JP2002538920A - 改良型パルス酸素濃度計プローブオフ検出器 - Google Patents
改良型パルス酸素濃度計プローブオフ検出器Info
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7221—Determining signal validity, reliability or quality
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
- A61B5/14551—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6843—Monitoring or controlling sensor contact pressure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
- A61B2560/02—Operational features
- A61B2560/0266—Operational features for monitoring or limiting apparatus function
- A61B2560/0276—Determining malfunction
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- Investigating Or Analysing Materials By Optical Means (AREA)
Abstract
Description
早期検出は、不十分な酸素供給が数分で脳障害及び死に至らしめることから、例
えば、重症者管理及び外科的処置などの医療分野において重要である。パルス酸
素測定法は、酸素供給の指標である動脈血の酸素飽和度を測定するために広く容
認された無侵襲的手法である。パルス酸素測定システムは、患者に取りつけられ
たセンサ、モニタ及びセンサとモニタを接続するケーブルから構成される。従来
より、パルス酸素測定センサは、赤色光及び赤外(IR)発光ダイオード(LE
D)エミッタの両方と光ダイオード検出器を有する。センサは一般に、患者の手
の指又は足の指に、或いは非常に若い患者の場合は足に取りつけられる。指の場
合、センサは、エミッタが指の爪を通してその下の血管及び毛細血管に光を投じ
るように、構成される。光ダイオードは、LEDの透過光が指の組織から現れた
ときに、それを検出するように、爪と反対側の指先に配置される。
の波長の動脈血による吸収の差を計算することによって、酸素飽和度を決定する
。パルス酸素濃度計は、センサのLEDエミッタの駆動と光ダイオード検出器に
より発生される結果生じる電流の読み取りとを交互に行う。この電流は、検出さ
れた光の強度に比例する。パルス酸素濃度計は、検出した赤色光と赤外光の強度
の比を計算し、得られた比に基づいて、動脈の酸素飽和値を経験に基づいて決定
する。パルス酸素濃度計は、センサを制御し、センサ信号を処理し、患者の酸素
飽和度及び脈拍数を表示するための回路を含む。パルス酸素濃度計は、本発明の
譲受人に譲渡された米国特許第5,632,272号に記載されている。
、酸素化ヘモグロビンのHbO2、脱酸素化ヘモグロビンHbの光の吸収の差に
基づき、それぞれの動脈血中の濃度を計算する。この吸収の差は、センサの赤色
光の波長及び赤外光の波長で測定される。さらに、パルス酸素測定法は、動脈血
の脈動性質に基づき、ヘモグロビンの吸収と周囲の組織の他の成分の吸収を区別
する。収縮期と弛緩期の光の吸収は、末梢組織部位における動脈血の流入と流出
によって血液量が変化するため、変化する。この組織部位は、それぞれ光を吸収
する、皮膚、筋肉、骨、静脈血、脂肪、色素などを含む場合もある。これらの周
囲の組織によるバックグラウンド吸収は一定で無視することができると考えられ
る。したがって、血中酸素飽和度測定は、検出した赤色光信号と赤外光信号の時
間により変化する部分、即ちAC部分の時間により変化しない部分、即ちDC部
分に対する比に基づく。このAC/DC比は信号を正規化し、測定した組織を通
る光の光路の長さの変化を補償する。
では、パルス酸素濃度計の入力ゲインは、センサ部位で、不透明な皮膚に適合す
るように高く調整され、また半透明な皮膚に適合するように低く調整される。セ
