Functional architecture of the splenic vein in the adult human

The spatial arrangement of the muscular, elastic and collagenous fibers was examined in 20 splenic veins of adult humans. Histologic and panorganographic sections were stained by the following methods: azan, resorcinfuchsin (Weigert), Verhoeff-van Gieson's stain and Masson's trichrome. Unstained sections were examined under polarized light. The results show that the muscular and collagenous fibers of the splenic vein exhibit an elongated spiral arrangement with no polarization. The elastic fibers form a threedimensional network disposed predominantly in a longitudinal direction. Hemodynamics are discussed based on the spatial structure of the muscular, elastic and collagenous elements of the vein wall and its relationship with the circulatory functions of the spleen.     

Elastic fibers in the anulus fibrosus of the dog intervertebral disc

A light microscopic investigation of the anulus fibrosus in cervical intervertebral discs of the dog was conducted to ascertain the arrangement and distribution of elastic fibers. Elastic fibers were observed in all lamellae of the anulus fibrosus. However, collagenous fibers were the predominant type of connective tissue fiber, and elastic fibers were randomly dispersed among them. Intralamellar (collagenous and elastic) fibers were vertically and obliquely oriented in both superficial and deep lamellae of the anulus fibrosus. All intralamellar fibers were densely and regularly arranged in superficial lamellae, but they were more loosely organized in deep lamellae. A narrow border of interlamellar, elastic fibers was observed between broader, contiguous lamellae in the superficial zone of the anulus fibrosus. Interlamellar elastic fibers wer vertically and obliquely arranged in superficial lamellae; however, they were radially oriented in deep lamellae. The deepest lamella of the anulus fibrosus consisted of a loose, three-dimensional network of intermeshing collagenous and elastic fibers. These observations suggest that elastic fibers are integral components of the articular and shock absorption mechanisms of the anulus fibrosus, and the cervical intervertebral disc of the dog is a suitable model for experimental investigation of the role of elastic fibers in intervertebral disc herniation.     

Reticular meshwork of the spleen in rats studied by electron microscopy

The reticular meshwork of the rat spleen, which consists of both fibrous and cellular reticula, was investigated by transmission electron microscopy. The fibrous reticulum of the splenic pulp is composed of reticular fibers and basement membranes of the sinuses. These reticular fibers and basement membranes are continuous with each other. The reticular fibers are enfolded by reticular cells and are composed of two basic elements: 1) peripheral basal laminae of the reticular cells, and 2) central connective tissue spaces in which microfibrils, collagenous fibrils, elastic fibers, and unmyelinated adrenergic nerve fibers are present. The basement membranes of the sinuses are sandwiched between reticular cells and sinus endothelial cells and are composed of lamina-densalike material, microfibrils, collagenous fibrils, and elastic fibers. The presence of these connective tissue fibrous components indicates that there are connective tissue spaces in these basement membranes. The basement membrane is divided into three parts: the basal lamina of the reticular cell, the connective tissue space, and the basal lamina of the sinus endothelial cell. When the connective tissue space is very small or absent, the two basal laminae may fuse to form a single, thick basement membrane of the splenic sinus wall. The fibrous reticulum having these structures is responsible for support (collagenous fibrils) and rebounding (elastic fibers). The cells of the cellular reticulum--reticular cells and their cytoplasmic processes, which possess abundant contractile microfilaments, dense bodies, hemidesmosomes, basal laminae, and a well-developed, rough-surfaced endoplasmic reticulum, and Golgi complexes, which are characteristic of both fibroblasts and smooth muscle cells--are considered to be myofibroblasts. They may play roles in splenic contraction and in fibrogenesis of the fibrous reticulum. The contractile ability may be influenced by the unmyelinated adrenergic nerve fibers that pass through the reticular fibers. The three-dimensional reticular meshwork of the spleen consists of sustentacular fibrous reticulum and contractile myofibroblastic cellular reticulum. This meshwork not only supports the organ but also contributes to a contractile mechanism in circulation regulation, in collaboration with major contractile elements in the capsulo-trabecular system.     

