ABSTRACT. We aimed to study the feasibility of a comfortable and secure intubation achieved with the Disposcope endoscope or Macintosh laryngoscope when glottis viewing is difficult. Forty adults scheduled for elective surgery under general anesthesia, in whom glottis viewing was difficult with the Macintosh laryngoscope (classified as CormackLehane Grade III or IV), were randomized into 2 groups (N = 20 each): Disposcope endoscope (Group D) and Macintosh laryngoscope (Group M). We recorded the successful glottis viewing rate; intubation time; successful intubation rate; incidence of systolic blood pressure (SBP) ≥140 mmHg and heart rate (HR) ≥90 bpm from the beginning of intubation to 5 min after intubation; and postoperative sore throat and hoarseness. Successful glottis viewing rate and successful first intubation rate were higher in Group D than in Group M (P < 0.05); Patient glottis viewing difficulty the number of intubations taking >3 min and with SBP ≥140 mmHg and HR ≥90 bpm were less in Group D (P < 0.05). The visual analogue scale of postoperative sore throat 1 day after extubation was higher in Group M than in Group D (P < 0.05). No significant differences were found in other indices (P > 0.05). Better stability of hemodynamics, less intubation time, higher successful first intubation rate, and fewer incidences of postoperative sore throat were achieved in Group D than in Group M. Thus, comfortable and secure intubation can be achieved using the Disposcope endoscope in patients in whom glottis viewing is difficult.
28Although the mechanisms that control growth are now well understood, the mechanism by which 29 animals assess their body size remains one of the great puzzles in biology. The final larval instar 30 of holometabolous insects, after which growth stops and metamorphosis begins, is specified by a 31 threshold size. We investigated the mechanism of threshold size assessment in the tobacco 32 hornworm, Manduca sexta. The threshold size was found to change depending on the amount of 33 exposure to poor nutrient conditions whereas hypoxia treatment consistently led to a lower 34 threshold size. Under these various conditions, the mass of the muscles plus integuments was 35 correlated with the threshold size. Furthermore, the expression of myoglianin (myo) increased at 36 the threshold size in both M. sexta and Tribolium castaneum. Knockdown of myo in T. 37 castaneum led to larvae that underwent supernumerary larval molts and stayed in the larval stage 38 permanently even after passing the threshold size. We propose that increasing levels of Myo 39 produced by the growing tissues allow larvae to assess their body size and trigger metamorphosis 40 at the threshold size. 41 42 43 44 Keywords 45 Myoglianin; threshold size; body size; muscle growth; Manduca sexta 46 BACKGROUND 47
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