The aim of the present study was to evaluate the characteristics and outcome of adolescent patients with nasopharyngeal carcinoma (NPC) disease. The study concerned 46 pediatric NPC patients treated during the period 1999-2002 at the National Institute of Oncology, Rabat. The median age of the patients was 16 years. The male/female ratio was 2.8/1. Histologically, all patients had undifferentiated carcinoma. A total of 93% presented nodal metastasis. Four (9%) had distant metastasis. All patients received neoadjuvant multiagent chemotherapy containing cisplatin, followed by radiotherapy. Kaplan-Meier curves were used to evaluate prognostic factors. The log-rank test was used to evaluate the differences between the groups. While none of the patients had locoregional failure, nine patients (29%) developed distant metastasis. The disease-free survival and overall survival (OS) rate for the entire group were 73 and 41%, respectively. Responders to chemotherapy had superior OS (P < 0.001). We suggest that combined modality management using multi-agent chemotherapy and RT as an effective treatment of NPC disease which will achieve satisfactory locoregional control and OS of NPC pediatric patients. Response to chemotherapy was an important prognostic factor.

1. Experiments were designed to study the involvement of alpha-adrenoceptors and dopamine receptors in the hypotensive and bradycardic actions of bromocriptine in rats. 2. Intravenous administration of bromocriptine reduced blood pressure and heart rate which was inhibited by ganglionic blocking agents or by pithing. 3. The fall in blood pressure produced by bromocriptine was not modified by atropine, atenolol, prazosin, yohimbine, bilateral vagotomy or carotid ligation, but was blocked by sulpiride, domperidone and haloperidol. 4. The bradycardia produced by bromocriptine in intact rats was assumed to be mediated by the autonomic nervous system since it was partly reduced by bilateral vagotomy or atenolol, and entirely prevented by pithing. Furthermore, sulpiride but not yohimbine antagonized this effect. 5. In pithed rats, bromocriptine decreased both the pressor response (above 10 micrograms kg-1) and the tachycardia (above 50 micrograms kg-1) elicited by electrical stimulation of spinal cord outflow. Both effects were inhibited by sulpiride or yohimbine. 6. In pithed rats, bromocriptine did not affect the hypertension due to exogenous noradrenaline, phenylephrine, B-HT 920, nor the bradycardia evoked by stimulation of the cardiac muscarinic receptors by carbachol. 7. These results suggest that, in rats, bromocriptine produces hypotension via an action on presynaptic and/or ganglionic dopamine receptors, and causes bradycardia by activation of central dopamine receptors.

No abstract

A 60-years-old man with a history of hypertension and hypercholesterolemia and no associated disease complained of knee pain. He had been still working and practicing sports. Vascular investigations revealed a fusiform and subarticular popliteal aneurysm, 37 mm in diameter (Fig. 1A) and 40 mm in length (Fig. 1B), with a mural thrombus and three patent crural vessels (Fig. 1C). Because the patient had refused the bypass procedure, an endovascular treatment was chosen. Under local anaesthesia, a covered Viabahn ® stent (8 mm × 100 mm) (W.L. Gore & Associates, Inc., Flagstaff, Arizona, USA) was inserted via an ipsilateral percutaneous femoral puncture. Control colour duplex ultrasound at 1 and 9 months showed no endoleak and confirmed the patency of the stent. At 12 months, the patient had no complaint, but the colour duplex ultrasound and computed tomography (CT)-scan showed a large endoleak with an aneurysm perfusion. The mechanism of the leak was thought to be related to fracture of the stent and complete tear in the polytetrafluoroethylene (PTFE) membrane at the level of the articular interline (Fig. 2). We attempted to provide clear information about this infrequent complication already described in active patients. However, the patient still refused the bypass procedure as he was asymptomatic. A redo stenting was then successfully performed with the same device (Viabahn ® stent (8 mm × 100 mm)). DiscussionThe Viabahn ® endoprosthesis (W.L. Gore & Associates, Inc., Flagstaff, Arizona, USA), which is a modified version of Hemobahn ® , is a self-expandable stent; it consists of an ultra-thin lining of PTFE and an external support of nitinol (NiTi = nickel : titanium) extending the length of the PTFE to confer this great flexibility.Despite its properties, fractures of the nitinol support of Hemobahn/Viabahn endoprostheses have been described, but complete rupture with both the stent fracture and tear of the PTFE is rare.1-3) In these two studies, complete rupture was not described as so, even though a leak re-feeding of the aneurysm was reported. Moreover, no imaging evidence has been reported in order to demonstrate the type III leakage. The first case was about an Complete Rupture of Polytetrafluoroethylene-covered Endoprosthesis after Exclusion of a Popliteal AneurysmIssam Abouliatim, MD, Khaoula El Alaoui, MD, Marec Majewski, MD, and Jean-pierre Becquemin, MD Popliteal artery aneurysm (PAA) is the most commonly reported peripheral artery aneurysm. The usual treatment is exclusion bypass with a saphenous vein. However, the availability of medium size covered stent graft is an attractive option. By performing this procedure percutaneously, we can shorten the hospital stay of the patient. Favourable early and long-term results have been reported; however, little is known about the durability of the procedure. Given the mobile location of the stent-graft close to the knee joint, graft damage can be expected. We describe a case of complete rupture of a Viabahn ® endoprosthesis which was inserted to exclude a PAA.

No abstract