US20010009979A1 - Impact-damped biopsy instrument - Google Patents
Impact-damped biopsy instrument Download PDFInfo
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- US20010009979A1 US20010009979A1 US09/799,594 US79959401A US2001009979A1 US 20010009979 A1 US20010009979 A1 US 20010009979A1 US 79959401 A US79959401 A US 79959401A US 2001009979 A1 US2001009979 A1 US 2001009979A1
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- canula
- biopsy instrument
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- tube
- biopsy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/0233—Pointed or sharp biopsy instruments
- A61B10/0266—Pointed or sharp biopsy instruments means for severing sample
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B2010/0208—Biopsy devices with actuators, e.g. with triggered spring mechanisms
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Abstract
Description
- This is a continuation-in-part of application Ser. No. 08/783,204, filed Jan. 14, 1997, which is a division of application Ser. No. 08/378,402, filed Jan. 26, 1995, now U.S. Pat. No. 5,655,542, issued Aug. 12, 1997.
- 1. Field of the Invention
- The present invention relates to a biopsy instrument, and to methods and apparatus for collecting tissue samples or the like from humans or animals, in particular by excising a segment from a tissue, using the biopsy instrument. The invention also relates to a loading assembly for a biopsy instrument and an impact damping element for biopsy instruments.
- 2. Description of the Related Art
- The invention departs from an apparatus for collecting tissue samples by excising a segment from tissue, and a corresponding method for harvesting of tissue samples described in U.S. Pat. No. 5,655,542 (Weilandt), the entire disclosure of which is incorporated by reference into this specification.
- In this specification, the terms “proximal” and “distal” are used with respect to the person extracting a biopsy sample. Thus, the proximal end of a biopsy apparatus is its rear end, proximate the practitioner, and pointing away from the patient.
- The biopsy instrument of the '542 patent includes a first part having an end with means for penetrating a tissue at the end, and a wall having an opening extending through the wall of the first part; and a second part adapted for being slidingly disposed on the first part, excision means for separating a segment of the tissue then penetrated by the first part provided on the second part such that sliding movement of the second part on the first part in one direction causes the excision means to pass through the opening in the wall of the first part thereby separating a segment of the tissue for extraction.
- The method of harvesting biopsy samples of the '542 patent includes the steps of injecting the biopsy instrument into tissue to a position proximal of a sample to be taken; displacing simultaneously the first part and the second part of the biopsy instrument for reception of the sample in the first part; displacing the second part to sever the sample from the tissue.
- The first part may take the form of a canula and the second part that of a tube in which the canula is slidingly arranged. The tube is provided with a finger at its distal end, the finger entering an opening in the canula wall in the tissue-severing step when the tube is displaced in a distal direction with respect to the canula.
- The joint displacement of the first part and the second part following the injection step is accomplished by spring means, in particular a steel coil. Compression steel coils have been found to work well in practice, except for very powerful springs providing high acceleration to the combination of the first and the second part. High acceleration is attractive since, thereby, the use of separate driving force for the second step becomes superfluous, the displacement of the second part with respect to the first part being accomplished through the inertia of the second part. Moreover, high acceleration allows for less variation in sample quality when using the instrument with a variety of tissues. The loading of a biopsy instrument provided with powerful spring means which have to be compressed in the loading procedure constitutes another problem.
- The present invention provides a biopsy instrument that can be reliably driven by strong spring means. The invention also provides a means for damping the impact of a stylet or canula in a biopsy instrument. In addition, the invention provides a loading assembly for loading a biopsy instrument, in particular one with a powerful compression spring.
- The invention is a biopsy instrument of the aforementioned kind including means for damping oscillations of the first part with respect to the second part arising from the sudden stop of the first part at the end of the first step when hitting a stopper and that of the second part at the end of the second step. On impact the thin-walled tubiform first and second parts become elongated in their axial direction. In general the canula and the finger tube of electropolished steel have very thin walls of from about 0.05 to 0.1 mm thick while their length varies from about 15 to about 20 cm.
