EP0213139A1 - Dispositif d'injection avec detecteur - Google Patents

Dispositif d'injection avec detecteur

Info

Publication number
EP0213139A1
EP0213139A1 EP19850904428 EP85904428A EP0213139A1 EP 0213139 A1 EP0213139 A1 EP 0213139A1 EP 19850904428 EP19850904428 EP 19850904428 EP 85904428 A EP85904428 A EP 85904428A EP 0213139 A1 EP0213139 A1 EP 0213139A1
Authority
EP
European Patent Office
Prior art keywords
cannula
suction
injection
skin
injector
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP19850904428
Other languages
German (de)
English (en)
Inventor
Wolfgang Dr.Med. Wagner
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Wagner Wolfgang Drmed
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of EP0213139A1 publication Critical patent/EP0213139A1/fr
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/42—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests having means for desensitising skin, for protruding skin to facilitate piercing, or for locating point where body is to be pierced
    • A61M5/425—Protruding skin to facilitate piercing, e.g. vacuum cylinders, vein immobilising means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/168—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
    • A61M5/172—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic
    • A61M5/1723—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic using feedback of body parameters, e.g. blood-sugar, pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/168—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
    • A61M5/172—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic
    • A61M5/1723—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic using feedback of body parameters, e.g. blood-sugar, pressure
    • A61M2005/1726—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic using feedback of body parameters, e.g. blood-sugar, pressure the body parameters being measured at, or proximate to, the infusion site

