Cooling device having a plurality of controllable cooling elements to provide a predetermined cooling profile

Abstract
A cooling device for removing heat from subcutaneous lipid-rich cells of a subject having skin is provided. The cooling device includes a plurality of cooling elements movable relative to each other to conform to the contour's of the subject's skin. The cooling elements have a plurality of controllable thermoelectric coolers. The cooling elements can be controlled to provide a time-varying cooling profile in a predetermined sequence, can be controlled to provide a spatial cooling profile in a selected pattern, or can be adjusted to maintain constant process parameters, or can be controlled to provide a combination thereof.
Description
TECHNICAL FIELD

The present application relates generally to cooling devices, systems, and methods for removing heat from subcutaneous lipid-rich cells, and more particularly, but not exclusively, to a cooling device having a plurality of controllable cooling elements to create a spatial cooling profile and/or a time-varying cooling profile in order to more efficiently affect subcutaneous lipid-rich cells.


BACKGROUND

Excess body fat increases the likelihood of developing various types of diseases such as heart disease, high blood pressure, osteoarthrosis, bronchitis, hypertension, diabetes, deep-vein thrombosis, pulmonary emboli, varicose veins, gallstones, hernias, and several other conditions.


In addition to being a serious health risk, excess body fat can also detract from personal appearance and athletic performance. For example, excess body fat can form cellulite, which causes an “orange peel” effect at the surface of the skin. Cellulite forms when subcutaneous fat protrudes into the dermis and creates dimples where the skin is attached to underlying structural fibrous strands. Cellulite and excessive amounts of fat are often considered to be unappealing. Thus, in light of the serious health risks and aesthetic concerns associated with excess fat, an effective way of controlling excess accumulation of body fat is urgently needed.


Liposuction is a method for selectively removing body fat to sculpt a person's body. Liposuction is typically performed by plastic surgeons and dermatologists using specialized surgical equipment that mechanically removes subcutaneous fat cells via suction. One drawback of liposuction is that it is a serious surgical procedure, and the recovery may be painful. Liposuction can have serious and occasionally even fatal complications. In addition, the cost for liposuction is usually substantial.


Conventional non-invasive treatments for removing excess body fat typically include topical agents, weight-loss drugs, regular exercise, dieting, or a combination of these treatments. One drawback of these treatments is that they may not be effective or even possible under certain circumstances. For example, when a person is physically injured or ill, regular exercise may not be an option. Similarly, weight-loss drugs or topical agents are not an option when they cause an allergic or negative reaction. Furthermore, fat loss in selective areas of a person's body cannot be achieved using general or systemic weight-loss methods.


Other non-invasive treatment methods include applying heat to a zone of subcutaneous lipid-rich cells. U.S. Pat. No. 5,948,011 discloses altering subcutaneous body fat and/or collagen by heating the subcutaneous fat layer with radiant energy while cooling the surface of the skin. The applied heat denatures fibrous septae made of collagen tissue and may destroy fat cells below the skin, and the cooling protects the epidermis from thermal damage. This method is less invasive than liposuction, but it still can cause thermal damage to adjacent tissue, and may be painful for the patient.


Another method of reducing subcutaneous fat cells is to cool the target cells as disclosed in U.S. Patent Publication No. 2003/0220674, the entire disclosure of which is incorporated herein. This publication discloses, among other things, reducing the temperature of lipid-rich subcutaneous fat cells to selectively affect the fat cells without damaging the cells in the epidermis. Although this publication provides promising methods and devices, several improvements for enhancing the implementation of these methods and devices would be desirable, including providing a plurality of controllable cooling elements to create a spatial cooling profile and/or a time-varying cooling profile in order to more efficiently affect subcutaneous lipid-rich cells.


U.S. Patent Publication No. 2003/0220674 also discloses methods for selective removal of lipid-rich cells and avoidance of damage to other structures including dermal and epidermal cells. A method for more efficiently and precisely controlling these effects is desirable. Therefore, a method for spatially cooling lipid-rich cells over a predetermined time-varying cooling profile, selected spatial cooling profile, or maintaining constant process parameters is also needed.





BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, identical reference numbers identify similar elements or acts. The sizes and relative positions of elements in the drawings are not necessarily drawn to scale. For example, the shapes of various elements and angles are not drawn to scale, and some of these elements are arbitrarily enlarged and positioned to improve drawing legibility. Further, the particular shapes of the elements as drawn are not intended to convey any information regarding the actual shape of the particular elements, and have been solely selected for ease of recognition in the drawings.



FIG. 1 is an isometric view of a system for removing heat from subcutaneous lipid-rich cells in accordance with an embodiment of the invention.



FIGS. 2A, 2B, 2C, and 2D are isometric views of a cooling device for removing heat from subcutaneous lipid-rich cells in accordance with embodiments of the invention.



FIG. 3 is an exploded isometric view of the cooling device of FIG. 2A for removing heat from subcutaneous lipid-rich cells in accordance with an embodiment of the invention.



FIG. 4 is a further exploded isometric view of the cooling device of FIG. 3 illustrating additional components of the cooling device in accordance with another embodiment of the invention.



FIG. 5A is an isometric view of a plurality of heat exchangers connected in series in accordance with another embodiment of the invention. FIG. 5B is an isometric top view of a plurality of heat exchangers connected in series in accordance with yet another embodiment of the invention. FIG. 5C is an isometric bottom view of the heat exchangers in FIG. 5B.



FIG. 6A is an exploded isometric view of one of the heat exchangers shown in FIG. 5A. FIG. 6B is an isometric view of an alternative configuration of a cooling element of a heat exchanger in accordance with an embodiment of the invention.



FIG. 7 is a cross-sectional view of one of the cooling elements along line 7-7 of FIG. 5A.



FIG. 8 is an isometric top view of an alternative cooling device for removing heat from subcutaneous lipid-rich cells in accordance with an embodiment of the invention.



FIG. 9 is an isometric bottom view of the alternative cooling device of FIG. 8.



FIG. 10 is an exemplary sectional view of a lateral cooling pattern in the dermis of the skin in accordance with another embodiment of the invention.



FIG. 11 is a block diagram showing computing system software modules for removing heat from subcutaneous lipid-rich cells in accordance with another embodiment of the invention.





DETAILED DESCRIPTION

A. Overview


The present disclosure describes devices, systems, and methods for cooling subcutaneous lipid-rich cells. The term “subcutaneous tissue” means tissue lying underneath the dermis and includes adipocytes (fat cells) and subcutaneous fat. It will be appreciated that several of the details set forth below are provided to describe the following embodiments in a manner sufficient to enable a person skilled in the relevant art to make and use the disclosed embodiments. Several of the details and advantages described below, however, may not be necessary to practice certain embodiments of the invention. Additionally, the invention can include other embodiments that are within the scope of the claims but are not described in detail with respect to FIGS. 1-11.


Reference throughout this specification to “one embodiment” or “an embodiment” means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment of the present invention. Thus, the occurrences of the phrases “in one embodiment” or “in an embodiment” in various places throughout this specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments.


The headings provided herein are for convenience only and do not interpret the scope or meaning of the claimed invention.


The present invention is directed toward a cooling device for removing heat from subcutaneous lipid-rich cells of a subject. The cooling device includes a plurality of cooling elements movable relative to each other so as to be conformable to the skin of the subject.


One aspect is directed toward a cooling device for removing heat from subcutaneous lipid-rich cells. The cooling device includes a plurality of cooling elements contained within interconnected frame members rotatable about at least one axis, a plurality of heat exchanging elements, and a housing. Alternatively, the cooling device includes a plurality of cooling elements contained on a flexible substrate. The cooling elements can use a number of cooling technologies including, for example, thermoelectric coolers, recirculating chilled fluid, vapor compression elements, or phase change cryogenic devices. One skilled in the art will recognize that there are a number of other cooling technologies that could be used and that the cooling elements need not be limited to those described here.


Another aspect is directed toward a cooling device having a plurality of cooling members using thermoelectric Peltier principles or other cooling technologies. The cooling device also includes a heat dissipating member in thermal communication with the cooling members and a plurality of interface members having heat exchanging surfaces configured to contact a subject's skin. The cooling members can be capable of reducing a temperature of a region such that lipid-rich cells in the region are affected while non-lipid-rich cells are not generally affected.


Further aspects include that the cooling device can include a plurality of interconnected hinged segments for rotating to conform to a body portion. Alternatively, the cooling elements may also be disposed on a flexible substrate and movable relative to each other.


Another aspect is directed toward a cooling device having a plurality of cooling members individually controlled to provide a spatial cooling profile and/or a time-varying cooling profile. The cooling profile can, for example, be configured to provide cooling members along a perimeter of the cooling device at a lower or a higher temperature than cooling members at an interior of the cooling device. Alternatively, the cooling profile can be configured to provide cooling members in regions of the cooling device at a lower or a higher temperature than cooling members in adjacent regions of the cooling device. Further aspects include that the cooling profile can vary over time to provide a decreasing or an increasing temperature profile during treatment.


Another aspect is directed toward a method of applying a cooling device having a plurality of cooling elements contained on a plurality of interconnected hinged segments, each adjacent pair of hinged cooling elements being rotatable about at least one axis. The cooling elements can have a plurality of heat exchanging surfaces capable of removing heat from the subject's skin. The method includes rotating hinged segments containing the cooling elements to achieve a desired configuration of the cooling device, cooling the heat exchanging surfaces of the plurality of cooling elements to a desired temperature, placing the plurality of cooled heat exchanging surfaces proximate to the subject's skin, and reducing the temperature of a region such that lipid-rich cells in the region are affected while non-lipid-rich cells in the region are not generally affected. Alternatively, the cooling elements may be disposed on a flexible substrate and movable relative to each other.


Further aspects include a method for applying and maintaining pressure on the contact region. Further aspects include securing the cooling device in position with a retention device. Further aspects include providing a time-varying profile to increase or decrease the temperature of the cooling elements over a selected time period. Further aspects include spatially varying the temperature of each cooling element of the cooling device to provide discrete cooling regions in the cooling device.


Another aspect is directed toward a system for removing heat from subcutaneous lipid-rich cells. The system includes a cooling device having a plurality of frame segments containing cooling elements movable relative to each other, the frame segments capable of achieving a desired orientation between each other, and a heat sink coupled to the cooling device to dissipate heat generated by the cooling device. In one embodiment, the frame segments are hinged. When placed proximate to a subject's skin, the plurality of cooling elements can be capable of reducing a temperature of a region such that lipid-rich cells in the region are affected while non-lipid-rich cells in the epidermis and/or dermis are not generally affected.


Further aspects include the cooling device being configured to follow the contours of the body. Further aspects include that the cooling device includes a handle and/or can include a strap or other retention device for holding the cooling device in a selected position. Further aspects include a control system for individually controlling the temperature of the cooling elements in a predetermined pattern. Further aspects include a processing unit for controlling a time-varying cooling profile of the cooling device.


B. System for Selectively Reducing Lipid-Rich Cells



FIG. 1 is an isometric view of a system 100 for removing heat from subcutaneous lipid-rich cells of a subject 101 in accordance with an embodiment of the invention. The system 100 can include a cooling device 104 placed at an abdominal area 102 of the subject 101 or another suitable area for removing heat from the subcutaneous lipid-rich cells of the subject 101. Various embodiments of the cooling device 104 are described in more detail below with reference to FIGS. 2-11.


The system 100 can further include a cooling unit 106 and supply and return fluid lines 108a-b connecting the cooling device 104 to the cooling unit 106. The cooling unit 106 can remove heat from a coolant to a heat sink and provide a chilled coolant to the cooling device 104 via the fluid lines 108a-b. Examples of the circulating coolant include water, glycol, synthetic heat transfer fluid, oil, a refrigerant, and any other suitable heat conducting fluid. The fluid lines 108a-b can be hoses or other conduits constructed from polyethylene, polyvinyl chloride, polyurethane, and other materials that can accommodate the particular circulating coolant. The cooling unit 106 can be a refrigeration unit, a cooling tower, a thermoelectric chiller, or any other device capable of removing heat from a coolant. Alternatively, a municipal water supply (i.e., tap water) can be used in place of the cooling unit.


As explained in more detail below, the cooling device 104 includes a plurality of thermoelectric cooling elements, such as Peltier-type thermoelectric elements, which can be individually controlled to create a custom spatial cooling profile and/or a time-varying cooling profile. The system 100 can further include a power supply 110 and a processing unit 114 operatively coupled to the cooling device 104. In one embodiment, the power supply 110 can provide a direct current voltage to the thermoelectric cooling device 104 to effectuate a heat removal rate from the subject 101. The processing unit 114 can monitor process parameters via sensors (not shown) placed proximate to the cooling device 104 through power line 116 to adjust the heat removal rate based on the process parameters. The heat transfer rate can be adjusted to maintain constant process parameters. Alternately, the process parameters can vary either spatially or temporally. The processing unit 114 can be in direct electrical communication through line 112, or alternatively, may be connected via a wireless communication. Alternatively, the processing unit 114 can be preprogrammed to provide a spatially distributed cooling profile and/or a time-varying cooling profile. The processing unit 114 can include any processor, Programmable Logic Controller, Distributed Control System, and the like.


In another aspect, the processing unit 114 can be in electrical communication with an input device 118, an output device 120, and/or a control panel 122. The input device 118 can include a keyboard, a mouse, a touch screen, a push button, a switch, a potentiometer, and any other device suitable for accepting user input. The output device 120 can include a display screen, a printer, a medium reader, an audio device, and any other device suitable for providing user feedback. The control panel 122 can include indicator lights, numerical displays, and audio devices. In alternative embodiments, the control panel 122 can be contained on the cooling device 104. In the embodiment shown in FIG. 1, the processing unit 114, power supply 110, control panel 122, cooling unit 106, input device 118, and output device 120 are carried by a rack 124 with wheels 126 for portability. In alternative embodiments, the processing unit 114 can be contained on the cooling device 104. In another embodiment, the various components can be fixedly installed at a treatment site.


C. Cooling Device Having a Plurality of Cooling Elements



FIGS. 2A, 2B, and 2C are isometric views of a cooling device 104 in accordance with embodiments of the invention suitable for use in the system 100. In this embodiment, the cooling device 104 includes a control system housing 202 and cooling element housings 204a-g. The control system housing 202 includes a sleeve 308 (FIG. 3) that may slide into collar 310 and/or may mechanically attach to the cooling element housings. The cooling element housings 204a-g are connected to the heat exchanging elements (not shown) by attachment means 206. The attachment means can be any mechanical attachment device such as a screw or pin as is known in the art. The plurality of cooling element housings 204a-g can have many similar features. As such, the features of the first cooling element housing 204a are described below with reference symbols followed by an “a,” corresponding features of the second cooling element housing 204b are shown and noted by the same reference symbol followed by a “b,” and so forth. The cooling element housing 204a can be constructed from polymeric materials, metals, ceramics, woods, and/or other suitable materials. The example of the cooling element housing 204a shown in FIG. 2A-C is generally rectangular, but it can have any other desired shape.


