JP6202561B2 - Medical equipment - Google Patents

Description

  The present invention relates to a medical device including a capsule endoscope that acquires an in-vivo image such as a digestive tract and an extracorporeal device that reproduces the image outside the body.

  In recent years, there has been known a medical device that performs inspection of a body such as a digestive tract using a capsule endoscope. A capsule endoscope in such a medical device generally does not require a tube that passes through an esophagus or the like for operating the endoscope like a conventional endoscope, and thus a burden on an examinee is reduced. Less. The capsule endoscope is passively advanced in the body by a peristaltic movement of the stomach or intestine after the examinee swallows it from the mouth. Moreover, when it has a self-propelled function, after swallowing from a mouth or inserting from an anus, it can move to the place which wants to test | inspect itself. Such a capsule endoscope acquires an image by photographing the inside of a body using a built-in illuminator or a camera. The medical device inspects the inside of the body based on the image, or collects body fluid or tissue using a sampling device built into the capsule endoscope, or is built into the capsule endoscope. Treatment (for example, medication etc.) can be performed using a treatment device. Thereafter, the capsule endoscope is discharged from the anus to the outside of the body.

  In many cases, such a capsule endoscope includes a wireless capsule-side communication element using radio waves, as shown in Patent Document 1, and reproduces an image acquired by the capsule endoscope outside the body. Send image data to the device.

JP 2004-000645 A

  However, radio waves are greatly attenuated in moisture, while the human body is mostly occupied by moisture. Therefore, depending on the position of the capsule endoscope or the thickness of the body, the attenuation of radio waves in the body is large, making transmission to the extracorporeal device difficult, and the extracorporeal device is highly sensitive and highly sensitive to receiving radio waves. An accurate extracorporeal communication element or the like is required.

  SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned reasons, and an object of the present invention is to easily transfer in-vivo image data acquired by the capsule endoscope to the extracorporeal device in a medical device including the capsule endoscope and the extracorporeal device. Another object of the present invention is to provide a medical device that can transmit wirelessly with increased reliability.

In order to achieve the above object, the medical device according to claim 1 is a medical device including a capsule endoscope and an extracorporeal device, wherein the capsule endoscope acquires an image in the body and outputs an electrical image signal. An image processing unit for outputting, a modulation circuit unit for modulating the image electric signal with a carrier wave having a frequency in the ultrasonic region and outputting a modulated image electric signal, and converting the modulated image electric signal into an ultrasonic signal At least one capsule-side communication element that transmits to the center, the center of gravity is located below the center point in front view, and at least one capsule-side communication element is provided below the center of gravity. The extracorporeal device receives at least one extracorporeal communication element that receives the ultrasonic signal from the capsule endoscope and converts the ultrasonic signal into an electric signal, and demodulates the electric signal to demodulate the image signal. Signal output Characterized in that it comprises a circuit portion, and an image reproducing unit for reproducing the image from the demodulated image electric signal.

The medical device according to claim 2 is the medical device according to claim 1 , wherein the capsule endoscope has an inner case inside the case, the case and the inner case. A space is filled with a liquid, and at least one capsule-side communication element is attached to the inner casing.

A medical device according to a third aspect is the medical device according to the first or second aspect , wherein the extracorporeal device includes a bag body to be attached to a human body, and the bag body is filled with a liquid or a flexible material. And at least one of the extracorporeal communication elements is attached to a side surface of the bag body opposite to the mounting surface to the human body.

The medical device according to claim 4 is the medical device according to any one of claims 1 to 3 , wherein the extracorporeal device includes a plurality of extracorporeal communication elements, and the extracorporeal communication. A position detection unit is provided that detects the position of the capsule endoscope based on the positions of the elements and the time difference between the ultrasonic signals received by the elements.

The medical device according to claim 5 is the medical device according to any one of claims 1 to 4 , wherein the extracorporeal device includes a plurality of the extracorporeal communication elements, and the extracorporeal communication. The direction and / or speed of travel of the capsule endoscope by measuring the difference due to the Doppler effect between the frequency of the carrier component of the ultrasonic signal received by the element and the frequency of the carrier wave of the capsule endoscope It is characterized by having a progress detection unit for detecting.

