[On changes in the iron level and serum protein fractions after cytostatic therapy with N-oxide mustard gas and a nitrogen mustard phosphamide ester].
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Antineoplastic Agents↗
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Results for “MUSTARD GAS”
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[Treatment of psoriasis vulgaris with external sulfur mustard gas with particular reference to its potential carcinogenic risk. III. Clinical and experimental studies on the extent of percutaneous and inhalational uptake of sulfur mustard gas].
Concerning the often discussed carcinogenic risk of psoriasis treatment with 0.005% S-mustard-vaseline (so-called Russian Ointment) -- especially by inhalation -- 19 patients were treated with a radioactive labeled S-mustard-ointment and examined. The patients' whole bodies were inuncted for 1--2 days with about 50 g of radioactive S-mustard vaseline (U14C, 3 muCi/g). Afterwards the radioactivity was determined in the patients' expired air, blood, urine, and in their surrounding air. In three patients punch biopsy material from normal and psoriatic skin was assayed for radioactivity after combustion. In the skin, radioactivity distinctly decreased from the epidermis (13.1 pCi/mg) to the subcutis (0.77 pCi/mg) without significant differences between normal skin and psoriatic lesions as confirmed by autoradiography. In all samples of air, body fluids and tissue, definitive amounts of radioactivity were found, which, however, were far below the US-American MAK-values. Between skin surface and shirt, the values varied from 1.5 to 13.7 nCi/20 l air, at a distance of 2 meters by 0.3 nCi/100 l air, in the breath by 0.5 nCi/20 l. The radioactivity decreased to 1/10 of the maximum values after 1--2 hours. In blood the activity was at the limit of detection and was parallelled by the activity of the urine. Generally, 1--7% of the radioactivity applied to the skin was eliminated with the urine within one week. Thus, the carcinogenic risk may be very low in the external S-mustard therapy of psoriasis and other skin diseases.
Air↗
Studies on mustard gas (betabeta'-dichlorodiethyl sulphide) and some related compounds: 3. The preparation and use of mustard gas containing (a) radioactive sulphur and (b) deuterium.
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Journal Article↗
Studies on mustard gas (betabeta'-dichlorodiethyl sulphide) and some related compounds: 7. The immunological properties of proteins treated with mustard gas and some related compounds.
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Journal Article↗
Toxicology of mustard gas.
The devastating effects of mustard gas were first observed in World War I. The advent of the Gulf War fueled renewed fears of further use of toxic gases in battle, with the possible exposure of large civilian populations--while understanding of the mechanism of action of the alkylating sulfur mustards was still quite restricted. In this article Uri Wormser discusses the structure--activity studies that are available, and the limited pharmacological measures that can be taken to protect against mustard gas attack. In addition to systemically administered sulfhydryl agents, new percutaneous preparations are being developed in the author's laboratory which offer better protection than is possible with simple adsorbant powders.
Animals↗
Delayed haematological complications of mustard gas.
Haematopoiesis could be affected by mustard gas. We randomly selected 318 chemical victims exposed to mustard gas and compared their cell blood counts and peripheral blood smears (PBS) with those of 377 healthy men, and also various haematological indices of 57 of these victims compared with previous data 5 years ago. The average number of red blood cells and haemoglobin of victims compared with the controls was not significantly different, but they were increased compared with data from 5 years ago. White blood cell counts, neutrophils and lymphocytes did not show any clinically meaningful difference compared with the control group but 20 cases with atypical lymphocytes in their PBS have been found. Change in lymphocyte shape may be related to committed stem cell involvement. Further studies on bone marrow cells and cell markers are needed to document this hypothesis. The mild increase in erythroid cells and haemoglobin concentration may be due to chronic obstructive pulmonary disorder and other respiratory diseases in these patients.
Case-Control Studies↗
Late respiratory complications of mustard gas poisoning in Iranian veterans.
