Comparison of Intra-arterial and Subcutaneous Testicular Hyaluronidase Injection Treatments and the Vascular Complications of Hyaluronic Acid Filler

The effect of digestion with Streptomyces hyaluronidase upon certain histochemical reactions of hyaluronic acid-containing tissues has been studied in a series of human, mammalian and avian specimens. These histochemical reactions are those for the demonstration of neutral and sulfated and nonsulfated acid mucosaccharides such as periodic acid-Schiff, Alcian Blue (pH 1.0), azure A (pH 1.5), high iron diamine, aldehyde fuchsin, Alcian Blue (pH 2.5), Alcian Blue (pH 2.5)-periodic acid Schiff, azure A (pH 4.5), low iron diamine and colloidal iron. In addition, the effect of digestion with testicular hyaluronidase upon the same reactions of the same tissues was observed for comparison. Digestion with Streptomyces hyaluronidase diminishes the staining reactions due to hyaluronic acid but fails to affect those for neutral and sulfated acid mucosaccharides. These results indicate that digestion with Streptomyces hyaluronidase is a method of choice for the identification of hyaluronic acid in mucosaccharide histochemistry.

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Degradation of synovial fluid and hyaluronic acid by serum and testicular hyaluronidase, and by l-Ascorbic acid and the effect of inhibitors

Clinica Chimica Acta ◽

10.1016/0009-8981(69)90065-5 ◽

1969 ◽

Vol 26 (3) ◽

pp. 395-400 ◽

Cited By ~ 9

Author(s):

J.C. Caygill ◽

Z. Ali

Keyword(s):

Ascorbic Acid ◽

Hyaluronic Acid ◽

Synovial Fluid ◽

Effect Of Inhibitors ◽

Testicular Hyaluronidase

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Safe Glabellar Wrinkle Correction With Soft Tissue Filler Using Doppler Ultrasound

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa197 ◽

2020 ◽

Cited By ~ 1

Author(s):

Won Lee ◽

Hyoung-Jin Moon ◽

Ji-Soo Kim ◽

Eun-Jung Yang

Keyword(s):

Hyaluronic Acid ◽

Botulinum Toxin ◽

Soft Tissue ◽

Doppler Ultrasound ◽

Vascular Complications ◽

Level Of Evidence ◽

Filler Injection ◽

Subcutaneous Layer ◽

Soft Tissue Filler

Abstract Background Glabellar wrinkle corrections are usually performed by injecting botulinum toxin and hyaluronic acid fillers. The glabella is one of the most dangerous locations for filler injection because of possible visual complications. Objectives The aim of this study was to use Doppler ultrasound to determine the anatomic relation between glabellar wrinkles and the supratrochlear artery pathway, perform safe hyaluronic acid filler injection to correct glabellar wrinkles, and determine the efficacy of the procedure. Methods From January 2019 to July 2019, 42 patients (74 glabellar wrinkle lines; 32 bilateral and 10 unilateral wrinkles) were evaluated. Glabellar wrinkle lines were corrected with hyaluronic acid filler. Doppler ultrasound was used to avoid the supratrochlear artery. Results Among the 74 wrinkle lines, the supratrochlear arteries were located either at the glabellar wrinkle lines (30/74, 41%) or lateral to the glabellar wrinkle lines (44/74, 59%). In the latter 44 wrinkles, fillers were injected into the subdermal layer of the glabellar wrinkle lines. In the 30 wrinkles where supratrochlear artery was located at the glabellar wrinkle lines, the artery was located at the deep subcutaneous layer in 24 and at the subdermal layer in 6; thus, filler injection was not performed. Conclusions The supratrochlear artery may be located either at or lateral to the glabellar wrinkle lines. When performing glabellar wrinkle correction, Doppler ultrasound can be used to confirm the location of the supratrochlear artery before filler injection, which helps in avoiding vascular complications. Level of Evidence: 4

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Interfacial behaviour of bovine testis hyaluronidase

Biochemical Journal ◽

10.1042/bj20060485 ◽

2006 ◽

Vol 398 (3) ◽

pp. 569-576 ◽

Cited By ~ 10

Author(s):

Silvia Belem-Gonçalves ◽

Pascale Tsan ◽

Jean-Marc Lancelin ◽

Tito L. M. Alves ◽

Vera M. Salim ◽

...

