JPH04158856A - Ultrasonic processor - Google Patents

Abstract

PURPOSE:To enable use as a common versatile driver for treatments and operations by arranging multiple kinds of probes on multiple kinds of handpieces to connect the handpieces to a driver for transmission of signals to the driver. CONSTITUTION:Handpieces 1a and 1b have an ultrasonic vibrator 2 built thereinto. Multiple kinds of probes 4a-4c are connected selectively to a horn 3 of the ultrasonic vibrator 2. They are of a short type, bending type, long type and the like and are selected according to the application of treatment and operation to be clamped on the handpieces 1a and 1b with a screw or the like. One end of a cable 5 as signal transmitting section is connected to the handpieces 1a and 1b and a connector 6 is provided at the other end thereof. The handpieces 1a and 1b are connected selectively to a driver 7.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Application Field] The present invention relates to an ultrasonic treatment device that uses ultrasonic vibrations to incise or emulsify living tissue or crush stones.

[Prior Art] An ultrasonic treatment device that uses ultrasonic vibrations to incise or emulsify living tissue or crush stones includes a handpiece with a built-in ultrasonic vibrator and a handpiece attached to the handpiece. It consists of a probe that excites the ultrasonic transducer and a drive device that excites the ultrasonic transducer. By the way, conventionally, the types of handpieces that are connected to a drive device are limited, and therefore,
Its uses are also limited.

On the other hand, this type of ultrasonic treatment device has the advantage of being able to preserve relatively elastic tissue such as blood vessels and nerve tissue without removing it, and remove other parenchymal tissue, making it ideal for liver surgery with a large number of blood vessels and brain surgery with a large number of nerves. It has a wide range of applications, including not only surgery, but also all kinds of surgical procedures, as well as endoscopic procedures, which are becoming more and more minimally invasive.

[Problem to be solved by the invention] However, although conventional ultrasonic treatment devices have the potential for application in all fields, various settings for use, such as settings for ultrasonic output, water supply amount, etc. must be set to be optimal for each application. Therefore, it is necessary to prepare a different drive device for each application.

On the other hand, if a plurality of types of handpieces and probes are prepared depending on the application, and by increasing the variation, a large number of them with different drive characteristics are created, the problem arises that the drive device becomes complicated and large.

This invention was made with attention to the above-mentioned circumstances, and its purpose is to provide a wide variety of handpieces and probes depending on the purpose of treatment and surgery, and which can be used with a common drive device. An object of the present invention is to provide an ultrasonic treatment device.

[Means and effects for solving the problem] This invention has the following features:
In order to solve the above problem, a plurality of types of handpieces each having a built-in ultrasonic transducer, and a plurality of types of probes that are selectively attached to the handpiece and brought into contact with tissue for treatment;
It has a drive device that supplies power to the ultrasonic transducer to drive it, and a connector that is connected to the handpiece on one side and the drive device on the other, and transmits signals with the drive device and identifies the handpiece. It consists of a signal transmission section having means for

There are various types of handpieces, including a flexible type for neurosurgery, a standard type for general surgery, and a powerful type for plastic surgery and surgery using an endoscope. Probes also come in different types with different tip shapes and lengths and curved types for treating various affected areas. These handpieces and probes are combined and used by connecting to a drive device depending on the purpose of treatment or surgery. Each handpiece is connected to a connector for connection to a drive device, and is further provided with identification means for identifying the type of handpiece. Therefore, by combining the handpiece and probe according to the purpose of treatment or surgery and connecting the connector to the drive device, the drive device can identify the handpiece and use the ultrasonic transducer built into the handpiece to find the optimal Driven by conditions.

[Example code] Embodiments of the present invention will be described below based on the drawings.

FIGS. 1 to 8 show one embodiment, and as shown in FIG. 1, a standard type hand piece 1 a % strong type hand piece 1
There are two types: b. handpiece la.

