Background/Aims: Recently, endoscopic papillary large balloon dilation (EPLBD) using a large balloon (12 - 20 mm) for extraction of difficult common bile duct (CBD) stones has been widely accepted with favorable outcomes. However, there is no consensus with regard to the ballooning time. The aim of our study was to evaluate the efficacy and safety of immediate balloon deflation in EPLBD for the treatment of difficult bile duct stone. Methods: This was a retrospective study of 80 consecutive patients with bile duct stones who were treated with an immediate balloon deflation method in EPLBD combined with endoscopic sphincterotomy (EST) between January 2010 and December 2012. Overall success rate, success rate at first ERCP, and the frequency of mechanical lithotripsy for complete stone removal were assessed for efficacy and safety was evaluated by assessing major complications. Results: Overall success rate for complete stone removal was high (78/80, 97.5%) and success rate for complete stone removal at first ERCP was 86.3% (69/80). The use of mechanical lithotripsy was 0% (0/80). The overall complication rate was favorable (5/80, 6.3%). PostERCP pancreatitis was observed in 3 patients (two: mild, one: moderate). In subgroup analysis, the presence of periampullary diverticulum was the only factor affecting the success rate at first ERCP. Conclusion: This study demonstrated the favorable outcome of immediate balloon deflation for treatment of difficult CBD stones and can be considered for clinical application.

Isoflavone, a group of phytoestrogen, reduces postmenopausal symptoms and the risk of osteoporosis of women. Glycosidic forms of isoflavones are presented in non-fermented soyfoods such as tofu and they are less bioavailable than the aglycone isoflavones. Aglycone forms of isoflavones or more bioavailable forms can be increased by acid hydrolysis during tofu processing. The present study investigated the possibility of increasing the aglycone forms of isoflavones by acid hydrolysis. We used five types of tofu in this study: soybean tofu with hydrolysis, soybean meal tofu with hydrolysis, soybean tofu in general process, soybean meal tofu in general process, and commercial tofu. Defatted soybean meal was used as the major ingredient in the tofu which was made by using the new method—acid hydrolysis. To identify the isoflavone quantities in all five types of tofu, high performance liquid chromatography with diode array detection (HPLC-DAD) analysis was employed. The genistein ratio between hydrolyzed tofu and standard tofu was 1:1-8, and the daidzein ratio between hydrolyzed tofu and standard tofu was 1:6-12. The five types of tofu were analyzed for the crude protein and micronutrients such as calcium (Ca), magnesium (Mg), potassium (K), iron (Fe), zinc (Zn), and selenium (Se) by the modified Kjeldahl method and inductively coupled plasma emission spectroscopy (ICP-ES), respectively. The mean crude protein concentration of hydrolyzed tofu