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These so-called immunoaffinity separations depend on Ab-Ag reactions to remove selected analytes from patient samples treatment 5th metatarsal fracture generic 100mg solian mastercard. Similar to the sandwich assay described below, an immobilized specific antibody is used to capture the antigen of interest. Advances in technology have allowed these chromatographic columns to be placed in capillary-based microfluidic chambers embedded in a slide or chip. Generally, with a tube-based system, an immune agent bound to a paramagnetic bead can be used to sequester analytes of interest while nonspecific particles can be removed through aspiration. Common Assays Labeled assays have evolved away from the use of radiotracers toward enzymatic and fluorescent tracers, while many of the other aspects of their design have remained the same. Due to their historical importance, some detail has been given to the use of radiotracers in laboratory immunoassay development, as well as to illustrate the similarities among assay designs of more contemporary assays. It is also important to note that some facilities still use radiotracers in their diagnostic efforts, especially when it comes to reference methods and assays with the need for low levels of detection. However, contemporary assays are more often designed using enzymatic, fluorescent, and chemiluminescent tracers. Of additional importance, many of the assays have been adapted from their manual roots for incorporation in fully automated analyzers. It is supplied as a high specific- activity sodium iodide from several commercial sources. This radioisotope was selected for most assays based on a compromise between obtaining high activity and extended shelf life; the shorter the radioactive shelf life, the more intense the radioactive emission (reduced detection limits). Therefore, the radioactive antigen and patient antigen compete for antibody binding. The supernatant is decanted and the precipitate is measured for radioactivity using a gamma counter and compared with calibrators and controls. IgE is associated with allergic responses and can be used to diagnose clinically relevant hypersensitivity. This support is then incubated with patient plasma overnight, washed, and a radiolabeled (125I) anti-human IgE antibody is applied and incubated. This diagrammatic representation uses two antibodies, one attached to a solid phase and the other labeled with a radioisotopic tracer. Although the first of its kind, the design has been modified successfully with all tracer types. The earliest versions of immunoradiometric assays used an excess of polyclonal antibody and a solid support antigen (adsorbent) to bind and remove unreacted radiolabeled antibody.
However medicine overdose solian 100 mg free shipping, despite differences between commercially available antibody panels, quantification of cell populations between panels has been shown to have good correlation. B-Cell Phenotyping B cells represent between 7 and 23% of the peripheral lymphocyte population. Thus, in T cells, as in any other cell lineage differentiation, diagnostic identification of cell populations is performed using multiple markers. Several T-cell subpopulations are commonly examined for diagnostic purposes in a clinical setting. For example, it has been well established that a larger overall number of memory T cells and their subsets are a good prognostic indicator of vaccine efficacy. They are named for their morphological features including the presence of cytotoxic lysosomal granules, which were historically easy to stain using cellular dyes; one of the earliest methods employed for the phenotyping of immune cells, specifically, granulocyte populations. Lysosomal granules can contain lysozyme, myeloperoxidase, lactoferrin and others, and are either released during an immune response or are the target organelles used in eliminating potentially pathogenic molecules and bacterial cells. Accumulating evidence suggests an increased role for granulocytes, and in particular, neutrophils, in both bloodborne and solid-tumor pathophysiology. In addition to their well-established role in microbial elimination, emerging evidence indicates a role of neutrophil expansion in poorer prognosis for patients with a variety of cancers, including ovarian, breast, and pancreatic cancer. However, they are found increased in circulation during inflammatory and allergic disease responses. Monocytes Monocytes are known to be the circulating form of the tissue-invading macrophages, an important component of the innate immune response. Monocyte markers are also useful for the identification of tissue-invading macrophages and other cells derived from this lineage including osteoclasts, Kupfer cells in the liver, dendritic cells, mast cells, and Langerhans cells. Lymphoblasts and myeloblasts are typically isolated to the bone marrow in normal populations; however, during the course of malignancy, blast populations are commonly found in the peripheral blood and are often the first indicator of disease. In some clinical cases, pathologists are expected to determine a diagnostic and prognostic workup for a leukemia based on peripheral blood immunophenotyping alone, despite significant differences in the population of these cells in the bone marrow. However, specific markers are indicative of different disease etiologies and most practitioners recommend using a standard, upfront panel followed by a more disease-specific panel. Flow cytometry has greatly aided in the quantification of these populations through the cytometric assessment of patient bone marrow specimens. Furthermore, the presence of lymphoid or myeloid precursor populations in peripheral blood is diagnostically indicative of specific disease processes. Both T and B lymphoblasts have similar morphological features on blood and bone marrow smears, including a variation in size from mature lymphocytes and the presence of low to moderated basophilic cytoplasm. Indeed, the classification of lymphoblasts, based on marker profiles, is typically used to determine the age and maturity of these cells. Characterization of lymphoblasts by immunophenotyping often occurs only in the identification of malignancies. They are normally present in large quantities in the bone marrow with a very rare presence in peripheral blood.
