The utility of a multibending endoscope for selective cannulation during ERCP in patients with a Billroth II gastrectomy (with video).

Background: Selective cannulation in patients with a Billroth II gastrectomy is still challenging.

Objective: To evaluate the usefulness of a multibending, forward-viewing endoscope (M-scope) for selective cannulation during diagnostic or therapeutic ERCP in patients with a Billroth II gastrectomy.

Design: Case series.

Effects of vardenafil, a phosphodiesterase type-5 inhibitor, on sphincter of Oddi motility in patients with suspected biliary sphincter of Oddi dysfunction.

Background: The therapeutic approach in patients with sphincter of Oddi (SO) dysfunction (SOD) aims to reduce the resistance to the flow of bile or pancreatic juice. Vardenafil inhibits the activity of phosphodiesterase type 5 (PDE-5), which degrades cyclic guanossine monophosphate (cGMP) and results in relaxation of smooth muscle.

Objective: The present study was performed to determine the effects of vardenafil on SO motility in patients with suspected SOD.

Imaging features of adult choledochal cysts: a pictorial review.

Choledochal cysts are rare congenital anomalies which are principally diagnosed by disproportional dilatation of the extrahepatic bile ducts. In addition, choledochal cysts are believed to arise from the anomalous union of the common bile duct and pancreatic duct outside the duodenal wall which is also proximal to the sphincter of the Oddi mechanism. The various types of choledochal cysts have been classified on the basis of these anomalous unions (Komi classification) and their anatomical locations (Todani classification).

A phase II study of gemcitabine in combination with oxaliplatin as first-line chemotherapy in patients with inoperable biliary tract cancer.

Purpose: The aim of this study is to investigate the efficacy and safety of gemcitabine and oxaliplatin combination chemotherapy as first-line therapy in patients with inoperable biliary tract cancer (BTC).

Methods: The treatment of this non-randomized phase II study consisted of gemcitabine 1,000 mg/m(2) intravenously (i.v.

Prevalence of clonorchiasis in patients with gastrointestinal disease: a Korean nationwide multicenter survey.

Aim: To investigate prevalence of Clonorchis sinensis in patients with gastrointestinal symptoms, and the relation of the infection to hepatobiliary diseases in 26 hospitals in Korea.

Methods: Consecutive patients who had been admitted to the Division of Gastroenterology with gastrointestinal symptoms were enrolled from March to April 2005. Of those who had been diagnosed with clonorchiasis, epidemiology and correlation between infection and hepatobiliary diseases were surveyed by questionnaire.

Review of 67 patients with autoimmune pancreatitis in Korea: a multicenter nationwide study.

Objectives: The ideal diagnostic criteria of autoimmune pancreatitis (AIP) are still challenging. Therefore, we investigated the clinical features of AIP in Korea and assessed the clinical use of new Korean diagnostic criteria.

Methods: We reviewed 67 patients with AIP enrolled in 16 hospitals via a multicenter study.

[Effectiveness and tolerance of duodenoscopic bowel preparation for colonoscopy].

Background/aims: Bowel preparation for colonoscopy remains an unpleasant experience because oral solutions have unpleasant tastes and may provoke abdominal pain, nausea, vomiting, and sleep disturbance. Duodenoscopic bowel preparation is an alternative method for patients who are unwilling to take oral preparation solution or for those who are supposed to have both gastroscopic and colonoscopic examination on the same day. We assessed the effectiveness and tolerance of duodenoscopic bowel preparation.

Diagnostic utility of interleukin-6 (IL-6) for primary bile duct cancer and changes in serum IL-6 levels following photodynamic therapy.

Objectives: Difficult diagnoses and a lack of effective therapy complicate biliary tract malignancies. Interleukin-6 (IL-6) is a human bile duct epithelium growth factor correlated with tumor burden. We evaluated the usefulness of serum IL-6 in the diagnosis of primary BDC and measured changes in serum IL-6 levels following photodynamic therapy (PDT).

Relevance of ineffective esophageal motility and hyperactive acid sensitization in patients with gastroesophageal reflux.

Background And Aim: Esophageal motor abnormalities including ineffective esophageal motility (IEM) and visceral hypersensitivity have been frequently observed in patients with gastroesophageal reflux. The aim of this study was to observe the incidences of hypersensitivity to acid infusion and motor abnormalities in non-erosive reflux disease (NERD) compared with erosive esophagitis.

Methods: We performed upper GI endoscopy, an acid perfusion test and esophageal manometry on 113 NERD patients and 37 erosive esophagitis patients.

Endoscopic Ultrasonograpic Findings of Benign Mediastinal and Abdominal Lymphadenopathy Confirmed by EUS-guided Fine Needle Aspiration.

Background/aims: Distinguishing benign and malignant lymph nodes by the findings of endoscopic ultrasonography (EUS) is still controversial. We tried to evaluate EUS findings of benign mediastinal and abdominal lymphadenopathy (BLAP) confirmed by EUS-guided fine needle aspiration (FNA).

Methods: A total of 37 patients with enlarged mediastinal or abdominal lymph nodes (diameter >/=1 cm) were enrolled and EUS-FNA was performed.

Electronic structure of P-doped ZnO films with p-type conductivity.

The electronic structure of laser-deposited P-doped ZnO films was investigated by X-ray absorption near-edge structure spectroscopy (XANES) at the O K-, Zn K-, and Zn L3-edges. While the O K-edge XANES spectrum of the n-type P-doped ZnO demonstrates that the density of unoccupied states, primarily O 2p-P 3sp hybridized states, is significantly high, the O K-edge XANES spectrum of the p-type P-doped ZnO shows a sharp decrease in intensity of the corresponding feature indicating that P replaces O sites in the ZnO lattice, and thereby generating P(O). This produces holes to maintain charge neutrality that are responsible for the p-type behavior of P-doped ZnO.

