13455234555953  

醫美亂象專題3-2 假藥水貨充斥醫美也不安

2014/02/28(中央社記者陳清芳台北28日電)

食品有假,醫美界也有假藥和水貨,知名診所相繼遭人檢舉及調查,消費者若聽到「韓星都在做的醫美」、「美國FDA核准」,當心有假。

台南地檢署日前獲愛爾麗醫美集團涉嫌使用禁藥及逃漏稅,搜索集團旗下5間診所、3間管理處及7家生技公司等35個處所,查扣無衛生福利部核准字號標示醫療器材玻尿酸針劑247盒及禁藥「降解酶」針劑2支,帶回常姓負責人及劉姓總經理等,兩人訊後重金交保。

無獨有偶,整形外科診所郭姓醫師遭人檢舉使用未經核准的韓國肉毒桿菌,台北地檢署指揮台北市調查處前往所搜索,並以被告身分約談郭男。診所聲稱上游廠商供應禁藥,願退費補償消費者。

一家合法肉毒桿菌素藥廠業者指出,近年流入台灣醫美的非法藥品,主要來自中國大陸及韓國,不只醫師會自行從韓國挾帶進口,更有貿易商專門進口賺取暴利,有的非法肉毒桿菌素產品稀釋分裝後,只在玻璃瓶身黏貼雷射列印的標籤,完全不知道有無雜質,更沒有安全保障。

更恐怖的是,消費者不知道用了什麼產品,部落客陳小姐就說,她定期注射肉毒菌素縮小國字臉,有一次臉頰紅腫發炎,事後回想,她只看到針頭扎進兩頰的咀嚼肌,完全沒看到藥劑的原裝藥瓶。

理律法律事務所律師蘇宜君說,偽禁藥在台灣的嚴重程度難以評估,除非消費者保留相關證物,否則難以舉證受害,國內對此類案件的罰責雖重,但與美國相較,司法機關最終判決的刑度較輕,可能還有不少的糾紛私下和解,只有賠償條件談不攏,才會鬧上檯面或進入訴訟。

衛生福利部僅核准2款肉毒桿菌上市,台灣皮膚科醫學會理事長楊志勛強調,即使外國合法的產品,只要是未經衛福部核准上市,就是偽禁藥,業者所謂「韓星都在做的醫美項目」、「美國食品藥物管理FDA核准」,只是行銷術,不必當真。

民眾也別被櫻花雷射、粉餅雷射、淨膚雷射、白瓷娃娃雷射等名詞搞昏頭。台灣皮膚科醫學會副秘書長黃毓惠表示,說穿了都是紅寶石雷射、鉺雅客雷射之類的廣告名詞包裝,搞不好還是同一台機器換個機殼的冒牌貨。

合法業者與專業醫師建議,民眾做醫美療程前,可以要求先看產品或器材是否具有衛福部核准字號、中文名稱、完整檢驗封籤,可以現場拍照,單瓶包裝者現場拆封,把用完的空瓶、用過的光療儀器探頭給帶回家存證。

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2013-05-10_085134  

醫美亂象專題3-1 醫美削價消費者貪便宜反吃虧

2014/02/28(中央社記者陳清芳台北28日電)

醫美療程削價競爭,買愈多折扣愈大,消費者可別以為賺到便宜。患者白花錢做無效治療倒也罷了,有的人斑愈打愈多,打出大花臉

李先生不讓女士專美於前,注射肉毒桿菌、玻尿酸、抽眼袋、打斑等微整形療程,樣樣都試過,日前他在電視購物頻道看到促銷活動,28次醫療療程只要新台幣4980元還贈送美容液,心動之餘詢問客服人員。得知一次在臉上做4個部位就算4個療程,28次療程實際只有7次,他覺得被唬了,決定先不要購買療程。

台灣皮膚科醫學會理事長楊志勛指出,網路、購物頻道的醫美廣告說得天花亂墜,民眾登門後,往往不是先由醫師診斷該用什麼療程,而由被所謂的顧問介紹某某療程組合有多划算,民眾撿便宜心態,大量購買療程卷,結果用出問題

