No abstract

We have utilized hydroxypropyl methylcellulose in the therapy of 20 patients suffering from dry eye in the initial stage. The effects of the substance have been evaluated both from a clinical and a morphological standpoint. In particular, transmission and scanning electron microscopy were applied to investigate the ultrastructural features of the conjunctival epithelium before and after treatment. In addition, lectin cytochemistry was carried out to analyse semiquantitatively the presence of glycoconjugates in the conjunctival mucus produced by goblet and non-goblet epithelial cells. Hydroxypropyl methylcellulose did not improve the tear film stability as demonstrated by the clinical tests. The normal surface of the conjunctival epithelium did not appear recovered as well. Only a minimal increase in the density of the second mucus system vesicles was observed. From a cytochemical point of view, the content of glycosidic residues appeared altered in dry-eye patients both before and after treatment. This alteration can lead to changes in the physical and functional properties of the mucus, impairing its role as a surfactant. We conclude that the common treatment by means of lubrificant-like substances palliates the dryness condition. The search for a drug which reintegrates the correct composition of the conjunctival mucus should be seriously considered as a valid alternative.

No abstract

The association between tuberous sclerosis complex (TSC) and renal angiomyolipomas (RAML) is widely recognized, but the evidence of intraglomerular microlesions of angiomyolipoma in TSC is extremely rare. We report a 36-year-old woman with TSC, presenting as gross hematuria and hypovolemic shock. The patient was diagnosed with bilateral RAML and spontaneous rupture of right RAML. She underwent right nephrectomy. Microscopic examination revealed multiple bilateral RAML composed of dysmorphic blood vessels, smooth muscle, epithelioid cells and adipose tissue, as well as intraglomerular microlesions of these components in continuity with the glomerular basement membrane but without adhesion to the Bowman's capsule. In this report we describe the histopathologic features and immunohistochemical markers of TSC-associated RAML with multiple parenquimatous lesions and isolated micro foci in the glomerular tuft. We also review recent discoveries related to possible pathogenesis of renal and intraglomerular lesions.