The detection limits medications containing sulfa order solian 50mg on-line, also known as sensitivity, determine the extreme values of detection for the assay and are also an important validation value. For clinical assays, the most important component is the clinical sensitivity, or positivity in disease, but assay developers also look at the function sensitivity, i. Finally, the linearity of an assay should be assessed by making dilutions of high- concentration specimens or by using spiked specimens. If serum is the base solution, an analyte-free serum should be used for all diluted specimens, as changes to background may affect results. In addition to the above factors, assays must be validated for interfering substances and in conditions of antigenic excess. Clinical sample types should dictate if body fluids, in addition to blood, serum, and plasma should be validated for specific tests. Assays are valid only for conditions in which they are validated; therefore, even commercially available tests with external validation in serum or blood may require internal validation with commonly tested body fluids. Standard method validation practices should be employed on any newly developed or adopted assay in order to ensure quality clinically-relevant results, and results should be reported only on validated specimen types, except under atypical circumstances. A clinical validation for an assay is used to determine the reference interval for a specific test, including differences in age, sex, and other factors. It may be used to establish "cut-off" values between normal and abnormal results, as well as clinical sensitivity (disease positivity) and clinical specificity (healthy negativity). An important aspect of external quality assessment is the performance of proficiency testing on commonly run assays. Proficiency testing is performed to ensure that laboratory personnel are accurately and appropriately performing tests. Typically, each clinical diagnostic laboratory participates in at least one external control program. Periodically, these organizations will send specimens to labs to be tested as a normal sample using routine procedures. The results are then returned to the program administrators, evaluated, and compared with other laboratories using the same or similar methods. Due to the rapid advances occurring in laboratory and medical technologies, it is imperative that employees keep abreast of changes in technology and scope of practice. Beyond the essential competencies, such as understanding safe laboratory practices, all employees should be thoroughly trained in each assay that they conduct, and a record of that process documented. Completion of this documentation is typically required for an individual to be deemed competent to perform an assay for use in diagnosis. This section covers the general procedures and safety precautions performed as part of several major types of immunodiagnostic laboratories. While many immunodiagnostic tests can be performed on cell and bacterial cultures, the predominant source of biological specimens used in clinical diagnostics still derives from a patient blood draw or body fluid collection. In the later chapters, many of the blood components commonly used in serology and immunodiagnostics will be described from the perspective of their biological activity and diagnostic utility. Depending on their usage, the handling of blood products can be heavily regulated by a variety of agencies.
