WO1995031929A1 - Instrument for the diagnosis of cervical changes - Google Patents
Instrument for the diagnosis of cervical changes Download PDFInfo
- Publication number
- WO1995031929A1 WO1995031929A1 PCT/US1995/006050 US9506050W WO9531929A1 WO 1995031929 A1 WO1995031929 A1 WO 1995031929A1 US 9506050 W US9506050 W US 9506050W WO 9531929 A1 WO9531929 A1 WO 9531929A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- cervical
- fluorescence
- cervix
- effacement
- dilation
- Prior art date
Links
- 0 *C(CCCC1)C1=C Chemical compound *C(CCCC1)C1=C 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
- A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0071—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by measuring fluorescence emission
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0075—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/43—Detecting, measuring or recording for evaluating the reproductive systems
- A61B5/4306—Detecting, measuring or recording for evaluating the reproductive systems for evaluating the female reproductive systems, e.g. gynaecological evaluations
- A61B5/4318—Evaluation of the lower reproductive system
- A61B5/4331—Evaluation of the lower reproductive system of the cervix
Definitions
- This invention relates to a non-invasive method for detecting changes in cervical connective tissue using light-induced native fluorescence spectroscopy. More exactly, this invention relates to a procedure useful for determining changes in cervical tissues by recording connective tissue intrinsic fluorescence signals from the cervix of females using light-induced native fluorescence spectroscopy. The extent and progress of such changes relate to maternal readiness for fetal delivery and may be used to diagnose slow progress of labor or other complications.
- the cervix is composed almost entirely of connective tissue comprising collagen and macromolecular components which make up the extracellular matrix of this tissue.
- connective tissue comprising collagen and macromolecular components which make up the extracellular matrix of this tissue.
- Many biochemical studies show that there are changes in cervical connective tissue during cervical ripening and dilation during labor. Collagen degradation resulting from increased collagenase activity may be a major element in cervical changes associated with labor.
- Fluorescence spectroscopy is a widely utilized research tool in the biosciences (Udenfriend, 1962) , primarily because of the amount of information that it can reveal in terms of molecular physical states (Cantor and Schimmel, 1980) . Fluorescent spectra offer important details on the structure and dynamics of macromolecules and their location at microscopic levels (Lakowicz, 1986) .
- Native fluorescence from intrinsic fluorophors in tissues and cells provides a basis for diagnostic techniques relating to certain diseases (Glassman, 1993) .
- the intrinsic fluorophors functioning as part of the unique but complicated biological system, change along with the status of cells and tissues.
- tissue fluorescence can provide the medical and veterinary medical fields with a minimally invasive yet highly accurate diagnostic technique.
- This fluorescence technique has been found to be useful for distinguishing some of the physiological states of abnormal tissues as compared to the corresponding normal tissues (Alfano and Yao, 1981; Alfano et al . , 1984; Alfano et al . , 1984; Alfano et al . , 1987; Alfano et al . , 1991) .
- the present invention provides, for the first time, the ability to accurately and quantitatively determine the status of cervical dilation during pregnancy, and particularly during the last stages of pregnancy and during labor. Differences in the intrinsic fluorescence spectra from the irradiated cervix are observed and compared at various time points during pregnancy and during labor, giving the physician, veterinarian or research scientist instant knowledge of the status of the cervix and cervical opening of an animal or human subject. This knowledge is important for determination of proper treatments.
- the present invention offers a great improvement over manual palpation and subjective estimation of cervical status as currently practiced. Use of the method described herein will enable safer and more accurate diagnoses concerning the preparation or lack thereof of a prenatal human or animal patient for delivery and recovery.
- the present invention relates to a method and instrumentation for detecting the physiological and biochemical changes in cervical connective tissues associated with various stages of pregnancy, labor, delivery and recovery.
- This method uses an optical system comprising laser or other light induced native fluorescence spectroscopies (LIF) from the cervix for monitoring these changes.
- LIF light induced native fluorescence spectroscopies
- the method is non-invasive and instant. It operates by shining excitation light of a selected wavelength on the cervix and measuring fluorescent emissions . The measurement is completed in seconds and a decrease in fluorescence or other relative changes in the fluorescence spectral profiles indicates dilation progress.
- This method fulfills an immediate clinical need for determining the status of cervical dilatation during labor.
- the present invention involves a method for measuring relative cervical dilation to follow the state of labor and anatomical readiness for fetal delivery.
- the method can be used to monitor effacement, the obliteration of the cervix in labor when it is so changed that only the thin external os remains.
- This method comprises irradiating cervical tissue with excitation light in an amount and at a wavelength sufficient to excite intrinsic fluorophors in cervical connective tissue to fluoresce.
