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Results for “Muscular Disorders, Atrophic”

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PubMed1998

Myopathy as the persistently isolated symptomatology of primary autoimmune hypothyroidism.

Although disorders of thyroid function may cause a wide range of muscle disturbances, an overt myopathy has been rarely reported as an isolated clinical presentation of hypothyroidism. We observed 10 patients (5 males and 5 females) who had been referred to the department of neurology because of muscular fatigability, myalgia, cramps, or proximal weakness. Laboratory investigation showed that all patients had hypothyroidism due to Hashimoto's thyroiditis (atrophic variant in 9/10). Classic symptoms/signs of hypothyroidism such as lethargy, constipation, cold intolerance, myxedematous facies, and/or bradycardia were absent, as assessed independently by the three coauthoring thyroidologists. Muscular complaints improved greatly and then disappeared after substitutive levothyroxine treatment. Muscle biopsy revealed nonspecific changes. Nicotinamide adenine dinucleotide reductase (NADH-TR)-hyporeactive cores were present in two patients (10% and 90% of type 1 fibers). On electron microscopy, the core areas showed disorganized myofibrils, Z-band streaming, rod formation, and paucity of mitochondria and glycogen granules. Desmin intermediate filaments were overexpressed only in some cores. The similarity of the pattern of desmin expression between hypothyroid cores and target lesions of denervated fibers supports the hypothesis that, at least in some of our patients, myopathy was the result of an impaired nerve-mediated action of thyroid hormones on skeletal muscle. Our observations suggest that an isolated myopathy as the sole manifestation of hypothyroidism is not a rare event. We postulate that our cases may constitute a peculiar subgroup of Hashimoto's thyroiditis patients: (1) the strikingly abnormal F/M ratio of 1:1; (2) the relatively younger age; (3) the rarity of the goitrous variant; (4) the unusual finding of antithyroglobulin (Tg-Ab) > antithyroid peroxidase (TPO-Ab). Thorough evaluation of thyroid function is appropriate in patients with myopathy of uncertain origin.

Adolescent↗

PubMed1975

[Lysosomal hydrolases in the process of muscular atrophy and dystrophy (a histochemical study)].

Non-specific esterase, acid phosphotase, beta-glucoronidase, and N-acetyl-beta-glucosamindase were revealed using the histochemical method of asocombinations in biopsy specimens of the muscular tissue taken from 99 patients suffering from neurogenic and myogenic disorders. Biopsy specimens were taken also from 7 healthy persons. Concentrations of the granular product of the reaction correlated with autofluorescence in the same section. Some bioptic materials were investigated using electron-microscopy. It was established that activity of lysosomal hydrolases in the normal muscular tissue was low, being increased with age. Autofluorescence in the majority of cases was well noticible. In the groups of atrophic fibres in neurogenic atrophy there were observed focal elevation of the lysosomal enzymatic activity. Product of the reaction, which pointed to the activity of nonspecific esterase and acid phosphotase, was localized predominantly along the periphery of muscular fibres. Autofluorescence of the product of the reaction was considerable. On the other hand, there were extensive areas of muscular fibres in which the concentration of the reaction product did not exceed the normal level. Activity of hydrolases in cells of the mesenchyma was of a low degree. Ist type of the lysosomal activity was observed in myogenic dystrophy with an acute course of the disease; it was characterized by structural changes in the muscular tissue, activation of the all hydrolases under study, absence of autofluorescence on the areas of localization of the reaction product, participation of the mesenchyma cells in the lysosomal activation. IInd type of the lysosomal activity was noted in the muscular tissue in neurogenic atrophy. There was no difference in principle between neuro- and myogenic lesions as far as the type of lysosomal activity is concerned. Collation of the results obtained in the investigations with the data reported in available literature enabled the authors to put forward the concept of the two types of the lysosomal activity in muscular lesions: 1) diffuse elevation of the lysosome activity associated with structural changes in the muscular tissue; 2) focal elevation of the physiological activity due to formation of lipopigment.

Acetylglucosaminidase↗

PubMed1984

[2 autopsy cases of congenital muscular dystrophy of Fukuyama type--a typical and an atypical cases].