楊志勛說,每次的光療最好間隔36個月,低能量光療至少好間隔34,曾遇到患者把醫美當成做臉,每週做一次,導致黑色素細胞休眠,皮膚出現白斑,斑斑點點,宛如梅花鹿。

有粉領族進了台北長庚醫院皮膚科主治醫師黃毓惠診間,開口就問:「我臉上的班點愈來愈多,醫師,我現在要做什麼療程才好?」黃毓惠的答案是什麼都不要做。

台北醫學大學皮膚科兼任副教授蔡仁雨則常常替病人收爛攤。他指出,病人有的是被光療弄出大花臉,或是注射肉毒桿菌素造成眉眼歪斜,或注射玻尿酸引起紅腫發炎,其中不乏是別家醫師開單轉介病患,拜託他善後。

蔡仁雨說,用粉底化妝品蓋住斑點,換個部位注射肉毒桿菌、使用消炎藥物,可以挽救醫美失誤,可是有不少人根本是醫美做過了頭,皮膚休息是最好的治療

皮膚科醫界日益關注皮膚能禁得起多少醫美療程的「折騰」。黃毓惠解釋,有肝斑體質的人,頻繁打雷射、脈衝光等,會讓潛在的肝斑冒出來,中國大陸還有研究認為這可能增加皮膚癌風險;注射肉毒桿菌素除皺的愛好者,會出現「耐受性」問題,別人一次療可撐6個月,對這類愛好者可能撐不到4個月。

楊志勛說,也許是光療造成花臉的糾紛頻傳,醫美機構和器材廠商反其道而行,把一次就可以做好的療程拆成好幾個,或是把光療儀器輸出能量調到最低,強調不易發生副作用。

不易發生副作用,也可能就是沒作用」,黃毓惠舉例說明,東方人的膚質比西方人容易反黑,以紅寶石雷射、鉺雅客雷射臉部除斑,一次療程就OK,療程後皮膚反黑,大約3個月會消退,想要不反黑而調降光療能量,除斑效果跟著大打折扣。

楊志勛說,一旦能量低到不能再低,「差不多像是用手拍打臉部」,患者做完光療覺得毛孔變小、皮膚變平滑、氣色變好,只是發紅水腫造成的假象,一星期後一切如舊,錢就白花了。

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BXBA00_P_01_01  

整形隆乳抽脂美容手術 18

中國時報朱芳瑤台北報導 20140228

醫美風行,許多未成年人希望自己可以擁有和明星一樣的臉蛋,不惜花錢美容。但衛福部昨日公布,未成年人除非醫療需要,即日起不得執行割雙眼皮、隆鼻、隆乳等侵入性美容;圖為醫美中心為愛美人士進行療程。(本報資料照片)

 

未成年人想割雙眼皮、隆鼻,若是「非醫療必要的純美容」將禁止

衛生福利部昨天正式公告,醫師不能對未滿18歲的未成年人進行非醫療必要的美容手術。但有醫生表示,醫療必要性有時很難界定,例如不幫孩子美容,孩子心裡過不去,甚至影響社交和學習,一旁家長也促「動刀」時,就很難說違法。

 

違者最重廢止醫師證書

根據衛福部公告,禁止醫師對18歲以下未成年人實施非醫療必要的美容手術項目,包括眼部整形、鼻部整形、植髮、抽脂、削骨、臉部削骨、顱顏重整、拉皮、胸部整形(縮乳及隆乳)

違規醫師將依據醫師法第28條之4,開罰10萬至50萬元罰鍰,得併處限制執業範圍、停業處分1個月至1年或廢止執業執照,情節重大甚至可廢止其醫師證書。

衛福部曾統計,全國1年約800例未成年人接受醫學美容,其中不到1成是要「動刀」的美容手術。據了解,未成年人最常做的美容手術,以割雙眼皮最多,價格約2萬至3.5萬元,也有人會想隆鼻,約3.5萬元至10萬元,視材質而定。

