US 2955592 A
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Description (OCR text may contain errors)
Oct. 11, 1960 K; s. M cLEAN smcnoswzc ms'mumm 2 Sheets-Sheet 1 Filed Dec. 29, 1955 INVENTOR Keane/ J l/azlmm ATTORNEYS Oct. 11, 1960 K. s. M LEAN DIAGNOSTIC INSTRUMENT 2 Sheets-Sheet 2 Filed Dec. 29, 1955 [III/ A. FEQ
INVENTOR Kenny/h S. flarlam ATTORNEYS United States Patent TO DIAGNOSTIC INSTRUMENT Kenneth S. MacLean, 130 E. 65th St., New York, N.Y. Filed Dec. 29, 1955, Ser. No. 556,182
9 Claims. c1. 128-2) This invention relates to a structurally and functionally improved diagnostic instrument and especially an instrument, by means of which samples of cells may be readily collected from the areas of the upper lung or stomach and examined with a view of especially determing if a condition of cancer prevails.
It is a primary object to furnish a relatively simple apparatus, the use of which will involve an uncomplicated technique cap-able of being practiced by the usual physician who will be able to reach definite conclusions based upon his findings.
A further object is that of providing an appliance of this character which may readily. be manipulated by the physician with assurance that an adequate cell sample from the desired area will be rendered available; the entire technique requiring the expenditure of only a minimum amount of time without substantial discomfort on the part of the patient.
Still another object of the invention is that of furnishing for employment in an instrument assembly of this character, a cell-collecting element, which will preferably have a one-time use, such that after the material has been rendered available that element may be discarded.
An additional object is that of providing an assembly of parts, each individually simple and rugged in construction and capable of ready manufacture to provide a unitary mechanism operating over long periods of time with freedom from all difiiculties.
With these and other objects in mind, reference is had to the attached sheets of drawings illustrating practical embodiments of the invention and in which:
Fig. 1 isa side elevation of an instrument especially useful in connection with the sampling of lung cells;
Fig. 2 is a fragmentary sectional side view of theinstrument and showing the same in operative condition;
, Fig. 3 shows in its two illustrations the preferred components of the sheath structure;
Fig. 4 is an enlarged sectional view of the end portion the instrument as shown in Figs. 1 and 2;
Fig. 5 shows an alternative form of cell-collecting unit which may be associated with the instrument;
Fig. 6 is a transverse sectional view taken along'the line -6-6 in the direction of the arrows as indicated in Fig. 5;
' Fig. 7 is a view similar to Fig. 1, but showing an instrument primarily intended for use in connection with the sampling of stomach cells;
' Fig. 8 is an enlarged fragmentary sectional view of the instrument as illustrated in Fig. 7 and showing a collecting element in association therewith;
Fig. 9 is a view similar to Fig. 8 but showing the parts adjusted to expand the collecting element to an operative condition;
Fig. 10 is a transverse sectional view taken along the line 1010 in the direction of the arrows as shown in Fig. 9; and
Fig. 11 is a perspective view of the expandible portion it the adjacent end of the wire 21.
of the instrument and removed from the remainder of the mechanism.
Referring primarily to Figs. 1 and 2, the numeral 15 indicates a tube conveniently formed of metal and preferably having an angularly extending'rear end portion 16. To the latter, there may be attached a handle or gripping part 17 which is bored to accommodate an actuator 18. This actuator is capable of limited reciprocation within the handle 17 and a spring 19 may be interposed between these parts to normally maintain the actuator to the position shown in dot-and-dash lines in Fig. 1.
Tube 15 is continued adjacent its outer end in the form of a conduit conveniently comprising a compound wire coil sheath. This embraces an outer convoluted layer 20 enclosing an inner similar layer 20'. The convolutions of the latter, as shown in the lower portion of Fig. 3, normally tend to expand. However, when they are forced into bearing engagement with each other, they will provide a tube defining a substantially cylindrical sheath, the bore of which aligns with the bore of tube 15. A unit such as a wire 21 circular in section extends through the bore of tube 15. It is attached against movement in any suitable manner at its rear end to actuator 18. -At its forward end, the convolutions 20 and terminates adjacent the outer end of that sheath, at which point it is rigidly attached to the end of the compound sheath where it joins the hereinafter described chuck. This wire is so formed or treated that it has a pronounced curve or. set. To this end, the wire is preferably of steel and tempered. The direction and degree of the set is such that the wire normally tends to assume a position substantially at right angles body 22 having a rearwardly extending bore to receive the end zone of sheath 20 and will also have attached to Additionally, this unit will embrace a provision for mounting a cell-collecting abrader element. clude a screw-threaded socket within which the correspondingly threaded stem 23 of the element projects.
