Pharmaceutical composition for treating influenza virus infections

Abstract

To improve efficiency in treating an influenza virus infectious disease.SOLUTION: There is provided a pharmaceutical composition for treating an influenza virus infectious disease, containing an anti-influenza virus agent as an active ingredient, wherein the anti-influenza virus agent is administered to a patient determined to be positive for the influenza virus infectious disease based on an intraoral image captured using an intraoral imaging apparatus.SELECTED DRAWING: Figure 26

Description

Technical Field

[0001] The present invention relates to a pharmaceutical composition for treating influenza virus infection. Alternatively, the present invention can also be said to relate to a method for treating and preventing influenza virus infection containing an anti-influenza virus agent as an active ingredient, and the use of an active ingredient for the production of an anti-influenza virus agent for treating and preventing influenza virus infection.

Background Art

[0002] Non-Patent Document 1 reports that the lymphoid follicles that appear in the deepest part of the pharynx have a pattern specific to influenza virus infection. Lymphoid follicles having such a pattern will be referred to as influenza follicles. Influenza follicles are a sign characteristic of influenza and are considered to appear about 2 hours after the onset of the disease.

Prior Art Documents

Non-Patent Documents

[0003]

Non-Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] The accurate discrimination of influenza follicles is expected to lead to a dramatic improvement in the accuracy of diagnosis. However, the appropriate determination of influenza follicles requires intensive training through many cases and is not at all easy for general physicians. Unfortunately, the above research results have only been utilized among a limited range of physicians. From this, there is room for improvement in the treatment efficiency of influenza virus infection.

[0005] Therefore, an object of the present invention is to improve the treatment efficiency of influenza virus infections.

Means for Solving the Problems

[0006] To solve the above-described problems, a first aspect of the present invention is a pharmaceutical composition for treating influenza virus infections, comprising an anti-influenza virus agent as an active ingredient, administering an anti-influenza virus agent to a patient determined to be positive for influenza virus infection based on an intraoral image taken using an intraoral imaging device, and a pharmaceutical composition for treating influenza virus infections, characterized in that is provided.

[0007] In the pharmaceutical composition for treating influenza virus infections according to the first aspect of the present invention having the above-described configuration, the intraoral imaging device includes an imaging device that acquires an image of the oral cavity, a light source that irradiates light onto a subject of the imaging device, a storage device that stores an algorithm for determining influenza virus infection, an arithmetic device, and is provided with the arithmetic device performs a determination process for determining the possibility of influenza virus infection based on the image and the algorithm, and an output process for outputting the result of the determination process, and may be configured to execute.

[0008] Further, in the pharmaceutical composition for treating influenza virus infections according to the first aspect of the present invention having the above-described configuration, the imaging device acquires an image of the pharynx, and the determination process may include a determination as to whether a pattern specific to influenza virus infection appears in the pharynx.

[0009] In addition, in the pharmaceutical composition for treating influenza virus infection according to the first aspect of the present invention having the above-described configuration, the anti-influenza virus agent may be selected from baloxavir, oseltamivir, zanamivir, peramivir, and laninamivir, but is not limited thereto.

[0010] In addition, the second aspect of the present invention is a pharmaceutical composition for preventing influenza virus infection containing an anti-influenza virus agent as an active ingredient, characterized in that an anti-influenza virus agent is administered to a close contact of a patient determined to be positive for influenza virus infection based on an intraoral image taken using an intraoral imaging device, a pharmaceutical composition for preventing influenza virus infection is provided. Here, the close contact refers to, for example, a person who has acted together with, come into contact with, or sat in adjacent seats at an aircraft, workplace, etc. with a patient determined to be suspected of having influenza virus infection, and includes cohabiting family members and persons living together.

[0011] In addition, in the pharmaceutical composition for treating influenza virus infection according to the second aspect of the present invention having the above-described configuration, the close contact may be an elderly person 65 years of age or older, a patient with chronic respiratory disease or chronic heart disease, a patient with a metabolic disease including diabetes, or a patient with renal dysfunction who may become a high-risk patient when infected with influenza virus infection.

[0012] In addition, in the pharmaceutical composition for treating influenza virus infection according to the second aspect of the present invention having the above-described configuration, the intraoral imaging device is an imaging device that acquires an image of the inside of the mouth, a light source that irradiates light to the subject of the imaging device, a storage device that stores an algorithm for determining influenza virus infection An arithmetic unit, is provided with, The arithmetic unit, Based on the image and the algorithm, a determination process for determining the possibility of influenza virus infection, An output process for outputting the result of the determination process, may be executed.

[0013] Further, in the pharmaceutical composition for treating influenza virus infection according to the second aspect of the present invention having the above-described configuration, The imaging device acquires an image of the pharynx, The determination process may include a determination as to whether a pattern specific to influenza virus infection appears in the pharynx.

[0014] Further, a third aspect of the present invention is, A pharmaceutical composition for preventing influenza virus infection containing an anti-influenza virus agent as an active ingredient, Administering an anti-influenza virus agent to a person who has a patient suffering from influenza infection among its close contacts and has been determined to be negative for influenza virus infection based on an intraoral image taken using an intraoral imaging device, A pharmaceutical composition for preventing influenza virus infection, characterized by is provided.

[0015] In the pharmaceutical composition for treating influenza virus infection according to the third aspect of the present invention having the above-described configuration, The former reporter may be an elderly person 65 years of age or older, a patient with chronic respiratory disease or chronic heart disease, a patient with a metabolic disease including diabetes, or a patient with renal dysfunction.

[0016] Further, in the pharmaceutical composition for treating influenza virus infection according to the third aspect of the present invention having the above-described configuration, The intraoral imaging device, An imaging device that acquires an image inside the mouth, A light source that irradiates light onto the subject of the imaging device, A storage device that stores an algorithm for determining influenza virus infection, An arithmetic unit, Comprising, The arithmetic unit, Based on the image and the algorithm, a determination process for determining the possibility of influenza virus infection, An output process for outputting the result of the determination process, May also execute.

[0017] Also, in a pharmaceutical composition for treating influenza virus infection according to the third aspect of the present invention having the above configuration, The imaging device acquires an image of the pharynx, The determination process may include a determination as to whether a pattern specific to influenza virus infection appears in the pharynx.

Effect of the Invention

[0018] According to the present invention, the treatment efficiency of influenza virus infection can be improved.

Brief Description of the Drawings

[0019]

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Mode for Carrying Out the Invention

[0020] Hereinafter, representative embodiments of the present invention will be described in detail with reference to the drawings. However, the present invention is not limited to such embodiments and drawings. Further, since the drawings are for conceptually explaining the present invention, for ease of understanding, dimensions, ratios, or numbers may be exaggerated or simplified as necessary. In the following disclosure, influenza virus infection may be abbreviated as "influenza". Also, the range "X to Y" shown in this specification means "X or more and Y or less".

[0021] In this embodiment, a medical device including an intraoral imaging device is used for the determination of influenza, and it is assumed that an anti-influenza virus agent is administered to patients determined to be positive for influenza virus infection and their cohabiting family members or persons living together. Here, although intraoral imaging is performed using an intraoral imaging aid for the oral cavity (especially the pharynx), the present invention is not limited to this. Also, the intraoral imaging aid may be used in combination with other devices such as a smartphone and a tablet terminal. Hereinafter, the intraoral imaging aid and the intraoral imaging device included in the medical device will be described, and then the procedure until the administration of the anti-influenza virus agent will be described.

[0022] 1 Outline of the medical device With reference to FIG. 1, the outline of the medical device 1 of this embodiment will be described. As shown in the figure, the medical device 1 includes an intraoral imaging device 5 and an intraoral imaging aid 3. The intraoral imaging device 5 is preferably used in combination with the intraoral imaging aid 3, but may also be used alone or in combination with other aids.

