Changes in neural and humoral mechanisms of the heart in sudden death due to myocardial abnormalities.

Quantitative neurohistochemical study of adrenergic elements of the myocardium and the adrenal medulla in victims of sudden death revealed an unequal and focal depletion of catecholamines attributable to prior pathologic processes in the myocardium. The greatest changes in cardiac innervation were found in cases of acute myocardial infarction and alcoholic cardiomyopathy, and the adrenergic plexuses were better preserved in cases of coronary heart disease without focal myocardial changes. Ultrastructural study of cardiac innervation in patients who died suddenly showed more pronounced changes in the nerve plexuses of the sinus node than in the perinodal nerves of the working myocardium. The changes in coronary artery innervation were usually related to the severity of stenosis due to fibrous plaque; desympathization of the vessels and the adjoining myocardial zone was also found in cases with 50% or greater occlusion of the lumen. The bulk of chromaffinocytes were depleted and weakly luminescent in the adrenal glands of patients with acute myocardial infarction who died suddenly. In contrast, chromaffinocytes with moderate and bright luminescence were prevalent in cases of sudden death with scarring from previous myocardial infarction and with alcoholic cardiomyopathy. Ultrastructural and histochemical examinations demonstrated that changes in the neurons of sympathetic ganglia increased with more severe atherosclerotic lesions of the aorta and with greater changes in the vessels supplying the ganglia. In experiments on rabbits and dogs, both coronary artery ligation and electrostimulation produced cardiac fibrillation followed by a local increase in luminescence intensity of the myocardial nerve plexuses when their density remained high. Chemoreceptors located along the coronary vessels and pulmonary artery in dogs included small cells with bright fluorescence and adrenergic nerve fibers.

[Ultrastructure of the skin after electroacupuncture]. / Ul'trastruktura kozhi pri élektroakupunkture.

Electron-microscopic examination of the nervous apparatus of the acupuncture points of the rabbit ear has shown that the motor receptor structure of reflexotherapeutic impacts seems to be bundles of nerve fibers with their microenvironment--blood vessels, mast cells, histiocytes. Acupuncture with electrical stimulation and acupuncture based on direct mechanical impact (trauma, compression) and the resultant local inflammation irritate the nerve conductors and initiate the effects of reflexotherapy.

[Reflexotherapeutic effects on biologically active points of the concha auriculae]. / Issledovanie refleksoterapevticheskikh vozdeistviiakh na biologicheski aktivnye tochki rakoviny.

By means of histochemical method, for revealing cholinergic nervous structures, and electron microscopy, innervation of biologically active points (BAP) and that of neutral areas of the rabbit ear skin has been studied, normal and after acu-, electro- and electroacupuncture. The BAP have more intensive vascularization and innervation, their specific feature is presence of well pronounced nervous fasciculi. The latter are formed by 6-10 fibers 1-6 mcm in diameter. The diameter of the fasciculi is within the limits 25-30 mcm up to 40-45 mcm. Under the electron microscopic investigation myelin and amyelin fibers are revealed in the nervous fasciculi. In the area of the epidermal basal layer and in the epidermis itself, single nerve terminals are found; they are considered as the point pain receptors. After acu-, electro- and electroacupuncture, intensity of the nervous fibers staining increases, thus demonstrating an increment of acetylcholine esterase activity. After insertion of acupuncture needles and after electrical irritation, the changes in the nervous and cellular elements in the BAP areas are studied electron microscopically. After the effects mentioned, mast cells situating in the BAP area become, as a rule, degranulated. After repeated electroacupuncture irritation of the BAP, an inflammatory focus appears with peculiarities specific for the given process. The reflexotherapeutic effect is supposed to be transferred via the nervous system. The mechanical irritation of the nerve fasciculi and the accompanying traumatization of the surrounding cellular elements initiate the mechanism of reflexotherapy.