TWI584777B - Flexible deep magnetic field generating apparatus - Google Patents

Flexible deep magnetic field generating apparatus Download PDF

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TWI584777B
TWI584777B TW103129044A TW103129044A TWI584777B TW I584777 B TWI584777 B TW I584777B TW 103129044 A TW103129044 A TW 103129044A TW 103129044 A TW103129044 A TW 103129044A TW I584777 B TWI584777 B TW I584777B
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magnetic field
flexible
strip
field generating
generating device
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TW201607496A (en
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戴政祺
陳建璋
張家榮
王瑋成
陳永祥
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國立成功大學
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Description

可撓深度磁場產生裝置 Flexible depth magnetic field generating device

本發明係應用於一種產生裝置,特別應用於一種可撓深度磁場產生裝置。 The invention is applied to a production device, in particular to a flexible depth magnetic field generating device.

現有腫瘤之熱治療方式包含微波熱療、射頻燒灼熱療及超聲聚焦熱療。其中,微波熱療與射頻燒灼熱療皆是在腫瘤內直接插入針狀電極;微波熱療利用通電後微波電極末端的微波輻射器產生熱效應,而射頻燒灼熱療則是利用電極針的射頻電流,經由離子激化轉換成熱能,造成局部腫瘤組織的凝固性壞死,從而達到對腫瘤治療的目的。然而上述方式的治療費用皆相當高,且造成病人較大的痛楚。 Existing thermal treatments for tumors include microwave hyperthermia, radiofrequency ablation hyperthermia, and ultrasound focused hyperthermia. Among them, microwave hyperthermia and radiofrequency ablation hyperthermia are directly inserted into the needle electrode in the tumor; microwave thermotherapy uses the microwave radiator at the end of the microwave electrode to generate thermal effect, while radiofrequency ablation hyperthermia uses the RF current of the electrode needle. It is converted into heat energy by ionization, causing coagulative necrosis of local tumor tissue, thereby achieving the purpose of treating tumors. However, the cost of treatment in the above manner is quite high, and causes a great pain to the patient.

因此,現有一種電磁熱治療方式,其係利用一線圈之交變磁場作用於一電磁針上,使電磁針產生渦電流而轉換成熱,進而燒灼腫瘤組織,這種方式可大幅降低治療費用及病人痛苦。而對這種方式而言,作用的電磁場就顯得相當重要。另外,由於目前的線圈皆是對應人體的某一特定部位而設計,若是人體的患病部位不是在該部位,則無法使用該線圈進行熱治療。此外,現有之線圈皆是設置於人體患病部位之上,因而其產生之深度磁場到達患病部位的位置時已有相當程度的衰減,導致電磁針的加熱溫度無法到達較高的溫度,而降低治療效果。 Therefore, there is a method of electromagnetic heat treatment in which an alternating magnetic field of a coil is applied to an electromagnetic needle to cause an eddy current to be converted into heat, thereby burning the tumor tissue, which can greatly reduce the treatment cost and The patient is suffering. In this way, the applied electromagnetic field is very important. In addition, since the current coil is designed to correspond to a specific part of the human body, if the diseased part of the human body is not in the part, the coil cannot be used for thermal treatment. In addition, the existing coils are disposed on the diseased part of the human body, so that the depth magnetic field generated by the existing magnetic field reaches a certain degree of attenuation, and the heating temperature of the electromagnetic needle cannot reach a higher temperature. Reduce the treatment effect.

因此,如何提供一種深度磁場產生裝置,能夠產生高強度之深度磁場,而提升電磁感應效能,並能應用於人體之各個部位,進而提升治療品質,實為當前重要課題之一。 Therefore, how to provide a deep magnetic field generating device capable of generating a high-intensity deep magnetic field and improving the electromagnetic induction performance, and being applicable to various parts of the human body, thereby improving the quality of treatment, is one of the current important topics.

有鑒於上述課題,本發明之一目的在於提供一種可撓深度磁 場產生裝置,其能產生高強度之深度磁場,而提升電磁感應效能,並能應用於人體之各個部位,進而提升治療品質。 In view of the above problems, it is an object of the present invention to provide a flexible depth magnetic The field generating device can generate a high-intensity deep magnetic field, improve the electromagnetic induction performance, and can be applied to various parts of the human body, thereby improving the treatment quality.

