Objectives: The tolerable ischemic time for many cardioplegia solutions has not been established yet. The aim of this study was to estimate the effect of a single-dose of cardioplegia solution Normacor (solution No. 1) and to establish the tolerable ischemic time in a normothermic cardiopulmonary bypass mini-pig model on the background of intraoperative anemia. Methods: Five female mini-pigs (34plus-or-minus sign3 kg, 6-month-old) were subjected to 180 min or 210 min of cardiac arrest by single-dose 400 ml Normacor cardioplegia (solution No. 1). A needle biopsy was taken from the left ventricle before the aortic cross-clamping and every 30 minutes after it. The restoration of left ventricle contractility was assessed by the clinical indicators, catecholamine support, morphological and immunohistochemical examination. Results: The morphological signs of cardiomyocytes ischemia were found after 120 minutes of aortic cross-clamping. According to the content of succinate dehydrogenase and hypoxia-inducible factor, the signs of the cardiomyocytes ischemic injury onset were detected at the same time point. During the entire period of aortic cross-clamping atrial activity was observed in all cases. The proposed single-dose ischemic time for re-dosing of cardioplegia is 120 minutes or ventricular activity onset. Conclusions: Safe and effective cardioprotection can be achieved with warm blood cardioplegia Normacor (solution No. 1) within 120 minutes for a single-dose infusion.
COVID-19 and cosmetic skin-fillers are two prevalent topics of today’s medicine, yet their interaction is not sufficiently studied. This article is based on a clinico-morphological case where the patient, a 37-year-old female, visited the clinic with complaints of painless palpable subcutaneous pathologic nodular lesions at the site of collagen cosmetic filler injection after severe acute respiratory syndrome coronavirus 2 infection. In order to verify the pathological processes of the lesions, punch biopsy of the affected skin was taken, and histological, histochemical, and immunohistochemical studies were conducted. Atrophy, acanthosis, parakeratosis with vacuolisation of nuclei of the epidermis; sclerosis and abnormal deposition of collagen fibres in the subepithelial layer of dermis; and vasculitis with endothelial hypertrophy and lymphoid perivascular infiltration (CD3 lymphocytes and CD68 macrophages) were found. Spike and nuclear capsid proteins of severe acute respiratory syndrome coronavirus 2 were localised in cells of perivascular inflammatory infiltrates, endothelial cells, and epithelium of glands and epidermis of the skin. The association between the dermatopathy in COVID-19 virus infection and cosmetic fillers were established. The authors discuss and hypothesise possible autoimmune processes that lead to autoimmune vasculitis.
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