Notes: Objective To investigate the effects of syncytiotrophoblast microvillous membranes (STBM) in concentrations, found in vivo in women with pre-eclampsia, on endothelial function in isolated resistance arteries.Setting Department of Obstetrics and Gynaecology, Huddinge University Hospital, Stockholm.Sample Twenty-nine myometrial resistance arteries isolated from biopsies of healthy term pregnant women, obtained during caesarean section.Methods The myometrial arteries were mounted in a pressure arteriograph and perfused intraluminally for three hours with STBM (20 to 2000ng/mL) or with erythrocyte membranes or physiological salt solution as controls, all substituted with 0.5% bovine serum albumin. Bradykinin concentration-response curves were performed before and after perfusion.Main outcome measures The bradykinin concentrationresponse curves were fitted to the Hill equation and maximal dilation and the pEC50 values were determined from these fits. Differences within groups were analysed with a paired Student's t test. Electron microscopic evaluation of the endothelium was performed.Results Neither STBM nor erythrocyte membrane perfusion affected maximal dilation or the pEC50 values of the bradykinin concentration-response curves at any concentration. Examination by electron microscopy showed no obvious damage to the endothelium after perfusion with STBM or erythrocyte membranes.Conclusion Perfusion with STBM in concentrations up to 100 times those reported in pre-eclampsia has no significant effect on bradykinin-mediated dilation in isolated myometrial arteries.

Notes: 1. We investigated trophic interactions between benthic heterotrophic nanoflagellates (HNF) and oligochaetes and microcrustaceans (cladocerans and copepods) transferred from a silty, littoral freshwater habitat to laboratory microcosms. With a newly adapted experimental design we were able to compute (i) predation rates on benthic HNF by the tested metazoan organisms and (ii) growth rates of the natural benthic HNF population when losses because of this predation were excluded.2. The experiments covered a temperature range of 4–27 °C and a fivefold variation of predator densities (September 2000–February 2002). For 60% of these experiments, significant predation of oligochaetes and microcrustaceans on benthic HNF was revealed. Predation rates on HNF ranged from 0 to 0.256 day−1. Growth rates of the benthic HNF assemblage varied from −0.098 to 0.353 day−1; they were used to estimate the significance of the measured losses in comparison with possible other loss factors.3. The data suggested that during the major part of the year a high percentage of the HNF production was consumed in the surficial sediment of the investigated system, resulting in a relatively constant and low HNF standing stock and an uncoupling of benthic bacteria and their protistan grazers. Top–down control by microcrustaceans and oligochaetes was identified as one significant, frequently prevailing regulatory factor, while other parameters responsible for the control of benthic HNF densities remain to be examined.

Notes: A 9-year-old boy presented with a history of fever, malaise, and sore throat for 1 day. He was seen by his family physician who diagnosed tonsillitis. The past medical history was unremarkable. There was no previous history of allergy to medications. After a throat swab had been taken and sent for bacterial culture, the patient was started on amoxicillin, 250 mg three times daily.Two days later, the child developed an extensive pruritic eruption over the body. We were consulted at this point. On examination, the child was afebrile. His pulse rate was 74/min and his blood pressure was 90/60 mmHg. An erythematous, maculopapular eruption was noted on the face, neck, trunk, buttocks, and extremities (〈link href="#f1"〉Fig. 1). The palms and soles were also involved, but to a lesser extent. The pharynx and tonsils were erythematous. Yellowish exudates were seen in the tonsillar area. There were shotty lymph nodes in the cervical area. The spleen and liver were not palpable. The rest of the physical examination was normal.〈figure xml:id="f1"〉1〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD1699_1:IJD_1699_f1"/〉An erythematous maculopapular eruption on the extremitiesA provisional diagnosis of infectious mononucleosis was made. In the meantime, the throat swab culture came back as negative. Amoxicillin therapy was discontinued. Hydroxyzine hydrochloride, 10 mg four times daily as required, was given to relieve the itchiness.Laboratory investigations showed a hemoglobin of 125 g/L, white blood cell count of 12 × 109/L with 75% lymphocytes, 23% neutrophils, 5% monocytes, and 2% eosinophils, and a platelet count of 200 × 109/L. Many atypical lymphocytes were seen in the peripheral smear. Monospot test was positive, confirming the diagnosis of infectious mononucleosis.The child was reassessed 7 days later. By then, the pruritus had subsided and the eruption had cleared without desquamation. The pharynx and tonsils looked normal and there was no cervical lymphadenopathy.The child was seen by his family physician 5 months later because of a left-sided earache. He was diagnosed with left otitis media and was treated with amoxicillin, 250 mg three times daily for 7 days. No skin eruption was noted with the use of amoxicillin on this occasion.

Notes: Four Chinese females aged 21–35 years with Mongolian spots are reported. Two patients had the spots on their arms while the other two had the spots on their shoulders. The persistence of Mongolian spots in Chinese adults has not been previously reported.

Notes: Scrotal hair in infancy is extremely rare. We report identical twins who had scrotal hair at 1 month of age. The condition is likely owing to hypersensitivity of the scrotal hair follicles to transiently elevated androgen levels in the first few months of life. Our patients are the youngest reported in the literature. Most cases are sporadic. The present cases suggest that the condition can be familial.

Notes: A Chinese baby girl was born after an uncomplicated pregnancy and a normal spontaneous vaginal delivery to a gravida 2, para 1, 32-year-old mother at 37 weeks' gestation. Neither parent had a history of alcohol or drug ingestion. There was no history of consanguinity.The Apgar scores were 7 at 1 min and 9 at 5 min. Her birth weight was 5 lb 14 oz and her length was 46 cm. At birth, she was noted to have grayish areas on the face and lower back.The infant was seen at 3 months of age because of persistent regurgitations. On average, she regurgitated 7–8 times a day. Physical examination showed that the infant was not in distress. Her weight was 6 lb 4 oz and length 47 cm. She had a Mongolian spot measuring 0.8 × 1.2 cm in the left temporal area (〈link href="#f3-1"〉Fig. 1) and another Mongolian spot measuring 4 cm in diameter in the lumbar area. The Mongolian spots were grayish in color and the pigmentation was uniform in intensity. The rest of the examination was essentially normal. The infant was diagnosed to have Mongolian spots and gastroesophageal reflux. The latter was treated with postural therapy, thickened feedings, and metoclopramide 0.35 mg q.i.d.〈figure xml:id="f3-1"〉1〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD1212-4:IJD_1212_f3-1"/〉Mongolian spot in the left temporal areaThe infant was seen again at 4 months of age for a reassessment. There was no noticeable change in shape, size, or color of the Mongolian spots.