Source: http://www.freepatentsonline.com/y2008/0275392.html
Timestamp: 2020-02-26 17:35:58
Document Index: 767206854

Matched Legal Cases: ['art 32', 'art 33', 'art 32', 'art 34', 'art 33', 'art 34', 'arts 32', 'art 32', 'art 33', 'art 34', 'arts 61', 'arts 61', 'art 62', 'art 62', 'art 63', 'art 63', 'art 61', 'art 61', 'art 62', 'art 63', 'arts 61', 'arts 61', 'arts 71', 'art 71', 'art 72', 'art 73', 'art 91', 'art 61', 'art 91', 'art 91']

SYRINGE SET - Olympus Corporation
United States Patent Application 20080275392
Nagamatsu, Ryuji (Tokyo, JP)
12/173468
604/97.02
A61F2/958; A61M5/00; A61M25/00
Download PDF 20080275392 PDF help
20090157021 ARTICLES WITH INFORMATIVE PATTERNS, AND METHODS OF MAKING THE SAME June, 2009 Sullivan et al.
1. A syringe set for balloon catheter, comprising: a first syringe having a first capacity to expand a balloon catheter to a size corresponding to the first capacity, the first syringe having a side air outlet hole to define the first capacity; a second syringe having a second capacity to expand the balloon catheter to a size corresponding the second capacity, the second syringe having a side air outlet hole to define the second capacity, the second capacity being larger than the first capacity, the diameter of the outer circumference of the second syringe being larger than that of the first syringe; a syringe holder at least having a first holding part to fit to a part of the outer circumference of the first syringe for holding the first syringe in removable manner and a second holding part to fit to a part of the outer circumference of the second syringe for holding the second syringe in removable manner.
2. The syringe holder for a balloon catheter according to claim 1, wherein the holding parts are arranged in order of sizes.
3. The syringe holder for a balloon catheter according to claim 1, wherein each holding part has a surface that restricts a longitudinal movement of a plunger of the corresponding syringe to prevent the plunger from dropping off.
The cylinder 6 includes a distal portion 6a having smaller diameter at the distal end thereof, and a connecting portion 8 extends therefrom along the axial line. The connecting portion 8 is formed with an outlet port 9 for communicating the interior of the cylinder 6 with the outside along the axial line thereof. The outlet port 9 is for introducing air to a balloon catheter, described later. The connecting portion 8 is also provided with a cylindrical portion 10 so as to cover the outlet port 9, and the cylindrical portion 10 is formed with an inner thread 10a. A proximal portion 6b of the cylinder 6 is formed with an insertion port 11a so as to allow the plunger 7 to be inserted therein. The proximal portion 6b of the cylinder 6 is formed also with a flange 12a extended in the direction substantially orthogonal to the axial line of the cylinder 6 and in the radial direction of the cylinder 6. The cylinder 6 has a substantially uniform inner diameter to the insertion port 11a at the proximal portion 6b except for the distal portion 6a with reduced diameter. The inner peripheral surface near the insertion port 11a is formed with a projection (not shown) for preventing the plunger 7 from coming off.
The cylinder 6 is formed with a scale 13a on the outer peripheral surface along the axial line thereof. The scale 13a shows a capacity of a space formed in the cylinder with reference to the side of the distal portion 6a. However, the scale is not limited thereto, and may be that indicating the outer diameter of the expended balloon when a seal member 19a, described later, is moved from the position on the scale to the distal end.
The cylinder 6 is formed with a hole 14 so as to align with the scale 13a. The hole 14 communicates between the inside and the outside of the cylinder 6, and is formed at a position where a predetermined capacity (first capacity) is defined in the cylinder 6. The first capacity corresponds, for example, to the amount of air which expands the balloon to 8.5 mm in diameter.
The plunger 7 has a main body 18a formed by two plate strips 17a intersected into a cross-shape. The main body 18a has a size which can be inserted into the cylinder 6, and is attached with the seal member 19a at the distal end thereof. The seal member 19a has a sealing surface 20a which is kept in sliding contact with the inner peripheral surface of the cylinder 6, so as to establish air-tightness between the inner peripheral surface of the cylinder 6 and the seal member 19a. The main body 18a is provided with a disk-shaped pressing portion 21 at the proximal end thereof.
