Malignant schwannoma is a malignant neoplasm of nerve sheath cells. It develops in a solitary fashion or associated with Von Recklinghausen disease.

We experienced a malignant schwannoma in a 20-year old man with Von Recklinghausen disease. The lesion was gure, irregular, cystic and solid mass with septations in the right retroperitoneal region, inferior to the kidney. The histologic findings of retroperitoneal and pulmonary mass was compatible with malignant schwannoma. Incomplete excision due to infiltration to the adjacent tissue, radiotherapy and combined chemotherapy were performed.

We report a case of retroperitoneal malignant schwannoma associated with Von recklinghausen disease.

Ulcerative colitis is a chronic inflammatory disease, characterized by diffuse ulceration of colorectal mucosa and submucosa. It is relatively frequent in the western countries, but is relatively rare in Korea. However, the diagnostic rate shows a tendency to increase with various diagnostic method and attention to the diseases of the patients.

Author has experienced 31 cases of ulcerative colitis diagnosed with clinical symptoms, radiologic and endosopic examination from March, 1983 to August, 1989 at Ewha Womans University Hospital.

The results are as follows;

1) The peak incidence of age was 20~29(41.9%) and the ratio of male to female was 1:2.1

2) The chief complaints on admission were bleeding, diarrhea and abdominal pain.

3) The duration from the onset of the symptoms to the first visit was less than 1 month in 18 cases(58.1%).

4) The most common involved site of the disease was rectosigmoid colon.

5) The operations were performed in 6 cases and their indications were unresponsive to medical treatment(3cases), perforation(2 cases) and one primary peritonitis.

6) The operations were J shaped ileal pouch-anal anastomosis after total colectomy and subtotal colectomy (2 cases), total proctocolectomy with permanent ileostomy( 1 cases), left hemicolectomy with end to end anastomosis (1 case), right hemicolectomy with ileostomy(l case) and one exploratory eaparotomy.

7) There were 2 proctitis in complication and no mortality.

Colorectal disease including cancer is increasing tendency in this country, and so acurate diagnosis and early treatment might be saved patients.

Since Turell described colonofiberscopy in 1963, colonofiberscopy has been much developed and applied clinically for the more acurate diagnosis and treatment.

I experienced five hundred cases who were taken barium examination before performing colonofiberscopy at the department of surgery. Ewha Womans University Hospital during past 8 years (1981-1988).

Clinical analysis of these cases were made and comparison of colonofberscopy and barium enema in five hundred patients with colorectal disease were presented.

A review was made of 98 fiberoptic colonoscopies performed between January 1984 and August 1987 on aged 9 month to 14 years. Deep sedation was used in all procedures under demerol(1mg/kg), thorazine(0.625mg/kg), seconal enema(10mg/kg) and valium(0.3mg/kg). Indications were anorectal bleeding in 31 cases, diagnostic evaluation of abdominal pain in 37 cases, recurrent intussusception in 10 cases and chronic diarrhea, colon polyps, anemia, colon mass and loss of defication sense in 20 cases. The cecum was reached in 96% of diagnostic examinations. Bleeding sufficinet to find lesions was seen in 12/31 cases with anorectal bleeding and abdominal pain in 12/37. One minor complication and no major complication occurred. Colonoscopy is usually the most sensitive and accurate diagnostic tool for the evaluation of colonic disease, but barium enema and colonoscopy are complementary tests and barium enema should usually precede colonoscopy with certain exceptions.

The reliability of postoperative CEA testing in the recurrent colorectal cancer was studies using serial CEA determinations for the early detection of the recurrent colorectal cancer. The data was derived 15 patients in my experience. The results were as follows. 1) In the aspect of the relation of CEA levels and the clinucal stages of colorectal cancer, the CEA levels did not correlate well parallel with the Dukes stages of colorectal cancer in this study. 2) The postoperative CEA levels are remarkably reduced 13 out of 15 patients. And 2 patients are slightly increased, which is not significant because they were within normal limit pre- and postoperatively. 3) The CEA levels were elevated remarkably in recurrent cancers. Especially in the patient with liver metastesis, the serum CEA levels were elevated abruptly. And in case with preoperatively high CEA levels, interval to recurrences was shortened.