ンサ部位で血液の潅流が変動することによって、入力信号強度が変動する。グラ
フ100は、ゲインの関数としての許容可能な入力感度を示す。y軸110は、
AC信号のピークからピークとDC信号の比をパーセントで示した信号の強度(
SS)である。x軸120はゲインを表し、x軸に沿って値が減少していく。グ
ラフ100には、パルス酸素濃度計の許容可能な動作範囲を表す影の付いていな
い領域130と、この動作範囲外の状態を表す影の付いた領域140があり、こ
の影の付いた領域が検出されると、パルス酸素濃度計の「プローブオフ」アラー
ムを発生する。動作範囲130は、ゲインが比較的低い最低値150を有し、こ
の最低値は、低い潅流で患者に対する感度が最も高いことを表している。入力ノ
イズはゲインと共に増大するため、動作範囲はコーナーポイント160も有し、
このポイントよりも下では、入力感度がノイズにより制限され、ゲインの増大と
共に低下する、即ち不透明性が増大する。
損ねる可能性がある。この問題は、センサが部分的に又は完全に患者から外れて
いるにも関わらず、依然としてパルス酸素濃度計の動作範囲内のAC信号を検出
し続けている場合に起こる。パルス酸素濃度計は、実際にプローブが患者に適切
に取り付けられていない場合でも通常の飽和度を表示する可能性があるため、プ
ローブオフのエラーは深刻であり、不飽和化の事象を見逃す可能性がある。
しなかった光を、エミッタから直接受け取る。エミッタから直接検出された光の
誘発されたどんな小さな変化も、生理的信号として処理されるのに充分な信号強
度を有するような、最も高い感度でパルス酸素濃度計を作動した場合、パルス酸
素濃度計は、プローブオフエラーを特に受け易い。プローブオフ状態では、検出
器のAC信号は、エミッタと検出器の間の直接的な光路の僅かな変化によって誘
発され得る。例えば、呼吸による胸の運動などの患者の僅かな運動によって、プ
ローブオフAC信号が誘発され得る。他の例では、折り畳みセンサを取り除いた
後センサが徐々に元の形状に戻るなどの、センサ構造の「クリープ」もプローブ
オフAC信号を誘発する可能性がある。図1に示す動作範囲130をさらに制限
することによって、プローブオフエラーを低減させることができる。しかしなが
ら、このような制限によって、パルス酸素濃度計が、弱い潅流で患者の飽和度測
定を行う能力も厳しく制限されてしまう。
ある。もちろん、プローブオフ状態を検出する他の方法を本発明の改良と組み合
わせることもできる。特に、知的なルールベースのプロセッサは、低潅流時の性
能に重大な悪影響を及ぼさずに、パルス酸素濃度計の動作範囲を制限するために
、信号品質測定値を使用する。これらの信号品質動作の限界は、プローブオフ検
出を向上させるために、図1の限界に付加される。このようにして、パルス酸素
濃度計は、図1の動作範囲130内にある充分な信号強度を有するが、プレチス
モグラフ信号ではないと思われるAC信号を拒否することができる。用いられる
信号品質測定値の一つは脈拍数密度であり、これは時間ごとに検出したパルスが
生理学的に許容できるモデルを満たすパーセントである。他の信号品質測定値は
エネルギー比であり、これはある脈拍数で起こる信号エネルギーとその高調波の
パーセントである。こうして、パルス酸素濃度計の動作範囲は、信号強度対ゲイ
ン、信号強度対PR密度、エネルギー比対予め定義したエネルギー比の限界によ
って画定される。
ローブオフ出力を有する。信号品質入力は、センサ出力と生理学的信号モデルと
の比較に基づく。プローブオフ出力は、センサが組織部位に適切に装着されてい
ない可能性があるという表示を与える。検出器は、信号強度計算機、信号強度と
信号品質の記憶された関係及び比較器を含む。信号強度計算機は、センサ信号と
通信する入力を有し、センサ信号の時間によって変化する成分に依存する信号強
度出力を与える。この記憶された関係は、センサの許容可能な動作範囲を画定す
る。比較器は、信号強度及び信号品質を入力として有し、信号強度及び信号品質
と記憶された関係との比較に基づくプローブオフ出力を与える。
が組織部位に適切に装着されているかどうかを判定するように処理される。この
処理ステップは、信号品質に依存する信号強度限界を設定するステップ、センサ
信号から信号強度値を計算するステップ、センサ信号から信号品質値を計算する
ステップ、及び信号強度が、先に決定した信号品質値の限界未満である場合にプ
