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Número de publicaciónUS3716054 A
Tipo de publicaciónConcesión
Fecha de publicación13 Feb 1973
Fecha de presentación11 Ago 1970
Fecha de prioridad11 Ago 1970
Número de publicaciónUS 3716054 A, US 3716054A, US-A-3716054, US3716054 A, US3716054A
InventoresHesse J, Hindsley F, Porter W
Cesionario originalPorter W
Exportar citaBiBTeX, EndNote, RefMan
Enlaces externos: USPTO, Cesión de USPTO, Espacenet
Apparatus for applying medication to teeth and body tissue
US 3716054 A
Resumen
Disclosed is a porous medication impregnated carrier for applying medication to a patient's teeth or body tissue. Disclosed also is structure for holding the carrier and connecting it to a D.C. voltage source, thereby to form apparatus which utilizes a small electric current to impel the medication into the patient's teeth or body tissue. The apparatus may be constructed to be portable, battery powered and for operation by the patient himself.
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Descripción  (El texto procesado por OCR puede contener errores)

United States Patent [19] Porter et a1.

[ APPARATUS FOR APPLYING MEDICATION TO TEETH AND BODY TISSUE [75] Inventors: William 1. Porter; Frank W. Hindsley; James E. Hesse, all of A1- buquerque, N. Mex.

[73] Assignee: William A. Porter, Albuquerque, N.

Mex.

[22] Filed: Aug. 11, 1970 [21] Appl. No.: 62,860

[52] US. Cl ..128/172.l, 128/404 [51] Int. Cl. Q. ..A61m 5/00 [58] Field of Search ..l28/172.1, 212, 404-409,

[56] References Cited UNITED STATES PATENTS 2,659,372 11/1953 Andresen ..l28/406 3,019,787 2/1962 Simmons.....

[4 1 Feb. 13, 1973 128/172.1 3,292,620 12/1966 Mahler .l28/l72.1 2,834,344 5/1958 Kanai ....l28/l72.l 3,048,170 8/1962 Lemos ..128/172.l

Primary Examiner-Richard A. Gaudet Assistant Examiner-G. F. Dunne Attorney-McGrew and Edwards [57] ABSTRACT Disclosed is a porous medication impregnated carrier for applying medication to a patients teeth or body tissue. Disclosed also is structure for holding the carrier and connecting it to a DC voltage source, thereby to form apparatus which utilizes a small electric current to impel the medication into the patients teeth or body tissue. The apparatus may be constructed to be portable, battery powered and for operation by the patient himself.

6 Claims, Drawing Figures .PATENTEDFEB 13 ms SHEEIIUF 2 FIG.I

WlLLlAM l. PORTER FIG. 4 FRANK W. HINDSLEY JAMES E. HESSE 3.716054 sum 20F 2 v FIG. 5

INVENTORS WILLIAM I. PORTER FRANK W. HI NDSLEY JAMES E. HESSE 7 BY 72 ATTORNEYS APPARATUS FOR APPLYING MEDICATION T TEETH AND BODY TISSUE The present invention relates to apparatus for transferring medication to teeth or body tissue.

Selected medications are useful for desensitizing teeth and gums; decolorizing pigmented or tattooed skin areas; removing warts and moles; and treating lesions, such as cold sores, fever blisters and canker sores. Such medications may be ionic containing fluoride, chloride, iodide, bromide, zinc, strontium or other ions; may be subject to molecular mobility upon the passage of current therethrough; or maybe molecularly mobile without the application of current. The treatment of body tissue, for example, with such ionic or-molecularly mobile medications has the inherent advantage that the transfer of the medicaments into the tissue being treated generally has no adverse effects on the tissue treated, such as scarring or unwanted tissue discoloration.

In dental applications, for example, it is desirable to apply positive or negative desensitizing ions, such as strontium or fluoride ions, to sensitive tooth surfaces. In this manner, tooth sensitivity may be markedly reduced and even eliminated. The effectiveness of such treatments has primarily depended upon the ion activity of the ion concentrations at the time of application of the-ion concentrations to the teeth. One known manner to increase ion activity, for example in a fluoride concentration, has been to add moisture to the fluoride concentration. It is important that the addition of the moisture be at the time of application of the fluoride concentration to the teeth to be treated since it has been found that concentrations of fluoride ions which have been premoistened or premixed in solution show a marked decline in ion action in those cases where the fluoride ions were not used at the time of moistening or being placed in solution.

