Struma ovarii consists of thyroid tissue which is derived from germ cells in a mature teratoma. Five percent of struma ovarii are malignant, and of these only five percent metastasize. The rarity of this disease has resulted in difficulty in agreeing on treatment regimens and in limited imaging and monitoring difficulties encountered in their management. We have experienced two cases of malignant struma ovarii with brief review of the literature.
Germ Cells ; Neoplasms, Germ Cell and Embryonal ; Struma Ovarii* ; Teratoma ; Thyroid Gland

In solid tumor, there is a hypoxic region where oxygen supply is insufficient. In this study, we found that one of the quinolone antibiotics, levofloxacin, made a human ovarian cancer cells, SK-OV-3, resistant to hypoxia, even in the presence of a platinum-based anti-cancer therapeutic, carboplatin; when the cells (2 X 10(5) cells/12 well multi culture dish) were grown in no glucose medium (0 g/l) under hypoxia (1% O2), all the cells became dead after 24 hours of culture in the absence of levofloxacin and carboplatin, whereas the cells still survived, at least, until 36 hours of culture in the presence of levofloxacin (10-100 microgram/ml) alone or in combination with carboplatin. The results might have some implications in treating solid tumor; if cancer patients should be treated for infection with antibiotics, quinolone antibiotics can aggravate tumor by making cancer cells more resistant to hypoxia. This is also true even when a patient is treated with carboplatin. Therefore, the results strongly suggest that we should be careful in choosing antibiotics when they are used for cancer patients. In this regard, our work could be a new guideline in choosing antibiotics when antibiotics are applied for treating cancer patients.
Anoxia ; Anti-Bacterial Agents ; Carboplatin* ; Cell Survival ; Glucose ; Humans ; Levofloxacin* ; Ovarian Neoplasms* ; Oxygen

The aim of this systematic review was to evaluate the surgical, radiological, and functional outcomes of posterior-only versus combined anterior-posterior approaches in patients with traumatic thoracolumbar burst fractures. The ideal approach (anterior-only, posterior-only, or combined anterior-posterior) for the surgical management of thoracolumbar burst fracture remains controversial, with each approach having its advantages and disadvantages. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed (registration no., CRD42018115120). The authors reviewed comparative studies evaluating posterior-only approach compared with combined anterior-posterior approaches with respect to clinical, surgical, radiographic, and functional outcome measures. Five retrospective cohort studies were included. Postoperative neurological deterioration was not reported in either group. Operative time, estimated blood loss, and postoperative length of stay were increased among patients in the combined anterior-posterior group in one study and equivalent between groups in another study. No significant difference was observed between the two approaches with regards to long-term postoperative Cobb angle (mean difference, −0.2; 95% confidence interval, −5.2 to 4.8; p =0.936). Moreover, no significant difference in functional patient outcomes was observed in the 36item Short-Form Health Survey, Visual Analog Scale, and return-to-work rates between the two groups. The available evidence does not indicate improved clinical, radiologic (including kyphotic deformity), and functional outcomes in the combined anterior-posterior and posterior-only approaches in the management of traumatic thoracolumbar burst fractures. Further studies are required to ascertain if a subset of patients will benefit from a combined anterior-posterior approach.

Lung cancer is the leading cause of cancer-related death around the world, being the top cause of cancer-related deaths among men and the second most common cause of cancer-related deaths among women in Singapore. Currently, no screening programme for lung cancer exists in Singapore. Since there is mounting evidence indicating a different epidemiology of lung cancer in Asian countries, including Singapore, compared to the rest of the world, a unique and adaptive approach must be taken for a screening programme to be successful at reducing mortality while maintaining cost-effectiveness and a favourable risk-benefit ratio. This review article promotes the use of low-dose computed tomography of the chest and explores the radiological challenges and future directions.