The presently disclosed subject matter relates to a link mechanism for an arm portion.
Conventionally, when a medical instrument is supported at one end of a rotatable arm mounted in a medical apparatus, a counterweight is attached to the other end of the arm to balance the weight of the entire arm, as disclosed in Japanese Patent Publication No. 2011-224387. Balancing the weight of the entire arm makes it possible to hold the medical instrument at a predetermined position and operate the arm free from a sense of the weight of the medical instrument.
However, in an arrangement having a counterweight attached to the other end of the arm, the medical apparatus is relatively large and is therefore comparatively heavy. Although a spring is often used in place of a counterweight, it is difficult in this scheme to ensure a given balance because the holding torque varies depending on the arm angle.
The presently disclosed subject matter has been made in order to solve such problems. In other words, it is an object to provide a link mechanism for an arm portion that can contribute achieving a small, lightweight medical apparatus and facilitating arm balancing.
A link mechanism for an arm portion includes an arm portion, a non-rotating arm attachment portion, a variable-length rod, and a fixed-length rod. The arm portion holds a medical instrument. The arm portion is attached to the arm attachment portion to be rotatable about an arm rotational axis as a center. The variable-length rod has a variable total length and includes an elastic member which biases an elastic force to turn back against a pressing force. The fixed-length rod has a fixed total length. One end of the variable-length rod is pivotably attached to the arm attachment portion and the other end of the variable-length rod is pivotably connected to one end of the fixed-length rod. The fixed-length rod has its other end attached to the arm portion to be movable about the arm rotational axis upon rotation of the arm portion. When the center of gravity of the arm portion is horizontally aligned with the arm rotational axis, the direction of action of the elastic force is set so as to be matched with a tangential direction to the rotational trajectory along which the other end of the fixed-length rod is movable.
The medical instrument preferably includes a magnetic stimulation coil used in a magnetic stimulation treatment which magnetically stimulates a living body.
An embodiment of the presently disclosed subject matter will be described below with reference to the accompanying drawings. The following description is intended to limit neither the technical scope nor the meanings of terms defined in “What is claimed is.” The dimensional ratios of the drawings may be exaggerated for the sake of descriptive convenience and different from actual ones.
The magnetic stimulation treatment system 10 illustrated in
Referring to
The seat 30 includes a seating surface portion 31, a backrest portion 32, a foot support portion 33, a base portion 34 which supports the seating surface portion 31, and casters 35 mounted on the lower surface of the base portion 34. The angles of inclination of the seating surface portion 31, the backrest portion 32, and the foot support portion 33 can be adjusted in accordance with the posture of the patient. Armrests 36 are attached to the seating surface portion 31 on its lateral sides. A headrest 37 which fixes the head of the patient is attached to the top of the backrest portion 32. The casters 35 can move the seat 30.
The magnetic stimulation apparatus 20 includes a magnetic stimulation coil 21 (to be also simply referred to as the “coil 21” hereinafter) as a medical instrument, a coil attachment portion 22, an arm portion 23, an arm attachment portion 24, a post portion 25, and a cart portion 26. The coil attachment portion 22 holds the coil 21 attached on its lower surface. The arm portion 23 supports the coil attachment portion 22 suspended from it. The arm attachment portion 24 holds the proximal end portion of the arm portion 23. The post portion 25 supports the arm attachment portion 24. The cart portion 26 holds the post portion 25. The medical instrument is not limited to the coil 21 and widely includes instruments, requiring posture adjustment, which are used in a therapeutic device, a diagnostic device, a research device, an inspection device, and the like.
The coil 21 magnetically stimulates the head of a living body (patient). Coil elements built into the coil 21 can have a circular, figure-of-eight, or conical shape as appropriate. Since the shape of a magnetic field applied to the head varies in each individual shape of the coil elements, a suitable shape is selected in accordance with, for example, the type of neurological disorder. Because a high current on the order of several thousand amperes is supplied to the coil elements, a cooling unit (not illustrated) which cools the coil elements surrounds the coil elements. The coil 21 is detachably attached to the coil attachment portion 22. The coil 21 is replaced with a new coil 21 including coil elements with a different shape, in accordance with kinds of a treatment. The cooling unit for the coil 21 is connected to a chiller 41 built into the cart portion 26. The chiller 41 supplies a cold refrigerant to the cooling unit through a supply hose 42a. The refrigerant having cooled the coil elements is returned from the cooling unit to the chiller 41 through a discharge hose 42b.
The arm portion 23 supports the coil attachment portion 22 suspended from the lower surface of its distal end through a ball joint 43. The posture of the coil attachment portion 22 relative to the arm portion 23 can be adjusted to a desired posture by the ball joint 43. The proximal end portion of the arm portion 23 is attached to the arm attachment portion 24 through an articulated portion 44. The articulated portion 44 can pivot the arm portion 23 in a vertical plane. The arm attachment portion 24 is attached to the post portion 25 through a bearing portion (not illustrated). The bearing portion can pivot the arm attachment portion 24 in a horizontal plane. The post portion 25 is set on the upper surface of the cart portion 26 to be slidable in the direction coming close to or moving away from the patient (the horizontal direction on the sheet surface of
The posture of the coil 21 relative to the head of the patient can be adjusted to a desired posture by adjusting the posture of the coil attachment portion 22 relative to the arm portion 23, pivoting the arm portion 23 in a vertical plane, pivoting the arm attachment portion 24 in a horizontal plane, and sliding the post portion 25. A magnetic stimulus needs to be precisely applied to a specific site in the head of the patient. Therefore, once the posture of the coil 21 has been adjusted, the ball joint 43, the articulated portion 44, the bearing portion, and the sliding mechanism are locked in an inoperable state. This accurately positions the coil 21.
The cart portion 26 houses not only the chiller 41 but also a current supply device 45 and a controller 46. The current supply device 45 accommodates electrical components for supplying a high current to the coil elements. The controller 46 controls the operation of the entire magnetic stimulation treatment system 10. The temperatures of the coil elements, signals from the chiller 41, signals from the current supply device 45, vital sign signals obtained from a living body, and the like are input to the controller 46 via an input/output unit. Examples of the vital sign signals may include electrocardiographic signals of the patient (to generate electrocardiographic data), the transmittances of the blood flowing through the fingertips of the patient for red light and infrared light (to measure an arterial oxygen saturation (to be referred to as SpO2 hereinafter)), and myoelectric signals of the living body (to generate electromyographic data). Signals for controlling the operation of the chiller 41, signals for controlling the operation of the current supply device 45, and the like are output from the controller 46 via the input/output unit. The cart portion 26 holds a monitor 47 connected to the controller 46. The monitor 47 displays the operating state of the current supply device 45, the state of the patient, and the like. The controller 46 uses the vital sign signals to control activation of the current supply device 45 and, in turn, to control the intensity of a magnetic stimulus applied to the living body by the coil 21.
