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botulinum toxin associated with fissurectomy and anoplasty for hypertonic chronic anal fissure: A case-control study

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World Journal of Clinical Cases 2021年第32期9卷 9722-9730页

作者： Beatrice D'Orazio Girolamo Geraci Fausto Famà Gloria Terranova Gaetano Di Vita Department of Surgical Oncological and Stomatological SciencesUniversity of PalermoPalermo 90100SicilyItaly Department of Human Pathology in Adulthood and Childhood"G.Barresi" University Hospital of MessinaMessina 98121SicilyItaly Department of Surgical Oncological and Stomatological SciencesPostgraduate Medical School in General SurgeryUniversity of PalermoPalermo 90100SicilyItaly

BACKGROUND Lateral internal sphincterotomy is still the approach of choice for the treatment of chronic anal fissure(CAF)with internal anal sphincter(IAS)hypertonia,but it is burdened by high-risk postoperative faecal incontinence(FI).Sphincter saving procedures have recently been reconsidered as treatments to overcome this *** most employed procedure is fissurectomy with anoplasty,eventually associated with pharmacological *** To evaluate whether fissurectomy and anoplasty with botulinum toxin injection improves the results of fissurectomy and anoplasty *** We conducted a case-control study involving 30 male patients affected by CAF with hypertonic IAS who underwent fissurectomy and anoplasty with V-Y cutaneous flap *** patients were divided into two groups:Those in group I underwent surgery alone,and those in group II underwent surgery and a botulinum toxin injection directly into the *** were followed up for at least 2 *** goals were to achieve complete healing of the patient and to assess the FI and recurrence rate along with manometry *** The intensity and duration of post-defecatory pain decreased significantly in both groups of patients starting with the first defecation,and this reduction was higher in group *** days after surgery,we achieved complete wound healing in all the patients in group II but only in 80%of the patients in group I(Pbotulinum toxin A in association with fissurectomy and anoplasty with a V-Y advancement flap improves the results of surgery alone in patients affected by CAF with IAS hypertonia.

关键词： Proctology Fissurectomy Anoplasty Anal fissure botulinum toxin

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botulinum toxin augmented bilateral lateral rectus recession versus three muscles surgery in large-angle intermittent exotropia

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International Journal of Ophthalmology(English edition) 2022年第10期15卷 1665-1670页

作者： Hala Kamal Mattout Sameh Mosaad Fouda Wael M El-Haig Department of Ophthalmology Faculty of MedicineZagazig UniversityZagazig 44519Egypt

AIM: To report the surgical outcomes of correcting large angle intermittent exotropia in adult patients by bilateral lateral rectus muscle recession with intraoperative use of botulinum toxin and to compare the results with those of bilateral lateral rectus muscle recession and unilateral medial rectus resection. METHODS: The medical records of patients who underwent surgical correction of large angle intermittent exotropia [exotropia >50 prism dioptre(PD)] were retrospectively reviewed. Two groups of patients were identified;Group Ⅰ(21 patients) had bilateral lateral recti recession augmented with intraoperative botulinum toxin A(BTA) injection into the recessed muscles and group Ⅱ(30 patients) were treated by bilateral lateral recti recession with unilateral medial rectus muscle resection. Preoperative data were extracted for age, gender, refraction, type of exotropia, angle of stereopsis and angle of deviation. The main outcome measures were the postoperative angle of deviation and stereoacuity angle by Titmus test measured at the end of one year of postoperative follow up. RESULTS: By the end of the first postoperative year, 10 patients in group Ⅰ(47.6%) and 20 patients in group Ⅱ(66.7%) achieved esotropia/esophoria <5 PD or exotropia/exophoria <10 PD. The difference in surgical success rate was not statistically significant(P=0.1) but there was a statistically significant higher rate of undercorrection in group Ⅰ(P=0.03). On the other hand, 3 patients in group Ⅰ(14.3%) and 5 patients in group Ⅱ(16.7%) had improved stereopsis;this difference in the sensory outcome was not statistically significant(P=0.8). In the BTA augmented surgery group, good stereoacuity and smaller preoperative angle of deviation were associated with significantly higher surgical success rate(P=0.004, 0.01 respectively). CONCLUSION: BTA augmented bilateral lateral recti recession is associated with higher rate of undercorrection as compared to bilateral lateral recti recession with unilater

