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| United States Patent Application |
20030099580
|
| Kind Code
|
A1
|
|
Pressman, Norman J.
;   et al.
|
May 29, 2003
|
Universal microscope slide cassette
Abstract
A microscope slide cassette for use with specimen handling apparatus. A
plurality of opposed pairs of shelves carried by the side walls of the
cassette are adapted to support specimen slides by their ends in the
cassette. The shelves have a top surface on which a specimen slide can
rest, and a resilient bottom surface configured to pinch the slide below
against the shelf below to frictionally retain the pinched slide in the
cassette. The bottom surface may comprise a spring. An inclined shelf
lead-in ramp guides slides during insertion. Drainage ports in the side
walls above and/or below the shelves make the cassette well suited for
use in staining baths. Two laterally spaced racks on the rear wall,
vertically spaced indexing marks corresponding to each slide position,
and a sensor window at each slide position make the cassette well-suited
for use in automated slide cassette handling mechanisms. The cassette is
stackable with others for compact storage.
| Inventors: |
Pressman, Norman J.; (Glencoe, IL)
; Mayer, William J.; (South Barrington, IL)
; Wroblewski, Lucien J.; (Downers Grove, IL)
|
| Correspondence Address:
|
FOLEY AND LARDNER
SUITE 500
3000 K STREET NW
WASHINGTON
DC
20007
US
|
| Assignee: |
MONOGEN, INC.
|
| Serial No.:
|
274365 |
| Series Code:
|
10
|
| Filed:
|
October 21, 2002 |
| Current U.S. Class: |
422/400; 422/63 |
| Class at Publication: |
422/104; 422/63 |
| International Class: |
G01N 035/02 |
Claims
1. A microscope slide cassette for use with specimen handling apparatus,
the cassette comprising: a body having opposed left and right side walls
joined to opposed top and bottom walls, and an open front face defined by
the side walls and the top and bottom walls through which specimen slides
can be inserted and removed; and a plurality of opposed pairs of shelves
carried by the side walls for supporting specimen slides by their ends in
the cassette, substantially all of the shelves having a top surface on
which a specimen slide can rest and a resilient bottom surface configured
to pinch the slide below against the shelf below to frictionally retain
the pinched slide in the cassette.
2. A microscope slide cassette according to claim 1, wherein the bottom
surface comprises a spring.
3. A microscope slide cassette according to claim 2, wherein the spring
comprises a beam spring.
4. A microscope slide cassette according to claim 3, wherein the top
surface comprises a raised ledge.
5. A microscope slide cassette according to claim 4, wherein substantially
all of the shelves have an inclined lead-in ramp for guiding slides
during insertion.
6. A microscope slide cassette according to claim 1 or claim 5, wherein at
least one side wall has drainage ports above and/or below substantially
all of the shelves.
7. A microscope slide cassette according to claim 6, wherein each side
wall has drainage ports above and/or below substantially all of the
shelves.
8. A microscope slide cassette according to claim 7, wherein the body and
the shelves are integrally molded.
9. A microscope slide cassette according to claim 8, further comprising a
rear wall joined to the side, top and bottom walls, the shelves being
attached to the rear wall.
10. A microscope slide cassette according to claim 9, wherein the rear
wall has an opening that extends across all slide positions to
accommodate a slide handling mechanism.
11. A microscope slide cassette according to any one of claims 1-5,
wherein the body and the shelves are integrally molded.
12. A microscope slide cassette according to claim 11, further comprising
a rear wall joined to the side, top and bottom walls, the shelves being
attached to the rear wall.
13. A microscope slide cassette according to claim 12, wherein the rear
wall has an opening that extends across all slide positions to
accommodate a slide handling mechanism.
14. A microscope slide cassette according to claim 1, wherein the open
front face is sized to accommodate the rear of another like cassette so
as to be stackable for compact storage.
15. A microscope slide cassette according to claim 1, wherein each
cassette has a unique machine-readable identifier.
16. A microscope slide cassette for use with specimen handling apparatus,
the cassette comprising: a body having opposed left and right side walls
joined to opposed top and bottom walls, and an open front face defined by
the side walls and the top and bottom walls through which specimen slides
can be inserted and removed, and a plurality of opposed pairs of shelves
carried by the side walls for supporting specimen slides by their ends in
the cassette, wherein at least one side wall has drainage ports above
and/or below substantially all of the shelves.
17. A microscope slide cassette according to claim 16, wherein each side
wall has drainage ports above and/or below substantially all of the
shelves.
18. A microscope slide cassette according to claim 16 or claim 17, wherein
the body and the shelves are integrally molded.
19. A microscope slide cassette according to claim 18, further comprising
a rear wall joined to the side, top and bottom walls, the shelves being
attached to the rear wall.
20. A microscope slide cassette according to claim 19, wherein the rear
wall has an opening that extends across all slide positions to
accommodate a slide handling mechanism.
21. A microscope slide cassette according to claim 16, wherein the open
front face is sized to accommodate the rear of another like cassette so
as to be stackable for compact storage.
22. A microscope slide cassette according to claim 16, wherein each
cassette has a unique machine-readable identifier.
23. A microscope slide cassette for use with specimen handling apparatus,
the cassette comprising: a body having opposed left and right side walls,
opposed top and bottom walls joined to the side walls, a rear wall joined
to the side, top and bottom walls, and an open front face defined by the
side walls and the top and bottom walls through which specimen slides can
be inserted and removed, and a plurality of opposed pairs of shelves
carried by the side walls and the rear wall for supporting specimen
slides by their ends in the cassette, wherein the rear wall has two
laterally spaced vertical racks adapted to engage the pinion gears of a
slide cassette handling mechanism.
24. A microscope slide cassette according to claim 23, wherein the rear
wall has vertically spaced indexing marks corresponding to each slide
position and adapted to be sensed by a slide cassette handling mechanism.
25. A microscope slide cassette according to claim 24, wherein the rear
wall has a window at each slide position through which a sensor of a
slide cassette handling mechanism can determine the presence or absence
of a slide.
26. A microscope slide cassette according to claim 25, wherein the rear
wall has an opening that extends across all slide positions to
accommodate a slide handling mechanism.
27. A microscope slide cassette according to claim 23, wherein the rear
wall has a window at each slide position through which a sensor of a
slide cassette handling mechanism can determine the presence or absence
of a slide.
28. A microscope slide cassette according to claim 27, wherein the rear
wall has an opening that extends across all slide positions to
accommodate a slide handling mechanism.
29. A microscope slide cassette according to any one of claims 23 to 28,
wherein the body and the shelves are integrally molded.
30. A microscope slide cassette according to claim 23, wherein the open
front face is sized to accommodate the rear of another like cassette so
as to be stackable for compact storage.
31. A microscope slide cassette according to claim 23, wherein each
cassette has a unique machine-readable identifier.
32. A microscope slide cassette for use with specimen handling apparatus,
the cassette comprising: a body having opposed left and right side walls,
opposed top and bottom walls joined to the side walls, a rear wall joined
to the side, top and bottom walls, and an open front face defined by the
side walls and the top and bottom walls through which specimen slides can
be inserted and removed, and a plurality of opposed pairs of shelves
carried by the side walls and the rear wall for supporting specimen
slides by their ends in the cassette, wherein the rear wall has
vertically spaced indexing marks corresponding to each slide position and
adapted to be sensed by a slide cassette handling mechanism.
33. A microscope slide cassette according to claim 32, wherein the rear
wall has an opening that extends across all slide positions to
accommodate a slide handling mechanism.
34. A microscope slide cassette according to claim 32 or claim 33, wherein
the body and the shelves are integrally molded.
35. A microscope slide cassette according to claim 32, wherein the open
front face is sized to accommodate the rear of another like cassette so
as to be stackable for compact storage.
36. A microscope slide cassette according to claim 32, wherein each
cassette has a unique machine-readable identifier.
37. A microscope slide cassette for use with specimen handling apparatus,
the cassette comprising: a body having opposed left and right side walls,
opposed top and bottom walls joined to the side walls, a rear wall joined
to the side, top and bottom walls, and an open front face defined by the
side walls and the top and bottom walls through which specimen slides can
be inserted and removed, and a plurality of opposed pairs of shelves
carried by the side walls and the rear wall for supporting specimen
slides by their ends in the cassette, wherein the rear wall has a window
at each slide position through which a sensor of a slide cassette
handling mechanism can determine the presence or absence of a slide.
38. A microscope slide cassette according to claim 37, wherein the rear
wall has an opening that extends across all slide positions to
accommodate a slide handling mechanism.
39. A microscope slide cassette according to claim 37 or claim 38, wherein
the body and the shelves are integrally molded.
40. A microscope slide cassette according to claim 37, wherein the open
front face is sized to accommodate the rear of another like cassette so
as to be stackable for compact storage.
41. A microscope slide cassette according to claim 37, wherein each
cassette has a unique machine-readable identifier.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of commonly owned U.S.
provisional application Nos. 60/330,092, filed Oct. 19, 2001, 60/372,080,
filed Apr. 15, 2002, and 60/373,658, filed Apr. 19, 2002, all of which
are incorporated herein by reference. This application also is related to
commonly owned U.S. non-provisional application Ser. No. 10/122,151,
filed Apr. 15, 2002, which is also incorporated herein by reference.
TECHNICAL FIELD
[0002] The present disclosure is directed to apparatus and methods for
collecting and processing specimens of particulate matter-containing
liquid, e.g., biological fluid, including collecting and depositing onto
a microscope slide or other surface a uniform layer of particulates
therefrom (e.g., cells) suitable for examination (e.g., use in cytology
protocols).
BACKGROUND ART
[0003] Diagnostic cytology, particularly in the area of clinical
pathology, bases cytological interpretations and diagnoses on examination
of cells and other microscopic objects. The accuracy of the screening
process and diagnosis, and the preparation of optimally interpretable
samples from specimens typically depends upon adequate specimen and
sample preparation. In this regard the ideal sample would consist of a
monolayer of substantially evenly spaced cells, which enables
cytotechnologists, cytopathologists, other medical professionals, and
automated screening and diagnostic equipment to view or image the cells
more clearly so that abnormalities can be identified more readily, more
accurately and more reproducibly. Newer methodologies such as
immunocytochemistry and cytometric image analysis require preparation
apparatus and methods that are safe, effective, accurate, precise,
reproducible, inexpensive, efficient, fast and convenient.
[0004] Cytological examination of a sample begins with obtaining specimens
including a sample of cells from the patient, which can typically be done
by scraping, swabbing or brushing an area, as in the case of cervical
specimens, or by collecting body fluids, such as those obtained from the
chest cavity, bladder, or spinal column, or by fine needle aspiration or
fine needle biopsy. In a conventional manual cytological preparation, the
cells in the fluid are then transferred directly or by
centrifugation-based processing steps onto a glass microscope slide for
viewing. In a typical automated cytological preparation, a filter
assembly is placed in the liquid suspension and the filter assembly both
disperses the cells and captures the cells on the filter. The filter is
then removed and placed in contact with a microscope slide. In all of
these endeavors, a limiting factor in the sample preparation protocol is
adequately separating solid matter from its fluid carrier, and in easily
and efficiently collecting and concentrating the solid matter in a form
readily accessible to examination under a microscope.
[0005] Currently, biological specimens are collected for cytological
examinations using special containers. These containers usually contain a
preservative and transport solution for preserving the cytology specimen
during shipment from the collection site to the diagnostic cytology
laboratory. Further, cytology specimens collected from the body cavities
using a swab, spatula or brush are also preserved in special containers
with fixatives (e.g., alcohol or acetone fixatives) prior to transferring
cells onto the slide or membrane for staining or examination. Specimen
containers are known that allow a liquid-based biological specimen to be
processed directly in the container so as to obtain a substantially
uniform layer of cells on a collection site (in a filter housing defining
a particulate matter separation chamber) that is associated with the
container itself. See, for example, U.S. Pat. Nos. 5,301,685; 5,471,994;
6,296,764; and 6,309,362, of Raouf A. Guirguis, all of which are
incorporated herein by reference.
[0006] The filtration techniques taught in these patents in practice have
yielded fairly good results in terms of obtaining close to a monolayer of
cells on slides, but there is room for improvement. Further, the types of
specimen containers disclosed in these patents require specially
configured apertured covers and adapters therefor that are designed to
mate with the filter housing, and with suction equipment (e.g., a syringe
or a mechanized vacuum source) used to aspirate liquid from the container
and draw it through the filter. In addition, extraction of the filter so
that it can be pressed against a microscope slide to transfer collected
cells to the slide requires disassembly of the cooperating parts of the
cover and/or adapters associated therewith. If the processing is done by
automated equipment, special handling devices are required to carry out
such disassembly. All of this complexity adds time, and material and
labor cost to the processing required prior to the actual cytology
examination.
[0007] In general, automated equipment thus far developed for processing
liquid-based specimens have not performed with sufficient consistency,
reliability, speed and automation to satisfy current and projected needs
in cancer screening and other cytology-based medical, analytical,
screening and diagnostic procedures. The vial-based automated processing
system disclosed herein provides a safe, elegant and effective solution
to these problems.
SUMMARY DISCLOSURE OF THE INVENTION
[0008] The specimen vial disclosed herein houses a complete processing
assembly, typically one for mixing the liquid-based specimen therein and
for holding a filter on which a uniform layer of cells can be collected
from the specimen. It is expected that the specimen vial would be
prepackaged with a liquid preservative solution, as is commonplace, and
sent to the point-of-care site for specimen collection.
[0009] The processing assembly is coupled to a simple cover for the vial
by means of a simple and inexpensive releasable coupling. When the cover
is removed at the point-of-care site (physician's office, clinic,
hospital, etc.), the processing assembly remains with the cover to allow
medical personnel easy access to the container interior for insertion of
a biological specimen into the vial. The cover, along with the attached
processing assembly, is then replaced to seal the vial. The vial may then
be sent to a laboratory for processing.
[0010] When the vial is manipulated in a simple way while still closed,
the processing assembly detaches from the cover and remains in the vial
for access by automated or manual laboratory equipment when the cover is
subsequently removed. In a preferred embodiment, a downward force on the
center of the cover is all that is required to detach the processing
assembly from the cover. In contrast with the prior art specimen vials
discussed above, the vial of the present invention requires no further
interaction with the cover, which can be removed by a simple uncapping
device and is discarded to avoid contamination. Ribs inside the vial
support the processing assembly in the proper position for access during
processing. This self-contained vial and processing assembly arrangement
minimizes human operator exposure to biohazards, such as tuberculosis or
other pathogens in sputum or in other specimens types, such as urine,
spinal tap fluid, gastric washings, fine-needle aspirates, and
gynecological samples.
[0011] The automated specimen processing apparatus disclosed herein is
referred to as the "LBP" device (for liquid-based preparation), and is
designed to produce slides of high quality and consistency. The LBP
device also can be interfaced with a device for detecting and/or
quantifying multiple morphologic, cytochemical, and/or molecular changes
at the cellular level.
[0012] During the past two years or so, a review of the literature and
reanalysis of existing data have led to the identification of a panel of
molecular diagnostic reagents that are capable of detecting and
characterizing lung cancer, which is the most common cancer, with high
sensitivity and specificity. See, for instance, commonly owned U.S.
patent application Ser. Nos. 10/095,297 and 10/095,298, both filed Mar.