衛福部去年9月就以行政指導的方式,要求醫療院所不能幫18歲以下青少年做侵入性的美容手術,如今更納入法定醫生不得執行的醫療行為。

 

狐臭、整疤痕未列入

預告草案曾想對「狐臭治療」及「疤痕重整」下達18歲禁令,昨天正式公告時則未列入。李偉強說,醫界反應青少年容易遇到狐臭與皮膚疤痕問題導致的身心困擾,前來門診求助,假使禁止,爭議會較多,衛福部因此尊重專業建議,調整草案。

馬偕醫院醫學美容中心主任董光義舉例,門診就曾遇過青春期因荷爾蒙分泌旺盛、有狐臭問題的青少年,被同儕嘲笑,希望醫生能幫忙。

台灣皮膚科醫學會美容醫學教育委員會主委蔡仁雨指出,美容手術是否具醫療必要性,有時很難認定,假使有家長帶孩子來割雙眼皮,並稱孩子因為容貌相當憂鬱、情緒封閉,則醫師是否該認定有醫療必要性?這種情況恐怕也很難取締違法。

蔡仁雨另說,政策立意良好,但成效待觀察,且要避免有些醫師為生存和業績,硬找理由幫未滿18歲者執行侵入性手術美容。

李偉強說,18歲以下身體、心理還沒完全成熟,單純因追求美觀而動手術,「實在太早了!」之後將請地方衛生局加強稽查。

 

小檔案

醫美分3類:光療、注射、手術

美容醫學可分為3大類,「光電治療」例如雷射、脈衝光;「針劑注射治療」例如施打肉毒桿菌、玻尿酸;「美容手術」則是指要「動刀」的侵入性醫美手術,包括削骨、拉皮、隆乳、拉皮等。

衛生福利部自103226日起,禁止醫師對未滿18歲之未成年人實施非醫療必要的美容手術,項目則包括了眼部整形、鼻部整形、植髮、抽脂、削骨、臉部削骨、顱顏重整、拉皮以及胸部整形(縮乳及隆乳)等。

(朱芳瑤)

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human_blastocyst_hair_scale

gif1

image1iPSCwhatcando_3nature09228-f1.2nature10397-f2.2nbt.2139-F1ncb0511-490-f2nm.3225-F2nrm1744-f1nrm1744-f3scrt99-1-lstem_cells_categorieste-166-4  

Human blastocyst-derived pluripotent cell

Human blastocyst-derived, pluripotent cell lines are described that have normal karyotypes, express high levels of telomerase activity, and express cell surface markers that characterize primate embryonic stem cells but do not characterize other early lineages.

After undifferentiated proliferation in vitro for 4 to 5 months, these cells still maintained the developmental potential to form trophoblast and derivatives of all three embryonic germ layers, including gut epithelium (endoderm); cartilage, bone, smooth muscle, and striated muscle (mesoderm); and neural epithelium, embryonic ganglia, and stratified squamous epithelium (ectoderm).

These cell lines should be useful in human developmental biology, drug discovery, and transplantation medicine.

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Rodolfa03  

Inducing pluripotency3

Four techniques for restoring developmental potential to a somatic nucleus have been described in the literature. In nuclear transfer, the genetic material of an oocyte or zygote is replaced with that of a differentiated cell such as a fibroblast. Following development to the blastocyst stage, Pluripotent ntES cells can be derived as from fertilized embryos. In cellular fusion, hybridization between ES cells and somatic cells yields Tetraploid ES cell lines. In direct reprogramming, the retroviral-mediated introduction of a small number of transcription factors is sufficient to confer a pluripotent phenotype. Finally, explantation of testes tissue from neonatal and adult mice into appropriate culture conditions has been shown to result in the production of Multipotent adult spermatagonialMAScells.