关键词： botulinum toxin intermittent exotropia large angle deviation augmented surgery

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botulinum toxin injection for Cockayne syndrome with muscle spasticity over bilateral lower limbs:A case report

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World Journal of Clinical Cases 2021年第18期9卷 4728-4733页

作者： Lin-Chieh Hsu Po-Ying Chiang Wei-Pin Lin Yao-Hong Guo Pei-Chun Hsieh Ta-Shen Kuan Wei-Chih Lien Yu-Ching Lin Department of Physical Medicine and Rehabilitation National Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainan 704Taiwan Department of Physical Medicine and Rehabilitation College of MedicineNational Cheng Kung UniversityTainan 704Taiwan Medical Device Innovation Center National Cheng Kung UniversityTainan 704Taiwan

BACKGROUND Cockayne syndrome(CS)is a rare inherited disease characterized by progressive motor symptoms including muscle weakness,joint contracture,ataxia,and *** neurotoxin type A has been used for conditions such as dystonia and spasticity,but it has rarely been used in patients with *** SUMMARY We report a 6-year-and-9-mo old girl diagnosed with CS who received an injection of botulinum neurotoxin type A to manage her difficulty with walking.A total dose of 210 units of botulinum neurotoxin type A was administered into the bilateral tibialis posterior and gastrocnemius *** evaluate the treatment effects on spasticity,joint contracture,pain,and ataxia,measurement tools including the Modified Ashworth Scale,the passive range of motion,the Faces Pain Scale-Revised,and the Scale for the Assessment and Rating of Ataxia,were *** first week after the injection,the Modified Ashworth Scale score for the plantar flexors and foot invertors improved bilaterally,along with advancements in the passive range of motion of the bilateral ankles and a lower score for the Faces Pain *** treatment effects persisted to the 8th week post-injection,but returned to baseline values at the 12th week post-injection,except for the pain *** botulinum toxin injection can thus be considered as a treatment option for lower extremity spasticity,joint contracture,and pain derived from CS.

关键词： Cockayne syndrome botulinum toxin Spasticity Pain Ataxia Case report

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botulinum toxin and benign prostatic hyperplasia

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Asian Journal of Urology 2018年第1期5卷 33-36页

作者： Lay Guat Ng Department of Urology Singapore General HospitalSingapore

Benign prostatic hyperplasia(BPH)is a clinical condition where lower urinary tract symptoms are caused by both a physically obstructing prostate as well as tight smooth muscles around the bladder *** of this condition with botulinum toxin has been used since 2003,but this interest has somewhat died down after two large randomized controlled trials(RCTs)showing equivalence of results between their treatment and placebo ***,with review of animal studies and unexplained exaggerated effect of the placebo arms of the two RCTs,together with recent data of sustained benefits after 18 months of treatment,the place of botulinum toxin in the BPH field is probably still present.

关键词： Benign prostatic hyperplasia botulinum toxin Bladder outlet obstruction

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Intragastric injection of botulinum toxin for the treatment of obesity. Where are we?

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World Journal of Gastroenterology 2008年第12期14卷 1805-1809页

作者： Diego Garcia-Compean Hector Maldonado Garza Department of Gastroenterology Faculty of Medicine University Hospital. Ave Madero y Gonzalitos Col Mitras Centro Monterrey 64700 Mexico

Obesity has reached epidemic proportions particularly in western countries. Most non-surgical treatments of this condition are disappointing. Since 2005, several studies evaluating the effect of botulinum toxin type A (BT-A) in gastric antrum by means of endoscopy for the treatment of obesity have been published. This treatment modality was based on the observation that gastric injection of BT-A in laparatomized rats induced a significant reduction of food intake and body weight. Nowadays, 6 studies have been published yielding conflicting results. Differences in selection of patients, doses of BT-A, method of administration of the toxin and instruments of evaluation of some parameters among these studies may be the cause of divergent results. We discuss herein some important features of these studies pointing out on differences among them. At the same time, based on the knowledge of physiological characteristics of normal and abnormal gastric function related with feeding, we discuss the probable causes of failure observed in these trials. Finally, we give some guidelines concerning the way that future research in this field may follow, not without calling attention to disadvantages of this treatment.

