snique balance of aetsailec studi “In our laboratory _we cave fr clinical Subjects treated with --+I anc simultaneous studies cn the long tem. e-fects of =< \cestrasiin aa ast - #k. addition te 13iT on thyroids of rats, rarticciariy the formaticn neoplasms. the work on radiation e Led out under shi S contract, the crag [-sral investigator: has been an active rarana the cooperative Thyrotcxi= isis Follow-up was prematize. Study cr 19,900 patients <reatec with on 26 centers. The prove! neoplasms <s terminated but it ls now <xnow. that the sntenval ror the development mucn longer than was provided =xor. The recrening of nc Study is — gently needed. ne od -“en7 _—-— woe be =n pane - -~ —s — ——_ The principal investigatcr has Deen a participant in the studies cf fae Marshallese bomb casualties (whose —3 mary insult was from radicicdines). He nek seen the surges; Le as operating the individuals and c=rrying out the laborattry studies a at om rne tissue reHe has been one cr the consultants screening the southern VtE—n and Nevada children for goiter in the falisut area, a study concluded without = sitive findings pertaining to radiation, but yielding other scientific data on thyrc f= disease (the last manuscript has just been scbmitted‘for publication). These cot l=teral studies Por work carrie: have contributed greatly to the experimental cbjectives. and desi movec. outunder this contract. The laboratory and perse:r2l that are supported mainly under tx rs ERDA contracz” are a part of Cleveland Metresclitan General Hospital and Case Wests r= Reserve Uniyaysity. This laboratcry is responsible for all diagnostic and they E>eutic use of I in thyroid disease at Cleveland Metropolitan General Hospital. All costs for the routine work and many of ty special radioiodine studies are c= raed by the hosrita The principal investigatcr is = surgeon and because of research ints mests, consults sn all medical or surgical thyroi= problems in this hospital. This a rides a umigue crpcr esial study in «noon. the thyroid is necessary, this also provides m opportunity to procure thyroid tis; Ls2 under speciai conditions and with precise creparation so that the most pertinent i-tformation concermning radiation effect can be chtained frem the tissue removed. tunity to select from a large nospital population any patient for a radiation effect is to be m-oduced with 1311. When an operation ;‘ Radiation Effects of Therape sn Doses of 1311 in the Thyroid in Cl Imical Subjects with ht SS ae Hyperthyroidism Serial observations contimue on selected patients whom we are eating with large The uptake of 1311 by the thyrc [—, its disappearanc day by day from the gland ane =he amount of radioactivity circulatifs for several weeks as well as the loss of the isccope in the urine for 3 days are fol hwved after thene t dose of 1341, ment dose is given to get a better idea of the kinetics of the doses of 911 for hyperthyroic¢iam. This is ultimately related tc che changes that take place in the J smical picture and the degree of recovery from ryoerthyroidism. These observations a — providing better information from which the acvaal rad dose delivered to the thyre 3E can be calculatec. Some patients develop hypothyroidism very rapidly in spite of me fact that tre dose of radiation per estimate= gram of gland was thought to be apy mopriate to bring the patient slowlyto a euth,rcid state. Other patients seem rela} cvely uneffectec by what was calculated to be =. effective dose. Multiple doses me; >e required in scm of these patients. such cases, the serial studies have been re Seated to see haw the behavior of the +311 the second time compares with the first, specially if there is some but not enough radiacticn effect. As nas been pointed out F—- previous reports, some of these data collected in the past represent some of the m5 complete observati: on individual patients availe=le. In additicn to encrmous amounts == chemical data collected over several months on each patient, there is in progres the long term foll: up of physiological function <= the gland. The only way to judge f= possible outcome " \