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P Haage

Publications and source records attributed to P Haage.

40 records · Page 3Linked to original sources

Ultrasonography of the pancreas. 2. Harmonic imaging.

Tissue harmonic imaging (THI) is a relatively new ultrasonographic imaging modality which has been implemented in many modern scanners. As several previous studies have pointed out, THI can help to overcome some shortcomings of conventional B-mode ultrasonography (US). The aim of this article is to give a compact summary of the potentials of THI, focused on pancreatic imaging. Beginning with a recapitulation of the technical background of THI, the particularities and suitable applications of THI in US of the pancreas are discussed. Examination protocols and typical indications are presented together with example images. Finally, new trends and developments in B-mode sonography of the pancreas such as panorama US, compound imaging, and photopic US are mentioned.

Humans↗

Ultrasound thrombolysis in hemodialysis access: in vitro investigation.

PURPOSE: To evaluate the effectiveness of ultrasound thrombolysis in occluded hemodialysis access shunts using an in vitro model. METHODS: Thrombosed hemodialysis accesses were simulated by clotted bovine blood in a flow model (silicone tubing; inner diameters 4, 6, and 9 mm). After retrograde and antegrade sheath placement (7 Fr), mechanical thrombolysis was performed using an ultrasound probe (Acolysis, Angiosonics, Morrisville, NC, USA). The tip of the device measured 2.2 mm in diameter. During sonication, the catheter was moved slowly back and forth using an over-the-wire system. Thirty complete occlusions [tubing diameters 4 mm (n = 12), 6 mm (n = 12), 9 mm (n = 6)] were treated. Initial thrombus weights were 3.5 (+/- 0.76) g, 7.7 (+/- 1.74) g, and 19.4 (+/- 2.27) g for the three diameters. Maximum sonication time was 15 min for each probe. RESULTS: With this device, we were able to restore a continuous lumen in all 12 occluded 4 approximately mm silicone tubes. No wall-adherent thrombi remained after sonication for 3.5--9.6 min. In hemodialysis access models with diameters of 6 mm, thrombus fragments persisted in 25% (3/12 accesses). These were located in the medial portion of the access loop and near to the puncture sites. However, flow was re-established after 5.0--13.0 min of treatment in all settings. Mechanical dissolution of thrombus material failed in five of six access models with diameters of 9 mm, even though ultrasound energy was applied for the maximum of 15 min. CONCLUSION: In a clotted hemodialysis shunt model, successful ultrasound thrombolysis was limited to small access diameters and small amounts of thrombus.

Equipment Design↗

Magnetic resonance angiography of nonferromagnetic iliac artery stents and stent-grafts: A comparative study in sheep.

PURPOSE: To compare nonferromagnetic iliac artery prostheses in their suitability for patency monitoring with magnetic resonance angiography (MRA) using conventional angiography as a reference. METHODS: In experiment 1, three Memotherm stents were inserted into the iliac arteries of each of six sheep: two "tandem" stents on one side and a single stent on the other side. In experiment 2, four prostheses (normal and low-porosity Corvita stent-grafts, Memotherm, ZA-stent) were inserted in each of 11 sheep. Patency was monitored before and 1, 3, and 6 months after insertion with 3D phase-contrast and two 2D time-of-flight sequences (TOF-1: TR/TE = 18/6.9, TOF-2: 13/2.5) with and without contrast at 1.5 T. On 206 coronal MIP images (72 pre-, 134 post-stenting), three readers analyzed 824 iliac segments (206 x 4) for patency and artifacts. RESULTS: There was no difference in the number of artifacts between tandem and single iliac Memotherm stents. The ZA-stent induced significantly fewer artifacts than the other prostheses (p < 0.00001). With MRA, patency of the ZA-stent was correctly diagnosed in 88% of cases, which was almost comparable to nonstented iliac segments (95%), patency of the Memotherm stent in 59%, and of the Corvita stent-grafts in 57% and 55%. The TOF-2 sequence with contrast yielded the best images. CONCLUSION: MRA compatibility of nonferromagnetic prostheses depends strongly on the design of the device. MRA may be used to monitor the patency of iliac ZA-stents, whereas iliac Memotherm stents and Corvita stent-grafts appear to be less suited for follow-up with MRA.

Animals↗

An audit of cushioned diabetic footwear: relation to patient compliance.

The recurrence rate of neuropathic foot ulcers is reported in 51 diabetic patients regularly attending a diabetic foot clinic. All of the patients were provided with protective footwear reducing peak plantar pressure at the forefoot area by 50% (versus normal shoes), and were followed up for up to 4 years. Compliance with this footwear was recorded by assessing the daily time of wearing protective or normal shoes, and compliance with foot care was recorded from the entries in the patients charts. The results of this observational study demonstrate that wearing protective shoes for > 60% of the daytime significantly (p = 0.0002) reduced the ulcer relapse rate by > 50% in comparison with shorter wearing times for these shoes. In addition, patients without ulcer relapses had foot care significantly more frequently than patients with relapse (p < 0.05). It is concluded that cushioned protective footwear in association with frequent foot care is essential in the prevention of neuropathic diabetic foot ulcer recurrence.

Aged↗