WO2005117691A2 - Vorrichtung und verfahren zum betrieb eines patientenmonitors - Google Patents
Vorrichtung und verfahren zum betrieb eines patientenmonitors Download PDFInfo
- Publication number
- WO2005117691A2 WO2005117691A2 PCT/EP2005/005950 EP2005005950W WO2005117691A2 WO 2005117691 A2 WO2005117691 A2 WO 2005117691A2 EP 2005005950 W EP2005005950 W EP 2005005950W WO 2005117691 A2 WO2005117691 A2 WO 2005117691A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- signal
- transceiver
- transponder
- data
- measurement signal
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
-
- 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
- A61B2560/04—Constructional details of apparatus
- A61B2560/0443—Modular apparatus
- A61B2560/045—Modular apparatus with a separable interface unit, e.g. for communication
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
- A61B2562/22—Arrangements of medical sensors with cables or leads; Connectors or couplings specifically adapted for medical sensors
- A61B2562/225—Connectors or couplings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
- A61B2562/22—Arrangements of medical sensors with cables or leads; Connectors or couplings specifically adapted for medical sensors
- A61B2562/225—Connectors or couplings
- A61B2562/227—Sensors with electrical connectors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body
Definitions
- the invention relates to a device and a method for operating a patient monitor, in particular with a device for measuring the blood pressure of a patient.
- a patient monitor or monitor In general in intensive care medicine, but especially when performing operations, vital parameters of the patient's condition are recorded by measurement and displayed on a display or recording device, a so-called patient monitor or monitor, and recorded over a certain period of time. Furthermore, such a patient monitor comprises various evaluation functions, so that an alarm signal can be output in the event of abnormal or abnormally changing monitored parameters, so that life-saving measures can be carried out by the medical personnel in particular.
- the display of invasive blood pressure is the second most common display of a vital parameter on the patient monitor.
- the invasive blood pressure can and is usually measured extracorporeally, statically coupled to the blood pressure at the distal tip of a catheter via the principle of the communicating columns, and dynamically retarded via the pressure wave that usually spreads in the column filled with physiological saline solution (0.8) with an extracorporeal pressure sensor, a so-called transducer, which Infusion stand is attached at the level of the right atrium.
- Such a transducer is designed either as a single-use transducer with an internal volume that is in fluid communication with the liquid column coupled to the blood circulation, or as a reusable transducer that is connected to the fluid system via a pressure dome that can be clipped on, for example. Such a connection can particularly advantageously also be made directly via the fluid column of an infusion applied.
- Such transducers and pressure domes are described, for example, in WO 99/37983, WO 02/03854, or DE 10321 099 (republished) and the other documents mentioned therein. From DE 20202 131 Ul it is known to use a transponder for the wireless transmission of various biometric data including blood pressure.
- the invasive blood pressure can also be measured with a tip transducer on the tip of an inserted catheter.
- a measurement obtained in this way is much more precise in the dynamic range because it is not damped by the hose system.
- such a measurement is very expensive and therefore limited to a very small number of applications (a few thousand per year worldwide) for cost reasons, based on the very large number of invasive blood pressure measurements (over 20 million times per year worldwide).
- Blood pressure control is therefore an important characteristic for monitoring vital functions.
- the provision of the measurement signal for invasive blood pressure and the requirements in the event of signal interference when monitored by patient monitors are described in DIN EN 60601-2-34 and DIN EN 60601-2-49 in accordance with IEC 60601-2-34 and IEC 60601-2- 49 set internationally.
- the measurement signal voltage must then be derived from a voltage provided by the patient monitor and must be 5 ⁇ V / V / mmHg (5 microvolts per volt supply voltage and pressure in millimeter of mercury). With a typical supply voltage of 5 V, the measurement signal is then 25 ⁇ V / mmHg.
- the normal disposable transducer or the reusable transducer with dome has a piezoresistive chip as the measuring cell, usually the size 2 mm x 2 mm, the membrane of which bends when pressure is applied. The deflection is measured with a Wheatstone bridge circuit.
- the Wheatstone bridge is operated with typically 5 V supply voltage and typically 15 mA supply current from the patient monitor via the patient monitor pressure transducer connecting cable.
- the chip which usually supplies signal voltage between 10 and 15 ⁇ V / V / mmHg due to the manufacturing tolerances, is provided with a Thick film circuit on ceramic substrate is trimmed down to the 5 ⁇ V / V / mmHg specified in the standard.
