title: Clinical features on nerve gas terrorism in Matsumoto.
abstract: Clinical features on the first unexpected nerve gas terrorism using sarin (isopropyl methylphosphonofluoridate) on citizens in the city of Matsumoto is described. The nerve gas terrorism occurred at midnight on 27 June, 1994. About 600 people including residents and rescue staff were exposed to sarin gas. Fifty-eight victims were admitted to hospitals and seven died. Theoretically, sarin inhibits systemic acetylcholinesterase and damages all the autonomic transmission at the muscarinic and nicotinic acetylcholine receptor. Miosis was the most common finding in the affected people. In cases with severe poisoning, organophosphate may affect the central nervous system and cause cardiomyopathy. A few of the victims complained of arrhythmia and showed a decreased cardiac contraction. Abnormal electroencephalograms were recorded in two patients. The clinical features and follow-up studies are discussed with reference to the Tokyo subway terrorism and related articles.
authors.affiliation: Department of Intensive and Critical Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan. okudera@hsp.md.shinshu-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okudera
mesh_terms: D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D009202:Cardiomyopathies / Q000139:chemically induced; D002490:Central Nervous System / Q000187:drug effects; D002619:Chemical Warfare Agents / Q000506:poisoning*; D004569:Electroencephalography; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data; D005128:Eye Diseases / Q000139:chemically induced / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan; D008137:Longitudinal Studies; D015877:Miosis; D009200:Myocardial Contraction / Q000187:drug effects; D009422:Nervous System Diseases / Q000139:chemically induced / Q000503:physiopathology; D016273:Occupational Exposure / Q000706:statistics & numerical data; D010564:Personnel, Hospital / Q000706:statistics & numerical data; D011041:Poisoning / Q000453:epidemiology / Q000401:mortality; D012524:Sarin / Q000506:poisoning*; D023481:Terrorism
chemical_list: D002619:Chemical Warfare Agents; D012524:Sarin