WO2017086709A1

WO2017086709A1 - Medical apparatus using ultrasonic waves, and method for moving and controlling transducer

Info

Publication number: WO2017086709A1
Application number: PCT/KR2016/013261
Authority: WO
Inventors: 강동환; 이수건
Original assignee: 주식회사 제이시스메디칼
Priority date: 2015-11-17
Filing date: 2016-11-17
Publication date: 2017-05-26
Also published as: KR101725189B1; KR20160059972A

Abstract

A method for moving and controlling a transducer according to various embodiments of the present invention may comprise the steps of: transmitting first ultrasonic waves and receiving the reflected first ultrasonic waves; analyzing the time and strength of the reflected first ultrasonic waves and outputting structural information on skin tissue on the basis of the analysis result; receiving an input selecting at least a portion of the output structural information on the skin tissue; and controlling the movement of the transducer in order to form a second ultrasonic wave focusing point for the transducer at a region to be treated corresponding to the at least one portion that is selected.

Description

Movement Control Method of Medical Device and Transducer Using Ultrasound

The present invention relates to a medical apparatus using ultrasonic waves, and more particularly, to a method of controlling the movement of a transducer mounted in a medical apparatus using ultrasonic waves.

Ultrasound is a wave having a frequency of 20KHz or more, and has a property of permeating water, and is widely used in medical fields such as an ultrasound diagnostic device and an ultrasound therapy device.

The use of ultrasound in the medical field is the most representative of the ultrasound imaging apparatus using the transmission and reflection properties of the ultrasound. For example, there is an apparatus that visualizes the reflected time and intensity while the ultrasound penetrates the human body and penetrates each organ, thereby obtaining a cross-sectional image in the human body.

In addition, by using the heat generated by high-intensity focused ultrasound to burn specific subcutaneous tissues such as tumors in the skin burned, or to cause degeneration and regeneration of skin tissues to generate skin beauty or skin shaping effect such as wrinkle improvement have.

However, in the conventional medical apparatus using high-intensity focused ultrasound, the transducer inside the cartridge does not move, so in order to perform the ultrasonic treatment over a large area, the operator has to perform the procedure by moving the handpiece little by little. Therefore, not only very troublesome, but also the interval can not be kept constant, there was a problem that a non-uniform procedure must be made over the entire treatment area.

The present invention seeks to provide a device capable of controlling three-dimensional spatial movement of a transducer inside a cartridge.

The present invention is to provide an apparatus that can automatically control the movement of the transducer to form the ultrasound focus point on the desired treatment site.

According to various embodiments of the present disclosure, a method of controlling a movement of a transducer may include transmitting a first ultrasonic wave and receiving the reflected first ultrasonic wave; Analyzing time and intensity of the received reflected first ultrasonic waves and outputting structure information of skin tissue based on the analysis result; Receiving an input for selecting at least some of the output structure information of the skin tissue; And controlling movement of the transducer so that a second ultrasonic focusing point of the transducer is formed at a treatment site corresponding to the selected at least part.

According to various embodiments of the present disclosure, a medical apparatus using ultrasound may include at least one transducer configured to convert vibration current into ultrasound; A drive unit having at least three motors; And transmitting a first ultrasonic wave, receiving the reflected first ultrasonic wave, analyzing time and intensity of the reflected first ultrasonic wave, and outputting structure information of skin tissue based on the analysis result, A main controller configured to receive an input for selecting at least some of the structural information of the skin tissue and to control the movement of the transducer such that a second ultrasonic focusing point of the transducer is formed at a treatment site corresponding to the selected at least part Can be.

The medical apparatus using ultrasound according to various embodiments of the present disclosure may provide an apparatus capable of changing a depth of irradiation of a large surgical area and focusing ultrasound.

The medical apparatus using ultrasound according to various embodiments of the present disclosure may provide a device capable of accurately performing a procedure by automatically adjusting the position of the transducer.

1 is a configuration diagram of a medical apparatus 100 using ultrasound according to various embodiments of the present disclosure.

2 is an exemplary diagram of a method of controlling three-dimensional movement of the transducer 131 according to various embodiments of the present disclosure.

3 is a flowchart illustrating a method of automatically controlling movement of the transducer 131 according to various embodiments of the present disclosure.

4 is a schematic diagram of a connecting portion according to various embodiments.