- In experiments with strong steel coils, oscillations of amplitudes of up to 1.15 mm were observed. In addition, the first and second part do not necessarily oscillate in phase; they may even oscillate in opposite phase. Undampted, the oscillations often damaged the finger, resulting in incomplete severing of the sample or breakage of the finger. The damage occurs by the finger hitting the distal rim of the opening in the tube wall. Thereby the finger is excessively bent or broken.
- According to the present invention, oscillation damping means are provided by appropriate design of the stopper stopping the movement of the first part. With reference to the preferred embodiment of the '542 patent, the first stopping element is the plunger stop960 modified according to the teaching of the present invention. By using a powerful steel compression spring the actuator coil 94 can be dispensed with. The displacement of the second part in relation to the first part then is caused entirely by inertia.
- It is preferred for the steel coil of the biopsy instrument to exert a force of 35 N and more in a compressed state. Particularly preferred is a coil exerting a force of at least 50 N, most preferred of at least 65 N.
- A reduction of oscillation by damping so as to keep oscillation of the first part with respect to the second part below 0.4 mm provides a satisfactory result and is preferred. Even more preferred is to keep oscillation within 0.35 mm, even within 0.30 mm and less.
- A biopsy instrument according to the invention combines a powerful steel compression spring of the kind described above, an impact damping means to reduce oscillation of a canula with respect to a finger tube slidingly disposed on the canula arising on impact of the canula holder on a stopper, and a design dispensing with the use of spring means to displace the finger tube in a distal direction after the canula has been stopped by the stopper.
- The impact damping means of the invention can also be advantageously applied to stop (decelerate) canulas and stylets in biopsy instruments other than that of U.S. Pat. No. 5,655,542, in particular canulas and stylets accelerated by a powerful compression spring, such as one which can be compressed to more than 35 N, preferably more than 50 N, most preferred more than 65 N. The damping means of the invention preferably constitutes an acrylonitrile-butadiene-styrene copolymer (ABS) having a yield tensile strength above 35 Mpa and an Izod impact strength of more than 325 J/m, or any other medical grade polymer or other material meeting these requirements.
- The loading assembly of a biopsy apparatus incorporates, in a housing, the biopsy instrument according to the invention includes a loading arm swivellingly attached at its one end to the housing, an intermediate arm swivellingly attached at its one end to the loading arm and at its other end to a catch holding the canula holder during tensioning and in a tensioned position with respect to a tension spring or during compression, or in a compressed position with respect to a compression spring (the latter being preferred). The catch is displaceable in a proximal direction against the resistance of the spring and is adapted to be held there for intentional release. It is obvious that this loading assembly can also be advantageously used for tensioning or compressing spring means arranged for displacement of one or several elements of a biopsy apparatus different from that of the invention.
- Further advantages of the present invention will become obvious from the study of a preferred but not limiting biopsy instrument and a corresponding apparatus according to the invention which is illustrated in a drawing of which the individual figures are described briefly as follows:
- FIG. 1 illustrates a canula with its holder, in a perspective view from a distal viewpoint, only the rear (proximal) portion of the canula being shown;
- FIG. 2 illustrates a finger tube with its holder, in the same view as in FIG. 1, only the rear (proximal) portion of the finger tube being shown;
- FIG. 3 illustrates the canula and finger tube holders, in a mounted state before and during a first step of an excision procedure, in the same view as in FIGS. 1 and 2;
- FIG. 4 illustrates the canula, the finger tube, and their respective holders, in a mounted state in the same view as before, at the end of a second step of the excision procedure;
- FIG. 5 illustrates a stopper, in the same view as before;
- FIG. 6 illustrates the canula holder, the finger tube holder, and the stopper, in a mounted state at the end of the second step, in the same view as before;
- FIG. 7 illustrates the assembly of FIG. 6 before and during the first step, in a symmetric longitudinal section;
- FIG. 8 illustrates a biopsy apparatus incorporating the biopsy instrument of FIGS.1-7, in a loaded condition and in a symmetric longitudinal section;
- FIG. 9 illustrates the apparatus of FIG. 8, in a released condition at the end of the first step, in the same view as in FIG. 8;
- FIG. 10 illustrates the apparatus of FIG. 8, in a released condition at the end of the second step, in the same view as in FIG. 8;
- FIG. 11 illustrates the apparatus of FIG. 8, after withdrawal of the finger from the canula but before sample expulsion and loading, in the same view as in FIG. 8;
- FIG. 12a illustrates the catch of the loading assembly of the apparatus of FIG. 8, in a plan view from above;
- FIG. 12b illustrates the catch of FIG. 12a, in the same view as the apparatus of FIGS. 8-11.
