US3720199A - Safety connector for balloon pump - Google Patents

Safety connector for balloon pump Download PDF

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Publication number
US3720199A
US3720199A US00143392A US3720199DA US3720199A US 3720199 A US3720199 A US 3720199A US 00143392 A US00143392 A US 00143392A US 3720199D A US3720199D A US 3720199DA US 3720199 A US3720199 A US 3720199A
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United States
Prior art keywords
balloon
output signal
catheter
pneumatic
patient
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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.)
Expired - Lifetime
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US00143392A
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English (en)
Inventor
M Rishton
A Federico
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KONTROL CARDIOVASCULAR Inc
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Avco Corp
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Assigned to KONTROL CARDIOVASCULAR INC. reassignment KONTROL CARDIOVASCULAR INC. ASSIGNMENT OF ASSIGNORS INTEREST. Assignors: AVCO CORPORATION, A CORP. OF DE
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Classifications

    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F04—POSITIVE - DISPLACEMENT MACHINES FOR LIQUIDS; PUMPS FOR LIQUIDS OR ELASTIC FLUIDS
    • F04B—POSITIVE-DISPLACEMENT MACHINES FOR LIQUIDS; PUMPS
    • F04B45/00—Pumps or pumping installations having flexible working members and specially adapted for elastic fluids
    • F04B45/02—Pumps or pumping installations having flexible working members and specially adapted for elastic fluids having bellows
    • F04B45/033—Pumps or pumping installations having flexible working members and specially adapted for elastic fluids having bellows having fluid drive
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/10—Location thereof with respect to the patient's body
    • A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
    • A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
    • A61M60/135—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel inside a blood vessel, e.g. using grafting
    • A61M60/139—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel inside a blood vessel, e.g. using grafting inside the aorta, e.g. intra-aortic balloon pumps
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/20—Type thereof
    • A61M60/295—Balloon pumps for circulatory assistance
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/40—Details relating to driving
    • A61M60/497—Details relating to driving for balloon pumps for circulatory assistance
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/50—Details relating to control
    • A61M60/508—Electronic control means, e.g. for feedback regulation
    • A61M60/515—Regulation using real-time patient data
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/50—Details relating to control
    • A61M60/508—Electronic control means, e.g. for feedback regulation
    • A61M60/538—Regulation using real-time blood pump operational parameter data, e.g. motor current
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/80—Constructional details other than related to driving
    • A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
    • A61M60/871—Energy supply devices; Converters therefor
    • A61M60/878—Electrical connections within the patient's body
    • 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
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/60—General characteristics of the apparatus with identification means
    • A61M2205/6018—General characteristics of the apparatus with identification means providing set-up signals for the apparatus configuration
    • 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
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/60—General characteristics of the apparatus with identification means
    • A61M2205/6027—Electric-conductive bridges closing detection circuits, with or without identifying elements, e.g. resistances, zener-diodes
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/20—Type thereof
    • A61M60/247—Positive displacement blood pumps
    • A61M60/253—Positive displacement blood pumps including a displacement member directly acting on the blood
    • A61M60/268—Positive displacement blood pumps including a displacement member directly acting on the blood the displacement member being flexible, e.g. membranes, diaphragms or bladders
    • A61M60/274—Positive displacement blood pumps including a displacement member directly acting on the blood the displacement member being flexible, e.g. membranes, diaphragms or bladders the inlet and outlet being the same, e.g. para-aortic counter-pulsation blood pumps

