BACKGROUND: Propofol and ketamine had been used for anesthesia induction and for total intravenous anesthesia. The nature of any hypnotic interactions occurring between propofol and ketamine are unknown. A comparison of maternal and neonatal effects among propofol-ketamine combination, ketamine and propofol were studied when used for anesthesia induction in Cesarean section. METHODS: Forty five patients in ASA class I or II scheduled for Cesarean section randomly assigned to either propofol 2 mg/kg (n=15), ketamine 1 mg/kg (n=15) or propofol 1 mg/kg - ketamine 0.5 mg/kg combination group (n=15) as an induction agent. Maternal systolic and diastolic blood pressure, heart rate, Apgar score and umbilical blood gas analysis were measured. RESULTS: Before intubation, systolic and diastolic pressure were decreased in propofol group but increased in ketamine and propofol-ketamine combination group. Heart rate were increased in all three groups. But there were no significant differences among three groups (p<0.05). After intubation, there were significant increase in systolic, diastolic pressure and heart rate in three groups but no significant differences among three groups (p<0.05). And there was no significant neonatal depression as assessed by Apgar scores and blood gas analyses. CONCLUSIONS: Propofol-ketamine combination was found to be similar to propofol or ketamine only in the effects on the mother and neonate. But propofol-ketamine gained more stable hemodynamic change than propofol or ketamine before intubation. Therefore propofol-ketamine appears to be a suitable alternatives to propofol or ketamine as an induction agent for anesthesia in Cesarean section.
Anesthesia ; Anesthesia, Intravenous ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Depression ; Female ; Heart Rate ; Hemodynamics ; Humans ; Infant, Newborn ; Intubation ; Ketamine* ; Mothers ; Pregnancy ; Propofol*

OBJECTIVES: OSAS (obstructive sleep apnea syndrome) is a common disorder and its consequences are often serious. It is important to detect the disorder early in the course for proper treatment. This study is to grasp the snoring clinic visitors' knowledge level of OSAS. METHODS: One hundred and seventy-nine visitors at the of snoring clinic of Seoul National University Hospital were surveyed by questionnaire about reasons of visit and knowledge of treatment methods of snoring and OSAS, diagnostic method, OSAS-related symptoms, and complications. RESULTS: Most of the respondents (89.4%) "have already heard about OSAS" and the major sources of information was the mass media (58.1%) such as television and radio. More than half (60.3%) were aware that snoring is closely related to OSAS. More than half (59.8%) recognized that a nocturnal polysomnograpy was necessary for proper diagnosis. Two thirds (67%) of the respondents noted surgery as a treatment for snoring. More than half (55.9%) answered that they would follow the doctor's advice on the treatment choice. Only 12.3% of respondents "have heard about nCPAP". No one chose nCPAP (nasal continuous positive airway pressure) as a treatment for either snoring or OSAS. About one third (34.6%) of the respondents were aware that OSAS is related to hypertension. Only 12.8% noted that OSAS is related to diabetes mellitus. CONCLUSION: Visitors at the snoring clinic were found to have substantially limited knowledge of health risks and proper treatments of OSAS. We suggest that it is crucially important to educate patients and offer easy-to-understand information on snoring and OSAS. We predict that provision of educaiton and information to patients and general public will faciliate the diagnosis and treatment of snoring and OSAS and reduce the related disorders such as hypertension, stroke, and diabetes mellitus.
Diabetes Mellitus ; Hand Strength ; Humans ; Hypertension ; Mass Media ; Surveys and Questionnaires ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring ; Stroke ; Television

Solid pseudopapillary tumor (SPT) is a low grade malignant tumor in the pancreas, and extrapancreatic SPT is extremely rare. We report a case of a 61-year-old woman who complained abdominal pain with diffuse tenderness. She was diagnosed with extrapancreatic SPT with extensive peritoneal dissemination and hepatic metastases. Although a few cases have reported imaging findings of extrapancreatic SPT, there have been no reports of extrapancreatic SPT with aggressive tumor behavior and dismal prognosis. Although imaging features closely resembled those of classical pancreatic SPTs, malignant transformation of extrapancreatic SPT should be considered when focal discontinuity of the tumor capsule with ill-defined margin and invasion of adjacent structures were identified.
Abdominal Pain ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Pancreas ; Prognosis ; Ultrasonography