Kosin Medical Journal

Review article

Fat embolism syndrome: a review in cosmetic surgery: Hongil Kim, Bommie Florence Seo, Gregory Randolph Dean Evans; Kosin Med J. 2024;39(3):169-178. Published online September 25, 2024; DOI: https://doi.org/10.7180/kmj.24.126

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The growing popularity of cosmetic procedures such as liposuction and fat grafting has been accompanied by a rise in associated side effects. Among these, fat embolism syndrome stands out as a potential complication that sometimes has critical consequences. It is important to recognize that fat embolism affects organs through distinct mechanisms from those involved with other types of embolisms. Early diagnosis is crucial. Unfortunately, no effective treatments have been established for this condition. Therefore, starting with a more detailed categorization of diagnoses, developing new treatment methods for each subtype is essential.

Citations

Citations to this article as recorded by

Safety and Efficacy of Subcutaneous Buttock Augmentation in Indian Population: A Retrospective Analysis
Rajat Gupta, Priya Bansal, Gautam Chaudhury, Nandini Singh Tanwar
Indian Journal of Plastic Surgery.2025;[Epub] CrossRef
The Relationship Between Non-Traumatic Fat Embolism and Fat Embolism Syndrome (FES) in Patients with Cancer
Beáta Ágnes Borsay, Barbara Dóra Halasi, Zoltán Hendrik, Róbert Kristóf Róbert, Katalin Károlyi, Teodóra Tóth, Péter Attila Gergely
Diseases.2025; 13(6): 174. CrossRef

Original article

Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction: Soo-Jin Kim, Moo Hyun Kim, Kwang Min Lee, Jin Woo Lee, Young Shin Cha, Da Eun Koh, Joo Yeong Hwang, Jong Sung Park; Kosin Med J. 2023;38(4):252-258. Published online December 20, 2023; DOI: https://doi.org/10.7180/kmj.23.133

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Background
Acute pulmonary thromboembolism (APTE) is often confused with myocardial infarction. Previous studies have shown that patients with APTE exhibit lower initial and peak cardiac troponin I (CTI) levels, but higher D-dimer (DD) levels, than patients with myocardial infarction. The present study aimed to reaffirm the tree model algorithm using an entirely new set of data.
Methods
We reviewed retrospective clinical and laboratory data from patients who were diagnosed with APTE or non-ST-elevation myocardial infarction (NSTEMI) between 2015 and 2016. Subjects who were not classified with a diagnosis or did not have their CTI or DD levels assessed were excluded. We categorized patients according to the previous algorithm and compared the outcomes with the previous test dataset.
Results
The analysis involved data from 156 patients with APTE and 363 patients with NSTEMI. In the validation data set, the APTE group showed higher initial DD levels (9.80±10.84 μg/mL) and lower initial CTI levels (0.17±0.54 μg/mL) than the NSTEMI group. The accuracy rate for the test dataset and the validation set were similar. The test set accuracy rate was 91.0%, while the accuracy rate in the validation set improved to 88.6%.
Conclusions
Patients with APTE exhibited lower initial and peak CTI levels, but higher DD levels than NSTEMI patients. The accuracy rate estimates were similar between the test set obtained from the tree model algorithm and the validation set. The study findings demonstrate that the assessment of cardiac biomarkers can be useful for differentiating between APTE and NSTEMI.

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The old biomarkers you know are still useful: D-dimer and troponin I
Sanghyun Lee
Kosin Medical Journal.2023; 38(4): 229. CrossRef

Case reports

Multiple extraintestinal manifestations in a patient with acute severe ulcerative colitis: a case report: Eun Young Park, Dong Hoon Baek, Seung Min Hong, Geun Am Song; Kosin Med J. 2022;37(4):361-366. Published online July 27, 2022; DOI: https://doi.org/10.7180/kmj.22.027

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Abstract PDF PubReader ePub: Patients with inflammatory bowel disease (IBD) are at risk for extraintestinal manifestations (EIM) over the course of their disease. As EIMs can involve nearly every organ, and strongly influence the quality of life, early recognition and adequate treatment are necessary to prevent severe morbidity and mortality in affected patients. Pyoderma gangrenosum is a highly severe and debilitating skin condition that occurs in 1% to 10% of ulcerative colitis (UC) patients. Thromboembolic events are also serious EIMs and usually present as deep vein thromboses in the legs or as pulmonary embolisms. A 19-year-old woman presented with bloody diarrhea lasting for 3 months and deep ulceration on the right foot. She was diagnosed with UC. The patient's skin lesions did not improve with intravenous corticosteroids and oral mesalazine. After she was started on infliximab, we observed rapid resolution of the skin lesions. She continued to complain of mild dyspnea while in the hospital. Computed tomography performed using the thromboembolism protocol revealed pulmonary thromboembolism and deep venous thrombosis. The patient underwent anticoagulant therapy with low-molecular-weight heparin, and her dyspnea gradually improved. Anticoagulation was continued with warfarin. It is rare for IBD patients to have multiple EIMs; however, this case demonstrates that multiple EIMs are a possible presentation in UC and underscores the importance of a meticulous clinical examination and adequate evaluation in the management of IBD patients presenting with EIMs.