It is, accordingly, an object of the present invention to provide novel apparatus for applying selected ions to teeth or body tissue which includes a porous portion for holding ionic medications so that such medications may be moistened to increase their ion activity just for operation by 'a patient himself and thus is suitable for home use.

It is, additionally, an object of the present invention to provide novel apparatus, as set forth, for applying selected ions to teeth or body tissue which is characterized by being adapted to receive'an insertable ion impregnated carrier or cartridge.

It is still another object of the present invention to provide novel apparatus, as set forth, for applying selected ions to teeth or body tissue which is characterized by being battery powered, convenient to use, and relatively easy and inexpensive to manufacture.

It is yet another object of the present invention to provide novel apparatus for applying selected ions to teeth or body tissue which utilizes a relatively small electric current for applying the ions to the teeth or body tissue.

It is also an object of the present invention to provide novel apparatus for applying selected medications to teeth or body tissue which is characterized by having structure for receiving and holding medication impregnated material and which may selectively employ an electrical means for applying the medications.

Additional objects of the present invention reside in the specific construction of the exemplary apparatus hereinafter particularly described in the specification and shown in the several drawings.

In accomplishing these and other objects, there has been provided in accordance with the present invention apparatus including a DC. power source means, such as a dry cell flashlight type battery. Structure is included for receiving and holding a porous medication impregnated material or carrier means so that the impregnated carrier may be applied to a patients teeth or body tissue by the patient himself. The carrier may be impregnated with an ionic medication containing selected ions and is preferably moistened to increase ion activity at the time of application to the patients teeth or body tissue. First and second terminal means are included in the apparatus which, respectively, connect the appropriate battery pole to the impregnated carrier and contacts the other battery pole. Conducting meansare included for connecting the second terminal to the patients body so that whenever a patient applies the medication impregnated material to his teeth or body tissue a closed electrical circuit is formed. Asmall electric current then flows from the first terminal which is in contact with one battery pole through the impregnated carrier, the patients teeth and/or body, and back to the battery through the conducting means and second terminal. The flow of current through the impregnated carrier occurs in the case of an ion impregnated carrier by the repulsion of the ions from the one battery pole into the patients teeth being treated. Thus, a novel apparatus is provided which utilizes an electromotive force, i.e., electric current, for applying selected medications to teeth body tissue.

A better understanding of the present invention may be had from the following detailed description when read in conjunction with the accompanying'drawings, in which: i

FIG. 1 is a side sectional view of an apparatus particularly suited for-applying desensitizing ions to teeth or gum tissue in accordance with the present invention;

FIG. 2 is a side sectional view of the apparatus of FIG. 1 showing its outer cover portion partially removed;

FIG. 3 is a perspective view of the apparatus of FIG. 1 with its outer cover portion removed and showing a battery being inserted therein;

FIG. 4 is a perspective view of the cover portion of the apparatus of FIG. 1;

FIG. 5 is a side exploded view of an alternate embodiment of apparatus for applying selected medications to teeth or body tissue in accordance with the present invention; and I FIG. 6 illustrates the apparatus of FIG. 5 assembled for use in situ in the hand of a patient.

Referring to the drawings in more detail, there is shown in FIGS. 1-4 a dental apparatus generally metal, such as chrome.

The body portion 2 has end means or pieces 4 and 5 connected by intermediate structure 6. The end pieces 4 and are preferably at least in part conically shaped to form tips 7 and 8, respectively, remote from the intermediate structure 6. The intermediate structure 6 is preferably in the form of a half-cylinder and is constructed for receiving a standard dry cell flashlight type battery 9, as shown in FIG. 3. The structure 6 supports the battery 9 so that the battery extends longitudinally between the end pieces 4 and 5. v I

The metal cover portion 3 is preferably cylindrical and is designed for fitting around the half-cylindrical structure 6 and a battery 9 therein, thereby to hold the battery 9 in the apparatus 1. The conical end piece 4 has a disc-like support means 4a formed on its base 4b.