" The element in these views and in Fig. -4, conveniently 24 preferably of twisted wire includes a mounting core strands, from which a row of bristles 25 extends radially in the form of a screw.
, g If, in lieu of the socket structure shown in Fig. -2, it
is desired to employ a gripping structure such as a true I chuck, then as in Fig. 4 the body 26 to which the adjacent and wire 21 are secured may terminate in a threaded annular flange 27. This.
outer ends of the sheath 20-20' flange will have a flared surface 28 adjacentits outer end and mount, by means of its threads, a constricting collar 29. Jaws 30 are interposed between the constricted end of the collar and the flange. In this instance, the spindle of the collecting brush indicated at 31 will be in the form of an unthreaded piece of stock of a diameter such that it 'may be received within the space defined between the Thereupon, the latter may be drawn together byjaws. tightening collar 29. Under these circumstances, the brush will become fixed with respect to of the instrument.
Where a brush abrader is employed, the bristles of the latter should be relatively quite stiff. Their'ends should embody characteristics such that they will scrape or scar ify the surface of tissues with which they are engaged.
Also, it is definitely preferred that'the outer ends of the Patented Oct. 11, 1960,
it extends through the bore defined by That mounting may simply. in-:
the outer portion 1 bristles be disposed in a spiral path. As will be hereinafter brought out, with such disposition and under conditions of rotation of the brush core 24 with respect to an adjacent tissue surface, the brush will function as a screw to traverse its body over the surface of the tissues. Thus, in addition to collecting samples of the cells at an initial location, where the brush is brought into engagement therewith, that brush will traverse an entire tissue zone and collect further samples throughout the area thereof. In this manner, a physician will be assured that a general evaluation of cells is being achieved rather than merely a limited zone sampling.
In lieu of an element embracing a bristle structure, such as 25, a scarifying and cell-collecting abrade-r unit of the nature shown in Figs. and 6 may be employed. In that view, the numeral 32 indicates a hollow body suitably attached in any desirable manner to the outer end of the flexible sheath. The body is conveniently of generally conical configuration and formed, in its side face, with an opening 33. A scraper blade 34 is attached to the body by, for example, a screw 35. So attached, it will extend slightly beyond the plane or outer face of body 32. This has been illustrated in somewhat exaggerated manner in Fig. 6. In any event, it is apparent that if body 32 traverses tissues and with the edge of blade 34 in contact with the latter, the surface of the tissue will be scraped and cells from the same will be diverted through the opening 33 into the interior of the body. So diverted, it will remain against all probability of displacement within that interior, which will thus serve as a sample-collecting chamber. With the removal of blade 34 or if body 32 embraces a number of detachably coupled sections, it is apparent that the cell samples may readily be reached for inspection and examination according to accepted techniques.
Considering the apparatus insofar as has been presently described, it is apparent that with the assembly as shown in Fig. 1 and the extensible parts of the same occupying positions such as have been indicated in dotted lines, a physician might ensleeve tube and the outer or cell-collecting end of the instrument within a suitable sleeve (not shown) of, for example, plastic material. Thus enclosed, the operative end of the instrument may be introduced to occupy a position adjacent the upper zone of the lungs. If employed, the plastic or other sleeve may now be retracted over the tube 15 so as to expose the coil and the brush or its equivalent. Now, if the physician resorts to a projection of part 18 against the influence of spring 19, wire 21 will be projected. Under these circumstances, the convolutions of the coils 20 and 20' will be expanded. Therefore, with the aforementioned set of wire 21, the latter will, for example, extend at right angles to the axis of tube 15 and as shown in full lines in the right-hand portion of Fig. 1 and in Fig. 2. Accordingly, the cell-collecting element will assume a position at which it contacts the surface of the lung lobe adjacent its junction with the bronchial tube. Now, by rotating handle 17, tube 15 will be similarly moved as will also the brush 25. Accordingly, the outer ends of the bristles of the latter will traverse the lung. surface and will lightly scarify the same.
Now, by allowing the spring 19 to shift wire 21 rearwardly or to the left, as viewed in Figs. 1 and 2, the outer end of the instrument is caused to assume a position substantially in line with the axis of the adjacent end of tube 15. Thereupon, by retracting the instrument within the plastic sheath or tube through which it was initially introduced, the ends of bristles 25 will be enclosed and protected. Accordingly, the entire instrument may now be retracted with its sheath so as to be free of the patient. Thereupon cells adhering to the bristles may be removed and examined. Obviously, the same results are achieved if a collecting element of the nature shown in Figs. 5 and 6 is employed.