12, 2002, and Ser. No. 10/241,753, filed Sep. 12, 2002. Here, the cells
can be reacted with antibodies and or nucleic-acid "probes" that identify
a pattern of changes that is consistent with a diagnosis of cancer. The
molecular system can utilize algorithms fine tuned for that tumor
heterogeneity.
[0013] Identifying molecular changes at the cellular level is one of the
ways cancer can be detected early and at a more curable stage. Such
molecular diagnostic devices can be used for early detection and
diagnosis with the necessary sensitivity and specificity to justify their
use as population-based screens for individuals who are at-risk for
developing cancer. Such a molecular diagnostic device also can be used to
characterize the tumor, thereby permitting the oncologist to stratify
his/her patients, to customize therapy, and to monitor patients in order
to assess therapeutic efficacy and disease regression, progression or
recurrence. The availability of such tests will also foster the
development of new and more effective therapeutic approaches for the
treatment of early stage disease.
[0014] Such molecular diagnostics are designed to balance cost and test
performance. While screening tests must exhibit high sensitivity and
specificity, cost is always a critical factor, as the tests are typically
directed to performing on a large number of individuals who, while
at-risk, do not typically have symptomatic evidence of the disease. In
this respect, the present LBP device can be interfaced with a molecular
diagnostic device to develop a system for automatically diagnosing
cancer, with a minimum or no human intervention. Alternatively, the
present LBP device can be interfaced with a pathology work station, where
medical professionals can observe individual slides prepared by the LBP
device. The resulting diagnosing system, regardless whether an automated
device or a manual observation device is interfaced, can be interfaced
with an integrated data management system based on specialized software
and a computer operating system to manage data entry and exchange of
information, and network with the laboratory and hospital information
systems.
[0015] The present LBP device transports multiple specimen vials of the
novel type mentioned above sequentially through various processing
stations and produces fixed specimens on slides, each slide being
bar-coded and linked through a data management system to the vial and the
patient from which it came. Fresh slides are automatically removed one at
a time from a cassette, and each is returned to the same cassette after a
specimen is fixed thereon. Multiple slide cas
settes can be loaded into
the LBP device, and the device will automatically draw fresh slides from
the next cassette after all of the slides of the preceding one have been
used. The slide cas
settes preferably are configured for liquid immersion
and interfacing with automated staining equipment that will stain the
specimens without having to remove the slides from the cassette. In this
regard the cas
settes preferably have slots that allow for liquid
drainage, and slots or other means that cooperate with the hooks normally
used in the staining equipment to suspend other types of slide holders.
The same slide cassettes are also configured to interface with automated
diagnostic equipment and other devices that are part of an integrated
system.
[0016] While specimen vials can be loaded into the transport manually, the
full benefits of automation can be realized by using an optional vial
handling system that automatically loads specimen vials for processing,
and removes each one after its processing is complete. In one example of
such a handling system the vials initially are loaded manually into
special space-saving trays that hold up to forty-one vials each. Up to
eight trays can be loaded into the LBP device, and the device will
process all of them sequentially, removing one at a time from a tray and
returning processed (and resealed) vials to a tray. The trays also can be
used for storing and retrieving processed vials.
[0017] Each vial is transported through the LBP device on a
computer-controlled conveyor, in its own receptacle. (In the example
disclosed the conveyor has thirty receptacles.) The vials and the
receptacles are keyed so that the vials proceed along the processing path
in the proper orientation, and cannot rotate independently of its
respective receptacle. They first pass a bar code reader (at a data
acquisition station), where the vial bar code is read, and then proceed
stepwise through the following processing stations of the LBP device: an
uncapping station including a cap disposal operation; a primary mixing or
dispersal station; a filter loading station; a specimen acquisition and
filter disposal station; a cell deposition station; and a re-capping
station. There is also a slide presentation station, at which a fresh
microscope slide is presented to the specimen acquisition station for
transfer of the specimen to the slide. Each of the stations operates
independently on the vial presented to it by the conveyor, but the
conveyor will not advance until all of the operating stations have
completed their respective tasks.
[0018] The vial uncapping station has a rotary gripper that unscrews the
cover from the vial, and discards it. Before doing so, however, the
uncapping head presses on the center of the cover to detach the internal
processing assembly from the cover. The primary mixing station has an
expanding collet that grips the processing assembly, lifts it slightly
and moves (e.g., spins) it in accordance with a specimen-specific
stirring protocol (speed and duration). The filter loading station
dispenses a specimen-specific filter type into a particulate matter
separation chamber (manifold) at the top of the processing assembly. The
specimen acquisition station has a suction head that seals to the filter
at the top of the processing assembly and first moves the processing
assembly slowly to re-suspend particulate matter in the liquid-based
specimen. Then the suction head draws a vacuum on the filter to aspirate
the liquid-based specimen from the vial and past the filter, leaving a
monolayer of cells on the bottom surface of the filter. Thereafter the
monolayer specimen is transferred to a fresh slide, and the vial moves to
the re-capping station, where a foil seal is applied to the vial.
[0019] An improved filter system ensures that the highest quality
monolayer specimens are produced. Specimen liquid flows through the
filter as well as substantially across the front surface of the filter.
Specifically, the specimen liquid is made to have a secondary flow
component across the filter surface. The secondary flow is designed to
flow radially outwardly or have a substantial radial component, which
creates a shearing action that flushes or washes clusters of relatively
weakly adhering particulates so that a more uniformly distributed and
thinner layer can be formed on the front surface of the filter. In this
respect, the present system includes a peripheral outlet through which
specimen liquid can flow from the area adjacent the front surface of the
filter.
[0020] The filter assembly preferably has a holder, a frit seated in the
holder, and a membrane filter positioned over and in contact with the
outer surface of the frit. The frit can extend beyond the end of the
holder. The membrane filter can be attached to the holder. The sidewall
portion extending beyond the holder forms an area through which the
specimen liquid can flow, creating a secondary flow. The holder can be
configured so that the frit is slightly bowed outwardly at the center so
that when pressure is applied to a slide during the specimen transferring
step, the central portion of the frit flattens to more evenly contact the
membrane filter to the slide for more effective transfer.
[0021] The manifold at the upper end of the processing assembly seats the
filter assembly with the membrane filter side facing down. The manifold
preferably has a substantially conically configured bottom wall that
rises from the central inlet (which communicates with the depending
suction tube portion of the processing assembly). The filter assembly and
the conically configured bottom wall form a manifold chamber that has a
slight gap at its periphery, forming a peripheral outlet, by virtue of
raised members or standoffs that act as spacers. The standoffs can have
channels between them through which the specimen liquid can flow out of
the manifold chamber.
[0022] Various preferred materials and possible alternatives are specified
herein for several components of the system. It is to be understood that
material choices are not limited to the specific materials mentioned, and
that the choice of an alternate material is governed by many factors,
among them functionality, molding accuracy, durability, chemical
resistance, shelf life, cost, availability, and/or optical clarity (e.g.,
to address user requirements or marketing issues).
[0023] The invention claimed herein concerns a microscope slide cassette
for use with specimen handling apparatus. The cassette has a body having
opposed left and right side walls joined to opposed top and bottom walls,
and an open front face defined by the side walls and the top and bottom
walls through which specimen slides can be inserted and removed.
[0024] According to one aspect of the invention, a plurality of opposed
pairs of shelves are carried by the side walls for supporting specimen
slides by their ends in the cassette. Substantially all of the shelves
have a top surface on which a specimen slide can rest, and a resilient
bottom surface configured to pinch the slide below against the shelf
below to frictionally retain the pinched slide in the cassette. The
bottom surface may comprise a spring, e.g., a beam spring. The top
surface may have a raised ledge. Substantially all of the shelves may
have an inclined lead-in ramp for guiding slides during insertion.
[0025] According to a second aspect of the invention, at least one side
wall of the cassette has drainage ports above and/or below substantially
all of the shelves.
[0026] In another aspect of the invention, the cassette has a rear wall
with two laterally spaced vertical racks adapted to engage the pinion
gears of a slide cassette handling mechanism.
[0027] In yet another aspect of the invention, the rear wall of the
cassette has vertically spaced indexing marks corresponding to each slide
position and adapted to be sensed by a slide cassette handling mechanism.
[0028] In still another aspect of the invention, the rear wall of the
cassette has a window at each slide position through which a sensor of a
slide cassette handling mechanism can determine the presence or absence
of a slide.
BRIEF DESCRIPTION OF THE DRAWING FIGURES
[0029] Preferred embodiments of the disclosed system and the invention,
including the best mode for carrying out the invention, are described in
detail below, purely by way of example, with reference to the
accompanying drawing, in which:
[0030] FIG. 1 is a vertical sectional view through a specimen vial for use
with the LBP device, showing the processing assembly (stirrer) in the
vial coupled to the cover;
[0031] FIG. 2a is a front elevational view of the container portion of the
vial;
[0032] FIG. 2b is a top plan view of the container, shown with the stirrer
removed;
[0033] FIG. 3 is a top plan view of the stirrer;
[0034] FIG. 4 is a bottom plan view of the liner that fits within the
cover;
[0035] FIG. 5 is an exploded vertical sectional view of the stirrer and a
filter assembly adapted for use in the stirrer;
[0036] FIG. 6 is a vertical sectional view of the upper portion of the
stirrer, showing the filter assembly in place in the particulate matter
separation chamber;
[0037] FIG. 7a is a partial schematic view of the arrangement depicted in
FIG. 6, showing the flow of liquid and particulate matter separated
therefrom;
[0038] FIG. 7b is a view similar to FIG. 7a, showing liquid flow in a
prior art filter system;
[0039] FIG. 8 is an exploded, cross-sectional view of the filter assembly;
[0040] FIG. 9 is a schematic illustration of the dimensional configuration
of the flow manifold;
[0041] FIG. 10 is a vertical sectional view of the specimen vial similar
to FIG. 1, but showing the stirrer detached from the cover;
[0042] FIG. 10a is a partial vertical sectional view similar to FIG. 10,
showing a modification of the stirrer;
[0043] FIG. 11 is a top plan view of the LBP device;
[0044] FIG. 11a is a schematic diagram of the operating sequence of the
LBP device;
[0045] FIG. 12 is a front perspective view of the LBP device, with certain
parts removed for clarity;
[0046] FIG. 13 is a rear perspective view of a portion of the LBP device,
showing the auto loader/unloader mechanism;
[0047] FIG. 14 is a top plan view of the auto loader/unloader mechanism;
[0048] FIG. 15 is a front elevational view of the auto loader/unloader
mechanism;
[0049] FIG. 15a is a detail sectional view taken along line 15a-15a in
FIG. 14;
[0050] FIG. 16 is an elevational view of an alternative embodiment of a
gripper for the auto loader/unloader mechanism;
[0051] FIG. 17 is a perspective view of a specimen vial tray used in the
auto loader/unloader mechanism;
[0052] FIG. 18 is an enlarged detail view taken at encircling line 18 in
FIG. 17;
[0053] FIG. 19 is a bottom perspective view of the specimen vial tray of
FIG. 17;
[0054] FIG. 20 is a perspective view of three stacked specimen vial trays;
[0055] FIG. 21 is a block diagram showing specimen vial handling and data
flow;
[0056] FIG. 21a is a pictorial diagram showing an overall laboratory
system incorporating the LBP device;
[0057] FIG. 21b is a relational database table;
[0058] FIG. 22 is a block diagram showing a computer or work station;
[0059] FIG. 23 is a facsimile of a computer screen;
[0060] FIG. 24 is a facsimile of another computer screen;
[0061] FIG. 25 is a facsimile of two computer screens;
[0062] FIG. 26 is a vertical sectional view of a specimen vial being
uncapped;
[0063] FIG. 27 is a front elevational view, partly in section, of a
specimen vial engaged by the uncapping head of the LBP device;
[0064] FIG. 28 is a top plan view of the uncapping head, taken along line
28-28 in FIG. 27;
[0065] FIG. 29 is a side elevational view of the uncapping station of the
LBP device;
[0066] FIG. 30 is a sectional view taken along line 30-30 in FIG. 29;
[0067] FIG. 31 is a top plan view of the uncapping station of FIG. 29;
[0068] FIG. 32 is a vertical sectional view of a specimen container
showing engagement by the primary stirring head;
[0069] FIG. 33 is a side elevational view of the primary stirring station
of the LBP device;
[0070] FIG. 34 is a front elevational view of the primary stirring
station;
[0071] FIG. 35 is a top plan view of the primary stirring station;
[0072] FIG. 36 is a vertical sectional view of a specimen container during
filter loading;
[0073] FIG. 37 is a side elevational view of the magazine portion of the
filter loading station of the LBP device;
[0074] FIG. 38 is a front elevational view of the pusher portion of the
filter loading station;
[0075] FIG. 39 is a top plan view of the pusher portion of the filter
loading station;
[0076] FIG. 40 is a top plan view of the magazine portion of the filter
loading station;
[0077] FIG. 41 is a vertical sectional view of a specimen container during
specimen acquisition;
[0078] FIG. 42 is a vertical sectional view of a specimen container during
specimen transfer to a slide;
[0079] FIG. 43 is a side elevational view of the specimen acquisition
station of the LBP device;
[0080] FIG. 44 is a front elevational view of the lower portion of the
specimen acquisition station;
[0081] FIG. 45 is a top plan view of the specimen acquisition station,
partly in section, taken along line 45-45 in FIG. 43;
[0082] FIG. 46 is a top plan view of the specimen acquisition station;
[0083] FIG. 47 is a schematic of a bubble flow meter used in the specimen
acquisition station;
[0084] FIG. 47a is a schematic of a modification of the flow meter of FIG.
47;
[0085] FIG. 48 is a schematic of a vacuum system used in the specimen
acquisition station;
[0086] FIG. 49 is an operation chart for the vacuum system of FIG. 48;
[0087] FIG. 50 is a front perspective view of the re-capping station of
the LBP device;
[0088] FIG. 51 is a side elevational view of the re-capping station;
[0089] FIG. 52 is a front perspective view of a slide cassette used in the
LBP device;
[0090] FIG. 53 is a detail perspective view of the slide cassette taken
from FIG. 52;
[0091] FIG. 54 is a rear perspective view of the slide cassette;
[0092] FIG. 55 is a side elevational view of the slide cassette;
[0093] FIG. 56 is a top plan view of the slide presentation system of the
LBP device; and
[0094] FIG. 57 is a side elevational view of the slide presentation
system.
DETAILED DESCRIPTION OF BEST MODE
[0095] A full description of this vial-based specimen handling and
processing system must begin with the vial itself, which consists of a
container, a cover and a processing assembly (stirrer) in the vial.
[0096] Specimen Vial
[0097] Referring to FIGS. 1, 2a and 2b, the vial 10 comprises a container
20, a cover 30 and a processing assembly 40. Processing assembly 40 is
designed to carry out several functions, among them mixing, and for this
preferred rotary embodiment will be referred to as a stirrer for the sake
of convenience. Container 20 preferably is molded of a translucent
plastic, preferably polypropylene, and has a substantially cylindrical
wall 21, surrounding its longitudinal axis, joined to a conical bottom
wall 22. Possible alternative plastics include ABS and
polycyclohexylenedimethylene terephthalate, glycol (commercially
available from Eastman Kodak Co. under the name EASTAR.RTM. DN004). A
small portion 24 of wall 21 preferably is flat, the outer surface of the
flat portion adapted to receive indicia, e.g., a bar code label,
containing information concerning the specimen placed in the vial.