 

2. Nuclear transfer

Building on the early work of developmental biology pioneers such as SpemannGurdon and Byrne, 2003; Spemann, 1938, Nuclear transferNTalso commonly called Somatic cell nuclear transferSCNTexperiments were first devised in the 1950s as a means to investigate the constancy of the genome: that is, whether cells maintained the full complement of genomic information as they became more differentiated. At the time, many believed that each cell fate decision during development involved the progressive loss of genes that would not be used by the more differentiated progeny. For instance, ectoderm precursors eliminating all endoderm- and mesoderm-specific genes, then eliminating skin-specific genes as the decision to become a neural precursor is made, eventually yielding a specific type of neuron with a minimal genome containing only the genes which would actually be transcribed. NT experiments in the frogs Rana pipiens by Briggs and KingBriggs and King, 1952and Xenopus laevis by GurdonGurdon et al., 1958Gurdon et al., 1975indicated that, although the generation of clones became less and less efficient as the developmental age of the donor nucleus increased, it was possible to obtain heartbeat-stage tadpoles from terminally differentiated adult cells. It was not until the more recent cloning of Dolly the sheepWilmut et al., 1997, however, that researchers succeeded in using a cell from an adult animal to generate another healthy, fertile adult, thereby demonstrating that the nuclei of at least some cells in the adult maintained a full developmental capacity. While an important finding, many speculated that the rare cloned adult animals could have arisen from the nucleus of an equally rare somatic stem cell. Definitive demonstration that terminally differentiated adult nuclei maintain full developmental capacity was later achieved in mouse studies using Mature lymphocytesHochedlinger and Jaenisch, 2002Inoue et al., 2005and Olfactory neuronsEggan et al., 2004as NT donors.

Dolly's birth and an initial report of the derivation of human ES cells from discarded in vitro fertilizationIVFembryos shortly thereafterThomson et al., 1998led to wide speculation in both the media and scientific community about the possibility of therapeutic cloning. That is, performing Nuclear transfer with a patient's Somatic cells to generate a Preimplantation embryo from which patient-specific ES cells might be derived for use in personalized regenerative medicine. With this motivation, several studies in mouse have sought to compare the properties of SCNT-derived ESntEScells with those derived from naturally fertilized embryosBrambrink et al., 2006; Wakayama et al., 2006, as well as show proof-of-principle demonstrations of these cells’ utility in regenerative medicineBarberi et al., 2003; Rideout et al., 2002; Tabar et al., 2008. The equivalence of ntES cells to ES cells from fertilized embryos was of particular concern because of the low efficiencies and common health defects associated with animals brought to term after reproductive cloningEggan et al., 2001; Gurdon and Byrne, 2003; Humpherys et al., 2001. Despite these defects, however, two studies evaluating the transcriptional profiles, DNA methylation patterns, and in vitro differentiation capacity found that mouse ntES cell lines were identical in all regards to genetically-matched control ES cell lines derived after fertilizationBrambrink et al., 2006; Wakayama et al., 2006. These reassuring results, paired with reports using ntES cells to treat mouse models of both severe compromised immunodeficiencyRideout et al., 2002and Parkinson's diseasesBarberi et al., 2003Tabar et al., 2008after in vitro genetic manipulations and differentiation into the required cell types, generated immense hope that applications to human diseases were immediately on the horizon.

While ntES cells hold great promise for the field of regenerative medicine, the technique has several significant drawbacks that hinder its potential for widespread application to medicine or even to the study of the process of nuclear reprogramming. Obstacles associated with the requirement for a scarce and politically charged cell type, human oocytes, as a recipient cytoplasm are only amplified by the extreme technical challenge of a method plagued with inherent inefficiencies. Moreover, the experimental requirements for successful nuclear transfer in primates appear to be considerably different than other species, with attempts to apply the methods and techniques from mouse directly to human thus far yielding nothing more than false startsKennedy, 2006and the rare report of NT-derived blastocysts but with no ES cell lines derived from themFrench et al., 2008; Stojkovic et al., 2005. Likewise, only very recently has successful nuclear transfer in monkeys been reportedByrne et al., 2007, but the technical refinements developed here have failed to immediately translate into advances with human cells.