5 is a schematic diagram of

cartridges

510 and 520 according to the first embodiment.

6 is a schematic diagram of a cartridge 620 according to a second embodiment.

7 is a schematic diagram of a cartridge 720 according to a third embodiment.

8A and 8B are exemplary views for comparing a case where an ultrasound image of the skin is obtained by using an image probe and a case where an ultrasound image of the skin is obtained by using a therapeutic ultrasound transducer.

Hereinafter, various embodiments of the present disclosure will be described with reference to the accompanying drawings. However, this is not intended to limit the techniques described in this document to specific embodiments, but should be understood to cover various modifications, equivalents, and / or alternatives to the embodiments of this document. . In connection with the description of the drawings, similar reference numerals may be used for similar components.

The terminology used herein is for the purpose of describing particular embodiments only and may not be intended to limit the scope of other embodiments. Singular expressions may include plural expressions unless the context clearly indicates otherwise. The terms used herein, including technical or scientific terms, may have the same meaning as commonly understood by one of ordinary skill in the art. Among the terms used in this document, terms defined in the general dictionary may be interpreted as having the same or similar meaning as the meaning in the context of the related art, and ideally or excessively formal meanings are not clearly defined in this document. Not interpreted as In some cases, even if terms are defined in the specification, they may not be interpreted to exclude embodiments of the present disclosure.

Medical device 100 using the ultrasound according to various embodiments of the present invention may be largely composed of the main body 110 and the connecting portion may be connected to the main body 110 and the connection. The connection part may be composed of the handpiece 120 and the cartridge 130 again, and the main body part 110 may transmit a control signal to the cartridge 130 through the handpiece 120 of the connection part.

The main body 110 may include a main controller 111, a memory 113, a high frequency oscillator 112, an input / output interface 114, a display 115, and an imaging circuit 116 that control the entire system. . In some embodiments, the medical apparatus 100 using ultrasound may omit at least one of the components or may further include other components.

The main controller 111 may include one or more of a central processing unit (CPU), an application processor (AP), or a communication processor (CP). The main controller 111 may execute, for example, arithmetic or data processing related to control and / or communication of at least one other component of the medical apparatus 100 using ultrasound.

The memory 113 may include volatile and / or nonvolatile memory. The memory 113 may store, for example, instructions or data related to at least one other component of the medical apparatus 100 using ultrasound. According to an embodiment, the memory 113 may store software and / or a program.

The high frequency oscillator 112 may include one or more of a semi-coupled oscillator, a negative resistance oscillator, and a crystal oscillator. The high frequency oscillator 112 emits a continuous vibration current inside the cartridge 130 of the medical apparatus 100 using, for example, ultrasonic waves so that the transducer inside the cartridge 130 can be changed to the ultrasonic waves of the same frequency. do.

The input / output interface 114 may serve as, for example, an interface capable of transferring a command or data input from a user or another external device to other component (s) of the medical apparatus 100 using ultrasound.

Display 115 includes, for example, a liquid crystal display (LCD), a light-emitting diode (LED) display, an organic light-emitting diode (OLED) display can do. The display 115 may include a touch screen, and for example, may receive a touch input using an electronic pen or a part of a user's body.

The imaging circuit 116 may image the structure information of the skin tissue output by the main controller 111. That is, when the main controller 111 analyzes the time and intensity of the reflected ultrasound received by the transducer 131, the imaging circuit 116 receives the analysis result from the main controller 111 and converts the result into an image. Can be performed. The imaging circuit 116 is a component necessary only when outputting the structure information of the skin tissue as an image, and may be omitted when the structure information of the skin tissue is not output as the image. The handpiece 120 connecting the 130 and the handpiece 120 may include a cartridge 130 that is removable and attachable and includes a transducer.

The handpiece 120 may include a handpiece controller 121. The handpiece controller 121 may control the driver 122 of the handpiece 120 by receiving a signal from the main controller 111 and may serve as a hub of a signal between the main body 110 and the connection part. .

The handpiece 120 may include a driver 122. The driving unit 122 according to an embodiment of the present invention includes at least three motors, and each motor may be configured to control the X, Y, and Z axis movements of the transducer. Each motor can be configured in various ways using a solenoid, a step motor, a linear motor, and the like. According to some embodiments, one or more motors may be omitted, and other components may be used to impart similar drive power to the motors.

