Effects of different insertion methods on reducing needle deflection.

Needle steering in medical procedures has attracted considerable attention in recent years. For example, in prostate brachytherapy, it is desired to insert a flexible beveled-tip needle with minimum deflection. To date, different methods of insertion which incorporate needle rotation about its insertion axis have been proposed in order to reduce needle deflection and target displacement. In this paper, needle deflection resulting from different methods of insertion are compared with our "model-based" method which estimates the amount of needle deflection using Euler-Bernoulli beam equations. Experiments are performed in gelatin phantoms and animal tissue. The results show that the proposed "model-based" method reduces the amount of needle deflection more than other methods. In this paper, some factors for choosing the appropriate method of insertion are also discussed.

c-Kit in early onset of diabetes: a morphological and functional analysis of pancreatic beta-cells in c-KitW-v mutant mice.

c-Kit tyrosine receptor kinase, a well-established stem cell marker, is expressed in a variety of tissues including the pancreas. The involvement of c-Kit in fetal rat and human endocrine pancreatic development, survival, and function has been well characterized but primarily using in vitro experimental approaches. Therefore, the aim of the current study was to examine whether deficiency of a functional c-Kit receptor would have physiological and functional implications in vivo. We characterized the c-Kit mutant mouse, c-Kit(W-v/+), to evaluate the in vivo role of c-Kit in beta-cell growth and function. Here we report that male c-Kit(W-v/+) mice, at 8 wk of age, showed high fasting blood glucose levels and impaired glucose tolerance, which was associated with low levels of insulin secretion after glucose stimulation in vivo and in isolated islets. Morphometric analysis revealed that beta-cell mass was significantly reduced (50%) in male c-Kit(W-v/+) mice when compared with controls (c-Kit(+/+)) (P < 0.05). In parallel, a reduction in pancreatic duodenal homeobox-1 and insulin gene expression in whole pancreas as well as isolated islets of c-Kit(W-v/+) male mice was noted along with a decrease in pancreatic insulin content. Furthermore, the reduction in beta-cell mass in male c-Kit(W-v/+) mice was associated with a decrease in beta-cell proliferation. Interestingly, these changes were not observed in female c-Kit(W-v/+) mice until 40 wk of age. Our results clearly demonstrate that the c-Kit receptor is involved in the regulation of glucose metabolism, likely through an important role in beta-cell development and function.

Minimization of needle deflection in robot-assisted percutaneous therapy.

BACKGROUND: Needle deflection and tissue deformation are two problems encountered during needle insertion into soft, non-homogeneous tissue. They affect the accuracy of needle placement, which in turn affects the effectiveness of needle-based therapies and biopsies. METHODS: In this study, a needle is inserted using a robot with two degrees of freedom. The needle is modelled as a flexible beam with clamped support at one end, and its deflection is estimated using online force/moment measurements at the needle base. To compensate for the needle deflection, the needle is axially rotated through 180 degrees . The needle deflection estimation data is used to find the insertion depths at which needle rotations are to be performed. RESULTS: A bevelled-tip needle was inserted into animal tissue. The needle deflection at the target was reduced by about 90%. It was observed that minimization of needle deflection reduced tissue deformation. The proposed method reduced needle deflection more than when needle insertion was performed with constant rotation. CONCLUSIONS: Estimating needle tip position using online force/moment measurement improves the accuracy of robot-assisted percutaneous procedures when imaging feedback is not available.

The role of hemodialysis machines dedication in reducing Hepatitis C transmission in the dialysis setting in Iran: a multicenter prospective interventional study.

BACKGROUND: Hepatitis C virus (HCV) infection is a significant problem among patients undergoing maintenance hemodialysis (HD). We conducted a prospective multi-center study to evaluate the effect of dialysis machine separation on the spread of HCV infection. METHODS: Twelve randomly selected dialysis centers in Tehran, Iran were randomly divided into two groups; those using dedicated machines (D) for HCV infected individuals and those using non-dedicated HD machines (ND). 593 HD cases including 51 HCV positive (RT-PCR) cases and 542 HCV negative patients were enrolled in this study. The prevalence of HCV infection in the D group was 10.1% (range: 4.6%- 13.2%) and it was 7.1% (range: 4.2%-16.8%) in the ND group. During the study conduction 5 new HCV positive cases and 169 new HCV negative cases were added. In the D group, PCR positive patients were dialyzed on dedicated machines. In the ND group all patients shared the same machines. RESULTS: In the first follow-up period, the incidence of HCV infection was 1.6% and 4.7% in the D and ND group respectively (p = 0.05). In the second follow-up period, the incidence of HCV infection was 1.3% in the D group and 5.7% in the ND group (p < 0.05). CONCLUSIONS: In this study the incidence of HCV in HD patients decreased by the use of dedicated HD machines for HCV infected patients. Additional studies may help to clarify the role of machine dedication in conjunction with application of universal precautions in reducing HCV transmission.