Kyösola K, Partanen S, Korkala O, Merikallio E, Penttilä O, Siltanen P
Virchows Arch A Pathol Anat Histol. 1976 Aug 23;371(2):101-19. doi: 10.1007/BF00444927.
The existence of both adrenergic and cholinergic innervation of the atrial myocardium of the adult human heart was demonstrated by means of fluorescence induced by formaldehyde or glyoxylic acid and by electron microscopy. The adrenergic fluorescing axons (1) followed the course of blood vessels as typical perivascular nerve plexuses, and (2) formed a three-dimensional fairly dense nerve net obviously not related to the blood vessels. The varicosities frequently came into close apposition on myocardial cells. Several types of nerve terminals were differentiated at electron microscopy: (1) an "adrenergic" type containing small (diameter 450-700 A) dense-cored vesicles and usually (in various proportions) small "empty" and/or large (900-1500 A) dense-cored vesicles, (2) a "cholinergic" type containing small (ca. 500 A) "empty" vesicles and occasionally also some large (mean diameter ca. 1200 A) dense-cored vesicles, (3) a "pale" type containing only a few or no vesicles, (4) a "disintegrated" type containing degenerated mitochondria, autophagic vacuoles, and occasional normal-looking mitochondria, (5) nerve terminals containing a large number of mitochondria in addition to varying vesicle populations, and (6) a (possibly baroreceptive type of) nerve terminal containing myelinlike lamellated structures. The "disintegrated" and the "pale" types of nerve terminals possibly represent different stages of axonal degeneration, or may correspond to diminution in the transmitter substance concentration under certain pathophysiologic conditions, respectively. Nerve terminals crowded with mitochondria may be sensory and involved in mechano-or chemoreceptive functions. In preliminary experiments convincing evidence was obtained that the glyoxylic acid-induced fluorescence histochemical method will be suitable for comparative studies on (human) clinical specimens, e.g., for analyzing the degree of the functional activity of the intrinsic adrenergic innervation of the myocardium under various pathophysiologic conditions. The modification which appeared most appropriate for such studies is described in detail, and is proposed for use as a standard method in other similar or related studies on human clinical series. The essential criteria for analyzing the specimens at fluorescence microscopy are suggested as well.
通过甲醛或乙醛酸诱导的荧光以及电子显微镜技术，证实了成人心脏心房肌中同时存在肾上腺素能和胆碱能神经支配。肾上腺素能荧光轴突：（1）作为典型的血管周围神经丛，沿着血管走行；（2）形成一个三维的、相当密集的神经网，明显与血管无关。膨体常常与心肌细胞紧密相邻。在电子显微镜下可区分出几种类型的神经末梢：（1）“肾上腺素能”型，含有小（直径450 - 700 Å）的有致密核心的囊泡，通常（比例各异）还有小的“空”囊泡和/或大（900 - 1500 Å）的有致密核心的囊泡；（2）“胆碱能”型，含有小（约500 Å）的“空”囊泡，偶尔也有一些大（平均直径约1200 Å）的有致密核心的囊泡；（3）“淡色”型，仅含有少数囊泡或无囊泡；（4）“崩解”型，含有退化的线粒体、自噬泡以及偶尔正常的线粒体；（5）除不同类型的囊泡外，还含有大量线粒体的神经末梢；（6）含有类髓鞘层状结构的（可能是压力感受型的）神经末梢。“崩解”型和“淡色”型神经末梢可能分别代表轴突退变的不同阶段，或者对应于某些病理生理条件下递质物质浓度的降低。充满线粒体的神经末梢可能是感觉性的，参与机械或化学感受功能。在初步实验中获得了令人信服的证据，表明乙醛酸诱导的荧光组织化学方法适用于（人类）临床标本的比较研究，例如用于分析各种病理生理条件下心肌内源性肾上腺素能神经支配的功能活动程度。详细描述了最适合此类研究的改良方法，并建议将其用作人类临床系列其他类似或相关研究的标准方法。还提出了在荧光显微镜下分析标本的基本标准。
