US 2847990 A
Description (OCR text may contain errors)
J. E. AYRE Aug. 19, 1958 INSTRUMENT FOR BTAINING CELLS FOR CYTODIAGNOSIS Filed Maron -2o, 1956 f lf la Il Il .vllVJ Il if r Rabb .:.........:lmm I.| Ill l VENToR. JAMES ERNEST AYRE .ATTORNEYSl ENSTRUMENT FOR OBTAINING CELLS FOR CYTODIAGNOSIS `Farines Ernest Ayre, Miami, Fla. Application March 20, 1956, Serial No. 572,733 12 Claims. (Cl. 12S- 2) This invention relates to instruments for the medical profession and, more particularly, to an instrument for use in diagnosing pathologic conditions of the tissue of the stomach and other organs cf the body.
The operating mechanism of the present invention is an improvement of the mecha-nism disclosed in my pending application, Serial No. 359,505, tiled lune 4, 1953, and now Patent No. 2,739,585, and may be used with the flexible tube assembly disclosed therein, as well as with the presently disclosed, improved, tube and brush assembly.
This invention provides improved means for introducing into organs of the body having accessible orices, such aS the oral cavity, the throat, 4the bronchus, the intrauterine cavity, the rectum, the colon, the stomac and the urinary bladder, a brush device, the bristles of which may be controllably moved over the interior surface of the organ to collect, in the bristles, specimen cells of the tissue of the organ. Upon withdrawing the brush from the organ, the collected cells are transferred to a microscope slide and processed for diagnosis in a conventional manner.
An object of this invention, therefore, is to provide an improved specimen collecting device for instruments used in diagnosing pathologic conditions of such organs which is simple and efficient in operation and easily manipulated.
A further object of this invention is to provide an improved operating mechanism for specimen gathering devices of the type that :are introduced into such body cavities, that is operative to both extend and rotate the specimen gathering device by a single stroke movement of the operating mechanism.
Other objects, advantages and features of the present invention will become apparent from a consideration of the following description and accompanying drawings, in which:
Figure 1 is a front elevational View of an instrument made in accordance with this invention, showing the operating plunger in depressed operating position and the associated specimen lcollecting brush means in an extended position, portions of the brush means being enlarged to show added detail, and the plunger also being shown in broken lines to indicate a withdrawn or inoperative position;
Figure 2 is an enlarged view similar to Figure l, but with parts `broken away and parts removed to disclose the internal construction of the instrument, and showing the relationship of the parts with the plunger in completely withdrawn position;
Figure 3 is an enlarged sectional View of the tubular cam and follower assembly shown in Figure 2, partly exploded and with the housing removed, with parts broken away to show the construction of the mechanism; and
Figure Ll is a side View of a modified form of housing for the specimen collecting brush and brush actuating shaft, wherein the housing is constructed of rigid stock.
Referring now to Figure 1 of the drawing, the instru- 2,347,990 Patented Aug.. 19, 1953 ment is shown to include an operating assembly 10 and an associated flexible shielded tube assembly 11.
The shielded tube assembly 11 which is shown, fOr purposes of illustration, to be of a shorter length than that actually used in practice, includes an exterior flexible tube 13 that may be made of any suitable material, such as polyethylene. As shown in Figure 2, one end of the tube 13 is secured to the reduced portion 15 of a rigid shielding tube or sleeve 17 and the opposite end is secured to one extremity of a rigid reducing coupling 19. The opposite extremity of the coupling 19 is adapted to threadingly engage an internally threaded nose 20 of the -operating assembly, and has an externally knurled portion 22 for facilitating the assembly of the parts. The coupling also serves to permit the axial movement of a rigid operating rod as will be hereinafter described. A exible drive shaft 21 is telescopically received within the tube 13 and is threadingly secured at one end to a tubular union 23 and secured to a ferrule 25 of a brush assembly 27 that `contains a large 4number of flagged bristles 28 at its opposite end. The tubular union 23 is adapted to `threadingly engage a second tubular union 29 of a retractable actuating rod 31 forming a part of the operating assembly 10.
A modified form of a shielded tube assembly 12 is shown in Figure 4 of the drawing. This assembly includes a rigid tube 14, inside of which a llexible shaft 16 is disposed for longitudinal and rotational movement. One extremity 18 of the .tube is enlarged to provide a shield for a specimen collecting brush that is connected to the drive shaft 16 and disposed therein in retracted position in much the same manner as the brush ferrule 2S in the `case of the liexible tube assembly 11. The other extremity lof the tube is provided with a knurled portion 24 and an externally threaded portion 26 that is adapted to directly, threadingly, engage the internally threaded nose 20 of the operating assembly. As is the case with the flexible tube assembly, the drive shaft is adapted to operatively engage the tubular union 29 of the operating rod 31.