Although only one flat portion is shown, the container could be
configured without a flat portion, or with two or more flat portions,
each adapted to receive indicia. Alternatively, the indicia could be
located on a curved portion of wall 21. The bottom end of flat portion 24
has an arcuate notch 25 which acts to keep the container in a proper
orientation when handled by the LBP device, which as noted is designed to
cradle the container and move it through various processing stations. A
differently shaped notch (e.g., V-shaped) can be used as long as the
notch properly mates with the LBP device. Other suitable mating
structures can be used instead.
[0098] Four longitudinal ribs 26 project inwardly from wall 21. The upper
ends 27 of ribs 26 form rests for the stirrer 40 when it is detached from
cover 30 (see FIG. 10). The top of container 20 has an opening 28 and a
standard right-hand helical thread 29 that preferably extends for one and
one half turns and mates with a similar thread on cover 30. Other types
of cover-to-container coupling may be used, such as a bayonet coupling,
snap-fit arrangement, etc.
[0099] Cover 30 comprises a commercially available simple molded plastic
threaded cap 31, and a novel liner 32 retained in the cap. Cap 30
preferably is molded of polypropylene, but ABS and EASTAR.RTM. DN004,
among others, are alternative plastic material choices. Cap 31 has a flat
solid top, and an externally knurled depending flange with an internal
helical thread 33 that mates with thread 29 on container 20. Referring to
FIG. 4, liner 32 is molded of plastic material, preferably polyethylene,
and has a substantially flat base 34 sized to fit snugly within cap 31,
behind thread 33, so that the liner is not readily separated from the
cap. As seen in FIG. 1, liner base 34 serves as a gasket-type seal
between the cap 31 and the rim of the container wall 21.
[0100] Liner base 34 has a coupler in the form of an annular projection 35
that preferably is slightly conical in shape, preferably forming an angle
of about 5.degree. to its central axis. In other words, the inner
diameter of annular coupler 35 is greater at its proximal end, where it
joins liner base 34, than at its distal end. Liner base 34 also has a
central annular boss 36 that projects further from base 34 than annular
coupler 35 so as to interact with stirrer 40, as described below. While
the use of a separate liner mated to a standard cap is preferred, the
cover could be integrally molded in one piece to include the annular
coupler 35 and the central annular boss 36. Such a one-piece cover (or
even the two-piece cover described above) could instead be configured to
act as a plug-type seal by projecting into and sealing against the inside
of the rim of container wall 21.
[0101] Referring to FIGS. 1, 3 and 5, stirrer 40 is molded of plastic,
preferably polypropylene, and has a circular base or bottom wall 41,
sloped at its center, with a central inlet port 42; a central depending
suction tube 43 with two diametrically opposed suction ports 44 near the
bottom of the tube; and a dispersing (mixing) element in the form of
laterally extending vanes 45. The upper portion of the stirrer 40 has a
cup-shaped particulate matter separation chamber or manifold 46 defined
by base 41 and an upstanding annular wall 47. The upper edges of wall 47
are beveled, the inner edge 48 preferably being beveled to a greater
degree to facilitate placement of a filter assembly F in manifold 46, as
described below. Possible alternative plastic material for the stirrer
include ABS and EASTAR.RTM. DN004.
[0102] Annular wall 47 serves as a coupler for releasably coupling the
stirrer 40 to cap liner 32, and is therefore dimensioned to fit snugly
within annular coupler 35 (see FIG. 1). Specifically, there is a friction
or press fit between couplers 35 and 47 such that normal handling of the
closed vial, and normal handling of cover 30 when removed from container
20 (e.g., to place a biological specimen in the container) will not cause
separation of the stirrer from the cover. Coupler 47 is dimensioned
relative to coupler 35 so that there is a very slight initial diametrical
interference, preferably about 0.31 mm. Coupler 47 is stiffer than
coupler 35, so assembly of the stirrer to the cover involves slight
deformation principally of coupler 35, resulting in a frictional force
that keeps the stirrer and the cover engaged. Application of an external
force to the vial that overcomes this frictional retention force will
cause stirrer 40 to detach from cover 30 and drop by gravity further into
container 20 (see FIG. 10).
[0103] The external separation force preferably is applied to the central
portion of cover 30 (see the arrow in FIG. 10), which deflects cap 31 and
liner 32 inwardly. As illustrated in FIG. 1, central boss 36 on liner 32
is dimensioned such that its distal end just contacts or lies very close
to base 41 of the stirrer. Thus, when the central portion of the cover is
depressed, central boss 36 will deflect further than annular coupler 35
on liner 32 and push stirrer 40 out of engagement with coupler 35. Inward
deflection of liner 32 also causes coupler 35 to spread outwardly,
thereby lessening the retention force and facilitating detachment of the
stirrer. The separation force applied to cover 30 and required to detach
the stirrer should be in the range of 5 to 30 lbs., preferably about 12
lbs.
[0104] Once detached from the cover 30, stirrer 40 comes to rest on the
upper ends 27 of ribs 26. See FIG. 10. The particulate matter separation
chamber (manifold) 46 thus is stably supported near the container opening
and easily accessed by the LBP processing heads, which will manipulate
the stirrer so as to process the specimen directly in the container. At
least three ribs 26 are required to form a stable support for the
stirrer, but four are preferred because that number seems to promote more
thorough dispersion of the particulate matter in the liquid during
stirring. Should the stirrer inadvertently become detached from the cover
at the point-of-care site, the physician or an assistant simply places
the stirrer loosely in the vial so that it descends into the specimen and
then screws the cover on as usual. This is not difficult because the ribs
in the vial allow insertion of the stirrer in only one direction. Once
the vial is closed with the specimen inside, the stirrer remains in the
vial throughout processing and is sealed therein when the vial is
re-capped.
[0105] A small percentage of patient specimens, as may be found in
gynecological Pap test and other specimen types, contain large clusters
of cells, artifacts, and/or cellular or noncellular debris. Some of these
large objects, if collected and deposited on a slide, can obscure the
visualization of diagnostic cells and, consequently, result in a less
accurate interpretation or diagnosis of the slide sample. Since most of
these features are not of diagnostic relevance, their elimination from
the sample is, in general, desirable. To achieve this result, the side
suction ports 44 in the stirrer suction tube 43 preferably are eliminated
(see FIG. 10a) in favor of close control of the interface between the
bottom of the suction tube 43 and the small projection 23 at the center
of bottom wall 22 of the container 20. This interface effectively forms a
metering valve whose geometry (orifice) 23a is created when the stirrer
40 rests on the ribs 26 of the container 20 (see FIG. 10). Proper sizing
of the annular flow orifice 23a prevents large objects from entering the
suction tube 43, while allowing the passage of smaller objects that may
be diagnostically useful. While the orifice 23a has a thin passage
section and a small metering area, clogging is not an issue due to its
large diameter. The annular orifice 23a preferably has an outside
diameter on the order of 0.105 in. and an inside diameter on the order of
0.071 in., yielding a passage width on the order of 0.017 in. This
orifice size is optimized for gynecological specimens.
[0106] Filter System
[0107] FIGS. 6 and 8 illustrate one embodiment of a filter assembly F
according to the present invention. FIGS. 3 and 6 illustrate one
embodiment of a manifold 46 (in stirrer 40) according to the present
invention. The filter system includes the filter assembly F and the
manifold 46.
[0108] Referring to FIGS. 6 and 8, the filter assembly F comprises a
filter housing or holder 200, a porous frit 202, and a porous membrane
filter 205. FIG. 8 shows these components more clearly in an exploded
view. The holder 200 can be cup- or container-shaped, having a recess or
cavity 206 for seating the frit 202 and a chamber 207 between the frit
202 and the holder 200. The frit 202 and the membrane filter 205 can be
made of the materials disclosed in the Guirguis patents identified above,
namely U.S. Pat. Nos. 5,301,685 and 5,471,994, the disclosures of which
are incorporated herein by reference.
[0109] In the present filter assembly F the membrane filter 205, the frit
202, and the holder 200 are assembled together as a unit. The flit 202,
which has a cylindrical shape, is first seated in the holder 200. Then
the membrane filter 205 is permanently affixed, adhered, joined, or fused
to the holder 200. In the illustrated embodiment, the outer perimeter or
edge of the membrane filter 205 is fused to the holder 200. In this
regard, the holder 200 has a bevel or chamfer 208 formed around an outer
circumferential comer 209. The chamfer 208 provides an angled surface to
which the membrane filter 205 can be attached using a conventional
bonding technique, such as ultrasonic welding. The holder 200 and the
membrane filter 205 should be made of materials that will fuse together.
Preferably both are made of polycarbonate, although an ABS holder will
work with a polycarbonate membrane filter. Thermoplastic polyester could
be used for the holder if the membrane filter is made of the same
material. The frit 202 preferably is made of polyethylene.
[0110] Referring to FIG. 8, the holder 200 preferably is cylindrical and
comprises a substantially cup-shaped body having a bottom wall or base
210 and a substantially upright cylindrical sidewall 211 extending
therefrom and terminating in a rim 211a. The sidewall 211 has an annular
shoulder 212 extending radially inwardly, toward the center. The shoulder
212 acts as a seat that accurately positions the frit 202. Frit 202
preferably is dimensioned so that the frit's outer or front face 213 is
proud of (extends beyond) the rim 211a when the peripheral portion of the
frit's rear face abuts the shoulder 212.
[0111] The inner diameter of the sidewall 211 can be dimensioned to
frictionally engage and hold the frit 202 in place. In this respect, the
flit's outer diameter can substantially correspond to the inner diameter
of the sidewall 211 to mechanically, i.e., frictionally, hold the frit
202 in place. However, since the membrane filter 205 covers the frit 202,
the frit need not be frictionally held to the holder. That is, the frit
202 can be loosely seated in the holder. Frictionally seating the frit
202 in the holder 200, however, maintains the frit 202 in place so that
attachment of the member filter 205 can be done at a remote site. It also
simplifies and reduces the cost of mass production of filter assemblies
because the holder 200 and the frit 202 can be joined to make a secure
subassembly and stored for later attachment of the membrane filter 205.
[0112] After the frit 202 is seated in the holder 200, the membrane filter
205 is draped over the frit's outer face 213 and the exposed portion 214
of the frit's side wall 215 that extends beyond the holder 200, and is
attached to the chamfer 208, as is better seen in FIG. 6. The flit's
exposed outer sidewall portion 214 provides an annular surface area
through which the specimen liquid can flow to provide a dual flow path,
as schematically illustrated in FIG. 7a.
[0113] The filter assemblies F can be coded to denote different pore size
and pore density (number of pores per unit cross-sectional area) as may
be required for specific processing protocols. Color coding of filter
assemblies is preferred, although any form of machine-detectable coding
can be used, including distinguishing projections, such as small nipples,
for tactile-based sensor recognition. The LBP device is provided with a
sensor that can discriminate between these colors or other codes to
ensure proper filter selection. The filter assemblies also can be
provided in paper carriers for easy insertion into the LBP device.
[0114] Referring back to FIG. 8, the holder's bottom wall 210 has a
central opening 204 through which vacuum can be applied to draw specimen
liquid therethrough. The holder 200 further includes a central projection
or protrusion 216 extending into the holder from the bottom wall 210. The
central protrusion 216 is aligned with the opening 204 and positioned in
the chamber 207, which is defined by the frit's inner face 218, the inner
face 219 of the bottom wall 210 and the inner side 220 of the sidewall
211. The protrusion 216 is substantially hollow and has a plurality of
side openings 221 that distribute vacuum to the chamber 207 and provide a
substantially symmetrical flow through the chamber. The specimen liquid
drawn through the membrane filter 205 and the frit 202 fills the chamber
207 and exits the chamber 207 through the side openings 221 and the
central opening 204.
[0115] The protrusion 216 has an abutting surface 217 that faces and
extends toward the holder's open face. The abutting surface 217 is
configured to abut against the frit's rear face 218. In particular, the
abutting surface 217 is slightly proud of the annular shoulder 212. That
is, the abutting surface 217 lies slightly above or beyond the level of
the annular shoulder 212 so that the frit's outer face 213 bows slightly
outwardly when the frit is installed in the holder. For example, the
abutting surface 217 can extend beyond the height of the annular shoulder
212 by about 0.002 inch. The resulting slight bow created by the
protrusion pushing out the central portion of the frit 202 ensures that
the central part of the membrane filter 205 contacts the slide. The
pressure applied to the slide during imprinting flattens the frit's front
surface 213, ensuring full contact of the membrane filter 205 with the
slide to more effectively transfer the collected particulates to the
slide and minimizing any deposition artifacts. If this slightly bowed
configuration is desired, the frit 202 preferably is securely seated in
the holder 200, such as by friction as previously explained.
[0116] Due to the bowed frit configuration, the membrane filter 205 need
not be taut. This simplifies the manufacturing process, reduces cost, and
reduces the rejected part rate. Anything short of a major wrinkle can
work effectively. As noted, the frit 202 preferably is slightly
deformable, its compliance allowing it to flex and flatten against a
glass slide post aspiration to transfer cells and other objects of
interest from the filter to the slide. To accomplish this the frit should
have an elasticity that allows it to be crushed flat by application of a
force of 8 lbs. through a displacement of 0.0016 in. Good frit materials
include sintered polyethylene and sintered polyester. The frit 202 may be
a porous material, with spatially random pores, typically with pore sizes
in the range of about 50-micrometer to 70-micrometer. A significant
attribute of this material is that it is of low fluidic impedance
relative to the material of the thin membrane filter 205 (which typically
has pore sizes of about 5-micrometer to 8-micrometer). In other words,
the pressure drop across the frit 202 is much less than the pressure drop
across the membrane filter 205. Thus, fluid that passes through the
filter flows freely through the frit. Alternatively, instead of having
randomly positioned pores, the frit 202 may be made of a material or
structure that has many parallel channels of small (e.g., 50-micrometer
to 70-micrometer) inner diameters through which aspirated fluid and
particulates may flow. Such a parallel-channel arrangement would behave
as an inner fluid-pervious medium with an apparent low fluidic impedance.
In fact, any material or device with the proper low fluidic impedance and
deformability/resilience characteristics may be used in the specimen
acquisition station, whether it has pores or not.
[0117] It has been found that flowing the specimen liquid substantially or
mostly in an axial direction, i.e., perpendicular to the membrane filter,
can accumulate layers or clusters of particulates, as schematically
illustrated in FIG. 7b, particularly if the vacuum is applied through the
membrane filter for a longer period than necessary. This can happen even
with the Guirguis dual flow design, which provides some secondary flow
components that are radially directed. See, for example, FIGS. 4 and 12
of Guirguis' U.S. Pat. Nos. 5,471,994 and 5,301,685. It seems that the
secondary flow generated by that configuration is insufficient to create
an effective flushing, or shearing action across the membrane filter. An
earlier Guirguis patent, namely U.S. Pat. No. 5,137,031, discloses a
funnel- or cone-shaped manifold. In that arrangement, however, there is
no secondary radial outflow at its periphery. As there is no flow other
than directly through the filter itself, there is no substantial radial
flow component. Accordingly, the specimen liquid only flows substantially
perpendicularly to the membrane filter.
