The application of the fine needle aspiration(FNA) cytology to the soft tissue tumors has been used increasingly in the preoperative diagnosis of these tumors due to its usefulness and accuracy.

We present a case of liposarcoma, showing mosly myxoid component, but small portions of round cell and dedifferentiated component, diagnosed by FNA cytology with histologic confirmation. Good correlation between histologic and FNA cytologic findings was found. Although the cytologic appearances of liposarcomas varied with histologic type, the main criterion was the presence of atpical multivacuolated lipoblast with characgteristically scalloped nuclei.

A clinical study was carried out on 227 cases of gastric cancer managed at Department of General Surgery of EWHA Woman's University Hospital, from January 1986 to December 1992.

The results were as follows :

1) The age were 27 years to 92 years, and the most freguent age group was 6th decade.

2) The sex ratio of male to female was 1.8:1.

3) The duration of symptom were less than 6 months in 62.5% and more than 6 months in 37.5%.

4) The most common subjective symptoms were epigastric pain & discomfort(79.2%), indigestion(33%), weight loss(13.2%) and nausea & vomiting(11.8%) respectively.

5) The proportion of blood group A among all cases was 37% which was slight higher than that of general population 32.6%.

6) Epigastric tenderness was most common physical finding(44.9%), but 14.5% of all cases had no physical findings.

7) The most common lesion location were antrum & pylorus in 69%, body and fundus were 27% and 4% respectively.

8) 99.6% of all acse were adenocarcinoma.

9) Early gastric cancer were found in 21.1% of cases.

10) The operability was 92.5%, and resectability was 85.9%.

11) Postoperative morbidity was 18%, Wound infection and enterocutaneous fistula were most common complications.

Most of the progress in the diagnosis and treatment of biliary tract disease has been made in the last century. but the gallstones and their sequelae which cause most of the clinical problems. are not malady of modern times.

Alternatives to traditional cholecystectomy were developed during the 1980s and are currently undue evaluation. They include oral chemolysis. extracorporeal shock wave lithotripsy. percutaneous dissolution and extaction, and laparoscopic cholecystectomy.

One of the goals of interventional surgery is to simplify patient care by performing surgical techniques percutaneously. Cholecysrectomy is one technique that, lends itself to interventioal approach. one acan envision replacing surgery with a four step procedure. 1) percutaneous cholecystostomy 2) percutaneous stone removal 3) sclerosis and fibrosis of the gall bladder 4) cystic duct occlusion.

Both percutaneous cholecystostomy and stone removal have been performed frequently and are in the interventional repertoire. Sclerosis of biliary system may be derived from experience with chemical agents. The aim of this study is a preliminary clinical application of chemical fibrosis of gallbladder with 95% Ethanol and 5% Phenol for treatment of gallbladder diseases.

The following results were obtained:

1) The values of liver function test were normnal on postoperative 1 day. 1 week and 4 weeks in cystic duct ligated control group.

2) AST, ALT and ALP were increased markedly on postoperative 1 day after 10, 30 and 60 minutes injection groups into gallbladder with both 95% ethanol and 5% phenol.

3) The edema, congestion and inflammatory changes of gallbladder were mildly developed on postoperaive 1 day. 1 week and 4 weeks in 10, 30, and 60 minutes cystic duct ligated control group.

4) The fibrosis of gallbladder was moderately to severely developed on postoperative 4 weeks after 10, 30 and 60 minutes injection group into gallbladder with 95% ethanol.

5) The fibrosis of gallbladder was moderately developed on postoperative 4 weeks after 10, 30 and 60 minutes injection group into gallbladder with 5% phenol.

Inspite of a limited number of observation, the chemical sclerosing agents may be useful treatmental method for gallstone patient if applied in selected cases and it should he opened for further study in lager experimental group.

The hepatobiliary stone is one of the most common surgical disease in Korean population, and intrahepatic stone is found in 9~22% of the biliary calculous disease in Korea. A retrospective clinical study was done in 25 cases of intrahepatic stones who underwent operation in Ewha Womans University Hostpital during from Jan. 1986 to Sept. 1990

The result obtained are follows :

1) The incidence of intraphepatic stones to all gall stones during the period was 12%.

2) The incidence of sex was slightly predominent in famale than male with the ratio of 1 : 1.3. The peak age incidence was 4th decade. the mean age was 51.8 years old.

3) Left intrahepatic duct stones were found in 9 cases(36%), right intrahepatic duct stones were found in 4 cases(16%), both intrahepatic duct stones were found in 4(16%) cases.

4) Subjective symptoms were RUQ pain, jaudice, and fever and chills.

5) The most valuable diagnostic methods were endoscopic retrograde cholangiopancreatog. ram(ECRP), percutaneous transhepatic cholangiogram(PTC), computed axial tomography(CT) and abdominal sonography.

