Pseudoexfoliation syndrome in diabetic patients: transmission electron microscopy study of anterior lens epithelial cells.

Purpose: to examine the lens epithelial cells in diabetic patients with pseudoexfoliation to ultramicroscope and to compare the findings with those of patients without diabetes mellitus (DM) and/or without pseudoexfoliation (PEX). Materials and Methods: Forty patients aged 65-86 years were enrolled in the study. All patients had senile cataract and were divided into four groups of ten patients in each group. Group I: patients without pseudoexfoliation, without DM, Group II: without pseudoexfoliation, with DM, Group III: with pseudoexfoliation, without DM, Group IV (Pseudoexfoliation-Diabetic Group): with pseudoexfoliation, with DM. In all cases, part of the central portion of anterior lens capsule was removed during routine cataract surgery, and was properly prepared in order to be examined under a transmission electron microscope. Results: In the control group, mainly degenerative alterations to varying extents were observed. In all groups, intracellular and extracellular oedema, multilayering, apoptosis, completely destroyed cells adjacent to normal cellswere described. In the diabetic group, alterations were more severe with respect to group I. In PEX cases, the additionalirregularity of the epithelium surface, loose intercellular connection, as well as the loose connection between cells and basement membrane were described with the presence of PEX material free and within the basement membrane. In cases with PEX and DM, degenerative alterations and PEX material were observed as well, but the epithelium was better conserved compared to the PEX group. Conclusion: the observed lesions were more extended and more frequent in the pseudoexfoliation group, followed by the diabetic group. The pseudoexfoliation-diabetic group presented less intense modifications raising questions about the interaction of these different diseases. Abbreviations: DM = Diabetes Mellitus, PEX = Pseudoexfoliation, PXM = Pseudoexfoliative Material, AD = Alzheimer disease, TGF-ß1 = Transforming Growth Factor beta 1, WHO = World Health Organization, LEC = Lens Epithelium Cells, BM = Basement Membrane, CM = Cytoplasmic Membrane.

Histologic evaluation of femoral nerve demyelinating and axonal neuropathy in Wistar rats due to alendronate intake: a randomised study.

BACKGROUND: Bisphosphonates (BPs) are forceful inhibitors of osteoclast-mediated bone resorption. Long-term BP use is associated with multiple rare but severe adverse effects. The objective of this study was to investigate the possible effects of BPs in the structure of femoral nerve. Specimens from the femoral nerve of ten female 12-month old Wistar rats were used as control group and ten female 12-month old Wistar rats to which Alendronate (Fosamax, Merck) was administered per os for 13 weeks, were used as research group. Samples were observed under a Transmission Electron Microscope. G ratio measurements and statistical analysis with SPSS program were also performed. RESULTS: The control group showed no major changes of the nerve's histologic image, with the exception of some spots of thickness of the nerve myelin sheath. The research group showed major morphological changes which varied from partial disorganization or thickening of the myelin to severe myelin thickening and axon strangulation. A statistically significant difference of the G ratio between the two groups was observed. CONCLUSIONS: The reported values (found in literature) for the morphologic measurements of the femoral nerve in Wistar rats are not complying with the ones we found in our study. There was a significant reduction of all three variables (the mean axon like diameter, the myelin thickness, G ratio) studied in the femoral nerve of the research group in contrast to control group. Our study demonstrates a possible correlation between alendronate administration and femoral nerve's function, nevertheless due to the small specimen further research is needed.