Cytochemical visualization of anions in collagenous and elastic fiber-associated connective tissue matrix in neonatal and adult rat lungs using iron-containing stains

The cytochemical reactivity of pulmonary connective tissue matrix component in neonatal and adult rat was evaluated using high iron diamine (HID) to detect sulfate ester end groups and dialyzed iron (DI) to detect sulfated and carboxylated end groups of complex carbohydrates, including glycoproteins and glycosaminoglycans at the ultrastructural level. The HID reaction product, in the form of discrete 5-12 nm silver particles following appropriate intensification with thiocarbohydrazide-silver proteinate, was found associated with cell surfaces, the elastin component of elastic fibers, and at regular intervals along the length of collagen fibers in large airways and deep lung interstitium. Staining was similar in adult and neonatal rats, except in areas where connective tissues were presumably still rapidly developing in the neonatal animals. Here large gaps or spaces containing filamentous structures were observed between collagen and elastic fibers. The distribution of DI-reactive sites was similar to that seen with HID with the exception of elastic fibers in which only the microfibrillar portion stained. The collagen-associated reaction was not regularly disposed like that stained with HID, but rather it formed a tight continuous density around the fiber. These results indicated the presence and location of glycoproteins and glycosaminoglycans in connective tissue ground substance regions prior to the full development of elastic and collagenous elements in neonatal pulmonary airways and parenchyma. They also demonstrate cytochemically the presence of a sulfate ester-containing complex sugar found associated with the elastin component of elastic fibers in the lung.     

Cytochemical visualization of anions in collagenous and elastic fiber-associated connective tissue matrix in neonatal and adult rat lungs using iron-containing stains

Summary The cytochemical reactivity of pulmonary connective tissue matrix components in neonatal and adult rat was evaluated using high iron diamine (HID) to detect sulfate ester end groups and dialyzed iron (DI) to detect sulfated and carboxylated end groups of complex carbohydrates, including glycoproteins and glycosaminoglycans at the ultrastructural level. The HID reaction product, in the form of discrete 5–12 nm silver particles following appropriate intensification with thiocarbohydrazide-silver proteinate, was found associated with cell surfaces, the elastin component of elastic fibers, and at regular intervals along the length of collagen fibers in large airways and deep lung interstitium. Staining was similar in adult and neonatal rats, except in areas where connective tissues were presumably still rapidly developing in the neonatal animals. Here large gaps or spaces cointaining reactive filamentous structures were observed between collagen and elastic fibers. The distribution of DI-reactive sites was similar to that seen with HID with the exception of elastic fibers in which only the microfibrillar portion stained. The collagen-associated reaction was not regularly disposed like that stained with HID, but rather it formed a tight continuous density around the fiber. These results indicated the presence and location of glycoproteins and glycosaminoglycans in connective tissue ground substance regions prior to the full development of elastic and collagenous elements in neonatal pulmonary airways and parenchyma. They also demonstrate cytochemically the presence of a sulfate ester-containing complex sugar found associated with the elastin component of elastic fibers in the lung.Supported by Public Health Servece Grant HL 24748     

A Rapid Digestive Technique to Expose Networks of Vascular Elastic Fibers for Sem Observation

The NaOH sonication digestion technique permits rapid isolation and exposure of intact networks of elastic fibers in vascular tissue for 3-dimensional observation with the SEM. The configuration of the network of elastic fibers within the vascular wall of large elastic arteries (aorta) is generally agreed to be a flexible framework through which smooth muscle cells and collagenous fibers are interwoven. However, the configuration of elastic fiber networks in muscular arteries, medium sized veins and smaller vessels remains unknown. When the lengthy standard biochemical elastin purification techniques were applied to vessels containing lesser amounts of elastic tissue and finer elastic fibers, the vessels were completely digested. In contrast, the digestion and sonication technique isolated and exposed intact networks of delicate elastic fibers in blood vessels which do not contain large amounts of elastic tissue. Unfixed vessels were cut into short segments, placed in 0.5 N NaOH and sonicated for 20-40 min. The specimens were rinsed in deionized distilled H₂O, then autoclaved for 30 min. The tissue was rinsed a second time, fixed and processed routinely for SEM. Elastic stains and enzymatic digestion with chromatographically purified elastase and collagenase confirmed that the digestion and sonication technique produced clean, isolated networks of elastic fibers. Knowledge of the configuration of the networks of elastic fibers in different vessels enhances understanding of distensibility characteristics of individual vessels and serves as a baseline for studying alterations in the elastic framework which occur during aging and disease processes such as atherosclerosis, arterial hypertension and aneurysms.     