Mustard gas or sulfur mustard (SM) is an alkylating chemical warfare agent that was widely used during the World War I and in the Iran-Iraq conflict. We aimed to study late toxic effects of SM on the respiratory system of severely intoxicated Iranian veterans. Respiratory examination, spirometry, arterial blood gas (ABG) analysis, and high resolution computed tomograpghy (HRCT) of the chest were performed on all severely SM-poisoned veterans in the province of Khorasan, Iran. HRCT abnormalities were classified into four grades based on the number of lung lobes involved. ABG and spirometric results were compared with each other, as well as, with the severity grades of HRCT abnormalities, using Spearman's rank correlation test. Forty male subjects with confirmed SM poisoning 16 to 20 years ago, were studied. Main respiratory complications were diagnosed as chronic obstructive pulmonary disease (COPD) (35%), bronchiectasis (32.5%), asthma (25%), large airway narrowing (15%), pulmonary fibrosis (7.5%), and simple chronic bronchitis (5%) patients. While there was a significant correlation (p<0.05) between ABG and spirometric results, the severity grades of HRCT abnormalities revealed a significant correlation (p<0.05) only with PaO2. We concluded that SM-induced respiratory complications tend to progress over the years. While spirometry is a valuable diagnostic tool for evaluation of pulmonary impairment during regular follow-ups, ABG and HRCT are more objective and should be more considered for evaluation of the severity and for diagnosis of the respiratory complications.
Adult↗
Long-term pulmonary complications in combatants exposed to mustard gas: a historical cohort study.
BACKGROUND: Sulphur mustard (mustard gas), the most widely used chemical agent in the Iran-Iraq war, affects many organs including the skin, the gastrointestinal and respiratory tracts, and the central nervous system. The aim of this study was to assess the cumulative incidence rate and annual incidence rate of pulmonary complications, and the rate ratio of related factors. METHODS: In a retrospective cohort study of 1337 soldiers with a history of mustard gas exposure, factors such as age, smoking habit, number of exposure episodes, and the use of gas masks were determined, together with an assessment of their relationship to the occurrence of long-term pulmonary complications. All patients residing in the Tehran area were enrolled in the study. Data collection was based on the subjects' medical records and included clinical, spirometric, and in some cases histopathological findings. RESULTS: The cumulative incidence rate of pulmonary complications was 31.6%; the lowest annual incidence rate was noted during the first year of follow-up (0.75/1000), and the highest rate recorded in the seventh year (76.9/1000). Estimated relative risks (RR) for various age groups are as follows: 1.13 (95% CI: 0.88, 1.46) for those aged 21-25 years; 1.49 (95% CI: 1.10, 2.01) for ages 26-30; 1.70 (95% CI: 1.20, 2.40) for ages 31-35; and 2.09 (95% CI: 1.57, 2.77) for subjects aged >/=36. RR with regard to other factors were: more than one versus single exposure 0.69 (95% CI: 0.42, 1.12); smoking versus non-smoking 1.08 (95% CI: 0.80, 1.45), and unprotected exposure versus protective mask use 3.04 (95% CI: 2.20, 4.20). CONCLUSION: The estimated risk of pulmonary complications from war exposure to mustard gas increased with age and for soldiers who had not worn masks.
Adult↗
Analysis of thiodiglycol in urine of victims of an alleged attack with mustard gas.
A procedure for the semi-quantitative determination of thiodiglycol, a metabolite of the vesicant mustard gas, in urine has been developed. Thiodiglycol was converted into mustard gas using concentrated HCl at temperatures close to 100 degrees C. The headspace of the solution containing mustard gas, was trapped on an adsorption tube filled with Tenax-GC which was subsequently analyzed by gas chromatography/mass spectrometry. Using 10 mL of urine, a detection limit of a few ng/mL of thiodiglycol was achieved. The procedure was applied to urine samples obtained from Iranian patients who were the alleged victims of an attack by chemical warfare agents (probably mustard gas). A number of control samples were investigated as well. Thiodiglycol was found in the urine of the Iranian patients in concentrations varying between 3 and 140 ng/mL. However, the detection of thiodiglycol in concentrations up to 55 ng/mL in control samples excluded the unambiguous verification of the use of mustard gas against the Iranian patients.
Adult↗
Protection against systemic poisoning by mustard gas, di(2-chloroethyl) sulphide, by sodium thiosulphate and thiocit in the albino rat.