- the measurement of the fluorescent emissions from the irradiated cervical tissue is utilized to monitor changes in the state of cervical dilation, with a decrease in fluorescence indicating an increase in cervical dilation.
- the excitation light is preferably ultraviolet, more preferably from 300 to 380 nm, and even more preferably between 315 and 350 nm.
- ultraviolet is meant light of wavelengths just shorter than visible light.
- Fluorescent emissions measured are from 340 to 700 nm, more preferably from 340 to 500 nm, and may vary according to the excitation wavelength.
- An instrument for measuring cervical tissue fluorescence from the surface is described.
- Such an instrument comprises an excitation means capable of producing light in the wavelength range from 300 to 380 nm.
- Such means includes a lamp or laser, as well as appropriate gratings, prism, lenses and/or filters.
- Any light source with grating, prism with selection slit and/or optical filters and lens that will produce a narrow band or even a monochromatic excitation light spectrum between about 300 nm to about 380 nm is suitable for the present invention.
- a preferred embodiment comprises a Xenon lamp and a narrow band 340 nm filter associated with a lens, however other light sources and means that produce the preferred excitation light would also be acceptable.
- Other exemplary light sources might include, but are not limited to mercury lamps, selected monochromatic laser lights, for example, argon-ion lasers, pulsed nitrogen lasers, pulsed Ti:sapphire lasers and the like. It is also understood that any other light source yielding adequate amounts of the necessary wavelengths of light, either directly or after appropriate filtering, or through grating or prism or other optical systems, to excite connective tissue compositions to fluoresce may be used.
- Fluorescent light from the irradiated tissue is collected via a second optical fiber, or optical fiber bundle, that transmits fluorescent light through the appropriate lenses and filters, or grating or prism system, to a means for measurement and/or spectral analysis.
- the means for measurement includes various optical sensing systems well known to those of skill in the art, such as optical multichannel analysis, charge- coupled devices or photomultiplier tubes, for example.
- Spectral analysis is accomplished by comparing the measured fluorescence intensities, fluorescence spectral profile changes, and/or the changes in the ratios of the fluorescence intensities at different wavelengths.
- the instrument of the present invention may further comprise a small optical catheter suitable for use in a human patient.
- a catheter comprises a means for holding optical fiber bundles such that the tips of said bundles may be placed near the cervix, by for example, insertion of the catheter into the vagina.
- the catheter may further comprise an endoscope to aid the practitioner in locating the catheter near the cervix.
- FIG. 1 Fluorescence spectrum of collagen when excitation wavelength is 351 nm.
- FIG. 2 A schematic of instrumentation for measuring the cervix fluorescence spectra.
- FIG. 3 An exemplary excitation light spectrum.
- FIG. 4 Average spectrum and the 95% confidence interval from the middle band of cervix of the rats on 19 days of pregnancy.
- FIG. 5 Average spectrum and the 95% confidence interval from the middle band of cervix of the rats on 22 days of pregnancy but non-delivery.
- FIG. 6. Average spectrum and the 95% confidence interval from the middle band of cervix of the rats on 22 days of pregnancy and in delivery.
- FIG. 7. Average spectrum and the 95% confidence interval from the middle band of cervix of the rats on normal 17 days of pregnancy.
- FIG. 8 Average spectrum and the 95% confidence interval from the middle band of cervix of the rats on 17 days of pregnancy with RU 38.486 treatment.
- FIG. 9 Total fluorescence counts between wavelength range 370 nm to 500 nm versus different stages of gestation. Error bars indicate the Mean+SEM.
- FIG. 10 Fluorescence spectrum of elastin when excitation wavelength is 351 nm.
- FIG. 11 Fluorescence spectrum of free NADH.
- FIG. 12 Schematic diagram of the catheter for use in human patients in a side view and top view.
- FIG. 13 Schematic diagram of the catheter in place in the vagina of a subject.
- the present invention concerns an instrument and procedure for measuring cervical changes to objectively evaluate the state of the cervix before during or even after labor. Such objective evaluation has not been possible before the present invention.
- Optical methods using fluorescence spectroscopy and optical fiber technology may be used to evaluate connective tissues changes in the reproductive system. The method is based on changes in fluorescence spectra of the cervix due to cervical tissue alterations during dilation in labor.
- the cervix contains connective tissue comprising collagen and macromolecular components that make up the extracellular tissue matrix (Fosang et al ) and there are biochemical changes in cervical connective tissue during cervical ripening and dilation during labor (Fosang et al . ; Granstrom et al . , 1989).
- Collagen degradation from increased collagenase activity associated with labor may be a major element in cervical changes (Osmers et al . , 1990; Kokenyesi and Woessner, 1991) .
- Collagen presents a characteristic fluorescence spectrum as shown in FIG. 1 (Glassman, 1993) .