The cooling device 104 is shown in a first relatively flat configuration in FIG. 2A; in a second slightly curved configuration in FIG. 2B; and in a third curved configuration in FIG. 2C. As shown in FIGS. 2B and 2C, each segment of the cooling element housings 204a-g are rotatably connected to adjacent segments and moveable about connection 207a-f to allow the cooling device 104 to curve. The connection 207a-f, for example, can be a pin, a ball joint, a bearing, or other type of rotatable joints. The connection 207 can accordingly be configured to rotatably couple the first cooling element housing 204a to the second cooling element housing 204b. According to aspects of the invention, the first cooling element housing 204a can rotate relative to the second cooling element housing 204b (indicated by arrow A), each adjacent moveable pair of cooling elements being such that, for example, the angle between the first and second cooling element housings 204a and 204b can be adjusted up to 45°. In this way, the cooling device is articulated such that it can assume a curved configuration as shown in FIG. 2B or 2C, conformable to the skin of a subject.


One advantage of the plurality of rotatable heat exchanging surfaces is that the arcuate shape of the cooling device may concentrate the heat transfer in the subcutaneous region. For example, when heat exchanging surfaces are rotated about a body contour of a subject, the arcuate shape can concentrate heat removal from the skin.


The control system housing 202 can house a processing unit for controlling the cooling device 104 and/or fluid lines 108a-b and/or electrical power and communication lines. The control system housing 202 includes a harness port 210 for electrical and supply fluid lines (not shown for purposes of clarity). The control system housing 202 can further be configured to serve as a handle for a user of the cooling device 104. Alternatively, the processing unit may be contained at a location other than on the cooling device.


As shown in FIGS. 2A, 2B, and 2C, the cooling device 104 can further include at each end of the cooling device 104 retention devices 208a and 208b coupled to a frame 304. The retention devices 208a and 208b are rotatably connected to the frame by retention device coupling elements 212a-b. The retention device coupling elements 212a-b, for example, can be a pin, a ball joint, a bearing, or other type of rotatable joints. Alternatively, the retention devices 208a and 208b can be rigidly affixed to the end portions of the cooling element housings 204a and 204g. Alternately, the retention device can attach to control system housing 202.


The retention devices 208a and 208b are each shown as tabs 214, each having a slot 216 therein for receiving a band or elastomeric strap (not shown for purposes of clarity) to retain the cooling device 104 in place on a subject 101 during treatment. Alternatively, the cooling device may not contain any attached retention device and may be held in place by hand, may be held in place by gravity, or may be held in place with a band, elastomeric strap, or non-elastic fabric (e.g., nylon webbing) wrapped around the cooling device 104 and the subject 101.


As shown in FIGS. 2A-2C, the cooling element housings 204a-g have a first edge 218 and an adjacent second edge 220 of a reciprocal shape to allow the cooling device 104 to mate and, thus, configure in a flat configuration. The first edge 218 and the second edge 220 are generally angular in the Figures; however, the shape could be curved, straight, or a combination of angles, curves, and straight edges that provide a reciprocal shape between adjacent segments of the cooling element housings 204a-g.



FIG. 2D shows an isometric view of an alternative cooling device 104 in accordance with embodiments of the invention suitable for use in the system 100. In this embodiment, the cooling device 104 includes a plurality of heat exchanging elements 300a-g contained within a flexible substrate 350. As described with respect to FIGS. 2A-2C, adjacent heat exchanging elements 300a-g are fluidicly coupled in series by fluid lines 328.


According to aspects of the embodiment, the cooling elements 302a-g may be affixed to the flexible substrate 350, or may be embedded in the flexible substrate 350. The flexible substrate 350 can be constructed from polymeric materials, elastomeric materials, and/or other suitable materials. The flexible substrate 350 can further be an elastomer such as silicone or urethane or can be a fabric, such as nylon. The flexible substrate 350 can also be a thin polymer such as polypropylene or ABS. The example of the flexible substrate 350 shown in FIG. 2D is generally rectangular, but can have any other desired shape, including a matrix configuration or an anatomy specific shape. According to aspects of this embodiment, the flexible substrate 350 acts as a living hinge between cooling elements 302a-g to allow the cooling elements 302a-g to conform to the skin of a subject.



FIG. 3 is an exploded isometric view of a cooling device 104 in accordance with one embodiment of the invention suitable for use in the system 100. In this embodiment, the cooling device 104 includes a frame 304 having a plurality of rotatably connected segments 305a-g. The rotatably connected segments 305a-g are connected by hinges 306a-g. Alternatively, the rotatably connected segments 305a-g of the frame 304 could be connected by a connection that allows rotation, such as a pin, living hinge, flexible substrate, such as webbing or fabric, or the like. According to one aspect of the invention, the links or hinges are made of plastic to insulate the cooling elements from each other.


A plurality of heat exchanging elements 300a-g are contained on the frame 304. The heat exchanging elements 300a-g include cooling elements 302a-g having covers 301a-g. The covers 301a-g are affixed on a top side of the cooling elements 302a-g. The covers 301a-g may be affixed by various mechanical means as described further herein and as are known in the art. According to aspects of the invention, the covers 301a-g are fluidicly sealed to the cooling elements 302a-g. According to further aspects of the invention, the hinges 306a-g are configured so as to be adjacent to the subject's skin, in use, to maintain close proximity between the heat exchanging elements 300a-g when the heat exchanging elements 300a-g are in a rotated position.


The cooling elements 302a-g are attached by cooling element attachment means 307 to the frame 304 such that the first heat exchanging element 300a is located at the first segment 305a of the frame 304 and the second heat exchanging element 300b is located at the second segment 305b of the frame 304. The cooling element attachment means 307 are shown as a tab 313 extending from the frame 304 and a screw 315 fixedly attaching the tab 313 of the frame 304 to the cooling elements 302a-g. Alternatively, mechanical fixation devices as are known in the art may be used.


The cooling elements 302a-g of the cooling device 104 are generally configured to rotate to allow the cooling device 104 to conform to an arcuate portion of a subject 101. Once positioned on a subject 101, the cooling device 104 can further be strapped to or otherwise configured to be releasably attached to the subject 101. The cooling elements 302a-g can be configured to move relative to each other or rotate to position the cooling elements 302a-g for applying pressure to the treatment area during operation. Cooling elements 302a-g are movable or rotatable relative to each other such that cooling device 104 is conformable to the skin of the subject. These features are described in more detail below with reference to specific examples of the cooling devices.


The first cooling element 302a can include the cooling element housing 204a, a fluid inlet port 310 and a fluid outlet port 316a. The fluid inlet port 310 is fluidicly coupled to the supply fluid line 108a. As shown in FIG. 3, adjacent cooling elements are fluidicly coupled in series by fluid lines 328 at fluid inlet ports 314a-f and fluid outlet ports 316a-f. The cooling element 302g further includes a fluid outlet port 312 fluidicly coupled to the return fluid line 108b.


One expected advantage of providing cooling elements fluidicly coupled in series is a uniform flow rate through each cooling element 302a-g to provide more consistent cooling of the cooling device. Another expected advantage of providing cooling elements 302a-g fluidicly coupled in series is fewer supply lines into the cooling device to provide a more reliable, less cumbersome and easier to house fluid flow configuration for the cooling device.



FIG. 4 is a further exploded isometric view of the cooling device of FIG. 3 in accordance with one example of the invention for use in the system 100. This further exploded view is substantially similar to previously described examples, and common acts and structures are identified by the same reference numbers. Only significant differences in operation and structure are described below. The cooling device 104 includes cooling elements 302a-g having a plurality of thermoelectric coolers 402 configured to reduce the temperature of a subcutaneous region of the subject 101 for selectively affecting lipid-rich cells in the region. The plurality of thermoelectric coolers 402, also known as a Peltier-type element, has a first side 404 and a second side 406. The first side 404 is in thermal communication with the cooling element 302, and the second side 406 is in thermal communication with an interface member 418. The thermoelectric coolers 402 can be connected to an external power supply (not shown) to transfer heat between the first side 404 and the second side 406. One suitable thermoelectric cooler is a Peltier-type cooling element (model #CP-2895) produced by TE Technologies, Inc. in Traverse City, Mich.


The thermoelectric coolers 402 are contained within the segments 305a-g of the frame 304. According to aspects of the invention, the frame 304 may contain individual guides for each thermoelectric cooler 402. Alternatively, the thermoelectric coolers 402 may be retained on the cooling elements 302a-g, for example, by thermal epoxy or by a combination of solder, mechanical compression and thermal grease.


As shown in FIG. 4, the plurality of cooling elements 302a-g can further include a plurality of interface members 418 in thermal communication with the thermoelectric cooler 402 having heat exchanging surfaces 420 for transferring heat to/from the subject 101. In one example, the interface members 418 are generally planar, but in other examples, the interface members 418 are non-planar (e.g., curved, faceted, etc.) The interface members 418 can be constructed from any suitable material with a thermal conductivity greater than 0.05 Watts/Meter Kelvin, and in many examples, the thermal conductivity is more than 0.1 Watts/Meter Kelvin. Examples of suitable materials include aluminum, other metals, metal alloys, graphite, ceramics, some polymeric materials, composites, or fluids contained in a flexible membrane.


By applying power to the thermoelectric coolers 402, heat can be effectively removed from the subject's skin to a circulating fluid in cooling elements 302a-g. For example, applying a current to the thermoelectric coolers 402 can achieve a temperature generally below 37° C. on the first side 404 of the thermoelectric coolers 402 to remove heat from the subject 101 via the interface members 418. The thermoelectric coolers 402 pull heat from the second side 406 to the first side 404 where the heat is then transferred to the circulating fluid. The cooling unit 106 then removes the heat from the circulating fluid.


The thermoelectric coolers 402 can be configured to withdraw a sufficient amount of heat quickly from the subject 101 without using a high-current power supply for the cooling unit 106. In order to facilitate thermal transfer, the interface members 418 can be an aluminum plate configured generally the same dimensions at the thermoelectric coolers 402. According to aspects of the invention, the thermoelectric coolers 402 can be Peltier-type thermoelectric elements rated at about 160 watts. As such, the cooling device 104 can cool a portion of the subject's skin from a temperature of about 37° C. to about −20° C. quickly and effectively. The cooling unit 106 can use a normal voltage power supply (e.g., 120 VAC) because the power consumption is not excessive. This enables the system to be used in hospitals, clinics, and small offices without more costly high voltage electrical systems.



FIG. 5A is an isometric view of a plurality of heat exchanging elements 300a-g connected in series with the housing removed to better show the plurality of heat exchanging elements 300a-g and interconnected fluid lines. According to aspects of the invention, the heat exchanging elements 300a-g are rotatably contained on linked segments of the frame 304 to provide a cooling device that is wider than it is tall. Thus, the cooling device is compliant and will form to follow contours. According to aspects of the invention, the cooling device is dimensionally small in a first dimension so that curvature of the treatment area in a second dimension does not significantly impact the amount of surface area in contact between the skin and the cooling device.


According to further embodiments of the invention, FIG. 5B is an isometric top view of a plurality of heat exchangers connected in series by a hinge 350a, 350b, wherein the hinge connection is connected directly to the heat exchanger 302a, 302b. The hinge 350a, 350b as shown in FIG. 5B is a piano hinge that extends along adjacent edges of the heat exchanger 300a, 300b for the length of the heat exchanger 300a, 300b, alternatively, the hinge 350a, 350b may extend a portion of the length of the adjacent sides of the heat exchanger 300a, 300b or the hinged connection may include a plurality of hinges 350a 350b. Unlike in FIG. 5A, no frame is employed to connect the heat exchangers 300a, 300b or provide support for the hinged connection between heat exchangers 300a, 300b. FIG. 5C is an isometric bottom view of the heat exchangers in FIG. 5B. According to further aspects of the invention, alternative hinged mechanical connections as is known in the art may be used alone or in combination; or, alternative chemical connections such as flexible adhesives or a living hinge as is known in the art may be used in the hinged connections; or, electromechanical connections such as magnets may be used between heat exchangers to connect the heat exchangers.



FIG. 6A is an exploded isometric side elevation view of the heat exchanging element 300a shown in FIG. 5A to further show the flow of fluid in the heat exchanging element 300a. Like reference symbols refer to like features and components in the Figures. As shown in FIG. 6A, the heat exchanging element 300a can include a fluid chamber 610 having a serpentine shape within the cooling element 302a. As shown in FIG. 6B, the heat exchanging element 300a can include fins 612 to direct fluid flow through the fluid chamber 610. The fluid chamber 610 can be in fluid communication with the associated fluid ports such that fluid can circulate through the fluid chamber 610. The fluid chamber 610 can be configured to accept fluid coolants, such as water, glycol, a synthetic heat transfer fluid, oil, refrigerants, air, carbon dioxide, nitrogen, and argon. According to further aspects of the invention, the fluid chamber 610 may be configured in a variety of configurations as is known in the art in order to distribute the fluid throughout the cooling element 302a.



FIG. 7 is a cross-sectional view of one cooling element 302a. The cooling element 302a is fluidicly sealed by cover 301a containing an o-ring seal 722, held in place by an attachment means 326. According to aspects of the invention, the cooling element 302a can further include at least one sensing element 710 proximate to the heat exchanging surface 420 (FIG. 4). The sensing element 710, for example, can be generally flush with the heat exchanging surface 420. Alternatively, it may be recessed or protrude from the surface. The sensing element 710 can include a temperature sensor, a pressure sensor, a transmissivity sensor, a bio-resistance sensor, an ultrasound sensor, an optical sensor, an infrared sensor, a heat flux sensor, or any other desired sensor as described further herein.


In one example, the sensing element 710 can be a temperature sensor configured to measure the temperature of the first heat exchanging surface 420 and/or the temperature of the skin of the subject 101. For example, the temperature sensor can be configured as a probe or as a needle that penetrates the skin during measurement. Examples of suitable temperature sensors include thermocouples, resistance temperature devices, thermistors (e.g., neutron-transmutation-doped germanium thermistors), and infrared radiation temperature sensors. In another example, the sensing element 710 can be an ultrasound sensor configured to measure crystallization or change in viscosity of subcutaneous fat in the treatment region of a subject. In yet another example, the sensing element 710 can be an optical or infrared sensor configured to monitor an image of the treatment region to detect, for example, epidermal physiological reactions to the treatment. The sensing element 710 can be in electrical communication with the processing unit 114 via, for example, a direct wired connection, a networked connection and/or a wireless connection.


Accordingly, the cooling device 104 can be in electrical communication with the processing unit 114, and the cooling temperature can be automatically adjusted by the processing unit 114. According to further aspects of the invention, the temperature of the interface member 418 can be sensed by the sensing element 710 and the sensed electrical signal can be converted by the processing unit 114 into a process value for the temperature. In one embodiment, the processing unit 114 can include a Proportional, Integral and Derivative controller, which can adjust the power output to the thermoelectric coolers 402 to achieve and/or maintain the desired temperature.