Some authors refer alternately to the layers as the cover of the vocal folds (superficial epithelium symptoms when pregnant cheap solian 50 mg line, primary and secondary layers of lamina propria) and the body (third layer of lamina propria and thyroarytenoid muscle) of the vocal folds. The anterior boundary of the frame of the aditus is the epiglottis, with the folds of membrane and muscle slung between the epiglottis and the arytenoids (the aryepiglottic folds) comprising the lateral margins of the aditus. The second set of prominences posterior to the first two are from the corniculate prominences of the corniculate cartilages on the arytenoids. Larynx that has been cut sagittally with the sides reflected, revealing the false folds, true folds, and laryngeal ventricle. Note that true vocal folds appear white upon examination as a result of the superficial layer of squamous epithelial tissue. These prominences arise from the presence of the corniculate and cuneiform cartilages deep in the aryepiglottic folds. Same view of vocal folds, but with the membranous lining and supportive muscle of larynx removed, to reveal only cartilages and the thyroarytenoid muscle (thyrovocalis and thyromuscularis). The membranous margin of the vocal folds is approximately 12 to 15 mm long in adults, while the cartilaginous margin is approximately 7 to 9 mm long. The vestibule is the space between the entryway or aditus and the ventricular (or vestibular) folds. The ventricular folds are also known as the false vocal folds because they are not used for phonation except in rare (and clinically significant) cases. The lateral walls are comprised of the aryepiglottic folds, and the posterior walls are made up of the membrane covering the arytenoid cartilages, which project superiorly to the false folds. The false vocal folds are made up of a mucous membrane and a fibrous vestibular ligament, but not muscular tissue. The middle space of the larynx lies between the margins of the false vocal folds and the true vocal folds below. This space is the laryngeal ventricle (or laryngeal sinus), and the anterior extension of this space is the laryngeal saccule (also known as the appendix of the ventricle). The saccule (or pouch) is endowed with more than 60 mucous glands that secrete lubricating mucus into the laryngeal cavity. The thyroepiglottic muscle passes between the saccule and the thyroid cartilage, and when this muscle contracts it squeezes on the saccule, causing release of mucus onto laryngeal tissue. There are, in reality, mucous glands throughout the larynx, including the surface of the epiglottis and aryepiglottic folds. The fibrous wall can break down and weaken, allowing a herniation of the saccule, which is termed a laryngocele and is a rare occurrence (Gulia, Yadav, Khaowas, Basur, & Agrawal, 2012). An internal laryngocele may expand under the aryepiglottic fold, ultimately reaching the valleculae.
Older devices used fixed blanking periods following ventricular events medicine lookup buy 100 mg solian free shipping, which could lead to underestima tion of the atrial rate during atrial flutter and inappro priate therapy (due to the incorrect calculation that V > A rate). Intermittent farfield R wave oversensing or frequent premature complexes dis rupt the pattern, leading to algorithm error and tachycardia misclassification. From top to bottom are shown the atrial electrogram, ventricular nearfield electrogram, and markers. There is an ongoing sinus tachycardia with a premature atrial complex in the atrium tracked by the ventricle (vertical arrows). The horizontal arrows are the same length, showing that the ventricular complex marked by the asterisk came earlier than expected, making this a premature ventricular (or less likely, junctional) complex. From top to bottom are the atrial and ventricular electrograms, the V intervals, the calculated stability, and the atrial and ventricular rates. However, because the ventricular rate is greater than the atrial rate, the stability inhibitor is bypassed and appropriate is therapy delivered. The benefit of this algorithm is that it requires no custom programming; the limitation is that its errors cannot be corrected by troubleshooting. As a prac tical matter, if farfield Rwave oversensing is consist ently present or absent, the algorithm functions effectively. This subalgorithm determines whether sensed events on the atrial channel are due to atrial events or sensing of the farfield R wave. Though this is tested separately, the same default value of 12% is used for both ventricles. An average of three intervals is calculated and compared with the subsequent interval. If the difference between the two is less than 12% then that interval is considered stable. Lastly, if the ventricular rate is stable, the ventricu lar intervals are a multiple of the atrial interval, thus establishing an N: 1 relationship and a diagnosis of atrial flutter. By pacing the ventricle at a rate greater than the tachycar dia, the pacing impulses may enter the tachycardia circuit, to collide with the orthodromic tachycardia wave front and extinguish reentry (further discussed in Chapter 1, Pacing and Defibrillation: Clinically Relevant Basics for Practice). The success rates increases with additional sequence to 91% with up to three sequences, but so does the risk for acceleration. V Rate > A Rate V Rate < A Rate V Rate = A Rate V Stable V Unstable V Stable V Unstable Are the A and V stable Top: in "burst" mode, a series of pacing pulses are given at the same cycle length. Subsequent bursts may have a shorter or an adaptive cycle, but the rate does not change within a burst. Bottom: in "ramp" mode, each pulse within a sequence comes at a progressively shorter interval. Terminology varies among manufacturers, with that of Boston Scientific shown in the figure.
