Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.2.1.36 (hyaluronidase)
 4,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this randomized, double-blind study was to compare 300 units of hyaluronidase per one-half liter to 150 units per one-half liter in patients receiving brief infusions for subcutaneous hydration. Twenty-five evaluable patients were randomized to receive a local injection of 300 units of hyaluronidase or 150 units of hyaluronidase immediately before two 1-hr infusions of two-thirds dextrose 5% and one-third normal saline solution (500 cc volume). The following day a crossover took place, and patients received the alternate treatment before each of the two 1-hr infusions. The intensity and swelling as reported by the patient (visual analogue scale 0-100), and the intensity of edema and rash as assessed by the investigator (score 0-4) were not significantly different between groups. The patients' and investigators' final choice was also not significantly different. Patients could not distinguish between bolus and their previous experience with overnight clysis. Our results suggest that brief infusions are well tolerated for subcutaneous hydration of patients with advanced cancer. A concentration of 150 units of hyaluronidase per one-half liter is well tolerated in this population.
J Pain Symptom Manage 1995 Oct
PMID:Comparison of two different concentrations of hyaluronidase in patients receiving one-hour infusions of hypodermoclysis. 880 76

Despite current clinical practice, there is no objective evidence to demonstrate the efficacy or pain on injection when hyaluronidase is added to lidocaine as an anesthetic combination for local anesthesia. To evaluate the usefulness of hyaluronidase added to lidocaine in affecting pain on injection and effectiveness of local anesthesia, a prospective, randomized, double blind study comparing 1% lidocaine preparations with and without hyaluronidase (15 U/cc) was conducted. A paired experiment was done with each subject receiving both treatments. Solutions of these local anesthetics were prepared. A 0.5-cc intradermal injection of each was administered to the dorsum of the nondominant hand of 25 volunteers. After showing study participants a standard pain with a peripheral nerve stimulator, pain of anesthetic infiltration was rated by the subject using a visual analog scale. The amount of tissue deformation on injection was assessed. The area of anesthetized skin surrounding each injection was measured at 1/2, 1, 2 1/2, 4 1/2, 8, and 12 minutes after injection. The area of anesthesia achieved by 1% lidocaine infiltration can be significantly enhanced by the addition of hyaluronidase at a concentration of 15 U/cc (p = 0.0003). This raises the pH of the anesthetic to a slightly more physiologic level (6.33 versus 6.20) and makes the pH closer to the pK of the lidocaine. In addition, the hyaluronidase additive significantly decreases the amount of tissue distortion (p < 0.0001) without decreasing the efficacy of anesthetic action (p = 0.01). However, adding hyaluronidase to 1% lidocaine significantly increased the pain on injection (p = 0.0002). The injections of small amounts of hyaluronidase-containing solutions in this experiment did not produce any visible effects at 5 to 7 days after injection; however, the effect of hyaluronidase upon wound healing was not studied.
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PMID:The effects of hyaluronidase on the efficacy and on the pain of administration of 1% lidocaine. 946 68

Millions of patients with chronic sciatica are still treated with epidural corticosteroids. The efficacy of epidural corticosteroids remains questionable, especially in the chronic failed back surgery syndrome (CFBSS). The affected nerve root sleeve(s) are localized with the help of fluoroscopy and contrast dye. Local anesthetic diluted in 1,500 U hyaluronidase and 40 mg methylprednisolone is injected. Twenty patients with CFBSS, a small retrospective pilot study group, were treated. The success rate is evaluated using a verbal pain rating scale, 1 month and 3 months after the last injection. Initially, 12 patients obtained very good pain relief, sustained for >3 months in 11 patients. In one patient, pain returned after >1 month. No complications were observed. This technique is worthwhile for patients with CFBSS and where epidural fibrosis is suspected to be the pain origin.
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PMID:Transforaminal nerve root sleeve injection with corticosteroids, hyaluronidase, and local anesthetic in the failed back surgery syndrome. 958 73