The lethal effects of mustard gas, di(2-chloroethyl) sulphide, in the albino rat have been counteracted by Thiocit, a mixture of sodium thiosulphate and trisodium citrate in the ratio 10:1, administered intraperitoneally in a dose of 2.75 g./kg. Thiocit afforded complete protection against greater than the median lethal dose of mustard gas whether given 10 min. before or 10 min. after mustard gas and raised the LD50 of mustard gas by approximately three times. The protection appeared whether the total dose of Thiocit was given in one injection or serially over 30 min. The effective doses of sodium thiosulphate and of Thiocit in rats were of the order of 3.0 g./kg. Sodium thiosulphate alone and Thiocit have been administered in single doses by slow infusion, by stomach tube and in drinking water. Both have shown activity by all routes of administration, but activity was greatest by intraperitoneal injection. The use of Thiocit in conjunction with mustard gas therapy is suggested.
Animals↗
Mustard gas: clinical, toxicological, and mutagenic aspects based on modern experience.
Based on a study of the literature and our own experience treating fisherman poisoned by mustard gas, this article outlines the clinical effects, and toxicological and mutagenic properties of the agent. Mustards are very persistent chemical agents that easily penetrate clothing. Mustard gas usually causes clinical symptoms after the liquid penetrates the skin or the vapor is inhaled. Skin lesions are similar to first- or second-degree burns and usually heal spontaneously in 4 to 6 weeks. Eye symptoms are photophobia and reduced vision. Following inhalation of the agent, pulmonary edema and long-term dyspnea may be seen. As mustard gas is an alkylating substance, it is conceivable that the risk of developing cancer may be increased, as observed in people who were involved with the production of mustard gas and in animals exposed to the gas. Also, transient significantly increased sister chromatid exchange rates have been found in fishermen exposed to mustard gas. Patients exposed to mustard gas must be treated immediately after exposure. Treatment should consist of cleaning of the exposed skin and clothes with an antigas powder and water and soap. The skin lesions should be treated as burns. Eye lesions and respiratory problems should be treated symptomatically.
Eye Diseases↗
Keratoplasty after mustard gas injury: clinical outcome and histology.
PURPOSE: Ocular injury by mustard gas can lead to severe eye damage with a delayed course. We report the corneal histology and follow-up after keratoplasty in a patient with mustard gas injury. METHODS: The patient presented with recurrent painful corneal inflammation in both eyes not improving under local therapy. Visual acuity impaired to handmovements. A penetrating keratoplasty was performed on the left eye and afterwards an autorotation keratoplasty on the right eye with a later corneal graft. RESULTS: After the operation of the left eye the patient was immediately painfree and the visual acuity improved to 0,4. So far there have been no signs for transplant rejection or inflammation. Histology of the cornea revealed massive stromal necrosis, and signs of chronic inflammation. Despite denervation of the cornea after autorotation keratoplasty the right eye was still painful and became only painfree after corneal transplantation. CONCLUSION: There has been not much experience with corneal transplantation after mustard gas injury and there is a high risk for transplant rejection due to inflammation and vascularisation of the cornea. Successful and painfree healing with keratoplasty seems only possible after complete removal of the necrotic material.
Burns, Chemical↗
Testicular effect of mustard gas.
OBJECTIVES: To explain the testicular effect of mustard gas. METHODS: Eighty-one patients who had been exposed to sulfur mustard and had the presenting symptom of infertility underwent evaluation of their reproductive system. Three semen analyses, serum hormonal determinations (luteinizing hormone, follicle-stimulating hormone, and testosterone), and genital examinations were completed for all patients, as were testicular biopsies in 24 patients. RESULTS: Azoospermia and severe oligospermia were diagnosed in 42.5% and 57.5% of patients, respectively. Hormone studies revealed an elevated plasma follicle-stimulating hormone level and normal plasma luteinizing hormone and testosterone concentrations. Testicular biopsy showed selective atrophy of the germinal epithelium, intact Sertoli cells, and normal-appearing Leydig cells. CONCLUSIONS: Mustard gas can cause defective spermatogenesis years after exposure.
Adult↗
[Study on DNA damage in rat bone marrow cells induced by mustard gas].