- Indications of lateral direction such as ‘from above’, ‘underside’, ‘top side’ are defined by the view of FIGS.8-11. The steel coil compression spring is only shown in FIG. 8.
- The biopsy instrument illustrated in FIGS.1-7 includes a
canula 101, afinger tube 201, and astylet 301 of the same kind as in U.S. Pat. No. 5,655,542, where the design and function of these elements is explained in detail and thus need not be repeated here. In some of the figures of the present specification rear (proximal) end portions of thecanula 101, thefinger tube 201, and thestylet 301 are shown to illustrate their relationship with theirrespective holders - FIG. 1 shows the rear portion of the
canula 101 mounted to itsholder 100 by gluing. The flat and substantially rectangular top section ofholder 100 has a sturdy and somewhat wider foot section integral with its underside which has a transverseflat impact face 102 facing in a distal direction. By having a width in excess of that of the rectangular top section a pair of upwardly facing slide ways of which only one, 103, is shown are formed on the foot section. The rectangular top section is provided with laterally facing slide ways of which only one, 104 is shown.Slide ways flexible arms neck 112 of a T-formed displacement limiter protrudes from the distally facing rim of the opening. At their free ends thearms teeth - FIG. 2 shows the rear portion of the
finger tube 201 disposed in achannel 218 of a holder 200 to which it is mounted by gluing. The rear (proximal) end of the finger tube does not protrude from the rear end of the holder 200. The foot section includes aheel 202 and a rectangular base of the same width as the foot section of thecanula holder 100. On top of the rectangular base is disposed a substantially rectangular top section. At its rear end the top section includes twoarms top face 209 of the rectangular holder base. The outer (lateral) faces ofarms indentations teeth canula holder 100. At their rear free endsarms hook portions neck 112 of the displacement limiter. The holder 200 is provided with two pairs of slide ways forming L-shaped guide ways similar to those ofholder 100. Of them only one pair, 203; 204 is shown. The left and the right guide ways ofholders 100 and 200 are disposed in line. As is evident from FIG. 7 the top section of the holder 200 has a hollow portion distally offarms tongue 213. Thetip 214 oftongue 213 projects above the upper surface of the top wall. Thetongue 213 is somewhat flexible and can be depressed into the hollow space beneath it. - FIG. 3 shows the
canula 101 with itsholder 100 and thefinger tube 201 with its holder 200 in an assembled state before and during the first step in which both travel together. Whereas thecanula holder 100 is pushed forward (in a distal direction) by a strong steel coil (not shown; compressed to 70 N) affecting its rear (proximal) end, the finger tube holder 200 is pushed forward by thecanula holder 100 with which it is in abutment at 120, 121, 122.Canula holder teeth distal indentation finger tube 201. - FIG. 4 shows the same arrangement after the forward travel of
canula holder 100 has come to an end while the finger tube holder continues its movement by inertia, only to be stopped by the rear side of the transverse bar of the T-formeddisplacement limiter 112 abutting faces 215, 216 ofhooks front face 221 of the distal heel portion cooperating with a rearward facingwall 415 of the stopper 400 (see below; see FIG. 7 which however illustrates the assembly before or during the joint displacement of thecanula 101 and the finger tube 201). In this figure thecanula 101, thefinger tube 201, and thestylet 301 are shown except for their distal ends.Stylet holder 300 is fixed to the housing (not shown) and thus does not move. - FIG. 5 shows a fork-
like stopper 400 for restricting the travel of thecanula 101 and thefinger tube 201. Byarms stopper 400 can be set at several positions along the canula/stylet axis to select one of a number of predetermined tissue penetration depths. Theprongs - The impact is damped by hemi-
