Although regulation of angiotensin II receptor (AT) binding in vascular and uterine smooth muscle is similar in nonpregnant animals, studies suggest it may differ during pregnancy. We, therefore, examined binding characteristics of myometrial AT receptors in nulliparous (n = 7), pregnant (n = 24, 110-139 d of gestation), and postpartum (n = 21, 5 to 2 130 d) sheep -15%/85%). In studies of ANG II-induced force generation, myometrium from pregnant ewes (n = 10) demonstrated dose-dependent increases in force (P < 0.001), which were inhibited with an AT1 receptor antagonist. Postpartum myometrial responses were less at doses 2 10-9 M (P < 0.05) and unaffected by AT2 receptor antagonists. Vascular and myometrial AT receptor binding are differentially regulated during ovine pregnancy, the latter primarily reflecting decreases in AT2 receptor expression. This is the first description of reversible changes in AT receptor subtype in adult mammals. (J.

Aims-To examine the eVects of light on retinal development and function in preterm infants as measured by the electroretinogram (ERG). Secondary outcomes included visual acuity testing, the incidence of retinopathy of prematurity, and general wellbeing, reflected in feeding tolerance, rate of weight gain, and length of hospital stay. Methods-Eligibility criteria for enrolment were birthweight < 1250 g and gestational age < 31 weeks. Sixty one infants were randomly allocated by 6 hours after birth to a control or treatment group which wore 97% light filtering goggles for a minimum of four weeks or until the infant reached 31 weeks postmenstrual age. Results-There were no significant diVerences between the two groups in the numbers of electroretinograms performed at 36 weeks of postmenstrual age. Although the sample size was not large enough to exclude clinically important diVerences in secondary outcomes, no significant diVerences were observed between the groups in visual acuity testing at 4-6 months corrected age, incidence of retinopathy of prematurity, weight gain, or length of stay. Conclusion-These data support the safety and feasibility of this intervention. A much larger study will be needed to determine whether light reduction to the eyes of very low birthweight infants will reduce the incidence of retinopathy of prematurity or enhance general wellbeing.

Saccharomyces cerevisiae (brewer's or baker's yeast) is an extremely rare cause of fungal sepsis. It is an asporogenous yeast that is used in the production of baked goods, beer, wine, and occasionally found in health foods. It colonizes the human respiratory tract, gastrointestinal tract, urinary tract, and vagina. Severe immunosuppression, prolonged hospitalization, prior antibiotic therapy, and prosthetic cardiac valves are the settings where Saccharomyces infection has been observed. 1 S. cerevisiae has been classified within the yeast species as a new or emerging pathogen since 1990. Increasing case reports in the medical literature are an indication of emerging yeast infections. 2,3 In this report we will describe a 35-week-old neonate who had feeding intolerance and frequent episodes of presumed sepsis treated empirically with vancomycin, cefotaxime, and gentamicin. The patient had no other underlying problems, or central venous catheters. CASE REPORTThis is a 1409-g, small for gestational age, 34-week-old female born by vaginal delivery. The mother had prenatal care and was diagnosed with pyelonephritis and pre-eclampsia just before delivery. The mother was on Procardia for chronic hypertension and received aztreonam 12 hours before the delivery. The delivery was uneventful and Apgars were 7 at 1 minute and 8 at 5 minutes. The patient was admitted to the intensive care unit with mild respiratory distress diagnosed as transient tachypnea of the newborn. This resolved within the first day of life and required no ventilatory management. The rest of the physical exam was within normal limits. The patient was started on ampicillin and claforan secondary to suspected sepsis related to prematurity and respiratory distress. During the following days the patient remained asymptomatic until enteral feeds were started on the fourth day of life. The patient at that point had feeding intolerance manifested by abdominal distention and dilated loops of bowel on a KUB. There was no evidence of necrotizing enterocolitis and the patient was NPO for a total of 5 days. Feedings were restarted slowly but the patient developed abdominal distention again. No other signs or symptoms were present at that time and the antibiotics were stopped on day of life 14 as two sets of blood cultures and CSF cultures from admission were negative. CBC and CRP were within normal limits. On day of life 16 the patient continued having feeding problems, had a temperature of 1018F, and lethargy. A sepsis workup was done. The CRP was 3.5 mg/dl (normal 0 to 0.8 mg/dl).The CBC was: 12,300 WBC, 41% neutrophils, 16 bands, 34 lymphocytes, and two sets of blood cultures were positive for S. cerevisiae. CSF and urine cultures were negative. A head ultrasound, echocardiogram, abdominal and renal ultrasound, and ophthalmologic evaluation were normal. Amphotericin B was started at 1 mg/kg per day and 26 days of treatment were completed. The patient started tolerating feedings at day of life 20 and remained asymptomatic afterwards. Blood cultures after 22 day...

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