In lieu of the specific structure shown in Figs. 1 and wire extends beyond the guide and is secured adjacent its outer end to a knob 38. An actuating assembly conveniently embraces a disc-like member 39 provided with a tubular extension 40, the bore of which is screwthreaded. A clamping pin 41 is similarly threaded and has its end in a position at which it may bear against the actuator 36 and lock the latter against axial movement. A handle 42 may be integral with pin or stem 41 and project beyond guide 40. By means of this handle, the pin may be projected or retracted to thus lock or release part 36.
In many respects, an instrument of this type may de-- sirably be employed in connection with diagnoses of the stomach surfaces and permits a sampling of those cells adjacent the upper entrance end of the stomach. Obviou-sly, the instrument might be employed in connection with, for example, lung diagnosis and the instrument heretofore described with especial reference to Figs. 1 and 2 might be utilized to secure samples of the surface of the stomach. In any event, as also illustrated in Figs. 7 and 8, an enclosing or guiding tube 43 preferably formed of plastic material has been illustrated. This tube, when projected, encloses the scarifying and sample-collecting element of the instrument. When retracted, it will of course clear the operative end of the instrument. To permit of its being readily shifted, its inner end is conveniently ensleeved within and attached to a collar 44, the bore of which adjacent its free end may present a flared surface 45. That surface may engage the tapered, outer edge zone of a truncated end portion 46, affixed to the manipulating element 39. With the friction fit thus established, tube 43 will be maintained in its retracted position. However, it may obviously be freed from restraint by simply gripping tube 44 and projecting the latter to cause the outer element of sleeve 43 to enclose the operative portions at the outer end of coils 20 and 20.
Under certain circumstances, it may be preferred to not simply reciprocate wire 21 by a direct pull or push action exerted either manually or by, for example, a spring such as 19. With a view to furnishing a structure allowing of relatively slow axial movement of the wire with respect to the sheath 20 or corresponding elements,
an actuator 47 (Fig. 9) may be furnished which in configuration will be similar to actuator 39. This unit will be formed with a threaded bore, within which a similarly threaded stem 48 is disposed. At the outer end of the latter, a knob 49 is conveniently secured. At its inner end, the stem is attached to wire 21. It is apparent that by rotating actuator 47, with respect to stem 48, the wire will be gradually retracted or projected according to the direction of rotation. In lieu of employing a wire which is circular in cross-section, a wire or flexible member 51 may be provided. This has been shown especially in Figs. 9 and 10. That wire, as illustrated, is conveniently substantially flat or oval. By embodying such a configuration, a more definite set may be imparted to it. The tube should, under these circumstances, have a substantially rectangular bore. Also, in the manipulation of the instrument, at more alfirmative contact between the cell-collecting element and the surface of the tissue may be maintained without, however, sacrificing the desirable cushioned or yielding contact between these parts. Obviously, a flattened or oval wire such as 51 will function as heretofore described to impart an angular bend to the outer or operative end of the instrument, when the parts are once adjusted to achieve this result.
Especially in the case of diagnosis of the stomach tissues, it may be desirable to utilize a collecting and abrad- 7 its functional equivalent and,
ing element different from the types shown in Figs. 2, 4 and 5. The abrader element may conveniently embrace a distendible body formed of natural or artificial rubber. Such an element has been shown in detail in Figs. 8 and 9 and includes a hollow, cylindrical body 52 closed at one end and formed with a neck portion or opening to its interior. That opening accommodates the sheath 20 or if desired, this neck portion may be constricted by employing a retaining element 53 to maintain it against displacement with respect to the outer end of the instrument. Scarifying, collecting and retaining structures are associated with body 52, preferably by mounting on the latter a number of strands in the form of tufts or bristles '54. 'Iheseas illustrated may be arranged in the form of groups and be relatively short and stiff. Formed of suitable material, it is apjarent that when they are wiped across a tissue surface, they will remove and retain a certain amount of cells. In this connection, it will be understood that during the withdrawal of the instrument, the operative outer part of the same is preferably encased within the sheath 43 as illustrated in Fig. 7. Accordingly, the removed cells will not be wiped or otherwise freed from contact with the bristles 54. In the forms of the device shown for example in Figs. 7. 8 and 9, it is apparent that it is unnecessary to employ a chuck or gripping structure of the character shown in Figs. 2 or 4. Also, in the device as illustrated in these figures, the rear end of the sheath assembly 20-20 is received within a sleeve 52 which, in the last figure, is firmly attached against displacement with respect to the actuator 47. The outer end of the instrument terminates, insofar as the sheath is concerned, in a cap 55.
