GB1575322A - Apparatus for pulse current action on the central nervous system - Google Patents
Apparatus for pulse current action on the central nervous system Download PDFInfo
- Publication number
- GB1575322A GB1575322A GB1533577A GB1533577A GB1575322A GB 1575322 A GB1575322 A GB 1575322A GB 1533577 A GB1533577 A GB 1533577A GB 1533577 A GB1533577 A GB 1533577A GB 1575322 A GB1575322 A GB 1575322A
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- GB
- United Kingdom
- Prior art keywords
- current
- unit
- pulse
- pulses
- output
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/36014—External stimulators, e.g. with patch electrodes
- A61N1/36021—External stimulators, e.g. with patch electrodes for treatment of pain
Description
(54) IMPROVEMENTS IN APPARATUS FOR PULSE
CURRENT ACTION ON THE CENTRAL NERVOUS SYSTEM
(71) We, MOSKOVSKY OBLASTNOI NAUCHNO-ISSLEDOVATELSKY IN
STITUT AKUSHERSTAVA, a Russian
Institute, of 1 Ginekologii-USSR, Moscow,
Pokrovskie Vorota, Lepekhinsky Tupik 3,
U.S.S.R. do hereby declare the invention for which we pray that a patent may be granted to us, and the method by which it is to be performed, to be particularly described in and by the following statement.
The present invention relates to an improvement in apparatus for pulse current action upon the central nervous system.
The invention can be used for carrying out prescribed anesthesia and treatment programs, for example, in cases of childbirth.
Claim 1 of our prior Specification No.
1,535,413 is for electro-anaesthesia apparatus, for current pulse action upon the central nervous system of a patient by the application of current pulses to the patient in order to attain the second level of the first stage of general anesthesia, said apparatus including the series combination of rhythmical current pulse generating means, means for adjusting the duration of the individual pulses, means for adjusting the amplitude of the current constituting the pulses, and means for indicating the mean current intensity value in the output of the apparatus, patient protection means being provided whereby the application of the current pulses to the patient is automatically discontinued if said current amplitude exceeds a predetermined value, whereby the second level of the first stage of general electro-anesthesia can be attained without causing any side effects in the patient.
In this prior apparatus, the output of the patient protection unit is connected to the input of a power supply unit so that in case the current pulse amplitude is above a predetermined level, said patient protection unit disconnects the power unit for the current pulse generating means, the means for adjusting the duration of the individual pulses and the pulse current amplitude adjusting means.
When the power unit is disconnected from the above-mentioned units, the device stops operating and discontinues the current pulse action on the central nervous system.
This sharply reduces the effectiveness of electroanesthesia and makes it impossible to attain the second level of the first stage of general electroanesthesia.
When applying current pulses to a patient, it is necessary to stabilize the second level of the first stage of general electroanesthesia once it is attained; this has to be done without increasing the mean current intensity level in the patient circuit even in case of a change in the impedance at the points where the electrodes are attached, which may be the result of a change in the functional state of the central nervous system.
It is an object of the present invention to make use of our discovery that the impedance at the electrode connections to a patient may be reduced by superimposing a continuous direct current upon the output pulses of the apparatus. It is thus possible to provide a specific pulse action level for each patient, in accordance with a prescribed anesthesia and treatment program.
The present invention provides electroanaesthesia apparatus constituting a modification of apparatus as claimed in claim 1 of
Patent No. 1,535,413 for current pulse action upon the central nervous system of a patient by the application of current pulses to the patient in order to attain the second level of the first stage of general anesthesia, said apparatus of the modification including the series combination of rhythmical current pulse generating means, means for adjusting the duration of the individual pulses. means for adjusting the amplitude of the current constituting the pulses, and means for indicating the mean current intensity value in the output of the apparatus, said apparatus including patient protection means whereby the current amplitude of the current pulses to the patient is automatically prevented from exceeding a predetermined value, and further including means for generating uninterrupted direct current of adjustable magnitude and means for combining said direct current with said current pulses.
