• 제목/요약/키워드: BoNT-A

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구강 악안면 영역에서 보툴리눔 독소 주사 후 사망 부작용의 예방 (The prevention of mortality after botulinum toxin injection in oral maxillofacial region)

  • 이원강;최영찬;최문종;김성택
    • 구강회복응용과학지
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    • 제30권4호
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    • pp.299-306
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    • 2014
  • 보툴리눔 독소는 여러 영역에서 치료적 목적으로 사용되어 왔으며, 그 사용량과 적용범위가 점차 커지는 추세이다. 보툴리눔 독소가 강력한 독성 물질임에도 불구하고, 그 효과가 6개월이면 사라지는 가역적 치료방법이라는 인식이 강해서, 부작용이나 사용시 주의사항을 중요하게 생각하지 않는 경향이 있었다. 하지만 미국에서 부작용으로 사망하는 사례가 발생하여, 사용시 사망에 대한 주의사항이 추가되었다. 이에 본 종설은 보툴리눔 독소가 인체 내에서 대사되는 과정과, 발생 가능한 부작용, 사용시 유의사항, 사망 부작용 사례 등에 대해 지금까지 보고된 문헌들을 토대로 자세히 검토하고자 한다.

Botulinum neurotoxin injection for treating plunged nose and post-rhinoplasty: anatomical perspectives of depressor septi nasi, nasalis, leveator labii superioris alaeque nasi muscle

  • Kyu-Ho Yi;Ji-Hyun Lee;Seon-Oh Kim;Hyewon Hu;Hyung-Jin Lee;You-Jin Choi;Tae-Hwan Ahn;Hee-Jin Kim
    • Anatomy and Cell Biology
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    • 제56권4호
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    • pp.409-414
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    • 2023
  • Botulinum neurotoxin (BoNT) injection for the treating plunged nose, post-rhinopasty and hyaluronic filler migration is common procedures in clinical settings. However, the lack of thorough anatomical understanding makes it difficult to locate the nose region muscles. The anatomical considerations concerned with BoNT injection into the nasalis, levator labii superioris alaeque, and depressor septi nasi muscles were reviewed in this study. The injection spots have been presented for the nasalis, levator labii superioris alaeque, and depressor septi nasi muscles, with the recommended injection technique for each muscle. We have suggested the ideal injection sites in association with outer anatomical landmarks of the nose region. Moreover, these proposals would support a more accurate procedure of BoNT injection in relieving plunged nose, preventing post-rhinoplasty deviation, and migration of the hyaluronic acid filler.

만성편두통 치료를 위한 측두 부위의 보툴리눔 독소 주사 자입점 제시 (A proposal of injection points of botulinum toxin into temporal region for chronic migraine)

  • 김영건;배정희;김성택
    • 구강회복응용과학지
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    • 제33권1호
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    • pp.1-6
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    • 2017
  • 보툴리눔 독소 주사는 이마, 눈가 주름치료 등 미용성형분야 뿐만 아니라 만성 편두통(chronic migraine), 근육긴장이상(dystonia), 경직(spasticity), 측두하악장애의 치료 등에 사용되어 왔다. 특히 보툴리눔 독소 주사는 만성편두통환자의 예방적 치료요법으로 현재까지 유일하게 승인된 요법이다. 기존에 잘 알려진 운동신경에서의 마비효과와는 달리, 편두통에 대한 작용기전은 감각신경에서 말초감작과 신경원성염증과 관련되는 substance P, CGRP, glutamate 등 비콜린성 신경전달물질의 유리를 차단하여 통증신호를 차단하는 역할을 한다는 가설이 제기되고 있다. 본 논문에서는 보툴리눔독소가 갖는 진통효과에 대한 고찰과 함께 이를 통하여 추후 만성편두통환자에 대한 주사법 개발에 대한 방향성을 제시하고자 한다.

