Prepulse inhibition and habituation of the startle response are stable neurobiological measures in a normal male population.

Prepulse inhibition (PPI) and habituation of the startle response are operational measures of sensorimotor gating and information processing. Changes in the normal inhibition and habituation of the startle response may provide trait markers for illnesses such as schizophrenia that have altered neurotransmitter control of the neural circuitry that modulates these measures. The stability of PPI and habituation was assessed in 10 normal male subjects. Prepulse inhibition was found to be most stable in the more intense prepulse conditions, and habituation was most stable in the early portion of the test session. These data support the hypothesis that PPI and habituation are relatively stable neurobiological markers.

Disruption in prepulse inhibition after alpha-1 adrenoceptor stimulation in rats.

The role of the alpha-1 adrenoceptor in prepulse inhibition (PPI) was evaluated in rats. The alpha-1 adrenergic agonist cirazoline disrupted PPI; this effect was reversed by the alpha-1 adrenergic antagonist prazosin or the atypical antipsychotic quetiapine. Alpha-1 adrenoceptors may thus be involved in the regulation of PPI and in the psychotherapeutic actions of certain antipsychotics.

Prednisone as adjunctive therapy in the management of pulmonary tuberculosis. Report of 12 cases and review of the literature.

A retrospective chart review was conducted over a 5-year period (1988 to 1993) in a tertiary inpatient care center on the effects of the addition of prednisone to the treatment regimens of 12 patients with pulmonary tuberculosis who continued to spike high temperatures and lose weight while showing bacteriologic response to effective antituberculosis therapy. After exclusion of other causes of fever, all patients were treated with 20 to 60 mg of prednisone daily until normalization of temperature and clinical improvement. Analyzed data included twice weekly sputum bacillary count, temperature record every 4 h, weekly patient weight, serum albumin level, liver function tests, and chest roentgenogram. The patients continued to spike temperatures of 38.3 degrees C to 40.5 degrees C (mean +/- SD = 39.6 degrees C +/- 0.6 degrees C) even after 18 to 53 days (mean +/- SD = 33.9 +/- 9.8 days) of antituberculosis therapy. Within 24 h after the addition of oral prednisone, temperature decreased in all 12 patients from a daily highest spike mean of 39.6 degrees C +/- 0.6 degrees C (SD) to 38.1 degrees C +/- 0.6 degrees C (SD) (p = 0.0022). The duration of required prednisone therapy was 20.1 +/- 9 days (mean +/- SD). During this period patients' appetites improved, and their weight increased from a mean (+/- SD) of 53.6 +/- 5.7 kg to 58.1 +/- 6.4 kg (p = 0.0022). The serum albumin level increased from a mean (+/- SD) of 2.51 +/- 0.4 g/dL to 3.21 +/- 0.4 g/dL (p = 0.0033). All the patients also showed clinical evidence of a decrease in toxic reactions associated with tuberculosis. There were no side effects from the addition of prednisone. This study shows the need for randomized controlled clinical trials to clarify the role of prednisone as adjunctive therapy in the management of pulmonary tuberculosis.

Malacoplakia of the endometrium, a probable cause of postmenopausal bleeding.

A 60-year-old woman, 20 years post-menopausal, who had deforming rheumatoid arthritis of 7 years' duration and Sjögren's syndrome of 1 year's duration, had had postmenopausal bleeding for a month prior to admission to the hospital. A diagnosis dilatation and curettage was interpreted as showing acute suppurative endometritis. The patient was discharged, only to have recurrent vaginal bleeding. She was readmitted five weeks later, at which time results of another dilatation and curettage were interpreted as showing xanthromatous endometritis. Total hysterectomy with bilateral salpingo-oophorectomy was done. Examination of Epon-embedded endometrium 1 micrometer thick by light microscopy and subsequently by electron microscopy disclosed intracellular bacilliform organisms within phagolysosomes of atypical histiocytes, lamellar bodies, and various developing stages of calcospherites, Michaelis-Gutmann bodies. The curettings were then received and classic Michaelis-Gutmann bodies were identified in periodic acid--Schiff-stained sections.