Device and method for determining analyte levels

Information

  • Patent Grant
  • 9931067
  • Patent Number
    9,931,067
  • Date Filed
    Tuesday, September 13, 2016
    7 years ago
  • Date Issued
    Tuesday, April 3, 2018
    6 years ago
Abstract
Devices and methods for determining analyte levels are described. The devices and methods allow for the implantation of analyte-monitoring devices, such as glucose monitoring devices that result in the delivery of a dependable flow of blood to deliver sample to the implanted device. The devices include unique architectural arrangement in the sensor region that allows accurate data to be obtained over long periods of time.
Description
FIELD OF THE INVENTION

The present invention relates generally to devices and methods for determining analyte levels, and, more particularly, to implantable devices and methods for monitoring glucose levels in a biological fluid.


BACKGROUND OF THE INVENTION

The continuous measurement of substances in biological fluids is of interest in the control and study of metabolic disorders. Electrode systems have been developed for this purpose whereby an enzyme-catalyzed reaction is monitored (e.g., by the changing concentrations of reactants or products) by an electrochemical sensor. In such electrode systems, the electrochemical sensor comprises an electrode with potentiometric or amperometric function in close contact with a thin layer containing an enzyme in dissolved or insoluble form. Generally, a semipermeable membrane separates the thin layer of the electrode containing the enzyme from the sample of biological fluid that includes the substance to be measured.


Electrode systems that include enzymes have been used to convert amperometrically inactive substances into reaction products that are amperometrically active. For example, in the analysis of blood for glucose content, glucose (which is relatively inactive amperometrically) may be catalytically converted by the enzyme glucose oxidase in the presence of oxygen and water to gluconic acid and hydrogen peroxide. Tracking the concentration of glucose is thereby possible since for every glucose molecule reacted a proportional change in either oxygen or hydrogen peroxide sensor current will occur [U.S. Pat. Nos. 4,757,022 and 4,994,167 to Shults et al., both of which are hereby incorporated by reference]. Hydrogen peroxide is anodically active and produces a current that is proportional to the concentration of hydrogen peroxide. [Updike et al., Diabetes Care, 11:801-807 (1988)].


Despite recent advances in the field of implantable glucose monitoring devices, presently used devices are unable to provide data safely and reliably for long periods of time (e.g., months or years) [See, e.g., Moatti-Sirat et al., Diabetologia 35:224-30 (1992)]. For example, Armour et al., Diabetes 39:1519-26 (1990), describes a miniaturized sensor that is placed intravascularly, thereby allowing the tip of the sensor to be in continuous contact with the blood. Unfortunately, probes that are placed directly into the vasculature put the recipient at risk for thrombophlebosis, thromboembolism, and thrombophlebitis.


Currently available glucose monitoring devices that may be implanted in tissue (e.g., subcutaneously) are also associated with several shortcomings. For example, there is no dependable flow of blood to deliver sample to the tip of the probe of the implanted device. Similarly, in order to be effective, the probe must consume some oxygen and glucose, but not enough to perturb the available glucose which it is intended to measure; subcutaneously implanted probes often reside in a relatively low oxygen environment in which oxygen or glucose depletion zones around the probe tip may result in erroneously low measured glucose levels. In addition, implantable devices that utilize electrode sensors require membranes of the appropriate composition to protect the sensor from harsh in vivo environmental conditions. Current membrane technology has allowed the development of a single structural membrane that performs the same functions that previously required multiple membranes. However, these single membranes have been observed to delaminate and thus prevent accurate long-term glucose monitoring. Finally, the probe may be subject to “motion artifact” because the device is not adequately secured to the tissue, thus contributing to unreliable results. Partly because of these limitations, it has previously been difficult to obtain accurate information regarding the changes in the amounts of analytes (e.g., whether blood glucose levels are increasing or decreasing); this information is often extremely important, for example, in ascertaining whether immediate corrective action is needed in the treatment of diabetic patients.


There is a need for a device that accurately and continuously determines the presence and the amounts of a particular analyte, such as glucose, in biological fluids. The device should be easy to use, be capable of accurate measurement of the analyte over long periods of time, and should not readily be susceptible to motion artifact.


SUMMARY OF THE INVENTION

The present invention relates generally to devices and methods for determining analyte levels, and, more particularly, to implantable devices and methods for monitoring glucose levels in a biological fluid.


In one aspect of the present invention, an implantable device for measuring an analyte in a biological fluid is provided, which includes the following: a housing including an electronic circuit; and a sensor operably connected to the electronic circuit of the housing, the sensor including i) a member for determining the amount of glucose in a biological sample ii) a bioprotective membrane, the bioprotective membrane positioned more distal to the housing than the glucose determining member and substantially impermeable to macrophages, and iii) an angiogenic layer, the angiogenic layer positioned more distal to the housing than the bioprotective membrane.


The present invention further encompasses a method of monitoring glucose levels, the method including the steps of providing a host, and an implantable device as described above and implanting the device in the host under conditions such that the device measures glucose for a period exceeding 360 days.


In one embodiment of this aspect, the invention encompasses a method of measuring glucose in a biological fluid that includes the steps of providing a host, and an implantable device as provided above, wherein the glucose determining member of the implantable device is capable of continuous glucose sensing, and implanting the device in the host.


Definitions


In order to facilitate an understanding of the present invention, a number of terms are defined below.


The term “accurately” means, for example, 95% of measured values within 25% of the actual value as determined by analysis of blood plasma, preferably within 15% of the actual value, and most preferably within 5% of the actual value. Alternatively, “accurately” means that 85% of the measured values fall into the A and B regions of a Clarke error grid, or preferably 90%, or most preferably 95% of the measured values fall into these regions. It is understood that like any analytical device, calibration, calibration validation and recalibration are required for the most accurate operation of the device.


The term “analyte” refers to a substance or chemical constituent in a biological fluid (e.g., blood or urine) that can be analyzed. A preferred analyte for measurement by the devices and methods of the present invention is glucose.


The terms “sensor interface,” “sensor means,” “sensor” and the like refer to the region of a monitoring device responsible for the detection of a particular analyte. For example, in some embodiments of a glucose monitoring device, the sensor interface refers to that region wherein a biological sample (e.g., blood or interstitial fluid) or a portion thereof contacts (directly or after passage through one or more membranes or layers) an enzyme (e.g., glucose oxidase); the reaction of the biological sample (or portion thereof) results in the formation of reaction products that allow a determination of the glucose level in the biological sample. In preferred embodiments of the present invention, the sensor means comprises an angiogenic layer, a bioprotective layer, an enzyme layer, and an electrolyte phase (i.e., a free-flowing liquid phase comprising an electrolyte-containing fluid [described further below]). In some preferred embodiments, the sensor interface protrudes beyond the plane of the housing.


The term “tissue interface” refers to that region of a monitoring device that is in contact with tissue.


The terms “operably connected,” “operably linked,” and the like refer to one or more components being linked to another component(s) in a manner that allows transmission of, e.g., signals between the components. For example, one or more electrodes may be used to detect the amount of analyte in a sample and convert that information into a signal; the signal may then be transmitted to electronic circuit means (i.e., the electrode is “operably linked” to the electronic circuit means), which may convert the signal into a numerical value in the form of known standard values.


The term “electronic circuit means” or “electronic circuit” refers to the electronic circuitry components of a biological fluid measuring device required to process information obtained by a sensor means regarding a particular analyte in a biological fluid, thereby providing data regarding the amount of that analyte in the fluid. U.S. Pat. No. 4,757,022 to Shults et al., previously incorporated by reference, describes suitable electronic circuit means (see, e.g., FIG. 7); of course, the present invention is not limited to use with the electronic circuit means described therein. A variety of circuits are contemplated, including but not limited to those circuits described in U.S. Pat. Nos. 5,497,772 and 4,787,398, hereby incorporated by reference.


The terms “angiogenic layer,” “angiogenic membrane,” and the like refer to a region, membrane, etc. of a biological fluid measuring device that promotes and maintains the development of blood vessels microcirculation around the sensor region of the device. As described in detail below, the angiogenic layer of the devices of the present invention may be constructed of membrane materials alone or in combination such as polytetrafluoroethylene, hydrophilic polyvinylidene fluoride, mixed cellulose esters, polyvinylchloride, and other polymers including, but not limited to, polypropylene, polysulfone, and polymethylmethacrylate.


The phrase “positioned more distal” refers to the spatial relationship between various elements in comparison to a particular point of reference. For example, some embodiments of a biological fluid measuring device comprise both a bioprotective membrane and an angiogenic layer/membrane. If the housing of the biological fluid measuring device is deemed to be the point of reference and the angiogenic layer is positioned more distal to the housing than the bioprotective layer, then the bioprotective layer is closer to the housing than the angiogenic layer.


The terms “bioprotective membrane,” “bioprotective layer,” and the like refer to a semipermeable membrane comprised of protective biomaterials of a few microns thickness or more that are permeable to oxygen and glucose and are placed over the tip of the sensor to keep the white blood cells (e.g., tissue macrophages) from gaining proximity to and then damaging the enzyme membrane. In some embodiments, the bioprotective membrane has pores (typically from approximately 0.1 to approximately 1.0 micron). In preferred embodiments, a bioprotective membrane comprises polytetrafluoroethylene and contains pores of approximately 0.4 microns in diameter. Pore size is defined as the pore size provided by the manufacturer or supplier.


The phrase “substantially impermeable to macrophages” means that few, if any, macrophages are able to cross a barrier (e.g., the bioprotective membrane). In preferred embodiments, fewer than 1% of the macrophages that come in contact with the bioprotective membrane are able to cross.


The phrase “material for securing said device to biological tissue” refers to materials suitable for attaching the devices of the present invention to, the fibrous tissue of a foreign body capsule. Suitable materials include, but are not limited to, poly(ethylene terephthalate). In preferred embodiments, the top of the housing is covered with the materials in the form of surgical grade fabrics; more preferred embodiments also contain material in the sensor interface region (see FIG. 1B).


The phrase “member for determining the amount of glucose in a biological sample” refers broadly to any mechanism (e.g., enzymatic or non-enzymatic) by which glucose can be quantitated. For example, some embodiments of the present invention utilize a membrane that contains glucose oxidase that catalyzes the conversion of glucose to gluconate: Glucose+O2=Gluconate+H2O2. Because for each glucose molecule converted to gluconate, there is a proportional change in the co-reactant O2 and the product H2O2, one can monitor the current change in either the co-reactant or the product to determine glucose concentration.


The phrase “apparatus for transmitting data to a location external to said device” refers broadly to any mechanism by which data collected by a biological fluid measuring device implanted within a subject may be transferred to a location external to the subject. In preferred embodiments of the present invention, radiotelemetry is used to provide data regarding blood glucose levels, trends, and the like.


The terms “radiotelemetry,” “radiotelemetric device,” and the like refer to the transmission by radio waves of the data recorded by the implanted device to an ex vivo recording station (e.g., a computer), where the data is recorded and, if desired, further processed (see, e.g., U.S. Pat. Nos. 5,321,414 and 4,823,808, hereby incorporated by reference; PCT Pat. Publication WO 94/22367).


The term “host” refers to both humans and animals.


The phrase “continuous glucose sensing” refers to the period in which monitoring of plasma glucose concentration is continuously carried out. More specifically, at the beginning of the period in which continuous glucose sensing is effected, the background sensor output noise diminishes and the sensor output stabilizes (e.g., over several days) to a long-term level reflecting adequate microcirculatory delivery of glucose and oxygen to the tip of the sensor (see FIG. 2).


The term “filtrate layer” refers to any permeable membrane that is able to limit molecules from passing through the membrane based on their properties including molecular weight. More particularly, the resistance layer, interference layer and bioprotective membrane are examples of layers that can function as filtrate layers, depending on the materials from which they are prepared. These layers can control delivery of analyte to a sensing means. Furthermore, these layers can reduce a number of undesirable molecular species that may otherwise be exposed to the sensor for detection and provide a controlled sample volume to the analyte sensing means.





BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1A depicts a cross-sectional drawing of one embodiment of an implantable analyte measuring device of the present invention.



FIG. 1B depicts a cross-sectional exploded view of the sensor interface dome of FIG. 1A.



FIG. 1C depicts a cross-sectional exploded view of the electrode-membrane region of FIG. 1B detailing the sensor tip and the functional membrane layers.



FIG. 2 graphically depicts glucose levels as a function of the number of days post-implant.



FIG. 3 is a graphical representation of the number of functional sensors versus time (i.e. weeks) comparing control devices including only a cell-impermeable domain (“Control”), with devices including a cell-impermeable domain and a barrier-cell domain (“Test”).



FIG. 4A is a photograph of an intact composite bioprotective/angiogenic membrane after implantation in a dog for 137 days.



FIG. 4B is a photograph of a delaminated ePTFE bilayer membrane after implantation in a dog for 125 days.





DETAILED DESCRIPTION OF THE INVENTION

The present invention relates generally to devices and methods for determining analyte levels, and, more particularly, to implantable devices and methods for monitoring glucose levels in a biological fluid. In a preferred embodiment, the device and methods of the present invention are used to determine the level of glucose in a host, a particularly important measurement for individuals having diabetes.


Although the description that follows is primarily directed at glucose monitoring devices and methods for their use, the devices and methods of the present invention are not limited to glucose measurement. Rather, the devices and methods may be applied to detect and quantitate other analytes present in biological fluids (including, but not limited to, amino acids and lactate), especially those analytes that are substrates for oxidase enzymes [see, e.g., U.S. Pat. No. 4,703,756 to Gough et al., hereby incorporated by reference]. Moreover, the devices and methods of the present invention may be utilized to present components of biological fluids to measurement methods which are not enzyme-based, including, but not limited to, those based on surface plasmon resonance, surface acoustic waves, optical absorbance in the long wave infrared region, and optical rotation of polarized light.


For example, surface plasmon resonance sensors that analyze a region within less than one wavelength of analysis light near the flat surface of the sensor have been described (See U.S. Pat. No. 5,492,840). These sensors have been used, for example, in the study of immunochemistry and other surface bound chemical reactions (Jonsson et al., Annales de Biologies Clinique 51 (10:19, 1993). This type of sensor may be incorporated into the implantable device of the present invention for the detection of a number of different analytes including glucose. One skilled in the art would recognize that the surface plasmon resonance sensor is an optical sensor and that the implantable device of the present invention may further include a source of coherent radiation (e.g. a laser operating in the visible or near infrared).


In one application, referred to here as a consumptive approach, an enzyme that consumes the analyte producing a detectable product is immobilized on the sensor in the filtrate layer. When the enzyme consumes the analyte, the reaction products diffuse away from the enzyme at a rate dependent on the permeability of the layers distal to the enzyme layer. As a result, reaction products will accumulate at a higher concentration near the sensor, within one wavelength of analysis light, where they may be detected and measured. One example of such a system that detects the presence of glucose would immobilize a glucose oxidase enzyme layer on the sensor surface.


The layers of the present invention play an important role in the effective operation and function of this type of sensor. In particular, the angiogenic layer assures a constant supply of analyte from the tissues of the subject, the bioprotective membrane protects the underlying layers from cellular attack, the resistance layer controls the rate of delivery of analyte and the filtrate layer performs many functions including; providing a low molecular weight filtrate, reducing the number of undesirable molecular species available to the sensor for detection and providing a controlled volume of sample for detection by the sensor. As mentioned above, the bioprotective membrane, resistance layer and interference layer can function as filtrate layers. For example, it is well within the contemplation of the present invention that the bioprotective membrane can be made of a material that is able to exclude certain molecules from passing through the membrane based on their size.


One skilled in the art would recognize that the reaction kinetics associated with each type of enzyme that may be selected for use with this sensor is unique. However, in general, if an excess of enzyme is provided, the enzyme turnover rate is proportional to the flux of analyte to the enzyme and independent of the enzyme concentration. Therefore, the actual analyte concentration may be calculated utilizing the diffusion rate of the detectable analyte across the bioprotective resistance layers.


In another application, referred to here as a non-consumptive approach, an analyte-binding compound is provided on the surface plasmon resonance sensor surface within one wavelength of analysis light. This compound reversibly binds, but does not consume, the analyte. In this application, the analyte moves reversibly onto and off of attachment sites on the binding compound. This reaction provides a steady state condition for bound and unbound analyte that may be quantitated and analyte concentration mathematically calculated. One skilled in the art would recognize that the reaction kinetics associated with binding and release of the analyte is unique for each type of binding compound selected. Examples of such a system that detects the presence of glucose provide a binding compound comprised of conconavalin A or a wide range of borate containing compounds (See U.S. Pat. No. 6,011,985).


Since this is a chemical equilibrium-based approach, a filtrate layer is not necessarily required to maintain an analyte concentration near the sensor. However, such a membrane would still be desired to reduce the number of undesirable molecular species available to the analyte-binding layer. Preferably, the bioprotective layer is thin to allow rapid sensor equilibration to changes in analyte levels. As described above, one skilled in the art would recognize that the function of the filtrate layer could be incorporated into the bioprotective membrane by selection of the appropriate molecular exclusion, such as exclusion by molecular weight, if desired.


A variety of materials may be utilized to construct a combination angiogenic/bioprotective membrane, many of which are described below under the angiogenic layer and bioprotective membrane headings. Preferably, this combination membrane is ePTFE embedded in a layer of PVP containing urethane hydrogel. However, any material that performs a similar function as the PVP containing polyurethane hydrogel could be substituted.


In either application, consumptive or non-consumptive, one skilled in the art would recognize that the response time of the sensor is subject to Fick's law of diffusion. More specifically, sensors with thick membrane layers or that have low analyte diffusivity will respond slower to change in analyte concentration than sensors with thin membranes or that have high analyte diffusivity. Consequently, reasonable optimization experimentation with the membrane and layers would be required to meet various use requirements.


One skilled in the art would further recognize that the consumptive or non-consumptive approaches of the previous example could be applied to additional sensor modalities as follows:


1. Another sensor that may be incorporated into the device of the present invention that has been previously described is a surface acoustic wave sensor (See U.S. Pat. No. 5,932,953). This sensor, also referred to as a bulk-acoustic wave piezoelectric resonator, typically includes a planar surface of piezoelectric material with two respective metal layers bonded on opposite sides that form the electrodes of the resonator. The two surfaces of the resonator are free to undergo vibrational movement when the resonator is driven by a signal within the resonance band of the resonator. One of these surfaces is adapted to provide reversible binding sites for the analyte being detected. The binding of the analyte on the surface of the resonator alters the resonant characteristics of the resonator and changes in the resonant characteristics may be detected and interpreted to provide quantitative information regarding the analyte concentration.


2. Another sensor that may be incorporated into the device of the present invention is an optical absorbance sensor (See U.S. Pat. No. 6,049,727). This sensor utilizes short to medium wavelength infrared light that is passed through a sample with the unabsorbed infrared light being monitored by an optical detector.


Previously developed methods for analysis of analytes such as glucose in tissues and blood have been relatively unsuccessful for two reasons, interference from other chemicals present in the complex biological sample and signal variation due to poor control of sample volume. These problems may be solved by providing a low molecular weight filtrate of biological fluid in a controlled volume of sample to the sensor. In one system of the present invention, biological analyte is provided to the sensor through the angiogenic layer. This analyte is then filtered through the bioprotective membrane to produce a desirable filtrate. Alternatively, a third filtrate layer, such as an interference layer, may be utilized having specific filtration properties to produce the desired filtrate. The three-dimensional structure of the bioprotective membrane and/or other filtrate layers is utilized to define and stabilize the sample volume. One skilled in the art would recognize that any material that provides a low molecular weight filtrate to the sensor in a controlled volume might be utilized. Preferably, this material is polyurethane.


The sensor may be enhanced by partial metallization of the distal side of the filtrate producing material that would serve to isolate by reflection the optical signal to the space within the filtrate region directly adjacent to the sensor. This metal film may be a durable metal including, but not restricted to, gold or platinum and may be vacuum deposited onto the filtrate producing material.


One skilled in the art would recognize that the optical absorbance sensor requires a source of short to medium wavelength infrared light. Consequently, the implantable device of the present invention would further include a source of infrared radiation and an optical detector.


3. Another sensor that may be incorporated into the device of the present invention that has been previously described is a polarized light optical rotation sensor (See U.S. Pat. No. 5,209,231). This sensor may be used to detect an analyte that rotates polarized light such as glucose. In particular, glucose concentrations in biological fluids in the range of 0.05 to 1.00% w/v may be detected and quantitated. Normal non-diabetic subjects generally have biological glucose concentrations ranging from 0.07 to 0.12% w/v.