The cart portion 26 has casters 48 mounted on its lower surface. The casters 48 can move the cart portion 26 and, by extension, the magnetic stimulation apparatus 20.
To be brief, a magnetic stimulation treatment is performed using the magnetic stimulation treatment system 10 as follows.
First, before the start of therapy by a magnetic stimulation treatment, the operator precisely sets the position of the coil 21 to a position suitable for treating symptoms in the patient. It can be checked by display (in a site subjected to a magnetic stimulus) on the monitor 47 whether the position of the coil 21 is appropriate.
When therapy is started, the controller 46 controls the current supply device 45 to supply a current to the coil 21. An electric field is induced from the coil 21 into the skull of the patient to magnetically stimulate his or her head. Such magnetic stimulation is performed to treat neurological disease such as Parkinson's disease. The controller 46 controls the intensity of a magnetic stimulus by changing the magnitude of a current output to the coil 21 and the interval and time to supply a current.
The controller 46 displays electrocardiographic data, SpO2, electromyographic data, and the like on the monitor 47, based on vital sign signals (electrocardiographic signals, transmittances, and myoelectric signals) of the patient. The operator can easily determine the therapeutic situation and the condition of the patient during therapy by observing these types of displayed information. The operator suitably adjusts the intensity of a magnetic stimulus in accordance with the state of the patient while monitoring this state.
The magnetic stimulation treatment requires precisely setting the position of the coil 21 to a position suitable for treating symptoms in the patient, as described above. To improve the workability of adjusting the position of the coil 21, the magnetic stimulation apparatus 20 is expected to satisfy the following requests.
First, it is easy to adjust the posture of the comparatively heavy coil 21 relative to the arm portion 23.
Second, it is possible to operate the arm portion 23 supporting the comparatively heavy coil 21, free from a sense of the weight of the coil 21.
Third, it is easy to adjust the position to which the arm assembly 500 is slid.
Fourth, it is easy to replace the coil 21. Such requirements will be described below in sequence.
For the first request, a posture locking device 100 for a medical instrument which facilitates adjustment of the posture of the coil 21 relative to the arm portion 23 will be described.
Conventionally, when a medical instrument is supported with its posture adjustable by a support body such as an arm, a ball joint including a ball portion and a rod portion is commonly used. It is also a common practice to lock the posture of the medical instrument relative to the support, using an electromagnetic brake which non-pivotably locks the ball portion of the ball joint into the receiving portion of the support. The electromagnetic brake includes a shoe, a spring, and an electromagnet. The shoe can come into contact with the outer peripheral surface of the ball portion. The spring biases an elastic force to press the shoe against the outer peripheral surface of the ball portion. The electromagnet generates a magnetic force to draw the shoe by attraction in the direction in which the shoe separates from the outer peripheral surface of the ball portion, against the elastic force of the spring. When the electromagnet is energized, the shoe separates from the outer peripheral surface of the ball portion against the elastic force of the spring. The posture of the medical instrument can thus be adjusted. When the electromagnet stops being energized, the shoe is biased by the elastic force of the spring and pressed against the outer peripheral surface of the ball portion. The frictional force between the ball portion and the shoe prevents the ball portion from pivoting due to the self-weight of the medical instrument to lock the posture of the medical instrument relative to the support.
However, since such a structure supports the self-weight of the medical instrument using only friction caused by the force of the spring, it is difficult for this structure to support a comparatively heavy medical instrument. In addition, at the time of unlocking, the medical instrument gets completely free so that the load of the medical instrument rapidly acts on the hand of the operator who is adjusting the posture of the medical instrument. It is, therefore, hard for the operator to finely position the medical instrument.
In the magnetic stimulation apparatus 20 according to the embodiment, the posture locking device 100 for a medical instrument has the following arrangement.
To be brief, the posture locking device 100 for a medical instrument (to be also simply referred to as the “posture locking device 100” hereinafter) according to the embodiment includes a medical instrument and a braking mechanism 104. The medical instrument is connected to a rod portion 102 of a ball joint 43 including a ball portion 101 and the rod portion 102. The braking mechanism 104 non-pivotably locks the ball portion 101 of the ball joint 43 into a receiving portion 103 to, in turn, locks the posture of the medical instrument relative to the support. The braking mechanism 104 includes a first braking portion 105, a second braking portion 106, a first switch 107, and a second switch 108. The first braking portion 105 includes a first shoe 109 which can come into contact with the outer peripheral surface of the ball portion 101. The first braking portion 105 presses the first shoe 109 against the outer peripheral surface of the ball portion 101 to bias a first resistive force f1 as a resistance against pivoting of the ball portion 101 due to the self-weight of the medical instrument. The second braking portion 106 includes a second shoe 110 which can come into contact with an area different from that contacted by the first shoe 109, on the outer peripheral surface of the ball portion 101. The second braking portion 106 presses the second shoe 110 against the outer peripheral surface of the ball portion 101 to bias a second resistive force (f2) as a resistance against pivoting of the ball portion 101 due to the self-weight of the medical instrument. The first switch 107 selectively turns on or off biasing with the first resistive force f1 by the first braking portion 105. The second switch 108 selectively turns on or off biasing with the second resistive force f2 by the second braking portion 106. In finely adjusting the posture of the medical instrument, the posture locking device 100 biases only one of the first resistive force f1 and the second resistive force f2. In locking the posture of the medical instrument, the posture locking device 100 biases both the first resistive force f1 and the second resistive force f2. In the embodiment, the above-mentioned “medical instrument” is implemented in a coil 21 used in a magnetic stimulation treatment which magnetically stimulates a living body (for example, a head). Note, however, that “the self-weight of the medical instrument” described above is defined as the self-weights of both the coil 21 and the coil attachment portion 22 because the coil 21 is connected to the rod portion 102 of the ball joint 43 via the coil attachment portion 22. Details will be described below.