As shown in FIG. 3B, the syringe 3 includes a cylinder 22 which is larger in inner diameter and in outer diameter than the syringe 2, and a plunger 23 to be slidably inserted into the cylinder 22, and has the same structure as the syringe 2. In other words, the cylinder 22 is provided with the connecting portion 8 at a distal portion 22a, and is formed with an insertion port 11b at a proximal portion 22b. The proximal portion 22b is provided with a flange 12b extended therefrom. The cylinder 22 is formed with two holes 24, 25 at a position corresponding, for example, to the amount of air (second capacity) which expands the balloon to 11.5 mm in diameter with reference to the distal portion 22a. The hole 24 is formed on a scale 13b, and the hole 25 is formed at a position shifted by about 90° in the circumferential direction from the hole 24. The plunger 23 has a size corresponding to the cylinder 22, and a main body 18b having plate strips 17b intersected to each other is provided with a seal member 19b at the distal end thereof. The seal member 19b is formed with a sealing surface 20b on the outer peripheral surface thereof which is kept in sliding contact with the inner peripheral surface of the cylinder 22 so as to establish air-tightness.
As shown in FIG. 3A, the syringe 4 includes a cylinder 26 larger than the syringe 3 in inner diameter and outer diameter, and a plunger 27 to be slidably inserted in the cylinder 26, and has the same structure as the syringes 2 and 3. In other words, the cylinder 26 is provided with the connecting portion 8 at a distal portion 26a thereof, and an insertion port 11c at the proximal portion 26b. The cylinder 26 is also provided with a flange 12c at a proximal portion 26b thereof. The cylinder 26 is formed with two holes 28, 29 at positions corresponding, for example, to the amount of air (third capacity) which can expand the balloon to 15 mm in diameter with reference to the distal portion 26a. The hole 28 is provided on a scale 13c, and the hole 29 is formed at a position shifted by about 90° from the hole 28 in the circumferential direction. The plunger 27 has a size corresponding to the cylinder 26 and a main body 18c having plate strips 17c intersected to each other is provided with a seal member 19c at the distal end thereof. The seal member 19c has a sealing surface 20c on the outer peripheral surface thereof which is kept in sliding contact with the inner peripheral surface of cylinder 26 so as to establish air-tightness therebetween.
The syringe set 1 including the aforementioned syringes 2, 3 and 4 and the syringe holder 5 for storing these syringes is shown in FIG. 1 and FIG. 2. The syringe holder 5 has a main body 31 formed of a sheet of substantially rectangular in plan view having a flange 30 along the peripheral edge thereof, and the inner side of the flange is protruded upward. The main body 31 is formed into a trapezoidal shape in side view, in which the flange 30 corresponds to the bottom side. The shorter side of the main body 31 is shorter than the length of the syringes 2, 3 and 4. The main body 31 includes a side surface 31a and a side surface 31b located on the side opposite from the side surface 31a.
As shown in FIG. 1, the holding part 32 includes a storage groove opening on the upper side, and the storage groove is partitioned into a cylinder storage groove 35a, a flange storage groove 36a, and a plunger storage groove 37a from the side of the side surface 31a. These grooves 35a, 36a and 37a communicate with each other, and the main body 31 is formed with an opening 32a on the side surface 31a and the opposing side surface 31b of the main body 31 is closed.
The cylinder storage groove 35a has larger width and depth in comparison with the diameter of the cylinder 6 and, in addition, the edge of an upper opening 32b of the cylinder storage groove 35a is protruded so as to reduce the width of the upper opening 32b.
The flange storage groove 36a continues to the cylinder storage groove 35a, and is larger than the cylinder storage groove 35a in width. FIG. 4 is a cross-sectional view taken along a cutting line (FIG. 4-FIG. 4) in FIG. 1, showing that no syringe is mounted. As shown in FIG. 4, a side wall of the flange storage groove 36a has an inclination being reduced in width toward the bottom, and the bottom has a form of a smooth depression. FIG. 5 shows a cross-sectional view taken along a cutting line (FIG. 5-FIG. 5) in FIG. 1, showing that no syringe is mounted. As shown in FIG. 5, the depth of the flange storing groove 36a is deeper than that of the cylinder storage groove 35a, and a boundary plane between the flange storage groove 36a and the cylinder storage groove 35a is formed to have an inclination. In the same manner, a boundary plane between the flange storage groove 36a and the plunger storage groove 37a is formed to have an inclination.