According to further aspects of the invention, the sensing element 710 can alternatively be a pressure sensor to sense the pressure exerted by the cooling element 302a against the subject 101. In one embodiment, the interface member 418 can be attached to the frame 304 such that pressure applied against the heat exchanging element 300a is transferred via the housing 204a to the pressure sensor. The pressure sensor can alternatively be configured to sense the pressure in the fluid chamber 610 for monitoring pressure variations in the fluid chamber 610. Alternatively, the pressure could be inferred from force and the known contact area of the cooling elements. For example, the sensing element 710 can be any type of load-sensitive pressure sensing element such as a load cell (model #LC201-25) produced by OMEGA Engineering, Inc. in Stamford, Conn. Direct pressure measurement could also be performed by placing a pressure measurement membrane directly at the interface between the cooling element and the skin.


The cooling elements 302a-g can have many additional embodiments with different and/or additional features without detracting from the operation of the elements. For example, an adjacent cooling element may or may not have a sensing element proximate to the heat exchanging surface. Alternatively, the cooling elements can be constructed from a material that is different from that of the adjacent cooling element.



FIG. 8 shows an isometric view of a plurality of thermoelectric coolers contained in a matrix design. FIGS. 8 and 9 are isometric views of an alternative cooling device for removing heat from subcutaneous lipid-rich cells in accordance with an embodiment of the invention. As shown in FIGS. 8 and 9, the cooling device 810 includes a cooling element 804 configured in a planar matrix. The cooling device 810 can include a band 812 for retaining the cooling element 804 in place during use. The cooling device can further include a handle 814, a wiring harness 818 and a flap 816 for releasably securing the band 812 to the cooling element 804. The cooling element 804 can further include a sleeve 822 as described further above.


As shown in FIG. 9, the cooling element 804 includes a planar matrix 824 including a plurality of thermoelectric coolers 826. The thermoelectric coolers 826 are contained on a flexible substrate 830. The flexible substrate 830 can be an elastomer such as silicone or urethane or can be a fabric, such as nylon. According to further aspects, the flexible substrate 830 can be a thin polymer such as polypropylene or ABS. As described in greater detail herein, the thermoelectric coolers 826 can have small protective interface plates (not shown) glued to the cold surface of the thermoelectric coolers 826 with a thermal epoxy. According to alternative embodiments of the invention, additional mechanical restraints can further be included in the flexible substrate 830 to capture the thermoelectric coolers 826. As described in greater detail herein, the thermoelectric coolers 826 can include a heat exchanger (shown and described with respect to FIGS. 3-7) on the hot side to cool the hot side. According to aspects of this embodiment, each thermoelectric cooler 826 can have a corresponding heat exchanger to provide increased flexibility to the planar matrix. Alternately, a single flexible heat exchanger can be coupled to the hot side of the thermoelectric coolers (e.g., a bladder or other flexible membrane that water can be circulated through).


According to alternative aspects of the embodiment, the planar matrix 824 can further include temperature or other sensors (not shown) captured between the interface plate and the thermoelectric coolers and/or can have a separate sleeve that houses temperature sensors as further discussed herein.


D. Operation of the Cooling Device



FIG. 10 is an exemplary sectional view of a lateral cooling pattern in the dermis of the skin. The cooling pattern radiates from the cooling elements 302a-f through the epidermis and dermis of the skin such that when it affects the targeted dermis layer containing the lipid-rich cells, the cooling pattern forms a uniform cooling layer and any gaps between the segments of the frame are mitigated. One expected advantage of this cooling pattern is that the cooling of the dermis layer is uniform during treatment. FIG. 10 discloses cooling device 104 applied to a generally flat portion of a subject's body. Cooling elements 302a-f of the cooling device are movable relative to each other (as shown in FIGS. 2B, C and D), to conform to the contours of the subject's skin.


Without being bound by theory, it is believed that, in operation, effective cooling from the cooling device 104, which cools through conduction, depends on a number of factors. Two exemplary factors that impact heat removal from the skin area are the surface area of the cooling element and the temperature of the interface member. When conduction is between two materials that are placed in physical contact, i.e., the skin and the cooling element, there is a certain amount of thermal resistance known as contact resistance. The contact resistance takes the form of a temperature differential between the two materials. Higher contact resistance means less effective cooling; therefore, in the cooling device it is desirable to minimize contact resistance.


One means to minimize contact resistance and maximize the contact surface area is with an interface member that is flexible and will conform to the natural body contours. According to alternative aspects, contact pressure can be reduced by increasing the pressure of the applicator on the skin. Surface pressure has an additional benefit in a skin cooling application. Sufficient pressure on the skin can cause internal capillaries to constrict, temporarily reducing the flow of blood into the treatment region. Reduced blood flow into the treatment area allows the area being cooled to cool more efficiently and improves the effectiveness of the treatment.


Thus, according to aspects of the invention, the cooling device also incorporates a flexible strapping material or belt that wraps around the subject following the curvature of the cooling device. By tightening the strapping, pressure is applied and can be maintained between the subject and the cooling device. According to aspects of the invention, the strap can incorporate a hoop or d-ring through which the strapping can be looped to provide mechanical advantage in tightening the strap. According to further aspects of the invention, the strap also incorporates Velcro or a latch or buckle to hold the pressure once the strap has been tightened.


In operation, an operator can hold the cooling device 104 in one hand by grasping the control system housing 202 or another type of suitable handle (not shown). Then the cooling elements 302a-g can be moved or rotated to achieve a desired orientation. The operator can place the cooling device 104 having the cooling elements 302a-g in the desired orientation proximate to the subject's skin to remove heat from a subcutaneous region of the subject 101. In one embodiment, the operator tightens retention devices 208a-b affixed to the cooling device 104 to apply pressure to the subject's skin. In another embodiment, the operator can manually press the cooling device 104 against the subject's skin. The operator can also monitor and control the treatment process by collecting measurements, such as skin temperatures, from the sensing element 710. By cooling the subcutaneous tissues to a temperature lower than 37° C., more preferably lower than 25° C., subcutaneous lipid-rich cells can be selectively affected. The affected cells are then resorbed into the patient through natural processes.


According to aspects of the invention, interface members 418, for example thin aluminum plates, are mounted to the bottom of the thermoelectric coolers in a manner to ensure good thermal contact between the thermoelectric coolers and the interface members. The interface members can be coupled to the cooling element by a variety of mechanical fixation means such as are known in the art. For example, the coupling means can include using thermally conductive epoxy or using thermal grease such as zinc oxide.


In operation, cooling is efficiently distributed through the heat exchanging elements 300a-g. For example, the cooling device includes a series of interface members 418 approximately 1 mm in thickness. The interface members 418 are in thermal communication with the cooling elements 302a-g by mechanical fixation such as thermal epoxy. The cooling elements 302a-g are cooled by a plurality of thermoelectric coolers to provide a more efficient cooling system to the treatment region. The cooling elements 302a-g are contained on segments that are movable relative to each other to conform to the contours of the subject's skin. Alternatively, the cooling elements are rotatable relative to each other, similar to the joined segments of a metal watch band, thus allowing the assembly to curve.


As designed, the interface members and cooling elements protect the thermoelectric coolers while maintaining good heat transfer between the thermoelectric coolers and the skin. The interface members are sized such that they do not present a significant thermal mass. In one design, each thermoelectric cooler could be 1″×1.5″. The interface member or aluminum plate could also be 1″×1.5″ with a thickness of 0.04″. If the thermoelectric coolers' cooling power is approximately 10 W, which is appropriate based on the heat flux expected to conduct from the skin, then the aluminum plate would cool from an ambient temperature of 20° C. to a treatment temperature of −10° C. in about 7 seconds. The change in internal energy of the plate is described by the following equation:

ΔE=ρ·V·C·ΔT

where ΔE is the change in internal energy, ρ is the material density, V is the material volume, C° is the heat capacity of the material, and ΔT is the temperature change. In the problem described above, the volume of the aluminum plate is V=1 in×1.5 in×0.04 in or 0.06 in3 (9.8×10−7 m3). For a typical grade of aluminum, C°=875 J/kg*° C. and ρ=2770 kg/m3. Solving the equation using these constants:

ΔE=2770 kg/m3*9.8×10−7 m3*875 J/kg*° C.*30° C.=71.3 J


If the thermoelectric coolers have a cooling power of 10 W, then 71.3 J could be removed from the aluminum plate in 7.1 seconds, as is shown in the calculation below:

71.3 J/(10 J/second)=7.13 seconds


A small gap or recess in the frame at the skin surface may be included in one embodiment. Prior to applying the cooling device to the skin, a thermally conducting fluid or coupling agent can be applied to the device and to the skin to minimize contact resistance and increase heat transfer between the cooling device and the skin. This coupling agent will fill the gap in the cooling device and allow for limited lateral conduction between the thermoelectric coolers' plates. This will create a more uniform temperature gradient across the surface area of the skin when the cooling is applied to the skin.


The coupling agent may be applied to the skin or to the interface member to provide improved thermal conductivity. The coupling agent may include polypropylene glycol, polyethylene glycol, propylene glycol, and/or glycol. Glycols, glycerols, and other deicing chemicals are efficient freezing-point depressants and act as a solute to lower the freezing point of the coupling agent. Propylene glycol (CH3CHOHCH2OH) is one exemplary component of deicer or non-freezing coupling agents. Other components include polypropylene glycol (PPG), polyethylene glycol (PEG), polyglycols, glycols, ethylene glycol, dimethyl sulfoxide, polyvinyl pyridine, calcium magnesium acetate, sodium acetate, and/or sodium formate. The coupling agent preferably has a freezing point in the range of −40° C. to 0° C., more preferably below −10° C. as further described in U.S. Provisional Application 60/795,799, entitled Coupling Agent For Use With a Cooling Device For Improved Removal of Heat From Subcutaneous Lipid-Rich Cells, filed on Apr. 28, 2006, herein incorporated in its entirety by reference.


One expected advantage of using the cooling device 104 is that subcutaneous lipid-rich cells can be reduced generally without collateral damage to non-lipid-rich cells in the same region. In general, lipid-rich cells can be affected at low temperatures that do not affect non-lipid-rich cells. As a result, lipid-rich cells, such as subcutaneous adipose tissue, can be affected while other cells in the same region are generally not damaged even though the non-lipid-rich cells at the surface are subject to even lower temperatures. Another expected advantage of the cooling device 104 is that it is relatively compact because the cooling device 104 can be configured as a handheld device. Yet another advantage is that the cooling device can be applied to various regions of the subject's body because the cooling elements 302a-g can be adjusted to conform to any body contour. Another expected advantage is that by pressing the cooling device 104 against the subject's skin, blood flow through the treatment region can be reduced to achieve efficient cooling. Yet another expected advantage is the use of pressure by constriction of the band to restrict blood flow to the treatment region and thereby reduce heat transfer (by mass transport). Thus, the band can not only provide a means for holding the cooling element in place, but also ensures good thermal contact between the cooling device and the skin, and further constricts the flow of blood in the treatment region. Still another expected advantage is that the plurality of the cooling elements 302a-g more efficiently remove heat from the skin compared to a single cooling element.


E. Spatially Controlled Cooling Element Profile


Many skin cooling devices rely on a relatively thick piece of aluminum or other conductive material between a thermoelectric cooler or other cooling source and the skin. When a cooling device is applied to a relatively insulating material, such as skin tissue, the aluminum plate becomes isothermal and maintains a constant temperature profile across the skin's surface. The drawback of this design is that when the device initially cools, or during thermal cycling, the thermal mass presented by the aluminum plate requires a large cooling power. This either translates into increased cooling time or increased power required from the cooling device or both.


According to aspects of the invention, the cooling device has a low thermal mass that will still maintain a constant temperature profile across the skin's surface. Further, according to aspects of the invention, a plurality of cooling elements are provided to allow different regions of the skin to be treated at different temperatures during one treatment session. There are some circumstances where it may be desirable to cool different regions of the skin to different temperatures or for different time periods. According to aspects of the invention, each thermoelectric cooler can be individually controlled to cool different regions of the skin to different temperatures and/or for different time periods and/or to ensure uniform temperature throughout the treatment region. One reason this may be desirable is that the composition of tissue is different in different locations of the body. Some regions have thicker layers of adipose tissue than others, which influence the thermal response of the skin. In other regions, the presence of bone or other organs will affect the heat transfer to the skin.


According to aspects of the invention, a spatially controlled temperature profile can provide more efficient cooling to the treatment region. The plurality of thermoelectric coolers allows the cooling device to accommodate spatial cooling. For example, thermoelectric coolers contained at the perimeter of the cooling device may have a lower or higher temperature or duration than thermoelectric coolers contained at the interior of the cooling device because of different boundary conditions in the different areas of the treatment zone. According to aspects of the invention, the cooling device will quickly and efficiently cool skin to a prescribed temperature. In addition, the cooling device described here has the additional ability to treat a large area in a single treatment while cooling different regions to different temperatures and/or for different durations.


This variation in localized cooling could alternatively be achieved using a cooling device that is relatively small such that many treatments are performed, cooling to different temperatures in different regions. However, this type of cooling device would require many treatments, thereby increasing the overall treatment time and the opportunity for operator error. In addition, a cooling device with a large thermal mass would require a longer cooling time during each treatment.


According to aspects of the invention, the device can accommodate spatially controlled cooling temperature profiles which may provide at least the following advantages: (1) increased efficiency; (2) decreased power consumption with comparable efficacy; (3) increased patient comfort; or (4) decreased treatment time. For example, according to aspects of the invention, the plurality of thermoelectric coolers will allow adjustment for anatomical differences between patients by selectively enabling or disabling portions of the apparatus based on anatomical differences of the patient. One example includes disabling the thermoelectric coolers around bony anatomy for patient comfort or for power conservation.


Alternatively, a particular pattern of controlled cooling may be customized to match an individual patient's pattern of cellulite, thus increasing the efficacy of the treatment. Similarly, treatment regions requiring a higher intensity of treatment may be pre-identified by ultrasound or other devices. The device can then be spatially controlled to provide higher intensity treatment to pre-identified areas. Further advantages include increased patient comfort and safety by allowing spatial control of cooling to accommodate unnatural anatomy (e.g. lumps, blemishes, nipples, hairy areas, scars, wounds, presence of implants, jewelry, or areas of heightened sensitivity.)


