is installed to form a part of the upper surface of the closed space included in the housing unit 300 and discharges the fragrance contained in the specific capsule unit 110 moved to a predetermined position by the moving unit 200 for a predetermined period of time. It is a component that As another embodiment, the fragrance discharge unit 400 may include a through hole 410, a cover part 420, and a double partition wall guide part 440. Here, since the configuration of the through hole 410 and the cover portion 420 of the fragrance dispensing unit 400 is also the same as that of the first embodiment described above, only the double partition guide portion 450 will be described in detail.

Like the hollow protruding part 430 and the moving guide part 440, the double bulkhead guide part 450 also discharges most of the fragrance emitted from the capsule part 110 through the through hole 410 without being scattered to other places. As an auxiliary component, as shown in FIG. 9B, a plurality of capsule parts 110 seated in the seating groove 211 of the bottom plate part 210 among the upper housing 330, especially the lower surface of the disc member 331, and It may include an inner partition wall part 451 and an outer partition wall part 452 that are spaced apart from each other and extended with a predetermined length so as to have a width into which the capsule unit 110 can be inserted vertically at opposite positions.

In this way, when the fragrance dispensing unit 400 includes the double partition wall guide part 450, a plurality of spaces inside the double partition wall guide part 450, that is, between the inner partition wall part 451 and the outer partition wall part 452. Since the upper end of the capsule unit 110 must be inserted while maintaining a very close distance to the lower surface of the upper housing 330, that is, the lower surface of the disc member 331, the height of the side housing 320 is set to the disc member 331. The lower surface of the capsule and the upper part of the capsule can be adjusted to maintain a very close distance. When configured as described above, the double partition wall guide part 450 can be guided by the moving unit 200 so that the upper end of the specific capsule part is located in the through hole 410 of the fragrance dispensing unit 400 so that it can move without friction during movement.

Although not specifically described, the olfactory threshold and false positive self-test device 1 having the above-described configuration is powered by a housing unit 300 rather than a known wired cord type so that it can be easily used at a patient's home as well as in a hospital. It can also be used as a portable device with a built-in battery.

Next, looking at the olfactory test, particularly the olfactory threshold test method according to the present invention using the olfactory threshold and false positive self-test device having the above-described configuration, as shown in FIG. 7, the basic evaluation step, the pause step, and the first evaluation stage, secondary evaluation stage, and tertiary evaluation stage.

First, the basic evaluation step is a step of evaluating whether the highest concentration of butanol fragrance is discharged from the capsule unit in which butanol is embedded for several seconds to several tens of seconds, and whether the patient can detect the discharged fragrance. Since the strongest scent is emitted in this step, if the patient does not detect the scent emitted in this step, there is a high probability that there is a problem with the olfactory function or that the patient is making a false choice. Therefore, if the patient does not detect the discharged fragrance in the basic evaluation step, there is no need to perform the subsequent steps, so the test may be terminated and at least one of the olfactory false positive test and the olfactory recognition test may be performed. The resting step is a step to avoid adaptation of the patient's sense of smell exposed to the very strong butanol fragrance in the basic evaluation step, and waits without discharging the fragrance for about several minutes.

The first evaluation step is a step of performing at least one of the first detection step, the resting step, and the second detection step. If the sense of smell is sensitive, the olfactory threshold result can be obtained only in the first evaluation step. Since the olfactory threshold result cannot be obtained only in the first evaluation step, the second and third evaluation steps may be performed sequentially.

Here, in the first sensing step, the fragrance adjusted to the nth concentration, which is the lowest concentration, is discharged in a random order from three capsule units each containing butanol, arbitrary fragrance material 1, and arbitrary fragrance material 2, and discharged for several seconds to several tens of seconds, respectively. As a step in which the capsule part with the butanol scent is selected by the patient who sequentially smells the fragrance, when the concentration of the fragrance is adjusted in 16 steps as an embodiment, in the first detection step performed first, the n-th concentration is the weakest. It may mean a concentration adjusted to the 16th step with fragrance. Therefore, in the basic evaluation step, the fragrance adjusted to the concentration of the first step, which is the highest concentration, is discharged, and in the first detection step in the first evaluation step performed first, the fragrance adjusted to the concentration of the 16th step, which is the weakest concentration, is discharged. can be ejected. The pausing step is to avoid adaptation of the patient's sense of smell and is performed by pausing for several seconds to several tens of seconds. The second sensing step is a step in which the first sensing step is re-performed after the pausing step is performed.

