Tissue motion due to needle deflection.

Various concepts of steerable needles have been developed in order to reduce placement errors during insertions and to enable complex procedures through curved trajectories in minimally invasive surgery. When inserted into soft tissue, motion of the targeted location ahead of the needle tip has to be taken into account for controlling such tools. This paper investigates the motion caused by flexible bending needles in comparison to rigid straight ones when inserted into a homogeneous tissue phantom. A laser based experimental setup is used to measure displacements of the substrate around the needles. Displacements are transformed into the local frame in order to quantify the relative substrate motion. It is shown that the radial contribution of the displacements is higher for bending needles and that this effect increases with higher path curvatures. This motion must be taken into account for controlling steerable needles along curved trajectories to reduce placement errors in applications such as multi-targeting or reinsertions in soft tissue.

Influence of hydration state on plasma volume changes during ultrafiltration.

To assess the influence of hydration state on plasma volume (PV) changes during ultrafiltration, 11 clinically normhydrated patients on maintenance hemodialysis were studied intraindividually during 2 hydration states differing by 2-15% of lean body mass (LBM). Plasma volume was measured continually during a 15-min ultrafiltration test including an ultrafiltration of 1% of target weight and during a 45-min follow-up period of blood recirculation through the dialyzer without ultrafiltration. In all patients a maximal decrease in relative PV was more pronounced when there was less hydration and when the grade of hydration correlated inversely with the maximal response of PV decrease (r = -0.68, p < 0.001). The same was observed between the hydration state and the slope of the PV decrease (r = -0.69, p < 0.001). Plasma refilling was estimated in the period following ultrafiltration. The slope of the plasma volume increase correlated with the grade of hydration (r = 0.31, p < 0.05) as did the asymtote of PV (r = 0.4, p < 0.01). It is concluded that the less hydrated a dialysis patient is, the more pronounced will be the fall of the ultrafiltration-induced plasma volume and the less distinct will be the recovery of the plasma volume after the discontinuation of ultrafiltration.