Rongelap 45 HOSPITAL OF THE BROOKHAVEN UPTON, Area Code MEDICAL RESEARCH CENTER, NATIONAL LABORATORY NEW YORK 11973 516 YAphank 4-6262 (NAME) 8-45-41R [UNIT NO) DISCHARGE SUMMARY ADMITTED: June 2, 1973 DISCHARGED: June 10, 1973 This 54-year-old Marshallese woman was brought to this Hospital for study of possible thyroid nodularity and evaluation of physical status for thyroid surgery. MEDICAL HISTORY: The examination in March revealed a suspicious area of firmness about 2.5 centimeters in diameter in the region of the lower right thyroid pole. There was uncertainty as to whether it was in the thyroid gland, but because of her radiation history it was thought surgical exploration was indicated. adenopathy and she appeared euthyroid. There was no lymph- She was exposed to fallout radiation in 1954, receiving about 69 rads whole-body gamma radiation and about 134 rads to her thyroid gland from absorption of radio- iodines from the fallout. She had mild radiation effects with slight transient hematological depression and superficial beta burns to the skin. She recovered from these effects within the year and in subsequent years only minor medical findings were noted. Among these were pleural thickening of the right hemidiaphragm, chronic endocervicitis, gonorrhea, pingueculae (left) and partial prolapse of the vaginal wall. She has always appeared euthyroid and several thyroxin levels were in the normal range, though the March level was somewhat low. PHYSICAL EXAMINATION: This lady was well-nourished and somewhat overweight. The thyroid examination revealed an area of firmness as described above, in the lower right thyroid region near the clavicle. Again, it was uncertain as to whether this was actually thyroid tissue being palpated. The patient appeared euthyroid and no lymphadenopathy was noted. The physical examination was otherwise generally negative except for slight cardiac enlargement and eye findings noted above. LABORATORY AND X-RAY DATA: appeared normal. good. The thyroid scans showed no evidence of thyroid nodularity and the thyroid gland The RAE uptake was normal and the response to TSH stimilation was Her chest x-ray showed slight cardiac enlargement and some tenting of the diaphragm on the right from scarring, probably due to an old inflammatory disease. The hemogram was normal except for a high sedimentation rate (which is frequently seen in the Marshallese, particularly the women). were generally normal. PTTAL The blood chemistry findings During her 8-day stay here, she remained generally asymptomatic exce.. for slight pain in the right shoulder at night relieved by aspirin, and nasal congestion on several occasions which was relieved by nose drops. She was discharged BNL 720A - 124 -