The transducer may be configured to be physically connected to three or more motors of the driving unit 122. The handpiece controller 121 may receive a control signal from the main controller 111 of the main body unit 110 and control the movement of the transducer 131 by adjusting a motor in the driving unit according to the received control signal. have.

The cartridge 130 may include a transducer 131 which is detachable and attachable to the handpiece 120 and receives high frequency pulses from the main body 110 and converts them into ultrasonic waves. The main body 110 and the cartridge 130 are connected through the handpiece 120 to control the transducer 131 in the cartridge 130.

According to various embodiments of the present disclosure, at least three or more motors of the medical apparatus using ultrasound may be an X-axis motor, a Y-axis motor, and a Z-axis motor.

According to various embodiments of the present disclosure, at least one transducer of the medical apparatus using ultrasound may include an imaging probe and a therapeutic ultrasound transducer.

According to various embodiments of the present disclosure, at least one transducer of a medical apparatus using ultrasound may include a therapeutic ultrasonic transducer, wherein the therapeutic ultrasonic transducer transmits a first ultrasonic wave and reflects the first ultrasonic wave. It may be characterized in that for receiving.

According to various embodiments of the present disclosure, a main controller of a medical apparatus using ultrasound may analyze structural information of at least some selected skin tissues to calculate a required amount of movement of a transducer for focusing a second ultrasonic wave on a corresponding treatment site. It may be characterized in that the configuration.

According to various embodiments of the present disclosure, a main controller of a medical apparatus using ultrasound may control the transducer to generate heat by radiating a second ultrasonic wave corresponding to a high intensity focused ultrasound to a specific position inside a selected human body. can do.

According to various embodiments of the present disclosure, the input for selecting at least some of the structure information of the output skin tissue of the medical apparatus using ultrasound may be a manual selection by a user or an automatic selection according to a preset instruction. .

Referring to FIG. 2, the handpiece 120 may include at least three motors. At least three motors may be mounted on the X-axis, Y-axis, and Z-axis, respectively, and the motors mounted on each of the axes may give power for linear reciprocating motion within a predetermined range of the transducer 131. . For example, the Z-axis motor adjusts the vertical height of the transducer 131 to adjust the depth of the focusing point 132 of the transducer 131, the X-axis motor and Y-axis motor is perpendicular to the Z-axis It is possible to control the movement of the transducer 131 on the plane.

That is, the movement of the transducer 131 may be controlled so that ultrasonic waves may be focused on a portion to be treated in a state in which the cartridge 130 is in close contact with the skin surface without moving the cartridge 130.

In operation S310, the first ultrasonic wave may be transmitted and received. The first ultrasonic wave refers to ultrasonic waves of a specific frequency for acquiring a cross-sectional image in the human body, and preferably may be ultrasonic waves within a range of 1 MHz to 10 MHz. In a state where the cartridge is in close contact with the surface of the skin, the transducer 131 may transmit the first ultrasonic wave, and may receive the ultrasonic wave that passes through the body and is reflected back. According to various embodiments of the present disclosure, transmission and reception of the first ultrasonic wave may be performed by using one transducer 131. In other words, two or more transmission transducers 131 and a receiving transducer 131 may be provided. Transducer 131 may be used.

In operation S320, the structured information of the skin tissue may be output by analyzing the reflected first ultrasonic waves.

According to various embodiments, the main controller 111 may output the structure information of the skin tissue by analyzing the reflected first ultrasonic waves. For example, the main controller 111 may control to output the structure information of the skin tissue through a user interface or to perform a predetermined instruction by using the output structure information of the skin tissue.

According to various embodiments, the output through the user interface may be a method of displaying on the display 115 using the imaging circuit 116. For example, the imaging circuit 116 may image the structure information of the skin tissue output by the main controller 111. That is, when the main controller 111 analyzes the time and intensity of the reflected ultrasound received by the transducer 131, the imaging circuit 116 receives the analysis result from the main controller 111 and converts the result into an image. Can be performed. Again, the imaging circuit 116 may transfer the information converted into an image to the main controller 111, and the main controller 111 may control the display 115 to output the converted image. For example, the epidermal layer, dermal layer and subcutaneous fat layer can be displayed in the form of a cross-sectional structure.