As shown in FIG. 2, 1b has an ultrasonic transducer 2 built therein. A plurality of types of probes 4a to 4c are selectively connected to the horn 3 of the ultrasonic transducer 2. These probes 4a to 4c are of short type, bent type, long type, etc., and can be selected depending on the purpose of treatment or surgery.
It is fastened to a and lb with screws or the like. hand piece l
One end of a cable 5 serving as a signal transmission section is connected to a and lb, and a connector 6 is provided at the other end. 7 is a drive device, and this drive device 7 is a movable trolley 8
It is installed in. The drive device 7 is provided with a connector receiver 9 to which the connector 6 is connected and a water supply roller pump 10. A suction pump 11 and an aspirate tank 12 are mounted on the movable cart 8, and the aspirate tank 12 is connected to the hand pieces la and lb via a suction tube 13. The water supply roller pump 10 is connected to a liquid supply bottle 15 for saline or the like via a water supply vibrator 14, and is connected to a handpiece la via a water supply tube 6.

1b. Further, the drive device 7 is provided with a foot switch 17 that is operated by the operator.

The drive device 7 includes a handpiece la.

1b is selectively connected to these handpieces la, l.
One of the probes 4a to 4c is selectively connected to b. Among the probes 43 to 4c, a sheet-type probe 4a is used for general surgery, a bent-type probe 4b is used for microscopic surgery such as neurosurgery, and a long-type probe 4c is used for transendoscopy. When using the bent type and long type probes 4b and 4c, the impedance characteristics during driving are different from those of the sheet type probe 14a. That is, for the ultrasonic transducer 2, bent type and long type probes 4b, 4c are used.
Compared to the sheet-type probe 4a, the ultrasonic vibration load is larger and a larger amount of power is required. Therefore, it is necessary to drive with high voltage. In addition, the bending type and long type probes 4b, s, and 4c require a larger amount of heat when subjected to ultrasonic vibration than the sheet type probe 4a, and therefore it is necessary to increase the amount of water supplied during treatment or surgery to cool the probes. We need to do more.

In this way, the following means are provided to cope with different drive characteristics depending on the types of handpieces la, lb and probes 4a to 4c used, and to cope with changes in various settings.

That is, the connector 6 has a hand piece la.

] b is provided with identification means 18 for identifying each type. Specifically, the identification means 18 may be a resistive element 18a shown in FIG. 3(a) or a Zener diode 18b shown in FIG. 3(b). In the case of the resistance element 1.8a, the resistance value may be changed depending on the type of handpieces la and lb, and in the case of the Zener diode 18b, the Zener voltage value may be changed. In both cases of the resistive element 1.8a and the Zener diode 18b, the connector 6 has an identification terminal 20 protruding in parallel with one signal transmission terminal, and is connected to the connector receiver 9 of the drive device 7. .

Further, the identification means 18 may be used to determine whether or not the handpieces la, lb are connected to the drive device 7. Furthermore, if the ultrasonic transducer 2 differs depending on the type of handpiece], a, and lb, the drive device 7
In order to match with the drive circuit of the same figure (
As shown in C), the signal transmission terminal 19 in the connector 6
You may change the array of .

Next, the drive device 7 will be explained. It is constructed as shown in FIG. 4. 21 is a control section, and this control section 21 is connected to a drive circuit 22. The drive circuit 22 is connected to a detection circuit 23 that detects the voltage V and current I of the drive signal, and this detection circuit 23 is connected to the primary side of the output transformer 25 via a switching relay 24. The secondary side of the output lance 25 is connected to a contact 26 of the connector receiver 9. In addition, the control section 21
is connected to the contact 28 of the connector receiver 9 via the identification circuit 27 of the identification means 18.

Furthermore, the control unit 21 is configured to control the water supply roller pump 10.
and a solenoid valve 29 provided in the middle of the suction tube 13
A control signal is output to the display panel 30, and a display signal is also output to the display panel 30.

According to the ultrasonic treatment apparatus configured in this way, the connector 6 of one hand piece 1a to which the probe 4a is connected
When connected to the connector receiver 9 of the drive device 7, the signal transmission terminal 19 is connected to the contact 26 of the connector receiver 9, and then to the identification terminal 20 or the contact 28. And identification means 1
The resistive element 18a as 8 is connected to the identification circuit 27, and the ultrasonic transducer 2 is connected to the drive circuit 22.

When the control unit 21 first commands the drive circuit 22 to drive the hand piece 1a with a weak signal, the voltage and current detection results may differ depending on the type of probes 4a to 4C fastened to the hand piece 1a. The types of probes 4a to 4c are identified using Specifically, the bent type and long type probes 4b and 4c are Z1
1=v/I value is 22-V/ of sheet type probe 4a
Identification is possible because it is larger than I.