[0118] Referring to FIG. 6, the inner diameter of the upright wall 47 of
the manifold 46 at the top of stirrer 40 is dimensioned to be slightly
larger than the outer diameter of the filter assembly F, namely the
holder's sidewall 211, so that the manifold 46 can receive and seat the
filter assembly F, with the membrane filter 205 facing down, as
illustrated. The filter assembly F can be loosely seated in the manifold
46. When the filter assembly F is seated in the manifold 46, the outer
peripheral edge of the membrane filter 205 rests on the bottom wall 41.
The bottom wall 41 is configured to have a well or recess that forms a
manifold chamber M when the filter assembly F is seated in the manifold
46. The chamber M is thus bounded by the outer surface of the membrane
filter 205 and the upper surface 41 S of the bottom wall 41.
[0119] The present dual flow arrangement solves the problem of particulate
build-up or accumulation on the face of the membrane filter. This
arrangement causes a shearing force or action across the front face of
the membrane filter that is sufficient to flush the particulates aside
and keep them from building up or layering. Built-up or layered
particulates have a weaker bond to the layer underneath them as they
build up, because the suction power decreases as the pores of the
membrane filter 205 become covered with particulates. A shearing force is
created by imparting a tangential or substantially radial flow component
to the specimen liquid across the front face of the membrane filter 205.
This flow component is substantially parallel to the front face of the
membrane filter, i.e., it is perpendicular to the built-up direction of
the layers, and flushes the particulates radially outwardly, away from
the front face of the membrane filter.
[0120] To provide a secondary or radial flow path, the manifold 46 is
configured to provide a small spacing or gap G (see FIG. 6) at the
periphery of the manifold chamber M, between the front face of the
membrane filter 205 and the upper surface 41 S of the bottom wall 41, to
allow flushed particulates to exit the manifold chamber M, away from the
front face of the membrane filter. The gap G must be large enough to
prevent the particulates from clogging it. That is, if the gap G is made
too small for the particulates being filtered, the gap G can get clogged,
cutting off the secondary flow. The minimum size of the gap ultimately
depends on the particulate size, the viscosity of the specimen liquid,
and the temperature of the specimen liquid. It has been determined that
the gap G should be at least 0.004 in. to prevent clogging by cellular
particulates.
[0121] Referring to FIGS. 3 and 6, to create the gap G, which forms an
outflow nozzle, the bottom wall 41 of manifold 46 includes a plurality of
spaced standoffs or raised ribs 48a around the periphery of the manifold
46. The spaces 49 between the ribs 48a provide a passage for specimen
liquid to exit the chamber M. In the illustrated preferred embodiment,
the manifold 46 has an inner diameter of 23.4 mm, and has thirty-six ribs
48a, evenly spaced at 10.degree.. The ribs are 0.150 mm high and
arcuately blend into the surrounding shoulder with a radius R of 0.63 mm,
as illustrated. Of course, the present invention contemplates other
configurations of spaced ribs or standoffs, which are intended to
precisely space the filter assembly from the bottom wall 41 so that a
precise outflow area is created. Depending on the number and thickness of
ribs or standoffs, the total outflow area can be reduced as much as 50%
as compared to the inlet area.
[0122] It has been observed in the Guirguis type filter arrangement
referred to above that specimen liquid traveling radially outwardly loses
velocity. The present dual flow filter system compensates for the
velocity slowdown by providing a shallow, substantially conical surface
across which the specimen liquid flows. This surface forms a
substantially conical distribution manifold chamber M confronting the
membrane filter 205. The chamber M according to the present invention has
an annular radial outlet O, through spaces 49, having an area that is
about equal to or smaller than the maximum area of the central inlet I.
Referring to FIG. 9, the "face" area of the radially directed annular
flow passage is cylindrical and is defined (bounded) at any given radius
R.sub.1, R.sub.x, R.sub.y, . . . , R.sub.2 by the front surface of the
membrane filter 205 and the conical surface 41S of the manifold. As the
specimen liquid travels outwardly, the radius increases while the
manifold height decreases. The manifold chamber M can be configured so
that the height H.sub.1, H.sub.x, H.sub.y, . . . , H.sub.2 decreases at a
rate which maintains the face area of the annular passage substantially
uniform from the inlet I to the outer perimeter outlet O of the manifold,
yielding a substantially linear radial flow velocity across the face of
the membrane filter 205.
[0123] In this regard, still referring to FIG. 9, the maximum theoretical
radial flow area of a round manifold inlet I can be defined as the
circumference (2.pi.R.sub.1) multiplied by the height of the manifold
chamber H.sub.1. In this instance, 2.pi.R.sub.2H.sub.1 defines the total
circumferential area of the manifold inlet I. The maximum circumferential
flow area of a round manifold outlet O can be defined as
2.pi.R.sub.2H.sub.2. If the outlet flow area is to equal the inlet flow
area, then the inlet and outlet areas can be expressed as:
2.pi.R.sub.1H.sub.1=2.pi.R.sub.2H.sub.2
R.sub.1H.sub.1=R.sub.2H.sub.2
[0124] Using this expression, the heights, e.g., H.sub.x, H.sub.y, can be
defined at their given radii, e.g., R.sub.x, R.sub.y from the inlet I to
the outlet O. If the heights H.sub.1, . . . , H.sub.x, . . . , H.sub.y, .
. . H.sub.2 from the inlet to the outlet are plotted, the resulting
surface 41S would be curved, not linear. However, it has been observed
that a significantly curved lower manifold surface does not work as
effectively as a linear surface 41S. Accordingly, the present preferred
embodiment contemplates a linear or substantially or nearly linear
surface 41S (which can be slightly curved) extending from the inlet to
the outlet. Also, there is a minimum height H.sub.2 of about 0.006 inch
clearance for the specimen liquid to effectively flow. Based on this
requirement, the minimum R.sub.1 can be defined as 0.006R.sub.2/H.sub.1
inches. With this configuration, as the specimen liquid is drawn through
the filter, the specimen liquid traverses the front face of the membrane
filter 205 in a direction that is substantially parallel to or
approaching nearly parallel to the front face of the membrane filter,
creating the desired shearing action.
[0125] Empirical study has revealed that for a linear conical surface 41S,
the area of the outlet O preferably should be less than or equal to the
maximum area of the inlet I. That is, R.sub.1H.sub.1 R.sub.2H.sub.2. For
example, the exemplary manifold can have the following dimensions (all
units here in mm): R.sub.1=1.24, H.sub.1=1.32, R.sub.2=10.00,
H.sub.2=G=0.15. The maximum inlet area would thus be 3.27.pi. mm.sup.2
and the outlet area 3.00.pi. mm.sup.2, which is slightly less than the
maximum inlet area, but greater than the average inlet area, which can be
defined as 50% of the maximum inlet area (1.64.pi. mm.sup.2). Thus, the
outlet area can fall between the maximum inlet area and the average inlet
area. Another example can have the following dimensions (all units here
in inches): R.sub.1=0.040, H.sub.1=0.060, R.sub.2=0.400, H.sub.2=0.006.
The maximum inlet area would thus be 0.0048.pi. in.sup.2, which is equal
to the outlet area.
[0126] In summary, the manifold chamber M that confronts the substantially
flat membrane filter should have a shallow, funnel-shaped configuration
and a peripheral outlet so as to create a substantial radial flow across
the outer surface of the membrane filter. The radial flow creates a
shearing action that washes or flushes away any particulates that are
relatively weakly attached so as to leave a very thin layer of
particulates--a monolayer--on the surface of the membrane filter.
[0127] LBP Device and Method
[0128] FIGS. 11-57 illustrate a preferred embodiment of an LBP device
according to the present invention. The LBP device is an automated
machine for preparing slides for viewing, imaging or optical analysis.
The LBP device can use the above-described dual flow filtering system
(FIGS. 6, 7a, 9) to collect monolayers or thin layers of cells and
transfer them onto slides.
[0129] Referring to FIG. 11, the illustrated embodiment of the LBP device
can be compartmentalized into at least six discrete processing stations:
data acquisition station (bar code reader) 230; uncapping station 400;
primary stirring station 500; filter placement station 600; specimen
acquisition station 700; and re-capping station 800. These six stations
are structured for parallel processing, meaning that all these stations
can operate simultaneously and independently of the other. The LBP device
also includes a separate data reading station, a slide presentation
station, a slide handling station, and a cassette handling station, all
of which can be incorporated as an integrated system 900. The LBP device
further includes a transport mechanism 240 for moving the specimen
containers to the various operating stations. It can further incorporate
an auto loading mechanism 300 that automatically loads and unloads
specimen vials onto and from the transport mechanism. All stations are
computer-controlled. FIG. 11a shows the operating sequence of the LBP
device. This is the top-level table from which the operating software is
structured.
[0130] FIG. 12 shows the basic structural elements of the LBP device,
namely a frame 260 preferably made of extruded aluminum, preferably on
casters (not shown) for mobility, and a machined aluminum base plate 262
supported by the frame and on which the main operating mechanisms are
mounted. Beneath the base plate is a compressor 264 for supplying
compressed air for powering some of the components; a vacuum pump (not
shown) which provides a vacuum source for various components; stainless
steel shelves for holding the vial trays used in the auto loading
mechanism 300; and electrical components, including power supplies and
controllers, and miscellaneous equipment. A compressor would not be
required if electrically-powered actuators were used instead of
air-powered actuators. A user interface, e.g. a touch-sensitive LCD
display (not shown), is mounted to the left of the transport mechanism
240 and gives the technician control over machine operation beyond the
normal automated processing protocols. See FIG. 25, which shows examples
of a log-in screen (top) and a navigation screen (bottom) as they might
appear on the user interface. Of course, other screens would be presented
to the user as he/she interacts with the user interface.
[0131] An "economy" version of the LBP device can take the form of a
counter-top model for processing a more limited number of specimens at a
time. In such a model certain components can be eliminated, such as frame
260 and auto loading mechanism 300, while other components can be scaled
back, such as the capacity of filter placement station 600. External
sources of vacuum and compressed air could be used to power such a
device, while other components (power supplies, controllers, etc.) could
be repositioned to one or more modules adjacent to or on a modified
machine base plate. Various ways of implementing these modifications will
be readily apparent to those skilled in the art.
[0132] Transport Mechanism
[0133] Referring to FIG. 11, the transport mechanism 240 comprises an
endless link-belt conveyor 242 driven by a stepper motor (not shown)
around precision sprockets 242, 244. The conveyor has a plurality of
receptacles or carriers 246, linked by pins 248, for receiving a
corresponding number of specimen vials. The illustrated embodiment in
FIG. 11 has 30 receptacles, numbered 1 through 30. Depending on the
sample vial size and the length of the conveyor, the LBP device can use
fewer than or greater than 30 receptacles, as desired or feasible,
sufficiently long to permit all processing to be completed in a single
line.
[0134] The receptacles 246 of the link-belt conveyor are guided between
the sprockets by pairs of guide rails 250 forming tracks, and has a
conventional position correction system (not shown) to accurately
position the receptacles. The LBP device can track the position of each
receptacle and step-drive or index them in a conventional manner. For
instance, the LBP device can include linear position sensors, such as
optical sensors or a photo-interrupter on each link, that can feed the
position to a controller for registering carrier position and precisely
indexing each carrier at each of the processing stations along the
processing path. The manner of driving the conveyor for precise alignment
and positioning is conventional and thus will not be described further.
[0135] The guide rails 250 that form tracks in Z and Y axes engage slots
machined in the sides of the receptacles. See, for example, FIGS. 29, 33,
37 and 43. The mechanical tracks and drive sprockets can be constructed
of a self-lubricating plastic for operation without the need to add an
external lubricant. The receptacles 246 each can have a window 247 (see
FIG. 12) for allowing access to laser or optical scanning of the bar code
on the specimen containers. The conveyor can be hard-coated aluminum,
.RTM.-impregnated with PTFE7 for easy cleaning. The link pins 248 can be
precision ground and hardened. The link pins can be axially fixed in
location in the non-rotating link bore. Rotating link bores can be fitted
with a suitable bearing material capable of operation without additional
lubricant. For operator safety, the conveyor operation can be interlocked
with the cover of the machine (not shown).
[0136] The receptacles 246 are also configured so that they receive or
seat the specimen vials in a particular orientation. That is, the
specimen vials and the receptacles are complementarily configured or
keyed so that the vials can only be seated in the receptacles in a
particular orientation. For example, the vials can be "D" shaped, namely
having a flat side (see FIGS. 2a, 2b), and the receptacles can be "D"
shaped so that the flat sides align with each other. In this way the
vials do not rotate relative to the receptacles, while allowing
unrestricted vertical movement relative to the receptacles. In addition
to the D shape, each vial can have a bottom notch 25 (see FIG. 2a), and
the receptacles can have a mating peg or stud (not shown) that keys into
the notch 25. While the illustrated notch and peg are arcuate, they can
take on other mating shapes (e.g., V-shaped).
[0137] Vial Loading/Unloading Mechanism
[0138] FIGS. 12, 13 and 14 show the automated vial loading and unloading
mechanism 300. A pivoted pick-and-place arm 304 is mounted on an elevator
carriage 306 driven by a vertical (Y-axis) lead screw motor 308 atop a
vertical standard 310. Arm 304 has a conventional electrically- or
pneumatically-operated jaw-type gripper 312 adapted to grasp and move
specimen vials 10 in three degrees of freedom. Arm motion in horizontal
planes is afforded by lateral lead screw motor 314, which is pivotally
mounted in a clevis-type bracket 316 to elevator carriage 306. Instead of
a jaw-type gripper as shown, the pick-and-place arm can be equipped with
a conventional pneumatically operated suction-head type gripper as shown
in FIG. 15. Such a gripper has a silicone rubber bellows 318 which seals
against the cover 30 of a vial when placed against the cover and subject
to suction through a suction line 320. Whether mechanical or pneumatic,
actuation of the gripper is accomplished through the programmed operation
of the machine as is understood by those skilled in the art.
[0139] Referring to FIGS. 17-20, specimen vials 10 are stored in special
injection molded plastic vial trays 330 that slide into the machine on
shelves 320 (see FIG. 12). To avoid confusion, it should be pointed out
that FIGS. 13-15 show a different form of tray (made of stamped steel),
but the operation of the mechanism that rotates the trays, regardless of
their construction, is the same. The plastic vial trays 330 are the
preferred form, and are preferably made of polypropylene. The term "tray"
as used herein is not limited to the embodiments shown, and should be
construed to cover any type of carrier, rimmed or rimless, that can
support and move a generally planar array of discrete articles generally
in the manner described herein.
[0140] Each tray 330 has forty-one circular recesses 332 sized and
configured to receive specimen vials 10 only in one orientation. The
upper edge of each recess 332 preferably has a beveled edge 333, which
facilitates smooth insertion of vials. The recesses are arranged in a
close-pack array of four concentric rows, preferably as follows. The
outermost row has sixteen recesses; the next row in has eight recesses;
the third row in has nine recesses; and the innermost row has eight
recesses. The receptacles of adjacent rows are offset for closer spacing.
The receptacles of the second row are radially aligned with the
receptacles of the fourth (innermost) row. The receptacles of the
outermost row are spaced at 18.degree. on center. The receptacles of each
of the other rows are spaced at 36.degree. on center. Of course, other
receptacle arrays could be used as long as they permit access of all
vials by the pick-and-place arm 304. Each receptacle has a unique and
addressable location, so that any vial can be accessed at will and in any
sequence.