[0023] The intraoral imaging device 5 includes an imaging device 57 that acquires an image of a subject, and dedicated software is pre-installed in this device 5. A user (for example, a doctor) causes a determination target person 7 (for example, a patient) suspected of having influenza to hold the intraoral imaging aid 3 to secure a field of view for imaging. Thereafter, the user inserts the imaging device 57 into the intraoral imaging aid 3 and images the pharynx 72 of the target person 7. Further, the user can also image the oral cavity 71 of the target person 7 by adjusting the insertion depth and insertion angle of the intraoral imaging aid 3. Alternatively, the user may insert the intraoral imaging aid 3 with the imaging device 57 housed inside into the mouth of the determination target person 7, or may cause the determination target person 7 to insert the intraoral imaging aid 3 into the mouth.

[0024] The captured image is processed by a pre-generated determination algorithm. Although such processing is assumed to be performed by the intraoral imaging device 5, it may also be performed by another computer. For example, the determination algorithm detects pharyngeal symptoms (patterns) specific to influenza such as influenza follicles and displays the likelihood of influenza. Thereby, even a doctor or intern with little experience can accurately and early diagnose influenza. Also, for an experienced doctor, useful judgment materials can be obtained. Furthermore, by increasing the correct diagnosis rate of influenza, the patient can complete a hospital visit in one visit and receive appropriate treatment earlier.

[0025] 2-1 Intraoral Imaging Aid Referring to FIGS. 2-4, the intraoral imaging aid 3 of the present embodiment will be described in detail. The intraoral photography assistant tool 3 is an auxiliary tool used for photographing the inside of the mouth (inside of the oral cavity 71 and pharynx 72) of a person (subject) 7. More specifically, the intraoral photography assistant tool 3 is inserted into the oral cavity 71 when photographing the inside of the mouth, in order to obtain a good field of view of the photographing area including the oral cavity 71 or pharynx 72. From the viewpoint of obtaining a better field of view, it is preferable that the intraoral photography assistant tool 3 has translucency. In this embodiment, a mouthpiece is assumed as an example of the intraoral photography assistant tool 3, but is not limited thereto.

[0026] As shown in Fig. 2, the intraoral photography aid 3 includes a main body 31, a flange 34, and a restricting portion 35. However, it is sufficient for the intraoral photography aid 3 to have the main body 31, and it is not necessary for the intraoral photography aid 3 to have both or either of the flange 34 and the restricting portion 35. In this embodiment, the intraoral photography aid 3 is assumed to be an integrally molded resin product, but the intraoral photography aid 3 may be made of other materials such as paper, cloth, elastic rubber, or metal, or may be made of a plurality of materials. In addition, the intraoral photography aid 3 is assumed to be a disposable type, but may be a reusable type.

[0027] The main body 31 has a cylindrical shape as a whole. When the main body 31 is inserted deeply into the oral cavity 71, as can be seen, for example, by comparing Fig. 1 with Fig. 27, the tongue 73 is pushed downward and the soft palate 74 is pushed upward. In other words, the intraoral photography aid 3 can be said to be a tongue depressor. This makes it possible to ensure a good view of the pharynx 72 from inside the intraoral photography aid 3 (main body 31), as can be seen, for example, by comparing Fig. 4 with Fig. 28.

[0028] In this embodiment, the main body 31 extends substantially linearly. That is, the inner and outer diameters of the main body 31 are substantially constant along the longitudinal direction. However, the main body 31 may be partially or entirely curved, and the inner or outer diameter of the main body 31 may vary, as long as the sliding of the imaging device 57 on its inner circumferential surface is not impeded.

[0029] As the cross-sectional shape of the main body 31, a perfect circle is assumed here. However, the cross-sectional shape may be elliptical, may have a polygonal cross-section such as a quadrilateral, or may have an asymmetric shape such as a substantially D-shaped. When the main body 31 has an elliptical, polygonal or asymmetric cross-sectional shape, the imaging device 57 corresponding to the shape of the main body 31 is restricted or suppressed from moving (i.e., rotating) in the circumferential direction around the axial direction of the main body 31 during sliding within the main body 31. Therefore, an intraoral image with the same orientation, suitable for determination, can be obtained.

[0030] When the main body 31 has a perfect circular cross-sectional shape, as will be described later with reference to FIG. 6, the rotation of the imaging device 57 within the main body 31 may be restricted by providing rails and protrusions that engage with each other on the outer surface of the imaging device 57 and the inner circumferential surface of the main body 31.

[0031] As shown in FIG. 3, the main body 31 includes end portions 32 and 33 located on opposite sides of each other. When the intraoral imaging aid 3 is mounted in the oral cavity 71, the end portion 32 is exposed to the outside, and the end portion 33 is located in the oral cavity 71.

[0032] The outer peripheral surface of the main body 31 is smooth, and the main body 31 and the end portion 33 are also connected so as to be smoothly continuous and integrated via a connection surface 36. That is, the outer surface of the main body 31 is smoothly processed so as not to damage the oral cavity 71.

[0033] The main body 31 may have a scale 37. The scale 37 is arranged along the longitudinal direction of the main body 31 and functions as a guide for how deeply the main body 31 is inserted into the oral cavity 71. The scale 37 may be provided on either the outer peripheral surface or the inner circumferential surface of the main body 31. When the scale 37 is provided on the outer peripheral surface, as shown in FIG. 2, it may be provided on the side where the upper lip and the upper front teeth 75 contact, that is, on the upper side. The scale 37 may be arranged at a predetermined interval (for example, in 1 cm increments). Also, the scale 37 shown in FIG. 2 has a length of nearly half a circumference in the circumferential direction of the main body 31, but is not limited to this, and may be short or long.

[0034] In the present embodiment, as an example of the scale 37, a plurality of ridges aligned along the longitudinal direction of the main body 31 are assumed. The surface of the ridge is preferably processed smoothly so as not to damage the oral cavity of the subject 7. However, the scale 37 may be, for example, a substantially linear convex portion extending in the longitudinal direction of the outer peripheral surface of the main body 31, or may be printed or displayed on the outer peripheral surface or the inner peripheral surface of the main body 31.

[0035] As shown in FIG. 3, the end portion 32 has an opening 32A, and an imaging device 57 can be inserted into the opening 32A. Therefore, the imaging device 57 is inserted into the main body 31 from the opening 32A and taken out of the main body 31 from the opening 32A.

[0036] A flange portion 34 may be provided on the end portion 32. The flange portion 34 extends radially outward from the end portion 32 toward the main body 31. When the main body 31 enters deep into the oral cavity 71, the flange portion 34 contacts the lip or front teeth of the subject 7, preventing the subject 7 from accidentally swallowing the intraoral imaging aid 3. That is, the flange portion 34 functions as a stopper. In the present embodiment, the flange portion 34 is provided over the entire circumference of the end portion 32. However, for example, it may be partially formed at positions corresponding to the upper lip and the lower lip at the end portion 32. Further, the outer edge of the flange portion 34 may be circular as shown in FIG. 2, may be elliptical, or may be a polygonal shape such as a quadrilateral.

[0037] For example, when the subject 7 coughs, droplets from the subject 7 hit the flange portion 34. That is, the flange portion 34 also helps the doctor avoid droplets from the subject 7. To provide this droplet avoidance function, for example, the shape and dimensions of the flange portion 34 may be appropriately selected according to the age of use, physique, etc.

[0038] The end portion 33 may also be open, forming a window portion 33A. This window portion 33A is for providing a view from the inside of the main body 31 to the outside of the main body 31. Here, the lens of the imaging device 57 inside the main body 31 is exposed to the outside. However, the window portion 33A may be covered with, for example, a transparent member. This transparent member may be integrally formed with the main body 31 or may be formed separately from the main body 31. The member covering the window portion 33A is preferably made of a material that has been subjected to an anti-fogging process or measure or is difficult to fog up in order to prevent fogging due to the oral cavity temperature of the determination target person 7 or their breath. As the anti-fogging process or measure, there are methods such as applying an anti-fogging coating to the member covering the window portion 33A or raising the temperature of the member covering the window portion 33A using a heating wire or other heat source, but it is not limited to these.

