In a multi-disciplinary retrospective study we examined 105 house painters employed for at least ten years (median 27 years, range 10-36 years). Fifty-three workers from various professions (non-painters), who were matched with regard to age, occupational training and socio-economic status served as the control group. In both groups no cases of a clinically manifest polyneuropathy or encephalopathy were found. The neurophysiological examinations (EEG and NCV-measurement) showed no differences in painters and controls that would indicate adverse effects of organic solvents. There were no cases with neuroradiological findings of a diffuse cerebral atrophy. Furthermore the evaluation of certain brain structures (ventricular diameter, cella media index) of the CAT films did not reveal any significant differences. In the neurobehavioral tests significant differences in the results were only found in the subtests "change of personality" and "short term memory capacity" in a subgroup of painters with repeated prenarcotic symptoms at the workplace. Ambient air monitoring measurements at 30 representative workplaces showed that the concentrations of the main components of the solvent-mixtures were well below the MAK-values. The results of the "Erlangen Painter Study" does not confirm former epidemiologic findings from other countries, mainly Denmark. However, there are some aspects, such as minor solvent exposure in German house painters, insufficient diagnostic and etiological procedures as well as misclassifications which may explain the different experiences.
"Progressive lipodystrophy" or "partial lipodystrophy of the cephalothoracic type" is a rare, acquired condition of unknown aetiology with onset in childhood and a complete loss of subcutaneous fat of face, neck, trunk and upper extremities. The disease is more common in females than males and causes a disfigurement of the face; that it cannot be regarded only as a harmless variation, is above all due to a typical concomitant disease, membranoproliferative glomerulonephritis with hypocomplementaemia. Laboratory investigations nearly always reveal a complement-activation by the "alternative pathway" with consumption and lack of complement-component C3, a finding which allows a clear distinction between partial lipodystrophy and congenital or acquired forms of total lipodystrophy ("Berardinelli-Seip-Syndrom", lipoatrophic diabetes) and other circumscript lipodystrophies.
This report concerns the course of an eosinophil pituitary adenoma in an acromegalic female (16 years of age when first symptoms appeared) over a period of ten years. The case was complicated by craniocerebral trauma and CSF rhinorrhoea. After several operations, dedifferentiation, and invasive growth into the orbit and the petrous bone were observed with walling in of the VIIIth cranial nerve. The possible causes of the dedifferentiation of the adenoma are discussed.
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