[0141] As noted above, orientation of specimen vials during the processing
is critical, so the proper orientation of the stored vials in these trays
ensures that the pick-and-place arm 304 will properly position each vial
in a conveyor receptacle 246. Accordingly, each recess 332 has at its
bottom (see FIG. 19) a fixed indexing peg 334 that is sized to fit into
notch 25 in the vial. The pegs 334 are installed, e.g., by adhesive, in
grooves 335 that are molded into the tray adjacent the bottoms of the
recesses 332. Some of the pegs have been omitted from FIG. 19 for
illustrative purposes.
[0142] The pegs 334 are arranged at specific angles with respect to the
median plane of the tray 330 such that each vial removed from the tray is
delivered to a transport receptacle with its notch aligned with the
mating peg in that receptacle, and vice versa. Each of these angles is
dictated by the rotational position of the tray 330 when a vial in a
specific recess 332 is to be accessed by the pick-and-place arm 304, and
the angular rotation of the pick-and-place arm from the point of vial
pick-up to the point of vial placement in the conveyor receptacle 246.
The determination of these angles is considered to be within the
abilities of one of ordinary skill in the art.
[0143] The tray 330 also has three upstanding guide posts 336, each with a
spring-loaded ball 338 at its tip, which cooperate with guides (not
shown) above each shelf 302 and serve to guide the tray into the machine
as it is inserted and ensure its proper orientation. The guide posts 336
also serve as stacking posts when the trays are stacked for storage (see
FIG. 20), the balls 338 engaging dimples 339 (see FIG. 19) in the bottom
of the superior tray.
[0144] The tray 330 also has a large flared notch 340 which is oriented
toward the machine when the tray is inserted on a shelf 302. The
innermost portion of the notch 340 has opposed keyways 342 which are
adapted for engagement by floating keys, as described below. The keyways
preferably are formed in a milled brass hub insert 343 that is recessed
flush with the top of the tray and secured thereto by screws.
[0145] Referring to FIGS. 14, 15 and 15a, a rotary outer spindle 350 is
journaled at its top and its bottom in bearings 352, 354, respectively.
Outer spindle 350 engages and rotates only one tray at a time so that the
pick-and-place arm 304 can access vials therefrom by moving downwardly
through an opening 266 in base plate 262 and past any idle trays via
their homed notches 340. FIG. 14 shows the home positions of the trays in
dashed lines, with their notches 340 aligned and embracing outer spindle
350. Spindle 350 is rotated in a precision manner from the bottom by a
computer-controlled rotation stepper motor 356 and a timing belt 358
engaging timing gears 360, 362. A downwardly facing optical rotary
position sensor 363 located over the aligned tray notches detects when
and how far a tray is rotated from its home position and provides control
feedback for rotation of stepper motor 356.
[0146] Within outer spindle 350 is an inner spindle 364 carrying eight
pairs of opposed keys 365, one pair for each tray. The keys 365 project
from outer spindle 350 through opposed slots 366 in the outer spindle
(see FIG. 15a, which is a sectional view through the spindles and the
center portions of the bottom two trays). The inner spindle 364 is moved
vertically within the outer spindle 350 by an internal lead screw 372.
Lead screw 372 is rotated by lead screw stepper motor 374 through a
timing belt 376 and timing gears 378, 380. A key "home" sensor 382 (see
FIG. 15) is located at the top of inner spindle 364 to provide a
reference point, i.e., when the machine is turned on, it will "home" the
inner spindle to the key home sensor 382 and then reference its movements
from there.
[0147] The even vertical spacing of the pairs of keys can be seen in FIG.
15. This spacing, or pitch, differs from the pitch of the keyways 342 in
a full complement of installed trays 330. Accordingly, which keyways are
engaged by the keys depends on the vertical position of inner spindle,
and only one pair of keyways (tray) can be engaged at any time. The
enlarged view of FIG. 15a shows that the keyways 342 of bottom tray 330-1
are engaged by keys 365, while the keyways of the tray above it, 330-2,
are not engaged by any keys. Movement of inner spindle 364 by one-eighth
the pitch difference disengages one tray and engages the immediately
adjacent tray. The operation of the loading and unloading mechanism is
unaffected by the absence of one or more trays from the tray slots, which
are defined by shelves 302.
[0148] When a selected tray is to be accessed by the pick-and-place arm
304 (as determined by the computer controller), the lead screw motor 374
moves the inner spindle the appropriate distance so that the appropriate
keys engage the keyways of the selected tray. The rotation motor 356 then
rotates the keyed tray to the proper angular position so the arm 304 can
access a particular recess 332. The superposed arrangement of the trays,
the way in which a selected tray is accessed by the gripper 312 through
the flared notches 340 of superior trays, and the close-pack spacing of
the recesses 332 in each tray make for an extremely compact, high
capacity and efficient vial handling system that is readily incorporated
into the compact base of the LBP device.
[0149] In the embodiment shown, the LBP device can accommodate up to eight
trays holding forty-one specimen vials each. One of the forty-one
recesses can be reserved for a cleaning vial, which would contain a
cleaning solution and be run through the LBP device to clean the various
parts of the device that normally come into contact with specimen fluid.
Alternatively, the forty-first vial could contain a typical control
specimen for calibration purposes. Thus the LBP device can accommodate up
to at least 320 vials containing specimens to be processed. The device is
therefore capable of operating continuously unattended for a long
duration--at least eight hours--so that specimen processing can be
carried out even when laboratory personnel are not normally present, such
as at night.
[0150] When the trays 330 are bar-coded or otherwise labeled with
machine-readable identifying data, they can be used in an automated
storage device that can access a particular tray on command. The
tray-identifying data can be input into the integrated data management
system so that the location of any specimen vial in tray storage can be
readily ascertained.
[0151] A cost reduction in tray-based storage of specimen vials can be
achieved by using a liner-type system in conjunction with trays 330. For
example, vials can be supported and stored in thin sheet-like liners (not
shown) that conform to trays 330 and slip readily into recesses 332. The
liners are stiff enough to be self-supporting when fully loaded, can be
stacked, and can be housed in wheeled carts for ease of mobility.
[0152] Data Accessioning and Specimen Management
[0153] It is, of course, important to keep track of each specimen vial and
the specimen slides produced from each vial. Accordingly, the LBP device
typically communicates with the integrated data management system (DMS)
104 through an accessioning station 102 or other computer. FIG. 21
schematically illustrates specimen vial handling and the flow of data
that is integrated into to operation of the LBP device. The communication
link between the LBP device and the DMS can be made via ethernet or other
protocol using a direct peer-to-peer connection, or through a
server-based network.
[0154] The specimen processing operation begins with collecting or
transferring data from the labeled specimen vial, e.g. via a bar code
reader on a data entry terminal or accessioning station, to the DMS via
either a direct connection or over a network. Specimen tracking data can
include, for example, the patient's name, test identification (ID)
number, patient data, and any special processing instructions. For
example, the bar-coded specimen vial can be linked to the patient
information initially by a paper requisition form and subsequently by an
assigned, unique numerical ID in the database. In a preferred embodiment,
the patient and test information including the vial bar code can be
entered into the networked DMS database at the point-of-care site (e.g.,
physician's office), thereby eliminating entirely the need for a paper
requisition form. U.S. Pat. No. 5,963,368 (incorporated herein by
reference), which is assigned to AccuMed International, Inc. (now
Molecular Diagnostics, Inc., or MDI) discloses a similar concept as
applied to a computer-controlled instrument for analyzing biological
specimens (a microscope) and storing data from each analysis. The '368
patent is exclusively licensed to MonoGen, Inc. (the owner of this
application) in the field of liquid-based cytology in combination with or
for use with non-fluorescence based image analysis devices, processes,
systems and/or instruments. MonoGen's commercially available pathology
work station and data management system implement the concept disclosed
in the '368 patent.
[0155] Each specimen vial includes an identification (ID) symbol or label
(e.g., bar code) and/or a stored information label or symbol such as a
hologram or a memory chip or device. The present embodiment contemplates
reading an ID label using an optical reader, such as a bar code reader,
which provides the information to a DMS for sharing information between
different work stations or instruments at the same or different
locations, such as laboratories, doctors' offices, hospitals, or other
patient care providers. FIG. 21a depicts an overall laboratory system
wherein the DMS is expanded to link specimen/patient data through a
server to a variety of specimen processing devices and/or computerized
work stations for fully integrated specimen management.
[0156] A separate bar code reader 230 (see FIG. 11) is mounted on the LBP
machine itself, and scans all specimen vials prior to processing through
a slit in each transport receptacle 246. Each of the transport
receptacles 246 is tracked using this symbol or code, such as a bar code
that can be read with a conventional optical reading device. The bar code
readers used in the LBP device can be any commercially available type,
such as Keyence BL-600, with a minimum BCR target code capability of
Interleaved 2 of 5, Code 128c, or EAN-128. The bar code readers
preferably are sealed in liquid-tight enclosures for operator protection.
After reading, specimen vial/transport receptacle ID data are transmitted
to the DMS of the host database or work station. The host database or
local work station can then transmit back to the LBP device the specific
processing protocol to be performed on that individual specimen.
[0157] Some of the most important functions of the data management system
(DMS) include:
[0158] Obtaining data on the patient and the specimen during accessioning,
and making this available to each instrument as required to set
processing parameters and to provide medical data to the slide reviewer;
[0159] Maintaining chain of custody of specimens and slides to ensure data
integrity;
[0160] Compiling data and printing required forms for regulatory,
compliance, and laboratory management reports;
[0161] Generating medical reports and ensuring integrity using safeguarded
digital electronic signatures;
[0162] Managing billing for instruments on "per use" charges;
[0163] Storing optimal processing protocols for each process and supplying
to the instrument in accordance with the specimen type and/or user
requirements; and
[0164] Facilitating remote diagnostics and repair, and providing user
manuals and troubleshooting guides.
[0165] FIG. 21b shows an example of a relational database table that can
be used to accomplish these tasks.
[0166] The DMS can provide paper-free data flow among the different stages
of the cytology process, saving a significant amount of personnel time
and cost, reducing transcription errors, improving accuracy, and
eliminating the space required to store paper records. By automating and
managing data acquisition, storage and retrieval, each operation becomes
more efficient, significantly reducing the turn-around time for
specimens. Specimen quality is enhanced by automated calibration and
cross-checking routines that identify potential problems early. Flexible
foreign language support for worldwide sales assists laboratories in
multicultural environments.
[0167] The DMS provides a common user interface that provides detailed
information on the operation of each connected laboratory device and work
station, and together with online user manuals and training aids eases
use and minimizes training. The DMS
handles the exchange of all relevant
patient and specimen data with the users' own LIS (or other data
management systems) through a provided software interface. Moreover,
remote instrument diagnostic capabilities ensure maximum
interruption-free operation. The reduction in paperwork, ready
cross-compatibility with other instruments and existing computer
networks, and integration with the central hospital or laboratory
information system provides significant user benefits.
[0168] In typical operation, the laboratory: (1) receives a requisition
from the healthcare provider along with the pre-bar-coded specimen vial,
(2) assigns a unique ID number (accession number) to the specimen, and
(3) based on information on the requisition, enters a specific LBP test
ID to specify the process to be used. FIG. 23 shows an example of the
accessioning (data entry) screen that is presented to the technician,
into which the vial bar code, accession number and LBP process code are
entered. When the specimen vial is loaded into the LBP device for
processing, the LBP device automatically reads the bar code on the
specimen vial and transmits the bar code number (106) to the DMS, which
sends back the processing parameters for the selected test, and the
number of slides to be produced. The LBP device returns an acknowledgment
(108) and processes the specimen, making one or more slides as instructed
via the DMS. Immediately before the LBP device imprints a specimen slide
with material filtered from a specimen vial, the LBP device reads the bar
code from the pre-bar-coded slide that is to receive the specimen sample.
The LBP device sends each slide bar code (110) and its associated vial
bar code to the DMS which updates the patient database with the slide bar
code number, cross-references it to the correct vial number, and signals
(112) the LBP device to proceed. The LBP device then imprints a
cytological sample from the specimen onto one or more slides and readies
the onboard data log for the next specimen to be processed. FIG. 24 shows
an example of a DMS menu screen showing data items that are now linked in
the DMS database, including the vial number, slide number(s) and patient
data. The DMS can produce a printable report listing slide ID numbers and
associated vial ID numbers, patient data and processing protocols.
[0169] At a minimum the protocol variables include specimen mixing
parameters (stirring speed and time) and filter selection. Typically,
primary stirring speed can be varied from 500 rpm to 3,000 rpm selectable
in 50 rpm steps. The stirring interval can be varied from 5 to 120
seconds, selectable in 5 second increments. Choice of filter type is
based on average pore size diameter: either 5 micron (red housing), e.g.
for non-gynecological specimens, such as sputum specimens, or 8 micron
(white housing), e.g. for gynecological specimens, depending on the test
protocol selected.
[0170] The LBP device is capable of processing mixed sample-runs (i.e.,
runs that may include vials containing various types of specimens)
interchangeably and without the need for batch processing of same-type
specimens. Specimen processing can include at least 100 different
processing protocols resident within the DMS and accessible to users.
Predefined procedure codes (test ID's) such as the following can be used
to simplify operator input and specify which processing protocol is used:
[0171] 1 breast cyst, L
[0172] 2 breast cyst, R
[0173] 3 bronchial brushing
[0174] 4 bronchial washing
[0175] 5 bronchoalveolar lavage
[0176] 6 cerebrospinal fluid
[0177] 7 colonic brushing/wash
[0178] 8 esophageal brushing/wash
[0179] 9 gastric brushing/wash
[0180] 10 gingival (buccal) scrape
[0181] 11 gyn PAP test
[0182] 12 intestinal brushing/wash
[0183] 13 nipple discharge, L
[0184] 14 nipple discharge, R
[0185] 15 ovarian cyst, L
[0186] 16 ovarian cyst, R
[0187] 17 pericardial effusion
[0188] 18 peritoneal effusion
[0189] 19 pleural effusion
[0190] 20 rectal brushing/wash
[0191] 21 sputum, induced
[0192] 22 sputum, spontaneous
[0193] 23 urine, catheterized
[0194] 24 urine, voided
[0195] Each specimen is processed with a new filter to prevent the
possibility of cross contamination. In the present embodiment, either of
two or more different filter types can be specified for versatility in
test selection (the device's eight filter tubes allow for up to eight
different filter types). Processing parameters for each type of specimen
preparation can be determined remotely and in advance, and communicated
to the processing device using a bi-directional communication link
utilizing the specimen vial bar code as the key identifier. The LBP
device can utilize default (pre-loaded into the DMS) process protocols as
well as laboratory-generated process protocols that users can add to the
DMS.
[0196] An overfilled-vial sensor (not shown) can be positioned at or just
downstream of the bar code reader 230 to detect whether an excessive
amount of fluid is present in each translucent vial. Opening and
processing an overfilled vial can result in hazardous spillage or
ejection of biological fluid. Accordingly, if an overfilled vial is
detected, the DMS will be so notified and the complete LBP processing
protocol for that vial will be canceled, allowing the overfilled vial to
proceed through the processing path unopened. Alternatively, an
overfilled condition can be sensed at the conveyor holder 246 into which
vials are loaded by the vial loading mechanism 300. If an overfilled vial
is detected there, the DMS will be so notified and the loading mechanism
will be instructed immediately to return the overfilled vial to its tray
330.
