This disclosure relates to medical devices for tissue sample collection, and more particularly, to medical devices for tissue sample collection resulting in greater cellular or other tissue yield.
Certain medical tests require sampling of cells from target areas of a subject's body. For instance, a screening test for detecting potentially pre-cancerous and cancerous tissues in a subject's body may include taking samples of tissue or cells from a target area of the subject's body. A tissue collection device may be used to collect cells or other tissues from the target area. Different tissue collection devices may differ in the amount of cells or other tissues they are able to collect or in the amount of cells or other tissues that are able to be successfully harvested from the tissue collection device. Devices that have higher cell or other tissue collection rates or higher harvestability of collected cells or other tissues may be beneficial.
This disclosure relates to medical devices for tissue sample collection, and more particularly, to medical devices for tissue sample collection resulting in greater cellular or other tissue yield. In a first illustrative embodiment, a cell sample collection device may comprise an elongated shaft extending from a proximal end to a distal end and a tissue collection feature extending distal of the distal end of the elongated shaft. In some embodiments, at least a portion of the tissue collection feature may dissolve when placed in a fixation medium.
Additionally, or alternatively, in any of the embodiments above with respect to the first illustrative embodiment, the portion of the tissue collection feature that dissolves when placed in the fixation medium may comprise a resin.
Additionally, or alternatively, in any of the embodiments above with respect to the first illustrative embodiment, the portion of the tissue collection feature that dissolves when placed in the fixation medium may comprise a pre-polymer.
Additionally, or alternatively, in any of the embodiments above with respect to the first illustrative embodiment, the portion of the tissue collection feature that dissolves when placed in the cell fixation medium may comprise polycarbonate.
Additionally, or alternatively, in any of the embodiments above with respect to the first illustrative embodiment, the portion of the tissue collection feature that dissolves when placed in the fixation medium may comprise acrylonitrile butadiene styrene (ABS).
Additionally, or alternatively, in any of the embodiments above with respect to the first illustrative embodiment, the portion of the tissue collection feature that dissolves when placed in the fixation medium may dissolve in under one hour when placed a fixation medium comprising a 1:1 solution of methanol and acetone.
Additionally, or alternatively, in any of the embodiments above with respect to the first illustrative embodiment, the portion of the tissue collection feature that dissolves when placed in the fixation medium may dissolve in under one hour when placed in a fixation medium comprising 100% liquid acetone.
Additionally, or alternatively, in any of the embodiments above with respect to the first illustrative embodiment, the portion of the tissue collection feature that dissolves when placed in 100% liquid xylene.
Additionally, or alternatively, in any of the embodiments above with respect to the first illustrative embodiment, the tissue collection feature comprises a brush, the brush comprising a center post and bristles connected to the center post.
Additionally, or alternatively, in any of the embodiments above with respect to the first illustrative embodiment, the portion of the tissue collection feature that dissolves when placed in the fixation medium comprises the bristles.
Additionally, or alternatively, in any of the embodiments above with respect to the first illustrative embodiment, the center post comprises a flat post, and wherein the bristles comprise a micropattern formed on the edges of the center post.
In a second illustrative embodiment, a cytology brush may comprise an elongated shaft including a proximal portion and a distal portion and a plurality of bristles disposed on the distal portion. In some embodiments, the bristles may be soluble in a fixation medium.
Additionally, or alternatively, in any of the embodiments above with respect to the second illustrative embodiment, the fixation medium comprises one of: a 1:1 solution of methanol and acetone, 100% liquid acetone, 100% methanol, 100% ethanol, formalin, and/or gluteraldeyde.
Additionally, or alternatively, in any of the embodiments above with respect to the second illustrative embodiment, the bristles comprise a resin.
Additionally, or alternatively, in any of the embodiments above with respect to the second illustrative embodiment, the bristles comprise at least one of: polycarbonate, ABS, and a polycarbonate and ABS blend.
Additionally, or alternatively, in any of the embodiments above with respect to the second illustrative embodiment, the bristles may dissolve in under one hour when placed in the fixation medium.
Additionally, or alternatively, in any of the embodiments above with respect to the second illustrative embodiment, the elongated shaft may be soluble in the fixation medium.
