Background: Incomplete ureteric duplication can be associated with either ureteropelvic obstruction involving the lower moiety or reflux between the ureters (yo-yo reflux). Yo-yo reflux can be a cause of repeated urin...Background: Incomplete ureteric duplication can be associated with either ureteropelvic obstruction involving the lower moiety or reflux between the ureters (yo-yo reflux). Yo-yo reflux can be a cause of repeated urinary tract infection with subsequent renal damage. Aim of the work: The current study evaluated the presence of yo-yo reflux as reason of upper moiety dilation in cases with incomplete duplication of upper urinary tract. Methodology: 10 cases with a dilated upper moiety of duplex renal pelvicalyceal system were examined with color duplex ultrasonography. All were further investigated with intravenous pyelography (IVP), and ascending/micturating cystography. Results: 9 cases with upper moiety dilation showed complete duplication of the pelvicalyceal systems and ureters and 1 case with dilated upper moiety showed incomplete ureteric duplication in which the diagnosis of Yo-yo reflux was confirmed by color duplex ultrasound in addition to the intravenous pyelography findings. Conclusion: The presence of antegrade/retrograde flow within the dilated moiety of a duplex kidney during color duplex study in addition to the intravenous pyelography findings can confirm the diagnosis of yo-yo reflux.展开更多
Occlusion of the common carotid artery(CCA) is rare. CCA occlusion(CCAO) can present as drowsiness and right hemiplegia related to emboli after total arch replacement. Although we selected a follow-up at first because...Occlusion of the common carotid artery(CCA) is rare. CCA occlusion(CCAO) can present as drowsiness and right hemiplegia related to emboli after total arch replacement. Although we selected a follow-up at first because color duplex sonography showed retrograde flow from the left external carotid artery to the internal carotid artery, this patient had epilepsy and single-photon emission computed tomography(SPECT) acquired quantitative results of actual brain perfusion and showed insufficient collateral blood flow. To improve brain perfusion, we performed a bypass of the left subclavian artery to left CCA bypass. Postoperatively, the patient did not have epilepsy and drowsiness. Also, right hemiplegia improved enough for him to walk with support. SPECT showed increased left cerebral flow(the asymmetry ratio was 71% to 81%). Evaluation of the carotid artery with color duplex sonography alone was insufficient when CCAO showed retrograde or collateral flow. We should have performed quantitative evaluation with SPECT at the same time.展开更多
文摘Background: Incomplete ureteric duplication can be associated with either ureteropelvic obstruction involving the lower moiety or reflux between the ureters (yo-yo reflux). Yo-yo reflux can be a cause of repeated urinary tract infection with subsequent renal damage. Aim of the work: The current study evaluated the presence of yo-yo reflux as reason of upper moiety dilation in cases with incomplete duplication of upper urinary tract. Methodology: 10 cases with a dilated upper moiety of duplex renal pelvicalyceal system were examined with color duplex ultrasonography. All were further investigated with intravenous pyelography (IVP), and ascending/micturating cystography. Results: 9 cases with upper moiety dilation showed complete duplication of the pelvicalyceal systems and ureters and 1 case with dilated upper moiety showed incomplete ureteric duplication in which the diagnosis of Yo-yo reflux was confirmed by color duplex ultrasound in addition to the intravenous pyelography findings. Conclusion: The presence of antegrade/retrograde flow within the dilated moiety of a duplex kidney during color duplex study in addition to the intravenous pyelography findings can confirm the diagnosis of yo-yo reflux.
文摘Occlusion of the common carotid artery(CCA) is rare. CCA occlusion(CCAO) can present as drowsiness and right hemiplegia related to emboli after total arch replacement. Although we selected a follow-up at first because color duplex sonography showed retrograde flow from the left external carotid artery to the internal carotid artery, this patient had epilepsy and single-photon emission computed tomography(SPECT) acquired quantitative results of actual brain perfusion and showed insufficient collateral blood flow. To improve brain perfusion, we performed a bypass of the left subclavian artery to left CCA bypass. Postoperatively, the patient did not have epilepsy and drowsiness. Also, right hemiplegia improved enough for him to walk with support. SPECT showed increased left cerebral flow(the asymmetry ratio was 71% to 81%). Evaluation of the carotid artery with color duplex sonography alone was insufficient when CCAO showed retrograde or collateral flow. We should have performed quantitative evaluation with SPECT at the same time.