In this type of sensor, the optical detector receives polarized light passed through a biological sample and then further through a polarizing filter. The optical activity of an analyte in the sample rotates the polarized light in proportion to its concentration. Unfortunately, accurate measurements of glucose in complex biological samples has proven difficult because of the optical activity of interfering substances and poor control of sample volume. These problems may be solved by providing a low molecular weight filtrate of biological fluid in a controlled volume to the sensor. The present invention meets this criterion by providing a continuous supply of biological glucose to the sensor through the angiogenic layer that is filtered through a bioprotective membrane and/or a filtrate layer as described previously for the optical absorbance sensor. One skilled in the art would recognize that any material that provides a low molecular weight filtrate to the sensor in a controlled geometry might be utilized. Preferably, this material is polyurethane. In addition, one skilled in the art would recognize that the polarized light optical rotation sensor requires a source of polarized light. Consequently, the implantable device of the present invention would further include a source of polarized radiation.


4. Another sensor that may be incorporated into the device of the present invention that has been previously described is a fluorescence sensor (See U.S. Pat. No. 5,341,805). The invention of Colvin provides a method for incorporating an ultraviolet light source and fluorescent sensing molecules in an implantable device. However, Colvin does not describe how the sensor would survive harsh in vivo environmental conditions, how the device would be functionally integrated into body tissues or how a continuous supply of glucose would be maintained for detection by the sensor. These problems may be solved by providing a low molecular weight filtrate of biological fluid in a controlled volume to the sensor.


In this example, a continuous supply of biological glucose passes to the sensor through the angiogenic layer that prevents isolation of the sensor by the body tissue. The glucose is then filtered through the bioprotective membrane to produce a desirable filtrate having fewer interfering molecules and to protect the sensor from in vivo environmental conditions. Alternatively, a filtrate layer may be utilized having specific filtration properties to produce the desired filtrate. The three-dimensional structure of the bioprotective membrane and/or filtrate layer also provides stabilized sample volume for detection by the sensor.


One skilled in the art would recognize that a fluorescence sensor requires a source of light. Consequently, the implantable device of the present invention would further comprise a source of radiation, as well as fluorescent sensing molecules to detect the presence of analyte.


I. Nature of the Foreign Body Capsule


Devices and probes that are implanted into subcutaneous tissue will almost always elicit a foreign body capsule (FBC) as part of the body's response to the introduction of a foreign material. Therefore, implantation of a glucose sensor results in an acute inflammatory reaction followed by building of fibrotic tissue. Ultimately, a mature FBC including primarily a vascular fibrous tissue forms around the device (Shanker and Greisler, Inflammation and Biomaterials in Greco RS, ed. Implantation Biology: The Host Response and Biomedical Devices, pp 68-80, CRC Press (1994)).


Although fluid is frequently found within the capsular space between the sensor and the capsule, levels of analytes (e.g., glucose and oxygen) within the fluid often do not mimic levels in the body's vasculature, making accurate measurement difficult.


In general, the formation of a FBC has precluded the collection of reliable, continuous information, reportedly because of poor vascularization, the composition of a FBC has prevented stabilization of the implanted device, contributing to motion artifact that renders unreliable results. Thus, conventionally, it has been the practice of those skilled in the art to attempt to minimize FBC formation by, for example, using a short-lived needle geometry or sensor coatings to minimize the foreign body reaction (“Biosensors in the Body” David M. Fraser, ed.; 1997 pp 117-170. Wiley & Sons Ltd., West Sussex, England),


In contrast to the prior art, the teachings of the present invention recognize that FBC formation is the dominant event surrounding long term implantation of any sensor and must be orchestrated to support rather than hinder or block sensor performance. For example, sensors often do not perform well until the FBC has matured sufficiently to provide ingrowth of well-attached tissue bearing a rich supply of capillaries directly to the surface of the sensor. With reference to FIG. 2, stabilization of device function generally occurs between about 2 and 8 weeks depending on the rate of healing and formation of new capillaries. In some cases, devices are functional from the time of implant, and sometimes it may take as long as 12 weeks. However, the majority of devices begin functioning between weeks 2 and 8 after implantation. This maturation process, when initiated according to the present invention, is a function of biomaterial and host factors that initiate and modulate angiogenesis, and promote and control fibrocyte ingrowth. The present invention contemplates the use of particular materials to promote angiogenesis adjacent to the sensor interface (also referred to as the electrode-membrane region, described below) and to anchor the device within the FBC.


II. The Implantable Glucose Monitoring Device of the Present Invention


The present invention contemplates the use of a unique micro-geometry at the sensor interface of an implantable device. Moreover, the present invention contemplates the use of materials covering all or a portion of the device to assist in the stabilization of the device following implantation. However, it should be pointed out that the present invention does not require a device comprising particular electronic components (e.g., electrodes, circuitry, etc). Indeed, the teachings of the present invention can be used with virtually any monitoring device suitable for implantation (or subject to modification allowing implantation); suitable devices include, but are not limited, to those described in U.S. Pat. No. 6,001,067 to Shults et al.; U.S. Pat. No. 4,703,756 to Gough et al., and U.S. Pat. No. 4,431,004 to Bessman et al.; the contents of each being hereby incorporated by reference, and Bindra et al., Anal. Chem. 63:1692-96 (1991).


In the discussion that follows, an example of an implantable device that includes the features of the present invention is first described. Thereafter, the specific characteristics of, for example, the sensor interface contemplated by the present invention will be described in detail.


Generally speaking, the implantable devices contemplated for use with the present invention are cylindrical or oval shaped; of course, devices with other shapes may also be used with the present invention. The sample device includes a housing composed of radiotransparent ceramic. FIG. 1A depicts a cross-sectional drawing of one embodiment of an implantable measuring device. Referring to FIG. 1A, the cylindrical device includes a ceramic body 1 and ceramic head 10 houses the sensor electronics that include a circuit board 2, a microprocessor 3, a battery 4, and an antenna 5. Furthermore, the ceramic body 1 and head 10 possess a matching taper joint 6 that is sealed with epoxy. The electrodes are subsequently connected to the circuit board via a socket 8.


As indicated in detail in FIG. 1B, three electrodes protrude through the ceramic head 10, a platinum working electrode 21, a platinum counter electrode 22 and a silver/silver chloride reference electrode 20. Each of these is hermetically brazed 26 to the ceramic head 10 and further affixed with epoxy 28. The sensing region 24 is covered with the sensing membrane described below and the ceramic head 10 contains a groove 29 so that the membrane may be affixed into place with an o-ring.


In a preferred embodiment, the device is cylindrical, as shown in FIG. 1A, and is approximately 1 cm in diameter, and 5.5 cm long. The sensing region is situated at one extreme end of the cylinder. The sensor region includes a dome onto which the sensing membranes are attached.


Maintaining the blood supply near an implanted foreign body like an implanted analyte-monitoring sensor requires stable fixation of FBC tissue on the surface of the foreign body. This can be achieved, for example, by using capsular attachment (anchoring) materials (e.g., those materials that includes the sensor interface and tissue anchoring layers) developed to repair or reinforce tissues, including, but not limited to, polyester (DACRON®, DuPont; poly(ethylene terephthalate)) velour, expanded polytetrafluoroethylene (TEFLON/®, Gore), polytetrafluoroethylene felts, polypropylene cloth, and related porous implant materials. In a preferred embodiment, porous silicone materials are used for anchoring the device. In another embodiment, non-woven polyester fibers are used for anchoring the device. Tissue tends to aggressively grow into the materials disclosed above and form a strong mechanical bond (i.e., tissue anchoring); this fixation of the implant in its capsule is essential to prevent motion artifact or disturbance of the newly developed capillary blood supply.


In a preferred embodiment, the anchoring material is attached directly to the body of the device. In the case of non-woven polyester fibers, they may be sutured into place by rolling the material onto the circumferential periphery of the device and further encircling the membrane with PTFE sutures and tying the sutures to hold the membrane in place. In another preferred embodiment, porous silicone is attached to the surface of the cylindrical device using medical grade silicone adhesive. In either case, the material may be further held in place by an o-ring (FIG. 1B).


As shown in FIG. 1A, the interior of the housing contains one or more batteries 4 operably connected to an electronic circuit means (e.g., a circuit board 2), which, in turn, is operably connected to at least one electrode (described below); in another embodiment, at least two electrodes are carried by the housing. In a preferred embodiment, three electrodes are used. Any electronic circuitry and batteries that render reliable, continuous, long-term (e.g., months to years) results may be used in conjunction with the devices of the present invention.


The housing of the devices of the present invention preferably contain a biocompatible ceramic material. A preferred embodiment of the device contains a radiofrequency transmitter and antenna within the body of the ceramic device. Ceramic materials are radiotransparent and, therefore, are preferred over metals that are radioopaque. Ceramic materials are preferred over plastic materials (which may also be radiotransparent) because they are more effective than plastics at preventing water penetration. In one embodiment of the invention, the ceramic head and body are connected at an approximately 0.9 cm long taper joint sealed with epoxy. In other embodiments, the head and body may be attached by sealing with metals to produce a completely hermetic package.



FIG. 1C depicts a cross-sectional exploded view of the electrode-membrane region 24 set forth in FIG. 1B detailing the sensor tip and the functional membrane layers. As depicted in FIG. 1C, the electrode-membrane region includes several different membrane layers, the compositions and functions of which are described in detail below. The top ends of the electrodes are in contact with the electrolyte phase 30, a free-flowing fluid phase. The electrolyte phase is covered by the sensing membrane 32 that contains an enzyme, e.g., glucose oxidase, and several functional polymer layers (as described below). In turn, a composite bioprotective/angiogenic membrane 33 covers the sensing membrane 32 and serves, in part, to protect the sensor from external forces that may result in environmental stress cracking of the sensing membrane 32.


In one preferred embodiment of the inventive device, each of the membrane layers is affixed to the ceramic head 10 in FIGS. 1A and 1B by an o-ring. The o-ring may be formed of fluoroelastomer.


The present invention contemplates the construction of the membrane layers of the sensor interface region using standard film coating techniques. This type of membrane fabrication facilitates control of membrane properties and membrane testing.


III. The Sensor Interface Region


As mentioned above and disclosed in FIG. 1C, in a preferred embodiment, the sensor interface region includes several different layers and membranes that cover the electrodes of an implantable analyte-measuring device. The characteristics of these layers and membranes are now discussed in more detail. The layers and membranes prevent direct contact of the biological fluid sample with the electrodes, while permitting selected substances (e.g., analytes) of the fluid to pass therethrough for electrochemical reaction with the electrodes.


Measurement of analyte in a filtrate of biological fluid samples has been shown to be preferred over direct measurement of analyte in biological fluid in order to minimize effects of interfering substances and improve control of sample volume. It is well known in the art that electrode surfaces exposed to a wide range of biological molecules will suffer poisoning of catalytic activity and failure. However, utilizing the layers and membranes of the present invention, the active electrochemical surfaces of the sensor electrodes are preserved, allowing activity to be retained for extended periods of time in vivo. By limiting exposure of the platinum sensor surface to certain molecular species (e.g., molecules having a molecular weight below 34 Daltons, the molecular weight of hydrogen peroxide), in vivo sensor operating life in excess of one year in canine subjects has been observed.


A. Angiogenic Layer


For implantable glucose monitoring devices, a sensor/tissue interface must be created which provides the sensor with oxygen and glucose concentrations comparable to that normally available to tissue comprised of living cells. Absent such an interface, the sensor is associated with unstable and chaotic performance indicating that inadequate oxygen and/or glucose are reaching the sensor. The development of interfaces in other contexts has been reported. For example, investigators have developed techniques that stimulate and maintain blood vessels inside a FBC to provide for the demanding oxygen needs of pancreatic islets within an implanted membrane. [See, e.g., Brauker et al., J. Biomed. Mater. Res. (1995) 29:1517-1524]. These techniques depend, in part, on the use of a vascularizing layer on the exterior of the implanted membrane. However, previously described implantable analyte-monitoring devices have not been able to successfully maintain sufficient blood flow to the sensor interface.


As described above, the outermost layer of the electrode-membrane region includes an angiogenic material. The angiogenic layer of the devices of the present invention may be constructed of membrane materials such as hydrophilic polyvinylidene fluoride (e.g., Durapore®; Millipore Bedford, Mass.), mixed cellulose esters (e.g., MF; Millipore Bedford, Mass.), polyvinyl chloride (e.g., PVC; Millipore Bedford, Mass.), and other polymers including, but not limited to, polypropylene, polysulphone, and polymethylmethacrylate. Preferably, the thickness of the angiogenic layer is about 10 μm to about 20 μm. The angiogenic layer comprises pores sizes of about 0.5 μm to about 20 μm, and more preferably about 1.0 μm to about 10 μm, sizes that allow most substances to pass through, including, e.g., macrophages. The preferred material is expanded PTFE of a thickness of about 15 μm and pore sizes of about 5 μm to about 10 μm.


To further promote stable foreign body capsule structure without interfering with angiogenesis, an additional outermost layer of material comprised of a thin low-density non-woven polyester (e.g., manufactured by Reemay) can be laminated over the preferred PTFE described above. In preferred embodiments, the thickness of this layer is about 120 μm. This additional thin layer of material does not interfere with angiogenesis and enhances the manufacturability of the angiogenic layer. [See U.S. Pat. No. 5,741,330 to Brauker et al., hereby incorporated by reference; also U.S. Pat. Nos. 5,782,912, 5,800,529, 5,882,354 5,964,804 assigned to Baxter].


B. Bioprotective Membrane


The inflammatory response that initiates and sustains a FBC is associated with both advantages and disadvantages. Some inflammatory response is needed to create a new capillary bed in close proximity to the surface of the sensor in order to i) continuously deliver adequate oxygen and glucose and ii) create sufficient tissue ingrowth to anchor the implant and prevent motion artifact. On the other hand, inflammation is associated with invasion of tissue macrophages that have the ability to biodegrade many artificial biomaterials (some of which were, until recently, considered nonbiodegradable). When activated by a foreign body, tissue macrophages degranulate, releasing from their cytoplasmic myeloperoxidase system hypochlorite (bleach), H2O2 and other oxidant species. Both hypochlorite and H2O2 are known to break down a variety of polymers, including polyurethane, by a phenomenon referred to as environmental stress cracking. [Phillips et al., J. Biomat. Appl., 3:202-227 (1988); Stokes, J. Biomat. Appl. 3:228-259 (1988)]. Indeed, environmental stress cracking has been shown to limit the lifetime and performance of an enzyme-active polyurethane membrane stretched over the tip of a glucose sensor. [Updike et al., Am. Soc. Artificial Internal Organs, 40:157-163 (1994)].


Because both hypochlorite and H2O2 are short-lived chemical species in vivo, biodegradation will not occur if macrophages are kept a sufficient distance from the enzyme active membrane. The present invention contemplates the use of a bioprotective membrane that allows transport of glucose and oxygen but prevents the entry of inflammatory cells such as macrophages and foreign body giant cells. The bioprotective membrane is placed proximal to the angiogenic membrane. It may be simply placed adjacent to the angiogenic layer without adhering, or it may be attached with an adhesive material to the angiogenic layer, or it may be cast in place upon the angiogenic layer as described in Example 1. The devices of the present invention are not limited by the nature of the bioprotective layer. However, the bioprotective layer should be biostable for long periods of time (e.g., several years); the present invention contemplates the use of polymers including, but not limited to, polyurethane, polypropylene, polysulphone, polytetrafluoroethylene (PTFE), and poly(ethylene terephthalate) (PET).


The bioprotective membrane and the angiogenic layer may be combined into a single bilayer membrane as more fully described in Example 1. The active angiogenic function of the combined membrane is based on the presentation of the ePTFE side of the membrane to the reactive cells of the foreign body capsule and further to the response of the tissue to the microstructure of the ePTFE. This bioprotective/angiogenic membrane is unique in that the membrane does not delaminate as has been observed with other commercially available membranes (see FIG. 4A as compared with FIG. 4B). This is desirable for an implantable device to assure accurate measurement of analyte over long periods of time. Although the physical structure of the ePTFE represents a preferred embodiment, many other combinations of materials that provide the same function as the membrane of Example 1 could be utilized. For example, the ePTFE could be replaced by other fine fibrous materials. In particular, polymers such as spun polyolefin or non-organic materials such as mineral or glass fibers may be useful. Likewise, the polyurethane bioprotective layer of Example 1, which includes a biostable urethane and polyvinylpyrrolidone (PVP), could be replaced by polymers able to pass analyte while blocking macrophages and mechanically retaining the fine fibrous material presented to the reactive cells of the foreign body capsule.


C. Sensing Membrane


The present invention contemplates membranes impregnated with enzyme. It is not intended that the present invention be limited by the nature of the enzyme membrane. The sensing membrane of a preferred embodiment is depicted in FIG. 1C as being a single, homogeneous structure. However, in preferred embodiments, the sensing membrane includes a plurality of distinct layers. In a particularly preferred embodiment, the sensing membrane includes the following four layers (in succession from the bioprotective membrane to the layer most proximal to the electrodes): i) a resistance layer; ii) an enzyme layer; iii) an interference layer; and iv) an electrolyte layer.


Resistance Layer


There is a molar excess of glucose relative to the amount of oxygen in samples of blood. Indeed, for every free oxygen molecule in extracellular fluid, there are typically more than 100 glucose molecules present [Updike et al., Diabetes Care 5:207-21 (1982)]. However, an immobilized enzyme-based sensor using oxygen (O2) as cofactor must be supplied with oxygen in non-rate-limiting excess in order to respond linearly to changes in glucose concentration while not responding to changes in oxygen tension. More specifically, when a glucose-monitoring reaction is oxygen-limited, linearity is not achieved above minimal concentrations of glucose. Without a semipermeable membrane over the enzyme layer, linear response to glucose levels can be obtained only up to about 40 mg/dL; however, in a clinical setting, linear response to glucose levels are desirable up to at least about 500 mg/dL.


The resistance layer includes a semipermeable membrane that controls the flux of oxygen and glucose to the underlying enzyme layer (i.e., limits the flux of glucose), rendering the necessary supply of oxygen in non-rate-limiting excess. As a result, the upper limit of linearity of glucose measurement is extended to a much higher value than that which could be achieved without the resistance layer. The devices of the present invention contemplate resistance layers comprising polymer membranes with oxygen-to-glucose permeability ratios of approximately 200:1; as a result, one-dimensional reactant diffusion is adequate to provide excess oxygen at all reasonable glucose and oxygen concentrations found in the subcutaneous matrix [Rhodes et al., Anal. Chem., 66:1520-1529 (1994)].


In preferred embodiments, the resistance layer has a thickness of less than about 45 μm, more preferably in the range of about 15 to about 40 μm, and most preferably in the range of about 20 to about 35 μm.


The resistance layer is desirably constructed of a mixture of hydrophobic and hydrophilic polyurethanes.


Enzyme Layer


In addition to glucose oxidase, the present invention contemplates the use of a membrane layer impregnated with other oxidases, e.g., galactose oxidase, uricase. For an enzyme-based electrochemical glucose sensor to perform well, the sensor's response must, neither be limited by enzyme activity nor cofactor concentration. Because enzymes, including the very robust glucose oxidase, are subject to deactivation as a function of ambient conditions, this behavior needs to be accounted for in constructing sensors for long-term use.


Excess glucose oxidase loading is required for long sensor life. When excess glucose oxidase is used, up to 1.5 years of performance may be possible from the glucose-monitoring devices contemplated by the present invention.


In one preferred embodiment, the enzyme layer includes a polyurethane latex.


Interference Layer


The interference layer includes a thin, hydrophobic membrane that is non-swellable and restricts diffusion of low molecular weight species. The interference layer is permeable to relatively low molecular weight substances, such as hydrogen peroxide, but restricts the passage of higher molecular weight substances, including glucose and ascorbic acid. The interference layer serves to allow analytes and other substances that are to be measured by the electrodes to pass through, while preventing passage of other substances.


Preferred materials from which the interference layer can be made include polyurethanes. In one desired embodiment, the interference layer includes an aliphatic polyetherurethane.


The interference layer has a preferred thickness of less than about 5 μm, more preferably in the range of about 0.1 to about 5 μm and most preferably in the range of about 0.5 to about 3 μm. Thicker membranes also may be useful, but thinner membranes are preferred because they have a lower impact on the rate of diffusion of hydrogen peroxide from the enzyme membrane to the electrodes.