Additionally, or alternatively, in any of the embodiments above with respect to the second illustrative embodiment, the proximal portion of the elongated shaft may comprise a round shaft and wherein the distal portion of the elongated shaft comprises a flat shaft.
Additionally, or alternatively, in any of the embodiments above with respect to the second illustrative embodiment, the elongated shaft may comprise a twisted wire.
In a third illustrative embodiment, a method of preparing a cytology sample for analysis may comprise dissolving at least a portion of a cell sample collection device containing cells in a fixation medium.
In a fourth illustrative embodiment, a method of preparing a DNA or RNA sample for analysis may comprise dissolving at least a portion of a cell sample collection device containing cells in a buffer such as chloroform, phenol or a combination.
In a fifth illustrative embodiment, a method of preparing a tissue sample for histological analysis may comprise embedding a tissue sample collection in a histological media and dissolving at least a portion of the tissue collection device with Xylene.
Additionally, or alternatively, in any of the embodiments above with respect to the fifth illustrative embodiment, the histological media comprises one of paraffin or plastic.
Additionally, or alternatively, in any of the embodiments above with respect to the fifth illustrative embodiment, the method may further comprise sectioning the histological media with a microtome.
In a sixth illustrative embodiment, a tissue sample collection device may comprise an elongated shaft having a longitudinal axis including a proximal portion and a distal portion. The device may further comprise at least one ribbon spiraling around the longitudinal axis. In some embodiments, the ribbon may comprise a plurality of cuts extending in an outer edge of the ribbon extending toward the longitudinal to form bristles.
Additionally, or alternatively, in any of the embodiments above with respect to the sixth illustrative embodiment, at least a portion of the tissue sample collection device is soluble in a fixation medium.
Additionally, or alternatively, in any of the embodiments above with respect to the sixth illustrative embodiment, the bristles of the tissue sample collection device are soluble in a fixation medium.
The above summary of the present disclosure is not intended to describe each embodiment or every implementation of the present disclosure. Advantages and attainments, together with a more complete understanding of the disclosure, will become apparent and appreciated by referring to the following detailed description and claims taken in conjunction with the accompanying drawings.
The disclosure may be more completely understood in consideration of the following detailed description of various embodiments in connection with the accompanying drawings, in which:
While the disclosure is amenable to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to limit aspects of the disclosure to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the scope of the disclosure.
For the following defined terms, these definitions shall be applied, unless a different definition is given in the claims or elsewhere in this specification.
All numeric values are herein assumed to be modified by the term “about”, whether or not explicitly indicated. The term “about” generally refers to a range of numbers that one of skill in the art would consider equivalent to the recited value (i.e., having the same function or result). In many instances, the term “about” may be indicative as including numbers that are rounded to the nearest significant figure.
The recitation of numerical ranges by endpoints includes all numbers within that range (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).
Although some suitable dimensions, ranges and/or values pertaining to various components, features and/or specifications are disclosed, one of skill in the art, incited by the present disclosure, would understand desired dimensions, ranges and/or values may deviate from those expressly disclosed.
As used in this specification and the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term “or” is generally employed in its sense including “and/or” unless the content clearly dictates otherwise.
The following detailed description should be read with reference to the drawings in which similar elements in different drawings are numbered the same. The detailed description and the drawings, which are not necessarily to scale, depict illustrative embodiments and are not intended to limit the scope of the disclosure. The illustrative embodiments depicted are intended to be only exemplary. Selected features of any illustrative embodiments may be incorporated into any other described embodiments unless clearly stated to the contrary.
In other cases, however, tissue collection device 10 may be used to collect cells or other tissues from locations within the esophagus, the gastro-intestinal tract, the vascular system, the cervix, or other locations within a patient's body. These collected cells or other tissues may then be used in one or more analyses. For instance, the cells or other tissues may be used in a histological analysis, flow cytometry analysis, immunohistochemstry analysis, molecular phenotyping analysis, nucleic acid detection, mRNA detection, or other types of analyses. These are just a few examples of how the collected cells or tissues may be used. In at least some of these embodiments, in order for the cells or tissues to be prepared for analysis, the cells or other tissues are placed in a fixation medium. The fixation medium may generally be configured to preserve the cells or other tissues from decay.
