• 제목/요약/키워드: Botulinum toxin A

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보툴리눔 독소의 약리 (The Pharmacology of Botulinum Toxin)

  • 이상혁;이현섭;진성민
    • 대한후두음성언어의학회지
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    • 제23권2호
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    • pp.93-98
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    • 2012
  • Botulinum toxins are the most potent toxins known to mankind. Botulinum toxin acts by blocking the cholinergic neuromuscular or the cholinergic autonomic innervation of exocrine glands and smooth muscles. Seven distinct antigenic botulinum toxins (A, B, C, D, E, F and G) produced by different strains of Clostridium botulinum have been described and only A and B type of botulinum toxins were clinically used. Toxins were consisted of a heavy chain with a molecular weight of 100 kD and a light chain with a molecular weight of 50 kD. Toxins are bound with an astounding selectivity to glycoprotein structures located on the cholinergic nerve terminal. Subsequently light chain of toxin is internalized and cleaves different proteins of the acetylcholine transport protein cascade transporting the acetylcholine vesicle from the intracellular space into the synaptic cleft. After a decade of therapeutic application of the toxin, no anaphylaxis or deaths have been reported and systemic adverse effects have not been reported so far. However the toxin's immunologic properties can lead to the stimulation of antibody production, potentially rendering further treatments ineffective. Botulinum toxin is a safe and effective treatment. Use of botulinum toxin in clinical medicine has grown exponentially in recent years, and many parts of the human body are now being targeted for therapeutic purposes.

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뚜렛 증후군에서 보툴리눔 톡신의 임상 효과 : 증례보고 및 고찰 (The Clinical Effect of Botulinum Toxin in a Patient with Tourette's Syndrome: A Case Report and Review)

  • 현정근;이준형;이창민;임명호
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제24권2호
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    • pp.90-95
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    • 2013
  • Botulinum toxin, a neurotoxin, is known to be an inhibitor of cholinergic neuromuscular transmission. Recently, it was reported that the administration of botulinum toxin is effective for the treatment of focal neurological motor disorders such as cervical dystonia, blepharospasm, hemifacial spasm, spasmodic dysphonia, and writer's cramp. Several case studies reported that the botulinum toxin was administered for the treatment of motor tic or vocal tic. It was found that this toxin reduces the frequency and severity of the tic as well as the premonitory urge and symptoms. In our case study, a noticeable decrease of motor tic symptom was observed after an intramuscular injection of 300mg of botulinum toxin in an 18-year-old patient with Tourette's disorder who showed only a little improvement of motor tic and vocal tic symptoms after treatment with antipsychotic drugs for several years. This case is reported in our study and literature survey was undertaken for reviewing similar cases. In our study, an 18-year-old boy diagnosed with Tourette's disorder based on Diagnostic and Statistical Manual of Mental Disorders, fourth edition presented with the following scores : the Clinical Global Impression scale, Yale Global Tic Severity Scale (motor/vocal/severity), Premonitory Urge Score, Korean Attention-Deficit Hyperactivity Disorder Rating scale, and Kovac Depression scale which were performed prior to the treatment were 5, 21/5/50, 100, 17, and 18 points, respectively. Two weeks after the injection of botulinum toxin, the scores were 4, 17/5/40, 50, 16, and 19 points, respectively. Eight weeks after the injection of botulinum toxin, they had become 3, 15/5/30, 25, 16, and 20 points, respectively, which clearly indicates a noticeable decrease of motor tic symptom.

보툴리눔독소를 이용한 후두전적출술후 식도발성장애 및 식도이완불능증의 치료 (Botulinum Toxin Injection for Postlaryngectomy esophageal speech failure and Achalasia)

  • 최홍식;문형진;한재욱;서진원;김광문
    • 대한기관식도과학회지
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    • 제3권2호
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    • pp.302-306
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    • 1997
  • Persistent pharygoesophageal spasm has been demonstrated to be responsible for poor speech rehabilitation after laryngectomy Management of these patients has included bougienage and pharyngeal neurectomy. Achalasia is a disorder of swallowing in which the lower esophageal sphincter fails to relax. Botulinum toxin injection of the upper esophageal sphincter or lower esophageal sphincter has been successfully used diagnostically and therapeutically for esophageal speech failure or achalasia. So, we report the use of botulinum toxin, a paralytic agent, for the treatment of these conditions.

