Neuroblastoma accounts for 24 of 109 patients who have been managed by the pediatric tumor outpatient clinic of our university hospital. Among the malignant solid tumors, neuroblastomas are the most numerous. We investigated neuroblastomas found by mass screening oncologically and epidemiologically. Up until March 31, 1991, seven cases were detected from 64,885 infants who received mass screening by the Kitakyushu City System which we had introduced in 1985. This system is based on an individual health survey program for infants in the city. Six of seven cases found by the screening were treated in our department. None of them, including stage Ⅲ and stage Ⅳ cases, showed any conventional risk factors such as high serum levels of neuron specific enolase, ferritin, amplification of N-myc gene, nor cytogenetic abnormalities. Histopathological studies revealed that ganglioneuroblastoma was observed in 9 of 13 cases over one year of age, whereas it was observed only in two screened cases out of 11 cases under one year of age. According to the classification of Shimada et al., there was one stroma-rich tumor, which is rare in infants and usually a matured type, in the screened cases. Interestingly, another one of the six screened cases regressed spontaneously without any treatment. These cases suggested that some neuroblastomas in the process of maturation or spontaneous regression could be detected by mass screening. On the other hand, 9 of 13 non-screened cases over one-year-old died. Although mass screening at six months of age decreased the mortality rate by neuroblastoma in infancy, the prognosis of neuroblastoma in patients over one-year-old remained still poor. Mass screening should be carried out in a health survey program at one year and six months of age in order to improve the outcome.

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Breakthrough times of organic vapors on an adsorption column packed with activated carbon particles were measured under intermittent airflow conditions. Vapors were introduced into the column intermittently at intervals of between 10 minutes to 24 hours. The breakthrough times obtained under intermittent airflow conditions were compared with those under steady state ones. The results indicated that the breakthrough times of ethyl acetate under intermittent flow conditions were significantly shorter than those under steady states when the time interval was 24 hours. The breakthrough times of toluene under both conditions were not significantly different.

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An evaluation of frozen sections at all surgical margins (Mohs' surgery) was attempted in three patients, in order to determine whether or not a tumor persisted at the surgical margins following surgery for carcinoma of the oral cavity. However, sectioning from the fresh tissue was difficult, and moreover, duration of the surgery was lengthened. It thus seems that this method is not suitable for a routine evaluation of the surgical margins. Based on this, surgical specimens after formalin fixation were evaluated in eight patients. The use of paraffin-embedded sections compensates the disadvantages in using frozen sections. On the other hand, when a residual tumor is detected, any additional excision should be delayed. In two patients, who were evaluated using paraffin-embedded sections, a persistent tumor was detected. In another patient a recurrent tumor developed, despite having completely tumor-free margins. In this patient, the growth of the tumor appeared to be discontinuous. When skip lesions are histologically suggested, adjuvant therapy including radiotherapy should be considered, even when a persistent tumor is not evident. A reliable evaluation of all surgical margins is difficult in either a T4 tumor or in a malignant tumor of the gingiva and hard palate. Microscopic evaluation of all surgical margins using paraffin-embedded sections is considered to be practical in helping to elucidate the microscopic extent of a tumor, although there are several limitations in its application.

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Early detection of neurophysiological abnormalities is believed to be most effective for the early diagnosis of chronic manganism. The static sensography was applied during the periodical health examination and the significance of total distance of the postural sway (i.e. postural sway index) as a neurophysiological index was studied in relation to the blood and urine manganese concentrations. Sixty-six workers in a manganese (Mn)-refining factory, aged 29－59 (mean 47) years, were examined from 1984 to 1989. Mn-exposed workers had been engaged in alternating shifts and the mean duration of Mn exposure was 22.6 years before the health examination in 1984. Air-borne dust and Mn levels in the working environment were 0.07－2.74 mg/m³ and 0.02－0.46 mg/m³. The mean values of the parameters in Mn-exposed workers fluctuated as follows: blood Mn concentrations 19.1－26.9 μg/ℓ [control; Mean 17.8 (Standard deviation 5.2) μg/ℓ], urine Mn concentration 2.60－4.22 μg/g Creatinine [control; Geometric mean 1.16 (Geometric standard deviation 1.93) μg/g Creat.] and postural sway index 51.4－94.6 cm/30 sec [control; Geometric mean 59.7 (Geometric standard deviation 1.4) cm/30 sec.]. Although there were no significant correlations between the postural sway index and blood and urine manganese concentrations, the usefulness of this kind of simple neurophysiological test should be further investigated in combination with other established examinations.

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A 32-year-old man developed a rash on his body and extremities following acute fever of a few days duration, and also noticed pain and spontaneous tingling sensations in his lower extremities. Because severe pneumonia with dyspnea and low arterial blood oxygen concentration were found on examination, he was admitted and treated. After recovering from pneumonia in two months, he complained of abdominal symptoms, such as constipation, nausea and vomiting, spontaneous tingling sensations in the lower extremities, and orthostatic dizziness and fainting. On neurological examination, a mild to moderate muscle weakness was found in the distal muscles of both extremities. The ankle jerk was absent. Both superficial and deep sensations were moderately to severely decreased in the feet with positive Romberg's sign. Constipation and vomiting with nausea were noted. Clinical and laboratory examinations revealed marked orthostatic hypotension and hypohidrosis. Motor and sensory conduction studies indicated the presence of axonal degeneration and segmental demyelination and remyelination in the limbs nerves. CSF examination indicated that protein was 150 mg/dl and the cell count to be 18/mm³. Titer of antibody to rubella virus was significantly elevated. There were no other abnormalities to indicate the cause of motor, sensory and autonomic neuropathies. Therefore, the diagnosis of acute polyradiculoneuropathy with autonomic disturbances after rubella infection, which is rare in the literature, was made.

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There are occupancy problems such as where m balls (m kinds) are thrown into n urns (n kinds). They are known as cases where balls and urns are distinguishable. Also, occupancy problems, such as where balls and urns are indistinguishable, are related to the number of partitions. If each kind of m has several of the same balls, and if each kind of n has several of the same urns, this problem can become very complicated and difficult to solve. No practical solution to this problem has been found yet. Our aim in this paper is to find a practical key to solve this problem.

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Robert Graves's reputation as a war poet, as an Oxford Professor of Poetry, and as a maniacally faithful historical novelist, seems to have gone beyond the clouds of oblivion. Instead, as a fastidious mossback poet haunted by the leprous White Goddess, he has only been looked back on from time to time in the ominous context of the Goddess myth. It seems to me, however, that before then there had been a premonitory power that had driven the poet forward to the Goddess Cult. Christianity and Jesus Christ Himself were the power, and through an antagonism against and an inverted image of this driving force, he finally reached his own identification after a long period of desperate struggle. In my view, this process involves three extraordinary aspects: 1) he is the kind of poet who constructs his own self by disapproval and denouncement of the other self, 2) on the stage of this drama of rejection and reprobation, the main character is a fallen angel whose name is "Presumption," and 3) in the eyes of the poet, the sin of "presumption" is not such a dire, ominous concept dwelling in the dark innermost recesses of the human mind, but an image of a sadistic executioner who rapturously chases a man into the easthetic impasse of tragedy. Contrary to everyone's expectations, these aspects are explicitly or implicitly reflected, not in his poetry, but in his prose works which he often insisted he had written for money. Therefore, through an inquiry into his historical as well as Biblical rewritings, I would like to illustrate what kind of hidden course he had pursued before he reached his ultimate identification with the Goddess's helpmate.

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