Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The proteinase-proteinase inhibitor balance plays an important role in mediating inflammation-associated tissue destruction. alpha 2-Macroglobulin (alpha 2M) is a high-affinity, broad-spectrum proteinase inhibitor found abundantly in plasma and interstitial fluids. Increased levels of alpha 2M and proteinase-alpha 2M complexes can be demonstrated in patients with sepsis, emphysema, peridontitis, rheumatoid arthritis, and other inflammatory diseases. Despite these increased levels, proteolysis remains a significant problem. We hypothesized that a mechanism for inactivating alpha 2M-mediated proteinase inhibition must exist and recently demonstrated that alpha 2M isolated from human rheumatoid arthritis synovial fluid is oxidized and has decreased functional activity. The oxidant responsible for alpha 2M inactivation and the mechanism of such destruction were not studied. We now report that while hypochlorite and hydroxyl radical both modify amino acid residues on alpha 2M, only hypochlorite can abolish the ability of alpha 2M to inhibit proteinases. Hydrogen peroxide, on the other hand, has no effect on alpha 2M structure or function. Protein unfolding with increased susceptibility to proteolytic cleavage appears to be involved in alpha 2M inactivation by oxidation. The in vivo relevance of this mechanism is supported by the presence of multiple cleavage fragments of alpha 2M in synovial fluid from patients with rheumatoid arthritis, where significant tissue destruction occurs, but not in patients with osteoarthritis. These results provide strong evidence that hypochlorite oxidation contributes to enhanced tissue destruction during inflammation by inactivating alpha 2M.
 ...
PMID:Mechanism of hypochlorite-mediated inactivation of proteinase inhibition by alpha 2-macroglobulin. 1052 45

Sodium hypochlorite (NaOCl) is currently used in the debridement and disinfection of the root canal system, supporting the mechanical procedures. Although it is considered a safe irrigant, the literature reports a few cases of adverse reaction caused by NaOCl: They range from injection through the apical foramen to air emphysema and allergic reactions as complications during endodontic treatment. The present report shows the possible severe clinical consequences of concentrated NaOCl extruding through the periapical tissues during root canal irrigation in a patient not allergic to NaOCl.
 ...
PMID:Unusual case of adverse reaction in the use of sodium hypochlorite during endodontic treatment: a case report. 1856 Jun 44

Sodium hypochlorite solution is toxic to vital tissues, causing severe effects if extruded during endodontic treatment. This paper presents a report on the tissue damage related to inadvertent extrusion of concentrated sodium hypochlorite solution during root canal treatment. A 65-year-old woman was referred with moderate pain, ecchymosis, and severe swelling of the right side of the face. These symptoms appeared immediately after a root canal treatment of the maxillary right canine, which had been started 21 hours earlier. It was diagnosed as air emphysema related to sodium hypochlorite solution extravasation during the endodontic treatment. To avoid this, an initial radiograph should be taken to determine the correct canal working length and confirm root canal integrity.
 ...
PMID:Tissue damage after sodium hypochlorite extrusion during root canal treatment. 1944 41

Root canal treatment is performed routinely in dental practice, using sodium hypochlorite which serves as an effective irrigant. The literature reviewed shows that several complications following irrigation with sodium hypochlorite may occur, but few practitioners are aware of it and its management. Such complications include injury to skin, oral mucosa and eyes, damage to clothing, air emphysema, allergic reactions, and injection beyond the foramen. In this article, a case report of injection with sodium hypochlorite beyond the foramen is presented, together with a review of the recent literature regarding common manifestations and case histories. The literature shows no standard management of this condition, but symptomatic therapies are discussed. It is important to minimize the risk of sodium-hypochlorite-induced damage during root canal therapy by use of protective measures, appropriate instrumentation and techniques, and consider alternate irrigation solutions.
 ...
PMID:Root canal complications: 'the hypochlorite accident'. 2118 Feb 88

The high frequency of iatrogenic incidents during endodontic treatment is a source of stress for the practitioner. These incidents may occur during the different steps of a root canal treatment. During irrigation, extrusion of sodium hypochlorite beyond the apex is a rare but impressive accident. Sodium hypochlorite, is the most common irrigant used in modern endodontics, but when it comes in contact with the periapical tissue, it can cause complications ranging from mild discomfort to serious tissue damage such as the hematoma and hemato-emphysema. The aims of this article are to discuss through the presentation of two clinical cases: Etiological and predisposing factors; Signs guiding to suspicion of accidental injection of sodium hypochlorite. In this work, we focused on clinical keys that help the practitioner in better understanding this accident in order to prevent it or to manage it well when it occurs.
 ...
PMID:[Accidental injection sodium hypochlorite during endodontic therapy. Better understand to better manage]. 2693 Jul 73