Two autopsy cases of congenital muscular dystrophy of Fukuyama type (F-CMD) were described. The first case was diagnosed clinically and pathologically as its typical case. Neither his family history nor the history of his prenatal period were contributory. He had suffered from muscle weakness and atrophy since his birth. Serum CPK was markedly elevated. EMG and muscle biopsy proved dystrophic changes of the skeletal muscles. In addition, he manifested mental retardation and attacks of convulsion. EEG failed to elicit remarkable changes, but PEG represented ventricular dilatation. He died of respiratory insufficiency at age 12. His postmortem examination showed variegated anomalies in the nervous system. Extensive micropolygyria was present in the cerebrum and cerebellum accompanied by adhesions between the bilateral cerebral hemispheres. Assymmetry of the longitudinal fibers was pointed out in the pontine base. Anterior horn cells were atrophic and moderately depopulated. On the other hand, the second patient was an atypical F-CMD case in symptoms, signs and pathology. His grand-mothers on both father's and mother's sides wee first cousins. His three siblings showed no similar disorders. His mother developed slight gestational toxicosis in the sixth and seventh months of pregnancy. His muscle weakness, contracture of the bilateral hip-joints and clubfoot had been observed since his birth. Physical and neurological examinations at age 6 showed deformity of the skull, myopathic face, macroglossia, high-arched palate, pigeon chest, scoliosis of the thoracic spine. In addition, generalized muscular atrophy, hypotonia and areflexia were recognized. Pseudohypertrophy of the muscles was absent. Sensation was intact to all modalities. Serum CPK and LDH were moderately increased.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2003

Expression of the intermediate filament protein synemin in myofibrillar myopathies and other muscle diseases.

Synemin is a member of the intermediate protein superfamily. Previous studies in avian and rodent skeletal and cardiac muscles have demonstrated that synemin localises at the Z-band, where it associates with desmin and alpha-actinin. In the present study, the distribution of synemin was examined using immunohistochemistry in muscle biopsy specimens from patients suffering from myofibrillar myopathy (MM, n=6), dermatomyositis (DM, n=3), inclusion body myositis (IBM, n=5), oculopharyngeal muscular dystrophy (OPD, n=3) and denervation atrophy (DA, n=3), to investigate the possible participation of this protein in the pathogenesis of various muscular diseases. Of patients affected by MM, two showed the presence of mutations in the desmin gene; none had mutations in the alphaB-crystallin gene; and no mutations were identified in synemin or syncoilin genes of three patients. Synemin immunohistochemistry disclosed a faint staining corresponding to the Z-bands in the cytoplasm of control muscle fibres; in contrast, focal aggregates of synemin were seen in patients with MM. Increased synemin immunoreactivity was identified diffusely or in the subsarcolemmal space of scattered fibres in patients with DM, and in vacuolated fibres of patients with IBM and OPD. Strong synemin immunoreactivity was observed in target formations and atrophic fibres of patients with denervating disorders, as well as in atrophic fibres, regardless of their origin, in all patients studied. Synemin co-localised with desmin, as seen on consecutive serial sections immunostained with anti-synemin or anti-desmin antibodies. These observations demonstrate abnormal accumulations containing both synemin and desmin in muscle fibres in patients with MM, IBM, DM, OPD and DA. Considering the important role of synemin as one of intermediate filaments of skeletal and cardiac muscle, its destruction and accumulation in the intracellular debris suggest that synemin may participate in the pathogenesis of these disorders.

Adult↗

PubMedDate not supplied

Childhood onset oculopharyngeal muscular dystrophy.

Oculopharyngeal muscular dystrophy is an inherited disorder, usually autosomal dominant, which typically becomes symptomatic during the fifth decade of life with slowly progressive ptosis and dysphagia; childhood onset has not been reported. A 13-year-old female of French-Canadian descent developed nasal speech and strabismus at 5 years of age; there was no family history of neuromuscular disease. Ptosis and mild facial and proximal muscle weakness were present by 9 years of age. Over the next 4 years, the patient developed dysphagia, palatal paralysis, weight loss, decreased ocular motility, scoliosis, shortness of breath, and obstructive apnea. Tracheostomy and gastrostomy were required. Creatine kinase and repetitive facial nerve stimulation were normal. Edrophonium testing was negative and electromyography revealed myopathic motor units in the iliopsoas muscle. A preponderance of type I fibers and scattered atrophic and angulated muscle fibers were present in 3 muscle biopsies. The clinical presentation and findings are consistent with childhood onset oculopharyngeal muscular dystrophy.