A particularly severe limitation of human therapeutic cloning which has significantly hindered researchers’ capacity to develop the technique is the difficulty in obtaining donated oocytes. A 2007 study in mouse suggests that there may be alternative sources for the recipient cytoplastEgli et al., 2007. While early mouse NT studies in which the enucleated interphase zygote was used as a recipient lead to the conclusion that reprogramming capacity was lost following fertilizationMcGrath and Solter, 1984Wakayama et al., 2000, Egli and coworkers demonstrated that by removing the chromatin from a zygote arrested in metaphase just prior to the first cell division and introducing the chromatin from a metaphase-arrested somatic cell into this cytoplast, reprogramming could occur with success rates comparable to NT into the mature oocytewhich is naturally arrested in metaphasesee Figure 3. The authors reasoned, therefore, that nuclear factors, trapped in the interphase nucleus but present in the cytoplasm during metaphase due to nuclear envelope breakdown, were necessary for reprogramming to occur. Not only might the Metaphase zygote therefore serve as an appropriate recipient for NT, but this result suggests that other Cleavage-stage blastomeres, arrested in mitosis, may be as well. These findings both shed some mechanistic light on the process of reprogramming and open the door to using a wider range of materials for human NT experiments. Although on the surface this study holds great promise for human NT experiments, it is unfortunately not common IVF practice to freeze or discard zygotes or early cleavage-stage embryos, as embryo quality can be difficult to assess so soon following fertilizationSalumets et al., 2001. Of particular interest, however, Egli et al. further demonstrated that Polyspermic zygotesthat is, embryos fertilized with multiple spermcould be used for successful nuclear transfer. Multiple fertilization is relatively common in IVFroughly 3–5% of zygotesand these embryos, which have no clinical use, are routinely discardedAnon, 2004van der Ven et al., 1985. As such, discarded polyspermic IVF embryos may present a valuable new avenue towards success in human nuclear transfer.

 

Figure 3. Reprogramming capacity in NT depends on cell-cycle status, as demonstrated by Egli et al.Egli et al., 2007.

 

Development fails after replacing the interphase nucleus of either a germinal-vesicle stage oocyte or pronuclear zygote with somatic chromatin. However, Transfer of somatic chromatin into either the MII-arrested oocyte or a Zygote arrested with a drug in the first mitosis allows for the generation of cloned mice and ntES cells.

Despite the challenges and limited achievements in human, NT remains the “Gold standard” in Nuclear reprogramming with clear demonstrations of the production of both Healthy clones and Pluripotent stem cells identical to those derived from fertilized embryos. Nevertheless, the development of more robust and technically simple reprogramming methodsdiscussed belowappears to be at hand, leading some authors to write obituaries for SCNTCibelli, 2007Highfield, 2007. Whether these eulogies are premature or whether the quality of pluripotent cells generated by newer techniques will prove to be as high as ntES is presently an area of intense investigation.

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Rodolfa02  

Inducing pluripotency2

The second advantage of autologous ES cells over existing lines concerns the ability to create effective disease models. While some success has been reported recently in the in vitro Modeling of degenerative diseases by introducing known Disease-causing alleles into ES cellsDi Giorgio et al., 2007; Nagai et al., 2007; Yamashita et al., 2006, or by using ES cell lines established from embryos following Preimplantation genetic diagnosisEiges et al., 2007, such models are severely limited in their scope as they can only investigate the mechanisms of diseases for which causal genetic liaisons have been identified. Unfortunately, however, this is not the case for many conditions. For instance, fewer than 10% of patients with Amyotrophic Lateral SclerosisALS, also know as Lou Gehrig's Diseasesuffer from a familial form of the disease with a known genetic correlateDunckley et al., 2007. It therefore remains unclear whether recent progress with models studying a handful of known disease-causing alleles is applicable to the vast majority of patients with sporadic forms of this degenerative condition. Disease models using pluripotent cells generated directly from patients with these sporadic conditions could directly address such questions, as well as provide new insights into the mechanisms and progression of such syndromes.