cylindrical recesses prongs holders stopper 400 are produced by injection molding. In combination with a serpentine geometry of the prong end portions, provision is made for good damping of the oscillatory movement of thecanula 101 and thefinger tube 201 with theirholders 100, 200. With the teaching of the invention in mind the person skilled in the art will be able to produce the damping effect also by modifications of the stopper design other than hemi-cylindrical recesses, for instance by a zigzag design, by bores, etc. - Proper damping (with respect to spring force, etc.) can be determined by experiments in which the depth and/or the number of recesses is varied. In the preferred embodiment according to the invention described above, a steel coil compressed to 70 N was used. The oscillation amplitude of the
canula 101 with respect to thefinger tube 201 was found experimentally to be in the range from 0.30 to 0.35 mm. In a device identical with that of the invention, except for the hemi-cylindrical recesses - Between the
handle 401, which is provided with stiffeningribs 407, and theprongs transitional portion 406 which can be bent to allow the fork shaft handle 401 of thestopper 400 disposed in a latch arranged in the housing wall to be moved in distal/proximal direction between three positions, for instance to latch 503 which position provides for maximal stroke length. The ends 402, 403 of the fork shaft handle 401 protrude through slits at opposite sides of thehousing 500 and are thus maneuverable from outside. A central groove 408 cooperates with acorresponding groove 218 in the finger tube holder 200 and another one (not shown) in thecanula holder 100 is provided for receiving the stylet/canula/finger tip tube assembly. - In FIG. 6 the
stopper 400 is shown mounted with the stylet/canula/finger tube assembly of FIG. 4 at the end of the movement of thefinger tube 201. FIG. 7 is a corresponding longitudinal section. - The
biopsy apparatus 500 of FIGS. 8-12 b incorporates the biopsy instrument of FIGS. 1-7 in ahousing 500 consisting of two substantially symmetrical halves sectioned perpendicular to the larger faces of theholders 100, 200 and of thecatch 540. Only one half is shown. The housing which has the approximate form of a rectangular bar can be of a suitable polymer, for instance polycarbonate, or of metal, such as aluminum. The housing halves fit by appropriate design ofrims 501 and other elements, such as snaps (not shown). The halves can be connected by gluing, welding, or similar process. - The
holder 300 ofstylet 301 is firmly fixed at the housing and can only move with it. Thestylet 301, thecanula 101 and thefinger tube 201, which are disposed substantially centrally in thehousing 500 in a distal direction, protrude from the front wall after passage through an opening (at 502) of a diameter slightly greater than the outer diameter of thefinger tube 201. The walls of thehousing 500 halves have inner profiles functioning as guide rails forholders 100 and 200 which can move forth and back in the housing to the extent permitted by other elements, such as thestopper 400 and the spring 610. - The housing is provided with a loading assembly by which
holders 100, 200 are brought to a ‘loaded’ position from which they can be released for tissue sampling. - To provide for easy loading by which the sturdy spring coil601 has to be compressed the assembly makes use of three elements: a
loading arm 520, anintermediate arm 530, and acatch 540 holding thecanula holder 100 during compression or in a compressed (loaded) position. With its hook-likefront end 541 thecatch 540 grips thetip 214 of the finger tube holder's 200tongue 213, as shown in FIG. 8 where the apparatus is in a loaded state. Thecanula holder 100 in turn is held in position by some of its front faces abutting rear faces of finger tube holder 200, such as at 120 (FIG. 3). - The canula holder/finger