ローブオフ状態を示すステップを含む。
拍数密度に基づいて、どのように変更されるかを例示している。PR密度の計算
は、1998年12月30日に出願された米国仮出願番号第60/114,127号及び本願の譲受
人に譲渡され、本明細書中に参考として援用する、1999年12月23日に出願された
、"Plethysmograph Pulse Recognition Processor"という名称の米国出願番号第
09/471,510号に記載されている。本明細書中で説明するプロセッサは、入力IR
波形内の複数の潜在的パルスを決定する候補となるパルス部分を有する。次いで
プロセッサの生理学的モデル部分が、これらの潜在的パルスのうち生理学的に許
容できるパルスを決定する。プロセッサは、許容可能なパルスに関する統計項目
を提供する。ある1つの統計項目は脈拍数密度であり、これは、許容可能なパル
スの周期のIR入力波形のブロック又は「スナップショット」の持続時間に対す
る比である。
のグラフ200を示す。動作範囲260は影を付けずに示され、プローブオフ領
域270は影を付けて示されている。0.02の信号強度最低値230(これよ
り小さな値では、PR密度の全ての値に対してプローブオフ状態が存在する)が
、動作範囲260の一部分を決定する。即ち、どれほど多くの検出されたプレチ
スモグラフパルスが生理学的に許容可能であっても、信号強度が0.02未満な
らば、パルス酸素濃度計はプローブオフ状態を示す。0.25の信号強度最高値
250(これより大きな値では、パルス酸素濃度計がPR密度の全ての値に対し
て有効動作範囲にある)が、動作範囲260の別の部分を決定する。即ち、信号
強度が0.25よりも大きければ、信号品質は無視される。信号強度の最低値2
50と最高値250の間では、許容可能な信号強度はPR密度によって変わる。
この関係を定義する境界の勾配は、以下の通りである。 勾配=- (0.25-0.02)/(0.5-0.2) = -0.23/0.3 = -0.7667 ...(1) したがって、この境界を以下の等式で定義することができる。 SS = -0.7667・PR密度 + 0.4033 ...(2) PR密度 = -1.3043・SS + 0.5261 ...(3)
グラフ200を示す。このグラフは、信号強度の最高値250が0.05に設定
されている以外、図2Aのグラフと同一である。したがって、信号強度が0.0
5より大きい限りは、PR密度によって示される信号の品質は無視される。
えられる。エネルギー比は、ある脈拍数で起こるIR信号エネルギーと関連する
高調波のIRエネルギー全体と比べたパーセントである。エネルギー比は、当業
界で周知であるように、IR信号の各ブロックを周波数ドメインに変換すること
によって計算される。エネルギー比は、得られたスペクトルの各ピークを特定す
ることによって、計算される。一実施の形態では、ある脈拍数で起こるピークと
その高調波が特定され、加算される。この値を、全てのピークの大きさとエネル
ギー比としての出力の合計で除算する。計算が、IR信号を二乗した大きさでは
なく、ピークの大きさに基づくため、このように計算したエネルギー比は、真の
エネルギー計算値ではないことに留意されたい。本実施の形態では、脈拍数が3
0以上であれば最小エネルギー比は0.6となり、その他の場合は0.5となる
。即ち、信号の60%(脈拍数が低い場合は50%)がその脈拍数の周波数又は
その高調波にある筈であり、パルス酸素濃度計はプローブオフ状態を示すであろ
う。この計算で用いる脈拍数の計算方法は、本願の譲受人に譲渡され、本明細書
中に参考として援用する、1997年4月14日に出願された"Improved Signal Proces
sing Apparatus and Method"という名称の米国特許第6,002,952号に記載されて
いる。
ブロック図である。検出器は、信号強度計算機310、限界セレクタ330及び
プローブオフ論理回路350を有する。信号強度計算機310は、IR信号31
2の入力を有する。この信号は、逆多重化、増幅、フィルタリング及びデジタル
化の後の検出されたセンサ信号である。特定の実施の形態では、IR信号は、6
2.5Hzのサンプリング速度で、また、それぞれが前のブロックから25サン
プルだけずれた、390個のサンプルがオーバーラップする「スナップショット