Morphological Changes in the Mandibular Condyle Following Botulinum Toxin Injection into the Human Masseter Muscle

  • Younjung Park;Junghoon Hong;Hyok Park;Naoya Kakimoto;Seong Taek Kim
    • Journal of Oral Medicine and Pain
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    • 제48권1호
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    • pp.16-24
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    • 2023
  • Purpose: To determine the effects of botulinum toxin (BoNT) injection into the human masseter muscle on the morphology of the mandibular condyle bone using cone-beam computed tomography (CBCT). Methods: Twenty volunteers were randomly assigned to one of two groups. Group I received a single BoNT injection; Group II received two injections, with the second being administered 4 months after the first. CBCT scans of both temporomandibular joints (TMJs) were performed before and 6 months after the first injection. Bony changes in the cortical layers of the condyle heads were evaluated and the long and short axes of both mandibular condyles were measured. The thickness at the thinnest part of glenoid fossa was also quantitatively measured. Results: There was no significant difference between pre- and post-injection CBCT images. Furthermore, no changes in the cortical layers of the condyle heads were observed among the subjects who exhibited mild degenerative TMJ changes. The quantitative measurements (long axis, short axis, and the thickness of thinnest part of glenoid fossa roof) did not differ significantly between pre- and post-injection except for the long axis in Group I. Conclusions: Within the limitations of this study, it appears that BoNT injections into human masseter muscles do not alter the morphology of the mandibular condyle bone in healthy adults.

삼차신경 손상에 의한 신경병증성 통증에서 보툴리눔 독소의 진통 효과 (Analgesic Effect of Botulinum Toxin on Neuropathic Pain after Trigeminal Nerve Injury)

  • 김영건;김성택
    • 구강회복응용과학지
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    • 제28권2호
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    • pp.171-178
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    • 2012
  • 보툴리눔 독소 주사는 이마, 눈가 주름치료 등 미용성형분야 뿐만 아니라 구강 악안면 분야에서는 만성 편두통(chronic migraine), 근육긴장이상(dystonia), 경직(spasticity), 측두하악장애(temporomandibular disorders, TMD)의 치료 등에 사용되어 왔다. 최근 보툴리눔 독소 주사가 운동신경에서 마비효과 뿐만 아니라 감각신경에서 말초감작과 신경원성염증과 관련되는 substance P, CGRP, glutamate 등 비콜린성 신경전달물질의 유리를 차단하여 통증신호를 차단하는 역할을 한다는 가설이 제기되고 있다. 따라서 본 연구는 쥐, 토끼 등 동물 신경 손상 모델에 대한 실험과 치과 치료 후 발생한 신경 손상 환자에서 보툴리눔 독소의 진통 효과 및 작용 기전을 살펴보고자 한다.

Prognostic impact of chromogranin A in patients with acute heart failure

  • Kim, Hong Nyun;Yang, Dong Heon;Park, Bo Eun;Park, Yoon Jung;Kim, Hyeon Jeong;Jang, Se Yong;Bae, Myung Hwan;Lee, Jang Hoon;Park, Hun Sik;Cho, Yongkeun;Chae, Shung Chull
    • Journal of Yeungnam Medical Science
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    • 제38권4호
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    • pp.337-343
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    • 2021
  • Background: Chromogranin A (CgA) levels have been reported to predict mortality in patients with heart failure. However, information on the prognostic value and clinical availability of CgA is limited. We compared the prognostic value of CgA to that of previously proven natriuretic peptide biomarkers in patients with acute heart failure. Methods: We retrospectively evaluated 272 patients (mean age, 68.5±15.6 years; 62.9% male) who underwent CgA test in the acute stage of heart failure hospitalization between June 2017 and June 2018. The median follow-up period was 348 days. Prognosis was assessed using the composite events of 1-year death and heart failure hospitalization. Results: In-hospital mortality rate during index admission was 7.0% (n=19). During the 1-year follow-up, a composite event rate was observed in 12.1% (n=33) of the patients. The areas under the receiver-operating characteristic curves for predicting 1-year adverse events were 0.737 and 0.697 for N-terminal pro-B-type natriuretic peptide (NT-proBNP) and CgA, respectively. During follow-up, patients with high CgA levels (>158 pmol/L) had worse outcomes than those with low CgA levels (≤158 pmol/L) (85.2% vs. 58.6%, p<0.001). When stratifying the patients into four subgroups based on CgA and NT-proBNP levels, patients with high NT-proBNP and high CgA had the worst outcome. CgA had an incremental prognostic value when added to the combination of NT-proBNP and clinically relevant risk factors. Conclusion: The prognostic power of CgA was comparable to that of NT-proBNP in patients with acute heart failure. The combination of CgA and NT-proBNP can improve prognosis prediction in these patients.