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Clostridium botulinum Type F Toxin의 면역학적 효소방법에 의한 검출에 관한 연구 (Enzyme-Linked Immunosorbent Assay (ELISA) for Detection of Clostridium botulinum Type F Toxin)

  • Lee, Jeong-Kug;K. H. Yang
    • 한국미생물·생명공학회지
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    • 제10권3호
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    • pp.205-209
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    • 1982
  • The enzyme-linked immunosorbent assay using the so-called "double-sandwich"technique was applied to determine Clostridium botulinum type F toxin. Polystyrene tubes were coated with horse anti-type F toxin serum and then toxin sample was added. The tubes were subsequently treated with rabbit anti-type F toxin IgG and sheep anti-rabbit serum IgG-horseradish peroxidase conjugate. By this technique, about 10 mouse intraperitoneal 50% lethal doses (ip LD/50/) of type F toxin could be detected. Low back-ground reading was achieved with the use of phosphate-buffered saline containing 0.05% Tween 20 and 1% bovine serum albumin as diluents of rabbit IgG and conjugate. Addition of EDTA in the diluents of toxin increased ELISA extinction value significantly. No cross-reaction was observed with botulinum type A and B toxin, but type E toxin gave sleight cross-reaction.

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보툴리눔독소 주입에 의한 음성장애 및 언어장애의 치료 (Botulinum Toxin Injection for the Treatment of Voice and Speech Disorders)

  • 최홍식
    • 음성과학
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    • 제3권
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    • pp.5-17
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    • 1998
  • Botulinum toxin, a neurotoxin derived from Clostridia Botulinum, has been injected into the target muscle(s) for the treatment of several kinds of voice and speech disorders at the Voice Clinic, Yonsei Institute of Logopedics and Phoniatrics since December 1995. Criteria for the diagnosis and method of injection for spasmodic dysphonia, mutational dysphonia, muscle tension dysphonia, dysphonia after total laryngectomy, and stuttering were summarized. Among 144 patients with adductor type spasmodic dysphonia, who were injected one time to maximum 8 times during the 27 months, 90% were recognized as having better than slight improvement. Even though the injected cases were small, not only the abductor type spasmodic dysphonia, but also the intractable mutational dysphonia or muscle tension dysphonia resistant to voice therapy revealed that botulinum toxin injection would be another options for treatment. Patients who cannot phonate after total laryngectomy and some forms of adulthood stutterers can also be candidates for the injection of botulinum toxin.

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Frey 증후군의 치료에 있어서 보툴리눔 독소 A형의 유용성 (Effectiveness of Botulinum Toxin A in Treatment of Frey's Syndrome)

  • 김국현;박은수;윤창운;이영만;김용배
    • 대한두개안면성형외과학회지
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    • 제10권2호
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    • pp.114-119
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    • 2009
  • Purpose: Several therapeutic approaches have been introduced and tried to treat Frey syndrome following parotidectomy. However they were not proved as an effective treatment. A new therapeutic modality using botulinum toxin injections was presented previously by several study groups. But, the duration of the demonstrated positive effect was essentially unknown so far. The purpose of this clinical investigation is to demonstrate the effectiveness of Botulinum toxin type A(BTXA) in patients with Frey syndrome. Methods: For this study, 12 patients were treated, They were assessed with the Minor's iodine-starch test and interviewed before and after treatment. Botulinum toxin is injected with $1.0cm^2$ apart into the skin where symptoms of Frey's syndrome has manifestated. The patients were classified according to the concentration of botulinum toxin and dosage of botulinum toxin. Results: The outcome measures were the time of reappearance of gustatory sweating(subjective study), and the results of an Minor's iodine-starch test(objective study) of 3 weeks, 3 months, 6 months, 9 months, 12 months after treatment. This treatment was effective in all groups of patients. The concentrations and the amount of dosages did not affect the treatment. But high concentration produced faster effectiveness in subjective. Conclusion: Botulinum toxin type A(BTXA) for Frey syndrome is easy, convenient and effective withouts severe complication. And the patients has no difficulty and limitation in their life.

이갈이를 동반한 교근비대증 환자에서 보툴리눔 A형 독소 주사의 효과 경험예 (A case of the effect of botulinum toxin type injection for the masseter hypertro patient with bruxism)

  • 김성택;함종욱;최종훈;김종열
    • 대한치과의사협회지
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    • 제41권6호통권409호
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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.