We have evaluated the effects of the volume and speed of administration of local anaesthetic during peribulbar anaesthesia. One hundred and forty patients scheduled for cataract surgery were randomly allocated to one of four groups of 35. Each patient received an injection of the same mixture of lignocaine, bupivacaine and hyaluronidase. Patients in group A were given 9 ml at a speed of 5 ml.min-1, group B were given the same volume at 12 ml.min-1, group C were given 13.5 ml at 5 ml.min-1 and group D were given 13.5 ml at 12 ml.min-1. A significantly higher incidence of satisfactory akinesia was found in group D, whose pain score at injection was no higher than for the other groups. Large volumes of local anaesthetic significantly affected intra-ocular pressure. The incidences of early and late ptosis or diplopia were not affected by either the rate of injection or the volume of local anaesthetic.
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PMID:The effects of volume and speed of injection in peribulbar anaesthesia. 965 24

This is an overview of the biochemistry, biological function and therapeutic uses of hyaluronidase and its substrate, hyaluronate. We focus on the role of hyaluronate and its receptor CD44 in cell-cell and cell-matrix adhesion and cell activation as well as on the putative role of hyaluronate and hyaluronidase in morphogenesis. Variants of CD44 and their putative role in tumor metastasis are also included. Other topics that are discussed are the chemical and enzymatic nature of hyaluronidase, i.e. the mode of substrate degradation, pharmacodynamical and pharmacokinetic aspects of this enzyme and its role as spreading factor. Purification methods, possible contaminations and techniques of activity determinations are mentioned as well as the physiological role of hyaluronidase and tumor-associated alterations in serum and tissue enzyme levels. As far as therapeutic applications are concerned, we discuss uses of hyaluronidase in ophthalmology and regional anesthesia as well as pain management in osteoarthritis using hyaluronate.
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PMID:Hyaluronidase and its substrate hyaluronan: biochemistry, biological activities and therapeutic uses. 983 14

The purpose of the study was to compare 1% ropivacaine and hyaluronidase 75 units/ml with a 1:1 mixture of 2% lignocaine and 0.5% bupivacaine and hyaluronidase 75 units/ml for peribulbar anaesthesia in cataract surgery. We conducted a double-blind randomized trial involving 100 patients. Group 1 received a peribulbar injection of 8 ml of 1% ropivacaine and hyaluronidase 75 units/ml. Group 2 received a peribulbar injection of 8 ml of a 1:1 mixture of 2% lignocaine and 0.5% bupivacaine and hyaluronidase 75 units/ml. Parameters measured were ocular and eyelid movement scores, time suitable for surgery, need for supplementary injections, verbal pain score and complications. No statistical differences were found between the two groups regarding any of the study parameters. Both groups had excellent surgical analgesia and akinesia. We conclude that 1% ropivacaine is a suitable agent for single injection peribulbar anaesthesia for cataract surgery.
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PMID:Comparison of 1% ropivacaine and a mixture of 2% lignocaine and 0.5% bupivacaine for peribulbar anaesthesia in cataract surgery. 1038 55

In a single centre, randomised, double-blind study, 54 patients underwent intraocular surgery under peribulbar anaesthesia with either ropivacaine 1% or a mixture of bupivacaine 0.75% and lignocaine 2%, both with hyaluronidase 7.5 iu.ml-1. There were no significant differences in volume of anaesthetic required, time to onset of block, peri-operative pain scores or frequency of adverse events between the ropivacaine group and the lignocaine and bupivacaine group.
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PMID:A comparison of 1% ropivacaine with a mixture of 0.75% bupivacaine and 2% lignocaine for peribulbar anaesthesia. 1059 16

