1) The peptic ulcer perforation is most common disease, it has been estimated that about 10% of the population of Western Countries at some time during life and duodenal perforation about 2.5%, stomach perforation about 22.2% in case of Korea.

2) The peptic ulcer perforation are one of the complications : Hemorrhage, Obstruction, Intractability.

3) The sex ratio between male and female was 12:1 in gastric ulcer and 8.8:1 in duodenal ulcer.

4) In age distribution, the peak incidence was 5th decade in gastric ulcer and 20-40 age in duodenal ulcer.

5) Positive finding of physical examination were epigastric tenderness, abdominal rigidity and rebound tenderness.

6) The dignosis was done by chest and abdominal plain films were revealed subdiaphragmatic free air shadow.

7) The treatment is extremity rare in conservative and then all most surgical procedure.

1) Pendred's syndrome is very rare disease in western countries, although 5% of all case of congenital deafness by Pendred's syndrome, and until not reported in Korea.

2) Pendred's syndrome, believed to be one of the more frequent cause of autosomal recessive deafness, has been considered until rescently to present a consistant clinical picture of sensorineural hearing loss and nodular goiter.

3) Goiter generally appears in these patients at puberty or later, but may be in early childhood.

4) It is a deficiency of thyroxine synthesis occurs, thyroid stimulating hormone increase, and goiterous enlargement is seen in the thyroid tissue, most affected persons are clinically euthyroid, but hypothyriodism.

5) Two patients was performed subtotal thyroidectomy, and one is right lobectomy with combined isthmus.

Tuberculosis of the breast is an extremity rare disease in western countries and about 0.5% among entire breast in Korea and most of which involved persons between 20 to 40 years of age in female but it rarely developed in male, elderly patient and prepubertal woman. It may be primary-confined to the breast or secondary to tuberculosis elsewhere because of it's diagnostic difficult. Tuberculosis of breast, is confused to actinomycosis infection, abscess and carclnom.

So, it is only diagnosed by histopathologic finding or inoculation in experimental animal. I expirienced 3 cases of tuberculosis of the breast in 23 years which were treated with antibiotics, antituberculosis medication and combined with surgical excision.

The author reviewed 31 cases of splenectomy between January 1975 and June 1984, at the department of surgery, college of medicine, Ewha womans'university. The results of analysis are summerized as follow; 1) The highest incidences of age range were 3rd and 4th decades, and male to female ratio was 1.6:1. 2) The causes of traumatic splenic injury were traffic accident(58.33%), violence (25%) and falling down(16.67%) in order of frequency. 3) The traumatic injury was composed of mutiple injury(58.33%) and single splenic injury (41.67%). The most common associated injury was intraabdominal bleeding(58.33%) and rib fracture was 16.67% as extraabdominal injury. 4) The hematologic findings on admission were as follow; 1. The value of hemoglobin was below 10mg/dl in 66.67%. 2. The hematocrit level was below 35% in 33.33%. 3. The leukocyte count was above 15000/mm³ in 50%. 5) The abdominal paracentesis were performed in 10 cases and 7 cases(70%) showed the positive findings. 6) The time interval between injury and operation was within 8 hours in 8 cases(66.67%). 7) The incidence of postoperative complication was 16.13%, and the rate of wound infection, atelectasis and intestinal obstruction was 0.65% in each. 8) The seasonal distribution suggested that spletic injury was more prevalent in summer(58.33%). 9) The motality was 1 case(3.23%) but this was not associated with traumatic injury.

The traumatic liver injury rising rapidly in its frequency with the increase of traffic accident, industrial accident and violence, etc. Mortality rate due to liver injuries has decreased due to the speedy transpotation and improvement in management, but about 15 to 30% of the mortality rate is still noted.

The report a clinical study of experiences with 19 cases of liver injuries which were treated by surgical intervention at the Ewha Womans University Hospital from January 1977 to June 1978.

The following results were obtained:

1) The sex distribution was 16 males and 3 females with a significant high incidence in male and ratio 5.3:1 and the age distribution revealed a high incidence in the 2nd decade.

2) The seasonal distribution showed that liver injury was more prevalent in summer season, comparative statistics for the 7 years suggested that the liver injury has been gradually increasing recently.

3) The nature of the injury was blunt trauma in 17 cases(89.47%) and penetrating injury in 2 cases(10.53%) respectively. There were 15 cases of traffic accident trauma. There were 2 industrial accident, and all the penetrating injury was made with knife, no gunshot injury was noted.

4) There was predilection between the right lobe(84.21%) and the left lobe(36.84%) while there was incidence of bilateral involvement of the liver(21.05%)

well related to the mortality rate. The chest injury was the most common among the associated injures.

6) The peritoneal irritation sign was present in the majority of the case(94.74%) and 72.73% of the cases were diagnosed with paracentesis with most probable diagnostic accuracy.