OBJECTIVE: To study the damage of DNA in rat bone marrow cells induced by mustard gas. METHOD: Male SD rats were randomly divided into six groups. Physiological saline, propylene glycol and mustard gas(0.2, 0.4, 0.8, 1.6 mg/kg) were given separately by i.p. injection. 5 rats in each group were killed after 0, 24, 48, 72 hours of exposure. The DNA damage in rat bone marrow cells was assayed by single cell gel electrophoresis (SCGE). RESULTS: There is no significant difference of DNA damage among all groups at 0 h(P > 0.05). The rates of DNA migration and the lengths of DNA migration of the rat bone marrow cells in propylene glycol group at 24, 48, 72 hours were 15.4% +/- 0.21%, 16.0% +/- 0.19%, 15.7% +/- 0.23% and (11.4 +/- 0.2), (13.5 +/- 0.3), (12.8 +/- 0.2) micron respectively, and they were significantly higher than those of physiological saline group at the same time(P < 0.05). The rates of DNA migration and the lengths of DNA migration of the rat bone marrow cells in mustard gas groups at 24, 48, 72 hours were significantly higher than those in physiological saline group and propylene glycol group at the same time(P < 0.05). CONCLUSION: Mustard gas could induce DNA damage in rat bone marrow cells. The damage was likely to rise as the dose increased and was time-dependent.
Animals↗
Mustard gas crosslinking of proteins through preferential alkylation of cysteines.
Mustard gas, bis(2-chloroethyl)sulfide, treatment of proteins is shown to generate significant amounts of covalently crosslinked protein dimers. This is due to the preferential alkylation of cysteine residues. Crosslinking does not occur in the model protein staphylococcal nuclease, which has no cysteine residues. Treatment of cysteine-containing mutants of staphylococcal nuclease with this chemical warfare agent did result in crosslinking. However, these dimers are slowly cleaved back to monomers by an unknown mechanism. The alkylation and crosslinking of cysteine-containing proteins by mustard gas may contribute to its toxicity.
Alkylation↗
Chronic neuropathic symptoms after exposure to mustard gas: a long-term investigation.
BACKGROUND: Long-term investigations of persons exposed to mustard gas are few and have primarily focused on its carcinogenic properties. To our knowledge neuropathic pain has never been described. OBJECTIVE: We investigated late symptoms in the skin after exposure to sulfur mustard. METHODS: Five patients exposed to mustard gas during battlefield operations in the Middle East and five fishermen accidentally exposed to sulfur mustard by pulling shells leaking the chemical agent aboard their fishing vessels participated in this study. Clinical examination of the patients from the Middle East and telephone interviews with the fishermen were performed. RESULTS: All patients suffered from neuropathic pain or other deafferentation symptoms. CONCLUSION: Persistent damage to the afferent nerve system resulting in chronic neuropathic symptoms is probably a frequent complication in persons exposed to mustard gas.
Accidents, Occupational↗
Chronic bronchiolitis in a 5-yr-old child after exposure to sulphur mustard gas.
Exposure to sulphur mustard (SM) gas may have extensive immediate effects on the respiratory system. However, long-term effects are far less known. This case report describes a Kurdish male child who was exposed to SM gas during a chemical attack in Iraq at 5 yrs of age. In the acute phase, the child developed severe respiratory symptoms with a chemical pneumonia. Extensive burning of the skin occurred. In the course of 10 yrs, lung function deteriorated progressively to a forced expiratory volume in one second of 30% of predicted value. Severe air-trapping occurred. The lung function abnormalities were not reversed by treatment with corticosteroids or bronchodilators. Infectious exacerbations of the child's lung disease occurred. High resolution computed tomography scan showed multiple bronchiectasis. The histological picture of an open lung biopsy was best described as a "chronic bronchiolitis".
Biopsy↗
Post-traumatic stress disorder among World War II mustard gas test participants.
Open-minded and structured interviews were conducted to assess post-traumatic stress disorder (PTSD) and other psychosocial outcomes among 24 men who had participated in the military's mustard gas testing program during World War II. Most men had volunteered (92%) and had participated in chamber tests (96%). During the tests, few (22%) understood the danger involved. The majority (67%) were ordered to refrain from discussing their participation with anyone. Most men (83%) experienced physical symptoms subsequent to the test. At present, the men were less psychologically and physically healthy than expected for men of similar age. The current prevalence of PTSD due to the mustard gas was 17%. The current prevalence of subdiagnostic mustard-gas-related PTSD was 25%. Lifetime estimates for full and subdiagnostic PTSD was 17 and 33%, respectively. The only mustard gas experience that predicted lifetime full or subdiagnostic PTSD was the number of exposures to the gas.
Aged↗