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van Leeuwen WMA, Kircher A, Dahlgren A, Lützhöft M, Barnett M, Kecklund G, Åkerstedt T. Sleep, Sleepiness, and Neurobehavioral Performance While on Watch in a Simulated 4 Hours on/8 Hours off Maritime Watch System. Chronobiol Int 2013; 30:1108-15. [DOI: 10.3109/07420528.2013.800874] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Verheul F, Smolders J, Trojano M, Lepore V, Zwanikken C, Amato MP, Grand'Maison F, Butzkueven H, Marrosu M, Duquette P, Comi G, Izquierdo G, Grammond P, Lus G, Petersen T, Bergamaschi R, Giuliani G, Boz C, Coniglio G, Van Pesch V, Lechner-Scott J, Cavalla P, Granella F, Avolio C, Fiol M, Poehlau D, Saladino ML, Gallo P, Deri N, Oleschko Arruda W, Paine M, Ferro M, Barnett M, Cabrera-Gomez JA, Slee M, Moore F, Shaw C, Petkovska-Boskova T, Rutherford M, Engelsen O, Damoiseaux J, Hupperts R. Fluctuations of MS births and UV-light exposure. Acta Neurol Scand 2013; 127:301-8. [PMID: 22970985 DOI: 10.1111/ane.12007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Patients with multiple sclerosis (MS) are more frequently born in spring when compared to autumn. Fluctuation of UV-light has been hypothesized to drive this phenomenon. AIM To assess the correlation between fluctuation of sunlight and birth season in persons with MS. METHODS For this record-linkage study, we collected from the international MSBase and the Italian MS iMed-web databases the dates of birth of 11,415 patients with MS from 36 centres from 15 countries worldwide and compared these to dates of live-births from national registries. From all participating sites, we collected data on UV-light fluctuation and assessed its correlation with seasonal fluctuation in MS births. RESULTS Compared with the reference cohort, an increased proportion of persons with MS were born in spring and a decreased proportion in autumn (odds ratio (OR) to be born in spring versus autumn = 1.158, χ² = 36.347, P < 0.001). There was no significantly increased fluctuation of MS births with increased quartile of ambient UV-light fluctuation (Ptrend = 0.086). CONCLUSION Seasonal fluctuation of MS births as found in this worldwide cohort of patients with MS did not correlate with variation in seasonal fluctuation of UV-light. Most likely, it results from a complex interplay between fluctuation of sunlight, behavioural factors, other environmental factors and (epi)genetic factors.
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Hughes S, Spelman T, Gray O, Boz C, Trojano M, Zwanikken C, Lugaresi A, Izquierdo J, Duquette P, Girard M, Grand'Maison F, Grammond P, Oreja-Guevara C, Hupperts R, Petersen T, Bergamaschi R, Giuliani G, Lechner-Scott J, Barnett M, Edite Rio M, van Pesch V, Pia Amato M, Iuliano G, Fiol M, Slee M, Verheul F, Cristiano E, Fernández Bolaños R, Saladino D, Poehlau M, Deri N, Oleschko Arruda W, Cabrera-Gomez J, Paine M, Vella N, Herbert J, Skromne E, Savino A, Shaw C, Moore F, Vucic S, Petkovska-Boskova T, Vetere S, McDonnell G, Hawkins S, Kee F, Butzkueven H. EXPOSURE TO INTERFERON-β THERAPY IN EARLY PREGNANCY: A LITERATURE REVIEW OF PREGNANCY OUTCOMES IN WOMEN WITH MULTIPLE SCLEROSIS. Journal of Neurology, Neurosurgery and Psychiatry 2012. [DOI: 10.1136/jnnp-2012-304200a.64] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bowen D, Thornquist M, Goodman G, Omenn GS, Anderson K, Barnett M, Valanis B. Effects of incentive items on participation in a randomized chemoprevention trial. J Health Psychol 2012; 5:109-15. [PMID: 22048829 DOI: 10.1177/135910530000500103] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Behavioral research has an important role in increasing and maintaining participation in disease prevention trials, both in interventions and in follow-up visits. We conducted a randomized experiment among participants in the lung cancer chemoprevention trial, CARET (Carotene and Retinol Efficacy Trial) to test the effects of providing two incentives on retention. The items used for this study were a Certificate of Appreciation and one of two lapel pins, provided in a 2 2 design. Providing incentives, whether alone or in combination, had no statistically significant effect on retention by the two-year follow-up point. The successful implementation of this randomized incentive study has two implications for future research: (1) study of behavioral interventions and issues is feasible in the context of large controlled trials of disease end-points; and (2) such study is necessary to determine whether selected incentives can increase retention.