[0039] The end portion 33 protrudes toward the inside of the main body 31, forming a restricting portion 35. The restricting portion 35 is provided to restrict the imaging device 57 inside the main body 31 from coming into contact with and passing through the end portion 33. However, the restricting portion 35 may not be provided on the end portion 33. For example, the guiding portion 141 (recess or groove), which will be described later in relation to FIG. 6, contacts the engaging protrusion 57A of the imaging device 57 at its terminal end and restricts the movement of the imaging device 57 toward the back side, thus also serving as the restricting portion 35.

[0040] When photographing the pharynx 72 using the above-described intraoral photographing assistive device 3, the user inserts the intraoral photographing assistive device 3 into the oral cavity 71 of the determination target person 7 as shown in FIG. 1. At this time, the main body 31 pushes the tongue 73 downward and the soft palate 74 upward. After that or simultaneously, the user inserts the imaging device 57 into the main body 31. At this time, as shown in FIG. 4, neither the tongue 73 nor the soft palate 74 enters the field of view of the imaging device 57, or if they do enter, they only occupy a small range. Therefore, a good view of the pharynx 72 can be obtained.

[0041] In addition, the flange portion 34 can prevent the subject 7 from accidentally swallowing the intraoral imaging aid 3. At the same time, the flange portion 34 can suppress the scattering of droplets from the mouth of the subject 7 to the user, and can reduce the risk of secondary infection of infectious diseases such as influenza to the user.

[0042] Furthermore, the scale 37 enables the intraoral imaging aid 3 to be arranged at an appropriate oral cavity depth according to the physique of the subject 7 and the imaging site. This contributes to taking a clear image of the intended site, and can suppress the discomfort and choking of the subject 7 caused by inserting the main body 31 deeper than necessary.

[0043] 2-2 First modification example of the intraoral imaging aid With reference to FIGS. 5 to 7, the intraoral imaging aid 13 according to the first modification example of the present embodiment will be described. The intraoral imaging aid 13 includes components of the same type as those of the above-described intraoral imaging aid 3, and further includes a substantially linear guide portion 141. On the other hand, the imaging device 57 includes an engagement protrusion 57A that engages with the guide portion 141. Therefore, the guide portion 141 enables the imaging device 57 to slide within the main body 131 without rotating with respect to the main body 131.

[0044] In the first modification example, as shown in FIG. 6, an example of the guide portion 141 is a groove that extends substantially linearly from the end portion 132 toward the end portion 133 so as to correspond to the engagement protrusion 57A on the outer peripheral surface of the imaging device 57. Alternatively, the guide portion 141 may be a pair of rails protruding from the inner peripheral surface of the main body.

[0045] Optionally, when the cross-sectional shape of the main body 131 is an elliptical shape, a polygonal shape, or an asymmetric shape such as a substantially D-shaped shape, for example, and the imaging device 57 has an outer shape corresponding to the cross-sectional shape of the main body 131, the imaging device 57 can slide within the main body 131 without rotating with respect to the main body 131. Therefore, in this case, the inner peripheral surface of the main body 131 also functions as a guide portion.

[0046] As shown in FIG. 5, an instruction display 142 for facilitating the positioning of the main body 131 with respect to the lips of the person 7 to be determined is provided on the outer surfaces of the main body 131 and the flange portion 134. As shown in FIG. 7, the instruction display 142 may be disposed, for example, at a position corresponding to the central portion of the upper lip of the person 7 to be determined or the upper front teeth 75, that is, at the center of the upper part. When the user mounts the intraoral imaging aid 3 in the oral cavity 71 with the instruction display 142 aligned with the center of the upper lip of the person 7 to be determined, for example, the orientations of the images captured by the imaging device 57 will be substantially the same. This facilitates machine learning using the images and the determination process for a specific disease (such as influenza).

[0047] 2-3 Modification Example 2 of the Intraoral Imaging Aid Referring to FIG. 8, the intraoral imaging aid 23 according to Modification Example 2 of the present embodiment will be described. The intraoral imaging aid 23 includes components of the same type as those of the intraoral imaging aid 3 described above, and further has at least one hole 243 in the main body 231. The hole 243 penetrates between the inside and the outside of the main body 231. Such a hole 243 makes it easier for the person 7 to be determined who holds the intraoral imaging aid 23 to breathe, and can give a sense of security to the person 7 to be determined. Note that the size, number, and arrangement of the holes 243 may be appropriately set so that saliva of the person 7 to be determined does not easily enter. The components of Modification Example 2 described above, such as the guide portion, can also be applied to the above-described embodiment and Modification Example 1.

[0048] 2-4 Modification Example 3 of the Intraoral Imaging Aid Referring to FIGS. 9 and 10, the intraoral imaging aid 43 according to Modification Example 3 of the present embodiment will be described. The intraoral imaging aid 43 includes components of the same type as those of the intraoral imaging aid 3 described above.

[0049] The main body 431 of the intraoral imaging aid 43 is a transparent or translucent resin molded product. Therefore, the imaging area of the intraoral imaging device 5 extends further than the range visible from the window portion 433A, and a wider field of view can be obtained. Also, the inner diameter of the main body 431 slightly decreases from the end portion 432 toward the end portion 433, which facilitates the resin molding of the intraoral imaging aid 43.

[0050] As shown in FIG. 10, the scale 437 is formed on the inner peripheral surface of the main body 431, whereby the outer peripheral surface of the main body 431 can be smoothed. The scale 437 may be a protrusion protruding from the inner peripheral surface of the main body 431 or a mark displayed or applied on the inner peripheral surface.

[0051] As shown in FIG. 9, the outer edge of the flange portion 434 has an elliptical shape that is long in the vertical direction, whereby the intraoral imaging aid 43 can be easily positioned with respect to the lips of the determination subject 7. Also, the outer edge of the flange portion 434 protrudes toward the end portion 433 or is formed to be thicker than other portions. Thereby, the necessary strength is ensured while reducing the amount of material and cost of the flange portion 434.

[0052] 2-5 Modification Example 4 of the Intraoral Imaging Aid With reference to FIGS. 11 and 12, the intraoral imaging aid 530 according to Modification Example 4 of the present embodiment will be described. As shown in the drawing, the intraoral imaging aid 530 includes a cylindrical main body 531 having end portions 532 and 533.

[0053] The end portion 532 is open to guide the imaging device 57 of the intraoral imaging device 5 into the main body 531. The end portion 532 has a pair of flange portions 534 that protrude toward the outside of the main body 531 and has a notch 537 that engages with a protrusion provided on the intraoral imaging device 5 to position the intraoral imaging device 5.

[0054] The opposite end portion 533 has a window portion 535 that faces the imaging device 57 in the main body 531. Here, although a transparent member that covers the end portion 533 is assumed as the window portion 535, the window portion 535 may be an opening provided in the end portion 533.

[0055] From the main body 531, a pressing piece 536 extends. The pressing piece 536 serves as a tongue presser that presses the tongue 73 of the person 7 to be judged so that the pharynx 72 of the person 7 to be judged can be clearly seen through the imaging device 57 in the main body 531. Therefore, as shown in FIG. 12, the pressing piece 536 is inclined so as to move away from the axis X of the main body 531 as it goes toward the pharynx 72 side.

[0056] In this way, by sharing the protection function of the imaging device 57 and the function as a tongue presser between the main body 531 and the pressing piece 536 respectively, the intraoral imaging aid 530 can be miniaturized. As a result, the burden (for example, choking, shortness of breath) on the person 7 to be judged when wearing the intraoral imaging aid 530 is reduced, and the convenience of the intraoral imaging aid 530 is improved.

[0057] 2-6 Modification example 5 of the intraoral imaging aid Referring to FIGS. 13, 14, and 15, the intraoral imaging aid 630 according to Modification example 5 of the present embodiment will be described. As shown in the figure, the intraoral imaging aid 630 includes a cylindrical main body 631 having ends 632 and 633.

