`
`US 20040242976A1
`
`(19} United States
`{12) Patent Application Publication (IO) Pub. N0.: US 2004/0242976 A1
`
` Abrcu (43) Pub. Date: Dec. 2, 2004
`
`
`(54) APPARATUS AND METHOD FOR
`MEASURING BIOLOGIC PARAMETERS
`
`Publication Classification
`
`(76)
`
`Inventor: Marci0 Marc Abra", New Haven, CT
`(Ub)
`
`cormspondcncc Addie-“5:
`JACOBSON HOLMAN Pudc
`4:00 SEVENTH STREET N'w'
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`fiUlTE‘ 60? ‘
`‘
`WA5H1N('10N’ 1"“ 20004 (US)
`(21) APPL Nu:
`101,786,623
`
`{32
`
`Filed;
`
`Feb. 26, 2004
`
`Related U.S. Application Data
`_
`I
`_
`_
`_
`(63) Cflmmuamn'm'pa” “f apphcalm“ NU' min-20395!
`mud 0" Apr‘ 22’ 2003'
`{60} Provisional application No. 60t374,l33, filed on Apr.
`22. 2002. Provisional application No. 6(tt449,800,
`filed on Feb. 26, 2003. Provisional application No.
`60r'475,470, filed on Jun. 4, 2003. Provisional appli-
`cation No. 60f497,306, filed on Aug. 25, 2003.
`
`Int. CL" ..................................................... .. A618 Slot]
`(51)
`(52) U.S. CI.
`............................................................ .. 600E315
`(57}
`ABS'I'RACT
`
`Support structures for positioning sensors on a physiologic
`tunnel
`for measuring physical, chemical and biological
`parameters of the body and to produce an action according
`to the measured value of the parameters. The support
`structure includes a sensor titted on the support structures
`using a special geometry lior acquiring continuous and
`undisturbed data on the phystology ol the body. Signals are
`
`transmitted to a remote station by wireless transmission such
`as by electromagnetic waves, radio waves. infrared. sound
`and the like or by being reported locally by audio or visual
`transmission. The physical and chemical parameters include
`brain function, metabolic function, hydrodynamic function,
`hydration status. levels of chemical compounds in the blood,
`and the hkc'
`lhc Nippon Structure includes pawl-165‘ cup?”
`eyeglasses. head mounted gear and the like. containing
`passive or active sensors positioned at the end of the tunnel
`with sensing systems positioned on and accessing a physi-
`ologic tunnel.
`
`0001
`
`US. Patent No. 8,652,040
`
`Apple Inc.
`APL1053
`
`Apple Inc.
`APL1053
`U.S. Patent No. 8,652,040
`
`0001
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`Patent Application Publication Dec. 2, 2004 Sheet 65 of 95
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`0082
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`
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`Patent Application Publication Dec. 2, 2004 Sheet 82 of 95
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`US 2004/0242976 A1
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`FIG. 72
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`1062
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`0083
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`0083
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`Patent Application Publication Dec. 2, 2004 Sheet 83 of 95
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`1514
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`1506'
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`0084
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`0084
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`Patent Application Publication Dec. 2, 2004 Sheet 84 of 95
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`US 2004;0242976 A1
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`75A
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`FIG.
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`time'
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`temp
`
`0085
`
`0085
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`
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`Patent Application Publication Dec. 2, 2004 Sheet 35 of 95
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`US 2004;0242976 A1
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`FIG. 758
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`date),
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`
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`
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`Patent Application Publication Dec. 2, 2004 Sheet 36 of 95
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`US 2004;0242976 A1
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`FIG. 750
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`Patent Application Publication Dec. 2, 2004 Sheet 37 of 95
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`US 2004/02429?6 A1
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`FIG. 76A
`
`FIRST STEP: C. SCREEN
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`Patent Application Publication Dec. 2, 2004 Sheet 88 of 95
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`US 2004/02429?6 A1
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`FIG. 77Afi
`
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`
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`Patent Application Publication Dec. 2, 2004 Sheet 39 of 95
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`US 2004!02429T6 A1
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`
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`Patent Application Publication Dec. 2, 2004 Sheet 90 of 95
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`FIG. 79A
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`Patent Application Publication Dec. 2, 2004 Sheet 91 of 95
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`Patent Application Publication Dec. 2, 2004 Sheet 92 of 95
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`FIG. 81C
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`Patent Application Publication Dec. 2, 2004 Sheet 93 of 95
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`US 2004/0242976 A1
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`FIG; 82
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`
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`0094
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`Patent Application Publication Dec. 2, 2004 Sheet 94 of 95
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`FIG. 83
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`
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`Patent Application Publication Dec. 2, 2004 Sheet 95 of 95
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`FIG. 85A
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`Dec. 2, 2004
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`APPARATUS AND METHOD FOR MEASURING
`BIOLOGIC PARAMETERS
`
`[0001] This application is a continuation-in-part of US.
