Revascularisation of a giant coronary artery aneurysm in suspected incomplete Kawasaki-disease.

Kawasaki disease leads to typical vascular complications in up to 20 % of untreated cases. We describe a 47-year-old patient with coronary vessel disease, involving the right coronary artery with a huge aneurysmatic dilatation, suspicious for an incomplete form of Kawasaki disease. We found little information about the surgical treatment and postoperative course of this disease in adults. Typically, these infrequent patients present with acute myocardial infarction and require interdisciplinary decision-making.

Cytological evaluation of the tissue-implant reaction associated with subcutaneous implantation of polymers coated with titaniumcarboxonitride in vivo.

The aim of the present study was to evaluate the influence of titanium-coated polymers on the inflammatory response and remodeling of connective tissue during wound-healing processes. Discs of polyethyleneterephthalate (PET) and silicone as well as high-weight meshes of polypropylene (PP) were coated with a titaniumcarboxonitride (Ti(C,N,O)) layer by a plasma-assisted chemical vapor deposition process (PACVD) and implanted subcutaneously in the dorsal lumbar region of Wistar rats. Light microscopic and histological evaluation of capsule thickness, capsule quality, implant-tissue interface and collagen composition was performed 7, 14, 21 and 28 days post-operatively. All implants were surrounded by a fibrous capsule with decreasing thickness after 2-4 weeks post-implantation. Titaniumcarboxonitride-coated polymers showed no significant differences in capsule thickness and inflammatory cellular response. An increased collagen type III/I ratio, especially for titaniumcarboxonitride-coated materials, was found in week one after implantation remaining elevated up to week 4. This might be associated with disordered collagen metabolism and immature scar reaction. In contrast to previous in vitro experiments, Ti-coating of polymers did not improve biocompatibility after subcutaneous implantation in rats. Material reduction to low-weight meshes and enlargement of pore size may demonstrate a benefit of Ti-coated meshes with an increased biocompatibility.

Prostaglandin-H-synthase isozyme expression in normal and neoplastic human skin.

Expression of prostaglandin-H-synthase (PGHS) isozymes was analyzed in 50 biopsies of normal human skin and of pre-malignant and malignant skin lesions, by means of quantitative RT-PCR, immunoprecipitation and Western blotting, as well as immunohistochemistry. Normal skin constitutively expressed PGHS-1 in all cell layers of the epidermis, in endothelial cells of small blood vessels and in sweat-gland epithelium. PGHS-2 expression was very low and restricted to a few keratinocytes of the interfollicular and follicular epidermis. Steady-state concentrations of PGHS-1 and PGHS-2 mRNA were similar in normal skin and in basal-cell carcinomas, but PGHS-1 mRNA was reduced and PGHS-2 mRNA was elevated in actinic keratoses, squamous-cell carcinomas and keratoacanthomas. PGHS-1 protein was detected in all tumor biopsies, being occasionally increased in basal-cell carcinomas. High amounts of PGHS-2 protein were found in actinic keratoses, squamous-cell carcinomas and keratoacanthomas, but not in basal-cell carcinomas. Four malignant melanomas included in this study contained PGHS-1 but no PGHS-2 protein. Immunohistochemical analysis of the biopsies identified keratinocytes, in addition to cells of inflammatory infiltrates and of dendritic morphology, as the major PGHS-expressing cell types. PGHS-2-specific signals were spread throughout the epidermal part of actinic keratoses and squamous-cell carcinomas. These data suggest that constitutive up-regulation of PGHS-2 expression is a consistent pre-malignant event in squamous-cell cancer development in man, as it is in animal models of skin carcinogenesis. Thus, pre-cancerous lesions such as actinic keratoses present a likely target for chemoprevention of skin cancer by selective PGHS-2 inhibitors.