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Changing Concepts of the Mechanism of Pulmonary Atelectasis: Title and subTitle BreakA Study of Smooth Muscle Elements in the Human Lung FREE

Guenter Corssen, MD
[+] Author Affiliations

Associate Professor, Department of Anesthesiology, The University of Michigan Medical School.


JAMA. 1963;183(5):314-317. doi:10.1001/jama.1963.03700050046010
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This study is an attempt to challenge the generally accepted concept that the human lung is merely an elastic sponge with no musculature existing beyond the terminal bronchioles. Photomicrographs of human lung tissue taken in situ, and specifically stained, reveal minute smooth muscle fibers in the most distally located portion of the air passage including alveolar sacs. While such smooth muscle elements are present in the normal lung tissue, a marked increase of these structures is noted in the lungs of individuals with bronchitis, emphysema, and, particularly, pulmonary hypertension. The existence of alveolar musculature can explain the ability of the human lung to contract actively, as may be the case in nonobstructive pulmonary collapse or "contraction atelectasis."

REFERENCES

Mendelssohn, A.: Der Mechanismus der Respiration und Zirkulation oder das explicierte Wesen der Lungenhyperaemien , Berlin: B. Behrs, 1848;.
Coryllos, P.N., and Birnbaum, G.L.:  Studies in Pulmonary Gas Absorption in Bronchial Obstruction , Amer J Med Sci 183:317-326 ( (March) ) 1932;.
Pasteur, W.:  Massive Collapse of Lung , Lancet 2:1351-1355, 1908;.
Prinzmetal, M.; Brill, S.; and Leake, C.D.:  Postoperative Pulmonary Subventilation , Surg Gynec Obstet 56:129-136 ( (Feb) ) 1933;.
Von Neergard, K.:  Neue Auffassungen ueber einen Grundbegriff der Atemmechanik, abhaengig von der Oberflaechenspannung in den Alveolen , Z Ges Exp Med 66:373-394 ( (June) ) 1929;.
Mead, J.; Whitenberger, J.L.; and Radford, E.P.:  Surface Tension as Factor in Pulmonary Volume Pressure Hysteresis , J Appl Physiol 10:191-196 ( (March) ) 1957;.
Brown, E.S.; Johnson, R.P.; and Clements, J.A.:  Pulmonary Surface Tension , J Appl Physiol 14:717-720 ( (Sept) ) 1959;.
Sturm, A.:  Der Lungenkrampf (Kontraktionsatelektase durch Pulmonalen Spasmus) , Deutsch Med Wschr 71:201-206 ( (Oct) ) 1946;.
Xalabarder, C.:  What is Atelectasis? Tubercle 30:266-283 ( (Dec) ) 1949;.
Hoffstaedt, W.G.W.:  A Modern Concept of Pulmonary Collapse , Tubercle 34:234-245 ( (Sept) ) 1953;.
Scott, W.J.M., and Joelson, J.J.:  Postoperative Massive Atelectasis: Influence of Posture , Arch Surg 15:855-870 ( (Dec) ) 1927;.
DeTakats, G.; Fenn, G.K.; and Jenkinson, E.L.:  Reflex Pulmonary Atelectasis , JAMA 120:686-690 ( (Oct) ) 1942;.
Miller, W.S.: The Lung , 2nd ed, Springfield, Ill.: Charles C Thomas, 1947;.
Liebow, A.A.; Loring, W.E.; and Felton, W.L.:  Musculature of Lungs in Chronic Pulmonary Disease , Amer J Path 29:885-911 ( (Sept-Oct) ) 1953;.
Baltisberger, W.:  Ueber die glatte Muskulatur der menschlichen Lunge , Z Anat Entwicklungsgesch 61:249-282 ( (Aug) ) 1921;.
Bronkhorst, W., and Dijkstra, C.:  Das Neuromuskulaere System der Lunge. Anatomische und Physiologische Untersuchungen ueber die Lungenmuskulatur und ihre Bedeutung fuer die Klinik der Tuberkulose , Beitr Klin Tuberk 94:445-503 ( (May) ) 1940;.
Macklin, C.C.:  Musculature of Bronchi and Lungs , Physiol Rev 9:1-60 ( (Jan) ) 1929;.
Engel, S.:  Die Muskulatur der Lunge , Deutsch Med Wschr 73:382 ( (Sept) ) 1948;.
Goldner, J.:  Modification of Masson Technique for Routine Laboratory Purposes , Amer J Path 14:237-243 ( (March) ) 1938;.
Carleton, N.M., and Drury, R.A.B.: Histologic Techniques for Normal and Pathological Tissues and Identification of Parasites , London: Oxford University Press, 1957;.