Referring to
Referring to
The first braking portion 105 includes a first shoe 109 and a spring 115. The first shoe 109 can come into contact with the outer peripheral surface of the ball portion 101. The spring 115 is interposed between the cover member 112 and the upper disk 114 and biases an elastic force to press the first shoe 109 against the outer peripheral surface of the ball portion 101. The first braking portion 105 uses the elastic force of the spring 115 to bias the first resistive force f1 as a resistance against pivoting of the ball portion 101 due to the self-weights of both the coil 21 and the coil attachment portion 22.
The second braking portion 106 is implemented in a toggle clamp which uses a toggle mechanism acting as a servomechanism. The second braking portion 106 includes a shaft 116 and a control lever 118. The shaft 116 is inserted into the central hole 109a in the first shoe 109. The control lever 118 is connected to the shaft 116 via a toggle mechanism 117. The shaft 116 includes, at its lower, distal end illustrated in
The first switch 107 includes a releasing cam 119 disposed on the lower surface of the upper disk 114. The releasing cam 119 includes a rotating shaft 120, an eccentric cam 121, and a control lever 122. The eccentric cam 121 is attached to the rotating shaft 120. The control lever 122 is connected to the rotating shaft 120 and arranged at outside of the casing 111. When the control lever 122 pivots from the position shown in
The second switch 108 is equipped with the toggle mechanism 117 in the second braking portion 106. When the control lever 118 is tilted downwards to the position shown in
The first switch 107 is connected to an electrical switch (not illustrated). Locked/free of other movable portions (for example, the articulated portion 44, the bearing portion, and the sliding mechanism) is switched to interlock with the operation of the first switch 107. More specifically, when the first braking portion 105 biases the first resistive force f1, other movable portions are also locked in an inoperable state to interlock with the operation of the first switch 107. This fixes the posture and position of the coil 21. In contrast, in cancelling biasing with the first resistive force f1 by the first braking portion 105, other movable portions are also freed in an operable state to interlock with the operation of the first switch 107. With this operation, the posture and position of the coil 21 can be adjusted by moving the arm assembly 500. Independently of the first switch 107, an operating switch dedicated to switching locked/free of other movable portions (for example, the articulated portion 44, the bearing portion, and the sliding mechanism) can even be used. When a dedicated operating switch is used, the position of the coil 21 can be adjusted by moving other joints of the arm portion 23 while a given posture of the coil 21 is maintained by biasing with the first resistive force f1.
In the embodiment, the posture locking device 100 biases only a biasing, second resistive force f2 (
A second resistive force f2 biased in finely adjusting the posture of the coil 21 is preferably smaller than a maximum pivoting force Fmax of pivoting forces to allow the ball portion 101 to pivot due to the self-weights of both the coil 21 and the coil attachment portion 22 at positions that fall within the range in which the coil 21 is movable through the ball joint 43. If the second resistive force f2 is equal to or larger than the maximum pivoting force Fmax, an operating force to adjust the posture of the coil 21 is large. This makes it impossible to finely adjust the posture of the coil 21. If the second resistive force f2 is smaller than the maximum pivoting force Fmax, a relatively small operating force suffices to adjust the posture of the coil 21, although slight movement may occur due to the self-weights of both the coil 21 and the coil attachment portion 22, depending on the posture of the coil 21. This improves the workability of finely adjusting the posture of the coil 21.
Actions will be described below.
When the posture of the coil 21 relative to the arm portion 23 is finely adjusted while the posture of the coil 21 is kept locked, the operator uses the first switch 107 to cancel biasing with the first resistive force f1 by the first braking portion 105 while he or she uses the second switch 108 to keep biasing with the second resistive force f2 by the second braking portion 106. More specifically, the control lever 122 of the releasing cam 119 pivots to the position shown in
The operator sets the position of the coil 21 to a position suitable for treating symptoms in the patient. At this time, the second braking portion 106 biases the second resistive force f2 so that the coil 21 and the coil attachment portion 22 are not completely free. The operator requires no force to support the self-weights of both the coil 21 and the coil attachment portion 22. This means that a relatively small operating force suffices to adjust the posture of the coil 21, thus improving the workability of finely adjusting the posture of the coil 21.
In locking the posture of the coil 21 after the end of fine adjustment of the posture of the coil 21, the operator uses the first switch 107 to bias the first resistive force f1 by the first braking portion 105 while he or she uses the second switch 108 to keep biasing with the second resistive force f2 by the second braking portion 106. More specifically, the control lever 122 of the releasing cam 119 pivots to the position shown in
In significantly changing the posture of the coil 21 while the posture of the coil 21 is kept locked, the operator uses the second switch 108 to cancel biasing with the second resistive force f2 by the second braking portion 106 and further uses the first switch 107 to cancel biasing with the first resistive force f1 by the first braking portion 105. More specifically, the control lever 118 of the second braking portion 106 is tilted upwards to the position shown in
The operator significantly changes the position of the coil 21. At this time, since biasing with the first resistive force f1 and biasing with the second resistive force f2 have been cancelled, the coil 21 and the coil attachment portion 22 are completely free. Although the operator requires a force to support the self-weights of both the coil 21 and the coil attachment portion 22, no braking force acts to impair the workability of significantly changing the posture of the coil 21.
In another mode, the posture of the coil 21 may be changed by moving the coil 21 along a guide member having a special shape such as a curved shape. However, if the operator uses no such guide member having a special shape, he or she can hardly rely on instinct to perform the operation involved. In the embodiment, the coil 21 is supported by the arm portion 23 through the ball joint 43 used in various machines, the operator can instinctively perform an operation for adjusting the posture of the coil 21.
In the Modification illustrated in
Roughening the outer peripheral surface of the ball portion 101 increases the frictional force between the first shoe 109 and the outer peripheral surface of the ball portion 101 and the frictional force between the second shoe 110 and the outer peripheral surface of the ball portion 101, resulting in a further increase in braking force to lock the posture of the coil 21. It is, therefore, possible to more stably support the comparatively heavy coil 21.
When the rod portion 102 of the ball joint 43 is most greatly tilted with respect to the vertical direction, both the first shoe 109 and the second shoe 110 preferably come into contact with the roughened outer peripheral surface.
Most greatly tilting the rod portion 102 with respect to the vertical direction maximizes the pivoting force to allow the ball portion 101 to pivot due to the self-weights of both the coil 21 and the coil attachment portion 22. Therefore, when the self-weights of both the coil 21 and the coil attachment portion 22 exert an influence the most, setting the braking force to lock the posture of the coil 21 makes it possible to more stably support the comparatively heavy coil 21.
