Surgery – Instruments – Light application
Reexamination Certificate
1999-12-27
2001-06-12
Dvorak, Linda C. M. (Department: 3739)
Surgery
Instruments
Light application
C606S010000, C607S089000
Reexamination Certificate
active
06245060
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates to a method and apparatus for forming an opening in the skin for the purpose of providing access to biological fluids for determining the concentration of analytes in the biological fluids.
2. Discussion of the Art
The prevalence of diabetes has been increasing markedly in the world. At this time, diagnosed diabetics represented about 3% of the population of the United States. It is believed that the total actual number of diabetics in the United States is over 16,000,000. Diabetes can lead to numerous complications, such as, for example, retinopathy, nephropathy, and neuropathy.
The most important factor for reducing diabetes-associated complications is the maintenance of an appropriate level of glucose in the blood stream. The maintenance of the appropriate level of glucose in the blood stream may prevent and even reverse many of the effects of diabetes.
Glucose monitoring devices of the prior art have operated on the principle of taking blood from an individual by a variety of methods, such as by needle or lancet. An individual then coats a paper strip carrying chemistry with the blood, and finally insert the blood-coated strip into a blood glucose meter for measurement of glucose concentration by determination of change in reflectance.
There are numerous devices currently available for diabetics to monitor the level of blood glucose. The best of these devices require the diabetic to prick a finger and to collect a drop of blood for placement on a strip, which is inserted into a monitor that determines the level of glucose in the blood. Pricking one's finger tends to be painful. Moreover, a relatively large wound is produced by the pricking device, typically a lancet or a needle. It is known that the pain arising from the finger prick deters diabetics from compliance with the monitoring regimen. Lack of compliance increases the risk of complications due to diabetes. Thus there is a need for a more painless and less traumatic means of collecting biological samples for monitoring one's level of glucose in blood.
Several patents have proposed that the level of glucose in blood can be monitored by measuring the level of glucose in interstitial fluid. In order to obtain samples of interstitial fluid, the barrier function of the stratum corneum must be overcome. Jacques, U.S. Pat. No. 4,775,361, discloses a method of ablating the stratum corneum of a region of the skin of a patient by using pulsed laser light of a wavelength, pulse length, pulse energy, pulse number, and pulse repetition rate sufficient to ablate the stratum corneum without significantly damaging the underlying epidermis. This patent discloses the use of laser light having a wavelength of 193 nm or 2940 nm. Laser light having wavelengths of 193 nm or 2940 nm can be provided by an excimer or Er:YAG light source, respectively, both of which are extremely expensive.
Tankovich, U.S. Pat. No. 5,423,803, discloses a process for the removal of superficial epidermal skin cells in the human skin. A contaminant having a high absorption in at least one wavelength of light is topically applied to the surface of the skin. Some of the contaminant is forced to infiltrate into spaces between superficial epidermal cells. The skin section is illuminated with short laser pulses at the above wave-length, with at least at least one of the pulses having sufficient energy to cause some of the particles to explode tearing off the superficial epidermal cells. In a preferred embodiment, the contaminant includes 1 micron graphite particles and the laser used in a Nd:YAG laser.
Zahrov, WO 94/09713, discloses a method for perforating skin comprising the steps of (a) focusing a laser beam in the shape of an ellipse at the surface of the skin with sufficient energy density to create a hole at least as deep as the keratin layer and at most as deep as the capillary layer; and (b) creating at least one hole, each hole having a width between 0.05 and 0.5 mm and a length of equal to or less than 2.5 mm. This patent discloses a variety of lasers suitable for carrying out this method. However, the method disclosed in Zahrov is limited to light source having a wavelength of 2940 nm. As stated previously, laser light of this wavelength can be provided by a Er:YAG light source, which is very expensive. Moreover, such a light source is relatively large, with the result that it would not be practical for use in a hand-held device.
It would be desirable to provide a method for providing an opening in the surface of the skin wherein an inexpensive light source is utilized, wherein the light source is of a size small enough to be portable and holdable in the hand of the user.
SUMMARY OF THE INVENTION
In one aspect, this invention provides a method for increasing the permeability of the stratum corneum by means of a source of light, preferably a laser, more preferably a pulsed laser. By increasing the permeability of the stratum corneum, access to the interstitial fluid is achieved, thereby enabling measurement of analytes in the interstitial fluid. The method comprises the steps of:
(a) providing a source of light having a wavelength of from about 930 nm to about 1040 nm, preferably from about 950 nm to about 1010 nm, more preferably from about 970 nm to about 990 nm; and
(b) exposing a region of the stratum corneum of the patient to said source of light for a period of time sufficient to form an opening in the stratum corneum.
Preferably, exposure of the region of the stratum corneum to the source of light is ceased when an amount of interstitial fluid fills the opening in the stratum corneum, which amount is sufficient to cause the scatter intensity of the light reflected from the surface of the interstitial fluid occupying the opening in the stratum corneum to differ from the scatter intensity of the light reflected from a region of the stratum corneum that is substantially free of interstitial fluid.
The wavelength at which the source of light is set is most preferably about 980 nm. A source of light set at a wavelength of about 980 nm does not require the use of energy absorbing dyes, because a naturally occurring water band in the human body occurs at 980 nm. The source of light is preferably a laser, more preferably a pulsed laser.
In a preferred embodiment, an elliptical region of the stratum corneum is illuminated, the light source being a pulsed laser directed at the stratum corneum at an incident angle of from about 18° to about 32°, as measured from the surface of the stratum corneum to the source of light. The scatter intensity is observed by a broadband detector. As the stratum corneum is being removed, the opening in the skin in the region where the stratum corneum is removed will become filled with interstitial fluid, thereby changing the scatter intensity of reflected radiation. When the scatter intensity of light reflected from the surface of interstitial fluid occupying the opening formed in the stratum corneum measured after a given pulse of the laser (i. e., the nth pulse where n>2) differs from the scatter intensity of light reflected from the stratum corneum measured after the first pulse of the laser (i. e., n=1) by approximately 5% to 10% or greater, the laser is turned off to prevent damage to the tissue underlying the stratum corneum.
In another aspect, this invention provides an apparatus capable of carrying out the above-described method. The apparatus comprises:
(a) a source of light, preferably a pulsed laser, for providing energy to form an opening in the stratum corneum;
(b) a lens assembly for collimating and focusing light from the source of light onto the surface of the stratum corneum;
(c) a broadband detector for detecting a signal related to the intensity of light reflected from the surface of the stratum corneum and from interstitial fluid that fills the opening formed in the stratum corneum by the collimated, focused light from the source of light;
(d) an amplifier for increasing the signal detected by the broadband detec
Bojan Peter M.
Henning Timothy P.
Loomis Neil W.
Muetterties Andrew J.
Pope Mark R.
Abbott Laboratories
Dvorak Linda C. M.
Gibson Roy
Weinstein David L.
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