Papalagi, once considered to be the record of the Western Samoan chief Tuiavii’s first sightseeing tour of Europe at the time of World War I, which is an iconic work for the youth of his homeland, is today considered a forgery. Furthermore, this view was pioneered by the German linguist Senft. He claimed in his book that Scheuermann who translated Tuiavii’s words into German and published “Papalagi” in 1920, actually created the Papalagi himself. And that Senft claimed Scheuermann that he had plagiarized Lukanga Mukala by Hans Paasche, a German politician and pacifist. If the book is a forgery, it should be taken as Scheuermann’s own criticism of modern civilization. This takes on special significance when the text is juxtaposed with the German poet Hölderlin’s masterpiece Hyperion, an epistolary novel writings from the young Greek Hyperion to his friend Bellarmin. The best-known section of the work is the so-called “criticism of Germany,” which appears in the novel’s second part. Here, we draw the reader’s attention to the civilization-critical framework of the novel, in which Hölderlin, himself German, vehemently criticizes his modern homeland through his protagonist Hyperion, a Greek. This paper discusses the possibilities and problems of Papalagi through a comparison with Hyperion and Paasche’s Lukanga Mukala.

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Using medical and surgical records, we retrospectively reviewed 1,430 cases of amputated limbs and fingers/toes, including 977 replantations, over 40 years （April 1981-March 2021） at Kumamoto Kinoh Hospital. The compiled data revealed that amputations occurred more frequently in upper than in lower limbs, with affected sites being more often peripherally located, and more frequently in legs than in feet. Amputations more frequently involved fingers/toes than limbs, with finger amputations predominating （1,163 cases）. The most commonly affected finger was the forefinger, followed by the middle finger, ring finger, and thumb. However, finger amputations declined gradually over the period; by 2016, the rate had fallen to less than one third of that in 1981, when replantation began. Upper and lower arm amputations began declining in 2000 and 2006 respectively, without a decrease in hand amputations. Successful engraftment of replanted fingers exceeded 95％ during 1981-2000 and subsequently reached almost 100％; for toes, hands, and sites other than thighs （upper/lower arms, lower limbs, and feet）, the rates were 88％, 98％, and 100％ respectively. After unsuccessful toe replantation, subsequent reconstruction using a toe-to-finger or wrap-around flap （requiring minimum sacrifice at the donor site） method achieved 100％ success. Age at adult amputation ranged from 20 to 64 years; many childhood （＜9 years） amputations were also observed. Amputations occurred less often on Sundays than on other days, and more often during the 9:00-17:00 period. The main causes were machinery in factories or on construction sites, followed by power saws and agricultural machinery. In Kumamoto Prefecture, agriculture and forestry accounted for almost twice the number of amputations occurring in factories, reflecting the local predominance of the former industries.

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Bronchogenic cyst （BC） is a rare congenital anomaly caused by tracheobronchial system malformation during the embryonic period. Since BC has a high risk of infection and malignant transformation, complete resection is the standard treatment. Moreover, most tumors occur in the lungs or the mediastinum; however, we present a case of a BC found anterior to the sacrum. We placed the patient in a prone position and performed excision of the tumor as well as the skin overlying the lesion using a trans-sacral approach. During the 1-year postoperative follow-up, no tumor recurrence was observed. In this report, we describe the characteristics of BC and compare the transabdominal and trans-sacral approaches for resection of presacral tumors. We conclude that, when compared to the transabdominal approach, the trans-sacral approach is preferable for operations in the presacral area due to its lesser invasiveness and ability to resect even extremely large tumors.

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Cleft foot is an extremely rare congenital anomaly characterized by central ray deficiency of the foot with one or more missing metatarsals. To prevent further deformity, the cleft should be closed in early childhood and, bone correction must be performed, if required. We report a case of a 14-year-old girl with bilateral cleft foot who had not undergone surgery previously because she was able to lead her daily life without any serious concerns; however, she was concerned about her appearance, and her wide feet caused fitting problems with commercial shoes. We report the results of interdigital closure using the flap-bag technique and bone correction using modified digital linear metatarsal osteotomy. We also discuss the current literature on this topic.

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