That is, FIG. 5 shows the characteristics when the vertical axis is the impedance Z1 and the horizontal axis is the frequency f. In FIG. 5, the impedance of the bent and long probes 4b and 4c is Z, and the same In Figure (b), the impedance of the short type probe 4a is Z2, and when compared, z,
>22 relationships appear.

As shown in FIG. 6, the identification means 18 includes a resonance point detection circuit 3 between the drive circuit 22 and the switching relay 24.
1, and the probes 4a to 4C are designed and manufactured so that the resonance point frequencies differ depending on the type of the probes 4a to 4C. As shown in FIGS. 7(a)(,b), depending on the type of probes 4a to 4C, the resonance point frequency f, , f2
It is also possible to distinguish by detecting that the values are different.

In this way, the drive device 7 or the handpiece la.

1b and the types of probes 4a to 4C, the identification circuit 27 obtains the handpiece la.

The result of the type determination of 1b is input to the control section 21. The control unit 21 instructs the drive circuit 22 to specify the maximum value of electric power input to the ultrasonic transducer 2 . Further, based on the result of determining the type of the probes 48 to 4C, the control unit 21 operates the switching relay 24 to change the winding ratio of the output transformer 25, thereby responding to the difference in drive characteristics (impedance). , matching is performed to enable driving. Furthermore, the settings of the water supply roller pump 10 are changed and optimized. Each such setting change is
This is done using the setting routine shown in FIG.

First, when the connector 6 is connected to the connector receiver 9, it is determined in step S1 whether or not the hand piece 1a or 1b is connected.If "YES", the display panel 30
Press the setup switch 30a. In step S2, it is determined whether or not the set-up switch 30a is turned on. If YES is determined in step S2, the process moves to step S3, and the types of handpieces la and lb are determined. Then, the control unit 21 changes each setting based on the result of determining the type of handpieces la and lb. Next, the process moves to step S4, and the types of the probes 4a to 4c are determined. Then, the control section 21 changes each setting based on the result of determining the type of the probes 4a to 4c.

When the types of handpieces la, lb and probes 4a to 4c are identified and each setting is completed, a display indicating completion of setup is displayed on display panel 30.

Thereafter, by operating the foot switch 17, each operation of ultrasonic oscillation, water supply, and suction can be controlled.

According to this embodiment, a wide variety of handpieces la, lb, and probes 4a to 4c can be used with the common drive device 7, depending on the purpose of treatment or surgery. Therefore, it can be applied to various surgical operations.

However, handpiece la, 1. If b is replaced, various conditions such as amplitude setting and water supply amount setting must also be changed and set. In contrast, each setting can be changed to each handpiece la.
, 1. It is necessary to provide a means for storing each b.

9 to 12 show an IC on the operation panel 40 of the drive device 7.
handpiece to an external storage device such as a memory card], a.
This figure shows an ultrasonic treatment apparatus having a means for storing the type of lb and the like, and the same components as in one embodiment are given the same numbers and the explanation will be omitted.

The operation panel 40 shown in FIG. 9 is provided with a power switch 41 that turns on and off the power to the drive device 7, a suction mode switch 42 that performs suction continuously, and a synchronized switch 43 that performs suction operation simultaneously with ultrasonic oscillation. ing. 44
is a level meter for setting the amplitude of ultrasonic oscillation, and is provided with a down switch 44a and an up switch 44b.

45 is a level meter for setting the amount of water to be fed, and is provided with a down switch 45a and an up switch 45b. Furthermore, the normal switch 46 for changing the ultrasonic output pulse mode is in a mode that outputs ultrasonic waves continuously and at a constant value.
The first pulsation switch 47 is in a mode in which the ultrasonic output is turned on and off at a constant cycle, and the second pulsation switch 48 is in a mode in which the ultrasonic output is turned on and off at a different cycle than the first pulsation switch 48. mode.

Further, the operation panel 40 is provided with a card insertion slot 50 into which an IC memory card 49 is inserted.
A memory switch 51 for storing data in the C memory card 49 is also provided.