As another Modification in which the braking force to lock the posture of the medical instrument is increased, the ball portion 101 of the ball joint 43 may be formed into a specific shape.
In other words, the ball portion 101 of the ball joint 43 preferably has a non-perfect spherical shape (elliptical cross-section) defined such that the distance between the first shoe 109 and the receiving portion 103 is larger when the rod portion 102 is tilted with respect to the vertical direction than when the rod portion 102 extends vertically.
With such an arrangement, as the self-weights of both the coil 21 and the coil attachment portion 22 are more likely to exert an influence, the distance between the first shoe 109 and the receiving portion 103 gets larger and the frictional force between the first shoe 109 and the outer peripheral surface of the ball portion 101 gets stronger. Therefore, the comparatively heavy coil 21 can be more stably supported by setting the braking force to lock the posture of the coil 21 stronger.
Similarly, the ball portion 101 of the ball joint 43 preferably has a non-perfect spherical shape (elliptical cross-section) defined such that the distance between the second shoe 110 and the receiving portion 103 is larger when the rod portion 102 is tilted with respect to the vertical direction than when the rod portion 102 extends vertically.
With such an arrangement, as the self-weights of both the coil 21 and the coil attachment portion 22 are more likely to exert an influence, the distance between the second shoe 110 and the receiving portion 103 gets larger and the frictional force between the second shoe 110 and the outer peripheral surface of the ball portion 101 gets stronger. Therefore, the comparatively heavy coil 21 can be more stably supported by setting the braking force to lock the posture of the coil 21 stronger.
As described above, with the posture locking device 100 for a medical instrument according to the embodiment, the braking mechanism 104 includes a first braking portion 105 and a second braking portion 106. The first braking portion 105 and the second braking portion 106 bias the first resistive force f1 and the second resistive force f2 as a resistance against pivoting of the ball portion 101 due to the self-weights of both the coil 21 and the coil attachment portion 22. The braking mechanism 104 biases only the second resistive force f2 in finely adjusting the posture of the coil 21, and biases both the first resistive force f1 and the second resistive force f2 in locking the posture of the coil 21.
With such an arrangement, even in finely adjusting the posture of the coil 21, the second braking portion 106 biases the second resistive force f2 so that the coil 21 and the coil attachment portion 22 are not completely free. The operator requires no force to support the self-weights of both the coil 21 and the coil attachment portion 22. This means that a relatively small operating force suffices to adjust the posture of the coil 21, thus improving the workability of finely adjusting the posture of the coil 21. In locking the posture of the coil 21, both a first resistive force f1 and a second resistive force f2 are biased, resulting in an increase in braking force to non-pivotably lock the ball portion 101 into the receiving portion 103. It is, therefore, possible to stably support the comparatively heavy coil 21.
A second resistive force f2 biased in finely adjusting the posture of the coil 21 is set smaller than a maximum pivoting force (Fmax) of pivoting forces to allow the ball portion 101 to pivot due to the self-weights of both the coil 21 and the coil attachment portion 22 at positions that fall within the range in which the coil 21 is movable through the ball joint 43.
With such an arrangement, a relatively small operating force suffices to adjust the posture of the coil 21, although slight movement may occur due to the self-weights of both the coil 21 and the coil attachment portion 22, depending on the posture of the coil 21. This improves the workability of finely adjusting the posture of the coil 21.
On the outer peripheral surface of the ball portion 101, an area 131 contacted by the first shoe 109 and an area 132 contacted by the second shoe 110 are roughened.
Such an arrangement increases the frictional force between the first shoe 109 and the outer peripheral surface of the ball portion 101 and the frictional force between the second shoe 110 and the outer peripheral surface of the ball portion 101, resulting in a further increase in braking force to lock the posture of the coil 21. It is, therefore, possible to more stably support the comparatively heavy coil 21.
When the rod portion 102 of the ball joint 43 is most greatly tilted with respect to the vertical direction, both the first shoe 109 and the second shoe 110 come into contact with the roughened outer peripheral surface.
With such an arrangement, when the self-weights of both the coil 21 and the coil attachment portion 22 exert an influence the most, the braking force to lock the posture of the coil 21 can be set stronger to more stably support the comparatively heavy coil 21.
The ball portion 101 of the ball joint 43 has a non-perfect spherical shape defined such that the distance between the first shoe 109 and the receiving portion 103 is larger when the rod portion 102 is tilted with respect to the vertical direction than when the rod portion 102 extends vertically.
With such an arrangement, as the self-weights of both the coil 21 and the coil attachment portion 22 are more likely to exert an influence, the braking force to lock the posture of the coil 21 can be set stronger by producing a greater frictional force between the first shoe 109 and the outer peripheral surface of the ball portion 101. It is, therefore, possible to more stably support the comparatively heavy coil 21.
The ball portion 101 of the ball joint 43 has a non-perfect spherical shape defined such that the distance between the second shoe 110 and the receiving portion 103 is larger when the rod portion 102 is tilted with respect to the vertical direction than when the rod portion 102 extends vertically.
With such an arrangement, as the self-weights of both the coil 21 and the coil attachment portion 22 are more likely to exert an influence, the braking force to lock the posture of the coil 21 can be set stronger by producing a greater frictional force between the second shoe 110 and the outer peripheral surface of the ball portion 101. It is, therefore, possible to more stably support the comparatively heavy coil 21.
The coil 21 is suspended from the arm portion 23 through the ball joint 43.
With such an arrangement, the posture of the coil 21 inflicted with the suspension load can be stably supported.
The medical instrument includes a magnetic stimulation coil 21 used in a magnetic stimulation treatment which magnetically stimulates a living body (for example, a head).
With such an arrangement, the position of the coil 21 can be set to a position suitable for treating symptoms in the patient by finely adjusting the posture of the coil 21.
The posture locking device 100 for a medical instrument is not limited to the above-described arrangement and can be modified as appropriate.
The arrangements of the first braking portion 105 and the second braking portion 106 are not limited to the above-described arrangements and can be any appropriate arrangements as long as a first resistive force f1 and a second resistive force f2 to act as braking forces on the ball portion 101 of the ball joint 43 can be biased. For example, the shaft 116 of the second braking portion 106 may be replaced with a spring. Further, a resistive force may be formed using not only the elastic force of a spring but also an electromagnetic force or a fluid pressure.