為達上述目的,依本發明之一種可撓深度磁場產生裝置包含一條狀可撓導電元件以及一條狀可撓絕緣元件。條狀可撓絕緣元件係包覆條狀可撓導電元件,且二者之間存在一空間。 To achieve the above object, a flexible depth magnetic field generating apparatus according to the present invention comprises a strip of flexible conductive element and a strip of flexible insulating element. The strip-shaped flexible insulating member covers the strip-shaped flexible conductive member with a space therebetween.

在一實施例中,條狀可撓導電元件係由複數片狀金屬貼合構成。 In one embodiment, the strip of flexible conductive elements are comprised of a plurality of sheet metal bonds.

在一實施例中,條狀可撓導電元件係由一軟性金屬製成。 In an embodiment, the strip of flexible conductive element is made of a soft metal.

在一實施例中,條狀可撓導電元件係由一螺旋狀金屬構成。 In one embodiment, the strip of flexible conductive element is comprised of a spiral metal.

在一實施例中,條狀可撓導電元件係由一絞線構成。 In one embodiment, the strip of flexible conductive element is comprised of a stranded wire.

在一實施例中,可撓深度磁場產生裝置係構成具有至少一匝之線圈。 In one embodiment, the flexible depth magnetic field generating device constitutes a coil having at least one turn.

在一實施例中,條狀可撓導電元件之二端部與條狀可撓絕緣元件連結。 In one embodiment, the ends of the strip of flexible conductive elements are joined to the strip of flexible insulating elements.

在一實施例中,空間係容置一冷卻液體或一冷卻氣體。 In one embodiment, the space accommodates a cooling liquid or a cooling gas.

在一實施例中,當可撓深度磁場產生裝置接收一交流電時,其係產生一平面深度磁場。 In one embodiment, when the flexible depth magnetic field generating device receives an alternating current, it produces a planar deep magnetic field.

在一實施例中,可撓深度磁場產生裝置係應用於熱治療或工程加熱。 In an embodiment, the flexible depth magnetic field generating device is applied to thermal therapy or engineering heating.

承上所述,在本發明之可撓深度磁場產生裝置中,由於導電元件與絕緣元件皆為條狀且為可撓,因此可撓深度磁場產生裝置能按照人體之患病部位變化為不同形狀,例如可構成直徑較小的線圈以環繞手臂或脖子,並可構成直徑較大的線圈以環繞人體的胸部或腰部。另外,在上述的態樣中,可撓深度磁場產生裝置係產生一平面深度磁場,而非傳統技術之垂直深度磁場,而平面深度磁場的衰減相較於垂直深度磁場大為減少,以致本發明所應用之熱治療針可被加熱較高的溫度。此外,本發明之可撓深度磁場產生裝置能視需求而構成為不同匝數的線圈以達到不同的加熱效果。因此,本發明之可撓深度磁場產生裝置,其能產生高強度之深度磁場,而提升電磁感應效能,並能應用於人體之各個部位,進而提升治療品質。 As described above, in the flexible depth magnetic field generating device of the present invention, since the conductive member and the insulating member are both strip-shaped and flexible, the flexible depth magnetic field generating device can be changed into different shapes according to the diseased part of the human body. For example, a coil having a smaller diameter may be formed to surround the arm or neck, and a coil having a larger diameter may be formed to surround the chest or waist of the human body. In addition, in the above aspect, the flexible depth magnetic field generating device generates a planar deep magnetic field instead of the vertical deep magnetic field of the conventional technique, and the attenuation of the planar deep magnetic field is greatly reduced compared to the vertical deep magnetic field, so that the present invention The applied heat treatment needle can be heated to a higher temperature. In addition, the flexible depth magnetic field generating device of the present invention can be configured as coils of different numbers according to requirements to achieve different heating effects. Therefore, the flexible depth magnetic field generating device of the present invention can generate a high-intensity deep magnetic field, thereby improving the electromagnetic induction performance, and can be applied to various parts of the human body, thereby improving the treatment quality.