FIG. 10 shows the internal structure of the drive device 7, in which the microprocessor unit 52 is connected to the display switch 5 of the operation panel 40.
3, and is also connected to a control circuit 54 that controls the ultrasonic force of the ultrasonic transducer 2. The control circuit 54 sends the ultrasonic signal to the amplifier 55, and the amplifier 55 amplifies the ultrasonic signal. The amplified signal is applied to the transformer 56 to drive the ultrasonic transducer 2 connected to the secondary side of the transformer 56. IC memory card 4
9 is connected to the microprocessor unit 52 to exchange information. Further, the handpiece type detection circuit 57 is connected to the microprocessor unit 52 and detects the handpiece la at that time.

Microprocessor unit 5 determines the presence and type of 1b.
Tell 2.

FIG. 11 shows the operation routine of the drive device 7. When the power switch 41 is turned on, the presence or absence of the hand piece is detected in step S1. If "NO", the settings at the time of the previous power-off are used, and if rYEsJ, step S1 is performed. Move to IC
It is checked whether the memory card 49 is connected. If rYESJ is selected in step 2, change the panel settings corresponding to the handpiece connected at that time to the IC.
5 microprocessor units with 4 memory cards
2 reads and changes panel settings. rN in step 2
During OJ, settings corresponding to the handpiece connected at that time are read out from the microprocessor unit 52 and panel settings are performed.

FIG. 12 shows the operation routine of the drive device 7 when the power switch 41 is already turned on.

When the handpiece is connected, it is checked in step S1 whether or not four IC memory cards are connected. If step S1 is YESJ, the panel settings corresponding to the handpiece connected at that time are set to IC.
The microprocessor unit 5 is reloaded by the memory card 49.
Read 2 and change the panel settings. r in step S1
When NOJ is selected, the settings corresponding to the connected bead at that time are changed to the microprocessor unit 5.
2 and perform panel settings.

When a handpiece is connected, connect the IC memory card 49 and turn on the memory switch 51 to save the panel settings or the type of handpiece as well as the IC memory card 49.
It is stored in the memory card 49. Therefore, by preparing as many IC memory cards as the number of surgeons, it is possible to store the settings of each individual surgeon. Furthermore, if the IC memory card 49 is not present, the information is stored in the microprocessor unit 52 corresponding to the handpiece. At this time, the handpiece that was connected when the power switch 41 was turned off and the panel settings at that time are combined and stored. Further, when the handpiece is replaced, the settings for the new handpiece are read out, the panel settings are changed, and the settings before the change and the type of handpiece are combined and stored.

With the above operation, even when using the handpiece while replacing various handpieces, the panel settings automatically correspond to the handpiece each time, and the usability is greatly improved. Furthermore, by giving the IC memory card 49 to each individual operator, even when one drive device 7 is used by multiple operators, it is possible to memorize the individual settings of each operator, so it is possible to store the individual settings of each operator. You can use it as if it were a dedicated device.

By the way, as mentioned above, when using a handpiece in combination with various probes, it is necessary to obtain a desired tip amplitude for each probe. Therefore, conventionally, the connecting part and vibration transmitting part that constitute the probe have been changed for each probe.

However, if the connection part and vibration transmission part that make up the probe were changed for each probe, it was impossible to standardize the parts, which caused an increase in cost. The above-mentioned problem can be solved by making it common and configuring the vibration transmitting part so that a desired amplitude and tip shape can be obtained.

That is, as shown in FIG. 13, a first probe 61 and a second probe 62 are used interchangeably in the ultrasonic transducer 60. The ultrasonic transducer 60 includes a horn 63 and a backing plate 6.
4, a plurality of piezoelectric elements 65 are disposed between them, and the piezoelectric elements 65 are tightened with bolts 66. Each piezoelectric element 65
An electrode 67 is provided between them, and the electrode 67 is connected to a drive power source (not shown). The lumens of the horn 63 and the bolt 66 are formed as a suction channel 68 and are connected to a suction pump (not shown). Note that 69 is a cover. The ultrasonic transducer 60 is configured as one resonant system and vibrates resonantly. At this time, the piezoelectric element 65 has an amplitude of A. The amplitude is expanded by the amplitude expansion rate M of the horn 63, and the end of the horn 63 has an amplitude A. It is transmitted with a magnitude of XM.