The medical device according to claim 6 is the medical device according to any one of claims 1 to 5 , wherein the extracorporeal device generates a control electric signal generating unit that generates a control electric signal, and the control electric signal. A second modulation circuit unit that modulates with a carrier wave having a frequency of an ultrasonic region and outputs a modulation control electric signal, and transmits a second ultrasonic signal from at least one of the extracorporeal communication elements, In the capsule endoscope, at least one of the capsule-side communication elements receives the second ultrasonic signal, converts the second ultrasonic signal into an electric signal, and demodulates the electric signal to control demodulation. A second demodulating circuit unit that outputs an electric signal and a control signal reproducing unit that reproduces the control electric signal from the demodulated control electric signal are provided.

  According to the medical device of the present invention, in a medical device including a capsule endoscope and an extracorporeal device, the image data of the peripheral portion acquired by the capsule endoscope can be easily and reliably transmitted to the extracorporeal device by an ultrasonic signal. More wireless transmission

It is a mimetic diagram showing the composition of the medical device concerning the embodiment of the present invention. It is typical sectional view sectional drawing which shows the outline of a structure of the capsule endoscope of a medical apparatus same as the above. It is typical front view sectional drawing which shows the gravity center of the capsule endoscope of a medical apparatus same as the above. It is typical front view sectional drawing which shows the two cases which provided multiple capsule side communication elements of the capsule endoscope of the medical apparatus same as the above. The embodiment modification of the capsule endoscope of the medical device is schematically shown, in which (a) is a sectional view in front view and (b) is a sectional view in side view. The further embodiment modification of the capsule endoscope of a medical device same as the above is shown typically, (a) is front view sectional drawing, (b) is side view sectional drawing. The case where a plurality of extracorporeal communication elements of the extracorporeal device of the medical device is provided is shown, (a) is a side view and (b) is a side view seen from the head side. The case where the bag body of the external device of a medical device same as the above is shown, (a) is a side view, (b) is the side view seen from the head side. The case where another bag of the extracorporeal device of the medical device is provided is shown, (a) is a side view and (b) is a side view seen from the head side. It is a schematic diagram which shows the structure of embodiment modification at the time of providing multiple in-vivo communication elements of the external device of a medical device same as the above. It is a schematic diagram which shows the structure which added the capsule endoscope control function of the medical apparatus same as the above. It is typical sectional view sectional drawing which shows the outline of a structure of the capsule endoscope which added the capsule endoscope control function of the medical apparatus same as the above.

  Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings. A medical device 1 according to an embodiment of the present invention performs an inspection or the like inside the body of an examinee, and includes a capsule endoscope 2 and an extracorporeal device 3 as shown in FIG.

  Although the shape and size of the capsule endoscope 2 are not particularly limited, in many cases, the capsule endoscope 2 has a generally cylindrical shape and proceeds in the axial direction (longitudinal direction). The capsule endoscope 2 is not particularly limited in terms of the presence or absence of a self-propelled function. The capsule endoscope 2 does not have a self-propelled function and is only passively advanced by the peristaltic movement of the stomach and intestines. This includes those that have a function and can move to where they want to inspect themselves. The capsule endoscope 2 has, for example, a diameter (diameter perpendicular to the axial direction) of about 1 cm and a length in the axial direction of about 2.5 cm when the self-running function is not provided. When it has, it can be set to about 2.5 cm to about 4.5 cm. The examinee swallows the capsule endoscope 2 from the mouth, or in the case of having a self-propelled function, swallows the capsule endoscope 2 from the mouth or inserts it from the anus and then undergoes an examination or the like. The capsule endoscope 2 advances in the body of the subject.

  As shown in FIG. 2, the capsule endoscope 2 includes an image processing unit 21. The image processing unit 21 uses an illuminator 21a that irradiates light to the peripheral part of the capsule endoscope 2 in the body such as the digestive tract, and a camera 21b that images the peripheral part of the capsule endoscope 2 in the body. Acquire images inside the body. The front part (left side in FIG. 2) of the capsule endoscope 2 is transparent to the extent that light can pass. The image processing unit 21 outputs an electrical image signal using an image processing circuit 21c that processes the acquired image. For example, the image processing circuit 21c can digitally convert the acquired image, perform compression processing, and output a digital image electrical signal. The capsule endoscope 2 includes a power supply unit 22 that supplies power to each unit such as the image processing unit 21.