According to some embodiments, the output through the user interface may be a method of displaying the analysis result by the main controller 111 on the display 115 in a data format. For example, the epidermis, dermis, and hypodermis may be classified and displayed on the display 115 according to the analysis result (eg, Dermis: xx mm).

According to some embodiments, when the main controller 111 performs a predetermined instruction using the output structure information of the skin tissue, the structure information of the skin tissue may not be output through the user interface.

In operation S330, an input for selecting at least some of the output structure information of the skin tissue may be received.

According to various embodiments, the input for selecting at least some of the structure information of the skin tissue may be manual selection by a user or automatic selection according to a preset instruction.

The manual selection by the user may be, for example, a method of selecting at least a portion of an image displayed on the display 115, a method of selecting at least a portion of data displayed on the display 115, or the like. According to some embodiments, the user may select at least some of the structure information of the skin tissue through the input / output interface 114 or another external device.

In the automatic selection according to the preset instruction, for example, when the instruction is set to select the dermis, the main controller 111 may control to automatically select at least a part of the section corresponding to the dermis.

In operation S340, the main processor 111 may analyze the structural information of at least some selected skin tissues and calculate a necessary amount of movement of the transducer 131 for focusing the second ultrasound on the corresponding treatment site.

According to some embodiments, the main processor 111 analyzes the structural information of at least some selected skin tissues to determine whether the intention of the user is to select a dermal layer, a subcutaneous layer, a layer boundary, and the like. In operation S350, the main processor 111 may control the transducer 131 to move based on the analyzed result.

The main controller 111 may drive the respective X-axis, Y-axis, and Z-axis motors based on the calculation result. That is, the main controller 111 allows the handpiece controller 121 to control the driving unit 122 so that the ultrasound focusing point 132 may be formed at a specific position inside the human body corresponding to the selected coordinates. You can move it.

In operation S360, the second ultrasonic waves corresponding to the high intensity focused ultrasound may be radiated to a specific position inside the selected human body to generate heat. Using the heat generated, wrinkles may be improved by causing removal of certain subcutaneous tissues (coagulation necrosis) such as tumors in the skin or degeneration and regeneration of skin tissues.

According to various embodiments of the present disclosure, controlling the movement of the transducer in the method of controlling the movement of the transducer may include controlling at least three motors physically connected to the transducer to control movement in three-dimensional space. Can be.

According to various embodiments of the present disclosure, at least three or more motors of the movement control method of the transducer may be an X-axis motor, a Y-axis motor, and a Z-axis motor.

According to various embodiments of the present disclosure, the controlling of the movement of the transducer in the method of controlling the movement of the transducer may be performed by analyzing structure information of at least some selected skin tissues and focusing the second ultrasonic wave on a corresponding treatment site. The method may further include calculating a required amount of movement of the producer.

According to various embodiments of the present disclosure, the method of controlling the movement of the transducer may further include generating heat by radiating a second ultrasonic wave corresponding to the high intensity focused ultrasound to a specific position inside the selected human body.

According to various embodiments of the present disclosure, the movement control method of the transducer may be characterized in that an input for selecting at least some of the output structure information of the skin tissue is a manual selection by a user or an automatic selection according to a preset instruction. have.

The connection unit according to various embodiments of the present disclosure may be configured to attach and detach the cartridge 130 to the handpiece 120.

The transducer 131 may be attached to the inside of the cartridge 130, and the space inside the cartridge 130 may be filled with the acoustic liquid 134. The acoustic liquid 134 may act as a medium for transmitting the ultrasonic waves generated by the transducer 131 into the skin tissue of the subject, and may also serve to cool the heat generated by the transducer 131. have.

The image probe 133, which is an ultrasound transducer 131 for imaging, may be combined to obtain structural information of skin tissue of a subject. The image probe 133 is designed to detect and receive a weak signal of ultrasonic waves reflected from the living body. The image probe 133 is not an essential component and may be omitted as necessary. The shape in which the image probe is combined will be described in detail with reference to FIG. 6.

In order to prevent the loss of the acoustic liquid in the cartridge 130, the cartridge 130 may be formed so that the inside and the outside are completely sealed.

The transducer 131 may be formed and arranged to irradiate ultrasonic waves toward one focal point. The cross-sectional structure of the transducer 131 has a concave shape. Accordingly, the ultrasonic waves generated by the ultrasonic transducer 131 may be focused to the concave center point of the transducer 131. As such, the focusing point 132 of the ultrasonic wave may be formed at the concave center point of the transducer 131.