[0058] An opening 632A for guiding the imaging device 57 of the intraoral imaging device 5 into the main body 631 is formed at the end 632. The end 632 has a pair of jaw portions 634 protruding toward the outside of the main body 631, and has a notch 637 that engages with an engagement protrusion 57A (see FIG. 6) provided on the imaging device 57 of the intraoral imaging device 5 to position the intraoral imaging device 5.

[0059] The end 633 located on the side opposite to the end 632 of the main body 631 has a window portion 635 facing the tip of the imaging device 57 when the imaging device 57 is inserted into the main body 631. The window portion 635 can be composed of, for example, a transparent member that covers the end 633. However, the specific configuration of the window portion 635 is not particularly limited as long as the imaging device 57 arranged in the main body 631 can image the oral cavity 71 through the window portion 635. The window portion 635 may be, for example, an opening formed in the end 633.

[0060] Further, when the window portion 635 is made of a transparent member, for example, it may be made of the same material as the constituent material of the main body 631, or it may be made of a material different from the constituent material of the main body 631. When the window portion 635 is made of a material different from the constituent material of the main body 631, it can be configured to have physical properties different from those of the constituent material of the main body 631. The material of the window portion 635 can be arbitrarily selected based on viewpoints such as strength, translucency, cost, and ease of manufacturing work according to the product specifications of the window portion 635.

[0061] When the main body 631 is made of a resin material, it can be manufactured by injection molding using a mold. When the window portion 635 is made of a material different from the constituent material of the main body 631 as described above, for example, insert molding can be employed in which a resin material is injected into the mold with a transparent member set in the mold.

[0062] As shown in FIGS. 13 and 14, a deformable portion 632B can be formed at the end portion 632 of the main body 631. The deformable portion 632B can be composed of, for example, a plurality of slits that are continuous with the opening 632A and extend substantially linearly from the opening 632A side toward the tip side (the side where the end portion 633 is located) of the main body 631. Each of the plurality of slits can be arranged at a predetermined interval along the circumferential direction of the main body 631. Each of the plurality of slits penetrates the outer surface and the inner surface of the main body 631. Note that the number and specific shape of the slits are not particularly limited.

[0063] When the user inserts the imaging device 57 into the main body 631 through the opening 632A formed in the end portion 632, the deformable portion 632B formed in the end portion 632 can deform the end portion 632 to expand it outward (in the direction away from the axis X). Therefore, even when the main body 631 is made of a hard material that is difficult to deform, when the outer shape (outer diameter) of the imaging device 57 is larger than the outer shape (inner diameter) of the opening 632A, or when the outer shapes of the imaging device 57 and the opening 632A are different, the user can easily insert the imaging device 57 into the main body 631 through the opening 632A formed in the end portion 632.

[0064] Note that the specific configuration of the deformable portion 632B is not limited as long as it can improve the workability of the user when inserting the imaging device 57 into the main body 631. For example, the deformable portion 632B may be a thin-walled portion with a thinner wall thickness of the end portion 632 than other portions of the main body 631, a flexible portion formed of a material more flexible than other portions of the main body 631 for the end portion 632, or a combination of these structures and slits selectively.

[0065] As shown in FIGS. 13 and 14, the main body 631 has a pressing piece 636 extending toward the tip side of the main body 631.

[0066] The pressing piece 636 presses the tongue 73 of the determination target person 7 when photographing the oral cavity 71 with the imaging device 57, similar to the pressing piece 536 (see FIG. 12) provided in the intraoral photographing assisting tool 530 according to the fourth modification. The user can clearly see through the pharynx 72 by pressing down the tongue 73 of the determination target person 7 with the pressing piece 636.

[0067] As shown in Fig. 14, the pressing piece 636 is inclined so as to move away from the axis X of the main body 631 as it approaches the pharynx 72 side. The pressing piece 636 can be formed to have a shape that is convex, for example, in a direction intersecting the protruding direction of the pressing piece 636 (the left - right direction when the main body 631 is viewed from the front), as shown by the arrows A1 - A2 in Fig. 13. Also, as shown by the arrows B1 - B2 in Fig. 13, the pressing piece 636 can be formed to have a shape that is convex, for example, in the protruding direction of the pressing piece 636.

[0068] When the user assists in photographing the oral cavity 71 using the intra - oral photographing aid 630, by pressing the curved pressing piece 636 against the tongue 73 of the determination subject 7, the pressing piece 636 can be fitted to the rounded shape of the tongue 73. Therefore, while the user is using the intra - oral photographing aid 630, displacement of the pressing piece 636 from the tongue 73 can be suppressed. Also, while the pressing piece 636 is being pressed against the tongue 73 of the determination subject 7, since the pressing piece 636 is arranged along the rounded shape of the tongue 73, the discomfort felt by the tongue 73 is reduced.

[0069] When the pressing piece 636 is formed to be convexly curved in each of the direction intersecting the protruding direction of the pressing piece 636 and the protruding direction of the pressing piece 636, the curvature of the pressing piece 636 in each direction is not particularly limited.

[0070] Note that the pressing piece 636 may be formed so as not to be within the viewing angle of the imaging device 57 while the intra - oral photographing aid 630 is being used to assist in imaging the oral cavity 71 of the determination subject 7, or it may be formed so as to be within the viewing angle of the imaging device 57. When the pressing piece 636 is formed so as not to be within the viewing angle of the imaging device 57, since the pressing piece 636 does not appear in the captured image, a clear image of the pharynx 72 can be obtained. On the other hand, when the pressing piece 636 is formed so as to be within the viewing angle of the imaging device 57, the user can visually confirm the position of the pressing piece 636 during imaging, and thus can proceed with the work with a sense of security.

[0071] As shown in FIG. 15, on the lower surface (the tongue side surface) of the pressing piece 636, when the pressing piece 636 is arranged with respect to the tongue 73 of the person 7 to be determined, a slip prevention portion 636A for suppressing the displacement of the pressing piece 636 from the tongue 73 can be formed.

[0072] The slip prevention portion 636A can be constituted by, for example, uneven portions formed by embossing. The uneven portions formed by embossing prevent the pressing piece 636 from being displaced from the tongue 73 by increasing the frictional force generated between the tongue 73 and the lower surface of the pressing piece 636. Note that the specific configuration of the slip prevention portion 636A is not limited as long as it can prevent the pressing piece 636 from being displaced from the tongue 73. The slip prevention portion 636A can also be constituted by, for example, a coating for increasing the frictional force, a groove having an uneven shape, a portion having a large surface roughness, a combination thereof, and the like. Further, the slip prevention portion 636A may be formed, for example, on the entire lower surface of the pressing piece 636 or only on a part of the lower surface of the pressing piece 636.

[0073] For example, a pattern (for example, a character), a pattern, a color, a mark, a scent, a taste, or an arbitrary combination thereof can be added to the pressing piece 636. By adopting such a configuration, for example, when the person 7 to be determined is a child, the anxiety and stress felt by the person 7 to be determined can be alleviated. Note that the above-mentioned pattern or the like may be added to the main body 631.

[0074] 2-7 Other Modification Examples of the Intraoral Photographing Aid The main body 31 does not necessarily have substantially the same inner diameter from the end portion 32 to the end portion 33. For example, the main body 31 may be configured such that the inner diameter increases toward the end portion 32. With such a trumpet-shaped main body 31, a plurality of intraoral photographing aids 3 can be stacked, and the space for transportation and storage can be reduced. In addition, although the intraoral imaging aid 3 is assumed to be an integrally molded resin product, it may be made of a material such as rubber having elasticity, and may be designed to be worn so as to cover all or part of the intraoral imaging device 5 like a condom.

[0075] Also, as the imaging device 57, a camera mounted on a smartphone or a tablet terminal may be adopted. In order to fix the positional relationship between such a camera and the intraoral imaging aid 3 (opening 32A), a frame or a clip may be provided on the main body 31 or the flange portion 34. For example, the intraoral imaging aid 3 may include a clip for sandwiching the smartphone from the upper edge or the side edge, or an L-shaped frame for pressing against the corner portion of the smartphone.

