Appendix 10 Hospital Records of Thyroid Cases, 1972-1974 Rongelap 75 HOSPITAL OF THE MEDICAL RESEARCH CENTER, BROOKHAVEN NATIONAL LABORATORY UPTON, NEW YORK 11973 — Area Code 516 YAphank 4-6262 08-42-33 R AME (UNIT NO) DISCHARGE SUMMARY ADMITTED: 7 November 1972 DISCHARGED: 13 November 1972 This 29-year-old Marshallese lady was admitted to this Hospital for evaluation of thyroid nodularity and physical status for thyroid surgery, HISTORY OF PRESENT ILLNESS: She was brought to this Hospital from the Marshall Islands with another Rongelap girl who also had thyroid nodularity. Both had been exposed to radioactive fallout in 1954. They were accompanied by a Marshallese interpreter, Thorough thyroid studies and evaluation of her general physical status prior to surgery were carried out, Before the detection of her thyroid abnormality in September 1972, the thyroid examinations have always been negative and she had always appeared euthyroid with normal thyroxin levels, The patient was exposed to a whole body dose of 175 rads of gamma radiation and the thyroid gland received an estimated dose of 500 rads, largely from absorption of radioiodines in the fallout, Following her exposure to fallout, the patient experienced slight nausea and some itching and burning of the skin. She developed supericial beta burns over parts of her body which healed within a few months. She also had transitory platelet depression and mild leukocyte depression which returned to normal levels within a year, Until the development of thyroid lesions, her past history had been generally negative excepf fer the occurrence of virus pneumonia as a child. Her growth and development had been normal and she has had six normal deliveries and one miscarriage, Her FAMILY and SOCIAL HISTORY were noncontributory, PHYSICAL EXAMINATION: individual, Tre patient is a well-developed and well-nourished, alert and cooperative Except for thyroid findings, the physical examination was essentially negative. The thyroid examination revealed a 2-cm mass in the upper right lobe which was non-tender and only moderately hard, The lower part of the right lobe was enlarged but the left lobe was barely palpable. No nodea were palpated except for a small one in.fhe posterior cervical chain, LABORATORY & X-RAY DATA: - in the right lobe of the gland. Thyroid scan with 9907. showed both functioning and non-functioning nodules 14 level was normal (8.3 18%) and showed good Thyroxin levels will be recorded later, MR and cholesterol were normal. remainder of the Laboratory and X-Ray Workup was negative, except for the presence of trichuris trichuria and ascaris lumbricoides in the stools. The increase after TSH stimilation, Before TSH edministration (10 units) the 1231 uptake was 39.9% and after the administration of the hormone the uptake was 55.5%. -l- ONL 720A -~ 118 -