- the fluorophors in the collagen are identified as pyridinoline, a 3-hydroxypyridinium ring derived from three residues of hydroxylysine. Pyridinoline plays a role in crosslinking the collagen fibers (Eyre et al . , 1984).
- Connective tissue changes of the reproductive system in pregnancy and during labor may be monitored by measuring native fluorescence spectra.
- the native fluorescence spectra from the cervix of pregnant rats demonstrate such monitoring.
- the fluorescence spectra from the cervix of pregnant rats in the process of labor were measured. Differences were found between fluorescence spectra from pregnant rats and from pregnant rats in labor. Cervical dilation is accompanied by a decrease in fluorescence around certain wavelengths. Therefore, cervical dilation may be monitored by a comparison of intrinsic fluorescence from the cervical tissue over the course of time, with a decrease in fluorescence indicating cervical dilation.
- a preferred method of quantifying these differences is by comparing the fluorescence peak intensity at about 390 nm either by its absolute fluorescence intensity and/or by its relative fluorescence intensities compared to the intensities at other wavelengths or from other objects. These differences may be observed when exciting tissue with a light source (laser or lamp) . Detection and measurement of fluorescence is preferably accomplished with filters, a monochromator, an OMA or CCD camera, or photomultiplier tubes and a computer system with display and print or platter. This method preferably uses optical fibers to deliver the excitation light and to collect fluorescence signals.
- the excitation light source can be in the wavelength range of 315 nm to 380 nm, produced by a lamp with selective filters or selective means with grating or prism, or lasers which have output wavelength in this range.
- a preferred lamp is a Xenon lamp.
- Fluorescence intensity is preferably measured from 320 nm to 700 nm, which can be varied according to the excitation light.
- the fluorescence wavelength is always greater than the excitation wavelength.
- the equipment 10 used in the fluorescence spectral measurement of rat cervix is schematically shown in FIG. 2.
- the excitation light source 12 is a xenon lamp (Type No. L2274, with power supply (150W-GS) Model C2499-01, HAMAMATSU PHOTONICS) .
- Light passes through an ACS lens 14 (Newport Corporation) placed in front of the light house with a ground glass window to collect the light.
- the excitation wavelength is selected with a narrow band optical filter 16 with center wavelength at 340 nm (Model No. 53390, Orial Corp., P.O. Box 872, Stratford, CT
- the ground glass window and the 340 nm narrow band filter shaped the excitation light spectrum as a narrow peak centered at 348 nm with band width of 5 nm (as shown in FIG. 3) .
- the light power at this point is about 12 ⁇ W.
- the fluorescence emission light is collected by the tips 27 of a second optical fiber 28 (Ensign-Bickford Optics Company, 150 Fisher Drive, Avon, Connecticut 06001) .
- the other end 30 of collecting fiber 28 is located at the focus point of a BK7 glass lens 32.
- the collected signals are transmitted through a long path color glass filter 34 (0-51, ESCO products Inc.) with cut off wavelength at 360 nm (1% transition at this wavelength) , focused by an achromatic lens (PAC 052, Newport, Co) 36, off a mirror 38 into a grating monochromator 40 (1200G/mm, Instruments SA, Inc., 173 Essex Avenue, Metuchen, New Jersey 08840) .
- the spectra are then recorded by an optical multichannel analyzer 42 (OMA) (Model 1460, EG & E Princeton Applied Research, 6 DeAngelo Drive, Bedford, Massachusetts 01730) .
- OMA optical multichannel analyzer
- the time required for taking a complete spectrum is less than 10 seconds. This time may be greatly reduced by the use of a more sensitive recording system such as CCD camera 44.
- a charge-coupled device (CCD) camera would also make it possible to monitor the signal changes on a real time basis.
- the spectra measuring time can be decreased if the excitation light power increases. However, for in vivo applications, it is better to use low light power and more sensitive detection devices.
- excitation light fiber 52 tip 55 and the emission light fiber 53 tip 55 were placed at 15 degree angles. The tips were kept the same distance of 1 mm away from the measuring site of the tissue.
- a catheter design is also disclosed (FIG. 12) that is suitable for applications in human patients.
- Rats were anesthetized with IP injection of Ketamine HCI/Xylazine (15 mg/2mg) . Dissection was performed to open abdomens of the rats in order to allow optical fiber tips to reach the cervix. The measurements were performed in vivo on various locations of the middle band of the cervix.
- Rats were separated into 9 groups as shown in Table 1 (which indicates the number of rats and total points of measurement) .
- the groups were first divided according to the days of pregnancy: 15 days (dl5) , 17 days (dl7) , 19 days (dl9) , 20 days (d20) and 21 days (d21) .