[0076] The structures of the intraoral imaging aids described in the embodiments and each modification can be appropriately combined as long as the essential functions of the intraoral imaging aids are not impaired.

[0077] 2-8 Packaging Example of Intraoral Imaging Aid The intraoral imaging aid 3 may be sterilized and individually packaged in a bag 9 on which an identifier 91 is displayed as shown in FIG. 16, whereby hygienic management of the intraoral imaging aid 3 becomes possible. Note that the identifier 91 may be displayed on the intraoral imaging aid 3.

[0078] The identifier 91 includes identification information including, for example, the product ID of the intraoral imaging aid 3. Examples of the identifier 91 include a barcode and an RF tag, but considering reading by the intraoral imaging device 5 and use in a medical institution of the medical device 1, a barcode is preferable. As the barcode, either a one-dimensional barcode or a two-dimensional barcode can be used.

[0079] For example, before intraoral imaging, the imaging device 57 captures the identifier 91, and by reading the identification information of the intraoral imaging aid 3 in the bag 9 into the intraoral imaging device 5, the lot information of the corresponding intraoral imaging aid 3 can be confirmed. Thereby, traceability can be ensured even when harmful events occur to the patient due to contact with the oral cavity, and it is also possible to detect the reuse of the intraoral imaging aid 3, thereby preventing contamination and secondary infection and ensuring safety in terms of hygiene.

[0080] 3-1 Intraoral Imaging Device Referring to FIGS. 17-25, the intraoral imaging device 5 will be described in detail. The intraoral imaging device 5 is a computer including an imaging device, an arithmetic device, and a storage device. Here, it is assumed that the intraoral imaging device 5 is composed of one computer, but it may also be composed of multiple computers. For example, in remote image diagnosis, the imaging function and the determination function may be executed by separate computers. As shown in FIG. 18, the intraoral imaging device 5 includes an imaging device 57, a central processing unit (CPU) 51 as an example of an arithmetic device, a random access memory (RAM) 52 and a read-only memory (ROM) 53 as examples of storage devices, a communication interface 54, an input device 55, an output device 56, and a light source 58.

[0081] The communication interface 54 is a wired or wireless communication module and is used, for example, for obtaining and updating application programs and determination algorithms, and for collecting (transmitting) the captured images. As the wireless communication interface, for example, devices that meet any of the wireless LAN standards such as Wi-Fi, short-range wireless communication standards such as BLUETOOTH (registered trademark), and the third-generation / fourth-generation mobile communication standards are assumed, but it is not limited thereto.

[0082] The input device 55 is an example of an input device that receives user input, and is, for example, various operation buttons and operation keys as shown in FIG. 17. Alternatively, the input device 55 may be other input means such as a touch panel, a microphone, an operation dial, a stylus, or the like. The input device 55 may be disposed in the main body (housing) of the intraoral imaging device 5, or may be disposed in the imaging device 57, for example. The output device 56 is an example of an output device that outputs a determination result, and is, for example, a display, a speaker, or a printer.

[0083] The imaging device 57 acquires an image. In this embodiment, a moving image is assumed as the image acquired by the imaging device 57. The size of the acquired image is, for example, 640×480 pixels, and the frame rate is, for example, 30 fps, which is sufficient. However, the image size and the frame rate are not limited thereto. Optionally or additionally, the imaging device 57 may be enabled to capture a still image. When capturing a still image, it is desirable for the imaging device 57 to have a continuous shooting function, but it is not limited thereto.

[0084] In this embodiment, as shown in FIG. 17, the imaging device 57 is assumed to be separated from the main body (housing) of the intraoral imaging device 5 and inserted into the intraoral imaging aid 3 alone. The imaging device 57 preferably has an outer shape (for example, a cylindrical shape) corresponding to the inner peripheral surface of the main body 31 of the intraoral imaging aid 3. However, the imaging device 57 may be incorporated into the main body of the intraoral imaging device 5, such as a smartphone or a tablet terminal, for example.

[0085] The imaging device 57 has an autofocus mechanism (not shown), and for example, the focus may be set so as to match a specific site in front of the lens. The imaging device 57 may also have a function of automatically recognizing a specific site (for example, the posterior pharyngeal wall) and focusing thereon. The imaging device 57 further has a zoom function, and for example, may be set to capture an image at an appropriate magnification according to the size of the posterior pharyngeal wall or the follicles.

[0086] During the operation of the imaging device 57, light may be irradiated from the light source 58 toward the subject, thereby ensuring a high-quality image. Here, the light irradiated by the light source 58 may be visible light, or may be non-visible light such as, for example, near-infrared light or infrared light. Further, for example, a plurality of light sources 58 may be each responsible for irradiating light of a specific wavelength range, such that one light source irradiates visible light and the other light source irradiates near-infrared light or infrared light.

[0087] On the other hand, the imaging device 57 preferably has a type and number of light receiving elements capable of appropriately receiving the light emitted by the light source 58. For example, when the light source 58 emits visible light, the imaging device 57 has a light receiving element suitable for receiving visible light, and when the light source 58 emits non-visible light, the imaging device 57 may have a light receiving element suitable for receiving non-visible light. The light source 58 may be, for example, a light emitting diode (LED) or an organic electroluminescence (OEL).

[0088] Optionally, during the operation of the imaging device 57, it may be programmed such that an image being photographed and a semi-transparent illustration are superimposed and displayed on the display as the output device 56. When the user moves the imaging device 57 so that the illustration and the image of the corresponding part (for example, the uvula or the palatine tonsil) overlap, it becomes possible to obtain an appropriate image for determination.

[0089] The ROM 53 stores an application program for executing various processes in the intraoral imaging device 5 and an algorithm for determining a specific disease. The ROM 53 may also store the image acquired by the imaging device 57, the identification information of the intraoral imaging aid 3, various information input from the input device 55 (for example, information of the determination target person 7), and the determination result. The ROM 53 may be of a built-in type, a removable type such as, for example, a USB memory or a MicroSD card, or may further include a storage area of a storage device of an external computer such as an external server.

[0090] The CPU 51 can read the application program stored in the ROM 53 into the RAM 52 and execute various processes including the following processes (a) to (d). Note that when the image acquired by the imaging device 57 is a single still image, the extraction process may be omitted.

[0091] 3-2 Main Processes Executed by the CPU (a) Extraction Process The CPU 51 extracts at least one still image that satisfies a predetermined condition from the image acquired from the imaging device 57. For example, when the imaging device 57 captures a moving image, the CPU 51 extracts at least one still image from among the plurality of still images included in the moving image. When capturing a moving image, still images are recorded at a predetermined frame rate. Among them, there should be those with good shooting conditions and those without. Several images with good shooting conditions are selected as the images to be used in the following determination process.

[0092] For example, based on a large amount of similar image data in advance, it is found that when all or part of a specific shooting angle, the illumination condition of a specific light, the width of a specific field of view, the depiction position of a specific part (e.g., pharynx, etc.), and the degree of focus on a specific part are satisfied, the diagnostic determination accuracy of a specific disease (e.g., influenza) is high. This condition is used as the criterion for judging the quality of the shooting conditions. When such a criterion is adopted, the extraction process, for example, as shown in FIG. 23, ranks the images based on the depiction position of the shooting object (step S31), ranks the images based on the degree of focus on the specific part (step S32), ranks the images based on the light irradiation state (step S33), and finally selects several images that are ranked high in the overall ranking (step S34). Additionally, before calculating the overall ranking, the images may be ranked according to the criterion of the field of view width or the shooting angle. Alternatively, a deep learning function may be used for the extraction process.