The first switch 107 and the second switch 108 are not limited to manually-controlled arrangements and may selectively turn on or off biasing with resistive forces using electromagnetic forces or fluid pressures.
For the second request, a link mechanism for an arm portion 23 which can operate the arm portion 23 supporting the coil 21, free from a sense of the weight of the coil 21, will be described next.
In the magnetic stimulation apparatus 20 according to the embodiment, the link mechanism for the arm portion 23 has the following arrangement.
Referring to
As denoted by symbol “*” illustrated in
Referring to
The elastic member 204 of the variable-length rod 202 is made of, for example, a compression spring. The elastic member 204 can be made of a gas spring.
An axis which connects one end 202a of the variable-length rod 202 to the arm attachment portion 24 will be referred to as a “spring fixed axis x1” hereinafter. The other end 202b of the variable-length rod 202 is connected to one end 203a of the fixed-length rod 203 and is free to move. An axis defining this movement will be referred to as a “spring free axis x2” hereinafter. The other end 203b of the fixed-length rod 203 is movable upon rotation of the arm portion 23. An axis defining this movement will be referred to as a “spring movable axis x3” hereinafter. The rotational trajectory along which the other end 203b of the fixed-length rod 203 is movable will be referred to as a “spring movable axis rotational trajectory x4” hereinafter.
When the direction of action Y of an elastic force coincides with a tangential direction to the spring movable axis rotational trajectory x4, the total elastic force can be used as a rotating torque, thus maximizing the efficiency. As the arm portion 23 rotates from this position, the direction of action Y of an elastic force is shifted from the tangential direction and the tangential force reduces. For example, as shown in
The direction of action of an elastic force can be significantly changed during rotation of the arm portion 23, by using the fixed-length rod 203 and providing a spring movable axis in the vicinity of the arm rotational axis 201.
When the arm center-of-gravity angle is negative, the required arm holding torque is small. Accordingly, as a greater effect is produced in the direction of action of an elastic force with the increased elastic force, the spring supporting torque gets smaller.
A spring supporting torque Tspring is given by:
Tspring=r·kδL·cos θ (1)
where r is the radius of the spring movable axis rotational trajectory, k is a spring constant, δL is the spring expansion/contraction length, and θ is the angle of spring action.
A link mechanism for the arm portion 23 which makes Tarm nearly equal to Tspring, as illustrated in
kδL′·cos θ′/kδL·cos|θ0|<1 (2)
where δL′ is the spring expansion/contraction length and θ′ is the angle of spring action upon movement of the center of gravity of the arm portion 23 from the horizontal position (θ0).
As described above, with the link mechanism for the arm portion 23 according to the embodiment, one end 202a of the variable-length rod 202, including the elastic member 204, is pivotably attached to the arm attachment portion 24 and the other end 202b of the variable-length rod 202 is pivotably connected to one end 203a of the fixed-length rod 203. The fixed-length rod 203 has its other end 203b attached to the arm portion 23 to be movable about the arm rotational axis 201 upon rotation of the arm portion 23. When the center of gravity of the arm portion 23 is horizontally aligned with the arm rotational axis 201, the direction of action of an elastic force is set so as to be matched with a tangential direction to the rotational trajectory along which the other end 203b of the fixed-length rod 203 is movable. A tolerance can be defined for the tangential direction, using a damper for holding a frictional force or a resistance on the arm rotational axis 201.
With such an arrangement, a holding torque corresponding to the angle of the arm portion 23 can be obtained to enable the arm portion 23 to be operated free from a sense of the weight of the suspension load. The aforementioned handling can easily be practiced for the angle of depression as well. A small, lightweight magnetic stimulation apparatus 20 can be achieved more easily than the scheme that uses a counterweight.
The medical instrument includes a magnetic stimulation coil 21 used in a magnetic stimulation treatment which magnetically stimulates a living body (for example, a head).
With such an arrangement, the arm portion 23 that holds the coil 21 can be operated free from a sense of the weight of the coil 21 to easily set the position of the coil 21 to a position suitable for treating symptoms in the patient.
For the third request, a sliding device 300 for a medical apparatus which facilitates adjustment of the position to which the arm assembly 500 is slid will be described next.
Conventionally, in a medical apparatus equipped with an arm assembly including, for example, an arm and a post portion which supports the arm, the arm assembly is slid to adjust the front-to-back position of a medical instrument attached to the arm.
However, depending on the degree of tilt of the medical apparatus, unlocking the position of the arm assembly may cause an unexpected sliding of the arm assembly. If the medical instrument is relatively heavy as well, unlocking the position of the arm assembly may cause an unexpected sliding of the arm assembly toward the center of gravity of the arm. Such unexpected sliding leads to trouble encountered upon positioning of the medical instrument or the like.
In the magnetic stimulation apparatus 20 according to the embodiment, the sliding device 300 for a medical apparatus has the following arrangement.
To be brief, the sliding device 300 for a medical apparatus according to the embodiment (to be also simply referred to as the “sliding device 300” hereinafter) includes a sliding table 301, a belt member 302, one or a plurality of roller members 303, and a tension applying member 304. The arm assembly 500 that holds a medical instrument is attached to the sliding table 301. The arm assembly 500 includes a post portion 25 that supports the arm portion 23, which holds a medical instrument. The belt member 302 is arranged along the direction in which the sliding table 301 moves. The roller members 303 are mounted on the sliding table 301 and have the belt member 302 bridged over them. The tension applying member 304 applies a tension to the belt member 302 is bridged over the roller members 303. The belt member 302 bridged over the roller members 303 biases a load on the sliding table 301 upon sliding. The medical instrument includes a coil 21 used in a magnetic stimulation treatment which magnetically stimulates a living body (for example, a head). Details will be described below.
Referring to
Referring to
At least one braking pulley 303c of the plurality of roller members 303 includes a locking mechanism 306 which stops its rotation. If one roller member is used, this roller member includes a locking mechanism 306. The locking mechanism 306 is implemented in, for example, an electromagnetic brake equipped with an electromagnetic clutch. When the electromagnetic brake is energized, the lock is disabled so that the braking pulley 303c freely rotates. When the electromagnetic brake stops being energized, the lock is enabled so that the braking pulley 303c stops its rotation. The position of the sliding table 301 can be locked by stopping by the locking mechanism 306 rotation of the roller member 303 (braking pulley 303c) including the locking mechanism 306. The braking pulley 303c and the idle pulleys 303a and 303b rotate upon movement of the sliding table 301.