[Intraductal ultrasonography for the selection of self expandable metal stent in extrahepatic bile duct carcinoma].

Background/aims: Endoscopic stent insertion with self expandable metal stent (SEMS) is one of the standard palliative treatments for the patients with unresectable bile duct carcinoma. The aim of this study was to determine whether detection of longitudinal spread of extrahepatic bile duct carcinoma by intraductal US (IDUS) would be helpful in the selection of metal stent for the palliative drainage in bile duct carcinoma.

Methods: Seventeen patients with histologically proven unresectable extrahepatic bile duct carcinoma who underwent endoscopic retrograde cholangiography with IDUS were included.

[The expression of p53, p16, cyclin D1 in esophageal squamous cell carcinoma and esophageal dysplasia].

Backgrounds/aims: p53 is known to play a central role in sensing and signaling for the growth arrest and apoptosis in cells with DNA damage. Mutation of p53 is a frequent event in esophageal squamous cell carcinoma (ESCC). p16 protein binds to cyclin dependent kinase 4 (CDK4) inhibiting the ability of CDK4 to interact with cyclin D1, and stimulates the passage through the G1 phase of cell cycle.

[A case of complete regression of hepatocellular carcinoma during administration of COX-2 inhibitor].

Overexpression of cyclooxygenase-2 (COX-2) has been associated with hepatocarcinogenesis. Inhibitors of COX-2 have proapoptotic and antiproliferative effects on malignant tumors and inhibit tumor invasion to the surrounding tissues. We report here a case of complete regression of advanced hepatocellular carcinoma (HCC) during COX-2 inhibitor administration.

[Detection of Intrahepatic HBV DNA in HBsAg-negative liver diseases].

Backgrounds/aims: Occult HBV infection is characterized by the presence of HBV infection with undetectable HBsAg. This study was carried out to find out the frequency of HBV infection in HBsAg- negative patients.

Methods: Fifty-six HBsAg-negative patients including 17 anti-HCV positive patients were evaluated.

Variation in expression of gastric leptin according to differentiation and growth pattern in gastric adenocarcinoma.

Leptin is an adipocyte-derived hormone that regulates body fat stores and feeding behavior. The presence of leptin in stomach epithelium was recently demonstrated in the rat and humans, and gastric leptin has been linked to the control of meal size, local inflammatory responses, and paracrine and autocrine functions through leptin receptors in the stomach. We compared the expression patterns of leptin and of the long variant of the leptin receptor (Ob-Rb) between areas with non-ulcerated mucosa and with hyperplastic polyps, adenoma, or adenocarcinoma to evaluate the expression relative to different disease states.

Clinical features of chronic pancreatitis in Korea: a multicenter nationwide study.

Background/aims: No reliable nationwide clinical data about chronic pancreatitis (CP) was available in Korea. The etiology and clinical features of CP were investigated using a multicenter nationwide study.

Methods: 814 cases of CP were enrolled retrospectively over the past 4 years at 13 hospitals.

The role of extracorporeal shock wave lithotripsy combined with endoscopic management of impacted cystic duct stones in patients with high surgical risk.

Background/aims: Cholecystoscopic lithotripsy can be an alternative procedure for the treatment of impacted cystic duct stones in patients who are high risk for surgery. Conventional methods, including electrohydraulic lithotripsy (EHL), occasionally fail due to the inability to access or capture the impacted stones in the narrow, spirally long cystic duct. Using extracorporeal shock wave lithotripsy (ESWL) may be more effective to disintegrate cystic duct stones.

The detection of bile duct stones in suspected biliary pancreatitis: comparison of MRCP, ERCP, and intraductal US.

Objectives: Early ERCP and endoscopic sphincterotomy for stone extraction can benefit the prognosis in patients with severe biliary pancreatitis, but are associated with complications. The ability to identify choledocholithiasis by noninvasive means in biliary pancreatitis is limited. The aim of this study was evaluation of the ability of MRCP to detect choledocholithiasis in patients with acute biliary pancreatitis.

Wire-guided endoscopic snare papillectomy for tumors of the major duodenal papilla.

Background: Endoscopic excision for adenoma of the major duodenal papilla was introduced as an alternative to surgery, but postprocedure pancreatitis is a serious drawback. This study assessed the feasibility and the safety of endoscopic papillectomy with a guidewire and pancreatic-duct stent insertion to prevent pancreatitis.

Methods: Six patients were enrolled.

[Comparison of survival of advanced hilar cholangiocarcinoma after biliary drainage alone versus photodynamic therapy with external drainage].

Background/aims: Photodynamic therapy (PDT) has a promising effect on non-resectable hilar cholangiocarcinoma. The aim of this study was to compare overall survival of PDT plus biliary drainage versus biliary stent alone in advanced hilar cholangiocarcinoma.

Methods: Twenty patients who were treated with endoscopic biliary drainage alone (Group A) and 27 patients treated with PDT under percutaneous cholangioscopy and additional percutaneous biliary drainage (Group B) were analyzed retrospectively.

Endoscopic treatment of retained bile-duct stones by using a balloon catheter for electrohydraulic lithotripsy without cholangioscopy.

Background: Electrohydraulic lithotripsy is a highly effective method for fragmenting biliary stones, but direct visual control is required. The efficacy and the safety of electrohydraulic lithotripsy without cholangioscopy by using a balloon catheter were evaluated in patients with bile-duct stones that could not be extracted by using standard techniques.

Methods: Nineteen patients with extrahepatic bile-duct stones that could not be extracted by using conventional endoscopic methods, e.