`Ser. No. 10f420,295, filed Apr. 22, 2003, which claims the
`benefit of U.S. Provisional Application Ser. No. $874,133,
`l'lled Apr. 22, 2002, and claims the benefit 01" the priority of
`No. firm-149,800, filed Feb. 26, 2003, No. 60f475,470, filed
`Jun. 4, 2003 and No. 60(491306, liled Aug. 25, 2003, herein
`incorporated in their entirely by reference.
`
`FIELD OF THE INVENTION
`
`[0002] The present invention includes support and sensing
`structures positioned in a physiologic tunnel for measuring
`bodily functions and to manage abnormal conditions indi-
`cated by the measurements.
`
`BACKGROUND OF THE INVENTION
`
`Interfering constituents and variables can introduce
`[0003]
`significant source of errors that prevent measured biologic
`parameters from being of clinical value. In order to bypass
`said interfering constituents and achieve undisturbed sig-
`nals, invasive and semi-invasive techniques have been used.
`Such techniques have many drawbacks including difficulties
`in providing continuous monitoring for long periods oftirne.
`Noninvasive techniques also failed to deliver the clinical
`usefulness needed. The placement of a sensor on the skin
`characterized by the presence of interfering constituents do
`not allow obtaining clinically useful nor accurate signals due
`to the presence of said interfering constituents and back-
`ground noise which greatly exceeds the signal related to the
`physiologic parameter being measured.
`
`[0004] The most precise, accurate, and clinically useful
`way of evaluating thermal status ofthe body in humans and
`animals is by measuring brain temperature. Brain tempera-
`ture measurement is the key and universal indicator of both
`disease and health equally, and is the only vital sign that
`cannot be artificially changed by emotional states. The other
`vital signs (heart rate, blood pressure, and respiratory rate)
`all can be influenced and artificially changed by emotional
`states or voluntary etl'ort.
`
`[0005] Body temperature is determined by the temperature
`ofblood, which emits heat as far-infrared radiation. Adipose
`tissue (fat
`tissue) absorbs far-infrared and the body is
`virtually completely protected with a layer of adipose tissue
`adherent
`to the skin. Thus measurement of temperature
`using the skin did not achieve precision nor accuracy
`because previous techniques used
`placed on skin
`characterized by the presence of adipose tissue.
`
`[0006] Because it appeared to be impossible with current
`technology to non-invasiver measure brain temperature,
`attempts were made to determine internal body temperature,
`also referred to as core temperature. An invasiVe, artificial,
`inconvenient, and costly process is currently used to mea—
`sure internal (core) temperature consisting of inserting a
`catheter with a
`temperature sensor in the urinary canal,
`rectum or esophagus. But such methodology is not suitable
`for routine measurement, it is painful, and has potential fatal
`complications.
`
`Semi~invasive techniques have also being tried.
`[0007]
`Abreu disclosed in U.S. Pat. No. 6,120,460 apparatus and
`methods {or measuring core temperature continuously using
`
`a contact lens in the eyelid pocket, but the contact lens is a
`semi-invasive device which requires prescription by a phy-
`sician and sometimes it is not easy to place the contact lens
`in the eye of an infant or even in adults and many people are
`afraid of touching their eyes.
`
`'I'here are several drawbacks and limitations in the
`[0008]
`prior art for continuous ands’or core measurement of tem-
`perature.
`
`[0009] Measurement of temperature today is non-continu-
`ous, non-core and nurse dependent. Nurses have to stick a
`thermometer in the palient’s mouth, rectum or ear. To get
`core temperature nurses invasively place a tube inside the
`body which can cause infection and costly complications.
`
`[0010] Measurement of core temperature on a routine
`basis in the hospital andfor continuously is very difficult and
`risky because it requires an invasive procedure with inser-
`tion of tubes inside the body or by ingesting a thermometer
`pill. The thermometer pill can cause diarrhea, measure
`temperature of the tluidtfood ingested and not body tem-
`perature, and have fatal complications if the pill obstructs
`the pancreas or liver ducts. Placement of sensors on the skin
`do not provide clinically useful measuremean because of
`the presence of many interfering constituents including fat
`tissue.