The myeloid and monocytic cells are described below medicine 7 solian 100 mg with visa, which have fundamental roles in both innate and adaptive systems. Absent from this discussion are the lymphocytes, in which a more robust discussion is provide in a subsequent chapter. Their cytoplasms are rich in granulocytic factors that develop in the bone marrow. During infections, neutrophil production increases and neutrophils migrate to tissues for pathogen clearance. Eosinophils are granulocytes with bi-lobed nuclei and which contain secretory granules. Eosinophils are known to modulate functions of other immune cells by secretion of growth factors and molecular cues known as chemokines. Similarly, mast cells are granulated leukocytes that originate in the bone marrow. Engagement of receptors on mast cells leads to degranulation, causing the release of histamines, proteases, and other molecules that aid in pathogen clearance. Macrophages are large mononuclear leukocytes that inhabit lymphoid and nonlymphoid organs. They are important sentinels of immune surveillance because of their superior phagocytic capacity. Phagocytosis allows them to sample their environment for potential tissue damage or infection, leading to initiation of mechanisms to kill pathogens, mitigate damage, and reestablish tissue homeostasis. Macrophages are a heterogeneous population of cells and are highly plastic; their immediate environments shape their properties. The different kind of macrophages are Kupffer cells in the spleen, Langerhans cells in the skin, and microglia in the brain. Complement Cascade In the late 19th century, Hans Buchner, a German bacteriologist, is credited with describing, for the first time, protective substances, which he called alexins; alexins were capable of killing microorganisms. These humoral molecules were later called "complement" by Paul Ehrlich, when they were found to be important in both cellular and humoral responses. Unlike the antibody system, also described by Ehrlich, the complement system is considered a nonadaptive piece of the humoral response. Currently, the term "complement" describes 35 proteins found in plasma or on the cell surface. Specifically, the classical pathway of complement activation is through an antibody-dependent trigger. The first complement components are recruited to pathogens or host-cell membranes through the initial binding of immunoglobulins (Igs), both IgG and IgM, with IgM being the most efficient activator. The first recruited element is named C1 and is broken into subunit C1q, C1r, and C1s. C1 has two substrates, C4 and C2, the next two molecules activated in the classical pathway.
Diseases
Reagent aliquoting is also commonly performed to preserve agents that may lose efficacy through repeated freeze-thaw cycles or due to potential contamination treatment diffusion buy generic solian 50 mg on-line. Specimen Labeling Specimen tubes that enter the immunodiagnostic laboratory should be labeled by phlebotomy/or other specimen collection personnel at the time of collection, and should be double checked for accuracy upon arrival. If samples are to be aliquoted or transferred to another tube, the technologist should provide enough information on any secondary tube for a fellow technologist to continue his or her work. Incorrectly labeled tubes may lead to misdiagnosis or delayed diagnosis, sometimes with life-threatening consequences. Specimen Storage and Transport Methods of storage and transport should consider not only the stability of the specimen but also the risks that the specimen poses. Safe methods of management for infectious materials between and within the laboratory should attempt to contain agents to protect personnel from exposure. Containment is assured through good techniques, the proper handling of equipment, and through appropriate facility design and construction. The four main storage temperatures are: liquid nitrogen, ultra-low, cold, and room temperature, and are applied for biological specimens depending on the specimen type and expected usage. A wide variety of biomarkers and serological immunomarkers have been maintained at these temperatures successfully for several years. Many reagents cannot handle repeated freeze-thaw cycles, and are therefore, aliquoted in smaller volumes and stored at refrigerated or frozen temperatures. Finally, specimens are sometimes kept at room temperature, usually for short periods of time. Platelets, however, are typically stored at room temperature before therapeutic use in the blood bank. Although not considered a usual storage condition, when conducting ongoing cell culture experiments important for viral infection and some cellular function tests, laboratories sometimes must maintain a living culture at physiological body temperatures in an incubator. Three days earlier, he had been observed with similar conditions at an outpatient center in which the physician noted similar symptoms. The patient was told to seek attention because of suspected influenza with respiratory infection. Initial Laboratory Analysis A blood chemistry panel was performed and showed signs of renal failure (creatinine: 6.