tube holder assembly 100, 200 can be released from the loaded state by an oblong trigger 600 disposed between thecatch 540 and canula holder/fingertube holder assembly 100, 200. The rear end of trigger 600 forms arelease button 602, which passes through an opening in the rear wall of thehousing 500. By pressing therelease button 602 the trigger 600 is pushed forward (direction A in FIG. 8), thereby dislocating downwards, by its slanting front end abutting the slanting rear face of tongue tip 214 (direction B in FIG. 8), thereby releasing the canula holder/fingertube holder assembly 100, 200. The biopsy apparatus can be secured in a loaded position by a transverselydisplaceable locker pin 603 disposed near the rear end of the housing in through-bores 602 of the housing. When inserted thelocker pin 603 cooperates with an arc-formed cutout of the trigger 600. - Prior to sampling, the
cannula 101 is inserted into the tissue to a depth at which a sample is intended to be collected. Injection is made easy by the use of a canula of small diameter having a thin wall and a sharp cutting edge. - In the first sampling step the
canula holder 100 and the finger tube holder 200 are dislocated together in a distal direction until the canulaholder foot face 102 hits the rear end of the stopper 400 (at arrow heads F in FIG. 5). In the second sampling step the finger tube holder 200 with thefinger tube 201 continues to travel by inertia until stopped by rear faces of the cannula holder (at 123; FIG. 4) and the stopper (at 415; FIG. 7). At the end of the second step (FIG. 10) the finger (not shown) of thefinger tube 201 has entered the interior of thecanula 101 through a wall opening, thereby cutting off a substantially cylindrical tissue sample disposed in the canula. On withdrawal of the biopsy apparatus the tissue sample remains in the canula and can be recovered. - By pushing the
rear end 544 of theloading arm 520 away from thehousing 500 thetransverse bar 521 of the front end of the L-shapedloading arm 520 is made to swivel around apivot 522 by which it is fixed at the housing. This releases the rear end of theloading arm 520 from a snap connection made up of asnap hook 535 of the upper transverse bar of an F-formed intermediate arm end portion engaging with a shoulder 524 of theloading arm 520 pertaining to the wall of anopening 523 therein. Thevertical bar 532 of the F-shapedintermediate arm 530 portion is slidingly disposed in thehousing 500. The lowertransverse bar 533 protrudes from thehousing 500 through a wide slit extending over a substantial portion of the housing 550 in a distal direction from close its rear end. Near its other end theintermediate arm 530 is fastened to theloading arm 520 rotatably about alink 531. A further joint 537 is provided in theintermediate arm 530 where its straight portion extending from thelink 531 is joined to the lowertransverse bar 533. This joint 537 is obtained by the provision of a recess which makes the relatively thin (1-2 mm) portion of reduced thickness easy to bend; a flexible polymer, such as polyethylene or nylon, is an appropriate material for theintermediate arm 530. - When loading
arm 520 is pushed or pulled from thehousing 500 the F-shaped intermediate arm portion travels in a distal direction and thecatch 540 of which engages a recess 543 (FIG. 12b). The frontend hook portion 541 of the catch eventually overrides thetongue tip 214 by forcing it to bend downwards through pressure applied against its slanting rear face. After engagement of thehook portion 541 with thetongue tip 214 further movement of thecatch 540 in a distal direction is prevented by thestops 538 on thecatch 540 abutting the inwardly rounded stop pins 110, 111 of thecanula holder 100. Just before reaching thestops 538 the stop pins 110, 111, and with them the resiliently-flexible arms canula holder 100, are pressed outward byshoulders 539 of lateral, outward facing guide walls (FIG. 12a) and remain in that position when abutting stops 538. Thecatch 540 now has reached its extreme distal position. Further movement of the finger tube holder 200 with respect to thecanula holder 100 is prevented by their abutment at 123 (FIG. 4). - Since the