A further advantage of spatial control of the device includes utilizing only a subset of the cooling elements in order to treat only the region requiring treatment. It is advantageous to use one device that can accommodate small and large treatment regions without over treating (e.g. a large device that cannot be spatially controlled) or having to move the device multiple times thus extending the treatment time (e.g. a treatment device smaller than the treatment region). Thus, according to aspects of the invention, a selected region of thermoelectric coolers can be controlled to a few degrees warmer than another region of thermoelectric coolers. Alternatively, a first region of the cooling device can be turned off while a second region of the cooling device is activated, such that only a selected region of the subject is treated, thus limiting the treatment region. Other advantageous spatially controlled patterns include treating areas within the treatment region more intensely, conserving power by alternating thermoelectric coolers, increasing cooling at a perimeter in order to provide a uniform cooling pattern across the treatment area, and a combination of these spatially controlled patterns in order to increase treatment efficacy, reduce treatment time, decrease power consumption and provide for patient comfort and safety.


F. Time-Varying Cooling Profiles


In certain embodiments, once a desired temperature is achieved, the temperature of the region can be maintained for a predetermined period of time. The cooling cycle can be terminated by separating the heat exchanging surfaces 420a-g from the skin. After a certain period of time, if desired, the cooling device 104 can be reapplied to the same portion of the skin as described above until the lipid-rich cells are affected an amount sufficient to produce a desired reduction in lipid-rich cells. In another embodiment, the cooling device 104 can be applied to a different portion of the skin as described above to selectively affect lipid-rich cells in a different subcutaneous target region.


Alternatively, the cooling elements 302a-g can be controlled according to a predetermined time-varying cooling profile to cool, heat, re-cool, and/or cool in a stepped temperature pattern over time. In particular, according to aspects of the invention, patterns of controlled cooling over time provide at least the following advantages: (1) increased efficiency; (2) decreased power consumption with comparable efficacy; (3) increased patient comfort; or (4) decreased treatment time. One exemplary cooling pattern includes cooling to −5° for 15 minutes, warming to 30° for 5 minutes, cooling to −3° for 10 minutes. According to aspects of the present invention, any desired time-varying cooling profile can be programmed into the device. For example, a gradual or stepped cooling rate may decrease power requirements. Alternatively, a rapid cooling rate may be used in order to supercool the treatment region. Exemplary cooling rates include 5 to 1000 degrees per minute, more preferably 30 to 120 degrees per minute, and most preferably 35 to 100 degrees per minute.


One expected advantage of controlling the time-temperature profile of the device is that in practice, tissue is sensitive to cooling rates and thus tissue damage can be controlled by controlling the rate of cooling of the treatment region. Further, cooling the treatment region down over an extended period of time, or in phases, will increase patient comfort.


Another expected advantage of several of the embodiments described above is that the cooling device 104 can selectively reduce subcutaneous lipid-rich cells without unacceptably affecting the dermis, epidermis, and/or other tissues. Another expected advantage is that the cooling device 104 can simultaneously selectively reduce subcutaneous lipid-rich cells while providing beneficial effects to the dermis and/or epidermis. These effects may include: fibroplasia, neocollagenesis, collagen contraction, collagen compaction, collagen density increase, collagen remodeling, and acanthosis (epidermal thickening). In the treatment of cellulite, it is expected that dermal thickening above the herniating superficial fat lobules will help reduce the appearance of cellulite and improve the longevity of the effect. Another expected advantage is that the cooling device 104 can conform to various body contours of a subject by rotating or moving the cooling elements 302a-g to achieve a desired orientation. Yet another expected advantage is that the cooling device 104 can be configured as a handheld device for ease of operation. Furthermore, another expected advantage is that the system 100 with the handheld cooling device 104 and the rack-mounted processing unit 114 and cooling unit 106 are compact and efficient such that the method described above can be administered in an outpatient clinic or a doctor's office instead of in a hospital. Yet another expected advantage is that the cooling device 104 can be strapped in place to free the clinician's hands and allow the clinician to do other tasks with the treatment is in process.


G. Method of Applying Cooling Devices with a Plurality of Rotatable or Movable Cooling Elements


In operation, the angle between the heat exchanging surfaces 420 is selected by rotating or moving the cooling elements 302a-g. The angle between the cooling elements 320a-g is often selected to conform the heat exchanging surfaces 320a-g to various body contours of the subject 101 and/or a desired clamping arrangement. In the embodiment shown in FIG. 2A, the angle between the heat exchanging surfaces 320a-g can be generally 180°, i.e., the heat exchanging surfaces 320a-g are generally coplanar for applying the cooling device to a treatment region. In the embodiment shown in FIG. 2B, the angle can be less than 180° to allow the cooling device to curve about a subject's body. In the embodiment shown in FIG. 2C, the cooling device is further curved to conform to a subject's body. In other embodiments, the angle can be any angle to conform to a subject's body, as would be recognized by one skilled in the art.


After configuring the cooling elements 302a-g, an operator places the cooling device 104 proximate to the skin of the subject 101. In the embodiment shown in FIG. 2A (where the angle is in a generally flat configuration), the cooling elements 302a-g are initially placed flat against a subject's skin. The operator then rotates or moves the cooling device to conform to a subject's body. The cooling device can be tightened by a strap, and a pressure can be increased by tightening the strap further. Optionally, the pressure sensor can be used to sense the clamping pressure applied via the interface members 418, and the sensed clamping force can be processed by the processing unit 114 and displayed on the output device 120. The pressure can then be adjusted based on the displayed values. Depending on the location of the cooling device, the pressure, for example, can be higher than the systolic pressure in the skin to impede or block the blood flow into the treatment region. Applying such pressure enables more effective cooling of the target region because there is less blood flow to transfer core body heat to the treatment region.


Applying the cooling device with pressure to the subject's skin or pressing against the skin can be advantageous to achieve efficient cooling. In general, the subject 101 has a body temperature of about 37° C., and the blood circulation is one mechanism for maintaining a constant body temperature. As a result, blood flow through the dermis and subcutaneous layer of the region is a heat source that counteracts the cooling of the subdermal fat. As such, if the blood flow is not reduced, cooling the subcutaneous tissues would require not only removing the specific heat of the tissues but also that of the blood circulating through the tissues. Thus, reducing or eliminating blood flow through the treatment region can improve the efficiency of cooling and avoid excessive heat loss from the dermis and epidermis.


By cooling the subcutaneous tissues to a temperature lower than 37° C., subcutaneous lipid-rich cells can be selectively affected. In general, the epidermis and dermis of the subject 101 have lower amounts of unsaturated fatty acids compared to the underlying lipid-rich cells forming the subcutaneous tissues. Because non-lipid-rich cells usually can withstand colder temperatures better than lipid-rich cells, the subcutaneous lipid-rich cells can be selectively affected while maintaining the non-lipid-rich cells in the dermis and epidermis. An exemplary range for the cooling elements 302a-g can be from about −20° C. to about 20° C., preferably from about −20° C. to about 10° C., more preferably from about −15° C. to about 5° C., more preferably from about −10° C. to about 0° C.


The lipid-rich cells can be affected by disrupting, shrinking, disabling, destroying, removing, killing, or otherwise being altered. Without being bound by theory, selectively affecting lipid-rich cells is believed to result from localized crystallization of highly saturated fatty acids at temperatures that do not induce crystallization in non-lipid-rich cells. The crystals can rupture the bi-layer membrane of lipid-rich cells to selectively necrose these cells. Thus, damage of non-lipid-rich cells, such as dermal cells, can be avoided at temperatures that induce crystal formation in lipid-rich cells. Cooling is also believed to induce lipolysis (e.g., fat metabolism) of lipid-rich cells to further enhance the reduction in subcutaneous lipid-rich cells. Lipolysis may be enhanced by local cold exposure, inducing stimulation of the sympathetic nervous system.


H. Computing System Software Modules



FIG. 11 is a functional diagram showing exemplary software modules 940 suitable for use in the processing unit 114. Each component can be a computer program, procedure, or process written as source code in a conventional programming language, such as the C++ programming language, and can be presented for execution by the CPU of processor 942. The various implementations of the source code and object and byte codes can be stored on a computer-readable storage medium or embodied on a transmission medium in a carrier wave. The modules of processor 942 can include an input module 944, a database module 946, a process module 948, an output module 950, and, optionally, a display module 951. In another embodiment, the software modules 940 can be presented for execution by the CPU of a network server in a distributed computing scheme.


In operation, the input module 944 accepts an operator input, such as process setpoint and control selections, and communicates the accepted information or selections to other components for further processing. The database module 946 organizes records, including operating parameters 954, operator activities 956, and alarms 958, and facilitates storing and retrieving of these records to and from a database 952. Any type of database organization can be utilized, including a flat file system, hierarchical database, relational database, or distributed database, such as provided by a database vendor such as Oracle Corporation, Redwood Shores, Calif.


The process module 948 generates control variables based on sensor readings 960, and the output module 950 generates output signals 962 based on the control variables. For example, the output module 950 can convert the generated control variables from the process module 948 into 4-20 mA output signals 962 suitable for a direct current voltage modulator. The processor 942 optionally can include the display module 951 for displaying, printing, or downloading the sensor readings 960 and output signals 962 via devices such as the output device 120. A suitable display module 951 can be a video driver that enables the processor 942 to display the sensor readings 960 on the output device 120.


Unless the context clearly requires otherwise, throughout the description and the claims, the words “comprise,” “comprising,” and the like are to be construed in an inclusive sense as opposed to an exclusive or exhaustive sense; that is to say, in a sense of “including, but not limited to.” Words using the singular or plural number also include the plural or singular number, respectively. When the claims use the word “or” in reference to a list of two or more items, that word covers all of the following interpretations of the word: any of the items in the list, all of the items in the list, and any combination of the items in the list.


The above detailed descriptions of embodiments of the invention are not intended to be exhaustive or to limit the invention to the precise form disclosed above. While specific embodiments of, and examples for, the invention are described above for illustrative purposes, various equivalent modifications are possible within the scope of the invention, as those skilled in the relevant art will recognize. For example, while steps are presented in a given order, alternative embodiments may perform steps in a different order. The various embodiments described herein can be combined to provide further embodiments.


In general, the terms used in the following claims should not be construed to limit the invention to the specific embodiments disclosed in the specification, unless the above detailed description explicitly defines such terms. While certain aspects of the invention are presented below in certain claim forms, the inventors contemplate the various aspects of the invention in any number of claim forms. Accordingly, the inventors reserve the right to add additional claims after filing the application to pursue such additional claim forms for other aspects of the invention.


The various embodiments described above can be combined to provide further embodiments. All of the U.S. patents, U.S. patent application publications, U.S. patent applications, foreign patents, foreign patent applications and non-patent publications referred to in this specification and/or listed in the Application Data Sheet are incorporated herein by reference, in their entirety. Aspects of the invention can be modified, if necessary, to employ cooling devices with a plurality of cooling elements, thermally conductive devices with various configurations, and concepts of the various patents, applications, and publications to provide yet further embodiments of the invention.


These and other changes can be made to the invention in light of the above-detailed description. In general, in the following claims, the terms used should not be construed to limit the invention to the specific embodiments disclosed in the specification and the claims, but should be construed to include all cooling that operates in accordance with the claims. Accordingly, the invention is not limited by the disclosure, but instead its scope is to be determined entirely by the following claims.

Claims
  • 1. A cooling device for removing heat from subcutaneous lipid-rich cells of a subject having skin, the cooling device comprising: a body;a surface configured to face the subject's skin;an inlet port configured to be coupled to a supply line;an outlet port configured to be coupled to an output line; anda cooling element positioned along a flow path between the inlet and outlet ports such that liquid from the inlet port flows through the cooling element, the cooling element including: a thermoelectric cooler,an interface member made of a metal or metal alloy and having one or more heat exchanging surfaces,a serpentine shaped internal fluid chamber in thermal communication with the interface member and a plurality of fluid ports in fluid communication with opposite ends of the serpentine shaped internal fluid chamber, wherein the fluid ports are configured to allow the liquid to circulate in one direction through the serpentine shaped internal fluid chamber, wherein the liquid in communication with the serpentine shaped internal fluid chamber is circulated through a device that chills the liquid, wherein adjacent sections of the serpentine shaped internal fluid chamber are defined by a cover containing an o-ring, wherein the cooling element is attached to the body such that the one or more heat exchanging surfaces of the interface member form at least a temperature controlled portion of the surface configured to face the subject's skin and the thermoelectric cooler is within the body, anda sensing element proximate to the interface member; andwherein the cooling device is configured to reduce a temperature of a target region such that the subcutaneous lipid-rich cells in the target region are reduced while non-lipid-rich cells proximate to the one or more heat exchanging surfaces are not significantly affected.
  • 2. The cooling device of claim 1, wherein the cooling element is configured to reduce the temperature of the subcutaneous lipid-rich cells in the target region to between −20° C. and 5° C.
  • 3. The cooling device of claim 2, wherein the cooling element is controlled according to a predetermined time-varying temperature profile.
  • 4. The cooling device of claim 3, further comprising a processing unit programmed to cause the cooling element to operate to cool the subcutaneous lipid-rich cells in the target region to a sufficiently low temperature so as to selectively disrupt the subcutaneous lipid-rich cells.
  • 5. The cooling device of claim 4, wherein the predetermined time-varying temperature profile comprises changing the temperature to be above about 30° C. and then lowering the temperature to about 0° C. or below.
  • 6. A cooling device for removing heat from subcutaneous lipid-rich cells of a subject having skin, the cooling device comprising: a body;a surface configured to face the subject's skin;an inlet port configured to be coupled to a supply line;an outlet port configured to be coupled to an output line;a cooling element positioned along a flow path between the inlet and outlet ports such that liquid from the inlet port flows through the cooling element, wherein the cooling element is configured to reduce a temperature of the subcutaneous lipid-rich cells in the region to between −20° C. and 5° C. according to a predetermined time-varying temperature profile, the cooling element including: a thermoelectric cooler,an interface member,an internal fluid chamber in thermal communication with the interface member,a plurality of fluid ports in fluid communication with the internal fluid chamber, wherein the fluid ports are configured to allow liquid circulation through the internal fluid chamber, wherein the interface member is made of a metal or metal alloy and has at least one heat exchanging surface, and wherein the cooling element is coupled to the body such that the at least one heat exchanging surface forms at least a portion of the surface configured to face the subject's skin and the thermoelectric cooler is within the body,a processing unit programmed to store predetermined time-varying cooling profiles for different target sites, at least one of the predetermined time-varying cooling profiles has at least three segments each including a predetermined period of time and associated setpoint temperature for a target site, andcontrol the cooling device according to the predetermined time-varying cooling profile to cause the cooling elements to operate to sequentially cool the subcutaneous lipid-rich cells of the subject to reduce a temperature of the subcutaneous lipid-rich cells in the region to between −20° C. and 5° C. so as to selectively disrupt the subcutaneous lipid-rich cells, andheat the subject's cooled tissue, anda sensing element proximate to the interface member; andwherein the cooling device is configured to reduce the temperature of a target region such that lipid-rich cells in the target region are reduced while non-lipid-rich cells proximate to the heat exchanging surfaces are not significantly affected.
  • 7. The device of claim 6, wherein the predetermined time-varying temperature profile comprises changing the temperature to above about 30° C. and then cooling to a temperature below 0° C.
  • 8. The device of claim 6, wherein the supply line and/or the output line is a hose.
  • 9. The device of claim 6, wherein the cooling element includes an additional thermoelectric cooler, wherein the internal fluid chamber is configured to circulate the liquid such that the liquid absorbs heat from each of the thermoelectric coolers.
CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent application Ser. No. 16/415,684, filed May 17, 2019, now U.S. Pat. No. 11,179,269, which is a continuation of U.S. patent application Ser. No. 14/825,841, filed Aug. 13, 2015, now U.S. Pat. No. 10,292,859, which is a continuation of U.S. patent application Ser. No. 13/616,186, filed Sep. 14, 2012, now U.S. Pat. No. 9,375,345, which is a continuation of U.S. patent application Ser. No. 11/528,225, filed Sep. 26, 2006, now U.S. Pat. No. 9,132,031. Each of these applications are incorporated herein by reference in their entireties.