Definitions

  • the invention also relates to the field of medical technology, more particularly to injection technology.
  • it has the task of improving the treatment of diabetics who require insulin.
  • the metabolism of the patient should be made known to him frequently and as regularly as possible, in order to make it easier for him to maintain his diet and to compensate for changes in lifestyle from a rigid norm by adapting insulin treatment.
  • the treating physician should be able to gain insight into the patient's diet and to adapt his dosage suggestions for insulin. From this resolution, there is the task of creating an injector that can be used by people with disabilities by automating its functions, and which favors more frequent daily applications.
  • the injector should be as small and handy as possible, safe in its functions, without health hazards and, if possible, in its use associated with little annoyance.
  • suction injection in which the skin is lifted into the cannula by means of negative pressure and a firm connection between the injector and the skin is ensured until the suction cup is re-ventilated, is particularly favorable for solving the task of combining the sugar measurement with the injection. But especially with regard to the suction injection technology, adjustments to the measuring technology and further improvements with regard to storage, mixing and metering of the insulin, but also the generation and use of the negative pressure are required.
  • Metabolism examinations directly at the bedside via automated sampling have long been known, and measurement data are also stored (for example Hudspeth, CL, Richardson, Ph. Cl., Inter alia in DE 24 37 467).
  • the insulin infusion device Biostator from Miles has made it possible to continuously supply insulin while monitoring the blood glucose concentration in recent years.
  • the relatively extensive equipment can only be used at the bedside.
  • the "implantable electrochemical sensor” as stated by Leblanc jun., Among others (DE 26 45 048), is inserted into a vessel within a casing and serves to monitor the ion activity. It shows hydration by drip infusion. It is also proposed to take blood samples for analysis via a lying probe (Clemens, Anton Hubert, E. Myers, R.
  • a coated sensor is attached directly to an insulin-supplying cannula for joint insertion under the skin. Instead of a specific ferment reaction with glucose, which is more susceptible to faults, the osmolarity of the blood is measured and deducted from any water withdrawal from the body with simultaneous salt determination. The measurement results are arithmetically coordinated with a dosing program.
  • the insulin pumps which are particularly useful for adolescents and metabolically unstable, and which are worn on the body with the so-called permanent cannula, serve to supply a controllable minimum amount of insulin with the possibility of arbitrarily changing additional doses before meals by the patient himself (e.g. Hearten, R. and Cress H, DE 25 13 467).
  • a Blood glucose meter is not available here.
  • Loeb MP and Olson AM (DE 32 41 313) specify a curved syringe to be carried on the body with catheter application.
  • One is concerned with the wireless transmission of dosing instructions to such a device (Prestek K. and Franzeski M.
  • Sepharose-Concanavalin A has been used for some time to bind cardiac glycosides and other sugar derivatives.
  • sugars are non-conductors and, in higher concentrations, increase the electrical resistance of an electrolytic solution; why in sugar chemistry resistance measurements are used to track down sugar (a fact that I owe to the personal communication from Prof. Dr. Mauch Berlin).
  • the plaster-adhesive skin fixation during the injection also has precursors, but still without skin lifting.
  • one of stone (DE 14 91 840) specified injection device uses the principle of a drug supply through the metering syringe plunger through a valve in the same from a storage bottle, but the need for separation between the outside air and the storage bottle content is not taken into account. Needle-free injection by means of overpressure is prohibited for long-term use due to the considerable tissue damage. In general, too little attention has been paid to the need to prevent patients from cleaning device components.
  • Suction injection offers the special part in connection with the metabolically controlling sensor cannula that the duration of skin contact is automatically increased;
  • the milling of the cannula shaft into a kind of skeletal cannula which receives the drug delivery channel and the sensor, saves the cannula from thickening due to the sensor coating, which would negate an essential advantage due to the painfulness of the puncture. which the modern fine triangular loop cannulas and suction injection bring with them.
  • By dividing the cannula shaft into the metal skeleton part and an attached sensor part - which can also be applied to hoses inserted into the channel-shaped cannula shaft - it is possible to separate between two electrically divided parts with their own lead paths and thereby gain a further reference electrode.
  • a tube inserted into such a half-open cannula can have a small amount of clearing when the skin is pierced, in order to be expanded thanks to its elasticity under the pressure of the injection liquid. In this way, a faster injection can be made possible (or such a solution of more liquid solutions or of suspensions as depotinsulins often represent).
  • a further advantage can result from the fact that foreign substances stored on the tube surface come into contact with tissue fluid or blood through capillary suction, but the introduction of such foreign substances into the body can be avoided.
  • the automatic dosage adjustment to the metabolic situation determined in each case precludes incorrect calculations and estimates as well as incorrect operation by the patient and allows different ones to be taken into account
  • an automatic program allows the doctor to correct a gross incorrect dosage or to adapt it to new living and nutritional conditions without medical assistance.
  • the use of immediate-acting old insulin and depot insulin next to each other enables a short-term metabolic correction in addition to long-term care of the body, similar to insulin pumps.
  • the nuisance caused by a device worn on the body and especially by the cannula inserted into the abdominal cavity or in the subcutaneous tissue and fixed there with that in diabetic patients is eliminated increased risk of wound infection.
  • Programming by means of switching rings that are rotatably arranged in blocks on the housing simplifies the overview. The selection of profile numbers allows the entire program line to be printed in the patient file without complicated technical aids.
  • Lockability of the programming and the possibility of restricting compensation options and program changes by the patient are indispensable prerequisites for avoiding serious incidents due to misconceptions, idiosyncraticness and unintentionality of the patient or willful interventions by third parties.
  • advancing it to the phase of industrial packaging of the cannula appears advantageous, particularly when the higher expenditure of the triggering device for a storage container which maintains the negative pressure and is surrounding the cannula is relocated to the injector which is used again and again.
  • Surface changes in the storage potty during skin suction can be
  • the solution of vacuum generation via air dilution within a heated chamber is particularly suitable for electrically operated dose delivery.
  • the use of several chambers increases the independence from the power grid and thus the freedom of design in the daily routine.
  • the advantages of a demand-controlled permanent vacuum can be used within a handy device by a gas jet pump in connection with a household carbon dioxide cartridge, after problems due to the high gas outlet pressure and the valve icing during gas release have been eliminated by a special lock valve.
  • the vacuum generation in a spring-operated be considered cylinder-piston pump, if the feeding of the air from the suction bell prevents the piston and cylinder from the finest quartz grains from the skin pores from being affected in their surface quality.
  • the vacuum preparation is expediently bound to the movement of a closure cover for the suction bell, the mechanism for changing the cannula also being actuated.
  • Bowden cables allow space-saving power transmission. The one-sidedness of the detection of a suction piston by means of a lateral raster device with the risk of the piston tilting is counteracted in that the suction piston is already held approximately in the raster position by magnets and spring lock. The effort required to trigger the suction cup is reduced considerably.
  • a delay in the pumping movement also occurs, which can be used to close a pressure relief valve.
  • the latter is used to derive the. air compressed due to the skin approaching the cannula in the suction cup to save suction. If the thinning of the upper skin layers by shortening the skin allows the cannula shaft to be shortened, stacking the cannula in a tube or tube contributes to further space savings.
  • the height of the stacking cannula can be further reduced by the fact that, with appropriate securing against rotation in relation to the lateral medication entry points, for example by one-sided flattening of the cannula magazine, which still ensures tight sealing of the lateral cannula opening, the liquid channel, which comes into cover with the medicament outlet opening of the device runs down as a channel in or on the wall of the cannula housing before it enters the cannula shaft.
  • An articulated connection between the stacking cannulas - which can be a thread - permits cannula transport by train, a spring mounted in the magazine or a sealing body in front of a compressed gas line a conveyance by pressure.
  • the side entry of medication via an annular groove of the cannula body facilitates the loading of the cannula shaft with several types of medication, as well as the cannula removal by means of a claw-like lid device.
  • the cannula arrangement in a row also facilitates the removal of the cannula after use, whereby the space of the previously unused cannula can be taken up in a space-saving manner.
  • the displacement of the cannula after the injection before it is removed brings about a valve closure of the medicament flow channel.
  • the cannula magazine as a whole for example under suction in the suction bell onto a septum connected to the magazine, can be lowered counter to the injection of the skin and raised again when it is ventilated again.
  • a central pin inside the suction cup near the cannula conveys the condition of the skin lift.
  • the three release pins distributed around the edge of the suction cup in other examples have also been improved by a more clever arrangement of the rooms and by the fact that their resilience to the skin is lifted or weakened after it has been raised.
  • the distance between the skin and the cannula after the injection to avoid cuts is ensured by springing back of the suction cup, which is still blocked during the injection.
  • the suction cup is only ventilated again after loading Injection is terminated (in the mechanically controlled examples) if a previously tensioned spring mechanism is only activated after the sliding parts controlling the dosage have hit the dose-limiting obstacle.
  • the spring mechanism is to be equated with a magnetic attraction of the ventilation valve, whereby a fluttering of the valve is prevented by means of a special locking mechanism when a permanent suction is applied.
  • the central pin advantageously occupies a center point of an elliptical suction bell, while the cannula takes the other in order to keep the seals around the central pin and cannula and the suction bell rim at the necessary distance.
  • the dosing device was installed as a short-stroke piston or cuff in the end of the medication supply hose from the container just in front of the cannula and actuated from outside the hose, then in other solutions, the task can be performed in an electromagnetic manner by applying pressure periodically from outside the hose so that moving parts in the hose are eliminated. Only a pin bearing a ring bar inside the hose as a counter-pressure bearing is useful. Short shaking movements to fill up The addition of Zirlkchlorid as an additive to depot insulin is required to obtain an injectable suspension. The control of a discharge valve in connection with a flow measurement is considered from the point of view of saving space.
  • auxiliary liquid instead of the medication for dosing (using the displacement effect) saves or facilitates the cleaning of the dosing device. If the auxiliary liquid is placed behind the piston of a stage syringe, the higher viscosity of the auxiliary liquid prevents it from being added to the medication. Considerable space for the auxiliary liquid can be saved if a locking piston pushing up the separating piston is used, so that the same limited amount of auxiliary liquid always oscillates between the metering device and the step syringe.
  • the invention also includes a number in the illustrated or in a new combination. Essential advantages for solving the task, which are apparent from the following text in conjunction with the drawings.
  • a cannula serving the input of liquids is at the same time designed as a sensor which, after the cannula has been introduced into the body of a mammal, changes in physical and chemical states in the body of the latter
  • the senor itself can serve as an electrical voltage source Je (for example in the case of the so-called catalytic sensor), the voltage changes or current output of which are used for processing the measurement signals;
  • the sensor can also change its conductivity for externally supplied electrical currents under the physical-chemical influence of the state of the body and thereby supply measurement data to the measuring instrument.
  • at least one layer is usually applied to at least parts of the cannula shaft, which produces the sensor property.
  • the invention reacts to the body mainly with the glucose of the body in order to react with it as a kind of electrical cell or through the addition of glucose or its reaction - or synthetic products (such as glycogen, starch or lower carbohydrate chains) the electrical conductivity via the cannula or past the cannula depending on the glucose concentration of blood or tissue (depending on the position of the cannula within a blood vessel or in the subcutaneous tissue or in the abdominal cavity) to change.
  • glucose or its reaction - or synthetic products such as glycogen, starch or lower carbohydrate chains
  • liquid it is also possible for the liquid to be dispensed via a tube with sensor properties on the surface, the clearing of which is placed in a tight connection to the bore of the syringe attachment or, where such is not available, to the infusion tube in such a channel-shaped hollow cannula shaft without the free end thereof must be emptied via the tip of the cannula itself (this can be useful if the cannula shaft is very short, in order to guarantee the injection of medication under the skin).
  • the application in connection with insulin pumps also appears with the possibility of recording measured values over a long period of time lying cannulas particularly advantageous.
  • the subdivision of the cannula shaft into at least two compartments that are electrically insulated from one another can be suitable for saving an additional comparative electrode outside the cannula. Power is supplied and discharged via lines which are expediently connected to the measuring device in places within the infusion tube (embedded in and insulated by its wall).
  • the sensor coating of the cannula is irreversibly changed under the influence of metabolic products, in particular of sugar or more specifically glucose, and the measurement parameters are obtained from the extent of these changes.
  • glucose can be on the cannulas covering (for example, to plant carbon or fermentative) and by enriching the sugar as an electrical non-conductor, the conductivity of the sensor coating chosen as a good conductor is reduced depending on the sugar supply, taking into account the time function.
  • Another solution is the miniaturization of optical measurements and their relocation in the area of the cannula.
  • light is directed through at least one optical fiber or directly through the cannula shaft against an optical indicator zone, and the light, which is reflected by the change reflected under the influence of metabolic products, is measured and evaluated.
  • Another solution without color indicators uses polarized light, and the property of some metabolites (including glucose) to change the polarization level of such light depending on its concentration.
  • the polarized light is deflected back by a medium of different density, which is preferably introduced in the area within the cannula tip, after contact with the metabolic product and compared with a reference beam or a calibration standard by means of suitable detectors. Adherence to the time required for measurement and injection is best ensured when using suction injection, i.e.
  • the edge of the suction bell (for example coated with silver chloride-silver or using a contact gel or a double-sided adhesive electrode ring) can be used as a reference electrode. Instead of lifting the skin through suction, this can also be achieved by plastering.
  • the completion of the measurement and the calculation ganges to adjust the dosage to be administered can serve as a trigger signal for the dosing pump. This eliminates the intrinsically advantageous injection initiation by contact pins or by earth leakage of the cannula within the raised skin.
  • An inventive step is also the programming by means of rotatable switching rings which are put together into program blocks, since they record the simultaneous overview of the starting point of the programming.
  • a print-type-like majesty of the program symbols and their arrangement in a transverse program line as a whole allows the intended program to be printed in the patient register or otherwise without special technical facilities.
  • the blocking against rotation of the switching disks beyond the set locking step by lateral jamming by means of a screw to be operated by key is facilitated by lateral profile formation on the support rings below the switching rings.
  • the cannula For cases in which, for example for conductivity measurements, the possibility of coating only the cannula surface would arise (in order not to have to enlarge the cannula diameter in order to increase the injury), the cannula must penetrate into the
  • Skin from the side of the dosing pump the delivery of a small NEN drug (for example in the form of a single volume-reduced basic cycle of the metering device) is provided to prevent a capillary suction of blood or tissue fluid and a power line in the bypass over this.
  • a small NEN drug for example in the form of a single volume-reduced basic cycle of the metering device
  • the medicine is practically a non-conductor.
  • the injection is expediently started before the measurement is completed in order to keep the time of the injector contact within limits.
  • the injection pressure is limited because of the risk of tissue damage.
  • the computer can initiate a limited immediate correction even after a basic rate has been injected.
  • the device for suction injection itself was further developed according to the invention, not least for its downsizing, which only allows it to add the measuring and control unit for the sensor cannula without losing the necessary handiness.
  • a piston-cylinder pump Since the vacuum requirement of the suction bell is relatively low and the human hand is capable of considerable force concentration, a piston-cylinder pump remains an economical method for storing energy in a spring.
  • a sand filter between the vacuum pump and suction bell must be switched into the suction channel to prevent the destruction of the piston cylinder surface by the finest quartz grains, as they are torn out of the fine skin pores by the suction.
  • Such a pump is operated in a space-saving manner via Bowden cables.
  • the tensioning process for the spring is expediently connected to the pivoting movement of the cover over the suction bell.
  • the suction piston is locked from the suction bell by weakening the breakaway force of the spring by means of a clamping device or the liability of Permanent magnets. In this way, the risk of canting is mitigated if the suction generation is triggered on one side eccentrically from the suction lock.
  • the delay caused by this Ent relief mechanism favors the conclusion of a spring-loaded over pressure valve, which compensates for the air pressure compression that occurs when the suction cup is placed on the skin and when the suction cup is raised against the cannula.
  • the raising of the suction cup rim against spring pressure and the release of the locking of the return movement of the suction cup during its re-ventilation result in a distance between the cannula and the skin after the injection.
  • Auxiliary functions are conveniently effected when a lid flap is closed (with a reminder for the device not being ready for use), so that the pressure on the skin of the central pin which triggers the vacuum pump can be reduced.
  • the possibilities were tested to deflect the pressure of release pins, which initially protrude from the area around the edge of the suction cup, after activation of the vacuum source from the skin. This is done by the action of wedge bevels on a spring-loaded ring, which releases the pin movement upwards with little friction after passing the wedge bevels. A return movement until the spring-loaded ring acts on the wedge bevels takes place via an elastic one
  • the temple ends lie on the edge of the suction curl.
  • the bracket When the potty is pressed manually against the skin, the bracket is stretched and then suddenly all of a sudden bent in the opposite direction, the ends being pulled from the edge of the suction cup and lifted into the suction cup.
  • the valve pin pops up and with its tip breaks the membrane over the end of its tube after it has been stretched out a little.
  • the air pressure between the vacuum accumulator and the suction bell is thus equalized. Since the suction bell may only be re-ventilated when the injection is complete, a spring mechanism was tensioned on the device before use, which is triggered by the injection mechanism as it expires.
  • a ventilation valve is proposed, the double-acting magnet of which draws the valve membrane onto the ventilation channel during suction generation (the fixation then provides the negative pressure) in order to keep the valve membrane away from the ventilation channel during the re-ventilation.
  • the vent valve is opened by actuating a valve tappet in the last phase of syringe emptying within a contracting bellows, supported by the attraction of permanent magnets, which also prevent valve flutter by changing the opening and closing positions.
  • the resuscitation mechanism can be replaced for the duration of the injection by a nozzle, through which air gradually penetrates into the suction cup after the suction has been switched off.
  • hose rings are preferably filled with an auxiliary liquid via metering chambers delimited by edge rings on a pin in the medication tube near the cannula attachment of electromagnetically operated pumps.
  • Piezoelectric actuating elements surrounding the hose can also be used as metering valves.
  • the auxiliary liquid can also be introduced behind the plunger of a stepped syringe, the effect of a metering hydraulic system with powerful and slow advancement of the plunger of the stepped syringe.
  • the piston can out
  • a special coupling valve consists of a slide valve with springback in the device part and a kind of slidable sleeve over a side opening for the access of auxiliary liquid into the staged syringe, the sleeve being forced to on the step syringe is moved into the device. In this way, an air-free coupling of both liquid systems is guaranteed.
  • the space required for the auxiliary liquid can essentially be saved if only a quantity exceeding the individual metering stroke and the leakage loss is injected via the metering device between the separating piston and a supporting piston, and the supporting piston is guided to the separating piston above the medicament and is then blocked from movement.
  • the auxiliary liquid swings on this
  • a type of lock valve following the channel on the opening mandrel of a pressurized gas cartridge is also important, in which a small-sized poppet valve inside the plate of a larger poppet valve is first opened with less effort.
  • the gas which is under high pressure, then accumulates in a chamber, which is closed by a slide valve behind the seat valves.
  • the large seat valve can then be opened easily.
  • the gas flow then reaches the gas jet pump via the open slide valve.
  • the gas capsule can be lifted into the opening mandrel by means of a swelling pin (made of agar-agar, for example) while absorbing water.
  • An automatic cannula change is facilitated by a stacking cannula, whereby in the case of a vertical arrangement within a magazine tube or hose, the preceding cannula shaft lies in a hollow in the body of the subsequent cannula and the medication is supplied laterally via an annular groove in the cannula body with a bore opening into the cannula shaft.
  • an elastic septum of let terem can be perforated centrally.
  • the drug supply can also be via vertical channels or
  • Channels are made along the cannula body.
  • Gluing or thread-like attachment between the cannula bodies can enable transport by train, which preferably originates from the claws at the end of the receiving tube inside the suction cup cover.
  • Pressure effect on the stacking cannulas can originate from a compression spring which is tensioned by the thrust effect of used cannulas when they are manually pushed in the circuit from the receiving tube over the end of the magazine tube.
  • Thrust movement is important for the advancement of a stacking cannula into an open position in alignment with the drug exit points in the magazine.
  • a leaf spring actuated by means of a switching pin on the cover can serve as the switching mechanism.
  • the raising of the central pin in the suction bell can also allow a cannula to be lowered by means of a ball grid, which in this other solution example takes place under the action of compressed gas on a sealing piston in the magazine hose. (Fig.18, Fig.19).
  • Flattening or oval shape of the magazine and cannulas can serve as a rotation lock and allow the effectiveness of the joint elements between the cannulas as well as a better contact and sealing of the medicinal channels (Fig. 27).
  • the dosing accuracy in the case of small circumferential dimensions is increased in that two hoses are guided in parallel over two hose pumps acting in the same way; further characterized in that the hoses can only expand within the pump between the grooves of the discs carrying the rollers and in that the reunited hose section, for example, between the pump and the cannula to reduce the wind boiler function is surrounded with a solid jacket.
  • An even better solution results from the introduction of a small piston pump directly in front of the cannula socket, which causes the medication to be dispensed in preprogrammed pump cycles either via the guide of a spring-operated disc or by repeated actuation of an electromagnet.
  • the storage of the piston pump within the medication tube when actuated from the outside via the mediation of a cross plate on the pump plunger saves cleaning and facilitates the replacement of the metering system in accordance with the overall object of the invention.
  • the replacement of a fitting piston with an elastic sleeve, the hollow of which is pressed against a contact surface, for example of a pierced plug laterally welded to the tube, by means of the plunger for dose delivery, is particularly advantageous with regard to the production costs, while the end of the plunger passed through the bore of the plug is widened and, in push-pull, closes the plug bore to the cannula attachment cone.
  • a special pump housing can be saved if the stopper (114) directly into a hose extension vulcanized, whereby the hose extension can only expand to a limited extent within an axis bushing of the injector (Fig. 92).
  • the drive of the dosing device also takes over the function of the vibrator for mixing the medication and avoids the permanent squeezing of the tube by the pump rollers, which remains problematic even if, as in the example shown, the tube is always clamped by the rollers at the same place practically through the process the rolls in one direction with the addition of the metering distances is very likely to be avoided.
  • Grooves of the carrier disks for the metering rollers enclosing a hose each reduce the expansion of the hoses within the pump, which is additionally compensated for by spring tension at the end of the hoses emerging from the pump. (Fig. 66).
  • Two pairs of rollers can also be arranged radially one above the other in such a way that they enclose the hoses between them (FIG. 74).
  • the pulling effect of the rollers can also be countered by fixing the pair of tubes via a crossbar between the tubes, which is interrupted in the manner of a rope ladder for a fixed ring gear (FIG. 75).
  • a slightly contracting thin-walled membrane i.e.
  • a simple pouch was considered as a simplification (Fig. 66).
  • this can be arranged within a further rigid-walled pouch when compressed gas is stored between the pouches (FIG. 35).
  • the medication feed by means of the pressure effect in the container means dosing free of air bubbles (air can penetrate from the cannula even if there is negative pressure in the hose system or there could be a suction effect through the cannula
  • the prewarning before the drug supply is used up results in the solution from a gradually lowered screw cap - which can be tracked in a cylinder slot along a metering scale - from the attachment of a removable obstruction against the descending screw cap at the point of the lower limit for a sufficient single dose before the supply is exhausted (Fig. 78). It can also be - especially within the difficult to see compressed gas storage bottles (Fig. 82) - between the bellows and the container lid a thread is attached, which actuates a warning device when tightening, as they can be purchased inexpensively as electronic melody in greeting cards. Finally, medication consumption can also be electronically monitored (Fig. 93) and read off (Fig. 94).
  • a pre-warning margin can be selected and the function of the injector can be blocked if the remaining amount falls short of the single dose.
  • the function control has been improved in many ways.
  • the control mimic for triggering the injection or re-ventilation is pretensioned at the same time as the cannula-carrying vacuum reservoir is inserted; it is therefore not cumbersome to operate a special lever, but as actuators there is at least one pin which projects downward beyond the cannula attachment piece.
  • Suction cup edge in one example (Fig. 86), which enables the trigger pins to be brought closer to the device center without reducing the adhesion due to a smaller skin contact area.
  • Pins stored inside the suction cup must be sealed towards the suction cup roof (Fig. 22).
  • such pins first cause a ring to rotate against its suspension in order to then be able to step upwards with little friction (Fig. 80).
  • the pins By turning that ring If the pins move from the opposite direction, they engage with openings in the ring and the lowering caused by manual pressure can open the valve between the suction bell and the vacuum accumulator.
  • the negative pressure is generated in three chambers of equal size, which are arranged in a ring around and above the suction bell (Fig.
  • the chamber heating is switched off via a temperature sensor (e.g. bimetallic switch) or a short-term switch after the maximum temperature has been reached, and the chambers are then cooled.
  • Spring-loaded valve flaps allow the hot air to escape from the chambers via the suction bell, which also serves as a side effect of cleaning them, while pins from above each lever one of the valve flaps out of their seats for air pressure compensation between the chamber and the suction bell.
  • the suction bell is formed by a rubber-elastic sleeve of the injector (FIG. 78) into which the vacuum accumulator is pushed in a sealed manner becomes.
  • a memory of the two-chamber system in which a distinction is made between the storage space and the suction bell chamber and the cannula emerges uncovered, then resembles a memory of the single-chamber system in which the cannula is located as a whole and to the tip behind the end membrane.
  • the dead space around the exposed part of the cannula shaft can be reduced by saving it by filling it with an annular piston.
  • the ring piston must be held against the vacuum accumulator before use.
