To the editor: Both the Airway Scope (Pentax-AWS system; AWS; Pentax, Tokyo, Japan) and the Airtraq (ATQ; Prodol Meditec, Vizcaya, Spain) are anatomically shaped new intubation devices which provide an indirect view of the glottis without requiring the laryngoscopist's line of sight [1][2][3]. They both have a tube channel in the right side of the blade which holds the endotracheal tube (ETT) and directs it towards the vocal cords. Japan is the fi rst country to have obtained approval for the clinical use of both these devices, and we have noticed that many anesthesiologists confuse the AWS with ATQ.Although the two devices have very similar blade confi gurations, the tip positions for elevating the epiglottis are different. According to the manufacturer's manual, the AWS tip position should be inserted posterior to the epiglottis, directly elevating it out of the way (Miller-type approach), whereas it is recommended that the ATQ tip be placed in the vallecula for indirect lifting of the epiglottis (Macintosh-type approach). For the ATQ, the Miller-type approach is also possible as an alternative. But for the AWS, there is no description of an alternative (Macintosh-type) approach.These different approaches indicate that the routes that the blade passes through are different for each device. The AWS tip should be pass through a posterior route, in that the blade is inserted along the palate and posterior pharyngeal wall to facilitate passage behind the epiglottis, with the insertion being similar to that of a laryngeal mask airway. On the other hand, the recommended ATQ approach uses an anterior route, in that the blade tip glides on the tongue surface to the base of the tongue and is to be inserted into the vallecula.We performed intubation with both devices, using two different approaches with each device. After the obtaining of institutional ethical committee approval, 15 anesthesiologists performed intubation on a manikin intubation trainer (Airsim Multi; TruCorp, Belfast, UK). Intubation with the recommended technique for each device was successful in all attempts. However, AWS intubation using a Macintosh-type approach failed in 12 of 15 attempts due to ETT impingement onto the epiglottis, whereas ATQ intubation using the Millertype approach was successful in 15 of 15 attempts including 3 in which ETT impingement onto the arytenoid occurred, and Fig. 1. Difference between the Pentax Airway Scope (AWS) and the Airtraq (Prodol Meditec) (ATQ). Two blades holding the endotracheal tube (ETT) in the channel are shown. The TT advanced from the AWS blade (upper panel) seems to go upward, so there is no space between the ETT and the blade tip, resulting in frequent impingement onto the epiglottis when using the Macintosh-type (Mac) approach for intubation. Therefore, only the Miller-type (Mil) approach should be used for ATQ intubation. The ETT advanced from the ATQ blade (lower panel) seems to go downward, so there is a space between the ETT and the tip (white arrow), which contributes to successful ETT placement d...

During intubation with the Bullard laryngoscope, use of the Parker Flex-Tip tube is associated with more rapid success and a lower incidence of re-direction of the Bullard laryngoscope during endotracheal intubation when compared to a standard endotracheal tube.

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Aconsciousness survey concerning the demand for and supply of dental care was con − ducted among the inhabitants in Nagasaki city having an excess of dentists ， in Takashima − cho having no dentist and in Sasebo city which is the intermediate type between the above two areas ． As a result ， the inhabitants in Nagasaki city were quantitatively satisfied with the provlslQn of dental care ， while there was an extremely high demand for the care in Taka − shima − cho ． In Sasebo city ， the degree of satisfaction with the dental care tended to be the same as that in Nagasaki city ，

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