By Michael Swash M.D. (London), F.R.C.P. (London), M.R.C. Path., Martin S. Schwartz M.D. (Maryland) (auth.)

During the final twenty years the improvement of enzyme histochemical concepts has contributed enormously to wisdom of muscle pathology. in spite of the fact that, those and different new tools, similar to electron microscopy and immunocytochemistry, have in basic terms really lately develop into gener­ best friend to be had for regimen use in histopathology. Muscle biopsy is a common strategy in scientific perform, having been brought via Duchenne in 1868 (Arch. Gen. Med. , eleven, 5-179). notwithstanding, the needle strategy utilized by Duchenne used to be now not usually followed, even supposing Shank and Hoagland defined an identical approach in 1943 (Science, ninety eight, 592). in this time muscle biopsies required a surgery and this used to be a substantial disincentive to their use. It used to be no longer until eventually Bergstrom (1962; Scand. J. Clin. Lab. make investments. , 14, Suppl. sixty eight) and Edwards (1971; Lancet, ii, 593--6) constructed an easy biopsy needle appropriate for muscle paintings in reference to workout body structure that the benefits of needle muscle biopsies got here to be preferred. in view that then, muscle biopsies became a comparatively minor strategy. This has ended in the expanding use of muscle biopsy in scientific perform, either for prognosis and for assessing growth in repeated biopsies through the process a disease and its therapy. the complete variety of enzyme histochemical and ultrastructural histological ideas might be utilized to those small biopsies and plenty of of the older histological staining equipment is usually used. This ebook is meant to function a pragmatic consultant in muscle pathology, relatively for histopathologists, and for these in training.

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It is often helpful to use specific histological methods for intrasarcoplasmic RNA and DNA. Methods are also available for intracellular calcium deposition and such as von Kossa's method and alizarin red. Immunoperoxidase methods for demonstration of serum immunoproteins Laboratory methods 25 in muscle fibres or in inflammatory cells, or of immune complexes in capillaries are occasionally of value. 4. 4 Special histological techniques applicable to cryostat sections of muscle Method Indication Toluidine blue A quick method, comparable to HE as a screening stain.

Mastaglia and J. N. Walton), Churchill Livingstone, Edinburgh. Swash, M. and Fox, K. , (1972a), The effect of age on human skeletal muscle: studies of the morphology and innervation of muscle spindles. f. Neural. , 16, 417-32. Swash, M. and Fox, K. P. (1972b), Techniques for the demonstration of human muscle spindle innervation in neuromuscular disease. f. Neural. , 15, 291-302. 4 Histological features of myopathic and neurogenic disorders It is usually not difficult to decide whether a muscle biopsy is normal or abnormal.

Smaller branches can rarely be recognized without silver impregnations. The nerve bundles contain myelinated fibres of various diameters, including motor axons innervating extrafusal and intrafusal muscle fibres, the alpha and gamma motor fibres, respectively, and large sensory axons innervating sensory receptors in muscle spindles, Golgi tendon organs and Pacinian capsules. Small C fibres mediating pain are also present. Fig. 4 Muscle spindle in transverse section. x 560. (a) The spindle capsule, periaxial space and intrafusal muscle fibres can be seen.

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