The depth of the plunger storage groove 37a is almost the same as that of the flange storage groove 36a, and the radius of curvature of the bottom is smaller than that of the pressing portion 21 of the plunger 7. As shown in FIG. 4, the width of the plunger storage groove 37a is smaller than that of the flange storage groove 36a. The side surface 31b side of the plunger storage groove 37a is closed by a closed surface 38a, and the closed surface 38a is inclined so that the depth of the plunger storage groove 37a is reduced toward the bottom (see FIG. 5).
As shown in FIG. 1 and FIG. 4, the storage groove of the holding part 33 is partitioned into a cylinder storage groove 35b, a flange storage groove 36b, and a plunger storage groove 37b, and an opening 33a is formed on the side surface 31a side. The width and the depth of the cylinder storage groove 35b are larger than those of the cylinder storage groove 35a. The width and the depth of the flange storage groove 36b are larger than those of the cylinder storage groove 35b, and the bottom is formed into a recessed shape. The depth of the plunger storage groove 37b is about the same as that of the flange storage groove 36b, and the width thereof is smaller than that of the flange storage groove 36b. The closed surface 38b on the side of the side surface 31b of the plunger storage groove 37b, a boundary plane between the plunger storage groove 37b and the flange storage groove 36b, and a boundary plane between the flange storage groove 36b and the cylinder storage groove 35b are inclined as in the same manner as the surfaces corresponding to the holding part 32.
The holding part 34 has the same structure as the holding part 33 except that the width and the depth are different. In other words, the holding part 34 is provided with an opening 34a on the side surface 31a side, and is partitioned into a cylinder storage groove 35c, a flange storage groove 36c and a plunger storage groove 37c. The width and the depth of the flange storage groove 36c are larger than those of the cylinder storage groove 35c, and the bottom is formed into a recessed shape. The depth of the plunger storage groove 37c is almost the same as that of the flange storage groove 36c, and the width thereof is smaller than that of the flange storage groove 36c. The closed surface 38c on the side of the side surface 31b of the plunger storage groove 37c, a boundary plane between the plunger storage groove 37c and the flange storage groove 36c, and a boundary plane between the flange storage groove 36c and the cylinder storage groove 35c are inclined as in the same manner as the surfaces corresponding to the holding parts 32, 33.
FIG. 6 shows a balloon catheter 40 and an operating portion 49. The balloon catheter 40 includes a flexible catheter (sheath) 41 to be inserted into the luminal structure, and a balloon 42 is mounted to the distal end of the catheter 41. The balloon 42 is a tube formed, for example, of natural rubber latex, and the distal portion of the catheter 41 is inserted through the tube, and then both ends 42a thereof are fixed by being bound by strings 43 (FIG. 7) and applied with adhesive agent. When air is supplied to the balloon 42, an intermediate portion 42b which is not fixed can be expanded, as shown in FIG. 7.
An expansion lumen 44 is formed in the catheter 41. The expansion lumen 44 is closed at the distal portion thereof, and is formed with a side hole 45 in communication with the intermediate portion 42b of the balloon 42. The catheter 41 is formed therein with a guide lumen 46 and a liquid-delivery lumen 47 arranged in substantially parallel to each other. A guide wire or a stylet is inserted through the guide lumen 46 when inserting the distal portion of the catheter 41 into the luminal structure. The liquid-delivery lumen 47 is used for injecting the barium meal into the luminal structure. The distal portion of the liquid-delivery lumen 47 is closed and is provided with a side hole 48 for communicating with the outside. It is also possible to inject the barium meal using the guide lumen 46 instead of forming the liquid-delivery lumen 47.
The syringe 2 is stored in the holding part 32 of the syringe holder 5. More specifically, the syringe 2 is pushed in the syringe holder 5 from the upper opening 32b so that the flange 12a of the cylinder 6 is stored in the flange storage groove 36a. The cylinder 6 is inserted so as to open the edge of the upper opening 32b of the cylinder storage groove 35a. At this time, since the length of the cylinder storage groove 35a is shorter than the cylinder 6, the distal portion 6a side of the cylinder 6 projects from the side surface 31a of the syringe holder 5. The flange 12a of the cylinder 6 is stored in the flange storage groove 36a, and the pressing portion 21 is stored in the plunger storage groove 37a.