A rapid digestive technique to expose networks of vascular elastic fibers for SEM observation

The NaOH sonication digestion technique permits rapid isolation and exposure of intact networks of elastic fibers in vascular tissue for 3-dimensional observation with the SEM. The configuration of the network of elastic fibers within the vascular wall of large elastic arteries (aorta) is generally agreed to be a flexible framework through which smooth muscle cells and collagenous fibers are interwoven. However, the configuration of elastic fiber networks in muscular arteries, medium sized veins and smaller vessels remains unknown. When the lengthy standard biochemical elastin purification techniques were applied to vessels containing lesser amounts of elastic tissue and finer elastic fibers, the vessels were completely digested. In contrast, the digestion and sonication technique isolated and exposed intact networks of delicate elastic fibers in blood vessels which do not contain large amounts of elastic tissue. Unfixed vessels were cut into short segments, placed in 0.5 N NaOH and sonicated for 20-40 min. The specimens were rinsed in deionized distilled H2O, then autoclaved for 30 min. The tissue was rinsed a second time, fixed and processed routinely for SEM. Elastic stains and enzymatic digestion with chromatographically purified elastase and collagenase confirmed that the digestion and sonication technique produced clean, isolated networks of elastic fibers. Knowledge of the configuration of the networks of elastic fibers in different vessels enhances understanding of distensibility characteristics of individual vessels and serves as a baseline for studying alterations in the elastic framework which occur during aging and disease processes such as atherosclerosis, arterial hypertension and aneurysms.     

Role of cell wall components in yeasts of the genus Candida in the morphology of the cell

The object of this work was to study the function of the mannan and glucan layers in the cell wall of Candida yeasts. When the outer mannan layer was removed with proteinases, the cells became round and their volume increased by a factor of 2.2. The contribution of the above layers into the elastic properties of the cell wall was estimated in qualitative terms. Apparently, mannans play a more important role in cell morphogenesis than it was supposed earlier.     

Preservation of elastic system fibers and of collagen molecular arrangement and stainability in an Egyptian mummy

The present findings show that both elastic system fibers and collagen markedly resisted change in tissues more than 2000 years old. The distribution of elastic fibers and elastic-related fibers (namely, oxytalan and elaunin fibers) in mummified tissues coincided with the observations made on the modern human tissues used as controls. The collagenous structures present in tissue sections obtained from the Egyptian mummy studied took on a deeply red colour when stained in the Picrosirius solution indicating that, as well as in the fresh controls, the basic groups in the collagen molecules were available for reacting with the strongly acidic dye Sirius Red. When viewed with polarized light, the collagen in the same tissue sections displayed an increased birefringence, which shows that the collagen molecules in mummified tissues maintain the oriented disposition which is typical of the modern human tissues used as controls. The methods employed have proved to be useful for the delineation of the elastic system fibers and of the collagenous scaffolding, which may be used as valuable landmarks in the study of the histoarchitecture of organs that have undergone considerable distortion.     

Preservation of elastic system fibers and of collagen molecular arrangement and stainability in an Egyptian mummy

Summary The present findings show that both elastic system fibers and collagen markedly resisted change in tissues more than 2000 years old.The distribution of elastic fibers and elastic-related fibers (namely, oxytalan and elaunin fibers) in mummified tissues coincided with the observations made on the modern human tissues used as controls.The collagenous structures present in tissue sections obtained from the Egyptian mummy studied took on a deeply red colour when stained in the Picrosirius solution indicating that, as well as in the fresh controls, the basic groups in the collagen molecules were available for reacting with the strongly acidic dye Sirius Red. When viewed with polarized light, the collagen in the same tissue sections displayed an increased birefringence, which shows that the collagen molecules in mummified tissues maintain the oriented disposition which is typical of the modern human tissues used as controls.The methods employed have proved to be useful for the delineation of the elastic system fibers and of the collagenous scaffolding, which may be used as valuable landmarks in the study of the histoarchitecture of organs that have undergone considerable distortion.Supported in part by Grant no. 43.83.0610/00 from Financiadora de Estudos e Projetos (FINEP-FNDCT). G.S. Montes is Career Investigator of the Brazilian National Research Council (CNPq)     