7) 14 cases of patients were admitted within 6 hours after injury.

8) In most cases suture repair, adequate hemostasis and drainage procedure were employed but in 3 cases, common bile duct was exploration and cholecystectomy needed and also 2 cases, hepatic resection and 5 cases, segmental resection was performed.

9) The incidence of postoperative complication was 36.84%(7 cases) and common complication were wound infection, intestinal obstruction and persistant bleeding.

10) The overall mortality rate was 15.79%(3 cases) and this 3 cases of the associated injuries of other organs were noted.

The pattern of the surgical breast diseases in Korea may be different to that of the Western countries. In our partcular situation, it has been believed that suppurative diseases of the breast ought to be considered into as one of the so called Big Three; dysplasia, fibroadenoma. carcinoma. The purpose of the present article is present a clinical and epidemiological review on 793 cases of suppurative diseases of breast treated at Surgical Department of Ewha Womans University Hospital from January, 1973 to September 1982. Analysis of these cases provided the following results. 1) Among the suppurative diseases of the breast, The 542 cases(68.35%) were patients with simple mastitis. and the 251 cases(31.65%) were patients with breast abscess. 2) The peak incidence was in the age group from 21 to 30, and its number of patients was 379 cases(47.79%) The extreme of age was presented by age of 19 days and 73 years old. 3) The disease was more frequently occured in primipara(69.88%) than multipara(30.12%). Along the subsequent parity, it was decreased in number. 4) The disease was most frequently occured within postpartum 1 month. In this review, the suppurative diseases occured within postpartum 1 month were 75.70% of the postpartum patients. 5) On physical examination, everyone with the suppurative disease of the breast had tenderness(100%). 6) There was no predilection area between the right and left breast, its ratio right to left was 1.2 : 1. And the ratio unilateral to bilateral was 3.8 : 1. 7) More than a half of the patients with suppurative disease of the breast came to clinics for treatment within 1 week(57.76%). 8) Reviewing the yearly distribution, In 1978, the largest number of patients, 154 cases(19.42%), were treated. 9) According to 253 cases whose bacteriological survays were available, Staphy-lococcus aureus was the most predominating organism(86.56%). 10) In treatment, incision and drainage combined with antibiotic therapy were performed in 39.85%, and incision and drainag only was performed in 15.13%.

The report is on the clinical analysis of 57 patients of intestinal tuberculosis who were treated at Ewha Womens University hospital for last 6 years from Jan. 1075 to Dec. 1980. The results are summerized as fllows; 1. The male to female ratio 1:1.85(m, 20 f, 37) and the peak incidence was between twenties and forties dcades(68.4%). 2. The frequent incidence of interval from onset of sympton to visit hospital was within 3 months as 82.5% 3. The frequent subjective symptoms were abdominal pain, abdominal distension, abdominal mass and diarrhea. 4. There were 23 cases (40,4%) of tuberculous disease in his pastmedical history. 5. The positive physical findings were abodominal tenderness(49%), ascites(28.1%), abdominal mass(26.3%), fever(24.6%), abdominal rigidity (14.0%) and generalized edema(12.3%) in the order of frequency. 6. The chest P·A revealed negative in 56.1% of all patients. 7. The C.B.C findings showed anemia in 47.4%, elevated E.S.R in 86% and normal range of W.B.C count with elevated number of polymorphocyte. 8. The postoperative complications were wound infection, intestinal obstruction and fecal fistula, etc. 9. The everall motality ratr was 5.3%.

More than 30 years have passed since Dr. Whipple discribed a 2 stage resection for cancer of pancreas in 1935. Through these years, there has been varying enthusiasm for pancreaticoduodenal resection in the management of pancreatic cancer, but high incidence of post-operative complication and mortality were still remained. This 61 years old male patient was admitted to our hospital on 10th December. Physical examination revealed marked yellowish discoloration on entire body, systemic edema, and non-tender palpeble right upper quadrant mass. Liver function tests revealed remarkablly increase level of glucose, total bilirubin, S.G.O.T. and S.G.P.T. E.R.C.P. was suggest pancreatic pseudocyst. Pancreatic biospy from shows infiltration by atypical gland with filbrosis with final diagnosis of pancreatic adenocarcinoma. This paper is concerned with our experience of drainage procedure of the extensively involved pancreatic cancer and reviewed with current oncepts in the manageme nt in literature.

A 7 years old boy with chief complants of acute abdominal pain, fever, nausea and vomiting, was preoperatively diagnosed as acute appendicitis. However, it was postoperatively confirmed that the above distress were due to acute primary Mekel's diverticulitis. The size of the diverticulum was 8cm in length and 4cm in width. It was located at approximately 70cm above ileo-cecal junction. Macroscopically and histologically acute inflammatory changes were found. The patient was discharged on 7th hospital day with satisfactory convalescence.