This chapter focuses on the methods and techniques available for the production of Patient-specific pluripotent cells, the promises and limitations of each technology, and a discussion of the current progress towards this goal. Several techniques have been described for restoring developmental potential to a terminally differentiated nucleussee Figure 2. These includeNuclear transfer, wherein the chromatin of an oocyte or zygote is replaced with that of a somatic donor cell;

Fusion of somatic cells to ES cells;

Cell-culture-induced reprogramming after explantation of tissue from neonatal or adult testes;

and the Retroviral-mediated introduction of a small number of genes known to play a role in pluripotency. The advances, breakthroughs, and challenges surrounding each of these methods are discussed in detail below.

 

Figure 2. Methods of nuclear reprogramming, their advantages and limitations.

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Rodolfa01  

Inducing pluripotency1

Kit T Rodolfa,

Harvard Stem Cell Institute, Stowers Medical Institute, Department of Stem Cell and Regenerative Biology, Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA 02138, USA

http://www.stembook.org/node/514

 

The prospect of personalized regenerative medicine promises to provide treatments for a wide range of degenerative diseases and medical conditions. An important first step in attaining this goal is the production of Pluripotent stem cells directly from individual patients, thereby providing autologous material which, after correcting intrinsic genetic defects and differentiation into required cell types or tissues, could be transplanted into the patient. This chapter reviews the current progress towards this first step, focusing on the techniques used to generate pluripotent cells, the advantages that each offers and the challenges that must be overcome.

 

1. Introduction

Much of the hope invested in embryonic stemEScell research surrounds its promise to provide a broad spectrum of medical applications. The development of such treatments relies on the production of pluripotent stem cells genetically identical to patients. Such stem cells, following differentiation into the disease-relevant cell types, would serve as the key substrate for disease models to study the patient's condition, drug discovery to slow or stop cellular degeneration, and cell replacement therapies after any intrinsic disease-causing genetic defects were repairedsee Figure 1. Beyond providing a renewable source of material that might be transplanted into a patient without suppressing their immune system, the generation of Autologous pluripotent stem cells provides two key advantages over the large number of existing stem cell lines. First, evidence exists that off-target effects of immunosuppressant drugs commonly used in tissue and organ transplants may directly interfere with the function of transplanted tissues, such as the inhibition of β-cell replication that has been observed with drugs used in the treatment of Type I DiabetesNir et al., 2007.

 

Figure 1. The steps of regenerative medicine.

 

The production of cellular therapies requires the optimization of four steps

First, Isolating and Culturing cells that can be readily obtained from a patient in a non-invasive fashion.

Second, the Reprogramming of these cells into a Pluripotent state.

Third, the Directed differentiation of those patient-specific pluripotent cells into the Cell type relevant to their disease.

And, fourth, Techniques for Repairing any intrinsic disease-causing genetic defects and Transplantation of the repaired, differentiated cells into the patient.

Notably, these disease-relevant patient cells can also be used for in vitro disease modeling which may yield new insights into disease mechanisms and drug discovery.

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注射肉毒桿菌除皺變全身癱瘓小心除皺聖品肉毒桿菌、玻尿酸遇「假貨」!

作者:林宜慧台北報導 | 中時電子報 – 2014227

中國時報【林宜慧台北報導】

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醫學美容當道,坊間削價競爭下,愛美人士施打除皺聖品肉毒桿菌、玻尿酸,小心遇「假貨」!