- dl7RU There is a second group (dl7RU) of rats at 17 days of pregnancy. These rats were treated with IP injection of vehicle (castor oil & benzoyl benzoate) plus RU 38.486
- RU 38.486 is a progesterone receptor antagonist that is used as an abortifacient and contraceptive.
- RU 486 is the popular name for mifepristone and RU 38.486 is the popular name for mifegyne, 11?- [4- (N, N-dimethylamino)phenyl] -17 ⁇ ;-
- RU 38.486 (prop-1-ynyl) - ⁇ 4 ' 9 -estradiene-17/3-ol-3-one.
- Administration of RU 38.486 induces cervical softening and preterm delivery. This effect of the drug would also result in cervical changes similar to those seen in normal labor and delivery. Therefore, RU 38.486 is a positive control for the methods disclosed herein.
- the results show the clear changes of the native cervical fluorescence during various stages of gestation with high statistical significance.
- the amount of fluorescence decreases when the pregnancy is close to term, and reaches its lowest point when pups are engaged and in delivery.
- RU 38.486 treatment on day 16 of gestation also caused the native fluorescence to decrease.
- the decrease in fluorescence in the RU38.486 treated rats did not reach the levels of decrease in delivering rats, this is simply because the treated rats were not monitored through delivery. Had the treated rats been monitored through delivery, it is understood that the fluorescence would have reached the lower levels observed in untreated delivering rats.
- Table 2 A priori Comparisons Results between Groups (LSD Method) .
- collagen fluorescence has a relatively sharp fluorescence peak at 390 nm when the excitation wavelength is close to 350 nm.
- Free NADH has a fluorescence band with a peak at 460 nm, which is blue shifted to 450 nm when the NADH is in the bound state.
- Elastin has a wide fluorescence spectrum band with peak at 420 nm when the excitation wavelength is close to 350 nm.
- the peak or shoulder structure at the wavelength range of 380-390 nm are more likely the result of collagen fluorescence.
- the small fluorescence band at wavelength range 400 nm to 500 nm is more likely the result of elastin and NADH.
- the dip which sometimes occurs at wavelength 415 nm to 420 nm is caused by the reabsorption of blood (Glassman, 1993; Tang et al . , 1989; Liu et al . , 1990) .
- results described demonstrate the usefulness of this new technique and instrument in the monitoring cervical changes during pregnancy and labor and in determining the physiological or biochemical state of the cervix during the final stages of pregnancy.
- a small size fiber optical catheter is used for a human subject. Because the human cervix is also rich in collagen and because the cervix is accessible to the instrument disclosed herein, human cervical dilation may be similarly measured by positioning the optical catheter through the vagina.
- the particular fluorescent intensities may differ from species to species, but the relative decrease in, e . g. , collagen fluorescence, that is monitored over time will allow a more quantitative or objective measurement of cervical changes incipient to birth and will be a valuable diagnostic and prognostic tool in the field of obstetrics.
- a preferred embodiment of the present invention is an optical catheter suitable for use in a human patient as schematically shown in a side view and a top view in FIG. 12.
- the catheter 50 comprises a hollow tube 51 with an outer diameter of about 8 mm or less and forming an obtuse angle near the midpoint for correct positioning.
- the optical fiber bundles for transmission of the excitation light 52 and the optical fiber bundles for the collection of emission light 53 are disposed within the hollow tube and exit the tube through one end to be connected to the excitation light source and measuring means, respectively.
- a receptacle 54 of about 4 mm in height and about 12 mm in diameter to receive the tips 55 of the two types of optical fiber bundles and to position the tips adjacent the measuring site on the cervix.
- the catheter may also comprise an endoscope 56 with an endoscope head 57 projecting past the optical fiber tips to assist in locating the catheter near the cervix.
- FIG. 13 is an illustration of the optical catheter 50 in place in the vagina of a subject.
- the endoscope 56 facilitates placing the catheter near the cervix 62, which separates the vaginal wall 61 from the uterine wall 60.
- a pregnant patient visits her obstetrician for a routine perinatal exam at e.g., 26 weeks of pregnancy.
- the physician uses the methods and instruments disclosed herein to evaluate the state of the cervix.
- the physician inserts the optical fiber probe (FIG. 12) into the vagina of the patient after dilating the vagina with the aid of a speculum to expose the cervix.
- Several regions of the cervix are probed and fluorescence spectra are obtained. These spectra are compared to known normal and abnormal readings.
- the physician may treat the patient with an agent (e.g. an antiprostaglandin) to inhibit cervical dilation and then may follow the progress of this treatment with the methods disclosed herein. If a patient fails to dilate at term with advancing uterine contractions, the physician may stimulate cervical dilation (e.g. with a prostaglandin) and follow the progress of the induced dilation with the methods of the invention.
