Rongelap unexposed 829 HOSPITAL OF THE MEDICAL RESEARCH CENTER, BROOKHAVEN NATIONAL LABORATORY UPTON, NEW YORK 11979 Ares Code 516 YAphank 4-6262 (NAME) . 08-45-30R UNIT NO) DISCHARGE SUMMARY ADMITTED: 6/2/73 DISCHARGED: 6/10/73 During the March medical survey in the Marshall Islands, this 36 year-old Marshallese woman who is part of the comparison population unexposed to fallout was found to have a thyroid nodule and was brought to the United States and admitted to this hospital for thyroid studies and evaluation of physical status for possible thyroid surgery. thar st HISTORY During the March examination a,ynodule, a discrete spherical mass was detected which was moderately firm, movable and slightly tender to palpation. No lymphadenopathy was noted. She appeared euthyroid and previous examinations showed no evidence of thyroid abnormalities. Along with the population exposed to fallout she has been examined as part of the comparison population for the past 16 years. She is the mother of 11 children and has been healthy. With only a few findings of any significance - slight anemia at one time, one miscarriage, cervical erosion and occasional fungus infections of the skin. Her FAMILY and SOCIAL HISTORY are non-contributory. FHYSICALEXAMINATION : ; This slender, well nourished Marshallese lady appeared alert and euthyroid. The thyroid findings were the same as those reported above during the March examination, The remainder of the physical examination was essentially negative except for slight abdominal tenderness and discomfcrt which she experiences prior to menstruation. AND DAT: of the gland, wags good. Thyroid scans showed a 2 cm, poorly functioning nodule in the lower left lobe Radioactive iodine uptake was normal and response to TSH stimulation Serum was nonreactive for antithyroid globulin antibodies. and EKG were normal. Tests X-Ray The hemogram showed slight lymphocytosis and an elevation of the ESR to 38 (which is not unusual in the Marshallese.) In view of her previous anemia it was interesting that her fe and TIBC were within normal limits. Tests for liver and kidney function, electrolytes and lipide were normal. Serum proteins were somewhat high (9G) but the electrophretic pattern was not unusual for the Marshallese (high gamma globulin levels). The stools were negative for ova and parasites. HOSPITALCOURSE: During FAe early part of her 8-day stay, here, she had premenstrual abdominal discomfort and anorexia. With onset of menstruation these symptoms disappeared and she remained a symptomatic for the rest of her hospital stay here. Just prior to discharge on June 10th, for travel to Cleveland for surgery she was given 25 4 Ci 131; orally in order to carry out autoradiographic procedures on thyroid tissues to be removed at surgery. BNL 720A - 132 -