」即ちブロックで、信号強度計算機310に入力される。信号強度計算機310
は、図4を参照して以下に説明するように、これらの入力ブロックのそれぞれに
対する信号強度スカラーのセットからなる信号強度ベクトル出力314を生成す
る。
。感度モード入力334の値が1の場合、パルス酸素濃度計が図2Aに対応する
通常の感度モードにあることを示す。値0は、パルス酸素濃度計が図2Bに対応
する高感度モードにあることを示す。パルス酸素濃度計のオペレータは、この感
度モードを選択する。限界セレクタ330はまた、エネルギー比限界336及び
信号強度限界338の出力も有し、これらの出力は、エネルギー比と信号強度の
絶対最小値(この値より小さな値では、プローブオフ状態が350で示される可
能性がある)としてプローブオフ論理回路350に入力される。脈拍数332及
び感度モード334の入力の関係並びにエネルギー比336及び信号強度338
の出力の関係を以下に説明する。
334及び信号強度ベクトル314を有する。これらの入力を、限界セレクタ3
30からのエネルギー比限界336及び信号強度限界338の出力と比較してパ
ルス酸素濃度計の動作範囲を決定する。プローブオフ論理回路350はまた、時
間ヒューズ入力356も有する。時間ヒューズ356は、許容可能なパルスを含
まないIR波形ブロックの数を示すカウンタである。許容可能なパルスは、PR
密度354の計算について上記に説明したように、決定される。起動時からブロ
ックに許容可能なパルスがない場合、時間ヒューズ356の入力値は−1になる
。入力ブロックに対して許容可能なパルスが検出されなかった場合ごとに、時間
ヒューズ356は0にリセットされる。許容可能なパルスがないブロックごとに
、時間ヒューズ356は1だけ増分される。時間ヒューズによって、エネルギー
比の限界及び信号強度の限界のその部分が最低値230よりも上になる(図2A
−2B)。これによって、過渡的な事象に対してプローブオフ警告が発生する可
能性が低減する。特定の実施の形態では、時間ヒューズ356は−1及び5の定
数と比較される。即ち、起動時から、又は先行するIR信号ブロックが5個より
多くある場合に許容可能なパルスがないならば、エネルギー比の限界及び信号強
度の限界が使用可能となる。
動していることをプローブオフ論理回路350が検出したときに1に設定される
、ブールプローブオフ出力358を有する。そうでない場合は、プローブオフ出
力358は0である。センサを検査したり再装着するか又は他の適切な処置を行
うように医療従事者に警告する目的でプローブオフ警告及びエラーメッセージを
トリガするために、パルス酸素濃度計でプローブオフ出力を使用することができ
る。プローブオフ論理回路350は、図5を参照して以下により詳細に説明する
。
390個のサンプルブロックはそれぞれ、最初に410でフィルタされて、信号
強度の計算に誤差を生ずるようなIR信号312のあらゆるトレンドを除去する
。特定の実施の形態では、フィルター410は、50Hzと550Hzのカット
オフ周波数及び形状パラメータ3.906の151タップカイザーウィンドウを
有するバンドパスFIRフィルターである。その結果、150個のサンプルが3
90個のサンプル入力ブロックから失われる。したがって、フィルタされたIR
出力412は、240個のサンプルブロックからなる。
30で多数のオーバーラップするサブブロックに変換される。特定の実施の形態
では、サブブロックはそれぞれ100個のサンプルからなり、各サブブロックは
先行するサブブロックから10サンプルだけずれている。したがって、サブブロ
ック変換器430は、240個のフィルタされたIRサンプルブロックのそれぞ
れに対して15個のサブブロック出力432を生成する。各サブブロックに対し
て最大−最小計算460を実行する。即ち、特定のサブブロックの最小のサンプ
ルの大きさを、そのサブブロックの最大のサンプルの大きさから減算する。最大
−最小出力462はそれぞれ、特定のサブブロックの信号強度を表す単一のスカ
ラーである。スカラー−ベクトル変換器490は、最大最小出力462を合わせ
て、IR信号312の特定のブロックの信号強度を表す複数の信号強度値を含む
ベクトル出力314に変換する。
フ論理回路350は、それぞれがブール出力を生成する3つの機能チェックを有
する。エネルギー比チェック510は、エネルギー比352と、上の表に説明し
