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FOR SEVERAL WEEKS prior to the formation of mature muscle cells, the process of which is virtually completed by the fifth fetal month in humans,1 the cell exists as a myotube. Similar muscle cells were seen in the biopsy of an adolescent boy with a muscle-wasting disorder.Since this unusual pathological occurrence appears to be unique, it is the purpose of this report to present the clinical, pathological, cytochemical, and electron microscopic studies of this disease. An attempt will also be made to correlate these findings with previously reported studies in myogenesis. MethodsBiopsy specimens of gastrocnemius muscle were removed on two separate occasions (September 1962 and January 1965) after infiltration of the overlying skin with a local anesthetic. The initial specimen was removed with sutures and fixed in Zenker's solution; the second specimen was removed with a C-shaped clamp designed for that purpose, and fixed in Bouin's solution. Both specimens were oriented in a manner whereby both cross and longitudinal sections could be made. The fixed sections from the first biopsy were stained with hematoxylin and eosin. In addition to this, the sections from the second biopsy were stained with the hematoxylin-van Gieson, Gomori trichrome, periodic acid-Schiff (PAS) and Lillie allochrome techniques.2 During the second biopsy, a muscle specimen was frozen in isopentane cooled to \p=m-\160 C by liquid nitrogen. Thin sections cut in a cryostat were stained unfixed for histochemical and cytochemical studies. Sections were stained with the modified Gomori trichrome technique for morphological de¬ tail.3 Mitochondrial oxidative enzymatic activity and enzymes involved in electron transport were studied with the cytochrome oxidase,1 nicotinamide adenine nucleotide dehydrogenase (NADH),5 and succinic dehydrogenase (SDH) reactions." Myofibrillary activity was sudied using adenosine triphosphatase (ATPase).7 Individual sarcoplasmic contents were studied utilizing amylophosphorylase and the periodic acid-Schiff stain.Lipids were stained using scharlach-R and Sudan black. Sections were also stained for acid phosphatase.8 Immunofluorescence studies were done using rabbit anti-human myosin and fluorescein labelled anti-rabbit globulin.8 Electron Microscopy.-For electron microscopy, tissue immediately frozen at -160 C in liquid nitrogen and stored at -4 C for four weeks was thawed at room temperature and fixed in 1'% osmium tetroxide in barbital (Veronal) acetate buffer10 for two hours. Dehydration was carried on in ascending solutions of acetone, and English Araldite * was used for embedding. A microtome was used for sectioning of the blocks. The sections were examined in an electron microscope.A 12-year-old white boy was admitted to Chil¬ dren's Hospital of Philadelphia in January 1965 for evaluation of muscle weakness and repeat muscle biopsy. This was prompted by uniquely abnormal fibers found in routine review of the patient's muscle biopsy done in 1962.This boy (Fig 1) was the product of his then 30-year-old mother's fifth...
FOR SEVERAL WEEKS prior to the formation of mature muscle cells, the process of which is virtually completed by the fifth fetal month in humans,1 the cell exists as a myotube. Similar muscle cells were seen in the biopsy of an adolescent boy with a muscle-wasting disorder.Since this unusual pathological occurrence appears to be unique, it is the purpose of this report to present the clinical, pathological, cytochemical, and electron microscopic studies of this disease. An attempt will also be made to correlate these findings with previously reported studies in myogenesis. MethodsBiopsy specimens of gastrocnemius muscle were removed on two separate occasions (September 1962 and January 1965) after infiltration of the overlying skin with a local anesthetic. The initial specimen was removed with sutures and fixed in Zenker's solution; the second specimen was removed with a C-shaped clamp designed for that purpose, and fixed in Bouin's solution. Both specimens were oriented in a manner whereby both cross and longitudinal sections could be made. The fixed sections from the first biopsy were stained with hematoxylin and eosin. In addition to this, the sections from the second biopsy were stained with the hematoxylin-van Gieson, Gomori trichrome, periodic acid-Schiff (PAS) and Lillie allochrome techniques.2 During the second biopsy, a muscle specimen was frozen in isopentane cooled to \p=m-\160 C by liquid nitrogen. Thin sections cut in a cryostat were stained unfixed for histochemical and cytochemical studies. Sections were stained with the modified Gomori trichrome technique for morphological de¬ tail.3 Mitochondrial oxidative enzymatic activity and enzymes involved in electron transport were studied with the cytochrome oxidase,1 nicotinamide adenine nucleotide dehydrogenase (NADH),5 and succinic dehydrogenase (SDH) reactions." Myofibrillary activity was sudied using adenosine triphosphatase (ATPase).7 Individual sarcoplasmic contents were studied utilizing amylophosphorylase and the periodic acid-Schiff stain.Lipids were stained using scharlach-R and Sudan black. Sections were also stained for acid phosphatase.8 Immunofluorescence studies were done using rabbit anti-human myosin and fluorescein labelled anti-rabbit globulin.8 Electron Microscopy.-For electron microscopy, tissue immediately frozen at -160 C in liquid nitrogen and stored at -4 C for four weeks was thawed at room temperature and fixed in 1'% osmium tetroxide in barbital (Veronal) acetate buffer10 for two hours. Dehydration was carried on in ascending solutions of acetone, and English Araldite * was used for embedding. A microtome was used for sectioning of the blocks. The sections were examined in an electron microscope.A 12-year-old white boy was admitted to Chil¬ dren's Hospital of Philadelphia in January 1965 for evaluation of muscle weakness and repeat muscle biopsy. This was prompted by uniquely abnormal fibers found in routine review of the patient's muscle biopsy done in 1962.This boy (Fig 1) was the product of his then 30-year-old mother's fifth...
of striated muscle follows different types of injury. After ischemic necrosis, muscle can be repaired to complete normality. In rabbit, ligation of the anterior tibial artery results in necrosis of the distal two thirds of the muscle. By intensive proliferation of cells that may originate from the satellite cells of Mauro,1 muscle is restored within 90 days by a cycle that strongly resembles histogenesis during ontogeny of muscle.2-4 In this paper, the results of morphologic studies on the regeneration of the anterior tibial muscle are described and compared to ontogeny of rabbit muscle. The biochemical changes in enzymes of regenerating muscle are reported in a second paper.5 Materials and MethodsFifteen adult rabbits of different species, origin, and sex were used. Weights varied between 2,350 and 5,100 gm. The anterior tibial artery of the right hind limb was prepared as suggested by Clark et al6 and the main stem ligated with silk. The animals were allowed to survive 1, 4, 6, 8. 10, 25, 35, 45, and 90 days respectively and were then killed. The tibial muscles of both sides were removed immedi¬ ately after death. The distal third was cut and liberated from the tendon. A proximal part was taken between the proximal third and the prox¬ imal half of the muscle. Both pieces were cut longitudinally into equal halves. One was fixed in Bouin's solution; the other was frozen and stored at -20 C for biochemical analysis. The muscles of the nonoperated side were treated the same way and served as control muscles.Six female rabbits were copulated 10, 20, and 30 days before the animals were killed. The embryos were collected immediately after death and the leg muscles were dissected. Part of these muscles were frozen, the remainder fixed in Bouin's solution. Histological TechniquesThe muscle specimens were fixated in Bouin's solution and in 4% formaldehyde solu¬ tion. Sections of 7µ were made after embed¬ ding in paraffin in order to control the course of the fibers. Exact longitudinal and cross sec¬ tions were obtained. The sections were stained with hematoxylin and eosin, according to van Gieson for connective tissue.
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