BACKGROUND: The laryngeal tube is a variant of the esophageal obturator airway. We compared laryngeal tube (LT), laryngeal mask airway classicTM (LMA) and laryngeal mask airway ProsealTM (PLMA) as a airway management device during general anesthesia. METHODS: Forty-five fasted healthy adult patients were enrolled in this study into one of three groups in a randomized, single-blinded protocol. Group 1 was to receive LT for airway management, LMA for Group 2, and PLMA for Group 3. General anesthesia was induced identically in three groups with thiopental sodium 5 mg/kg followed rocuronium 0.6 mg/kg. 90 seconds later, LT, LMA or PLMA was placed for airway management. Blood pressure and heart rate were measured immediately pre-induction control value, post-insertion of device 0 min, 1 min, 3 min and 5 min. We also compared times of insertion, the amounts of secretion, blood stain, and postoperative sore throat. RESULTS: There was no significant change of SBP, DBP and HR within three groups. All the groups showed stable hemodynamic results. The success rate on the first attempt was 93.6% (14/15, Group 1), 93.6% (14/15, Group 2) and 86.6% (13/15, Group 3). Minimum cuff volume to prevent gas leakage was 69.9+/-0.5 ml (Group 1), 11.1+/-4.3 ml (Group 2) and 11.9+/-3.2 ml (Group 3). The corresponding cuff pressure was 61.6+/-22.0 cmH2O (Group 1), 4.8+/-0.9 cmH2O (Group 2) and 4.6+/-1.5 cmH2O (Group 3). Moderate, severe sore throat was 20% (3/15, Group 1), 6.6% (1/15, Group 2) and 6.6% (1/15, Group 3). Moderate, profuse secretion was 40% (6/15, Group 1), 20% (3/15, Group 2) and 13.3% (2/15, Group 3). There was a 20% (3/15, Group 1) and 13.3% (2/15, Group 3) blood stain. But there was no blood stain for the Group 2. There was a 20% (3/15) gas leakage in Group 1, so we had to insert gas intermittently, but there were no gastric distension, regurgitation, aspiration, hypoxia, airway obstruction and laryngospasm in all three groups. CONCLUSIONS: All the groups revealed stable hemodynamics, no serious complications such as regurgitation, aspiration, hypoxia and airway obstruction during general anesthesia. But we did not find any evidence that LMA and PLMA have the remarkable advantages than laryngeal tube. So we suggested that laryngeal tube could be an alternative airway management device, even though further study will be needed.
Adult ; Airway Management ; Airway Obstruction ; Anesthesia, General* ; Anoxia ; Blood Pressure ; Blood Stains ; Heart Rate ; Hemodynamics ; Humans ; Laryngeal Masks* ; Laryngismus ; Pharyngitis ; Thiopental

BACKGROUND: Although elevated serum cholesterol level has been considered as a significant health problem because it is associated with coronary artery disease, the relation with various health problem (esp. depression) from low serum cholesterol is not well known in Korean people. The authors tried to observe the degree of depression in low serum cholesterol group for its better management. METHODS: The study population was selected among adults who visited the National University Hospital Health Screening Center between May and July 1998. They had no history of cancer and liver disease and no significant medical illnesses which may affect blood cholesterol level. Using the Korean standard BDI, we evaluated the degree of depression scale. RESULTS: The number of subjects with low serum cholesterol was 77 (males 42, females 35) and that of the control group was 82 (males 47, females 34). The low serum cholesterol group had a statistically significantly higher BDI score(12.2+/-8.2) than the control group (7.6+/-6.3) (P<0.05). In males the mean BDI score of 11.9+/-7.4 in the low serum cholesterol group was significantly higher than the mean score of 5.0+/-3.8 in the control group (P<0.05). In females, there was no significant difference in depression scale between both groups. CONCLUSION: Since the male low serum cholesterol group had a high depression scale, the multi-disciplinary approaches which include psychological supports may be required to manage and treat them. And persistent significant association between low serum total cholesterol level and psychological problems suggests that further long-term study on the association of low cholesterol with depression is necessary.
Adult ; Cholesterol* ; Coronary Artery Disease ; Depression* ; Female ; Humans ; Liver Diseases ; Male ; Mass Screening

Background: The association between renal dysfunction and cardiovascular outcomes has yet to be determined in patients with hypertrophic cardiomyopathy (HCM). We aimed to investigate whether mildly reduced renal function is associated with the prognosis in patients with HCM. Methods: Patients with HCM were enrolled at two tertiary HCM centers. Patients who were on dialysis, or had a previous history of heart failure (HF) or stroke were excluded. Patients were categorized into 3 groups by estimated glomerular filtration rate (eGFR): stage I (eGFR ≥ 90 mL/min/1.73 m2 , n = 538), stage II (eGFR 60–89 mL/min/1.73 m2 , n = 953), and stage III–V (eGFR < 60 mL/min/1.73 m2 , n = 265). Major adverse cardiovascular events (MACEs) were defined as a composite of cardiovascular death, hospitalization for HF (HHF), or stroke during median 4.0-year follow-up. Multivariable Cox regression model was used to adjust for covariates. Results: Among 1,756 HCM patients (mean 61.0 ± 13.4 years; 68.1% men), patients with stage III–V renal function had a significantly higher risk of MACEs (adjusted hazard ratio [aHR], 2.71; 95% confidence interval [CI], 1.39–5.27; P = 0.003), which was largely driven by increased incidence of cardiovascular death and HHF compared to those with stage I renal function. Even in patients with stage II renal function, the risk of MACE (vs. stage I: aHR, 2.21’ 95% CI, 1.23–3.96; P = 0.008) and HHF (vs. stage I: aHR, 2.62; 95% CI, 1.23–5.58; P = 0.012) was significantly increased. Conclusion This real-world observation showed that even mildly reduced renal function (i.e., eGFR 60–89 mL/min/1.73 m2 ) in patients with HCM was associated with an increased risk of MACEs, especially for HHF.