  • it can have a transverse groove in which a retaining collar or cover extensions from retaining tongues extend from the lower edge of the vacuum reservoir into this transverse groove and thus prevent the inward movement of the annular piston under vacuum influence before use.
  • retaining pins or lamellae snap into the injector and, after removal of the retaining collar or the suction cup cover, hold the annular piston in place until the injection is triggered.
  • the more complex transverse groove can be replaced by producing an annular piston with an open ring notch in the same shape with the vacuum accumulator. The latter is then transported via a conveyor carousel to an adhesive device, for example an ultrasound head, and connected with a circular, stretchable film. Then the ring piston is placed under a vacuum reservoir and the edges of the circular film are glued to the edge of the vacuum reservoir.
  • this edge is broadened like a hat brim and can also have a linear sealing contact with the suction cup sleeve of the injector.
  • the transverse groove or the ring notch can be designed horizontally or obliquely in alternating sectors, on the one hand to support the locking effect of the cover tongues or cuff pins, and on the other hand to facilitate the unlocking of the retaining pins or lamellae of the injector (Fig. 85). Since the cover of the vacuum accumulator is held rigid in this solution example, the cannula is approached in use except by raising the skin due to the flexibility of the suction cup cuff.
  • the increase in the range of motion between the skin and the injector can serve to release the negative pressure effect on the skin within the suction bell, but can also trigger the metering device for injection on a subsequent switching path.
  • the correct vertical movement of the injector against the skin is a prerequisite for the trigger actuation that the suction bell cuff can only be lifted simultaneously with the lifting of a cylinder segment which has a tightly fitting ring to the outer surface of the cylindrical receptacle for the vacuum accumulator, which jams against the wall of the receptacle when the movement is one-sided. In this way it is ensured that the injection is only triggered after the suction bell has come into contact with the skin safely and under vacuum.
  • FIG. 66 the correct vertical movement of the injector against the skin is a prerequisite for the trigger actuation that the suction bell cuff can only be lifted simultaneously with the lifting of a cylinder segment which has a tightly fitting ring to the outer surface of the cylindrical receptacle for the vacuum accumulator, which jams against the
  • the rotary pumps are only activated after the negative pressure effect on the skin has been determined, as in previous patent applications.
  • a button serves as a "suction switch", which controls changes in shape of the vacuum accumulator.
  • these changes in shape concern the cover and the cannula opening cone.
  • a circumscribed elastic part is pulled in under the influence of the negative pressure in the reservoir; after the vacuum is reduced by balancing with the suction cup space, this membrane will rise slightly.
  • the usable performance is low. Therefore, a slide valve working with low friction was provided as the switching element.
  • the associated button is first advanced by means of a pneumatic piston against the elastic membrane, which is operated by a bellows, which is compressed when the vacuum accumulator is inserted into the injector and remains pressed together until a re-ventilation takes place via the slide valve mentioned.
  • the expansion of the bellows which is optionally reinforced by an additional spring, actuates the switching element for the further functions of the device (Fig. 76).
  • a slight edge projection of a welded-on cover membrane can offer resistance to a resilient holding device, as a result of which a more expensive transverse channel in the piston can be avoided.
  • a device that acts laterally on the cover in a wedge shape can be useful for removing the vacuum accumulator after use (FIG. 70).
  • a stretchable elastic membrane spans a bottom ring within half of the vacuum accumulator, which in turn has a high guide cylinder which is loosely inserted into that vacuum potty.
  • An inner part of that bottom ring is glued to another ring-shaped cover ring, which rests with its edge on the lower edge of the vacuum reservoir and, after the latter has been evacuated, prevents the bottom ring from being lifted until an edge streak occurs strip that cover ring along a predetermined breaking line is removed by pulling it down.
  • the unicameral system has the largest vacuum storage space in terms of the overall size of the vacuum storage pot. Sterility of the cannula is guaranteed even without external packaging.
  • the function control for the ventilation of the suction bell was improved in that in each case an easy-to-operate slide valve is first closed with energy storage for the return of the valve lifter before actuating the metering device.
  • valve actuation mechanism is blocked until the metering mechanism has completely run off, which is activated by deflecting a moving locking element on a steep flank of the link guide on the housing (Fig. 69, Fig. 77, Fig. 81).
  • the mixing of the medicinal components can also be brought about by mechanically coupling the buzzer of the electronically controlled warning device to the hose parts leading around the pump in such a way that its vibrations are communicated to the inside of the hose (Fig. 91), even just before the injection .
  • An edge ring (223) on the cylinder (5) that maintains negative pressure serves both for better attachment of the boundary membrane (6) and for a more favorable seal to the injector (FIG. 85).
  • the dosage is weighed by means of a kind of magnet-clocked rocker, provided the medicinal tube is sufficiently resistant (e.g. made of silicone), whereby the type of clamping prevents the inflow from the reservoir from squeezing the tube (for example, inside a dosing screw, the turns of which are also present) are successively narrowed over the hose by flattening it (Fig. 99).
  • FIG. 1 shows a top view of a filled injection syringe with a sensor cannula in connection with a measuring device.
  • FIG. 2 shows in longitudinal section a storage potty which maintains negative pressure and has a sensor cannula in conjunction with a hand-operated metering device and a measuring device.
  • FIG. 3 shows a longitudinal view of an insulin pump in connection with a sensor cannula and measuring device.
  • Figure 4 shows in longitudinal section and on the right in cross section the detail of a cannula connection piece in connection with a hose coupling piece.
  • Figure 5 gives a block diagram for data storage and reading in a device according to Figures 1 to 3.
  • Figure 6 shows a refinement of the block diagram of Figure 5.
  • FIG. 7 shows a circuit diagram of the reader of a device as in FIGS. 5 and 6.
  • Figure 8 shows in natural size, with the exception of a shortening of approximately 40 mm, the housing cylinder with a discharge hose, bellows and receiving pipe socket for the insertion cylinder in a longitudinal section.
  • Figure 9 shows the insertion cylinder, which can be inserted from below into the housing cylinder of Figure 8, with a maximally filled injection syringe in longitudinal section.
  • Figure 10 shows a cross section through the iron plate closing the insertion cylinder upwards, the position of the six permanent magnets and the trigger tube for the re-ventilation valve being shown interrupted is.
  • FIG. 11 shows in longitudinal section parts of a housing cylinder similar to that in FIG. 8 with deviations in the design of the re-ventilation valve.
  • Figure 12 shows in a reduction on a scale of about 1: 5 a water jet pump with line connection suitable for the operation of the device in a longitudinal view.
  • Figure 13 shows a longitudinal section through an injector which is operated by means of a CO2 compressed gas capsule for a medicinal product with an automatic cannula change.
  • Figure 14 shows a cross section at height A - B of Figure 13.
  • FIG. 15 shows a cross section at height CD of FIG. 13.
  • FIG. 16 shows a longitudinal section through the detail of one of the two liquid coupling valves for FIG. 13.
  • FIG. 17 shows a cross section through the gas jet pump of FIG. 13.
  • Fig. 18 shows on the left in longitudinal section and on the right in cross section a detail at the end of the cannula magazine on a scale of 5: 1 for FIG. 13.
  • FIG. 19 shows a side view of the cover flaps on one side of FIG. 13; to the right of this is a vertical section and below it a cross section at height A - B.
  • Figure 20 shows in vertical section along D - E of Fig.13 details of the control of the triggering and the change of the dosage. Below is a cross section.
  • Figure 21 shows on a scale of 2: 1 details of Figure 20. Below you can see a cross-section along A - C. On the right, the position of the release spring of the trigger can be seen in two details rotated by 90 degrees.
  • FIG. 22 shows a partial top and bottom view in longitudinal section and in the middle in cross sections A - B and C - D details of the control mechanism.
  • FIG. 23 shows in longitudinal section the counting and locking mechanism of the device according to FIG. 13 and the following. Below this is the cross section at height A - B.
  • Figure 24 shows on a scale of 5: 1 the detail of the implementation of the lifting movement in the rotation of the counter.
  • Figure 25 shows the grooves in the guide bushing in a 10: 1 scale.
  • FIG. 26 shows a cannula magazine and variations of stacking cannulas on the left in a longitudinal section, which encloses a cross section on a scale of 5: 1, and FIG. 27 on the right in longitudinal section likewise on a scale of 5: 1.
  • FIG. 28 shows a metering pump for auxiliary liquid on a scale of 10: 1 on the left in longitudinal section and on the right in two cross sections of different heights.
  • FIG. 29 shows in longitudinal section an electrically operated injector with step syringes for two different medicines.
  • Figure 30 shows a cross section at height A - B of Figure 29.
  • FIG. 31 shows a circuit diagram in TTL for FIG. 29, 30.
  • FIG. 32 shows in longitudinal section a variant of FIG. 29, which has a motor with a manual transmission for two metering peristaltic pumps.
  • FIG. 34 shows a medicine supply bottle with compressed gas within a bellows in longitudinal section.
  • FIG. 35 shows a longitudinal section through a medication bag inside a pressurized gas bag.
  • Fig. 36 gives a schematic top view of a suction injector as a preferred embodiment, the inventi. The storage of stacking cannulas of two different constructions is shown in longitudinal section in the magazine tube.
  • FIG. 37 shows a longitudinal section through the suction injector, which follows the line AB in FIG. 36.
  • a cross-section through the suction bell (height indicated by an auxiliary line) and a cross-section below the suction piston can be seen on the right.
  • FIG. 38 shows a longitudinal section along the line A - B of FIG. 36 through the injector.
  • FIG. 39 shows a top view of the suction cup roof together with cylinder (304) with cannula magazine along the line D - E.
  • FIG. 40 shows a schematic longitudinal section along the line F - G to explain the piston guide mechanism via the movement of the suction cup cover in the waiting position before the injection.
  • FIG. 41 largely corresponds to Figure 40, but shows the stage after the injection.
  • Figure 42 shows the stage after the lid is closed.
  • FIG. 43 shows a variation of the trigger mechanism for the suction piston with the line of the longitudinal section as in FIG. 36; the suction cup is shown in side view.
  • Figure 44 shows a schematic longitudinal section of a connection possibility between the old and new storage bag for partial replenishment of the old one.
  • Figure 45 shows a longitudinal section at the top, including a cross section of two metering pumps for the injector according to Fig. 26 ff and a locking of the storage bag.
  • Figure 46 shows in longitudinal section on a scale of 5: 1 the detail of a metering pump in connection with one of the magnetically operated metering pumps.
  • FIG. 47 schematically shows the course of a peristaltic dosing movement in a variation of the pump arrangement in order to save dosing pumps.
  • Figure 48 shows in a longitudinal section on a scale of 5: 1 a stacking cannula according to Figure 25.
  • Figure 49 largely corresponds to Figure 48 and represents a cannula variation.
  • FIG. 50 shows a special sensor in longitudinal section and below in cross section along line A - B cannula with partial shaft replacement by plastic on a scale of 5: 1.
  • FIG. 51 shows a cannula variation with an inner coating in longitudinal section and on a scale of 5: 1.
  • FIG. 52 shows a cannula, which corresponds to the configuration of FIG. 50 with an inserted sensor tube or thread with an intact shaft.
  • FIG. 53 shows a cannula, which corresponds to the representation of FIG. 50, with a tube being inserted into the split shaft.
  • Figure 54 shows in longitudinal section on a scale of 10: 1 a sensor cannula for reflex photometric measurement.
  • Figure 55 shows in longitudinal section on a scale of 10: 1 egg sensor cannula for optical measurements with optical fibers only up to the base of the shaft.
  • Figure 56 shows in longitudinal section on a scale of 10: 1 the variation of a stacking cannula corresponding to Figures 48, 49 within a device bore with light supply via a swivel segment.
  • Figure 57 shows the top and bottom in cross section of the switching ring arrangement on a device cylinder for a device according to Fig. 25 ff.
  • Figure 58 shows a functional diagram for the electrical control and programming.
  • FIG. 60 shows a processor-controlled program sequence for an injector according to FIG. 25 ff.
  • FIG. 61 shows a refinement of block 6 from FIG. 60;
  • FIG. 62 is a continuation of FIG. 61.
  • Figure 63 is a continuation of Figure 62.
  • Figure 64 is a continuation of Figure 63.
  • Figure 65 is a continuation of Figure 64.
  • Figure 66 shows an example of an injector with two parallel and identically operated peristaltic pumps as a metering device, with a storage bag of great wall flexibility and a vacuum storage pot 42-not submitted 43 -
  • Figure 77 shows a highly schematic of four functional stages A to D of a mechanism for re-ventilation by means of a slide valve.
  • Figure 78 shows a longitudinal section through an injector with a metering device integrated within a hose according to a type of piston-cylinder pump, a screw cap with a mechanism for automatically reducing the size of the medicine-storing container and a suction bell rim with elastic lips, which belongs to the injector and also to the one Trigger device for the bottom cylinder of a vacuum potty which is to be assigned to the injector and which takes over the holding function of a potty-specific support device removed before use in the injector.
  • Figure 79 shows in cross section A - B of Figure 78 a trigger mechanism.
  • Figure 80 shows a schematic longitudinal section of Figure 79 in rollup.
  • FIG. 81 shows a highly schematic of three functional stages A - C in Fig. 78 of a mechanism for re-ventilation by means of a slide valve.
  • FIG. 82 shows a longitudinal section through an injector with an electromagnetically operated hose-integrated pump similar to that of FIG. 78, wherein a film roll as chemical carrier for the gradual formation of compressed gas in conjunction with an overpressure valve ensures uniform medication feed and a device for the thermal generation of the vacuum for the suction bell is available in three separately activated storage chambers.
  • FIG. 83 shows a cross section in the direction A - B through the vacuum storage chambers and suction bell of FIG. 82.
  • Figure 84 shows a schematic unrolling of the Mechanism for opening the valve flaps to the vacuum chambers.
  • Fig. 84 On the left (I) in Fig. 84 is shown part of the schematic roll-up of the groove guide for the cam of the shift cylinder of Fig. 82 to explain the sectoral rotation thereof after lowering the medicine container against the pump housing.
  • Figure 85 shows a variation of a vacuum storage potty similar to that in Figure 78. On the left half of the picture, the bottom cover locking in the transverse groove can be seen, in the right half of the picture after removal of the latter, the locking of the ring piston by a locking plate of the injector.
  • FIG. 86 shows a schematic cross section through the suction cup sleeve of an injector with a cross section lobed like a cloverleaf and the position of the trigger pins outside the suction cup.
  • FIG. 87 shows a longitudinal section of a vacuum potty according to the single-chamber system with a removable cover for the suction bell, with a schematic illustration of a locking mechanism for the insert cylinder carrying the base ring, which belongs to the injector, and a device for checking the cannula seat with regard to its blood vessel contact.
  • FIG. 88 shows the process steps for producing a vacuum storage potty according to FIG. 85 in a highly schematic manner.
  • FIG. 89 shows a vacuum potty of the type used in FIG. 66 inside the guide cylinder in the stage of the skin being pulled up by air pressure compensation in a longitudinal section.
  • Figure 90 shows on a scale of 2: 1 a schematic roll-up of the two opposing profile strips for deflecting the valve tappet in an injector according to Figure 78 in a functionally clarifying approach to each other.
  • Figure 91 shows a schematic longitudinal section of a mounting bracket as a rigid connection between an electrical buzzer and a ring around a metering pump as a device for mixing medication.
  • FIG. 92 shows in longitudinal section a drug-carrying bellows, which is emptied via a hose with this integrated metering pump without a special pump housing.
  • FIG. 93 shows a block diagram of a prewarning device with regard to the depletion of medication for injectors as described in FIGS. 37, 78, 82.
  • Figure 94 gives the circuit diagram for Fig. 93.
  • Figure 95 shows in longitudinal section a locking device of the drug supply until the supply is exhausted.
  • Figure 96 shows a variant of the metering hydraulics in longitudinal section.
  • FIG. 97 shows a top view above, below and in the middle a longitudinal section in section line A - B of the top view and below likewise in a longitudinal section in section line C - D of the top view a metering device which is pressurized by the electric magnet (546).
  • Figure 98 shows in longitudinal section a helical metering device similar to that in Figure 97.
  • FIG. 99 shows a metering device in longitudinal section, by means of a piezo pressure transmitter under photoelectric and switch-controlled influence control, particularly for use with a narrow outflow flow path.
  • Figure 100 shows in cross section a hose throttle valve in connection with an electronic flow measurement.
  • FIG. 101 shows in longitudinal section a dose changeover by means of a gearbox, that is to say a metering device for two medicaments by means of a motor.
  • FIG. 102 also shown in longitudinal section - fulfills the same task by means of different pulling speeds of a piezo pressure sensor.
  • FIG. 103 shows in longitudinal section in two functional stages the movement of the cannula magazine to and from the skin by means of suction.
  • Figure 104 shows a longitudinal section of two functional stages of an injection with skin lifting by plaster.
  • FIG. 105 shows the polarization-photometric metabolic control through the top of the skin raised in a suction cup.
  • FIG. 106 shows the basic experiment on influencing the conductivity of a membrane with Sepharose concanavalin A by glucose.
  • FIG. 1 shows a top view of a filled injection syringe (233), on which a clamp (227) is placed, from which contact terminals (228) emanate from the sensor covering of the cannula (326).
  • Lead wires (234) lead from the contact terminals to the housing with the measuring device (288) and the reading device (289) with printer.
  • the cable (240 connects the measuring device to the contact patch (228) for the skin, which serves as a reference electrode.
  • Figure 2 shows a device similar to that of Figure 1.
  • the injection cannula (326) -with the sensor covering is, however, within a storage potty which keeps the oppression (as was shown in Canadian Patent No.1189412 of June 25, 1985 in FIGS. 3 and 4 and in application 0 103 664 of the European application).
  • the cast lead wires (234) during manufacture lead to plug sockets (235) in the cover.
  • the valve pin (229) lies within its guide tube (230), which has been moved into the center of the storage pot (here in an elliptical shape, into one of its centers) and, as a further innovation, has a leaf spring resting on the suction cup edge (231).
  • This has a convex curve towards the skin and is attached in the center to the valve pin, the pointed end of which is at a distance from the stretchable cover film (232).
  • the cannula is next to the valve pin but not in projection on the leaf spring.
  • the contact patch is through the ring-shaped adhesive electrode (239) on the suction edge of the bell with its cast-in contact line (236 (236) to the socket.
  • the plugs of the lead (236) and the cable (240) to the measuring device (388) are inserted into the sockets (235)
  • Injection syringe (233) filled in this way is attached to the cannula socket, the protective film ring (237) is removed from the adhesive electrode (238) on the edge of the suction cup, and if the storage potty is pressed against the skin for injection preparation, the valve pin is raised The spring absorbs tension and finally flips upwards with its ends leaving the edge of the suction cup.
  • the valve pin is shot up explosively and breaks with the tip of the cover film (after it has been stretched out), which leads to air pressure compensation and lifting of the skin into the suction cup.
  • the measuring device (288) can also preferably be worn on a resilient link bracelet (241) and the adhesive electrode can then be replaced by a contact pad (242) below the measuring device. Similar to that of FIGS. 78 or 82, the metering device contains a pump which can be actuated intermittently by hand locking via the handle bar (180). The same is built into the hose (44) and is held by the container cylinder (19) with slotted walls by means of the screw connection (578). The medicinal bellows (731) is attached to the tank cylinder by means of a fastening ring (579).
  • the loading festigunnsring serves the compression spring (500) as a counter bearing to move the plunger (110) back and thus cause the medication to be expelled.
  • the measurement result can be awaited and also one of corrected dose calculated by a computer can be administered intermittently.
  • FIG. 3 shows the combination of the sensor and dose compensation device (ie the computer) with a commercially available insulin infusion pump (245).
  • the measuring device (288) and reading (289) and computer (246) are attached to the housing of the infusion pump.
  • the lead wires (234) connected to the parts of the sensor cannulas are insulated for a distance within the wall of the supply hose (236) and then with their own insulation to the sockets (235) in the housing of the control unit (175).
  • FIG. 4 shows in longitudinal section and on the right in cross section the detail of a cannula connection piece in connection with a hose coupling piece.
  • the cannula connector (47) is in close contact with the plug cone (570) of the supply hose (236).
  • the retainer clip with the sliding contact (254) inside has not yet snapped into the annular groove (581) towards the cannula, from which contact with the cannula shaft (79) is made via the wire (577).
  • the cable (240) leads a distance from the sliding contact, isolated in the wall of the supply hose, to the measuring device.
  • Another wire leads from the sensor covering through the cannula shaft to the internal contact (253) inside the bore of the cannula socket. There it comes into contact with the conductive surface of the plug-in cone and thus via the lead wire (234) with the measuring device.
  • a measurement value storage device is preferably useful for the device according to FIG. 3 in order to display the behavior of the measurement values when the device is lightly loaded by the device for the patient for the doctor by a display device (255) in numbers and possibly as curves on a screen do.
  • FIG. 5 shows the block circuit diagram of such a device.
  • Process hardware was used as hardware controlled system described in order to store and evaluate measured values and to take account of self-indicators and key parameters of the system itself.
  • the core of the system is a CPU.
  • EPROM / ROM is used as the firmware for the operating system
  • RAM is used to store non-volatile but variable data (e.g. master parameters) as an intermediate value memory.
  • FIG. 6 describes the basic structure of a circuit which is able to store measured values at regular time intervals (for example of 15 minutes), which are read out by a processor system with suitable interfaces.
  • Measured value recording During the last measured value reading process, all memories and the address counter are set to "zero". The first timer pulse describes the current measured value in the memory cell of the address (000) and increases the address counter by one via the clock input. The second timer pulse repeats this procedure with the next address (001) etc.
  • Figure 8 shows in natural size, with the exception of a shortening of approximately 40 mm, the housing cylinder with the discharge hose, bellows and receiving pipe socket for the insertion cylinder in longitudinal section.
  • the device is particularly suitable for operation by means of a continuous suction source. Water jet pumps or vacuum cleaners can serve as such.
  • the housing cylinder (701) with the base ring (702) carries the pipe socket (703) with the bayonet groove guide (704) for fastening the insert cylinder (FIG. 9).
  • the bellows (705) is included means of a holder ring (706) screwed tightly to the base ring (702) and by means of the fastening ring (707) to the piston (708), the guide sleeve (709) of which prevents tilting.
  • the sliding tube (710) in a loose sliding fit, which is sealed by screwing to the tent-like membrane (711), which is screwed tightly to the piston (708) by means of the ring (712).
  • the sliding tube (710) continues at the top in the discharge hose (713), which lies in spirals under the cover cap (714) thanks to the pre-tensioned tension and leaves this to a water jet pump or another suction source via the mounting bushing (715).
  • the trigger tube (721) for the valve tappet with seal also slides into a sliding fit through a peripheral hole, which slides slightly under spring pressure for better air flow as an octagon in the capped valve bore.
  • the channel (722) leads laterally out of the valve bore to an upwardly open slot in the guide sleeve (709) in order to let the outside air in through the cap bore (722).
  • Figure 9 shows the insertion cylinder in longitudinal section. (724) with a shoulder for the seal (725), the two bayonet pins (726) and the suction cup opening (727) downwards.
  • the sliding sleeve (728) is arranged, which is pressed by the weak compression spring (729) against the iron plate (730) glued onto the insertion sleeve. while holding the syringe (233) up on its flange.
  • the often unnecessary cover cap (732) for the suction bell is made of rubber-elastic material, while the remaining parts - apart from the sliding tube (710) and trigger tube (721), which can also be made of metal - are expediently made of a little fragile acetate plastic, Delrin or the like are made.
  • a sliding contact (254) in the insertion cylinder is directed against the cannula shaft, a contact spring (576) against the cannula connection piece of a suitably contacted sensor cannula. (Instead of the conductive coating on the plug-in cone (570, as in Fig. 4), the outer surface of the needle hub is conductive).
  • the lead wire (234) and the cable (240) connect the injector to the measuring device.
  • the syringe is filled from the bottle in the usual way, then provided with the sensor cannula and inserted with the tip forward through the opening in the iron plate (330) of the insertion cylinder so that the flange of the syringe cylinder is inserted through the oval Hole (see Fig. 10) of the iron plate.
  • the syringe insertion cylinder is inserted with the syringe plunger down into the pipe socket (703) of the housing cylinder - the syringe is then rotated axially on the plunger by approximately 45 ° to prevent it from falling out.
  • the suction injector is best constantly connected to a permanent suction source, for example a water jet pump, as shown in FIG.
  • a conically widened end of a water hose is preferably shortened until it can be pushed tightly over the part of the household tap with the outlet opening, where it is clamped by means of a band clamp (738), which holds the holding arm (739 ) wearing.
  • the tube (743) of the water jet pump can be inserted into this at any height and clamped using the wing screw (742). Since the mouth of the jet pump can be aligned as desired and the water jet is first passed through a Verwirbelungsvorrich device (744), the tap can be easily used, air being sucked in through the nozzle (745) with the discharge hose (713).
  • the patient has to take the injector hanging on a hook or on a shelf from the drape and point the suction cup against any part of the body (as long as it does not prove unsuitable for the injection due to its sensitivity and nature, such as the skull area , Anus and palms or palms) after he has opened the tap and thus actuated the jet pump according to the arrangement of Fig. 12.
  • the suction then lifts the skin into the suction cup and holds it there, then the membrane (711) with the smooth-running sliding tube (710) and finally the piston (708) with the bellows (705) and thus initially the In the injection syringe (233) pressed against the compression spring (729).
  • the syringe plunger is lowered to the stop and the syringe is emptied.
  • the carrier ring (716) carried by the piston (708) whose magnetic pins are attracted by the iron plate (730), which favors the raising of the trigger tube (721) and thus the opening of the re-ventilation valve, so that the outside air can penetrate through the channel (722), which means that the vacuum under the membrane (711 ) the syringe lifts under the action of the compression spring (729) while the skin retracts from the suction cup, while bellows with piston (708) continue to be held down by the magnetic force.
  • the patient can determine this when the housing cylinder (701) is transparent or through the side longitudinal slot (733) in this case, if necessary, by touching it with his finger before placing the injector. If the screwing of the insertion cylinder (724) is loosened while turning the pins (720) in the bayonet groove guide (704), the iron plate (730) moves away from the magnetic pins and the bellows expands again due to its inherent elasticity, and the check valve is opened his compression spring closed.
  • FIG. 11 shows part of a device similar to that of FIGS. 8 to 10, which shows a variant of the re-ventilation valve and its automatic operation.
  • the housing cylinder (701) is separated by a gap (746) with a wall bevel in an upper and lower part, which are held together by the fastening sleeve (747).
  • the piston (708) is connected to the bellows (705) and contains in its central bore the sliding tube (710), which has a notch (748) at the top and the inner lumen of which continues upwards into a small bellows (749). This in turn continues into the discharge hose (713), which is sealed in the cover plate (749) by means of a fastening bushing (715).
  • a transverse bore of the piston (708) two pins (750) with rounded end caps are slidably mounted, whose elastic sealing caps (751) within the bores (752) can cover the edges at the entrance to the smaller bores (753). Channels (722) lead from the smaller bores (753) upwards for re-ventilation.
  • the lower end of the sliding tube (710) widens and extends to a pot (754).
  • the bellows (705) is relaxed, the small bellows (799) stretch, the pins lie inward over the wall slope of the gap (746) during the upward movement within the depth of the notch (748) and the sealing caps (751) become the small holes pressed tight.
  • the piston (708) can sink under suction; after contact with the cover plate (30) of the insertion cylinder, the pot (754) and thus also the sliding tube (710) is raised, the bevel of the notch (748) pushing the pins (750) outwards, precisely at the stage of the piston lowering , in which their ends fit into the gaps (746) of the
  • FIG. 13 shows a longitudinal section of an injection device which, by means of a CO2 pressure gas capsule (256) via the gas jet pump (257), generates the negative pressure for the suction bell (173), which is maintained there by the check valve (323).