Adolescent↗

PubMed2000

Proteasome expression in the skeletal muscles of patients with muscular dystrophy.

Previous investigators have suggested that proteolysis by calpain, a Ca2+-dependent protease, causes muscle fiber degradation in Duchenne and Becker muscular dystrophies (DMD/BMD). Recent evidence indicates that the nonlysosomal ATP-ubiquitin-dependent proteolytic complex (proteasomes) participates in muscle wasting during various catabolic states and in muscle fiber degradation in physiological or pathological conditions. To elucidate the possible role of proteasomes in dystrophic muscles, routine histochemistry and immunohistochemistry of 26S proteasomes were performed on muscle biopsy specimens obtained from patients with various neuromuscular disorders including DMD/BMD, polymyositis (PM), amyotrophic lateral sclerosis, and peripheral neuropathies, and on normal human muscle specimens. Immunohistochemically, proteasomes were located in the cytoplasm in normal human muscle, but their staining intensity was faint. Compared to control muscles, abnormal increases in both proteasomes and ubiquitin were demonstrated mainly in the cytoplasm of necrotic fibers and to a lesser extent in regenerative fibers in DMD/BMD and PM. Non-necrotic, atrophic fibers in all diseased muscles showed moderate or weak immunoreactions for the proteins; their staining intensities were stronger than those of control muscle fibers. Both proteins often colocalized well. Not all dystrophin-deficient muscle fibers showed a strong reaction for proteasomes. Our results showed increased proteasomes in necrotic and regenerative muscle fibers in DMD/ PMD, although this may not be disease-specific up-regulation. We suggest that the ATP-ubiquitin-dependent proteolytic pathway as well as the nonlysosomal calpain pathway may participate in muscle fiber degradation in muscular dystrophy.

Adolescent↗

PubMed1983

[Polyneuropathy caused by parathion: clinical, electrophysiologic and histologic studies of a case].

A case of 38 year old man who worked with organochlorinated and Parathion during 5 years is reported. His follow-up was up to 2 years. The onset of the disease was characterized by cholinergic signs, headache, loss of weight, trembling, miokimias, fasciculations, ataxia, myotonic phenomena (in hands only) and motor sensitive peripheral polyneuropathy (affecting the lower limbs symmetrically). Low concentrations of blood cholinesterases confirmed the etiology. Myotonic phenomena disappeared spontaneously 6 months after the initial observation. One year later, the concentration of erythrocyte acetylcholinesterase was found to be low and plasma cholinesterase was normal, suggesting that the patient was carrier of a congenital deficiency of acetylcholinesterase. In literature relationship between myotonia and intoxication due to organophosphorus was not found. The whole clinical picture, cholinergic symptoms, transitory phenomena and spontaneous motor activity could be explained by an excess of acetylcholine. Electromyography (EMG) in the first observation showed neuromuscular transmission blocking characterized by deficiency or absence of voluntary activity, unexcitability of fibular nerves, with fibrillations and positive peaks as described previously with Mipafox (another organophosphorus agent). During 2 years of observation numerous end-plates potentials of muscular fibres persisted in the EMG. A progressive increase in voluntary activity showed by unit motor potential of almost normal amplitude and very increased duration was observed. No potentials of reinnervation were noted. The results of EMG were explained as disturbances of neuromuscular transmission associated with moderate signs of denervation. The Eaton-Lambert's test and the stimulation of a single unit motor potential confirmed disorder of neuromuscular synapses. The histochemistry of brachial biceps showed scattered atrophic and angulated type I and II fibres. Teased-fibres preparations showed nerve fibres with B, C, and G alterations as defined by Dyck et al. indicating axonal degeneration. These results were according to velocity of sensitive conduction. The conduction velocity of fibular nerves was strongly delayed during all the evolution indicating serious disorders of motor nerves myelin.(ABSTRACT TRUNCATED AT 400 WORDS)

Acetylcholine↗

PubMed2003

The tongue: structure and function relevant to disease and oral health.