  In addition, the capsule endoscope 2 includes a modulation circuit unit 23. The modulation circuit unit 23 includes a transducer 23a, and generates a carrier wave that is an electric signal having a frequency (16 kHz or more) in the ultrasonic region by directly or frequency-dividing from the transducer 23a. The modulation circuit unit 23 modulates the electrical image signal output from the image processing unit 21 by this carrier wave, and outputs a modulated electrical image signal. Various modulation schemes are possible, but in order to modulate a digital image electrical signal, a digital phase modulation scheme such as DPSK (Differential Phase Shift Keying) or a digital frequency such as MFSK (Multi Frequency shift Keying) is used. Modulation schemes are possible.

  The capsule endoscope 2 includes a capsule communication element 24. The capsule-side communication element 24 converts the modulated image electrical signal output from the modulation circuit unit 23 into an ultrasonic signal and transmits it to the outside. This ultrasonic signal includes image data of the peripheral portion acquired by the image processing unit 21. As the capsule-side communication element 24, for example, an element that generates a ultrasonic signal by applying a voltage of a modulated image electrical signal to a piezoelectric element and mechanically vibrating the piezoelectric element can be used.

  The ultrasonic signal transmitted by the capsule endoscope 2 having such a configuration passes through moisture or an organ, muscle, blood, or the like flowing into the stomach or intestine while being slightly attenuated. The degree of attenuation is much smaller than radio waves. For example, the attenuation in water in the range of 16 kHz to 1 MHz increases for both the ultrasonic signal and the radio wave as the frequency increases, whereas the attenuation of the radio wave is about 4 dB / m to 30 dB / m. Is about 0.0001 dB / m to 0.3 dB / m. Since moisture such as human organs, muscles and blood occupies about 50 to 65% of the standard human body, the characteristics of ultrasonic signals transmitted through the human body are close to those of ultrasonic waves transmitted through water.

  Therefore, the capsule endoscope 2 using the ultrasonic signal can easily transmit the image data with increased certainty until reaching the outside of the body.

  On the other hand, the ultrasonic signal is very attenuated in a gas such as air. Therefore, when there is not much water flowing into the stomach or intestine, if the water or the ultrasonic signal from the capsule communication element 24 is not properly transmitted directly to the organ wall, the ultrasonic signal is received outside the body. It becomes difficult to do. Several configurations for facilitating transmission of ultrasonic signals from the capsule-side communication element 24 to the moisture or organ wall even when the amount of moisture flowing into the stomach or intestine is not large will be described below.

  First, as shown in FIG. 3, the center of gravity G of the capsule endoscope 2 is decentered from the front view center point (center point seen from the traveling direction) C to one direction side, and below the front view center point C (gravity). The capsule-side communication element 24 can be provided on the lower side (lower side in the direction of gravity) which is a further one direction side of the center of gravity G. In this way, since the capsule-side communication element 24 is in a stable state when located below the gravity direction, the capsule-side communication element 24 is placed in the moisture or organ wall that accumulates below the gravity direction in the stomach or intestine. Will contact and the ultrasonic signal will be transmitted.

  The number of capsule-side communication elements 24 is not limited to one, and a plurality of capsule-side communication elements 24 can be provided as shown in FIGS. FIG. 4A shows a case where a plurality (four in this example) of capsule-side communication elements 24 are provided at a predetermined interval from the upper side to the lower side. FIG. 4B shows that the center of gravity G of the capsule endoscope 2 is decentered from the front view center point C in one direction without providing the capsule communication element 24 on the upper side, and below the front view center point C. (At the lower side in the direction of gravity), and at least one of the plurality (three in this example) of the capsule-side communication elements 24 is located on the lower side (in the direction of gravity) of the center of gravity G. The lower case) is shown. In this way, even if the capsule endoscope 2 is largely rotated around the center point C in frontal view due to the influence of the peripheral portion, the ultrasonic signal from any one of the capsule communication elements 24 is not in the stomach or intestine. It will be transferred to the water flowing in or to the organ wall.

