We developed an accurate three-dimensional blood vessel search (3D BVS) system and an automatic blood sampling system. They were implemented into a point-of-care system designed for medical care, installed in a portable self-monitoring blood glucose (SMBG) device. The system solves problems of human error caused by complicated manual operations of conventional SMBG devices. We evaluated its accuracy of blood-vessel position detection. The 3D BVS system uses near-infrared (NIR) light imaging and the stereo and autofocus hybrid method to determine blood vessel locations accurately in three dimensions. We evaluated the accuracy of our 3D BVS system using a phantom of human skin, blood vessels, and blood. Additionally, we established an automatic blood sampling system for SMBG and assessed its performance in relation to punctures, blood suction, transport, and discharge on an enzyme sensor. The 3D BVS and automatic blood sampling system are adequate for use in a portable SMBG device. 1. Introduction Recently, the rapidly increasing number of diabetic patients has [1] become a major social problem throughout the world. Diabetic patients must independently measure blood glucose concentrations using a self-monitoring blood glucose (SMBG) device and self-inject insulin several times each day [2, 3]. Diabetes patients and candidates might constitute up to one-fifth of the world population [1]. Therefore, SMBG devices are expected to play an increasingly important role in daily medical care. The commercial SMBG devices of various kinds that are on the market today can be categorized as either noninvasive or minimally invasive. Noninvasive devices adopt infrared spectroscopy [4], FT-IR-ATR method [5], photoacoustic spectroscopy [6], and so on. However, these methods present severe problems of low accuracy and unreliability. In contrast, minimally invasive devices [7, 8] can measure blood glucose concentrations with high accuracy [9], but puncture with a needle or knife edge is painful. In addition, such devices frequently induce human error because of their complicated manual operations during puncture, treatment of small blood samples, self-measurement, and so on. Therefore, many improvements are necessary for SMBG devices. Several groups have developed minimally invasive SMBG devices equipped with a blood vessel search system to reduce human error. For example, Yamakoshi et al. developed a device to detect the positions of blood vessels in the arm using reflected near-infrared (NIR) light [10], but the blood vessel depth could not be determined accurately.
M. Miyazaki, “Reliability related to small size and simple blood sugar weighing device and the usages,” Journal of Clinical Laboratory Instruments and Reagents, vol. 28, no. 4, pp. 291–304, 2005 (Japanese).
[3]
N. Ozeki, Y. Kamata, Y. Okuzumi, et al., “Examination related to measurement accuracy of small electrode type blood sugar measuring instrument Antisense ,” Journal of Medicine and Pharmaceutical Science, vol. 53, no. 3, pp. 361–370, 2005 (Japanese).
[4]
K. Jungheim and T. Koschinsky, “Risky delay of hypoglycemia detection by glucose monitoring at the arm,” Diabetes Care, vol. 24, no. 7, pp. 1303–1306, 2001.
[5]
K. Fujita, K. Tamura, K. Wataru, H. Ishizawa, and E. Toba, “Development of noninvasive blood glucose sensor using the infrared spectroscopy,” Transactions of the Institute of Electrical Engineers of Japan C, vol. 129, no. 9, pp. 1759–1765, 2004 (Japanese).
[6]
T. Karatsu, D. Iwata, T. Nakajima et al., “Determination of the glucose in serum by the FT-IR-ATR method,” Japan Analyst, vol. 54, no. 2, pp. 149–154, 2005.
[7]
E. Nakamachi, S. Jinninn, Y. Uetsuji, K. Tsuchiya, and H. Yamamoto, “Sputter generating and characterization of a titanium alloy microneedle for applying to Bio-MEM,” Transactions of the Japan Society of Mechanical Engineers A, vol. 72, no. 716, pp. 471–477, 2006.
[8]
T. Asakura and H. Seino, “Basic study of a micro-tapered needle (TN-3305) used for insulin pre-filled products,” Japanese Journal of Pharmaceutical Health Care and Sciences, vol. 30, no. 6, pp. 368–376, 2004 (Japanese).
[9]
H. A. MacKenzie, H. S. Ashton, S. Spiers et al., “Advances in photoacoustic noninvasive glucose testing,” Clinical Chemistry, vol. 45, no. 9, pp. 1587–1595, 1999.
[10]
K. Yamakoshi, S. Ishimaru, A. Nakabayashi, et al., “Development of a compact device for self-monitoring of venous blood glucose using miniature needle and infra-red CCD monitor,” Transactions of the Japanese Society for Medical and Biological Engineering, vol. 42, p. 198, 2003 (Japanese).
[11]
Y. Horiike, Y. Ogawa, M. Niihashi, A. Oki, M. Takai, and M. Nagai, “Development of a health-care-chip,” Chemical Devices, pp. 81–85, 2004.
[12]
H. Kandani, Y. Uetsuji, K. Tsuchiya, and E. Nakamachi, “Development of blood vessel searching system for HMS,” in Proceedings of the SPIE Optics and Photonics, vol. 7055, SanDiego, Calif, USA, 2008.
[13]
E. Nakamachi, T. Kuroda, K. Tsuchiya, Y. Uetsuji, and T. Uenoya, “Development of a three-dimensional blood vessel searching system by using the near infra-red light,” Transactions of the Japan Society of Mechanical Engineers C, vol. 73, no. 731, pp. 2088–2094, 2007.
[14]
M. Tamura, M. Kaneko, K. Shimizu, K. Yamamoto, and T. Mikami, “Basic study for visualization of blood vessels using near-infrared light,” Tech. Rep. MBE89, IEICE, 1989.
[15]
M. Kono, H. Ueki, and S. Umemura, “A new method for the identification of individuals by using of vein pattern matching of a finger,” in Proceedings of the 5th Symposium on Pattern Measurement, pp. 9–12, Yamaguchi, Japan, 2000.
[16]
E. Nakamachi, S. Jinninn, Y. Uetsuji, K. Tsuchiya, and H. Yamamoto, “Sputter generating and characterization of a titanium alloy microneedle for applying to Bio-MEM,” Transactions of the Japan Society of Mechanical Engineers A, vol. 72, no. 716, pp. 471–477, 2006.
[17]
N. Furuya, “3D measuring system for assembly robot using stereo camera. Camera model and parameter calibration by geometrical method,” Journal of the Japan Society for Precision Engineering, vol. 65, no. 8, pp. 1116–1120, 1999.
[18]
E. Nakamachi, “Development of automatic operated blood sampling system for portable type self-monitoring blood glucose device,” in Proceedings of the 32nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC '10), pp. 335–338, September 2010.