The tongue (L. lingua; G. glossa) functions as a digestive organ by facilitating the movement of food during mastication and assisting swallowing. Other important functions include speech and taste. The tongue consists of striated muscle and occupies the floor of the mouth. The dorsal mucosal surface consists of stratified squamous epithelium, with numerous papillae and taste buds. The tongue, a voluntary muscular structure, is attached by a fold, called the frenulum, to the floor of the mouth. Typically, between 8 and 12 circumvallate papillae are arranged in an inverted V-shape towards the base of the tongue. This anatomical review focuses on structure, function relationships and diseases affecting the tongue. From a primary oral health care perspective, this overview will facilitate the process of differential diagnosis in persons presenting with vesiculo-bullous, ulcerative, atrophic and cystic disorders of the tongue. Suspicious lesions should be biopsied to rule out carcinoma.

Humans↗

PubMed1993

[Disorder of swallowing muscles in iron deficient rabbits].

Plummer-Vinson syndrome is a clinical entity associated with dysphagia, sideropenic anemia and atrophic glossitis. Using rabbits with iron deficiency anemia, the author investigated the cause of dysphagia in this syndrome. Iron deficient animals were produced by bolus feeding without iron and intramuscular injection of an iron-chelating agent. The fibers of swallowing muscles (the thyro-pharyngeal, cricopharyngeal and cervicoesophageal muscles) were classified into three types (Type 1, 2A and 2B fibers) by actomyosin ATPase staining. No significant difference between the muscles of sideropenic rabbits and those of normal rabbits were found in the composition and distribution of their muscle fibers. By NADH-TR staining, however, the disturbance of the intermyofibrillar network and/or a "Moth Eaton" appearance, known to be caused by leakage of mitochondria, were observed in Type 1 fibers of the swallowing muscles of sideropenic rabbits. These morphological changes are similar to those observed in progressive muscular dystrophy. The quantity of iron in the swallowing muscles of sideropenic rabbits was significantly reduced in comparison with that in the sternothyroid and femoral muscles. This finding suggests that a selective decrease in myoglobin occurs in the swallowing muscles of iron deficient animals. From these observations, it might be concluded that dysphagia in iron deficiency anemia is caused by a myogenic disorder.

Anemia, Hypochromic↗

PubMed1998

Cell death and oxidative damage in inflammatory myopathies.

There is evidence that muscle fibers in denervating disorders and muscular dystrophies undergo apoptosis. In 21 patients with autoimmune inflammatory myopathies, we found no features of muscle fiber apoptosis such as DNA fragmentation or expression of apoptosis-related proteins. However, muscle fibers in myositis displayed distinct up-regulation of inducible and neuronal nitric oxide synthase (NOS). While inducible NOS was distinctly up-regulated on the sarcolemma of all kinds of muscle fibers neuronal NOS displayed increased expression in the sarcoplasm of damaged as well as atrophic muscle fibers. There were no disease-specific patterns in the different myositis subtypes. Enhanced expression of NOS with production of nitric oxide may contribute to oxidative stress mediating muscle fiber damage and muscle fiber necrosis representing the predominant cell death mechanism in myositis. Nevertheless, inflammatory cells displayed numerous DNA-fragmentation-positive nuclei and expression of apoptosis-related proteins indicating that apoptosis plays a role in the regulation of the inflammatory cellular response.

Adolescent↗

PubMedDate not supplied

[Effect of weightlessness on the course of the reparative process in the muscles of the biosatellite Kosmos-2044 rats].