- an agent e.g. an antiprostaglandin
- a patient appears in labor and delivery either at term or preterm in labor.
- a physician quickly evaluates the patient's cervix with the methods of the present invention to determine the extent of dilation and then follows the patient continuously until delivery as in Example 4.
- a nonpregnant patient may require a dilation and curettage (D&C) for abnormal uterine bleeding.
- D&C dilation and curettage
- the physician treats the patient with an agent such as a prostaglandin to dilate the cervix and then follows the progression of cervical dilation with the methods disclosed herein.
- the curettage of the uterine wall is completed.
- the present example demonstrates that the methods and instruments of the present invention will also be useful in the treatment and monitoring of animals.
- a veterinarian is called upon to monitor the delivery of a valuable animal such as a horse, cow, dog or the like that is in labor, but is suffering from dystocia (i.e. the inability for labor to progress) .
- the practitioner examines the cervix of the animal with the methods and instruments of the present invention.
- the practitioner may then either treat the animal appropriately with a labor accelerating agent such as oxytocin or prostaglandin, or may abstain from treatment and follow the progression of the cervix with the disclosed methods.
Abstract
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP7530357A JPH10505244A (en) | 1994-05-19 | 1995-05-12 | An instrument for diagnosing changes in the cervix |
EP95919833A EP0759723A1 (en) | 1994-05-19 | 1995-05-12 | Instrument for the diagnosis of cervical changes |
AU25505/95A AU696913B2 (en) | 1994-05-19 | 1995-05-12 | Instrument for the diagnosis of cervical changes |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/246,060 US5450857A (en) | 1994-05-19 | 1994-05-19 | Method for the diagnosis of cervical changes |
US08/246,060 | 1994-05-19 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1995031929A1 true WO1995031929A1 (en) | 1995-11-30 |
Family
ID=22929178
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1995/006050 WO1995031929A1 (en) | 1994-05-19 | 1995-05-12 | Instrument for the diagnosis of cervical changes |
Country Status (6)
Country | Link |
---|---|
US (1) | US5450857A (en) |
EP (1) | EP0759723A1 (en) |
JP (1) | JPH10505244A (en) |
AU (1) | AU696913B2 (en) |
CA (1) | CA2190599A1 (en) |
WO (1) | WO1995031929A1 (en) |
Families Citing this family (49)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5991653A (en) * | 1995-03-14 | 1999-11-23 | Board Of Regents, The University Of Texas System | Near-infrared raman spectroscopy for in vitro and in vivo detection of cervical precancers |
US6258576B1 (en) | 1996-06-19 | 2001-07-10 | Board Of Regents, The University Of Texas System | Diagnostic method and apparatus for cervical squamous intraepithelial lesions in vitro and in vivo using fluorescence spectroscopy |
US5697373A (en) * | 1995-03-14 | 1997-12-16 | Board Of Regents, The University Of Texas System | Optical method and apparatus for the diagnosis of cervical precancers using raman and fluorescence spectroscopies |
US5699795A (en) * | 1995-03-31 | 1997-12-23 | Board Of Regents, The University Of Texas System | Optical probe for the detection of cervical neoplasia using fluorescence spectroscopy and apparatus incorporating same |
US5879293A (en) * | 1995-06-20 | 1999-03-09 | Spacelabs Medical, Inc. | Non-invasive uterine activity sensor |
US5626133A (en) * | 1995-08-11 | 1997-05-06 | Johnson; Mary A. | Gestational computer |
JP3621704B2 (en) * | 1995-09-26 | 2005-02-16 | カール.ストルツ.ゲゼルシャフト.ミット.ベシュレンクテル.ハフツング.ウント.カンパニー | Photodynamic diagnostic equipment |
ZA967500B (en) * | 1995-12-21 | 1998-03-05 | Unilever Plc | Device for the identification of acne, microcomedones, and bacteria on human skin. |
US5842995A (en) * | 1996-06-28 | 1998-12-01 | Board Of Regents, The Univerisity Of Texas System | Spectroscopic probe for in vivo measurement of raman signals |
CA2264870C (en) * | 1996-08-02 | 2005-07-26 | Board Of Regents, The University Of Texas System | Apparatus for the characterization of tissue of epithelial lined viscus |
US6039701A (en) * | 1996-09-05 | 2000-03-21 | Ob Inovations, Inc. | Method and apparatus for monitoring cervical diameter |
