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Infliximab is not superior to placebo in preventing clinical recurrence after CD-related resection. However, infliximab does reduce endoscopic recurrence. ClinicalTrials.gov ID NCT01190839.

Infliximab 5 mg/kg or 10 mg/kg, given every 8 weeks, is effective for the maintenance of remission and maintenance of fistula healing in patients who have responded to infliximab induction therapy. Adalimumab 40 mg weekly or every other week is effective for the maintenance of remission in patients who have responded to adalimumab induction therapy. Certolizumab pegol 400 mg every 4 weeks is effective for the maintenance of remission in patients who have responded to certolizumab induction therapy. No comparative trials have evaluated the relative efficacy of these agents. Adverse events are similar in the infliximab, adalimumab, and certolizumab groups compared with placebo, but study size and duration generally are insufficient to allow an adequate assessment of serious adverse events associated with long-term use.

Amebiasis, caused by the protozoan parasite Entamoeba histolytica, affects more than 50 million people worldwide, with over 100,000 deaths annually. The majority of cases are asymptomatic; however, significant morbidity and mortality are associated with illness in the remaining 10% of cases. Recent advances in the understanding of the mechanism of infection by E. histolytica, the role of the innate immune system, and the role of genetic disposition to infection will allow the development of novel detection and treatment methods. The disease mechanisms, clinical findings, therapeutic strategies, and important developments regarding amebiasis are discussed here.

Background: Endoscopic metallic stenting bilaterally for malignant hilar biliary obstruction has been considered difficult and complex. Difficulties were to pass the stent mesh of delivery system at stent placement and re-intervention. Recently, Niti-Y stent with central wide-open mesh was developed and reported easy to place bilaterally. However, weak points were difficulty of through the mesh other portion than center area and weak radial force around the center portion. We evaluated the newly designed Niti-S stent (large-cell-D type; LCD) with easy to through the mesh and sufficient radial force in all portions. Methods: Between November 2007 and August 2008, 12 patients (m/f: 7/5, mean age 66) with malignant hilar obstruction were received LCD placement endoscopically. Causative diseases were cholangiocarcinoma 3, gallbladder cancer 6, intrahepatic cholangiocarcinoma 1, and lymph node metastasis 2. According to Bismuth classification, there was type I: 1, type II: 5, type III: 5, and type IV: 4. We analyzed technical success, complications and stent patency. Results: LCD placed bilaterally in 6 patients and unilaterally in 6 patients, and successfully in all cases. The median stent patency was 202 days, and occlusion was 4 (33.3%); tumor ingrowth in 3 and sludge in 1. Two patients received successfully by insertion of an additional 2 plastic stent as stent-in-stent both side. One patient underwent percutaneous biliary drainage (PTBD) because of duodenal obstruction. One patient underwent PTBD in another hospital. One of 4 cholangitis without stent occlusion required additional PTBD and remaining cases improved by antibiotics. Two liver abscess drained percutaneously and improved soon. Conclusions: LCD was easy to place bilaterally and manage of occluded stent. Although with large-cell, LCD showed good stent patency without increasing tumor ingrowth.Background: Double balloon enteroscopy (DBE) is a technique that allows for access deep into the small intestine. Indications for DBE are expanding to include using it to perform endoscopic retrograde cholangio-pancreatography (ERCP) in patients with surgical alteration of the upper GI tract. Aims and Methods: The aim of this review was to report safety and feasibility of DBE for ERCP in patients with UGI tract surgical reconstruction. This was a retrospective review of DBE for ERCP in patients that were referred to our institute from February 2007 to November 2008. Results: Twenty patients have undergone a total of twenty nine DBE for ERCPs: mean age 57.9 years (range 26-85), female 10. Indications for DB included: Roux-en-Y hepaticojejunostomy 7 patients, Roux-en-Y gastrojejunostomy 5 patients, Roux-en-Y esophagojejunostomy 1 patient, Whipple's resection with choledochojejunostomy 1 patient and Billroth II gastroenterostomy 6 patients. Twelve patients (12/20, 60%) had previous unsuccessful ERCP with either a sideview duodenoscope (9/12) or a pediatric colonoscope (3/12). Indications for ERCP were choledocholithiasis (10/29, 34.5%), suspicious stricture (8/29, 2...