Apparatus according to the invention may further comprise a current pulse amplification unit of which the input is arranged to be selectively coupled by way of a switch to receive either the output of the unit for adjusting the duration of said current pulses so as to produce the second level of the first stage of general electro-anesthesia, or the output of an intermittent electro-analgesia unit arranged to apply intermittent trains of current pulses to the patient, other inputs of the current pulse amplification unit and of a unit for adjusting the value of said direct current being connected to a power unit and to the outputs of said patient protection unit which is arranged to limit the level of general electro-anesthesia produced when said current pulses act on the central nervous system of a patient, the outputs of these units being connected to the inputs of a means for adjusting the pulse current amplitude.
In a preferred embodiment of the invention the pulse current amplitude adjusting means are arranged to prevent an increase in the mean current value in the patient circuit resulting from reduced impedance in the electrode areas due to changes in the functional state of the central nervous system.
In using electro-anaesthesia apparatus of the present invention for pulse current action on the central nervous system, the current pulses are applied to a patient via electrodes, i.e. a cathode attached in the forehead area of the patient, and an anode attached in the neck area, under the mastoids, so as to produce the second level of the first stage of general electro-anesthesia in the central nervous system of the patient.
Apparatus according. to the invention for pulse current action on the central nervous system makes it possible to carry out current pulse anesthesia and treatment for prolonged periods of time, as well as to ensure complete electrical safety of the patient and a stable level of general electroanesthesia.
The device makes it unnecessary for the physician to control the intensity of the pulse action on the central nervous system and constantly keep an eye on the patient during electro-anesthesia.
Preferred features and advantages of the present invention will be more readily understood from the following detailed description of a preferred embodiment thereof to be read in conjunction with the accompanying drawings, wherein:
Figure 1 is a block diagram of a device for pulse current action on the central nervous system, in accordance with the invention;
Figure 2 is a circuit diagram of the device of Figure 1 except for a unit for producing rhythmical current pulses and a the unit for controlling the relation between -the repetition frequency and duration of the current pulses, and the mean current intensity indicator.
Referring to the accompanying drawings, the illustrated device for pulse current action on the central nervous system comprises in series: a unit 1 (Figure 1) for generating rhythmic current pulses for action on the central nervous system, a unit 2 for controlling the relation between the repetition frequency and pulse duration of the current pulses, intended to enable a specific approach to treating each patient upon reaching the second level of the first stage of general electroanesthesia in the central nervous system of the patient, an intermittent analgesia unit 3 intended to be operable by the patient to provide enhanced analgesia at each onset of labor pains, a unit 4 for adjusting the pulse duration of the individual current pulses, intended to ensure the second level of the first stage of general electroanesthesia without any side effects on the part of the patient, and a unit 5 including means for developing pulses of a shape different from that of the input pules and means for selecting as the output from the circuit either these modified current pulses, appropriate to produce the second level of the first stage of general electroanesthesia in weak patients and children, or the input pulses.
The units 1 through 5 are connected to an output 6 of a power supply unit 7.
The apparatus further includes a current pulse amplification unit 8 whose input 9 is electrically coupled via a switch 10 to the output of the unit 5 for changing the shape of current pulses (position I of the switch 10) so as to produce the second level of the first stage of general electroanesthesia, or directly to the output of the intermittent analgesia unit 3 (position II of the switch 10) so as to counteract growing pain.
The device still further includes a unit 11 for adjusting the magnitude of an additional constant direct-current component of the output, whose input 12 is connected to an output 13 of the power unit 7; it has been found that this makes it possible to reduce the impedance at the points where there are attached electrodes, i.e. a cathode 14 and an anode 15 (shown ct)nventionally). The electrodes are of the conventional type. The cathode 14 is attached in the forehead area, and the anode 15 in the neck area, under the mastoids, so as to produce the second level of the first stage of general electroanesthesia in the central nervous system.
Inputs 16 and 17, and 18 and 19 of the amplification unit 8 and the unit 11 for adjusting the magnitude of the additional constant d.c. component, respectively, are connected to the output 6 of the power unit 7 and to outputs 20 and 21 of a patient protection unit 22 so that, while the central nervous system is acted upon by the current pulses, the general electroanesthesia level can be limited according to an anesthesia and treatment program prescribed for each patient. Outputs 23 and 24 are connected to inputs 25 and 26 of a means 27 for adjusting the pulse current amplitude of the output, hereinafter called the pulse current regulator.