US Referenced Citations (710)
Number Name Date Kind
681806 Mignault Sep 1901 A
889810 Robinson Jun 1908 A
1093868 Leighty Apr 1914 A
2516491 Swastek Jul 1950 A
2521780 Dodd Sep 1950 A
2726658 Chessey Dec 1955 A
2766619 Myron et al. Oct 1956 A
2851602 Cramwinckel et al. Sep 1958 A
3093135 Hirschhorn Jun 1963 A
3132688 Nowak May 1964 A
3282267 William Nov 1966 A
3341230 Louis Sep 1967 A
3502080 Hirschhorn Mar 1970 A
3566871 Richter et al. Mar 1971 A
3587577 Smirnov et al. Jun 1971 A
3591645 Selwitz Jul 1971 A
3692338 Nick Sep 1972 A
3703897 Mack et al. Nov 1972 A
3710784 Taylor Jan 1973 A
3786814 Armao Jan 1974 A
3827436 Stumpf et al. Aug 1974 A
3942519 Shock Mar 1976 A
3948269 Zimmer Apr 1976 A
3986385 Johnston et al. Oct 1976 A
3993053 Grossan Nov 1976 A
4002221 Buchalter Jan 1977 A
4008910 Roche Feb 1977 A
4026299 Sauder May 1977 A
4140130 Storm Feb 1979 A
4149529 Copeland et al. Apr 1979 A
4178429 Scheffer Dec 1979 A
4202336 Van May 1980 A
4266043 Fujii et al. May 1981 A
4269068 Molina May 1981 A
4381009 Del Apr 1983 A
4396011 Mack et al. Aug 1983 A
4459854 Richardson et al. Jul 1984 A
4470263 Lehovec et al. Sep 1984 A
4483341 Witteles Nov 1984 A
4528979 Marchenko et al. Jul 1985 A
4531524 Mioduski Jul 1985 A
4548212 Leung Oct 1985 A
4555313 Duchane et al. Nov 1985 A
4585002 Kissin Apr 1986 A
4603076 Bowditch et al. Jul 1986 A
4614191 Perler Sep 1986 A
4644955 Mioduski Feb 1987 A
4664110 Schanzlin May 1987 A
4700701 Montaldi Oct 1987 A
4718429 Smidt Jan 1988 A
4741338 Miyamae May 1988 A
4758217 Gueret Jul 1988 A
4764463 Mason et al. Aug 1988 A
4802475 Weshahy Feb 1989 A
4832022 Tjulkov et al. May 1989 A
4846176 Golden Jul 1989 A
4850340 Onishi Jul 1989 A
4869250 Bitterly Sep 1989 A
4880564 Abel et al. Nov 1989 A
4905697 Heggs et al. Mar 1990 A
4906463 Cleary et al. Mar 1990 A
4930317 Klein Jun 1990 A
4935345 Guilbeau et al. Jun 1990 A
4961422 Marchosky et al. Oct 1990 A
4962761 Golden Oct 1990 A
4990144 Blott Feb 1991 A
5007433 Hermsdoerffer et al. Apr 1991 A
5018521 Campbell May 1991 A
5024650 Hagiwara et al. Jun 1991 A
5065752 Sessions et al. Nov 1991 A
5069208 Noppel et al. Dec 1991 A
5084671 Miyata et al. Jan 1992 A
5108390 Potocky et al. Apr 1992 A
5119674 Nielsen Jun 1992 A
5139496 Hed Aug 1992 A
5143063 Fellner Sep 1992 A
5148804 Hill et al. Sep 1992 A
5158070 Dory Oct 1992 A
5160312 Voelkel Nov 1992 A
5169384 Bosniak et al. Dec 1992 A
5197466 Marchosky et al. Mar 1993 A
5207674 Hamilton May 1993 A
5221726 Dabi et al. Jun 1993 A
5264234 Windhab et al. Nov 1993 A
5277030 Miller Jan 1994 A
5314423 Seney May 1994 A
5327886 Chiu Jul 1994 A
5330745 Mcdow Jul 1994 A
5333460 Lewis et al. Aug 1994 A
5334131 Omandam et al. Aug 1994 A
5336616 Livesey et al. Aug 1994 A
5339541 Owens Aug 1994 A
5342617 Gold Aug 1994 A
5351677 Kami et al. Oct 1994 A
5358467 Milstein et al. Oct 1994 A
5362966 Rosenthal et al. Nov 1994 A
5363347 Nguyen Nov 1994 A
5372608 Johnson Dec 1994 A
5386837 Sterzer Feb 1995 A
5411541 Bell et al. May 1995 A
5427772 Hagan Jun 1995 A
5433717 Rubinsky et al. Jul 1995 A
5456703 Beeuwkes Oct 1995 A
5472416 Blugerman et al. Dec 1995 A
5486207 Mahawili Jan 1996 A
5497596 Zatkulak Mar 1996 A
5501655 Rolt et al. Mar 1996 A
5505726 Meserol Apr 1996 A
5505730 Edwards Apr 1996 A
5507790 Weiss Apr 1996 A
5514105 Goodman et al. May 1996 A
5514170 Mauch May 1996 A
5531742 Barken Jul 1996 A
5558376 Woehl Sep 1996 A
5562604 Yablon et al. Oct 1996 A
5571801 Segall et al. Nov 1996 A
5575812 Owens Nov 1996 A
5603221 Maytal Feb 1997 A
5628769 Saringer May 1997 A
5634890 Morris Jun 1997 A
5634940 Panyard Jun 1997 A
5647051 Neer Jul 1997 A
5647868 Chinn Jul 1997 A
5650450 Lovette et al. Jul 1997 A
5651773 Perry et al. Jul 1997 A
5654279 Rubinsky et al. Aug 1997 A
5654546 Lindsay Aug 1997 A
5660836 Knowlton Aug 1997 A
5665053 Jacobs Sep 1997 A
5672172 Zupkas Sep 1997 A
5700284 Owens Dec 1997 A
5725483 Podolsky Mar 1998 A
5733280 Avitall Mar 1998 A
5741248 Stern et al. Apr 1998 A
5746702 Gelfgat et al. May 1998 A
5746736 Tankovich May 1998 A
5755663 Larsen et al. May 1998 A
5755753 Knowlton May 1998 A
5755755 Panyard May 1998 A
5759182 Varney et al. Jun 1998 A
5759764 Polovina Jun 1998 A
5769879 Richards et al. Jun 1998 A
5785955 Fischer Jul 1998 A
5792080 Ookawa et al. Aug 1998 A
5800490 Patz et al. Sep 1998 A
5802865 Strauss Sep 1998 A
5814040 Nelson et al. Sep 1998 A
5817050 Klein Oct 1998 A
5817145 Augustine Oct 1998 A
5817149 Owens Oct 1998 A
5817150 Owens Oct 1998 A
5830208 Muller Nov 1998 A
5833685 Tortal et al. Nov 1998 A
5844013 Kenndoff et al. Dec 1998 A
5853364 Baker et al. Dec 1998 A
5865841 Kolen et al. Feb 1999 A
5871524 Knowlton Feb 1999 A
5871526 Gibbs et al. Feb 1999 A
5885211 Eppstein et al. Mar 1999 A
5891617 Watson et al. Apr 1999 A
5895418 Saringer Apr 1999 A
5901707 Goncalves May 1999 A
5902256 Benaron May 1999 A
5919219 Knowlton Jul 1999 A
5944748 Mager et al. Aug 1999 A
5948011 Knowlton Sep 1999 A
5954680 Augustine Sep 1999 A
5964092 Tozuka et al. Oct 1999 A
5964749 Eckhouse et al. Oct 1999 A
5967976 Larsen et al. Oct 1999 A
5980561 Kolen et al. Nov 1999 A
5986167 Arteman et al. Nov 1999 A
5989286 Owens Nov 1999 A
5997530 Nelson et al. Dec 1999 A
6017337 Pira Jan 2000 A
6023932 Johnston Feb 2000 A
6032675 Rubinsky Mar 2000 A
6039694 Larson et al. Mar 2000 A
6041787 Rubinsky Mar 2000 A
6047215 Mcclure et al. Apr 2000 A
6049927 Thomas et al. Apr 2000 A
6051159 Hao Apr 2000 A
6071239 Cribbs et al. Jun 2000 A
6074415 Der Jun 2000 A
6093230 Johnson et al. Jul 2000 A
6102885 Bass Aug 2000 A
6104952 Tu et al. Aug 2000 A
6104959 Spertell Aug 2000 A
6106517 Zupkas Aug 2000 A
6113558 Rosenschein et al. Sep 2000 A
6113559 Klopotek Sep 2000 A
6113626 Clifton et al. Sep 2000 A
6120519 Weber et al. Sep 2000 A
6139544 Mikus et al. Oct 2000 A
6150148 Nanda et al. Nov 2000 A
6151735 Koby et al. Nov 2000 A
6152952 Owens Nov 2000 A
6171301 Nelson et al. Jan 2001 B1
6180867 Hedengren et al. Jan 2001 B1
6226996 Weber et al. May 2001 B1
6241753 Knowlton Jun 2001 B1
6264649 Whitcroft et al. Jul 2001 B1
6273884 Altshuler et al. Aug 2001 B1
6290988 Van et al. Sep 2001 B1
6311090 Knowlton Oct 2001 B1
6311497 Chung Nov 2001 B1
6312453 Stefanile et al. Nov 2001 B1
6350276 Knowlton Feb 2002 B1
6354297 Eiseman Mar 2002 B1
6357907 Cleveland et al. Mar 2002 B1
6375673 Clifton et al. Apr 2002 B1
6377854 Knowlton Apr 2002 B1
6377855 Knowlton Apr 2002 B1
6381497 Knowlton Apr 2002 B1
6381498 Knowlton Apr 2002 B1
6387380 Knowlton May 2002 B1
6401722 Krag Jun 2002 B1
6405090 Knowlton Jun 2002 B1
6413255 Stern Jul 2002 B1
6425912 Knowlton Jul 2002 B1
6426445 Young et al. Jul 2002 B1
6430446 Knowlton Aug 2002 B1
6430956 Haas et al. Aug 2002 B1
6438424 Knowlton Aug 2002 B1
6438954 Goetz et al. Aug 2002 B1
6438964 Giblin Aug 2002 B1
6453202 Knowlton Sep 2002 B1
6458888 Hood et al. Oct 2002 B1
6461378 Knowlton Oct 2002 B1
6470216 Knowlton Oct 2002 B1
6471693 Carroll et al. Oct 2002 B1
6475211 Chess et al. Nov 2002 B2
6478811 Dobak et al. Nov 2002 B1
6494844 Van et al. Dec 2002 B1
6497721 Ginsburg et al. Dec 2002 B2
6508831 Kushnir Jan 2003 B1
6514244 Pope et al. Feb 2003 B2
6519964 Bieberich Feb 2003 B2
6523354 Tolbert Feb 2003 B1
6527765 Kelman et al. Mar 2003 B2
6527798 Ginsburg et al. Mar 2003 B2
6544248 Bass Apr 2003 B1
6547811 Becker et al. Apr 2003 B1
6548297 Kuri-harcuch et al. Apr 2003 B1
6551255 Van et al. Apr 2003 B2
6551341 Boylan et al. Apr 2003 B2
6551348 Blalock et al. Apr 2003 B1
6551349 Lasheras et al. Apr 2003 B2
6569189 Augustine et al. May 2003 B1
6585652 Lang et al. Jul 2003 B2
6592577 Abboud et al. Jul 2003 B2
6605080 Altshuler et al. Aug 2003 B1
6607498 Eshel Aug 2003 B2
6620187 Carson et al. Sep 2003 B2
6620188 Ginsburg et al. Sep 2003 B1
6620189 Machold et al. Sep 2003 B1
6623430 Slayton et al. Sep 2003 B1
6626854 Friedman et al. Sep 2003 B2
6632219 Baranov et al. Oct 2003 B1
6635053 Lalonde et al. Oct 2003 B1
6643535 Damasco et al. Nov 2003 B2
6645162 Friedman et al. Nov 2003 B2
6645229 Matsumura et al. Nov 2003 B2
6645232 Carson Nov 2003 B2
6648904 Altshuler et al. Nov 2003 B2
6656208 Grahn et al. Dec 2003 B2
6660027 Gruszecki et al. Dec 2003 B2
6662054 Kreindel et al. Dec 2003 B2
6682524 Elbrecht et al. Jan 2004 B1
6682550 Clifton et al. Jan 2004 B2
6685731 Kushnir et al. Feb 2004 B2
6694170 Mikus et al. Feb 2004 B1
6695874 Machold et al. Feb 2004 B2
6697670 Chomenky et al. Feb 2004 B2
6699237 Weber et al. Mar 2004 B2
6699266 Lachenbruch et al. Mar 2004 B2
6699267 Voorhees et al. Mar 2004 B2
6718785 Bieberich Apr 2004 B2
6741895 Gafni et al. May 2004 B1
6743222 Durkin et al. Jun 2004 B2
6746474 Saadat Jun 2004 B2
6749624 Knowlton Jun 2004 B2
6753182 Kadkade et al. Jun 2004 B1
6764493 Weber et al. Jul 2004 B1
6764502 Bieberich Jul 2004 B2
6789545 Littrup et al. Sep 2004 B2
6795728 Chornenky et al. Sep 2004 B2
6820961 Johnson Nov 2004 B2
6821274 Mchale et al. Nov 2004 B2
6840955 Ein Jan 2005 B2
6849075 Bertolero et al. Feb 2005 B2
6878144 Altshuler et al. Apr 2005 B2
6889090 Kreindel May 2005 B2
6892099 Jaafar et al. May 2005 B2
6904956 Noel Jun 2005 B2
6918903 Bass Jul 2005 B2
6927316 Faries et al. Aug 2005 B1
6942022 Blangetti et al. Sep 2005 B2
6945942 Van et al. Sep 2005 B2
6948903 Ablabutyan et al. Sep 2005 B2
6969399 Schock et al. Nov 2005 B2
7005558 Johansson et al. Feb 2006 B1
7006874 Knowlton et al. Feb 2006 B2
7022121 Stern et al. Apr 2006 B2
7037326 Lee May 2006 B2
7054685 Dimmer et al. May 2006 B2
7060061 Altshuler et al. Jun 2006 B2
7077858 Fletcher et al. Jul 2006 B2
7081111 Svaasand et al. Jul 2006 B2
7083612 Littrup et al. Aug 2006 B2
7096204 Chen et al. Aug 2006 B1
7112712 Ancell Sep 2006 B1
7115123 Knowlton et al. Oct 2006 B2
7141049 Stern et al. Nov 2006 B2
7183360 Daniel et al. Feb 2007 B2
7189252 Krueger Mar 2007 B2
7192426 Baust et al. Mar 2007 B2
7204832 Altshuler et al. Apr 2007 B2
7220778 Anderson et al. May 2007 B2
7229436 Stern et al. Jun 2007 B2
7258674 Cribbs et al. Aug 2007 B2
7267675 Stern et al. Sep 2007 B2
7276058 Altshuler et al. Oct 2007 B2
7318821 Lalonde et al. Jan 2008 B2
7331951 Eshel et al. Feb 2008 B2
7347855 Eshel et al. Mar 2008 B2
7367341 Anderson et al. May 2008 B2
7532201 Quistgaard et al. May 2009 B2
7572268 Babaev Aug 2009 B2
7604632 Howlett et al. Oct 2009 B2
7613523 Eggers et al. Nov 2009 B2
7615016 Barthe et al. Nov 2009 B2
7713266 Elkins et al. May 2010 B2
7780656 Tankovich Aug 2010 B2
7799018 Goulko Sep 2010 B2
7824437 Saunders Nov 2010 B1
7828831 Tanhehco et al. Nov 2010 B1