In general, tissue collection feature 14, or at least a portion of tissue collection feature 14, may be configured to be dissolvable within one or more commonly used fixation mediums or during one or more commonly used tissue processing techniques. For instance, tissue collection feature 14, or a portion of tissue collection feature 14, may be fully dissolvable within twenty minutes without agitation when placed in a 1:1 solution of methanol and acetone. However, in other embodiments, the ratio may range from between about 0.25:1 to about 1:0.25. In further embodiments, tissue collection feature 14, or a portion of tissue collection feature 14, may be additionally or alternatively fully dissolvable within twenty minutes when placed in 100% liquid acetone or when washed with 100% liquid xylene. In still further embodiments, tissue collection feature 14, or a portion of tissue collection feature 14, may be additionally or alternatively fully dissolvable within twenty minutes when placed in chloroform, phenol, triazol, or a mixture of chloroform, phenol, and/or triazol.
Some example materials that tissue collection feature 14 may be formed from include various pre-polymers and/or resins. Resins are generally solid or highly viscous substances, usually containing pre-polymers with reactive groups. Some more specific example materials include polycarbonate, acrylonitrile butadiene styrene (ABS), and blends of polycarbonate and ABS. Further specific example materials include Cycology™ Resin: HC1204HF, which is a blend of polycarbonate and ABS, Lexan™ Resin HP4, which is a medium flow polycarbonate, and Cycolac™ Resin HMG47MD, which is an ABS material. In other embodiments, tissue collection feature 14 may be formed from one or more polymers that have the desired dissolvability characteristics. Additionally, tissue collection feature 14 may be formed from any combination of these materials. It should be understood, however, that these are just a few example materials. Other materials which may dissolve in commonly used fixation mediums are also contemplated by this disclosure.
In further embodiments, the dissolvability of tissue collection feature 14 may differ. For instance, tissue collection feature 14 may be comprised of a material or materials that such that tissue collection feature 14, or at least a portion of tissue collection feature 14, dissolves in one or more common fixation mediums without agitation in under five hours, in under four hours, in under three hours, in under two hours, in under one hour, in under fifty minutes, in under forty minutes, in under thirty minutes, in under ten minutes, or any other suitable period of time.
The dissolvability of tissue collection feature 14 may increase the yield of the cellular material or other tissue collected on tissue collection feature 14 after sampling a target site within the patient. For instance, instead of attempting to separate the collected cells or other tissues from tissue collection feature 14, tissue collection feature 14 may be dissolved within the fixation medium, assuring a greater transfer of the collected cells or other tissues from tissue collection feature 14 to the fixation medium.
In some embodiments, tissue collection device 10 and/or tissue collection feature 14 may include one or more features that allow tissue collection device 10 and/or tissue collection device 10 to be viewable under one or more imaging modalities. For instance, in some embodiments, tissue collection device 10 and/or tissue collection feature 14 may be formed from a material having echogenic properties or may be formed to have structures that give tissue collection device 10 and/or tissue collection feature 14 echogenic properties. These echogenic properties may allow tissue collection device 10 and/or tissue collection feature 14 to be viewable under ultrasound. Additionally, or alternatively, tissue collection device 10 and/or tissue collection feature 14 may formed from radiopaque materials. For instance, radiopaque markers may be embedded along various portions of tissue collection device 10 and/or tissue collection feature 14. Alternatively, radiopaque materials may be mixed with the other materials used to form tissue collection device 10 and/or tissue collection feature 14 in order to allow tissue collection device 10 and/or tissue collection feature 14 to be viewed under fluoroscopy.
In different embodiments, tissue collection feature 14 may comprise different types of features. For instance, in some embodiments, tissue collection feature 14 may comprise bristles. However, in other embodiments, tissue collection feature 14 may be a flat, twisted ribbon with a micro-pattern formed on the edges of the ribbon. These and other embodiments will be described below with respect to other figures.
Shaft 12 of tissue collection device 10 may be connected to tissue collection feature 14. Alternatively, shaft 12 and tissue collection feature 14 may be formed as one, unitary component. In either embodiment, shaft 12 may be made from a variety of materials. For instance, shaft 12 may act as a pushwire for tissue collection feature 14, allowing tissue collection feature 14 to be advanced and retracted by advancing and retracting shaft 12. Accordingly, shaft 12 may be sufficiently rigid to transfer forces applied to shaft 12 at a point away from tissue collection feature 14 to tissue collection feature 14. However, where tissue collection device 10 needs to be maneuvered through one or more tortuous passageways of a patient to arrive at the target sampling site, shaft 12 may also need to be flexible enough to navigate those tortuous passageways.
