Inhibition of Bacterial Adherence on the Surface of Stents and Bacterial Growth in Bile by Bismuth Dimercaprol

Bacterial infection and biofilm formation on the surface of biliary stents is believed to be one of the main factors in stent occlusion. This study explored the role of the new reagent, bismuth dimercaprol, in preventing bacterial adherence and bacterial biofilm formation on the surface of biliary stents. Sterile porcine bile preparations, infected separately with Escherichia coli, Klebsiella pneumoniae, Enterobacter , and Enterococcus , were used as the perfusion media in an in vitro perfusion system. The bacterial growth in the media and the bacterial adherence on the surface of stents were tested when different concentrations of bismuth dimercaprol were used in the perfusion media. BisBAL (5 μ M ) did not inhibit the growth of any of the tested bacterial species. It did, however, significantly decrease the amount of bacteria adhering to the surface of stents for all bacterial strains except Escherichia coli . Bismuth dimercaprol (20 μ M ) significantly inhibited the growth of Escherichia coli, Klebsiella pneumoniae , and Enterobacter and, thereby, significantly decreased the amount of these bacteria adhering to the surface of stents. The unique bactericidal and anitbiofilm activities of bismuth thiols might contribute to delaying the process of biliary stent occlusion if the effective concentrations of bismuth thiols could be delivered to the target sites. The feasibility of this application of bismuth thiols deserves further investigation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44439/1/10620_2005_Article_2702.pd

THE NEUROENDOCRINE CONTROL OF GASTROINTESTINAL MOTOR-ACTIVITY

Here we describe interactions between peptide hormones and the enteric, autonomic and central innervation, and to the regulation of some major digestive events. The neuronal functions, the variety of neurochemically distinct neurons and some recent results on chemical marker combinations in the neurons are mentioned. A classification of the substances potentially acting as neurotransmitters or neuromodulators of gut motility is also reported. The major motor events taken into account include the migrating motor complex, the peristaltic reflex. the gastric emptying and the gallbladder/sphincter of Oddi relationships. The demonstration that numerous peptides may be detected in. and secreted by, the neurons has opened a fascinating area of study. Various difficulties hampering the comprehension of modalities according to which gastrointestinal motility is regulated, are discussed. Experimental evidence however, has to be considered cautiously. Expressions such as 'the peptidergic control of motility' may suggest that these peptides are the primary subjects in the strategy leading to the motor events, rather than the transmitters of impulses whose strategy is decided at higher levels. The autonomy of the peripheral regulatory system is apparent in certain conditions and has an important supplementary value. In general. however, the neuroendocrine regulation remains a global phenomenon testifying the unity of the living organism

Blood pH: a test for assessment of severity in proctocolitis.

Acid base balance was studied in 58 patients with active idiopathic proctocolitis; the condition of 10 of them was complicated by toxic megacolon. Arterial blood pH increased progressively with increased severity of the colitis and as the lesions became more widespread. Statistically significant differences were observed in pH values between the mild/moderate and severe forms and between the severe and complicated forms ('toxic megacolon'). A linear correlation was found between pH and the amount of intestinal gas, pulse rate, and plasma albumin

Gallbladder volume variations after meal ingestion

Objective: To assess gallbladder (GB) volume variations in response to a standard meal. Methods: We assessed these variations with ultrasonography at brief intervals over the postprandial period, which included the emptying and refilling phases of the GB. Results: During both emptying and refilling of the GB, the volume fluctuated continuously, with brief alternating volume decrements and increments. The phases of emptying and refilling appear to be the net result of the algebraic sum of these volume fluctuations. In the emptying phase, the volume decrements showed a greater volume (35.7 +/- 10.7 ml vs. 14.8 +/- 8.4 ml) and lasted longer (158 +/- 37 min vs. 85 +/- 44 min) than the volume increments, whereas the opposite took place in the refilling phase (4.3 +/- 3.4 ml vs. 16.4 +/- 12.2 ml; 39 +/- 20 min vs. 84 +/- 37 min). Conclusion: It is probable that the continuous GB volume fluctuations are the expression of hepatic bile recycling in the GB during the entire postprandial period, and the amount of bile recycled by the GB is greater during the emptying than the refilling phase