An input 28 of the patient protection unit 22 and an input 29 of the pulse current amplitude regulator 27 are connected to the output 6 of the power unit 7.
Outputs 30, 31 and 32 of the pulse current regulator 27 are respectively connected to inputs 33 and 34 of the patient protection unit 22, a current pulse amplitude indicator 35 and a mean output current intensity indicator 36, to whose output there are connected the above-mentioned electrodes i.e. the cathode 14 and the anode 15.
Figure 2 is a circuit diagram of some units of the proposed device for the units 3, 4, 5, 7, 8, 11, 22, 27 and 35.
The units 1, 2 and 36 are of the conventional type.
The intermittent analgesia unit 3 (Figure 2) for performing intermittent analgesia in the course of delivery comprises a bistable trigger including transistors 37 and 38, resistors 39, 40, 41 and 42, capacitors 43 and 44 and diodes 45 and 46. These components form a bistable circuit having a 1:1 mark/ space ratio. When transistor 38 is operable it is turned on and off by pulses applied to its base from unit 2 via diode 46 and these pulses appear across resistor 42 and for the output to unit 4. When transistor 37 is operable it is likewise turned on and off by pulses from unit 2 applied to its base via diode 45, but the corresponding pulses 'appearing across resistor 39 are not applied to unit 4.
At the point of connection of the diodes 45 and 46. one of the inputs of the unit 3 is
connected to the output of the unit 2 for
adjusting the relation between the repeti
tion frequency and duration of the current
pulses, whereas its other input is connected
to the output 6 of the power unit 7. The
collector of the transistor 38 forms the
output of the intermittent analgesia unit 3
and is connected to the input of the unit 4 for adjusting the duration of current pulses and to the switch 10.
The unit 4 for adjusting the duration of current pulses is a one-shot multivibrator with collector-base capacitive couplings, built around transistors 47 and 48, resistors 49, 50, 51, 52 and 53, an adjustable resistor 54 and capacitors 55, 56 and 57. The adjustable resistor 54 serves to adjust the pulse duration of the individual current pulses acting upon the central nervous system.
One of the inputs of the unit 4 for adjusting the duration of current pulses is the capacitor 57 which is connected to the output of the intermittent analgesia unit 3, where as the second input of the unit 4 is connected to the output 6 of the power unit 7.
The unit 5 for changing the shape of current pulses acting on the central nervous system is a shaper producing pulses with an exponential trailing edge, comprising a common-collector transistor 58, resistors 59 and 60 and capacitors 61 and 62.
The output signal pulse shape is determined by the position of a switch 63 which serves as one of the inputs of the unit 5 for changing the shape of the current pulses.
The switch 63 is cor necked to the output of the unit 4 for adjusting the duration of current pulses, i.e. to the collector of the transistor 48. The second input of the unit 5 is connected to the output 6 of the power unit 7.
The collector of the transistor 48 is the output of the unit 4 and, depending on the position of the switch 63 of the unit 5 for changing the shape of current pulses, is connected either to the base of the transistor 58 or to the switch 10. Thus either the rectangular-wave pulses of variable duration developed in unit 4. or the modified pulses developed in unit 5 may be applied to the input of unit 8.
The output of the unit 5 for changing the shape of current pulses, i.e. the switch 63, is connected to the switch 10. When in position II, the switch 10 makes it possible to perform analgesia intermittently from throe to throe and ensures pulse trains having a constant on-off time ratio equal to unity. i.e.
the time interval between successive pulse trains is equal to the duration of each pulse train; when in position I, the switch 10 makes it possible to produce the second level of the first stage of general electroanesthesia by trains of pulses in which the individual pulses have a variable duration.
The current pulse amplification unit 8 is built around a comn-lon-emitter transistor 64 and a resistor 65.'The transistor 64 serves for amplitude amplification of current pulses acting upon the patient's central nervous system.
The input 9 of the current pulse amplification unit 8, which is the base of the transistor 64, is connected to the switch 10.
