Role of environmental factors in autoantibody production - importance of a detailed analysis in a small cohort

In the previous issue of Arthritis Research & Therapy, Muro and colleagues reported a detailed epidemiologic analysis in central Japan on one of the new myositis-specific autoantibodies to MDA-5 (melanoma differentiation-associated gene 5), which is associated with clinically amyopathic dermatomyositis accompanying interstitial lung disease. The increasing prevalence of anti-MDA-5, higher prevalence in small rural towns, and geographical clustering in two areas along the Kiso River suggest a role of environmental factors associated with rural communities or the river/water system or both. A detailed analysis of a small cohort may offer clues, which is ignored in multi-center studies, to the pathogenesis of systemic rheumatic diseases and autoantibody production.     

OPERATIONS ON THE PANCREAS—Some Technical Considerations

Many diseases of the pancreas formerly universally considered fatal, now are known to be amenable to surgical therapy. Pancreatic cysts, pseudocysts, calculi, inflammation, and benign and malignant tumors all can be dealt with effectively by operation. In this presentation various surgical techniques which have proved to be of therapeutic importance are considered.