Referring to
The tension applying member 304 can apply an adjustable tension to the timing belt 302. The tension is adjusted by turning the adjusting bolt 316 clockwise or counterclockwise as appropriate to adjust the position to which the slider 310 moves. Adjusting the strength of a tension applied to the timing belt 302 by the tension applying member 304 allows adjustment of the magnitude of a load acting upon sliding of the sliding table 301. Since the magnitude of a load acting upon sliding can be adjusted, an operating force to slide the arm assembly 500 can, in turn, be adjusted to a desired magnitude.
Actions will be described below.
In adjusting the position of the coil 21, when the arm assembly 500 is extended to or retracted from the patient, the locking mechanism 306 of the braking pulley 303c is unlocked to slide the arm assembly 500 forwards or backwards and adjust the front-to-back position of the coil 21.
At this time, the timing belt 302 is bent using the three pulleys 303a, 303b, and 303c upon being applied with a tension. The bent timing belt 302 biases a load on the sliding table 301 upon sliding. Because a moderate biasing load is biased on the sliding table 301, the operator can slide the arm assembly 500 with good operation sense.
Even when the magnetic stimulation apparatus 20 is used with only a slight tilt, since a moderate biasing load is biased on the sliding table 301, the arm assembly 500 does not unexpectedly slide even after unlocking of the locking mechanism 306 of the braking pulley 303c. Further, since the coil 21 is a relatively heavy medical instrument, the center-of-gravity position of the arm portion 23 is shifted to the distal end side. Even in such a case, since a moderate biasing load is biased on the sliding table 301, the arm assembly 500 does not unexpectedly slide in the direction of the center of gravity of the arm portion 23 even after unlocking of the locking mechanism 306 of the braking pulley 303c. Without such unexpected sliding, no trouble is encountered upon positioning of the coil 21 or the like.
When the position to which the arm assembly 500 is slid is determined upon the completion of positioning of the coil 21, rotation of the braking pulley 303c is stopped by the locking mechanism 306. This locks the position of the sliding table 301.
As described above, the sliding device 300 for a medical instrument according to the embodiment includes a sliding table 301, a belt member 302, one or a plurality of roller members 303, and a tension applying member 304. The sliding device 300 uses the belt member 302 bridged over the roller members 303, that is, pulleys 303a, 303b, and 303c to bias a load on the sliding table 301 upon sliding.
With such an arrangement, a moderate biasing load is biased on the sliding table 301 so that the operator can slide the arm assembly 500 with good operation sense. Even when the magnetic stimulation apparatus 20 is used with only a slight tilt or the center-of-gravity position of the arm portion 23 is shifted to the distal end side, since a moderate biasing load is biased on the sliding table 301, the arm assembly 500 does not unexpectedly slide. Unexpected sliding can thus be prevented, enabling accurate positioning of the coil 21 or the like.
The tension applying member 304 can apply an adjustable tension. The magnitude of a load acting upon sliding can be adjusted by adjusting the strength of a tension applied to the belt member 302 by the tension applying member 304.
With such an arrangement, since the magnitude of a load acting upon sliding can be adjusted, an operating force to slide the arm assembly 500 can, in turn, be adjusted to a desired magnitude.
In the tension applying member 304, the strength of a tension applied to the belt member 302 is adjusted by turning the adjusting bolt 316 to move the position where the belt member 302 is held.
With such an arrangement, the strength of a tension applied to the belt member 302 can be easily adjusted simply by turning the adjusting bolt 316. It is, therefore, possible to easily adjust the magnitude of a load acting upon sliding and, in turn, to easily adjust an operating force to slide the arm assembly 500 to a desired magnitude.
The belt member 302 is implemented in a belt (a timing belt or a flat belt) which can engage with the roller members 303. The braking pulley 303c includes a locking mechanism 306, which can lock the position of the sliding table 301 by stopping rotation of the braking pulley 303c.
With such an arrangement, the arm assembly 500 can be easily locked at an arbitrary position after the arm assembly 500 is slid.
The medical instrument includes a magnetic stimulation coil 21 used in a magnetic stimulation treatment which magnetically stimulates a living body (for example, a head).
With such an arrangement, the arm assembly 500 can be slid forwards or backwards and locked to set the position of the coil 21 to a position suitable for treating symptoms in the patient.
The sliding device 300 for a medical instrument is not limited to the above-mentioned arrangement and can be modified where necessary.
For example, although the tension applying member 304 is exemplified by a mode in which the position of one end portion of the timing belt 302 is changed, the presently disclosed subject matter is not limited to this mode. A tension may be applied to the timing belt 302 using an arrangement which raises the axis of the braking pulley 303c while the two end portions of the timing belt 302 are fixed in position. In addition, the magnitude of a tension applied can be adjusted by enabling vertical adjustment of the axis position of the braking pulley 303c.
For the forth request, an attaching and detaching device 400 which facilitates replacement of the coil 21 will be described next.
In a magnetic stimulation treatment, the shape of coil elements used needs to be selected in accordance with the type of neurological disorder. This requires easily replacing a coil mounted in a magnetic stimulation apparatus.
However, the conventional magnetic stimulation apparatus is designed without consideration of a mechanism for easy coil replacement.
Under the circumstances, in the magnetic stimulation apparatus 20 according to the embodiment, the attaching and detaching device 400 for the coil 21 has the following arrangement.
To be brief, the attaching and detaching device 400 for the magnetic stimulation coil 21 (to be also simply referred to as “the attaching and detaching device 400 for the coil 21” hereinafter) according to the embodiment includes the coil 21, a coil attachment portion 22, a first engagement portion 401, a second engagement portion 402, a locking portion 403, and an unlocking portion 404. The coil 21 is used in a magnetic stimulation treatment which magnetically stimulates a living body (for example, a head). The coil attachment portion 22 is supported by the arm portion 23 and holds the magnetic stimulation coil 21. The first engagement portion 401 is formed in the coil 21 and has a rail shape. The second engagement portion 402 is formed in the coil attachment portion 22 and has a rail shape that allows engagement with the first engagement portion 401 by relatively sliding the first engagement portion 401. The locking portion 403 maintains the engaged state between the first engagement portion 401 and the second engagement portion 402. The unlocking portion 404 releases the state in which the first engagement portion 401 and the second engagement portion 402 are engaged with each other in the locking portion 403. Details will be described below.