Electrolyte Layer


To ensure electrochemical reaction, the electrolyte layer comprises a semipermeable coating that maintains hydrophilicity at the electrode region of the sensor interface. The electrolyte layer enhances the stability of the interference layer of the present invention by protecting and supporting the membrane that makes up the interference layer. Furthermore, the electrolyte layer assists in stabilizing operation of the device by overcoming electrode start-up problems and drifting problems caused by inadequate electrolyte. The buffered electrolyte solution contained in the electrolyte layer also protects against pH-mediated damage that may result from the formation of a large pH gradient between the hydrophobic interference layer and the electrode (or electrodes) due to the electrochemical activity of the electrode.


Preferably, the coating includes a flexible, water-swellable, substantially solid gel-like film having a “dry film” thickness of about 2.5 μm to about 12.5 μm, preferably about 6.0 μm. “Dry film” thickness refers to the thickness of a cured film cast from a coating formulation onto the surface of the membrane by standard coating techniques. The coating formulation includes a premix of film-forming polymers and a crosslinking agent and is curable upon the application of moderate heat.


Suitable coatings are formed of a curable copolymer of a urethane polymer and a hydrophilic film-forming polymer. Particularly preferred coatings are formed of a polyurethane polymer having anionic carboxylate functional groups and non-ionic hydrophilic polyether segments, which is crosslinked in the present of polyvinylpyrrolidone and cured at a moderate temperature of about 50° C.


Particularly suitable for this purpose are aqueous dispersions of fully reacted colloidal polyurethane polymers having cross-linkable carboxyl functionality (e.g., BAYBOND®; Mobay Corporation, Pittsburgh, Pa.). These polymers are supplied in dispersion grades having a polycarbonate-polyurethane backbone containing carboxylate groups identified as XW-121 and XW-123; and a polyester-polyurethane backbone containing carboxylate groups, identified as XW-110-2. Particularly preferred is BAYBOND® 123, an aqueous anionic dispersion of an aliphate polycarbonate urethane polymer, sold as a 35 weight percent solution in water and co-solvent N-methyl-2-pyrrolidone.


Polyvinylpyrrolidone is also particularly preferred as a hydrophilic water-soluble polymer and is available commercially in a range of viscosity grades and average molecular weights ranging from about 18,000 to about 500,000, under the PVP K® homopolymer series by BASF Wyandotte (Parsippany, N.J.) and by GAF Corporation (New York, N.Y.). Particularly preferred is the homopolymer having an average molecular weight of about 360,000, identified as PVP-K90 (BASF Wyandotte). Also suitable are hydrophilic, film-forming copolymers of N-vinylpyrrolidone, such as a copolymer of N-vinylpyrrolidone and vinyl acetate, a copolymer of N-vinylpyrrolidone, ethylmethacrylate and methacrylic acid monomers, and the like.


The polyurethane polymer is crosslinked in the presence of the polyvinylpyrrolidone by preparing a premix of the polymers and adding a cross-linking agent just prior to the production of the membrane. Suitable cross-linking agents can be carbodiimides, epoxides and melamine/formaldehyde resins. Carbodiimide is preferred, and a preferred carbodiimide crosslinker is UCARLNK® XL-25 (Union Carbide, Chicago, Ill.).


The flexibility and hardness of the coating can be varied as desired by varying the dry weight solids of the components in the coating formulation. The term “dry weight solids” refers to the dry weight percent based on the total coating composition after the time the crosslinker is included. A preferred useful coating formulation can contain about 6 to about 20 dry weight percent, preferably about 8 dry weight percent, of polyvinylpyrrolidone; about 3 to about 10 dry weight percent, preferably about 5 dry weight percent of cross-linking agent; and about 70 to about 91 weight percent, preferably about 87 weight percent of a polyurethane polymer, preferably a polycarbonate-polyurethane polymer. The reaction product of such a coating formulation is referred to herein as a water-swellable cross-linked matrix of polyurethane and PVP.


D. The Electrolyte Phase


The electrolyte phase is a free-fluid phase including a solution containing at least one compound, usually a soluble chloride salt that conducts electric current. The electrolyte phase flows over the electrodes (see FIG. 1C) and is in contact with the electrolyte layer of the enzyme membrane. The devices of the present invention contemplate the use of any suitable electrolyte solution, including standard, commercially available solutions.


Generally speaking, the electrolyte phase should have the same or less osmotic pressure than the sample being analyzed. In preferred embodiments of the present invention, the electrolyte phase includes saline.


E. The Electrode


The electrode assembly of this invention may also be used in the manner commonly employed in the making of amperometric measurements. The interstitial fluids containing the analyte to be measured is in contact with a reference electrode, e.g., silver/silver-chloride, and the anode and cathode of this invention, which are preferably formed of platinum. In the preferred embodiment, the electrodes are connected to a circuit board in the body of the sensor, the current is read and the information is radiotransmitted to a receiver. The invention is not limited to this preferred embodiment. Indeed the membranes of the present invention could be used with any form of implantable sensor and adapted to the particular features of the sensor by one skilled in the art.


The ability of the present device electrode assembly to accurately measure the concentration of substances such as glucose over a broad range of concentrations enables the rapid and accurate determination of the concentration of those substances. That information can be employed in the study and control of metabolic disorders including diabetes.


IV. Sensor Implantation and Radiotelemetric Output


Long-term sensor performance is best achieved, and transcutaneous bacterial infection is eliminated, with implanted devices capable of radiotelemetric output. The present invention contemplates the use of radiotelemetry to provide data regarding blood glucose levels, trends, and the like. The term “radiotelemetry” refers to the transmission by radio waves of the data recorded by the implanted device to an ex vivo recording station (e.g., a computer), where the data is recorded and, if desired, further processed.


Although totally implanted glucose sensors of three month lifetime, with radiotelemetric output, have been tested in animal models at intravenous sites [see, e.g. Armour et al., Diabetes, 39:1519-1526 (1990)], subcutaneous implantation is the preferred mode of implantation [see, e.g., Gilligan et al., Diabetes Care 17:882-887 (1994)]. The subcutaneous site has the advantage of lowering the risk for thrombophlebitis with hematogenous spread of infection and also lowers the risk of venous thrombosis with pulmonary embolism. In addition, subcutaneous placement is technically easier and more cost-effective than intravenous placement, as it may be performed under local anesthesia by a non-surgeon health care provider in an outpatient setting.


Preferably, the radiotelemetry devices contemplated for use in conjunction with the present invention possess features including small package size, adequate battery life, acceptable noise-free transmission range, freedom from electrical interference, and easy data collection and processing. Radiotelemetry provides several advantages, one of the most important of which is the ability of an implanted device to measure analyte levels in a sealed-off, sterile environment.


The present invention is not limited by the nature of the radiotelemetry equipment or methods for its use. Indeed, commercially available equipment can be modified for use with the devices of the present invention (e.g., devices manufactured by Data Sciences). Similarly, custom-designed radiotelemetry devices like those reported in the literature can be used in conjunction with the implantable analyte-measuring devices of the present invention [see, e.g., McKean and Gough, IEEE Trans. Biomed. Eng. 35:526-532 (1988); Shichiri et al., Diabetes Care 9:298-301 (1986); and Shults et al., IEEE Trans. Biomed. Eng. 41:937-942 (1994)]. In a preferred embodiment, transmitters are programmed with an external magnet to transmit at 0.5 or 5-minute intervals, depending on the need of the subject; presently, battery lifetimes at transmission intervals of 5 minutes are approximately up to 1.5 years.


V. Experimental


The following examples serve to illustrate certain preferred embodiments and aspects of the present invention and are not to be construed as limiting the scope thereof.


In the preceding description and the experimental disclosure which follows, the following abbreviations apply: Eq and Eqs (equivalents); mEq (milliequivalents); M (molar); mM (millimolar) μM (micromolar); N (Normal); mol (moles); mmol (millimoles); μmol (micromoles); nmol (nanomoles); g (grams); mg (milligrams); μg (micrograms); Kg (kilograms); L (liters); mL (milliliters); dL (deciliters); μL (microliters); cm (centimeters); mm (millimeters); μm (micrometers); nm (nanometers); h and hr (hours); min. (minutes); s and sec. (seconds); ° C. (degrees Centigrade); Astor Wax (Titusville, Pa.); BASF Wyandotte Corporation (Parsippany, N.J.); Data Sciences, Inc. (St. Paul, Minn.); DuPont (DuPont Co., Wilmington, Del.); Exxon Chemical (Houston, Tex.); GAF Corporation (New York, N.Y.); Markwell Medical (Racine, Wis.); Meadox Medical, Inc. (Oakland, N.J.); Mobay (Mobay Corporation, Pittsburgh, Pa.); Sandoz (East Hanover, N.J.); and Union Carbide (Union Carbide Corporation; Chicago, Ill.).


Example 1

Preparation of Composite Membrane of the Present Invention


The angiogenic layer may be an ePTFE filtration membrane (Zefluor™, 3.0 μm P5PI001, Pall Gelman, Ann Arbor, Mich.) and the bioprotective membrane (C30P) may then be coated on the angiogenic layer. For example, the C30P coating solution was prepared by placing approximately 706 gm of dimethylacetamide (DMAC) into a 3 L stainless steel bowl to which a polycarbonateurethane solution (1325 g, Chronoflex AR 25% solids in DMAC and 5100 cp) and polyvinylpyrrolidone (125 g, Plasdone K-90D) were added. The bowl was then fitted to a planetary mixer with a paddle type blade and the contents were stirred for 1 hour at room temperature. This solution was then coated on the ePTFE filtration membrane by knife-edge drawn at a gap of 0.006″ and dried at 60° C. for 24 hours.


Alternatively, the C30P solution prepared above can be coated onto a PET release liner using a knife over roll coating machine. This material is then dried at 305° F. for approximately 2 minutes. Next, the Zefluor™ is immersed in 50:50 (w/v) mixture of tetrahydrofuran/DMAC and then placed upon the coated polyurethane polyvinylpyrrolidone material. Light pressure atop the assembly intimately embeds the ePTFE into the C30P layer. The membrane is then dried at 60° C. for 24 hours.


Example 2

Preparation of the Sensing Membrane


The sensing membrane includes a resistance layer, an enzyme layer, an interference layer and an electrolyte layer. The resistance layer was prepared by placing approximately 281 gm of DMAC into a 3 L stainless steel bowl to which a solution of polyetherurethaneurea (344 gm of Chronothane H, 29,750 cp at 25% solids in DMAC) was added. To this mixture was added another polyetherurethaneurea (312 gm, Chronothane 1020, 6275 cp at 25% solids in DMAC). The bowl was fitted to a planetary mixer with a paddle type blade and the contents were stirred for 30 minutes at room temperature. The resistance layer coating solution produced is coated onto a PET release liner (Douglas Hansen Co., Inc. Minneapolis, Minn.) using a knife over roll set at a 0.012″ gap. This film is then dried at 305° F.


The enzyme layer was prepared by placing 304 gm polyurethane latex (Bayhydrol 140AQ, Bayer, Pittsburgh, Pa.) into a 3 L stainless steel bowl to which 51 gm of pyrogen free water and 5.85 gm of glucose oxidase (Sigma type VII from Aspergillus niger) is added. The bowl was then fitted to a planetary mixer with a whisk type blade and the mixture was stirred for 15 minutes. Approximately 24 hr prior to coating, a solution of glutaraldehyde (15.4 ml of a 2.5% solution in pyrogen free water) and 14 ml of pyrogen free water was added to the mixture. The solution was mixed by inverting a capped glass bottle by hand for about 3 minutes at room temperature. This mixture was then coated over the resistance layer with a #10 Mayer rod and dried above room temperature preferably at about 50° C.


The interference layer was prepared by placing 187 gm of tetrahydrofuran into a 500 ml glass bottle to which an 18.7 gm aliphatic polyetherurethane (Tecoflex SG-85A, Thermedics Inc., Woburn, Mass.) was added. The bottle was placed onto a roller at approximately 3 rpm within an oven set at 37° C. The mixture was allowed to roll for 24 hr. This mixture was coated over the dried enzyme layer using a flexible knife and dried above room temperature, preferably at about 50° C.


The electrolyte layer was prepared by placing 388 gm of polyurethane latex (Bayhydrol 123, Bayer, Pittsburgh, Pa. in a 3 L stainless steel bowl to which 125 gm of pyrogen free water and 12.5 gm polyvinylpyrrolidone (Plasdone K-90D) was added. The bowl was then fitted to a planetary mixer with a paddle type blade and stirred for 1 hr at room temperature. Within 30 minutes of coating, approximately 13.1 ml of carbodiimide (UCARLNK) was added and the solution was mixed by inverting a capped polyethylene jar by hand for about 3 min at room temperature. This mixture was coated over the dried interference layer with a #10 Mayer rod and dried above room temperature preferably at about 50° C.


In order to affix this multi-region membrane to a sensor head, it is first placed into phosphate buffer (pH 7.4) for about 2 minutes. It is then stretched over the nonconductive body of sensor head and affixed into place with an o-ring.


Example 3

In Vivo Evaluation of Glucose Measuring Devices Including the Biointerface Membranes of the Present Invention


In vivo sensor function was determined by correlating the sensor output to blood glucose values derived from an external blood glucose meter. We have found that non-diabetic dogs do not experience rapid blood glucose changes, even after ingestion of a high sugar meal. Thus, a 10% dextrose solution was infused into the sensor-implanted dog. A second catheter is placed in the opposite leg for the purpose of blood collection. The implanted sensor was programmed to transmit at 30-second intervals using a pulsed electromagnet. A dextrose solution was infused at a rate of 9.3 ml/minute for the first 25 minutes, 3.5 ml/minute for the next 20 minutes, 1.5 ml/minute for the next 20 minutes, and then the infusion pump was powered off Blood glucose values were measured in duplicate every five minutes on a blood glucose meter (LXN Inc., San Diego, Calif.) for the duration of the study. A computer collected the sensor output. The data was then compiled and graphed in a spreadsheet, time aligned, and time shifted until an optimal R-squared value was achieved. The R-squared value reflects how well the sensor tracks with the blood glucose values.


To test the importance of the composite membrane of the invention described in Example 1, implantable glucose sensors including the composite and sensing membranes of the present invention were implanted into dogs in the subcutaneous tissues and monitored for glucose response on a weekly basis. Control devices including only a bioprotective C30P layer (“Control”) were compared with devices including both a bioprotective and an angiogenic layer (“Test”), which corresponded to the composite bioprotective/angiogenic membrane of the device of the present invention described in Example 1.


Four devices from each condition were implanted subcutaneously in the ventral abdomen of normal dogs. On a weekly basis, the dogs were infused with glucose as described above in order to increase their blood glucose levels from about 120 mg/dl to about 300 mg/dl. Blood glucose values were determined with a LXN blood glucose meter at 5-minute intervals. Sensor values were transmitted at 0.5-minute intervals. Regression analysis was done between blood glucose values and the nearest sensor value within one minute. Devices with an R-squared value greater than 0.5 were considered functional. FIG. 3 shows, for each condition, the cumulative number of functional devices over the 12-week period of the study. The Test devices performed better than the Control devices over the entire 12 weeks of the study. All of the test devices were functional by week 8. In contrast, none of the control devices were functional until week 10, after which 2 were functional for the remaining 2 weeks. The data shows that the use of the inventive biointerface membrane enables the function of implantable glucose sensors.


The description and experimental materials presented above are intended to be illustrative of the present invention while not limiting the scope thereof. It will be apparent to those skilled in the art that variations and modifications can be made without departing from the spirit and scope of the present invention.

Claims
  • 1. An implantable sensor system for measuring glucose, the system comprising: an optical absorbance sensor configured to measure glucose;sensor electronics operably connected to the sensor; anda membrane disposed on at least a portion of the sensor, wherein the membrane comprises an outermost domain, wherein the outermost domain is configured to interface with tissue or a biological fluid, wherein the outermost domain comprises a metal portion.
  • 2. The system of claim 1, wherein the membrane comprises polyurethane.
  • 3. The system of claim 2, wherein the polyurethane is polyurethaneurea.
  • 4. The system of claim 1, wherein the membrane comprises an enzyme.
  • 5. The system of claim 4, wherein the enzyme is glucose oxidase.
  • 6. The system of claim 1, wherein the metal is platinum.
  • 7. An implantable sensor system for measuring glucose, the system comprising: an optical absorbance sensor configured to measure glucose;sensor electronics operably connected to the sensor; anda membrane disposed on at least a portion of the sensor, wherein the membrane comprises polyurethane, wherein the membrane comprises an outermost domain, wherein the outermost domain is configured to interface with tissue or a biological fluid, wherein the outermost domain comprises a metal portion, wherein the metal portion comprises platinum.
  • 8. An implantable sensor system for measuring glucose, the system comprising: an optical absorbance sensor configured to measure glucose;sensor electronics operably connected to the sensor; anda membrane disposed on at least a portion of the sensor, wherein the membrane comprises polyurethaneurea, wherein the membrane comprises an outermost domain, wherein the outermost domain is configured to interface with tissue or a biological fluid, wherein the outermost domain comprises a metal portion, wherein the metal portion comprises platinum.
INCORPORATION BY REFERENCE TO RELATED APPLICATIONS

Any and all priority claims identified in the Application Data Sheet, or any correction thereto, are hereby incorporated by reference under 37 CFR 1.57. This application is a continuation of U.S. application Ser. No. 14/553,382, filed Nov. 25, 2014, now U.S. Pat. No. 9,439,589, which is a continuation of U.S. application Ser. No. 13/949,088, filed Jul. 23, 2013, now U.S. Pat. No. 8,923,947, which is a continuation of U.S. application Ser. No. 13/411,414, filed Mar. 2, 2012, now U.S. Pat. No. 8,527,026, which is a continuation of U.S. application Ser. No. 12/696,003, filed Jan. 28, 2010, now U.S. Pat. No. 8,155,723, which is a continuation of U.S. application Ser. No. 11/546,157, filed Oct. 10, 2006, now abandoned, which is a continuation of U.S. application Ser. No. 11/039,269, filed Jan. 19, 2005, now U.S. Pat. No. 7,136,689, which is a continuation of U.S. application Ser. No. 09/916,858, filed Jul. 27, 2001, now U.S. Pat. No. 6,862,465.