As described above, the second evaluation step is performed in the first detection step and the second detection step according to the patient's butanol capsule portion selection result obtained in at least one of the first detection step and the second detection step performed in the first evaluation step. If all are correct, the threshold test is terminated, or if either of the first and second detection steps is incorrect, at least one of the first detection step and the second detection step is performed with the fragrance adjusted to a concentration two steps higher than the current concentration discharged. It is a step to

As an embodiment, if the capsule part containing butanol is selected in the first detection step of the first evaluation step and the capsule part containing butanol is selected in the second detection step performed after the resting step, the threshold test is terminated and 16 points are given to the patient. can be determined by the olfactory threshold of

However, if any one of the first and second sensing steps is incorrect, the first and second sensing steps may be performed in the same manner as described above in a state in which the fragrance adjusted to a concentration two steps higher than the current concentration is discharged.

For example, in the first detection step performed in the first evaluation step in which the scent adjusted to the concentration of 16 levels is discharged, the patient could not select the butanol capsule part, or the patient selected the butanol capsule part in the first detection step. In the second sensing step, if the selection is not possible, the first sensing step is performed again with the fragrance adjusted to the 14th level being discharged.

In the third evaluation step, according to the patient's selection result of the butanol capsule part obtained in at least one of the first detection step and the second detection step performed in a state in which the fragrance adjusted to the second high concentration is discharged in the second evaluation step, If both of the first detection step and the second detection step are correct, at least one of the first detection step and the second detection step is performed in a state in which the fragrance adjusted to a concentration lower than the current concentration by one step is discharged, or the first detection step is performed. This is a step of performing at least one of the first detection step and the second detection step in a state in which the fragrance adjusted to a concentration two steps higher than the current concentration is discharged if any one of the steps and the second detection step is incorrect.

For example, if the patient selects the butanol capsule unit in the first sensing step performed in the state in which the fragrance adjusted to the 14-step concentration is discharged and the patient selects the butanol capsule unit in the second sensing step performed after the resting step, The first detection step can be performed again with the fragrance adjusted to step 15 lower than the discharged current concentration (level 14 concentration) discharged. At this time, also, when the patient selects the butanol capsule part, step 15 after the step of stopping A second sensing step may be performed with the concentration.

However, in the first detection step performed with the fragrance adjusted to the concentration of 14 steps discharged, the patient could not select the butanol capsule part, or in the first detection step adjusted to the concentration of 14 steps, the patient selected the butanol capsule part. However, if it is not correctly selected in the second detection step performed after the pause step, the first detection step resumes with the scent adjusted to the concentration of the 12th step, which is two steps higher than the current concentration (the concentration of the 14th step), discharged. that will be carried out

Therefore, in the above-described third evaluation step, the patient's butanol capsule portion selection result obtained when at least 10 turning points are generated or the first detection step and the second detection step are performed in a state where the fragrance adjusted to the nth concentration is discharged. This may be repeated several times until all are correct. Terms such as the nth evaluation step, the n-1st evaluation step, the n+1st evaluation step, the 4th evaluation step, and the 5th evaluation step used below are all evaluated according to the above-mentioned criteria until seven turning points are reached. This refers to the steps in which the secondary evaluation step is repeated, and is named differently for the convenience of classification.

Here, the turning point is that the concentration of the fragrance discharged in the first and second detection steps of the n-1 evaluation step prior to the n-th evaluation step is the fragrance discharged in the first and second detection steps of the n-th evaluation step. When it is lower than the concentration of n+ when the concentration of the fragrance discharged in the first and second detection steps of the first evaluation step is lower than the concentration of the fragrance discharged in the first and second detection steps of the nth evaluation step, and n- When the concentration of the fragrance discharged in the first and second detection steps of the first evaluation step is higher than the concentration of the fragrance discharged in the first and second detection steps of the nth evaluation step, the first and second evaluation steps of n+1 When the concentration of the fragrance discharged in the second sensing step is higher than the concentration of the fragrance discharged in the first and second sensing steps of the n-th evaluation step, when such conditions are met, the inflection point that occurs naturally in the n-th evaluation step it means.