Unlike the appendage treatment 4 syphilis cheap solian 50 mg with visa, the remainder of the atrium is not trabeculated, and active fixation leads are usually required to obtain mechanical stability. Pacing for the reduction or prevention of atrial fibrillation remains somewhat controversial. However, techniques that have been used include positioning the lead in the atrial septum or the use of two atrial leads. The course of the defibrillation leads is through the inferior vena cava to the right atrium and right ventricular position. Also seen is an extravascular subcutaneous patch over the left heart, necessary to create a shocking vector encompassing the left ventricle. Note indentation (arrow) of the lead as it passes under the clavicle, signifying compression of the lead. A large posterior curve suggests placement in the coronary sinus, although it could also suggest placement across a patent foramen ovale or atrial septal defect into the left atrium. Transvenous ventricular leads For many years, transvenous ventricular leads were routinely placed in the right ventricular apex. The position of the heart, vertical or relatively more horizontal, largely determines the position of the lead in relation to the cardiac apex and varies among patients. The lateral view is necessary to distinguish an apical position in which the lead tip is anterior and caudally directed, is directed posteriorly in the right ventricle, or is on the posterior surface of the heart; that is, within the coronary sinus. The small diameter of the lead, 4 Fr, makes it somewhat more difficult to see on the radiograph. The ventricular lead position is also inadequate; that is, too little slack has been left on the lead. Because of the potential benefit of avoiding the adverse consequences of right ventricular apical lead positioning, lead placement in the right ventricular outflow tract or septal positions continues to gain popularity. Excessive redundancy has been left on the ventricular lead in an effort to allow for future growth. However, leads intended for rightsided placement may reach the left ventricular cavity through perforation of the ventricular septum, the lead having inadvertently crossed a patent foramen ovale, atrial septal defect, or ventricular septal defect during transvenous placement, and in the pericardial space as a result of perforation. There is evidence of an abandoned bipolar lead in the vicinity of the pulse generator. There are two ventricular leads: one bipolar (white arrows) and one unipolar (black arrow). The bipolar lead is abandoned, so the unipolar lead must be connected to this bipolar singlechamber pulse generator. This was accomplished by placing an indifferent electrode in the connector block where the (+) portion of an inline bifurcated bipolar lead would have been connected.
Oral chemesthesis is the process of detection of chemical stimuli by thermal and pain receptors within the mouth (Green symptoms 32 weeks pregnant buy generic solian 100 mg line, 2012). Obviously, pain is an aversive stimulus that typically causes a person to stop whatever activity induced the pain (think of the last time you burned your finger). In contrast, thermal stimuli (heat and cold) mediate qualities of the bolus that are important, although there are extremes there as well. A warm drink is very satisfying in winter, but if it is too hot, the sense of pain takes over. We will talk about pain and thermal sense shortly, but first let us consider the interaction of these protective senses in gustation. Some chemesthetic stimuli enhance swallowing function by lowering the threshold of the swallow, although others signal the body that a foreign and potentially dangerous material has been introduced. Oral chemesthesis can tell your body that it has been invaded by bacteria that have caused chemical changes in the oral mucosa, for instance, causing sneezing or nasal rhinorrhea (Green, 2012). We regularly indulge in foods that trigger responses from pain and thermal sensors. Carbonated water, with and without the addition of the thermal irritant ginger (in strong ginger ale) (Krival & Bates, 2012), as well as high concentrations of sucrose, salt, and citric acid (Pelletier & Dhanaraj, 2006) all have increased linguapalatal pressure in people with normal swallow function. Although to date no studies have examined the effectiveness of these chemesthetic stimuli on swallowing over time, the fact that immediate changes in swallowing occur suggests that capitalizing on the oral chemesthetic sense has promise for increasing lingual force and pharyngeal swallowing in people with dysphagia. A caution: In many of these studies, the effect on swallowing was achieved only when the bolus was so strongly irritating that it was deemed unpalatable by the research participants (Logemann, 1995; Pelletier & Dhanaraj, 2006). Olfaction Olfaction (the sense of smell) plays a vital role in appetite and taste. Molecules arising from food pass over olfactory chemoreceptors to increase the magnitude of the taste perception, a fact to which you can relate if you remember how flat your favorite food tasted when you had nasal congestion. In fact, if you tightly occlude your nares and blindly take a bite of apple and then a bite of onion, you will likely not be able to taste the difference. Olfactory sensors arise from the olfactory bulb and have the distinction of a short life and continual replacement. There are small cilia protruding from the olfactory sensor, similar to the microvilli of the taste cell. These cilia are highly specialized, in that they transduce the molecular stimulant into the perception of smell that is transmitted to the olfactory bulb located within the cranial space. Recent research has revealed that although the basic structure of the odor receptors on the cilia is similar for all olfactory sensors, the specific structure of the receptor varies slightly, so that more than 1,000 different odors are decoded by the olfactory system. After an odorant stimulates a specific receptor, information that the receptor has been activated is transmitted to the olfactory bulb, which resides within the braincase. More than 1,000 axons of sensory cells converge on each olfactory interneuron (termed a glomerulus) in the olfactory bulb. Information from some of these brain centers is routed through the thalamus and subsequently relayed to the frontal lobe of the cerebral cortex, orbital region.
Unbound antigens symptoms 1974 cheap solian 100 mg visa, smallest in size, will filter through these columns first, followed by unbound antibody, and then AbAg complexes. In this method, two incubations occurred, the first with the solid support antibody and the patient sample, serum or plasma; and the second incubation, after several washes, with the radiolabeled antibody. This was further refined to include the use of the more-specific monoclonal antibody instead of the less-specific polyclonal variety. Enzyme Assays Enzyme coupling was initially developed because fluorescence was traditionally difficult to quantitatively assess, and radioisotopes had limited shelf stability and used radioactive materials, which are potentially harmful for lab workers. Enzyme-labeled tests concurrently using colorimetric, fluorimetric, and chemiluminescent systems are some of the most widely used immunoassay procedures. Specifically, an enzymatic response elicits a change in a secondary tracer, such as a change in color or fluorescence. Enzyme use allows sensitive detection of a small concentration of antigen, as well as reducing signal to noise ratio, as enzymes are signal amplifiers; each enzyme-Ab-Ag complex can catalyze multiple product-forming reactions, as opposed to the single signal molecule or direct fluoro- or radio- label conjugated to an enzyme. As with all enzymatic reactions, measurement is determined by examining the turnover of substrate into product. Often, this results from the conversion of a colorless chromogenic substrate into a colored product, through photometry, for instance, indicating the formation of an Ab-Ag complex. In a biological setting, they are often used to assess immune response, including cytokine secretion and quantified antibody levels to assess immune response to an allergen immunization. They have been used to assess levels of low-frequency T cells specific to cancer or other antigens, B-cell response, and humoral response as well. It is commonly considered a backbone method for diagnostic testing in infectious disease. The enzymes most frequently used are conjugated via glutaraldehyde to an antibody, without loss of antibody- antigen binding or enzyme functionality, and catalyze a reaction in which the product is visually detectable. Following binding, bound molecules are immobilized, and unbound antibody and sample are washed from the formed complex. Bound sample is then exposed to the enzyme substrate, and an enzymatic reaction is allowed to proceed either for a set amount of time or to a set color density, at which point the reaction is quenched through washing. Relative levels of absorption or speed at which set absorption is reached can then be used to determine the number of enzymes present, which indicates the amount of Ab-Ag complex. An antibodydetection method is also employed to find patient antibodies (not shown) in which an antigen is bound to the solid phase; then the patient serum is added, followed by an antihuman IgG with label. The solution is then developed to reveal positive coloration when antigen/cells are present. Fluorophores, or fluorochromes, were first bound to antibodies in the mid-1940s, and were useful due to their ability to absorb energy from an incident light source and convert it to lower energy but longer wavelength light, thus allowing for light-aided detection of bound molecules.
Tufail, 27 years: Typically, if the patient has experienced more than one shock within 24 h they should seek medical attention. The adult female filaria of the Wuchereria bancrofti species within lymph nodes release microfilaria into the blood stream. The alternating contraction of these mandibular elevators is interspersed with the depression of the mandible, which allows the lingual musculature to move the bolus onto and off the molars. The potential exists for signals other than those of intrinsic ventricular activity to be sensed and to inhibit ventricular output.
Renwik, 23 years: From this single view, it also appears that both leads are "shallow"; that is, suboptimal redundancy on the ventricular lead and suboptimal "J" on the atrial lead. The internal intercostal muscles are predominantly muscles of expiration, with the exception of the interchondral (cartilaginous) component. In this configuration, a volume of information is distilled into a single response. The thyrovocalis (often abbreviated as vocalis) originates from the inner surface of the thyroid cartilage near the thyroid notch.
Ayitos, 37 years: When the traveling wave perturbs the basilar membrane, the shearing action on the cilia is produced in the medial-proximal dimension because of the hinge-like function of the lamina. Typically, if IgG antibodies are present, the individual is expected to be immune to further infection/disease. Pulmonary Fibrosis In pulmonary fibrosis, lung tissue- particularly the alveolar walls- becomes scarred and thickened. Elasticity is the property of material that causes it to return to its original shape after being displaced.
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