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Chohan G, Puhl P, Barnett M, Redell S, Pollard J. 5. Phenotypic, electrophysiological and pathophysiological heterogeneity of sarcoid peripheral neuropathy. Clin Neurophysiol 2012. [DOI: 10.1016/j.clinph.2011.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lechner-Scott J, Spencer B, de Malmanche T, Attia J, Fitzgerald M, Trojano M, Grand'Maison F, Gomez JAC, Izquierdo G, Duquette P, Girard M, Grammond P, Oreja-Guevara C, Hupperts R, Bergamaschi R, Boz C, Giuliani G, van Pesch V, Iuliano G, Fiol M, Cristiano E, Verheul F, Saladino ML, Slee M, Barnett M, Deri N, Flechter S, Vella N, Shaw C, Herbert J, Moore F, Petkovska-Boskova T, Jokubaitis V, Butzkueven H. The frequency of CSF oligoclonal banding in multiple sclerosis increases with latitude. Mult Scler 2011; 18:974-82. [PMID: 22185806 DOI: 10.1177/1352458511431729] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND With the advent of MRI scanning, the value of lumbar puncture to assess oligoclonal band (OCB) status-for the diagnosis of multiple sclerosis (MS) is increasingly uncertain. One major issue is that the reported frequency of cerebrospinal fluid (CSF)-restricted oligoclonal banding for the diagnosis of MS varies considerably in different studies. In addition, the relationship between OCB positivity and disease outcome remains uncertain, as reported studies are generally too small to assess comparative disability outcomes with sufficient power. METHODS In order to further investigate variation of OCB positivity in patients with MS, we utilized MSBase, a longitudinal, Web-based collaborative MS outcomes registry following clinical cohorts in several continents and latitudes. We also assessed whether OCB positivity affects long-term disability outcome. RESULTS A total of 13,242 patient records were obtained from 37 MS specialist centres in 19 different countries. OCB status was documented in 4481 (34%) patients and 80% of these were OCB positive. The presence of OCB was associated with degree of latitude (p = 0.02). Furthermore, the outcome of patients negative for CSF-specific OCB was significantly better in comparison to the OCB positive patients, as assessed by Expanded Disability Status Scale change (p < 0.001). CONCLUSIONS The results of this study indicate that latitude could explain some of the inconsistencies in OCB status reported in different populations. The study confirms that OCB positivity in MS is associated with a worse long-term prognosis.
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Angelini S, Turrini E, Ravegnini G, Soverini S, Martinelli G, Kalebic T, Barnett M, Hrelia P. A pharmacogenetic approach towards personalised anti-cancer drug use. J Biotechnol 2010. [DOI: 10.1016/j.jbiotec.2010.08.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Soverini S, Angelini S, Barnett M, Thornquist M, Turrini E, Rosti G, Hrelia P, Kalebic T, Baccarani M, Martinelli G. Association between imatinib transporters and metabolizing enzymes genotype and response in newly diagnosed chronic myeloid leukemia (CML) patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
This article describes an initiative pioneered by the Met Office which uses weekly weather forecasts to enable the chronic obstructive pulmonary disease (COPD) outreach team in Plymouth to target patients most at risk of developing exacerbations. An active management plan is implemented during the winter to help prevent further deterioration in the patient's condition and possible hospital admissions.