The input 16 of the unit 8 is connected to the output 6 of the power unit 7. The input 18 of the unit 8, which is the emitter of the transistor 64, is connected to the output 20 of the patient protection unit 22. The output 23 of the current pulse amplification unit 8 is the collector of the transistor 64 and is connected to the input 25 of the pulse current regulator 27.
The patient protection unit 22 is built around common-collector transistors 66 and 67, an adjustable resistor 68 and a capacitor 69. The combined bases of the transistors 66 and 67 are connected to the adjustable resistor 68, which makes it possible to limit the general electroanesthesia level in accordance with an anesthesia and treatment program prescribed for each patient.
The output 20 of the patient protection unit 22, which is the emitter of the transistor 66, is connected to the input 18 of the current pulse amplification unit 8, i.e. to the emitter of the transistor 64, which makes it possible to set an upper limit to the current amplitude of current pulses applied to act on the central nervous system of a patient in accordance with an anesthesia and treatment program worked out for each patient.
The output 21 of the patient protection unit, i.e. the emitter of the transistor 67, is connected to the input 19 of the unit 11 for adjusting the additional constant d.c. component value. The input 28 of the patient protection unit is connected to the output 6 of the power unit 7. The input 33 of the patient protection unit 22 is coupled at the point of connection of the adjustable resistor 68 and the capacitor 69 to the output 30 of the pulse current regulator 27.
The unit 11 for adjusting the magnitude of the additional constant d.c. component is build around a common-emitter transistor 70, a resistor 71 and an adjustable resistor 72 which makes it possible to adjust the magnitude of the additional constant d.c.
output component.
The input 12 of the unit 11 for adjusting the magnitude of the additional constant d.c. component is the adjustable resistor 72 and is connected to the output 13 of the power unit 7. The latter incorporates a unit which feeds an additional constant d.c.
component to the output of the apparatus via the unit 11. The input-17 of the unit 11 is connected to the output 6 of the power unit 7. The input 19 of the unit 11 is the emitter of the transistor 70 and is connected to the output 21 of the patient protection unit 22, i.e. to the emitter of the transistor 67. The output 24 of the unit 11 for adjusting the magnitude of the additional constant d.c.
component is the collector of the transistor 70 and is connected to the input 26 of the current pulse amplitude regulator 27.
The pulse current regulator 27 includes transistors 73 and 74 and ensures that for a constant output voltage from unit 8, a constant current flows in the patient circuit, irrespective of changes in the impedance at the points where the electrodes are attached in the forehead and neck areas. The regulator 27 also includes resistors 75, 76, 77 and 78, an adjustable resistor 79, and a capacitor' 80. Such a circuitry makes it possible to maintain the second level of the first stage of general electroanesthesia irrespective of changes in the functional state of the patient's central nervous system.
The input 25 of the pulse current regulator 27 is the adjustable resistor 79 and is connected to the output 23 of the current pulse mplification unit 8. At the point of connection of the resistor 75, the adjustable resistor 79 and the capacitor 80, the input 26 of the unit 27 is coupled to the output 24 of the unit 11 for adjusting the value of the additional constant component, i.e. to the collector of the transistor 70. The input 29 of the unit 27 is connected to the output 6 of the power unit 7. The output 30 of the unit 27, i.e. the resistor 76, is connected to the input 33 of the patient protection unit 22 at the point of connection of the adjustable resistor 68 and tile capacitor 69, which makes it possible to carry out an anesthesia and treatment program prescribed for each patient. The output 31 of the unit 27 is connected to the input 34 of the output current amplitude indicator 35. The output 32 of the unit 27 is the emitter of the transistor 74 and is connected to the mean current intensity indicator 36 and the electrodes 14, 15.
The output current amplitude indicator 35 is a peak voltage detector built around a transistor 81, a capacitor 82 and a diode 83.
The unit 35 also includes a measuring instrument 84. The input 34 of the unit 35 is connected to the output 31 of the current pulse amplitude regulator 27.