- This signal is relatively small (at the typical supply voltage of 5 V and a pressure of 100 mHg, it is 2.5 mV, a 10 mmHg difference corresponds to a signal change of only 0.25 mV) and is therefore prone to failure. Furthermore, the signal is transmitted analogously, the typically 2 long connection cable is shielded, but typical cable shielding is not sufficient for the sometimes large interference. The short cable of a disposable transducer to is omitted for cost reasons, because it is only used once. The standard-compliant measurement signal is therefore very susceptible to interference if the operation is carried out with an eectrosurgical device or a laser instead of a scalpel.
- the signal is only saved in the patient monitor, i.e. the patient monitor can even evaluate the signal via plausibility checks, if necessary, and suppress a disturbed signal with loss of the actual measurement data, as is known from DE 19835252 AI.
- the standard for invasive blood pressure monitors DIN EN 60601-2-34, section 5 assumes that the pressure signal on the patient monitor is often disturbed and requires that the signal only be undisturbed 10 seconds after the fault has been switched off. The duration of a disturbance is not limited. This clearly proves that it is state of the art that the transmission of the standard-compliant pressure signal is subject to massive disturbances and that a corresponding failure when monitoring a patient is also tolerated by the standard.
- the invention is therefore based on the object of reducing the susceptibility to interference of a measurement signal for invasive blood pressure provided in accordance with the standard.
- a device for transmitting a measurement signal for the blood pressure of a patient from a pressure sensor to a display or recording device comprising at least one first transmission device (transponder) with at least one analog / digital converter for converting the analog measurement signal into digital Measurement data, a first microprocessor for linking the digital measurement data with test data and an output stage for sending out the linked digital signal from measurement data and test data, a second transmission device (transceiver) with a second microprocessor for separate processing of measurement data and test data, a comparison device for comparing the test data with reference data and an output stage for providing the measurement data or the measurement signal for a display or recording device, and a transmission path between the transponder and the transceiver.
- the measurement signal can not only be transmitted digitally, which reduces the susceptibility to interference, but does not substantially eliminate it, but the test data allows the quality of the transmitted data to be checked by the last link in the transmission chain, and thus disturbed data, without being influenced by the measurement data discarded, and undisturbed data for the display or recording device (patient monitor) are provided. Even in Significantly reduce the signal for the patient's blood pressure and limit it to fractions of a second due to the high possible repetition rate. Monitoring of the vital parameters of a patient can thus be significantly improved.
- the transceiver has an output for transmitting a trigger signal and the transponder has a trigger input for briefly activating its output stage. This makes it possible to control the output stage of the transponder only when a signal is requested from the transceiver, and thus the energy consumption is reduced.
- the transceiver is integrated in a plug for connection to a display or recording device.
- the transponder is integrated in the transducer housing of the pressure transducer or is attached directly to the transducer or is arranged on a holder for receiving disposable transducers.
- Transceiver also a current measuring device for detecting the supply current for operating transceivers, transducers, and
- the device according to the invention is characterized in that the output of the transceiver is at the same time designed to send digital reference data or a signal to generate the test data in the transponder. It is possible that the data to be used as test data can be specified by the microprocessor of the transceiver and allows a particularly reliable and simple test for interference-free transmission by the transceiver.
- the object is further achieved by a method for transmitting a measurement signal for the blood pressure of a patient and the provision of a signal for a display or recording device, in which an electrical signal corresponding to the directly or indirectly recorded blood pressure is generated by a measurement transducer the signal is converted into a digital measurement signal in a first transmission device (transponder) and linked with a test signal, and the linked signal is output to a transmission link on request from a second transmission device (transceiver), the linked signal being received by the transceiver and the test signal is compared with a reference signal, and the digital measurement signal is rejected as disturbed if the test signal deviates from the reference signal, or the digital measurement signal is output to a display or recording device if the test signal is not from the reference Signal deviates, and wherein the transceiver requests a re-output of a linked signal from the transponder if the received digital measurement signal has been rejected as disturbed or a predetermined period of time Tl has elapsed since the last reception of an interference-free
- the measurement signal will not only be transmitted digitally, which reduces the susceptibility to interference, but does not substantially eliminate it, but by checking the data, the quality of the transmitted data can be checked by the last link in the transmission chain and thus unaffected by the measurement data disturbed data are discarded, and undisturbed data are provided for the display or recording device (patient monitor). Even in a highly disturbed environment, it is therefore possible to reduce the downtime of the signal for the patient's blood pressure considerably and to limit it to fractions of a second due to the high possible repetition rate. Monitoring of the vital parameters of a patient can thus be significantly improved.
- the digital measurement signal is temporarily stored in the transceiver for output to a display or recording device until it is replaced by a new digital measurement signal.