Some histological aspects of the hip joint capsule in the vervet monkey

Microscopic studies show that the capsule of the hip joint in the vervet monkey (Cercopithecus aethiops pygerythrus) is preponderantly collagenous. Among the collagen fiber bundles are varying quantities of elastic fibers that demonstrate a definite, differential regional distribution. The highest concentration of elastic tissue is found in the posterior, postero-inferior, and inferior aspects of the hip joint capsule, whereas the anterior and superior aspects of the capsule are preponderantly collagenous. It is postulated that this regional distribution of elastic tissue is related to the differential functional requirements of the posterior, postero-inferior, and inferior aspects of the capsule for flexibility and stretchability. These requirements appear to be a consequence of the habitual postures and locomotory positions assumed at the hip joint by these primarily quadrupedal primates. Collagen, on the other hand, being much more resistant to deformation and relatively noncompliant, is the predominant tissue in the anterior and superior aspects of the joint.     

Glycosaminoglycans contribute to extracellular matrix fiber recruitment and arterial wall mechanics

Elastic and collagen fibers are well known to be the major load-bearing extracellular matrix (ECM) components of the arterial wall. Studies of the structural components and mechanics of arterial ECM generally focus on elastin and collagen fibers, and glycosaminoglycans (GAGs) are often neglected. Although GAGs represent only a small component of the vessel wall ECM, they are considerably important because of their diverse functionality and their role in pathological processes. The goal of this study was to study the mechanical and structural contributions of GAGs to the arterial wall. Biaxial tensile testing was paired with multiphoton microscopic imaging of elastic and collagen fibers in order to establish the structure–function relationships of porcine thoracic aorta before and after enzymatic GAG removal. Removal of GAGs results in an earlier transition point of the nonlinear stress–strain curves \((p<0.05)\). However, stiffness was not significantly different after GAG removal treatment, indicating earlier but not absolute stiffening. Multiphoton microscopy showed that when GAGs are removed, the adventitial collagen fibers are straighter, and both elastin and collagen fibers are recruited at lower levels of strain, in agreement with the mechanical change. The amount of stress relaxation also decreased in GAG-depleted arteries \((p<0.05)\). These findings suggest that the interaction between GAGs and other ECM constituents plays an important role in the mechanics of the arterial wall, and GAGs should be considered in addition to elastic and collagen fibers when studying arterial function.     

Elastic and collagenous networks in vascular diseases

Supravalvular aortic stenosis (SVAS), Marfan syndrome (MFS) and Ehlers-Danlos syndrome type IV (EDS IV) are three clinical entities characterized by vascular abnormalities that result from mutations of structural components of the extracellular matrix (ECM). Analyses of naturally occurring human mutations and of artificially generated deficiencies in the mouse have provided insights into the pathogenesis of these heritable disorders of the connective tissue. SVAS is associated with haploinsufficiency of elastin, one of the two major components of the elastic fibers. SVAS is characterized by narrowing of the arterial lumen due to the failure of regulation of cellular proliferation and matrix deposition. Mutations in fibrillin 1 are the cause of dissecting aneurysm leading to rupture of the ascending aorta. Fibrillin-1 is the building block of the microfibrils that span the entire thickness of the aortic wall and are a major component of the elastic fibers that reside in the medial layer. The vascular hallmark of EDS IV is rupture of large vessels. The phenotype is caused by mutations in type III collagen. The mutations ultimately affect the overall architecture of the collagenous network and the biomechanical properties of the adventitial layer of the vessel wall. Altogether, these genotype-phenotype correlations document the diversified contributions of distinct extracellular macroaggregates to the assembly and function of the vascular matrix.     

Development of elastic-system fibers in human vocal cords

The morphogenesis of elastic fibers in human, fetal and adult vocal cords was studied by light microscopy and transmission electron microscopy. The elastic system includes elastic, elaunin and oxytalan fibers at different stages. The development of elastic-system fibers in human vocal cord is characterized by every stage of maturation, whether normal, stifled or accelerated, according to areas.     