[0197] A similar approach can be used to deal with other anomalies
detected as each vial is loaded into the conveyor. For example, a sensor
(not shown) can be used to detect an unreadable bar code on the vial, or
detect when a vial is improperly position in the holder 246. When any
such condition is detected, the DMS will be so notified and the loading
mechanism will be instructed immediately to return the overfilled vial to
its tray 330.
[0198] FIG. 22 is a block diagram showing the components of a general
purpose computer system or work station 270, which can be used to run the
DMS. The computer system 270 typically includes a central processing unit
(CPU) 272 and a system memory 274. The system memory 274 typically
contains an operating system 276, a BIOS driver 278, and application
programs 271, such as a DMS. In addition, the computer system 270 can
include input devices 273, such as mouse, keyboard, microphone, joystick,
optical or bar code reader, etc., and output devices, such as a printer
275P, and a display monitor 275M.
[0199] The computer system or work station can be connected to an
electronic network 280, such as a computer network. The computer network
280 can be a public network, such as the Internet or Metropolitan Area
Network (MAN), or other private network, such as a corporate Local Area
Network (LAN) or Wide Area Network (WAN), or a virtual private network.
In this respect, the computer system 270 can include a communications
interface 277, such as ethernet, USB, or Firewire, which can be used to
communicate with the electronic network 280. Other computer systems 279,
such as a remote host database, other types of work stations including
automated analyzers, and computers or databases (e.g., LIS) of a
hospital, laboratory, or other medical establishment, can also be linked
to the electronic network 280. Other LBP devices, as well as other types
of specimen processing instruments (e.g., automated slide stainers and
coverslippers) 279a can also be connected to each other and the DMS via
the network.
[0200] One skilled in the art would recognize that the above-described
system includes typical components of a general purpose computer system
connected to an electronic network. Many other similar configurations can
be used to control the LBP device and its processes. Further, it should
be recognized that the computer system and network disclosed herein can
be programmed and configured by one skilled in the art to implement the
methods, system, and software discussed herein, as well as provide
requisite computer, data and electronic signals to implement the present
invention.
[0201] In addition, one skilled in the art would recognize that the
"computer" implemented invention described further herein may include
components that are not computers per se, but include devices such as
Internet appliances and Programmable Logic Controllers (PLCs) that may be
used to provide one or more of the functionalities discussed herein.
Furthermore, while "electronic" networks are generically used to refer to
the communications network connecting the processing sites of the present
invention, one skilled in the art would recognize that such networks
could be implemented using optical or other equivalent technologies. One
skilled in the art would recognize that other system configurations and
data structures can be provided to implement the functionality of the
present invention. All such configurations and data structures are
considered to be within the scope of the present invention. In this
context, it is also to be understood that the present invention may
utilize known security and information processing measures for
transmission of electronic data across networks. Therefore, encryption,
authentication, verification, compression and other security and
information processing measures for transmission of electronic data
across both public and private networks are provided, where necessary,
using techniques that are well known to those skilled in the art.
[0202] Uncapping Station
[0203] One of the advantages of the present vial-based LBP device and
system is that it minimizes operator exposure to the specimens, which can
contain potential biohazards. Referring to FIGS. 26-31, the LBP device
has an uncapping mechanism 400 that first automatically separates the
stirrer 40 in the vial from cover 30, and then removes and discards the
cover--all without intervention by an operator. See FIG. 26, which shows
the stirrer resting on vial ribs 26 after the cover 30 is removed.
[0204] A closed specimen vial 10 which has arrived at the uncapping
station in its transport receptacle 246 is met by an uncapping head 402
which is lowered onto the cover 30 of the specimen vial. See FIGS. 27 and
28. Uncapping head 402 has four tapered legs 404 that form a tapered
gripping cavity having chisel-like inner edges 406 spaced and sized to
progressively tighten onto cover 30 as head 402 is lowered. Once the
cover is tightly engaged by the legs, a central spindle or plunger 408 is
lowered into contact with the center of cover 30 and applies a downward
force to the cover to cause the stirrer 40 to detach from the cover 30,
as described above, and drop down in the vial onto ribs 26. Then the
plunger is retracted and the uncapping head 402 is rotated
counterclockwise (FIG. 28) to unscrew cover 30 and remove it from
container 20. Thereafter the uncapping head with the removed cover in its
grip moves laterally to the position shown in dashed lines 410 in FIGS.
29 and 11, and plunger 408 is again lowered, this time to eject cover 30,
which falls into a waste chute or bin (not shown) beneath the uncapping
head. Alternatively, a movable waste chute can be brought beneath the
uncapping head to catch the ejected cover, so that lateral movement of
the uncapping head is not required. Covers are not reused to eliminate
the possibility of cross-contamination.
[0205] The plunger 408 is driven by a pneumatic cylinder 412, mounted on
an L-bracket 415 at the top of the uncapping head, that can apply a force
on the cover of up to about 30 lbs. A coil spring 413 returns the plunger
to its retracted position when cylinder 412 is deactivated. The head 402
is capable of applying an uncapping torque through the gripping legs of
up to about 10 lb-ft, which is sufficient to loosen the cover. The
gripping legs can be of the self-energizing type so that precise
alignment with the cover or small variations in cover geometry do not
frustrate their grip.
[0206] The uncapping mechanism has a mounting frame 414 supported on
blocks 416 that slide laterally of the processing path on rails 418. A
Y-axis stepper motor 420 and lead screw 422 effect lateral motion. The
uncapping head 402 is rotatably mounted in a bearing block 424. Bearing
block 424 is secured to a C-frame 426 that is vertically slidable on
mounting frame 414. Vertical movement of C-frame 426 and, hence,
uncapping head 402 is effected by Z-axis stepper motor 428 and lead screw
430. Lead screw 430 can be vertically compliant to accommodate upward
movement of the cover 30 as it is unscrewed. However, it is preferred
that stepper motor 428 be actuated during the uncapping sequence so that
head 402 rises at about the same rate as, but no faster than, the
unthreading cover. Uncapping head 402 is rotatably driven by uncapper
motor 432 through a gear reduction unit 433, a timing belt 434 and timing
pulleys 436, 438.
[0207] The uncapping head described above would also work with vials
having a conventional "press and turn" bayonet-type coupling between the
container and the cover. The downward force of the plunger 408 would be
sufficient to release the internal anti-turn lock of the coupling,
allowing the gripper to rotate and remove the cover. Vials having covers
that do not require rotation for removal, e.g., a snap-on cover, would
require a differently designed uncapping head, tailored to the type of
cover connection involved.
[0208] Alternatives to the above-described plunger 408 can be employed at
or upstream of the uncapping station for applying the required external
force to the covered vial to effect separation of the stirrer from the
cover. For example, a cam, lever arm or other movable mechanical element
can contact and press down on the cover. Alternatively, an abrupt upward
external force can be applied to the vial to yield an acceleration force
that overcomes the frictional retention force between couplers 35 and 47,
effectively pulling the stirrer out of engagement with the cover. This
can be done by, e.g., moving the closed vial rapidly downwardly to rap
the bottom of the container 20 against a rather hard surface, e.g., by
mechanically and/or pneumatically thrusting the closed vial into the
transport carrier 246 that will hold the vial during the subsequent
processing steps, or by dropping the vial down a chute into the carrier a
sufficient distance to dislodge the stirrer. Another way to exert an
abrupt upward external force on the vial is to strike the bottom of the
container 20 with a striking member. This can be accomplished by, e.g.,
cradling the container 20 and momentarily thrusting a striker against the
bottom of the container, e.g. through a bottom opening in the vial
carrier 246, by pneumatic and/or mechanical means. The design of these
and other variants of suitable automated mechanisms for accomplishing
these tasks is within the grasp of those skilled in the mechanical arts.
[0209] Preprocessing (Primary Stirring) Station
[0210] After uncapping is completed, the transport mechanism indexes the
specimen container to a station where preprocessing occurs. The
preprocessing station is the location at which preprocessing operations,
such as specimen dispersal within its container, are performed prior to
the container and its specimen moving to the specimen acquisition
station. The preprocessing station typically performs a dispersal
operation. In the preferred embodiment, the dispersal operation is
performed by a mechanical mixer, which rotates at a fixed speed and for a
fixed duration within the specimen container. In this example, the mixer
serves to disperse large particulates and microscopic particulates, such
as human cells, within the liquid-based specimen by homogenizing the
specimen. Alternatively, the specimen may contain subcellular sized
objects such as molecules in crystalline or other conformational forms.
In that case, a chemical agent may be introduced to the specimen at the
preprocessing station to, for example, dissolve certain crystalline
structures and allow the molecules to be dispersed throughout the
liquid-based specimen through chemical diffusion processes without the
need for mechanical agitation. In this example, the chemical
preprocessing station introduces its dispersing agent through the
preprocessing head.
[0211] In the illustrated preferred embodiment preprocessing occurs at the
primary stirring station 500, which uses a specified or instructed
stirring protocol to stir the specimen, if needed, using the stirrer 40
in the container, at a specified speed (rpm) for a specified duration.
The stirring protocol chiefly depends on the specimen, as described
above, and is normally intended to disaggregate any mucous material and
disperse it and/or other particulate material in the specimen liquid.
[0212] Referring to FIGS. 32-35, the primary stirring station 500 has a
stirring head 502 in the form of an expanding steel collet. The collet is
formed at the lower end of a shaft 503 which splits into six flexible
fingers 504 defined by six equally spaced slits 506. Shaft 503 is
rotatable in a bearing block 508 secured to a C-frame 510 that is
vertically slidable on a mounting frame 512. Vertical movement of C-frame
510 and, hence, stirring head 502 is effected by a Z-axis stepper motor
514 and a lead screw 516. Stirring head 502 is rotatably driven by a
stirring motor 518 through a timing belt 520 and timing pulleys 522, 524.
[0213] The inner surfaces of the collet fingers 504 taper uniformly
inwardly toward the lower end of the collet. A central plunger 526,
movable vertically by a pneumatic cylinder 528 atop a bracket 530,
expands the fingers 504 outwardly when it descends and encounters the
narrowing passage defined by the tapering fingers. Thus the diameter of
the lower end of the stirring head (collet) 502 increases when the
plunger descends. This end is sized to fit loosely but closely within the
annular wall 47 at the top of stirrer 40 when the collet is not expanded.
When plunger 526 descends, the fingers 504 expand outwardly to wedge
against the inside of wall 47, in manifold M, securely engaging the
stirrer.
[0214] In operation, the stirring head 502 is first lowered so that the
collet enters the manifold M. The dashed motor and bracket lines in FIGS.
33 and 34 indicate this lowered position. Then plunger 526 descends to
lock the stirring head to the stirrer. Then the stepper motor 514 is
operated to slightly raise the stirring head and the attached stirrer 40.
This vertical movement need only be very small, such as 0.050 in., just
to free the stirrer from the ribs 26 and prevent interference with the
container during stirring. Then DC stirring motor 518 is operated in
accordance with the specimen-specific stirring protocol. Stirring speed
can vary, and is usually in the range of about 500 rpm to about 3,000
rpm. The stirring time can vary from about 5 seconds to about 90 seconds.
The base or bottom wall 41 of the stirrer acts as a slinger to thrust any
liquid that may rise along the stirrer against the container wall, and
prevents the escape of liquid from the container. Withdrawing the plunger
526 from the collet releases the stirrer 40 from the collet 502 so the
specimen container can move on to the next station.
[0215] A contracting collet could be used instead of expanding collet 502.
In that case, the collet fingers would fit around the outside of annular
wall 47, and would be squeezed together to clamp around the wall by a
descending sleeve that surrounds the fingers.
[0216] Filter Placement Station
[0217] At the filter placement station 600 an appropriate filter assembly
F (see FIG. 5) is loaded into the open manifold M at the top of the
stirrer 40. Filter assemblies can come in different filter configurations
for automated machine recognition. For example, one set of filter
assemblies can be colored red (5 micrometers), another set white (8
micrometers), each having different filtering properties, and a color
sensor can detect which type of filter is before it and cause the proper
filter to be loaded. The filter assemblies are dispensed by a pusher from
a magazine having multiple filter tubes.
[0218] FIGS. 36-40 show the structure and operation of the filter
placement station. Referring to FIGS. 37 and 40, a filter dispensing head
610 comprises a filter magazine in the form of a turret 612 rotatable on
a spindle 614 by a stepper motor 616. Vertical post 611 provides the main
support for the turret. Turret 612 has a top support plate 618 with eight
equally spaced holes 620 near its periphery, each hole opening through
the edge of the plate 618 with a slot 622. A bottom guide plate 624 on
spindle 614 has a similar arrangement of holes that are aligned with the
holes and slots in the top support plate.
[0219] Eight steel filter tubes 626, each having an upper support shoulder
628, are supported vertically in holes 620 and the aligned holes beneath
them, with shoulders 628 resting on the top of top plate 618. Each filter
tube 626 has a full-length slot 630, and its bottom portion is split into
four springy fingers 632 by slots 634. Just above the bottom end the
fingers 632 curve inwardly, forming rounded inner shoulders 636 against
which a filter assembly F rests. The filter tube is dimensioned such that
the shoulders 636 keep up to a full stack of filter assemblies F from
falling out of the tube, but deflect to allow a filter assembly to pass
when the stack is pushed downwardly without damage to the filter
assembly. Fingers 632 thus form a springy choke.
[0220] FIG. 39 shows the position of the filter magazine 612 in relation
to the processing path and the adjacent processing stations, namely the
primary stirring station 500 to the left, and the specimen acquisition
station 700 to the right, all located on one side of the processing path
as defined by guide rails 250. On the other side of the processing path
opposite the filter magazine 612 is the assembly that supports and drives
a pusher arm 640. This assembly comprises a support post 642 supporting a
Z-axis lead screw 644 driven by a stepper motor (not shown) which moves a
shuttle 646 that carries pusher arm 640. A filter sensor 650 positioned
opposite bottom guide plate 624 monitors the passage (drop) of the lowest
filter assembly F in the filter tube presented to (i.e., directly above)
the specimen container. Sensor 650 also detects when the filter tube is
empty. A second sensor 651 monitors filter type.
[0221] Filter assemblies of the same type are stacked in the proper
orientation, with the membrane filter side (beveled edge) facing down, in
each tube. For example, 54 filter assemblies can be housed in each tube;
thus a total of 432 filter assemblies can be loaded into the magazine.
Fifty-four filter assemblies can be prepackaged in a stack that is
inserted into a filter tube with a wrapper tab projecting from slot 630,
and unwrapped by pulling the tab outwardly. Alternatively, filter
assemblies of the same type can be dumped onto a vibratory feeder, which
can recognize their orientation by geometric configuration, and properly
orient and feed the filter assemblies onto the tubes. Several of these
feeders can be used, one for each type of filter assembly.
[0222] In operation, with the pusher arm 640 in its home (top) position,
indicated by the dashed shuttle outline in FIG. 38, the filter magazine
612 is rotated by stepper motor 616 until sensor 650 detects the presence
of the specified type of filter assembly in the filter tube before it.
Shuttle 646 then moves downwardly with pusher arm 640 moving through slot
630 to press the stack of filter assemblies in that tube downwardly,
until the lowest filter assembly drops from the tube into the manifold M
in stirrer 40. When filter drop is sensed, the shuttle 646 with its
pusher arm 640 stops its advance. In an alternative arrangement, a weight
sensor can be used to monitor the weight of the filter stack, and detect
by weight change when a filter assembly has dropped from the stack and
when the filter tube is empty.
