No abstract available.
Hyaluronoglucosaminidase* ; Radiculopathy*

BACKGROUND: A variety of hyaluronic acid (HA) fillers demonstrate unique physical characteristics, which affect the quality of the HA filler products. The critical factors that affect the degradation of HA gels have not yet been determined. OBJECTIVE: Our objective was to determine the characteristics of HA gels that affect their resistance to the degradation caused by radicals and enzymes. METHODS: Three types of HA fillers for repairing deep wrinkles, Juvederm Ultra Plus (J-U), Restylane Perlane (Perlane), and Cleviel, were tested in this study. The resistance of these HA fillers to enzymatic degradation was measured by carbazole and displacement assays using hyaluronidase as the enzyme. The resistance of these fillers to radical degradation was measured by the displacement assay using H2O2. RESULTS: Different tests for evaluating the degradation resistance of HA gels can yield different results. The filler most susceptible to enzymatic degradation was J-U, followed by Perlane and Cleviel. The HA filler showing the highest degree of degradation caused by H2O2 treatment was Perlane, followed by J-U, and then Cleviel. Cleviel showed higher enzymatic and radical resistances than J-U and Perlane did. Furthermore, it exhibited the highest resistance to heat and the lowest swelling ratio among all the fillers that were examined. CONCLUSION: The main factor determining the degradation of HA particles is the gel swelling ratio, which is related to the particle structure of the gel. Our in vitro assays suggest that the decrease in the swelling ratio will lead to a retarding effect on the degradation of HA fillers.
Gels ; Hot Temperature ; Hyaluronic Acid* ; Hyaluronoglucosaminidase

We are reporting a rare case of a delayed hypersensitivity reaction caused by hyaluronidase allergy following a lumbar transforaminal epidural block. Using an intradermal skin test, we have provided evidence that the systemic allergic reaction resulted from hypersensitivity to hyaluronidase. To our knowledge, this is a rare case of a delayed hypersensitivity reaction to epidural hyaluronidase, comprised of an initial exposure to hyaluronidase with no subsequent allergic response in prior block followed by a subsequent delayed reaction to hyaluronidase during a second epidural block.
Hyaluronoglucosaminidase* ; Hypersensitivity* ; Hypersensitivity, Delayed ; Skin Tests

A new method so-called peribulbar anesthesia for the lid and the eyeball was clinically investigated to reduce the complication of the retrobulbar anesthesia and to simplify the technique. In twenty-eight cases of extracapsular cataract extraction with posterior chamber lens implantation, each 3.5ml of the 2% lidocaine without combination of hyaluronidase or any anesthetic agent was injected into upper portion and lower portion of the orbit. Akinetic effect for the lid began to appear at about 10 minutes after the injection and at 20 minutes, the effect was sufficient to operate. By 30 minutes the lid akinesia was sufficient to operate in 92.7% of twenty-eight cases. The effect lasted for 51 minutes. The globe akinesia began to appear at about 15 minutes after the injection and at 25 minutes the akinesia was sufficient to operate. By 30 minutes the globe akinesia was sufficient to operate in 78.6% of twenty-eight cases. The effect lasted for 71 minutes.
Anesthesia* ; Cataract Extraction ; Hyaluronoglucosaminidase ; Lidocaine ; Orbit

Alpha-chymotrypsin, trypsin and hyaluronidase were added to the rabbit's vitreous humor which was filtered through the glass filter. The viscosity was measured by Ostwald type viscosimeter with O.5mm capillary bore size. The relative viscosity of normal vitreons humor was 1.085. The relative viscosities of vitreous humor, to which 1mg and 2mg of alpha-chymotrypsin and 100 H.U.M. and 200 H.U.M. of trypsin were added, showed no significant changes. On the other hand, the vitreous humor which had been treated by 100 T.R.U. of hyaluronidase showed a marked reduction in the viscosity. The viscosity of normal vitreous humor, which had been preserved at 20 degrees for 3 hours, was significantly reduced.
Capillaries ; Glass ; Hand ; Hyaluronoglucosaminidase* ; Trypsin* ; Viscosity* ; Vitreous Body*

