The purpose of this report was to describe prosthodontic treatment for a clarinet player using sound analysis. The patient required a removable partial denture for

his maxillary anterior teeth. Sound analysis was performed before and after denture adjustment, and the patient completed a questionnaire regarding his perceptions while playing his clarinet. After adjustment, the denture showed better performance, and patient satisfaction increased compared with that before adjustment. “
“A limited opening of the mouth is defined as microstomia. Microstomia is caused by burns, postoperative head and neck trauma, radiotherapy, or scleroderma. The prosthetic treatment of microstomia presents particular challenges, and patients often complain of an inability to insert or remove the prosthesis. The cause and severity of microstomia can influence the approach to treatment. Different Roscovitine cost treatment methods have been suggested, including the fabrication of two-piece find more partial dentures. This clinical report describes the construction of a sectional impression tray and

a collapsed partial denture using a hinge attachment for a patient with microstomia. “
“Heat-polymerized acrylic resins are used in dentistry for complete denture fabrication. Despite the polymerization method, conversion of monomer into polymer is often incomplete with free or unreacted residual monomer remaining in the polymerized resin. The aim of this study was to determine the amount of residual monomeric methyl methacrylate (MMA) leaching in the saliva of patients wearing complete dentures in their postinsertion period.

Thirty edentulous participants as first-time complete denture wearers (age 60 to 65 years) were selected. All the prostheses many were fabricated using a similar standard technique with a heat-cured acrylic resin denture base material. Saliva samples were collected at time intervals of 1 hour, 1 day, and 3 days postdenture insertion. Participants were asked to discharge saliva every 30 seconds into a pre-weighed screw-capped container for a 5-minute period. MMA levels were measured using high performance liquid chromatography. Data were analyzed by ANOVA and Tukey-HSD. The maximum concentration of monomer released into saliva peaked 1 day after insertion of the complete dentures. The mean (SD) MMA content was 0.04 ± 0.01 (μg/ml) 1 hour after insertion, and 0.3 ± 0.09 (μg/ml), and 0.05 ± 0.01 (μg/ml) on the first and third days postinsertion, respectively. Although the released monomeric MMA was not at toxic levels, it could potentially sensitize complete denture patients or elicit an allergic reaction. The risk of the residual material as a primary irritant for a sensitizing reaction could be minimized by immersion of the denture in water for 24 hours before insertion.

For us as scientists, it might be pleasing when we can indicate a mimic’s model with taxonomic precision. When we consider the anglerfish and the caudal-luring snakes, we can say the aggressive mimic’s model was the prey of the aggressive mimic’s prey, but without specifying

any particular species. It might be tempting to say that the three femmes fatales we considered are more precise aggressive mimics than the anglerfish and the snakes because the models used by each femmes fatale are the signals that are used by a particular prey species during male–female AZD1208 order interactions (female moths of particular species when the mimic was a bolas spider, male Euryattus when the mimic was Portia fimbriata and a mature, receptive female Portia AZD1152-HQPA purchase labiata when the mimic was a subadult female P. labiata). However, if our goal is to understand why aggressive mimicry works, it is the prey’s own classification system that matters, not formal scientific taxonomy. Curio (1976) used the expression ‘predatory versatility’ for predators that deploy a conditional predatory strategy consisting of distinctly different prey-specific prey-capture tactics, with each of these tactics being used for distinctly different prey. In turn, a predator’s repertoire of different prey-capture tactics reveals a predator’s own prey-classification schemes. Aggressive mimics may be especially predisposed

to predatory versatility and it is with Portia that we find the most pronounced expression of predatory versatility known for spiders and among the most pronounced for any predators. Predatory versatility in Portia illustrates, in a striking way, the importance of being clear about the classification system referred to when the labels ‘generalist’ and ‘specialist’ are applied to predators. In community ecology, the intended meaning is that a generalist’s diet is wide and a specialist’s is narrow,

although euryphagous and stenophagous are actually more appropriate words for this distinction. Spiders, in general, are often characterized as being primarily euryphagous predators (Wise, 1993), with the underlying notion being that they tend to feed rather indiscriminately on Erastin molecular weight a wide variety of insects and other arthropods, including other spiders. As Portia’s natural diet is dominated by spiders, it might be tempting to label Portia as stenophagous, and perhaps this is useful in the context of community ecology. However, it is Portia’s own prey-classification scheme that pertains to how Portia experiences its prey (Jackson & Wilcox, 1998; Harland & Jackson, 2004). Portia assigns prey to more distinct categories than is known for any other spider and, in the animal kingdom as a whole, there are few predators known to have behaviour specific to as many different prey categories as is known for Portia. When we consider how predators categorize prey, ‘euryphagy’, not ‘stenophagy’, is the appropriate label for Portia.

