Diuresis and improved renal hemodynamics produced by prostaglandin E1 in the dog with norepinephrine-induced acute renal failure.

Unilateral acute renal failure was induced in dogs by renal artery infusion of norepinephrine. Renal hemodynamics and function were studied before and 5 days after norepinephrine infusion, and during subsequent renal artery infusion of prostaglandin E1. After norepinephrine, the infused kidney exhibited decreased urine volume, sodium excretion, and creatinine clearance. Cortical blood flow, determined with radioactive microspheres, also decreased. No redistribution of intracortical blood flow occurred. Arteriographically, proximal vessels were constricted and the cortical nephrogram density diminished. During prostaglandin E1 infusion, urine volume, sodium excretion, and cortical blood flow increased. Creatinine clearance did not change significantly. Blood flow was redistributed from the outer third to the inner third of the cortex. Proximal vessels were dilated and the cortical nephrogram density was enhanced. The apparent dissociation of cortical blood flow from creatinine clearance suggests that prostaglandin E1-induced diuresis and natriuresis result from a mechanism other than increased glomerular filtration.

Dermatopathic lymphadenopathy a clinicopathologic analysis of lymph node biopsy over a fifteen-year period.

Forty cases of dermatopathic lymphadenopathy were found in a series of 906 consecutive lymph node biopsies (4.8 per cent). The histologic development and progression of the disease was correlated with the clinical state of the patient. In 35 of 40 cases the patients had active skin disease at the time of the biopsy; one of the remaining five patients had Hodgkin's disease, one had multiple myeloma and one had secondary syphilis. In the other two, no organic cause was found. In nine cases (22.5 per cent), the histological pattern typical of dermatopathic lymphadenopathy was associated with malignant lymphoma. Except for two biopsies, which showed coexisting malignant lymphoma and dermatopathic lymphadenopathy, no histologic features were found which distinguished patients with malignant lymphoma from the remainder. While the pathogenesis of the lymph node changes remains obscure, the histologic features suggest that it is at least in part an immune response, although the nature of the responsible antigen is unknown.