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Lung volume reduction surgery (LVRS) has become an accepted therapeutic option to relieve symptoms of selected patients with severe emphysema. In a majority of these, it causes objective as well as subjective functional improvement. A proper understanding of the physiological determinants underlying these beneficial effects appears very important in order to better select patients for the procedure which is currently largely done on an empirical basis. On the average, LVRS results in two distinct effects. First, it increases the lung elastic recoil which explains at least partially the enhanced maximal expiratory flow. Second, it is associated with a reduction of hyperinflation which allows for an increase in global inspiratory muscle strength and in diaphragmatic contribution to tidal volume (VT) as well as a decrease if the inspiratory elastic load imposed by the inward movement of the chest wall at the beginning of inspiration. Taken together, these effects result in a reduced dyspnea and increased exercise capacity after surgery. The improved lung recoil and the reduced hyperinflation after volume reduction surgery were the primary postulates upon which the usual selection criteria for the procedure were based. It is now likely that these were correct. Nevertheless, some patients do not benefit from LVRS and the current literature does not allow us to refine the selection process from a physiological point of view. The exact mechanisms underlying the improvement of lung recoil, lung mechanics, and respiratory muscle function remain incompletely understood. Moreover, the effects of LVRS on gas exchange and pulmonary hemodynamics are still to be more fully investigated. An analysis of the characteristics of patients who do not benefit from the procedure and the development of an animal model fro LVRS would probably help us to address these important issues

Proefschriften --- Thèses --- Pneumonectomy --- Pulmonary Emphysema --- Dyspnea --- Cricetinae --- Academic collection

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Carcinogenicity testing --- Hamsters --- Pathology, Comparative --- Tumors --- Diseases --- Animal models --- -Pathology, Comparative --- -Neoplasms --- Tumours --- Pathology --- Cysts (Pathology) --- Oncology --- Comparative pathology --- Medicine, Comparative --- Cricetinae --- Cricetini --- Muridae --- Carcinogenesis --- Carcinogenic activity testing --- Carcinogens --- Testing for carcinogenicity --- Chronic toxicity testing --- Oncology, Experimental --- Testing --- -Diseases --- -Comparative pathology --- Neoplasms --- Hamsters - Diseases --- Tumors - Animal models

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Malignant neoplasms occurring in the biliary tract and pancreas remain a therap- tic challenge. The mechanism of carcinogenesis as well as the growth and spread of these tumors is still poorly understood, making the development of rational tre- ment strategies difficult. In order to improve the clinical results achieved by sur- cal or other medical treatment of such malignant tumors, the establishment of an experimental animal model is critical. For this purpose, attempts were made to induce carcinoma experimentally in the biliary tree and finally an animal model using the hamster was established in 1994 at our laboratory. Because the tumor in this model mimicked the characteristics of human tumors, a series of experimental investigations were conducted to clarify the pathological characteristics of biliary carcinoma, the genetic alterations during biliary carcinogenesis, and the relationship between biliary inflammation and c- cinogenesis. The chemopreventive effects on the occurrence of biliary carcinoma were also successfully examined. In addition, in vitro studies led to the establi- ment of transplantable biliary cancer cell lines and biliary epithelial cell lines by utilizing the hamster model. This monograph represents the collective efforts in hepato-biliary and pancreatic disease research over the past 20 years. I hope that this monograph will be a source of useful knowledge for basic researchers as well as for clinicians involved in the care of patients with hepato-biliary and pancreatic neoplasms. Takashi Kanematsu, M.D., Ph.D.

Animal Physiology. --- Cancer -- Animal models. --- Cytology -- Technique. --- Biliary Tract Neoplasms --- Pancreatic Neoplasms --- Cricetinae --- Liver Neoplasms --- Models, Animal --- Carcinoma --- Pancreatic Diseases --- Digestive System Neoplasms --- Muridae --- Endocrine Gland Neoplasms --- Neoplasms, Glandular and Epithelial --- Investigative Techniques --- Liver Diseases --- Biliary Tract Diseases --- Endocrine System Diseases --- Digestive System Diseases --- Neoplasms by Histologic Type --- Analytical, Diagnostic and Therapeutic Techniques and Equipment --- Neoplasms by Site --- Rodentia --- Diseases --- Neoplasms --- Mammals --- Vertebrates --- Chordata --- Animals --- Eukaryota --- Organisms --- Oncology --- Gastroenterology --- Medicine --- Health & Biological Sciences --- Liver --- Biliary tract --- Pancreas --- Animal models. --- Biliary tree --- Medicine. --- Cancer research. --- Hepatology. --- Surgical oncology. --- Animal anatomy. --- Animal physiology. --- Biology --- Biomedicine. --- Cancer Research. --- Biological Techniques. --- Animal Anatomy / Morphology / Histology. --- Surgical Oncology. --- Technique. --- Digestive organs --- Endocrine glands --- Exocrine glands --- Bile --- Abdomen --- Oncology. --- Cytology --- Morphology (Animals). --- Clinical medicine. --- Research --- Methodology. --- Cancer --- Oncologic surgery --- Oncological surgery --- Surgical oncology --- Medicine, Clinical --- Animal physiology --- Anatomy --- Animal morphology --- Body form in animals --- Zoology --- Morphology --- Cell biology --- Cellular biology --- Cells --- Cytologists --- Tumors --- Excision --- Treatment --- Physiology --- Biology—Technique. --- Animal anatomy --- Cancer research