title: Sarin poisoning on Tokyo subway.
abstract: On the day of the disaster, 641 victims were seen at St. Luke's International Hospital. Among those, five victims arrived with cardiopulmonary or respiratory arrest with marked miosis and extremely low serum cholinesterase values; two died and three recovered completely. In addition to these five critical patients, 106 patients, including four pregnant women, were hospitalized with symptoms of mild to moderate exposure. Other victims had only mild symptoms and were released after 6 hours of observation. Major signs and symptoms in victims were miosis, headache, dyspnea, nausea, ocular pain, blurred vision, vomiting, coughing, muscle weakness, and agitation. Almost all patients showed miosis and related symptoms such as headache, blurred vision, or visual darkness. Although these physical signs and symptoms disappeared within a few weeks, psychologic problems associated with posttraumatic stress disorder persisted longer. Also, secondary contamination of the house staff occurred, with some sort of physical abnormality in more than 20%.
authors.affiliation: Department of Internal Medicine, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Ohbu
authors.forename: A
authors.initials: A
authors.lastname: Yamashina
authors.forename: N
authors.initials: N
authors.lastname: Takasu
authors.forename: T
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: T
authors.initials: T
authors.lastname: Murai
authors.forename: K
authors.initials: K
authors.lastname: Nakano
authors.forename: Y
authors.initials: Y
authors.lastname: Matsui
authors.forename: R
authors.initials: R
authors.lastname: Mikami
authors.forename: K
authors.initials: K
authors.lastname: Sakurai
authors.forename: S
authors.initials: S
authors.lastname: Hinohara
mesh_terms: D000293:Adolescent; D000328:Adult; D017109:Akathisia, Drug-Induced / Q000209:etiology; D001049:Apnea / Q000139:chemically induced; D002423:Cause of Death; D002800:Cholinesterase Inhibitors / Q000506:poisoning*; D002802:Cholinesterases / Q000097:blood; D003371:Cough / Q000139:chemically induced; D004190:Disasters; D004417:Dyspnea / Q000139:chemically induced; D005128:Eye Diseases / Q000139:chemically induced; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000139:chemically induced; D006323:Heart Arrest / Q000139:chemically induced; D006760:Hospitalization; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D015877:Miosis / Q000139:chemically induced; D018908:Muscle Weakness / Q000139:chemically induced; D009325:Nausea / Q000139:chemically induced; D009784:Occupational Diseases / Q000139:chemically induced; D010146:Pain / Q000139:chemically induced; D011247:Pregnancy; D012524:Sarin / Q000506:poisoning*; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D014041:Tokyo; D014186:Transportation; D014754:Violence; D014786:Vision Disorders / Q000139:chemically induced; D014839:Vomiting / Q000139:chemically induced
chemical_list: D002800:Cholinesterase Inhibitors; D012524:Sarin; D002802:Cholinesterases