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

Twenty patients had retrobulbar anesthesia with 5 ml mepivacaine (Scandicain) without or with addition of 150 units of hyaluronidase (Kinetin). Before and 15 min after injection, we determined--by means of oculo-oscillo-dynamography--the systolic retinal and ciliary perfusion pressures, the respective ocular blood pressures (intramural pressures) and the ocular pulsation volume (PVoc) as well as the intraocular pressure (Pio; hand-applanation tonometer). Without hyaluronidase, the ocular perfusion and blood pressures were lowered by 11.8 and 3.9 mmHg, respectively, and PVoc was reduced by 0,40 microliters, whereas Pio was increased by 7.9 mmHg With hyaluronidase, the ocular perfusion and blood pressures were decreased by averages of 12.7 and 6.8 mmHg, respectively, PVoc was reduced by 0.42 microliters, and Pio was increased by 6.0 mmHg. Within each group, all changes were significant. There were, however, no significant differences between the two groups, i.e., the "spreading factor" hyaluronidase does not influence the inhibitory effects of retrobulbar anesthesia on ocular circulation.
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PMID:[Effect of hyaluronidase on ocular circulatory changes caused by retrobulbar anesthesia]. 185 46

We prospectively studied 76 patients to analyze the effectiveness of peribulbar anesthesia during strabismus surgery. The patients, ranging in age from 14 to 77 years, were given anesthesia with standard preoperative medication and a peribulbar injection of a mixture of 2% mepivacaine hydrochloride and hyaluronidase. Only one of the 76 patients required an additional injection of anesthetic to achieve adequate anesthesia. No morbidity was associated with the peribulbar anesthesia. Local anesthesia, particularly retrobulbar anesthesia, has been used as an alternative technique in an attempt to reduce the morbidity and mortality associated with general anesthesia in ocular surgery, particularly in those patients with high-risk characteristics. Even with retrobulbar anesthesia, however, there is a risk of morbidity and, in rare cases, mortality. Our results suggest that the use of peribulbar anesthesia is a safe and effective means of anesthesia in strabismus surgery because of minimal associated morbidity.
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PMID:Peribulbar anesthesia for strabismus surgery. 234

Forty-nine patients, ranging in age from 12 to 77 years, underwent strabismus surgery under local anesthesia. With standard preoperative medication and a retrobulbar injection of 2% mepivacaine hydrochloride (hyaluronidase added in 12 patients), effective anesthesia was obtained. Twenty-four patients were observed during the immediate postoperative period, and return of extraocular muscle function and visual acuity was found to be complete an average of 3.8 hours after the injection. The addition of hyaluronidase significantly altered the duration of the anesthetic. Local anesthesia may be a preferable technique in terms of decreased morbidity, especially in the older patient. The short duration of anesthesia and lack of side effects also enable the surgeon to use adjustable sutures and make the final adjustment relatively early in the postoperative period.
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PMID:Retrobulbar anesthesia in strabismus surgery. 647 50

Hyaluronidase is a goat testicular protein that hydrolyzes hyaluronic acid, a structural component of the intercellular matrix. It is commonly used as a spreading factor to improve the diffusion of drugs, including local anesthetics and chemotherapeutics. We experienced a 55-yr-old female with generalized urticaria that developed within 1 hr after the epidural injection of hyaluronidase. She had a history of allergic rhinitis, and had suffered from post-herpetic neuralgia and a herniated disc for several years. To relieve her pain, she had been given epidural injections consisting of mepivacaine hydrochloride, triamcinolone acetonide, and morphine sulfate biweekly for one year. Hyaluronidase had been administered several times with these drugs before this episode of generalized urticaria. Skin prick testing showed a positive response to 1,500 IU/mL of hyaluronidase extract, as compared to histamine. The patient's serum hyaluronidase-specific IgE level, determined using an enzyme-linked immunosorbent assay (ELISA), was markedly elevated, as compared to unexposed healthy controls. An IgE immunoblot analysis using hyaluronidase extract and the patient's serum showed IgE binding components at 31 and 21 kDa, whereas no corresponding IgE binding component was found in healthy controls. An ELISA inhibition test showed significant, dose-dependent inhibition with the serial addition of hyaluronidase extract. This is the first case of an IgE-medicated allergic reaction to goat (Naemorhedus goral raddenus) hyaluronidase, demonstrated by skin testing and a specific IgE and immunoblot assay.
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PMID:Acute urticaria caused by the injection of goat-derived hyaluronidase. 2022 71