Referring to the operation principle of the medical apparatus 100 using ultrasonic waves according to an embodiment of the present invention, after the cartridge 130 of the present invention in close contact with the skin tissue of the subject such as the face, the transducer 131 is ultrasonic An ultrasound scan is performed on the focal point of the skin tissue, which is the treatment site. When the image probe 133 is installed in the transducer 131, the skin tissue of the focal region to be irradiated with ultrasound may be imaged to observe a thermal coagulation state of the skin tissue region.

Hereinafter, a method of automatically controlling the movement of the transducer 131 according to various embodiments will be described with reference to various embodiments.

제1실시예First embodiment

The method for automatically controlling the movement of the transducer 131 according to various embodiments of the present disclosure may be a method using two or more cartridges 130.

5 is a schematic view of cartridges according to the first embodiment.

Referring to Figure 5, two or more cartridges with different uses are shown. For example, (a) may be a cartridge 510 containing an image probe 511 and (b) may be a cartridge 520 containing a therapeutic ultrasonic transducer 521. First, the cartridge 510 containing the image probe 511 is connected to the handpiece of the medical apparatus using ultrasonic waves, and the first ultrasonic wave is transmitted and received while being in close contact with the skin surface to obtain structural information of skin tissue in the human body. Can be obtained. When acquiring structural information of the skin tissue in the human body, the cartridge 510 containing the image probe 511 may be detached and the cartridge 520 containing the therapeutic ultrasonic transducer 521 may be attached. When the cartridge 520 containing the therapeutic ultrasonic transducer 521 is attached, the high intensity focused ultrasound may be radiated onto a desired treatment site by using the method of automatically controlling the movement of the transducer.

This method has a problem in that the cartridge needs to be replaced, and since the cartridge must be separated from the surface of the skin, accurate ultrasound radiation is difficult at a desired area even when a cross-sectional image is obtained.

제2실시예Second embodiment

The method for automatically controlling the movement of the transducer 131 according to various embodiments of the present disclosure may be a method using a cartridge 130 in which two or more transducers 131 are embedded.

6 is a schematic view of a cartridge according to a second embodiment.

Referring to FIG. 6, the cartridge 620 may include an image probe 622 and a therapeutic ultrasound transducer 621. The image probe 622 is vertically spaced apart from the focusing point 132 of the therapeutic ultrasound transducer 621 and has a structure capable of effectively converging the irradiated ultrasound waves without surrounding interference. However, the therapeutic ultrasound transducer 621 may not have a full hemisphere shape due to the image probe 622. Therefore, the coupling layer 623 may be installed under the therapeutic ultrasound transducer 621, and the high intensity focused ultrasound may form the focal point 132 at the lower portion of the coupling layer 623. 625 may be installed. On the other hand, since the image probe 622 does not require the focusing point 132, the acoustic lens may not be installed.

Referring to the method of automatically controlling the movement of the transducer using the cartridge 620 illustrated in FIG. 6, while the cartridge 620 is in close contact with the surface of the skin, the image probe 622 is used to determine the skin tissue in the human body. After obtaining the structural information, the therapeutic ultrasound transducer 621 may radiate the high intensity focused ultrasound to a desired treatment site by using a method of automatically controlling the movement of the transducer.

Since this method is made in a state where the cartridge 130 is in close contact with the surface of the skin, it is possible to focus the high-intensity focused ultrasound on the precise area to be treated.

제3실시예Third embodiment

The method for automatically controlling the movement of the transducer 131 according to various embodiments of the present disclosure may be a method using a cartridge 130 in which one transducer 131 is embedded.

7 is a schematic view of a cartridge according to a third embodiment.

Referring to FIG. 7, there is shown a therapeutic ultrasound transducer 721 having a hemispherical shape in the cartridge 720.

Referring to the method of automatically controlling the movement of the transducer using the cartridge 720 shown in Figure 7, by adjusting the frequency of the therapeutic ultrasonic transducer 721 (preferably 1MHz ~ 20MHz) to be irradiated in the human body Can be. In this case, the structured information may be obtained by receiving the irradiated ultrasonic waves without adopting a separate image probe 133. When acquiring structural information of the skin tissue, high-intensity focused ultrasound may be emitted to a desired treatment area by adjusting the frequency of the therapeutic ultrasonic transducer 131 at high frequency and automatically controlling the movement of the transducer. Can be.