A clinical study of 138 cases of patient with peptic ulcer perforations was performed with emphasis on group analysis. The patients were admitted to the Department of General Surgery, College of Medicine, Ewha Womans University, from Jan. 1976 to Dec. 1985. The result were summarized as follow; 1) The most frequent location of perforation was the pylorus(36.7%) of stomach, and then antrum(29.6%) and 1st portion of duodenum were followed. 2) The sex distribution ratio of male and female was 26.6:1. 3) The age distribution was more fregquent in 3rd and 4th decades. 4) The duration of peptic ulcer history was 1-3 years(24.6%), and greater than 5 years was 23.2%. 5) The duration of perforation to operation was more freqent in 12-24 hours(40.6%). 6) As the operative procedures, simple closure was performed in 108 cases(78.3%) and subtotal gastrectomy in 29 cases(21.0%). 7) Associated diseases were pulmonary Tbc, hypertension and pneumonia. 8) The postoperative complications not significant difference between resection group and non-resection group of perforation. 9) The late complication were noted in 5.0% and pyloric obstruction and ulcer intractibility and reperforation were noted. 10) There was no case of death.

Amebic colitis is an acute disease caused by organism Entamoeba histolytica. This disease is diagnosed with clinical symptoms, laboratory studies, and endoscopy with biopsy.

Now, we report the colonoscopic findings of amebic colitis. Colonoscopic findings are very variable.

There are punctate ulcer, pseudomembrane, pseudopolyp, and hemorrhage. Between above mentioned findings, punctate ulcers are found in almost all patients, except in asymptomatic patients. The lesion of the colon is very friable. So, involved tissue is bleeding with touch.

12 injuries of the duodenum and pancreas were treated at Ewha Womans University Hospital From 1976 to 1982 and 10 of 12 cases were treated operatively. The result was as follows 1) 12 injuries were due to blunt(11) and Stab(1). 5 of the 11 cases of blunt trauma were due to road traffic accident. Other injuries were due to blow(3), fall(2) and kick(1). 2) There were 7 isolated duodenal injuries, 3 isolated pancreas injuries and 2 combined pancreaticoduodenal injuries. 3) Serum amylase determination preoperatively was done in all cases. 9 of 12 patients was elevated. 4) Associated and concomitant injuries were present in 7 patients including the following injuries organ : Stomach(3), Jejunum(2) and Retroperitoneal vessel(2). 5) Three main methods of treatment were used simple suture & drainage(4), simple suture and adjuctive operations(4). pancreaticoduodenetomy(2). 6) The postoperative complications were would infection, pancreatic fistula, duodenal leakage & fistula, pneumonia and sepsis. Among the complications, duodenal leakage and wound infections were most common ones. 7) 3 death occurred in these groups and the mortality was 30 percent. Th causes of death were sepsis and hypovolemia.

The effects of cold temperature were studied nearly 300 years ago by Robert Boyle, who published a monograph entitled New Experiments & Observations Touching Cold. Since then numerous studies have been published on the subject of cryobiology. In recent years, detailed and comprehensive works about cryobiology and cryosurgery have been described by many investigators, among them Parkes, Rowbotham et al, Meryman, Hankinson, Smith, Von Leden and Cahan. This work for comparative studies on effects of skin cryodestruction was attempt to investigate a difference between Frigitronics and Walnuts instruments for the effects of skin cryodestruction.

Gallstone ileus can be defined as mechanical intestinal obstruction due to intraluminal occlusion by a biliary calculus. In most large series of intestinal obstruction, gallstone account for some 1 to 2 percent of all cases. In order to occlude the lumen of the intestine, the gallstone must be necessarily be large 1 inch (2.5cm) or more diameter. The commonest site for impaction of the gallstone is in the lower ileum, but the stone may lodge anywhere along the alimentary canal. The diagnoses should certainly be through of when an elderly female patient, giving a previous history of gallbladder disease, presents with features of intestinal obstruction. The four main radiological findings which are felt to be diagnostic are: 1) Air in the biliary tree 2) Dilated loops of small bowel 3) Demonstration of an opaque stone, especially if can be localized in the small bowel at the approximate level of obstruction 4) Change in location of the stone, if demonstrated, or of the obstruction level. The decreasing mortality, from 75% in 1925 to 13.6% in recently. This is a case of gallstone ileus in a 69-year-old female. The common symptoms was fever, vomiting, abdominal pain and abdominal distension. The stone was impacted in the ileum 30cm proximal to the ileocecal junction.