Interestingly, isolate VIRUBRA 4/009 significantly differed from the other three Czech isolates and was the only European isolate that showed the highest nucleotide identity with American isolates. Moreover, the PVM isolates from the Czech Republic

and Germany differed in their host range. Phylogenetic analysis based on ORF5 coding for coat protein showed that the Czech isolates could be classified in two of the three groupings of the phylogenetic tree obtained. This is the first report on molecular and biological analysis of the genome sequences of PVM isolates from the Czech Republic. “
“The white pine blister rust caused by Cronartium ribicola is one of the most severe diseases of Pinus armandii Franch in Yunnan Province, Selleckchem IDH inhibitor China, and controlling the disease is very difficult. A mycoparasite (Trichoderma atroviride P. Karsten SS003) we isolated can effectively destroy aeciospores. Microscopic analysis showed that aeciospore warts started to fall off 3 days after SS003 inoculation, and the outer wall of the aeciospores was deformed and completely broken 5 days after treatment. SS003 treatment indoors and in the field was effective against C. ribicola. SS003 mycelium grew well on aeciospore piles, and the

outer walls of most aeciospores were broken when examined by microscope. The average efficacy of SS003 against Armandii pine blister rust reached 71.85% after Selleckchem Enzalutamide continuous treatment for 1.5 years in the field. Additionally, safety tests SAHA HDAC concentration showed that P. armandii seedlings experienced no side effects when they were inoculated with either conidial suspensions or mycelium solution of SS003. Our results suggest that T. atroviride SS003 is a promising mycoparasite for controlling Armandii pine blister rust. “
“Melia azedarach var. japonica trees with leaf yellowing, small leaves and witches’ broom were observed for the first time in Korea. A phytoplasma from the symptomatic leaves was identified based on the 16Sr DNA sequence as a member of aster yellows group, ribosomal subgroup 16SrI-B. Sequence analyses of more variable regions such

as 16S–23S intergenic spacer region, secY gene, ribosomal protein (rp) operon and tuf gene showed 99.5−100% nucleotide identity to several GenBank sequences of group 16SrI phytoplasmas. Phylogenetic analysis confirmed that the Melia azedarach witches’ broom phytoplasma belongs to aster yellows group. “
“We investigated the effect of 2,6-dimethoxy-1,4-benzoquinone (DMBQ) on induced resistance to Magnaporthe oryzae in rice. DMBQ concentrations greater than 50 μg/ml inhibited spore germination and appressorium formation in M. oryzae. When rice leaves pretreated with 10 μg/ml DMBQ, which did not show antifungal activity against spore germination and appressorium formation of M. oryzae, were inoculated with M.

8 Tumor size (maximum diameter, expressed in cm) was assessed on imaging. When available, in patients in whom the diagnosis of HCC was histologically confirmed by fine-needle aspiration biopsy, surgical specimen, or explanted liver, the tumor was graded according to the Edmondson and Steiner classification.20 For consistency, we grouped grades I and II (well and moderately

VX770 differentiated) and grades III and IV (poorly differentiated) tumors.21 This study included patients who were treated with curative intent alone, considering curative the surgical (orthotopic liver transplantation, hepatic resection) and percutaneous ablative (percutaneous ethanol injection [PEI] or radiofrequency thermal ablation [RFTA]) techniques. Alpha-fetoprotein

was determined at the time of HCC diagnosis. Alpha-fetoprotein levels were classified as normal (≤20 ng/mL), mildly elevated (21-200 ng/mL), and markedly elevated (>200 ng/mL). Overall survival was calculated from the time of HCC diagnosis to death or to December 2008. Patients lost to follow-up (n = 22, 10.7%) were censored at the time of the last clinical examination. Continuous data are expressed as median value and range, Lumacaftor and discrete variables as absolute and relative frequencies. To compare continuous variables we applied the Mann-Whitney U test and the Kruskal-Wallis test, whereas discrete variables were compared with the χ2 test with Yates’ correction and Fisher’s exact test, as appropriate. Patient survival was assessed according to the Kaplan-Meier method and compared by the log-rank test. A receiver operating characteristic (ROC) curve was used to identify the alpha-fetoprotein value with the highest accuracy for discriminating between survivors and deceased patients. Moreover, the ROC curve was used to identify the cutoff prevalence-adjusted positive and negative predictive values, and positive and negative likelihood ratios for death. A 2-tailed P-value < 0.05 was considered statistically significant. Statistical analysis was performed using MedCalc statistical package (MedCalc Software, Mariakerke, Belgium). The

