• Journal of The Korean Dental Society of Anesthesiology
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• v.9 no.1
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• pp.17-23
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• 2009

배경: 보툴리눔 독소 A형은 강직성 질환을 비롯한 여러 질환의 치료제로 널리 사용되고 있다. 최근에 보툴리눔 독소 A형은 근육비대를 치료하기 위해 널리 이용되고 있다. 하지만 보툴리눔 독소의 근육비대의 치료효과에 대해서 알려진 바가 거의 없다. 본 연구는 토끼 정강뼈 근육에 보툴리눔 A, B형을 주입 후 시간경과에 따른 근육의 위축을 확인하여 근육비대의 치료에 보툴리눔 B형이 효과적인지 확인하고자 하였다. 방법: 36마리의 토끼를 4그룹으로 분류하였다(1 그룹: 생리식염수 주사: 2 그룹: 보툴리눔 독소 A, B - 2U, 3 그룹: 보툴리눔 독소 A, B - 5U, 4 그룹: 보툴리눔 독소 A, B - 10U). 정강뼈근육에 보툴리눔 독소 A, B형을 주입 후 1, 2, 4주에 정강뼈 근육의 부피를 측정하였다. 신경자극기를 이용하여 독소 주입 후 1, 2, 4주의 근육의 단일 수축을 확인하여 근육기능의 변화여부를 확인하였다. 결과: 보툴리눔 독소 B형을 주입시 통계적으로 유의하지 않지만 A형에 비해 근육 부피의 감소가 관찰되었다(P>0.05). 반면, 근육의 단일 수축은 보툴리눔의 용량에 관계없이 B형을 주입한 근육에서 더 높게 관찰 되었다. 결론: 보툴리눔 독소 B형을 주입한 경우 근육 기능의 회복속도는 빠른 반면 근육의 위축은 A형에 비해 더 오랫동안 지속되었다. 따라서 근육비대의 치료에 있어 보툴리눔 독소 B형이 A형보다 보다 더 효과적이라고 사료된다.

• Journal of Oral Medicine and Pain
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• v.38 no.1
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• pp.53-67
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• 2013

This study was aimed to evaluate the masticatory efficiency after botulinum toxin type A (BTX-A) injection during 12 weeks using objective and subjective test. Also, we compared the difference of masticatory efficiency between group that injected into the masseter muscle only (M-group) and group that injected into the masseter and temporalis muscle (M-T group). The mixing ability index (MAI) was used as the objective indicator, and visual analogue scale (VAS) and food intake ability (FIA) index were used as the subjective indicators. It was concluded that masticatory efficiency was significantly lowered after a BTX-A injection into the masticatory muscle, but it gradually recovered in a predictable pattern by the 12 weeks. The disturbance of subjective masticatory efficiency was lasted longer than objective masticatory efficiency. The masticatory efficiency was lower in M-T group than M group. It was statistically significant in the VAS and FIA at 4 weeks, but the MAI showed no significancy. After 4weeks, there was rapid recovery of muscle function in M-T group, and the difference between two groups was not significant. It could be concluded that there will be no serious disturbance of mastication compared to injection is done only into the masseter muscle, even if injection is done into the masseter and temporalis muscle in dose of this study. According to the food properties, it was confirmed that people feel more discomfort on taking hard and tough foods after BTX-A injection and not only hard foods, but also intake of soft and runny foods were influenced by botulinum toxin injection.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.2
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• pp.185-187
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• 2000

The etiology of vocal fold granuloma was identified : post-endotracheal intubation, vocal abuse, acid reflux and idiopathic. The identification of the cause or causal factor is important, since the treatment must be fundamental directed at them. Treatment have included voice therapy and antireflux measures. Surgical excision is considered in patients who do not respond to medical management. In this study, a case of vocal fold granuloma resolved who underwent injection of the affected vocal fold. Botulinum toxin type A is probably successful by decreasing the strength during adduction in the arytenoid region which, when very intense, would perpetuate the granuloma. Localized injection of this neurotoxin is promising both as an initial treatment and as an alternative treatment in patients who do not respond to standard therapy.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.247-251
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• 2011