As described above, the coil attachment portion 22 has its posture adjustable relative to the arm portion 23. Adjusting the posture of the coil attachment portion 22 relative to the arm portion 23, in turn, adjusts the posture of the coil 21 attached to the coil attachment portion 22 relative to the arm portion 23. The use of the coil attachment portion 22 as an intermediary obviates the need to provide the coil 21 itself with a mechanism for posture adjustment, such as a ball joint. This achieves a small, lightweight coil 21.
Referring to
The locking portion 403 includes a lug portion 405 and a recessed portion 406 (see
The unlocking portion 404 includes a pressing portion 407 which relatively separates the first engagement portion 401 and the second engagement portion 402 from each other. The pressing portion 407 relatively separates the first engagement portion 401 and the second engagement portion 402 from each other to release fitting between the lug portion 405 and the recessed portion 406 (see
The pressing portion 407 is unremovably held by the coil attachment portion 22 (see
The pressing portion 407 abuts against the second engagement portion 402 of the coil attachment portion 22 without abutting against the first engagement portion 401 of the coil 21 to separate the second engagement portion 402 from the first engagement portion 401 (see
The first engagement portion 401, the second engagement portion 402, the locking portion 403, and the unlocking portion 404 are preferably made of a non-metal material. This is because avoiding the use of a metal member such as a screw or a coil spring in fixing the coil 21 prevents degradation in performance of the coil 21.
Actions will be described below.
In replacing the coil 21 already attached to the coil attachment portion 22, the pressing portion 407 of the unlocking portion 404 is pressed (see
The operator relatively slides the first engagement portion 401 of a new coil 21 along the second engagement portion 402 of the coil attachment portion 22 (see
As described above, the attaching and detaching device 400 for the coil 21 according to the embodiment includes the coil 21, a coil attachment portion 22, a first engagement portion 401, a second engagement portion 402, a locking portion 403, and an unlocking portion 404. The first engagement portion 401 is formed in the coil 21 and has a rail shape. The second engagement portion 402 is formed in the coil attachment portion 22 and has a rail shape that allows engagement with the first engagement portion 401 by relatively sliding the first engagement portion 401.
With such an arrangement, the coil 21 can be easily attached to the coil attachment portion 22 by relatively sliding the first engagement portion 401 of the coil 21 along the second engagement portion 402 of the coil attachment portion 22. Since the locking portion 403 maintains the engaged state between the first engagement portion 401 and the second engagement portion 402, the coil 21 does not fall. In replacing the coil 21, the unlocking portion 404 releases the engaged state between the first engagement portion 401 and the second engagement portion 402 to allow easy removal of the coil 21. The first engagement portion 401, the second engagement portion 402, the locking portion 403, and the unlocking portion 404 can be made of a non-metal material and therefore do not degrade the performance of the coil 21.
The locking portion 403 includes a lug portion 405 on the second engagement portion 402 and a recessed portion 406 in the first engagement portion 401. The unlocking portion 404 uses the pressing portion 407 to relatively separate the first engagement portion 401 and the second engagement portion 402 from each other to release fitting between the lug portion 405 and the recessed portion 406.
With such an arrangement, the locking portion 403 can easily maintain the engaged state between the first engagement portion 401 and the second engagement portion 402, while the unlocking portion 404 can easily release the engaged state between the first engagement portion 401 and the second engagement portion 402.
The pressing portion 407 is unremovably held by the coil attachment portion 22.
With such an arrangement, the pressing portion 407 does not fall off the coil attachment portion 22 even when the coil 21 has not yet been attached to the coil attachment portion 22.
The pressing portion 407 abuts against the second engagement portion 402 of the coil attachment portion 22 without abutting against the first engagement portion 401 of the coil 21 to separate the second engagement portion 402 from the first engagement portion 401.
With such an arrangement, since the pressing portion 407 does not abut against the first engagement portion 401 of the coil 21 even upon pushing, the coil 21 is not pushed out at the time of release of engagement between the first engagement portion 401 and the second engagement portion 402. It is, therefore, possible to prevent the coil 21 from unexpectedly falling off the coil attachment portion 22.
The coil attachment portion 22 has its posture adjustable relative to the arm portion 23. Adjusting the posture of the coil attachment portion 22 relative to the arm portion 23, in turn, adjusts the posture of the coil 21 attached to the coil attachment portion 22 relative to the arm portion 23.
With such an arrangement, the use of the coil attachment portion 22 as an intermediary obviates the need to provide the coil 21 itself with a mechanism for posture adjustment, such as a ball joint. This achieves a small, lightweight coil 21.
The first engagement portion 401, the second engagement portion 402, the locking portion 403, and the unlocking portion 404 are made of a non-metal material.
With such an arrangement, the use of a metal member such as a screw or a coil spring is avoided in fixing the coil 21, thus preventing degradation in performance of the coil 21.
Although a link mechanism for an arm portion according to an embodiment of the presently disclosed subject matter has been described above, the presently disclosed subject matter is not limited to the above-described embodiment.
For example, the magnetic stimulation coil taken as an example in the above-described embodiment may be replaced with other medical instruments.
Other characteristic technical matters of the presently disclosed subject matter will be supplementarily described below.
First, provided is a posture locking device for a medical instrument which facilitates adjustment of the posture of the medical instrument relative to a support. A technique disclosed in Japanese Patent Publication No. 2005-125056 is known as a related-art technique.
(1) A posture locking device for a medical instrument, the device comprising:
a medical instrument connected to a rod portion of a ball joint comprising a ball portion and the rod portion; and
a braking mechanism which non-pivotably locks the ball portion of the ball joint into a receiving portion to, in turn, lock a posture of the medical instrument relative to a support,
the braking mechanism comprising:
a first braking portion which comprises a first shoe configured to come into contact with an outer peripheral surface of the ball portion, and presses the first shoe against the outer peripheral surface of the ball portion to bias the first resistive force (f1) as a resistance against pivoting of the ball portion due to a self-weight of the medical instrument;
a second braking portion which comprises a second shoe configured to come into contact with an area different from an area contacted by the first shoe, on the outer peripheral surface of the ball portion, and presses the second shoe against the outer peripheral surface of the ball portion to bias the second resistive force (f2) as a resistance against pivoting of the ball portion due to the self-weight of the medical instrument;
a first switch which selectively turns on or off biasing with the first resistive force (f1) by the first braking portion; and
a second switch which selectively turns on or off biasing with the second resistive force (f2) by the second braking portion,
wherein in finely adjusting the posture of the medical instrument, the device biases only one of the first resistive force (f1) and the second resistive force (f2), and
in locking the posture of the medical instrument, the device biases both the first resistive force (f1) and the second resistive force (f2).