`
`It is not possible to acquire precise and clinically
`[0011]
`useful measurements of not only brain temperature, but also
`metabolic parameters, physical para meters, chemical param-
`eters, and the like by simply placing a sensor on the skin.
`One key element is the presence of fat tissue. Fat varies from
`person to person, I‘at varies with aging, [at content varies
`from time to time in the same person, [at attenuates a signal
`coming from a blood vessel, l‘at absorbs heat, fat prevents
`delivery of undisturbed far-infra red radiation, fat increases
`the distance traveled by the element being measured inside
`the body and an external sensor placed on the surface ot'the
`skin.
`
`[0012] There is a need to identify a method and apparatus
`that can non—invasively, conveniently and continuously
`monitor brain temperature in a painless, simple, external and
`safe manner with sensors placed on the skin.
`
`[0013] There is further a need to identify a method and
`apparatus that can conveniently, non-invasively, safely and
`precisely monitor biological parameters including metabolic
`parameters. physical parameters, chemical parameters, and
`the like.
`
`[0014] There is a need to identify an apparatus and method
`capable of measuring biological parameters by positioning a
`sensor on a physiologic tunnel for the acquisition of und is-
`turbed and continuous biological signals.
`
`SUMMARY OF THE INVENTION
`
`[0015] The present invention provides methods, apparatus
`and systems that efiectively address the needs of the prior
`art.
`
`In general, the invention provides a set of sensing
`[0016]
`systems and reporting means which may be used individu-
`ally or in combination, which are designed to access a
`physiologic tunnel
`to measure biological, physical and
`chemical parameters. Anatomically and physiologically
`speaking, the tunnel discovered by the present invention is
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`an anatomic path which conveys undisturbed physiologic
`signals to the exterior. The tunnel consists of a direct and
`undisturbed connection between the source of the function
`(signal) within the body and an external point at the end of
`the tunnel located on the skin. A physiologic tunnet conveys
`continuous and integral data on the physiology of the body.
`An undisturbed signal from within the body is delivered to
`an external point at the end of the tunnel. A sensor placed on
`the skin at
`the end of the tunnel allows optimal signal
`acquisition without interfering constituents and sources of
`CITOT.
`
`included in the present invention are support struc«
`[0017]
`tures for positioning a sensor on the skin at the end of the
`tunnel. The present invention discloses devices directed at
`measuring brain temperature, brain function, metabolic
`function, hydrodynamic function. hydration status, hemo-
`dynarnic Function, body chemistry and the like. The com-
`ponents include devices and methods for evaluating biologi-
`cal parameters using patches, clips, eyeglasses, head
`mounted gear and the like with sensing systems adapted to
`access physiologic tunnels to provide precise and clinically
`useful information about the physiologic status oftbe wearer
`and for enhancing the safety and performance ol'said wearer.
`and helping to enhance and preserve the life of said wearer
`by providing adequate reporting means and alert means
`relating to the biological parameter being monitored. Other
`components provide for producing direct or indirect actions,
`acting on another device, or adjusting another device or
`article of manufacture based on the biological parameter
`measured.
`
`[0018] The search for a better way to measure biological
`parameters has resulted in long and careful research, which
`included the discovery of a Brain 'l‘emperature Tunnel (BTU
`and other physiologic tunnels in humans and animals. The
`present invention was the first to recognize the physiologic
`tunnel in the body. The present invention was yet the tlrst to
`recognize the end of the tunnel on the skin surface in which
`an optimal signal is acquired and measurements can be done
`without the presence of interfering constituean and back-
`ground noise that exceeds the signal being measured. The
`present invention was also the first
`to recognize and pre-
`cisely map the special geometry and location of the tunnel
`including the main entry point. The present invention was
`yet
`first
`to recognize the precise positioning of sensing
`systems at the main entry point for optimal signal acquisi—
`tion. Careful studies have been undertaken including soft-
`ware devalopment for characterizing infrared radiation to
`precisely determine the different aspects of the tunnel. This
`research has determined that
`the measurement of brain
`(core) temperature and other body parameters can be accom-
`plished in a non-invasive and continuous manner in humans
`and animals with sensors positioned in a confined area of the
`skin at the end of a physiologic tunnel.
