LIMITATIONS TO EXERCISE AFTER PNEUMONECTOMY

描述：(摘自摘要)这是一份为期五年的提案 延长一项为期三年的项目，以审查 犬全肺切除术后的运动限制。初步数据 表明狗的肺切除术比人的耐受性好得多。 肺和心脏的解剖扭曲程度的差异可能 解释了这两个物种之间的功能差异。通过 研究可能的机制，使狗可以如此有效 补偿全肺切除术的影响和限制 补偿，可能会获得关于如何应对的进一步洞察 在人类中得到改进。 以下具体问题将在成年狐狸猎犬身上得到解决 肺广泛切除：(1)防止肺过度扩张有何影响 由剩余的肺进行补偿？(2)低依从性如何 心窝影响心脏的代偿？(3)纵隔如何 班次会影响薪酬吗？以及(4)形态变化是如何关联的 有功能补偿吗？这些问题将分两部分来回答。 各阶段。在第一阶段，剩余肺扩张和纵隔移位 右全肺切除后将使用硅胶气球，模制而成 右半胸形状，充气或不溶于水 汽油。可以通过将假体中的空气替换为 石蜡或硅胶。对照组将接受右全肺切除术。 无空气充气的气囊植入。在阶段2中，限制 补偿将通过切除68%的肺进行测试，要么是 不平衡切除(即右全肺切除+左上肺叶切除 导致纵隔移位)或通过平衡切除而保持相等 无纵隔移位的双侧胸腔的肺体积。比较 这些小组检查了在固定的水平上纵隔移位的影响 在剩下的肺里扩张。薪酬将从功能上进行研究 在清醒的狗休息和锻炼中和在充气时的形态计量学 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.