  • the compressed gas is removed via the mandrel (258) with a channel, which is tightly screwed to the valve block (259).
  • cover bridge (260) two coupling valves connect to the valve block, then a control shaft with cannula magazine (262), a front and rear metering spindle (263) with thread for the associated metering nuts (264) - as shown in Fig.
  • the separating piston (275) between the medicinal and auxiliary liquid has the wax jacket (276) and ends in the hook-shaped outlet pipe (277) which extends laterally and extends from below into a bore in the cannula magazine (316). Insert part and device part are screwed together using the fastening spindle (279).
  • the spring-loaded ring (281) on which the pipe socket (282) with the hinge joint (322) can act by means of a rotary movement of the holding arm (341) with the hinge joint (322) for the suction cup cover (342) serves to tighten the counter nut (280) .
  • the angle arm (283) with power transmission between the locking bar (283) in the control shaft and the is used to determine the metering pump Above the cylinder of the pump housing (111) against the compression spring (284) displaceable sliding cylinder (285) which is guided in the outer cylinder (286). In incisions in the locking bar, the wedge (287) for the dose change and the holding slot for the pulling loops (288) are pivotable about a longitudinal axis. Since after the lip seal (290) a pipe-like tube (289) expanded like a pipe is brought into contact with the end of the used cannula by means of the holding arm when the lid is closed.
  • the compression spring (291) for the cover slide (292) and the receptacle sleeve (293) for the bag (256) with the Hi 1 fs liquid From the gas channels, one can see the cross channel (294) after the external sense valve - which is described in more detail in Figure 19 - which is behind the blocking ball of the check valve (295) via the channel (296) through the cannula (297) within a stopper membrane in the carrier sleeve (293) leads into the gas storage space (429) of the insert part.
  • the channel (299) leads to the gas jet pump (257) via the check valve (298) arranged parallel to the check valve (295), which continues the compressed gas line via a nozzle into the hose connection (431) to the end of the cannula magazine.
  • FIG. 14 shows a partial cross section through the injector according to FIG. 1 along the section plane A - B there.
  • the elliptical suction cup (51) with the central pin (433) and the cannula magazine (316) inside the step syringe cylinder (272), the outer cylinder (286) of the dosing pump for the auxiliary liquid, the dosing spindles (263) with dosing nuts (264) and the locking bar (283).
  • Figure 15 shows in cross section in the section guide A - B of Fig.19 the ceiling I slide (292) with its compression spring (291) and the bolt (449) of the flap hinge.
  • Figure 16 shows a liquid section in longitudinal section tion device in the approach of the slot to the cover bridge.
  • the liquid outlet opening (442) in the top-ventilated intake cylinder (443), which is closed by the spring-loaded sliding sleeve (444), corresponds to the liquid inlet opening (262) in the valve tube (273) of the stepped syringe cylinder (272).
  • FIG. 17 shows a cross section of the gas jet pump (257) with the gas inflow channel (446), the suction nozzle leading to the suction bell and the so-called non-return valve (448).
  • FIG. 18 shows the cannula changing mechanism on the right in longitudinal section on a scale of 2: 1.
  • the grid ball (432) is pushed by the central pin (433) into its bore (434) inside the receiving cone (435) for the housing (575) of the insertion part through a side slot in the cannula magazine and into the middle notch (436) of the cannula body.
  • the latter can only be lowered via the gas pressure, which is dammed up behind the cannula magazine for a short time, when the central pin is fully raised.
  • Its lateral flattening (437) allows the grid ball to withdraw from the cannula.
  • the cannula descends to the spring-loaded pawl (438).
  • the central pin If the central pin is lowered again, it displaces the grid ball again, since it can move into the upper notch of the lower one and into the lower notch of the upper cannula. If the pawl in the lid is actuated by the switch pin (356), the cannula can be transferred from the lip seal into the cannula damming tube. Since a slight lifting of the central pin when the lid is closed again allows a gap in the central pin to pass through the grid ball, the subsequent cannula is deeper.
  • the tubule (439) in the cannula body comes up in the same position the pawl is in register with the drug outlet opening (440) from the syringe.
  • the illustration on the right in cross section shows the oval shape of the cannula and cannula magazine (262) and the lip seal (441) above the locking mechanism described for the central pin (433)
  • FIG. 19 shows the flap hinges with the flaps (shown in broken lines) on the front on a longitudinal section near the surface.
  • a rectangular slot (452) is left in the center of the flap to allow the metering nuts to move freely.
  • the "lock valve” is shown on the left in a lower level.
  • the gas channel (294) from the CO2 compressed gas capsule leads into the overpressure chamber (455), which is closed by the large valve plate (456).
  • a small valve cone sits on the narrow-ended pin in front of a stop plate (457). The pin continues in the slider valve cylinder (458) and has a ping groove.
  • the gas from the overpressure chamber (455) is introduced laterally into the slide valve cylinder and, after the cap pin (461) has been lowered, is passed on via the annular groove to the transverse channel under the action of the wedge bevel of the slide (462).
  • gas accumulated in the overpressure chamber which allowed the large valve plate to be pushed open by means of the pressure plate.
  • the closed flaps (445) with the app hinges (450) are shown, the support arms (463) of which touch and the left of which the bolt (449 ) wearing.
  • the open flap is shown in dashed lines on the left.
  • the trigger (469) has the profile nose (470) for engagement in the notch of the locking bar (283). to which it is pressed by means of the leaf spring (471), whereby it can be rotated about the axis (472). On the right you can see the return spring (472) of the stud carrying the nub spring, which is secured against rotation by the guide pin (473) sliding in the slot.
  • the carrier plate (474) transmits the movements of the central pin (433) to the half-channel (475), which is adjacent to the outer cylinder (286) and is divided into two legs, to the cover slides.
  • the connection tab (476) which is vertically displaceable relative to the central pin, is shown for the rotationally secured fastening of the metering spindles (263).
  • the partial cross-section under Figure 20 makes the position of the parts even clearer.
  • Figure 21 shows the trigger for the liquid injection in detail on a 2: 1 scale.
  • the support of the profile nose (470) on a projection of the locking bar (283) is shown in cross section below.
  • the overhaul spring (477) which is sliding against the fork opening (483) (as shown in a view in the direction of arrow A to the right and rotated 90 degrees below).
  • the trigger slide (484) at the end of the central pin causes the upper one to be raised Wedge bevels against the overhaul spring, the evasive movement of the trigger (469), whereby it lies with its fork in the notch (485) under the influence of its leaf spring (471). If the central pin returns against the skin after the injection, the upper bevel of the notch (485) pushes the overhaul spring back and the trigger slide can overtake the trigger within the fork opening (483).
  • Figure 2 shows in a vertical section through the control shaft - which forms the space between the insert part and the metering pump - above the trigger on a scale of 2: 1 the mechanism for the metering stage selection. It can be seen that the pin (468) for switching the dosage can be raised with its bearing bush on the locking bar (283), while the counter pin (499) is fixed with its stronger compression spring. On the cross bolt (501) it can be lowered in the guide of the wall slot (500).
  • the pin (468) moves downwards under the action of its spring and the N-opposing spring (467) causes an axis pivoting of the switching cylinder and thus also the one at an angle due to its movement within the link guide (72) of the switching cylinder (which was drawn out on the left) attached to this wedge for dosing.
  • the change of the dosage level selection can thus be carried out without triggering the dosage.
  • FIG. 2 shows the control arms extending from the half-channel and the cover slide with counting and locking device in partial representation in longitudinal section and in the representation in the middle in the transverse direction cut and under this in a top view.
  • a vertical section is shown on the right.
  • the end roller (486) of the control arm of the central pin acts on the wedge bevel of the slide (487) when the same is lifted, displacing it to the left.
  • the spring-loaded locking pin (488) takes the valve opening slide (489) with it, which lowers the cap pin (461) by means of its wedge bevels and thus opens the valves after the CO2 gas pressure capsule.
  • the profile guide (490) of the cover plate (492) by deflecting the guide pin (491) for the raster pin, causes it to be displaced against its spring. This unlocks the two sliders (487, 489) from each other.
  • the edge rod (493) emanating from the central pin has a lateral switching knob (494) which, when raised, comes to rest for a stroke in an incision in the valve opening slide and thus its return movement under effect the compression spring (495) prevents.
  • the cover slide is only activated when, by lifting a dosing spindle (263) because of the connection of the same, the cross pin (266) has been raised via a locking step in the oblique slot (267) via the connecting bracket (476) (Fig. 13, 19).
  • the connecting strap but also the trigger rod (60) of the ventilation valve (324) attached to it is raised against its suspension and the suction bell is re-vented.
  • FIG. 24 shows the counter mechanism for the number of doses in longitudinal and above in cross section.
  • the stick (502) which extends from the half-channel in the extension of the central pin, actuates the counter transport by lifting the pinion (504) within the switching socket (503), the four switching cams (505) of which are guided within the four axial control grooves (406) become. Raising and lowering cause equal rotation of the high and narrow gear (507), which protrude from it onto the flat and wide gear 508), which serves as a counting wheel and carries a number scale.
  • the counter wheel is mounted on the pin (512) with a fine thread, which is gradually raised in its threaded bushing until the cam (509) - after emptying a cannula magazine - hits the locking pin (511) on the locking slide (510) sprung to the left
  • the lock can be released by pressing the same (after renewing the cannula magazine). If the insulin supply is exhausted, the cam (509) hits the locking bar (513) on the locking slide.
  • the lock is released by unscrewing the large gear (508) using the socket wrench (514).
  • the number of revolutions takes place according to a table attached to the device, to which the number of uses is assigned to the height of the two adjustable insulin doses.
  • Figure 25 shows in longitudinal section on a scale of 5: 1 the mechanism of the counter transport with pinion (504), switching cam (505) on this, switching socket (506) and small gear (507).
  • Figure 26 gives a 5: 1 scale of a winding of the inside of the switching socket (506), the arrows indicating the path of a switching cam (505).
  • Figure 27 shows a longitudinal section on a scale of 1: 1 Cannula magazine (262).
  • the cannula damming tube (289) at the bottom has been schematically and dashedly converted into one that returns used cannulas to the magazine.
  • a magazine cross section within the upper magazine sheet on a scale of 5: 1 with a flattening continues to the right in the sheet and shows in longitudinal section the position of stacking cannulas with a curved back (515), which is also shown in cross and vertical section.
  • the pressure spring (516) by thinning the magazine wall, causes the pressure against the medicine outlet opening.
  • FIG. 28 shows a metering pump in a longitudinal section on a scale of 5: 1, in which the drug flow is from bottom to top.
  • a pump can be used in devices according to FIG. 13, but also according to FIG. 78 or 82. It consists of an outer bulb (518) which is sealed against the cylinder (519) by means of the seal (517); further from the inner piston (520), which is displaceable in the inner bore of the outer piston and can be closed against the conical bevel (523) by means of the sealing ring (521) by lifting the inner piston on the piston rod (524).
  • the cross-sectional view to the right of the longitudinal section shows the liquid passage channels (525, 526).
  • a protective cover film is first pulled off over a slide-in part, which is replaced as a whole. Water is conveniently poured past the CO2 gas pressure capsule from a prepared syringe.
  • the insert part is then placed under the cover bridge (260), the fastening spindle (279) is inserted into the wall channel (460) of the insert part (see Fig. 14) and this is screwed to the device part when using the holding arm (341) as a lever arm.
  • the dosage levels are now set on the dosing screws by height adjustment on the spindles under comparison with a scale - for example for morning and down.
  • the compression spring (284) is tensioned by pulling down the drawstring (288) with inserted fingers.
  • the piston (168) is lowered and fills with auxiliary liquid from the bag (272) via the feed line (528) and the slide valve (Fig. 13). If the flaps (445) are pressed together, the cover slide is moved to the left against its compression spring (291).
  • the piston of the slide valve (265) is lowered and the discharge channel (529) to the syringe barrel Approved. Via the sockets (235), from which the lines (364) to the sliding contacts (584, Fig.
  • the connection to the measuring device follows first.
  • the counter wheel for the function lock after cannula or insulin reserve exhaustion must be turned back, otherwise the movement of the central pin in the switch socket (503) is blocked (Fig. 24).
  • the suction cup cover (342) is swiveled away, the last cannula closing the magazine - a shaftless cannula body at the beginning of the magazine - is removed via the cannula damming tube (289). If the suction cup is pressed against the skin, the slightly protruding central pin is raised before the suction cup edge is touched and the gas flow to the gas jet pump (257) is released.
  • the grid ball (527) returns to the flattening of the central pin (Fig. 18).
  • the cannula thus comes in deeper under the influence of the influence of the gas line between the back cheg valve (295) and the sealing body (585) at the end of the cannula magazine and the skin, the previous Broken cavity connection is restored between the cannula shaft and the medicine outlet opening (440).
  • the central pin which can take place on the slide (487) due to the special nature of the wedge profile design (Fig. 24) without resistance due to the skin being raised, the latter actuates the trigger (419, Fig. 20, 21).
  • the sliding cylinder (285) is moved by means of the compression spring (284) together with the piston (268) on its piston rod (524) as far as the wedge (287) comes to its stop. the dosing nut (264).
  • the auxiliary liquid is brought via the slide valve behind the separating piston (276) and with it also displaces the medication located underneath, which empties into the tissue via the cannula.
  • the conical narrowing of the syringe barrel is selected so that it abrades the wall of the wax jacket (276) compensates without any liquid transfer. Because of the higher viscosity of the auxiliary liquid, in the event of an accident, medication would rather be pushed up into the medicament than the auxiliary liquid downwards.
  • the play of the dosing spindles on their connecting plate (476) was included in the dosing distance. When the dosing spindles are raised, the slide valve is also raised and its cross pin extends beyond the short vertical distance in the oblique slot (267).
  • the sliding coupling tappet and the actuation of the ventilation valve (324) allow the sliding coupling (269). It is caused by the right movement of the cover slide under the flap opening. If the patient wants to make a dose correction after reading the measurement result by turning the dosing screw during skin contact, he keeps the two flaps pressed together until he wishes to be re-vented.
  • FIG. 29 shows a longitudinal section of an electrically operated injector with step syringes for two different medicines.
  • the two stage syringe cylinders (272) are inserted into the container cylinders (820).
  • the separating pistons (275) lie above the medicinal liquid, above them inside protective bellows (854) and the threaded spindles (856) are secured against rotation. Be shifted in height. the latter by the internal thread of the small gear wheels (839), which are driven by the large gear wheels (859) via the electric motors (855).
  • the cover plate (819) holds the gear wheels on the housing. While these motors are behind the cutting plane, the stepped syringes continue with their own cannula connection piece in the suction cup (173).
  • the pressure contacts must be closed in order to Switch on the compressor (830), which is located behind the suction bell.
  • the contact rods (858) for the cannulas are actuated by plugging them onto the respective cannula connection piece.
  • the central sensor pin (829) conveys through contact with the lift what initiates the injection process. It is generally sufficient to choose a type of earth fault contact here, without additional effort for a switch actuation.
  • the switching wheels (832) for preselecting the dose are arranged on both sides of the switch housing (839) with the control unit.
  • FIG. 30 shows a top view of the injector of FIG. 29.
  • the fastening screw and holder (878) can be seen. You can also see the switch button (864) for motor return to raise the threaded spindles before removing the syringe barrel, the program changeover switch (864) and the pressure switch (874) for the ventilation valve (875) with the ventilation channel (870). The location of the bat t er ie (845) is also given.
  • FIG. 31 shows a circuit diagram in TTL for FIGS. 29 and 30.
  • Section (A) designates the energy supply, (B) the selection of the dosing program, (C) the check of the start requirements, (D) programming of the dosing, (E) the recovery the starting conditions.
  • one of the contact rods (858) is actuated and the associated contact is closed and compared in part C by means of the two AND gates (1) TTL SN 7408 and the. EXOR gate TTL SN 7486. From there, the line leads to the AND gate (2) TTL SN 7408, which interrupts the circuit to the 830 compressor.
  • the flip-flop TT1 SN 7474 switches via the Transi. stor (1) the compressor (830) running in reverse, ie sucking. There is now a vacuum in the suction bell in the suction bell, the skin is lifted into this and in turn actuates the contact rod (829) and thus the NAND gate TTL SN 7400 from position low to high.
  • the stepper motor is closed via the NOR gates TTL NN 7402
  • the cam contact (856, 856) - shown in Fig. 29 - is actuated with every revolution of the metering wheel (859,859) and leads to the TTL SN 7490 decimal counter.
  • the counter is compared with the pre-selection switch using the TTL SN EXOR gate 7486 with assigned diodes IN 4148 until the current flow is switched from high to low at point E. From low at E the counter gate is set to zero via AND gate (3).
  • the compressor is switched off via the AND gate (4) and the flip-flop is tilted into the rest position via the AND gate (5).
  • the solenoid ventilation valve (368) is actuated by means of transistor (4) via monoflop TTL SN 74121 using the transistor (4), air entering the suction cylinder.
  • the air inlet into the suction bell can also be released via the ventilation duct (870) by actuating the pressure switch (874) by manually opening a seat valve.
  • FIG. 32 shows in longitudinal section a variant of FIG. 29.
  • the structure of the device is as follows:
  • the square shafts are located between the end plate (2) and the intermediate wall (884) of the housing (1) (885,886) in their bushings (887, 888, 889, 890).
  • the square shafts are secured against falling out by clamping rings; the shaft (885) is connected to the drive shaft of the electric motor (855) and this in turn to the compressor (830).
  • the first large gear wheel (893) sits on the square shaft (885) and is carried by it, the other gear wheels run on the bearing bushes except for the last large wheel (815), which is attached to the square shaft (886) and now slows down transfers the rotary motion to the metering disks (816,, 325).
  • shifting pinion (800) which can be moved on the square shaft (886), which through the bearing bush (890), which also acts as an S tappet sleeve while being fixed by a pawl (801) which engages in an annular groove, here in a drawn position in engagement with the inside toothed socket (802).
  • This socket is firmly connected to the metering disc (816), the rollers of which act on the medication tube and its disc bearing by means of its rollers and can displace the medicament to the associated cannula attachment nozzle. If the plunger of the axle beech (890) is pressed, the shift pinion moves to the right and comes into engagement with the internal toothing of the shift socket (820), which is firmly connected to the metering disc (325).
  • the metering takes place under control counting via the switch cam (856) and the electronic control unit (175).
  • the sealed housing is connected to the suction bell via the suction channel (809) and has the ventilation nozzle (869).
  • Start lever (803) and plunger sleeve (890) are sealed to the housing by bellows.
  • Spring-loaded contact pins (858) are located next to the two cannula connecting pieces.
  • the sensor (829) is located between the cannula connection piece and is actuated by the skin pulled up by the vacuum. There are three release pins (853) near the edge of the suction cup to start the engine.
  • the program is selected via contacts, which are activated with the end positions of the plunger sleeve (890). The energy supply is not shown.
  • Figure 33 shows a simplified electronic circuit diagram.
  • the specified voltage should be at the contact points labeled 5 V and the voltage of the switch-on reset at the contacts labeled R.
  • the wiring has been omitted, as have the diodes against the reverse currents.
  • the manual actuation of the switch-on reset after setting the program preselection switch for dosing causes the voltage 5 V to be slowly built up on a capacitor in order to bring the circuit into the zero position.
  • the bistable relay bie B is on program I or II and can be changed manually using the program change button.
  • the pressure contact (858 or 858) is closed by placing the cannula on the cannula attachment cone and compared in part C using the two AND gates (1) TTL SN 7408 and the EXOR gate TTL SN 7486.
  • the line leads from there to the AND gate (2) TTL SN 7408, which interrupts the circuit to the compressor (830). If the AND gate on the suction cylinder is closed three times (by placing it on the skin), the flip-flop TT1 SN 7474 switches on the reverse compressor, that is to say suction, via the transistor T (l).
  • the counter is compared with the pre-selection switch using the TTL SN 7486 EXOR gate with the assigned IN 4148 diodes to the point E the current flow is switched from high to low. From low at E, the counter is set to zero via AND gate (3).
  • the compressor is switched off via the AND gate (4) and the flip-flop is tilted into the rest position via the AND gate (5).
  • transistor (3) ensures that the bistable relay does not change its switching position when the device is switched on and off using button 821.
  • Figure 34 shows a side cross-section of a medication pressure bottle, the upper wall boundary of which is drawn into the bellows (831) in such a bowl-like manner that the bottle neck together with the hose (44) wrapped around the hose attachment nipple (838) fits into the bowl recess (822), which fits the Stacking of such bottles allowed.
  • a clamp closure (823) prevents the medication from escaping into the tube under gas pressure in the bellows.
  • FIG. 35 shows, in a lateral longitudinal section, a variation of the container consisting of a less elastic outer shell (827) which is filled with compressed gas. In its. Inside there is another membrane-like container (408) with liquid, which is only emptied through the hose (44) when the clamp closure (823) is removed.
  • FIG. 36 shows a schematic top view of a suction injector as a preferred embodiment of the invention.
  • the cannula magazine (262) which is designed as a spirally wound hose, the storage of stacking cannulas of two different constructions is shown in longitudinal section.
  • the cannulas mentioned, which allow an automatic cannula change, are described in more detail in FIGS. 48, 49).
  • the dosage is intended for two drugs, programmed and correctable depending on the measurement results.
  • the cutting planes for the following figures are given.
  • the banderole (400) corresponds to a magazine end before use.
  • FIG. 37 shows the suction injector in longitudinal section A - B of FIG. 36 with the suction bell cover already open before use.
  • the suction cylinder (301) with the sealingly ground suction piston (302) in its interior is held at its lower edge by the bottom cylinder (303) and at its upper edge by the cylinder (304) for the tensioning piston (405).
  • the tension spring (306) which extends between the suction and tensioning pistons and is attached to them, is in the tensioned state.
  • the suction piston is in the vicinity of the annular piston (307), which is somewhat displaceable along the central pin (308) fixed on the bottom cover of the bottom cylinder and whose concentrically arranged permanent magnets (309) which are fixed in the form of a pin on an annular skirting board on the bottom cylinder with one fixed iron ring (310) there in contact.
  • the upper ends of the permanent magnets (309) are embedded in a soft iron ring (311), which is tightly attached to an elastic-membrane septum (312).
  • This septum airtightly divides the cylinder space into a larger upper and a smaller lower part and is interrupted by the sliding check valve (323) in its supply line. the sand filter (393) is inserted.
  • the septum is also sealed around the central pin by screwing.
  • the central shaft has a spindle-shaped swell at its end with a flat curve rise at the top and a steeper slope at the bottom.
  • the spiral spring (325) acting inwards with its Kraftwir direction just lies against the lower portion of the curve, and the screen angle (327) is locked by its compression spring in a slide of the sleeve (369) which is attached to the suction piston.
  • the central telescopic tubes (328) between the suction and tensioning pistons are pulled apart.
  • the central locking plunger (329) is down after its spring has been extended drawn. As a result, the locking members (330) cannot withdraw from the niche slope of the roof attachment (331) under the action of the tension spring (306). The downward movement of the tensioning piston is therefore blocked.
  • the tappet of the ventilation valve (324) with the sand filter (393) is pressurized from the ring piston.
  • the suction cup (351) is arranged within the guide cylinder (313) against three compression springs (354) so that the movement downwards is limited by the raster spring (353) for cannula control by means of the switching knob (355) of the switching pin (356) becomes.
  • An elastic sealing sleeve (352) is stretched between the lower edge of the suction bell and the guide cylinder.
  • the suction bell also contains the downward one funnel-shaped opening (359) for the switching pin, the guidance of which with a certain elasticity of the holding arm (341) for the suction cup cover the vertical approach of the
  • Receiving tube (358) allowed for changing the cannula.
  • a small tube (459) which can be displaced against a compression spring on this receiving tube has claws (361) which act on the cannula by means of slits in the receiving tube at its lower end.
  • spring claws (360) originate from the ends of the receiving tube, which, after pushing back the spring-loaded tube (459) by pressing against the central holding tube (314), latches into the ring groove of the cannula last used after this had been depressed in the cannula magazine due to the momentary retrieval of the raster spring (353) by the switching pin (356) under the influence of the compression spring (Fig. 36).
  • the lowering of the tube (459) when closing the lid also causes the un cannulas inserted in the receiving tube are pushed further down by the claws (361).
  • the switching knob (355) passes through the raster spring (353), whereby the next cannula in the cannula magazine can step deeper. This then lies with the lower edge of her body of the detent spring, while the annular groove (381), which is in hollow connection to the cannula shaft, comes to rest through the bore in the cannula magazine for the angling (340) of the medication tube.
  • the previously used cannula is removed with the lid opening lying in the receiving tube, where the spring claws (360) prevent it from falling out.
  • the bayonet coupling (362) can be seen on the holding arm (341) under the suction bell cover (342).
  • FIG. 38 shows a schematic longitudinal section along section line C - D of FIG. 36 to supplement the device structure.
  • Zy cylinder (304) for the tensioning piston (305) this has been depressed under the influence of the tension spring (306).
  • the suction piston (302) in the suction cylinder (301) is in turn engaged by the spiral spring on the central pin (308) and under the action of the permanent magnets at the bottom via a septum with a check valve (323) and an annular piston (307).
  • Down in the insertion cylinder (334) are the two dosing devices (337, 338), one of the two elastic tubes with the bend (340) is recognizable.
  • FIG. 39 shows a schematic plan view of this suction cup cover (339).
  • a winding of the tube of the cannula magazine (316) can be seen above the insertion cylinder.
  • the tubes with the bend (340) enter the suction bell through the sealing sleeves (370) next to the central holding tube (314).
  • a slide is shown as a lock (357) for the suction cup roof.
  • FIG. 40 shows in a schematic longitudinal section along the section line E - F on FIG. 36 the position and function of the parts for the preparation of the suction pump function by pivoting the suction bell cover by means of the holding arm (341). Immediately before the injection, this was swiveled out of the position (shown in broken lines) with a suction cup cover closure by 180 degrees around the hinge joint (322) to cover the suction cup in continuation of the functional stage shown in FIG. 37.
  • FIG. 41 shows a partial representation of the functional stage after the injection and after the tensioning piston has been reset.
  • the suction cup cover (342) is still folded away.
  • the suction piston (302) was brought closer to the upstanding tensioning piston under the action of the tension spring (306).
  • the locking plunger (329) was raised under the action of its spring, so that the locking members (330) dodged into the ring notch of the locking plunger under the action of the lower wedge in the recess of the roof attachment.
  • the compression spring (332) was able to relax by pushing the tensioning piston (305), which had already been depressed under the influence of the suction piston and the tension spring (306), completely downwards by means of the Bowden cable in the casing (345) .
  • FIG. 42 shows the schematic functional sequence for the suction piston tensioning mechanism at the stage when the suction bell cover closes.
  • the tensioning piston ((305) has been pulled up on its bracket (531) via the strong Bowden cable in the sheath (346) while stretching its string-like end (348) into its upper latching position when the cover is closed.
  • the tension spring (306) was tensioned in the process
  • the Bowden cable in the casing (344) was relaxed and the lower guide piston (349) was lowered with the relaxed compression spring, whereby the upper guide piston (350) was also pushed down by the Bowden cable in the casing (345) in the cylinder tube (319)
  • the extended telescopic rail (343) can serve to extend the holding arm (341) for closing the suction bell cover .
  • Figure 43 shows in longitudinal section a detail of a variant of the trigger mechanism for the suction piston, which makes it possible to avoid the septum and the movable ring piston.
  • a plunger (406) is sealed by a bellows, which engages on the left with a notch in the suction piston (305)