The width and the depth of the cylinder storage groove 35a are larger than those of the cylinder 6 of the syringe 2, so that an allowance is formed with respect to the syringe 2. Therefore, high-pressure steam in the autoclave for sterilizing treatment or ethylene oxide gas can easily permeate therein. Since the flange 12a of the syringe 2 and the boundary plane between the flange storage groove 36a and the cylinder storage groove 35a come into abutment with each other, the syringe 2 is prevented from dropping off from the side of the opening 32a. Since the plunger storage groove 37a side is closed by the closed surface 38a, the syringe 2 does not come off from this side.
In the same manner, the syringe 3 is inserted from the upper opening 33b into the holding part 33 so as to be held thereby, and the syringe 4 is inserted from the upper opening 34b into the holding part 34 so as to be held thereby.
When inserting the balloon catheter 40 into the luminal structure and expanding the balloon 42, the inner thread 10a of the connecting portion 8 of a selected one of the three syringes 2, 3 and 4 is screwed onto the valve 54 to connect the same. When removing the syringe 2, 3 or 4 from the syringe holder 5, the operator holds the distal portion of the syringe 2, 3 or 4 exposed from the syringe holder 5 and pulls out the same. For example, when connecting the syringe 2 from the balloon catheter 40, the plunger 7 is pulled back toward the proximal portion 2b side of the syringe 2 in advance.
When the syringe 2 is connected, the operator holds the flange 12a of the cylinder 6 and the pressing portion 21 of the plunger 7 between his/her fingers of one hand, and holds the cylinder 6 with the other hand and pushes the plunger 7 slowly toward the distal portion 6a of the cylinder 6.
No air is supplied to the balloon 42 (see FIG. 3) until the sealing surface 20a of the seal member 19a of the plunger 7 reaches the holes 14 and 16. In other words, no air is supplied to the balloon 42 because although the capacity defined by the seal member 19a and the interior of the cylinder 6 is reduced when the plunger 7 is pushed therein, air corresponding to the reduced capacity is released through the two holes 14 and 15 which have less resistance.
When the operator further pushes the plunger and hence the seal member 19a moves toward the distal portion 6a beyond the position where the holes 14 and 15 are formed, air starts to be supplied to the balloon 42. In other words, since the seal member 19a is positioned on the side of the distal portion 6a with respect to the holes 14 and 15, the air in the space in the cylinder 6 is not released any longer from the holes 14 and 15, and hence the air corresponding to the reduced capacity is sent to the balloon catheter 40 from the outlet port 9. The air is supplied to the balloon 42 through the expansion lumen 44 shown in FIG. 6. Consequently, the balloon 42 expands according to the reduced amount of the capacity in the cylinder 6 (see FIG. 7).
In other words, when the plunger 7 is pushed into the distal portion 6a, the amount of air corresponding to the first capacity is sent into the syringe 2, and hence the balloon 42 is expanded to an extent corresponding to the first capacity. When the syringe 3 is selected, the amount of air corresponding to the second capacity is sent thereto, so that the balloon 42 is expanded. When the syringe 4 is selected, the amount of air corresponding to the third capacity is sent thereto, and the balloon 42 is expanded.
The respective holding parts 61, 62 and 63 extend from openings 61a, 62a and 63a which are formed on the side surface 31a of the main body 31 and then extended towards the side surface 31b. These holding parts 61, 62 and 63 differ from the first embodiment in the forms of cylinder storage grooves 64a, 64b and 64c.
As shown in FIG. 8 and FIG. 9, the cylinder storage groove 64a is formed substantially into a U-shape, and the width and the depth thereof are formed to be larger than those of the cylinder 6 in diameter. A bottom portion of the cylinder storage groove 64a is formed with three protrusions 65 at regular intervals. The protrusions 65 have shape and size which come into point contact with the cylinder 6, and the height thereof is such that the upper surface of the cylinder 6 does not project from an upper opening 61b of the cylinder storage groove 64a in a state in which the cylinder 6 is placed on the protrusion 65.