US Referenced Citations (818)
Number Name Date Kind
2830020 Christmann et al. Apr 1958 A
3220960 Wichterlet et al. Nov 1965 A
3381371 Russell May 1968 A
3562352 Nyilas Feb 1971 A
3607329 Manjikian Sep 1971 A
3610226 Albisser Oct 1971 A
3746588 Brown, Jr. Jul 1973 A
3775182 Patton et al. Nov 1973 A
3791871 Rowley Feb 1974 A
3838033 Mindt et al. Sep 1974 A
3898984 Mandel et al. Aug 1975 A
3943918 Lewis Mar 1976 A
4003621 Lamp Jan 1977 A
4017962 Palmer Apr 1977 A
4136250 Mueller et al. Jan 1979 A
4197840 Beck et al. Apr 1980 A
4225410 Pace Sep 1980 A
4240889 Yoda et al. Dec 1980 A
4253469 Asian Mar 1981 A
4255500 Hooke Mar 1981 A
4256561 Schindler et al. Mar 1981 A
4260725 Keogh et al. Apr 1981 A
4267145 Wysong May 1981 A
4273636 Shimada et al. Jun 1981 A
4292423 Kaufmann et al. Sep 1981 A
4324257 Albarda et al. Apr 1982 A
4340458 Lerner et al. Jul 1982 A
4353368 Slovak et al. Oct 1982 A
4353888 Sefton Oct 1982 A
4374013 Enfors Feb 1983 A
4403984 Ash et al. Sep 1983 A
4415666 D'Orazio et al. Nov 1983 A
4418148 Oberhardt Nov 1983 A
4431004 Bessman et al. Feb 1984 A
4431507 Nankai et al. Feb 1984 A
4436094 Cerami Mar 1984 A
4442841 Uehara et al. Apr 1984 A
4453537 Spitzer Jun 1984 A
4454295 Wittmann et al. Jun 1984 A
4477314 Richter et al. Oct 1984 A
4482666 Reeves Nov 1984 A
4484987 Gough Nov 1984 A
4493714 Ueda et al. Jan 1985 A
4494950 Fischell Jan 1985 A
RE31916 Oswin et al. Jun 1985 E
4527999 Lee Jul 1985 A
4545382 Higgins et al. Oct 1985 A
4554927 Fussell Nov 1985 A
4571292 Liu et al. Feb 1986 A
4602922 Cabasso et al. Jul 1986 A
4603152 Laurin et al. Jul 1986 A
4632968 Yokota et al. Dec 1986 A
4644046 Yamada Feb 1987 A
4647643 Zdrahala Mar 1987 A
4650547 Gough Mar 1987 A
4655880 Liu Apr 1987 A
4671288 Gough Jun 1987 A
4672970 Uchida et al. Jun 1987 A
4680268 Clark, Jr. Jul 1987 A
4684538 Klemarczyk Aug 1987 A
4685463 Williams Aug 1987 A
4686044 Behnke et al. Aug 1987 A
4686137 Ward, Jr. et al. Aug 1987 A
4689149 Kanno et al. Aug 1987 A
4703756 Gough et al. Nov 1987 A
4711245 Higgins Dec 1987 A
4721677 Clark, Jr. Jan 1988 A
4726381 Jones Feb 1988 A
4731726 Allen Mar 1988 A
4739380 Lauks et al. Apr 1988 A
4750496 Reinhart et al. Jun 1988 A
4757022 Shults et al. Jul 1988 A
4759828 Young et al. Jul 1988 A
4781733 Babcock et al. Nov 1988 A
4783658 Nakano et al. Nov 1988 A
4786657 Hammar et al. Nov 1988 A
4787398 Garcia et al. Nov 1988 A
4793555 Lee et al. Dec 1988 A
4795542 Ross et al. Jan 1989 A
4803243 Fujimoto et al. Feb 1989 A
4805624 Yao et al. Feb 1989 A
4805625 Wyler Feb 1989 A
4813424 Wilkins Mar 1989 A
4822336 DiTraglia Apr 1989 A
4823808 Ciegg et al. Apr 1989 A
4832034 Pizziconi May 1989 A
4852573 Kennedy Aug 1989 A
4861830 Ward, Jr. Aug 1989 A
4871440 Nagata et al. Oct 1989 A
4880883 Grasel et al. Nov 1989 A
4883057 Broderick Nov 1989 A
4886740 Vadgama Dec 1989 A
4890620 Gough Jan 1990 A
4890621 Hakky Jan 1990 A
4902294 Gosserez Feb 1990 A
4908208 Lee et al. Mar 1990 A
4909908 Ross et al. Mar 1990 A
4919141 Zier et al. Apr 1990 A
4927407 Dorman May 1990 A
4938860 Wogoman Jul 1990 A
4951657 Pfister et al. Aug 1990 A
4952618 Olsen Aug 1990 A
4953552 DeMarzo Sep 1990 A
4954381 Cabasso et al. Sep 1990 A
4960594 Honeycutt Oct 1990 A
4961954 Goldberg et al. Oct 1990 A
4970145 Bennetto et al. Nov 1990 A
4973320 Brenner et al. Nov 1990 A
4973493 Guire et al. Nov 1990 A
4986271 Wilkins Jan 1991 A
4988341 Columbus et al. Jan 1991 A
4992794 Brouwers Jan 1991 A
4994167 Shults et al. Feb 1991 A
5002572 Picha Mar 1991 A
5002590 Friesen et al. Mar 1991 A
5010141 Mueller Apr 1991 A
5019096 Fox, Jr. et al. May 1991 A
5034112 Murase et al. Jul 1991 A
5034461 Lai et al. Jul 1991 A
5045601 Capelli et al. Sep 1991 A
5050612 Matsumura Sep 1991 A
5063081 Cozzette et al. Nov 1991 A
5070169 Robertson et al. Dec 1991 A
5071452 Avrillon et al. Dec 1991 A
5089112 Skotheim et al. Feb 1992 A
5094876 Goldberg et al. Mar 1992 A
5100689 Goldberg et al. Mar 1992 A
5108819 Heller et al. Apr 1992 A
5115056 Mueller et al. May 1992 A
5120813 Ward, Jr. Jun 1992 A
5128408 Tanaka et al. Jul 1992 A
5130231 Kennedy et al. Jul 1992 A
5135297 Valint et al. Aug 1992 A
5137028 Nishimura Aug 1992 A
5147725 Pinchuk Sep 1992 A
5155149 Atwater et al. Oct 1992 A
5160418 Mullen Nov 1992 A
5165406 Wong Nov 1992 A
5165407 Wilson et al. Nov 1992 A
5169906 Cray et al. Dec 1992 A
5171689 Kawaguri et al. Dec 1992 A
5183549 Joseph et al. Feb 1993 A
5190041 Palti Mar 1993 A
5200051 Cozzette et al. Apr 1993 A
5202261 Musho et al. Apr 1993 A
5208313 Krishnan May 1993 A
5212050 Mier et al. May 1993 A
5219965 Valint et al. Jun 1993 A
5221724 Li et al. Jun 1993 A
5222980 Gealow Jun 1993 A
5227042 Zawodzinski et al. Jul 1993 A
5242835 Jensen Sep 1993 A
5249576 Goldberger et al. Oct 1993 A
5250439 Musho et al. Oct 1993 A
5262305 Heller et al. Nov 1993 A
5264104 Gregg et al. Nov 1993 A
5269891 Colin Dec 1993 A
5271736 Picha Dec 1993 A
5282848 Schmitt Feb 1994 A
5284140 Allen et al. Feb 1994 A
5286364 Yacynych et al. Feb 1994 A
5296144 Stemina et al. Mar 1994 A
5296891 Vogt et al. Mar 1994 A
5298144 Spokane Mar 1994 A
5299571 Mastrototaro Apr 1994 A
5302440 Davis Apr 1994 A
5310469 Cunningham et al. May 1994 A
5314471 Brauker et al. May 1994 A
5316008 Suga et al. May 1994 A
5321414 Alden et al. Jun 1994 A
5322063 Allen et al. Jun 1994 A
5324322 Grill et al. Jun 1994 A
5328451 Davis et al. Jul 1994 A
5331555 Hashimoto et al. Jul 1994 A
5334681 Mueller et al. Aug 1994 A
5336102 Cairns et al. Aug 1994 A
5337747 Neftel Aug 1994 A
5342693 Winters et al. Aug 1994 A
5344454 Clarke et al. Sep 1994 A
5352348 Young et al. Oct 1994 A
5352351 White Oct 1994 A
5368028 Palti Nov 1994 A
5372133 Hogen-Esch Dec 1994 A
5376400 Goldberg et al. Dec 1994 A
5380536 Hubbell et al. Jan 1995 A
5384028 Ito Jan 1995 A
5387327 Khan Feb 1995 A
5391250 Lord et al. Feb 1995 A
5397451 Senda et al. Mar 1995 A
5411647 Johnson et al. May 1995 A
5411866 Luong May 1995 A
5417395 Fowler et al. May 1995 A
5421923 Clarke et al. Jun 1995 A
5426158 Mueller et al. Jun 1995 A
5428123 Ward et al. Jun 1995 A
5429735 Johnson et al. Jul 1995 A
5431160 Wilkins Jul 1995 A
5431921 Thombre Jul 1995 A
5438984 Schoendorfer Aug 1995 A
5453278 Chan et al. Sep 1995 A
5458631 Xavier et al. Oct 1995 A
5462051 Oka et al. Oct 1995 A
5462064 D'Angelo et al. Oct 1995 A
5462645 Albery et al. Oct 1995 A
5464013 Lemelson Nov 1995 A
5466356 Schneider et al. Nov 1995 A
5466575 Cozzette et al. Nov 1995 A
5469846 Khan Nov 1995 A
5476094 Allen et al. Dec 1995 A
5480711 Ruefer Jan 1996 A
5482008 Stafford et al. Jan 1996 A
5482473 Lord et al. Jan 1996 A
5494562 Maley et al. Feb 1996 A
5497772 Schulman et al. Mar 1996 A
5507288 Boeker et al. Apr 1996 A
5508030 Bierman Apr 1996 A
5508509 Yafuso et al. Apr 1996 A
5513636 Palti May 1996 A
5518601 Foos et al. May 1996 A
5521273 Yilgort et al. May 1996 A
5529066 Palti Jun 1996 A
5531878 Vadgama et al. Jul 1996 A
5538511 van Antwerp Jul 1996 A
5541305 Yokota et al. Jul 1996 A
5545223 Neuenfeidt et al. Aug 1996 A
5549675 Neuenfeidt et al. Aug 1996 A
5552112 Sehiffmann Sep 1996 A
5554339 Cozzette Sep 1996 A
5564439 Picha Oct 1996 A
5568806 Cheney, II et al. Oct 1996 A
5569186 Lord et al. Oct 1996 A
5569462 Martinson et al. Oct 1996 A
5571395 Park et al. Nov 1996 A
5575930 Tietje-Girault et al. Nov 1996 A
5578463 Berka et al. Nov 1996 A
5582184 Ericson et al. Dec 1996 A
5582697 Ikeda et al. Dec 1996 A
5584813 Livingston et al. Dec 1996 A
5584876 Bruchman et al. Dec 1996 A
5586553 Halili et al. Dec 1996 A
5589133 Suzuki Dec 1996 A
5589498 Mohr et al. Dec 1996 A
5589563 Ward et al. Dec 1996 A
5593440 Brauker et al. Jan 1997 A
5593852 Heller et al. Jan 1997 A
5607565 Azarnia et al. Mar 1997 A
5611900 Worden Mar 1997 A
5624537 Turner et al. Apr 1997 A
5628890 Carter et al. May 1997 A
5640954 Pfeiffer Jun 1997 A
5653756 Clarke et al. Aug 1997 A
5653863 Genshaw et al. Aug 1997 A
5660163 Schulman et al. Aug 1997 A
5665222 Heller et al. Sep 1997 A
5670097 Dean et al. Sep 1997 A
5686829 Girault Nov 1997 A
5695623 Michel et al. Dec 1997 A
5700559 Sheu et al. Dec 1997 A
5703359 Wampler, III Dec 1997 A
5704354 Priedel et al. Jan 1998 A
5706807 Picha Jan 1998 A
5711861 Ward et al. Jan 1998 A
5713888 Neuersfeldt et al. Feb 1998 A
5733336 Neuenfeldt et al. Mar 1998 A
5735273 Kurnik et al. Apr 1998 A
5741319 Woloszko et al. Apr 1998 A
5741330 Brauker et al. Apr 1998 A
5743262 Lepper, Jr. et al. Apr 1998 A
5746898 Priedel May 1998 A
5756632 Ward et al. May 1998 A
5760155 Mowrer et al. Jun 1998 A
5766839 Johnson et al. Jun 1998 A
5771890 Tamada Jun 1998 A
5776324 Usala Jul 1998 A
5777060 van Antwerp Jul 1998 A
5782912 Brauker et al. Jul 1998 A
5786439 van Antwerp et al. Jul 1998 A
5791344 Schulman Aug 1998 A
5795453 Gilmartin Aug 1998 A
5800420 Gross Sep 1998 A
5800529 Brauker et al. Sep 1998 A
5804048 Wong et al. Sep 1998 A
5807375 Gross et al. Sep 1998 A
5807406 Brauker et al. Sep 1998 A
5807636 Sheu et al. Sep 1998 A
5820570 Erickson Oct 1998 A
5820622 Gross et al. Oct 1998 A
5833603 Kovacs et al. Nov 1998 A
5834583 Hancock et al. Nov 1998 A
5837377 Sheu et al. Nov 1998 A
5837454 Cozzette et al. Nov 1998 A
5837661 Evans et al. Nov 1998 A
5837728 Purcell Nov 1998 A
5840148 Campbell et al. Nov 1998 A
5843069 Butler et al. Dec 1998 A
5863400 Drummond et al. Jan 1999 A
5863972 Beckelmann et al. Jan 1999 A
5882354 Brauker et al. Mar 1999 A
5882494 van Antwerp Mar 1999 A
5885566 Goldberg Mar 1999 A
5895235 Droz Apr 1999 A
5897955 Drumheller Apr 1999 A
5906817 Moullier et al. May 1999 A
5914026 Blubaugh, Jr. et al. Jun 1999 A
5914182 Drumhelier Jun 1999 A
5931814 Alex et al. Aug 1999 A
5932299 Katoot Aug 1999 A
5944661 Swette et al. Aug 1999 A
5945498 Hopken et al. Aug 1999 A
5947127 Tsugaya et al. Sep 1999 A
5954643 van Antwerp et al. Sep 1999 A
5955066 Sake et al. Sep 1999 A
5957854 Besson et al. Sep 1999 A
5959191 Lewis et al. Sep 1999 A
5961451 Reber et al. Oct 1999 A
5963132 Yoakum Oct 1999 A
5964261 Neuenfeldt et al. Oct 1999 A
5964993 Blubaugh, Jr. et al. Oct 1999 A
5965380 Heller et al. Oct 1999 A
5967986 Cimochowski et al. Oct 1999 A
5969076 Lai et al. Oct 1999 A
5972199 Heller Oct 1999 A
5977241 Koloskl et al. Nov 1999 A
5985129 Gough et al. Nov 1999 A
5989409 Kurnik et al. Nov 1999 A
6001067 Shults et al. Dec 1999 A
6002954 van Antwerp et al. Dec 1999 A
6007845 Domb et al. Dec 1999 A
6011984 van Antwerp et al. Jan 2000 A
6013113 Mika Jan 2000 A
6018013 Yoshida et al. Jan 2000 A
6018033 Chen et al. Jan 2000 A
6022463 Leader et al. Feb 2000 A
6030827 Davis et al. Feb 2000 A
6039913 Hirt et al. Mar 2000 A
6043328 Domschke et al. Mar 2000 A
6049727 Grothall Apr 2000 A
6051389 Abt et al. Apr 2000 A
6059946 Yukawa et al. May 2000 A
6066083 Slater et al. May 2000 A
6066448 Wohlstadter et al. May 2000 A
6071406 Tsou Jun 2000 A
6074775 Gartstein et al. Jun 2000 A
6081736 Colvin et al. Jun 2000 A
6083710 Heller et al. Jul 2000 A
6088608 Schulman et al. Jul 2000 A
6091975 Daddona et al. Jul 2000 A
6093172 Funderburk et al. Jul 2000 A
6117290 Say Sep 2000 A
6119028 Schulman et al. Sep 2000 A
6121009 Heller et al. Sep 2000 A
6122536 Sun et al. Sep 2000 A
6134461 Say et al. Oct 2000 A
6144869 Berner et al. Nov 2000 A
6144871 Saito et al. Nov 2000 A
6162611 Heller et al. Dec 2000 A
6175752 Say et al. Jan 2001 B1
6180416 Kurnik et al. Jan 2001 B1
6190326 McKinnon et al. Feb 2001 B1
6200772 Vadgama et al. Mar 2001 B1
6201980 Darrow et al. Mar 2001 B1
6208894 Schulman et al. Mar 2001 B1
6212416 Ward et al. Apr 2001 B1
6221009 Doi et al. Apr 2001 B1
6223080 Thompson Apr 2001 B1
6223083 Rosar Apr 2001 B1
6230059 Duffin May 2001 B1
6233471 Berner et al. May 2001 B1
6248067 Causey, III et al. Jun 2001 B1
6254586 Mann et al. Jul 2001 B1
6256522 Shultz Jul 2001 B1
6259937 Schulman et al. Jul 2001 B1
6264825 Blackburn et al. Jul 2001 B1
6268161 Han et al. Jul 2001 B1
6271332 Lehmann et al. Aug 2001 B1
6272364 Kurnik Aug 2001 B1
6272382 Faltys et al. Aug 2001 B1
6275717 Gross et al. Aug 2001 B1
6284478 Heller et al. Sep 2001 B1
6285897 Kilcoyne et al. Sep 2001 B1
6294281 Heller Sep 2001 B1
6296615 Brockway et al. Oct 2001 B1
6299578 Kurnik et al. Oct 2001 B1
6300002 Webb et al. Oct 2001 B1
6303670 Fujino et al. Oct 2001 B1
6304788 Eady et al. Oct 2001 B1
6306594 Cozzette Oct 2001 B1
6309351 Kurnik et al. Oct 2001 B1
6309526 Fujiwara et al. Oct 2001 B1
6312706 Lai et al. Nov 2001 B1
6315719 Rode et al. Nov 2001 B1
6325979 Hahn et al. Dec 2001 B1
6326160 Dunn et al. Dec 2001 B1
6329161 Heller et al. Dec 2001 B1
6329488 Terry et al. Dec 2001 B1
6330464 Colvin, Jr. et al. Dec 2001 B1
6336900 Alleckson et al. Jan 2002 B1
6343225 Clark, Jr. Jan 2002 B1
6358557 Wang et al. Mar 2002 B1
6360888 McIvor et al. Mar 2002 B1
6366794 Moussy et al. Apr 2002 B1
6368274 van Antwerp et al. Apr 2002 B1
6368658 Schwarz et al. Apr 2002 B1
6387379 Goldberg et al. May 2002 B1
6400974 Lesho Jun 2002 B1
6405066 Essenpreis et al. Jun 2002 B1
6406066 Uegane Jun 2002 B1
6406426 Reuss et al. Jun 2002 B1
6407195 Sherman et al. Jun 2002 B2
6409674 Brockway et al. Jun 2002 B1
6413393 van Antwerp et al. Jul 2002 B1
6424847 Mastrototaro et al. Jul 2002 B1
6442413 Silver Aug 2002 B1
6447448 Ishikawa et al. Sep 2002 B1
6454710 Ballerstadt et al. Sep 2002 B1
6461496 Feldman et al. Oct 2002 B1
6466810 Ward et al. Oct 2002 B1
6484046 Say et al. Nov 2002 B1
6497729 Moussy et al. Dec 2002 B1
6512939 Colvin et al. Jan 2003 B1
6514718 Heller et al. Feb 2003 B2
6528584 Kennedy et al. Mar 2003 B2
6534711 Pollack Mar 2003 B1
6546268 Ishikawa et al. Apr 2003 B1
6547839 Zhang et al. Apr 2003 B2
6551496 Moles et al. Apr 2003 B1
6554982 Shin et al. Apr 2003 B1
6558320 Causey et al. May 2003 B1
6558321 Burd et al. May 2003 B1
6565509 Say et al. May 2003 B1
6569309 Otsuka et al. May 2003 B2
6579498 Eglise Jun 2003 B1
6587705 Kim et al. Jul 2003 B1
6591125 Buse et al. Jul 2003 B1
6598294 Lai et al. Jul 2003 B2
6613379 Ward et al. Sep 2003 B2
6615061 Khalil et al. Sep 2003 B1
6618934 Feldman et al. Sep 2003 B1
6633772 Ford et al. Oct 2003 B2
6642015 Vachon et al. Nov 2003 B2
6654625 Say et al. Nov 2003 B1
6666821 Keimel Dec 2003 B2
6670115 Zhang Dec 2003 B1
6689265 Heller et al. Feb 2004 B2
6692528 Ward et al. Feb 2004 B2
6695958 Adam et al. Feb 2004 B1
6699383 Lemire et al. Mar 2004 B2
6702857 Brauker et al. Mar 2004 B2
6702972 Markle Mar 2004 B1
6721587 Gough Apr 2004 B2
6737158 Thompson May 2004 B1
6740059 Flaherty May 2004 B2
6741877 Shults et al. May 2004 B1
6773565 Kunimoto et al. Aug 2004 B2
6784274 van Antwerp et al. Aug 2004 B2
6789634 Denton Sep 2004 B1
6793632 Sohrab Sep 2004 B2
6793789 Choi et al. Sep 2004 B2
6793802 Lee et al. Sep 2004 B2
6801041 Karinka et al. Oct 2004 B2
6802957 Jung et al. Oct 2004 B2
6804544 van Antwerp et al. Oct 2004 B2
6858218 Lai et al. Feb 2005 B2
6862465 Shults et al. Mar 2005 B2
6867262 Angel et al. Mar 2005 B1
6881551 Heller et al. Apr 2005 B2
6895263 Shin et al. May 2005 B2
6895265 Silver May 2005 B2
6893552 Wang et al. Jun 2005 B1
6908681 Tern et al. Aug 2005 B2
6932894 Mao et al. Aug 2005 B2
6936006 Sabra Aug 2005 B2
6952604 DeNuzzio et al. Oct 2005 B2
6965791 Hitchcock et al. Nov 2005 B1
6969451 Shin et al. Nov 2005 B2
6972080 Tomioka et al. Dec 2005 B1
6973706 Say et al. Dec 2005 B2
6991643 Saadat Jan 2006 B2
7008979 Schottman et al. Mar 2006 B2
7014948 Lee et al. Mar 2006 B2
7033322 Silver Apr 2006 B2
7052131 McCabe et al. May 2006 B2
7058437 Base et al. Jun 2006 B2
7074307 Simpson et al. Jul 2006 B2
7081195 Simpson et al. Jul 2006 B2
7108778 Simpson et al. Sep 2006 B2
7110803 Shults et al. Sep 2006 B2
7115884 Walt et al. Oct 2006 B1
7118667 Lee Oct 2006 B2
7120483 Russell et al. Oct 2006 B2
7134999 Brauker et al. Nov 2006 B2
7136689 Shults et al. Nov 2006 B2
7153265 Vachon Dec 2006 B2
7157528 Ward Jan 2007 B2
7166074 Reghabit et al. Jan 2007 B2
7169289 Schulein et al. Jan 2007 B2
7172075 Ji Feb 2007 B1
7192450 Brauker et al. Mar 2007 B2
7225535 Feldman et al. Jun 2007 B2
7226978 Tapsak et al. Jun 2007 B2
7229471 Gale et al. Jun 2007 B2
7241586 Gulati Jul 2007 B2
7248906 Dirac et al. Jul 2007 B2
7279174 Pacetti et al. Oct 2007 B2
7329239 Safabash et al. Feb 2008 B2
7335286 Abel et al. Feb 2008 B2
7336984 Gough et al. Feb 2008 B2
7344499 Prausnitz et al. Mar 2008 B1
7357793 Pacetti Apr 2008 B2
7364592 Carr-Brendel et al. Apr 2008 B2
7366556 Brister et al. Apr 2008 B2
7379765 Petisce et al. May 2008 B2
7404819 Darios et al. Jul 2008 B1
7417164 Suri et al. Aug 2008 B2
7423074 Lai et al. Sep 2008 B2
7426408 DeNuzzio et al. Sep 2008 B2
7470488 Lee et al. Dec 2008 B2
7471972 Rhodes et al. Dec 2008 B2
7583990 Goode, Jr. et al. Sep 2009 B2
7632228 Brauker et al. Dec 2009 B2
7637868 Saint et al. Dec 2009 B2
7651596 Petisce et al. Jan 2010 B2
7657297 Simpson et al. Feb 2010 B2
7711402 Shults et al. May 2010 B2
7771352 Shults et al. Aug 2010 B2
7775975 Brister et al. Aug 2010 B2
7792402 Peng Sep 2010 B2
7792562 Shults et al. Sep 2010 B2
7835777 Shults et al. Nov 2010 B2
7860545 Shults et al. Dec 2010 B2
7881763 Brauker et al. Feb 2011 B2
7899511 Shults et al. Mar 2011 B2
7901354 Shults et al. Mar 2011 B2
7970448 Shults et al. Jun 2011 B2
