The novel ESD using SB knife Jr in the colorectum offers a breakthrough in resection techniques for not only expert endoscopists but also general endoscopists.

Duodenal carcinoids are a rare form of neuroendocrine tumors, and tend to invade the submucosa during the early stage. Endoscopic treatment is generally recommended for duodenal carcinoids less than 10 mm in diameter. Although a few reports have described the use of endoscopic resection of duodenal carcinoids, there are no published studies on endoscopic mucosal resection with circumferential mucosal incision (EMR-CMI). We performed EMR-CMI for 5 cases of duodenal carcinoids in the duodenal bulb. The mean tumor diameter was 4.6 ± 1.8 mm. Although all of the tumors were located in the submucosa, R0 resection was performed without complication in each case. EMR-CMI may thus be a safe and effective treatment for duodenal carcinoids less than 10 mm in diameter.

[Purpose] Inflammatory bowel disease (IBD) is closely related to stress and fatigue. Human herpesvirus 6 (HHV-6) is reactivated by stress and fatigue and associated with IBD. This study aimed to clarify the relationship between IBD and HHV-6. [Methods] Antibody titers to SITH-1, a protein specific to HHV-6 latent infection, were measured in 163 patients with IBD (107 with ulcerative colitis [UC] and 56 with Crohn's disease [CD]); clinical scores and depression scores of UC and CD were analyzed to examine the relationship between SITH-1 and IBD. [Results] In patients with UC, CRP level was significantly higher (1.5 mg/L vs. 0.3 mg/L; P = 0.006) and disease relapse within 6 months after entry was significantly more common in the SITH-1 (+) group (20% vs. 0%; P = 0.0006). In patients with CD, there were no significant differences between the two groups in CRP levels and disease relapse within 6 months after entry. [Conclusion] SITH-1 (+) patients with UC have significantly higher CRP levels, frequent disease relapse, and high disease activity. Therefore, SITH-1 may be a predictor of relapse in UC.