The disc-like support 4a has a diameter slightly smaller than the diameter of the base 4b so that the cylindrical cover 3 may fit flush against the base 4b of the end piece 4 when slid over the disc-like support 40. It is noted that the outer diameter of the cylindrical cover 3 is made substantially equal to the diameter of the base 4b so that anessentially smooth interface is formed between the cover 3 and the end piece 4. The inner diameter of the cover 3 is slightly larger than the diameter of the disc-like support 4a so the cover 3 may be slid thereon.

In order to permit the cylindrical cover 3 to be slid onto the apparatus body 2, the portion of the conical end piece 5 from a region designated 5a on its surface to its flat base 5b is shaped to have a cylindrical surface of substantially the same diameter as the disc-like support 4a. Thereby, since the inside diameter of the cover 3 is designed to be just large enough to slide over the disc-like support 4a, the cylindrical cover 3 therefore clears and may be slid over the cylindrical portion of the end piece 5 in the manner shown in FIG. 2 until the cover 3 abuts against the base 4b of the end piece 4. The cover 3 is designed to have a flat end which is perpendicular to its outer cylindrical surface for abutting against the base 4b and to have a length which extends from the base 4b to the region 5a on the end piece 5. The end of the cover 3 adjacent the region 5a is preferably chamfered to form a smooth interface with the conical surface of the end piece 5, as shown in FIG. 1.

Inserted in the plastic end pieces 4 and 5, respectively, are electrical terminal means 15 and 16. The terminals l5 and 16 are inserted, respectively, in hollow portions of the end pieces 4, 5 which extend axially from the bases 4b, 5b to the tips 7, 8. The terminals 15 and 16 are each preferably hollow metal cylinders having metal contact portions 17 and 18, respectively, formed ontheir inner ends for contacting the electrical poles of a battery supported by the intermediate structure 6. Each of the terminals 15 and 16 are preferably designed not to protrude beyond the tips 7 and 8 of the ends 4 and 5, respectively, when inserted, thereby to prevent accidental grounding of the terminals 15 and 16. As shown in FIGS. 1 and 2, the cylindrical portion of the terminal 15 extends from the contact 17 to very near the tip 7. This hollow cylindrical portion of the terminal 15 provides holding means for a vehicle or carrier 19, shown in FIG. 1, which is inserted in the terminal 15. The carrier 19 may be a porous substance, such as wood, cellulose, paper, man made or natural fibers or compressed and woven material. The carrier 19 is preferably cylindrically shaped in the form 'of a cartridge and is impregnated with selected ions, such as desensitizing ions. The material or carrier 19 may be strontium chloride impregnated and it is essential that i the impregnated porous material 19 be inserted so as to firmly contact the terminal 15 while having its pointed tip 20 protruding from the tip 7 so'that the tip 20 may be applied directly to teeth or gum tissue to be treated and desensitized. The contact portion 17 of the terminal 15 extends beyond the surface of the disc-like support 4a so as to be particularly suited for contacting the positive pole of a conventional dry cell flashlight type battery.

The contact portion 18 of the terminal 16 is preferably embedded in the base of the end piece 5 and has a metal spring portion 21 connected therewith so as to be specifically suited for contacting the negative pole of a conventional dry cell flashlight type battery. The cylindrical portion of the terminal 16 extends from the contact 18 to near the tip 8 of the end piece 5 and is designed for receiving a plug 25. The plug 25 is made of a conductive material, such as a metal, and is long enough so that when inserted in the tip 8, the plug 25 contacts the cylindrical portion of the terminal 16. The plug 25 is also attached to one end of a conductive chain 26. The chain 26 may be made of metallic material and has its other end connected to the metal cover 3. Thus, a captive plug arrangement is formed with the plug 25 being permanently attached to the cover 3 so as to prevent loss and being electrically connected to the cover 3 by the chain 26 for reasons hereinafter explained.

To prepare the apparatus 1 for operation, the plug 25 is removed from the apparatus tip 8 and the cylindrical cover 3 is slid off the apparatus body 2, as shown in FIG. 2. A standard dry cell flashlight type battery 9 is inserted in the body structure 6 with the positive and negative electrical poles of the battery 9 oriented to contact the terminal contacts 17 and 18, respectively, as shown in FIG. 3. The metal cover 3 is replaced on the body 2 by sliding it over the end piece 5 to position the cover 3, as shown in FIG. 1, with its non-chamfered edge abutting the base 4b of the end piece 4. With the cover 3 positioned on the apparatus body 2, the plug 25 on the chain 26 is inserted in the tip 8 so that the metal plug 25 makes electrical contact with the cylindrical portion of the electrical terminal 16. A cartridge shaped carrier 19 impregnated with desensitizing or other selected ions is next inserted in the .tip 7 so as to be held therein by the cylindrical portion of the terminal l5 and protrude from the tip 7, as shown in FIG. 1. For purposes of illustration, a dry strontium chloride impregnated carrier 19 is inserted in the tip 7. The car-- rier 19 is thus impregnated with desensitizing positive strontium ions.

