Rongelap 51
HOSPITAL OF THE MEDICAL RESEARCH CENTER,
BROOKHAVEN NATIONAL LABORATORY
UPTON, NEW YORK 11973
08-50-52 R
Area Code 516 YAphank 4-6262
DISCHARGE SUMMARY
ADMITTED:
.
27 May 1974
NAME)
(UNIT NO}
CIRC 63
DISCHARGED:
3 June 1974
This 45-year-old Marshallese female
was admitted for evaluation of her
thyroid status in anticipation of possible surgery.
MEDICAL HISTORY:
In September 1973, a small nodule
0.5 cm in diameter was noted in che
tegion of the lower left lobe of the thyroid.
appeared co have grown alightly in size.
her T4 levels were in the normal range.
to fallouc radiation in 1954 at age 24.
By March 1974, the nodule
She had always appeared euthyroid and
The patient was accidentally exposed
She received an estimated 69 rads or
whole body gamma radiation which caused mild depression of her blood elements
during the first few weeks after exposure,
Falloue contamination of the skin
caused mild, transitory, beta burns of the skin during the first few weeks also,
She also absorbed internally some radionuclides, the most serious of which were
radioiodines. She remained generally healthy until about 1970, excepe that she
was somewhat underweight and had an early menopause (age 42), after having had
one miscarriage and one child,
Since 1971 she hag complained of frequent boucs
of coughing, dyspnea, night sweating at times, and chest pain.
She has had
white-to-yellowish spueum, burt danies hemoptysis.
She claims to become dyspneic
on exertion, and during the bouts of coughing sleeps propped up on pillows,
LABORATORY & X-RAY DATA:
Thyroid scan using 123) shows a focal
area of decreased radioactivity in
the middle and lower 1/3 of the left lobe of the thyroid laterally, Her RAL
uptake was 15.8%. Chest x ray showed increased lung markings, possible due to
chronic bronchial disease. Numerous exams for AFB of the sputum were negacive,
both on smear and by culture,
No other consistent pathogenic organisms vere
found in the sputum.
The EKG showed some T-wave abnormalities, which were noe
necessarily considered significant.
Her hem_pgram was negative except for
increased eosinophils which may have been related to che finding of whip-worm and
trichuris trichura in her stools.
She had slightly increased blood proteins,
particularly globulins, which is not an unusual finding in the Marshallese
people.
She had a positive syphilis serology, reactive, titer II.. (In the
Marshallese, infection with yaws, which was endemic years ago, not infrequently
resulcs in positive serology.)
HOSPITAL COURSE:
During the first few days of hospital{zaction, che patient remained in bed
a good deal of che time,
She coughed frequently and had slight increage in
respiration, bringing up a whitish-yellowish sputum,
She became dyspneic on
exertion.
She had a low-grade fever in the evenings, Her appetite was poor,
In view of possible TB infection, tsolation procedures were instituted, though
subsequent tasts and sputum findings did not substantifatesuch a diagnosis.
Considering the possibilicy of bronchial infection, she was given tetracyclines
and Tedral for cough,
She improved in the lase few days of hospitalization
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