台灣皮膚科醫學會發現,近來愈來愈多未經衛福部檢驗、不合格的肉毒桿菌,從大陸、韓國等國流入。在國外,甚至有患者注射過量肉毒桿菌,造成中毒全身癱瘓。

台灣皮膚科醫學會理事長楊志勛表示,目前台灣經衛生福利部核准的肉毒桿菌素僅有兩個品牌,但醫學會發現,最近從大陸、韓國等國流入多款偽禁藥,一些瓶身甚至直接以黑白列印的標籤貼上,民眾卻無從得知。

業者若擅自製造或輸入未經核准的肉毒桿菌素,可依《藥事法》處10年以下有期徒刑,另可罰1000萬元以下罰金。

楊志勛說,肉毒桿菌素屬於一種毒素,少量可幫助鬆弛肌肉,但如果注射過多或濃度不對,嚴重會全身鬆弛、癱瘓,甚至呼吸困難;如果內含雜質,注射部位也可能引起紅腫過敏反應。

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美國從2004年起,就陸續出現注射未經FDA核准肉毒桿菌的個案,甚至有醫師為了去除皺眉紋,幫自己和3名患者施打過量的非法藥劑,結果4人都肉毒桿菌中毒並癱瘓,賠償金額動輒千萬台幣起跳;在台灣,雖然沒有出現嚴重反應個案,但小問題也不少。

 

美妝部落客Momo指出,日前陪朋友去一家具規模的醫美中心打肉毒桿菌,醫師針對咀嚼肌部位施打後,朋友下巴連續一兩個星期紅、腫、熱、痛,連吃飯都困難,之後其他朋友赴同一家中心注射肉毒,也出現相同問題,讓她們大呼應該在施打前驗明藥品「正身」。

 

楊志勛強調,施打肉毒桿菌通常一個部位(如兩側魚尾紋、額頭)約34000元,若價格低,內容物一定有問題!但價高也不代表沒事,消費者在注射針劑前,應請醫師出示整瓶藥品完整包裝,檢查品牌、封條是否拆封、是否印有清晰的彩色專屬字號,以及衛福部核准的衛署菌疫輸字號等標示。

 

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51489  

肉毒桿菌除皺 辨識真假3「藥」訣

作者:華人健康網記者駱慧雯/台北報導 | 華人健康網 – 2014226

近年來民眾對微整形的接受度越來越高,導致許多不合格的、灌水分裝的產品流入市場美容醫學。

 

美容醫學風氣盛行,越來越多追求青春不老的民眾接受微整形,其中又以肉毒桿菌素注射較受青睞,龐大的醫美商機,導致許多不合格、灌水分裝的產品流入市場,嚴重影響使用者的消費和健康權益。對此,台灣皮膚科醫學會提醒,民眾接受肉毒桿菌注射前,應把握「用藥安全3藥訣」,睜大眼睛辨真偽。

 

肉毒桿菌注射夯 假貨趁機搶市

目前經衛福部核准使用的肉毒桿菌素注射劑,僅有「保妥適乾粉注射劑」和「儷緻注射劑」兩款,但台灣皮膚科醫學會理事長楊志勛醫師表示,近日醫學會發現,越來越多未經衛福部檢驗、不合格的肉毒桿菌素從海外如大陸、韓國流入國內,消費者被注射了偽禁藥,輕則沒有達到效果、浪費金錢,重則危害健康

理律法律事務所分析國內外法令與案例發現,雖然國內外皆有法律規範非法藥品的輸入、製造、販賣以及施打,但相較於國外的案例,台灣法令對於此類型案件的罰責較重,但最終判決的刑度整體而言似較國外輕,

此外,受到文化或風氣影響,亞洲人比起歐美人可能更不願意出面主張權利,加上肉毒桿菌素此類藥劑使用前經過稀釋處理,注射前一刻消費者已無法辦別注射筒裡的藥物來源,讓不肖業者有了鑽法律漏洞的機會。

 

醫美用藥價差大 睜大眼睛辨真偽

台灣醫美療程價格差異甚鉅,但以肉毒桿菌除皺來說,若每1 c.c.的價格低於4000元,就要小心可能是山寨版或灌水貨。台灣皮膚科醫學會表示,若不想成為非法偽禁藥的受害者,除了靠醫師嚴格把關之外,消費者也應衡量品質及價值,睜大眼睛辨別真偽。