Definitions

  • ABSTRACT An intra aortic balloon catheter assembly for use in a Y circulatory assist system which includes a special con- [52] US. Cl. ..128/1 D, 128/214 R Hector forjoining a balloon implanted in the patientm [51] it. Cl. 19/00 a control console which y house both pneumatic [58] F'eld 1 214 273 and electronic controls.
  • the connector is adapted to provide a signal which indicates volumetric displace- References C'ted ment of the balloon. This volume is compared to the UNITED STATES PATENTS volume of load gas utilized and shuts the system down if an over-inflation condition exists, prevents overm- 3,601,124 8/1971 Petree ..128/214E flation of the balloon, inadvertent use of an incor- 3,450,153 6/1969 Hildebrandt et al. ..128/214 E rectly sized balloon, and allows presterilization of the 3,465,746 9/1969 Guarino ..128/1 D whole assemb] 3,585,983 6/1971 Kantrowitz et al.
  • This invention relates to circulatory assist systems and in particular to an intra aortic balloon catheter assembly.
  • This catheter assembly increases the safety performance of circulatory assist devices and, therefore, enhances the utilization of such implantable systems in the human body.
  • the systemic circulation is maintained by the action of the left ventricle in pumping blood into the aorta.
  • Back-flow of blood into the left ventricle is prevented by the aortic valve.
  • the left ventricle works primarily against the elastic compliance of the aorta, raising the pressure in the aorta and distending it.
  • the aortic valve closes and the elastic contraction of the aorta then maintains a continuing flow of blood through the capillaries and other vessels (diastole).
  • the aorta thus acts as an elastic reservoir storing some of the energy supplied by the heart.
  • Heart failure may occur following a myocardial infarct.
  • Such a heart failure will exhibit low blood pressure during the systole cycle of the normal heart rhythm. This low blood pressure in turn reduces coronary blood flow, thereby, reducing further the blood pressure, creating adeteriorating cycle.
  • a mechanical device may be used to assist the circulation. I-Ieretofore, mechanical assistance to the systemic circulation has been attempted by veno-arterial pumping, arterio-arterio pumping, and a variety of counter-pulsation techniques have fallen short of certain desirable requirements,
  • intra arterial or ballon type pumps per se, for use, for example, in the aorta by insertion through the femoral artery, up the arterial tree and into the aorta, are well known.
  • the operation, of the pump is extremely critical since it must operate periodically in a transient or instantaneous pulsating manner which must be synchronized with the patients heart.
  • the stroke of such a pump must operate under various types of conditions such as at a different pressure relating to the pressure of the: patient.
  • the present invention assists 11C operation of such a system by providing means which will prevent the overinflation of the balloon pump. It is absolutely essential to the operation of any medical device used within the human body, that the device must be constructed as to prevent any forseeable hazards. Therefore, if a balloon is inserted and is overinflated because it is erroneously thought to be a larger balloon, the balloon may rupture or break in the patients circulatory system expelling injurious if not lethal amounts of gas into the blood stream. The above situation is prevented in accordance with the present invention by means of an electronic indicator. This indicator provides a signal to the control mechanism which in turn limits the amount of pressure provided to inflate the balloon.
  • An object of the present invention is to provide a safety mechanism for cardiac assist devices.
  • Another object of the invention is to prevent overinflation of balloon pump systems.
  • Another object of the invention is to provide an electronic indicator which may be used to determine the size of the balloon inserted into the aorta.
  • Still another object of the invention is to provide an intra aortic balloon catheter assembly which is an integrated system that may be presterilized as a unit.
  • a further object of this invention is to provide an intra aortic balloon assembly that iselectrically connected to the pneumatic systems.
  • Yet another object of the invention is to provide a mechanical safety connection between the balloon pump assembly and the balloon pump console.
  • FIG. 1 shows an overall view of an intra aortic balloon pump in accordance with the invention emplaced in a patient
  • FIG. 2 shows an expanded break away view of the safety connector, related electronics, and the balloo n pump console
  • FIG. 3 is a block diagram of the principal components of the balloon pump. console.
  • FIGS. 1 and 2 illustrate by way of example a preferred embodiment of the invention.