The operating assembly 10 includes a tubular main housing 33 that contains a tubular cam and follower assembly 35 which is supported for compound movement, longitudinal and associated rotational movement therein. Referring to Figure 3, this assembly 35 is shown t0 include a hollow tube 37 that has a spiral slot 39 of several convolutionsv extending thereabout which functions as a follower element in connection with a cam-like bearing element 41 that is disposed within the slot. The bearing element 41 is rotatably mounted on a shaft 43 that is secured to a longitudinally retractable plunger 45. A bushing 47 is carried by the inner extremity `of the plunger 45 to provide an enlarged bearing surface and is maintained in operative association therewith by the engagement of the bearing 41 and shaft 43 which extend through a transverse bore 49 thereof. The operating rod 31 also has an enlarged portion, that includees a tapered section 52 and a boss 53, and is threadingly secured to the internally threaded base of the hollow tube 37. A bushing 55, having an externally tapered portion 56, which slidably receives the plunger 45 is threadingly secured to the outer extremity of the hollow tube 37.
The assembled tubular cam and follower assembly 3S is operatively supported within the main housing 33 in the manner shown more clearly in Figure 2. The nose 20 which has an externally knurled portion 57 threadingly engages an externally threaded base portion 59 of the housing. A cap 61 having a knurled portion 63 is internally threaded and engages an externally threaded head portion (i5 of the housing 33. A plurality of ball bearings 6/ and a retaining washer 69 are disposed within the cap 61 for rotatably engaging the tapered portion 56 of the bushing 55 when the plunger is in the retracted position as shown in Figure 2. A plurality of similar ball bearings 71 and retaining washer 73 are disposed within the nose 2l) for rotatably engaging the tapered section 52 of the operating rod 3l. when the plunger is in the depressed position as shown in full lines in Figure l. The exterior surface of the main housing 33 also includes a pair of wing elements 75 that have finger-receiving apertures 77 so that the instrument may be firmly grasped for use. The plunger 45 includes a thumb-piece 79 that is secured thereto by a pin 80 and which has a thumbreceiving aperture 8l, whereby the plunger may be easily depressed and withdrawn in use.
In operating the instrument, either the flexible shielded tube assembly 11 or the rigid shielded tube assembly l2 may be used, depending upon the organ of the body to be investigated. Where the rigid tube assembly is used, the rigid tube lll is threadingly secured directly to the nose 20 of the operating assembly 10, and where the flexible tube assembly is used, the reducing coupling 19 to which the flexible tube 13 is attached, is threadingly secured to the nose 2t). ln either event, the tubular union 23 of the flexible shaft lo, 2l is also threadingly secured to the corresponding union 29 of the operating rod 31 to operatively connect the operating assembly 10 to the respective shielded tube assembly. The operation of the device from this point forth is identical regardless of which type of shielded tube assembly is used.
With the plunger 45 in completely retracted position, as shown in Figure 2 of the drawing, the brushes are disposed within the interior of the tube assembly, in which position, the tube is introduced into the body cavity. When the shielded tube assembly has been fully inserted into the said cavity, it is withdrawn about one inch as the brush 27 is gently forced out of the tube by exerting an inward pressure on the thumb-piece 79 relative to the housing 33, towards a partially depressed position. As this is done, the entire cam and follower assembly 3S is moved axially under the longitudinal movement of the cam which engages the follower slot 39, from a rst retracted position in which the tapered portion 56 of the bushing 55 is in engagement with the bearings 67 of the housing cap 6l, to a second depressed position wherein the tapered portion 52 of the operating rod 31 engages the bearings 71 of the nose 26 of the main housing. Once the cam and follower assembly has been moved to this position, the length of which movement substantially corresponds to the length of the brush 27, the brush will have been placed in fully extended position, as shown in Figure l, and in engagement with the lining of the stomach.
Continued pressure on the thumb-piece 79, however, is operative to cause rotation of the hollow tube 37 about the plunger and bushing i7 as the cam il is followed by the spiral slot; while the cam moves lorgitudinally, the housing must now rotate as a follower, thereby rotating the operating rod 3l and the brush 27 that is connected therewith through the flexible drive shaft f5, 2l. lt will be recognized that the brush will have been rotated a number of times corresponding to the number of convolutions of the spiral follower slot 3S?, after which, the plunger 45 will have reached its fully depressed position 45a, as shown in Figure l. The rotation of the brush in this manner is effective to cause the bristles 23 thereof to pick up a quantity of tissue for microscopic examination.