た限界セレクタ(図3)から出力されたエネルギー比限界336に対して比較す
る。エネルギー比チェック510は、エネルギー比352がエネルギー比限界3
36よりも小さい場合に「低エネルギー比」出力512を設定する。
なパルスが発生しないと時間ヒューズ356が示したかどうか(図3)を判定す
る。もし時間ヒューズがそのように示したならば、時間切れ出力522が設定さ
れる。特定の実施の形態では、時間ヒューズチェック520は、時間ヒューズ3
56が、起動時から又はIR信号312の5ブロックを超える長い時間許容可能
なパルスがないことを示す数値である−1か又は5より大きいかを判定するコン
パレータからなる。
に、パルス酸素濃度計が動作限界内にあるかどうかを判定する。信号強度ベクト
ル314によって決定された信号強度が最低値230(図2A−B)より小さい
場合、信号強度異常出力534が設定される。信号強度が最低値230(図2A
−B)よりも大きいか動作範囲外である場合、即ち最低値230(図2A−B)
より上の影の付いた領域270(図2A−B)内にある場合、「低信号強度」出
力532が設定される。
れた場合、論理積機能540が「低信号品質」の出力542を設定する。低信号
品質542又は信号強度異常534の出力が設定された場合、論理和機能550
がプローブオフ出力358を設定する。
ベクトル314は、610で15個の個々の信号強度スカラー612に変換され
る。相対的チェック620及び絶対的チェック630を15個のスカラー612
のそれぞれに実行する。各相対的チェック620は、信号強度がPR密度354
に対して信号強度限界内にあるかどうかを判定する。即ち、相対的チェックの各
出力622は、以下にしたがって設定される。上記の3つの式を参考のこと。
りも大きいかどうかを判定する。即ち、絶対的チェックの各出力632は、以下
にしたがって設定される。
する、和及び比較660によって処理される。和が5以上ならば、低信号強度出
力532が設定される。即ち、信号強度ベクトル314のスカラーのうち少なく
とも1/3が相対的チェック620に失敗した場合に、低信号強度が表示される
。同様に、15個の絶対的チェック出力632は、これらの出力632の算術和
を実行する和及び比較670によって処理される。和が5以上ならば、信号強度
異常出力534が設定される。即ち、信号強度ベクトル314のスカラーのうち
少なくとも1/3が絶対的チェック630に失敗した場合に、信号強度異常が表
示される。
種々の実施の形態に関連させて詳細に記載してきた。これらの実施の形態は例示
のためだけに記載されたもので、特許請求の範囲によって定義される本発明の範
囲を限定するためのものではない。当業者なら、本発明の趣旨内の多くの改変及
び変更を理解するであろう。
を例示するグラフであり、且つ通常の入力感度モードでのパルス酸素濃度計の信
号品質動作限界のグラフである。
を例示するグラフであり、且つ高い入力感度モードでのパルス酸素濃度計の信号
品質動作限界のグラフである。
なプロセッサのトップレベルブロック図である。
Claims (2)
- 【請求項1】 信号入力、信号品質入力及びプローブオフ出力を有するプロ
ーブオフ検出器の改良品であって、前記信号品質入力が、センサ出力と生理学的
信号モデルの比較に依存し、前記プローブオフ出力が、前記センサが組織部位に
適切に装着されていない可能性があるという表示を与え、前記改良品は、 前記信号と通信する入力を有し、前記信号の時間によって変化する成分に依存
する信号強度出力を提供する、信号強度計算機と、 前記センサの許容可能な動作範囲を画定する、前記信号強度と前記信号品質の
記憶された関係と、 前記信号強度及び前記信号品質を入力として有し、前記信号強度及び前記信号
品質の前記記憶された関係の比較に基づいて、前記プローブオフ出力を与える、
比較器と、を備える、 改良品。 - 【請求項2】 センサ信号を処理することによって、パルス酸素濃度計が組
織部位に適切に装着されていない可能性を検出する改良方法であって、 信号品質に依存する信号強度限界を設定するステップと、 前記センサ信号から信号強度値を計算するステップと、 前記センサ信号から信号品質値を計算するステップと、 前記信号強度が、前記計算ステップで求めた前記信号品質値の前記限界よりも