- an acoustic or visual warning signal is output if no undisturbed digital measurement signal has been received by the transceiver for a predetermined period T2.
- the digital measurement signal is converted into an analog measurement signal before being output to a display or recording device.
- the electrical energy required to operate at least the transceiver and the transponder is taken from the display or recording device.
- the electrical current drawn from the display or recording device is continuously monitored and if a predetermined threshold value is exceeded, the time period Tl is extended, preferably doubled, and / or the operating frequency of the transponder and / or transceiver is reduced.
- the current consumption of the electronic components of a corresponding device can be significantly reduced, by approximately 30% per halving of the clock frequency.
- the step of extending the time period T1 and / or reducing and / or the operating frequency is repeated until the threshold value of the electrical current is undershot.
- the measurement signal is subjected to temperature compensation in the transponder.
- a reference signal is transmitted from the transceiver to the transponder. wherein the reference signal received by the transponder is subsequently linked as a test signal with the measurement signal.
- the invention is particularly advantageous if it is used for the continuous monitoring of a patient's blood pressure.
- FIG. 1 is a schematic view of a device according to the invention
- FIG. 2 shows a basic circuit diagram of a device according to the invention
- Fig. 3 shows a connector with an integrated transceiver according to the invention.
- a first transmission device, a transponder 1, with a pressure sensor, a transducer 2, is accommodated in a common housing 3.
- the housing 3 is designed to be as radiation-proof as possible, e.g. a metal case.
- the housing 3 has a connection piece 4 for connection to a pressure dome which is separated from the fluid to be measured, e.g. Blood flowing through or connected to a fluid system that is in fluid communication with the bloodstream, e.g. to the liquid column formed by an infusion solution.
- a preferably single or double shielded connecting cable 5 emerges from one side of the housing 3.
- the connecting cable 5 can for example comprise two pairs of wires and forms the
- the transceiver 6 is advantageously integrated into the housing 7 of a plug 8 for connection to a patient monitor as a display or recording device.
- FIG. 3 provides a schematic view of such a connector 8.
- a light-emitting diode 10 is inserted into the housing 7, which is connected to the microcontroller circuit 9 and serves as a visual warning signal in the event of a fault.
- the housing 7 of the connector 8 also contains the usual contact pins 11 for the measurement signal and supply voltage.
- FIG. 2 schematically shows a basic circuit diagram of the device from FIG. 1, in addition to the pressure sensor or transducer 2, the housing 3 also contains the transponder 1, which is formed from a microcontroller circuit which, in addition to a first microprocessor 12 with integrated analog-digital Converter still a digital output stage 13 for feeding data into the connecting cable 5, and preferably an input stage 14 for receiving control signals from the transceiver 6, for example of trigger signals.
- the transponder 1 is formed from a microcontroller circuit which, in addition to a first microprocessor 12 with integrated analog-digital Converter still a digital output stage 13 for feeding data into the connecting cable 5, and preferably an input stage 14 for receiving control signals from the transceiver 6, for example of trigger signals.
- the transceiver 6 accommodated in the plug housing 7 contains in its microcontroller circuit a second microprocessor 15, a digital input stage 16 for receiving the signal transmitted via the connecting cable 5, and preferably an output stage 17 for transmitting control signals for the transponder 1. Furthermore, there is also an analog one Output stage 18 for providing the measurement data on connector 8 for a display or recording device (patient monitor) (not shown). For operation with a monitor according to the current one which the measurement data is converted to the standard-compliant analog format with a sensitivity of 5 ⁇ V / V / mmHg. Such a D / A converter stage can be dispensed with in future applications that permit direct digital processing of the data by a patient monitor. Appropriate data buffers are expediently provided, so-called buffers, in order to keep the respective data available at the outputs even after a processor cycle.
- the device is supplied with electrical energy from the connection of the patient monitor.
- the operation of the components is started immediately when the connection is established or the monitor is switched on, separate handling for switch-on processes or the like is not necessary.
- the integration of the transceiver in the connector 8 is readily possible, since the circuit has only such a small mass that the mechanical holding forces of the connector 8 are sufficient.
- the transducer can be a conventional pressure transducer, e.g. piezoresistive.
- the signal is a signal voltage proportional depending on the moving pressure.
- the digitally converted pressure values can be stored in a buffer 100 times per second at a sampling rate of, for example, but not necessarily limited to, and there for active queries by the transceiver arranged on the patient monitor side, which transposes the queried digital information back into the standardized ( according to DIN EN 60601-2-34) converts analog signal voltage back, be kept ready.