In operation, the apparatus 1 is used as an ionizer to impel the positively charged strontium ions from the ion-impregnated carrier or vehicle 19 into a patients teeth or gums. Prior to applying the ion-impregnated carrier 19 to the patient, the previously dry carrier 19 is moistened, for example, by dipping the protruding tip 20 of the porous carrier 19 into a glass of water, thereby to bring the strontium ions to a peak of activity. No current flows through the apparatus 1 prior to applying the carrier 19 to the patients teeth or gum tissue since no closed electrical circuit is formed in the apparatus 1 from one electrical pole of the battery 9 to its other electrical pole. No closed electrical circuit is formed because the end pieces 4 and 5 and the intermediate body structure 6 are all made of non-conductive plastic, thereby to electrically isolate the electrical terminals and 16 from each other.

In order for a patient to apply strontium ions to his teeth, the patient takes the apparatus 1 in his hand by gripping the metal cover 3 and applies the tip of strontium ion-impregnated carrier 19 protruding from the apparatus tip 7 to his teeth or gum tissue. Upon contact of the carrier 19 with the patients teeth or body tissue, a closed electrical circuit is made through the patients teeth and/or body between the positive and negative electrical poles of the battery 9. The closed electrical circuit through which current from the battery 9 flows is from the positive pole of the battery 9 through, sequentially, the terminal contact 17, the cylindrical portion of the terminal 15, the ion-impregnated porous carrier 19, the patients teeth or gum tissue to which the carrier 19 is applied, the patients body and in particular the patients hand gripping the metal cover 3, the conductive cover 3, the conductive chain 26, the conductive plug 25, the cylindrical portion of the terminal 16, and the terminal contact 18 with its associated spring 21 to the negative terminal of the battery 9. This current which flows through the patients teeth or gums and body is a minimal electrical current and provides the electromotive force for impelling the strontium ions in the carrier 19 into the patients teeth or gum tissue. i

The positively charged strontium ions in the carrier 19 are repelled by the positive pole of the battery 9 through the carrier 19 into the portion of the patients teeth or gums contacting the carrier 19. It is by this strontium ion flow that current flows through the porous carrier 19 and desensitizing ions are impelled into the patients teeth or gums, thereby to treat and desensitize the patients teeth or gum tissue. It is noted that since the strontium ions are positive that the positive pole of the battery 9 is connected to the carrier 19 through the terminal means 15, thereby to repel ions into the patients teeth or gum tissue to be treated. If it were desirable, however, to impel negative ions, such as fluoride ions, into a patients teeth, the apparatus 1 may be arranged to connect the negative terminal of the battery 9 to the ion-impregnated porous carrier 19.

Referring now to FIGS. 5 and 6, there is shown therein a simplified embodiment of apparatus for transferring ions from selected medications into teeth or body tissue being treated. The apparatus is generally designated by the numeral 101 and includes non-conductive end pieces 103 and 103 which are preferably made of plastic and have hollow axes. Hollow metal inserts 104 and 105, shown in dotted lines, are mounted in hollow axes of the plastic end pieces 102 and 103, respectively. The metal inserts 104 and 105 provide terminal means for contacting the terminals of a battery 106. The metal insert 104 protrudes slightly from the inner end of the end piece 102 for contacting the positive pole of the battery 106 while a metal spring 107 is connected on the inner end of the end piece 103 with the metal insert 105 for contacting the negative pole of the battery 106.