`
`[0019] The key function and critical factor for life pres—
`ervation and human performance is brain temperature. Brain
`tissue is the tissue in the body most susceptible to thermal
`damage, by both high and low temperature. Brain tempera-
`ture is the most clinically relevant parameter to determine
`the thermal status of the body and the human brain is
`responsible for 18 to 20% of the heat produced in the body,
`which is an extraordinary fact considering that the brain
`represents only 2% of the body weight. The great amount of
`thermal energy generated in the brain is kept in a confined
`
`space and the scalp, skull. fat and CSF {cerebral spinal fluid)
`form an insulating layer. The recognition of the B'l'l' by the
`present invention bypasses the insulating barriers and pro—
`vides a direct connection to inside the brain physiology and
`physics.
`
`a
`[0020] Anatomically and physiologically speaking,
`Brain Temperature Tunnel consists of a continuous, direct,
`and undisturbed connection between the heat source within
`
`the brain and an external point at the end of the tunnel. The
`physical and physiological events at one end of the tunnel
`inside the brain are reproduced at the opposite end on the
`skin. A BIT enables the integral and direct heat transfer
`through the tunnel without interference by heat absorbing
`elements, i.e., elements that can absorb far-infrared radiation
`transmitted as heat by blood within the brain. There are six
`characteristics needed to define a .BTT. These characteristics
`are:
`
`1) area without heat absorbing elements, i.e.,
`[0021]
`the area must not contain adipose tissue {fat tissue).
`This is a key and needed characteristic for defining
`a temperature tunnel,
`
`2) area must have a terminal branch of a
`[0022]
`vessel in order to deliver the integral amount of heat,
`
`3) terminal branch has to be a direct branch of
`[0023]
`a blood vessel from the brain,
`
`terminal branch has to be superficially
`4)
`[0024]
`located to avoid heat absorption by deep structures
`such as muscles,
`
`5) area must have a thin and negligible inter-
`[0025]
`face between a sensor and the motto of thermal
`energy to achieve high heat flow, and
`
`6) area must not have thermoregulatory arte-
`[0026]
`riovenous shuan.
`
`[0027] All six characteristics are present on the skin on the
`medial canthal area adjacent to the medial corner of the eye
`above the medial canthal tendon and in the medial third ol‘
`
`the upper eyelid. In more detail the end of B'I'T area on the
`skin measures about 11 mm in diameter measured from the
`
`medial corner of the eye at the medial canthal tendon and
`extends superiorly for about 6 mm and then extends into the
`upper eyelid in a horn like projection for another 22 mm.
`
`[0028] The BTT area is the only area in the body without
`adipose tissue, which is in addition supplied by a terminal
`branch, which has a superficial blood vessel coming from
`the brain vasculature, and which has a thin interface and no
`thermoregulatory shunts. The B'I‘T area is supplied by a
`terminal branch of the superior ophthalmic vein which is a
`direct connection to the cavernous sinus, said cavernous
`sinus being an endothelium-lined system of venous channels
`inside the brain which collects and stores thermal energy.
`The blood vessel supplying the BIT area is void of ther—
`morcgulatory arteriovenous shunts and it ends on the skin
`adjacent to the medial comer of the eye and in the superior
`aspect ofthe medialcanthal area right at the beginningofthe
`upper eyelid. The blood vessels deliver undisturbed heat to
`the skin on the medial canthal area and upper eyelid as can
`be seen in the color as well as black and white photos of
`infrared images shown in FIGS. 1 and 2. The undisturbed
`thermal radiation from the brain is delivered to the surface
`of the skin at the end of the tunnel. The heat is delivered to
`
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`an area of skin without fat located at the end of the tunnel.
`The blood vessel delivering heat is located just below the
`skin and thus there is no absorption of infrared radiation by
`deep structures.
`
`lithe blood vessel is located deep, other tissues and
`[0029]
`Chemical substances would absorb the heat, and that can
`invalidate the clinical usefulness of the measurement. "[‘here
`is direct heat transfer and the skin in the BTT area is the
`
`thinnest skin in the body and is void of thermoregulatory
`arteriovenous shunts. A very important aspect for optimal
`measurement of temperature is no interference by fat tissue
`and direct heat transfer.
`
`tissue in this particular and
`[0030] The absence of fat
`unique area in the body at the end of the tunnel allows the
`undisturbed acquisition of the signal. The combination of
`those six elements allows the undisturbed and integral
`emission of infrared radiation from the brain in the form of
`direct heat transfer at the B'I'I" area location, which can be
`seen in the infrared image photographs (FIGS. 1 to 8) The
`BTI' and physiologic tunnels are also referred in this
`description as the “Target Area“.
