• Archives of Plastic Surgery
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• 제41권4호
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• pp.325-329
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• 2014

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.

• Tuberculosis and Respiratory Diseases
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• 제68권2호
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• pp.55-61
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• 2010

Background: The underlying pathogenesis of fat embolism-induced acute lung injury (ALI) has not been elucidated. In the present study, the pathogenesis of fat embolism-induced ALI was probed in association with neutrophilic oxidative stress in oleic acid (OA)-induced ALI of S-D rats. Methods: OA was injected intravenously to provoke ALI in experimental rats. Five hours later, indices of ALI were measured to confirm the role of the neutrophilic respiratory burst. The effect of an inhibition of phospholipase A2 (PLA2) was also evaluated. Results: The accumulation of neutrophils in the lung due to OA caused increased neutrophilic oxidative stress in lung, which was ameliorated by mepacrine. What were the results from inhibition of PLA2. Conclusion: Excess neutrophilic oxidative stress contributes to OA-induced ALI, which is lessened by the inhibition of PLA2.

• 대한의생명과학회지
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• 제10권3호
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• pp.285-291
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• 2004

To determine the magnetic resonance (MR) imaging findings and natural history of cerebral fat embolism in a cat model, and to correlate the MR imaging and histologic fmdings. Intemel carotid artery of 11 cats was injected with 0.1 ml of triolein. T2-weighted, T1-weighted and Gd-enhanced T1-weighted images were obtained serially for 2 hours, 1 days, 4 days, 1 week, 2 weeks and 3 weeks after embolization. Any abnormal signal intensity was evaluated. After MR imaging at 3 weeks, brain tissue was obtained for light microscopic (LM) examination using hematoxylin-eosin (HE) and Luxol fast blue staining, and for electron microscopic examination. The LM examination with HE staining revealed normal histological findings in the greater part of an embolized lesion. Cystic change was observed in the gray matter of 8 cats, while in the gray and white matter of 3 cats. At LM examination, Luxol fast blue, staining demonstrated demyelination around the cystic change occurring in the white matter, and EM examination of the embolized cortex revealed sporadic intracapillary fat vacuoles (n=11) and disruption of the blood-brain barrier (n=4). Most lesions were normal, however, and perivascular interstitial edema and cellular swelling were mild compared with the control side. The greater part of an embolized lesion showed reversible findings at MR and histological examination. Irreversible focal necrosis was, however, observed in gray and white matter at weeks 3.

• Investigative Magnetic Resonance Imaging
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• 제14권1호
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• pp.69-73
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• 2010

뇌 지방 색전증은 비록 드물지만, 장골 골절의 잠재적, 치명적 합병증이다. 두부외상이 없이, 초기에는 명료한 의식을 보였으나, 추후 의식저하를 보이는 모든 환자는 뇌 지방 색전증을 염두에 둔 진단적 검사를 받아야한다. 본 증례에서, 자기공명영상 특히 확산-강조 영상이 뇌 지방 색전증의 진단에있어서 최고의 민감도를 보였다. 저자는 이 증례를 통해, 병리생리학적 근거를 바탕으로 한 뇌 지방 색전증의 자기공명영상의 특이점 해석과 치료를 보고하고자 한다.

• Journal of Korean Neurosurgical Society
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• 제51권5호
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• pp.312-315
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• 2012

We report magnetic resonance image (MRI) and magnetic resonance spectroscopy (MRS) findings in a patient of cerebral fat embolism (CFE) occurred in a 26-year-old woman after an autologous fat injection into the face. After initial neurologic symptom onset, MRI and MRS data were obtained two times to investigate repeated CFE. We obtained the MRS data in the two different time intervals and two different echo times to compare the lesions with normal brain parenchyma. The results of MRS data showed that a decrease in N-acetyl-aspartate, an increase in lactate and a very high early peak of free lipids between 0.9 and 1.4 ppm were obtained at the acute infarcted lesion as compared with normal brain parenchyma. In addition, these findings were more clearly detected on short echo time spectrum rather than long spectrum. A close relationship between the clinical manifestations and MRI and MRS findings of the brain can helpful to distinguish CFE with other conditions and to evaluate the cause materials of infarctions rather than conventional MRI or diffusion-weighted imaging.

• Tuberculosis and Respiratory Diseases
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• 제48권3호
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• pp.383-387
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• 2000

지방색전증은 주로 근 골격계 외상 후 발생하는 호흡기계, 신경계 및 피부 출혈성 반점을 특징으로 하는 질환으로 정확한 병인기전은 잘 모르는 상태이나 대개는 위험요소를 가지고 있는 경우에 발생하며 진단방법으로 조직 검사 외에 폐포세척술이나 폐동맥카테터를 이용한 지방체의 존재 증명법 등이 연구되고 있다. 치료는 대부분 보존적 치료가 행해지고 있다. 연자들은 특별한 위험요소 없이 건강하게 지내던 중년의 성인여성에서 발생한 폐출혈을 동반한 지방색전증 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한의생명과학회지
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• 제10권4호
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• pp.515-521
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• 2004

