PATHOLOGY 



to changes of function, also in the heakhy e^ aZ., Feldman), since the techniques used for 

 subject. It is very difficult and many times demonstration of the localization of antibod- 

 impossible to ascertain which are physiologi- ies does not permit an absolutely certain 

 cal variations and pathological phenom- separation of the pedicels and the thin cover- 

 ena. The latter word is used in'this paper to ing of endothelium from the basement mem- 

 describe morphological changes which differ brane. Thus the reaction may take place in 

 with reasonable certainty, quantitatively or any of these structures. Considering the 

 qualitatively, from what is seen in healthy chemical nature of the basement membrane, 

 subjects. as far as it is known, and the experimental 



evidence referred to above, the basement 



Glomerulonephritis membrane is the most probable locahzation, 



Experimental. Electron microscopic however, 



studies of glomerular changes in nephrotoxic Renal lesions in the acute generalized 



serum nephritis in rats and mice have been Schwartzman reaction were studied in rab- 



published by a number of authors (Simer, bits by Bohle et at. (1958) and in rats by 



1954; Pielei aZ., 1955; Reid, 1956; Miller and Pappas et al. (1958). The animals were 



Bohle, 1957; Sakaguchi et al., 1957; Vernier treated twice with 24 hours interlude with an 



et al., 1958b; Miller et al., 1958; and Bohle intravenous injection of hpopolj^saccharides 



et al., 1959). The earliest lesions observed from Escherichia coli. Light microscopy 



one hour after the serum injection was showed abundant thrombi in the glomerular 



a diffuse thickening of the basement mem- capillary lumina eight hours after the last in- 



brane and a slight swelhng of the capillary jection. Electron microscopy demonstrated 



endothelial and epithelial cells. According to vacuolization of the endothelial cell cyto- 



Bohle et al., an increased swelling and vacuo- plasm and fibrils with a periodicity of 371.5 



lization of the epithelial cells takes place dur- AU, probably representing fibrin in the 



ing the first 24 hours, accompanied by a thrombi. 



gradual and slow decrease of the diameters of Experimental glomerular lesions have also 



the basement membrane to normal values, been produced by Bencosme et al. (1959) in 



Between 24 and 72 hours the epithelial-cell rats treated with uranyl nitrate. They ob- 



changes subside and instead a marked swell- served a fusion of the foot processes and a 



ing of the endothelial cells takes place. These vacuolation of the epithelial cell cytoplasm 



cells increase in size to such an extent that with an accumulation of dark bodies cor- 



the capillary lumina may be completely ob- responding to hyaline droplets observed in 



literated. The latter changes have been ob- the light microscope. A foreign substance was 



serv'ed by all authors and are commonly precipitated between the capillary basement 



regarded as typical for experimental glom- membranes and large cells inside them, which 



erulonephritis. the authors regard as intercapillary cells. In 



Similar changes have been observed in rab- the newly formed masses collagen fibers were 



bits (Feldman, 1959) and in rats (Sitte, 1959) formed and the authors therefore consider 



after single intravenous injections of bovine that the intercapillary cells are not of endo- 



serum. thelial origin. 



It is possible that the initial swelling of the Human Glomerulonephritis and Lu- 

 basement membrane is produced by the reac- pus Erythematosus. A case of subacute 

 tion between antigen and antibody which, hemorrhagic glomerulonephritis was de- 

 according to many authors, takes place in this scribed by Bergstrand and Bucht (1956). A 

 site. This cannot be proved, however (Bohle number of large vacuoles were found in the 



207 