关键词： botulinum toxin Obesity Gastric emptying Gastric motility Gastroparesis

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botulinum toxin for chronic anal fissure after biliopancreatic diversion for morbid obesity

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World Journal of Gastroenterology 2012年第10期18卷 1021-1027页

作者： Serafino Vanella Giuseppe Brisinda Gaia Marniga Anna Crocco Giuseppe Bianco Giorgio Maria Department of Surgery Catholic School of Medicine University Hospital "Agostino Gemelli"

AIM: To study the effect of botulinum toxin in patients with chronic anal fissure after biliopancreatic diversion (BPD) for severe obesity. METHODS: Fifty-nine symptomatic adults with chronic anal fissure developed after BPD were enrolled in an open label study. The outcome was evaluated clinically and by comparing the pressure of the anal sphincters before and after treatment. All data were analyzed in univariate and multivariate analysis. RESULTS: Two months after treatment, 65.4% of the patients had a healing scar. Only one patient had mild incontinence to flatus that lasted 3 wk after treatment, but this disappeared spontaneously. In the multivariate analysis of the data, two registered months after the treatment, sex (P = 0.01), baseline resting anal pressure (P = 0.02) and resting anal pressure 2 mo after treatment (P botulinum toxin, despite worse results than in non-obese individuals, appears the best alternative to surgery for this group of patients with a high risk of incontinence.

关键词： botulinum toxin Anal diseases Anal fis- sure Severe obesity Bariatric surgery Biliopancreatic diversion

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Minimally invasive botulinum toxin type A injection from the ocular surface to extraocular muscles

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International Journal of Ophthalmology(English edition) 2011年第2期4卷 179-181页

作者： Xiao-Mei Wan, Hua-Qing Gong College of Medicine Qingdao University Qingdao 266071 Shandong Province China Shandong Eye Institute Qingdao 266071 Shandong Province China

AIM: To investigate a new, safe and effective injection method for strabismus patients. botulinum toxin type A (BTXA) was injected by pulling the extraocular muscles with a minimally-invasive technique into the ocular surface, and it was ensured that the extraocular muscles was maintained in the suspended state. METHODS: A total of 32 patients with different types of strabismus were treated at our institution from February to October 2010. A small conjunctival incision (= 21PD was 1u, 3u and 4u to 5u, respectively. RESULTS: Of the 32 treated patients, 11 (34.4%) were cured, and 18 (56.3%) were improved at 5 days after the operation; 12 (40%) were cured, and 15 (46.9%) were improved at 30 days. Five patients (15.6%) who had unsatisfactory response after BTXA injection at 30 days received repeated injections or underwent strabismus surgery. Ptosis was present in 2.5% of the injected eyes. No retrobulbar hemorrhage or ocular perforation was found in any eye. CONCLUSION: It is safe and efficient to inject BTXA by pulling ext

关键词： botulinum toxin paralytic strabismus microscope

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Inhibition of botulinum toxin's association with rat brain synaptosomes by toosendanin,an antibotulismic triterpenoid

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Neural Regeneration Research 2006年第6期1卷 489-492页

作者： Jianying Zhou Yuliang Shi Shanghai Institutes for Biological Sciences Chinese Academy of Sciences Shanghai 200031 China

BACKGROUND： Toosendanin （TSN）, a tnterpenoid derivative extracted from the bark of Melia toosendanin Sieb et Zucc, has been demonstrated to be an effective drug for treatment of experimental botulism. OBJECTIVE ： To explore its antibotulismic mechanism by observing the effect of toosendanin on association of botulinum toxin （BoTx） with rat brain synaptosomes under different conditions. DESIGN： A randomized controlled experiment SETTING： Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences MATERIALS： Sprague-Dawiey rats, weighing （220±12） g, were involved. TSN was a sample recrystallized in ethanol with a punty 〉 98%. BoTx/A and BoTx/C of 500 ku （1.8×10^7 mouse LD50/mg） were purchased from Wako （Japan）, Horse antitoxins to BoTx/A and/C （primary antibodies） were purchased from Lanzhou Institute of Biological Products （China）. METHODS ： Major experiments were finished between March 2005 and October 2005 in key laboratory of neurobiology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences. （1） Preparation of synaptosome of rats： one aliquot of synaptosome was pre-incubated with TSN （17 μmol/L） for 20 minutes at 4 % or 37 % （another aliquot of synaptosome which was untouched was used as control）. Then, BoTx was respectively added for another 20-minute incubation. （2） A homochronous expenment was still performed at 37 %. Differently, high level of K^＋ was used to stimulate synaptosome for 25 minutes. Two aliquots of synaptosomes with or without TSN （17 μmol/L）were preincubated for 15 minutes, Then, 30 mmol/L KCl was separately added in two aliquots, 5 minutes later, 13 nmol/L BoTx/C was separately added followed by 20-minute incubation. （3）The effect of TSN on BoTx binding was observed by Western blot and synchronization method. （4） t test was used for comparing the difference of measurement data. MAIN OUTCOME MEASURES ： The gray value of BoTx bands from western blot was used to estimate the bound amount of BoTx. RES