Botulinum toxin type A (BoNT-A) is used for treating bilateral masseter hypertrophy since 1994. Recently there have been more clinical studies in this area, with some authors reporting that BoNT-A can reduce the size of the masseter muscle, as documented by photography, ultrasonography, computed tomography, and 3D(three dimensional) laser scan. However, earlier studies were only for bilateral masseter hypertrophy cases, not for unilateral masseter hypertrophy cases. The aim of this study was to use 3D laser scanning to evaluate changes in the external facial contour induced by unilateral BoNT-A injection. BoNT-A was injected into hypertrophic masseter muscle unilaterally in 10 patients with asymmetric masseter hypertrophy. The clinical effects of unilaterally injected BoNT-A were evaluated before the injection and 4, 8, and 12weeks after the injection using 3D laser scan. And the mean values of both sides (injection and non-injection sides) were compared with. At injection side, mean values of the volume and the bulkiest height at each time point diminished significantly between pre-injection and 4, 8, and 12weeks post-injection. At non-injection side, in contrast, mean values of the volume and the bulkiest height diminished also but less than that of injected side, and there was no statistical significance. In this limited study, we concluded that the unilaterally BoNT-A injection side showed greater mean values of the reduction of muscle volume than non-injection side at 4, 8, and 12 weeks after the injection.

• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.121-129
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• 2005

In this experiment, eleven volunteers were followed up for 15 months after the injection of botulinum toxin type A on right and left masseter muscles. The measurement of masseter muscle atrophy for each volunteer was performed by CT(computed tomography) three times: before the injection, three and fifteen months after the injection. The thickness and area of muscle were measured in three positions which are 10 (position 1), 20 (position 2), and 40 mm (position 3) above the inferior border of mandible(the injection site was nearest the position 1). The thickness of masster muscle was decreased in all three positions three months after the injection, but no significant change was observed fifteen months after the injection. On the other hand, the area of masster muscle was decreased in all three positions three months after the injection. Furthermore, the area was decreased significantly in positions 1 and 2, but not in position 3 fifteen months after the injection. As a result, toxin is still in effect even fifteen months after the injection. Finally, the present study shows that the measurement of muscle area provides more precise informations than that of muscle thickness does.

• Journal of Oral Medicine and Pain
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• v.30 no.2
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• pp.247-255
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• 2005

The purpose of this study is to evaluate the effect of botulinum toxin type A on masseter muscle atrophy and the extent of masseter muscle affected from the injection site in relation to injection dose, with and without occlusal splint therapy through computed tomographic measurement. 32 volunteers were divided into four groups - group 25U (injection dose of 25 unit), group 25Us (injection dose of 25 unit with occlusal splint), group 35U (injection dose of 35 unit), group 35Us (injection dose of 35 unit with occlusal splint). Each group consisted of 8 people. 3 positions (position 1, 2, 3 - 10mm, 20mm and 40mm from the inferior border of the mandible, respectively) were selected for the evaluation of the masseter muscle change. The following results were obtained. 1. The thickness and the cross-sectional area of the masseter muscle had reduced in all groups except for the right side thickness at position 3 of group 25U and group 25Us, and the right side thickness as well as the left side cross-sectional area at position 3 of group 35Us. In group 35Us, the thickness and the cross-sectional area of the masseter muscle had reduced significantly in all positions (P < 0.05). 2. There was no significant difference in the masseter muscle change between the injection dose of 25unit and that of 35unit. 3. The groups with occlusal splint showed greater reduction of the masseter muscle thickness than the other groups (P < 0.05). From the above results, botulinum toxin type A injection together with occlusal splint therapy in the treatment of masseter muscle hypertrophy would be clinically effective.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.1
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• pp.69-75
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• 2010