  • the bending spring (325) in turn, brakes the upward movement of the suction piston under the action of the tension spring (306) on the piston-like expansion of the central pin (308).
  • the ventilation valve (324) is opened by resting the suction piston against the spring-loaded valve tappet and thus also connecting the suction bell to the outside air via the duct (532) via the sand filter (594).
  • the bore for the check valve (323) runs parallel to the tappet (406). If the suction cup is lifted, its trough (365) in the area of the tappet tip, which enters into this under the action of the wedge bevels of the notch in the lifting suction piston. Now the suction bell is locked, the vacuum that forms in the suction cylinder when the check valve (323) is opened and sucks the air out of the suction bell through the air duct (533). The ventilation valve (323) has closed and is only opened again by returning the suction plunger with ventilation of the suction cylinder via the electromagnetic valve (not shown), while the re-ventilation via the air duct 533) is until then closed by the check valve (323).
  • FIG. 44 shows schematically a longitudinal section through the detail of the suction cup area of a device and the function of refilling a storage container for medication in a device according to FIG. 37.
  • the central holding tube (314) is pushed down in its seal (534) in the suction bell cover.
  • the medication supply tube in question is pulled at its bend (340) out of the bore of the central holding tube and inserted into a bore of the socket (535), while the other bore of the socket is connected to the medication supply tube of the new storage container by inserting the cone at the end the hose (44).
  • the two metering pumps are shown in a longitudinal section in FIG. 45.
  • the medication tube (44) leads from the storage bag (408) to its sack-like extension between the pump cylinder (111) and the metering pump pins (337, 338) and continues into the tube with an angled bend (340), which via the transverse bore in the central holding tube (314) connects to the cannula shaft via the cannula body.
  • the arrangement of the liquid pumps (409, 410, 411, 412)) can be seen in FIG. 46, the enlargement on a 5: 1 scale allows the construction of a metering pump according to FIG.
  • Three ring-shaped notches each represent a metering chamber (416) on the pump pin.
  • the hose ring (415) assigned to this is fixed in height in a trough-shaped bulge in the axle bushing (116).
  • the hose ring inflates, it displaces the liquid from the metering chamber and its surroundings and then blocks the liquid flow, whereby it lies against the groove edges.
  • the liquid flow to the cannula leads via the channel (417).
  • the liquid pump in FIG. 46 represents a variant. Only one of the three liquid pumps for the auxiliary liquid assigned to a hose ring is shown.
  • the lifting magnet (413) and the return spring (414) act on the bellows (418) after the adjacent pulse sequence, which leads to the injection at I, while a medication return is effected at II.
  • Fig. 47 shows two liquid pumps for actuating a metering pump as double-acting piston-cylinder pumps in conjunction with a solenoid (413) and return spring (414), the two cylinder ends being connected to at least one hose ring (415) via hose connections stand.
  • the middle hose ring is connected to each of the two opposite cylinder ends by a hose.
  • Fig. 47 also illustrates the pump function. In the basic position A, both pistons are lowered under spring action. The top hose ring is relieved of liquid, while the lower and the middle hose ring are inflated by excess liquid. In position B the top magnet received an impulse, which inflated the top hose ring and relieved the middle one.
  • both magnets are excited, which relieves the pressure on the lower hose ring and inflates the other two.
  • the pulse sequence -, + -, ++ has the effect that a certain quantity of medication goes from top to bottom The cannula is displaced and the liquid flow is blocked.
  • FIG. 48 shows a 3: 1 enlargement of a stacking cannula (318) made of rubber-elastic material such as Perbunan. Special sealing elements, in particular around the medication inlet channel or in the cannula magazine, are not required for their use.
  • the upper and lower chamber are connected to each other via an articulated waist.
  • the upper chamber for receiving the shaft of the attached cannula can be designed to be relatively narrow, since bends in the magnesium tube are compensated for at the waist.
  • the silver-plated strip (382) extends from the bottom surface to the cannula shaft as a conduit.
  • the enzyme coating (383) is indicated on the cannula shaft.
  • the cannula bodies can be glued together at their edges before use, which guarantees sterility of the cannula shafts.
  • Figure 49 shows another stacking cannula in longitudinal section.
  • the cup-shaped cannula body (317) is divided by a partition (318) into a lower chamber for fastening the cannula shaft (379) in its base plate and into an upper chamber for receiving the cannula shaft of the subsequent cannula.
  • the upper chamber is closed off by a membrane (380) drilled in the center.
  • the cannula shaft bends at an angle to an annular groove (381) surrounding the cannula body, into which it opens.
  • the annular groove has a steep surface at the bottom, which holds the claws (361) of the cannula receiving tube, and gently slopes upwards to facilitate the transport of the cannula downwards, the claws having to leave the annular groove.
  • the distance of the annular groove up to the same has a strip with silvering, while the cannula shaft itself is platinum-plated in order to pass on weak currents to the contact spring in the central holding tube for the cannula magazine without voltage distortions.
  • the cannula body is made of cast plastic material such as polyvinyl chloride. The required ring seal within the central holding tube (314, Fig. 37) was not shown.
  • the enzyme coating (383) is shown.
  • the current is transferred via the silver chloride-silver layer of the detent spring (353) for changing the cannula, while the undersurface is electrically insulated to prevent skin contact.
  • a contact gel as is customary with cardiac current leads, is necessary in order to ensure the comparison electrode for measurements from the silver-plated edge of the suction cup.
  • a ring-shaped adhesive electrode (Fig. 94) that glues on both sides can also be used, which is glued to the edge of the suction cup and is well conductive to the silver layer.
  • FIG. 50 shows the variation of a lowering cannula in oblique view at the top in longitudinal section and at the bottom in cross section on a 5: 1 scale.
  • the cannula shaft is ground behind the area of the still closed tip (541), so that the cannula bore as a trough (542) would be open.
  • the shaft wall was closed to the cannula shaft by the plastic insert (543) with insulation zones (544).
  • FIG. 51 shows a different variation of the sensor cannula in longitudinal section and below in cross section.
  • an almost capillary thin tube (545) or a thread Inside the shaft there is an almost capillary thin tube (545) or a thread, the surface of which can have sensor properties.
  • tissue fluid can also be caused by the capillary effect (or can be sucked in by suction from the drug supply tube) for the determination of the measured value.
  • FIG. 52 shows a longitudinal section through the shaft end of a cannula, in which the wall in the tip region is thinned from the inside and coated with the sensor covering (383), so that the latter cannot be stripped off when the skin is pierced.
  • the stability of the cannula shaft is maintained by the thicker part.
  • a wire (577) for current dissipation can be seen inside the shaft.
  • FIG. 53 shows in longitudinal section a sensor cannula similar to that of FIG. 50. However, a tube (545) or thread with sensor properties is inserted into the open recess (542) of the shaft.
  • an electrolyte-containing gel with sugar-specific adsorbent as doping was provided as a coating for changing the electrical conductivity on the platinum cannula in connection with the measuring device (e.g. the adduct Sepharose -Concanavalin A from the Pharmazia FreiburgBreisgau).
  • FIG. 54 shows a photometric version of the sensor cannula, for example for glucose determination, the light source (560) and the optical detector (561) and the cannula being shown in longitudinal section.
  • the cannula attachment piece (47) which surrounds the cannula shaft (379), at least one fiberglass thread (885) leads later in the clearing of the shaft (379) to the cannula tip, which is applied with an indicator layer (886) under curvature or inclination. At least one other fiberglass thread runs back from that indicator layer through the shaft.
  • the contact ring (587), from which fiberglass bundles lead to the light source with polarization filter (583), and others lead back to the detector, lies around the end of the medicament to be supplied with the cannula attachment cone.
  • the attenuation of the returned light signals can be evaluated according to a calibration comparison to the measured value.
  • Two fiberglass threads can also lead to two indicator layers of different quality and back, the latter possibly being sensitive to different measuring times for different concentration ranks.
  • Such optical indicator layers for glucose determination are, for example, paper impregnated with glucose oxidase and peroxidase, to which 3.55.5 tetramethyl 1-benzidine-dihydrochloride or 4-aminoantipyrine dihydrochloride and sodium 3,5-dichloro-2-hydroxy-benzenesulphonate is added as colorant.
  • Figure 55 shows a longitudinal section of a sensor cannula, in which instead of a color indicator, a crescent-shaped mirror (588) is attached in the tip area of the interior of the shaft (the mirror can consist of evaporated silver, which is coated with silicon dioxide to protect it against oxidation).
  • the mirror can consist of evaporated silver, which is coated with silicon dioxide to protect it against oxidation
  • the free light beam to the mirror is shown in dashed lines, where it is reflected back through the tissue fluid from the other side of the mirror and a fiber of the optical fiber bundle meets the detector.
  • the rotation of the plane of polarization by the glucose is evaluated in the computer Figure 5.6 shows another embodiment of the invention according to Figure 55.
  • the light rays are emitted from the sparkling wine disc (589) directly through the center bore of a stacking cannula (317, for example) in the cannula shaft projected in and received from there again in the device part and forwarded to the detector in optical fibers (885).
  • the cannula bore is closed at the bottom by the window membrane (590), which allows the light rays to pass through, but not the medicine.
  • the latter is injected laterally from the annular groove (381) from the medication outlet opening (440) through the holding tube (314).
  • the centering cone (594) is pulled out of the central bore by lowering the sector disk (589) and the passage of the next cannula to the medication outlet opening is released by pivoting about the (only indicated) axis in the manner of a transport carousel (211).
  • the mirror (588), like that of FIG. 55, is vapor-deposited from silver or aluminum.
  • FIG. 57 shows in a side view and below in a cross section a part of the switching rings for the electronic programming of an injector as described in FIGS. 36-44.
  • the individual parameters such as tissue sugar values or insulin quantities for dosing can now be recognized in their respective target or actual values, displayed and evaluated arithmetically. In practice, 20 switching steps already seem sufficient.
  • the hourly intervals with a break between 0 and 5 a.m. (whereby a day-night reversal can be compensated by changing the timer), with the tissue sugar levels in mg /% 20.30.40 ... to 100, then 120, 140, 160 ... to 300, then 350 and 400, switching levels 0, 1, 2, 3 for the insulin quantities in units 4,8,12 ... 80 and for the multiplication constants (K1 for depot insulin and K2 for altinsulin). to 19.
  • Protruding edges (376) make it easier to turn the shift rings and prevent over-turning in one direction.
  • Adjacent switching rings, which are functionally assigned, can each have a pin (377) with a hook-like bend, which abuts against the edge (376) and thus causes the switching rings to be carried along automatically.
  • FIG. 58 shows a table with the compilation of example programs and their effects on insulin treatment. They were patients with morning insulin doses in the lowest to the highest doses corresponding to a very different response to this therapy. No determinations were made about the schedule, the tolerance range of the target sugar levels was set at 90 - 120 mg% with an ideal value of 120 mg%. The measured actual values for glucose are also simplified with one time 180 mg% and another time with 50 mg%. Only the correction factor K2 for depot insulin was varied according to the estimate and a correction with old insulin was not included. the columns of the dose correction, which is carried out by the computer, are shown for clarification.
  • FIG. 44 shows such a functional overview, from which any trained specialist can easily derive an electronic block diagram.
  • the functional organs with rectangles and circles such as timer (386), suction cup (173) with cannula in the earth fault through the skin pulled up by means of negative pressure, reminder and warning device (387) with the functions of acoustic and optical signal and vibrator to show the To facilitate operation for the disabled (all separately on hand switches 1/0), the electrical measuring device with the measured value display and printer (389), measuring display and printer for dispensing insulin units (390) and for old insulin units (391) as well as the metering pumps (337, 338 ).
  • the setting ranges of the switching rings can be found above it in rhombuses, and the measurement data of the actual glucose values and their arithmetical processing in rhombuses and rectangles with broken lines.
  • the timer gives the respective time of day via line (a) to the alarm clock for comparison.
  • a computing element determines how much time before the alarm time and afterwards a signal from the measuring device (388) towards the pumps via line (b) takes effect.
  • the path of line (d) from the cannula to the measuring device (388) and its display and printer is always clear. If the measuring device fails, the patient can still call up a standard dose via hand switch (390) in line (c).
  • the set wake-up time is shown on line (e) the warning device (387) activated. If the planned time for treatment has already been exceeded, the follow-up program is selected; this is also possible if program I is switched off on the hand switch (391). If program II is also switched off by hand, there is no dosing.
  • the amount of the deduction of depot insulin units is determined by arithmetical determination of the deviation from the ideal value and multiplication by the factor Kl determined by removing the lower rhombus from the standard dose, and after deduction from the Standard dose according to line (k) are made via line (l) display, registration and dosage.
  • Altinsulin delivery is switched off via line (m).
  • the line (s) leads to the activation of the program for the old insulin, whereby any preprogrammed administration of old insulin according to the arithmetical comparison between excessive value and target or ideal value after multiplication by the factor K2 over line (p ) is encouraged to register and dose.
  • the addition is made via line (q)
  • the program is reserved so that it can be recalled and used within the time limits programmed there using the warning device.
  • the electromagnetic valve at (368) is opened for re-ventilation. Revitalization also takes place via line (v) after measuring the tissue sugar level alone without delivering insulin (for example outside the specified time limits or at the patient's will).
  • the patient can use the pressure switch (392) to interrupt the course of the command in the direction of the injection after the skin has been sucked in during the measurement. If he lets go of the pressure switch after taking note of the measured values, the fuel is injected (somewhat delayed).
  • Additive counting of the quantities delivered by the individual pump controls the medication consumption and can be queried via the lines (w, x). After pre-programmed volume consumption, registration and alarm are carried out via the lines (r, s). The cannula consumption is also reported and registered via a counter after contact counting at the contact (392) in the area of the suction bell according to the actuation by the switching pin (356) via line (t).
  • the invention is based on the following writings and the literature drawn therein:
  • the patient can add additional insulin for injection, either pulse-wise or intermittently, if he carries it out the next minute after the command.
  • the doctor can limit the absolute amount of the total replacement dose within an already restricted scope.
  • a special switching ring is provided for the commands limiting a patient's choice.
  • its position means 1 blocking the automatic program (see below) for old insulin
  • 2 blocking the automatic program for depot insulin
  • 3 blocking the entire automatic program
  • 4 limiting the additional dose to 15 cycles
  • 5 limiting to 10 cycles
  • 7 blocking the additional doses
  • 8 limitation of the additional doses to 15 cycles and blocking of the automatic program for old insulin
  • 9 limitation of the additional doses to 10 cycles and blocking of the automatic program for old insulin
  • 11 blocking of the additional doses and the automatic program for old insulin
  • 12 limitation of the additional dose 15 cycles and blocking of the automatic program for depot insulin
  • 15 blocking of the additional doses and automatic program for depot insulin
  • 16 limiting of the additional doses to 15 and blocking of the entire automatic program etc.
  • a decoding disc (595) is on the device cover brought, which is expediently rotatable itself as a switching ring.
  • “Automatic program” is to be understood as the device which corrects incorrect programming for the dosage adjustments. If a correction dose is called up four times in succession in the same time block because of excessive measurement values, the depotinsulin dosage is increased by 1 cycle for the time preceding the measurement times. If the programmed correction dose reaches the set maximum value without full compensation (becomes an additional injection from the block
  • the depotinsulin dosage of the previous time block is increased by 2 cycles. The increase takes place within each block at every occasion after measurement. If the lower limit for dose correction is undershot with any use of the device, the depotinsulin doses are reduced by 1 cycle for the time block preceding the measurement time. If the lower limit for the dose stop is reached, there is a reduction by 2 cycles, insofar as the supplementary program in the past two hours
  • the patient's involvement is required to activate the automatic program for the old insulin.
  • the program key (597) is pressed, the time block allocation is overridden and block V is selected if no depot insulin injection has taken place in the last 6 hours.
  • the patient should eat a meal with 3 bread units of easily absorbable carbohydrates about 15 to 20 minutes before the button is pressed and is asked to carry out the control measurement within 15 to 20 minutes after the altinsulin dose, the amount of which corresponds to the pre-programmed correction program. If the measured (actual) value exceeds the ideal (target) value by more than 40 mg%, the dose correction factor (K2) is increased by 1. If the actual value falls below the setpoint by more than 20mg%, the Dose correction factor (K2) reduced by 1.
  • the display prompts the patient to occasionally repeat the program test.
  • the status of the actual program setting (in any deviation from the starting position readable by the switching ring position) can be made visible on the assigned display fields by a slight rotary movement on the switching rings.
  • the doctor can make the changed program values visible through the switching ring position by resetting the switching rings after resetting to the zero position (with simultaneous actuation of both contact pins on the switch strip (371) arranged, the extent of mobility is limited by the locking pin (275), which extends from the edge ring into a slot on the carrier ring, to a distance below the distances between the individual locking steps of the ball grid (373)
  • a shaft top of the inner profile of the switching ring hits the contacts (598, 599) of a contact strip on the housing.Cylinder (315) and closes the contact to the control unit when the knurled ring turns.
  • the return spring (600) between the edge ring and the switching ring interrupts it again.
  • the main program (HP) loop queries whether the cannula has skin contact (1) so that a measurement (6) can begin to determine whether the wake-up time (2) of an active time block has been reached, so that the user (by wake-up signal) Attention must be drawn to whether the user wishes to shift (8) the time blocks (3), whether (4, 5) one of the storage containers has been replaced, so that the storage counter is set to the value of a new container (9, 10) got to. (Fig.60)
  • Fig. 61 Figs. 62-65 are a refinement of block (6).
  • the position of the program selector is queried if a decision has not already been made on the same day. If the measured value is not within the tolerance window, the insulin doses are corrected (27, 28). If the measured value is exceeded, function blocks 27, 31 to 35 follow. In addition, the automatic program for depot insulin either 29, 30 or 31 to 35 becomes effective if it has not been blocked by a doctor (29, 31). (Fig. 63) The injection takes place after 15 s (41) if the user does not press the "Wait" button. Pressing this button (392, Fig. 59) twice (37) leads to an abort (42, 43) without injection. With the "+" and "-" buttons to make visible.
  • the edge ring (316) which is respectively supported on the switching ring (372) is rotatably arranged with respect to the former, the extent of the mobility by the locking pin (275), which extends from the edge ring into a slot on the carrier ring, a distance below the distances of the individual locking steps of the ball grid (373) is limited.
  • the sliding contact (226) on a shaft top of the inner profile of the switching ring strikes when the
  • Figure 66 shows in longitudinal section an example operated with spring force, in which a hose roller pump is used as a metering device.
  • a housing cylinder (1) On the housing cylinder (1) is on the closing plate (2) on the fastening tongue (3) Be a mounting plate (4) as a counter bearing for an interchangeable cylindrical vacuum reservoir (5).
  • the latter has a membrane cover (6) around the cannula opening cone, which is located in the center of the pin (7) and continues in the cannula shaft with its free end (8), which is surrounded by the ring coke (9).
  • the boundary membrane (10) divides the potty into the vacuum storage space (11) and the suction bell (12) and has the predetermined breaking grooves (13).
  • the support ring (15) On the fastening plate (4), the support ring (15) is fastened via four screw pins (14).
  • the base plate (17) is fastened by means of the plug lock (18), which plate carries the container cylinder (19) with a side slot for the Introduction of the medicine storage bag (20).
  • a cam engages in the longitudinal groove (22) of the sliding sleeve (23) from the base plate in order to rotate it. prevent.
  • a driver pin of the metering disc (25) causes its rotary movement in its spiral groove (24).
  • the drive of the metering disc (25) by moving the sliding sleeve is transferred via the pipe segment (29) to the disc with the latch (30) and to the coil spring (31).
  • the latch (30) acts on the locking gear (32) on the Rohrmanschet te (33).
  • the pinion (34) attached to the latter actuates the counter, whereby it engages in the ring gear of the counting wheel (35), which lies behind the image plane and is held by means of the pressure spring (36) against a support plate (77) on the housing cylinder.
  • the compression spring (39) of the support wall (37) is based, cause frictional contact with the Pinion the rotation of the counting wheel (38), whereby an armature on the support plate (77), via the actuation by a switching pin on the counting wheel (35), only allows rotation by one of 100 teeth on the counting wheel (38) after the respective counting wheel 35) made a full turn.
  • one of the spring-loaded pins which has a different center-to-center distance, engages in a bore of the pinion and also blocks the rotation of the metering disc (Fig. 68).
  • the force of the spiral spring (31) is transmitted to the carrier disks (40) for the axes of the two rollers (41).
  • the latter are pressed against the hoses (44) by two balls each in tubular bushings (42), the fluted ring (43) serving as a counter bearing.
  • the latter has a gap at the bottom for the passage of the two hose legs.
  • the hoses up to the T-piece (46) with the cannula attachment piece (47) are covered by an expansion-resistant jacket (45).
  • Tension springs (48) stretch the hose ends where they come out of the pump.
  • the pump unit can be moved along the sliding sleeve on the pipe sleeve (33) against the compression springs (49).
  • the pins for this purpose which extend from the carrier disks (40), are not shown in the associated transverse slots in the pipe sleeve).
  • the sliding movement is effected by four vibrating pins (50), which are arranged on an annular prism profile on the outside of the carrier disc (40) (Fig. 8).
  • the vibrating pins are embedded in the disk (51), which can be rotated independently of the pipe sleeve and engages with a cam in the spiral groove of the axle shaft (52).
  • the foot plate (53) At the free end of the axle shaft is the foot plate (53), at the other end a Nockensti ft (53) which engages in the longitudinal groove of the sliding sleeve and prevents the axis rotation.
  • the spiral spring (55) serves to drive the disk (51).
  • FIG. 67 shows in cross section along the line A - B of FIG. 66 the mechanism of the metering adjustment.
  • One of the spring steel tongues rests on the trigger pin (28) for dosing after it has passed the wedge profile bar (56) of the triggering mechanism for re-ventilation (Fig. 69).
  • Two of the spring steel tongues shown are in a kind of blind zone of the rotating sector of the metering disc (25), as it results from the need to support the coil spring on the housing cylinder (1) and from the possibility of producing the grooves in the sliding sleeve (23).
  • FIG. 68 shows in cross-section along the line C - D the dose counter, which indicates the drug consumption, and the blocking device for preventing injector use after the drug supply has been exhausted.
  • the pinion (34) for driving the counting wheel (35) is fastened on the tubular sleeve (33).
  • a cam pin (180) on this actuates the spring-loaded locking armature (57) after each revolution, which causes the large counting wheel (38) to rotate further by a tooth width under the influence of the friction of the recoilable pins by means of leaf springs.
  • FIG. 69 shows in a tangential cut along the line E - F of FIG. 66 the triggering mechanism for the re-ventilation and for the dose delivery after the shaking process.
  • the spring steel tongue (27) has overcome the wedge piece of the wedge profile bar (56) at the time shown. The latter was returned by the compression spring (64).
  • the slot guide (65) with the grooved pins prevents it from sliding sideways under the action of the leaf spring (63), which allows the locking rack (62) to engage in the locking teeth of the small gearwheel, causing it to rotate.
  • the turning of the large gear (58) connected to the small gear causes its saw teeth to engage the push pin (59) in a groove of the trip bar when the trip bar is raised (as shown).
  • FIG. 69 To the right of Fig. 69 is enlarged to a scale of 2: 1, part of the disk (51), which carries the vibrating pins, is drawn out in detail to represent one of the four openings (67) into which the round tip of the release pin (28) is located could avoid the influence of the inclined position of the spring steel tongue in order to be returned to the surface of the pane via a slope after the steep flank. In this way, the movement of the metering disc was released up to the stop of the next spring steel tongue.
  • Figure 70 shows a simplified cross section along the section line "G - H of Fig.
  • FIG. 71 shows in cross-section along the line J-K, in which the center of the vacuum storage container towards J is included, the mechanism for triggering the vibrating device and the triggering mechanism for re-venting the vacuum storage container.
  • the support ring (15) is designed here as a variant of a guide cylinder leading upwards to facilitate the introduction of the vacuum storage pots and has a lateral slot (68).
  • the flattened ramrod (69) extends through this. In the figure, the broad side is shown, with the lower edge of the wall of the vacuum storage potty (5) resting, while the probe angle (85) extends to the rear (which is why it is shown in broken lines according to its later position).
  • the ramrod continues into the drum (71) via the passage (70). This points the recessed link guide (72), into which the fixing bolt (73) of the end plate (2) protrudes.
  • the bearing for the drum is omitted for the sake of clarity of the drawing, as is the mounting of the grid wedge (75) for blocking the vibrating pins (50).
  • a cap (76) resilient around a hinge is placed on the grid wedge, which allows the vibrating pins to pass when the disk is turned to the right to tension the coil spring (55), but not when it is turned to the left.
  • the grid wedge has an oblique slot (77) for receiving a wire bracket (78), the square axis of which can be rotated within the articulated bore (79) of a slot in the spring-mounted retaining bolt (80).
  • the release notch (86) in the shaft above the drum is turned according to the position of the fixing bolt in the link guide from the transverse stem (87) of the grid wedge, which increases when the drum is raised with its rotation along the backdrop. If the vacuum potty is pushed all the way up, the stylus swivels by 90 degrees and comes to rest on the edge of the pin (7) in order to lie on the cannula shaft. This prevents the drum from lowering. The ramrod also rotates and is now turned on its narrow side to the side of the wall of the potty to lower past it.
  • the trigger mechanism for the re-ventilation consists of the trigger rod (60) with its compression spring and the rotation-preventing bridge bridge (88) between the mandrel (89) guided in a bushing and the fastening underneath the drum (71).
  • the push rod (59) is not yet in the locking position within the release rod (60).
  • FIG. 72 shows in cross section along the line L - M of FIG. 66 the position of the hose (44) between the rollers (41) and the grooved ring (43).
  • a section through the metering disc (25) in the direction of the arrow shows its profile cavity for. the receptacle of the two hoses.
  • FIG. 73 shows the vibrating mechanism of FIG. 66 in a roll-up, four vibrating pins (50) on the disk (51), with their rotation relative to the spline profile (56) of the metering pump, causing their jerky displacement against the pressure springs (49).
  • the plug lock (18) is pulled.
  • the axle shaft can be pulled out of the sliding sleeve.
  • the injector is dismantled into a right half with end plate (2), mounting plate (4) and Sehraubsti ften (14) together with the support ring (15) and the pump unit including the grooved ring (43) can be removed from the pipe sleeve (33) .
  • the medicine storage bag (20) is inserted through the slot in the container cylinder (19).
  • the latter with its attachment, belongs to the left half of the injector, which must be approached again by plugging the parts together.
  • the locking pin not shown, must be inserted into its longitudinal slot in the pipe sleeve (33)).
  • the cannula socket (47) is inserted through the hole in the mounting plate, and the plug lock (18) is closed. The dosage is then preselected by slightly lifting the spring steel tongues (27) and rotating them into the spaces indicated by numbering between two clamping pins (26).
  • the spring steel tongues rub elastically evasively thanks to the inclination of their ends over the end of the trigger pin (28) and the Keilpro filleiste (56), whereby the spring steel tongue for the first dosage then pushing back the keel profile bar in front of the trigger pin is locked by the latter.
  • the Keilpro fil bar can only be moved after the release rod (60) is raised and the notch of the movement of the push pin releases the movement of the large gear (58). This is done after inserting a pressure pot by lifting the ramrod up to its rotation by 90 degrees via the link guide (72) on the drum.