Elastoid Changes in the Gingiva of Aged Humans

Elastotic changes were demonstrable in the gingivae of both dentulous and edentulous jaws obtained from both male and female humans varying in age from 62–92 years. Sections of gingivae from all the aged individuals exhibited numerable thick fibers that stained positive with iron hematoxylin or orcein. These positive staining fibers were found in the lamina propria radiating into the connective tissue papillae, coursing throughout the zona reticularis, as well as appearing as black amorphous masses. Pretreatment of sections with acid hydrolysis before staining by the two elastic tissue stains led to a loss of stainable fibers for elastin. In contrast the gingivae of a young adult did not contain elastic positive fibers as seen in the aged gingivae. The thick elastotic fibers found in the aged gingivae were argyrophilic in nature when the sections were impregnated with silver nitrate indicating that they were collagenous in nature. It is felt that the elastoid-like fibers in aging gingiva are another phase in the altering of collagen during the aging process.     

Ultrastructural analysis of collagen fibers in the conductive and working myocardium of the sinoatrial region of the human heart

Qualitative and quantitative electron microscopic analysis of collagenous fibers has been performed in the sinusal node (SN) and perinodal working myocardium of the right atrium (RA) in the hearts of 22 men, died at the age of 23-63 years. Five of them died from alcoholic cardiomyopathy, 8--from coronary cardiac disease and 9--from noncardiac causes and craniocerebral trauma (group of comparison). In 21 cases seven types of ultrastructural changes of the collagenous fibers have been revealed in the SN (changes in the form, size and degree of their osmiophilia). As a whole the volumetric density of the collagenous fibers in the selection makes 24.4 +/- 1.6% from the volume of the SN conductive myocardium and 5.7 +/- 0.8% from the volume of the RA perinodal working myocardium. Content of the collagenous fibers in the SN does not depend on the death cause, age of the dead or on degree of the cardiac hypertrophy. Content of the collagenous fibers in the RA is 2.2 times higher at a sudden coronary death, than in the group of comparison. With age in the RA the volumetric density of the collagenous fibers increases by 1.9 times, and with rise in the cardiac mass, it increases by 2.2 times. The data obtained are discussed in order to understand the role of the collagenous fibers in functioning of the sinoauricular area both normal and at the cardiac pathology.     

Transcriptional diversity in myogenesis.

Duodenal morphogenesis in the chick embryo has been studied to see if changes in organization of extracellular fibers are associated with villus formation. Three major processes occur during morphogenesis; longitudinal ridges form, then these ridges become zigzag in shape, and finally a double row of villi form from each zigzag ridge. Tissues of different developmental stages were progressively trypsinized to remove cellular material and were prepared for scanning microscopy to show the organization of extracellular fibers. Results show that fiber systems of increasing complexity form as the dudoenum develops, and suggest that some cellular events such as initial ridge formation precede these changes. Tissues with longitudinal ridges contain only randomly organized fibers. In tissues with zigzag ridges, oriented fibers appear along the ridges and some extend laterally from flexures of each zigzag ridge, but interridge fibers are still randomly organized. When villi form, fibers in the body of the villus are random but fibers at the base of villi and between villi are highly oriented. Transmission microscopy and collagenase treatment of partially trypsinized tissue indicate that most, if not all extracellular fibers viewed by scanning microscopy are collagenous. Therefore, since collagen fiber organization is so closely related to morphogenetic changes, we presume it plays an important role.     

Histophysiological observations on the external auditory meatus,middle, and inner ear of the weddell seal (Leptonychotes weddelli)

The external auditory meatus, middle, and inner ear of the deep-diving Weddell seal (Leptonychotes weddelli) were studied with light microscopic, histological, and histochemical techniques in order to contribute to the open discussion on the orientation of this seal in the darkness of the deep Antarctic seas. The external auditory meatus is characterized by a well-developed venous plexus, single apocrine ceruminous, and numerous holocrine sebaceous glands and an incomplete tube of elastic cartilage. The tympanic membrane is comprised of two layers of radially and concentrically arranged collagen fibers and by elastic fibers which are concentrated in the outer part of the ear drum. The tympanic cavity is lined by a pseudostratified prismatic ciliated epithelium with goblet cells; a plexus of wide venous vessels marks the subepithelial lamina propria. The cochlea is about 10 mm high and forms about two and a half turns. The richly pigmented stria vascularis is well vascularized, while the cell-rich prominentia spiralis contains only single small blood vessels. The organ of Corti contains one row of inner and three rows of outer hair cells. Cells of Hensen, Claudius, and Boettcher are present. The basilar membrane is of comparatively uniform simple structure and is composed of abundant glycoproteins, proteoglycans, collagenous fibers, and the loose tissue of the tympanal layer. The spiral ligament is built up by abundant proteoglycans and a complex system of radial and concentric collagen fibers; close to the osseous wall of the bony cochlea it contains fine elastic fibers. The inner zone of the osseous wall of the cochlea strikingly contains hyaline cartilage. The thin lamina spiralis ossea is covered by a limbus spiralis with interdental cells secreting the lamina tectoria, which has a fibrous texture and contains glycoproteins and negatively charged components. J. Morphol. 234:25–36, 1997. © 1997 Wiley-Liss, Inc.     