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A Pilot Study to Evaluate the Efficacy and Safety of Treatment with Botulinum Toxin in Patients with Recalcitrant and Persistent Erythematotelangiectatic Rosacea

  • Park, Kui Young;Kwon, Hyun Jung;Kim, Jae Min;Jeong, Guk Jin;Kim, Beom Joon;Seo, Seong Jun;Kim, Myeong Nam
    • Annals of dermatology
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    • 제30권6호
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    • pp.688-693
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    • 2018
  • Background: There are few pharmacologic options to reduce erythema and flushing in patients with recalcitrant erythematotelangiectatic rosacea (ETR). We previously reported two cases of refractory flushing and erythema of rosacea that were successfully treated with intradermal botulinum toxin injection, and additional research is needed to prove the efficacy and safety of this treatment. Objective: To report the efficacy and safety of botulinum toxin injection as an aid in persistent erythema of rosacea patients. Methods: A total of 20 Korean patients with recalcitrant ETR were enrolled to receive treatment by injection of botulinum toxin. Patients received one treatment of intradermal botulinum toxin injection and were assessed 1, 2, 4, and 8 weeks after treatment. The severity of erythema and telangiectasia was investigated by a non-treating physician, and the Erythema Index (EI) was assessed by mexameter at each visit. Patient satisfaction and any adverse events were also assessed at each visit. Results: 17 patients completed all follow-up visits and were included in the analysis. Intradermal injection of botulinum toxin significantly reduced erythema severity and EI in ETR patients. Patients reported a satisfaction score of $2.94{\pm}0.56$ at 8 weeks after treatment. Except for three patients who discontinued the study early due to inconvenience of facial muscle paralysis, 17 patients participating in the final analysis did not report side effects except injection pain at the time of the procedure. Conclusion: Intradermal injection of botulinum toxin can be used as an effective and relatively safe adjuvant agent for recalcitrant and persistent erythema of ETR patients.

Effect of bisphosphonate on temporomandibular joint in osteopenia-induced rats by botulinum toxin A injection on masticatory muscle: a preliminary study

  • Kim, Jae-Young;Kim, Dae-Hoon;Jang, Hyo-Won;Park, Kwang-Ho;Huh, Jong-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제41권
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    • pp.11.1-11.6
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    • 2019
  • Background: Botulinum toxin injection on the masticatory muscle induces the osteopenic condition on the ipsilateral condyle. Bisphosphonate suppresses bone resorption and is used to treat osteopenic or osteoporotic condition. This study aimed to evaluate the effect of bisphosphonate administration on prevention of condylar resorption and botulinum toxin A-induced disuse osteopenia in rats. Results: The volume of the condyle and bone volume/tissue volume (BV/TV, %) showed a strong tendency towards statistical significance (p = 0.052 and 0.058). Trabecular thickness (Tb.Th, mm) and trabecular number (Tb.N, 1/mm) were significantly smaller in the Botox group than in the other groups (p < 0.05). The volume of the condyle and BV/TV in the bisphosphonate 100 and bisphosphonate 200 groups showed similar values when compared with the control group. Conclusion: Bisphosphonate administration after botulinum toxin A injection in the masticatory muscles appears to prevent condyle resorption and botulinum toxin-induced disuse osteopenia in rats.

Botulinum toxin A의 임상적 적용원리 및 기본원칙

  • 최진영
    • 대한치과의사협회지
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    • 제41권12호통권415호
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    • pp.826-830
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    • 2003
  • botulinum toxin type A는 anaerobic bacterium clostridium botulinum에서 유래된 poly peptide neurotoxin으로서 사시, 안면연축, 수부다한증등에 치료목적으로 안정적으로 사용되어오다 최근에는 이마주름, 눈가주름등 주름살의 개선 목적으로 널리 사용되어 오고있다. 특히 턱얼굴외과 영역에서는 이러한 주름살의 개선이외에도 사각턱, 안면 신경의 이상으로 인한 안면 비대칭등 적용범위가 상당히 넓고 치료효과도 만족할 만하다고 하겠다. 이에 턱얼굴외과의사 나아가 치과의사들의 많은 사용을 기대하여 botulinum toxin 사용의 역사적 배경, 약리 및 작용기전, 가능한 합병증, 턱얼굴영역에서의 적용가능성 등에 대해 알아보고자 한다.

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