[0223] The use of eight filter tubes 626 in magazine 612 enables
unattended processing of all of the specimens housed in the trays of the
vial autoloader 300. For a counter-top model of the type described above,
however, a single filter tube supported in a fixed position above the
processing path would suffice for processing specimens that require the
same type of filter.
[0224] Specimen Acquisition and Cell Deposition Station
[0225] Referring to FIG. 41, specimen acquisition station 700 has a
suction head 702 that descends to engage the upper portion of the stirrer
40. Before drawing a vacuum on the specimen through the filter assembly
F, the suction head grips, slightly lifts and rotates the stirrer 40,
this time more slowly than at the primary stirring station (typically no
more than 500 rpm for a 5 second interval), to re-suspend the particulate
matter in the specimen liquid. The re-stir motor can be a Maxon 24 volt
DC planetary gear-reduced type. Then suction is applied through suction
line 750 to aspirate specimen liquid from the container 20 through
suction tube 43, into the particulate matter separation chamber
(manifold) 46 and through the filter assembly F, leaving a monolayer or
thin layer of uniformly deposited cells on the bottom surface of the
filter as described above. It may also be possible to rotate the stirrer
slowly while the specimen liquid is being aspirated.
[0226] FIG. 6 shows how the suction head cooperates with the annular wall
47 of the stirrer manifold and the filter assembly F therein. The outer
portion 704 of the suction head envelops the wall 47 and has an O-ring
760 that seals against the outside of wall 47. The inner portion 706 of
the suction head has two concentric O-rings 762, 764 that seal against
the top of filter holder 200. Suction applied through port 750 creates a
vacuum around central opening 204 and within filter holder 200, which
draws liquid into the manifold 46 and through the filter 202. An O-ring
766 is interposed between the inner and outer portions of the suction
head.
[0227] Referring to FIG. 42, when aspiration of the specimen is complete,
the suction head 702 is raised. The inner portion 706 of the suction head
is extended at the same time by action of a pneumatic cylinder (not
shown) mounted above the suction head. As the suction head 702 is raised,
the outer portion 704 disengages from the stirrer 40, but the filter
assembly F is retained on the inner portion 706 by application of a
vacuum through suction line 752 to the annular space between O-rings 762
and 764. Thus the suction head 702 removes filter assembly F from the
stirrer, and can continue to apply light suction via suction line 750
through the filter to effect a desired degree of moisture control of the
cellular material on the filter.
[0228] The suction head 702 then moves laterally away from the transport
conveyor by pivoting 90.degree. about a vertical axis to the cell
transfer position "P" shown in FIG. 46, to position the filter assembly F
over a microscope slide S delivered from a slide cassette at slide
presentation station 900. This pivoting movement of suction head 702 can
also be seen in FIGS. 11 and 39. The inner portion 706 of the suction
head 702 then moves downwardly to press the filter against the slide S
with a tamping force in the range of 4 to 8 lbs. and transfer the
monolayer of cells thereto. The phantom lines in FIG. 42 show this change
in position of suction head 702 and contact of the filter with slide S.
Instead of being pivotally mounted, the suction head 702 could be mounted
for rectilinear movement to and from a different deposition site where
slides are presented, e.g., above the processing path.
[0229] Referring to FIGS. 43-46, suction head 702 is rotatably mounted on
a boom 716 that also carries the re-stirring motor 718, which rotates
suction head 702 through a timing belt 720. Boom 716 is pivotally
supported about a vertical axis 721 on a slide 722, which is vertically
movable along frame support 724 by means of a Z-axis stepper motor 726
and a lead screw 728. Motor 726 thus moves the entire suction head
vertically. Pivoting motion of boom 716 is effected by stepper a motor
717 operating through a gear train (not shown). Vertical motion of the
inner portion 706 of the suction head is effected by a pneumatic cylinder
and return spring (not shown) mounted above the suction head to an
L-bracket 719, substantially identical to the arrangement 412, 413, 415
(see FIG. 29) used to move the plunger 408 of the uncapping head 402.
[0230] The frame support 724 is mounted on a slide 730 so as to be movable
laterally of the transport path. A Y-axis stepper motor 732 and a lead
screw 734 effect this movement. After the slide is printed the suction
head is raised by the Z-axis motor, and the Y-axis stepper motor 732
advances the entire assembly to the dashed line position "X" shown in
FIG. 43. Then the suction head pivots back to its original orientation,
transverse to the transport path (position "S" in FIG. 46). The Y-axis
stepper motor 732 then pulls the entire assembly back toward its original
position (solid lines in FIG. 43). As the suction head 702 moves (to the
right as seen in FIG. 43), the still-retained filter assembly F is
"scraped" off the suction head by the edge 736 of an open-top used filter
(waste) tube 738 (see also FIGS. 11 and 39). This leaves suction head 702
free to engage a fresh filter assembly.
[0231] The vacuum source that communicates with the suction head 702 pulls
a slight vacuum, e.g., in the range of 3 in. to 10 in. Hg (adjustable by
a regulator), through suction line 750 to aspirate specimen liquid and
draw it through the filter assembly F. The separately regulated vacuum
applied through suction line 752 for holding the filter assembly to the
suction head 702 is higher, on the order of 20 in. Hg.
[0232] Formation of high-quality specimens on microscope slides depends
critically on the deposition of a monolayer of cells of specified
concentration (i.e., number of cells per unit area) on the surface of the
filter that will contact the slide. That, in turn, depends critically on
the aspiration rate and/or the aspirated flow volume. Since cell
concentration on the filter surface is a function of the number of filter
pores blocked by the solids suspended in the specimen liquid, the percent
of flow reduction from the maximum open filter condition correlates to
the blockage or amount of accumulation on the filter. Because of the
nature of biological specimens, solid particle concentration is a
significant variable in the process and must be taken into consideration.
Also, it is important to identify the total volume of material filtered
on a real time basis for other processing operations.
[0233] The specimen acquisition station thus further includes a deposition
control system for controlling the liquid draw vacuum duration by
monitoring the flow rate and/or aspirated volume. The monitored flow rate
or aspirated volume can be used to signal vacuum cut-off and/or suction
head retraction, which correlates to the specified concentration of cells
collected on the membrane filter surface. If a specified concentration
factor is not achieved before a specified volume of fluid is aspirated,
the system can also issue a retract signal.
[0234] Different types of deposition control systems or modules can be
used for these purposes. FIG. 47 schematically shows one such system,
which has a meter in the form of a digital level detector positioned
along a fluid column. This "bubble flow" system can use sensors in the
form of a plurality of LED emitters and corresponding number of
photosensors, such as Omron sensor, EE-SPX613 GaAs infrared LED, placed
along the length of the column. Any other type of sensors may be used.
Alternatively, LED sensors such as the Omron sensors mentioned above can
be used without corresponding emitters when they are positioned just at
the edge of a glass tube. The meniscus edge of the liquid in the tube
diffracts the light passing through the tube, and the sensor will detect
the shifted light pattern when the rising meniscus edge reaches the
sensor.
[0235] The fluid column is formed in a vertically extending transparent
tube or cylinder 770, e.g., one made of Pyrex glass 9 mm in diameter by 1
mm thick. The aspirated specimen fluid is drawn from the specimen
container through the membrane filter, and pulled into the glass cylinder
770 via suction line 750 and a 3-way valve 778, by means of a vacuum
source 772 connected to the top of the cylinder. The sensors 774 are
positioned evenly along the length of the cylinder 770, preferably at 1.5
ml capacity intervals, and are interfaced with a controller or
microprocessor 776.
[0236] In operation, in the normal state, with no fluid in the tube 770,
the sensor relay line is "low." Vacuum begins to draw fluid into the tube
through the filter, and the controller marks the beginning of the draw
sequence. When the fluid reaches the first sensor, the first sensor relay
line goes "high." The controller marks the time it took for the fluid to
reach the first sensor, indicating the nearly free-flow condition of the
filter, and the relative viscosity of the fluid in the test. When an
additional 1.5 ml of fluid is drawn into the tube, the second sensor
relay line goes "high." The time interval for the first 1.5 ml of fluid
(between the first and second sensors) is noted by the controller, and
this becomes the reference time base. As each additional 1.5 ml of fluid
is drawn into the system (and is detected by succeeding sensors), the
time base for that increment is computed. When the incremental time base
reaches an empirically derived percentage (e.g., 120%) of the original
(reference) time base, the controller indicates that cell collection is
completed, and a stop signal is transmitted, preferably to retract the
suction head 702 from the manifold in the specimen container. The
empirically derived figure mentioned above is variable with the protocol
and directly controls the cellularity of the specimen sample.
[0237] The best approximation of the free-flow condition of the filter is
obtained if the time it takes for the fluid to reach the first sensor 774
is kept to a practical minimum. This can be accomplished by incorporating
the first sensor into the suction head itself, as schematically
illustrated in FIG. 47a. In this embodiment, inner portion 706 of the
suction head carries an emitter 774a and an opposed sensor 774b, which
detects the leading edge of the fluid column very close to the filter
assembly F. The outer portion 704, which has teeth 775 engaged by timing
belt 720 (not shown), is rotatable about the inner portion 706 (note
interposed bearing 773) to rotate the stirrer (not shown) and stir the
specimen prior to aspiration.
[0238] During the specimen drawing operation, the controller records the
cumulative or total aspirated volume. If the cumulative volume reaches a
predetermined level before reaching the predetermined flow rate reduction
from the reference flow, the controller will also issue a stop signal and
a flag indicating that the stop signal issued not as a result of desired
reduced flow, but by reaching the maximum liquid draw limit. A slide
formed under the flagged condition will likely form a hypo-cellular
condition. The controller can imprint the slide and indicate to the DMS
that a hypo-cellular condition likely exists. Accordingly, if the flagged
condition exists, the controller issues a signal to purge the liquid in
the cylinder 770 and initiate a second draw. The cylinder is purged of
all liquid after each sample is taken.
[0239] Referring to FIG. 48, the deposition control system can have a
purge value so that when the draw cycle is completed, the stop signal
generated by the controller 776 will open the purge valve to vent the
vacuum supply line to the atmosphere and divert the liquid remaining in
the cylinder 770 into a waste container. The cylinder 770 can be
maintained under a negative pressure. The system is then ready for the
next cycle. Specifically, the system can have a 2-way solenoid valve V-3
in the suction line with one port 780 open to the atmosphere. The bottom
of the cylinder 770 is connected to a valve manifold 782 with two
solenoid valves V-2, V-4. The solenoid valves can be Lee LF series
designed for use in vacuum systems, 2-way valve LFVA 2450110H, viton
seal, 24 volt and 3-way valve, LFRX 0500300B, viton seal, 24 volt. The
2-way valve V-4 can port the specimen liquid to the bubble flow cylinder
770, or to vacuum by-pass 784. The 2-way valve V-2 can control the filter
dehydration vacuum source. FIG. 49 illustrates the valve logic.
[0240] The deposition control system can use an analog level indicator
instead of the digital sensors 774. The analog level indicator senses
capacitance of the aspirated liquid. The difference is only in the method
of sensing the volume and fill rate of the liquid in the cylinder 770.
Here two spaced electrodes are used, one around the outside of the
cylinder 770 and the other positioned down the center of the cylinder the
cylinder, separated from the aspirated liquid by a dielectric. A high
frequency, such as 10 kHz, low voltage current is applied across the
electrodes. Capacitance in this system is measured by a bridge circuit,
which provides an analog indication of capacitance in the circuit. As
fluid fills the column, capacitance in the circuit increases. A
10.times.differential in direct capacitance is easily obtained with this
system. Capacitance is indicated on a real time basis and can be sampled
frequently enough to provide control of the sampling system. This
arrangement, like the first two, uses a computer or microprocessor and a
bubble flow technology to measure the flow rate and the total fluid
volume in real time. The predetermined volume increment for these
arrangements can be in the range of about 0.1 ml to 5.0 ml, and
preferably is in the range of about 1.0 to 2.0 ml.
[0241] A different system can use an ultrasonic indicator for measuring
fluid movement through a tube. The ultrasonic system uses ultrasonic wave
propagation through a moving liquid. In this regard, the third system
employs an ultrasonic emitter and detector clamped across the liquid draw
tube (suction line 750) operating on the distal end of the filter
assembly F. This system provides a digital indication of fluid flow in
the tube, the total volume aspirated through the tube being calculated by
a flow interval calculation. It measures phase shift from the ultrasonic
wave generator source to a detector for measuring flow speed.
[0242] Another way to measure aspirated fluid volume and control the
duration of the specimen draw is to detect the change in the weight of
the specimen vial. This can be accomplished by using a sensor that makes
a high-precision measurement of the weight or mass of the vial containing
the specimen that is being aspirated. Vial weight or mass is repeatedly
measured at a high frequency such that the rate of change of the weight
or mass of the vial is accurately determined. Specimen aspiration is
completed when the rate of change in weight or mass has diminished by a
predetermined amount or percentage from the initial rate. The weight
sensor can be, e.g., a load cell in each conveyor receptacle 246, or a
single load cell beneath the conveyor at the specimen acquisition head
that rises to engage the container above it. In either case, the specimen
acquisition head can be raised slightly during aspiration to unload the
container so that the load cell can measure only the combined weight of
the container and the remaining specimen.
[0243] Although specimen acquisition preferably is accomplished through
aspiration (using a vacuum), it can also be accomplished by pressurizing
the container 20 through an appropriate head that seals against the top
of the container and forces specimen liquid up through tube 43 and
through the filter assembly by means of positive pneumatic pressure. The
fluid volume control schemes and mechanisms described above would also
work in conjunction with such a pressurized specimen acquisition system.
[0244] The cell concentration can be selected from low to high by defining
flow control cut-off. For a typical low cellularity result, the cut-off
can be 80% of the 120% reference discussed above, and for high
cellularity the cut-off can be set at 60% of the reference, selectable in
5% increments. The number of slides per specimen can range from one to
three. Some of the typical default protocols are as follows:
[0245] GYN: 1,000 RPM stir, 30 second interval, 8-micrometer filter,
60%--high cellularity, one slide.
[0246] Urine: 1,000 RPM stir, 20 second interval, 5-micrometer filter,
70%--medium cellularity, one slide.
[0247] Lung sputum: 3,000 RPM stir, 120 second interval, 5-micrometer
filter, 80%--high cellularity, two slides.
[0248] Re-Capping Station
[0249] After completing the specimen processing cycle, the specimen
container is resealed with the stirrer still inside the container. It is
preferred to use a thin, polypropylene-coated aluminum foil to form the
new cap, which is available in roll form. The foil is drawn across the
open end of the specimen container, thermally bonded to the container at
a seal temperature of about 365.degree. F. applied for about 3 seconds
with a seal force of 3 pounds, and cut from the roll. Of course, any
other type of re-capping material can be used as long as it is compatible
with the vial material and creates a safe and reliable seal. For example,
a foil backed with a thermosetting resin adhesive could be used; a
sticky-backed foil could be used that does not require heat to effect a
seal; or a plastic seal material can be bonded to the container
ultrasonically. To enhance unattended operation, an automatic threader
could be included for threading a new roll of sealing material into the
re-capping mechanism. Cutting caps from a roll can be eliminated if
roll-mounted pre-die-cut closures having peel-off tabs are fed to the
re-capping mechanism.
