A case report of giant hamartoma of both kidneys with spontaneous rupture and hemorrhage in a pregnant woman: A case report.

The aim of the present study was to describe a case of renal angiomyolipoma (RAML) in a 31-year-old woman who presented with massive hemorrhage, shock, severe anemia (Hb 63 g-l) and multiple lesions, prior to delivery of a dead fetus. A 31-year-old woman was admitted due to left flank and abdominal pain at 20 weeks of gestation age, and diagnosed with RAML complicated with spontaneous rupture and hemorrhage of the left kidney, for which emergency exploratory laparotomy, left kidney resection and splenectomy were performed. The patient delivered a dead fetus 3 days following surgery and recovered well postoperatively. Hemorrhagic RAML during pregnancy is a rare and complex vascular surgical emergency, and should be managed in a multidisciplinary manner. Spontaneous rupture is a serious threat to the life and health of pregnant women and fetuses. The present case is a typical example of RAML in a pregnant woman complicated by spontaneous rupture and hemorrhage, which highlights the importance of determining the risk of acute hemorrhage in early stages of pregnancy, and the significance of time and proper management. However, in cases of shock caused by spontaneous rupture and hemorrhage, the only way to save the life of the patient is to resect the lesion without delay.

Nitrate increases ethylene production and aerenchyma formation in roots of lowland rice plants under water stress.

Ethylene increases root cortical aerenchyma formation in maize (Zea mays L.), rice (Oryza sativa L.) and other species. To further investigate the effects of nitrate, ammonium and water stress on ethylene production and aerenchyma formation in roots, two lowland rice cultivars (Shanyou 63, hybrid indica, and Yangdao 6, inbred indica) were cultured hydroponically with 10% (w/v) polyethylene glycol to simulate water stress. Water stress decreased shoot biomass, stomatal conductivity and leaf water potential in cultivars fed with nitrate but not with ammonium. Water stress induced more aerenchyma formation in cultivars fed with nitrate rather than ammonium, and increased cortical aerenchyma was found in Yangdao 6. Endogenous ethylene production by roots increased significantly under water stress in plants fed with nitrate rather than ammonium. Exogenous ethylene stimulated root cortical aerenchyma formation. Expression of the ethylene biosynthesis gene 1-aminocyclo-propane-1-carboxylic acid (ACC) synthase (ACS5) was greater in roots fed with nitrate rather than ammonium in the presence and absence of water stress. The expression of ethylene signalling pathway genes involved in programmed cell death (lesion-simulating disease (L.S.D.)1.1 and L.S.D.2; enhanced disease susceptibility (EDS) and phytoalexin-deficient (PAD4)) were regulated by the N form and water stress. In plants of cultivars fed with ammonium, L.S.D.1.1 expression increased under water stress, whereas L.S.D.2, EDS and PAD4 expression decreased. In conclusion, nitrate increases ethylene production and cortical aerenchyma formation in roots of water-stressed lowland rice. However, ammonium increased L.S.D.1.1 expression in water-stressed roots, and decreased ACS5, EDS and PAD4 expression, which would inhibit ethylene production and aerenchyma formation.