ITA.LI.CA database management conforms to the past and current Italian legislation on the privacy and the present study conforms to the ethical guidelines of the Declaration of Helsinki. Approval for the study was obtained by the Institutional Review Board of the participating centers. old The main demographic, biochemical, and clinical characteristics of the 205 study patients are reported in Table 1. The main cause of liver cirrhosis was chronic infection with hepatitis viruses (n = 180, 87.8%). The Child-Pugh score was 5 in 151 patients (73.7%), and the maximum diameter of the HCC nodule was ≤2 cm in 122 patients (59.5%). Serum alpha-fetoprotein levels were within the normal range (≤20 ng/mL) in 116 patients (56.6%), mildly elevated (21-200 ng/mL) in 71 patients (34.6%), and markedly elevated (>200 ng/mL) in 18 patients (8.8%).

P. W.). Figure 3a shows one reconstructed cross section of a willow warbler feather, Fig. 3b the same cross section after segmentation and Fig. 3c the cross section after editing with the two perpendicular selleck products principal axes used to calculate the second moments of area. The images sometimes showed gaps in the lateral wall of the shafts (see Fig. 3b and c). There were in fact no gaps in the shaft and this phenomenon is a result of the image reconstruction and editing process: (1) portions of the lateral walls of the shaft are in some cases so thin

that they cannot be resolved in the image processing; (2) during hand editing, it often proved difficult to determine the limit of the shaft in the regions where barbs emerge and are close to the shaft; the removal of small volumes belonging to the lateral wall of the shaft only leads to a very small underestimation of the dorso-ventral second moment of area, because these volume elements are very close to the dorso-ventral bending axis. Each stack of bitmaps representing a scanned feather shaft segment was read into a three-dimensional matrix. The volume of keratin in the scanned shell (cortex) segment was determined by counting the number

of matrix elements representing keratin in the dataset, multiplied by the voxel volume of 20.35 μm3. The dorso-ventral and lateral bending axes were determined as the two principal axes of an anterior–posterior selleck kinase inhibitor projection of each cross section (Nash, 1977; Kranenbarg et al., 2005). The second moments of area were averaged over all images of each scan. All calculations were performed in matlab® 7.0. The general morphology of the rachis is very similar in the two species. The rachis has an approximate shape of a box girder; it consists of a compact shell (cortex) and is filled by the substantia medullaris, which contains air-filled dead cells and which is not visible in the scans. Neither transverse septa, a ventral grove nor dorsal ridges could be observed in 5-FU the scanned segments (for a comparison with pigeon primary feathers, see Purslow & Vincent, 1978); septa can, however, be seen in the more proximal parts

of the shaft (data not shown). Both lateral portions of the cortex from which the feather vane projects, are very thin. The central portion of the dorsal region and both ventral corners of the rachis are reinforced. The rachis is mainly designed to withstand dorso-ventral bending; generally, the second moment of area with respect to the dorso-ventral axis is roughly twice as big as the values with respect to the lateral axis (we only report values of I with respect to dorso-ventral bending). There is a strong positive relationship between cortex volume and the second moment of area I; this applies to the pooled data (r=0.88, n=42, P<0.0001) and for each single species (willow warbler: r=0.82, n=23, P<0.0001; chiffchaff: r=0.92, n=19, P<0.0001).