  • FIG. 1 illustrates the use of a balloon pump system in accordance with the invention as used in a patient with. a cardiac condition.
  • the balloon 15 which by way of example, as that described in U.S. Pat. No. 3,504,662 is introduced through the femoral artery and positioned. in the descending aorta of the patient. To facilitate the. insertion, the balloon is inserted in a deflated condition. the size of the balloon used with a particular patient is determined by the patients sex,
  • the balloon is attached to a conventional hollow catheter 16 which provides a channel for coupling fluid such as for example, helium from the pumping console to the balloon to inflate and deflate the implanted balloon during operation.
  • the end of the catheter 16 remote from the balloon is coupled to the electronics and pneumatics of the console 17 by the use of a special plug/socket type connection generally designated 18 which will be discusSed more fully hereinafter.
  • the balloon, catheter, and part of the connector make up an integral, replaceable unit which may be sterilized together prior to insertion into the human body.
  • the patients electrocardiac output (ECG) may for example, be monitored in the conventional manner via leads 19.
  • the ECG signal is used in providing the timing sequence for the cardiac assist device so that the balloon will be inflated during the cardiac diastole period.
  • the basic function of a typical console is to provide inflation of the balloon following closure of the aortic valve on the next heartbeat.
  • a typical block diagram of the principal components is shown in FIG. 3.
  • the ECG signal is fed into a R-wave detector 50.
  • the ECG signal consists of a scintilation pattern dependent upon the electrocardiac output, the highest positive going spiked portion of this signal occurs when the depolarization signal reaches the bundle of His in the heart prior to ventricular contraction. This positive spiked portion of the signal is known in electrocardiography as the R- wave which is sensed by the detector 50.
  • Each R-wave signal from detector 50 is fed to delay and exhaust time generator 51 which provides electrical signal to electromechanical pulse valve 52.
  • the R-wave starts a clock in the delay and exhaust time generator 51 from which the time of inflation an: deflation is measured. These times can be adjusted as fractions of the period between heartbeats by manual adjustments.
  • the electrical signals from generator 51 for inflation or deflation actuate a conventional pulse valve 52 which connects the console side 24a of the isolating piston 24 to the drive pressure supply 54 or the exhaust pressure supply 55 respectively.
  • the isolating piston is used for safety purposes. It is designed so that it does not noticeably decrease the rate of inflation or deflation of the balloon.
  • the isolating piston 24 separates the fluid in the drive mechanism on the console side 24a from the fixed amount of fluid or load gas on the patient side 24b used to inflate the balloon 15.
  • the isolating piston 24 separates the fluid in the drive mechanism on the console side 24a from the fixed amount of fluid or load gas on the patient side 24b used to inflate the balloon 15.
  • pressure transducer 56 on the patient side 24b of the isolating piston 53.
  • Load gas may be replaced through a load valve 57 from a load supply 58.
  • a vent valve 59 is provided on the patient side of the isolating piston which opens automatically in case of a circuit failure or the like and leaves the balloon in a deflated position.
  • FIGS. 1 and 2 On the front of the console as best shown in FIG. 2, is positioned an isolating piston control knob 20 for affecting control of the isolating piston 24 in the fixed volume pump 25 to provide a desired volume of the gas in the patient side of the pump 24b which determines the amount of load gas to be used.
  • the position of control knob 20 also provides an electrical signal by means of a potentiometer 26 that is fed to a conventional comparator 21 and an indicator 22 on the face of the console.
  • the control knob 20 is initially set according to a volume of less than or equal to the specified volumetric capacity of the balloon and its associated catheter. When control knob 20 is positioned correctly, the volume reading at indicator 22 should not exceed the rated capacity of the balloon by more than 2cc.
  • Allowing too large a displacement of the fixed volume pump can overpressure the balloon.
  • a meter reading more than about Sccs lower than the rated balloon volume should be avoided since this indicates that part of the balloon is not inflating and is then subject to possible thrombotic complications.
  • a balloon which does not fully inflate provides crevices which allow blood to stagnate and form clots which may impede flow and endanger the patient.
  • the mechanical connector 18 between the catheter and the console is shown in greater detail in FIG. 2.