6) Operative procedures underwent, left lobectomy and segmentectomy in 9 cases, choledochojejunostomy or choledochoduodenostomy in 14 cases.

7) Post operative coplication was 3 cases (12%) of subphrenic abscess, 1 cases(4%) of septicenmia and wound infection.

In conclusions, the valuable diagnostic methods of intrahepatic duct stones are ERCP, PTC, abdominal sonography and CT. The hepatic lobectomy or segmentectomy is the best procedure for intrahepatic duct stones.

Since extracorporeal shock waves lithotripsy in urinary tract has been proved successful, it leads to extend the technology to the treatment of gallstones. Before preliminary clinical application of extracorporeal shock wave lithotripsy for gall stone, I evaluated the effects of Extracorporeal SD-3 lithotripsy on the various abdominal organs of the dogs and its efficacy on experimentally induced cholelithiasis in the same species.

In spite of a limited number of observation, the high energy shock wave was not serious complication of abdominal organs, and experimentally induced gall stone in the dogs seems to be effectively fragmented and tolerated in the composition of cholesterol stone, but not effect in pigment stone.

In conclusion, the biliary lithotripsy with extracorporeal shock wave may be a useful treatmental method if applied in selected cases and it should be opened for further study in larger experimental group.

The nonfunctioning islet cell tumors of pancreas are not associated with obvious sign and symptoms of hormone overproduction. Symptoms, most commonly pain and jaundice, are due to the mass effect of the tumor and invasion of the surrounding structures, and unlike functioning tumors, the location of the tumor has a direct bearing on the patient's symptoms. We have experienced a case of benign nonfunctioning islet cell tumor of the pancreas in 47-year-old female. She was admitted to our hospital due to palpable large mass of her abdomen. She had no obvious sign and symptoms of hormone overproduction. The exploratory laparatomy was done under the impression of retroperitoneal tumor with the information of radiologic finding and abdominal C-T scan. The pathologic diagnosis was benign nonfunctioning islet cell tumor of the pancreas.

The formation of gall stone is considered to be occurred by vsrious factors. There major factors have been considered to be of etiologic importance : 1) a physiochemical disorders of bile, 2) stasis of bile, 3) infection or inflammation of the biliary system. Especially, bilirubin stone is found frequently in Korea and the formation of the bilirubin stones is much corelated to the infection or inflammation. This study is a review and analysis of 68 cases of the bile culture in the biliary tract disease that were admitted and treated at Ewha Womans University Hospital from June 1980 to June 1983. The results are as follows : 1) The age group of the highest incidence was 60 decades(29.4%) and 40 decades(25%) in next. 2) There was 22 male 46 female and male to female ratio was 1:2. 3) In 57 cases of calculus biliary tract disease, the location of stone were 29 cases(42.6%)in gall bladder, 11 cases(16.2%) in common bile duct and 11 cases(16.2%)in gall bladder and common bile duct. No stone was 11 cases(16.2%). 4) In 68 cases fo the biliary tract disease, 47 cases(69.1%) were positive culture and in 57 stone cases of biliary tract disease, 44 cases(77.2%) were positive culture. 5) In relation to postop. Dx. and bile culture, the positive culture in G.B. bile was 58.3% and positive culture in CBD bile was 100% in acute cholecystitis with stone cases, where as, the positive G.B. bile culture was 50% and the positive CBD bile was 59.3% in chronic cholecystitis with stone cases.

70 patients of abdominal trauma were reviewed for 8 years from June 1974 to June 1982 and the results were as follows:1) The monthly distribution indicated prominant incidence was September. 2) The male to female ratio was 5:1 and the prevalent age was third decade(42.9%). 3) The most common mode of injury was traffic accident(34.3%), stabbing(31.4%), blowing and kicking(25.7%), in order of frequency. 4) Among 70 cases, 48 cases(68.6%) were blunt trauma whereas 22 cases(31.4%) were penetrating injury. 5) 24 cases(49%) of injuried patients were operated within 6hrs. after injury and 40 cases(81.6%) of injuried patients were operated within 24hrs. after injury. 6) The clinical manifestations were abdominal pain(90%), tenderness(82%), rigidity(68.6%), rebound tenderness(60%). 7) Abdominal paracentesis was performed in 23 cases, of which 18 cases(78.3%) revealed positive findings. 8) The injuried intraperitoneal organs were small intestine(36.9%), mesentery(21.9%), spleen(10.9%), retroperitoneum in the order of frequency. 9) The associated injuries were chest injury, fracture of lower extremities, rib fracture, pelvic bone fracture in the order of frequency. 10) Primary closure of G-I tract, splenectomy was done mostly. 11) The complication were seen in 12 cases and the wound infection(41.7%) was the most common. 12) Overall mortality rate was 4.3% and the cause of death was hypovolemic shock in most part.