To measure regional cerebral blood volume (rCBV) with perfusion MR imaging of cerebral fat embolism by neutral fat and free fatty acids in cats. Triolein (group 1, n=15), oleic acid (group 2, n=9) and linoleic acid (group 3, n=11) were infused into unilateral internal carotid artery using microcatheter through the transfemoral approach. PVA particle was used as a non-fat embolic material in a control group (group 4, n=9). Perfusion-weighted MR image was obtained at 30 minutes and 2 hours postembolization, based on T2-and diffusion-weighted images. The data of lesion and contralateral normal area were transferred to personal computer, time-to-signal intensity curve was drawn and trans for used to △R2/sup */ curve in regular order. The process in the personal computer was done by using the author's developmental image processing program and interactive data language (IDL) softwares. Statistical significance was approved by paired t-test and ANOVA. rCBV of the lesion was decreased comparing to the normal area in all groups. The ratios of rCBV were as follows (group No, at 30 minutes, at 2 hours); group 1,32％, 51％; group 2, 30％, 44％; group 3, 39％, 61％; group 4, 21％, 36％. rCBVs of 2 hours was significantly increased compared to those of 30 minutes in all groups (P<0.005). rCBV was decreased at 30 minutes in cerebral fat embolism and recovered a little, but significantly at 2 hours. Perfusion-weighted images was useful method in offering hemodynamic information in cerebral fat embolism.

• 대한의생명과학회지
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• 제11권2호
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• pp.221-225
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• 2005

To investigate the spectroscopic findings of embolized lesions induced with a fat-emulsion technique with magnetic resonance images (MRI). A fat emulsion was made with 0.1 ml of triolein and 20 ml of normal saline. In 12 cats, the internal carotid artery was infused with the fat emulsion. Contrast-enhanced T1-weighted MRI and multivoxel spectroscopy were obtained at 1 hour, 1 and 4 days, and 1 week after embolization. NAA (N-acetylaspartate), Cr (creatine) and Cho (choline) were evaluated on the spectroscopy. Statitistical analysis wsperformed at the embolized and contralateral normal hemisphere in the integral and amplitude of NAA, Cr and Nho in time course. Also NAA/Cr and Cho/Cr were compared in both hemisphere and in time course. The emboli zed lesions showed contrast enhance ments on Gd-enhanced Tl-weighted i~ages at 1 hour. This contrast enhancement was decreased at day 1, and id not appear agter day 4. In spectroscopy, the embolized hemisphere showed no statistical difference to the normal contralateral side at 1 hour and in time course. NAA/Cr and Cho/Cr were not significantly different in both hemispheres at 1 hour and in time course. Cerebral-fat embolism induced by a triolein emulsion in cats revealed no statistical difference on MR spectroscopy. Triolein-emulsion can be used in the study of blood-brain barrier.

• 대한의생명과학회지
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• 제10권4호
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• pp.367-373
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• 2004

Evaluated the hyperacute embolic effects of triolein and oleic acid in cat brains by using MR image and electron microscopy. In fat embolism, free fatty acid is more toxic than neutral fat in terms of tissue damage. T2-Weighted imaging, diffusion-weighted imaging, and contrast-enhanced T1-weighted imaging were performed in cat brains after the injection of triolein (group 1, n=8) or oleic acid (group 2, n=10) into the internal carotid artery. MR image were quantitatively assessed by comparing the lesions with their counterparts on T2-weighted images, apparent diffusion coefficient (ADC) maps, and contrast-enhanced T1-weighted images. Electron microscopic findings in group 1 were compared with those in group 2. Qualitatively, MR images revealed two types of lesions. Type 1 lesions were hyperintense on diffusion-weighted images and hypointense of ADC maps. Type 2 lesions were isointense or mildly hyperintense on diffusion-weighted images and isointense on ADC maps. Quantitatively, the signal intensity rations of type 1 lesions in group 2 specimens were significantly higher on T2-weighted images (P=.013)/(P=.027) and lower on ADC maps compared with those of group 1. Electron microscopy of type 1 lesions in both groups revealed more prominent widening of the perivascular space and swelling of the neural cells in groups 1. MR and electron microscopic data on cerebral fat embolism induced by either triolein or oleic acid revealed characteristics suggestive of both vasogenic and cytotoxic edema in the hyperacute stage. Tissue damage appeared more severe in the oleic acid group than in the triolein group.

• 대한의생명과학회지
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• 제11권1호
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• pp.31-36
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• 2005

To evaluate the magnetic resonance imaging and electron microscopic findings of the hyperacute stage of cerebral fat embolism in cats and the time needed for the development of vasogenic edema. Magnetic resonance imaging was performed at 30 minutes (group 1, n=9) and at 30 minutes and 1, 2, 4, and 6 hours after embolization with triolein (group 2, n= 10). As a control for group 2, the same acquisition was obtained after embolization with polyvinyl alcohol particles (group 3, n=5). Electron microscopic examination was done in all cats. In group 1, the lesions were iso- or slightly hyperintense on T2-weighted (T2W) and diffusion-weighted (DWIs) images, hypointense on the apparent diffusion coefficient (ADC) map image, and markedly enhanced on the gadolinium-enhanced T1-weighted images (Gd-T1WIs). In group 2 at 30 minutes, the lesions were similar to those in group 1. Thereafter, the lesions became more hyperintense on T2WIs and DWIs and more hypoinfense on the ADC map image. In group 3, the lesions showed mild hyperintensity on T2WIs at 6 hours but hypointensity on the ADC map image from 30 minutes, with a tendency toward a greater decrease over time. Electron microscopic findings revealed discontinuity of the capillary endothelial wall, perivascular and interstitial edema, and swelling of glial and neuronal cells in groups 1 and 2. The lesions were hyperintense on T2WIs and DWIs, hypointense on the ADC map image, and enhanced on Gd-T1WIs. On electron microscopy, the lesions showed cytotoxic and vasogenic edema with disruption of the blood-brain barrier.