Botulinum toxin type A(BTX-A) has been applied successfully to treat masseteric hypertrophy. However it can cause muscle weakness. This study was designed to measure the change in maximum bite force(MBF) after BTX-A injection into human masseter muscle and to evaluate the influence of a booster(repeated) injection. Thirty volunteers completed 18-week follow-up and MBF was measured. At 18 weeks after the first injection, a booster injection was given to 14 patients and they were followed up until 18 weeks from the booster injection. The mean MBF was approximately 20% lower at 2 weeks than before the injection, and it recovered gradually after 4 weeks to return to the preinjection level at 12 weeks. The MBF differed significantly between before the injection and at 2, 4, and 8 weeks after the injection(p<0.05). In booster injection group(n=14),the MBF decreased markedly at 6 weeks(p<0.05),and it recovered gradually in 12 weeks. The MBF was significantly reduced after booster injection of BTX-A into the human masseter muscle. The degree of discomfort experienced by the subjects had little effect on normal mastication.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.3
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• pp.433-439
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• 2009

The purpose of this study was to assess the effect on mandibular growth of botulinum toxin type A (BTXA) injection into the unilateral massester muscle of growing rats at three different growing stages. Thirty six male Sprague-Dawley rats were divided into three groups according to the age (group 1: 4 week-old, group 2: 5week-old, group 3: 6week-old). Then each group was randomly divided into 3 subgroups (control group, unilateral injection group, bilateral injection group). Experimental animals were sacrificed after 4 weeks. Then the jaw measurements were evaluated. The results were as follows: 1. In the group 1, mandibular body length, condylar height and coronoid process height of the unilateral group(BTXA side) and the bilateral group were shorter than those of the control group (p<0.05). 2. In the group 2, anterior region height, condylar height, coronoid process height of the unilateral group(BTXA side) and the bilateral group were shorter than those of the control group (p<0.05). 3. In the group 3, mandibular body length, condylar height, coronoid process height of the unilateral group(BTXA side) and the bilateral group were shorter than those of the control group (p<0.05). 4. There was no significant difference in mandibular measurements between the control side and the injection side in the unilateral group in all age groups (p>0.05).

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.1
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• pp.295-301
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• 2017

Botulinum neurotoxin (BoNT/A) is a neurotoxin that selectively attacks the peripheral cholinergic nerve endings. It is produced by Gram -positive, endospore-forming strict anaerobic bacteria, Clostridium botulinum. Since BoNT/A could be a biothreat agent, as well as a contaminator of food and water supplies, the development of sensitive assays for toxin detection and potent antitoxin for the treatment of intoxication is necessary. In this study, for the purpose of producing monoclonal antibodies (mAbs) that are capable of neutralizing Botulinum neurotoxin type A (BoNT/A), scFv (single-chain variable domain fragment) libraries from the rabbit antisera against BoNT/A was fused to a human IgG. The resulting recombinant scFvIgG antibody protein was expressed in stable cell lines and was purified using a protein A affinity chromatography. The efficacy of scFvIgG mAb was confirmed by ELISA and was evaluated for the neutralization of BoNT/A in vivo. Such an in vivo toxin neutralization assay was performed using mice. Although scFvIgG antibody proteins (10 ug) failed to fully protect the mice challenged with BoNT/A (100,000 $LD_{50}$), it significantly prolonged the survival time. These results suggest that scFvIgG mAb may be capable of neutralizing BoNT/A single-chain variable domain fragment.

• The Journal of the Korean dental association
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• v.41 no.6 s.409
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• pp.450-454
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• 2003

The Purpose of this study is to report the effect botulinum toxin type A injection for the masseter hypertrophy patient with bruxism. Nine patients enrolled in this study were diagnosed as masseter hypertrophy associated with bruxism and the patients were injected with a 25U of botulinum toxin type A (BTXA:Lanzhou) to each masseter muscles. All nine patients showed marked reduction of masseter hypertrophy and eight patients reported the resolution of bruxism in 8 weeks after injection, with no significant complications. This preliminary study suggest that the botulinum toxin type A injection is an alternative method to treat the masseter hypertrophy with bruxism.