The first probe 61 has a connecting portion 70 with an amplitude expansion rate of M2.
and a vibration transmission section 71 having an amplitude expansion rate M3. The inner cavity of the vibration transmitting portion 71 is connected as a suction path 72 to a suction path 68 of the ultrasonic vibration]-60. And the first
The probe 61 and the ultrasonic transducer 60 are screws 73a, 7
3b, they are detachably connected.

Amplitude A at the end of the horn 63. x M + is A by the connecting part 70. It is enlarged to XM, xM2 and transmitted to the vibration transmitting section 71, and has a size of AoxM, xM2x~13. This or the first probe 6] tip amplitude A, -AoXM,
It is applied to the tissue as M2×M3, and the tissue is emulsified and aspirated. Since the first probe 61 uses a straight titanium alloy thin-walled pipe as the vibration transmission section 71, the amplitude expansion rate M3 of the vibration transmission section 71 is 1.

Is there a part of the thin-walled titanium alloy pipe that constitutes the vibration transmitting part 71 that is most likely to cause fatigue failure in terms of strength? It is important to select the amplitude expansion rate M2 of the vibration transmitting section 7] so that the amplitude that does not cause damage to the vibration transmitting section 71 is the desired tip amplitude for tissue emulsification and suction. It is necessary to select the wall thickness, material, etc.

The second probe 62 uses a common connecting portion 74 with the first probe 6, and has a vibration transmitting portion 75 connected to its tip. The vibration transmission section 75 is composed of a pipe section 76 and a distal tip 77 integrally connected to the distal end of the pipe section 76 by welding. The distal tip 77 has an amplitude expansion rate of M4, and the vibration transmission section 75 as a whole also has an amplitude expansion rate of M4. Once, the tip amplitude A2 of the second probe 62 is A2=A
oXM, xM2XM3 XM4. The second probe 62 is used when a larger tip amplitude than the first probe 61 is required. The length of the tip 77 is one λ (n·integer, λ, wavelength).

Also, the total length of the first and second probes 61, 62 is also -λ (n: integer, λ: wavelength).

In this way, since probes with different tip amplitudes can be obtained using a common connecting portion, parts can be made common and costs can be reduced. In addition, the vibration transmitting part is made by integrally connecting the pipe part and the tip to the tip by welding, or the welding is performed by TIG, laser, electron beam welding,
Diffusion welding, etc., is effective when hardened in a vacuum to increase the overall strength of the probe.

Furthermore, in order to remove the oxide film, cracks and scratches on the inner and outer surfaces of the vibration transmission part, and increase the strength, it is highly effective to perform a polishing process such as fluid polishing, sandblasting, huffing, electric field polishing, electric field compound polishing, etc. It is.

Preferably, the material of the connecting portion, vibration transmitting portion, and tip tip is a material with a low Young's modulus, such as a titanium alloy or an aluminum alloy such as duralumin.

In addition, handpieces can be used depending on the purpose, but
As shown in FIG. 14, the handpiece 80 and probe 8
The tip vibration amplitude value acting on the tissue is determined by the combination with 1. As a measure on the handpiece 80 and probe 81 side to accommodate all combinations, in the combination of the ultrasonic transducer 80a in the handpiece 80, the horn 80b, and the probe 81, the relational expression (1) is obtained, and generally The combinations of the various handpieces 80 and the various probes 81 are determined so that the relationship is as shown in equation (2). That is, N177 Amplitude expansion rate MP of the handpiece, , Amplitude expansion rate M n mar of the nib probe: When the maximum amplitude is determined based on the usage of various handpieces and probes, □-constant □(2) MT, ·Mp.

That is, the vibration amplitude of the ultrasonic transducer 80a itself is expanded by the horn 80b and the probe 81 to obtain the tip amplitude. Therefore, the amplitude value to be generated by the ultrasonic transducer 80a itself is kept constant. This means that the driving device only has to operate the ultrasonic transducer 802 to control the amplitude of the eye. Also, No. 1
It may be configured such that the amplitude value of the ultrasonic transducer 80a differs depending on the various handpieces 80 by determining the bead bead 80.