conoides specimens, but not in the two allied species T. ornata and T. decurrens. Results are discussed with regard to turbinaric acid as an interesting chemomarker isolated from T. conoides and the rapid discrimination of Turbinaria specimens using chemical assays. “
“Cyst formation is a characteristic feature of chrysophytes. Cyst morphology is used for species identification, and the distribution of cysts in sediment cores is used to infer past climate conditions. The affiliation

of stomatocyst demes with morphospecies, however, remains unclear. Here, we investigated the taxonomic and ecological value of the occurrence of www.selleckchem.com/products/rgfp966.html cyst formation and cyst morphology to differentiate chrysophyte flagellates of the Spumella-morphodeme, which are among the numerically dominant eukaryotes in many aquatic and terrestrial habitats. In the investigated 90 strains of Spumella-like flagellates, we observed encystment only in six strains despite the broad range of temperature regimes and chemical factors tested. Spumella-like flagellates that produce cysts are affiliated with different subclusters within the Chrysophyceae and are closely related to strains for which cyst formation is not known. The occurrence of cyst formation is therefore unsuitable as a taxonomic criterion. Cyst

morphology allows for differentiating some strains even selleck products though distinctly different strains may have similar or even identical-looking

cyst demes. Despite considerable changes in cell size of the vegetative cells related to the nutritional status, the size of the cysts was always larger than that of a typical vegetative cell. Cysts were colorless and had no chromatophores, and some granula were visible in the light microscope. None of the investigated strains and none of the so far published cyst descriptions of Spumella spp. entirely seem to match the cyst description of the generic type strain. However, taking methodological bias between light and electron microscopical investigations into account, Adenylyl cyclase the cysts 199hm (this paper) and N1846 (Yubuki et al. 2008) seem to correspond to the cyst of the generic type strain. We propose the strain 199hm as epitype for Spumella vulgaris Cienkowsky; we further describe Spumella rivalis Boenigk et Findenig sp. nov., Pedospumella encystans Boenigk et Findenig gen. et sp. nov., and Poteriospumella lacustris Boenigk et Findenig gen. et sp. nov. “
“Heterotrophic growth of the microalga Chlorella vulgaris Beij. in synthetic as well as sterilized municipal wastewater of a nonindustrialized city was measured. The city wastewater contained high levels of ammonium and nitrate, medium levels of phosphate, and low levels of nitrite and organic molecules and could not support heterotrophic growth of C. vulgaris.

Sensitivity, specificity, accuracy, positive

predictive value (PPV), negative predictive value (NPV), and positive likelihood ratio (LR+) of all clinical scores in prediction of SAP and mortality were calculated. Results: There were 372 patients with acute pancreatitis. SAP developed in 39 (10.5%) and mortality developed in 11 (3.0%). Predicted severe pancreatitis were 28.6%, 33.0%, 24.4%, and 49.2% by BISAP (≥2), Ranson (≥3), APACHE-II (≥8), and CTSI (≥3), respectively. FDA-approved Drug Library molecular weight BISAP had comparable sensitivity in predicting SAP and mortality compare to Ranson score. BISAP had highest LR+ in predicting SAP. All scores had high NPV (99–100%) in predicting mortality (table 1). Conclusion: With the prevalence of SAP of 10.5%, BISAP does not perform better than Ranson score in predicting severity and mortality of acute pancreatitis, its use is more practical without a need for 48-hour-waiting time. Key Word(s): 1. Acute pancreatitis; 2. BISAP; 3. Predicted severity; % (95% CI) Sensitivity Specificity PPV NPV Accuracy LR+ Post-test probability Severity BISAP ≥ 2 79.0% 77.2% 28.6% 97.0% 77.38% 3.46 28.56% (74.8–83.1%) (72.9–81.5%) (24.0–34.2%) (95.2–98.7%) Ranson 83.3% 73.5% 29.1% 97.1% 74.60% 3.14 29.14% (79.2–87.5%) (68.6–78.4%)

(24.1–33.2%) (95.3–99.0%) APACHE-II 63.2% 80.2% 27.3% 94.9% 78.39% 3.19 27.28% (58.2–68.1%) (76.1–84.3) (22.7–31.9%) (92.6-97.2%) CTSI 66.7% 56.0% 31.3% 84.6% 58.46% 1.52 31.25% (55.2–78.1%) (43.9–68.1%) (20.0–42.5%) (76.1–93.6%) Idasanutlin datasheet Mortality BISAP ≥ 2 81.8% 73.0% 8.6% 99.2% 73.30% 3.03