[0093] (b) Determination Process The CPU 51 determines the possibility of a specific disease based on the image acquired from the imaging device 57 (for example, at least one still image obtained by the extraction process) and the determination algorithm stored in the ROM 53. The specific disease is influenza in this embodiment. For the determination, information of the determination target person 7 (hereinafter referred to as patient information) input by the user via the input device 55 or acquired by other means may be used in combination. The patient information includes, for example, age, gender, elapsed time since onset, presence or absence of various influenza symptoms (such as cough, runny nose, chills, etc.), and contact history with other influenza patients. The patient information may include all or part of information regarding race, genetic information, date, season, location information (latitude and longitude of the medical examination location), weather information (such as weather, temperature, etc.), and the prevalence of influenza at a certain time in a certain area.

[0094] Here, the determination algorithm may be generated, for example, according to the procedure shown in FIG. 22. For example, in the case of influenza, first, at a medical institution, a pharyngeal image of a patient and a correct label indicating whether it is influenza or not are collected (step S21). The correct label is assigned, for example, based on the results of a rapid influenza test by swab, PCR test, or virus isolation culture test received from the patient. Although the PCR test and the virus isolation culture test take several weeks until the results are known, their results are highly accurate and thus are suitable as the correct label. Also, the correct label may include not only the image data but also the above patient information.

[0095] Next, teacher data (image data) labeled with the determination result of the above PCR test or virus isolation culture test as the correct answer is generated (step S22). Machine learning is performed based on this teacher data to generate a determination algorithm (step S23). This determination algorithm is an algorithm for determining whether an image given is likely to be influenza. As a result, the possibility of being influenza can be quantified and shown, for example, as "98.5%".

[0096] Optionally, for example, "Determination: Influenza positive" and "Determination: Influenza negative", positive or negative may be determined. In this case, in addition to the positive or negative determination, the reliability of the determination may be quantified or indicated by a stage evaluation such as high, medium, or low. Alternatively, the degree of certainty of influenza may be indicated by a stage evaluation such as high, medium, or low.

[0097] (c) Output processing The CPU 51 outputs the result of the determination process. An example of the output method is display on a display or transmission to another computer.

[0098] (d) Acquisition of identification information of the intraoral imaging aid Optionally, prior to a new determination, the CPU 51 may request the user to input the identification information of the intraoral imaging aid 3 for use in the determination. For example, when the user captures the identifier 91 with the imaging device 57, the CPU 51 acquires the identification information of the corresponding intraoral imaging aid 3 from the image of the identifier 91.

[0099] Next, the CPU 51 searches the records in the ROM 53 and checks for the presence of a record that matches the corresponding intraoral imaging aid 3. Alternatively, the CPU 51 may cause the usage record of the intraoral imaging aid 3 on an external server to be examined.

[0100] If there is no matching record, the CPU 51 allows a new determination. If there is a matching record, the CPU 51 determines that the corresponding intraoral imaging aid 3 has been used. Then, the CPU 51 may, for example, display an alarm on the display or terminate a series of processes. That is, the CPU 51 can limit a new determination according to the search result.

[0101] 3-3 Functional configuration of the intraoral imaging device FIG. 19 shows the functional configuration of the intraoral imaging device 5. The intraoral imaging device 5 includes an imaging unit 61, an extraction unit 62, a determination unit 63, a camera control 64, a storage unit 65, an input unit 66, an output unit 67, and a communication unit 68. In terms of the correspondence with the hardware configuration of the intraoral imaging device 5, the imaging unit 61 corresponds to the imaging device 57, the extraction unit 62, the determination unit 63, and the camera control 64 correspond to the CPU 51, the storage unit 65 corresponds to the ROM 53, the input unit 66 corresponds to the input device 55, the output unit 67 corresponds to the output device 56, and the communication unit 68 corresponds to the communication interface 54, respectively. Here, the camera control 64 controls the imaging device 57 to implement various functions such as an autofocus function and a zoom function.

[0102] As other functions, the intraoral imaging device 5 may have a timing function for acquiring the time when imaging is performed, a position information acquisition function for acquiring the position information where imaging is performed, and a weather information acquisition function for acquiring the weather information at the position. The timing function may be realized as a built-in clock, or may be a function of a communication interface for accessing an external time server. The position information acquisition function may be realized, for example, as a global positioning system (GPS). The weather information acquisition function may be a function of a communication interface for accessing an external weather server.

[0103] 3-4 Operating Example 1 of Intraoral Imaging Device Referring to FIG. 20, an operating example 1 of the intraoral imaging device 5 will be described. Here, an operation when the intraoral imaging device 5 captures a moving image is taken as an example. However, the intraoral imaging device 5 may capture a still image, and in this case, the intraoral imaging device 5 operates in the same manner.

[0104] When the power is turned on, the intraoral imaging device 5 starts imaging by the imaging device 57 and displays it on the display, and in step S1, determines whether a recording button (one of the input devices 55) has been pressed. When it is not confirmed that the recording button has been pressed, the intraoral imaging device 5 repeats step S1.

[0105] When it is confirmed that the recording button has been pressed, the intraoral imaging device 5 starts recording in step S2. At the same time, the intraoral imaging device 5 turns on the light source 58. The user attaches the intraoral imaging aid 3 to the oral cavity 71 of the person to be judged 7, and then inserts the imaging device 57 into the intraoral imaging aid 3 (see FIG. 1). The imaging device 57 images the oral cavity (oral cavity 71 or pharynx 72) of the person to be judged 7 even while sliding inside the intraoral imaging aid 3.

[0106] In step S3, the intraoral imaging device 5 extracts an appropriate still image for determination from among a plurality of still images included in the acquired moving image. At this time, the extracted still image may be displayed on the display as an extraction result.

[0107] In step S4, the intraoral imaging device 5 determines the presence of a specific disease based on the extracted still image and the determination algorithm, and outputs the determination result to, for example, the display in step S5. Thereby, a series of operations is completed.

[0108] In this way, since the possibility of a specific disease is evaluated using a determination algorithm generated by machine learning, highly accurate determination results can be expected. Since an image with good imaging conditions is selected for determination, the accuracy of determination is improved. When the intraoral imaging device 5 is used in combination with the intraoral imaging aid 3, a wide field of view and a clear image can be obtained. This contributes to an improvement in the determination accuracy.

[0109] 3-5 Operation Example 2 of Intraoral Imaging Device With reference to FIG. 21, operation example 2 of the intraoral imaging device 5 will be described. This operation example 2 includes steps of the same type as operation example 1 described above, and further includes a step of confirming the extracted image (S14) by the user, a step of inputting patient information (S16), and an overall determination (S17).

[0110] Specifically, when the power of the intraoral imaging device 5 is turned on, it checks for the pressing of the recording button (step S11), starts recording (step S12), and extracts an image for determination (step S13). Then, the intraoral imaging device 5 displays the extracted image on, for example, a display, and asks the user whether to use the image for determination (step S14). If the user selects "NO", steps S12 and S13 are executed again to present a new image for determination to the user.

[0111] When the user selects "YES" in step S14, the intraoral imaging device 5 determines the likelihood of a specific disease based on the extracted image (step S15).

[0112] Next, the intraoral imaging device 5 asks the user to input patient information (step S16). Here, the patient information is, for example, standardized and simple information such as body temperature at the time of consultation and the presence or absence of vaccination. Such patient information is input in a form that can be uniformly processed by software, as illustrated in FIG. 9. For example, a pull-down menu or an input form setting that rejects characters other than half-width numbers may be used. Alternatively, the intraoral imaging device 5 may obtain patient information from an external computer (e.g., an electronic medical record system) via a wired or wireless connection. Note that step S16 may be executed prior to step S11.

[0113] Then, both the above-mentioned patient information and the evaluation of the likelihood of a specific disease based on the image are integrated to calculate the overall likelihood of the disease (step S17). The calculation result is displayed on, for example, a display (step S18), and a series of procedures ends.

[0114] In this way, by the intraoral imaging device 5 evaluating the possibility of a specific disease based on the image confirmed by the user, the accuracy and reliability of the determination are improved. Furthermore, it is expected that the accuracy and reliability of the determination will be further improved if the determination is made based on patient information.