Keyword(s):

Enzyme Activity ◽

Hyaluronic Acid ◽

Protein Adsorption ◽

Pure Water ◽

Interfacial Properties ◽

Water Interface ◽

Hyaluronidase Activity ◽

Bovine Testicular Hyaluronidase ◽

Air Water Interface ◽

Testicular Hyaluronidase

The interfacial properties of bovine testicular hyaluronidase were investigated by demonstrating the association of hyaluronidase activity with membranes prepared from bovine testis. Protein adsorption to the air/water interface was investigated using surface pressure-area isotherms. In whichever way the interfacial films were obtained (protein injection or deposition), the hyaluronidase exhibited a significant affinity for the air/water interface. The isotherm obtained 180 min after protein injection into a pH 5.3 subphase was similar to the isotherm obtained after spreading the same amount of protein onto the same subphase, indicating that bovine testicular hyaluronidase molecules adopted a similar arrangement and/or conformation at the interface. Increasing the subphase pH from 5.3 to 8 resulted in changes of the protein isotherms. These modifications, which could correspond to the small pH-induced conformational changes observed by Fourier-transform IR spectroscopy, were discussed in relation to the pH influence on the hyaluronidase activity. Adding hyaluronic acid, the enzyme substrate, to the subphase tested the stability of the interfacial properties of hyaluronidase. The presence of hyaluronic acid in the subphase did not modify the protein adsorption and allowed substrate binding to a preformed film of hyaluronidase at pH 5.3, the optimal pH for the enzyme activity. Such effects of hyaluronic acid were not observed when the subphase was constituted of pure water, a medium where the enzyme activity was negligible. These influences of hyaluronic acid were discussed in relation to the modelled structure of bovine testis hyaluronidase where a hydrophobic region was proposed to be opposite of the catalytic site.

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A Safe Doppler Ultrasound–Guided Method for Nasolabial Fold Correction With Hyaluronic Acid Filler

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa153 ◽

2020 ◽

Cited By ~ 1

Author(s):

Won Lee ◽

Ji-Soo Kim ◽

Hyoung-Jin Moon ◽

Eun-Jung Yang

Keyword(s):

Hyaluronic Acid ◽

Doppler Ultrasound ◽

Rating Scale ◽

Vascular Complications ◽

Facial Artery ◽

Nasolabial Fold ◽

Filler Injection ◽

Ultrasound Evaluation ◽

Filler Injections ◽

Nasolabial Folds

Abstract Background Injection of hyaluronic acid filler, a common procedure for nasolabial fold correction, poses a risk of vascular compromise, which can result in skin necrosis and blindness. Objectives The aim of this study was to examine the facial arterial pathway in real time by Doppler ultrasound to avoid arterial complications during filler injections. Methods The facial artery pathway of 40 patients (80 nasolabial folds; 2 men and 38 women; mean age, 46.5 years; range, 28-72 years) was examined by Doppler ultrasound before hyaluronic acid filler injection. On the basis of this ultrasound evaluation, the filler injection targeted the subdermal, subcutaneous, and deep to submuscular layers by bypassing the facial artery. The efficacy of the filler injection was evaluated for each patient. Results The facial artery was detected lateral to the nasolabial fold in 31% of patients; it was detected beneath the nasolabial fold in the other patients as follows: subdermal layer, 13%; subcutaneous layer, 29%; muscular layer, 24%; and submuscular layer, 4%. The mean [standard deviation] Wrinkle Severity Rating Scale score was 3.68 [0.76] before injection and 2.28 [0.78] at 3 months after injection. Two patients experienced unilateral bruising of the nasolabial fold, which resolved after 2 weeks without treatment. Conclusions Doppler ultrasound can be considered as pretreatment tool for the prevention of vascular complications during filler injections to correct nasolabial folds. Level of Evidence: 4

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