Figure 2 Analysis of muscle and nerve histopathology and muscle mtDNA deletions (A) Representative muscle biopsy shows a cytochrome c oxidase (COX)-negative.

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Date of download: 5/29/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Reduced Aquaporin 4 Expression in the Muscle Plasma.

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Figure 2 Analysis of muscle and nerve histopathology and muscle mtDNA deletions (A) Representative muscle biopsy shows a cytochrome c oxidase (COX)-negative blue fiber in the middle; slightly above it to the left is a single concave atrophic fiber. Analysis of muscle and nerve histopathology and muscle mtDNA deletions (A) Representative muscle biopsy shows a cytochrome c oxidase (COX)-negative blue fiber in the middle; slightly above it to the left is a single concave atrophic fiber. Above the lower margin in the middle is a small group atrophy with moderately atrophic fibers, and basally, in the left corner, a small group with very small fibers is seen (asterisks). Frozen section, COX-succinate dehydrogenase activity stain, original magnification 200×, scale bar 50 µm. (B) Long range PCR on total muscle DNA was performed to detect mitochondrial DNA (mtDNA) deletions from patients and 2 control individuals without mtDNA deletions (Ctrl-1 and Ctrl-2). As a positive control, we used muscle DNA from a patient with progressive external ophthalmoplegia (PEO) caused by a variant in the RRM2B gene. The PCR primers were designed to overlap the 4977 bp common deletion between positions 13447-13459 and 8470-8482 and yielded a PCR product of ∼8 kb from undeleted mtDNA (arrow). The 8-kb band was readily detected in controls and patients. The patient with PEO had multiple smaller bands corresponding to deleted mtDNA molecules. Similar deletion bands were observed at lower intensity in patients F2:II-2, F1:IV-3, F14:III-1, and F1:III-9. This suggested that low levels of mtDNA deletions were present in many but not all of our patients. SM denotes size marker (GeneRuler 1 kb DNA ladder), H2O denotes negative control (water substituted for template). (C) High power field of sural nerve biopsy from autopsy material of patient F1:III-9 demonstrates subtotal loss of large myelinated fibers (arrow) with no marked hypertrophic changes, regenerative fiber groups, or demyelination. Plastic section, toluidine blue staining, original magnification 400×, scale bar 25 µm. Mari Auranen et al. Neurol Genet 2015;1:e1 © 2015 American Academy of Neurology