[0115] Operation Example 3 of Intraoral Imaging Device 3-6 Referring to FIG. 24, an operation example 3 of the intraoral imaging device 5 will be described. This operation example 3 includes a procedure (step S41) for acquiring identification information of the intraoral imaging aid 3.

[0116] Specifically, when the power of the intraoral imaging device 5 is turned on, in step S41, for example, via display on the display, the user is requested to input the identification information of the intraoral imaging aid 3. For example, when the user captures the identifier 91 on the bag 9 with the imaging device 57 or inputs the identification information via the input device 55, the intraoral imaging device 5 acquires the identification information of the intraoral imaging aid 3.

[0117] The intraoral imaging device 5 may use the identification information to check the lot information of the corresponding intraoral imaging aid 3. For example, the intraoral imaging device 5 may search the records in the ROM 53 to see if the product ID of the intraoral imaging aid 3 is included, or may have the external computer check for the presence or absence of the product ID.

[0118] If the corresponding product ID is in the internal or external record, the intraoral imaging device 5 may output an alarm or end a series of processes. Examples of the alarm include, for example, a display on the display indicating that the corresponding intraoral imaging aid 3 has been used. This restricts the reuse of the intraoral imaging aid 3 and enhances the safety of the intraoral imaging aid 3, including the prevention of secondary infection. Also, since the intraoral imaging aid 3 and the subject 7 to be judged using it can be made to correspond one-to-one, future follow-up investigations become easier.

[0119] Thereafter, the intraoral imaging device 5 performs intraoral imaging in step S42. Here, the intraoral imaging process may be the same as in the above-described operation examples 1 and 2, or may be performed according to the procedure described later. Then, the intraoral imaging device 5 determines the presence of a specific disease in step S43, outputs the determination result in step S44, and ends a series of processes.

[0120] 3-7 Other Examples of Intraoral Imaging Referring to FIG. 25, other procedures for intraoral imaging will be described. The procedures described here can be alternatives to the image acquisition procedures in the above-described operation examples 1 to 3. Also, this procedure can be used for collecting training data for machine learning.

[0121] First, in step S51, the intraoral imaging device 5 performs patient registration. Patient registration is performed, for example, by recording the patient ID input by the user to or photographed by the intraoral imaging device 5.

[0122] Next, in step S52, the intraoral imaging device 5 acquires an image. The image here is a still image, and for example, it may be composed of a set of still images extracted from the images photographed by the imaging device 57 at a predetermined time interval (for example, every 1 second).

[0123] Then, in step S53, the intraoral imaging device 5 displays the acquired image on, for example, a display and requests confirmation from the user. When approval is obtained from the user in step S54, the intraoral imaging device 5 saves the approved image in step S55 and ends a series of imaging processes. If approval from the user is not obtained, the process returns to step S52 to acquire an image again.

[0124] 4 Procedures from Intraoral Imaging to Administration of Anti-Influenza Virus Agent Referring to FIG. 26, the procedures from intraoral imaging to administration of an anti-influenza virus agent will be described.

[0125] In step S61, an intraoral image, particularly a pharyngeal image, is photographed using the intraoral imaging device 5. At this time, in order to obtain a clear image, any of the above-described intraoral imaging aids 3 (including those shown in the modified examples) can be used.

[0126] Next, in step S62, it is determined whether the patient is positive or negative for influenza virus infection based on the intraoral image. For example, this step preferably includes determining whether a pattern specific to influenza virus infection appears in the pharynx. This step can be executed by using the intraoral imaging device 5.

[0127] If the determination result in step S62 is negative for influenza virus infection, the series of procedures is terminated.

[0128] Conversely, if the determination result is positive for influenza virus infection, in step S63, an anti-influenza virus agent is administered to the patient, and the series of procedures is terminated. As a result, an anti-influenza virus agent can be administered promptly and accurately to a patient suspected of having influenza virus infection, enabling efficient treatment of influenza. In addition, by administering an anti-influenza virus agent to a patient determined to be positive for influenza virus infection, the emergence of drug-resistant strains, which is a social problem in Japan and around the world, can be prevented.

[0129] Here, examples of the anti-influenza virus agent include baloxavir, oseltamivir, zanamivir, peramivir, and laninamivir, but are not limited to these small molecule pharmaceuticals, and may also be other small molecule compounds having an antiviral action, peptide pharmaceuticals, antibody pharmaceuticals, nucleic acid pharmaceuticals, or even vaccines.

[0130] Examples of small molecule pharmaceuticals with antiviral activity include compounds with Cap endonuclease inhibitory activity, such as baloxavir; compounds with neuraminidase inhibitory activity, such as laninamivir, zanamivir, and AV-5080, which is an analog of zanamivir; compounds with RNA polymerase inhibitory activity, such as favipiravir; compounds with PB2 protein inhibitory activity, such as pimodivir and CC-42344; compounds with antiviral activity, such as nitazoxanide and tizoxanid; and compounds with G protein-coupled receptor (GPCR) antagonistic activity, such as GP-1001 and the like.

[0131] Examples of peptide pharmaceuticals with antiviral activity include flufirvitide-3, which consists of 16 amino acid residues and targets the hemagglutinin HA2 of influenza virus; cyclic peptides targeting hemagglutinin (HA), such as PD-001 (HA100, HA100-R14, iHA-100, iHA-24); peptides disclosed in US7645448 and its family targeting hemagglutinin (HA) (e.g., DAS-181); TCN-032, which is a fully human monoclonal IgG antibody using the extracellular amino-terminal region (M2e) of the matrix protein M2 of influenza A virus as an antigen; and VIS-410, which is a human IgG1 monoclonal antibody with a broad spectrum against influenza virus and inhibits the fusion of hemagglutinin (HA) and cell membrane.

[0132] Examples of antiviral antibody drugs include gedivumab, a recombinant human monoclonal IgG1κ antibody against influenza A virus; MEDI-8852, an IgG1κ monoclonal antibody that binds to the stem regions of hemagglutinin (HA) subtypes H5 and H7; and CF-404, a mixture of three human monoclonal antibodies disclosed in WO2014152841 and its family, which targets the conserved region of hemagglutinin (HA) of influenza virus.

[0133] Examples of antiviral nucleic acids include radavirsen, an antisense RNA / DNA consisting of 20 bases, and STP-702, a mixture of siRNAs that targets the influenza virus genes of 5N1, H1N1, and H7N9.