shoulders 539 slant slightly inwardly in a direction away from thestops 538, the stop pins 110, 111 with thearms teeth flexible arms proximal indentations tube holder arms canula holder 100 while theteeth distal indentations stop pin 110, theshoulder 539, and thestop 538 are dotted. - By carefully moving, in the following step, the
loading arm 540 towards thehousing 500 thecanula 101 and thefinger tube 201 are retracted while the sample is expelled by thestylet 301. The biopsy apparatus is now ready for re-loading to prepare it for removal of another sample of tissue.Arm 520 is pressed towards thehousing 500 until thehook 535 of the intermediate arm enters theopening 523 of theloading arm 520 and engages theshoulder 532 to form a snap connection. At the same time thefree end portion 532 of theintermediate arm 530 moves rearward and compresses the coil spring 610 viaintermediate holders 100, 200 of the biopsy instrument. The flat trigger 600 is only active in triggering release and, therefore, has been omitted from the drawings except for FIG. 8. - The construction of the loading assembly is also advantageous in that the
loading arm 520 with the apparatus in a loaded position forms a single body with thehousing 500 which is comfortable to hold and maneuver, and which is safe. It is also advantageous through its reduction of the force needed for compressing the spring coil. It is obvious to the person skilled in the art that the loading assembly also could be used with a strong tension spring which, for other reasons, however, is not as attractive in the present context as a compression spring. - The person skilled in the art will have no difficulty in modifying the invention by various combinations of its features, for example, without departing from its teaching. Accordingly, the present invention is to be limited not by the description of the preferred embodiments set forth above, but only by the appended claims.
Claims (27)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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US09/799,594 US6322523B2 (en) | 1995-01-26 | 2001-03-07 | Impact-damped biopsy instrument |
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
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US08/378,402 US5655542A (en) | 1995-01-26 | 1995-01-26 | Instrument and apparatus for biopsy and a method thereof |
US08/783,204 US5788651A (en) | 1995-01-26 | 1997-01-14 | Instrument and apparatus for biopsy |
US09/090,908 US6126617A (en) | 1995-01-26 | 1998-06-05 | Impact-damped biopsy instrument |
US09/404,785 US6196978B1 (en) | 1995-01-26 | 1999-09-24 | Impact-damped biopsy instrument |
US09/799,594 US6322523B2 (en) | 1995-01-26 | 2001-03-07 | Impact-damped biopsy instrument |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
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US09/404,785 Division US6196978B1 (en) | 1995-01-26 | 1999-09-24 | Impact-damped biopsy instrument |
Publications (2)
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US20010009979A1 true US20010009979A1 (en) | 2001-07-26 |
US6322523B2 US6322523B2 (en) | 2001-11-27 |
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Application Number | Title | Priority Date | Filing Date |
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US09/090,908 Expired - Lifetime US6126617A (en) | 1995-01-26 | 1998-06-05 | Impact-damped biopsy instrument |
US09/404,785 Expired - Lifetime US6196978B1 (en) | 1995-01-26 | 1999-09-24 | Impact-damped biopsy instrument |
US09/799,594 Expired - Lifetime US6322523B2 (en) | 1995-01-26 | 2001-03-07 | Impact-damped biopsy instrument |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
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US09/090,908 Expired - Lifetime US6126617A (en) | 1995-01-26 | 1998-06-05 | Impact-damped biopsy instrument |
US09/404,785 Expired - Lifetime US6196978B1 (en) | 1995-01-26 | 1999-09-24 | Impact-damped biopsy instrument |
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US (3) | US6126617A (en) |
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Also Published As
Publication number | Publication date |
---|---|
US6322523B2 (en) | 2001-11-27 |
US6126617A (en) | 2000-10-03 |
US6196978B1 (en) | 2001-03-06 |
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