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Barnett M, Stoney P, Kroeger D, Hafezi Y, Kind P. [P21]: Differential regulation of SynGAP isoforms. Int J Dev Neurosci 2006. [DOI: 10.1016/j.ijdevneu.2006.09.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Doocey R, Seftel M, Barnett M, Bredeson C, Forrest D, Hogge D, Lavoie J, Nantel S, Nevill T, Shepherd J, Sutherland H, Toze C, Smith C, Song K. Autologous stem cell transplantation for poor prognosis germ cell tumors: Long term follow-up of a multi-center experience. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Barnett M, Ramsay DA, Zhu Q. Studies of collisional selection rules in thioformaldehyde (H2CS) by microwave-optical double resonance. J Chem Phys 2005; 123:154310. [PMID: 16252951 DOI: 10.1063/1.2060708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Individual rotational levels in the A 1A2,v4=1 state of thioformaldehyde (H2CS) are excited by a cw laser and microwave transitions in the region of 8-12 GHz are measured. Some of the microwave frequencies are found to be characteristic of rotational levels other than the level being pumped. Since the microwave frequencies are characteristic of individual rotational levels in the excited state and the excited-state lifetime is approximately 170 micros, information is obtained concerning rotational selection rules during collisions. It is found that J can change by several units and Ka by 0, +/-2, +/-4, and +/-6. The latter result confirms that o-H2CS is not converted to p-H2CS by collisions. Observation of Ka doublets indicates that there are no appreciable differences between the two components.
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Candler PM, Hart PE, Barnett M, Weil R, Rees JH. A follow up study of patients with paraneoplastic neurological disease in the United Kingdom. J Neurol Neurosurg Psychiatry 2004; 75:1411-5. [PMID: 15377687 PMCID: PMC1738729 DOI: 10.1136/jnnp.2003.025171] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine the range of clinical phenotypes, tumour associations, relevant investigations, response to therapy and outcome in a large series of non-selected patients with paraneoplastic neurological disease (PND) affecting the central nervous system (CNS) in the United Kingdom. METHODS Data were obtained on patients either through direct referral or through the British Neurological Surveillance Unit (BNSU) from February 2000 to January 2001. Physicians were asked to supply information about age and sex of patients, presenting neurological syndromes, the basis of the diagnosis of PND, any associated malignancy, and treatment. Case notes were reviewed and follow up data obtained where possible one year after notification. RESULTS A total of 63 patients (48 females, 15 males) were identified, 48 through the BNSU and 15 through direct referral. Of these 52 were diagnosed as having definite PND, 10 probable PND, and 1 possible PND. The median age of onset of PND was 66 years (range 30-80 years) and only 7 patients (11%) were less than 50 years at presentation. In 53 patients (84%) the PND preceded the diagnosis of cancer. Paraneoplastic sensory neuronopathy, paraneoplastic encephalomyelitis, and paraneoplastic cerebellar degeneration (PCD) were the most common syndromes reported. The benefit of magnetic resonance imaging in the diagnosis of the disease was limited, while fluorodeoxyglucose positron emission tomography was shown to be useful for the detection of an occult malignancy in 10 out of 14 patients. Antineuronal antibodies were positive in 44/57 (77%) of cases. The following tumours were diagnosed: small cell lung cancer (30%), breast cancer (14%), ovarian cancer (8%), non-small cell lung cancer (8%), Hodgkin's lymphoma (6%), other (16%). With the exception of PCD associated with mesothelioma all other tumours diagnosed in these patients had been previously documented as being associated with PND. Only treatment of the tumour was found to be associated with a stable or improved neurological outcome at last follow up (Fisher's exact test = 4.7, p<0.03). Median survival time was 43 months (95% CI 28 to 57) from onset of neurological disease as calculated using the Kaplan-Meier survival analysis. CONCLUSIONS PND has a striking female preponderance usually affecting patients in their sixth decade and above. The median survival in our study was 43 months. The majority of patients with PND are not known to have cancer at the time of diagnosis. Our study confirms the importance of diagnosing and treating the underlying tumour.