(2) The posture locking device for a medical instrument according to above (1), in which one of the first resistive force (f1) and the second resistive force (f2) exerted for biasing in finely adjusting the posture of the medical instrument is smaller than a maximum pivoting force (Fmax) of pivoting forces to allow the ball portion to pivot due to the self-weight of the medical instrument at positions that fall within a range in which the medical instrument is movable through the ball joint.
(3) The posture locking device for a medical instrument according to above (1) or (2), in which on the outer peripheral surface of the ball portion, an area contacted by the first shoe and an area contacted by the second shoe have a roughened surface.
(4) The posture locking device for a medical instrument according to above (3), in which when the rod portion of the ball joint is most greatly tilted with respect to a vertical direction, both the first shoe and the second shoe come into contact with the roughened outer peripheral surface.
(5) The posture locking device for a medical instrument according to any one of above (1) to (4), in which the ball portion of the ball joint has a non-perfect spherical shape defined such that a distance between the first shoe and the receiving portion is larger when the rod portion is tilted with respect to the vertical direction than when the rod portion extends vertically.
(6) The posture locking device for a medical instrument according to any one of above (1) to (5), in which the ball portion of the ball joint has a non-perfect spherical shape defined such that a distance between the second shoe and the receiving portion is larger when the rod portion is tilted with respect to the vertical direction than when the rod portion extends vertically.
(7) The posture locking device for a medical instrument according to any one of above (1) to (6), in which the medical instrument is suspended from the support through the ball joint.
(8) The posture locking device for a medical instrument according to any one of above (1) to (7), in which the medical instrument comprises a magnetic stimulation coil used in a magnetic stimulation treatment which magnetically stimulates a living body.
Second, provided is a sliding device for a medical apparatus which facilitates adjustment of the position to which an arm assembly is slid. A technique disclosed in Japanese Patent Publication No. 2008-528108 is known as a related-art technique.
(1) A sliding device for a medical apparatus, the device comprising:
a sliding table equipped with an arm assembly which holds a medical instrument;
a belt member which extends in a direction in which the sliding table moves;
at least one roller member which is mounted on the sliding table and over which the belt member is bridged; and
a tension applying member which applies a tension to the belt member bridged over the roller member,
wherein the belt member bridged over the roller member biases a load on the sliding table upon sliding.
(2) The sliding device for a medical apparatus according to above (1), in which
the tension applying member is configured to apply an adjustable tension, and
adjusting a strength of the tension applied to the belt member by the tension applying member allows adjustment of a magnitude of the load acting upon sliding.
(3) The sliding device for a medical apparatus according to above (1), in which in the tension applying member, the strength of the tension applied to the belt member is adjusted by turning an adjusting bolt to move a position where the belt member is held.
(4) The sliding device for a medical apparatus according to any one of above (1) to (3), in which
the belt member is implemented in a belt engageable with the roller member,
at least one of the at least one roller member comprises a locking mechanism which stops rotation, and
the locking mechanism stops rotation of the roller member provided with the locking mechanism to allow the sliding table to be locked in position.
(5) The sliding device for a medical apparatus according to any one of above (1) to (4), in which the medical instrument comprises a magnetic stimulation coil used in a magnetic stimulation treatment which magnetically stimulates a living body.
Third, provided is an attaching and detaching device which facilitates replacement of a magnetic stimulation coil. A technique disclosed in Japanese Patent Publication No. 2008-528108 is known as a related-art technique.
(1) An attaching and detaching device for a magnetic stimulation coil, the device comprising:
a magnetic stimulation coil used in a magnetic stimulation treatment which magnetically stimulates a living body;
a coil attachment portion which is supported by an arm portion and holds the magnetic stimulation coil;
a first engagement portion which is formed on the magnetic stimulation coil and has a rail shape;
a second engagement portion which is formed on the coil attachment portion and has a rail shape that allows engagement with the first engagement portion by relatively sliding the first engagement portion;
a locking portion which maintains an engaged state between the first engagement portion and the second engagement portion; and
an unlocking portion which releases the engaged state between the first engagement portion and the second engagement portion in the locking portion.
(2) The attaching and detaching device for a magnetic stimulation coil according to above (1), in which
the locking portion comprises:
a lug portion formed on one of the first engagement portion and the second engagement portion; and
a recessed portion which is formed in the other of the first engagement portion and the second engagement portion and fits with the lug portion, and
the unlocking portion comprises a pressing portion which relatively separates the first engagement portion and the second engagement portion from each other, and uses the pressing portion to relatively separate the first engagement portion and the second engagement portion from each other to release fitting between the lug portion and the recessed portion.
(3) The attaching and detaching device for a magnetic stimulation coil according to above (2), in which the pressing portion is unremovably held by the coil attachment portion.
(4) The attaching and detaching device for a magnetic stimulation coil according to above (3), in which the pressing portion abuts against the second engagement portion of the coil attachment portion without abutting against the first engagement portion of the magnetic stimulation coil to separate the second engagement portion from the first engagement portion.
(5) The attaching and detaching device for a magnetic stimulation coil according to any one of above (1) to (4), in which
the coil attachment portion has a posture adjustable relative to the arm portion, and
a posture of the magnetic stimulation coil attached to the coil attachment portion is adjusted relative to the arm portion by adjusting the posture of the coil attachment portion relative to the arm portion.
(6) The attaching and detaching device for a magnetic stimulation coil according to any one of above (1) to (5), in which the first engagement portion, the second engagement portion, the locking portion, and the unlocking portion are made of a non-metal material.
The entire disclosure of Japanese Patent Application No. 2015-39334 filed on Feb. 27, 2013, Japanese Patent Application No. 2015-39337 filed on Feb. 27, 2013, Japanese Patent Application No. 2015-39340 filed on Feb. 27, 2013, and Japanese Patent Application No. 2015-39344 filed on Feb. 27, 2013 including specifications, claims, drawings and summaries are incorporated herein by reference in its entirety.
Number | Date | Country | Kind |
---|---|---|---|
2015-039334 | Feb 2015 | JP | national |
2015-039337 | Feb 2015 | JP | national |
2015-039340 | Feb 2015 | JP | national |
2015-039344 | Feb 2015 | JP | national |