Introduction of permanent cardiac stimulation/defibrillation leads via the retro-pectoral veins.

When the cephalic vein route is not easily accessible for the introduction of permanent stimulation/defibrillation leads, retro-pectoral veins can be looked for, which are usually present and suitable in most patients. As with the cephalic vein route, it is a safer approach than direct subclavian vein puncture. Moreover, using a guidewire and a split introducer increases the rate of successful cannulation.

Chronic bronchial allergic inflammation increases alveolar liquid clearance by TNF-alpha -dependent mechanism.

Bronchial inflammation in allergic asthma is associated with active exudation from the bronchial tree into the interstitial space of both mucosa and submucosa. The aim of this study was to evaluate epithelial and endothelial permeability as well as alveolar fluid movement in a model of chronic allergic inflammation in Brown-Norway rats sensitized and challenged with ovalbumin (OA). Control groups were challenged with saline solution (C), and rats were immunized by OA but not challenged (Se). Lung sections showed a marked inflammatory infiltrate associated with perivascular and peribronchiolar edema in OA. To measure alveolar liquid clearance, a 5% bovine albumin solution with 1 microCi of (125)I-labeled human albumin was instilled into the air spaces. Alveolar-capillary barrier permeability was evaluated by intravascular injection of 1 microCi of (131)I-labeled albumin. Endothelial permeability was significantly increased in OA, from 0.08 +/- 0.01 in the C group to 0.19 +/- 0.03 in OA group (P < 0.05). Final-to-initial protein ratio was also statistically higher in OA (1.6 +/- 0.05) compared with C (1.38 +/- 0.03, P = 0.01) and Se groups (1.42 +/- 0.03, P = 0.04). Administration of anti-tumor necrosis factor-alpha antibodies within the instillate significantly decreased this ratio (1.32 +/- 0.08, P = 0.003 vs. OA). To conclude, we demonstrated a tumor necrosis factor-alpha-dependent increase in alveolar fluid movement in a model of severe bronchial allergic inflammation associated with endothelial and epithelial leakage.

The breakup of a meteorite parent body and the delivery of meteorites to Earth.

Whether many of the 10,000 meteorites collected in the Antarctic are unlike those failing elsewhere is contentious. The Antarctic H chondrites, one of the major classes of stony meteorites, include a number of individuals with higher induced thermoluminescence peak temperatures than observed among non-Antarctic H chondrites. The proportion of such individuals decreases with the mean terrestrial age of the meteorites at the various ice fields. These H chondrites have cosmic-ray exposure ages of about 8 million years, experienced little cosmic-ray shielding, and suffered rapid postmetamorphic cooling. Breakup of the H chondrite parent body, 8 million years ago, may have produced two types of material with different size distributions and thermal histories. The smaller objects reached Earth more rapidly through more rapid orbital evolution.