Selenium nanoparticles: Properties, preparation methods, and therapeutic applications

Selenium nanoparticles (SeNPs) are a unique type of nano-sized elemental selenium that have recently found wide application in biomedicine. It has been shown that the properties of SeNPs can be varied by different fabrication methods. Moreover, SeNPs have various therapeutic effects in medical applications due to their excellent biological and adaptable physical properties. At the same time, SeNPs can be used as a carrier medium for various therapeutic substances, which can bring out the full curative effects of the drugs. In this review, the differences in bioactivity properties of SeNPs prepared from different substances were reviewed; the therapeutic effects and mechanisms of SeNPs in cancer, inflammation, neurodegenerative diseases, diabetes, reproductive diseases, cardiovascular diseases, and other diseases were discussed; and the importance of the development of SeNPs was further emphasized.

Fatigability of the external anal sphincter in anal incontinence

INTRODUCTION

Anal incontinence commonly results from external anal sphincter dysfunction. The muscle is routinely assessed by anorectal physiology studies. Fatigability is not routinely measured but should be an important factor in the maintenance of continence. The fatigue rate index has been developed to address this. The purpose of this study was to investigate the fatigability of the external anal sphincter in incontinent patients compared with that in controls and to determine its correlation with symptom severity and pudendal nerve terminal motor latency measurement.

METHODS

Forty-two patients with anal incontinence (33 female, 9 male) and 20 control patients (17 female, 3 male) were studied. As part of anorectal physiology studies, manometry was measured by a station pull-through technique with a closed-system microballoon. After a rest period of one minute, fatigue was measured over a 20-second squeeze at 1.5 cm in the anal canal with two consecutive readings separated by a further one-minute rest period. The fatigue rate index was calculated from the maximum squeeze pressure and fatigue rate. A validated symptom severity scoring system was used to assess symptomatology in patients with anal incontinence.

RESULTS

No difference was detected in demographic factors between the two groups. The fatigue rate index was significantly different between the control and incontinent groups (1.85 vs. 0.67 minutes, P = 0.001). No other factors were significantly different between the two groups (maximum squeeze pressure, 89.1 vs. 79 cm H(2)O, P = 0.42; fatigue rate, -85.8 vs. -101.2 cm H(2)O/min, P = 0.62). The fatigue rate index demonstrated a significant correlation with symptom score ( r = -0.44, P = 0.005). The fatigue rate index did not correlate with latency measurement.

CONCLUSIONS

A significant difference was detected in the fatigue rate index between incontinent and control patients. The Fatigue Rate Index demonstrated a significant correlation with symptom severity score and it may be a useful discriminating measure of external anal sphincter function.

Concomitant laparoscopic gastric and biliary bypass and bilateral thoracoscopic splanchnotomy: the full package of minimally invasive palliation for pancreatic cancer

INTRODUCTION

Pancreatic cancer is unresectable in 80% or more of patients. Biliary and duodenal obstruction and intractable abdominal and back pain are the most common complications of the disease. These complications may be palliated effectively using minimally invasive techniques. Their combined application in a single setting is presented and discussed in this article.

CASE REPORT

A 59-year-old man with a locally advanced carcinoma of the head of the pancreas presented with obstructive jaundice and intractable pain requiring opiate analgesia. An attempt at endoscopic biliary stenting was unsuccessful, and a percutaneous biopsy was deemed unsafe. Preoperative magnetic resonance cholangiography showed cystic duct insertion abutting the upper limit of the biliary stricture. A laparoscopic Roux-en-Y hepaticojejunostomy, prophylactic loop gastroenterostomy, and tumor biopsy were combined with a bilateral thoracoscopic splanchnotomy.

RESULT

Surgery and subsequent recovery were uneventful, and the patient was discharged from hospital on the fourth postoperative day off opiates. He remained free of jaundice and severe pain, until 6 months later, when he represented with jaundice, cachexia, and proximal small bowel obstruction secondary to multiple liver and peritoneal metastases. He underwent further palliative laparoscopic enteric bypass with resolution of the intestinal obstruction, but died of the disease 10 days later.

CONCLUSION

Laparoscopic gastric and biliary bypass and bilateral thoracoscopic splanchnotomy may be safely combined to provide an effective comprehensive minimally invasive palliation of incurable pancreatic cancer.