1‧‧‧可撓深度磁場產生裝置 1‧‧‧Flexible depth magnetic field generating device

11、11a、11b‧‧‧條狀可撓導電元件 11, 11a, 11b‧‧‧ strip flexible conductive elements

111‧‧‧片狀金屬 111‧‧‧Sheet metal

12‧‧‧條狀可撓絕緣元件 12‧‧‧Strip flexible insulation elements

2‧‧‧電磁針 2‧‧‧Electromagnetic needle

3‧‧‧深度磁場產生裝置 3‧‧‧Deep magnetic field generating device

E‧‧‧連接端子 E‧‧‧Connecting terminal

H1、H2‧‧‧深度 H1, H2‧‧‧ Depth

P1、P2‧‧‧加熱點 P1, P2‧‧‧ heating point

S‧‧‧空間 S‧‧‧ Space

圖1為本發明一實施例之一種可撓深度磁場產生裝置的示意圖。 1 is a schematic diagram of a flexible depth magnetic field generating apparatus according to an embodiment of the present invention.

圖2及圖3為本發明一實施例之條狀可撓導電元件之不同態樣的示意圖。 2 and 3 are schematic views of different aspects of a strip-shaped flexible conductive member according to an embodiment of the present invention.

圖4為本發明一實施例之可撓深度磁場產生裝置與一電磁針搭配使用的示意圖。 4 is a schematic view showing the use of a flexible depth magnetic field generating device in combination with an electromagnetic needle according to an embodiment of the present invention.

圖5A及圖5B分別為習知技術之深度磁場產生裝置與本發明一實施例之可撓深度磁場產生裝置所產生之深度磁場的示意圖。 5A and 5B are respectively schematic diagrams of a deep magnetic field generated by a deep magnetic field generating device of the prior art and a flexible depth magnetic field generating device according to an embodiment of the present invention.

以下將參照相關圖式,說明依本發明較佳實施例之一種可撓深度磁場產生裝置,其中相同的元件將以相同的參照符號加以說明。 DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a flexible depth magnetic field generating apparatus according to a preferred embodiment of the present invention will be described with reference to the accompanying drawings, wherein the same elements will be described with the same reference numerals.

圖1為本發明一實施例之一種可撓深度磁場產生裝置1的示意圖。如圖1所示,本實施例之可撓深度磁場產生裝置1包含一條狀可撓導電元件11以及一條狀可撓絕緣元件12。本發明不限制可撓深度磁場產生裝置1的應用範圍,其可例如應用於工業上的加熱用途或是醫療上的加熱用途,於此係以應用於醫療上之電磁熱治療(electromagnetic thermotherapy)並與一電磁針搭配應用作為說明。 FIG. 1 is a schematic diagram of a flexible depth magnetic field generating apparatus 1 according to an embodiment of the present invention. As shown in FIG. 1, the flexible depth magnetic field generating apparatus 1 of the present embodiment includes a strip-shaped flexible conductive member 11 and a strip-shaped flexible insulating member 12. The present invention does not limit the application range of the flexible depth magnetic field generating device 1, and can be applied, for example, to industrial heating applications or medical heating applications, and is applied to medical electromagnetic thermotherapy and Used in conjunction with an electromagnetic needle as an illustration.

條狀可撓導電元件11之「條狀」的定義可例如為其一軸向長度至少為其一徑向長度的10倍,藉此可提升其可撓性。條狀可撓導電元件11之材料係為導磁金屬,例如為銅、非晶質金屬或其他導磁材料。條狀可撓導電元件11可由一軟性金屬製成,例如非晶質金屬。條狀可撓導電元件11可藉由材料特性或結構特性而達到可撓性。在本實施例中,條狀可撓導電元件11係由複數片狀金屬111貼合構成,藉此達到可撓性。片狀金屬111例如為薄銅片。另外,如圖2所示,條狀可撓導電元件11a可由一螺旋狀金屬構成,並藉此達到可撓性。再者,如圖3所示,條狀可撓導電元件11b可由一絞線(Litz wire)構成,並藉此達到可撓性。另外,條狀可撓導電元件11亦可有其他結構,例如可構成為一蛇管而達到可撓性。 The definition of "strip" of the strip-shaped flexible conductive member 11 can be, for example, an axial length of at least 10 times its radial length, whereby the flexibility can be improved. The material of the strip-shaped flexible conductive member 11 is a magnetic conductive metal such as copper, an amorphous metal or other magnetically permeable material. The strip-shaped flexible conductive member 11 may be made of a soft metal such as an amorphous metal. The strip-shaped flexible conductive member 11 can be made flexible by material properties or structural characteristics. In the present embodiment, the strip-shaped flexible conductive member 11 is formed by laminating a plurality of sheet-like metals 111, thereby achieving flexibility. The sheet metal 111 is, for example, a thin copper sheet. Further, as shown in Fig. 2, the strip-shaped flexible conductive member 11a may be composed of a spiral metal and thereby achieve flexibility. Further, as shown in FIG. 3, the strip-shaped flexible conductive member 11b may be constituted by a Litz wire, thereby achieving flexibility. Further, the strip-shaped flexible conductive member 11 may have other structures, for example, it may be configured as a flexible tube to achieve flexibility.

