Absence of the epiglottis in an infant with Pierre Robin sequence

Epiglottis anomaly associated with Pierre Robin sequence (PRS) is a rare occurrence. Most infants with PRS have presented life-threatening symptoms of respiratory distress and severe feeding problems that usually end with death. To the knowledge of the authors, this is the first reported case of epiglottis agenesis associated with PRS. The clinician must be aware of this unusual presentation in a PRS, and the presented case reveals the challenges in the treatment of the respiratory and feeding problems. This case is discussed with a review of the literature.     

Bilateral Thoracic Ganglion Cyst : A Rare Case Report

Ganglion cysts usually arise from the tissues around the facet joints. It is usually associated with degenerative cahanges in facet joints. Bilateral thoracic ganglion cysts are very rare and there is no previous case that located in bilateral intervertebral foramen compressing the L1 nerve root associated with severe radiculopathy. We report a 53 years old woman who presented with bilateral groin pain and severe numbness. Magnetic resonance imaging revealed bilateral cystic mass in the intervertebral foramen between 12th thoracal and 1st lumbar vertebrae. The cystic lesions were removed after bilateral exposure of Th12-L1 foramens. The result of hystopathology confirmed the diagnosis as ganglion cyst. The ganglion cyst may compromise lumbar dorsal ganglion when it located in the intervertebral foramen. The surgeon should keep this rare entity in their mind for differential diagnosis.     

Factor-Xa inhibitors protect against systemic oxidant damage induced by peripheral-ischemia reperfusion

Factor-Xa inhibitors are often used for prophylaxis and for the treatment of thrombotic vascular disorders. However, it is not known whether they are beneficial during the recanalization of the thrombotic vascular segment and during tissue reperfusion. Herein, we describe an animal study that was designed to investigate the possible protective effects and antioxidant properties of factor-Xa inhibitors. Forty rats were included in the study and were randomly divided into five equal groups. The first group served as a control group from which we obtained basal oxidant and antioxidant parameters. Peripheral ischemia was induced in the second group (sham group) for 6 h, and plasma levels of nitrogen oxide (NO_x), prolidase and malondialdehyde (MDA) were obtained after 30 min of reperfusion. The sham group did not receive any drugs. Oral rivaroxaban (3 mg/kg) was administrated to Group III, intraperitoneal enoxaparin sodium (250 U/kg) was administrated to Group IV, and intraperitoneal bemiparine sodium (250 U/kg) was administrated to Group V 1 week prior to the induction of peripheral ischemia (for 6 h)–reperfusion. After 30 min of reperfusion, blood samples were obtained and NO_x, prolidase and MDA levels in these groups were detected, and the rats were sacrificed. NO_x levels were statistically similar (p > 0.05) between Groups I, II, III, IV, and V (20.7 ± 10.4, 17.4 ± 9.7, 25.9 ± 24.2, 27.0 ± 11.9, 23.3 ± 17.3 μmol/L, respectively). MDA levels were significantly lower (p < 0.05) in Groups III (rivaroxaban), IV (enoxaparin sodium), and V (bemiparine sodium) (24.9 ± 11.9, 25.9 ± 4.4, 25.4 ± 10.8 μmol/L, respectively) when compared with the sham group (Group II) (75.6 ± 24.3 μmol/L). Prolidase levels were higher (p > 0.05) in the ischemia reperfusion groups (659.2 ± 130.6 in II (sham), 1,741.0 ± 1,530.6 in III (rivaroxaban), 2,453.8 ± 1,590.4 in IV (enoxaparin sodium), and 889.2 ± 574.7 U/g in V (bemiparine sodium) than in the control group (144.6 ± 131.8 U/g). Ischemia-reperfusion events may occur in prothrombotic disorders. During these events, prophylactic or therapeutic factor-Xa inhibitors can protect against thrombosis and oxidative reperfusion injury. The new oral factor-Xa inhibitor, rivaroxaban, appears to provide the same antioxidant support as injectable low molecular weight heparins (LMWHs).