Postoperative complications of concomitant fat embolism syndrome, pulmonary embolism and tympanic membrane perforation after tibiofibular fracture: A case report.

BACKGROUND: Fat embolism syndrome (FES) is a rare disease characterized by pulmonary distress, neurologic symptoms, and petechial rash and seriously threatens human life and health. It is still neglected clinically because of the lack of verifiable diagnostic criteria and atypical clinical symptoms. No studies on FES with pulmonary embolism (PE) and tympanic membrane perforation have been reported to date. Here, we report a rare case of concomitant FES, PE and tympanic membrane perforation after surgery in a patient with a tibiofibular fracture. CASE SUMMARY: A 39-year-old man presented with right lower extremity pain due to a car accident while driving a motorbike on the road. X-ray and computed tomography scans revealed a fracture of the right mid-shaft tibia and proximal fibula categorized as a type A2 fracture according to the AO classification. A successful minimally invasive operation was performed 3 d after the injury. Postoperatively, the patient developed sudden symptoms of respiratory distress and hearing loss. Early diagnosis was made, and supportive treatments were used at the early stage of FES. Seven days after surgery, he presented a clear recovery from respiratory symptoms. The outcome of fracture healing was excellent, and his hearing of the left ear was mildly impaired at the last follow-up of 4 mo. CONCLUSION: Concomitant FES, PE and tympanic membrane perforation are very rare but represent potentially fatal complications of trauma or orthopedic surgery and present with predominantly pulmonary symptoms. Early diagnosis and treatment can reduce the mortality of FES, and prevention is better than a cure.

[High-performance liquid chromatography-based determination of plasma and renal tissue cisplatin levels after subcutaneous cisplatin implantation in mice].

OBJECTIVE: To develop a method for determining plasma and renal tissue concentrations of cisplatin (DDP) after subcutaneous DDP implantation in mice. METHODS: DDP was extracted from the plasma and tissue of mice receiving subcutaneous DDP implantation and reacted with sodium diethyldithiocarbamate (DDTC). The product Pt (DDTC)(2) extracted by diethyl ether was determined using high-performance liquid chromatography (HPLC) with the mobile phase of water and methanol at the ratio of 25:75 and the flow rate of 1.0 ml/min. The derivatives of DDP and nickel chloride were detected at the wavelength of 254 nm. RESULTS: The linear range of DDP was 0.1-10 microg/ml (r=0.9998 for plasma and 0.9993 for kidney). The intra-day and inter-day RSD was below 10%, and the minimum concentration detectable was 50 ng. CONCLUSION: The method is accurate and effective for determining plasma and tissue DDP levels after subcutaneous DDP administration and can be used in pharmacokinetic study of DDP.