The end of the wire 21 or "51 extends as at 56 beyond the sheath and cap structure. It is secured by soldering or riveting to the head portion 57 of an expansible element. Depending from that head portion are arms 58. These terminate in inwardly extending foot portions 59, each formed with a perforation 60. The wire 56 extends through all of these perforations and is thus slidably disposed with respect to these arms.
It is apparent that when no tension is exerted on the wire, the expandible element as shown in disassembled condition in Fig. 11, will occupy a space, the diameter of which is substantially coextensive with that of cap 55. Therefore, if a collecting element as heretofore described in connection with Fig. 8, is ensleeved over this assembly, that element will have a relatively reduced diameter. So reduced, it may readily be ensleeved within the outer end of tube 43 or its equivalent. However, when projected beyond that tube and upon a tension or pull being exerted upon wire 21 or 5 1, the head portion 57 will be drawn towards the foot portions 59. Under these circumstances, the legs 58 will bow outwardly as shown in Fig. 9 todistend the abrador and tissue-collecting element. That element will also extend at an angle to the axis of the instrument so that cells may be collected from those areas of the organ which are immediately adjacent the passage through which the instrument has been introduced. Under these circumstances, it is apparent that cells may be adequately collected and thereafter examined with full assurance that an effective diagnosis may be made.
Thus among others, the several objects of the invention as specifically aforenoted are achieved. Obviously, numerous changes in construction and rearrangements of the parts might be resorted to without departing from the spirit of the invention as defined by the claims.
1. A diagnostic instrument including in combination a flexible wire, a mounting for an abrasive cell-collecting element connected at one end thereof, an actuator connected at the opposite end of said wire, said wire at the end zone adjacent said mounting incorporating a set such that it tends to extend at an angle to the portions of its body short of that zone, a flexible and tubular sheath attached at one end to said mounting and enclosing said wire and at its opposite end being connected to said actuator, said sheath, in a zone adjacent said mounting, being compressible and when compressed incorporating rigidity such that it defines a tube of substantially straight configuration, said actuator initially occupying a position to maintain said wire under tension and said sheath under compression, and said actuator being projectable toward said sheath to relieve the compression of the latter to cause said wire at said zone to extend angularly with respect to the portions of its body short of that zone and to cause a similar extension of the adjacent sheath parts.
2. In a diagnostic instrument as defined in claim 1,
said sheathcomprising an outer body formed of spiral convolutions initially being in substantial contact with each other.
3. In a diagnostic instrument as defined in claim 1, said sheath comprising an outer body formed of spiral convolutions initially being in substantial contact with each other, and an inner expansible convoluted body.
4. In a diagnostic instrument as defined in claim 1, a substantially rigid tube enclosing said wire at a point between said sheath and actuator.
5. In a diagnostic instrument as defined in claim 1, a chuck structure carried by and substantially contained within said mounting.
6. In a diagnostic instrument as defined in claim 1, said wire within the zone of such set being non-circular in cross section.
7. In a diagnostic instrument as defined in claim 1, an expansible assembly carried by said mounting, the adjacent end of said wire being operatively connected to said assembly and said wire being shiftable to expand and constrict said assembly.
8. In a diagnostic instrument as defined in claim 7, a distensible abrading element ensleeved over said asesmbly and means for securing said element against detachment therefrom.
9. In a diagnositic instrument as defined in claim 1, a brush comprising the collecting element coupled with said mounting and said brush including a support and a plurality of bristles arranged in spiral row formation around said support.
References Cited in the file of this patent UNITED STATES PATENTS 654,763 Russell July 31, 1900 735,400 McCully Aug. 4, 1903 1,092,914 Jones Apr. 14, 1914 1,127,948 Wappler Feb. 9, 1915 1,425,435 Allen Aug. 8, 1922 1,711,352 Ieifreys Apr. 30, 1929 2,022,065 Wappler Nov. 26, 1935 2,701,559 Cooper Feb. 8, 1955 2,729,210 Spencer Jan. 3, 1956 2,739,585 Ayre Mar. 27, 1956 FOREIGN PATENTS 487,198 Germany Dec. 4,- 1929