Services and laboratories » Unità Operativa Semplice – (U.O.S.) Diagnostica delle Malattie Neuromuscolari » Diagnostic activities



Neuromuscular Outpatients’ Department and Day Hospital

Address:
Dipartimento di Scienze Neurologiche
U.O.S. Diagnostica Malattie Neuromuscolari
Universita' degli Studi di Milano
Ospedale Maggiore IRCCS Milano
Via F. Sforza 35 20122 Milano

Outpatient Department:

• Neuromuscular disorders:
  Medical examinations are held on Monday afternoon, Wednesday and Friday morning.
• Motorneuron diseases:
  Wednesday morning (3 times a month)
  For reservations call 0039-02-55033806 Monday to Friday 9.30 a.m.- 1.30 p.m.

Biopsies:
for reservations call 0039-02-55033827
Fax 0039-02-55033968

Examined patients are affected with different neuromuscular disorders:

• Muscular Dystrophies
• Inflammatory Myopathies (Polymyositis, Dermatomyositis, Inclusion Body Myositis)
• Congenital Myopathies
• Metabolic Myopathies
• Mitochondrial encephalomyopathies
• Iperckemias

Laboratories of Morphology Diagnostics and Skeletal Muscle and Peripheral Nerve Biopsies

Laboratories of Morphology Diagnostics

Tel. 0039-02-55033966 / 0039-02-55033827
Fax 0039-02-55033968
e-mail: maurizio.moggio@unimi.it

The laboratory has been operating for over 30 years and processes 250 muscle and nerve biopsies each year.
Samples are collected come from our Institute or from other Hospitals having an arrangement with our laboratory.

"In Samples"
The following Institutes have subscribed a legal agreement with our Unità Operativa Semplicefor both study and storage of their muscle biopsies:

• Ospedale Niguarda Ca'Granda di Milano
• Ospedale San Gerardo di Monza
• Ospedale San Paolo di Milano
• Istituti Clinici di Perfezionamento di Milano
• Casa di Cura Policlinico San Marco di Zingonia-Bergamo
• USL Ospedale Infermi di Rimini
• Ospedale Civile di Legnano
• Ospedale Predabissi di Melegnano - Milano
• Ospedale Policlinico di Pavia
• Ospedale Valduce di Como
• Azienda USSL n° 3 Presidio di Busto Arsizio
• Azienda USSL n° 32 Ospedale Santa Corona di Garbagnate
• Ospedale Regionale di Lugano Civico e Italiano
• Fondazione Pro Juventute Don Carlo Gnocchi di Milano
• Ospedale S. Antonio Abate di Gallarate-Varese
• Ospedale Civico di Vimercate
• A.S.L. di Ravenna (che comprende: Presidio Ospedaliero di Ravenna,
• Presidio Ospedaliero di Lugo di Romagna, Ospedale per gli infermi
  di Faenza)
• Istituto Policlinico San Donato
• Ospedale Civico di Desio
• Clinica pediatrica De Marchi - ICP, Milano
• Ospedali Riuniti di Bergamo
• Ospedale Bassini di Cinisello
• Azienda Ospedaliera Sant'Anna di Como
• Istituto Auxologico IRCCS di Milano
• Ospedale Sacco di Milano
• Dipartimento di Cardiochirurgia, Ospedale Niguarda, Milano

"Out samples"
We are presently collaborating with the following Italian and foreign Institutes and Research Centers, which use our samples for scientific studie:

• Dept. of Neurology, Columbia University, New York, USA
  Istituto Neurologico Besta, Milano, Italy
• Dipartimento di Patologia Umana ed Ereditaria, Università di Pavia, Italy
• Istituto La Nostra Famiglia IRCCS, Bosisio Parini (LC), Italy
• Red Cross Hospital, Athens, Greece
• Clinica neurologica II, Università di Messina, Italy
• Children’s Hospital Boston, USA.
• Genethon, Evry France
• Columbia University, New York, USA.
• Istituto G.Gaslini, Genova, Italy.
• Istituto Genetica Univ. Di Pavia, Italy.
• Università di Bari, Italy.
• Istituto di Fisiopatologia Universita' di Pavia, Italy

Skeletal muscle and peripheral nerve biopsies

We perform open skeletal muscle and peripheral nerve biopsies under local anesthesia in both Outpatients’ Department and Day-Hospital regimen. Patients undergo biopsy after medical examination, as described in A), or after being referred by colleagues from other hospitals. Should total anesthesia be required, patients are hospitalized for a few days.

Main methods of sample processing

Histology

• Ematoxylin-Eosin
  
• Gomori Trichrome
  
  

Histochemistry

• PAS
• OIL RED O
• ACID PHOSPHATASE
  
• NADH
• ATPase at 9.4, 4.6, 4.3 Ph
• SUCCINATE DEHYDROGENASE (SDH)
  
• CYTOCROME C OXYDASE (COX)
• MYOADENYLATE DEAMINASE
• MYOPHOSPHORILASE
• PHOSPHOFRUCTOKINASE
• CONGO RED
• ZIEHL NIELSEN
• ALIZARINA RED
• LILLIE’S FERROCYANIDE
  

Immunohistochemistry

• Dystrophin 30 Kd
  
• Dystrophin COOH
• Dystrophin NH 2
• Merosin
• Alpha-sarcoglycan
• Beta-sarcoglycan
• Gamma-sarcoglycan
• Delta-sarcoglycan
• Alpha-dystroglycan
• Caveolin
• Dysferlin
• Desmin
• Vimentin
• Emerin
• Actin
• Myosin
• Alpha-actinin
• Collagen VI
• Collagen IV
• HLA I
  
• MAC
• CD 4
• CD 8
• CD 19
• S 100
  

Nerve Biopsies


Nerve biopsies are also processed by means of morphometric analysis of nerve fibers and by single nerve fiber examination (teasing).

Electron Microscopy



1 µm thick semithin sections are cut and stained with toluidine blue whereas ultrathin sections (50-60 nm thick) are contrasted using uranyl acetate followed by lead citrate.

• Immuno electron microscopy
• Morphometric analysis
  

Molecular Biology

• In situ hybridization
  
• Single-fiber PCR
• In situ PCR