The repair process in the soleus and gastrocnemius muscles of SPF Wistar rats flown for 14 days on the biosatellite Cosmos-2044 was investigated. The muscles were injured 2 days before launch by means of clamp forceps. The exposure inhibited the process but did not impair its phasic development. As a result, the reparative field diminished and took the size of an atrophic muscle; thinner myofibers appeared that originated from the ends of injured atrophic fibers and fibers that underwent splitting. It is postulated that repair inhibition is caused by the same mechanisms that produce muscle atrophy in microgravity. It is suggested that both repair inhibition and muscle atrophy are induced by disorders in the neurotrophic regulation of metabolism due to partial disuse.

Animals↗

PubMed1976

[Dystrophic myotonia (a clinico-morphologic study)].

The paper contains data of a clinico-morphological study of 14 patients with dystrophic myotonia. The muscular bioptate was studied by means of electron microscopy. In the muscular filaments there were 2 types of changes. In the initial phase of the disease there were focal changes in the myofibrillar apparatus, a mild hypertrophy of the sarcotubular system and an increase of the mitochondria. These changes are similar to disturbances in Thomson's myotonia. The existence of common traits in these disorders, motor disturbances and similar morphologocal changes permit to consider that they are an expression of a myotonical phenomenon. The second type of disorders was characterized by dystrophical and atrophical changes, with distinct correlations between the severity of the disease and expressiveness of morphological changes.

Adult↗

PubMed1975

Nature of muscular change in osteomalacia: light- and electron-microscope observations.

Thirteen muscle biopsy specimens (mainly the gluteus maximus) from 12 patients with laboratory confirmation of osteomalacia and proximal muscle weakness in 10 were examined by light and electron microscopy. Light microscopy revealed mild diffuse non-specific atrophy of the muscle fibres in 10 cases, severe generalised atrophy in one and patchy group atrophy in one. There was no myopathic change in specimens from cases with either a nutritional aetiology, or a mixed aetiology. The former, mostly women gave a history of severe chronic malnutrition often accompanied by repeated pregnancies and prolonged lactation; those with a mixed aetiology gave, in addition, evidence of a metabolic or endocrine disorder such as hyperparathyroidism, hyperthyroidism, uraemia, or treatment with anti-epileptic drugs or were of uncertain origin. Electron-microscope examination of muscle from the nutritional group showed atrophic changes in the fibres, such as loss of myofibrils, prominence of mitochondria and glycogen, loosening and folding of the basement-membrane but good preservation of the remaining myofibrils. In contrast muscle from cases of mixed aetiology showed, in addition to the atrophic features, clear degenerative changes in the myofibrils and the mitochondria, accumulation of amorphous material at the site of myofibrillar loss and of lipofuscin in muscle fibres, vascular endothelium and satellite cells. The earliest degenerative change was in the "I" band, involving actin filaments and "Z" line. The triads were generally preserved but the sarcoplasmic reticulum appeared affected in a patient with tetany and severe mitochondrial degeneration. In a patient with thyrotoxicosis, proliferation of central nuclei, "Z" line streaming and formation of "T" tubular aggregates were seen. In one patient with hyperparathyroidism and hypercalcaemia, severe myofibrillar degeneration and mitochondria showing osmiophilic deposits, possibly of calcium phosphate, were encountered. It is concluded: (1) that all osteomalacic muscle weakness is not myopathic but a non-specific atrophy occurring probably on the basis of disuse and malnutrition, and (2) patients with an added metabolic or endocrinological disorder show in addition to the atrophy, degenerative changes in the muscle fibre and its sub-cellular components consistent with myopathy, and these patients should be clearly distinguished from those with a background of malnutrition only.

Adolescent↗

PubMed1980

[Ultrastructural and clinical studies in "inclusion body myositis" (author's transl)].

A non-hereditary slowly progressive neuromuscular disease occuring in a 39-year-old male, consisting of an asymmetrical wasting of the muscles of the shanks, is reported. Neither clinical nor electromyographic criteria can safely distinguish whether a primary neurogenic or a primary myogenic process is causally involved. The initial rise in serum CPK-activity indicates a myopathic origin. The lightmicroscopic aspect of the muscle-biopsy shows a muscular atrophy which resembles a primary neurogenic pattern with grouped clusters of atrophic fibers as well as a myopathic or rather myositic tissue-pattern with randomly scattered atrophic fibers. In addition there are numerous vacuoles which are equivalent to concentric lamellae of dense material in electronmicroscopy. Numerous fibrillary inclusions as well in the cytoplasm as in the cell-nucleus correspond to typical alterations in the so-called "inclusion body myositis". The disease is critically discussed as a nosological entity among neuromuscular disorders.

