Objective:To evaluate the accuracy of ultrasonography in determining the laryngeal mask airway position using three-dimensional CT reconstruction (3D-CTR) images as the standard.Methods:One hundred and thirty-four patients, aged 18-64 yr, weighing 30-100 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective cerebral vascular interventional stent surgery in our hospital, were selected.Cervical ultrasonography was performed before and after laryngeal mask airway placement, and digital subtraction angiography was performed during operation to obtain 3D-CTR images.Neck ultrasound and 3D-CTR images were analyzed and graded.Results:A total of 125 patients completed the study.At the vertical position of the laryngeal mask airway, ultrasonic grading was positively correlated to 3D-CTR grading ( r=0.742, P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ultrasound in determining the rotation of the laryngeal mask airway was 73.0% (95% CI: 62.0%-84.4%), 92.8% (95% CI: 86.9%-98.7%), 89.1% (95% CI: 80.5%-97.7%), 81.0% (95% CI: 72.6%-89.4%), and 74.2% (95% CI 65.2%-81.1%), respectively.In terms of laryngeal mask airway depth grading, the correlation between ultrasonic grading was positively correlated to 3D-CT grading ( r=0.332, P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ultrasound in determining the depth of the laryngeal mask airway was 58.5% (95% CI: 46.9%-70.1%), 93.3% (95% CI: 87.2%-99.4%), and 90.5% (95% CI: 82.0%-99.0%), 67.5% (95% CI: 57.7%-77.3%), and 33.2% (95% CI: 16.8%-47.8%), respectively.The positive predictive value of ultrasound in determining the optimal placement of the laryngeal mask airway was 61.1% (95% CI: 48.6%-73.6%). Conclusion:Although ultrasound cannot measure the depth of the tip of the laryngeal mask airway into the esophagus, it has higher accuracy in determining the rotation and can be used as a reliable tool for clinical detection of the position of the laryngeal mask airway, especially the rotation.

BACKGROUND: Composite with different ratios has various elastic noduli, and this can cause stress protection in implanted body so as to influence on biological integration between composite and host bone and plerosis of bone defection.OBJECTIVE: To measure elastic modulus of tissue engineering bone made of composite between true bone ceramic (TBC) granule and bone cement (BC) and provide experimental data for repairing bone defection at various sites.DESIGN: Controlled study.SETTING: Military Institute of Bone Tumor, Tangdu Hospital of the Fourth Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Military Institute of Bone Tumor, Tangdu Hospital of the Fourth Military Medical niversity of Chinese PLA from August 2002 to March 2003. Ten Kunming mice,weighing 10-15 g, of both genders, were selected in this study. Fresh longtubular cortical bone of 1-year calf, 6 samples of spongy bone at inferior extremity and 6 samples at iddle femur of fresh corpse were also selected in this study.METHODS: Bovine bone morphogenetic protein (bBMP) was xtracted to measure osteogenic-induced activity and make TBC granule. bBMP was mixed with TBC as the ratio of 1:25, and then with BC as the ratios of 0:10, 4:6, 5:5,6:4 and 7.5:2.5. In addition, elastic modulus of tissue engineering bone made of TBC-BC composite was measured and compared with elastic modulus of femur and spongy bone of normal adult males.MAIN OUTCOME MEASURES: Measurement and comparison of elastic modulus.RESULTS: Elastic modulus of composite containing 60% TBC (Ratio between TBC and BC was 6:4) was no significantly different from that of spongy bone at inferior extremity of femur of normal adult males (P ＞ 0.05),but other comparisons of every two subjects were significant difference [femur of the adults: (6.216 7±0.222 9) Mpa; spongy bone: (1.351 7±0.306 9) Mpa;TBC/BC (0:10): (5.710 0±0.166 3) Mpa; TBC/BC (4:6): (3.510 1±0.205 0) Mpa;TBC/BC (5:5): (2.004 1±0.150 0) Mpa; TBC/BC (6:4): (1.501 8±0.005 7) Mpa;TBC/BC (7.5:2.5): (0.900 4±0.025 1) Mpa, P ＜ 0.01].CONCLUSION: Elastic modulus of composite containing 60% tissue engineering bone made of TBC-BC composite is similar to that of spongy bone at inferior extremity of femur of adult males. The composite can be used to repair bone defection near by articular facet so as to prevent from articular degeneration.

Humans ; Urinary Bladder Neoplasms/pathology* ; Carcinoma, Transitional Cell/pathology* ; Genetic Markers ; Biomarkers, Tumor/genetics* ; Urothelium/pathology*