Intercostal muscle biopsy in human neuromuscular disease. Histochemical and electron microscopic studies.

Stern, Lawrence Z.; Payne, CM; Gruener, Raphael; Anderson, Robert M.; Hannapel, Linda K.

doi:10.1136/jnnp.38.9.900

Cited by 18 publications

(2 citation statements)

References 23 publications

(23 reference statements)

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“…Hence, their use is currently confined to specialized research centers [8]. In this study, we opted for external intercostal muscle biopsy, since it has been shown to be of unique usefulness in the study of human neuromuscular disease [9,10]. The external intercostal muscle is a short, flat muscle with abundant motor endplates allowing for detailed examinations of the NMJ.…”

Section: Electronic Supplementary Materialsmentioning

confidence: 99%

Complement deposition at the neuromuscular junction in seronegative myasthenia gravis

et al. 2020

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Section: Electronic Supplementary Materialsmentioning

confidence: 99%

Complement deposition at the neuromuscular junction in seronegative myasthenia gravis

et al. 2020

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“…function or with COPD are consistent with the histochemical profile of intercostal muscles obtained from autopsy of normal humans. Thus, the relative occurrence of ST fibres is the same (62%, table 2) [25, 47,48,50]. Some patients with COPD have a slightly lower value for ST fibre proportion ( 49% ), and this applies for both the inspiratory EXT and expiratory INT [51,52].…”

Section: Patients Results From Patients With Normal Ventilatorymentioning

confidence: 99%

Human respiratory muscles: fibre morphology and capillary supply

Mizuno

1991

Eur Respir J

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In man the diaphragm (DIA) and abdominal muscles comprise approximately 50% slow-twitch (ST) fibres, whereas a higher proportion (60%) is found in intercostal muscles and the scalenes. All respiratory muscles show an equal distribution of fast-twitch (FTa and b) fibres with the exception of the expiratory intercostal muscles which have few FTb fibres. The inspiratory muscles have a uniformly small fibre size, in contrast to the expiratory intercostal muscle fibres which are large. The fibre size of the inspiratory muscles is maintained with ageing, whereas that of the expiratory intercostal muscles appears to be reduced after the age of 50 yrs. Capillary supply is most abundant in the expiratory muscles followed by DIA and the inspiratory intercostal muscles. In patients with chronic obstructive pulmonary disease (COPD) it is unknown whether a reduction in fibre size of the thoracic respiratory muscles is caused by extreme use due to increased ventilatory work, or by disuse due to an increased involvement of the extrathoracic respiratory muscles. Histochemical characteristics suggest that, in normal humans, the load on the inspiratory muscles is relatively small during contractions, whereas the expiratory intercostal muscles are exposed to severe continuous activity with a heavy load.

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External Intercostal Muscle Biopsy

Stern¹,

Gruener²,

Anderson³

1975

Archives of Neurology

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External intercostal muscle biopsies were performed on 36 patients with neuromuscular disease, 13 patients un¬ dergoing thoracotomy for other diseases, and 3 healthy volunteers. The procedure is safe, of diagnostic value, and uniquely useful as a research tool, as it allows cor¬ relation of results of histochemical, ul¬ trastructural, physiological, pharmaco¬ logical, and biochemical studies on the same specimens. (Arch Neurol 32:779-780, 1975) External intercostal muscle biopsy has been shown to be of unique usefulness in the study of human neuromuscular disease.112 Providing intact fibers, it allows direct corre¬ lation of results of morphological, physiological, pharmacological, and biochemical studies on the same specimens. Recently, we presented evidence that the same histochemical and ultrastructural changes known to occur in limb muscle that had under¬ gone biopsy also occur in intercostal muscle in the muscular dystrophies and motor neuron disease.11 Previous reports have not, however, detailed the method of performing intercostal biopsy and treating the tissue. The purpose of this communication is to describe the surgical aspects of the biopsy, preparation of specimens, and our clinical experience. SUBJECTS AND METHODSThirty-six patients were recruited from among those being observed at the Univer¬ sity of Arizona Clinic for Neuromuscular Disorders. The diagnostic categories in¬ cluded various forms of muscular dys¬ trophy and spinal muscular atrophy, motor neuron disease, paramyotonia congenita, and the myopathies associated with acro¬ megaly and hyperthyroidism. Of these, seven had previously had diagnostic limb muscle biopsies elsewhere and two patients had both limb and intercostal biopsies here. Biopsies were also obtained from 13 adult patients without neuromuscular dis¬ ease, who were undergoing thoracotomy for other diseases, and from 3 healthy adult volunteers. Control subjects were all under 60 years of age. Informed consent was obtained after the nature of the proce¬ dure had been fully explained.A chest roentgenogram and pulmonary function studies were performed on all subjects prior to biopsy. As a precaution, patients were kept in the hospital for one night after the biopsy. Except in the tho¬ racotomy cases, specimens were obtained from the left sixth intercostal space in the midaxillary line, using paravertebral nerve block anesthesia. Blockage of four or five intercostal nerves (usually the fifth to ninth) gave consistently satisfactory anes¬ thesia. Lidocaine (1.5%) or bupivacaine (Marcaine) (0.25%) were the local anesthet¬ ics employed (each usually with 1:200,000 epinephrine). With the patient in the right lateral decubitus position, a 4.5-cm incision was made through the superficial thoracic fascia. The latissimus dorsi and the under¬ lying serratus anterior were divided in the direction of the fibers, exposing the sixth intercostal space. A 2 x 3-cm parallelogram of external intercostal muscle, weighing about 3.5 gm, was removed, with a rim of periosteum left attached to either e...

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Intercostal muscle biopsy in human neuromuscular disease. Histochemical and electron microscopic studies.

Cited by 18 publications

References 23 publications

Complement deposition at the neuromuscular junction in seronegative myasthenia gravis

Complement deposition at the neuromuscular junction in seronegative myasthenia gravis

Human respiratory muscles: fibre morphology and capillary supply

External Intercostal Muscle Biopsy

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