  • the connector 18 comprises a male type plug 30 permanently affixed to the balloon catheter 16, and a female type socket 40 attached to the catheter leading to the console.
  • a resistor 31 Disposed within the plug 30 is a resistor 31.
  • the valve of resistor 31 is chosen to reflect the volumetric displacement of the balloon 15 to which plug 30 is attached.
  • Resistor 31 is electrically connected between pins 32 and 33 which are carried by plug 30.
  • Catheter 16 is permanently and sealably connected to a rigid hollow tube 34 which is affixed to and protrudes a distance from the end surface of plug 30.
  • the female socket 40 is constructed as to receive plug 30, electrical insets 41 and 42 being adapted to receive pins 32 and 33 and recess 43 being adapted to sealably receive tube 34.
  • Recess 43 receives tube 34 with an air tight connection when plug 30 is mated with socket 40.
  • Recess 43 is permanently and sealably affixed to hollow tubinG 44 and which is removably connected to the fixed volume pump 25. This completes the pneumatic channel between the balloon and the console.
  • Insets 41 and 42 receive pins 32 and 33 when plug 30 is mated with socket 40.
  • the electrical inset 42 may provide for example, an electrical connection to ground, and electrical inset 41 may be electrically connected to comparator 21 contained within the consOle 17.
  • this circuit provides in conventional manner in comparator 21 a DC level based on resistor 31 which in turn is proportional to the size of the balloon being used.
  • the comparator in conventional manner compares the aforementioned DC level with the signal provided by the manual volume load adjusting mechanism for the isolating piston. If the volume of the load gas to be provided to the balloon exceeds the safety limits of the balloon, the comparator provides a signal operative to shut off the operation of the volume meter and rapidly vent the system to the atmosphere. By way of example, this may be accomplished by providing a signal from comparator 21 to activate vent valve 59.
  • resistor 31 used in the circuit is matched to the volume of the balloon 15, thus, for example, a 30cc balloon may have a 510 ohm resistor and, a 20cc balloon may have a 300 ohm resistor.
  • the circuit which is completed should be a low voltage (e.g., 2 volts) circuit in order to protect the patient from any electrical shock. Accordingly, only low impedence is necessary to complete the circuit through the resistor 31.
  • a circulatory assist system having pneumatic means including pneumatic pump means adapted to sequentially apply pressure to a load gas to inflate and deflate a balloon placed in an artery of a patient, means for providing a first output signal proportional to the volumetric displacement of said pneumatic pump means, and electronic timing means for controlling said pneumatic means by sequencing said inflation and deflation to the said patients heart rhythm, the improvement comprising:
  • a balloon coupled to one end of said catheter, said balloon being adapted to be placed in an artery;
  • first means for providing a second output signal proportional to the volumetric displacement of said balloon said first means comprising a connector for removeably coupling said catheter to said pneumatic pump means, said connector comprising first and second separable portions, said first portion being fixedly attached to the end of said catheter remote from said balloon, and impedance means carried by said first portion;
  • comparator means for receiving said first and second output signals and generating a third output signal when said first output signal is greater than said second output signal
  • venting means actuated by said third output signal for deactivating said pneumatic means.
  • said first portion includes terminal means for electrically connectlng said impedance means in circuit with said comparator means, said first portion including further means for coupling said load gas to said balloon via said catheter.
  • the device of claim 2 additionally including tube means connected between said second portion and said pneumatic pump means whereby said load gas may inflate and deflate said balloon.
  • the device of claim 3 additionally including insets disposed in said second portion for receiving said ter-' minal means.
  • the device of claim 4 additionally including conductors electrically coupled to said insets for providing electrical connection between said insets and said comparator.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Mechanical Engineering (AREA)
  • Hematology (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Veterinary Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Anesthesiology (AREA)
  • Vascular Medicine (AREA)
  • Medical Informatics (AREA)
  • Transplantation (AREA)
  • General Engineering & Computer Science (AREA)
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US00143392A 1971-05-14 1971-05-14 Safety connector for balloon pump Expired - Lifetime US3720199A (en)