  Further, as shown in FIG. 5, the capsule endoscope 2 has an inner casing 2b inside the casing 2a, and a liquid (for example, pure water or physiological) is provided between the casing 2a and the inner casing 2b. Saline solution or the like) can be filled, and the capsule communication element 24 can be attached to the inner casing 2b. In this case, the center of gravity G of the capsule endoscope 2 is decentered from the front view center point C in one direction and is located below the front view center point C (below the gravitational direction). At least one of the communication elements 24 is provided on the lower side (lower side in the direction of gravity) of the center of gravity G in one direction. The capsule side communication element 24 may be one or plural. In this way, even if the capsule endoscope 2 is largely rotated around the front view center point C due to the influence of the peripheral portion, the inner housing 2b does not follow it, and at least one of the capsule communication elements 24 Is always located below the gravitational direction, the ultrasonic signal from the capsule communication element 24 is transmitted through the liquid L between the housing 2a and the inner housing 2b, and the stomach 2 through the housing 2a. It is transmitted to the water or the organ wall that accumulates in the lower side of gravity in the intestines.

  5 shows that the inner casing 2b is supported by the liquid L so that the inner casing 2b can rotate relative to the casing 2a. Between the body 2b and the housing 2a, a support portion (not shown) that supports the inner housing 2b so as to be rotatable around the center point C in front view relative to the housing 2a may be provided. . Further, as shown in FIG. 6, the inner casing 2 b includes only a part of components including at least the capsule-side communication element 24, so that the inner casing 2 b and the partition wall 2 a ′ or between the inner casing 2 b and the casing. Between 2a, you may provide the support part (not shown) which supports the inner housing | casing 2b so that rotation around the center point C of front view is relatively possible with respect to the housing | casing 2a. FIG. 6 specifically shows a case where the illuminator 21a and the camera 21b are provided outside the inner casing 2b and the others are provided in the inner casing 2b. The camera 21b and the image processing are shown in FIG. The wiring between the circuits 21c or the periphery of the wiring has a waterproof structure.

  Next, the extracorporeal device 3 will be described.

  The extracorporeal device 3 includes an extracorporeal communication element 31 as shown in FIG. The extracorporeal communication element 31 receives an ultrasonic signal from the capsule endoscope 2 and converts the ultrasonic signal into an electric signal. The number of extracorporeal communication elements 31 is not limited to one, and a plurality of extracorporeal communication elements 31 can be provided as shown in FIG.

  The extracorporeal device 3 includes a demodulation circuit unit 32. The demodulation circuit unit 32 demodulates the electrical signal converted from the ultrasonic signal in the extracorporeal communication element 31 and outputs a demodulated image electrical signal. The demodulation method is a method corresponding to the modulation method of the modulation circuit unit 23 of the capsule endoscope 2. In addition, when there are a plurality of extracorporeal communication elements 31, it is possible to demodulate, for example, by selecting an electrical signal from the extracorporeal communication element 31 that has reached the earliest ultrasonic signal.

  The extracorporeal device 3 includes an image reproduction unit 33. The image reproducing unit 33 reproduces an image, that is, an image acquired by the capsule endoscope 2 from the demodulated image electric signal. The image reproduction unit 33 uses a method corresponding to the image processing method of the image processing circuit 21c. The image reproduced by the image reproduction unit 33 can be displayed on the monitor 34.

  By reproducing the image in this way, it is possible to inspect the body of the subject based on the image.

  In the extracorporeal device 3, the extracorporeal communication element 31 may be directly attached to the human body, or as shown in FIGS. 8 and 9, a bag body 35 to be attached to the human body may be provided. The bag body 35 is filled with a flexible material having little attenuation of liquid (for example, water) or ultrasonic signals, and at least one external communication element 31 is connected to the human body in the bag body 35. Is attached to the opposite side surface 35b of the mounting surface 35a. The bag 35 is wound around the human body as shown in FIG. 8, or is laid under the human body as shown in FIG. In this way, the ultrasonic signal from the capsule endoscope 2 can be transmitted to the extracorporeal communication element 31 without passing through the air in which attenuation is very large.

  Further, the extracorporeal device 3 in the case where a plurality of extracorporeal communication elements 31 for receiving ultrasonic signals is provided can have a special function described below.

  First, as shown in FIG. 10, the position of the capsule endoscope 2 (more specifically, the position of the capsule communication element 24) can be detected by providing the position detection unit 36. The position detector 36 detects the position of the capsule endoscope 2 based on the positions of the plurality of extracorporeal communication elements 31 and the time difference between the ultrasonic signals received by them.