Ey then t acting the thumb-piece 79, the entire cam and foll wer assembly 35 and the connected flexible shaft are moved longitudinally to a partially retracted position, whereby the brush is completely withdrawn into the flexible or rigid shielded tube assembly. At this point, however, the thumb-piece is only partially withdrawn. Further withdrawal of the thumb-piece and plunger d5 is then operative to cause rotation of the hollow tube 37, flexible shaft, and withdrawn brush, under the action of the cam 41 acting on the spiral follower slot 39; the direction of rotation in this case being opposite to the direction of rotation resulting from moving the plunger tcthe depressed position. The bearing assemblies 67, 71, in each case, assist the rotation of the hollow tube 37 and prevent any binding thereof which might otherwise occur.
Because of its simple construction, this instrument is easily assembled and disassembled for cleaning and for replacement of parts. The simplicity of its operation makes for a, quick and effective means of obtaining specivrens for study with a minimum amount of discomfort to the patient. Furthermore, because of the very simple operating mechanism, this instrument can be readily manipulated by a physician without additional assistance.
Therefore, while this invention has been described with particular reference to the specic forms shown in the drawing, it is to be understood that such showings are for illustrative purposes only and are not to be construed as imparting limitations upon the invention, which is best defined by the claims appended hereto.
l. Apparatus for collecting specimens for cytodiagnosis comprising, in combination, a tube; a shaft disposed within said tube for longitudinal and rotatable movement, cnc end of said shaft having specimen collecting means associated therewith and the other end of said shaft having an operating mechanism associated therewith; said operating mechanism comprising an axially movable plunger and means operatively connecting said plunger and said other end of said shaft; said means being operative to cause predetermined longitudinal and rotational movement of said shaft in response to axial movement of said plunger.
2. Apparatus for collecting specimen for cytodiagnosis comprising, in combination, a tube; a shaft disposed within said tube for `limited longitudinal and rotational movement; specimen collecting means associated with one end of said shaft and the other end of said shaft having an operating `mechanism associated therewith; said operating mechanism comprising a housing, an axially movable plunger disposed within said housing7 and means operatively connecting said plunger and said other end of said shaft for effecting predetermined longitudinal and rotational movement of said shaft in response to axial movement of said plunger within said housing.
3. Apparatus as set forth in claim 2, wherein said shaft is operative to extend said specimen collecting means out of said tube in response to limited axial movement of said plunger in a rst longitudinal direction.
4. Apparatus as set forth in claim 3, wherein said shaft is operative to rotate said specimen ycollecting means in a rst rotational direction in response to continued axial movement of said plunger in said lirst longitudinal direction.
5. Apparatus as set forth in claim 4, wherein said shaft is operative to withdraw said specimen collecting means into the interior of said tube in response to limited axial movement of said plunger in a second longitudinal direction opposite to said first longitudinal direction.
6. Apparatus as set forth in claim 5, `wherein said shaft is operative to cause rotation of said specimen col-- lecting means in a second rotational direction opposite to Said rst rotational direction in response to continued axial movement of said plunger in said second longitudinal direction.
7. Apparatus as set forth in claim 2, wherein said means operatively connecting said plunger and said other end of said shaft includes a rigid operating rod, said rod extending into said tube into operative engagement with said shaft.
8. Apparatus as set forth in claim 7, wherein said tube comprises a substantially flexible section and a rigid coupling, the length of said coupling corresponding substantially to the length of axial movement of said plunger', one end of said coupling being secured to said housing and the other end of said coupling being secured to one end of said exible section; whereby ysaid operating rod is spaced from said ileXible section.
9. Apparatus as set forth in claim' 7, wherein said tube is rigid, one extremity of which is adapted to receive said specimen collecting means and the other extremity of which is secured directly to said housing.
10. An operating mechanism for cytodiagnosis apparatus comprising, in combination, a housing, an axially movable plunger disposed Within said housing, a longitudinally and rotatably movable operating rod associated with said housing, and means operatively connecting said plunger and said operating rod, said means being operative to cause predetermined longitudinal movement of said operating rod in response to axial movement of said plunger relative to said housing.
11. An operating mechanism as set forth in claim 10, wherein said means comprises a cam and follower as- '6 sembly operatively yconnected operating rod.
to said plunger and said 12. An operating mechanism as set forth in claim 11,
wherein said cam comprises a can Medical Association, Octob 8, pp. 770-771.
roller and said follower er 23, 1954, Vol. 156, No.