关键词： antibotulismic mechanism measurement data botulinum toxin Western blot type A

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The use of botulinum toxin A in chemical component separation: a review of techniques and outcomes

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Plastic and Aesthetic Research 2020年第4期7卷 1-9页

作者： Sharbel A.Elhage Eva B.Deerenberg Jenny M.Shao Vedra A.Augenstein B.Todd Heniford Department of Gastrointestinal and Minimally Invasive Surgery Carolinas Medical CenterCharlotteNC 28204USA

Fascial closure is crucial for abdominal wall reconstruction (AWR) but can be especially difficult in patients with massive ventral hernias or loss domain. Recently, botulinum toxin A (BTA) has been increasingly utilized as an adjunct in AWR to aid in fascial closure. This review aims to evaluate the current literature on the use of BTA in AWR to assess current treatment regimens, side effects, outcomes and complications. A literature search was performed, yielding 10 studies that met the inclusion criteria. There was a significant amount of heterogeneity in treatment regimens, with studies differing in BTA injection timing, dosage, concentration, and location. The majority of studies showed that injection of BTA preoperatively was able to augment abdominal wall musculature, with many showing a decrease in mean transverse defect size and high rates of successful fascial closure. No major complications were reported from BTA administration, with only mild side effects reported by some studies. The most common side effects include a weak cough or sneeze, bloating, and back pain, which generally all resolved prior to surgery. While BTA appears to be a promising adjunct for AWR, further investigation is needed to determine optimal patient selection and treatment regimens.

关键词： Hernia abdominal wall reconstruction botulinum toxin botox chemical component separation

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botulinum toxin A in the Treatment of Oropharyngeal or Esophageal Dysphagia

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International Journal of Otolaryngology and Head & Neck Surgery 2013年第6期2卷 253-258页

作者： Caroline Beutner Katharina Bartsch Harald Schworer Rainer Laskawi Saskia Rohrbach Department of Otorhinolaryngology Duesseldorf University HospitalDuesseldorfGermany Department of Otorhinolaryngology Georg-August-University Hospital GottingenGottingenGermany Department of Gastroenterology and Endocrinology Georg-August-University Hospital GottingenGottingenGermany Department of Audiology and Phoniatrics ChariteBerlinGermany

Objectives: In this retrospective analysis, we explored the effect of botulinum toxin A (BTA) injection to treat oropharyngeal dysphagia or esophageal dysfunction caused by diseases of the upper (UES) and lower (LES) esophageal sphincter. Methods: In total, 48 patients (17 patients with UES disorders, and 31 patients with LES dysfunction;mean age 64 years) were treated between 1996 and 2007 in our hospital. Comorbid diseases as well as maintenance medication were documented to evaluate the overall health status of our patients. The mean duration of symptoms, the number of pre-treatments and the specification of dysphagia were considered. Results: One month after injection, the response rates were 73.3% (UES group) and 76.6% (LES group). Most patients in the UES group received 30-40 units BTA (Botox?) whereas most patients in the LES group were treated with 100 units BTA. In cases of re-injection, 50% of patients in the UES group experienced an escalation of dosage (up to 75 units), whereas the other 50% received the same dosage. The dosages in the LES group were mostly kept constant. Conclusion: Comparing the two groups with esophageal dysfunction of fundamentally different etiologies (UES/LES), a discrepancy in the level of symptom relief, onset and a longer cessation of clinical benefit were observed in the LES group. In this analysis, we were able to show that injection of BTA is an effective and safe treatment for disorders of the UES and LES.

关键词： botulinum toxin Dysphagia Upper Esophageal Sphincter Lower Esophageal Sphincter

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