LIMITATIONS TO EXERCISE AFTER PNEUMONECTOMY

描述：（改编自摘要）这是一个为期五年的提案 延长一个为期三年的项目，以审查 犬肺切除术后的运动限制。 初步数据 表明肺切除术在狗中的耐受性比在人中好得多 并且肺和心脏的解剖学变形的差异可能 解释了这两个物种之间的功能差异。 通过 研究狗能够有效地 补偿肺切除术的影响和这些限制， 补偿，可以进一步了解如何应对可能 在人身上得到改善。 以下具体问题将在成年猎狐犬解决后， 广泛肺切除术：（1）防止过度扩张如何影响 用剩下的肺来补偿吗 (2)低顺应性的 心窝影响心脏代偿功能？ (3)纵膈如何 转移影响补偿？ 和（4）形态变化如何相互关联 功能性补偿？ 这些问题将在两个 阶段 第1期，残存肺扩大，纵隔移位 右肺切除术后，将使用硅橡胶球囊进行预防， 右半胸的形状和充气或不溶性 气体 空气的体积可以通过用以下物质替换假体中的空气来调节： 石蜡或硅酮。 对照组将接受右肺切除术， 球囊植入，无需充气。 在第二阶段， 补偿将通过切除68%的肺进行测试， 不平衡切除（即;右肺切除+左上叶切除 导致纵隔移位）或通过平衡切除， 每侧胸腔的肺容积无纵隔移位。 比较 这些小组检查了在固定水平下纵膈移位的影响， 在剩余的肺中扩张。 将从功能上研究补偿 在清醒的狗休息和运动时， 处死后固定肺。

DESCRIPTION: (Adapted from Abstract) This is a proposal for a five year renewal of a three year project to examine the extent and mechanisms of exercise limitations after pneumonectomy in dogs. Preliminary data indicate that pneumonectomy is much better tolerated in dogs than in humans and that differences in anatomical distortion of the lung and heart may account for the functional differences between these 2 species. By examining the possible mechanisms whereby the dog can so effectively compensate for the effects of pneumonectomy and the limits of these compensations, further insight may be gained as to how the response might be improved in man. The following specific questions will be addressed in adult foxhounds after extensive lung resections: (1) How does preventing over-expansion affect compensation by the remaining lung? (2) How does a low compliance of the cardiac fossa affect compensation by the heart? (3) How does mediastinal shift affect compensation? and (4) How do morphologic changes correlate with functional compensation? These questions will be addressed in two stages. In stage 1, expansion of the remaining lung and mediastinal shift after right pneumonectomy will be prevented with a silastic balloon, molded to the shape of the right hemithorax and inflated with air or insoluble gas. Volume of air can be adjusted by replacing air in the prosthesis with paraffin or silicone. A control group will undergo right pneumonectomy and balloon implantation without air inflation. In stage 2, limits of compensation will be tested by removing 68 percent of the lungs, either by unbalanced resection (i.e.; right pneumonectomy + left upper lobectomy resulting in mediastinal shift) or by balanced resections leaving equal lung volumes in each hemithorax without mediastinal shift. Comparison of these groups examines the effects of mediastinal shift at a fixed level of expansion in the remaining lung. Compensation will be studied functionally in the awake dog at rest and exercise and morphometrically in the inflation fixed lung after sacrifice.