7850683 Elkins et al. Dec 2010 B2
7854754 Ting et al. Dec 2010 B2
7862558 Elkins et al. Jan 2011 B2
RE42277 Jaafar et al. Apr 2011 E
7938824 Chornenky et al. May 2011 B2
7959657 Harsy Jun 2011 B1
7963959 Da et al. Jun 2011 B2
7967763 Deem et al. Jun 2011 B2
7993330 Goulko Aug 2011 B2
7998137 Elkins et al. Aug 2011 B2
RE42835 Chornenky et al. Oct 2011 E
RE43009 Chornenky et al. Dec 2011 E
8133180 Slayton et al. Mar 2012 B2
8133191 Rosenberg et al. Mar 2012 B2
8192474 Levinson Jun 2012 B2
8246611 Paithankar et al. Aug 2012 B2
8247221 Fawcett Aug 2012 B2
8275442 Allison Sep 2012 B2
8285390 Levinson et al. Oct 2012 B2
8333700 Barthe et al. Dec 2012 B1
8337539 Ting et al. Dec 2012 B2
8366622 Slayton et al. Feb 2013 B2
8372130 Young Feb 2013 B2
8387631 Thonghara et al. Mar 2013 B1
8397518 Vistakula Mar 2013 B1
8414631 Quisenberry et al. Apr 2013 B2
8433400 Prushinskaya et al. Apr 2013 B2
8506486 Slayton et al. Aug 2013 B2
8523775 Barthe et al. Sep 2013 B2
8523791 Castel Sep 2013 B2
8523927 Levinson et al. Sep 2013 B2
8535228 O'connor et al. Sep 2013 B2
8603073 Allison Dec 2013 B2
8636665 Slayton et al. Jan 2014 B2
8641622 Barthe et al. Feb 2014 B2
8663112 Slayton et al. Mar 2014 B2
8672848 Slayton et al. Mar 2014 B2
8676332 Fahey Mar 2014 B2
8690778 Slayton et al. Apr 2014 B2
8690779 Slayton et al. Apr 2014 B2
8690780 Slayton et al. Apr 2014 B2
8702774 Baker et al. Apr 2014 B2
8758215 Legendre et al. Jun 2014 B2
9132031 Levinson et al. Sep 2015 B2
9149322 Knowlton Oct 2015 B2
9314368 Allison et al. Apr 2016 B2
9375345 Levinson et al. Jun 2016 B2
D777338 Coakley et al. Jan 2017 S
9581942 Shippert Feb 2017 B1
9844461 Levinson et al. Dec 2017 B2
9861520 Baker et al. Jan 2018 B2
10292859 Levinson et al. May 2019 B2
10383787 Rosen et al. Aug 2019 B2
10568759 Yee et al. Feb 2020 B2
20010005791 Ginsburg et al. Jun 2001 A1
20010023364 Ahn Sep 2001 A1
20010031459 Fahy et al. Oct 2001 A1
20010039439 Elkins et al. Nov 2001 A1
20010045104 Bailey et al. Nov 2001 A1
20010047196 Ginsburg et al. Nov 2001 A1
20020026226 Ein Feb 2002 A1
20020032473 Kushnir et al. Mar 2002 A1
20020049483 Knowlton Apr 2002 A1
20020058975 Bieberich May 2002 A1
20020062142 Knowlton May 2002 A1
20020068338 Nanda et al. Jun 2002 A1
20020068874 Zuckerwar et al. Jun 2002 A1
20020082668 Ingman Jun 2002 A1
20020103520 Latham Aug 2002 A1
20020107558 Clifton et al. Aug 2002 A1
20020117293 Campbell Aug 2002 A1
20020120315 Furuno et al. Aug 2002 A1
20020128648 Weber et al. Sep 2002 A1
20020151830 Kahn Oct 2002 A1
20020151887 Stern et al. Oct 2002 A1
20020156509 Cheung Oct 2002 A1
20020188286 Quijano et al. Dec 2002 A1
20020198518 Mikus et al. Dec 2002 A1
20030032900 Ella Feb 2003 A1
20030044764 Soane et al. Mar 2003 A1
20030055414 Altshuler et al. Mar 2003 A1
20030062040 Lurie et al. Apr 2003 A1
20030069618 Smith et al. Apr 2003 A1
20030077326 Newton et al. Apr 2003 A1
20030077329 Kipp et al. Apr 2003 A1
20030079488 Bieberich May 2003 A1
20030100936 Altshuler et al. May 2003 A1
20030109908 Lachenbruch et al. Jun 2003 A1
20030109910 Lachenbruch et al. Jun 2003 A1
20030109911 Lachenbruch et al. Jun 2003 A1
20030109912 Joye et al. Jun 2003 A1
20030114885 Nova et al. Jun 2003 A1
20030120268 Bertolero et al. Jun 2003 A1
20030125649 Mcintosh et al. Jul 2003 A1
20030187488 Kreindel et al. Oct 2003 A1
20030199226 Sommer et al. Oct 2003 A1
20030199859 Altshuler et al. Oct 2003 A1
20030220635 Knowlton et al. Nov 2003 A1
20030220674 Anderson Nov 2003 A1
20030236487 Knowlton Dec 2003 A1
20040002705 Knowlton et al. Jan 2004 A1
20040006328 Anderson Jan 2004 A1
20040009936 Tang et al. Jan 2004 A1
20040024437 Machold et al. Feb 2004 A1
20040030332 Knowlton et al. Feb 2004 A1
20040034341 Altshuler et al. Feb 2004 A1
20040039312 Hillstead et al. Feb 2004 A1
20040044384 Leber et al. Mar 2004 A1
20040049178 Abboud et al. Mar 2004 A1
20040073079 Altshuler et al. Apr 2004 A1
20040074629 Noel Apr 2004 A1
20040077977 Rave et al. Apr 2004 A1
20040082886 Timpson Apr 2004 A1
20040093042 Altshuler et al. May 2004 A1
20040104012 Zhou et al. Jun 2004 A1
20040106867 Eshel et al. Jun 2004 A1
20040116866 Gorman et al. Jun 2004 A1
20040159109 Harvie Aug 2004 A1
20040162596 Altshuler et al. Aug 2004 A1
20040176667 Mihai et al. Sep 2004 A1
20040186535 Knowlton Sep 2004 A1
20040199226 Shadduck Oct 2004 A1
20040206365 Knowlton Oct 2004 A1
20040210214 Knowlton Oct 2004 A1
20040210287 Greene Oct 2004 A1
20040215294 Littrup et al. Oct 2004 A1
20040249427 Nabilsi Dec 2004 A1
20040259855 Anderson et al. Dec 2004 A1
20040260209 Ella et al. Dec 2004 A1
20040260210 Ella et al. Dec 2004 A1
20040260211 Maalouf Dec 2004 A1
20040267339 Yon et al. Dec 2004 A1
20050010197 Lau et al. Jan 2005 A1
20050033957 Enokida Feb 2005 A1
20050049526 Baer Mar 2005 A1
20050049661 Koffroth Mar 2005 A1
20050113725 Masuda May 2005 A1
20050143781 Carbunaru et al. Jun 2005 A1
20050145372 Noel Jul 2005 A1
20050149153 Nakase et al. Jul 2005 A1
20050154314 Quistgaard Jul 2005 A1
20050154431 Quistgaard et al. Jul 2005 A1
20050159986 Breeland et al. Jul 2005 A1
20050177075 Meunier et al. Aug 2005 A1
20050182462 Chornenky et al. Aug 2005 A1
20050187495 Quistgaard et al. Aug 2005 A1
20050187597 Vanderschuit Aug 2005 A1
20050203446 Takashima Sep 2005 A1
20050215987 Slatkine Sep 2005 A1
20050222565 Manstein Oct 2005 A1
20050251117 Anderson et al. Nov 2005 A1
20050251120 Anderson et al. Nov 2005 A1
20050261753 Littrup et al. Nov 2005 A1
20050283144 Shiono et al. Dec 2005 A1
20060030778 Mendlein et al. Feb 2006 A1
20060035380 Saint-leger Feb 2006 A1
20060036300 Kreindel Feb 2006 A1
20060041704 Choi Feb 2006 A1
20060074313 Slayton et al. Apr 2006 A1
20060079852 Bubb et al. Apr 2006 A1
20060094988 Tosaya et al. May 2006 A1
20060106836 Masugi et al. May 2006 A1
20060111613 Boutillette et al. May 2006 A1
20060122509 Desilets Jun 2006 A1
20060188832 McCarren Aug 2006 A1
20060189964 Anderson et al. Aug 2006 A1
20060195168 Dunbar et al. Aug 2006 A1
20060200063 Munro et al. Sep 2006 A1
20060206040 Greenberg Sep 2006 A1
20060206110 Knowlton et al. Sep 2006 A1
20060234899 Nekmard et al. Oct 2006 A1
20060259102 Slatkine Nov 2006 A1
20060265032 Hennings et al. Nov 2006 A1
20060270745 Hunt et al. Nov 2006 A1
20060293734 Scott et al. Dec 2006 A1
20070010811 Stern et al. Jan 2007 A1
20070010861 Anderson et al. Jan 2007 A1
20070032561 Lin et al. Feb 2007 A1
20070038156 Rosenberg Feb 2007 A1
20070055156 Desilets et al. Mar 2007 A1
20070055173 Delonzor et al. Mar 2007 A1
20070055179 Deem et al. Mar 2007 A1
20070055180 Deem et al. Mar 2007 A1
20070055181 Deem et al. Mar 2007 A1
20070078502 Weber et al. Apr 2007 A1
20070088413 Weber et al. Apr 2007 A1
20070100398 Sloan May 2007 A1
20070106342 Schumann May 2007 A1
20070123962 Grahn et al. May 2007 A1
20070129714 Elkins et al. Jun 2007 A1
20070135876 Weber Jun 2007 A1
20070141265 Thomson Jun 2007 A1
20070179482 Anderson Aug 2007 A1
20070198071 Ting et al. Aug 2007 A1
20070219540 Masotti et al. Sep 2007 A1
20070239075 Rosenberg et al. Oct 2007 A1
20070239150 Zvuloni et al. Oct 2007 A1
20070249519 Guha et al. Oct 2007 A1
20070255187 Branch Nov 2007 A1
20070255274 Stern et al. Nov 2007 A1
20070255362 Levinson et al. Nov 2007 A1
20070265585 Joshi et al. Nov 2007 A1
20070265614 Stern et al. Nov 2007 A1
20070270925 Levinson Nov 2007 A1
20070282249 Quisenberry et al. Dec 2007 A1
20070282318 Spooner et al. Dec 2007 A1
20080014627 Merchant et al. Jan 2008 A1
20080046047 Jacobs Feb 2008 A1
20080058784 Manstein et al. Mar 2008 A1
20080077201 Levinson et al. Mar 2008 A1
20080077202 Levinson Mar 2008 A1
20080077211 Levinson et al. Mar 2008 A1
20080097207 Cai et al. Apr 2008 A1
20080139901 Altshuler et al. Jun 2008 A1
20080140061 Toubia et al. Jun 2008 A1
20080140371 Warner Jun 2008 A1
20080160480 Ruddle et al. Jul 2008 A1
20080161892 Mercuro et al. Jul 2008 A1
20080183164 Elkins et al. Jul 2008 A1
20080188915 Mills et al. Aug 2008 A1
20080195036 Merchant et al. Aug 2008 A1
20080248554 Merchant et al. Oct 2008 A1
20080269851 Deem et al. Oct 2008 A1
20080287839 Rosen et al. Nov 2008 A1
20080300529 Reinstein Dec 2008 A1
20080312651 Pope et al. Dec 2008 A1
20090012434 Anderson Jan 2009 A1
20090018623 Levinson et al. Jan 2009 A1
20090018624 Levinson et al. Jan 2009 A1
20090018625 Levinson et al. Jan 2009 A1
20090018626 Levinson et al. Jan 2009 A1
20090018627 Levinson et al. Jan 2009 A1
20090024023 Welches et al. Jan 2009 A1
20090054882 Hansen et al. Feb 2009 A1
20090076488 Welches et al. Mar 2009 A1
20090112134 Avni Apr 2009 A1
20090118722 Ebbers et al. May 2009 A1
20090149929 Levinson et al. Jun 2009 A1
20090149930 Schenck Jun 2009 A1
20090171253 Davenport Jul 2009 A1
20090171334 Elkins et al. Jul 2009 A1
20090209886 Tudico Aug 2009 A1
20090221938 Rosenberg et al. Sep 2009 A1
20090226424 Hsu Sep 2009 A1
20090276018 Brader Nov 2009 A1
20090281464 Cioanta et al. Nov 2009 A1
20090299234 Cho et al. Dec 2009 A1
20090306749 Mulindwa Dec 2009 A1
20090312676 Rousso et al. Dec 2009 A1
20090312693 Thapliyal et al. Dec 2009 A1
20090318851 Schenck Dec 2009 A1
20090326621 El-Galley Dec 2009 A1
20100015190 Hassler Jan 2010 A1
20100028969 Mueller et al. Feb 2010 A1
20100030306 Edelman et al. Feb 2010 A1
20100036295 Altshuler et al. Feb 2010 A1
20100042087 Goldboss et al. Feb 2010 A1
20100049178 Deem et al. Feb 2010 A1
20100081971 Allison Apr 2010 A1
20100087806 Da et al. Apr 2010 A1
20100106230 Buchanan et al. Apr 2010 A1
20100152824 Allison Jun 2010 A1
20100168726 Brookman Jul 2010 A1
20100179531 Nebrigic et al. Jul 2010 A1
20100198064 Perl et al. Aug 2010 A1
20100198204 Rogers Aug 2010 A1
20100217349 Fahey Aug 2010 A1
20100241023 Gilbert Sep 2010 A1
20100268220 Johnson et al. Oct 2010 A1
20100280582 Baker et al. Nov 2010 A1
20110009860 Chornenky et al. Jan 2011 A1
20110040235 Castel Feb 2011 A1
20110040299 Kim et al. Feb 2011 A1
20110046523 Altshuler et al. Feb 2011 A1
20110060323 Baust et al. Mar 2011 A1
20110066083 Tosaya et al. Mar 2011 A1
20110066216 Ting et al. Mar 2011 A1
20110077557 Wing et al. Mar 2011 A1
20110077723 Parish et al. Mar 2011 A1
20110112405 Barthe et al. May 2011 A1
20110112520 Michael May 2011 A1
20110144631 Elkins et al. Jun 2011 A1
20110152849 Baust et al. Jun 2011 A1
20110172651 Altshuler et al. Jul 2011 A1
20110189129 Qiu et al. Aug 2011 A1
20110196395 Maschke Aug 2011 A1
20110196438 Mnozil et al. Aug 2011 A1
20110202048 Nebrigic Aug 2011 A1
20110238050 Allison et al. Sep 2011 A1
20110238051 Levinson et al. Sep 2011 A1
20110257642 Griggs et al. Oct 2011 A1