No-Touch Radiofrequency Ablation of VX2 Hepatic Tumors In Vivo in Rabbits: A Proof of Concept Study

  • Kim, Tae-Hyung;Choi, Hyoung In;Kim, Bo Ram;Kang, Ji Hee;Nam, Ju Gang;Park, Sae Jin;Lee, Seunghyun;Yoon, Jeong Hee;Lee, Dong Ho;Joo, Ijin;Lee, Jeong Min
    • Korean Journal of Radiology
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    • 제19권6호
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    • pp.1099-1109
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    • 2018
  • Objective: In a proof of concept study, we compared no-touch radiofrequency ablation (NtRFA) in bipolar mode with conventional direct tumor puncture (DTP) in terms of local tumor control (LTC), peritoneal seeding, and tumorigenic factors, in the rabbit VX2 subcapsular hepatic tumor model. Materials and Methods: Sixty-two rabbits with VX2 subcapsular hepatic tumors were divided into three groups according to the procedure: DTP-RFA (n = 25); NtRFA (n = 25); and control (n = 12). Each of the three groups was subdivided into two sets for pathologic analysis (n = 24) or computed tomography (CT) follow-up for 6 weeks after RFA (n = 38). Ultrasonography-guided DTP-RFA and NtRFA were performed nine days after tumor implantation. LTC was defined by either achievement of complete tumor necrosis on histopathology or absence of local tumor progression on follow-up CT and autopsy. Development of peritoneal seeding was also compared among the groups. Serum hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) were measured via ELISA (Elabscience Biotechnology Co.) after RFA for tumorigenic factor evaluation. Results: Regarding LTC, there was a trend in NtRFA (80%, 20/25) toward better ablation than in DTP-RFA (56%, 14/25) (p = 0.069). Complete tumor necrosis was achieved in 54.5% of DTP-RFA (6/11) and 90.9% of NtRFA (10/11). Peritoneal seeding was significantly more common in DTP-RFA (71.4%, 10/14) than in NtRFA (21.4%, 3/14) (p = 0.021) or control (0%). Elevations of HGF, VEGF or IL-6 were not detected in any group. Conclusion: No-touch radiofrequency ablation led to lower rates of peritoneal seeding and showed a tendency toward better LTC than DTP-RFA.

Determination of Neurotoxin Gene Expression in Clostridium botulinum Type A by Quantitative RT-PCR

  • Shin, Na-Ri;Shin, Ji-Hun;Chun, Jeong Hoon;Yoon, So-Yeon;Kim, Bong Su;Oh, Hee-Bok;Rhie, Gi-eun
    • Molecules and Cells
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    • 제22권3호
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    • pp.336-342
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    • 2006
  • Real time reverse transcription (RT)-PCR was used to quantify the expression of the botulinum neurotoxin type A (BoNT/A) gene (cntA) by normalization with the expression of 16S rRNA. The method were confirmed by monitoring the mRNA levels of cntA during growth in five type A strains. In all but one of the strains the expression of cntA mRNA was maximal in the late exponential phase, and approximately 35-fold greater than in the early exponential phase. The concentration of the extracellular BoNT/A complex detected by ELISA was highest in stationary phase. Sodium nitrite and sorbic acid completely inhibited growth at 20 ppm and $4mg\;ml^{-1}$, respectively. CntA expression became lower in proportion to the concentration of sorbic acid, and this reduction was confirmed by mouse bioassay. Our results show that real time RT-PCR can be used to quantify levels of C. botulinum type A neurotoxin transcripts and to assess the effects of food additives on botulinal risk.