5| wed. To this must: be effects of chromium | vel, perhaps leading to a single sams ab nly MEM ie lee + done dake of such measurements wring platelet concenow accepted that plateimportant role in the bocytopenia, especially py to acute leukemia.* requests for platelet makes it important to ‘ation as simple as the Chis is particularly irue ocessing th after ate and heforgNr nsfuwill probabl ‘ove of npo ofsplhite AkAransfi} yield ca from a are a inajor component of fallout, and the aan. collects this iodine as avidly as it does the comme- stable isotope. Typically, one third of all ineeste: iodine is accumulated by the thyroid gland each dias and about 95 per cent of the body stores are can: -centrated in the 15-20-em. gland. The cleme:: resides in the gland for many wecks on the averay thus offering a chance for significant radiation exp. ,sure from even a small dose of isotope. That “£ should be hazardous is nO surpri«e Much prior evidence convincingly demonstrates th j carcinogenic effect of x-rays or my on the thyra: ;gland in animals. The Hiroshima and Nawasal -explosions feft their residue of tumors.’ Childhos. 1 papillary carcinoma of the gland is strongly assrciated with prior radiation, although in these cMant + IN en Ae MORIAA "of radioactive counts ision may be an expresible is the recent interlood volume” in terms be considerably Jarger for plasma and red-cell where in this issue of the Journal, are literally a, fivuratively a fallout of the cold war. It is depres ing to be reminded that American atomic tests ing vertently injured a significant number of jnnocepeople. ffowever, in a still-free society, both virty and faults are aired, and perhaps recording 44, analyzing these adverse cffects will contribute ; man’s slow learning process. The thyroid wand is especially vulnerable atomic injury since radioactive isotopes of iodiy. Paid aa, other than viability of omplicate work in this Mutelets can aggregate we from the circulation such as the lung and und show hemostatic tone might question whether the important. facte- pwas thymic or thyroid radiation. Recently, it hie »been observed that a reactor accident in the Wee smay have left its trail of thyroid nodules downwind * '4T in doses too small to cause cell death + ‘known to damage cell metabolism — for example. + imay prevent the response to a subsequent goitre- jgenie stimulus.2 This radiation lesion is intimateh cassociated with DNA metabolism, as shown in De‘byn’s report of abnormal cell nuclei Al Tindaw jand Wilsont have observed poor labeling of radiate:. O bu o Saudigya, 2. Dreserent palin afte hl use Bloud 4:45 x H ao 7 coc Ics andSatclan Presented af Protein Foundatiga, Boston, nofisien in teukemia and aphastic sent status af blood preservation tocessing technique. Presented: i joan Association af Blood Banks, 7, JUG3. LSERINeHatiOn: Continues CCl $9G5, " r J ri 3 be Pa ae 2 rat thyroid nuclei by ?H-thymidine and a rapid tun: -over of the accumulated label. The observatiow imply that the damaged nucleus can not divid “normally. The experience reported in the accompansiv: article by Conard et al. is unusual in that the priv: ‘response is multinodular goiter formation, rathe than induction of tumors. “Nodules,” but not nec essarily multinodular goiter, have been reported I» Sheline et al} and others to follow childhood ' therapy for Graves’s disease, but multinodular ger ‘ters have been difficult to produce by any expel smental mechanism. The documented associat with radiation, both experimentally and clinicalh thas been tumor formation, not multinodularity. Tl -factors dictating this unusual response are tae ;parent. * The authors are to be congratulated on their alu’ Tity to detect nodules of 2 to 3 min., but there ue 1 iia New) Ee x Fc Eng lad Sour nal med TST Sy Ba Wah x; reeKone Pratwata ee By. ait 401846 © 914 No. 25 SSACHIUSETES ° The Medica! Research Center sot be totenatchpment Oy ats theya FALLOUT OF THE COLD WAR Tue thyroid nedules occurring in Marshall tshay. ers, reported by Conard and his associates eh, ‘stood. = no total thyre gictable pccur: 13,3, i KehavenA ional Habe: EDENre. hazard ee yiciony Upton, L i in. tact w Yor The implications ure “ae now Islanders need constant medical supervision for life. Thyroid-supressive therapy is indicated although it nist be sdmitted that the experimental basis is lacking. Rapid institution of potassium iodide therapy for swppression of thyroid uptake is indicated in any population exposed to fallout.® Therapy with raciogtive iodine for childhood thyrotoxicosis must be yewed with reserve. c+ REFERENCES a. tHE NEW ENGLAND JOURNAL OF MEDICINE June 2h) pu ie Socolow, | ~ 1, Hashizume, A. Neriishi, $.. and Niitani. Ro Dla#roid carcinoma inoman cifter exposure lo jomivine tadiatien: summary of findings in’ Hireshima and Nayasaki, New Fae / “Med. 268-406-410, 14653. ‘Maloof, F., Dobyns, 8. Mo. and: Vickers, ALL. Effects of various doses of radioactive iodine on function and structure of thy raul of rat. Endocrinology 50:6012-638, 1952, $#Dobyns, B. M.. and Didtschenko, [, Nuclear changes in divreidal # epithelium following radiation from radioiodine, fe Clot Bnatoer nol. é? Metab. 21:699-720, 1961. «6 AlHindawi, A, Y¥., and Wilson, G. M. Effect of trradimien on $$ function and survival of rat thyroid cells. Glin, Se. 2B. 5949-57) 3% 1965. $* Sheline. G. EL, Lindsay, S.. McCormack. K. Ro and Gakuin. Mt 38 Thyroid’ nudules occurring fate alter treatinent of Urratentcns with radioiodine. ip. Chin, Endocrinal, & Metab. 22:8-18, 162, &Saxena, K. ML. Chapman, BE. M., and Pryles, c Vo Minna dosage of iodide required to suppress uptake of todine! ttn normal thyroid. Scieuee 1398:430-451, 1463. . OLD WORLD SURGEON §Tux Journal, through some oversight, failed to receive a notice of the death of Dr. Oscar Hirsch, over a year ago. This has been amply, if belatedly. corrected with an obituary prepared by one of his Annerican disciples, which is published elsewhere ih this issue of the Journal, #Dr. Hirsch, always unassuming, was nevertheless one of the most distinguished European medical qmigrés to find freedom in this country during the years immediately before World War LE. Not only was he a gifted neurosurgeon, trained in the exacting feld to which he made at least one notable contibution; he had also a liberal classical education and a firm devotion to Graeco-Roman history and literature. This was acquired during the vears of the late nineteenth and early twentieth century when the Gothic legacy of the Holy Roman Empire wa: blended with an Ottoman tincture. overlaid by the bizarre imagery of the baroque. “The story is told that he once accosted a tl Whom he overheard reciting ruminatively a choru fom Antigone, as he walked along a street i Montreal. So the two sat down to discuss the rel: tve merits of Sophocles and Euripides. 2Dr. and Mrs. Hirsch were known as a kindh ®acious, cultured couple, whe brought to their Neo World environment a valuable contribution from 1 old. AS py -14O3 Fume 23,/91L