US5807281A (en) * | 1996-10-01 | 1998-09-15 | Welch; Robert A. | Cervical ring to detect labor |
US6080584A (en) * | 1996-12-02 | 2000-06-27 | The Research Foundation Of City College Of New York | Method and apparatus for detecting the presence of cancerous and precancerous cells in a smear using native fluorescence spectroscopy |
CA2192036A1 (en) * | 1996-12-04 | 1998-06-04 | Harvey Lui | Fluorescence scope system for dermatologic diagnosis |
US5763860A (en) * | 1996-12-10 | 1998-06-09 | Denis; Diane T. | Gestational calculator |
US5935061A (en) * | 1997-01-03 | 1999-08-10 | Biosense, Inc. | Obstetrical instrument system and method |
US6826422B1 (en) | 1997-01-13 | 2004-11-30 | Medispectra, Inc. | Spectral volume microprobe arrays |
US6201989B1 (en) | 1997-03-13 | 2001-03-13 | Biomax Technologies Inc. | Methods and apparatus for detecting the rejection of transplanted tissue |
US5920399A (en) * | 1997-03-18 | 1999-07-06 | Sandia Corporation | Multispectral imaging method and apparatus |
EP0865760B1 (en) * | 1997-03-21 | 2005-01-12 | Stryker Corporation | Circumferential transillumination of anatomic junctions using light energy |
US6277067B1 (en) | 1997-04-04 | 2001-08-21 | Kerry L. Blair | Method and portable colposcope useful in cervical cancer detection |
US6088612A (en) * | 1997-04-04 | 2000-07-11 | Medtech Research Corporation | Method and apparatus for reflective glare removal in digital photography useful in cervical cancer detection |
US5989184A (en) * | 1997-04-04 | 1999-11-23 | Medtech Research Corporation | Apparatus and method for digital photography useful in cervical cancer detection |
US5876357A (en) * | 1997-11-20 | 1999-03-02 | Labor Control System (L.C.S.) Ltd. | Uterine cervix dilation, effacement, and consistency monitoring system |
US6377842B1 (en) | 1998-09-22 | 2002-04-23 | Aurora Optics, Inc. | Method for quantitative measurement of fluorescent and phosphorescent drugs within tissue utilizing a fiber optic probe |
US6411838B1 (en) | 1998-12-23 | 2002-06-25 | Medispectra, Inc. | Systems and methods for optical examination of samples |
US6697666B1 (en) | 1999-06-22 | 2004-02-24 | Board Of Regents, The University Of Texas System | Apparatus for the characterization of tissue of epithelial lined viscus |
JP3881142B2 (en) * | 1999-11-02 | 2007-02-14 | 富士フイルムホールディングス株式会社 | Fluorescence display method and apparatus |
GR1004180B (en) | 2000-03-28 | 2003-03-11 | ����������� ����� ��������� (����) | Method and system for characterization and mapping of tissue lesions |
US6421558B1 (en) | 2000-06-29 | 2002-07-16 | Ge Medical Systems Information Technologies, Inc. | Uterine activity monitor and method of the same |
JP2002172117A (en) * | 2000-09-05 | 2002-06-18 | Fuji Photo Film Co Ltd | Output device of optical tomographic image diagnostic information |
US6839661B2 (en) * | 2000-12-15 | 2005-01-04 | Medispectra, Inc. | System for normalizing spectra |
US6818903B2 (en) | 2002-07-09 | 2004-11-16 | Medispectra, Inc. | Method and apparatus for identifying spectral artifacts |
US6768918B2 (en) | 2002-07-10 | 2004-07-27 | Medispectra, Inc. | Fluorescent fiberoptic probe for tissue health discrimination and method of use thereof |
US20040064053A1 (en) * | 2002-09-30 | 2004-04-01 | Chang Sung K. | Diagnostic fluorescence and reflectance |
US8326404B2 (en) * | 2003-11-28 | 2012-12-04 | British Columbia Cancer Agency Branch | Multimodal detection of tissue abnormalities based on raman and background fluorescence spectroscopy |
US7527601B2 (en) * | 2005-12-29 | 2009-05-05 | Intrapartum Ventures, Llc | Cervimeter |
US7811239B2 (en) * | 2005-12-29 | 2010-10-12 | Intrapartum, Llc | Cervical dilation measurement apparatus |
US7713216B2 (en) * | 2006-04-10 | 2010-05-11 | Intrapartum, Llc | Method for cervical dilation and/or measurement |
US20070191675A1 (en) * | 2006-02-13 | 2007-08-16 | Joel Gerardo Diaz Sanchez | Actinic light colposcope and method to detect lesions in the lower female genital tract produced by human papilloma virus using an actinic light colposcope |
US8142352B2 (en) | 2006-04-03 | 2012-03-27 | Welch Allyn, Inc. | Vaginal speculum assembly having portable illuminator |