In some embodiments, shaft 12 may be made from a metal or alloy. For instance, shaft 12 may be made from stainless steel, such as various varieties of stainless steel numbers 304, 316, 420, and 440, or other appropriate stainless steel varieties. Alternatively, shaft 12 may be formed of a super-elastic material such as the alloys of nickel and titanium, commonly known as Nitinol. While Nitinol is the most common super-elastic material, any of a variety of other super-elastic materials may be used for elongate member 11. Other alloys by chemical name include: CuAlNi, CuSn, CuZn, InTi, NiAl, FePt, MnCu, and FeMnSi. In addition to super-elastic materials, linear-elastic materials may be used. In general, linear-elastic materials are composed of the same alloys above. However, different material processing strategies are used to provide properties which has many of the important characteristics of a super-elastic material without some of the difficulties related to machining, specifically grinding. As one example, shaft 12 may preferably be formed of a linear-elastic alloy of nickel-titanium.
In still further embodiments, shaft 12 may be formed from any of the materials discussed above with respect to tissue collection feature 14. For instance, shaft 12 may be formed from the same material as tissue collection feature 14. Although, in other embodiments, shaft 12 may be formed from one of materials listed above for tissue collection feature 14, but tissue collection feature 14 may be formed from a different one of the listed materials. In these embodiments, shaft 12 may have similar dissolvability properties as tissue collection feature 14.
In still other embodiments, shaft 12 may comprise a proximal portion and a distal portion formed from different materials. For instance, in some embodiments, the proximal portion of shaft 12 may be made from a metal, such as any of the ones listed above. The distal portion of shaft 12 may be formed from one or more of the materials listed above with respect to tissue collection feature 14 and may be attached to the proximal portion of shaft 12. In these embodiments, tissue collection feature 14 may comprise features connected to, or formed on, the distal portion of shaft 12. In other embodiments, shaft 12 may be formed from a single material, and tissue collection feature 14 may comprise a center shaft and one or more features connected to, or formed on, the center shaft. The center shaft of tissue collection feature 14 may then be connected to the distal end of shaft 12. These different embodiments will be described in more detail below with respect to other figures.
In some embodiments, tissue collection device 10 may be used as a stand-alone device. For instance, tissue collection device 10 may be maneuvered, using shaft 12, into a passageway of a patient proximate a site of interest. Tissue collection feature 14 may then collect sample cells or other tissues from the site of interest, and tissue collection device 10 may be withdrawn from the patient.
However, in other embodiments, tissue collection device 10 may be used with a catheter or endoscope, as represented by device 20 in
As shown in
In some cases, manifold 24 may be connected to proximal end 28 of elongate shaft 22. The manifold may include hub 27 and/or other structures to facilitate connection to other medical devices (e.g., syringe, stopcocks, Y-adapter, etc.) and to provide access to one or more lumens defined within elongate shaft 22. In some cases, hub 27 may include ports 6, 7, and 8, which provide individual access to one or more lumens extending through at least a portion of device 20. Some example lumens that may extend through device 20 may include at least one guidewire lumen, where device 20 is an over-the-wire device, and a working channel sized to cooperate with tissue collection device 10. The lumens that do extend through device 20 may terminate at or near distal portion 30 of elongate shaft 22. However, in other cases, hub 27 may have a single port, two ports, or any other number of ports. Manifold 24 may also include a strain relief portion adjacent proximal end 28 of elongate shaft 22.
