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Keitaro Yokoyama, MD; Yosuke Ogura, MD; Masahiko Kishimoto, MD; Fumihiko Hinoshita, MD, PhD; Sigeko Hara, MD; Akira Yamada, MD; Nobuhide Mimura, MD; Akira Seki, MD
Toranomon Hospital Tokyo, Japan

Osamu Sakai, MD
Jikei Medical University Tokyo, Japan

JAMA. 1995;274(5):379.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The terrorist attack using the nerve gas sarin that took place in the Tokyo subways on March 20, 1995, injured more than 5000 persons and caused 12 deaths. Two hundred thirty patients were seen at Toranomon Hospital. All of the patients were treated with 0.5 mg of intramuscular atropine sulfate, 10 mg of intravenous hydrocortisone, and 500 mL lactated Ringer's solution by intravenous drip. We encountered one patient with severe sarin poisoning who was resistant to this pharmacologic therapy, but whose condition significantly improved following blood purification.

A 45-year-old woman was brought to our hospital approximately 2 hours after the terrorist attack. On admission she was in a deep coma, had shallow respirations, and a blood pressure measurement of 160/80 mm Hg. Coarse crepitations were heard throughout both lung fields, and pupillary constriction (size of pupils, 1 mm in diameter) was observed. Chest radiography revealed severe pulmonary . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West), Margaret A. Winker, MD, Senior Editor, and Phil B. Fontanarosa, Senior Editor.

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