Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage, and renal failure. Among the various hemorrhagic complications of HFRS, the spontaneous rupture of an arteriovenous malformation of the testicular vessels with a retroperitoneal hematoma is a rare finding. Here, we report a case of HFRS complicated by a massive retroperitoneal hematoma that was treated with transcatheter arterial embolization.
Adult ; Arteriovenous Malformations/*complications ; Embolization, Therapeutic ; Hematoma/diagnosis/*etiology/therapy ; Hemorrhagic Fever with Renal Syndrome/*complications ; Humans ; Kidney Cortex/blood supply ; Male ; Retroperitoneal Space ; Rupture, Spontaneous ; Testis/blood supply

OBJECTIVETo evaluate perfusion characteristics of normal renal cortex with 64-slice spiral CT and to investigate the correlation between perfusion parameters and gender, age, and serum creatinine (Scr).

METHODSIn total 71 healthy subjects, the kidney non-enhanced imaging and perfusion imaging with 64-slice spiral CT were performed. Perfusion parameters of renal cortex including blood flow (BF), blood volume (BV), and permeability (PM) were calculated with Siemens Body PCT (VB20B) software. The differences of BF, BV and PM in different age and gender people were compared by one-way ANOVA. The correlation between age and perfusion parameters, Scr, and PM were analyzed.

RESULTSTechnical failures were experienced in 3 (3/71, 4.2%) subjects. Perfusion values of normal renal cortex in male, female, and all subjects were obtained separately. Male subjects (n = 56): BF = (229.8 +/- 49.9) ml/(100 ml x min), BV = (398.2 +/- 59.5) 1000:1, PM = (213.5 +/- 54.0) 0.5 ml/(100 ml x min); female subjects (n = 52): BF = (230.0 +/- 56.1) ml/(100 ml x min) BV = (358.1 +/- 49.7) 1000:1, PM = (186.2 +/- 32.1) 0.5 ml/(100 ml x min); all subjects (n = 108): BF = (229.9 +/- 52.7) ml/(100 ml x min), BV = (378.9 +/- 58.4) 1000:1, PM = (200.4 +/- 46.7) 0.5 ml/(100 ml x min). There was no significant difference in BF (F = 0.367, P = 0.547), BV (F = 3.088, P = 2.762), and PM (F = 3.308, P = 0.074) between male and female. In male, female, and all subjects, BF were all negatively correlated with age (r = -0.484, r = -0.429, r = -0.425; P < 0.01), while there was no correlation between BV (r = -0.152, r = -0.243, r = -0.043, P > 0.05) and PM (r = 0.053, r = 0.123, r = 0.172, P > 0.05) and age. There was no correlation between PM and Scr (r = 0.064, P > 0.05).

CONCLUSIONThe measurement of normal renal cortical perfusion characteristics with 64-slice spiral CT is feasible and can be used for the quantitative evaluation of the physiological functions of normal renal cortex.

Adult ; Aged ; Female ; Humans ; Kidney Cortex ; blood supply ; diagnostic imaging ; physiology ; Male ; Middle Aged ; Perfusion Imaging ; methods ; Reference Values ; Tomography, Spiral Computed ; methods ; Young Adult

OBJECTIVESTo explore the effects and significance of Huanshuai Recipe Oral Liquid (, HSR), a formula with supplementing qi, nourishing blood and activating blood on restructuring glomerular microvasculature and expression of vascular endothelial growth factor (VEGF) in subtotal nephrectomized (SNX) rats.

METHODSA total of 76 male Wistar rats were randomly divided into four groups: 16 in the sham-operated group and fed with tap water 10 mL/kg per day; 20 in the model group were operated with 5/6 SNX and fed with tap water 10 mL/ kg per day; 20 SNX rats in the HSR group were treated with HSR 10 mL/kg per day; 20 SNX rats in the losartan group were treated with losartan 40 mg/kg per day. Serum creatinine (SCr) and urinary protein excretion (Upro) were examined at the 2nd, 4th, 8th, and 12th weeks of the treatment, and the remnant kidneys were harvested. Changes in histological microstructure were evaluated using light microscopy, and the expression of VEGF was detected by using ELISA.

RESULTSUpro, microvasculature injury and glomerulosclerosis were found to be alleviated in HSR and Losartan groups, respectively. The change of VEGF expression showed positive correlation with glomerular capillary area and peritubular capillary number (r=0.448, r=0.422, P<0.01), but negative correlation with that of SCr and Upro (r=-0.592, r=-0.481, P<0.01).

CONCLUSIONSHSR could regulate the VEGF expression, reduce the loss of microvasculature, which demonstrated similar renal protective effects to losartan in SNX rats. Examination of Chinese herbal medicine influence on VEGF signaling and restructuring renal microvasculature may elucidate the molecular mechanism of renal protection to a certain degree.

Administration, Oral ; Animals ; Capillaries ; drug effects ; metabolism ; pathology ; Collagen Type IV ; metabolism ; Creatinine ; blood ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Extracellular Matrix ; drug effects ; metabolism ; Fibronectins ; metabolism ; Immunohistochemistry ; Kidney Cortex ; drug effects ; metabolism ; pathology ; Kidney Function Tests ; Kidney Glomerulus ; blood supply ; drug effects ; pathology ; physiopathology ; Microvessels ; drug effects ; Nephrectomy ; Proteinuria ; blood ; drug therapy ; physiopathology ; Rats ; Rats, Wistar ; Time Factors ; Vascular Endothelial Growth Factor A ; metabolism

The objective of this research is to investigate the influence of rhBMP-2 on the renal tissue of rat with renal ischemia reperfusion injury. In this program the ischemia reperfusion rat model was established and Wistar rats were divided into six groups: sham operation group (S group), renal ischemia reperfusion injury group (R group), rhBMP-2 treatment group (B1, B2, B3 and B4 group). In the rhBMP treatment groups, rhBMP-2 was intravenously administered with different doses before reperfusion. The contents of TNF-alpha, IL-6, IL-8, MDA and SOD in kidney tissue were observed. At the same time, renal function (blood creatine (Scr) and urea nitrogen (BUN)) were measured. As a result, compared with renal ischemia reperfusion group, administration of rhBMP-2 significantly reduced the content of IL-6 and IL-8 (P < 0.05) and ameliorated renal dysfunction cellular damages (P < 0.05). Higher dose of rhBMP-2 may reduce the content of TNF-alpha (P < 0.05) in kidney tissue. rhBMP-2 also increased activity of SOD and reduced the level of MDA, BUN and Scr. So, we can draw a conclusion that rhBMP-2 treatment attenuates renal ischemia reperfusion injury through inhibition of pro-inflammatory cytokines production and anti-oxidation activity.
Adrenal Cortex ; pathology ; ultrastructure ; Animals ; Blood Urea Nitrogen ; Bone Morphogenetic Protein 2 ; pharmacology ; Creatine ; blood ; Interleukin-6 ; metabolism ; Interleukin-8 ; metabolism ; Kidney ; blood supply ; metabolism ; Male ; Malondialdehyde ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Recombinant Proteins ; pharmacology ; Reperfusion Injury ; metabolism ; pathology ; Superoxide Dismutase ; metabolism ; Transforming Growth Factor beta ; pharmacology ; Tumor Necrosis Factor-alpha ; metabolism