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

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

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

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

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 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

OBJECTIVE: To evaluate the effect of hyaluronidase in patients with failed back surgery syndrome (FBSS) treated with interlaminar lumbar epidural injection (ILEI). METHOD: Sixty patients suffering from severe low back pain and sciatica were randomly allocated into three groups. Group T received ILEI with 2 ml triamcinolone 40 mg/ml and 5 ml bupivacaine 0.25%. Group H received ILEI with 1500 IU hyaluronidase and 5 ml bupivacaine 0.25%. Group TH received interlaminar lumbar epidural injection (ILEI) with 1500 IU hyaluronidase, 2 ml triamcinolone 40 mg/ml and 5 ml bupivacaine 0.25%. The effect was evaluated using Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) at pre-injection, 2 weeks, 6 weeks and 12 weeks after ILEI. RESULTS: After 2 weeks and after 6 weeks, patients in both Group T and Group TH had significant effectiveness more than Group H in decrease of VAS and ODI. After 12 weeks, only patients in Group TH had significant effectiveness in decrease of VAS and ODI (p<0.05). In every period, Group TH had the most effectivess in decrease of VAS and ODI after ILEI. CONCLUSION: ILEI for FBSS with triamcinolone and hyaluronidase is considered to have more long term effectiveness to reduce pain and improve function after ILEI than injection with triamcinolone alone or hyaluronidase alone.
Bupivacaine ; Failed Back Surgery Syndrome ; Humans ; Hyaluronoglucosaminidase ; Injections, Epidural ; Low Back Pain ; Sciatica ; Stress, Psychological ; Triamcinolone

When the skin and soft tissue necrosis occurs due to extravasation of intravenously administrated biological active materials and drugs, no specific mode of treatment modality is known except for supportive management or debridement and skin graft. This experiment was designed to determine the effective dosage of hyaluronidase and triamcinolone acetonide on the extravasation necrosis caused by calcium gluconate and to establish the optimal time of administration of the antidotes. Initially 0.4 ml of 10% calcium gluconate was injected subcutaneously into the rabbit back. Study I was designed to observe the skin change in 8 groups including control group with no treatment and treated groups with normal saline, saline with hyaluronidase(dosage: 150, 300, 600 unit), saline with triamcinolone acetonide(1 mg, 2 mg), and 150 unit hyaluronidase and 1 mg triamcinolone acetonide (all in volume 0.2 ml, treatment delay: immediate, 15-minutes, 30-minutes, 1-hour, 3-hours delay). The sizes of skin necrosis and induration were measured and compared between each group. Study II was designed to examine the histologic findings of the skin and evaluate the effect of hyaluronidase and triamcinolone acetonide on tissue damage. The sizes of induration and necrosis are smaller in all treated groups than non-treated group and the statistically significant protective effect on reducing the size of necrosis was found in groups treated with the drugs within 15 minutes to 30 minutes(p < 0.05). The most effective protection was obtained by the immediate injection of 150 unit dosage of hyaluronidase with 1 mg triamcinolone acetonide. This study suggests that intralesional injection of hyaluronidase and triamcinolone acetonide within half hour delay for the treatment of extravasation necrosis of calcium gluconate is the most effective, probably due to their diffusion, antiinflammatory effect and role in facilitating the resorption of calcium in the tissue.
Antidotes ; Calcium Gluconate* ; Calcium* ; Debridement ; Diffusion ; Hyaluronoglucosaminidase* ; Injections, Intralesional ; Necrosis ; Skin ; Transplants ; Triamcinolone Acetonide* ; Triamcinolone*