7974672 Shults et al. Jul 2011 B2
8155723 Shults et al. Apr 2012 B2
8200772 Saunders et al. Jun 2012 B2
8527025 Shults et al. Sep 2013 B1
20010021817 Brugger et al. Sep 2001 A1
20010039053 Liseo et al. Nov 2001 A1
20020042090 Heller et al. Apr 2002 A1
20020042561 Schulman et al. Apr 2002 A1
20020043471 Ikeda et al. Apr 2002 A1
20020055673 van Antwerp et al. May 2002 A1
20020071776 Bandis et al. Jun 2002 A1
20020123087 Vachon et al. Sep 2002 A1
20020128419 Terry et al. Sep 2002 A1
20020128546 Silver Sep 2002 A1
20020151816 Rich et al. Oct 2002 A1
20020169369 Ward et al. Nov 2002 A1
20020185384 Leong et al. Dec 2002 A1
20020188185 Sohrab Dec 2002 A1
20030006669 Pei et al. Jan 2003 A1
20030009093 Silver Jan 2003 A1
20030023317 Brauker et al. Jan 2003 A1
20030032874 Rhodes et al. Feb 2003 A1
20030036773 Whitehurst et al. Feb 2003 A1
20030059631 Al-Lamee Mar 2003 A1
20030065254 Schulman et al. Apr 2003 A1
20030069383 van Antwerp et al. Apr 2003 A1
20030070548 Clausen Apr 2003 A1
20030088166 Say et al. May 2003 A1
20030096424 Mao et al. May 2003 A1
20030100040 Bonnecaze et al. May 2003 A1
20030104273 Lee et al. Jun 2003 A1
20030125498 McCabe et al. Jul 2003 A1
20030125613 Enegren et al. Jul 2003 A1
20030130616 Steil et al. Jul 2003 A1
20030132227 Geisler Jul 2003 A1
20030134100 Mao et al. Jul 2003 A1
20030134347 Heller et al. Jul 2003 A1
20030138674 Zeikus et al. Jul 2003 A1
20030143746 Sage Jul 2003 A1
20030157409 Huang et al. Aug 2003 A1
20030181794 Rini et al. Sep 2003 A1
20030187338 Say et al. Oct 2003 A1
20030198744 Buse et al. Oct 2003 A1
20030199745 Burson et al. Oct 2003 A1
20030199878 Pohjonen Oct 2003 A1
20030203991 Schottman et al. Oct 2003 A1
20030211050 Majeti et al. Nov 2003 A1
20030211625 Cohan Nov 2003 A1
20030217966 Tapsak et al. Nov 2003 A1
20030225324 Anderson et al. Dec 2003 A1
20030225361 Sabra Dec 2003 A1
20030228681 Ritts et al. Dec 2003 A1
20030235817 Bartkowiak et al. Dec 2003 A1
20040006263 Anderson et al. Jan 2004 A1
20040011671 Shults et al. Jan 2004 A1
20040015063 DeNuzzio et al. Jan 2004 A1
20040018486 Dunn et al. Jan 2004 A1
20040045879 Shults et al. Mar 2004 A1
20040063167 Kaastrup et al. Apr 2004 A1
20040074785 Holker Apr 2004 A1
20040084306 Shin et al. May 2004 A1
20040087671 Tamada et al. May 2004 A1
20040106741 Kriesel et al. Jun 2004 A1
20040106857 Gough Jun 2004 A1
20040111017 Say et al. Jun 2004 A1
20040111144 Lawin et al. Jun 2004 A1
20040120848 Teodorczyk Jun 2004 A1
20040138543 Russell et al. Jul 2004 A1
20040143173 Reghabi et al. Jul 2004 A1
20040158138 Kilcoyne et al. Aug 2004 A1
20040167801 Say et al. Aug 2004 A1
20040173472 Jung et al. Sep 2004 A1
20040176672 Silver et al. Sep 2004 A1
20040180391 Grata et al. Sep 2004 A1
20040186362 Brauker et al. Sep 2004 A1
20040199059 Brauker et al. Oct 2004 A1
20040213985 Lee et al. Oct 2004 A1
20040224001 Pacetti et al. Nov 2004 A1
20040228902 Benz Nov 2004 A1
20040234575 Horres et al. Nov 2004 A1
20050008671 van Antwerp Jan 2005 A1
20050013842 Giu et al. Jan 2005 A1
20050031689 Shults et al. Feb 2005 A1
20050033132 Shults et al. Feb 2005 A1
20050044088 Lindsay et al. Feb 2005 A1
20050051427 Brauker et al. Mar 2005 A1
20050051440 Simpson et al. Mar 2005 A1
20050054909 Petisce et al. Mar 2005 A1
20050056552 Simpson et al. Mar 2005 A1
20050059871 Gough et al. Mar 2005 A1
20050070770 Dirac et al. Mar 2005 A1
20050077584 Uhland et al. Apr 2005 A1
20050079200 Rathenow et al. Apr 2005 A1
20050090607 Tapsak et al. Apr 2005 A1
20050096519 DeNuzzio et al. May 2005 A1
20050103625 Rhodes et al. May 2005 A1
20050107677 Ward et al. May 2005 A1
20050112169 Brauker et al. May 2005 A1
20050112172 Pacetii May 2005 A1
20050112358 Potyrailo et al. May 2005 A1
20050115832 Simpson et al. Jun 2005 A1
20050118344 Pacetti Jun 2005 A1
20050119720 Gale et al. Jun 2005 A1
20050121322 Say Jun 2005 A1
20050124873 Shults et al. Jun 2005 A1
20050139489 Oliver et al. Jun 2005 A1
20050143635 Kamath et al. Jun 2005 A1
20050154272 Dirac et al. Jul 2005 A1
20050173245 Feldman et al. Aug 2005 A1
20050176136 Burd et al. Aug 2005 A1
20050176678 Horres et al. Aug 2005 A1
20050177036 Shults et al. Aug 2005 A1
20050181012 Saint et al. Aug 2005 A1
20050182451 Griffin et al. Aug 2005 A1
20050184641 Armitage et al. Aug 2005 A1
20050196747 Stiene Sep 2005 A1
20050197554 Polcha Sep 2005 A1
20050209665 Hunter et al. Sep 2005 A1
20050211571 Schulein et al. Sep 2005 A1
20050225361 Rhee Oct 2005 A1
20050233407 Pamidi et al. Oct 2005 A1
20050239154 Feldman et al. Oct 2005 A1
20050242479 Petisce et al. Nov 2005 A1
20050245795 Goode et al. Nov 2005 A1
20050245799 Brauker et al. Nov 2005 A1
20050251083 Carr-Brendel et al. Nov 2005 A1
20050271546 Gerber et al. Dec 2005 A1
20050272989 Shah et al. Dec 2005 A1
20050274665 Heilmann et al. Dec 2005 A1
20050282997 Ward Dec 2005 A1
20060003398 Heller et al. Jan 2006 A1
20060007391 McCabe et al. Jan 2006 A1
20060008370 Massaro et al. Jan 2006 A1
20060015020 Neale et al. Jan 2006 A1
20060016700 Brister et al. Jan 2006 A1
20060019327 Brister et al. Jan 2006 A1
20060020186 Brister et al. Jan 2006 A1
20060036140 Brister et al. Feb 2006 A1
20060047095 Pacetti Mar 2006 A1
20060058868 Gale et al. Mar 2006 A1
20060065527 Samproni Mar 2006 A1
20060067908 Ding Mar 2006 A1
20060068208 Tapsak et al. Mar 2006 A1
20060078908 Pitner et al. Apr 2006 A1
20060079740 Silver et al. Apr 2006 A1
20060086624 Tapsak et al. Apr 2006 A1
20060134165 Pacetti Jun 2006 A1
20060142524 Lai et al. Jun 2006 A1
20060142525 Lai et al. Jun 2006 A1
20060142526 Lai et al. Jun 2006 A1
20060142651 Brister et al. Jun 2006 A1
20060148985 Karthauser Jul 2006 A1
20060155180 Brister et al. Jul 2006 A1
20060159718 Rathenow et al. Jul 2006 A1
20060171980 Helmus et al. Aug 2006 A1
20060177379 Asgari Aug 2006 A1
20060183178 Gulati Aug 2006 A1
20060183871 Ward et al. Aug 2006 A1
20060189856 Petisce et al. Aug 2006 A1
20060195029 Shults et al. Aug 2006 A1
20060198864 Shults et al. Sep 2006 A1
20060200019 Petisce et al. Sep 2006 A1
20060200022 Brauker et al. Sep 2006 A1
20060200970 Brister et al. Sep 2006 A1
20060204536 Shults et al. Sep 2006 A1
20060211921 Brauker et al. Sep 2006 A1
20060222566 Brauker et al. Oct 2006 A1
20060224108 Brauker et al. Oct 2006 A1
20060229512 Petisce et al. Oct 2006 A1
20060249381 Petisce et al. Nov 2006 A1
20060249446 Yeager Nov 2006 A1
20060249447 Yeager Nov 2006 A1
20060252027 Petisce et al. Nov 2006 A1
20060253012 Petisce et al. Nov 2006 A1
20060257995 Simpson et al. Nov 2006 A1
20060257996 Simpson et al. Nov 2006 A1
20060258761 Boock et al. Nov 2006 A1
20060258929 Goode et al. Nov 2006 A1
20060263763 Simpson et al. Nov 2006 A1
20060263839 Ward et al. Nov 2006 A1
20060269586 Pacetti Nov 2006 A1
20060270922 Brauker et al. Nov 2006 A1
20060270923 Brauker et al. Nov 2006 A1
20060275857 Kjaer et al. Dec 2006 A1
20060275859 Kjaer Dec 2006 A1
20060281985 Ward et al. Dec 2006 A1
20060289307 Yu et al. Dec 2006 A1
20060293487 Gaymans et al. Dec 2006 A1
20070003588 Chinn et al. Jan 2007 A1
20070007133 Mang et al. Jan 2007 A1
20070027370 Brauker et al. Feb 2007 A1
20070027385 Brister et al. Feb 2007 A1
20070032717 Brister et al. Feb 2007 A1
20070032718 Shults et al. Feb 2007 A1
20070038044 Dobbles et al. Feb 2007 A1
20070045902 Brauker et al. Mar 2007 A1
20070059196 Brister et al. Mar 2007 A1
20070116600 Kochar et al. May 2007 A1
20070123963 Krulevitch May 2007 A1
20070129524 Sunkara Jun 2007 A1
20070135698 Shah et al. Jun 2007 A1
20070142584 Schorzman et al. Jun 2007 A1
20070155851 Alli et al. Jul 2007 A1
20070161769 Schorzman et al. Jul 2007 A1
20070163880 Woo et al. Jul 2007 A1
20070166343 Goerne et al. Jul 2007 A1
20070166364 Beler et al. Jul 2007 A1
20070173709 Petisce et al. Jul 2007 A1
20070173710 Petisce et al. Jul 2007 A1
20070173711 Shah et al. Jul 2007 A1
20070197890 Boock et al. Aug 2007 A1
20070200267 Tsai Aug 2007 A1
20070203966 Brauker et al. Aug 2007 A1
20070235331 Simpson et al. Oct 2007 A1
20070244379 Boock et al. Oct 2007 A1
20070259217 Logan Nov 2007 A1
20070275193 DeSimone et al. Nov 2007 A1
20070299385 Santini et al. Dec 2007 A1
20070299409 Whitbourne et al. Dec 2007 A1
20080001318 Schorzman et al. Jan 2008 A1
20080021008 Pacetti et al. Jan 2008 A1
20080021666 Goode et al. Jan 2008 A1
20080027301 Ward et al. Jan 2008 A1
20080031918 Lawin et al. Feb 2008 A1
20080033269 Zhang Feb 2008 A1
20080034972 Gough et al. Feb 2008 A1
20080038307 Hoffmann Feb 2008 A1
20080045824 Tapsak et al. Feb 2008 A1
20080071027 Pacetti Mar 2008 A1
20080076897 Kunzler et al. Mar 2008 A1
20080081184 Kubo et al. Apr 2008 A1
20080113207 Pacetti et al. May 2008 A1
20080138497 Pacetti et al. Jun 2008 A1
20080138498 Pacetti et al. Jun 2008 A1
20080143014 Tang Jun 2008 A1
20080154101 Jain et al. Jun 2008 A1
20080242961 Brister et al. Jun 2008 A1
20080183061 Goode et al. Jul 2008 A1
20080187655 Markle et al. Aug 2008 A1
20080188722 Markle et al. Aug 2008 A1
20080188725 Markle et al. Aug 2008 A1
20080208025 Shults et al. Aug 2008 A1
20080210557 Heller et al. Sep 2008 A1
20080213460 Benter et al. Sep 2008 A1
20080228051 Shults et al. Sep 2008 A1
20080228054 Shults et al. Sep 2008 A1
20080262334 Dunn et al. Oct 2008 A1
20080296155 Shults et al. Dec 2008 A1
20080305009 Gamsey et al. Dec 2008 A1
20080305506 Suri et al. Dec 2008 A1
20080306368 Goode et al. Dec 2008 A1
20080312397 Lai et al. Dec 2008 A1
20090004243 Pacetti et al. Jan 2009 A1
20090012205 Nakada et al. Jan 2009 A1
20090012379 Goode et al. Jan 2009 A1
20090018418 Markle et al. Jan 2009 A1
20090018426 Markle et al. Jan 2009 A1
20090030294 Petisce et al. Jan 2009 A1
20090030297 Miller et al. Jan 2009 A1
20090036763 Brauker et al. Feb 2009 A1
20090045055 Rhodes et al. Feb 2009 A1
20090061528 Suri et al. Mar 2009 A1
20090062633 Brauker et al. Mar 2009 A1
20090081803 Gamsey et al. Mar 2009 A1
20090099434 Liu et al. Apr 2009 A1
20090177143 Markle et al. Jul 2009 A1
20090247855 Boock et al. Oct 2009 A1
20090247856 Boock et al. Oct 2009 A1
20090264719 Markle et al. Oct 2009 A1
20090287073 Boock et al. Nov 2009 A1
20100041971 Goode, Jr. et al. Feb 2010 A1
20100049024 Saint et al. Feb 2010 A1
20100076283 Simpson et al. Mar 2010 A1
20100087724 Brauker et al. Apr 2010 A1
20100096259 Zhang et al. Apr 2010 A1
20100099970 Shults et al. Apr 2010 A1
20100099971 Shults et al. Apr 2010 A1
20100204555 Shults et al. Aug 2010 A1
20100204559 Shults et al. Aug 2010 A1
20100256779 Brauker et al. Oct 2010 A1
20110124992 Brauker et al. May 2011 A1
20110144465 Shults et al. Jun 2011 A1
20110253533 Shults et al. Oct 2011 A1
20120179014 Shults et al. Jul 2012 A1
Foreign Referenced Citations (100)
Number Date Country
0 098 592 Jan 1984 EP
0 127 958 Dec 1984 EP
0 286 118 Oct 1986 EP
0 291 130 Nov 1988 EP
0 313 951 May 1989 EP
0 320 109 Jun 1989 EP
0 353 328 Feb 1990 EP
0 362 145 Apr 1990 EP
0 390 390 Oct 1990 EP
0 396 788 Nov 1990 EP
0 441 394 Aug 1991 EP
0 534 074 Mar 1993 EP
0 535 898 Apr 1993 EP
0 539 625 May 1993 EP
0 563 795 Oct 1993 EP
0 647 849 Apr 1995 EP
0 817 809 Jan 1998 EP
0 967 788 Dec 1999 EP
1 286 807 Dec 2002 EP
2656423 Jun 1991 FR
2760962 Sep 1998 FR
2149918 Jun 1985 GB
S-57156004 Sep 1982 JP
S-57156005 Sep 1982 JP
S-58163402 Sep 1983 JP
S-58163403 Sep 1983 JP
S-59029693 Feb 1984 JP
S 59049803 Mar 1984 JP
S-59049805 Mar 1984 JP
S-59059221 Apr 1984 JP
S-59087004 May 1984 JP
S-59209608 Nov 1984 JP
S-59209609 Nov 1984 JP
S-59209610 Nov 1984 JP
S-59211459 Nov 1984 JP
S-60245623 Dec 1985 JP
S-61238319 Oct 1986 JP
S-62058154 Mar 1987 JP
S-6283649 Apr 1987 JP
S-62074406 Apr 1987 JP
S-62102815 May 1987 JP
S-62227423 Oct 1987 JP
S-63067560 Mar 1988 JP
02002913 Jan 1990 JP
H-03293556 Dec 1991 JP
H-07083871 Mar 1995 JP
2002-189015 Jul 2002 JP
WO 1989-002720 Apr 1989 WO
WO 1990-000738 Jan 1990 WO
WO 1990-007575 Jul 1990 WO
WO 1991-009302 Jun 1991 WO
WO 1992-007525 May 1992 WO
WO 1992-013271 Aug 1992 WO
WO 1993-014185 Jul 1993 WO
WO 1993-014693 Aug 1993 WO
WO 1993-019701 Oct 1993 WO
WO 1993-023744 Nov 1993 WO
WO 1994-008236 Apr 1994 WO
WO 1994-022367 Oct 1994 WO
WO 1996-001611 Jan 1996 WO
WO 1996-014026 May 1996 WO
WO 1996-025089 Aug 1996 WO
WO 1996-030431 Oct 1996 WO
WO 1996-032076 Oct 1996 WO
WO 1996-036296 Nov 1996 WO
WO 1997-001986 Jan 1997 WO
WO 1997-011067 Mar 1997 WO
WO 1997-019188 May 1997 WO
WO 1997-043633 Nov 1997 WO
WO 1998-024358 Jun 1998 WO
WO 1998-038906 Sep 1998 WO
WO 1998-056613 Apr 1999 WO
WO 2000-013003 Mar 2000 WO
WO 2000-019887 Apr 2000 WO
WO 2000-032098 Jun 2000 WO
WO 2000-033065 Jun 2000 WO
WO 2000-059373 Oct 2000 WO
WO 2000-074753 Dec 2000 WO
WO 2001-012158 Feb 2001 WO
WO 2001-020019 Mar 2001 WO
WO 2001-020334 Mar 2001 WO
WO 2001-034243 May 2001 WO
WO 2001-043660 Jun 2001 WO
WO 2001-058348 Aug 2001 WO
WO 2001-068901 Sep 2001 WO
WO 2001-069222 Sep 2001 WO
WO 2001-088524 Nov 2001 WO
WO 2001-088534 Nov 2001 WO
WO 2002-053764 Jul 2002 WO
WO 2002-058537 Aug 2002 WO
WO 2003-063700 Aug 2003 WO
WO 2005-012873 Feb 2005 WO
WO 2005-044088 May 2005 WO
WO 2005-045394 May 2005 WO
WO 2005-057168 Jun 2005 WO
WO 2005-026689 Oct 2005 WO
WO 2006-018425 Feb 2006 WO
WO 2007-097754 Aug 2007 WO
WO 2007-114943 Oct 2007 WO
WO 2007-137288 Nov 2007 WO
Non-Patent Literature Citations (373)
Entry
Aalders et al. 1991. Development of a wearable glucose sensor; studies in healthy volunteers and in diabetic patients. Intl J Artificial Organs 14(2):102-108.
Abe et al. 1992. Characterization of glucose microsensors for intracellular measurements. Analytical Chemistry 64(18):2160-2163.
Abel et al. 1984. Experience with an implantable glucose sensor as a prerequisite of an artificial beta cell. Biomed Biochitn Acta 43(5):577-584.
Abel et al. 2002. Biosensors for In vivo glucose measurement: can we cross the experimental stage. Biosensors & Bioelectronics 17:1059-1070.
Alcock & Turner 1994. Continuous Analyte Monitoring to Aid Clinical Practice. IEEE Eng Med & Biol 13:319-325.
American Heritage Dictionary 4th Edition, 2000. Houghton Mifflin Company p. 82.
Amin et al. 2003. Hypoglycemia prevalence in prepubertal children with type 1 diabetes on standard insulin regimen: Use of continuous glucose monitoring system. Diabetes Care 26(3):662-667.
Answers.com. “xenogenlc.” The American Heritage Stedman's Medical Dictionary, Houghton Mifflin Company 2002, Answers.com Nov. 7, 2006 http:-www. Answers,com-topic-xenogenic.
Armour et al. Dec. 1990. Application of Chronic intravascular Blood Glucose Sensor in Dogs, Diabetes 39:1519-1526.
Asberg et al. 2003. Hydrogels of a Conducting Conjugated Polymer as 3-D Enzyme Electrode. Biosensors & Bioelectronics 19:199-207.
Atanasov et al. 1994. Biosensor for continuous glucose monitoring. Biotechnology & Bioengineering 43:262-266.
Atanasov et al. 1997. Implantation of a refillable glucose monitoring-telemetry device. Biosensors & Bioelectronics 12:669-680.
Aussedat et al. 1997. A user-friendly method for calibrating a subcutaneous glucose sensor-based hypoglycaemic alarm. Biosensors & Bioelectronics 12(11)1061-1071.
Bailey et al. 2007. Reduction in hemoglobin AIC with real-time continuous glucose monitoring: results from a 12-week observational study, Diabetes Technology & Therapeutics 9(3):203-210.
Baker et al. 1996. Dynamic delay and maximal dynamic error in continuous biosensors. Analytical Chemistry 88(8):1292-1297.
Bard et al. 1980. Electrochemical Methods, John Wiley & Sons pp. 173-175.
Beach et al. 1999. Subminiature implantable potentiostat and modified commercial telemetry device for remote glucose monitoring. IEEE Tran Instrument Meas 48(6):1239-1245.
Bellucci et al. 1986. Electrochemical behaviour of graphite-epoxy composite materials (GECM) in aqueous salt solutions. J Applied Electrochemistry 16(1): 15-22.
Bessman et al. 1973. Progress toward a glucose sensor for the artificial pancreas. Proceedings of a Workshop on ion-Selective Microelectrodes Jun. 4-5, 1973 Boston MA 189-197.
Biermann et al. 2008. How would patients behave if they were continually informed of their blood glucose levels? A simulation study using a “virtual” patient. Diabetes Technology & Therapeutics 10:178-187.
Bindra et al. 1989. Pulsed amperometric detection of glucose in biological fluids at a surface-modified gold electrode, Analytical Chemistry 61:2566-2570.
Bindra et al. 1991. Design and in Vitro Studies of a Needle-Type Glucose Sensor for Subcutaneous Monitoring. Analytical Chemistry 63:1692-1606.
Bisenberger et al. 1995. A triple-step potential waveform at enzyme multisensors with thick-film gold electrodes for detection of glucose and sucrose. Sensors and Actuators B 28:181-189.
Bland et al. 1990. A note on the use of the intraclass correlation coefficient in the evaluation of agreement between two methods of measurement. Comput Biol Med 20(5):337-340.
Bobbioni-Harsch et al. 1993. Lifespan of subcutaneous glucose sensors and their performances during dynamic glycaemia changes in rats. J. Biomed Eng 15:457-463.
Bode B. W. 2000. Clinical utility of the continuous glucose monitoring system. Diabetes & Therapeutics 2 {Suppl 1):S35-S41.
Bode et al. 1999. Continuous glucose monitoring used to adjust diabetes therapy improves glycosylated hemoglobin: A pilot study. Diabetes Research and Clinical Practice 46:183-190.