條狀可撓絕緣元件12係包覆條狀可撓導電元件11,且二者之間存在一空間S。條狀可撓絕緣元件12係由絕緣材料製成,絕緣材料例如但不限於為塑膠。由於條狀可撓絕緣元件12為絕緣,故當其接觸到病患時,病患不會有觸電的危險發生。條狀可撓絕緣元件12之長度係與條狀可撓導電元件11配合,例如至少長於條狀可撓導電元件11。在製作上,可直接將條狀可撓導電元件11置入條狀可撓絕緣元件12內,並將條狀可撓導電元件11之二端部與條狀可撓絕緣元件12連結而使二者相互固定。當然,上述二者之固定不僅可藉由端部達成,亦可藉由其他部位來達成。二者之固定可例如藉由鎖合、熱熔、卡合等等,或是藉由額外的固定元件來使二者固定,固定元件例如為一壓合元件。 The strip-shaped flexible insulating member 12 covers the strip-shaped flexible conductive member 11 with a space S therebetween. The strip-shaped flexible insulating member 12 is made of an insulating material such as, but not limited to, a plastic. Since the strip-shaped flexible insulating member 12 is insulated, the patient does not have the risk of electric shock when it comes into contact with the patient. The length of the strip-shaped flexible insulating member 12 is matched with the strip-shaped flexible conductive member 11, for example, at least longer than the strip-shaped flexible conductive member 11. In the production, the strip-shaped flexible conductive element 11 can be directly placed into the strip-shaped flexible insulating element 12, and the two ends of the strip-shaped flexible conductive element 11 are connected with the strip-shaped flexible insulating element 12 to make two They are fixed to each other. Of course, the fixation of the above two can be achieved not only by the end but also by other parts. The fixing of the two can be fixed, for example, by locking, hot-melting, snapping, etc., or by means of additional fixing elements, such as a pressing element.

空間S可容置一冷卻液體或一冷卻氣體。藉此可有效的帶走條狀可撓導電元件11所產生的熱。上述冷卻液體或氣體係藉由循環的方式將熱帶走。冷卻液體例如為水。 The space S can accommodate a cooling liquid or a cooling gas. Thereby, the heat generated by the strip-shaped flexible conductive member 11 can be effectively carried away. The above cooling liquid or gas system moves the tropics by circulation. The cooling liquid is, for example, water.

圖4為本實施例之可撓深度磁場產生裝置1與一電磁針2搭配使用的示意圖,其中,電磁針2係插設於一人體的腫瘤組織內。如圖4所示,可撓深度磁場產生裝置1由於其可撓性而能環繞使用者患病部位,因而大幅提升應用範圍。在應用上,可視實際需要將可撓深度磁場產生裝置1繞成具有至少一匝之線圈,於此係以二匝為例。可撓深度磁場產生裝置1之二端係接上連接端子E,而連接端子E可與一交流電供應器(圖未顯示)連接。這樣,可撓深度磁場產生裝置1可產生一深度磁場,而電磁針2可依據深度磁場產生渦電流而被加熱,進而燒掉腫瘤組織等等。 4 is a schematic view of the flexible depth magnetic field generating device 1 of the present embodiment used in combination with an electromagnetic needle 2, wherein the electromagnetic needle 2 is inserted into a tumor tissue of a human body. As shown in FIG. 4, the flexible depth magnetic field generating device 1 can surround the user's diseased part due to its flexibility, thereby greatly increasing the range of application. In application, the flexible depth magnetic field generating device 1 can be wound into a coil having at least one turn according to actual needs, and the second is taken as an example. The two ends of the flexible depth magnetic field generating device 1 are connected to the connection terminal E, and the connection terminal E can be connected to an AC power supply (not shown). Thus, the flexible depth magnetic field generating device 1 can generate a deep magnetic field, and the electromagnetic needle 2 can be heated according to the eddy current generated by the deep magnetic field, thereby burning off the tumor tissue and the like.