Furthermore, as shown in FIG. 9, the side walls near the upper opening 61b of the cylinder storage groove 64a are formed with protrusions 66 so as to protrude at opposed positions for reducing the width of the cylinder storage groove 64a. The positions where the protrusions 66 are formed are such that a predetermined clearance is formed with respect to the upper surface of the cylinder 6 in a state in which the cylinder 6 is placed on the protrusion 65. The protrusions 66 are reduced in width from the proximal portions continuing from the side walls of the cylinder storage groove 64a toward the distal portions, and the distal portions are formed into a flat surface extending in parallel with the vertical direction. As shown in FIG. 10, the inclination of a lower surface 66a of the protrusion 66, which is a side surface extending from the proximal portion to the distal portion, exposing itself to the bottom side of the cylinder storage groove 64a is less steep than an upper surface 66b. The protrusions 66 are disposed near the center of the main body 31 in the direction of the shorter side so as to oppose to each other, and extend in the direction of the length of the cylinder storage groove 64a respectively.
As shown in FIG. 8 and FIG. 9, the cylinder storage groove 64b of the holding part 62 is larger than the cylinder storage groove 64a in width and depth, and is formed with three protrusions 65 at the bottom thereof. The two each of protrusions 66 are formed near an upper opening 62b of the holding part 62 on the side walls of the cylinder storage groove 64b along the length of the cylinder storage groove 64b at opposed positions.
The cylinder storage groove 64c of the holding part 63 is larger than the cylinder storage groove 64b in width and depth, and three protrusions 65 are provided at the bottom thereof. The two each of protrusions 66 are formed near an upper opening 63b of the holding part 63 on the side walls of the cylinder storage groove 64c along the length of the cylinder storage groove 64c at opposed positions.
The syringe 2 is firstly stored in the holding part 61 of the syringe holder 60. When the syringe 2 is pushed into the holding part 61 from the upper opening 61b side so that the flange 12a of the cylinder 6 is stored in the flange storage groove 36a, the cylinder 6 is inserted therein so as to widen the distance between the protrusions 66, and is set in the cylinder storage groove 64a. After the cylinder 6 has passed, the protrusions 66 return to their original position.
In the stored state, the syringe 2 is supported mainly by the protrusions 65 at the bottom of the cylinder storage groove 64a. The cylinder storage groove 64a is larger than the syringe 2 so as to keep an allowance.
Likewise, the syringe 3 is stored in the holding part 62, and the syringe 4 is stored in the holding part 63. In this state, the respective syringes 3 and 4 are mainly supported by the protrusions 65 of the respective cylinder storage grooves 64b and 64c.
The syringe holder 60 in which the syringes 2, 3 and 4 are stored is placed in the sterilized package, and is subjected to sterilizing treatment together with the balloon catheter 40 and the like. At this time, since there are sufficient allowances between the syringes 2, 3 and 4 and the holding parts 61, 62 and 63, respectively, and the contact areas between the syringes 2, 3 and 4 and the holding parts 61, 62 and 63 are kept at the minimum areas owing to the protrusions 65, 66, gas can easily run through. Furthermore, since the flange storage grooves 36a, 36b and 36c and the plunger storage grooves 37a, 37b and 37c are formed into inclined surfaces or surfaces having the radius of curvature different from the syringes 2, 3 and 4 so as to form the clearances with respect to the syringes 2, 3 and 4, gas can easily run through. Therefore, the syringes 2, 3 and 4 are reliably sterilized by sterilizing gas.
As shown in FIG. 11, holding parts 71, 72 and 73 of a syringe holder 70 respectively have cylinder storage grooves 74a, 74b and 74c being substantially oval in cross-section.
The cylinder storage groove 74a is configured in such a manner that the portion near an upper opening 71b is protruded so as to be close to each other, so that protrusions 75a are formed, and the bottom side is formed into an oval shape. The number of contact portions between an inner wall of the cylinder storage groove 74a and the cylinder 6 are three positions at maximum including one on the bottom side and two on the side of the protrusions 75a. Each of them is subjected to linear contact. Other portions of the syringe 2 are not in contact with the holding part 71 and clearances are formed. The cylinder storage groove 74b of the holding part 72 is larger than the cylinder storage groove 74a, is provided with protrusions 75b near an upper opening 72b, and is oval shape on the bottom side. The cylinder storage groove 74c of the holding part 73 is larger than the cylinder storage groove 74b, is provided with protrusions 75c near an upper opening 73b, and is oval shape on the bottom side.