Where device 20 is a catheter or other flexible medical device configured to navigate tortuous body vessels, device 20, or at least elongate shaft 22, may be made from a polymer (some examples of which are disclosed below), a metal-polymer composite, and the like, or other suitable material. Some examples of suitable polymers may include polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM, for example, DELRIN® available from DuPont), polyether block ester, polyurethane (for example, Polyurethane 85A), polypropylene (PP), polyvinylchloride (PVC), polyether-ester (for example, ARNITEL® available from DSM Engineering Plastics), ether or ester based copolymers (for example, butylene/poly(alkylene ether) phthalate and/or other polyester elastomers such as HYTREL® available from DuPont), polyamide (for example, DURETHAN® available from Bayer or CRISTAMID® available from Elf Atochem), elastomeric polyamides, block polyamide/ethers, polyether block amide (PEBA, for example available under the trade name PEBAX®), ethylene vinyl acetate copolymers (EVA), silicones, polyethylene (PE), Marlex high-density polyethylene, Marlex low-density polyethylene, linear low density polyethylene (for example REXELL®), polyester, polybutylene terephthalate (PBT), polyethylene terephthalate (PET), polytrimethylene terephthalate, polyethylene naphthalate (PEN), polyetheretherketone (PEEK), polyimide (PI), polyetherimide (PEI), polyphenylene sulfide (PPS), polyphenylene oxide (PPO), poly paraphenylene terephthalamide (for example, KEVLAR®), polysulfone, nylon, nylon-12 (such as GRILAMID® available from EMS American Grilon), perfluoro(propyl vinyl ether) (PFA), ethylene vinyl alcohol, polyolefin, polystyrene, epoxy, polyvinylidene chloride (PVdC), poly(styrene-b-isobutylene-b-styrene) (for example, SIBS and/or SIBS 50A), polycarbonates, ionomers, biocompatible polymers, other suitable materials, or mixtures, combinations, copolymers thereof, polymer/metal composites, and the like.
Where device 20 is a device such as an endoscope or hysteroscope, device 20 may be made from a suitable metal. For example, device 20, or at least shaft 22 of device 20, may be made from a suitable medical grade stainless steel.
Accordingly, where tissue collection device 10 is configured to cooperate with device 20, tissue collection device 10 may be sized to fit within a lumen of device 20. For instance, shaft 12 and tissue collection feature 14 may have diameters smaller than a lumen or channel of device 20 to allow insertion of tissue collection device 10 into the lumen or channel. As described, device 20 may have a variety of different sizes depending on the location of the target sampling site. Accordingly, tissue collection device 10 may also have a variety of sizes depending on the location of the target sampling site.
In some embodiments, shaft 102 may terminate in atraumatic tip 106. Generally, atraumatic tip 106 may be configured to not catch on tissue as tissue collection device 100 is advanced inside a patient. Further embodiments of atraumatic tips that may be used with tissue collection device 100 are described with respect to
In the example of
Bristles 101 may be attached to shaft 102 in any suitable manner. For instance, bristles 101 may connected to shaft 102 using a suitable adhesive material. Alternatively, bristles 101 may be positioned between the two or more elongate components of shaft 102 before they are twisted or braided together. With bristles 101 disposed therebetween, the twisting or braiding of the elongate components of shaft 102 then secures bristles 101 between the elongate members of shaft 102. However, it should be understood that these are only a few examples of how bristles 101 may be attached or secured to shaft 102.
In some embodiments, tissue collection feature 124 may include cut-outs 121 which may provide an increase in the collection of cells or other tissues by tissue collection feature 124. For instance, cut-outs 121 may provide additional locations for cells or other tissue to collect as tissue collection feature 124 is maneuvered at a target sampling site.
Tissue collection device 120 device may include a rounded distal end 123. Rounded distal end 123 may provide an atraumatic end to tissue collection device 120 in order to not damage tissue as tissue collection feature 124 is maneuvered at a target sampling site. Other example atraumatic tips that other embodiments of tissue collection device 120 may include are depicted in
In some embodiments, tissue collection feature 140 may comprise tissue collection structures 146 disposed on the edges of ribbons 141, 143. In some embodiments, tissue collection structures 146 may be small cut-outs similar to cut-outs 121 of
In still other embodiments, tissue collection structures 146 may be micropatterns formed on the edges of ribbons 141, 143. The micropatterns may include a plurality of microstructures, for instance protrusions, extending radially outward from the outer edges of ribbons 141, 143. The microstructures may be cylindrical in some embodiments, with a circular cross-sectional shape. However, it should be understood that the microstructures may have any other suitable shape. For example, the microstructures may have a rectangular, oval, elliptical, oblong, spherical, triangular, hexagonal, or irregular cross-sectional shape.