- the microcontroller in the transceiver is queried with a
- the microcontroller of the transceiver is repeated if errors are found in the control bits until the error-free status is determined using the control bits. This can happen many hundreds of times due to the high speed of the microcontrollers, which are typically clocked at hundreds of MHz, and yet the pressure is transmitted every hundredth of a second.
- a light-emitting diode can also be provided as a visual warning signal on the transponder and on the transceiver.
- the signal in the first transmission device is converted into a digital measurement signal and linked with a test signal, and the linked signal is output to a transmission link (cable 5) at the request of the second transmission device (transceiver 6).
- the linked signal is received by the transceiver 6 and the test signal is compared with a reference signal.
- the digital measurement signal is rejected as disturbed if the test signal deviates from the reference signal or is identified as being faulty on the basis of a calculation algorithm. If the test signal is recognized as error-free, the digital measurement signal is output to a display or recording device (patient monitor).
- the transceiver 6 requests a new output of a linked signal from the transponder 1 if the received digital measurement signal has been rejected as disturbed or a predetermined time period Tl has elapsed since the last reception of an interference-free digital measurement signal.
- the digital measurement signal is temporarily stored in the transponder until it is replaced by a new digital measurement signal.
- the digital measurement signal for output to the monitor is temporarily stored in the transceiver 6 until it is replaced by a new digital measurement signal.
- An acoustic or visual warning signal is output, for example, via the LED 10 if no undisturbed digital measurement signal has been received by the transceiver 6 for a predetermined period T2.
- the digital measurement signal for output to the monitor is switched off if no undisturbed digital measurement signal has been received by the transceiver 6 for a predetermined period T3.
- the output stage 17 of the transceiver 6 is preferably designed in such a way that it is at the same time designed to transmit digital reference data or a signal to generate the test data in the transponder 1.
- the reference data to be used by the transceiver 6 for checking the data to be received are expediently used after initialization, e.g. when the supply voltage is applied, transmitted to the transponder 1 in this way.
- the reference data are stored in the transponder 1 and sent to the transceiver 6 as test data or test signal linked to the measurement data.
- an algorithm for generating the test signal can also be transmitted to the transponder 1, so that, for example during long-term operation, a temporal variance of the test signal can be obtained or the test signal can be encrypted when several such devices are operated simultaneously and in more immediate fashion Proximity is possible.
- the electrical current drawn from the patient monitor is continuously monitored and if a predetermined threshold value is exceeded, the time period T1 is extended, preferably doubled, and / or the operating frequency of transponder 1 and / or transceiver 6 is reduced. This step is repeated until the threshold value of the electrical current is undershot.
- the measurement signal in the transponder 1 is preferably subjected to temperature compensation.
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/547,964 US20070287924A1 (en) | 2004-06-02 | 2005-06-02 | Device And Method for Operating A Patient Monitor |
EP05749555A EP1750579A2 (de) | 2004-06-02 | 2005-06-02 | Vorrichtung und verfahren zum betrieb eines patientenmonitors |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE102004027044A DE102004027044A1 (de) | 2004-06-02 | 2004-06-02 | Vorrichtung und Verfahren zum Betrieb eines Patientenmonitors |
DE102004027044.9 | 2004-06-02 |
Publications (3)
Publication Number | Publication Date |
---|---|
WO2005117691A2 true WO2005117691A2 (de) | 2005-12-15 |
WO2005117691A3 WO2005117691A3 (de) | 2006-03-30 |
WO2005117691A9 WO2005117691A9 (de) | 2006-10-12 |
Family
ID=34969626
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/EP2005/005950 WO2005117691A2 (de) | 2004-06-02 | 2005-06-02 | Vorrichtung und verfahren zum betrieb eines patientenmonitors |
Country Status (4)
Country | Link |
