20 EFFECTS OF IONIZING Table 2.1—Patients Treated With Antibiotics PamirE NT ConpiTi0N or Davs A ntiBIboric 1 URI and bronchitis 1 Penicillin 2 Penicillin 1 2 Penicillin Penicillin 2 Penicillin 2 Penicillin 7 Penicillin 5 2 1 Gantrasin Penicillin Penicillin RADIATION several extra days and thought that the bleeding was more than usual but not. sufficient to cause them concern. 2.33 2,3 4,5 6 7 8 9 10 11 12 with high temperature. URI, severe, with pharyngitis and high temperature. Tooth extraction. __. Deep extensive slough of epidermis of foot. Inflamed tonsils with high temperature and URI. Rapid progressing undermining impetigo. Traumatic gangrene of foot. Cystitis......._._-Furuncle on buttock Furuncle on forehead. described in detail above. Each appeared to have evidence of a bacterial component associated with (TRI and antibiotics would have been indicated had they not been irradiated. All other individuals were not neutropenic at the time of treatment and were given antibiotics for specific indications. There was no instance in which it was considered necessary to give prophylactic antibiotics for neutropenia per se. 2.32 Clinical Observations and Platelet Counts a) 3 eo oe Crt oy All individuals with a platelet count of 100,000 or less were examined daily for evidence of hemorrhage into the skin, mucous membranes and retinae. Urine was examined daily for red cells and albumin, and women were questioned concerning excessive menstruation. There was no evidence of any hemorrhage even though 11 individuals reached platelet levels between 35,000 and 65,000. Two women menstruated when their platelet counts were 150,000 and 130,000 respectively. Both menstruated Hematocrit Changes In radiation injury an anemia can be produced by three phenomena: a. Partial or complete suppression of erythropoiesis: b. Hemorrhage; c. Hemolysis. (9). The existence of the latter is not universally accepted as a characteristic part of radiation injury. Since hemorrhagic phenomena were not. observed a severe anemia would have been expected only if erythropoiesis were suppressed severely for a long time. With complete suppression of erythropoiesis and an unchangedlife span of the red cell one would expect a deficit of 0.83 percent per day since the humanred blood cell has a life span of approximately 120 days. Nineteen individuals in Groups I and IT had hematocrits between 31 and 35 percent. Nine of the 19 were children, aged 1 to 5 years and would be expected to have a lower hematocrit than normal adults; four were over 70 years of age, in which age group a decreased hematocrit is frequently present without obvious cause. Two of the 19 had had menorrhagiapriorto the determination, two were 3 to + months pregnant and had notreceived supplementary iron, and two were young women. These hematoerits could be ascribed to physiological variations rather than to the effects of irradiation on hematopoiesis. Supplementary iron was the only therapy used for the mild anemias observed. Thus no definite evidence of prolonged erythropoietic suppression was observed evenin individuals who had received 175 r whole body radiation. 2.4 An Epidemic of Upper Respira- tory Infection Occurring During the 4th and 5th Post-Exposure Weeks Between Tue 27th and the 42nd post-exposure days an epidemic of upper respiratory disease (URI) occurred. The respiratory infection consisted of moderate malaise, pharyn-