  • the notch (86) overtakes the transverse pin (87) in order to finally stand above it on the shaft above the drum.
  • the support ring (15) is placed on the skin for application, the same is lifted when the pressure is exerted on the projecting ring piston (9) until the ringed predetermined breaking lines (13) of the boundary membrane (10) break while the suction cup rim is already covering the skin Suction cup closes.
  • the negative pressure effective from the storage space lifts the skin into the suction cup, but at the same time the pen approaches the cannula shaft (stripped of its support) of the skin (Fig. 89). However, this also reduces the feeler angle (74) and the release notch (86) into which the cross pin (87) can move (Fig. 71). This takes place under the thrust effect of the vibrating pin lying against the cap (76).
  • the wire bracket (78) under tension of the retaining bolt (80) then penetrates into the oblique slot (77) and causes the raster wedge (75) to return to the locked position before the passage of the next shaking pin.
  • the trigger pin (28) passes over the steep flank of the opening (67) in the disk (51), as a result of which the locking of the spring steel tongues (27) is released for a short time and the injection is initiated.
  • FIG. 74 shows, in a highly schematic manner on a scale of 2: 1, rollers (41) acting in pairs against one another, the outer counter-rollers (90) in this example only being moved passively freely, which is facilitated by their rubber-elastic surface.
  • Two rollers each are attached to a common swivel arm (91) by axles, the drive being carried out via a pinion running on a larger gear (92).
  • Figure 75 shows in natural size a schematic roll-up when looking at a metering pump (approximately in the direction of the arrow on Figure 74). It is demonstrated the possibility of hose routing in the case of a pair of hoses using pairs of rollers as in FIG. 74, specifically by the lateral outlet of the two hose legs, which rest firmly on the carrier disk (40) in that there is a type of gear between them, between them Tooth notches stretch rope-like bridge threads (94) between the two hoses (44).
  • FIG. 76 shows a variant of the example in FIGS. 66 to 75, the deviation relating to the type of starting mechanism for the metering.
  • the schematic drawing The upper part of a vacuum storage container again has an elastically closed window (85) in the rigid lid membrane. According to the rotational position of the fixing bolt in the guide of the drum (71), the ramrod (69) points with its broad side towards the wall of the potty and has lowered past it.
  • the bellows (96) which is stationary as a result of the axis (95) relative to the drum is fastened to the gallows (97) together and parallel to the pneumatic cylinder (98), the piston of which also represents the plunger of the push valve (99).
  • the slide valve which is open to the outside air, is connected to the bellows via line (100) and an open check valve. Via a closed check valve, the line (101) leads from the bellows into the pneumatic cylinder, which is connected via the line (102) to the opening of the pushing valve just closed here.
  • the current position of the slide valve follows from the lifting of the valve joint with the elastic membrane of the window (85). It was raised because pressure equalization during the skin lift in the suction cup weakened the negative pressure that drew up the membrane. If the charging pin is lifted when a new potty is inserted, the bellows is compressed by the air escaping through line (101) and the pneumatic piston being actuated.
  • FIG. 77 shows in a highly schematic manner in the functional stages A - D a variation of the mechanism for re-venting the suction bell, as is expedient for devices which, like that in FIG. 76, cannot be re-aerated by the destruction of the lid membrane of a potty.
  • the slide valve (99) can be moved as a whole on a rail (103) against the compression spring (104).
  • the valve tappet (106) with wedge profile for example by actuation a spring steel tongue (27, Fig. 66) has a separate compression spring (105).
  • the ventilation hose (107) leads from the slide valve into the suction cup space, which is easiest to do if the suction cup is part of the injector (Fig. 78).
  • a rocker-type locking slide (108) is actuated along a backdrop on the valve lifter. In stage A, the valve lifter is on the left and the slide valve is closed and left-handed for the state during the injection. In stage B the slide valve is shifted to the right and still closed. In stage C, the slide valve is still held in the right position by the locking slide, while the valve tappet is moved to the left under the action of its spring and is thereby opened. During this sliding movement of the valve tappet, the return movement of the slide valve as a whole is triggered by its spring (104) by actuating the locking slide. In stage D, the state of stage A is restored.
  • Figure 78 shows a longitudinal section of an injector, the metering pump of which consists of a pot-shaped elastic sleeve (109) which is immovably mounted on a plunger (110) which has a groove-like groove on its surface for the passage of the medicine.
  • the plunger is supported with its lower end inside the cannula attachment piece (47) with its upper end in the neck end of the pump housing (111).
  • the plunger ends at the top in a plate (112) drilled through for the passage of medication, which expands the hose (44) at this point, which bridges the distance between the medicine storage bag (20) designed as a bellows and the neck closure of the pump housing.
  • the sleeve (109) is directed with its cavity against the ring plate (113) fastened to the pump housing.
  • the latter continues in a downwardly conically tapered elastic and centrally pierced stopper (114).
  • the plunger carries the annular valve plate (115) below the plug.
  • the pump housing is inserted into the central axle bushing (116), around which the parts for the actuation of the pump are rotatably arranged, and which extend outwards continues in the housing cylinder (1).
  • the wheel (117) is mounted on a ball bearing, with its upward annular Kei lprofilance (56), which is similar in function and design of the vibrating device in Figures 66 and 73.
  • the latter transmits the impact movements of the rollers (118) onto the plate from above.
  • the ring plate (124) is also firmly connected to the axle bush. On a ball bearing, this rotatably connects the wheel (125) with a spline, which is directed downwards. against this, three rollers are directed on the outer cylinder (126), which is vertically displaceable against the subsequent inner wall of the housing cylinder.
  • the compression spring (127) acts against its ring plate and is supported against the bottom of the housing cylinder (1).
  • the wheel (125) is composed of parts of different 'edge diameter. The upper part carries a ring of ratchet teeth on the outside, in which the latch (128) engages.
  • the latter is attached to the narrow-ring disc (30), which can be rotated around the outer surface of the ring plate (.124). About the bridge angle (129) this rotation of the spiral spring (31) is communicated, which can be tensioned without the wheel (125) being rotated. After the reversal of movement, the spiral spring movement is shared by the pawl the wheel (125) and by this over the between wheel (125) and wheel (117) attached Cylinder segment (130) with the two wedge profile.
  • the pendulum movement of the outer cylinder (126) is transmitted from below to the plate (112) via three U-brackets (131) mounted in bores in the axle bushing.
  • the Be 1969erzy cylinder (19) is screwed onto the mounting plate (4) with an internal thread and carries a guide bush (132) for the square rod (133).
  • the lower pinion (134) attached to this engages in the correspondingly designed ring gear of the lower part of the wheel (125), while the upper pinion (135) is displaceable on the square bar and between the protruding disks (136, 137) of the cover (138 ) engages in the ring gear.
  • the lid has an external thread and is hereby screwed into the internal thread of the container cylinder (19).
  • the bore (140) serves to ventilate the interior of the container above the bellows. For the penetration of the upper pinion by d eft container r cylinder is provided in this slot (141).
  • Screw bolts (142) which can be displaced along a scale in the slots of the container cylinder allow the remainder of the medication, which corresponds to a corresponding dose level, to be determined before the start of use of a new bellows, by preventing the cover (138) from being lowered further by its stop on the screw bolt.
  • the left half of the image corresponds to the state before, the right half to the state during the use of the injector for injection.
  • the support ring (15) continues in a cylinder, which has a sliding ring (143) to the receiving cylinder (144) for the vacuum potty (5).
  • the ring (145) fastened on the intake cylinder serves to fasten the rubber-elastic sleeve (147) which carries the edge of the suction cup. It also contains the guide slots for the trigger pins (148) and is used to attach the trigger mechanism for suction on the skin. For this purpose, three locking lamellae (149) are inserted into the notch (150) of the ring piston (left side of Fig. 78).
  • the locking lamellae are moved similarly to the lamellae of the central lock of a camera from the indentation of the annular piston, which is favored by a beveling of the indentation, and the annular piston moves upwards under the influence of the negative pressure between the skin and the vacuum storage space for pressure equalization.
  • the size membrane (10) is rectified. The edge of the suction cup, which is initially pressed against the skin by the pressure from the suspension of the release pins, is raised a further distance with the support ring.
  • FIG. 80 shows the holding mechanism for the support ring (15) of the vacuum storage potty in cross section.
  • the mode of operation of the release pins (148) is illustrated in the longitudinal section in FIG. 80.
  • the control ring (154) which is fastened by means of three cap screws (155) on the ring (146) in slots, is held in the end position A by means of the compression springs from the fastening points (145) on the ring.
  • the bayonet-shaped kinked release pins (148) have a slant in the control ring.
  • the control ring is first displaced to the left in stage B while the compression springs are tensioned.
  • the control ring lies against the release pins, so that the return action of the compression springs on the release pins is not effective.
  • the first phase of their return is effected by the elasticity of the cuff to which they are attached.
  • the locking slats (149) are held against the locking function side by the cap screws (155).
  • a second axle pin (158) rotatably attaches it to the control ring (154).
  • FIG. 81 schematically shows a mechanism for re-ventilation to FIG. 78 through the hose (156). This runs in the slot (157) of the cylinder of the support ring.
  • the associated slide valve (99) is arranged by a sector th delay mechanism actuated.
  • the driver pin (163) dodges into the driver bore (160), whereby the return movement of the valve tappet remains locked until the hand lever has passed the steep flank again after returning to the O position.
  • the driver pin then leaves the driver bore thanks to the elasticity of the hand lever and the compression spring (105) can reopen the slide valve to re-vent the suction bell.
  • stage A denotes the state after the hand lever has returned and when the slide valve is open again.
  • Stage B denotes the state shortly before the hand lever returns to the O position with the slide valve still closed.
  • the square rod (133) is first detached from the lower pinion (134) and pulled out of the guide bushing (132).
  • the container cylinder (19) can now be unscrewed from the mounting plate (4).
  • the connection between the locking sleeve (123) and the elbow (122) can be released and the pump housing (11) with the needle hub (47) can be pulled up out of the axle bushing.
  • the lid (138) is screwed out of the container cylinder.
  • a new pump housing is inserted and the locking with the elbows is carried out by rotating the locking sleeve that is adhesively connected to the bellows in a thread-like manner.
  • the upper pinion (135) is pushed between the washers (136, 137) of the cover and then onto the square rod after the container cylinder (19) has been screwed back onto the mounting plate.
  • the four The square rod is inserted back into the guide bush after the container cylinder (19) has been screwed onto the mounting plate (49).
  • a vacuum reservoir is now removed from the sterile packaging and pushed into the receiving cylinder (144) by means of pressure against the bottom cover (165), guide grooves (166) ensuring the correct radial setting, since cams (167) in the guide cylinder correspond to them.
  • the release pins (148) must be pressed briefly before the locking slats pass. After the locking slats snap in, the bottom cover is removed, but in any case before the injection.
  • the slide valve is closed to re-vent the suction bell and after slightly depressing the hand lever, this is selected according to the dose to be selected when counting the locking steps of the
  • the set dosage can be checked by means of the position of a marking on the dose indicator disc on the scale on the container cylinder. If the support ring (15) is placed on the skin, it can only be lifted towards the receiving cylinder due to the otherwise jamming that occurs when the thrust direction is strictly vertical. Raising the edge of the suction cup on the cuff (147) causes the release pins (148) to be raised and thus the locking slats to withdraw from the indentation of the annular piston (9), which is lifted up with the skin. The edge of the suction cup continues to be raised until the rocker (152) is actuated and the injection is initiated.
  • valve plate (115) is removed from the stopper by lowering the tappet (110) and the edges of the sleeve (111) approach that of the ring plate (113). As the sleeve is lowered further, a certain quantity of liquid is expelled towards the cannula. Before the cuff lifts off the ring plate in the opposite direction, the valve plate has closed the plug opening again (with the appropriate roller guide).
  • Figure 81 shows a longitudinal section of an injector with an electromagnetic hose-integrated metering pump similar to that in Fig. 78, whereby a roll of tightly layered and chemical-coated film ensures a gradual release of gas in the container under the control of a pressure relief valve and thus an even medication feed!
  • FIG. 83 shows a cross section at height A - B of FIG. 82, which shows the distribution of the boilers (172) and their transverse walls (174) and the distribution of the heating wires (178).
  • Fig. 82 you can also see the loops (191) on the cannula connection piece inside the suction bell with the rubber-elastic edge and the inner lip (180), above it large (168) and small valve pistons (169) of the metering pump with plunger (110) ' and perforated plate (112) within the hose.
  • the resilient clamping jaws (171) which are moved by the spring-back lifting magnet (170), lie around the plate (112).
  • the medication container (19) is fastened via the locking bolt (195) and the locking screw (194).
  • In the cover (138) there is the pressure relief valve (181) and inside the bellows (20) with the medicine and the roller (182) for gas generation.
  • the brackets (190) serve to secure against rotation, while the switching cylinder (188) with ball bearing toward the container can be rotated with its pin according to the groove guide (193).
  • Cable connections (176) lead from the control unit (175) to the solenoid, to the heating wires, to the start contact (197) and to the sensor cannula.
  • the resistance heating wires (178) are stretched out between insulator rings (179).
  • the bellows (20) of the medicine is located inside the housing cylinder (19), which is screwed on by means of a sealed cover (138). Between the mounting plate (4) and the hose there is a seal (196) in the passage for them.
  • the bellows (20) contains in its central, bowl-shaped depression a rolled-up solid body package (182) for generating compressed gas.
  • Tension springs (183) which extend obliquely through the chambers are fastened to retaining pins of valve flaps (184) which are guided through bores in the suction bell slope. Eccentrically outside the sealing rings of the valve flaps, these are each reached by a vertical tappet (185), which is sealed in front of the switching ring (186).
  • the schematic A roll-up in the area of the switching ring (186) shows that only when all three cones are lifted by the spring-loaded release pins (148) under the action of the compression spring, a shifting of the switching ring to the left can occur.
  • the three release tongues (185) can penetrate into the elongated holes with wedge bevels while lowering the shift cylinder, causing the shift ring to rotate back against its spring.
  • the fact that the three trigger tongues and the nine elongated holes have the same spacing, but the valve tappets are arranged irregularly underneath the elongated holes - despite brief torque, it is possible to open one valve flap after the other.
  • the start contact (197) for the automatic dosing is actuated.
  • the suction bell is re-ventilated by opening the solenoid valve (368) by means of a pulse from the control unit. No reheating is required for the next two uses. Tightening the rope (139) triggers the electronic alarm under the lid when the medicine supply is almost exhausted.
  • FIG. 85 shows in longitudinal section a vacuum storage potty according to the two-chamber system, as can be used in the injector according to FIG. 78.
  • One of the three guide grooves (166) is drawn in, which, prior to passage past the blocking lamellae, forces the potty to rotate into a certain angular position.
  • the cams (167) secure this angular position in the end seat of the potty.
  • FIG. 86 shows in cross section through the suction cup area of an injector that the suction cup edge can also be cloverleaf-like in order to bring the three trigger pins (148) closer to the center of the injector without having to seal them upwards.
  • FIG. 88 shows a longitudinal section of a vacuum potty according to the single-chamber principle and a locking pin (204) which emits from the injector and whose function corresponds to a locking lamella.
  • the boundary membrane (10) is supported by the bottom ring of the Stitzzyli ders (205), which has a caliber jump inwards in its upper wall to leave space for the passage of the thin-walled bagging (206).
  • the inner edge of the base ring of the support cylinder (205), the boundary membrane (10) and the center of the base cover (165) are glued together by means of the annular welding edge (207).
  • the disposable potty includes the funnel for connection to the elastic tube (209) starting from the cannula attachment piece, which ends in a ball and to which negative pressure is transmitted through the cannula shaft.
  • the clamp (210) is raised to check for negative pressure, the ball being drawn in. After the skin has been sucked in, the clamp can be raised again to check whether the ball is filling with blood. During the injection, the clamp prevents medication from flowing into the ball.
  • FIG. 88 shows a roughly schematic diagram of a manufacturing process for a vacuum storage container as in FIG. 19.
  • stage A the potty and ring piston are injection molded side by side with the mold halves being pulled apart vertically (215, 216).
  • stage B for example, using three sector-overlapping transport carousels (211, 212, 213), the boundary membrane (l ⁇ ) produced by means of a knife cut is approached to the ring piston and welded to the ring piston using an ultrasound head (214).
  • the transport carousel (212) brings the combined parts under a printing press to attach the bottom cover (165) and then under the opening of the vacuum storage container.
  • the combined parts are placed in the evacuation chamber (217) when vacuum is generated by a compressor using the ultrasound head (218) welded in the area of contact between the boundary membrane and the edge ring (219).
  • FIG. 89 shows a vacuum storage potty of the type shown in FIG. 66 inside the sliding sleeve (23) in the state of skin suction.
  • FIG. 90 shows the profile strips (225) on the two wheels (117, 125) in FIG. 78 in a schematic roll-up, wherein they are approached to clarify their mutual functional interaction.
  • FIG. 91 shows, in a highly schematic manner, the attachment of an electrical buzzer, the warning device about the impending supply depletion, via the carrier (221) with a ring around the outlet of the two hose legs from a metering pump according to FIG. 66. With the vibrations of the buzzer, the hoses and the carrier disks (40) for the rollers of the metering pump are also set in vibration, so that the vibrating device is dispensed with.
  • FIG. 92 shows in longitudinal section a variation of the metering device from FIG. 78 in detail.
  • the hose (44) leading down from the bellows (20) extends underneath the plate (112), which is interrupted from the edge in a sector-like manner, by the plunger (III).
  • a further, stronger bulge of the hose replaces the pump housing and is replaced by the axle bushing (116)
  • the end of the plunger is formed by a valve cone (115), while a kind of bellows (109) serves as the metering chamber, and the tube at the enlarged end comprises the carrier plate of the cannula attachment cone (47), which can be added to the insert part.
  • FIG. 93 shows the block diagram of the control of the injector, as shown in FIGS. 82 and 83, consisting of a central processing unit (CPU), memory unit and input / output port.
  • FIG. 94 describes the program flow chart for a control unit according to FIG. 93.
  • Key 1 switches the contents of the supply counter to the display the first time it is pressed.
  • the safety reserve appears in the display. Only now do keys 2 and 3 have a function. Key 2 increases the safety reserve. Key 3 reduces the safety reserve of the storage container. Key 1 switches the display off when pressed three times. Button 4 is closed when changing the insulin reservoir. In the waiting position, the processor queries the four buttons and the switch (start contact 197). When the buttons are pressed, the processor operates the display and, if necessary, changes the size of the safety reserve as described above. The switch (197) triggers the injection. Then the stroke counter is loaded with the value of the dosing specification (there are, for example, memory modules for 2 to 20 piston strokes of four units of insulin each) and determines the frequency of the dosing pulses and thus the amount of medicinal liquid administered.
  • the dosing specification there are, for example, memory modules for 2 to 20 piston strokes of four units of insulin each
  • the medication tube (44) of which is located within the medication pipe (316) with the Au ring (601). This rests on the mounting plate (4), within which the transverse locking pins (330) lie on the outside against the spring-loaded locking bolts (329) with their domes, while the inner domes are locked in an annular groove of the medication tube.
  • the hose (44) continues down into the pump stem (337) with the cannula hub; in the area of the hose rings (415, Fig. 45-47) it is surrounded by the axle bushing (116) of the device tes.
  • the bellows is fastened by means of resilient louvres inside the slide-in cylinder (200) and can be detached through lateral cylinder slots. If the bellows is pushed together with it into the housing cylinder after it has been fixed in the sliding cylinder, the uncovered part of the hose around the pump pin comes into contact with the hose rings. The lock pin (330) will snap into place (as shown). After the drug is almost used up, the lower edge of the sliding cylinder lowers on the locking bolts and lowers them. The locking pins can now retreat from the annular groove of the medication tube when the cable (139) is pulled for the electronic warning device (387) and the bellows together with the tube can be pulled out again.
  • Figure 96 shows a variant of the metering hydraulics.
  • the separating plunger (275) is mounted above the medicament within a graduated syringe cylinder (272), and auxiliary liquid is stored above it, which is provided by a cover plunger (801) as a disposable part.
  • This is the device component of the support piston (802), which contains the cylinder bore with the large (168) and small (169) valve pistons, which fluid in the room with Hil emptied a hole.
  • the valve pistons are actuated by the solenoid (413) by means of the valve stem via the swivel lever (803).
  • valve lifter engages in two arms out of phase in oblique grooves (804) of a disk.
  • the latter is attached to the threaded rod (905), which is mounted in the threaded bush (805).
  • Figure 97 brings up a top view, below and in the
  • a metering device which is pressurized by the electric magnet (546).
  • This magnet sits above the short lever arms, which each belong to two plates (535) that can be folded in the hinge (547).
  • Lever arms and plates do not cross, not even at the end shown below, where the hose (44) is led out to the cannula.
  • the flap is opened, as shown, the outflow of medication is undershot due to the hose being clamped between the short lever arms.
  • plates and short lever arms cross over each other like scissors, which is why the inflow is unobstructed there.
  • the hose lies in a loop between the plates. If the plates are brought closer to each other under magnetic effect, the hose is first squeezed off at the inflow point (when the short lever arms are suspended) and then in the area of the loop between the plates. The returning hose leg is passed through the opening (549) to the outer surface of the top plate in order to avoid a flow inhibition.
  • the compression spring (549) is used for resetting.
  • Figure 98 shows the hose (44) in turns on a spiral ring which is embedded on the outside on an elastic rubber pyramid. The counter spiral is in engagement above the hose windings and is arranged within a keg-shaped cup.
  • FIG. 98 shows a further longitudinal metering device for the pulse operation. Piezoelectric pressure transmitters (564) operated with electrical voltage are mounted at the top against a fixed housing part and rest on an elastic jacket ring (556).
  • a hose friction (558), from which the hose continues via a lateral flattening of the jacket ring to a shut-off valve.
  • the latter is released at the opening of the lid of the injector in order to stop the outflow of medication even when there is no voltage in the area of the piezo elements.
  • the surface of the lens-like flattened hose friction is firmly connected to an adhesive plate (567), which in turn is fastened to the lower surface of the pressure sensor (564) by means of the locking slides (568). From the light source (560) on the left, optically conductive fibers lead through the jacket ring and are directed towards the wall of the partially transparent hose bladder.
  • light-guiding fibers (below the zone deformed by pressure) run in turn to the optical sensor (561), which is electrically connected to the control unit (175) as well as the piezoelectric switches (562, 563).
  • Command lines (555) lead from the control unit to the piezoelectric voltage-pressure transducers.
  • piezo elements Under the control of the height-adjustable switch (562), piezo elements receive voltages via their command lines via the control unit, which lead to their expansion and to the blocking of the medicinal inflow in the inflow area of the tube expansion.
  • the metering pulses are now converted into the excitation and expansion of larger parts of the pressure sensor (564), whereby the jacket ring is flattened and narrowed in the lumen and the hose swelling is reduced until the switch (563) reports the set low point of the pressure sensor.
  • the hose opens filling. Due to the sudden withdrawal of the pressure sensor, a vacuum first occurs inside the hose expander (due to the greater inertia of the fluid dynamics). The decrease in density and its disappearance due to the filling is reported back to the control unit via the optical sensor and the next dosing pulse is directed to the pressure transmitter before medication can flow freely from the medication container to the cannula.
  • the outflow speed can be regulated by the speed of the connection of individual sections of the pressure transmitter (as a data word in the control unit) (or distribution of the pressure effect on the time curve).
  • the outflow channel is particularly narrow (as it is aimed at in favor of a pain-free injection), the arnei release (in slow cycles) is initiated before the measurement of the metabolic parameters is completed. A certain base rate is then already applied before the further delivery is possibly interrupted according to a calculated correction.
  • FIG. 100 shows a rough schematic of the connection of a throttle valve (565) shown in cross section to a control unit, which is at the same time designed as an inductive flow meter and accomplishes the valve control in accordance with the flow rate reported via the measuring electrodes (566).
  • a throttle valve 565
  • FIG. 101 shows in longitudinal section a switching device from one metering device to another when only a single motor is used.
  • the electric motor (855) has a central bore in its drive shaft (603) for receiving the shift rod (604).
  • the force transmission bushing (605) acts only clockwise to convey the ratchet gear (607) via its pawl (606).
  • the ratchet wheel is firmly connected to the shift pinion (800) which can be freely rotated around the bearing bushing (887).
  • the gear wheel (859) is driven by the shift pinion on the threaded rod of a step syringe (for example), since it engages with it.
  • the ratchet gear (608) is permanently mounted on the shift rod and is driven by the pawl of the small power transmission bush (609) when turning to the left.
  • the movement of the ratchet wheel (608) is transferred to the drum (71) with the link guide (72) in which the fixing bolt (73) causes an increase and decrease on rotation.
  • This axis shift is transferred to the shift pinion and determines its position in relation to the gearwheels.
  • the motor only needs to turn half a turn through S tr om to perform pol un g. This means a considerable saving in space and weight.
  • FIG. 102 a device for changing the dose when using magnets or piezo pressure transmitters as a metering drive is shown at the top in a side view and at the bottom in a plan view.
  • the pivotably arranged cap (613) stands above the spring-loaded plunger (614), the spring lifting the plunger against the hose extension in a metering chamber after each pump cycle. He stays in contact with the cap. However, if a rapid pull impulse from the pressure transducer comes into effect, the cap leaves the tappet and a spring tensioned by means of a pressure lever (616) transports the cap by swiveling the plunger of the other dosing device.
  • Figure 103 shows in longitudinal section a variation of the mechanism for the vertical movement of the cannula magazine before and after the injection in the two functional states A and B.
  • the cannula magazine (316) can be easily moved together with the central holding tube without a seal in a socket of the suction cup cover.
  • the end of the central holding tube widens to form an annular plate (536) which is sealed to the suction cup roof by an elastic membrane (537).
  • Stage A shows how the skin was pulled up into the suction cup under the influence of suction and at the same time the ring plate (536) was lowered so that the skin and cannula meet.
  • FIG. 104 shows in longitudinal section a variation of an injector, in which a jacket (538) for protecting the cannula is present instead of a suction cup.
  • the jacket is designed as an ellipse, in one center of which the central holding tube (324) is arranged to be vertically displaceable, while in the other center a central pin (433) carries an annular plate (536) which has a bore for the passage of the central holding tube and the like Provided with a double-sided adhesive film (539).
  • the central shaft (similar to the example in Fig.
  • FIG. 105 shows a longitudinal section of the skin raised into a suction cup by means of negative pressure, polarized light being thrown through the top of the skin onto an opposite detector. The measured values determined in this way could be used for dose correction.
  • FIG. 106 shows the basic experiment on the left in a side view and on the right in a top view, which was commissioned to change the electrical conductivity at boundary membranes.
  • a filter paper was clamped onto the electrolytically defined silver chloride-silver plate in the side seal and Sepharose-Concanaval A was filled in between.
  • the other side of the membrane was rinsed with saline of various concentrations and measured against the calomel electrode (611). 600 V alternating current was used and significant differences in measurement results were confirmed.

