Utirik 2208 AME HOSPITAL OF THE MEDICAL RESEARCH CENTER, BROOKHAVEN NATIONAL LABORATORY 08-45-40R UPTON, NEW YORK 11973 (UNIT NO) Area Code 516 YAphank 4-6262 DISCHARGE SUMMARY ADMITTED: June 2, 1973 DISCHARGED: June 10, 1973 This 54 year old Marshallese woman who had been exposed to a slight amount of fallout in 1954 was brought to the United States and admitted to this hospital for evaluation of thyroid nodularity and physical status for possible thyroid surgery. HISTORY: the thyroid. Examination, this past March revealed 2 rather hard masses in the right lobe of These had not been noted on previous examinations. No lymph nodes were palpated and she has always appeared euthyroid. Her T-4 level enMvercn was 3.7 werk. She was accidentally exposed in 1954 to about 14 rad of g@&rima@ radiation and an estimated dose of 22 rads to the thyroid from fallout while she was living on Utirik Island. She showed no affects to this slight exposure. Following her initial exam ination she was not again examined until 1969 at which time she was found to have biood pressure readings of 200-220/100-110 and a systolic murmer was noted. Also reported was an umbilical hernia and a possible fibroid of the uterus. Her only complaints have been headaches, chronic joint pains, particularly of the right arm. EXAMINATION : This intelligent, alert, somewhat obese . Marshallese lady appeared to be healthy and euthyroid. The thyroid findings were as described above for the March examination. Other findings included inversion of the nipple of the right breast; enlargement of the heart with ea harsh systolic murmur, heard best over the aorta and PMI areas; blood pressure 180/86 with no evidence of decompensation; EKG was within normal limits; tenderness around the umbilicus though the hernia was not actually palpated; Pelvic examination revealed 3 small areas of hyperplasia of the cervix. AND DATA: The thyroid scan showed a poorly functioning nodule in che lower half of the right lobe. The radioactive iodine uptake was normal and the response to TSH stimulation was good. T*4 report is not yet in. Serum was non-reactive for antithyroid globutin antibodies. X-Ray of the cheat showed moderate cardiomegaly and arteriosclerosis. The lungs were clear. The hemogram was normal except for an ESR of 40 (high valuea are noted in the Marshallese). electrolytes generally normal. normal. HOSPITAL : Serology waa negative. Serum proteins negative, and Urine was negative and liver and kidney function tests During her 8-day hospital stay, she remained generally a_symptomatic except for some pain and stiffnees in her right arm which was relieved with aspirin. Her appetite was good and she was completely ambulatory. Her blood preasure remained normal after the alight elevation noted on admission. She was discharged on June 10th for travel to Cleveland. ONL 720A - 126 -