Nintedanib (BIBF 1120) 8.58% (77.9–85.8%) (68.5–77.6%) (5.7–11.4%) (98.4–100.1%) Ranson 88.9% 68.7% 7.8% 99.5% 69.23% 2.84 7.76% (85.4–92.4%) (63.5–73.8%) (4.8–10.7%) (98.8–100.3%) APACHE-II 81.8% 77.4% 10.2% 99.3% (77.8–85.8%) (73.1–81.7%) (7.1–13.4%) (98.4–100.2%) 77.56% 3.62 9.71% CTSI 100% 51.56% 3.13% 100% 52.31% 2.06 3.13% (100–100%) (39.4–63.7%) (−1.1–7.4%) (100–100%) Presenting Author: WENHUA HE Additional Authors: PI LIU, YONG ZHU, HAO ZENG, LIANG XIA, YOUXIANG CHEN, NONGHUA LU Corresponding Author: WENHUA HE, NONGHUA LU Affiliations: Department of Gastroenterology, The First Affiliated Hospital of Nanchang University,; Department of Gastroenterology, The First Affiliated Hospital of Nanchang University Objective: Clinical studies of acute pancreatitis need to collect and analyze large amounts of clinical data, the establishment of professional diseases database can improve the efficiency of clinical research. The purpose of this study is based on the revised atlanta classification of acute pancreatitis, design an automatic scoring, automatic diagnosis of AP database. Methods: The acute pancreatitis database was established by Epi Info7 software, a free of charge and can be downloaded from the Centers for Disease Control and Prevention (CDC).

campestris KC94-17-XCC, X. campestris pv. vesicatoria YK93-4-XCV, X. oryzae pv. oryzae KX019-XCO and X. sp SK12, which were found in the range of 10–14 and 8–12 mm, respectively. The minimum beta-catenin inhibitor inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of oil and the extracts were ranged from 125–250 and 125 500 μg/ml and 250–1000 and 250–2000 μg/ml, respectively. Also the oil had strong detrimental effect on the viable count of the tested

bacteria. Further, the oil displayed remarkable in vivo antibacterial effect up to 65 to 100% disease suppression efficacy against the tested strains of Xanthomonas spp. on greenhouse-grown oriental melon plants (Cucumis melo L. var. makuwa). These results suggest that the oil and extracts of M. glyptostroboides could be potential source of natural antibacterials for applying in food and agriculture industries selleck chemicals llc to control plant bacterial diseases caused by Xanthomonas spp. “
“Transmission of Pepino mosaic virus (PepMV) by the fungal vector Olpidium virulentus was studied in two experiments. Two characterized cultures of the fungus were used as stock cultures for the assay: culture A was from lettuce roots collected in Castellón (Spain), and culture B was from tomato roots collected in Murcia (Spain). These fungal cultures were maintained in their original host and irrigated with sterile water. The drainage water collected

from irrigating these stock cultures was used for watering PepMV-infected and non-infected tomato plants to constitute the acquisition–source plants of the assay, which were divided into six different plots: plants containing fungal culture A (non-infected and

PepMV-infected); plants containing fungal culture B (non-infected and PepMV-infected); PepMV-infected plants without the fungus; and plants non-infected either with PepMV and the fungus. Thirty-six healthy plants grouped into six plots, which constituted the virus acquisition–transmission plants of the assay, were irrigated with different drainage waters obtained by watering the different plots of the acquisition–source plants. PepMV was only transmitted Rebamipide to plants irrigated with the drainage water collected from PepMV-infected plants whose roots contained the fungal culture B from tomato with a transmission rate of 8%. No infection was detected in plants irrigated with the drainage water collected from plots with only a fungus or virus infection. Both the virus and fungus were detected in water samples collected from the drainage water of the acquisition–source plants of the assay. These transmission assays demonstrated the possibility of PepMV transmission by O. virulentus collected from tomato crops. “
“Red rot, caused by Colletotrichum falcatum, is the most significant problem of sugarcane worldwide. Pathological studies and three different marker systems were used to characterize 25 C.

[11, 15] Transition from olive-oil–based PN lipid to fish-oil–based Gefitinib clinical trial PN lipid emulsion may result in reversal of biochemical indicators of cholestasis.[37] However, 2 patients with persisting liver fibrosis 3 and 11 months after transition to fish-oil–based PN have been reported on.[38] In this study, we found abnormal liver histology, including mainly fibrosis (Metavir stage 2 in 50%) and steatosis with occasional portal inflammation, in 77% of patients after weaning off PN an average of 8.8 years before. Interestingly,

degree of liver fibrosis was comparable during and after weaning off PN, although the weak inverse correlation between Metavir stage and time after weaning off PN suggest that some resolution of fibrosis may occur over time. Bacterial overgrowth, epithelial changes, and impaired local immunity of the small intestine check details may provide potential mechanisms causing and maintaining liver injury in IFALD, both during and after weaning off PN.[39] In a mouse model of IF, PN-induced increase in intestinal permeability promotes Toll-like receptor 4–dependent Kupffer cell activation and liver injury, presumably caused by bacterial translocation.[42] In short bowel syndrome, loss of barrier function of the ileocecal valve, adaptation-induced bowel dilatation, and impaired motility after massive intestinal

