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W O Bell

Publications and source records attributed to W O Bell.

20 records · Page 2Linked to original sources

Interactions between the sympathetic and sensory innervation of the iris.

The interaction between peptidergic, sensory nerves and sympathetic fibers was examined in the rat iris. The putative peptide neurotransmitter, substance P, was used as an index of the sensory innervation, because the peptide is exclusively localized in the iris to trigeminal sensory fibers. Extirpation of the sympathetic, superior cervical ganglion resulted in an increase in iris content of substance P-like immunoreactivity (henceforth SP), suggesting that sympathetic terminals influence the peptidergic sensory innervation of the iris. The increase in iris peptide after sympathetic ganglionectomy was reversed by implantation of sympathetic ganglia into the anterior chamber of the eye. Pharmacological stimulation or blockade of sympathetic nerve impulse activity and pharmacological blockade of sympathetic axonal transport did not alter iris peptide, suggesting that these procedures did not mediate the sympathetic-sensory interaction. However, injection of nerve growth factor (NGF) systemically or into the anterior chamber increased iris peptide, reproducing the effects of ganglionectomy. Conversely, injection of antiserum to NGF (anti-NGF) into the anterior chamber decreased iris SP suggesting that endogenous trophic protein normally regulates sensory peptide. The effects of anti-NGF were transitory; iris peptide returned to normal after cessation of treatment. Consequently, anti-NGF administration apparently did not lead to sensory neuron destruction, but rather altered either the number of sensory fibers in the iris or the amount of peptide per fiber. Finally, injection of anti-NGF into the anterior chamber reversed the effects of sympathetic ganglionectomy, suggesting that NGF may mediate the sympathetic-sensory interaction. Our observations suggest that competition for target NGF may result in reciprocal regulation of the iris sympathetic and sensory innervation.

Adrenergic Fibers↗

Simple decompression and occasional microsurgical epineurolysis under local anesthesia as treatment for ulnar neuropathy at the elbow.

Decompression of the ulnar nerve in the cubital tunnel will reverse ulnar neuropathy at the elbow in most patients. We believe that operating under local anesthesia has allowed us to identify those few patients who will not respond to simple decompressive surgery. Among the 20 cases of ulnar neuropathy managed in this fashion, intraoperative motor-sensory improvement occurred after simple decompressive surgery in 16. Four patients who failed to improve after cubital tunnel decompression underwent microsurgical epineurolysis immediately thereafter, under the same local anesthetic, with prompt improvement. Local anesthesia and microsurgical epineurolysis seem to be useful adjuncts to simple decompressive surgery for ulnar neuropathy.

Female↗