[0250] Referring to FIGS. 50 and 52, the re-capping mechanism 800 has a
side support plate 802 secured to the machine base plate. The side
support plate carries a main frame 810 having a top plate 812 with slots
814, 816, and two side plates 818, 820. A driver capstan 822 is journaled
in side plates 818, 820. A foil advance motor 824, mounted on a bracket
826, drives the capstan. A pressure roller 828 is pivotally mounted to
the main frame 810 and resiliently engages the capstan under the
influence of a spring 830. Capstan 822 and pressure roller 828 define
between them a throat through which the foil runs, and have resilient
surfaces which grip the foil for positive feed. A handle 832 allows the
throat to be opened manually to allow the end of the foil to be fed into
the throat after first passing through slot 814. A spindle 804, carried
side support plate 802, supports a replaceable roll of foil.
[0251] FIG. 51 shows the foil path 834 through the throat. An L-shaped
cutter 836 is pivoted at its elbow to the rear of main frame 810. One end
of a single-acting pneumatic cutter actuator cylinder 838 is mounted on a
bracket 840, and the other end of the cylinder is linked to the upper leg
842 of cutter 836. The lower leg of the cutter has a blade 844 that
normally rests above the foil path downstream of the throat, held in that
position by a spring 845 linked between the upper leg 842 and the support
plate 802.
[0252] A rear post 850 pivotally supports an arm 852 that extends
forwardly toward main frame 810. Arm 852 carries a heated platen 854 and
a foil guide fork 856 having two tines that extend toward the throat and
are spaced apart so as to allow the platen 854 to pass between them. Arm
852 is kept elevated, in the rest position shown in FIG. 51, by a spring
858. During the re-capping operation a single-acting pneumatic cylinder
860 pulls down on the arm 852 to lower the platen 854 and the guide fork
856. Note the position of a container 20 in a transport receptacle (not
shown) beneath the platen 854.
[0253] In operation, the foil advance motor turns the capstan 822 to feed
a measured length of foil past the cutter blade 844, into the fork 856,
and to the position shown by the dashed line in FIG. 51. A p
hotocell 862
detects the leading edge of the foil and signals the motor to stop. Then
cylinder 838 is actuated to cut the foil, and cylinder 860 is actuated to
pull arm 852 down to the seal position. The cut length of foil is
sandwiched between the platen 854 and the container 20, and the container
is sealed. After about three seconds cylinder 860 is deactivated and the
arm 852 rises, returning to its rest position. A vacuum assist (not
shown) optionally may be used to help hold the cut length of foil in
position on the platen prior to sealing.
[0254] The foil caps applied by the re-capping mechanism are approximately
square in shape. The comers of the foil caps can protrude from the vials
and interfere with other recapped vials that are returned to the trays
330. Accordingly, a foil folding ring 870 (seen in phantom lines in FIG.
51) preferably is provided which acts to fold the edges and comers of
each foil cap down along the side of the container. The foil folding ring
870 preferably is mounted to act on the vial in the transport position
immediately downstream of the re-capping mechanism, i.e., position "FF"
in FIG. 51, and may be mounted on the recapping mechanism itself, e.g.,
to main frame 810, so that actuation of cylinder 860 serves
simultaneously to apply a foil cap to one container and fold the edges
and comers of the foil cap of the preceding (downstream) container.
Alternatively, the foil folding ring or an equivalent foil folding
mechanism can be mounted further downstream of the re-capping mechanism
so as to act independently thereof.
[0255] Foil folding ring 870 is a metal ring having an inner diameter that
is slightly larger than the outside diameter of the threaded portion of
the container 20. The ring 870 is mounted on an arm (not shown) that
moves downwardly when actuated to lower the ring 870 over the upper end
of the container. As the ring encircles the container, it folds the
overhanging portions 872 of the foil cap against the side of the
container. When the ring rises after folding the foil, the container is
held in position in its transport receptacle by a pin (not shown) that is
mounted on a leaf spring (not shown) and is situated in the center of the
ring 870. The leaf spring is carried by the arm that holds the ring, so
the pin resiliently presses down against the center of the foil cap until
the arm and the ring retract fully.
[0256] The foil seals applied to the processed containers are easily
punctured by a syringe or a pipette to obtain further liquid specimen
samples. The seals are very durable, however, withstanding rough handling
and preventing leakage in low ambient pressure conditions, e.g., in
aircraft flying as high as 40,000 ft. Further, the appearance of the foil
seal makes it readily distinguishable from the cover of an unprocessed
vial, making handling by low-skilled operators virtually foolproof. To
avoid the potential of puncturing the foil seal inadvertently, the
re-sealed container can be capped with an unused screw-on cover of a
distinct color.
[0257] Slide Handling and Presentation
[0258] The LBP device can use 30 and 40 slide plastic magazines
(cassettes), which can accept standard 25 mm.times.75 mm.times.1 mm and
1.times.3.times.0.040 in. slides. Metric and inch based slides can be
used interchangeably. FIGS. 52-55 show a 40-slide cassette C suitable for
use in the LBP device. The slide cassette is in some respects similar to
that disclosed in U.S. Pat. No. 5,690,892 (incorporated herein by
reference), but is specially adapted for use in other devices as well,
such as an automated stainer, an automated image analyzer, and a
pathology work station, so that the slides do not have to be unloaded and
reloaded into different magazines for use in those devices.
Machine-readable indicia on the cassette, such as a bar code or an
embedded microchip, provides cassette information that can be linked by
the DMS to the bar codes on the slides in the cassette so that the
location and status of any cassette and any slide in that cassette can be
tracked in a laboratory system. The cassettes are stackable for compact
storage and easy retrieval.
[0259] Specifically, the slide cassette is molded of plastic and has a
generally rectangular shape with an open front 902, a rear wall 904, a
top wall 906, a bottom wall 908 and side walls 910. The top wall 906
bears bar-coded information 909. A guide flange 912 extends laterally
outwardly from each side wall. Rear wall 904 has a rectangular central
opening 914 through which a slide shuttle can pass (see below) to extract
and return one slide at a time. An inwardly projecting ridge 916 around
the central opening acts as a stop against which the slides abut when
they are inserted into the cassette. The preferred material for the
cassette is ABS plastic; alternative choices include polyurethane,
thermoplastic polyester, and polypropylene. The open front face is sized
to accommodate the rear of another like cassette so as to be stackable.
[0260] The slides are supported on shelves 918 at each side of the
cassette. In the illustrated embodiment there are 41 pairs of left and
right shelves, and each pair (except for the top pair) supports one slide
that spans the space between the shelves. Referring to the detailed view
in FIG. 53, each shelf (except for the top and bottom shelves) has a
raised top ledge 920 on which the slide rests and an underside beam
spring 922 for applying a force to pinch and thereby frictionally
restrain the slide against the top ledge directly beneath it. This
arrangement keeps the slides from falling out of the cassette, even when
the cassette is held face down, yet enables each slide to be moved out of
and back into the cassette by the slide presentation apparatus, described
below, without blocking, scratching or interfering with the slide-mounted
specimens. Each shelf 918 also has a lead-in ramp 924 which guides the
slide during insertion into the cassette. Each shelf 918 (including
spring 922) preferably is integrally molded into the cassette and is
attached to both the rear wall 904 and a side wall 910. However,
separately fabricated springs, plastic or metal, may be inserted between
the shelves instead.
[0261] Each side wall is provided with multiple drainage ports 926 which
allow fluid to drain from the cassette after removal from a staining
bath. The last (top and bottom) drainage ports 923 on each side also
cooperate with a hanger assembly of a stainer for moving the cassette
from one staining bath to another. During the staining operation the
cassette is oriented generally on its side, hung from the last two
drainage ports on the upper side. An all-plastic construction makes the
cassette compatible with acid baths and all types of staining bath
compositions.
[0262] Referring to FIG. 54, rear wall 904 has two rows of apertures 927
that form two integrally molded gear racks 928, which are adapted to
engage pinion gears 936 (see below) for moving the cassette
longitudinally so that each slide can be accessed by the slide shuttle.
Two spaced parallel racks and two pinion gears enhance the smoothness and
accurate positioning of the cassette, as compared to a single rack and
single pinion. Also integral with the rear wall is a row of 40 cassette
position sensing slots 929 extending through the rear wall and coincident
with the positions of the slides to allow for optical sensing of each
slide. Further, rear wall 904 has a row of 40 blind recesses 925 (these
do not extend completely through the rear wall) that allow for accurate
sensing of cassette position when it is driven via the gear racks 928.
[0263] The molded cassette preferably is supplied wrapped in sealed
plastic for cleanliness, with slides installed. It is therefore well
suited for shipping, relatively low in cost, disposable yet reusable. It
has a high storage capacity and is stackable with others, thus providing
high density storage for specimen samples.
[0264] Slide cassettes populated with slides are manually loaded into the
LBP device in an elevated in-feed track 930 (see FIG. 11) located behind
the filter loading station 600 and the specimen acquisition station 700.
No latching is required to enter cassettes into the system. Up to ten
unprocessed cassettes can be loaded in the LBP device at any one time,
but only in a single orientation. The cas
settes can be marked with a top
indicator, and will not be accepted if they are installed backwards or
upside down. The cas
settes are loaded with their open fronts facing to
the right as seen in FIG. 11, with the lead cassette between vertical
rails 932.
[0265] The lead cassette moves down incrementally whenever a new slide is
to be withdrawn from the cassette for specimen printing. This is
accomplished by a stepper motor (not shown) driving pinion gears 936 that
engages the racks 928 on the back of the cassette C (see FIG. 54). When
all slides in the cassette have been processed, the cassette descends all
the way to outfeed track 940, and a stepper motor/lead screw pusher 938
moves the cassette to the right into outfeed track 940, and then
retracts. Then the next cassette in the infeed track 930 is advanced by a
motor/lead screw pusher (not shown) to the front position between
vertical rails 932, where it is engaged by the pinion gears 936 and moved
downwardly until the first (lowest) slide comes into position for
extraction. Each of the feed tracks can have a home sensor, which can be
Omron self-contained shutter type, and a cassette full sensor, which can
be Keyence fiber optic.
[0266] FIGS. 11, 56 and 57 show the slide presentation system, which uses
a slide shuttle feed system 960, e.g. AM Part No. 5000-1, for extracting
one slide at a time from the cassette along the X-axis and placing it on
a Y-axis handler, which moves the slide to the pressing (print) position.
The aforementioned U.S. Pat. No. 5,690,892 discloses a similar slide
cassette and shuttle arrangement used in a pathology work station
(microscope). The Y-axis handler 962 has a slide platen 964 secured to a
follower 966, 967. The handler is driven by a stepper motor 970 and a
lead screw 972, guided along a rail 968. A slide is held to the platen
under a fixed shoulder 974 (against a spring 976) and a pivoted arm 978
which is spring-biased in the counterclockwise direction as seen in FIG.
56.
[0267] When the handler 962 moves to the left, arm 978 moves off an
adjustable stop 980 and rotates over the slide. The full Y-axis slide
travel (shown as "T" in FIG. 57) brings the center of the slide to the
print position "P" (note the dashed line position of the slide and the
handler in FIG. 56). On its way to the print position the bar code number
on the slide is acquired by a bar code reader 982 and transmitted to the
host data base. When the print position is reached the suction head 702,
which has pivoted along arc "A" about axis 721, lowers the filter
assembly F into contact with the slide, as described above, depositing
(printing) the specimen on the slide. Vacuum on the filter is maintained
throughout the printing cycle to prevent over hydration of the sample and
unintentional dripping.
[0268] After printing the slide moves back to the right, pausing under a
fixative dispensing head 984. Here a solenoid-driven pump (not shown),
such as Lee LPL X 050AA, 24V, 20 microliter per pulse, yielding 12
microliters per pulse (maximum of 2 pulse/second), applies fixative to
the specimen. The total volume can be determined by the number of
solenoid cycles. The total fixative volume dispensed is programmable in
20 microliter increments. It can have a flexible connection to a
dispensing sapphire jet nozzle with a 0.030 in. orifice. The liquid can
be gravity-fed from a reservoir to the pump. The reservoir can be a tank
and can have a "fluid low" sensor connected to the operating system. More
than one fixative dispenser can be employed to provide alternative
fixatives as determined by processing protocols.
[0269] After the specimen is fixed, the completed slide moves all the way
to the right, where it is transferred by the slide shuttle mechanism back
to its original position in the cassette. When the cassette is fully
processed, the entire cassette is ejected into the outfeed track 940, as
described above.
[0270] A Complete Laboratory System
[0271] The present LBP device does not require that specimens be
pre-processed before loading, and can automate every step of the slide
preparation process. Moreover, the device does not require the operator
to open any of the specimen containers--an important operator safety
feature. The LBP device can automatically prepare high quality cytology
slides from all specimen types, including mucous-containing GYN and
non-GYN specimens, using the integral high-speed, high-shear mixing
station that facilitates mucous disaggregation. The incorporated
dual-flow filter system allows production of slides with optimal cell
separation, cell concentration, cell dispersion, and optimal preservation
of antigens, DNA, and morphologic characteristics to enhance the
performance of subsequent testing. The slide cassettes, containing up to
40 slides each, will be utilized in the follow-on laboratory processing
devices to avoid the labor-intensive need to transfer slides to different
racks before continuing with slide processing. Data on the patient, the
specimen, the vial, the cassette and the slide can be transferred
automatically to the LIS over the user's network, via a DMS software
interface.
[0272] The present LBP device can provide eight hours of unattended
operation. Thus, if the operator re-loads the device before leaving for
the day, a single-shift laboratory can produce two shifts of output per
day without added personnel or equipment costs. The total throughput can
exceed 160,000 slides per year, at a per-test cost significantly below
that of the current leading LBP system.
[0273] The LBP device also has the capability to process specimens for
current and future molecular diagnostic tests including quantitative DNA
analyses, and tests utilizing markers & probes. Features built into the
device include the capacity to employ multiple fixative dispensers in
order to provide non-routine fixatives that may be required for special
molecular diagnostic tests.
[0274] The complete laboratory system, illustrated, e.g., in FIG. 21a,
includes a pathology review station, a computer-aided microscopy work
station used by pathologists to review specimen slides and sign out
cytology cases. As with all components of the laboratory system, the
pathology review stations are networked to the DMS and thereby to all
other devices on the system, for rapid access to patient data and
specimen processing information. The pathology review station accepts
slide cassettes for automated loading and review of specimen slides.
Computerized, fully automated image analyzers will perform quantitative
analyses of DNA and molecular diagnostic tests, receiving their operating
instructions and reporting their results via specimen bar codes using the
integral DMS. See, for example, AccuMed/MDI U.S. Pat. Nos. 5,963,368;
6,091,842; and 6,148,096, which are incorporated herein by reference.
[0275] The laboratory system will also include, for example, slide
autostainers and autocoverslippers (and/or combination automated
stainer/coverslipper devices) controlled via the DMS that utilize the
same slide cassette as the present LBP device. Cassettes containing
processed slides can be utilized directly in these additional devices
without the need to unload slides and reload them into separate racks.
[0276] The inter-connectivity and high degree of automation of the
processing and analytical devices making up the laboratory system will
enable high-quality, high-throughput specimen processing and analysis at
relatively low cost.
INDUSTRIAL APPLICABILITY
[0277] The above disclosure presents a safe, effective, accurate, precise,
reproducible, inexpensive, efficient, fast and convenient vial-based
system and method for collecting, handling and processing liquid-based
cellular specimens, providing fully integrated specimen and information
management in a complete diagnostic cytology laboratory system.
* * * * *