Summary.-A nationwide study of nasopharyngeal cancer in Israel, during a 9-year period (1960-68) demonstrated a mean annual incidence rate of 1.0 per 100,000 in males and 0-4 per 100,000 in females. Significantly higher incidence was observed in residents born in North Africa (3-0 in males and 1.1 in females). Survival was relatively better in females among patients with lymphoepithelioma and in those without neurological complications. The results may support the presence of environmental factors in aetiology, though genetic predisposition cannot be ruled out.

Intention tremor, attributed to defective function of the cerebellum or its connections. is generally not amenable to medication. Although different in character from the rhythmic low-amplitude oscillations of essential tremor, favorable reports of the effectiveness of propranolol in the latter disorder [2] prompted us to try this drug on 2 brothers suffering from cerebellar ataxia.A 27-year-old serviceman, the son of a first-cousin marriage, was examined five years ago because of a disturbance in speech and loss of upper limb control first noted about a year previously. H e was markedly dysarthric and voluntary movements of the upper limbs were grossly affected by intention tremor, worse on the left. Ataxia of gait was only slight. Tendon reflexes were absent and the limbs were hypotonic. Corneal telangiectasia was not seen, nor were there any skeletal abnormalities. Laboratory investigations were normal.During the next two years his condition deteriorated; he had to drink from the tap-being unable to bring a tumbler to his mouth without spilling the contents-and ate by lowering his head to the plate. Treatment with propranolol. 40 mg three times a day, was begun with immediate benefit in motor performance and clarity of speech. When treatment was stopped two months later, the patient reverted to the previous state. Improvement followed reinstitution of therapy; a year later, a second temporary attempt to stop the drug resulted again in deterioration.Recently, the 19-year-old brother of the patient was found to have similar symptoms and signs. Again, function was grossly impaired in the upper limbs with marked intention tremor. Speech was notably dysarthric, but walking was only moderately atactic. Hypotonia was noted, and tendon reflexes were absent; there was no nystagmus or sensory loss. Laboratory tests were all normal.Propranolol, 40 mg three times day, brought about marked improvement in function within 48 hours. Simple quantitative tests indicated a three-to four-fold improvement.I t would be fruitless to speculate o n the site of action of the propranolol in our patients. The drug is known to enter the brain readily, but its various effects are not believed to be due to a central action 131. However Tremorscheinungen und deren therapeutisches BeeinHussbarkeit. Med Welt 24:237-240, 1973 33~53-65, 1967 The Association and 13 S controls (medical students, secretaries, laboratory personnel) replied to a postcard questionnaire that requested information on residential location (town, suburb, o r rural) and type (house, apartment). and frequent and close exposure between the ages of 8 and 16 years to cats, dogs, horses, chickens, rabbits, and cows. The two groups were remarkably similar with respect to the background characteristics assessed; nearly all came from rural and semirural areas in Vermont, Massachusetts, and northeastern New York.The Table compares the MS and control groups. The chi-square values demonstrate that previous exposure to cats, dogs (large or small), rabbits, and horses is not associa...

Alexia without agraphia occurred in a 41-year-old man suffering from a left occipital brain tumor. The syndrome disappeared following excision of the neoplasm.

Two patients with dermatomyositis were treated with methotrexate, given intravenously. They were unresponsive to corticosteroids. The patients were bedridden and paralysed and one seemed to be in the terminal phase of the disease. The response to courses of methotrexate treatment was satisfactory and sustained over a 2-year follow-up period; muscle enzyme studies indicate that the muscle disease is no longer active. Although steroid therapy alone may be effective, its usefulness is unpredictable and may lead to dependence and undesirable side effects.Our experience with these two patients suggests that a combination of the two drugs may be justified as initial treatment in severe cases.