For example, the position of the capsule endoscope 2 is (X, Y, Z), and the position of the extracorporeal communication element 31 is (X _i , Y _i , Z _i ) (where i represents N extracorporeal communication elements). Number in order). Then, the distance L _i from the capsule endoscope 2 to the extracorporeal communication element 31 is expressed by the following equation (1).

Also, the time in which the ultrasonic signal is required for traveling from the capsule endoscope 2 to the external communication element 31 and T + T _i (where, T is external communication selected from the capsule endoscope 2 one freely The time required for the ultrasonic signal to travel to the element 31, T _i is the time difference of the ultrasonic signal between the one extracorporeal communication element 31 and the i th extracorporeal communication element 31). Then, the distance L is expressed as the following formula (2).

  Here, v is the velocity of the ultrasonic signal, and a value measured in advance (a velocity in water of about 1500 m / s) may be used. Therefore, from the expressions (1) and (2), if a plurality of extracorporeal communication elements 31 are provided, the position (X, Y, Z) of the capsule endoscope 2 can be detected.

  Specifically, the position detection unit 36 can be realized by a program such as numerical solution using a computer. For example, it can be realized by a least squares program for obtaining a position (X, Y, Z) that minimizes Δ in the following expression (3) derived from the above expressions (1) and (2). it can.

  Thus, since the speed of the ultrasonic signal is very slow compared to the speed of radio waves (300,000 km / s), a time difference that can be measured for the ultrasonic signals received between the plurality of extracorporeal communication elements 31. The position of the capsule endoscope 2 can be detected from this time difference and the positions of the plurality of extracorporeal communication elements 31.

  Next, as shown in FIG. 10, by providing the progress detection unit 37, it is possible to detect the traveling direction of the capsule endoscope 2 or to detect the traveling speed. When an ultrasonic signal is transmitted while the capsule endoscope 2 travels, a Doppler effect occurs according to the traveling direction and traveling speed of the capsule endoscope 2, and the frequency of the carrier component of the ultrasonic signal is determined by the capsule endoscope. 2 deviates from the frequency of the carrier wave generated in step 2. The progress detection unit 37 measures the frequency of each ultrasonic signal received by the plurality of extracorporeal communication elements 31 and detects the traveling direction and / or traveling speed of the capsule endoscope 2.

For example, the angle between the direction from the capsule endoscope 2 toward the stationary extracorporeal communication element 31 and the traveling direction of the capsule endoscope 2 is θ. Then, the frequency f _i of the carrier wave component of the ultrasonic signal received by the extracorporeal communication element 31 is expressed as the following equation (4).

  Here, f is the frequency of the carrier wave generated by the capsule endoscope 2, and u is the traveling speed of the capsule endoscope 2. Therefore, from the equation (4), if a plurality of extracorporeal communication elements 31 are provided, the traveling direction and / or traveling speed of the capsule endoscope 2 can be detected.

  The medical device 1 described above can further add a function, and can control the capsule endoscope 2 by the extracorporeal device 3 using the second ultrasonic signal. Specifically, it can be as follows. That is, the extracorporeal device 3 outputs a modulation control electric signal by modulating a control electric signal generation unit 38 that generates a control electric signal, as shown in FIG. And a second modulation circuit unit 39 for transmitting a second ultrasonic signal from at least one of the extracorporeal communication elements 31. The second modulation circuit unit 39 may be the same as the modulation circuit unit 23 of the capsule endoscope 2, and the carrier wave is generated by various means using an independent vibrator or a system clock of a computer. be able to. The frequency of the second ultrasonic signal may be different from or the same as the frequency of the ultrasonic signal transmitted from the capsule endoscope 2. In the capsule endoscope 2, at least one of the capsule communication elements 24 receives the second ultrasonic signal and converts the second ultrasonic signal into an electric signal. As shown in FIG. 12, the capsule endoscope 2 demodulates the electrical signal and outputs a demodulation control electrical signal, and reproduces the control electrical signal from the demodulation control electrical signal. And a control electric signal regenerator 26. The reproduced control electrical signal performs control of the image processing unit 21 and the like (for example, control of the direction of the camera 21b, an instruction to start and stop image capturing, an instruction of an image capturing interval, etc.).

