BACKGROUND: Extramammary Paget's disease (EMPD) is an uncommon but distinctive tumor. Definitive diagnosis requires biopsy of the lesion and immunohistochemical staining. Immunohistochemical study using anti-cytokeratin monoclonal antibodies may be helpful for differentiating EMPD from other similar skin lesions and primary EMPD from pagetoid spread of underlying regional internal malignancy (secondary EMPD). OBJECTIVE: The purpose of this study was to identify clinical findings, histopathologic features and immunohistochemical characteristics of EMPD. METHODS: The twelve cases diagnosed as EMPD at our institution over ten years were included. Clinical records and pathology slides of the patients were reviewed retrospectively. Immunohistochemical stains for CK7, CK20, CEA, EMA, PSA, GCDFP15 and mucin stains such as PAS, d-PAS, alcian blue (pH 2.5) were done using paraffin blocks. RESULTS: 1. In most cases, EMPD developed on the scrotum of senile male patients. 2. In the pathologic findings, Paget cells were observed from the epidermis only in 2 cases, from the epidermis and intradermal skin appendages in 7 cases and from the dermis in 3 cases. 3. In all cases except for the single case associated with a transitional cell carcinoma of the urinary bladder, there were histochemical findings of alcian blue-, PAS- and immunohistochemical findings of CK7+, CK20-, CEA+, EMA+. 4. In the single case associated with transitional cell carcinoma of the urinary bladder, there were histochemical findings of alcian blue-, PAS- and immunohistochemical findings of CK7+, CK20+, CEA-, EMA-. CONCLUSION: The combination of CK7 and CK20 demonstrates these to be useful markers in distinguising primary EMPD from a pagetoid spread of extracutaneous malignancies. Namely, immunophenotypes other than CK7+/CK20- in Paget cells suggest underlying regional internal malignancy.
Male ; Humans ; Biopsy

This research has done for 262 people of the aged men and women that are more than 65 years old who are live in 9 areas of Yecheon as target; through twice of face to face interview for 24 hours recall method, the result of food intake for 2 days is as following. In case of energy, the aged men (women) of sixties ingested 67.7 (72.0)% of Korean RDA by 1,369 (1264) kcal, for the ages of seventies and eighties, 68.9 (66.9)% of Korean RDA and 76.3 (65.8)% by each 1,309 (1104) kcal and 1,368 (1052) kcal. The aged men ingested protein 46.0~49.6 g (70.6~82.9% of RDA), and aged women ingested protein 32.7~40.2 g (59.4~73.0% of RDA). Calcium intake of aged men was 388.8 mg, 319.8 mg, 284.4 mg by age range, and aged women was 291.9 mg (41.6% of RDA), 246.5 mg (35.3% of RDA), 240.1 mg (34.3% of RDA). Iron intake of aged men was 8.6~8.9 mg (72~74% of RDA), and aged women ingested 8.6 mg (71.3% of RDA), 7.5 mg (62.6 of RDA%), 6.6 mg (55.4% of RDA) for iron by age range. Vitamin B1 intake of aged men was 0.62~0.71 mg (62~71% of RDA), and aged women's intake was 0.50~0.60 mg (50~60% of RDA). Vitamin B2 intake of aged men was 0.59~0.60 mg (49% of RDA), and aged women's intake was 0.45~0.50 mg (37~42% of RDA). Vitamin C intake by age range, in case of aged men (women) in sixties was 53.1 (48.9) mg, in seventies was 49.9 (33.2) mg and more than eighties was 34.1 (33.4) mg. The average food intake by age range, in aged men (women) of sixties was 828.9 (670.8) g and seventies was 726.8 (568.8) g and more than eighties was 656.0 (525.3) g. Plant food intake of aged men was 490.8~569.5 g and aged women was 417.9~537.7 g. Aged men (women) of MAR by age range, sixties was 0.60 (0.58), seventies was 0.59 (0.50) and more than eighties was 0.56 (0.49), respectively. INQ for protein, phosphorus, iron, vitamin A, vitamin B, niacin, vitamin C was more than 1 in 60's and 70's aged men, but there was no nutrients in eighties of aged women. Aged men and women's KDDS points represent average 3.14 and 3.04 (out of 5 points), and while intake of the milk was the most lacking, but intake of the fruit was the most lacking in DDS.
Aged ; Ascorbic Acid ; Calcium ; Eating ; Female ; Fruit ; Gyeongsangbuk-do* ; Humans ; Iron ; Male ; Milk ; Niacin ; Phosphorus ; Plants ; Riboflavin ; Thiamine ; Vitamin A ; Vitamins

A seven-year-old boy with a history of recurrent aspiration pneumonia was admitted to the Seoul National University Hospital for suspension examination. Anesthesia was induced through the T-cannula with oxygen and enflurane, and ventilation of the lungs was performed easily and resulted in good bilateral breathing sounds. After administration of thiopental, atropine, and vecuronium, endotracheal intubation was administered through the tracheostomy site with an endotracheal tube. Manual ventilation through the pediatric circuit system failed to raise the chest wall. Breathing sounds were absent. Manual assessment of the reservoir bag revealed extremely poor compliance. Immediately, we examined the trachea via ventilation-assisted bronchoscopy and a 2 cm-long diverticulum located in the posterior wall 1.5 cm below the tracheostomy site was discovered. we could therefore understand the reason for the ventilation impairment. The tip of the tube impinged through the diverticulum. After widening the pathway, endotracheal intubation was accomplished successfully into the tracheostomy site and ventilation of the lung was performed easily and resulted in good bilateral breathing sounds. After suspension examination and T-cannula insertion the patient recovered from anesthesia and was transfered to the recovery room.
Anesthesia ; Atropine ; Bronchoscopy ; Compliance ; Diverticulum* ; Enflurane ; Humans ; Intubation, Intratracheal* ; Lung ; Male ; Oxygen ; Pneumonia, Aspiration ; Recovery Room ; Respiratory Sounds ; Seoul ; Thiopental ; Thoracic Wall ; Trachea ; Tracheostomy ; Vecuronium Bromide ; Ventilation