Bullrout envenomation is known to cause intense pain. Crude bullrout venom and venom fractions were assessed for protease, hyaluronidase, phospholipase and hemolytic activities, reactivity with stonefish antivenom, lethality to brine shrimp and ability to elicit pain in human subjects. Compared with venom obtained from frozen specimens, live fish venom-milking techniques rendered greater venom potency and improved storage characteristics. Although mild proteolytic and hemolytic activity was observed, crude venom demonstrated no hyaluronidase or phospholipase A2 activity, did not affect brine shrimp, or show antigenicity with stonefish antivenom. A single venom protein isolated from bullrout venom is attributed with causing pain in human subjects. The sensations elicited by this novel algesic protein are consistent with chemical stimulation of polymodal nociceptors.
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PMID:An investigation of the biological activity of bullrout (Notesthes robusta) venom. 1066 13

We compared the efficacy of deep topical fornix nerve block anaesthesia (DTFNBA) versus peribulbar nerve block in patients undergoing cataract surgery using phacoemulsification. We studied 120 patients, allocated randomly to two groups. Group 1 (n = 60) received peribulbar block with 5 ml of a 1:1 mixture of 0.5% plain bupivacaine and 2% lidocaine supplemented with hyaluronidase 300 i.u. ml-1. Group 2 received DTFNBA with placement of a sponge soaked with 0.5% bupivacaine deep into the conjunctival fornices for 15 min. No sedation was given to either group. Analgesia was assessed by the reaction to insertion of the superior rectus suture and by questioning during the procedure. A three-point scoring system was used (no pain = 0, discomfort = 1, pain = 2). Scoring was repeated at keratotomy, hydrodissection and hydrodelineation, phacoemulsification, irrigation and aspiration, and at intraocular lens insertion. If the patient's pain score was 0 or 1, no further action was taken. If the pain score at any stage of the operation was 2, intracameral injection of 1% preservative-free lidocaine was given. One patient in Group 2 needed intracameral lidocaine at the stage of phacoemulsification (P > 0.05) and four experienced discomfort at irrigation and aspiration (P = 0.043). We conclude that DTFNBA may be a useful needle-free anaesthetic technique in patients undergoing cataract surgery using phacoemulsification.
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PMID:Prospective evaluation of deep topical fornix nerve block versus peribulbar nerve block in patients undergoing cataract surgery using phacoemulsification. 1157 11

A boy presented at age 3.5 months with joint contractures, restlessness, and pain on handling. His skin was thickened and there were livid-red macular lesions over bony prominences. Infantile systemic hyalinosis (ISH) was diagnosed, a presumably autosomal recessive, progressive, and painful disorder of as yet unknown pathogenesis. Observation over three years confirmed the diagnosis as typical changes, such as nodules on both ears, pearly papules in the perinasal folds and on the neck, fleshy nodules in the perianal region, and gingival hypertrophy, developed. Skin lesions and painful joint contractures progressed in spite of intense physiotherapy, and at age 3, the child had marked motor disability. The central nervous system (CNS) appeared to be intact and the infant showed normal mental development. Radiologic findings included marked generalized osteopenia, osteolytic erosions in the metaphyses of the long bones, and cortical thinning. Electron microscopy of two skin biopsies demonstrated deposition of floccular amorphous substance that was abundant around, and appeared to originate from, small blood vessels in the dermis, partially interfering with collagen fiber formation. Lysosomal inclusions were not seen. Serum acid hyaluronidase activity was within the normal range, and the synthesis of hyaluronic acid and proteoglycans in cultured skin fibroblasts was similar to that of control cells. A younger sister presented at age two months with painful joint contractures and discrete livid-red macules over both malleoli, and showed a similar progression of the disorder over the first year of life. The diagnosis of ISH should be considered in infants and children presenting with painful joint contractures and skin lesions. The pathogenesis of this disabling and disfiguring disorder remains unclear. Our data confirm probable autosomal recessive inheritance, and do not support lysosomal storage, hyaluronidase deficiency, or a primary collagen disorder, but indicate that the amorphous material accumulating in the skin and articular soft tissues may originate from the blood circulation.
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PMID:Infantile systemic hyalinosis in siblings: clinical report, biochemical and ultrastructural findings, and review of the literature. 1129 73


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