For example, assuming that the n-th evaluation step is the 4th evaluation step (a step in which the 3rd evaluation step is repeated once), the n-1th evaluation step means the 3rd evaluation step, and the n+1th evaluation step is Since it means the 5th evaluation step (a step in which the 3rd evaluation step is repeated twice), as described above, the case where the concentration of the fragrance discharged in the 1st and 2nd detection steps of the 3rd evaluation step is 15th level is the 3rd evaluation step. It can be defined as the first detection step 1 of the evaluation step, and the case of the 12th step can be defined as the first detection step 2 of the 3rd evaluation step.

Therefore, the concentration of the fragrance discharged in the first and second detection steps of the 4th evaluation step is the first detection step 1 of the 3rd evaluation step, that is, in the case of the 15th step, both the patient in the first detection step and the second detection step If the butanol capsule part is selected, that is, if all are correct, it is the 16th step, and if any one is wrong, it is the 13th step. If all of the steps are correct, it is the 13th step, and if any one is wrong, it is the 10th step.

In addition, the concentration of the fragrance discharged in the first and second detection steps of the 5th evaluation step is 16th step if all of the concentrations of the fragrance discharged in the 1st and 2nd detection steps of the 4th evaluation step are 16th step. The concentration of is continuously matched to end the test, and if any one is wrong, the 14th step is reached. On the other hand, the concentration of the fragrance discharged in the first and second sensing steps of the 5th evaluation step is 14th level if all are matched when the concentrations of the fragrance discharged in the 1st and 2nd sensing steps of the 4th evaluation step are 13th level. , and if any one is wrong, it becomes the 11th step. In addition, the concentration of the fragrance discharged in the first and second detection steps of the 5th evaluation step is 11th step if all of the concentrations of the fragrance discharged in the 1st and 2nd detection steps of the 4th evaluation step are 10th. , and if any one is wrong, it becomes the eighth step.

Therefore, as an embodiment, looking at the case where the 4th evaluation step is the turning point, as described above, when the concentration of the fragrance discharged in the 4th evaluation step is the 13th step, the concentration of the fragrance discharged in the 3rd evaluation step is If it is step 15 and the concentration of the fragrance discharged in the 5th evaluation step is the 14th or 15th step, the 4th evaluation step becomes the turning point, and the score at that time is 13 points, which is the concentration of the fragrance discharged in the 4th evaluation step. can do.

In addition, when the concentration of fragrance discharged in the 4th evaluation step is 10th, the concentration of fragrance discharged in the 3rd evaluation step is 12th, and the concentration of fragrance discharged in the 5th evaluation is 15th and 14th. In the case of the step or the 11th step, the 4th evaluation step is the turning point, and the score at that time can be given 10 points, which is the concentration of the fragrance discharged in the 4th evaluation step.

In the above-described embodiment, only when the concentration of fragrance discharged in the 3rd evaluation step, which is the n-1st evaluation step, is higher than the concentration of fragrance discharged in the 4th evaluation step, which is the nth evaluation step, was exemplified. In the same way, it can be predicted that the inflection point occurring in the n-th evaluation step is a turning point only when the concentration of the fragrance discharged in the +1-th evaluation step is higher than that of the n-th evaluation step.

In this way, at least 7 turning points are calculated by calculating the turning points, or when the first detection step and the second detection step are performed in a state where the fragrance adjusted to the nth concentration, that is, the concentration of the 16th step is discharged, the patient's The third evaluation step is repeated several times until the selection results of the butanol capsule part are all correct.

As an embodiment, as shown in Table 1 below, the patient's threshold may be determined as an average value of 4 scores obtained later among scores obtained at 7 conversion points.

Furthermore, when patients show malingering for reasons such as secondary interests, equipment and methods for evaluating malingering are needed.