Bode et al. 2000. Using the continuous glucose monitoring system to improve the management of type 1 diabetes. Diabetes Technology & Therapeutics 2(Suppl 1):S43-S48.
Boedeker Plastics Inc. 2009. Polyethylene Specifications Data Sheet http:—www.boedeker.com-polye_p.htm [Aug. 19, 2009 3:36:33 PM].
Boland et al. 2001. Limitations of conventional methods of self-monitoring of blood glucose, Diabetes Care 24(11):1858-1862.
Bott A. W. 1997. A Comparison of Cyclic Voltammetry and Cyclic Staircase Voltammetry. Current Separations 16:1 23-26.
Bowman L. et al. 1986. The packaging of implantable integrated sensors. IEEE Trans Biomed Eng (BME) 33(2):248-255.
Brauker (Abstract) Baxter Healthcare Corp. Neovascularization of Cell Transplantation Devices: Membrane Architecture-Driven and Implanted Tissue-Driven Vascularization.
Brauker et al. 1995. Neovascularization of synthetic membranes directed by membrane Microarchitecture, J. Biomed Mater Res 29:1517-1524.
Brauker et al. 1996. Local Inflammatory Response Around Diffusion Chambers Containing Xenografts. Transplantation 61 (12): 1671-1677.
Brauker et al. 1998. Sustained expression of high levels of human factor IX from human cells implanted within an immunoisolation device into athymic rodents. Hum Gene Ther 9:879-888.
Brauker et al. 2001. Unraveling Mysteries at the Biointerface: Molecular Mediator of inhibition of Blood vessel Formation in the Foreign Body Capsule Revealed. Surfacts Biomaterials 6:1,5.
Braunwald 2008. Biomarkers in heart failure. NEJM 358:2148-2159.
Bremer et al. 2001. Benchmark data from the literature for evaluation of new glucose sensing technologies. Diabetes Technology & Therapeutics 3(3):409-418.
Brooks et al. 1987-88. Development of an on-line glucose sensor for fermentation monitoring. Biosensors 3:45-58.
Bruckel et al. 1989. In vivo measurement of subcutaneous glucose concentrations with an enzymatic glucose sensor and a wick method. Klin Wochenschr 67:491-495.
Brunner et al. 1998. Validation of home blood glucose meters with respect to clinical and analytical approaches. Diabetes Care 21(4):585-590.
Cai et al. 2004. A wireless remote query glucose biosensor based on a ph-sensitive polymer. Analytical Chemistry' 76 {4):4038-4043.
Campanella et al. 1993. Biosensor for direct determination of glucose and lactate in undiluted biological fluids. Biosensors & Bioelectronics 8:307-314.
Candas et al 1994. An adaptive plasma glucose controller based on a nonlinear insulin-glucose model. IEEE Trans Biomed Eng (BME) 41(2): 116-124.
Cass et al. 1984. Ferrocene-mediated enzyme electrodes for amperometric determination of glucose. Analytical Chemistry 36:667-71.
Cassidy et al. Apr. 1993, Novel electrochemical device for the detection of cholesterol or glucose, Analyst 118:415-418.
Chase et al. 2001. Continuous subcutaneous glucose monitoring in children with type 1 diabetes, Pediatrics 107:222-226.
Chatterjee et al. 1997. Poly(ether Urethane) and pol(ether urethane urea) membranes with high H2S-CH4 selectivity. J Membrane Science 135:99-106.
Chen et al. 2006. A noninterference polypyrrole glucose biosensor. Biosensors and Bioelectronics 22:639-643.
Ciba Specialty Chemicals, Inc. 1998. Ciba © Irgacure® 2959 Photoinitiator Product Description. Apr. 2, 1998. Basel Switzerland (3 pages).
Claremont et al. 1986. Potentially-implantable ferrocene-mediated glucose sensor. J Biomed Eng 8:272-274.
Claremont et al, 1986. Subcutaneous implantation of a ferrocene-mediated glucose sensor in pigs. Diabetologia 29:817-821.
Clark et al. 1981. One-minute electrochemical enzymic assay for cholesterol in biological materials. Clinical Chemistry 27(121):1978-1982.
Clark et al. 1987. Configurational cyclic voltantmetry: increasing the specificity and reliability of implanted electrodes. IEEE—Ninth Annual Conference of the Engineering in Medicine and Biology Society, pp. 0782-0783.
Clark et al. 1988. Long-term stability of electroenzymatic glucose sensors implanted in mice. Trans Am Soc Artif Internal Organs 34:259-265.
Clarke et al. 1987. Evaluating Clinical Accuracy of Systems for Self-Monitoring of Blood Glucose. Diabetes Care 10 {5):622-S28.
CLSi 2008. Performance metrics for continuous interstitial glucose monitoring; approved guideline CLSi document POCT05-A. Wayne PA: Clinical and Laboratory Standards institute: 2008 28(33) 72 pp.
Colangelo et al. 1967. Corrosion rate measurements in vivo. J Biomed Matls Res 1:405-414.
Colowick et al. 1976. Methods in Enzymology vol. XLIV Immobilized Enzymes. Introduction, pp. 1-7, Academic Press, New York, NY.
Cox et al. 1985. Accuracy of perceiving blood glucose in IDDM. Diabetes Care 8(6):529-536.
Csoregi et al. 1994. Design characterization and one-point in vivo calibration of a subcutaneously implanted glucose electrode. Analytical Chemistry 66(19):3131-3138.
Dai et al. 1999. Hydrogel Membranes with Mesh Size Asymmetry Based on the Gradient Crosslink of Poly(vinyl alcohol). J Membrane Science 156:67-79.
Danielsson et al. 1988. Enzyme thermistors. Methods in Enzymology 137:181-197.
D'Arrigo et al. 2003. Porous-Si based bioreactors for glucose monitoring and drugs production. Proc. of SPIE 4982:178-184.
Dassau et al. 2009. In silica evaluation platform for artificial pancreatic 13-cell development—a dynamic simulator for closed loop control with hardware-in-the-loop. Diabetes Technology & Therapeutics 11 (3):1-8.
Davies et al. 1992. Polymer membranes in Clinical sensor applications: An overview of membrane function. Biomaterials 13(14):971-978.
Dixon et al. 2002. Characterization in vitro and in vivo of the oxygen dependence of an enzyme-polymer biosensor for monitoring brain glucose. J Neuroscience Methods 19:135-142.
DuPont Dimension AR®. 1998. The chemistry analyzer that makes the most of your time money and effort. Catalog. Dade international Chemistry Systems. Newark DE [18 pages,].
El Degheidy et al. 1986. Optimization of an implantable coated wire glucose sensor. J Biomed Eng 8:121-129.
El-Sa'ad et al. 1990. Moisture Absorption by Epoxy Resins: the Reverse Thermal Effect. J Matls Science Res 25:3577-3582.
Ernst et al. 2002. Reliable glucose monitoring through the use of microsystem technology. Analytical & Bioanalytical Chemistry 373:758-761.
Fare et al. 1998. Functional characterization of a conducting polymer-based immunoassay system. Biosensors & Bioelectronics 13{3-4):459-470.
Feldman et al. 2003. A continuous glucose sensor based on wired enzyme technology—results from a 3-day trial in patients with type 1 diabetes. Diabetes Technology & Therapeutics 5(5):769-779.
Fischer et al. 1987. Assessment of subcutaneous glucose concentration: validation of the wick technique as a reference for implanted electrochemical sensors in normal and diabetic dogs. Diabetologia 30:940-945.
Fischer et al. 1989. Oxygen Tension at the Subcutaneous Implantation Site of Glucise Sensors. Biomed Biochem 11-12:965-972.
Freedman et al. 1991. Statistics Second Edition WAV, Norton & Company p. 74.
Frohnauer et al. 2001. Graphical human insulin time-activity profiles using standardized definitions. Diabetes Technology & Therapeutics 3(3):419-429.
Frost et al. 2002. Implantable chemical sensors for real-time clinical monitoring: Progress and challenges. Current Opinion in Chemical Biology 6:633-641.
Gabbay et al. 2008. Optical coherence tomography-based continuous noninvasive glucose monitoring in patients with diabetes. Diabetes Technology & Therapeutics 10:188-193.
Ganesan et al. 2005. Gold layer-based dual crosslinking procedure of glucose oxidase with ferrocene monocarboxylic acid provides a stable biosensor. Analytical Biochemistry 343:188-191.
Ganesh et al. 2008. Evaluation of the VIA® blood chemistry monitor for glucose in healthy and diabetic volunteers. J Diabetes Science and Technology 2(2):182-193.
Gao et al. 1989. Determination of Interfacial parameters of cellulose acetate membrane materials by HPLC. J Liquid Chromatography 12(11):2083-2092.
Garget al. 2004. Improved Glucose Excursions Using an implantable Real-Time continuous Glucose Sensor in Adults with Type 1 Diabetes. Diabetes Care 27:734-738.
Geller et al. 1997. Use of an immunoisolation device for cell transplantation and tumor immunotherapy. Ann NY Acad Sci 831:438-451.
Gerritsen et al. 1999. Performance of subcutaneously implanted glucose sensors for continuous monitoring. The Netherlands Journal of Medicine 54:167-179.
Gerritsen et al. 2001. Influence of inflammatory cells and serum on the performance of implantable glucose sensors. J Biomed Matls Res 54:69-75.
Gerritsen M. 2000. Problems associated with subcutaneously implanted glucose sensors. Diabetes Care 23(21:143-145.
Gilligan et al. 1994. Evaluation of a subcutaneous glucase sensor out to 3 months in a dog model. Diabetes Care 17(8):882-887.
Gilligan et al. 2004. Feasibility of continuous long-term glucose monitoring from a subcutaneous glucose sensor in humans. Diabetes Technology & Therapeutics 6:378-386.
Godsland et al. 2001. Maximizing the Success Rate of Minima! Mode! insulin Sensitivity Measurement in Humans: The importance of Basal Glucose Levels. The Biochemical Society and the Medical Research Society 101:1-9.
Gouda et al. Jul. 4 2003. Thermal inactivation of glucose oxidase. J Biol Chem 278(27):24324-24333.
Gough et al. 2000. Immobilized glucose oxidase in implantable glucose sensor technology. Diabetes Technology & Therapeutics 2(3):377-380.
Gough et al. 2003. Frequency characterization of blood glucose dynamics. Annals of Biomedical Engineering 31:91-97.
Gregg et al. 1990. Cross-Linked Redox Gels Containing Glucose Oxidase for Amperometric Biosensor Applications. Analytical Chemistry 62:258-263.
Gross et al. 2000. Efficacy and re-lability of the continuous glucose monitoring system. Diabetes Technology & Therapeutics 2(8upp! 1):S19-S28.
Gross et al. 2000. Performance evaluation of the MiniMed® continuous glucose monitoring system during patient home use. Diabetes Technology & Therapeutics 2(1):49-56.
Guerci et al. 2003. Clinical performance of CGMS in type 1 diabetic patients treated by continuous subcutaneous insulin infusion using insulin analogs. Diabetes Care 26:582-589.
Guo et al. 1998. Modification of cellulose acetate ultrafiltration membrane by gamma ray radiation (Abstract). Shuichuli Jishu Bianji Weiyuanhui 23(6):315-318.
Hall et al. 1998. Electrochemical oxidation of hydrogen peroxide at platinum electrodes, Part 1: An adsorption-controlled mechanism. Electrochimica Acta 43(5-6):579-588.
Hall et al. 1998. Electrochemical oxidation of hydrogen peroxide at platinum electrodes. Part II: Effect of potential. Electrochimica Acta 43(14-15):2016-2024.
Hall et al. 1999. Electrochemical oxidation of hydrogen peroxide at platinum electrodes. Part III: Effect of temperature. Electrochimica Acta 44:2455-2462.
Hall et al. 1999. Electrochemical oxidation of hydrogen peroxide at platinum electrodes. Part IV: Phosphate buffer dependence. Electrochimica Acta 44:4573-4582.
Hall et al. 2000. Electrochemical oxidation of hydrogen peroxide at platinum electrodes. Part V: Inhibition by chloride. Electrochimica Acta 45:3573-3579.
Hamilton Syringe Selection Guide. 2006. Syringe Selection, www.hamiltoncompany.com.
Harrison et al. 1988. Characterization of perfluorosulfonic acid polymer coated enzyme electrodes and a miniaturized intergrated potentiostat for glucose analysis in whole blood. Analytical Chemistry 60:2002-2007.
Hashiguchi et al. 1994. Development of a miniaturized glucose monitoring system by combining a needle-type glucose sensor with microdialysis sampling method:: Long-term subcutaneous tissue glucose monitoring in ambulatory diabetic patients. Diabetes Care17(5):387-396.
Heller A. 1992. Electrical Connection of Enzyme Redox Centers to Electrodes. J Phys Chem 96:3579-3587.
Heller A. 1999. Implanted electrochemical glucose sensors for the management of diabetes. Annu Rev Biomed Eng 1:153-175.
Heller A. 2003. Plugging metal connectors into enzymes. Nature Biotechnology 21:631-632.
Heller. 1990. Electrical wiring of redox enzymes. Acc. Chem. Res, 23:128-134.
Hicks 1985. In Situ Monitoring. Clinical Chemistry 31 (12):1931-1935.
Hitchman M, L, 1978. Measurement of Dissolved Oxygen, in Elving et al. (Eds.). Chemical Analysis vol. 49 Chap, 3, pp. 34-49 & 59-123, John Wiley & Sons, New York, NY.
Hoel, Paul G, 1976. Elementary Statistics Fourth Edition, John Wiley & Sons Inc,, pp. 113-114.
Hrapovic et al. 2003. Picoamperometric detection of glucose at ultrasmall platinum-based biosensors' preparation and characterization. Analytical Chemistry 75:3308-3315.
Hu et al. 1993. A needle-type enzyme-based lactate sensor for in vivo monitoring. Analytica Chimica Acta 281:503-511.
Huang et al. 1997. A 0.5mV passive telemetry IC for biomedical applications. Swiss Federal Institute of Technology (4 pages).
Huang et al. Aug. 1975. Electrochemical Generation of Oxygen. 1: The Effects of Anions and Cations on Hydrogen Chemisorption and Aniodic Oxide Film Formation on Platinum Electrode. 2: The Effects of Anions and Cations on Oxygen Generation on Platinum Electrode, pp. 1-116.
Hunter et al. 2000. Minimally Invasive Glucose Sensor and Insulin Delivery System. MIT Home automation and Healthcare Consortium, Progress Report No. 25.
Ishikawa et al. 1998. Initial evaluation of a 290-μm diameter subcutaneous glucose sensor: Glucose monitoring with a biocompatible flexible-wire enzyme-based amperometric microsensor in diabetic and nondiabetic humans. J Diabetes and its Complications 12:295-301.
Jaffari et al. 1995. Recent advances in amperometric glucose biosensors for in vivo monitoring. Physiol Meas 16:1-15.
Jensen et al. 1997. Fast wave forms for pulsed electrochemical detection of glucose by incorporation of reductive desorption of oxidation products. Analytical Chemistry 69(9):1776-1781.
Jeutter 1982. A transcutaneous implanted batter recharging and biotelemeter power switchin system. IEEE Trans Biomed Eng (BME) 29:314-321.
Jobst et al. 1996. Thin-Film Microbiosensors for Glucose-Lactate Monitoring. Analytical Chemistry 8(18):3173-3179.
Johnson et al. 1992. In vivo evaluation of an electroenzymatic glucose sensor implanted in subcutaneous tissue. Biosensors & Bioelectronics 7:709-714.
Jovanovic 2000. The role of continuous glucose monitoring in gestational diabetes mellitus. Diabetes Technology & Therapeutics 2(Suppl. 1):S67-S71.
Kamath et al. 2008. Calibration of a continuous glucose monitor: effect of glucose rate of change. Eighth Annual Diabetes Technology Meeting Nov. 13-15, 2008, p. A88.
Karube et al. 1993. Microbiosensors for acetylcholine and glucose. Biosensors & Bioelectronics 8:219-228.
Kaufman 2000. Role of the continuous glucose monitoring system in pediatric patients. Diabetes Technology & Therapeutics 2(Suppl 1):S49-S52.
Kaufman et al. 2001. A pilot study of the continuous glucose monitoring system. Diabetes Care 24(12):2030-2034.
Kawagoe et al. 1991. Enzyme-modified organic conducting salt microelectrode. Analytical Chemistry 63:2961-2965.
Keedy et al. 1991. Determination of urate in undiluted whole blood by enzyme electrode. Biosensors & Bioelectronics 6: 491-499.
Kendo et al. 1982. A miniature glucose sensor implantable in the blood stream. Diabetes Care. 5(3):218-221.
Kerner et al. 1988. A potentially implantable enzyme electrode for amperometric measurement of glucose. Horm Metab Res Suppl 20:8-13.
Kerrner et al. 1993. The function of a hydrogen peroxide-detecting electroenzymatic glucose electrode is marked by Impaired in human sub-cutaneous tissue and plasma. Biosensors & Bioelectronics 8:473-482.
Kiechle F.L, 2001. The Impact of continuous glucose monitoring on hospital point-of-care testing programs. Diabetes Technology & Therapeutics 3:647-649.
Klueh et al, 2003. Use of Vascular Endothelia Ceil Growth Factor Gene Transfer to Enhance Implantable Sensor Function in Vivo Biosensor Function and Vegf-Gene Transfer. J Biomed Matls Res 67A:1072-1086.
Klueh et al. 2007. Inflammation and glucose sensors: use of dexamethasone to extend glucose sensor function and life span in vivo. J Diabetes Sci Technology (4):496-504.
Kondo et al. 1982. A miniature glucose sensor, implantable in the blood stream. Diabetes Care 5(3):218-221.
Koschinsky et al. 1988. New approach to technical and Clinical evaluation of devices for self-monitoring of blood glucose. Diabetes Care 11 (8):619-619.
Koschinsky et al. 2001. Sensors for glucose monitoring: Technical and Clinical aspects. Diabetes Metab Res Rev 17:113-123.
Kost et al. 1985. Glucose-sensitive membranes containing glucose oxidase: activity swelling and permeability studies. J Biomed Matls Res 19:1117-1133.
Koudelka et al. 1989. in vivo response of microfabricated glucose sensors to glyceima changes in normal rats. Biomed Biochim Acta 48(11-12):953-956.
Koudelka et al. 1991. In-vivo behaviour of hypodermically implanted microfabricated glucose sensors. Biosensors & Bioelectronics 6:31-36.