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  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

Une cannule qui, en raison de sa conception et lors de son utilisation avec un dispositif de mesure permet, avant ou pendant l'injection par succion de liquides dans le corps d'un patient, de déterminer et d'enregistrer l'état d'échange de matériaux, principalement pour les personnes souffrant des reins et surtour les diabétiques. L'idée essentielle de l'invention concerne un injecteur qui, après ou pendant la détermination des sucres tissulaires, établit un rapport entre les valeurs mesurées et un dosage préréglable, et une correction de dosage; de plus, le cas échéant, l'injecteur règle automatiquement la programmation du dosage - au cas où des corrections fréquentes seraient nécessaires. Ce processus a lieu principalement dans un injecteur à succion qui attire la peau dans la cannule par suite d'une dépression et qui, en réglant le retour de l'air dans la cloche de succion détermine, de manière précise, la durée de mesure et d'injection. Mis à part l'arrangement de la cannule du détecteur en ce qui concerne sa forme, sa localisation et le type d'enrobage utilisé pour le détecteur ainsi que les sondes de mesure électrique ou optique, la particularité de l'amélioration apportée à l'injecteur à succion concerne sa maniabilité, son utilisation aisée et sa capacité de répondre aux exigences. Le type de système utilisé pour créer la sous-pression, le dosage et les caractéristiques des systèmes de contrôle du fonctionnement sont choisis de manière à atteindre ce but.
EP19850904428 1984-09-07 1985-09-07 Dispositif d'injection avec detecteur Withdrawn EP0213139A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE3433365 1984-09-07
DE3433365 1984-09-07