The cylinder storage groove 81 is substantially formed into a cross-shape with reference to an upper opening 81b. The cylinder 6 is mainly stored in a center portion of the cylinder storage groove 81, and clearances are defined with respect to the cylinder 6 by extended portions 81a extending in four directions from the center portion. The respective corners which correspond to the proximal ends of the extended portions 81a come into linear contact with the cylinder 6 at four positions at the maximum.
The cylinder storage groove 82 substantially formed into a T-shape with reference to an upper opening 82b. The width of the upper opening 82b is smaller than the cylinder 22. The bottom side is increased in width, and this widened portion 82a defines clearances with respect to the cylinder 22. The cylinder storage groove 82 is configured to come into linear contact with the cylinder 22 at three portions at the maximum including the corners of the widened portion 82a and the bottom.
The cylinder storage groove 83 is substantially formed into a triangular shape. In this case, the bottom corresponds to the bottom side of the triangle, and an upper opening 83b corresponds to one apex. The width of the upper opening 83b is smaller than the outer diameter of the cylinder 26, and the width of the portion near the bottom side is larger than the cylinder 26. The cylinder storage groove 83 is configured to define the clearance with respect to the cylinder 26, and contact with the cylinder 26 at three portions at the maximum including the bottom and the inclined two side walls.
With the cylinder storage grooves 74a, 74b, 74c, 81, 82 and 83, since the plurality of syringes 2, 3 and 4 can be held in line, usability is improved, and time for manipulation may be reduced. Since the clearances are defined between the syringes 2, 3 and 4 and the cylinder storage grooves 74a, 74b, 74c, 81, 82 and 83, gas can easily run through during gas sterilization, so that sufficient sterilization is achieved.
The syringe 92 includes the cylinder 26, which is provided with an indication 93 on the outer peripheral surface at a position shifted from the direction of extension of the flange 12c by about 90° in the circumferential direction. In FIG. 13, the indication 93 includes a statement such as “For 15 mm balloon” or “15 mm”. This indication means that this syringe 92 can expand the balloon 42 to a size corresponding to the expanded diameter of 15 mm at the maximum.
The holding part 91 of the syringe holder 90 differs from the holding part 61 in the second embodiment in the structure of a flange storage groove 94c. As shown in FIG. 14, the flange storage groove 94c includes a flat portion 95 as the bottom. The flat portion 95 is formed at a depth so that the flange 12c does not come into tight-contact with the flat portion 95 but the flat portion 95 prevents the rotation of the flange 12c when the syringe 92 is stored in the flange storage groove 94c. With this flat portion 95, movement in other directions, for example, the movement in the direction of extension of the flange 12c, or the movement in the direction of the depth of the flange storage groove 94c is allowed.
The syringe 92 is inserted to the holding part 91 of the syringe holder 90 so that the indication 93 is faced upward. At this time, the orientation of the flange 12c of the syringe 92 is constrained by the flat portion 95 of the flange storage groove 94c, and the flange 12c is kept substantially in the horizontal direction. The indication 93 of the syringe 92 can always be viewed from above.
When the operator wants to expand the balloon 42 to a size corresponding to 15 mm in diameter, the operator checks the respective indications 93 and selects the syringe 92 with the corresponding indication. After having held the distal portion of the syringe 92 and taken it out from the syringe holder 90, the plunger 7 is pulled back to the proximal portion 26b and connected to the balloon catheter 40. When air is sent to the balloon 42 by the syringe 92, the balloon 42 is expanded to a size corresponding to 15 mm in diameter.
Although not shown in the drawing, other syringes, for example, when the syringe having the indication 93 showing that the balloon 42 can be expanded to 11.5 mm in diameter is used, the balloon 42 is expanded to a size corresponding to 11.5 mm in diameter. When the holes 14 and 15 are provided on the cylinder 26, a final diameter of the balloon 42 which can be expanded by the capacity from the distal portion 26a of the cylinder 26 to the position where the holes 14 and 15 are formed is shown in the indication 93.
Furthermore, since the flat portion 95 is provided in the flange storage groove 94c of the holding part 91 so that the rotation of the syringe 92 in the stored state is prevented, the indication 93 can always be placed on the upper surface of the syringe set. Therefore, the contents of the indication 93 can easily be confirmed.
It is also possible to provide the flat portion 95 (see FIG. 14) in the flange storage grooves 36a, 36b and 36c of the syringe holders 5 and 70 in the first embodiment and the third embodiment.
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