`
`[0031] From a physical standpoint. the B'I'T is the equiva-
`lent of a Brain Thermal Energy tunnel with high total radiant
`power and high heat flow. The temperature of the brain is
`determiner] by the balance between thermal energy produced
`due to metabolic rate plus the thermal energy delivered by
`the arterial supply to the brain minus the heat that is removed
`by cerebral blood flow. Convection of heat between tissue
`and capillaries is high and the temperature of the cerebral
`venous blood is in equilibrium with cerebral tissue. Accord-
`ingly, parenchymal temperature and thermal energy of the
`brain can be evaluated by measuring the temperature and
`thermal energy of the cerebral venous blood. The superior
`ophthalmic vein has a direct and undisturbed connection to
`the cavernous sinus and carries cerebral venous blood with
`
`a thermal energy capacity of 3.6 J.ml“. (° (1)" at hemat-
`ocrit of 45%. Cerebral
`thermodynamic response. thermal
`energy, and brain temperature can be evaluated by placing a
`sensor to capture thermal energy conveyed by the cerebral
`venous blood at the end of the BTI‘.
`
`[0032] The research concerning BTT and physiologic tun-
`nels involved various activities and studies including: 1)
`In-vitro histologic analysis of mucosal and superficial body
`areas; 3) In~vivo studies with temperature evaluation of
`external areas in humans and animals; 3} In-vivo functional
`angiographic evaluation of heat source; 4) Morphologic
`studies of the histomorphometric features of the BTT area;
`5) In-vivo evaluation of temperature in the BTT area using:
`thermocouples, thermistors, and far-infrared; 6) Comparison
`of the BTl' area measurements with the internal eye anatomy
`and current standard most used (oral) for temperature mea-
`surement; 7) Cold and heat challenge to determine tempera-
`ture stability of BTI‘; and 8) Infrared imaging and isotherm
`determination. Software for evaluating geometry of tunnel
`was also developed and used. Simultaneous measurement of
`a reference temperature and temperature in the ET? area
`were done using pre-equally calibrated thermistors. A spe-
`cific circuit with multiple channels was designed for the
`eXperimean and data collection.
`
`[0033] The measurement of temperature in the BT'I' area
`showed almost
`identical
`temperature signal between the
`BTT area and the internal conjunctival anatomy of the eye,
`
`which is a continuation of the central nervous system.
`Measurement of the temperature in the internal conjunctival
`anatomy of eye as used in the experiment was described by
`Abreu in U.S.
`I’at. NOS. 6,120,460 and 6,312,393. The
`averaged temperature levels. for B'l’l‘ and internal eye Were
`within (11" C. (018° F.) with an average normothermia
`value equivalent of TH" C. (988° F.) for the BTT and 37°
`C. (98.6" F.)
`for the internal eye. Comparison with the
`standard most used, oral temperature, was also performed.
`The temperature voltage signal of the BTI‘ area showed an
`average higher temperature level
`in the BTT area of an
`equivalent of 0.3" (1 (05° 1?.) when compared to oral.
`
`[0034] Subjects underwent cold challenge and heat chal-
`lenge through exercising and heat room. The IoWering and
`rising of temperature in the BTT area was proportional to the
`lowering and rising in the oral cavity. However. the rate of
`temperature change was faster in the BTI‘ area than for oral
`by about 1.2 minutes, and temperature at the BTT site was
`0.50 C. (09° F.) higher on few occasions. Subjects of
`difierent race, gender. and age were evaluated to determine
`the precise location of the B'I'T area across a different
`population and identify anyr anatomic va riation. The location
`ol" the BTT was present at the same location in all subjects
`with no significant anatomic variation, which can be seen in
`a sample of infrared imaging of different subjects.
`
`[0035] The tunnel is located in a crowded anatomic area
`and thus the positioning of the sensor requires special
`geometry for Optimal alignment with the end of the tunnel.
`The clinical usefulness of the tunnel can only be achieved
`with the special positioning of the sensor in relation to
`anatomic landmarks and the support structure. The tunnel is
`located in a unique position with distinctive anatomic land-
`marks that help define the external geometry and location of
`the end of the tunnel. The main entry point of the tunnel.
`which is the preferred location for positioning the sensor,
`requires the sensor to