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Mendelssohn, A.: Der Mechanismus der Respiration und Zirkulation oder das explicierte Wesen der Lungenhyperaemien , Berlin: B. Behrs, 1848;.
Coryllos, P.N., and Birnbaum, G.L.:  Studies in Pulmonary Gas Absorption in Bronchial Obstruction , Amer J Med Sci 183:317-326 ( (March) ) 1932;.
Pasteur, W.:  Massive Collapse of Lung , Lancet 2:1351-1355, 1908;.
Prinzmetal, M.; Brill, S.; and Leake, C.D.:  Postoperative Pulmonary Subventilation , Surg Gynec Obstet 56:129-136 ( (Feb) ) 1933;.
Von Neergard, K.:  Neue Auffassungen ueber einen Grundbegriff der Atemmechanik, abhaengig von der Oberflaechenspannung in den Alveolen , Z Ges Exp Med 66:373-394 ( (June) ) 1929;.
Mead, J.; Whitenberger, J.L.; and Radford, E.P.:  Surface Tension as Factor in Pulmonary Volume Pressure Hysteresis , J Appl Physiol 10:191-196 ( (March) ) 1957;.
Brown, E.S.; Johnson, R.P.; and Clements, J.A.:  Pulmonary Surface Tension , J Appl Physiol 14:717-720 ( (Sept) ) 1959;.
Sturm, A.:  Der Lungenkrampf (Kontraktionsatelektase durch Pulmonalen Spasmus) , Deutsch Med Wschr 71:201-206 ( (Oct) ) 1946;.
Xalabarder, C.:  What is Atelectasis? Tubercle 30:266-283 ( (Dec) ) 1949;.
Hoffstaedt, W.G.W.:  A Modern Concept of Pulmonary Collapse , Tubercle 34:234-245 ( (Sept) ) 1953;.
Scott, W.J.M., and Joelson, J.J.:  Postoperative Massive Atelectasis: Influence of Posture , Arch Surg 15:855-870 ( (Dec) ) 1927;.
DeTakats, G.; Fenn, G.K.; and Jenkinson, E.L.:  Reflex Pulmonary Atelectasis , JAMA 120:686-690 ( (Oct) ) 1942;.
Miller, W.S.: The Lung , 2nd ed, Springfield, Ill.: Charles C Thomas, 1947;.
Liebow, A.A.; Loring, W.E.; and Felton, W.L.:  Musculature of Lungs in Chronic Pulmonary Disease , Amer J Path 29:885-911 ( (Sept-Oct) ) 1953;.
Baltisberger, W.:  Ueber die glatte Muskulatur der menschlichen Lunge , Z Anat Entwicklungsgesch 61:249-282 ( (Aug) ) 1921;.
Bronkhorst, W., and Dijkstra, C.:  Das Neuromuskulaere System der Lunge. Anatomische und Physiologische Untersuchungen ueber die Lungenmuskulatur und ihre Bedeutung fuer die Klinik der Tuberkulose , Beitr Klin Tuberk 94:445-503 ( (May) ) 1940;.
Macklin, C.C.:  Musculature of Bronchi and Lungs , Physiol Rev 9:1-60 ( (Jan) ) 1929;.
Engel, S.:  Die Muskulatur der Lunge , Deutsch Med Wschr 73:382 ( (Sept) ) 1948;.
Goldner, J.:  Modification of Masson Technique for Routine Laboratory Purposes , Amer J Path 14:237-243 ( (March) ) 1938;.
Carleton, N.M., and Drury, R.A.B.: Histologic Techniques for Normal and Pathological Tissues and Identification of Parasites , London: Oxford University Press, 1957;.
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