A conductive cover portion 108 is shown positioned between the end pieces 102 and 103 for holding the battery 106. The cover portion 108 is preferably cylindrically shaped, made of chrome and holds the poles of battery 106 in electrical contact with the terminals provided by the metal inserts 104 and 105. The ends of the cover 108 and the inner ends 102a and 103a of the end pieces 102 and 103 are arranged to mate in a screw-on relationship with each other so as to hold the battery 106 in position within the cover 108. Mounted on the cover 108 is a conductive chain 109. The chain 109 has a conductive plug 110, preferably made of metal, at tached to its end remote from the cover 108. The plug 110 has a rod-like portion which may be inserted into either of the hollow axes of the end pieces 102 or 103 to contact, respectively, the metal inserts 104 or 105. Thereby, the interconnected cover 108, chain 109 and plug 110 may be selectively connected with the positive or negative poles of the battery 106.

Shown positioned near the end piece 102 in FIG. 5 is a vehicle or carrier 111 for carrying a selected medication. The carrier 111 is porous, is preferably made of wood, and is impregnated with a selected medication carrying the specific ions with which it is desired to treat the patients body tissue or teeth. If the medication carries positive ions, the ion impregnated carrier 111 is inserted in the metal insert 104 mounted in the end piece 102 and the plug 110 is inserted in the metal insert 105 in the end piece 103. If, on the other hand, the impregnated carrier 111 carries negative ions then the carrier 111 is inserted in the metal insert 105 and the plug 110 in the metal insert 104.

With the battery 106 in place and the carrier 119 and plug 110 appropriately inserted in the end pieces 102 and 103, the assembled apparatus 101 is ready for use. A patient then grips the apparatus, as shown in FIG. 6, in his hand 112. While the medicament carried by the impregnated carrier 111 may be in a gel or solution form, it is preferably originally in a dry state in order that its ion activity does not decline before use. Prior to applying the carrier 111 to his teeth or body tissue to be treated, the patient first moistens dry medication carried by the porous carrier 111, for example, by dipping the tip of the carrier 111 into water or other suitable moistening solution. Once the medication has been moistened, the ion activity is at its peak and the patient may apply the tip of the carrier 111 to the selected part of his body to be treated. Upon contact of the carrier 111 with the patients body, a current flows from one pole of the battery 106 through the porous carrier 111, the patients body including his hand 112 and back to the other pole of the battery 106 through the plug 110, thereby to transfer and transmit the selected ions from the medication in the carrier 111 into the patients body tissue or teeth being treated. This procedure of introducing ionic medication into the superficial body tissues or teeth surfaces by use of a direct current is called iontophoresis. The selected ions introduced may be fluoride, chloride, iodide, bromide, zinc, strontium, metallic, non-metallic, organic and other ions.

Various modifications may be made in the apparatus 1 and 101 in accordance with the spirit of the present invention. For example, instead of using a standard dry cell flashlight type battery, other conventional DC. power sources of appropriate voltages may be employed. These conventional DC. power sources may be arranged to be carried by the apparatus 1 and 101 or may be separate therefrom and electrically connected thereto. Further, other equivalent types of means may be used for holding the ion-impregnated carrier and connecting it to a terminal of the DC. power source. Additionally, an apparatus in accordance with the present invention may be electrically connected to a patients body through means other than hand contact with the apparatus cover, thereby to permit ions to be applied to a patientteeth or body tissue by a third party instead of the patient himself.

The dry cell battery used in an exemplary apparatus constructed was 9 volts. However, depending on the tissue or teeth to be treated, it may be desirable to supply more or less direct current than the current which is supplied by a 9 volt battery. Therefore, a battery with a higher voltage could be connected into the apparatus through an ammeter and a current control device, such as a rheostat, in order to control the direct current flowing from the apparatus. In connection with the apparatus 1 and 101, it is noted that the medication impregnated carriers 19 and 111, respectively, could be inserted in the tip of either end of these apparatus, as appropriate, according to the polarity of the ions carried by the carriers 19 and 111. Therefore, to aid a patient in inserting the carriers 19 and 111 in the correct end of the apparatus 1 and 101, the tips of the apparatus may be color coded or otherwise marked to indicate whether they are associated with a positive or negative battery pole. The carriers 19 and 111 would then also be marked or colored coded to indicate the end of the apparatus 1 or 101 into which they should be inserted. Also, a device for switching the electrical polarity of the tips of the apparatus could be incorpo'rated in the apparatus in conjunction with the DC. voltage source therein. lt may also be desirable to incorporate into the exemplary apparatus vibrator means for selectively vibrating body tissues while medicament is being transferred thereto from the apparatus.