resection are known risk factors for bacterial overgrowth.[41] Together with increased intestinal permeability,[43] these alterations may promote bacterial translocation and subsequent liver injury also in IF patients.[44] Here, the number of blood culture-positive septic episodes, reflecting both central venous catheter- and bacterial translocation-related septic episodes, correlated positively with liver fibrosis and chronic cholestasis (periportal CK7 staining). Moreover,

the patients with the shortest Sitaxentan remaining small bowel and those without an ileocecal valve had the most advanced liver fibrosis stage. The exact mechanism of liver protection exerted by the small intestine is most likely multifactorial, but may involve enterohepatic circulation of bile acids.[45] Short length of the remaining small intestine also reflects decreased enteral absorption with increased and prolonged PN requirements. Accordingly, duration of PN and extensive small intestinal resection positively correlated with both fibrosis and steatosis. The fact that liver fibrosis stage was inversely related to young starting age of PN emphasizes the vulnerability of newborn liver function. In a multivariate analysis, age-adjusted small bowel length, portal inflammation, and absence of an ileocecal valve were the most significant predictors of Metavir fibrosis stage. Although APRI correlated with histological liver fibrosis, any of the conventional liver function tests were off normal limits only in 63% of patients on PN and in 18% of patients weaned off PN, whereas liver US was abnormal only in 4 patients.

The objective of our study is to define the pattern of GB wall thickening for classifying the diagnosis. Methods: Abdominal computed tomography images and pathologic results were obtained from 60 patients who underwent cholecystectomy due to diffuse gallbladder wall thickening were reviewed retrospectively. Enhancement patterns were divided www.selleckchem.com/products/bmn-673.html into 5 types. We compared CT findings with the pathologic results and categorized pathologic findings as inflammatory lesion and tumors. Tumors include adenomyoma, adenomyomatosis, and adenocarcinoma. Results: Enhancement was classified as one of the following five patterns. Type 1 pattern was a heterogeneously

enhancing one-layer gallbladder wall; type 2, strongly enhancing thick inner layer and weakly enhancing outer layer; type 3, borderline enhancement and thickness of the inner layer with small cystic spaces and non-enhancing outer layer; type 4, weakly enhancing thin inner layer and non-enhancing thin outer layer; type 5, weakly enhancing thin inner layer and non-enhancing thick outer layer. Type 1 and 3 showed tendency for tumorous condition but no statistical significance between gallbladder wall enhancement patterns and pathologic causes of diffuse gallbladder wall thickening was noted. PDGFR inhibitor Type;inflammatory lesion;tumor: Type 1;0;3, Type 2;5;1, Type 3;0;2, Type 4;25;2, Type 5;22;0 Conclusion: Analyzing the enhancement

pattern of a diffuse gallbladder wall thickening on CT may helpful in distinguishing gallbladder tumor from benign inflammatory lesion. The study with more patients is needed to confirm this result. Key Word(s): 1. gallbladder; 2. wall thickening; 3. GB ASK1 wall; 4. enhancement Presenting Author: JIN HONG KIM Additional Authors: MIN JAE YANG, GIL HO LEE Corresponding Author: JIN HONG KIM Affiliations: Ajou University Hospital, Ajou University Hospital Objective: Endoscopic

large balloon dilation (EPLBD) using large-diameter balloons (12–20 mm) was introduced to facilitate the removal of large bile duct stones and minimize the need for endoscopic mechanical lithotripsy (EML). Limited data exist on the maximal balloon size that would minimize fatal adverse events associated with EPLBD. In the current study, we aimed to assess the safety profiles of EPLBD according to balloon size and to identify the proper maximal size of a large balloon for treating large bile duct stones. Methods: From March 2004 to July 2013, we retrospectively reviewed the ERCP database system at our center. There were 114 patients in the EPLBD with endoscopic biliary sphincterotomy (EST) group and 165 patients in the EPLBD without EST group. In the EPLBD with EST group, there were 49 patients in the EPLBD with a larger balloon (>15 mm) group and 65 patients in the EPLBD with a smaller balloon (12–15 mm) group.