JP2010535579A (en) * | 2007-08-03 | 2010-11-25 | エスティーアイ・メディカル・システムズ・エルエルシー | Computer image analysis of acetic acid processed cervical intraepithelial neoplasia |
US20090062690A1 (en) * | 2007-08-29 | 2009-03-05 | Quaternion Investments Llc | Specimen Collecting |
EP2063309B1 (en) * | 2007-11-13 | 2012-09-26 | TRUMPF Medizin Systeme GmbH + Co. KG | Method for illuminating an operation point |
US7819825B2 (en) * | 2008-03-21 | 2010-10-26 | The Board Of Regents Of The University Of Oklahoma | Remote cervical dilation monitoring system and method |
CA2734512C (en) * | 2008-08-18 | 2020-06-30 | Glenveigh Medical, Llc | Cervical dilation meter |
EP2461733A1 (en) * | 2009-08-07 | 2012-06-13 | Dignity Health | Cervical, fetal-membrane, and amniotic examination and assessment device and method |
EP2632527B1 (en) * | 2010-10-27 | 2019-04-24 | Koninklijke Philips N.V. | Splittable needle with fiber probe |
US11666221B2 (en) * | 2017-05-18 | 2023-06-06 | Vanderbilt University | Method, system and speculum-free optical probe for optical assessment of cervix, and applications of same |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4905670A (en) * | 1988-12-28 | 1990-03-06 | Adair Edwin Lloyd | Apparatus for cervical videoscopy |
EP0359433A1 (en) * | 1988-08-26 | 1990-03-21 | Polartechnics Ltd | Physiological probe |
DE9112188U1 (en) * | 1991-09-30 | 1991-12-19 | Steiger, Erwin, Dipl.-Phys., 8038 Groebenzell, De | |
US5172693A (en) * | 1990-01-16 | 1992-12-22 | Doody Michael C | Prenatal non-invasive detection of meconium stained amniotic fluid |
US5261410A (en) * | 1991-02-07 | 1993-11-16 | Alfano Robert R | Method for determining if a tissue is a malignant tumor tissue, a benign tumor tissue, or a normal or benign tissue using Raman spectroscopy |
WO1994026168A1 (en) * | 1993-05-12 | 1994-11-24 | Board Of Regents, The University Of Texas System | Diagnosis of dysplasia using laser induced fluorescence |
Family Cites Families (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4476871A (en) * | 1982-04-23 | 1984-10-16 | American Home Products Corporation | Monitoring of cervical dilatation during labor |
US4498481A (en) * | 1982-09-28 | 1985-02-12 | Lemke Judith K | Estrus cycle monitoring system |
US5184619A (en) * | 1986-11-10 | 1993-02-09 | Peritronics Medical, Inc. | Intrauterine pressure and fetal heart rate sensor |
US4782819A (en) * | 1987-02-25 | 1988-11-08 | Adair Edwin Lloyd | Optical catheter |
US5135006A (en) * | 1988-03-31 | 1992-08-04 | Susan Bellinson | Method and apparatus for monitoring descent of fetus |
US5167237A (en) * | 1991-07-09 | 1992-12-01 | Long Island Jewish Medical Center | Apparatus for monitoring detrusor pressure exerted by a bladder |
US5348018A (en) * | 1991-11-25 | 1994-09-20 | Alfano Robert R | Method for determining if tissue is malignant as opposed to non-malignant using time-resolved fluorescence spectroscopy |
US5279308A (en) * | 1993-02-19 | 1994-01-18 | Graphic Controls Corporation | Intrauterine pressure catheter system |
-
1994
- 1994-05-19 US US08/246,060 patent/US5450857A/en not_active Expired - Lifetime
-
1995
- 1995-05-12 AU AU25505/95A patent/AU696913B2/en not_active Ceased
- 1995-05-12 CA CA002190599A patent/CA2190599A1/en not_active Abandoned
- 1995-05-12 WO PCT/US1995/006050 patent/WO1995031929A1/en active Search and Examination
- 1995-05-12 JP JP7530357A patent/JPH10505244A/en active Pending
- 1995-05-12 EP EP95919833A patent/EP0759723A1/en not_active Withdrawn
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0359433A1 (en) * | 1988-08-26 | 1990-03-21 | Polartechnics Ltd | Physiological probe |
US4905670A (en) * | 1988-12-28 | 1990-03-06 | Adair Edwin Lloyd | Apparatus for cervical videoscopy |
US5172693A (en) * | 1990-01-16 | 1992-12-22 | Doody Michael C | Prenatal non-invasive detection of meconium stained amniotic fluid |
US5261410A (en) * | 1991-02-07 | 1993-11-16 | Alfano Robert R | Method for determining if a tissue is a malignant tumor tissue, a benign tumor tissue, or a normal or benign tissue using Raman spectroscopy |
DE9112188U1 (en) * | 1991-09-30 | 1991-12-19 | Steiger, Erwin, Dipl.-Phys., 8038 Groebenzell, De | |
WO1994026168A1 (en) * | 1993-05-12 | 1994-11-24 | Board Of Regents, The University Of Texas System | Diagnosis of dysplasia using laser induced fluorescence |