The microstructures may further be spaced from each other to define a gap or space between adjacent microstructures. Cells or other tissues, or portions thereof, may enter these gaps between the microstructures and may be held therein by engagement with the microstructures on each side of the gaps. In some embodiments, the gaps between the microstructures may have a length in the range of 10-20 micrometers, and the microstructures may have a width of between 10 and 20 micrometers. The dimensions of the gap between the microstructures and the microstructures themselves may vary, however, based on the type of target cells or other tissues to capture. Of course, it should be understood that these are only a few examples of micropatterns that may be formed on ribbons 141, 143.
Proximal end 142 of tissue collection feature 140 may be attached to a shaft, such as shaft 12 of
In some embodiments, tissue collection feature 164 may further include tissue collection structures 166. Tissue collection structures 166 may be similar to any of the tissue collection structures described with respect to tissue collection structures 146 of
Additionally, in some embodiments of
Tissue collection device 160 may include an atraumatic tip connected to distal end 168. Example atraumatic tips that may be used with tissue collection device 160 are described with respect to
In some embodiments, frangible portion 176 may comprise an area of reduced cross-section, as shown in different embodiments in
In some embodiments, where shaft 172 is an extruded body, frangible portion 176 may be formed during the extrusion process by drawing down the diameter of the extruded material. Alternatively, frangible portion 176 may be formed after formation of shaft 172 by removing material in the area of frangible portion 176, such as by cutting, burning, or melting material off of shaft 172. In still other embodiments, frangible portion 176 may not represent an area of reduced cross-section or smaller outer diameter. Rather, frangible portion 176 may be a weakened area relative to the rest of shaft 172. For instance, frangible portion 176 may be formed of a different, weaker material or may be mechanically weakened after formation of shaft 172.
Tissue collection device may include shaft 304, tissue collection feature 306, and atraumatic tip feature 308. In the example of
In some embodiments, tissue collection device may be used in conjunction with sheath 302. Sheath 302 may be a part of a medical device, such as any described with respect to device 20 of
Once tissue collection device 300 has been positioned proximate the target sampling site, such as constriction 303, tissue collection device 300 may be advanced and retracted proximate the target sampling site to collect cells or other tissues, as at 254.
A portion of tissue collection device 300 containing tissue collection feature 306 may then be placed within the fixation medium to dissolve at least a portion of the tissue collection device, as at 258. In the example of
Steps 352-356 may be the same as steps 252-256 of
Next, the block may be sectioned into thin slices, as at 360.
Finally, one or more of sections 410a, 410b, and 410c may be placed in a liquid medium to dissolve sections 410a, 410b, and 410c, including any cells or other tissues embedded within sections 410a, 410b, and 410c, as at 362.
In some variations on method 350, instead of dissolving sections 410a, 410b, and 410c in a container, sections 410a, 410b, and 410c may be placed onto one or more slides. A fixation medium/solvent may then be applied to sections 410a, 410b, and 410c on the slides to dissolve the material of block of sections 410a-c and the portions of tissue collection device 400 embedded within sections 410a-c. Alternatively, the slides may be placed into the fixation medium/solvent instead of the fixation medium/solvent being applied to the slides. This process may leave the cells or other tissues on the slide and/or may fix the cells or other tissues.
In at least some embodiments, the method of
After the steps of either method 250 or method 350, the prepared cells or other tissues (e.g. dissolved in a fixation medium/solvent or disposed on slides) may be ready for analysis.
Those skilled in the art will recognize that the present disclosure may be manifested in a variety of forms other than the specific embodiments described and contemplated herein. Specifically, the various features described with respect to the various embodiments and figures should not be construed to be applicable to only those embodiments and/or figures. Rather, each described feature may be combined with any other feature in various contemplated embodiments, either with or without any of the other features described in conjunction with those features. Accordingly, departure in form and detail may be made without departing from the scope of the present disclosure as described in the appended claims.
This application claims priority under 35 U.S.C. §119 to U.S. Provisional Application Ser. No. 62/244,578, filed Oct. 21, 2015, the entirety of which is incorporated herein by reference.
Number | Date | Country | |
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62244578 | Oct 2015 | US |