Furthermore, in the above-mentioned ultrasonic treatment device, whether the excised diseased tissue is removed by suction or not, this suction means may include a suction pump, a suction tissue collection container,
It consists of a suction control section. Suction was always performed from the probe connected to the handpiece, regardless of whether the ultrasonic oscillation was on or off. However, if suction is performed constantly, the suction force may damage normal tissue when the tip of the probe is removed from the affected tissue. Therefore, in order to solve the above-mentioned problem, the 15th
The ultrasonic treatment apparatus shown in Figs. to 17 was constructed. Since this ultrasonic treatment apparatus is basically the same as that shown in FIG. 1, the same components are given the same numbers and the explanation will be omitted. An on-off valve 85 is provided in the suction tube 84 that connects the hand piece 82 and the aspirate tank 83, and a branch tube 86 that opens to the atmosphere is provided on the suction tube 84 between the on-off valve 85 and the hand piece 82. The branch tube 86 is connected to the branch tube 86 and is provided with a solenoid valve 87 .

When the foot switch 17 is turned on and is in an ultrasonic oscillation state, the electromagnetic valve 87 is in a closed state, or the on-off valve 85 is in an open state. When the foot switch air is turned off, the on-off valve 85 is closed and the suction tube 84 is cut off as shown in FIG. communicates with the atmosphere via a branch tube 86, and the handpiece 82
The negative pressure at the tip is released. Therefore, the handpiece 84 and the tissue can be quickly and safely separated.

Hospital operating rooms are also equipped with powerful suction equipment. Therefore, the suction tube 84 is used instead of the suction pump ] 1.
By connecting the device to the in-hospital suction equipment, suction can be performed without the need for a suction pump in the ultrasonic treatment device. In this case, since the on-off valve 85 is provided, the opening and closing of suction can be controlled no matter which equipment is used. Furthermore, the opening and closing of the suction tube 84 can be set depending on the application, such as a mode in which suction is performed in conjunction with ultrasonic oscillation or a mode in which suction is performed constantly.

[Effects of the Invention] As explained above, the present invention provides a plurality of types of probes that are selectively attached to a plurality of types of handpieces, a drive device that drives an ultrasonic transducer, and a drive device that drives an ultrasonic transducer. Since a signal transmission unit having a means for identifying the piece is provided and the handpiece is connected to the drive device to perform signal transmission with the drive device, the handpiece can be operated simply by connecting the handpiece to the drive device. can be identified, treated,
There is an advantage that a wide variety of handpieces and probes can be used depending on the surgical purpose, and they can be used with a common drive device.

[Brief explanation of the drawing]

Figures 1 to 8 show an embodiment of the present invention, in which Figure 1 is a block diagram of an ultrasonic treatment device, Figure 2 is a block diagram of a signal transmission section, and Figures 3 (a) to (c). 4 is a configuration diagram showing the different identification means for identifying the handpiece, FIG. 4 is a configuration diagram of the internal structure of the drive device, FIGS. 5(a) and 5(b) are characteristic diagrams showing the identification characteristics, and FIG. 6 is the identification means. 7(a) and 7(b) are characteristic diagrams showing identification characteristics, FIG. 8 is a flowchart showing a setting change routine, FIG. 9 is a front view showing the display panel of the drive device, and FIG. The figure is a block diagram of the drive device, No. 11.
12 and 12 are flowcharts of the operation routine of the drive device, FIG. 13 is a longitudinal cross-sectional side view of the handpiece and probe, FIG. 14 is an explanatory diagram showing the types of combinations of the handpiece and probe, and FIG. 15 is a super FIG. 16 is a front view of the sonic therapy device, FIG. 16 is a configuration diagram of a suction path, and FIG. 17 is a timing chart. 1a, lb...Hand piece, 2...Ultrasonic transducer, 4a-4C...Probe, 5...Cable (signal transmission section), 6...Connector, 7...Drive device. Applicant's Representative Patent Attorney Jun Tsuboi Figure 2 (C) Figure 3 (a) (b) Figure 5 Figure 6 (a) (b) Figure 7 Figure 8 119 Figure 11 Figure 15 Footprint F Suiana 17 prisoners -[-11]-Figure 17

Claims (1)

[Claims] A plurality of types of handpieces each having a built-in ultrasonic transducer, a plurality of types of probes that are selectively attached to the handpiece and brought into contact with tissue for treatment, and a drive that supplies power to and drives the ultrasonic transducer. a signal transmitting section having a connector connected to the hand piece on one side and connected to the driving device on the other side, transmitting signals with the driving device and having means for identifying the hand piece. An ultrasonic treatment device characterized by comprising: