roid function has been greatly improved bvthe
thyroid lesions is more recent, has not been on
use of radioimmunoassay techniques for measurtreatment long enoughfor evaluation. The zm utero
ing T4, T3 (triiodothyronine), and TSH.88.89 Studcase was not placed on thyroxine treatmentuntil
ies of serum iodoproteins, which had resulted in
after nodules nad been detected. Thyroid lesions
developedin several persons who were presumartifactual elevations in the serum PBI in the
Marshallese, are discussed below, as are more reably taking their thyroid medication regularly
cent measurements of thyroxine-bindingproteins
and who appearedto be euthyroid with normal
and serum thyroglobulin.
thyroxine levels; on the other hand, thyroid nodules disappeared in two cases (Nos. 53 and 40)
Studies of thyroid function have also included
during thyroxine treatment(in thelatter case, they
tests of radioiodine uptake and excretion on sevrecurred and weresurgically removed).
eral occasions. In the field these were done with a
beat:
Bel. OE sh oe
somewhatprimitive apparatus(Fig) e 38). 132]
™Folloy-up 2 MER Cl BMT Oe
“Giwas used to minimize the doseto the t
id. More
Caréful follow-up:studies on the'su bjects whe
‘extensive and sophisticated tests were done on paThadcancer,ioclu _ whale-body.sscans at Tripler
tients brought to BNL for evaluation prior to surgery elsewhere. These included tests of thyroid
=e
‘MedicatGenter,havesshown.no signs ofreradioiodine uptake and scans (technetium-99m)
.Socaae
as been seen of
before and after TSH stimulation; determination
eWopmeiber a
in the thyroid
remnants in the henign'case#.jnecause papillary
of basal metabolism rate, cholesterol, antithvrothyrgid caréinqmaprogresses very slowly, long
globulin antibodylevels; and a variety ofclinical
continued faligw-upobservation is necessary.
chemistry tests. In a number of cases a small *
Nodeaths or acute iinesses have been associ-
amountof 131] was administered prior to surgery ~~
idfunction:reqgltingiin varying degrees of
roundingtissues was studied by autoradiography.~'.
One 48-year-old man (No. 40) briefly developed-acute thyroiditis after TSH administration.
-
- ated-with the thyrofa abnormalities. Morbidity
Be
Bigisted to thedevelopment of reduced
Shypothyroidinn and $n one case of hypoparathv-
roidism follawigg thyroidectomy. Thelack ofstrict
+
ee, _ compliance:with the thyroid treatment program
in the operated cases involves the potenual danger
that serious hypothyroidism may develop, particularly in patients living on the outer islands and
therefore lessfrequently seen.
. *
+
2. Studies of Exposed Rongelap People
With Thyroid Abnormalities
Evidence of thyroid hypofunction and reduced
reserve was seen,an a few of the children prior to
surgery (Nos. 2, 20, 33, and 65) and to a greater
degree ir
in the two boys-who developed myxedema
Measurementof circulating thyroid hormone
has been an importantpart of the evaluation of
thyroid function in these surveys.Duringthefirst
10 years it was done by PBI analysis and subsequently by ion-exchange chromatography(thyroxine by column). Since 1972 evaluation of thy- tae" *Ehyroid uptake studies were done at Rongelap in 1965 and
FA97EbyDr. J.-E. Radi andin 1966 and 1973by Dr. J. Robbins. Ac
BNL thyroid function studies were done by Dr. H.L. Atkins. PBI
determinations were made by the Clinical Chemistry Section at
BNL andby Bio Science Laboratories, Van Nuys, Calif., who
aiso did other serum iodine analyses. T, and T3; by RIA, and dia-
lyzable Ty, TSH, and TBG by reverse-flow electrophoresis were
analyzed by Dr. P.R. Larsen at the University of Pittsburgh and
more recently at the Peter Bent Brigham Hospital, Boston. TGB
analysis by RIA was done by Drs. M. Gershengorn and J. Rob-
bins, and TG analysis by Drs. M. Izuma and J.-L. Baulieu.
=
Figure 38. Thyroid function testing
under field conditions, 1966.
og
30