Time course sequences of angiotensin converting enzyme and chymase-like activities during development of right ventricular hypertrophy induced by pulmonary artery constriction in dogs

ACE and chymase play crucial roles in the establishment of pressure overload-induced cardiac hypertrophy. In the present study, time sequences of ACE and chymase-like activities, and their correlation with hypertrophic changes including free wall thickness and cardiac fibrosis, were elucidated in dogs with constant pressure overload to the right ventricle. Pulmonary artery banding (PAB) was applied so that the diameter of the main pulmonary artery was reduced to 60% of the original size, right ventricular pressure was elevated by about 70%, and pulmonary artery flow was increased by about three times of that in sham operation groups. These increases remained unchanged 15, 60, and 180 days after PAB, suggesting that constant right ventricular pressure overload was obtained, at least during this period. The diameter of the right ventricular myocyte was slightly increased and the percentage of fractional shortening was decreased 15 days after PAB. Right ventricular wall thickness and interstitial collagenous fiber were, however, not different from those of sham-operated dogs, suggesting that this period is a period of adaptation to the overload. Sixty days after PAB, the diameter of the right ventricular myocyte was further increased, and right ventricular wall thickness and interstitial collagenous fiber were also increased. These changes were almost identical even 180 days after PAB. Thus, stable hypertrophy was elicited from 60 through 180 days after PAB. ACE activity was facilitated at the adaptation period to the overload (15 days after PAB), but chymase activity was not facilitated at this period. On the other hand, both ACE and chymase-like activities were unchanged in the earlier phase (60 days after PAB) of stable hypertrophy, but facilitated in the latter phase (180 days after PAB). These findings suggest the pathophysiologic roles of these enzymes may be different over the time course of pressure overload-induced hypertrophy.     

Actions of angiotensin peptides on the rabbit pulmonary artery

The presence of the angiotensin AT1A-like receptor subtype in the pulmonary artery and AT1B-like receptor subtype in the pulmonary trunk of the rabbit has been reported in two earlier studies. The present study further investigated these receptor subtypes using five other angiotensins (namely angiotensin II, angiotensin III, angiotensin IV, angiotensin-(1-7) and angiotensin-(4-8)). The direct action of the angiotensins on the rabbit pulmonary arterial and trunk sections and the ability of each angiotensin to further contract or relax preconstricted sections of the pulmonary artery and trunk were studied using the organ bath set-up. The effects of angiotensin III on the 3H overflow from re-uptaken [3H]noradrenaline in the electrically-contracted rabbit pulmonary arterial and trunk sections were also studied. The contractile response of the arterial and trunk section had the following rank order potency: angiotensin II > angiotensin III > angiotensin IV. The contractile response to these angiotensins was greatly reduced or absent in the pulmonary trunk. Angiotensin II further contracted the preconstricted arterial and trunk sections. In contrast, angiotensin III further contracted the preconstricted arterial section but relaxed the preconstricted trunk section. Angiotensin IV similarly relaxed the preconstricted trunk section but had minimum effect on the preconstricted arterial section. Angiotensin-(1-7) and angiotensin-(4-8) had no effect on both sections. The actions of the three angiotensins were inhibited by losartan, an AT1-selective antagonist. Indomethacin, a cyclo-oxygenase inhibitor, inhibited the relaxation caused by angiotensin III and angiotensin IV in the trunk section. The effects of angiotensin III on the electrically preconstricted sections of the pulmonary trunk and artery were not accompanied by any significant changes in 3H overflow. The differential responses produced by angiotensin II and its immediate metabolites via two positionally located and functionally opposing receptor subtypes suggest that the pulmonary trunk and artery is not a passive conduit but an important regulator of blood flow from the heart to the lung.