A case of rescuing a patient with acute cardiovascular instability from sudden and massive intraoperative pulmonary thromboembolism by extracorporeal membrane oxygenation: Won Jin Kim, Jin Gu Kang; Kosin Med J. 2018;33(3):477-482. Published online December 31, 2018; DOI: https://doi.org/10.7180/kmj.2018.33.3.477

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Intraoperative pulmonary thromboembolism is a high mortality situation. Early mortality in patients with pulmonary thromboembolism varies from 2% in normotensive patients to 30% in patients with cardiogenic shock. The use of extracorporeal cardiopulmonary resuscitation can improve survival and neurologic outcomes of cardiac arrest. We report a case of intraoperative massive pulmonary thromboembolism with circulatory collapse and cardiac arrest during anesthesia for pelvic bone fracture surgery, which were rescued by extracorporeal membrane oxygenation.

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Fat embolism syndrome: a review in cosmetic surgery
Hongil Kim, Bommie Florence Seo, Gregory Randolph Dean Evans
Kosin Medical Journal.2024; 39(3): 169. CrossRef

A Case of Pulmonary Hypertension Recurred by Graves’ Disease: Jun Seop Lee, Young Sik Choi, Jae Woo Lee, Jin Seok Yoo, Youn Jung Choi, Dong Hyun Park; Kosin Med J. 2013;28(2):171-176. Published online January 19, 2013; DOI: https://doi.org/10.7180/kmj.2013.28.2.171

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Abstract PDF PubReader ePub: A few cases of severe pulmonary hypertension with right heart failure associated with Graves’ disease were reported in the literature. However, cases of pulmonary hypertension with right heart failure recurred by Graves’ disease is very rare. We describe the case of a 60-year old woman who had been treated pulmonary hypertension caused by right pulmonary artery thromboembolism seven years ago. Recently, her pulmonary hypertension with right heart failure was recurred by Graves’ disease. The patient’s symptoms of pulmonary hypertension was resolved after treatment of Graves’ disease.

Original article

Clinical Manifestations of 6 Cases of Septic Pulmonary Embolism at Increased Risk Recently: Su-Min Park, Kyung-Han Kim, Neul-Bom Yoon, Il-Hwan Jeong, Hye-won Lee, Soo-Keol Lee, Ki-Nam Lee, Choonhee Son, Soo-Jung Um; Kosin Med J. 2012;27(2):99-103. Published online December 27, 2012; DOI: https://doi.org/10.7180/kmj.2012.27.2.99

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Objectives

The aim of this study was to investigate the clinico-radiologic features and microbiologic data of patients with SPE in a tertiary care hospital in Busan.

Methods

We retrospectively analyzed clinical and radiologic features of 6 cases with septic pulmonary embolism that occurred from March 2009 to March 2011 in Dong-A university medical center.

Results

The mean age of the study population was 58 years, and two men and four women were included. Clinical symptoms included general weakness (5 patients), febrile sensation (4 patients) and pleuritic chest pain (2 patients). Underlying conditions were chemoport infection (4 patients), dental abscess (1 patients), and cellulitis of hip (1 patient). Chest computed tomography revealed bilateral multiple nodular opacities in most patients, and cavitation, central necrosis, feeding vessels were identified. All patients received parenteral antimicrobial therapy with or without central catheter removal, drainage of the extrapulmonary infection. Causative organisms were Pseudomonas aeruginosa (2 patients), Candida albicans (1 patient), Bacillus species (1 patient), and Klebsiella pneumonia (1 patient).

Conclusions

Clinical and radiologic features of septic pulmonary embolism were various and nonspecific. The diagnosis was usually suggested by the presence of a predisposing factor of septic pulmonary embolism and CT findings of bilateral multiple nodular opacities in patients with infectious signs and symptoms. Most important underlying condition was intravascular device infection.

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Citations to this article as recorded by

Fat embolism syndrome: a review in cosmetic surgery
Hongil Kim, Bommie Florence Seo, Gregory Randolph Dean Evans
Kosin Medical Journal.2024; 39(3): 169. CrossRef

Case report

A Case of Acute Pulmonary Embolism with A Large Right Ventricular Thrombus: Hyun Su Kim; Kosin Med J. 2009;24(2):207-210. Published online December 31, 2009

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