Experimental retinal detachment was attempted in albino rabbits by the injection of hyaluronidase (2 TRU) between the retina and vitreous body. Retinal detachment was successfully induced in 12 eyes(62.5%) after 1-4 days. Hyaluronidase injection combined with mechanical injuries of the retina produced retinal detachment in 5 eyes(60.0%). When the retinal detachment was produced, amplitudes of the a- and b-waves decreased, maximum reduction being 41.6%(a-wave) and 34.5%(b-wave). Ten to 14 days after the treatment ERG waves began to increase gradually. ERG waves rose slightly in cases in which no detachment had been successfully produced.
Hyaluronoglucosaminidase ; Rabbits* ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Vitreous Body

Experimental vitreous hemorrhage was induced in rabbit eye by rupturing the choroidal vessels mechanically with a 26 gauge needle introduced into the eye through the supero-nasal quadrant of the sclera, 10mm posterior to the limbus. Absorption of vitreous hemorrhage was evaluated by indirect ophthalmoscopy in the following groups and pathological specimens were obtained three months after vitreous hemorrhage. Group I: after vitreous hemorrhage, no additional management was done for control(4 eyes). Group II: vitreous gel was disrupted mechanically with 26 gauge needle to liquefy the vitreous(4 eyes). Group III: 1cc of vitreous waS replaced with the same amount of normal saline prior to vitreous hemorrhage (4 eyes). Group IV: 0.3cc of hyaluronidase (75 units) was injected into the posterior vitreous prior to vitreous hemorrhage (4 eyes). In groups I, II, and IV, vitreous hemorrhages were completely absorbed in 8 to 10 weeks. whereas absorption time was shortened in group m to 6 to 8 weeks. Pathological specimen revealed no infiltrations of inflammatory cells, but only glial proliferations.
Absorption ; Choroid ; Hyaluronoglucosaminidase ; Needles ; Ophthalmoscopy ; Sclera ; Vitreous Hemorrhage*

Edema ; Episiotomy ; Female ; Humans ; Hyaluronoglucosaminidase ; Incidence ; Lacerations ; Parity ; Wounds and Injuries

Hyaluronidase has been gaining interest because it reduces tissue edema and fibrosis. Although rare, hyaluronidase has been shown to cause allergic reactions. A few cases of allergic reactions following hyaluronidase administration have been reported. Most of the described patients presented allergic reactions after peribulbar anesthesia for eye surgery. In this report, we describe three patients who experienced with allergic reactions to hyaluronidase following pain management. Two of the patients had a history of uneventful injection with hyaluronidase. All patients were afebrile and blood tests results were normal. Intradermal skin tests were positive. These clinical findings were helpful in establishing the differential diagnosis of infection. Although allergic reaction to hyaluronidase is rare and mostly benign, this must be considered before treating patients.
Anesthesia ; Diagnosis, Differential ; Edema ; Eye ; Fibrosis ; Hematologic Tests ; Humans ; Hyaluronoglucosaminidase ; Hypersensitivity ; Pain Management ; Skin Tests

BACKGROUND: Epidural steroid injections benefit certain patients with radicular pain, and often have only a limited duration. We compared the efficacy of hyaluronidase and triamcinolone and triamcinolone alone in patients with lumbar herniated disc disease treated with transforaminal epidural block. METHODS: Forty patients who had undergone a transforaminal epidural injection were retrospectively reviewed. The T group received triamcinolone and local anesthetics; whereas, the HT group received hyaluronidase, triamcinolone and local anesthetics. We evaluated the improvement as being good, moderate, mild or no improvement, and in those where the improvement was good or moderate, also evaluated the duration of pain relief. Data were collected from the medical records of patients or via phone calls, which were analyzed using Student t- and chi-squared tests. A value of P < 0.05 was considered significant. RESULTS: There were no significant differences in the degree of pain improvement or duration of pain relief between the two groups. CONCLUSIONS: A hyaluronidase and triamcinolone injection during transforaminal epidural block has on benefit with respect to the degree of pain improvement or its duration compared to a triamcinolone only injection.
Anesthetics, Local ; Humans ; Hyaluronoglucosaminidase* ; Injections, Epidural ; Intervertebral Disc Displacement ; Medical Records ; Retrospective Studies ; Triamcinolone*