Rongelap 40 NAMB HOSPITAL OF THE MEDICAL RESEARCH CENTER, BROOKHAVEN NATIONAL LASORATORY UPTON, NEW YORK 11973 O8-45-42R Area Gode 516 YAphank 4=6762 (UNIT NO.) OISCHARGE SUMMARY ADMITTED: June 2, 1973 DISCHARGED: June 10, 1973 Thia 48-year old Marshallese man who had been exposed to radicactive fallout in 1954 was admitted for evaluation of thyroid nedularity and physical status for possible thyroid surgery. HISTORY: A small nedule in the right lobe of the thyroid was first detected in 1965. He, along with other people of Rongelap who had been exposed to radiation had been placed on L-thyroxin treatment and the nodule disappeared on thig treatment. However,during che recent examinations in March, he was again discovered to have a hardened area in the tight lobe with indistinct boundaries. No lymphadenopathy was noted. He has always appeared euthyroid and his thyroxin levels have generally been in the normal range, with only one reading slightly slow. He was exposed to 175 rad of gamma radiation from accidential fallout of 1954 and his thyroid gland probably received about 330 rads partly from radioactive iodines absorbed. He had early acute effects with hemological depression and mild "beca” burns of the skin which he recovered from within a year. #xaminations over the past 19 years have revealed only a few findings: The hiatory of yaws in childhood, measles, occasion~ ally bronchitis, one possible attack of pneumonia, a fistula-in-ano which was surgicaily corrected. He has remained in very good health and is a hard worker and leader of his people. He waa magistrate of the village at the time of the fallout. His wife was operated for camcer of the thyroid, three sons for benign thyroid lesions, and 1 son died at 19 years of age with acute leukemia (possible from radiation exposure). EXAMINATION: This well developed, muscular, alert man appeared quite healthy and euthyroid. The thyroid findings noted were the same as were reported above for the March examination. The only other findings were bilateral pr¢ey;i.c , missing teeth and gingivitis. ANDDAT : Thyroid scans showed no distince nodularity buc slightly increased size of the right lobe. Radioactive icdine uptake was normal and response to TSH stimulation was fair. T-4 levels are not reported yee. Serum was nonreactive for antithyroid globulin anti- bodies. Chest X-Ray was normal. Hemogram was normal. Syphilis serology was reactive (titer of 4) bur this low level was not considered significant in view of his history of having had the yaws. Tests of kidney function and liver function were normal. trolytes normal, EKG normal, proteins normal, electrolytes and lipids normal. were positive for whipworn, HOSPITALCOURSE: Elec- Stools During the 8 days of his hospital stay, the patient was a symptomacic until the 5th day when following ISH injection (given the previous day) he developed an acute thyroiditis with low grade fever, nausea, anorexia and slight neutrophilia. Scan showed some enlargement of the gland... The thyroiditis reduced rapidly and at the aa. 720A we cy ‘a of C3 tT - 122 -