The present invention can provide an olfactory positivity test method that can identify malingering, false illness, or private disease using the olfactory threshold and false positive self-test device having the above-described configuration. To this end, two protocols can be used. First, a patient who cannot smell is a patient with true olfactory loss who has an abnormality in the first cranial nerve and olfactory nerve. However, since the 5th cranial nerve is normal in patients with true olfactory loss who have abnormal olfactory nerve, even if the 1st cranial nerve has an olfactory nerve abnormality, the trigeminal nerve, the 5th cranial nerve, controls the smell of ammonia, etc. can take on Using this, when the patient is instructed to smell the strong coffee aroma (olfactory nerve jurisdiction) and ammonia aroma (trigeminal nerve jurisdiction) familiar to the patient, patients with true olfactory loss cannot smell the coffee aroma, but can smell the ammonia aroma. Or, a patient who is a private soldier will state that he cannot smell both the coffee scent and the ammonia scent.

Therefore, the olfactory false positive test method according to the present invention using the olfactory threshold and false positive self-test device having the above configuration includes the steps of discharging coffee and ammonia aromas from two capsules in which coffee and ammonia are stored, respectively; inputting a patient's answer to whether or not the discharged fragrance is sensed; and evaluating false positives for the patient's sense of smell according to the patient's answer.

Here, in the step of evaluating false positives, as shown in FIG. 11, if the patient's answer is input as having detected both scents, the patient's sense of smell is determined to be normal, and if input as not detecting both scents, the patient It is judged that there is a false positive, and if it is input that only the smell of ammonia is detected, it is judged to be a true anosmia patient.

In addition, a olfactory identification test can be performed through the device of the present invention, and the olfactory identification test according to the present invention is a test that can simultaneously determine the degree of residual ability of a patient's sense of smell and false positives. , one is presented once and the other is presented twice, a total of three odors, and the odor presented only once is identified. In the case of 15 trials with different smells, a person with good residual olfactory ability will identify more times, and a person who cannot smell at all and cannot identify will have a statistically significant number of correct answers other than 0. You'll get about 1/3 of it, about 5 reps. Using this, it can be seen that a person who guesses 0 times is a person with a very high possibility of malingering.

Although the present invention has been shown and described with preferred embodiments as described above, it is not limited to the above embodiments, and to those skilled in the art within the scope of not departing from the spirit of the present invention Various changes and modifications will be possible.

1: olfactory threshold and false positive self-test device 2: web server
3: medical staff 4: patient
100: capsule unit 110: capsule unit
200: moving unit 300: housing unit
400: fragrance discharge unit 500: control unit
600: communication unit

Claims (4)

an olfactory threshold and false positive self-test device that generates information to evaluate the patient's olfactory test performance based on the patient's olfactory test information and the actual number of effective training sessions compared to the number of training sessions;
a web server including a patient database that integrates and manages the patient's sense of smell test information and the patient's sense of smell test performance evaluation information generated by the olfactory threshold and false-positive self-test device; and
The olfactory threshold and false positive self-test system including a medical staff terminal that communicates with the web server and provides the patient database, which is integrated and managed by the web server, to medical staff who provide feedback on the patient's olfactory examination results. According to claim 1,
The olfactory threshold and false positive self-test device is operated according to a preset olfactory test protocol,
The patient's olfactory test information includes at least one of the type of fragrance substance and olfactory training intensity, period, frequency, and training time,
The patient's olfactory test performance evaluation information consists of a process of comparing and analyzing the number of times the scent substance is discharged and the number of times the patient actually trains adjacent to the olfactory threshold and false-positive self-test device within a predetermined radius,
The web server includes a feedback database for integrated management of feedback information of the medical staff, and the olfactory threshold and false positive self-test device receives feedback information from the feedback database integrated and managed by the web server. system. According to claim 2,
The olfactory threshold and false positive self-test system is capable of resetting the olfactory test protocol based on the feedback information of the medical staff. According to claim 2,
The olfactory threshold and false-positive self-test system for allowing a medical staff to determine the olfactory test protocol for each patient based on the data accumulated in the web server.

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