圖5A及圖5B分別為習知技術之深度磁場產生裝置與本發明之可撓深度磁場產生裝置1所產生之深度磁場的示意圖。如圖5A所示,由於習知之深度磁場產生裝置3僅能置放於患病部位之上,因此其所產生之深度磁場為一垂直深度磁場,其對於一加熱點P1例如具有一深度H1。而如圖5B所示,由於本發明之可撓深度磁場產生裝置1能環繞患病部位,因此其所產生之深度磁場為一平面深度磁場,其對於一加熱點P2例如具有一深度H2。而下面提供二表以顯示本發明之深度磁場之強度以及所帶來加熱的效果如何優於習知技術。 5A and 5B are schematic diagrams showing the depth magnetic field generated by the deep magnetic field generating device of the prior art and the flexible depth magnetic field generating device 1 of the present invention, respectively. As shown in FIG. 5A, since the conventional deep magnetic field generating device 3 can only be placed on the diseased site, the depth magnetic field generated by it is a vertical depth magnetic field having a depth H1 for a heating point P1, for example. As shown in FIG. 5B, since the flexible depth magnetic field generating device 1 of the present invention can surround the diseased portion, the depth magnetic field generated by the present invention is a planar depth magnetic field having a depth H2 for a heating point P2, for example. The second table is provided below to show how the strength of the deep magnetic field of the present invention and the effect of the resulting heating are superior to the prior art.

由上述二表可知,本發明之深度磁場之強度以及所帶來加熱的效果係大幅優於習知技術。 As can be seen from the above two tables, the strength of the deep magnetic field of the present invention and the effect of the heating brought about it are substantially superior to those of the prior art.

綜上所述,在本發明之可撓深度磁場產生裝置中,由於導電元件與絕緣元件皆為條狀且為可撓,因此可撓深度磁場產生裝置能按照人體之患病部位變化為不同形狀,例如可構成直徑較小的線圈以環繞手臂或脖子,並可構成直徑較大的線圈以環繞人體的胸部或腰部。另外,在上述的態樣中,可撓深度磁場產生裝置係產生一平面深度磁場,而非傳統技術之垂直深度磁場,而平面深度磁場的衰減相較於垂直深度磁場大為減少,以致本發明所應用之熱治療針可被加熱較高的溫度。此外,本發明之可撓深度磁場產生裝置能視需求而構成為不同匝數的線圈以達到不同的加熱效 果。因此,本發明之可撓深度磁場產生裝置,其能產生高強度之深度磁場,而提升電磁感應效能,並能應用於人體之各個部位,進而提升治療品質。 In summary, in the flexible depth magnetic field generating device of the present invention, since the conductive member and the insulating member are both strip-shaped and flexible, the flexible depth magnetic field generating device can change into different shapes according to the diseased part of the human body. For example, a coil having a smaller diameter may be formed to surround the arm or neck, and a coil having a larger diameter may be formed to surround the chest or waist of the human body. In addition, in the above aspect, the flexible depth magnetic field generating device generates a planar deep magnetic field instead of the vertical deep magnetic field of the conventional technique, and the attenuation of the planar deep magnetic field is greatly reduced compared to the vertical deep magnetic field, so that the present invention The applied heat treatment needle can be heated to a higher temperature. In addition, the flexible depth magnetic field generating device of the present invention can be configured as coils of different numbers according to requirements to achieve different heating effects. fruit. Therefore, the flexible depth magnetic field generating device of the present invention can generate a high-intensity deep magnetic field, thereby improving the electromagnetic induction performance, and can be applied to various parts of the human body, thereby improving the treatment quality.

以上所述僅為舉例性,而非為限制性者。任何未脫離本發明之精神與範疇,而對其進行之等效修改或變更,均應包含於後附之申請專利範圍中。 The above is intended to be illustrative only and not limiting. Any equivalent modifications or alterations to the spirit and scope of the invention are intended to be included in the scope of the appended claims.