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Gaber KA, Barnett M, Planchant Y, McGavin CR. Attitudes of 100 patients with chronic obstructive pulmonary disease to artificial ventilation and cardiopulmonary resuscitation. Palliat Med 2004; 18:626-9. [PMID: 15540671 DOI: 10.1191/0269216304pm944oa] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
UNLABELLED One hundred clinically stable outpatients with chronic obstructive pulmonary disease were surveyed at home by respiratory nurse specialists (RNS) about their views towards cardiopulmonary resuscitation (CPR) and in hospital ventilation. Written information about COPD, CPR and ventilation was provided and consent obtained. The breathing problem-based quality-of-life questionnaire (BP-QoL) was completed. The following information was recorded: age, sex, spirometry, hospital admissions, and antidepressant and oxygen usage in the previous year. Patients were then asked to imagine a scenario in which they were admitted to hospital and their chest condition deteriorated in spite of standard treatment. 'Having reached that stage would you wish to have noninvasive ventilation (NIV), invasive ventilation (IV) or CPR?' Three months later patients were asked to complete a postal patient satisfaction questionnaire. RESULTS Of 100 patients 41 were male and the mean age was 74.1 years. Fifty four patients had a FEV1 <40% and 37 had a FEV1 between 40 and 59% predicted. Twenty-four patients were on long-term oxygen therapy, eight had taken antidepressants and 56 had been admitted to hospital in the previous year. Forty-eight patients wanted all additional treatments to be attempted if needed and 12 wanted none. Nineteen patients said 'no' for CPR and 10 said 'no' for CPR and IV. There was no significant statistical difference between the groups answering 'yes' or 'no'. Seventy-six per cent of patient satisfaction questionnaires were returned. All patients were satisfied with the way they had been approached and the information received, and 98% of them thought that this issue should be discussed with all patients. CONCLUSION Attitudes towards resuscitation can be discussed with COPD patients by RNS without causing distress. Attitudes to resuscitation could not be predicted from parameters of respiratory disease severity or age.
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Barnett M, Roy N, McCoard S, Sinclair B, Davis S, McNabb W. Protein synthesis in mammary epithelial cells
harvested from cows treated with growth hormone
or atropine. JOURNAL OF ANIMAL AND FEED SCIENCES 2004. [DOI: 10.22358/jafs/73940/2004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hayashi A, McCoard S, Roy N, Barnett M, Mackenzie D, McNabb W. Gene expression in bovine mammary somatic cells
isolated from milk. JOURNAL OF ANIMAL AND FEED SCIENCES 2004. [DOI: 10.22358/jafs/73947/2004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pacheco D, Knowles S, Deighton M, Stuttle K, Rounce J, Barnett M, McNabb W. Measurement of iron absorption in milk-fed calves
using a dual stable isotope technique. JOURNAL OF ANIMAL AND FEED SCIENCES 2004. [DOI: 10.22358/jafs/73888/2004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ball PA, Bethune K, Fox J, Ledger R, Barnett M. Particulate contamination in parenteral nutrition solutions: still a cause for concern? Nutrition 2001; 17:926-9. [PMID: 11744342 DOI: 10.1016/s0899-9007(01)00708-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES In consideration of a US Federal Drug Administration recommendation that all parenteral nutrition admixtures should be administered through an in-line filtration device, this observational study examined the number, size distribution, and sources of particulate contamination in parenteral nutrition admixture infusion systems. METHODS Samples were drawn from the terminal connection of the infusion tubing before connection to the patient. The particles were sized and counted by optical microscopy and further investigated by electron microscopy and energy disperse spectroscopy. RESULTS Large numbers of particles were found, and information gained about their possible origin. CONCLUSIONS This study provides further support for the adoption of this Federal Drug Administration recommendation.
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Barnett M. Abusive behaviors and HIV. POSITIVELY AWARE : THE MONTHLY JOURNAL OF THE TEST POSITIVE AWARE NETWORK 2001; 12:38-9. [PMID: 11785479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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O'Dell M, Barnett M. The national service framework for coronary heart disease 'A blueprint for collaboration'. Intensive Crit Care Nurs 2001; 17:259-61. [PMID: 11866416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Arnold RW, Barnett M, Limstrom SA, Swanson D. Vision loss associated with a stiff neck complicating strabismus surgery. BINOCULAR VISION & STRABISMUS QUARTERLY 2001; 16:181-6. [PMID: 11511284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
An exotropic 60 year old suffered a scleral-choroidal penetration and vitreous hemorrhage during and after strabismus surgery on a highly myopic eye when her anesthetic airway management was complicated by her previously asymptomatic and unrecognized rigid cervical spine which placed both the surgeon and the anesthetist in disadvantaged positions both physically and medically. Restoration of vision and binocularity ultimately required vitrectomy and intraocular lens implantation.