20110288537 Halaka Nov 2011 A1
20110300079 Martens et al. Dec 2011 A1
20110301585 Goulko Dec 2011 A1
20110313411 Anderson et al. Dec 2011 A1
20110313412 Kim et al. Dec 2011 A1
20120010609 Deem et al. Jan 2012 A1
20120016239 Barthe et al. Jan 2012 A1
20120022518 Levinson Jan 2012 A1
20120022622 Johnson et al. Jan 2012 A1
20120035475 Barthe et al. Feb 2012 A1
20120035476 Barthe et al. Feb 2012 A1
20120041525 Kami Feb 2012 A1
20120046547 Barthe et al. Feb 2012 A1
20120053458 Barthe et al. Mar 2012 A1
20120065629 Elkins et al. Mar 2012 A1
20120083862 Altshuler et al. Apr 2012 A1
20120101549 Schumann Apr 2012 A1
20120109041 Munz May 2012 A1
20120158100 Schomacker Jun 2012 A1
20120209363 Williams et al. Aug 2012 A1
20120238901 Augustine Sep 2012 A1
20120239123 Weber et al. Sep 2012 A1
20120253416 Erez et al. Oct 2012 A1
20120259322 Fourkas et al. Oct 2012 A1
20120277674 Clark et al. Nov 2012 A1
20120310232 Erez Dec 2012 A1
20130018236 Altshuler et al. Jan 2013 A1
20130019374 Schwartz Jan 2013 A1
20130035680 Ben-haim et al. Feb 2013 A1
20130066309 Levinson Mar 2013 A1
20130073017 Liu et al. Mar 2013 A1
20130079684 Rosen et al. Mar 2013 A1
20130116758 Levinson et al. May 2013 A1
20130116759 Levinson et al. May 2013 A1
20130150844 Deem et al. Jun 2013 A1
20130158440 Allison Jun 2013 A1
20130158636 Ting et al. Jun 2013 A1
20130166003 Johnson et al. Jun 2013 A1
20130190744 Avram et al. Jul 2013 A1
20130238062 Ron Edoute et al. Sep 2013 A1
20130245507 Khorassani Zadeh Sep 2013 A1
20130253384 Anderson et al. Sep 2013 A1
20130303904 Barthe et al. Nov 2013 A1
20130303905 Barthe et al. Nov 2013 A1
20130331914 Lee et al. Dec 2013 A1
20140005759 Fahey et al. Jan 2014 A1
20140005760 Levinson et al. Jan 2014 A1
20140142469 Britva et al. May 2014 A1
20140163582 Austen et al. Jun 2014 A1
20140200488 Seo et al. Jul 2014 A1
20140228718 Diller et al. Aug 2014 A1
20140277219 Nanda Sep 2014 A1
20150209174 Abreu Jul 2015 A1
20150216719 Debenedictis et al. Aug 2015 A1
20150216720 Debenedictis et al. Aug 2015 A1
20150216816 O'Neil et al. Aug 2015 A1
20150283022 Lee et al. Oct 2015 A1
20150328077 Levinson Nov 2015 A1
20150335468 Rose et al. Nov 2015 A1
20150342780 Levinson et al. Dec 2015 A1
20160051308 Pennybacker et al. Feb 2016 A1
20160051401 Yee et al. Feb 2016 A1
20160324684 Levinson et al. Nov 2016 A1
20170007309 DeBenedictis et al. Jan 2017 A1
20170079833 Frangineas, Jr. et al. Mar 2017 A1
20170105869 Frangineas, Jr. et al. Apr 2017 A1
20170165105 Anderson et al. Jun 2017 A1
20170196731 DeBenedictis et al. Jul 2017 A1
20170239079 Root et al. Aug 2017 A1
20170325992 DeBenedictis et al. Nov 2017 A1
20170325993 Jimenez Lozano et al. Nov 2017 A1
20170326042 Zeng et al. Nov 2017 A1
20170326346 Jimenez Lozano et al. Nov 2017 A1
20180161197 Baker et al. Jun 2018 A1
20180185081 O'neil et al. Jul 2018 A1
20180185189 Weber et al. Jul 2018 A1
20180263677 Hilton et al. Sep 2018 A1
20180271767 Jimenez Lozano et al. Sep 2018 A1
20180310950 Yee et al. Nov 2018 A1
20190125424 DeBenedictis et al. May 2019 A1
20190142493 DeBenedictis et al. May 2019 A1
20190365595 Rosen et al. Dec 2019 A1
Foreign Referenced Citations (173)
Number Date Country
2011253768 Jun 2012 AU
2441489 Mar 2005 CA
2585214 Oct 2007 CA
333982 Nov 1958 CH
86200604 Oct 1987 CN
2514795 Oct 2002 CN
2514811 Oct 2002 CN
1511503 Jul 2004 CN
1741777 Mar 2006 CN
1817990 Aug 2006 CN
2843367 Dec 2006 CN
2850584 Dec 2006 CN
2850585 Dec 2006 CN
200970265 Nov 2007 CN
101259329 Sep 2008 CN
101309657 Nov 2008 CN
2851602 Jun 1980 DE
4213584 Nov 1992 DE
4224595 Jan 1994 DE
4238291 May 1994 DE
4445627 Jun 1996 DE
19800416 Jul 1999 DE
263069 Apr 1988 EP
0397043 Nov 1990 EP
0406244 Jan 1991 EP
560309 Sep 1993 EP
0598824 Jun 1994 EP
1030611 Aug 2000 EP
1201266 May 2002 EP
1568395 Aug 2005 EP
2289598 Mar 2011 EP
2527005 Nov 2012 EP
854937 Apr 1940 FR
2744358 Aug 1997 FR
2745935 Sep 1997 FR
2767476 Feb 1999 FR
2776920 Oct 1999 FR
2789893 Aug 2000 FR
2805989 Sep 2001 FR
387960 Feb 1933 GB
2120944 Dec 1983 GB
2202447 Sep 1988 GB
2248183 Apr 1992 GB
2263872 Aug 1993 GB
2286660 Aug 1995 GB
2323659 Sep 1998 GB
58187454 Nov 1983 JP
S6094113 May 1985 JP
62082977 Apr 1987 JP
63076895 Apr 1988 JP
01223961 Sep 1989 JP
03051964 Mar 1991 JP
03259975 Nov 1991 JP
04093597 Mar 1992 JP
06261933 Sep 1994 JP
07194666 Aug 1995 JP
07268274 Oct 1995 JP
09164163 Jun 1997 JP
10216169 Aug 1998 JP
10223961 Aug 1998 JP
3065657 Apr 1999 JP
2000503154 Mar 2000 JP
2001046416 Feb 2001 JP
2002125993 May 2002 JP
2002224051 Aug 2002 JP
2002282295 Oct 2002 JP
2002290397 Oct 2002 JP
2002543668 Dec 2002 JP
2003190201 Jul 2003 JP
2004013600 Jan 2004 JP
2004073812 Mar 2004 JP
2004159666 Jun 2004 JP
2005039790 Feb 2005 JP
3655820 Mar 2005 JP
2005065984 Mar 2005 JP
2005110755 Apr 2005 JP
2005509977 Apr 2005 JP
2005520608 Jul 2005 JP
2005237908 Sep 2005 JP
2005323716 Nov 2005 JP
2006026001 Feb 2006 JP
2006130055 May 2006 JP
2006520949 Sep 2006 JP
2007270459 Oct 2007 JP
2008532591 Aug 2008 JP
2009515232 Apr 2009 JP
2009189757 Aug 2009 JP
200173222 Mar 2000 KR
20040094508 Nov 2004 KR
20090000258 Jan 2009 KR
20130043299 Apr 2013 KR
20140038165 Mar 2014 KR
2036667 Jun 1995 RU
532976 Nov 1978 SU
0476644 Feb 2002 TW
8503216 Aug 1985 WO
9114417 Oct 1991 WO
9300807 Jan 1993 WO
9404116 Mar 1994 WO
9623447 Aug 1996 WO
9626693 Sep 1996 WO
9636293 Nov 1996 WO
9637158 Nov 1996 WO
9704832 Feb 1997 WO
9705828 Feb 1997 WO
9722262 Jun 1997 WO
9724088 Jul 1997 WO
9725798 Jul 1997 WO
9748440 Dec 1997 WO
9829134 Jul 1998 WO
9831321 Jul 1998 WO
9841156 Sep 1998 WO
9841157 Sep 1998 WO
9909928 Mar 1999 WO
9916502 Apr 1999 WO
9938469 Aug 1999 WO
9949937 Oct 1999 WO
0044346 Aug 2000 WO
0044349 Aug 2000 WO
0065770 Nov 2000 WO
0067685 Nov 2000 WO
0100269 Jan 2001 WO
0113989 Mar 2001 WO
0114012 Mar 2001 WO
0134048 May 2001 WO
0205736 Jan 2002 WO
02102921 Dec 2002 WO
03007859 Jan 2003 WO
03078596 Sep 2003 WO
03079916 Oct 2003 WO
2004000098 Dec 2003 WO
2004080279 Sep 2004 WO
2004090939 Oct 2004 WO
2005033957 Apr 2005 WO
2005046540 May 2005 WO
2005060354 Jul 2005 WO
2005096979 Oct 2005 WO
2005112815 Dec 2005 WO
2006066226 Jun 2006 WO
2006094348 Sep 2006 WO
2006106836 Oct 2006 WO
2006116603 Nov 2006 WO
2006127467 Nov 2006 WO
2007012083 Jan 2007 WO
2007028975 Mar 2007 WO
2007041642 Apr 2007 WO
2007101039 Sep 2007 WO
2007127924 Nov 2007 WO
2007145421 Dec 2007 WO
2007145422 Dec 2007 WO
2008006018 Jan 2008 WO
2008039556 Apr 2008 WO
2008039557 Apr 2008 WO
2008055243 May 2008 WO
2008143678 Nov 2008 WO
2009011708 Jan 2009 WO
2009026471 Feb 2009 WO
2010077841 Jul 2010 WO
2010127315 Nov 2010 WO
2012012296 Jan 2012 WO
2012103242 Aug 2012 WO
2013013059 Jan 2013 WO
2013075006 May 2013 WO
2013075016 May 2013 WO
2013190337 Dec 2013 WO
2014151872 Dec 2014 WO
2015117001 Aug 2015 WO
2015117005 Aug 2015 WO
2015117026 Aug 2015 WO
2015117032 Aug 2015 WO
2015117036 Aug 2015 WO
2016028796 Feb 2016 WO
2016048721 Mar 2016 WO
Non-Patent Literature Citations (86)
Entry
Aguilar et al., “Modeling Cryogenic Spray Temperature and Evaporation Rate Based on Single-Droplet Analysis,” Eighth International Conference on Liquid Atomization and Spray Systems, Pasadena, CA, USA, Jul. 2000, 7 pages.
Al-Sakere, B. et al. “Tumor Ablation with Irreversible Electroporation,” PLoS One, Issue 11, Nov. 2007, 8 pages.
Alster, T. et al., “Cellulite Treatment Using a Novel Combination Radiofrequency, Infrared Light, and Mechanical Tissue Manipulation Device,” Journal of Cosmetic and Laser Therapy, vol. 7, 2005, pp. 81-85.
Ardevol, A. et al., “Cooling Rates of Tissue Samples During Freezing with Liquid Nitrogen,” Journal of Biochemical and Biophysical Methods, vol. 27, 1993, pp. 77-86.
Arena, C. B. et al., “High-Frequency Irreversible Electroporation (H-FIRE) for Non-Thermal Ablation Without Muscle Contraction,” BioMedical Engineering OnLine 2011, 10:102, Nov. 21, 2011, 21 pgs.
Becker, S. M. et al. “Local Temperature Rises Influence In Vivo Electroporation Pore Development: A Numerical Stratum Corneum Lipid Phase Transition Model,” Journal of Biomechanical Engineering, vol. 129, Oct. 2007, pp. 712-721.
Bohm, T. et al., “Saline-Enhanced Radiofrequency Ablation of Breast Tissue: an in Vitro Feasibility Study,” Investigative Radiology, vol. 35 (3), 2000, pp. 149-157.
Bondei, E. et al., “Disorders of Subcutaneous Tissue (Cold Panniculitis),” Dermatology in General Medicine, Fourth Edition, vol. 1, Chapter 108, 1993, Section 16, pp. 1333-1334.
Burge, S.M. et al., “Hair Follicle Destruction and Regeneration in Guinea Pig Skin after Cutaneous Freeze Injury,” Cryobiology, 27(2), 1990, pp. 153-163.
Coban, Y. K. et al., “Ischemia-Reperfusion Injury of Adipofascial Tissue: An Experimental Study Evaluating Early Histologic and Biochemical Alterations in Rats,” Mediators of Inflammation, 2005, 5, pp. 304-308.
Del Pino, M. E. et al. “Effect of Controlled Volumetric Tissue Heating with Radiofrequency on Cellulite and the Subcutaneous Tissue of the Buttocks and Thighs,” Journal of Drugs in Dermatology, vol. 5, Issue 8, Sep. 2006, pp. 714-722.
Donski, P. K. et al., “The Effects of Cooling no Experimental Free Flap Survival,” British Journal of Plastic Surgery, vol. 33, 1980, pp. 353-360.
Duck, F. A., Physical Properties of Tissue, Academic Press Ltd., chapters 4 & 5, 1990, pp. 73-165.
Duncan, W. C. et al., “Cold Panniculitis,” Archives of Dermatology, vol. 94, Issue 6, Dec. 1966, pp. 722-724.
Epstein, E. H. et al., “Popsicle Panniculitis,” The New England Journal of Medicine, 282(17), Apr. 23, 1970, pp. 966-967.
Fournier, L. et al. “Lattice Model for the Kinetics of Rupture of Fluid Bilayer Membranes,” Physical Review, vol. 67, 2003, p. 051908-1-051908-11.
Gabriel, S. et al., “The Dielectric Properties Of Biological Tissues: II. Measurements in the Frequency Range 10 Hz to 20 GHz,” Physics in Medicine and Biology, vol. 41, 1996, pp. 2251-2269.
Gage, A. “Current Progress in Cryosurgery,” Cryobiology 25, 1988, pp. 483-486.
Gatto, H. “Effects of Thermal Shocks on Interleukin-1 Levels and Heat Shock Protein 72 (HSP72) Expression in Normal Human Keratinocytes,” PubMed, Archives of Dermatological Research, vol. 284, Issue 7, 1992: pp. 414-417 [Abstract].
Hale, H. B. et al., “Influence of Chronic Heat Exposure and Prolonged Food Deprivation on Excretion of Magnesium, Phosphorus, Calcium, Hydrogen Ion & Ketones,” Aerospace Medicine, vol. 39—No. 9, Sep. 1968, pp. 919-926.
Heller Page, E. et al., “Temperature-dependent skin disorders,” Journal of the American Academy of Dermatology, vol. 18, No. 5, Pt 1, May 1988, pp. 1003-1019.