 

【美容醫學用藥安全3「藥」訣】

1.「藥」衛福部核准字號:每瓶原廠進口肉毒桿菌素都具有衛福部的核准字號,會有中文標示及「衛署菌疫輸字第XXXXXX」字樣。

2.「藥」封籤完整:每瓶原廠進口肉毒桿菌素都具有衛福部的檢驗封籤,其上皆有清晰的彩色專屬字號。

3.「藥」出示產品包裝:消費者可以請求醫師確認產品包裝是否封籤完整,以及使用藥品是否有經台灣衛福部核准。

 

【小辭典/肉毒桿菌素】

肉毒桿菌素(Botulinum Toxin,簡稱BTX)是一種毒素,可阻斷神經和肌肉間的神經衝動,藉由其神經麻醉劑的特性,放鬆過度收縮的小肌肉,進而達到除皺、抗老的效果。除此之外,臨床也將肉毒桿菌素廣泛運用於治療面部痙攣、眼瞼痙攣、尿失禁等症狀。肉毒桿菌素的毒性強,不當使用恐有過敏、中毒甚至癱瘓的風險,美國就曾有施打未經核准、過高劑量肉毒桿菌素且中毒的案例傳出。

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598(17)

醫美除皺當心肉毒桿菌素有假

中央社 – 2014226

(中央社記者陳清芳台北26日電)

衛生福利部僅核准兩款肉毒桿菌素上市,每c.c市價行情約新台幣8000。但近年非法產品、灌水分裝產品流入醫美市場,令消費者受害或上當。

衛福部食品藥物管理署指出,「西藥、醫療器材、含藥化粧品許可證查詢」系統顯示,僅有台灣愛力根「保妥適乾粉注射劑」、法商益普生台灣分公司「儷緻注射劑」這兩款肉毒桿菌素注射劑,核准用於治療臉部皺紋、眼瞼痙攣、半面痙攣、痙攣性斜頸、小兒腦性痲痹引起肌肉痙攣等症狀。

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不過,台北市衛生局接獲民眾檢舉醫師使用非法肉毒桿菌素產品,台灣皮膚科醫學會也發現,未經衛福部許可的中國大陸、南韓相關產品流入,以至醫美市場不僅價格亂,而且水貨、偽禁藥充斥,消費者使用後,輕則浪費錢,重則危害健康。

「民眾有權先驗貨再醫美治療」,皮膚科醫學會副秘書長黃毓惠表示,在接受醫美療程前,民眾可以要求先看產品是否具有衛福部核准字號、中文名稱,還要看檢驗封籤,避免用到掛羊頭賣狗肉的假貨

以肉毒桿菌素為例,應該要完整中文標示及「衛署菌疫輸字第XXXXXX號」字樣,每個產品的檢驗封籤都該有彩色清晰的衛福部專屬字號,原廠原瓶包裝應該封籤完整。

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坊間出現肉毒桿菌素1c.c大約2000元到4000元的價位,台灣皮膚科醫學會副秘書長黃毓惠說,合法產品標準濃度1 c.c大約8000部分醫美業者賤價俗賣的產品可能是假貨、灌水貨,民眾注射後除皺效果不佳,倒也罷了,萬一被注射到雜質,眼歪嘴斜、麻痺癱瘓、中毒等後果不堪設想

近年美國不時傳出醫師使用傳出非法肉毒桿菌素遭到重罰的事件,例如2008年時,休士頓一名醫師為超過170名病患施打保妥適冒牌貨,被處27個月有期徒刑,並處以1000美元罰鍰,且判賠98426美元。

皮膚科醫學會諮詢理律法律事務所分析,國內對於此類型案件的罰責雖重,但最終判決的刑度整體而言似較國外輕,醫美療程價格差異懸殊,除了靠醫師嚴格把關之外,消費者也得睜大眼睛辨認真偽。

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