[0134] As influenza vaccines, there are inactivated whole particle intranasal influenza vaccine (BK-1304) disclosed in WO2014103488 and its family, intradermal influenza preventive vaccines (DNK-651, KD-404), live attenuated quadrivalent nasal spray vaccine (MEDI-3250 / VN-0107 / FluMist® Quadrivalent / Fluenz® Tetra), sublingual tablet formulation of influenza HA vaccine (NSV-0001), pandemic influenza vaccine using recombinant hemagglutinin (HA) produced using transgenic silkworms disclosed in WO2014017493 and its family, monovalent influenza VLP vaccine against influenza A, intranasal recombinant pandemic influenza vaccine targeting influenza hemagglutinin (HA) using replication-deficient adenovirus vector, intranasal recombinant seasonal influenza vaccine targeting influenza hemagglutinin (HA) using replication-deficient adenovirus vector, H5N1 avian influenza vaccine (AE-443p) using synthetic peptide, alphavirus replicon vaccine (AVX-502) expressing influenza HA protein, DNA vaccine (pH7HA / GLS-3700) synthesized by incorporating the gene of hemagglutination (HA) influenza antigen derived from influenza H7N9 infected patients into pGX0001 expression vector, inactivated trivalent influenza vaccine (GSK-2186877A) using AS03 adjuvant, H7N9 influenza vaccine (GSK-3206641A) containing AS03 adjuvant and using influenza virus hemagglutinin protein (HA) as antigen, DNA vaccine (pH3HA) against H3N2 influenza virus, DNA vaccine (INO-3510) containing influenza A H5N1 vaccine (INO-3401) and H1N1 vaccines (INO-3605 and INO-3609) and administered intradermally using electroporation, RedeeFluTM vaccine (Bris10 M2SR) consisting of influenza virus with partial deletion of M2 gene, three standard seasonal inactivated influenza antigens from MerciaThe vaccine (MER-4101) formulated as a nanoparticle W / O emulsion by Pharma's MAS-1 (Mercia Adjuvant / delivery System-1), the vaccine (mRNA-1851) using mRNA encoding the membrane-bound hemagglutinin protein H7, the vaccine (MT-8972) targeting the Indonesian influenza A virus (A / Indonesia / 5 / 2005) disclosed in WO2009009876 and its family, the H5 influenza vaccine (nanoemulsion adjuvanted H5 influenza vaccine) containing a plant-derived influenza (influenza A / Indonesia / 5 / 2005) HA antigen (H5) and inducing anti-H5 antibodies, the vaccine (PDS-0103) in which influenza antigens are encapsulated in nanoparticles composed of a cationic lipid (DOTAP), a quadrivalent influenza vaccine targeting 1N1 (A / California / 04 / 09), H3N2 (A / Victoria361 / 2011) and two B strains (B / Wisconsin / 1 / 2010, B / Brisbane / 60 / 2008), the vaccine (MT-2271) in which Nicotiana benthamiana (tobacco) is used for the production of virus-like particles (VLP), the H5N1 influenza vaccine in which the H5 HA antigen of the H5N1 influenza virus (A / Vietnam / 1194 / 2004) is incorporated into an adenovirus vector (Ad4), the vaccine (PXVX-0103) that replicates in the small intestine and induces an antibody response, the VLP of Novavax (core virus-likeA tetravalent seasonal influenza vaccine containing type B influenza produced using the particle) technology, a 4-valent oral vaccine against seasonal influenza, an adenovirus (Ad5) containing an HA antigen and dsRNA encoding a TLR3 ligand is absorbed from the small intestine, and a vaccine in which dendritic cells are activated by the TLR3 ligand and antibody production is induced, and a preventive DNA vaccine against H5N1 and H7N9 avian influenza viruses, including universal consensus hemagglutinin (HA) derived from a plurality of different H5N1 viruses, universal consensus neuraminidase (NA) covering N1 subtypes such as H5N1 and H1N1, and a vaccine (VGX-3400X) composed of three kinds of DNA plasmids each containing universal consensus nucleoprotein (NP) fused to a part (m2e) of the m2 protein, etc.

[0135] In step S63, an anti-influenza virus agent may also be administered to a close contact of a patient determined to be positive for influenza virus infection. Thereby, it is possible to prevent the infection of influenza virus to the close contacts of a patient suspected of being infected with influenza virus, and it is possible to effectively suppress the spread of influenza virus infection. In particular, when the close contact is an elderly person 65 years of age or older, a patient with chronic respiratory disease or chronic heart disease, a patient with a metabolic disease including diabetes, or a patient with renal dysfunction who may become a high-risk patient when infected with influenza virus infection, a great preventive effect can be expected. Here, the close contact refers to, for example, a person who has acted together with, contacted, or sat in adjacent seats in an aircraft, workplace, etc. with a patient determined to be suspected of having influenza virus infection, and includes cohabiting family members and cohabitants.

[0136] As described above, representative embodiments of the present invention have been described, but the present invention is not limited thereto, and various design changes are possible, and they are also included in the present invention.

[0137] For example, the present invention can be understood as a method for treating and preventing influenza virus infections, and a therapeutic agent and a prophylactic agent, which contain an anti-influenza virus agent as an active ingredient. As a treatment method of the present invention, more specifically, it is a method for treating influenza virus infections, which contains an anti-influenza virus agent as an active ingredient, (1) In the oral cavity of a patient suspected of having influenza virus infection, perform an image diagnosis of influenza infection using an intraoral imaging device, and identify and select a patient determined to be positive for influenza virus infection. (2) It relates to a method for treating influenza virus infections, wherein the anti-influenza virus agent is administered to a patient determined to be positive for influenza virus infection.

[0138] Alternatively, the therapeutic agent may be a therapeutic agent for influenza virus infections, which contains an anti-influenza virus agent as an active ingredient, and the anti-influenza virus agent is administered to a patient determined to be positive for influenza virus infection based on an intraoral image taken using an intraoral imaging device.

[0139] Alternatively, the present invention can also be understood as the use of an active ingredient for the manufacture of an anti-influenza virus agent for treating and preventing influenza virus infections. More specifically, the present invention (1) In the oral cavity of a patient suspected of having influenza virus infection, perform an image diagnosis of influenza infection using an intraoral imaging device, and identify and select a patient determined to be positive for influenza virus infection. (2) It is characterized in that the anti-influenza virus agent is administered to a patient determined to be positive for influenza virus infection. It relates to the use of an active ingredient for the manufacture of an anti-influenza virus agent for treating influenza virus infections.

[0140] In this embodiment, an anti-influenza virus agent is administered to patients diagnosed as positive for influenza virus infection and their close contacts. However, even for subjects (negative determiners) diagnosed as negative for influenza virus infection, if there is a person with influenza infection among their close contacts, an anti-influenza virus agent may be administered to them. This can prevent the infection of influenza virus in those at risk of influenza virus infection and effectively suppress the spread of influenza virus infection. In particular, when the negative determiner is an elderly person aged 65 or older, a patient with chronic respiratory disease or chronic heart disease, a patient with a metabolic disease including diabetes, or a patient with renal dysfunction, a significant preventive effect can be expected.

Explanation of Signs

[0141] 1 ··· Medical device 3, 13, 23, 43, 530, 630 ··· Intraoral imaging aid 5 ··· Intraoral imaging device 31, 131, 231, 431, 531, 631 ··· Main body 34, 134, 234, 434, 534, 634 ··· Flange part 35, 135, 435 ··· Regulation part 37, 137, 237, 437 ··· Scale 55 ··· Input device 56 ··· Output device 57 ··· Imaging device 58 ··· Light source

Claims

1. An intraoral photography aid that is inserted into an oral cavity to photograph the oral cavity, A cylindrical body, a first end having an opening through which an imaging device can be inserted; a second end opposite the first end providing a field of view from inside the body to outside the body; an inner circumferential surface extending from the first end toward the second end and allowing the imaging device to slide; The body including: a pressing piece having one end connected to the main body and the other end formed outside the second end and extending in the longitudinal direction of the main body; An intraoral photography aid including:

2. The intraoral photography aid according to claim 1, wherein the pressure piece is capable of pressing the tongue of the subject into which the intraoral photography aid is inserted when the intraoral photography aid is inserted into the oral cavity.

3. The intraoral photography aid according to claim 1 , wherein the pressing piece is formed so that the other end is away from the longitudinal axis of the main body.

4. The intraoral photography aid according to claim 1 , wherein the pressing piece is formed so as to protrude from the second end in a protruding direction that is further outward than the second end.

5. The intraoral photography aid according to claim 4 , wherein the pressing piece has a shape that is curved convexly with respect to the protruding direction.

6. The intraoral photography aid according to claim 1 , wherein the second end portion has a window portion covered with a transparent member integrally molded with the main body.

7. The intraoral photography aid according to claim 1 , wherein the first end has an easily deformable portion for assisting insertion of the imaging device into the main body.

8. The intraoral photography aid of claim 7 , wherein the easily deformable portion is constituted by a plurality of slits arranged at a predetermined interval along the circumferential direction of the main body and extending from the opening to the second end.

9. The intraoral photography aid according to claim 1 , wherein the first end has a notch for engaging with a protrusion provided on the imaging device to position the imaging device.

10. The intraoral photography aid according to claim 1 , wherein the first end has a flange portion partially formed around the circumference of the main body so as to protrude radially outward from the main body.

11. The intraoral photography auxiliary tool according to claim 10 , wherein the flange portion has a through hole penetrating in a direction along the longitudinal direction of the main body.

Images