  The medical device 1 capable of controlling the capsule endoscope 2 by the extracorporeal device 3 using the second ultrasonic signal further includes the sampling device incorporated in the capsule endoscope 2, thereby By collecting body fluid or tissue based on the image reproduced by the image reproduction unit 33 or incorporating a treatment device in the capsule endoscope 2, the image reproduced by the image reproduction unit 33 of the extracorporeal device 3 It is also possible to perform treatment (for example, medication etc.) based on this.

  As mentioned above, although the medical device which concerns on embodiment of this invention was demonstrated, this invention is not restricted to what was described in embodiment, Various design change within the range of the matter described in the claim is carried out. Is possible.

DESCRIPTION OF SYMBOLS 1 Medical device 2 Capsule endoscope 21 Image processing part 21a Illuminator 21b Camera 21c Image processing circuit 22 Power supply part 23 Modulation circuit part 23a Vibrator 24 Capsule side communication element 25 2nd demodulation circuit part 26 Control electric signal reproduction | regeneration part 2a casing 2a 'partition 2b inner casing 3 extracorporeal device 31 extracorporeal communication element 32 demodulation circuit section 33 image reproduction section 35 bag body 35a mounting surface of the bag body to the human body 35b side surface opposite to the mounting surface of the bag body to the human body 36 Position detector 37 Progress detector 38 Control electrical signal generator 39 Second modulation circuit C Front view center of capsule endoscope G Center of gravity of capsule endoscope L Liquid

Claims (6)

In a medical device comprising a capsule endoscope and an extracorporeal device,
The capsule endoscope is:
An image processing unit that acquires an image in the body and outputs an electrical image signal;
A modulation circuit unit that modulates the image electrical signal with a carrier wave having a frequency of an ultrasonic region and outputs a modulated image electrical signal;
Comprising at least one capsule-side communication element that converts the modulated image electrical signal into an ultrasonic signal and transmits the signal to the outside,
The center of gravity is located below the center point in front view, and at least one capsule-side communication element is provided below the center of gravity ,
The extracorporeal device is:
At least one extracorporeal communication element that receives the ultrasound signal from the capsule endoscope and converts the ultrasound signal into an electrical signal;
A demodulation circuit unit that demodulates the electrical signal and outputs a demodulated image electrical signal;
An image reproducing unit that reproduces the image from the demodulated image electric signal. The medical device according to claim 1 , wherein
The capsule endoscope has an inner casing inside the casing, the liquid is filled between the casing and the inner casing, and at least one capsule-side communication element Is attached to the inner casing. The medical device according to claim 1 or 2 ,
The extracorporeal device includes a bag body to be attached to a human body, the bag body is filled with a liquid or a flexible material, and at least one of the extracorporeal communication elements is attached to the human body in the bag body. A medical device, wherein the medical device is attached to an opposite side of the surface. The medical device according to any one of claims 1 to 3 ,
The extracorporeal device is provided with a plurality of the extracorporeal communication elements, and detects the position of the capsule endoscope based on the positions of the extracorporeal communication elements and the time difference between the ultrasonic signals received by the extracorporeal communication elements. A medical device comprising a position detection unit that performs the above operation. The medical device according to any one of claims 1 to 4 ,
The extracorporeal device is provided with a plurality of the extracorporeal communication elements, the frequency of the carrier component of the ultrasonic signal received by the plurality of extracorporeal communication elements, and the frequency of the carrier of the capsule endoscope A medical device comprising: a progress detection unit that measures a difference due to the Doppler effect and detects a travel direction and / or a travel speed of the capsule endoscope. The medical device according to any one of claims 1 to 5 ,
The extracorporeal device includes a control electric signal generation unit that generates a control electric signal, a second modulation circuit unit that modulates the control electric signal with a carrier wave having a frequency in an ultrasonic region, and outputs a modulation control electric signal; And transmitting a second ultrasonic signal from at least one of the extracorporeal communication elements,
In the capsule endoscope, at least one of the capsule communication elements receives the second ultrasonic signal, converts the second ultrasonic signal into an electric signal, and demodulates the electric signal by demodulating the electric signal. A medical device comprising: a second demodulation circuit unit that outputs a control electric signal; and a control signal reproduction unit that reproduces the control electric signal from the demodulation control electric signal.

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