Annals of Occupational and Environmental Medicine

Case Report

A case of generalized argyria presenting with muscle weakness: Inha Jung, Eun-Jeong Joo, Byung seong Suh, Cheol-Bae Ham, Ji-Min Han, You-Gyung Kim, Joon-Sup Yeom, Ju-Yeon Choi, Ji-Hye Park; Ann Occup Environ Med 2017;29:45. Published online October 2, 2017; DOI: https://doi.org/10.1186/s40557-017-0201-0

Background

Argyria is a rare irreversible cutaneous pigmentation disorder caused by prolonged exposure to silver. Herein, we report a case of generalized argyria that developed after chronic ingestion of soluble silver-nano particles and presented with muscle weakness.

Case presentation

A 74-year-old woman visited our emergency room, complaining of fever and mental deterioration. She was diagnosed with acute pyelonephritis and recovered after antibiotic therapy. At presentation, diffuse slate gray-bluish pigmented patches were noticed on her face and nails. Two months prior to visiting our hospital, she was diagnosed with inflammatory myopathy and given steroid therapy at another hospital. We performed a nerve conduction study that revealed polyneuropathy. In skin biopsies from pigmented areas of the forehead and nose, the histopathologic results showed brown-black granules in basement membranes of sweat gland epithelia, which are diagnostic findings of argyria. We reviewed pathology slides obtained from the left thigh muscles and found markedly degenerated myofibers with disorganization of myofibrils without inflammatory reactions, consistent with unspecified myopathy, rather than inflammatory myopathy. The patient was diagnosed with generalized argyria with polyneuropathy and myopathy and transferred to a rehabilitation institution after being tapered off of steroids.

Conclusions

Clinicians should be aware of clinical manifestations of argyria and consider it in differential diagnosis when they examine patients who present with skin pigmentation and muscle weakness.

Citations

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Research Article

Risk factors of work-related upper extremity musculoskeletal disorders in male cameramen: Jung ho Kim, Byung seong Suh, Soo Geun Kim, Won sool Kim, You il Shon, Hee seung Son; Ann Occup Environ Med 2015;27:5. Published online January 24, 2015; DOI: https://doi.org/10.1186/s40557-014-0052-x

Abstract PDF PubReader ePub

Objective

The aim of this study is to determine the risk factors related to upper extremities work-related musculoskeletal disorders (WRMSDs) in cameramen.

Methods

A questionnaire survey was performed on 166 cameramen in a broadcasting station. The questionnaire consisted of questions on the general characteristics, the health behavior, work type and duration, physical burden, ergonomic posture, and musculoskeletal symptoms. Definition of musculoskeletal disorders was based on NIOSH criteria.

Results

The positive rate of WRMSDs symptoms by parts of the body was turned out to be the highest in the shoulder (14.5%) and the lowest in arm and elbow (6%). Logistic regression analysis revealed that symptoms in the shoulders increased with BMI (OR = 3.62, 95% CI = 1.03-12.71), physical burden (OR = 9.29, 95% CI = 1.72-61.78 in the very hard group) and ergonomic factors (OR = 4.50, 95% CI = 1.03-19.68). Ergonomic factors were only related to the symptoms of hand and wrist (OR = 10.21, 95% CI = 1.02-102.20). WRMSDs symptoms, in the whole upper extremities, were higher in the 50 or older age group (OR = 5.86, 95% CI = 1.03-33.26), higher BMI group (OR = 3.26, 95% CI = 1.28-13.53), non-exercise group (OR = 2.37, 95% CI = 1.24-12.59), high physical burden group (OR = 7.6, 95% CI = 1.34-52.74), and high grade ergonomic risk group (OR = 4.82, 95% CI = 1.29-16.06).

Conclusion

The most serious musculoskeletal disorders of male cameramen were shoulder pain. Ergonomic factors and physical burden were the most significant factors affecting WRMSDs in cameramen in this study. Cameramen should be educated to be able to improve the ergonomic occupational environment and to set up preventive measures against the risk factors during work.

Citations

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Development and validation of a tool for the comprehensive risk assessment of musculoskeletal disorders (CRAMUD) among employees of a steel industry
Saeid Yazdanirad, Gholamhossein Pourtaghi, Mehdi Raei, Mohammad Ghasemi
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Shoulder pain prevalence by age and within occupational groups: a systematic review
Christopher J. Hodgetts, Charlotte Leboeuf-Yde, Amber Beynon, Bruce F. Walker
Archives of Physiotherapy.2021;[Epub] CrossRef
Comparison of work-related musculoskeletal symptoms between male cameramen and male office workers
Han-Seur Jeong, Byung-Seong Suh, Soo-Geun Kim, Won-Sool Kim, Won-Cheol Lee, Kyung-Hun Son, Min-Woo Nam
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef
Scapholunate interosseous ligament dysfunction as a source of elbow pain syndromes: Possible mechanisms and implications for hand surgeons and therapists
Cigdem Ayhan, Seval Tanrıkulu, Gursel Leblebicioglu
Medical Hypotheses.2018; 110: 125. CrossRef

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Case Report

Hydrofluoric Acid Burns: A Case Report: Jieun Lee, Byung Seong Suh, Chanho Jo, Won Cheol Lee; Korean Journal of Occupational and Environmental Medicine 2011;23(2):225-233. Published online June 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.2.225

Abstract PDF

BACKGROUND
Hydrofluoric acid_(HF) is widely used in many industrial and domestic settings such as etching glass, and polishing metals. HF is one of the most corrosive inorganic acids and can produce progressive and serious tissue necrosis with severe pain. Since HF chemical burns can be asymptomatic for the first few hours, it is crucial to understand its toxicity and the early use of antidote.
CASE
A 37-year-old man presented with erythematous lesion and pain on his face, anterior neck, both forearms, both thighs, and left ankle after injury resulting from a chemical burn caused by HF. He showed normal vital signs and dyspnea, but complained of a sore throat. Liquid form of HF had splashed on his face and anterior neck first and run down his forearms and thighs while working at HF supply tanks. Some of the HF was splashed into his mouth. He immediately removed his clothes and showered with abundant water. A 4.5% calcium gluconate jel was applied to the involved area. He was given subcutaneous injection of 10% calcium gluconate solution. During 17 days of admission he didn't show any signs of systemic intoxication or deep tissue defects.
CONCLUSIONS
Immediate cleansing of the affected area with running cold water is the first critical treatment for a chemical burn due to HF. Applying calcium gluconate gel within one hour was very effective for preventing further damage to the injured area as well as systemic injury. In order to reduce the risk of accident and perform first-aid treatment quickly, it is imperative to provide workers with safety education and establish safety facilities.

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Dermal absorption and skin damage following hydrofluoric acid exposure in an ex vivo human skin model
Kathrin Dennerlein, Franklin Kiesewetter, Sonja Kilo, Thomas Jäger, Thomas Göen, Gintautas Korinth, Hans Drexler
Toxicology Letters.2016; 248: 25. CrossRef
Characteristics of composition and surface morphology of soil particles influenced by inorganic acids with different acidity
Dong-Sung Lee, Kyo-suk Lee, Ji-Soo Shin, Jae-Bong Lee, Ri-Na Joo, Myong-Youn Lee, Se-Won Min, Doug-Young Chung
Korean Journal of Agricultural Science.2015; 42(3): 191. CrossRef

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