Applications Claiming Priority (1)

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US14339271A 1971-05-14 1971-05-14

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JP (1) JPS5545220B1 (it)
CA (1) CA990802A (it)
CH (1) CH552986A (it)
DE (1) DE2221417C3 (it)
FR (1) FR2137521B1 (it)
GB (1) GB1390813A (it)
IL (1) IL39340A (it)
IT (1) IT957780B (it)
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Cited By (105)

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US3918459A (en) * 1972-04-17 1975-11-11 Sybron Corp Constant current electrotherapy device with plug-in current control means
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US3985123A (en) * 1975-07-17 1976-10-12 Avco Everett Research Laboratory, Inc. Method and means for monitoring cardiac output
US4004298A (en) * 1975-03-31 1977-01-25 Sinai Hospital Of Detroit Magnetically aligned releasable connector
US4051841A (en) * 1973-01-31 1977-10-04 Thoma Dipl Ing Dr Techn Herwig Method of and apparatus for automatically controlling heart-synchronized circulating pumps
US4369530A (en) * 1981-05-19 1983-01-25 Foxcroft Associates Hydraulically actuated cardiac prosthesis and method of actuation
US4376312A (en) * 1981-05-19 1983-03-15 Foxcroft Associates Hydraulically actuated cardiac prosthesis
US4381567A (en) * 1981-09-15 1983-05-03 Foxcroft Associates Hydraulically actuated total cardiac prosthesis with reversible pump and three-way ventricular valving
US4389737A (en) * 1981-09-15 1983-06-28 Foxcroft Associates Hydraulically actuated cardiac prosthesis with three-way ventricular valving
US4397049A (en) * 1981-09-15 1983-08-09 Foxcroft Associates Hydraulically actuated cardiac prosthesis with three-way ventricular valving
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US4770179A (en) * 1982-09-02 1988-09-13 Nellcor Incorporated Calibrated optical oximeter probe
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US5045051A (en) * 1989-03-14 1991-09-03 Abiomed, Inc. Leak detector
US5057120A (en) * 1988-10-27 1991-10-15 Farcot Jean Christian Apparatus for the performance of an angioplasty of long duration
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US5163904A (en) * 1991-11-12 1992-11-17 Merit Medical Systems, Inc. Syringe apparatus with attached pressure gauge
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US5201753A (en) * 1989-03-17 1993-04-13 Merit Medical Systems, Inc. Totally self-contained, digitally controlled, disposable syringe inflation system, and method for monitoring, displaying and recording balloon catheter inflation data
US5242374A (en) * 1991-03-29 1993-09-07 Aisin Seiki Kabushiki Kaisha Leak detector for an intra-aortic balloon pump
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US5312430A (en) * 1986-12-09 1994-05-17 Rosenbluth Robert F Balloon dilation catheter
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WO1995000198A1 (en) * 1993-06-25 1995-01-05 Boston Scientific Corporation Dilation catheter and method of treatment therewith
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US5431629A (en) * 1989-03-17 1995-07-11 Merit Medical Systems, Inc. System and method for monitoring, displaying and recording balloon catheter condition interval data
US5449345A (en) * 1989-03-17 1995-09-12 Merit Medical Systems, Inc. Detachable and reusable digital control unit for monitoring balloon catheter data in a syringe inflation system
US5449344A (en) * 1992-06-18 1995-09-12 Merit Medical Systems, Inc. Syringe apparatus with pressure gauge and detachable timer
US5453091A (en) * 1989-03-17 1995-09-26 Merit Medical Systems, Inc. RF transmission module for wirelessly transmitting balloon catheter data in a syringe inflation system
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GB1390813A (en) 1975-04-16
DE2221417A1 (de) 1972-11-30
IL39340A0 (en) 1972-07-26
NL7205917A (it) 1972-11-16
IL39340A (en) 1975-02-10
JPS5545220B1 (it) 1980-11-17
DE2221417C3 (de) 1981-09-10
SE380435B (sv) 1975-11-10
FR2137521A1 (it) 1972-12-29
IT957780B (it) 1973-10-20
CH552986A (fr) 1974-08-30
CA990802A (en) 1976-06-08
DE2221417B2 (de) 1981-01-29
FR2137521B1 (it) 1977-07-22

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