1‧‧‧可撓深度磁場產生裝置 1‧‧‧Flexible depth magnetic field generating device

11‧‧‧條狀可撓導電元件 11‧‧‧Strip flexible conductive elements

111‧‧‧片狀金屬 111‧‧‧Sheet metal

12‧‧‧條狀可撓絕緣元件 12‧‧‧Strip flexible insulation elements

S‧‧‧空間 S‧‧‧ Space

Claims (6)

一種可撓深度磁場產生裝置,與一電磁針搭配應用於熱治療,該電磁針係插設於一人體的腫瘤組織內,該可撓深度磁場產生裝置包含:一條狀可撓導電元件;以及一條狀可撓絕緣元件,係包覆該條狀可撓導電元件,且二者之間存在一空間,該空間係容置一冷卻液體或一冷卻氣體;其中該可撓深度磁場產生裝置係構成具有至少一匝之線圈,當該線圈接收一交流電時,該可撓深度磁場產生裝置係產生一平面深度磁場。 A flexible depth magnetic field generating device is applied to a thermal treatment in combination with an electromagnetic needle inserted in a tumor tissue of a human body, the flexible depth magnetic field generating device comprising: a strip of flexible conductive element; and a strip a flexible insulating member covering the strip-shaped flexible conductive member with a space therebetween for accommodating a cooling liquid or a cooling gas; wherein the flexible depth magnetic field generating device is configured to have At least one turn of the coil, the flexible depth magnetic field generating device generates a planar deep magnetic field when the coil receives an alternating current. 如申請專利範圍第1項所述之可撓深度磁場產生裝置,其中該條狀可撓導電元件係由複數片狀金屬貼合構成。 The flexible depth magnetic field generating device according to claim 1, wherein the strip-shaped flexible conductive member is formed by laminating a plurality of sheet metal. 如申請專利範圍第1項所述之可撓深度磁場產生裝置,其中該條狀可撓導電元件係由一軟性金屬製成。 The flexible depth magnetic field generating device of claim 1, wherein the strip-shaped flexible conductive member is made of a soft metal. 如申請專利範圍第1項所述之可撓深度磁場產生裝置,其中該條狀可撓導電元件係由一螺旋狀金屬構成。 The flexible depth magnetic field generating device of claim 1, wherein the strip-shaped flexible conductive member is composed of a spiral metal. 如申請專利範圍第1項所述之可撓深度磁場產生裝置,其中該條狀可撓導電元件係由一絞線構成。 The flexible depth magnetic field generating device of claim 1, wherein the strip-shaped flexible conductive member is composed of a stranded wire. 如申請專利範圍第1項所述之可撓深度磁場產生裝置,其中該條狀可撓導電元件之二端部與該條狀可撓絕緣元件連結。 The flexible depth magnetic field generating device of claim 1, wherein the two ends of the strip-shaped flexible conductive member are coupled to the strip-shaped flexible insulating member.
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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4392040A (en) * 1981-01-09 1983-07-05 Rand Robert W Induction heating apparatus for use in causing necrosis of neoplasm
US4527032A (en) * 1982-11-08 1985-07-02 Armco Inc. Radio frequency induction heating device
US5461215A (en) * 1994-03-17 1995-10-24 Massachusetts Institute Of Technology Fluid cooled litz coil inductive heater and connector therefor
US6083149A (en) * 1997-10-22 2000-07-04 Emf Therapeutics, Inc. Magnetic field device and method for inhibiting angiogenesis and retarding growth rates of tumors in mammals

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4392040A (en) * 1981-01-09 1983-07-05 Rand Robert W Induction heating apparatus for use in causing necrosis of neoplasm
US4527032A (en) * 1982-11-08 1985-07-02 Armco Inc. Radio frequency induction heating device
US5461215A (en) * 1994-03-17 1995-10-24 Massachusetts Institute Of Technology Fluid cooled litz coil inductive heater and connector therefor
US6083149A (en) * 1997-10-22 2000-07-04 Emf Therapeutics, Inc. Magnetic field device and method for inhibiting angiogenesis and retarding growth rates of tumors in mammals

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