Adult↗

PubMedDate not supplied

In vivo T1 characterization of genetically induced muscle atrophy.

In vivo spin-lattice relaxation times, T1, of water and lipid protons of normal and atrophic muscles were measured, using the spatially resolved spectroscopy (SPARS) sequence, in a genetic avian model of myopathy. These T1 values were compared with those of the hypertrophic muscles. Although the water T1 values of muscles were elevated in both types of lesions, the atrophic muscles showed a greater increase (54%) than the hypertrophic muscles (22%). The water T1 differentiation between the atrophic and hypertrophic muscles appeared to depend upon their bound water fractions that were calculated on the basis of the Fast Proton Diffusion model. The lipid T1 values of muscles were higher in the atrophic line of chickens compared to their genetic controls. In contrast, the lipid T1 values of muscles of the hypertrophic chickens and their controls were essentially identical. This suggests that the lipid T1 values may potentially complement the water T1 values in the differential diagnosis of muscle disorders.

Animals↗

PubMed1998

Immunohistochemical study of clathrin in distal myopathy with rimmed vacuoles.

Clathrin-coated vesicles are involved in three receptor-mediated intracellular transport pathways: export from the Golgi apparatus, transfer of lysosomal enzymes from the Golgi apparatus to lysosomes, and endocytosis at the plasma membrane. Seeking evidence of transport abnormalities in distal myopathy with rimmed vacuoles (DMRV), we performed immunohistochemistry for clathrin in muscle biopsy specimens from patients with this disorder or other neuromuscular disorders, and also in control muscle samples resected in orthopedic procedures. While most myofibers from control muscle did not stain for clathrin, some fibers revealed finely granular sarcoplasmic staining. In specimens from patients with Duchenne and Becker muscular dystrophy, amyotrophic lateral sclerosis, peripheral neuropathy, and DMRV, numerous clathrin-positive granules were often scattered through the sarcoplasm and seen to a lesser extent in subsarcolemmal regions. Quantitative immunohistochemical assessment showed more reactivity for clathrin in DMRV than in controls and other diseased muscles, particularly in atrophic fibers and type 2 fibers. Not all strongly clathrin-positive muscle fibers contained rimmed vacuoles, although most fibers with vacuoles were clathrin positive. The result suggests that the lysosome system is activated and receptor-mediated intracellular transport pathways function appropriately in the muscles of DMRV patients.

Adolescent↗

PubMed1978

[Mechanisms of development of histological and cytochemical changes in mammals (rats) during orbital flights].

The review surveys the publications on morphological and cytological changes in different functional systems of mammals (rats) flown on board the biological satellites of the Cosmos series. The paper gives an evidence that major changes in rats during orbital flights are induced by motor deprivation resulting in distinct metabolic disorders which histologically are represented as osteoporosis of the spongy segments of the long tubular skeletal bones, their periosteocytic osteolysis and atrophic developments in skeletal muscles. The paper discusses neurotrophic nature of these changes and emphasizes the contribution of stress reactions at different flight stages, especially on return to 1 g.

Animals↗

PubMed1991

The syndrome of Parsonage and Turner. Discussion of clinical features with a review of 8 cases.

A clinical analysis of 8 patients with brachial plexus neuropathy is presented. The disease may involve the upper, the lower, or the entire plexus. There is a higher incidence in men than in women. The syndrome is not uncommon but is frequently diagnosed incorrectly. The fairly typical pattern of symptoms and signs includes sudden onset with severe pain along one side of the shoulder girdle, followed in a few hours or days by atrophic paralysis of muscles over the affected shoulder. The disorder is occasionally bilateral. The paresis persists for months or even years. The overall prognosis is excellent despite the severity and extent of the lesion. The etiology is unknown, but decreased physical resistance is a predisposing factor.

Adult↗