Paraneoplastic temporal lobe epilepsy with testicular neoplasm and atypical amnesia.

We report a patient who, at age 38, presented with temporal lobe seizures and an atypical memory disorder 3 years before the discovery of a testicular tumor. Detailed neuropsychological testing revealed a relatively isolated amnestic syndrome. The amnesia was atypical as the patient could retain information for hour-long periods, only to lose it later. Serologic studies revealed the presence of a circulating autoantibody that demonstrated an unusual affinity for the nucleolus of cerebral cortical neurons. Western blot analysis of cortical neurons revealed that this antibody reacted with proteins different from other previously identified paraneoplastic neurologic antigens (Hu, Yo, Ri). We believe this to be a case of paraneoplastic limbic encephalitis secondary to the testicular tumor. This patient presents unique characteristics with respect to the mode of presentation, features of the amnesia, and the presence of a circulating antibody with an unusual reactivity pattern.

The Executive Skills Profile: a method for assessing development needs among family medicine faculty.

BACKGROUND AND OBJECTIVES: The purpose of this paper is to report on how the Executive Skills Profile, a measure of job demands and employee skills, can be used as a faculty development tool in academic family medicine departments. METHODS: The Executive Skills Profile (ESP) identifies 72 work activities and groups them into 12 scales, each of which is displayed graphically. Faculty identify the work activities that are relevant to their jobs and then identify the personal skills they must have to carry out those work activities. RESULTS: The ESP successfully characterized the job demands and personal skills of one family medicine department. The evaluation showed that overall perceived job demands were greater than the faculty's perceived personal skills, particularly in the areas of interpersonal and behavioral skills. CONCLUSIONS: The ESP can be used to characterize the job demands and personal skills of faculty.

Cooperativity of binding of anilinonaphthalenesulfonate to serum albumin induced by a second ligand.

When a ligand X is multiply bound to energetically identical, noninteracting sites of a protein, cooperative binding of this ligand can be induced by the presence of a second ligand Y. This effect should appear whenever multiple interactions exist between the bound X and Y ligands, and vanish when the concentration of Y is made sufficiently large to ensure Y saturation at all concentrations of X. These predictions have been verified for the binding of 8-anilino-1-naphthalenesulfonate to serum albumin, when Y, the effector ion, is 3,5-dihydroxybenzoate. In the presence of 2mM dihydroxybenzoate, the Hill coefficient for anilinonaphthalenesulfonate binding rose steadily from 1 to 1.5 as the number of molecules of ligand bound increased from 1 to 3.3 per albumin molecule. The theory of interactions between isolated ligands, applied in the previous paper (D. A. Kolb and G. Weber (1975), Biochemistry, preceding paper in this issue), is extended to cases of multiple interactions, and applied here to show that the experimental results are tolerably well reproduced for a model in which four anilinonaphthalensulfonate molecules are homogeneously coupled to four molecules of dihydroxybenzoate by free energies of 3.0 and 3.5 thermal units.

Quantitative demonstration of the reciprocity of ligand effects in the ternary complex of chicken heart lactate dehydrogenase with nicotinamide adenine dinucleotide oxalate.

The reciprocity of effects of two ligands simultaneously bound to a protein as a ternary complex may be proven by measurements of four standard free energies of binding. Two of these are for the binding of each ligand in the absence of the other, and the other two for the binding of each ligand in the presence of saturating amounts of the other (conditional free energies). These four quantities have been measured for the complexes of oxalate and nicotinamide adenine dinucleotide with chick heart lactate dehydrogenase. The differences between conditional and unconditional free energies are: oxalate, -1.1 +/- 0.3 kcal; NADH,-1.3 +/- 0.2 kcal, thus proving the reciprocity within experimental error.