434
EUTHYROID CARDIAC DISEASE, JAFFE ET AL
.
JAMA. Oct. 1, 1955
ie
the exception of locally applied antibiotic oj tments for
ee lesions and in one case parenterally given peni-
cillin.
m
The possibility that cancer might develop at the site
of some of these lesions must Se considered. Favoring
such development are the long life expectancy of the
numerous children in the exposed group, ‘constant exposure to tropical sunlight, and the possible:influence of
additional sublethal whole-body exposure. ‘Against such
r
development are the superficial nature of the lesions,
rapid healing with little in the way of residual gross defects, and only minimal evidence of histological damage
by six months.
i
Pigmentation of the semilunar area of the fingernails
and toenails was observed about the 23rd'day in most
of the Marshallese in the higher exposure groups and in
the five American Negroes but in none of
the white
progressed distally with growth of the nat;
A similar
Americans. The pigmentation was beneath'the
nail and
phenomenon has been observed in a Negro.woman after
local therapeutic irradiation.‘
if
ud
INTERNAL RADIATION HAZARD.
Radiochemical analysis of numerous
urine samples of
exposed personnel showed that the degreeof internal
absorption of radioactive materials was roughly proportional to the calculated external dose and, therefore,
to the concentrations of air-borne fission products. The
degree of internal radiation hazard was too'low to have
contributed significantly to the acute radiation syndrome
observed. The concentration and type ofinternal radio-
active contaminants minimize the probability of any
significant long-term effects from the interns radiation.
4
1.
After detonation of a thermonuclear
Marshall Islands in the spring of 1954,
radic
out occurred over an area of thousands of $quare miles
beyond the range of thermal and blast injuty. Marshal-
,
i
RADIOIODINE TREA
‘i
1
|
nf
lese and Americans were accidentally exposed on islands
in this area, receiving whole-body gammaradiation, beta
radiation injury to skin, and minimal internal contamination. The highest dose (an estimated 175 r) was received
by a group of 64 Marshallese. The dose of radiation re-
ceived proved to be sublethal. Though there was signifi-
cant. depression of hemopoiesis, no clinical signs or
symptoms developed that could be attributed with certainty to this effect. Prophylactic administration of antibiotics or other specific therapy was not found to be
in ij
t
j
Skin lesions and epilation developed in 90% of the
group beginning about two weeks after the exposure.
The lesions occurred largely on exposed parts of the
body not protected by clothing, and varying degrees of
protection were also afforded those who remained in-
doors or bathed during the fall-out period. Most of the
skin lesions were superficial and exhibited pigmentation,
dry, scaly desquamation; and rapid healing with little
pain, Some lesions were deeper, exhibiting wet desquamation, and a few became secondarily infected. Treatment was largely palliative except for use of antibiotics
for secondarily infected lesions. Histopathological examination ‘of lesions showed changes consistent with
radiation damage. Bluish-brown pigmentation was noted
in the fingernails and toenails of the dark-skinned people
but not in the white Americans, Minimal amounts of
radioactive material were detected in the urine. The internal] deposition was insufficient to contribute signifi-
cantly to the acute reaction, andit is believed there is no
long-term hazard. Examinations conducted one year
after the exposure revealed these people to be in gen-
erally good health. Slight depression of lymphocytes and
platelets persisted. A few pigment aberrations and minimal atrophy remained at the site of the deeper skin le-
sions.
6. Sutton, R. L.. Jr: Transverse Band Pigmentation of Fingernails
Alter X-Ray Therapy, J. A. M. A. 2501210 (Sept. 20) 1952.
OF EUTHYROID CARDIAC DISEASE
FOUR YEARS OF EXPERIENCE WITH TWO HUNDRED THIRTY-ONE PATIENTS
{!
Henry L. Jaffe, M.D., Maurice H. Rosenfeld, M.D., Frederick W. Pobirs, M.D.
Laurence J. Stuppy, M.D., Los Angeles
Two hundred thirty-one euthyroid, seriously ill car-
angina pectoris. Stuppy,* Jaffe,‘ Pobirs,* and Rosen-
tion therapy and the cardiac outpatient departmentof
1951, and upon end-results in 100 patients in June,
1952," In 1952, Chapman * described 23 treated cases.
Serber and his group * reported 24 cases in February,
diac patients have been treated with radioactive iodine
(I'"1) since February, 1950, in the department of radia-
the Cedars of Lebanon Hospital in Los Angeles. of
feld* reported upon 95 treated patients in November,
1Hyl 7
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