The power unit 7 comprises a voltage converter, a rectifier, a voltage source and a unit for supplying an additional constant d.c. component. The voltage converter is built around transistors 85 and 86, resistors 87, 88, 89 and 90, and a transformer 91. The voltage converter also includes a switch 92 electrically connected to a voltage source 93. The rectifier is built around a resistor 94, a capacitor 95 and a diode 96. The additional constant d.c. component unit is the resistor 90 which applies the additional constant d.c. component via the output 13 to the input 12 of the unit 11 for adjusting the value of the additional constant d.c.
component.
The operating principle of the proposed device for pulse current action on the central nervous system is as follows.
In order to produce the second level of the first stage of general electroanesthesia in the central nervous system of a patient, the unit 1 (Figure 1) for generating rhythmic current pulses produces a train of square pulses of a predetermined pulse repetition frequency (a pulse signal) which is applied via the unit 2 for controlling the relation between the pulse repetition frequency and pulse duration of the current pulses applied to the intermittent analgesia unit 3 which generates an intermittent train of square pulses, with a pulse train break-make ratio equal to unity, to combat surges of pain through the use of intermittent analgesia.
The same train of pulses is applied to the unit 4 for adjusting the pulse duration of the individual current pulses, which makes it possible to attain the second level of the first stage of general electroanesthesia without producing any side effects in the patient.
From the output of the unit 4, a signal of a preset duration controlled by variable resistor 54 (Figure 2) is applied to the input of the unit 5 for changing the shape of current pulses. Pulses with an exponential trailing edge are used to anesthetize weak patients and children.
By means of the switch 10 (position I), said signal is applied to the input 9 of the current pulse amplification unit 8, from whose output 23 said signal is applied to the input of the unit 27 which regulates the current amplitude of the output pulses.
Through the mean current intensity indicator 36, the train of pulses proceeds to the circuit of the cathode 14 attached in the forehead area, and to the circuit of the anode 15 attached in the neck area, under the mastoids.
In order to reduce the impedance in the electrode areas, the application of the pulse signal, produced at the output 32 of the current pulse amplitude regulator 27, is accompanied by applying to the electrodes an additional constant d.c. component which is applied thereto from the output 13 of the power unit 7 via the input 12 of the unit 11 for adjusting the magnitude of the additional constant d.c. component, the output 24 of the unit 11, the input 26 of the unit 27, the output 32 of the unit 27, and the unit 36. The purpose is to produce more rapidly the second level of the first stage of general electroanesthesia.
As the switch 10 is brought to position 11.
at the output 32 of the current pulse amplitude regulator 27 there is produced an intermittent pulse signal train with a constant on-off time ratio equal to unity. This signal is applied via the mean current intensity indicator 36 to the electrodes, i.e.
the cathode 14 and the anode 15. This makes it possible to anesthetize even the most acute pain.
The amplitude of the current in the output pulses is monitored by the current pulse amplitude indicator 35.
The patient protection unit 22 has no effect on the operation of the current pulse amplification unit 8 and the unit 11 for adjusting the value of the additional constant component if the mean current intensity in the patient circuit is not in excess of a value predetermined for each particular case and set in the unit 22 with the aid of the adjustable resistor 68 (Figure 2). in this case the second level of the first stage of general electroanesthesia is produced in the conventional manner.
If the mean current amplitude is in excess of a predetermined value, the patient protection unit 22 (Figure 1) reduces the current amplitude of the pulse signal at the output 23 of the unit 8 and the magnitude of the additional constant d.c. component at the output 24 of the unit 11.
As a result, the mean output current applied to the electrodes is never in excess of a prescribed value irrespective of variations in the load impedance.
When this feature is included in apparatus embodying present invention it ensures complete protection of the patient without discontinuing the operation of the device in cases of an increase in the mean current intensity as a result of reduced impedance at the points where the electrodes are attached.
At the same time, the illustrated apparatus embodying this invention ensures a constant pulse action level, which makes it unneccessary for medical staff to attend to a patient throughout. the duration of pulse current treatment or anasthesia.
