PURPOSE: Many articles have proposed that osteonecrosis of the femoral head (ONFH) is caused by fat embolism or intravascular coagulation linked to hyperlipidemia. To determine whether hyperlipidemia is an associated factor for ONFH, serum lipid levels were measured. MATERIALS AND METHODS: Nighty-eight patients presenting with ONFH and 110 controls were investigated. We compared the average value of serum lipid levels and the incidence of hyperlipidemia of the two groups. RESULTS: ONFH group showed generalized increase in lipid level and statistically significant difference in the average value of total cholesterol (P=0.0001), HDL-cholesterol (P=0.0261) and phospholipid (P=0.0465) compared with the control. The incidence of hyperlipidemia of the two groups showed statistically significant difference in HDL-cholesterol (P=0.019) and triglyceride (P=0.024). CONCLUSION: Hyperlipidemia seems to be associated with pathogenesis of ONFH. We speculated that hyperlipidemia might be a contributing factor of ONFH. Hyperlipidemia may play a role as a triggering factor in the pathogenetic process that results in osteonecrosis. However, it can not be ruled out that secondary hyperlipidemia might be a finding following ONFH.
Cholesterol ; Embolism, Fat ; Head* ; Humans ; Hyperlipidemias ; Incidence ; Osteonecrosis* ; Triglycerides

BACKGROUND: Liposuction is a procedure to reduce the volume of subcutaneous fat by physical force. Intracellular storage fat is composed of triglyceride, whereas circulating fat particles exist as cholesterol or triglycerol bound to carrier proteins. It is unavoidable that the storage form of fat particles enters the circulation system after these particles are physiologically destroyed. To date, however, no studies have clarified the fatal characteristics of fat embolism that occurs after the subclinical phase of free fat particles. METHODS: A mixture of human lipoaspirate and normal saline (1:100, 0.2 mL) was injected into the external jugular vein of rats, weighing 200 g on average. Biopsy specimens of the lung and kidney were examined at 12-hour intervals until postoperative 72 hours. The deposit location and transport of the injected free fat particles were confirmed histologically by an Oil Red O stain. RESULTS: Inconsistent with previous reports, free fat particles were transported from the intravascular space to the parenchyma. At 24 hours after infusion, free fat particles deposited in the vascular lumen were confirmed on the Oil Red O stain. At 72 hours after infusion, free fat particles were accumulated compactly within the parenchymal space near the perivascular area. CONCLUSIONS: Many surgeons are aware of the fatal results and undiscovered pathophysiologic mechanisms of free fat particles. Our results indicate that free fat particles, the storage form of fat that has been degraded through a physiological process, might be removed through a direct transport mechanism and phagocytotic uptake.
Animals ; Biopsy ; Carrier Proteins ; Cholesterol ; Embolism, Fat* ; Fats ; Humans ; Jugular Veins ; Kidney ; Lipectomy ; Lung ; Physiological Processes ; Rats ; Subcutaneous Fat ; Triglycerides

Pulmonary embolism is the obstruction of the pulmonary artery or its branches, commonly by thrombus or fat. We report an unusual case of double pathology - both pulmonary thromboembolism and fat embolism syndrome in a patient with bilateral femur and bilateral tibia fractures. This highlights the importance of a high index of suspicion of these conditions while managing patients with multiple long bone fractures. Morbidity and mortality can be significantly reduced with prompt and appropriate prevention strategies.
Thromboembolism ; Pulmonary Embolism ; Embolism, Fat

No abstract available.
Diagnosis* ; Embolism, Fat* ; Humans

The fat embolism is often major camplication of major trauma and demands the attention of physicians treating patients with bony injury. We have experienced 5 cases of fat embolism. In all cases there was a latent period between injury and onset of symptoms. This varied from 16 hours to 48 hours. There was marked variation in clinical presentation and laboratory finidngs. One case was died of complication of fat embolism.
Embolism, Fat ; Humans

No abstract available.
Embolism, Fat* ; Magnetic Resonance Spectroscopy*

BACKGROUND: A few studies have found that abnormal findings on diffusion-weighted magnetic resonance imaging (MRI) are useful for diagnosing cerebral fat embolism in the acute stage. CASE REPORT: We applied serial MRI to a case of cerebral fat embolism with cognitive impairment lasting for 2 months. Although marked resolution of the previous abnormal findings was demonstrated, T2*-weighted gradient-echo MRI revealed multiple tiny lesions. CONCLUSIONS:We suggest that T2*-weighted gradient-echo MRI is useful in defining the clinical severity of patients with cerebral fat embolism.
Embolism ; Embolism, Fat ; Humans ; Intracranial Embolism ; Magnetic Resonance Imaging