Kraver et al. 2001. A mixed-signal sensor interface microinstrument. Sensors and Actuators A 91:286-277.
Kruger et al. 2000. Psychological motivation and patient education: A role for continuous glucose monitoring. Diabetes Technology & Therapeutics 2(Suppl 1):S93-S97.
Kulys et al. 1994. Carbon-paste biosensors array for long-term glucose measurement. Biosensors & Bioelectronics 9:491-500.
Kunjan et al. 2008. Automated blood sampling and glucose sensing in critical care setting. J Diabetes Science & Technology 2(3):194-200.
Kunzler et al. 1993. Hydrogels based on hydrophilic side chain siloxanes. Poly Maas Sci and Eng 69:226-227.
Kunzler et al. Aug. 21, 1995, Contact lens materials. Chemistry & Industry 651-655.
Kusano 1989. Glucose enzyme electrode with percutaneous interface which operates independently of dissolved oxygen. Clin Phys Physiol Meas 10(1):1-9.
Lee et al. 1999. Effects of pore size void volume and pore connectivity on tissue responses. Society for Biomaterials 25th Annual Meeting, p. 171.
Lehmann et al. May 1994. Retrospective validation of a physiological model of glucose-Insulin interaction in type 1 diabetes mellitus. Med Eng Phys 16:193-202.
Lerner et al. 1984. An implantable electrochemical glucose sensor. Ann. N. Y. Acad. Sci.428:263-278.
Lewandowski et al. 1988. Evaluation of a miniature blood glucose sensor. Trans Am Soc Artif Intern Organs 34:255-258.
Leypoidt et al. 1984. Model of a two-substrate enzyme electrode for glucose, Analytical Chemistry 56:2898-2904
Linke et al. 1994. Amperometric biosensor for in vivo glucose sensing based on glucose oxidase immobilized in a redox hyrogel. Biosensors & Bioelectronics 9:151-158.
Loffler et al. 1995. Separation and determination of traces of ammonia in air by means of chromatomembrane cells. Fresenius J Anal Chem 352:613-614.
Lowe 1984. Biosensors. Trends in Biotechnology 2(3):59-65.
Luong et al. 2004. Solubilization of Multiwall Carbon Nanotubes by 3-Aminopropyitriethoxysilane Towards the Fabrication of Electrochemical Biosensors with Promoted Electron Transfer. Electronanalysis 16(1-2):132-139.
Lvandres et al. 2008. Progress toward an in vivo surface-enhanced raman spectroscopy glucose sensor. Diabetes Technology & Therapeutics 10(4):257-265.
Lyman D. 1960. Polyurethanes, I. The Solution Polymerization of Diisocyanates with Ethylene Glycol. J. Polymer Sci XLV:45-49.
Madaras et al. 1996, Microfabricated amperometric creatine and creatinine biosensors. Analyitica J Chimica Acta 319:335-345.
Maidan et al. 1992. Elimination of Electrooxidizable Interferent-Produced Currents in Amperometric Biosensors. Analytical Chemistry 64:288-2896.
Makale et al. 2003. Tissue window chamber system for validation of implanted oxygen sensors. Am J Physiol Heart Cir Physio. 284:H2288-H2294.
Maran et al. 2002. Continuous subcutaneous glucose monitoring in diabetic patients: A multicenter analysis. Diabetes Care 25(2);347-352.
Markwell Medical 1990. Direct 30-30® Blood Glucose Sensor Markwell Medical Catalog © 1990, ELCO Diagnostics Company(1 page).
Mascini et al. 1989. Glucose electrochemical probe with extended linearity for whole blood. J Pharm Biomed Anal 7(12): 1507-1512.
Mastrototaro et al. 1991. An electroenzymatic glucose sensor fabricated on a flexible substrate. Sensors and Actuators B 5:139-144.
Mastrototaro et al. 2003. Reproducibility of the continuous glucose monitoring system matches previous reports and the intended use of the product. Diabetes Care 26:256; author reply p. 257.
Mastrototaro J. J. 2000. The MiniMed continuous glucose monitoring system. Diabetes Technology & Therapeutics 2(Suppl 1):S13-S18.
Matsumoto et al. 1998. A micro-planar amperometric glucose sensor unsusceptible to interference species. Sensors and Actuators B 49:68-72.
Matsumoto et al. 2001. A long-term lifetime amperometric glucose sensor with a perfluorocarhon polymer coating. Biosensors & Bioelectronics 16:271-276.
Mazze et al. 2008. Characterizing glucose exposure for individuals with normal glucose tolerance using continuous glucose monitoring and ambulatory glucose profile analysis. Diabetes Technology & Therapeutics 10:149-159.
McCartney et al. 2001. Near-infrared fluorescence lifetime assay for serum glucose based on allophycocyanin-labeled concanavalin A. Analytical Biochemistry 292:216-221.
McGrath et al. 1995. The use of differential measurements with a glucose biosensor for interference compensation during glucose determinations by flow injection analysis. Biosensors & Bioelectronics 10:937-943.
McKean et al. Jul. 1998. A Telemetry instrumentation System for Chronically implanted Glucose and Oxygen Sensors, IEEE Trans Biomed Eng (BME) 35(7): 526-532.
Memoli et al. 2002. A comparison between different immobilised glucoseoxidase-based electrodes. J Pharm Biomed Anal 29:1045-1052.
Merriam Webster On-Line Dictionary 2008. Definition for “aberrant”, downloaded from http:www.merriam-websetr.com-dictionary Aug. 19, 2008 (1 page).
Merriam-Webster Online Dictionary 2007. Definition of “nominal”, downloaded from http:www.merriam-webster.com-dictionary-nominalm on Apr. 23, 2007 (1 page).
Merriam-Webster Online Dictionary 2010. Definition of “acceleration”, downloaded from http:--www.merriam-webster.com-dictionary-Acceleration on Jan. 11, 2010.
Merriam-Webster Online Dictionary 2010. Definition of “system”, downloaded from http:˜www.merriam-webster.com-dictionary-System on Jan. 11, 2010.
Meyerhoff et al. 1992. On line continuous monitoring of subcutaneous tissue glucose in men by combining portable glucosensor with microdialysis. Diabetologia 35:1087-1092.
Miller A. 1988. Human monocyte-macrophage activation and interleukin 1 generation by biomedical polymers. J Biomed Matls Res 23:713-731.
Miller et al. 1989. Generation of IL1-like activity in response to biomedical polymer implants: a comparison of in vitro and in vivo models. J Biomed Matls Res 23:1007-1028.
Moatti-Sirat et al. 1992. Evaluating in vitro and in vivo the interference of ascorbate and acetaminophen on glucose detection by a needle-type glucose sensor. Biosensors & Bioelectronics 7:345-352.
Moatti-Sirat et al. 1992. Towards continuous glucose monitoring: in vivo evaluation of a miniaturized glucose sensor implanted for several days in rat subcutaneous tissue. Diabetoloaia 35:224-230.
Moatti-Sirat et al. 1994. Reduction of acetaminophen interference in glucose sensors by a composite Nafion membrane: demonstration in rats and man. Diabetologia 37(8):610-616.
Morff et al. 1990. Microfabrication of reproducible economical electroenzymatic glucose sensors. Annual international Conference of the IEEE Engineering in Medicine and Biology Society 12(2):0483-0484.
Mosbach et al. 1975. Determination of heat changes in the proximity of immobilized enzymes with an enzyme termistor and its use for the assay of metabolites. Biochim Biophys Acta (Enzymology) 403:256-265.
Motonaka et al. 1993. Determination of cholesterol and cholesterol ester with novel enzyme microsensors. Analytical Chemistry 65:3258-3261.
Moussy 2002. lmplantable Glucose Sensor: Progress and Problems. Sensors 1:270-273.
Moussy et al. 1993. Performance of subcutaneously implanted needle-type glucose sensors employing a novel trilayer coating. Analytical Chemistry 85: 2072-2077.
Moussy et al. 2000. Biomaterials community examines biosensor biocompatibility. Diabetes Technology & Therapeutics 2:473-477.
Moussy Francis 2002. Implantable Glucose sensor: Progress and Problems. Sensors 1:270-273.
Mowery et al. 2000. Preparation and characterization of hydrophobic polymeric films that are thromboresistant via nitric oxide release. Biomaterials 21:9-21.
Murphy et al. 1992. Polymer membranes in clinical sensor applications, II: The design and fabrication of permselective hydrogels for electrochemical devices. Biomaterials 3(14):979-990.
Myler et al. 2002. Uitra-thln-polysitoxane-flim-composite membranes for the optimisation of amperometric oxidase enzyme electrodes. Biosensors & Bioelectronics 17:35-43.
Nam et al. 2000. A novel fabrication method of macroporous biodegradable polymer scaffolds using gas foaming salt as a porogen additive. J Biomed Matls Res 53; 1-7.
Ohara et al. 1994. “Wired” enzyme electrodes for amperometric determination of glucose or lactate in the presence of interfering substances. Analytical Chemistry 66:2451-2457.
Ohara et al. Dec. 1993. Glucose electrodes based on cross-linked [Os(bpy2C1]+/2+complexed poly(1-vinylimidazone) films. Analytical Chemistry 65:3512-3517.
Okuda et al. 1971, Mutarotase effect on micro determinations of D-glucose and its anomers with β-D-glucose oxidase. Analytical Biochemistry 43:312-315.
Oxford English Dictionary Online. Definition of “impending”, downloaded from http:-www.askoxford.com-results-?view=dev dict&fietd-12668446 Impending&branch on Jan. 11, 2010.
Palmisano et al. 2000. Simultaneous monitoring of glucose and lactate by an interference and cross-talk free dual electrode amperometric biosensor based on electropolymerized thin films. Biosensors & Bioelectronics 15:531-539.
Panetti 2002. Differential effects of sphingosine 1-phosphate and lysophosphatidlc acid on endothelial cells. Biochimica et Biophysica Acta 1582:190-196.
Park et al. 2002. Gas separation properties of polysiloxane-polyether mixed soft segment urethane urea membranes. J Membrane Science 204:257-269.
Patel et al. 2003. Amperometric glucose sensors based on ferrocene containing polymeric electron transfer systems—a preliminary report. Biosensors & Bioelectronics 18:1073-1076.
Peacock et al. 2008. Cardiac troponin and outcome in acute heart failure, NEJM 358:2117-2126.
Pegoraro et al. 1995. Gas transport properties of siloxane polyurethanes. J Applied Polymer Science 57:421-429 j.
Pfeiffer E.F. 1990. The glucose sensor: The missing link in diabetes therapy. Horm Metab Res Suppl 24:154-164.
Pfeiffer et al. 1992. On line continuous monitoring of subcutaneous tissue glucose is feasible by combining portable glucose sensor with microdialysis. Horm Metab Res 25:121-124.
Phillips and Smith, 1988. Biomedical Applications of Polyurethanes; Implications of Failure Mechanisms, J Biomaterials App, 3:202-227.
Pichert et al. 2000. Issues for the coming age of continuous glucose monitoring. Diabetes Educator 26(6}:969-980.
Pickup et al. 1987-88. Implantable glucose sensors: choosing the appropriate sensing strategy Biosensors 3:335-346.
Pickup et al. 1988. Progress towards in vivo glucose sensing with a ferrocene-mediated amperometric enzyme electrode. Horm Metab Res Suppl 20 20:34-36.
Pickup et al. 1989. In vivo molecular sensing in diabetes mellitus: an implantable glucose sensor with direct electron transfer. D iabetologia 32:213-217.
Pickup et al. 1989. Potentially-implantable amperometric glucose sensors with mediated electron transfer: improving the operating stability. Biosensors (4):109-119.
Pineda et al. 1996. Bone regeneration with resorbable polymeric membranes. III. Effect of poly(L- lactide) membrane pore size on the bone healing process in large defects. 3. Biomedical Matls Res 31:385-394.
Pinner et al. 1959. Cross-linking of cellulose acetate by ionizing radiation. Nature 184:1303-1304.
Pishko et al. 1991. Amperometric glucose microelectrodes prepared through immobilization of glucose oxidase in redox hydrogels. Analytical Chemistry 63:2268-72.
Pitzer et al. 2001. Detection of hypoglycemia with the GlucoWatch biographer. Diabetes Care 24(5):881-885.
Poitout et al. 1991. In Vitro and In vivo Evaluation in Dogs of a Miniaturized Glucose Sensor, ASAIO Trans 37:M298-M300.
Poitout et al. 1993. A glucose monitoring system for on line estimation in man of blood glucose concentration using a miniaturized glucose sensor implanted in the subcutaneous tissue and a wearable control unit. Diabetologia 36:658-663.
Poitout et al. 1994. Development of a glucose sensor for glucose monitoring in man: the disposable implant concept. Clinical Materials 15:241-246.
Postlethwaite et al. 1996. Interdigitated array electrode as an alternative to the rotated ring-disk electrode for determination of the reaction products of dioxygen reduction. Analytical Chemistry 68:2951-2958.
Prabhu et al. 1981. Electrochemical studies of hydrogen peroxide at a platinum disc electrode. Eledrochimica Acta 26(6):725-729.
Quinn et al. 1995. Kinetics of glucose delivery to subcutaneous tissue in rats measured with 0.3-mm amperometric microsensors. Am J Phys 269(Endocrinology Metabolism 32):E155-E161.
Quinn et al. 1997. Biocompatible glucose-permeable hydrogel for in situ coating of Implantable biosensors. Biomaterials 18:1665-1670.
Rabah et al. 1991. Electrochemical wear of graphite anodes during electrolysis of brine. Carbon 29(2):165-171.
Ratner B.D. 2002. Reducing capsular thickness and enhancing angiogenesis around implant drug release systems. J Controlled Release 78:211-218.
Reach et al. 1986. A Method for Evaluating in vivo the Functional Characteristics of Glucose Sensors. Biosensors 2:211-220.
Reach et al. 1992. Can continuous glucose monitoring be used for the treatment of diabetes? Analytical Chemistry 64(5):381-386.
Reach et al.1993. Continuous glucose sensing for the treatment of diabetes mellitus. Analysis Magazine 21(2):M35-M39.
Reach G. 2001. Which threshold to detect hypoglycemia? Value of receiver-operator curve analysis to find a compromise between sensitivity and specificity. Diabetes Care 24(5):803-804.
Rebrin et al. 1989. Automated feedback control o? subcutaneous glucose concentration in diabetic dogs. Diabetologia 32:573-576.
Rebrin et al. 1992. Subcutaneous glucose monitoring by means of electrochemical sensors: fiction or reality? J Biomed Eng 14:33-40.
Reuscb 2004. Chemical Reactivity. Organomet allic Compounds, Virtual Textbook of Organic Chem. pp. 1-16 http:--www.cem.msu.edu--reuschiVirtuaiText-orgmet_al.htm.
Rhodes et al. 1994. Prediction of pocket-portable and implantable glucose enzyme electrode performance from combined species permeability and digital simulation analysis. Analytical Chemistry' 66(9):1520-1529.
Rigla et al. 2008. Real-time continuous glucose monitoring together with telemedical assistance improves glycemic control and glucose stability in pump-treated patients. Diabetes Technology & Therapeutics 10:194-199.
Rivers et al. 2001. Central venous oxygen saturation monitoring in the critically ill patient. Current Opinion in Critical Care 7:204-211.
Sachlos et al. 2003. Making Tissue Engineering Scaffolds Work. Review on the Application of Solid Freeform Fabrication Technology to the Production of Tissue Engineering Scaffolds. European Cells and Materials 5:29-40.
Sakakida et al. 1992. Development of Ferrocene-Mediated Needle-Type Glucose Sensor as a Measure of True Subcutaneous Tissue Glucose Concentrations. Artif. Organs Today2(2):145-158.
Sakakida et al. 1993. Ferrocene-Mediated Needle Type Glucose Sensor Covered with Newly Designed Biocompatible Membrane. Sensors and Actuators B 13-14:319-322.
Salardi et al. 2002. The glucose area under the profiles obtained with continuous glucose monitoring system relationships with HbA1c in pediatric type I diabetic patients. Diabetes Care 25(10):1840-1844.
Samuels 2004. The effects of flight and altitude. Arch Dis Child 89:448-455.
Sansen et al. 1985. Glucose sensor with telemetry system, in Ko W. H. (Ed.), implantable Sensors for Closed Loop Prosthetic Systems. Chap. 12 pp. 167-175 Mount Kisco NY: Futura Publishing Co.
Sansen et al. 1990. A smart sensor for the voltammetric measurement of oxygen or glucose concentrations. Sensors and Actuators B 1:298-302.
Schmidt et al. 1993. Glucose concentration in subcutaneous extracellular space. Diabetes Care 16(5) 695-700.
Schmidtke et al. 1998. Measurement and modeling of the transient difference between blood and subcutaneous glucose concentrations in the rat after injection of insulin. Proc Natl Acad Sci USA 95 294-299.
Schoemaker et al. 2003. The SCGM1 system: Subcutaneous continuous glucose monitoring based on microdialysis technique. Diabetes Technology & Therapeutics5(4):599-608.
Schoonen et al. 1990. Development of a potentially wearable glucose sensor for patients with diabetes mellitus: design and in-vitro evaluation. Biosensors & Bioelectronics 5:37-46.
Schuler et al. 1999. Modified gas-permeable silicone rubber membranes for covalent immobilisation of enzymes and their use in biosensor development. Analyst 124:1181-1184.
Selam, J. L, 1997. Management of diabetes with glucose sensors and implantable insulin pumps, From the dream of the 60s to the realities of the 90s. ASAIO J 43:137-142.
Service et al 1970. Mean amplitude of glycemic excursions a measure of diabetic instability. Diabetes 19:644-655. ' J.
Service et al. 1987. Measurements of glucose control, Diabetes Care 10:225-237.
Sharkawy et al. 1996. Engineering the tissue which encapsulates subcutaneous implants. I. Diffusion properties. J Biomed Matls Res 37:401-412.
Shaw et al. 1991. In vitro testing of a simply constructed highly stable glucose sensor suitable for implantation in diabetic patients. Biosensors & Bioelectronics 6:401-406.
