Bronchogastric fistula successfully treated with the insertion of a covered bronchial stent

We present what we believe to be the first case of a bronchogastric fistula successfully treated with a plastic-covered metallic bronchial stent. This developed 5 years after a transhiatal oesophagectomy with gastric pull-up for carcinoma of the oesophagus. The successful outcome in this case suggests that this method of treatment should be considered in patients in whom this post-operative complication cannot be managed easily by other means.

Lamb production from Merino ewes mated to Merino or Damara rams

Damara sheep have recently been imported to Australia and are being crossed with Merino ewes as a diversification from wool to fat tail sheep production for live sheep export or meat markets. A comparison was made of the lamb outputs from Merino ewes mated to 2 Merino rams and 2 Damara fat tail rams. There were more multiple litters produced in the matings with the Damara rams than from the Merino rams (P = 0.01). The 5-month weights of the crossbred lamb groups (36.3 and 38.9 kg) were higher (P<0.05) than the Merino groups (33.4 and 32.3 kg). Ram lambs were slaughtered at 7 months of age and the carcasses dissected into 'trim lamb' lean portions, fat trims, bone and other oddments. Dressing percentage at slaughter of the crossbred lambs was 3–4% higher (P<0.001), reflecting lower wool production, than the Merino lambs. After adjustment for chilled carcass weight, there were no differences (P>0.05) between rams for the total amount of lean meat. However, the crossbred groups had more external carcass fat (2.59 and 2.64 kg) than the Merino groups (2.14 and 2.15 kg) and, in addition, had fat tail weights of 0.52 and 0.36 kg.

Factors affecting Merino wool contamination in crossbreeding

Fleeces of Merino ewes were tested to identify whether contaminant sheep fibres increased from Damara-ram mating alone, whether extent of colouration of the crossbred lamb coat, day of birth and number of lambs being reared affect transfer to the maternal fleece, and whether increased fleece bulk or shearing the ewes 3.5�months post-weaning reduced the concentration of contaminant fibres. Measurement of fleeces from 26 ewes mated to a Merino ram and 26 ewes mated to a Damara ram did not show a significant increase in the presence of pigmented or heavily medullated white fibres. In contrast, wool samples from 54 Merino ewes taken the day after weaning of their Damara crossbred lambs showed pronounced contamination by pigmented fibre as well as relatively high levels of heavily medullated white fibres. The concentrations of pigmented fibres were highest in the fleeces with short wool and proportionally diluted in the fleeces with long wool. Concentrations of heavily medullated white fibres from white-spotted coats of the crossbred lambs showed that ewes that reared multiple lambs had greater transfer while the day of birth after the start of lambing and the extent of coat colour on the lambs were both negatively related to transfer of these fibres. Side samples collected from the same 26 ewes at weaning and 3.5 months after weaning revealed declines in contaminant fibres greater than could be explained by dilution by new wool growth after weaning, implying physical loss from the fleece. However, the residual contaminant fibres after 3.5 months' delay in shearing remained excessive for Merino wool. Wool samples from the sheep's side produced similar concentrations of contaminant fibres as the fleece grid sample.

Bradyarrhythmias in acute myocardial infarction: should thrombolysis lower the decision threshold for temporary pacing?

Both acute myocardial infarction and reperfusion therapy with thrombolytic agents may be associated with bradyarrhythmias, and there may be a case for 'prophylactic' insertion of a temporary pacing wire in selected patients. We describe 4 patients in whom clinical decisions had to be made concerning the appropriateness and timing of temporary pacing, and discuss the implications for modern guidelines on the indications for pacing in such a setting.