小さい場合に、プローブオフ状態を示すステップと、を備える、 改良検出方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US12614899P | 1999-03-25 | 1999-03-25 | |
US60/126,148 | 1999-03-25 | ||
PCT/US2000/008005 WO2000056209A1 (en) | 1999-03-25 | 2000-03-24 | Improved pulse oximeter probe-off detector |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2002538920A true JP2002538920A (ja) | 2002-11-19 |
JP4644373B2 JP4644373B2 (ja) | 2011-03-02 |
Family
ID=22423233
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2000606119A Expired - Lifetime JP4644373B2 (ja) | 1999-03-25 | 2000-03-24 | 改良型パルス酸素濃度計プローブオフ検出器 |
Country Status (9)
Country | Link |
---|---|
US (5) | US6360114B1 (ja) |
EP (2) | EP2298159B1 (ja) |
JP (1) | JP4644373B2 (ja) |
AT (1) | ATE330536T1 (ja) |
AU (1) | AU3773300A (ja) |
BR (1) | BR0009290A (ja) |
CA (1) | CA2368613A1 (ja) |
DE (2) | DE60028953T2 (ja) |
WO (1) | WO2000056209A1 (ja) |
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JP2014198260A (ja) * | 2001-05-15 | 2014-10-23 | マシモ・コーポレイション | データ信頼度インジケータ、データ信頼度表示方法及び患者モニタ |
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US20090112073A1 (en) | 2009-04-30 |
US6654624B2 (en) | 2003-11-25 |
US7471969B2 (en) | 2008-12-30 |
BR0009290A (pt) | 2001-12-26 |
DE60028953T2 (de) | 2007-02-08 |
EP2298159B1 (en) | 2015-10-21 |
EP1171025B1 (en) | 2006-06-21 |
US6360114B1 (en) | 2002-03-19 |
US20020072660A1 (en) | 2002-06-13 |
EP2298159A1 (en) | 2011-03-23 |
US9730640B2 (en) | 2017-08-15 |
DE60045425D1 (de) | 2011-02-03 |
US8532728B2 (en) | 2013-09-10 |
US20140100434A1 (en) | 2014-04-10 |
WO2000056209A9 (en) | 2001-10-25 |
WO2000056209A1 (en) | 2000-09-28 |
EP1171025A4 (en) | 2003-05-14 |
ATE330536T1 (de) | 2006-07-15 |
JP4644373B2 (ja) | 2011-03-02 |
EP1171025A1 (en) | 2002-01-16 |
US20040158134A1 (en) | 2004-08-12 |
CA2368613A1 (en) | 2000-09-28 |
AU3773300A (en) | 2000-10-09 |
DE60028953D1 (de) | 2006-08-03 |
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