No abstract available.
Embolism, Fat* ; Humans ; Magnetic Resonance Spectroscopy*

Fat embolism is a condition in which fat appears in the circulating blood, not in the fine emulsion of a metabolic lipemia, but in droplets large enough to occlude arterioles and capillaries. It may occur as a complication of fracture, particularly multiple fractures of the long bones, pelvis, and ribs.. Since Zenker described the first case of fat embolism in 1862 there has never been a reliable diagnostic test for this condition. Lipid changes in the blood and demonstration of macroglobules could be used as aids for early post- traumatic fat embolism syndrome. The purpose of the present,study was to analyze the blood lipid changes in the fracture and to determine their value in the early detection of fat embolism syndrome. Twenty-three patients with at least one diaphyseal fracture of the lower extremity or a pelvic and spine fracture were included in the study. The mean age of the patients was 30.3 years. Men outnumbered women by a ratio of 2.9:1. Nineteen of the patients were injured in traffic accidents, two patients in fall, and one in the industrial accident. Ten volunteers were used for the control studies, nine men and one woman. Their mean age was 22.8 years. For determination of blood lipids blood sample was taken from cubital vein. The flrst blood sample was taken from tbe patients less than 2 hours after the iniury, and the later samples were obtained respectively in 12, 24, 48 and 72 hours, and 7 days after injury. The samples were centrifuged immediately (2,500 rpm, 4 min.). After centrifugation, each sample of plasma or serum was divided into two aliquots. The one aliquot was studied without flltering and the other was filtered through 8 microns millipore filter (Watmann No. 40. filter paper). Determination of triglyceride, cholesterol, and phospsolipids in blood was made from the unfiltered aliquot and from the other filtrate. Two groups were formed for comparission of the results; 1) Fracture Group; 2) Non-fracture Group as control. The triglycerides was determined using the technic of the micromethod of Van Handel and Elversmith, and the cholesterol was determined by the technic of Rosenthals color reagent method. For the determination of phospholipids Youngburg, modified method was used of The results of the study lead us to conclude that: 1. The triglycerides, cholesterol, phosphollpids fractions in the unflltered allquot was slightly higher than those of the filtrate. 2. Less than two hours after injury the triglycerides concentration in blood of fracture group was similar to the concentrations of the controls. But the triglycerides and macroglobule concentration in 12 and 24 hours after fracture were higher than those of the control group. 3. The average concentration of blood cholesterol level in fracture group was slightly higher than the control. Especially the serum concentrations of cholesterol in 12, and 24 hours after fracture were much higher than those of the controls. Statistically significant differences between the groups were observed. 4. The average phospholipids concentration in fracture patients was slightly higher than the average phospholipids concentration of the control but no significant differences between the groups were observed. 5. As to the total lipids, the average concentration of fracture group was little bit higher than the concentration of the control. There was no statistical differences between the fracture and the control group. 6. The concentrations of the total lipids gradually increased after 40 years of age. 7. The concentration of total serum lipids was increased in femoral fracture in site, and in multiple fractures than single fracture.
Accidents, Occupational ; Accidents, Traffic ; Arterioles ; Capillaries ; Centrifugation ; Cholesterol ; Diagnostic Tests, Routine ; Embolism, Fat ; Female ; Femoral Fractures ; Fractures, Multiple ; Humans ; Hyperlipidemias ; Lower Extremity ; Male ; Methods ; Micropore Filters ; Pelvis ; Phospholipids ; Plasma ; Ribs ; Spine ; Triglycerides ; Veins ; Volunteers

We report thin-section CT findings of pulmonary fat embolism which was confirmed by clinical features and microscopic examination of cells obtained by bronchoalveolar lavage. Initial thin-section CT showed extensive air space consolidation and multiple ill-defined nodular densities in both lungs. Follow-up CT revealed ground-glass appearance and faint nodules in both lungs. Perfusion scan showed multiple small perfusion defects in the peripheral portion of both lungs.
Bronchoalveolar Lavage ; Embolism, Fat* ; Follow-Up Studies ; Lung ; Perfusion