Shichiri et al. 1982. Wearable artificial endocrine pancreas with needle-type glucose sensor. Lancet 2:1129-1131.
Shichiri et al. 1983. Glycaemic Control in Pancreatectomized Dogs with a Wearable Artificial Endocrine Pancreas. Diabetologia 24:179-184.
Shichiri et al. 1985. Needle Type Glucose Sensor for Wearable Artificial Endocrine Pancreas, Chapter 15, pp. 197-210 in Implantable Sensors for Closed-Loop Prosthetic Systems by Ko (Ed.), Future Publishing Company. Ml. Kisco, NY.
Shichiri et al. 1986. Telemetry Glucose Monitoring Device with Needle-Type Glucose Sensor: A Useful Tool for Blood Glucose Monitoring in Diabetic individuals. Diabetes Care Inc. 9(3):298-301.
Shichiri et al. 1989. Membrane Design For Extending the Long-Life of an implantable Glucose Sensor. Dials Nutr Metab 2:309-313.
Shults et al. 1994. A telemetry-instrumentation system for monitoring multiple subcutaneously implanted glucose sensors. IEEE Trans Biomed Eng (BME) 41 (1Q):937-942.
Sieminski et al. 2000. Biomaterial-microvasculature interactions. Biomaterials 21:2233-224t.
Sigma-Aldrich Corp. 2005. Cellulose Acetate Product Description Apr. 7, 2005 Product No. 419028.
Sigma-Aldrich Corp. 2005. Nafion® 117 Solution Product Description Product No. 70180 Sigma-Aldrich Corp. St. Louis MO. Downloaded from https:--www.signaaldrich,com-cgi- bin-hsrun-Suite7-Suite HAHTpage-Suite.HsExternal Prod., on Apr. 7, 2005.
Skyler J. S. 2000. The economic burden of diabetes and the benifits of improved glycemic control: The potential role of a continuous glucose monitoring system. Diabetes Technology & Therapeutics 2(Suppl. j):S7-S12.
Slater-MacLean et al. 2008. Accuracy of glycemic measurements in the critically ill. Diabetes Technology & Therapeutics 10:169-171.
Sokol et al. 1980. Immobilized-enzyme rate-determination method for glucose analysis. Clinical Chemistry 26(1 ):89-92 \.
Sriyudthsak et al. 1996. Enzyme-epoxy membrane based glucose analyzing system and medical applications. Biosensors & Bioelectronics 11:735-742.
Steil et al. 2003. Determination of plasma glucose during rapid glucose excursions with a subcutaneous glucose sensor. Diabetes Technology & Therapeutics 5(1):27-31.
Stern et al. 1957. Electrochemical polarization: 1. A theoretical analysis of the shape of polarization curves. J Electrochemical Society 104(1 ):56-63.
Sternberg et al. 1988. Covalent enzyme coupling on cellulose acetate membranes for glucose sensor development. Analytical Chemistry 69:2781-2786.
Sternberg et al. 1988. Study and Development of Multilayer Needle-type Enzyme-based Glucose Microsensors. Biosensors 4:27-40.
Sternberg et al. 1994. Calibration problems of subcutaneous glucosensors when applied to “in-situ” in man, Horm Metab Res 26(11):523-525.
Sternberg et al. 1994. Calibration problems of subcutaneous glucosensors when applied “in-situ” in man. Horn Metab Res 26(11) 523-525.
Stokes 1988. Polyether Polyurethanes: Biostabte or Not? J. Biomaterials Applications 3:228-259.
Suh et al. 2002. Behavior of fibroblasts on a porous hyaluronic acid incorporated collagen matrix. Yonsei Medical J 43 {2): 193-202.
Sumino et al. 1998. Preliminary study of continuous glucose monitoring with a microdialysis technique. Proceedings of the IEEE 20(4):1775-1778.
Takegami et al. 1992. Pervaporation of ethanol water mixtures using novel hydrophobic membranes containing polydimethylsiloxane. J Membrane Science 75:93-108.
Tanenberg et al. 2000. Continuous glucose monitoring system: A new approach to the diagnosis of diabetic gastroparesis. Diabetes Technology & Therapeutics 2(Suppl 1);S73-S80.
Tang et al. 1993. Fibrin(ogen) mediates acute inflammatory responses to biomaterials. J Exp Med 178:2147-2156.
Tang et al. 1995. Inflammatory responses to biomaterials, Am J Clinical Pathology 103:466-471.
Tang et al. 1996. Molecular determinants of acute inflammatory responses to biomaterials. J Clin Invest 97:1329-1334.
Tang et al. 1998. Mast cells mediate acute inflammatory responses to implanted biomateriais. Proc Natl Acad Sci USA 95:8841-8846.
Thome-Duret et al. 1996. Modification of the sensitivity of glucose sensor implanted into subcutaneous tissue. Diabetes Metabolism 22:174-178.
Thome-Duret et al. 1998. Continuous glucose monitoring in the free-moving rat. Metabolism 47:799-803.
Thompson et al. 1986. In Vivo Probes: Problems and Perspectives. Department of Chemistry, University of Toronto, Canada, pp. 255-261.
Tibell et al. 2001. Survival of microencapsulated allogeneic parathyroid tissue one year after transplantation in nonimmunosuppressed humans. Cell Transplant 10:591-599.
Tierney et al. 2000. The GlucoWatch® biographer: A frequent automatic and noninvasive glucose monitor. Ann Med 32:632-641.
Tierney et al. 2000. Effect of acetaminophen on the accuracy of glucose measurements obtained with the GlucoWatch biographer. Diabetes Technology & Therapeutics 2:199-207.
Trecroci D. 2002. A Glimpse into the Future—Continuous Monitoring of Glucose with a Microfiber. Diabetes Interview 42-43.
Tse and Gough. 1987. Time-Dependent Inactivation of immobilized Glucose Oxidase and Catalase. Biotechnology & Bioengineering 29:705-713.
Turner A.P.F, 1988. Amperometric biosensor based on mediator-modified electrodes. Methods in Enzymology 137:90-103.
Turner and Pickup 1985. Diabetes mellitus: biosensors for research and management. Biosensors 1:85-115.
Turner et al, 1984. Carbon Monoxide: Acceptor Qxidoreductase from Pseudomonas Thermocarboxydovorans Strain C2 and its use in a Carbon Monoxide Sensor. Analytica Chimica Acta 163:161-174.
Unger et al. 2004. Glucose control in the hospitalized patient. Emergency Med 36(9):12-18.
Updike et al. 1967. The enzyme electrode. Nature 214:986-988.
Updike et al. 1982. Implanting the glucose enzyme electrode: Problems progress and alternative solutions. Diabetes Care 5(3):207-212.
Updike et al. 1988. Laboratory Evaluation' of New Reusable Blood Glucose Sensor. Diabetes Care 11:801-807.
Updike et al. 1994. Enzymatic glucose sensor: improved long-term performance in vitro an din vivo. ASAIO J 40(2):157-163.
Updike et al. 1997. Principles of long-term fully implanted sensors with emphasis on radiotelemetric monitoring of blood glucose form inside a subcutaneous foreign body capsule (FBC), in Fraser (Ed.), Biosensors in the Body, John Wiley & Sons, New York, NY, pp. 117-137.
Updike et al. 2000. A subcutaneous glucose sensor with improved longevity dynamic raise and stability of calibration. Diabetes Care 23(2):208-214.
Utah Medical Products Inc, 2003. Blood Pressure Transducers product specifications, 2003-2006 (6 pages).
Vadgama 1981. Enzyme electrodes as practical biosensors. J Medical Engineering & Technology 5(8):293-298.
Vadgama 1988. Diffusion limited enzyme electrodes. N ATO ASI Series: Series C Math and Phy. Sci J 226:359-377 I j
Vadgama 1998. Diffusion Limited Enzyme Electrodes. Analytical Uses of immobilized Biological I Compounds for Detection. Medical and industrial Uses 359-377 by D. Reidel Publishing Company I.
Van den Berghe 2004. Tight blood glucose control with insulin in “real-life” intensive care. Mayo Chin Proc 79(8):977-978.
Velho et al. 1989. In vitro and in vivo stability of electrode potentials in needle-type glucose sensors, Influence of needle material. Diabetes 38:164-171.
Velho et al. 1989. Strategies for calibrating a subcutaneous glucose sensor. Biomed Biochim Acta 48(11-12):957-964.
von Woedtke et al. 1989. In situ calibration of implanted electrochemical glucose sensors. Biomed Biochim. Acta 48(11-12):943-952.
Wagner et al. 1998. Continuous amperometric monitoring of glucose in a brittle diabetic chimpanzee with a miniature subcutaneous electrode. PNAS USA 95:6379-6382.
Wang et al. 1994. Highly Selective Membrane-Free Mediator-Free Glucose Biosensor. Analytical Chemistry 66:3600-3603.
Wang et al. 1997. Improved ruggedness for membrane-based amperometric sensors using a pulsed amperometric method. Analytical Chemistry 69:4482-4489.
Ward et al. 2000. Understanding Spontaneous Output Fluctuations of an Amperometric Glucose Sensor: Effect of Inhalation Anesthesia and Use of a Nonenzyme Containing Electrode. ASAIO J 46:540-546.
Ward et al. 2000. Rise in background current over time in a subcutaneous glucose sensor in the rabbit: Relevance to calibration and accuracy. Biosensors & Bioelectronics 15:53-61.
Ward et al. 2002. A new amperometric glucose microsensor: In vitro and short-term In vivo evaluation, Biosensors& Bioelectronics 17:181-189.
Ward et al. 2004. A wire-based dual-analyte sensor for glucose and lactate: in vitro and in vivo evaluation, Diabetes Technology & Therapeutics 6(3)389-401.
Wientjes K. J. C, 2000. Development of a glucose sensor for diabetic patients (Ph.D. Thesis) j.
Wikipedia 2006. intravenous therapy, downloaded from http:—en.wikipedia.org-wikiIntravenous_therapy, downloaded Aug. 15, 2006.
Wiley Electrical and Electronics Engineering Dictionary 2004. Definitions of “contact” and of “pad”, pp. 141-142 and 548-549, respectively. John Wiley & Sons, Inc., Hoboken, NJ.
Wilkins et al. 1988. The coated wire electrode glucose sensor. Horm Metab Res Suppl,20:50-55.
Wilkins et al. 1995. Integrated implantable device for long-term glucose monitoring. Biosensors & Bioelectronics 10:485-494.
Wilkins et al. 1995. Glucose monitoring: state of the art and future possibilities. Med Eng Phys 18:273-288.
Wilson et al. 1992. Progress toward the development of an implantable sensor for glucose. Clinical Chemistry 38(9):1613-1617.
Wilson et al. 2000. Enzyme-based biosensors for in vivo measurements. Chem Rev 100:2693-2704.
Wood W. et al. Mar. 199. Hermetic Sealing with Epoxy. Mechanical Engineering 1-3.
Woodward 1982. How Fibroblasts and Giant Ceils Encapsulate Implants: Considerations in Design of Glucose Sensor. Diabetes Care 5:278-281.
Worsley et al. 2008. Measurement of glucose in blood with a phenylboronic add optical sensor. J Diabetes Science & Technology 2(2}:213-220.
Wu et al. 1999. In situ electrochemical oxygen generation with an immunoisoiation device. Annals New York Academy of Sciences pp. 105-125.
Yamasaki 1984. The development of a needle-type glucose sensor for wearable artificial endocrine pancreas. Medical J of Osaka University 35(1-2):25-34.
Yamasaki et al. 1989. Direct measurement of whole blood glucose by a needle-type sensor, Clinica Chimica Acta 93:93-98.
Yang et al 1996. A glucose biosensor based on an oxygen electrode: in-vitro performances in a model buffer j solution and in blood plasma. Biomedical Instrument Tech 30:55-61.
Yang et al. 1998. Development of needle-type glucose sensor with high selectivity. Science and Actuators B 46:249-256.
Yang et al. 2004. A Comparison of Physical Properties and Fuel Ceil Performance of Nation and Zirconium Phosphate-Nafion Composite Membranes. J Membrane Science 237:145-161.
Ye et al. 1993. High Current Density ‘Wired’ Quinoprotein Glucose Dehydrogenase Electrode. Analytical Chemistry 65:238-241.
Zamzow et al. 1990. Development and evaluation of a wearable blood glucose monitor. ASAIO J 36: M588-M591.
Zethelius et al. 2008. Use of multiple biomarkers to improve the prediction of death from cardiovascular causes. NEJM 358:2107-2116.
Zhang et al 1993. Electrochemical oxidation of H202 on Pt and Pt + Ir electrodes in physiologies! buffer and its applicability to H202-based biosensors. J Electroanalytical Chemistry345:253-271.
Zhang et al. 1993. In vitro and in vivo evaluation of oxygen effects on a glucose oxidase based implantable glucose sensor. Analytica Chimica Acta 281:513-520.
Zhang et al. 1994. Elimination of the acetaminophen interference in an implantable glucose sensor. Analytical Chemistry 66(7):1183-1188.
Zhu et al. 1994. Fabrication and characterization of glucose sensors based on a microarray H202 electrode. Biosensors & Bioelectronics 9: 295-300.
Zhu et al. 2002. Planar amperometric glucose sensor based on glucose oxidase immobilized by chitosan film on prussian blue layer. Sensors 2:127-136.
Davis et al. 1983. Bioelectrochemical fuel cell and sensor based on a quinoprotein alcohol dehydrogenase. Enzyme Microb Technol 5:383-388.
Deutsch et al. 1994. Time series analysis and control of blood glucose levels in diabetic patients. Computer Methods and Programs in Biomedicine 41:167-182.
Durliat et al. 1976. Spectrophotometric and electrochemical determinations of L(+)-lactate in blood by use of lactate dehydrogenase from yeast. Clinical Chemistry 22(11):1802-1805.
Edwards Lifesciences 2002. Accuracy for you and your patients. Marketing materials (4 pages).
El-Khatib et al. 2007. Adaptive closed-loop control provides blood-glucose regulation using dual subcutaneous insulin and glucagon infusion in diabetic swine. J Diabetes Science and Technology 1(2):181-192.
Fahy et al. 2008. An analysis: hyperglycemic intensive care patients need continuous glucose monitoring—easier said than done. J Diabetes Science and Technology 2(2):201-204.
Fischer et al. 1995. (Abstract) Hypoglyeaemia-warning by means of subcutaneous electrochemical glucose sensors: an animal study. Horm Metab Research 27:53.
Johnson 1991. Reproducible electrodeposition of biomolecules for the fabrication of miniature electroenzylnatic biosensors. Sensors and Actuators B 5:85-89.
Kacaniklic et al. 1994. Amperometric Biosensors for detection of L- and D-Amino Acides based on Coimmobilized Peroxidase and L- and D-Amino Acid Oxidases in Carbon Paste Electrodes. Electroanalysis 6:5-6):381-390.
Kang et al. 2003. In vitro and short-term in vivo characteristics of a Kei-F thin film modified glucose sensor. Anal Sci 19:1481-1486.
Kargol et al. 2001. Studies on the structural properties of porous membranes measurement of linear dimensions of solutes. Biophys Chem 91:263-271.
Kurtz et al. 2005. Recommendations for blood pressure measurement humans and experimental animals: Part 2: Blood pressure measurement in experimental animals a statement for professionals from the subcommittee of professional and public education of the American Heart Association Council on High Blood Pressure Research. Hypertension 45:299-310.
Ladd et al. 1996. Structure Determination by X-ray Crystallography 3rd ed. Plenum 1996 Ch, 1 pp. xxi-xxiv and 1-58.
Marena et al. 1993. The artificial endocrine pancreas in clinical practice and research. Panminerva Medica 35(2):67-74.
Matin et al, 1999. Noninvasive Prediction of Glucose by Near-Infrared Diffuse Reflectance Spectroscopy. Clinical Chemistry 45:9 1651-1658.
Matthews et al. 1988. An amperometric needle-type glucose sensor testing in rats and man. Diabetic Medicine 5:248-252.
Miller et al. 1989. In vitro stimulation of fibroblast activity by factors generated from human monocytes activated by biomedical polymers. J Biomed Matls Res 23:911-930.
Muslu 1991. Trickling filter performance. Applied Biochemistry and Biotechnology 37:211-224.
Nakayama et al. 1992. Surface fixation of hydrogels; heparin and glucose oxidase hydrogenated surfaces, ASAIO Journal 38:M421-M424.
Pickup et al. 1993. Developing glucose sensors for in vivo use. TIBTECH 11:285-291.
Reach 2001. Letters to the Editor Re: Diabetes Technology & Therapeutics 2:49-56 (2000); Diabetes Technology & Therapeutics 3(1):129-130.
San Diego Plastics Inc. 2009. Polyethylene Data Sheet http:--www.sdplastics.com-polyeth.html.
Sanders et al. 2003. Fibrous Encapsulation of Sinale Polymer Microfibers Depends on their Vertical Dimension in Subcutaneous Tissue Polymer Microfibers. J Biomed Matls Res 66A:1181-1187.
Service R. F. 2002. Can sensors make a home in the body? Science 297:962-963.
Tatsuma et al. 1991. Oxidase-peroxidase bilayer-modified electrodes as sensors tor lactate pyruvate cholesterol and uric acid. Analytics Chimica Acta 242:85-89.
Thome- Duret et al. 1996. Use of subcutaneous glucose sensor to detect decreases in glucose concentration prior to observation in blood. Analytical Chemistry 68:3822-3826.
Thome et al. 1995. Can the decrease in subcutaneous glucose concentration precede the decrease in blood glucose level? Proposition for a push-pull kinetics hypothesis. Horm. Metab. Res. 27:53 (1 page).
Torjman et al. 2008. Glucose monitoring in acute care; technologies on the horizon. J Diabetes Science & Technology 2(2):178-181.
Wade Jr. L.G. et al. (Eds.) 1987. Chapter 17, Reactions of Aromatic Compounds, pp. 762-763, in Organic Chemistry, Pearson Education, Inc., Upper Saddle River, NJ.
Wright et al. 1999. Bioelectrochemical dehalogenaticns via direct electrochemistry of polyethylene oxide)-modified myoglobin. Electrochemistry Communications 1:603-611.
Related Publications (1)
Number Date Country
20170020418 A1 Jan 2017 US
Continuations (7)
Number Date Country
Parent 14553382 Nov 2014 US
Child 15264577 US
Parent 13949088 Jul 2013 US
Child 14553382 US
Parent 13411414 Mar 2012 US
Child 13949088 US
Parent 12696003 Jan 2010 US
Child 13411414 US
Parent 11546157 Oct 2006 US
Child 12696003 US
Parent 11039269 Jan 2005 US
Child 11546157 US
Parent 09916858 Jul 2001 US
Child 11039269 US