WHAT WE CLAIM IS:
1. Electro-anaesthesia apparatus constituting a modification of apparatus as claimed in claim 1 of Patent No. 1,535,413 for current pulse action upon the central nervous system of a patient by the application of current pulses to the patient in order to attain the seconcl level of the first stage of general anesthesia, said appear; us of the modification including the series combination of rhythmical current pulse generating means, means for adjusting the duration of the individual pulses, means for adjusting the amplitude of the current constituting the pulses, and means for indicating the mean current intensity value in the output of the apparatus, said apparatus including patient protection means ,whereby the current amplitude of the current pulses to the patient is automatically prevented from exceeding a predetermined value, and further including means tor generaling uninterrupted direct current of adjustable magnitude and means
**WARNING** end of DESC field may overlap start of CLMS **.
Claims (2)
1. Electro-anaesthesia apparatus constituting a modification of apparatus as claimed in claim 1 of Patent No. 1,535,413 for current pulse action upon the central nervous system of a patient by the application of current pulses to the patient in order to attain the seconcl level of the first stage of general anesthesia, said appear; us of the modification including the series combination of rhythmical current pulse generating means, means for adjusting the duration of the individual pulses, means for adjusting the amplitude of the current constituting the pulses, and means for indicating the mean current intensity value in the output of the apparatus, said apparatus including patient protection means ,whereby the current amplitude of the current pulses to the patient is automatically prevented from exceeding a predetermined value, and further including means tor generaling uninterrupted direct current of adjustable magnitude and means
for combining said direct current with said current pulses.
2. Electro-anaesthesia apparatus for pulse current action on the central nervous system, substantially as hereinbefore described with reference to the accompanying drawings.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GB1533577A GB1575322A (en) | 1976-04-09 | 1977-04-13 | Apparatus for pulse current action on the central nervous system |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GB1464576A GB1535413A (en) | 1976-04-09 | 1976-04-09 | Electro-anaesthesia apparatus |
GB1533577A GB1575322A (en) | 1976-04-09 | 1977-04-13 | Apparatus for pulse current action on the central nervous system |
Publications (1)
Publication Number | Publication Date |
---|---|
GB1575322A true GB1575322A (en) | 1980-09-17 |
Family
ID=26250699
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
GB1533577A Expired GB1575322A (en) | 1976-04-09 | 1977-04-13 | Apparatus for pulse current action on the central nervous system |
Country Status (1)
Country | Link |
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GB (1) | GB1575322A (en) |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB2148121A (en) * | 1983-10-22 | 1985-05-30 | Mo Oblastnoi Nii Akusherstva I | Apparatus for central electroanalgesia |
GB2154449A (en) * | 1984-02-22 | 1985-09-11 | Mo Oblasti Nii Akusherstva I G | Apparatus for central electroanalgesia |
GB2159719A (en) * | 1984-06-07 | 1985-12-11 | Pain Suppression Labs Inc | Electronic glaucoma treatment apparatus |
GB2181059A (en) * | 1985-10-01 | 1987-04-15 | Mems Technology Inc | Apparatus and method for micro-electric medical stimulation of cells of living animal tissue |
GB2231270A (en) * | 1989-05-04 | 1990-11-14 | Mo G Med I Im Ni Pirogova 2 | Electrotranquillizing device |
-
1977
- 1977-04-13 GB GB1533577A patent/GB1575322A/en not_active Expired
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB2148121A (en) * | 1983-10-22 | 1985-05-30 | Mo Oblastnoi Nii Akusherstva I | Apparatus for central electroanalgesia |
GB2154449A (en) * | 1984-02-22 | 1985-09-11 | Mo Oblasti Nii Akusherstva I G | Apparatus for central electroanalgesia |
GB2159719A (en) * | 1984-06-07 | 1985-12-11 | Pain Suppression Labs Inc | Electronic glaucoma treatment apparatus |
GB2181059A (en) * | 1985-10-01 | 1987-04-15 | Mems Technology Inc | Apparatus and method for micro-electric medical stimulation of cells of living animal tissue |
US4738250A (en) * | 1985-10-01 | 1988-04-19 | Mems Technology, Incorporated | Apparatus and method for micro-electric medical stimulation of cells of living animal tissue |
GB2231270A (en) * | 1989-05-04 | 1990-11-14 | Mo G Med I Im Ni Pirogova 2 | Electrotranquillizing device |
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