Appendix 10 Hospital Records of Thyroid Cases, 1972-1974 Rongelap 75 HOSPITAL OF THE MEDICAL RESEARCH CENTER, BROOKHAVEN NATIONAL LABORATORY UPTON, NEW YORK 11973 Aree Code 516 YAphank 4-6262 ama 08-42-33 R (UNIT NO) DISCHARGE SUMMARY ADMITTED: 7 November 1972 DISCHARGED: 13 November 1972 This 29-year-old Marshallese lady was admitted to this Hospital for evaluation of thyroid nodularity and physical status for thyroid surgery. HISTORY OF PRESENT TELNESS: She was brought to this Hospital from the Marshall Islands with anocher Rongelap girl who also had thyroid nodularity. Both had been exposed to radioactive fallout in 1954. They were accompanied by a Marshallese interpreter. Thorough thyroid studies and evaluation of her general physical status prior to surgery were carried out. Before the detection of her thyroid abnormality in September 1972, the thyroid examinations have always been negative and she had always appeared euthyroid with normel thyroxin levels. The patient was exposed to a whole body dose of 175 rads of gacma radiation and the thyroid gland received an astimated dose of 500 rads, largely from absorption of radioiodinea in the fallout. Following her exposure to fallout, the patient experienced slight nausea and some itching and burning of the skin. She developed supericial beta burns over parts of her body which healed within a few months. She also had transitory placelet depression and mild leukocyte depression which returned to normal levels within a year, Until che development of thyroid lesions, her past history had been generally negative except for the occurrence of virus pneumonia as a child. Her growth and development had been normal and she has had six normal deliveries and one miscarriage, Her FAMILY and SOCIAL HISTORY were aoncontributory, FHYSECAL EY EXAMNATION: ; Tre patient is a well-developed and well-nourished, alert and cooperative individual, Except for thyroid findings, the physical examination was essentially negative. The thyroid examination revesied a 2-cm masa in the upper right lobe which was non-tender and only moderately hard, The lower pare of the right lobe was enlarged but the left lobe was barely palpable. No nodes were palpated except for @ small one in the posterior cervical chain. . LABORATORY & X-RAY DATA: .. in the ‘right Lobe of the“Siand. ‘increase after TSH stimulation, | Thyroid sean with 9"Tc showed both - functioning and non-functioning nodules % level was normal (8.3 pg%) and showed Before TSH administration (10 units) the 1231 . uptakewag 39.9% end after the administration of the hormone the uptake was 55.5%, Thyrozin levels will be recorded later, SMR and cholesterol were normal, The remainder of the Laboratory and X-Ray Workup was negative, except for the presence of trichuris trichuria and ascaris lumbricoides in the stools. -l- am 720A - 118 -