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Barnett M. Alternative opioids to morphine in palliative care: a review of current practice and evidence. Postgrad Med J 2001; 77:371-8. [PMID: 11375449 PMCID: PMC1742058 DOI: 10.1136/pmj.77.908.371] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Van Voorhis BJ, Barnett M, Sparks AE, Syrop CH, Rosenthal G, Dawson J. Effect of the total motile sperm count on the efficacy and cost-effectiveness of intrauterine insemination and in vitro fertilization. Fertil Steril 2001; 75:661-8. [PMID: 11287015 DOI: 10.1016/s0015-0282(00)01783-0] [Citation(s) in RCA: 170] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine prognostic factors for achieving a pregnancy with intrauterine insemination (IUI) and IVF. To compare the effectiveness and cost-effectiveness of IUI and IVF based on semen analysis results. DESIGN Retrospective cohort study. SETTING Academic university hospital-based infertility center. PATIENT(S) One thousand thirty-nine infertile couples undergoing 3,479 IUI cycles. Four hundred twenty-four infertile couples undergoing 551 IVF cycles. INTERVENTION(S) IUI and IVF treatment. MAIN OUTCOME MEASURE(S) Multiple logistic regression analysis was used to assess the significance of prognostic factors including a woman's age, gravidity, duration of infertility, diagnoses, use of ovulation induction, and sperm parameters for predicting the outcomes of clinical pregnancy and live birth rate after the first cycle of IUI and IVF. The relative effectiveness and cost-effectiveness of these treatments were then determined based on sperm count results. RESULT(S) Female age, gravidity, and use of ovulation induction were all independent factors in predicting pregnancy after IUI. The average total motile sperm count in the ejaculate was also an important factor, with a threshold value of 10 million. For IVF, only female age was an important predictor for both clinical and ongoing pregnancy. When the average total motile sperm count was under 10 million, IVF with ICSI was more cost-effective than IUI in our clinic. CONCLUSION(S) An average total motile sperm count of 10 million may be a useful threshold value for decisions about treating a couple with IUI or IVF.
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Barnett M, Prosser J, Sutton I, Halmagyi GM, Davies L, Harper C, Dalmau J. Paraneoplastic brain stem encephalitis in a woman with anti-Ma2 antibody. J Neurol Neurosurg Psychiatry 2001; 70:222-5. [PMID: 11160472 PMCID: PMC1737194 DOI: 10.1136/jnnp.70.2.222] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A woman developed brain stem encephalopathy in association with serum anti-Ma2 antibodies and left upper lobe lung mass. T2 weighted MRI of the brain showed abnormalities involving the pons, left middle and superior cerebellar peduncles, and bilateral basal ganglia. Immunohistochemical analysis for serum antineuronal antibodies was confounded by the presence of a non-neuronal specific antinuclear antibody. Immunoblot studies showed the presence of anti-Ma2 antibodies. A premortem tissue diagnosis of the lung mass could not be established despite two CT guided needle biopsies, and the patient died as a result of rapid neurological deterioration. The necropsy showed that the lung lesion was an adenocarcinoma which expressed Ma2 immunoreactive protein. Neuropathological findings included prominent perivascular inflammatory infiltrates, glial nodules, and neuronophagia involving the brain stem, basal ganglia, hippocampus and the dentate nucleus of the cerebellum. Ma2 is an autoantigen previously identified in patients with germ cell tumours of the testis and paraneoplastic brain stem and limbic encephalitis. Our patient's clinical and immunopathological findings indicate that this disorder can affect women with lung adenocarcinoma, and that the encephalitic changes predominate in those regions of the brain known to express high concentrations of Ma proteins.
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