Publications (1)

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EP0213139A1 true EP0213139A1 (fr) 1987-03-11

Family

ID=6245150

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Application Number Title Priority Date Filing Date
EP19850904428 Withdrawn EP0213139A1 (fr) 1984-09-07 1985-09-07 Dispositif d'injection avec detecteur

Country Status (4)

Country Link
EP (1) EP0213139A1 (fr)
JP (1) JPS62500429A (fr)
IN (1) IN165367B (fr)
WO (1) WO1986001728A2 (fr)

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EP0221005A3 (fr) * 1985-09-07 1987-12-02 Wagner, Wolfgang, Dr.med. Dispositif d'injection avec capteur
DE3713846A1 (de) * 1986-03-20 1988-04-14 Wolfgang Dr Med Wagner Einrichtung zur saugdiagnostik oder sauginjektion
EP0301165A3 (fr) * 1987-03-10 1991-05-02 Wagner, Wolfgang, Dr.med. Dispositif pour le métabolisme
GB2222251A (en) * 1987-09-08 1990-02-28 Wolfgang Wagner Device for metabolism control
US5536249A (en) * 1994-03-09 1996-07-16 Visionary Medical Products, Inc. Pen-type injector with a microprocessor and blood characteristic monitor
DE4416656C2 (de) * 1994-05-11 1997-03-13 Vetter & Co Apotheker Vorrichtung zur Schaffung eines Venenzuganges
EP0800841A1 (fr) * 1996-03-16 1997-10-15 Wagner, Wolfgang, Dr.med. Appareil d'injection sans aiguille
US6554798B1 (en) * 1998-08-18 2003-04-29 Medtronic Minimed, Inc. External infusion device with remote programming, bolus estimator and/or vibration alarm capabilities
US6663602B2 (en) 2000-06-16 2003-12-16 Novo Nordisk A/S Injection device
US6669664B2 (en) 2001-09-07 2003-12-30 Avant Drug Delivery Systems, Inc. Vacuum control cycle for jet injector
US20040039289A1 (en) 2002-04-30 2004-02-26 Christensen Lars Hofmann Needle insertion sensor
US7842029B2 (en) 2004-05-07 2010-11-30 Aesthera Apparatus and method having a cooling material and reduced pressure to treat biological external tissue
WO2006114396A1 (fr) 2005-04-24 2006-11-02 Novo Nordisk A/S Dispositif d'injection
CA2625857C (fr) 2005-10-15 2013-05-28 F. Hoffmann-La Roche Ag Element d'analyse et systeme d'analyse pour l'analyse d'un liquide corporel
US9008764B2 (en) 2006-03-20 2015-04-14 Novo Nordisk A/S Determination of position of injection needle
ES2411732T3 (es) 2006-09-29 2013-07-08 Novo Nordisk A/S Dispositivo de inyección con medios de detección electrónicos
US8353878B2 (en) 2007-03-23 2013-01-15 Novo Nordisk A/S Injection device comprising a locking nut
US9108006B2 (en) 2007-08-17 2015-08-18 Novo Nordisk A/S Medical device with value sensor
ATE555822T1 (de) 2007-12-31 2012-05-15 Novo Nordisk As Elektronisch überwachte injektionsvorrichtung
US9533106B2 (en) 2011-12-29 2017-01-03 Novo Nordisk A/S Torsion-spring based wind-up auto injector pen with dial-up/dial-down mechanism
CN107876312A (zh) * 2017-12-19 2018-04-06 重庆鹏鑫达电子科技有限公司 电子加工用点胶装置
CN108489767A (zh) * 2018-05-15 2018-09-04 华北水利水电大学 一种微孔滤膜过滤的滤液提取装置与方法
CN109568130B (zh) * 2018-12-11 2021-02-05 管云 助力式配药器
CN112712872A (zh) * 2020-12-29 2021-04-27 查维祎 一种自动推注装置及其使用方法
CN113176254B (zh) * 2021-04-23 2022-09-16 津制仪表(天津)有限公司 一种环境气候多参数在线检测仪
CN113229815B (zh) * 2021-05-17 2022-07-08 庞尔亮 一种兽医用牲畜疫病检测装置
CN113662634B (zh) * 2021-07-30 2023-06-23 河北医科大学第二医院 一种心内科用心包穿刺抽液装置

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Also Published As

Publication number Publication date
IN165367B (fr) 1989-09-30
WO1986001728A2 (fr) 1986-03-27
JPS62500429A (ja) 1987-02-26
WO1986001728A3 (fr) 1986-05-09

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