Since this method is carried out in a state where the cartridge 130 is in close contact with the surface of the skin, it is possible to focus on the precise area desired for treatment, and because it has a perfect hemisphere shape, it is possible to efficiently focus ultrasonic energy.

8A and 8B are exemplary views for comparing a case in which structural information of skin tissue is converted into an image using an image probe and a case in which structural information of skin tissue is converted into an image using a therapeutic ultrasonic transducer.

8A illustrates a case in which structural information of skin tissue is converted into an image using an image probe, and the dermal layer 810 and the subcutaneous layer 820 are clearly divided and output as an image.

FIG. 8B illustrates a case in which structural information of skin tissue is converted into an image by using a therapeutic ultrasonic transducer, which is not clear as compared with the case of using an image probe, but is sufficient to distinguish the dermal layer 810 and the subcutaneous layer 820. Video is output.

As a result, it can be seen that the structure information of the skin tissue can be obtained using only the therapeutic ultrasound transducer without adopting the image probe 133, and the procedure can be performed using high intensity focused ultrasound.

The embodiments of the present disclosure disclosed in the specification and the drawings merely illustrate specific examples to easily explain the technical contents of and according to the embodiments of the present disclosure, and help to understand the embodiments of the present disclosure. It is not intended to be limiting. Therefore, the scope of various embodiments of the present disclosure should be construed that all changes or modifications derived based on the technical spirit of the various embodiments of the present disclosure, in addition to the embodiments disclosed herein, are included in the scope of the various embodiments of the present disclosure. .

Claims

In the movement control method of the transducer,

Transmitting a first ultrasonic wave and receiving the reflected first ultrasonic wave;

Analyzing time and intensity of the received reflected first ultrasonic waves and outputting structure information of skin tissue based on the analysis result;

Receiving an input for selecting at least some of the output structure information of the skin tissue; And

Controlling movement of the transducer such that a second ultrasound focus point of the transducer is formed at a treatment site corresponding to the selected at least part.
The method of claim 1, wherein controlling the movement of the transducer comprises:

At least three motors are physically connected to the transducer to control movement in three-dimensional space.
The method of claim 2,

Wherein said at least three or more motors are an X-axis motor, a Y-axis motor and a Z-axis motor.
The method of claim 1, wherein controlling the movement of the transducer comprises:

And analyzing the structural information of the selected at least some skin tissue to calculate the required amount of movement of the transducer for focusing the second ultrasound at the corresponding treatment site.
The method of claim 1,

And radiating a second ultrasonic wave corresponding to the high intensity focused ultrasound to a specific position inside the selected human body to generate heat.
The method of claim 1, wherein the input for selecting at least some of the output structure information of the skin tissue is a manual selection by a user or an automatic selection according to a preset instruction.
In a medical device using ultrasound,

At least one transducer for converting a vibration current into an ultrasonic wave;

A drive unit having at least three motors; And

Transmit a first ultrasonic wave, receive the reflected first ultrasonic wave, analyze time and intensity of the received reflected first ultrasonic wave, output structure information of skin tissue based on the analysis result, and output the output A main controller configured to receive an input for selecting at least some of structural information of the skin tissue and to control the movement of the transducer so that a second ultrasonic focusing point of the transducer is formed at a treatment site corresponding to the selected at least part Medical device.
The method of claim 7, wherein the at least three or more motors,

Medical device, characterized in that the X-axis motor, Y-axis motor and Z-axis motor.
The method of claim 7, wherein the at least one transducer,

A medical device comprising an imaging probe and a therapeutic ultrasonic transducer.
The method of claim 7, wherein the main controller,

And analyzing the structural information of the selected at least some skin tissue to calculate the required amount of movement of the transducer for focusing the second ultrasound at the corresponding treatment site.
The method of claim 7, wherein the main controller,

And the transducer controls the second ultrasonic wave corresponding to the high intensity focused ultrasound to generate heat by radiating the second ultrasonic wave to a specific position inside the selected human body.
The method of claim 7, wherein

And an input for selecting at least some of the output structure information of the skin tissue is manual selection by a user or automatic selection according to a preset instruction.