Also Published As
Publication number | Publication date |
---|---|
AU696913B2 (en) | 1998-09-24 |
JPH10505244A (en) | 1998-05-26 |
EP0759723A1 (en) | 1997-03-05 |
CA2190599A1 (en) | 1995-11-30 |
AU2550595A (en) | 1995-12-18 |
US5450857A (en) | 1995-09-19 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US5450857A (en) | Method for the diagnosis of cervical changes | |
US5983125A (en) | Method and apparatus for in vivo examination of subcutaneous tissues inside an organ of a body using optical spectroscopy | |
Mycek et al. | Colonic polyp differentiation using time-resolved autofluorescence spectroscopy | |
AU2001251164B2 (en) | Methods and apparatus for diagnostic multispectral digital imaging | |
US6697666B1 (en) | Apparatus for the characterization of tissue of epithelial lined viscus | |
US5172693A (en) | Prenatal non-invasive detection of meconium stained amniotic fluid | |
US20040010187A1 (en) | Colonic polyp discrimination by tissue fluorescence and fiberoptic probe | |
CA2400702A1 (en) | Method and system for characterization and mapping of tissue lesions | |
Glassman et al. | Changes in rat cervical collagen during gestation and after antiprogesterone treatment as measured in vivo with light-induced autofluorescence | |
US8768425B2 (en) | Device and method for identification of meconium in amniotic fluid | |
US20130090538A1 (en) | Method and System to Monitor the State and Function of the Cervix and Effects of Treatments for the Cervix | |
JP2000515407A (en) | Method and apparatus for characterization of epithelial covering visceral tissue | |
González‐Solís et al. | Detection of cervical cancer analyzing blood samples with Raman spectroscopy and multivariate analysis | |
Roy et al. | Diagnostic fluorescence spectroscopy of oral mucosa | |
AU738235B2 (en) | Instrument for the diagnosis of cervical changes | |
RU187874U1 (en) | MEDICAL COMPLEX ON THE BASIS OF OPTICAL SPECTROMETER FOR STRUCTURAL AND FUNCTIONAL NON-INVASIVE EXPRESS DIAGNOSTICS OF THE STATE OF TISSUES OF WOMEN'S REPRODUCTIVE SYSTEM OF WOMEN | |
US11666221B2 (en) | Method, system and speculum-free optical probe for optical assessment of cervix, and applications of same | |
Tchernyi et al. | Some results of multiwave in situ autofluorescence diagnostics | |
Das et al. | UV-fluorescence spectroscopic technique in the diagnosis of breast, ovarian, uterus, and cervix cancer | |
Glassman et al. | Fluorescence probe for cervical examination during various reproductive states | |
Borisova et al. | Multispectral autofluorescence diagnosis of non-melanoma cutaneous tumors | |
Huang et al. | Fluorescence diagnosis of gynecological cancerous and normal tissues | |
JPS63189125A (en) | Amniotic fluid turbidity measuring apparatus | |
Bigio et al. | Determination of the cervical transformation zone using elastic-scattering spectroscopy | |
Loschenov et al. | Study Of Tissue Fluorescence Snectrn In Situ |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AK | Designated states |
Kind code of ref document: A1 Designated state(s): AM AT AU BB BG BR BY CA CH CN CZ DE DK EE ES FI GB GE HU IS JP KE KG KP KR KZ LK LR LT LU LV MD MG MN MW MX NO NZ PL PT RO RU SD SE SG SI SK TJ TT UA UZ VN |
|
AL | Designated countries for regional patents |
Kind code of ref document: A1 Designated state(s): KE MW SD SZ UG AT BE CH DE DK ES FR GB GR IE IT LU MC NL PT SE BF BJ CF CG CI CM GA GN ML MR NE SN TD TG |
|
121 | Ep: the epo has been informed by wipo that ep was designated in this application | ||
DFPE | Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101) | ||
WWE | Wipo information: entry into national phase |
Ref document number: 2190599 Country of ref document: CA |
|
WWE | Wipo information: entry into national phase |
Ref document number: 1995919833 Country of ref document: EP |
|
WWP | Wipo information: published in national office |
Ref document number: 1995919833 Country of ref document: EP |
|
REG | Reference to national code |
Ref country code: DE Ref legal event code: 8642 |
|
WWW | Wipo information: withdrawn in national office |
Ref document number: 1995919833 Country of ref document: EP |
|
DPE2 | Request for preliminary examination filed before expiration of 19th month from priority date (pct application filed from 20040101) |