Hemmingsson, A. et al. “Attenuation in Human Muscle and Fat Tissue in Vivo and in Vitro,” Aera Radiologica Diagnosis, vol. 23, No. 2, 1982, pp. 149-151.
Henry, F. et al., “Les Dermatoses Hivernales,” Rev Med Liege, 54:11, 1999, pp. 864-866. [Abstract Attached].
Hernan, P. et al., “Study for the evaluation of the efficacy of Lipocryolysis (EEEL)”, Nov. 30, 2011.
Hernan, R. P., “A Study to Evaluate the Action of Lipocryolysis”, 33(3) CryoLellers, 2012, pp. 176-180.
Holland, DB. et al. “Cold shock induces the synthesis of stress proteins in human keratinocytes,” PubMed Journal of Investigative Dermatology; 101(2): Aug. 1993, pp. 196-199.
Holman, W. L. et al., “Variation in Cryolesion Penetration Due to Probe Size and Tissue Thermal Conductivity,” The Annals of Thoracic Surgery, vol. 53, 1992, pp. 123-126.
Hong, J.S. et al., “Patterns of Ice Formation in Normal and Malignant Breast Tissue,” Cryobiology 31, 1994, pp. 109-120.
Huang et al. “Comparative Proteomic Profiling of Murine Skin,” Journal of Investigative Dermatology, vol. 121(1), Jul. 2003, pp. 51-64.
Isambert, H. “Understanding the Electroporation of Cells and Artificial Bilayer Membranes,” Physical Review Letters, vol. 80, No. 15, 1998, pp. 3404-3707.
Jalian, H. R. et al., “Cryolipolysis: A Historical Perspective and Current Clinical Practice”, 32(1) Semin. Cutan. Med. Surg., 2013, pp. 31-34.
Kellum, R. E. et al., “Sclerema Neonatorum: Report of Case and Analysis of Subcutaneous and Epidermal-Dermal Lipids by Chromatographic Methods,” Archives of Dermatology, vol. 97, Apr. 1968, pp. 372-380.
Koska, J. et al., “Endocrine Regulation of Subcutaneous Fat Metabolism During Cold Exposure in Humans,” Annals of the New York Academy of Sciences, vol. 967, 2002, pp. 500-505.
Kundu, S. K. et al., “Breath Acetone Analyzer: Diagnostic Tool to Monitor Dietary Fat Loss,” Clinical Chemistry, vol. 39, Issue (1), 1993, pp. 87-92.
Kundu, S. K. et al., “Novel Solid-Phase Assay of Ketone Bodies in Urine,” Clinical Chemistry, vol. 37, Issue (9), 1991, pp. 1565-1569.
Kuroda, S. et al. “Thermal Distribution of Radio-Frequency Inductive Hyperthermia Using an Inductive Aperture-Type Applicator: Evaluation of the Effect of Tumor Size and Depth”, Medical and Biological Engineering and Computing, vol. 37, 1999, pp. 285-290.
Laugier, P. et al., “In Vivo Results with a New Device for Ultrasonic Monitoring of Pig Skin Cryosurgery: The Echographic Cryprobe,” The Society for Investigative Dermatology, Inc., vol. 111, No. 2, Aug. 1998, pp. 314-319.
Levchenko et al., “Effect of Dehydration on Lipid Metabolism” Ukrainskii Biokhimicheskii Zhurnal, vol. 50, Issue 1, 1978, pp. 95-97.
Lidagoster, MD et al., “Comparison of Autologous Fat Transfer in Fresh, Refrigerated, and Frozen Specimens: An Animal Model,” Annals of Plastic Surgery, vol. 44, No. 5, May 2000, pp. 512-515.
Liu, A. Y.-C et al., “Transient Cold Shock Induces the Heat Shock Response upon Recovery at 37° C. in Human Cells,” Journal of Biological Chemistry, , 269(20), May 20, 1994, p. 14768-14775.
L'Vova, S.P. “Lipid Levels and Lipid Peroxidation in Frog Tissues During Hypothermia and Hibernation” Ukrainskii Biokhimicheskii Zhurnal, vol. 62, Issue 1, 1990, pp. 65-70.
Maize, J.C. “Panniculitis,” Cutaneous Pathology, Chapter 13, 1998, 327-344.
Malcolm, G. T. et al., “Fatty Acid Composition of Adipose Tissue in Humans: Differences between Subcutaneous Sites,” The American Journal of Clinical Nutrition, vol. 50, 1989, pp. 288-291.
Manstein, D. et al. “A Novel Cryotherapy Method of Non-invasive, Selective Lipolysis,” LasersSurg.Med 40:S20, 2008, p. 104.
Manstein, D. et al. “Selective Cryolysis: A Novel Method of Non-Invasive Fat Removal,” Lasers in Surgery and Medicine: The Official Journal of the ASLMS, vol. 40, No. 9, Nov. 2008, pp. 595-604.
Mayoral, “Case Reports: Skin Tightening with a Combined Unipolar and Bipolar Radiofrequency Device,” Journal of Drugs in Dermatology, 2007, pp. 212-215.
Mazur, P. “Cryobiology: The Freezing of Biological Systems,” Science, 68, 1970, pp. 939-949.
Merrill, T. “A Chill to the Heart: A System to Deliver Local Hypothermia Could One Day Improve the Lives of Heart-Attack Patients,” Mechanical Engineering Magazine, Oct. 2010, 10 pages.
Miklavcic, D. et al. “Electroporation-Based Technologies and Treatments,” The Journal of Membrane Biology (2010) 236:1-2, 2 pgs.
Moschella, S. L. et al., “Diseases of the Subcutaneous Tissue,” in Dermatology, Second Edition, vol. 2, 1985 Chapter 19, Section II (W.B. Saunders Company, 1980) pp. 1169-1181.
Murphy, J. V. et al., “Frostbite: Pathogenesis and Treatment” The Journal of Trauma: Injury, Infection, and Critical Care, vol. 48, No. 1, Jan. 2000, pp. 171-178.
Nagao, T. et al., “Dietary Diacylglycerol Suppresses Accumulation of Body Fat Compared to Triacylglycerol in Men a Double-Blind Controlled Trial,” The Journal of Nutrition, vol. 130, Issue (4), 2000, pp. 792-797.
Nagle, W. A. et al. “Cultured Chinese Hamster Cells Undergo Apoptosis After Exposure to Cold but Nonfreezing Temperatures,” Cryobiology 27, 1990, pp. 439-451.
Nagore, E. et al., “Lipoatrophia Semicircularis-a Traumatic Panniculitis: Report of Seven Cases and Review of the Literature,” Journal of the American Academy of Dermatology, vol. 39, Nov. 1998, pp. 879-881.
Nanda, G.S. et al., “Studies on electroporation of thermally and chemically treated human erythrocytes,” Bioelectrochemistry and Bioenergetics, 34, 1994, pp. 129-134, 6 pgs.
Narins, D.J. et al. “Non-Surgical Radiofrequency Facelift”, The Journal of Drugs in Dermatology, vol. 2, Issue 5, 2003, pp. 495-500.
Nielsen, B. “Thermoregulation in Rest and Exercise,” Acta Physiologica Scandinavica Suppiementum, vol. 323 (Copenhagen 1969), pp. 7-74.
Nishikawa, H. et al. “Ultrastructural Changes and Lipid Peroxidation in Rat Adipomusculocutaneous Flap Isotransplants after Normothermic Storage and Reperfusion,” Transplantation, vol. 54, No. 5, 1992, pp. 795-801.
Nurnberger, F. “So-Called Cellulite: An Invented Disease,” Journal of Dermatologic Surgery and Oncology, Mar. 1978, pp. 221-229.
Pease, G. R. et al., “An Integrated Probe for Magnetic Resonance Imaging Monitored Skin Cryosurgery,” Journal of Biomedical Engineering, vol. 117, Feb. 1995, pp. 59-63.
Pech, P. et al., “Attenuation Values, Volume Changes and Artifacts in Tissue Due to Freezing,” Acta Radiologica ,vol. 28, Issue 6, 1987, pp. 779-782.
Peterson, L. J. et al., “Bilateral Fat Necrosis of the Scrotum,” Journal of Urology, vol. 116, 1976, pp. 825-826.
Phinney, S. D. et al., “Human Subcutaneous Adipose Tissue Shows Site-Specific Differences in Fatty Acid Composition,” The American Journal of Clinical Nutrition, vol. 60, 1994, pp. 725-729.
Pierard, G.E. et al., “Cellulite: From Standing Fat Herniation to Hypodermal Stretch Marks,” The American Journal of Dermatology, vol. 22, Issue 1, 2000, pp. 34-37, [Abstract].
Pope, K. et al. “Selective Fibrous Septae Heating: An Additional Mechanism of Action for Capacitively Coupled Monopolar Radiofrequency” Thermage, Inc. Article, Feb. 2005, 6pgs.
Quinn, P. J. “A Lipid-Phase Separation Model of Low-Temperature Damage to Biological Membranes,” Cryobiology, 22, 1985, 128-146.
Rabi, T. et al., “Metabolic Adaptations in Brown Adipose Tissue of the Hamster in Extreme Ambient Temperatures,” American Journal of Physiology, vol. 231, Issue 1, Jul. 1976, pp. 153-160.
Renold, A.E. et al. “Adipose Tissue” in Handbook of Physiology, Chapter 15, (Washington, D.C., 1965) pp. 169-176.
Rossi, A. B. R. et al. “Cellulite: a Review,” European Academy of Dermatology and Venereology, 2000, pp. 251-262, 12 pgs.
Rubinsky, B. “Principles of Low Temperature Cell Preservation,” Heart Failure Reviews, vol. 8, 2003, pp. 277-284.
Rubinsky, B. et al., “Cryosurgery: Advances in the Application of low Temperatures to Medicine,” International Journal of Refrigeration, vol. 14, Jul. 1991, pp. 190-199.
Saleh, K.Y. et al., “Two-Dimensional Ultrasound Phased Array Design for Tissue Ablation for Treatment of Benign Prostatic Hyperplasia,” International Journal of Hyperthermia, vol. 20, No. 1, Feb. 2004, pp. 7-31.
Schoning, P. et al., “Experimental Frostbite: Freezing Times, Rewarming Times, and Lowest Temperatures of Pig Skin Exposed to Chilled Air,” Cryobiology 27, 1990, pp. 189-193.
Shephard, R. J. “Adaptation to Exercise in the Cold,” Sports Medicine, vol. 2, 1985, pp. 59-71.
Sigma-Aldrich “Poly(ethylene glycol) and Poly(ethylene oxide),” http://www.sigmaaldrich.com/materials-science/materialscience-;products.htmi?TablePage=2020411 0, accessed Oct. 19, 2012.
Smalls, L. K. et al. “Quantitative Model of Cellulite: Three Dimensional Skin Surface Topography, Biophysical Characterization, and Relationship to Human Perception,” International Journal of Cosmetic Science, vol. 27, Issue 5, Oct. 2005, 17 pgs.
Thermage, News Release, “Study Published in Facial Plastic Surgery Journal Finds Selective Heating of Fibrous Septae Key to Success and Safety of Thermage ThermaCool System,” Jun. 20, 2005, 2 pages.
“ThermaCool Monopolar Capacitive Radiofrequency, The one choice for nonablative tissue tightening and contouring”, Thermage, Inc. Tech Brochure, Nov. 30, 2005, 8 pgs.
Vallerand et al. “Cold Stress Increases Lipolysis, FFA Ra and TG/FFA Cycling in Humans,” Aviation, Space, and Environmental Medicine 70(1), 1999, pp. 42-50.
Wang, X. et al., “Cryopreservation of Cell/Hydrogel Constructs Based on a new Cell-Assembling Technique,” Sep. 5, 2009, 40 pages.
Wharton, D. A. et al., “Cold Acclimation and Cryoprotectants in a Freeze-Tolerant Antarctic Nematode, Panagrolaimus Davidi,”, Journal of Comparative Physiology, vol. 170, No. 4, Mar. 2000, 2 pages.
Winkler, C. et al., “Gene Transfer in Laboratory Fish: Model Organisms for the Analysis of Gene Function,” in Transgenic Animals, Generation and Use (The Netherlands 1997), pp. 387-395.
Young, H. E. et al. “Isolation of Embryonic Chick Myosatellite and Pluripotent Stem Cells” The Journal of Tissue Culture Methods, vol. 14, Issue 2, 1992, pp. 85-92.
Zelickson, B. et al., “Cryolipolysis for Noninvasive Fat Cell Destruction: Initial Results from a Pig Model”, 35 Dermatol. Sug., 2009, pp. 1-9.
Zouboulis, C. C. et al., “Current Developments and Uses of Cryosurgery in the Treatment of Keloids and Hypertrophic Scars,” Wound Repair and Regeneration, vol. 10, No. 2, 2002, pp. 98-102.
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