Further, it is noted that the apparatus 1 and 101 may be utilized for applying certain nonionic medications to body tissue, such as medications that show as appreciable molecular mobility or dipole movement when influenced by an electrical field or current. Also, in certain situations it may be desirable to use the porous carriers l9 and 111 alone, i.e., without an electric current, for transferring medications to body tissue. The medications may also be colored with nonactive vegetable dyes so that the amount of medication used from a carrier may be determined by the color of the medication carrier, the dye fading as the medication in the carrier is exhausted. The porous carriers 19 and 111 which serve as vehicles forcarrying the selected medications are normally made of inexpensive materials, such as wood, so as to be expendable after use.

Thus, there has been provided a novel apparatus which utilizes electromotive force, i.e., an electric current, for applying selected medications to teeth or body tissue. The apparatus may be portable, battery operated and adapted for home use by a patient himself. Additionally, the apparatus may be easily and inexpensively manufactured and constructed for use with insertable expendable cartridges or carriers impregnated with selected medicaments.

We claim:

1. Portable apparatus for impelling medication into a user's teeth or body tissue, comprising:

a body formed of electrically non-conductive material including narrowing end portions and an intermediate channeled portion;

said end portions having aligned bores, alined extending from the channeled portion through the outer end of the narrowing portion;

a tubular terminal in each bore having its outer end terminating within the bore at the outer end thereof and having a conductive contact portion at its inner end;

means providing a DC. voltage source disposed in said channel portion in contact with the contact portion of each terminal;

a moist medication impregnated carrier fitted within one said terminal with its inner end contacting the contact portion of the associated terminal and its outer end extending beyond the outer end of said terminal for manipulative contact with the teeth or tissue of a user;

a tubular member of electrically conductive material slidable over one narrowing end portion into arresting engagement with the other narrowing portion for enclosing the channeled portion and voltage source and adapted to be held in the hand of a user during treatment;

and a conductive insert in conductive connection with said tubular member and normally held in the other said terminal, whereby a closed electrical circuit is formed from one to the other pole of said voltage source for impelling moist medication into a selected portion of a users body tissue or teeth during said manipulative contact.

2. The invention recited in claim 1, wherein said DC. voltage source means is a dry cell flashlight type battery.

3. The invention recited in claim 1, wherein said medication carrier is impregnated with a moist medication which is electrically conductive and which transfers to a users body tissue or teeth upon the flow of electric current therethrough.

4. The invention recited in claim 1, wherein said medication carrier is impregnated with a moist medication containing negatively charged fluoride ions and the negative and positive poles of said D.C.- voltage source means are connected to the respective terminals.

5. Portable apparatus for impelling medication into a user's teeth or body tissue, comprising:

a body formed of electrically non-conductive material, including end portions and an intermediate channeled portion joined to the end portions;

said end portions having bores extending from the channeled portion through the outer end of the end portion;

a tubular terminal in each bore having its outer end terminating within the bore at the outer end thereof and having a conductive contact portion at its inner end;

a dry cell battery disposed in said channel portion with its opposite electrical poles contacting the contact portions of the respective terminals;

a carrier impregnated with preselected ions fitted in one said terminal with an exterior portion adapted to be held against the tissue or teeth or a user; and

electrical conducting means adapted to be held by a user and connected to the second said terminal whereby a closed electrical circuit is formed from one to the other pole of said battery connected between said terminals for impelling ions into a users teeth or tissue whenever said impregnated carrier is held in contact with the users teeth or tissue and said second terminal is electrically connected to the users body holding said apparatus, one of said electrical terminals having a hollow cylindrical portion and said electrical conducting means including a cover portion, a plug and a chain, said chain connecting said plug to said cover portion and said cover portion, chain and plug being electrically conductive, said plug being insertable in said terminal whereby to electrically connect said terminal with a portion of a users body touching said cover, chain or plug. 6. The invention recited in claim 5, wherein said carrier is impregnated with charged ions selected from the 5 group consisting of fluoride ions, chloride ions, iodide

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Clasificaciones
Clasificación de EE.UU.604/20
Clasificación internacionalA61F13/40, A61N1/30, A61M19/00
Clasificación cooperativaA61N1/303, A61M19/00, A61M35/006
Clasificación europeaA61N1/30B, A61M35/00B2, A61M19/00