---|---|
US (1) | US20070287924A1 (de) |
EP (1) | EP1750579A2 (de) |
DE (1) | DE102004027044A1 (de) |
WO (1) | WO2005117691A2 (de) |
Families Citing this family (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE102007030163A1 (de) | 2007-06-27 | 2009-01-02 | Mhm Harzbecher Medizintechnik Gmbh | Messeinrichtung zur Erfassung der Ausbreitungsgeschwindigkeit von Pulswellen im menschlichen oder tierischen Blutkreislaufsystem und Verfahren |
DE102009039953A1 (de) * | 2009-08-28 | 2011-03-03 | Bernd Beck | Messdatenumsetzer für ein Patientenüberwachungssystem |
DE102009054319A1 (de) | 2009-11-24 | 2011-05-26 | Mhm Harzbecher Medizintechnik Gmbh | Messeinrichtung zur Erfassung der Ausbreitungsgeschwindigkeit von Pulswellen sowie Verfahren zur Bestimmung des Durchflussvolumenstroms einer diskontinuierlich arbeitende Pumpe |
US8797714B2 (en) | 2009-12-22 | 2014-08-05 | Mindray Ds Usa, Inc. | Cables for patient monitoring and related systems with integrated front end |
CA2882734C (en) | 2012-07-20 | 2019-02-05 | Endophys Holdings, Llc | Transducer interface system and method |
EP4218559A1 (de) * | 2014-02-25 | 2023-08-02 | ICU Medical, Inc. | Patientenuberwachungssystem mit gatekeeper-signal und entsprechendes verfahren |
CN105147272B (zh) * | 2015-09-10 | 2017-12-26 | 广州视源电子科技股份有限公司 | 血压测量装置及测量血压的方法 |
CA3105936C (en) | 2015-10-19 | 2023-08-01 | Icu Medical, Inc. | Hemodynamic monitoring system with detachable display unit |
JP6869765B2 (ja) * | 2017-03-23 | 2021-05-12 | 株式会社日立ハイテク | プラズマ処理装置及びプラズマ処理方法 |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
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US6416471B1 (en) * | 1999-04-15 | 2002-07-09 | Nexan Limited | Portable remote patient telemonitoring system |
WO2002067122A1 (en) * | 2001-02-15 | 2002-08-29 | I-Medik, Inc. | Wireless internet bio-telemetry monitoring system and interface |
US20020183976A1 (en) * | 2001-01-18 | 2002-12-05 | Pearce Marvin Jay | Patient monitoring and recording systems |
WO2003050643A2 (en) * | 2001-12-10 | 2003-06-19 | Medic4All Ag | Method and device for measuring physiological parameters at the wrist |
Family Cites Families (7)
Publication number | Priority date | Publication date | Assignee | Title |
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US5261412A (en) * | 1992-11-20 | 1993-11-16 | Ivac Corporation | Method of continuously monitoring blood pressure |
DE19802615A1 (de) * | 1998-01-24 | 1999-08-12 | Manfred Adolfs | Verbindungselement zur Verbindung eines Meßwertaufnehmers mit einem abgedichteten Fluidsystem |
DE19835252C2 (de) * | 1998-08-04 | 2000-10-12 | Alexander Dorn | Verfahren und System zur Übermittlung von Daten und/oder Steuerinformationen an eine Empfangsvorrichtung |
US6475153B1 (en) * | 2000-05-10 | 2002-11-05 | Motorola Inc. | Method for obtaining blood pressure data from optical sensor |
DE10032616A1 (de) * | 2000-07-08 | 2002-01-24 | Mhm Harzbecher Medizintechnik | Systemelemente zur Druckmessung in extrakorporalen Kreisläufen |
DE20202131U1 (de) * | 2002-02-12 | 2002-08-14 | Chips At Work Solutions For Wi | System zur kontinuierlichen Überwachung bzw. Auswertung von biometrischen Meßdaten mindestens eines Lebewesens, insbesondere eines Menschen |
DE10321099A1 (de) * | 2003-05-09 | 2004-11-25 | Cgs Sensortechnik Gmbh | Vorrichtung zur Druckmessung |
-
2004
- 2004-06-02 DE DE102004027044A patent/DE102004027044A1/de not_active Withdrawn
-
2005
- 2005-06-02 WO PCT/EP2005/005950 patent/WO2005117691A2/de active Application Filing
- 2005-06-02 EP EP05749555A patent/EP1750579A2/de not_active Withdrawn
- 2005-06-02 US US11/547,964 patent/US20070287924A1/en not_active Abandoned
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6416471B1 (en) * | 1999-04-15 | 2002-07-09 | Nexan Limited | Portable remote patient telemonitoring system |
US20020183976A1 (en) * | 2001-01-18 | 2002-12-05 | Pearce Marvin Jay | Patient monitoring and recording systems |
WO2002067122A1 (en) * | 2001-02-15 | 2002-08-29 | I-Medik, Inc. | Wireless internet bio-telemetry monitoring system and interface |
WO2003050643A2 (en) * | 2001-12-10 | 2003-06-19 | Medic4All Ag | Method and device for measuring physiological parameters at the wrist |
Also Published As
Publication number | Publication date |
---|---|
WO2005117691A9 (de) | 2006-10-12 |
WO2005117691A3 (de) | 2006-03-30 |
DE102004027044A1 (de) | 2005-12-29 |
EP1750579A2 (de) | 2007-02-14 |
US20070287924A1 (en) | 2007-12-13 |
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