Ucirik 2212 MOWITAL OF Tet mEOICAL RESTARCH CENTER, BLQOKHAYVIN NATIONAL LASORATORY Wiamll 8-45-3R UTOM, Nw YORK 1197) Aves Code 31¢ YAghant 4-4267 wnt NO) DISCHARGE SUMMARY -2in the urine, she was placed on {5 unlts NPH Insulin dally which controlled her diabetes. With the diabetes controlled, the slightly impaired kidney function was nut considered serlous enough co peeclude surgery and she was discharged June i0ch for transfer to Cleveland, At Cleveland Metropolitan General Hospital, thyroid surgery vas performed by Dr. Brown Dobyns, The day before surgery she was given 25 pCh t ty in order to da autoradiographic studies on the removed thyroid tissues. At Surgery, a left lobectomy was performed removing several cystic nodules From that lobe, A diagnosis of Hurthle cell adenomata on frozen section prompted the complete removal of that lobe. A further adenoma was removed from the isthmus and several tiny nodules were removed from the right lobe, The patient withstood surgery well and her convalescence was uneventful, She was continued on insulin and dietary treatment, FINAL DIACNOSIS: Mixed follicular cell and Hurthle cell adenomata of the thyroid. Borderline hypertenston with slightly reduced kidney function. DISCHARGE MEDICATION: Under normal circumstances with a lefe thyroid lobectomy and subtotal on the right, somewhat depressed metabolism might be expected and 0.1 to 0.2 mg of Lthyroxin would be given daily. However, since this lady is older, has diabetes and a tendency to hypertension, tt was deemed advisable to observe her for a few months before making the final decision on treatment, She was advised to attend the diabetic clinte at the Majuro hospital and maintain her diet. The practitioner accompanying the patients was advised to continue the insulin therapy. If the patient later was muved back to her isolated home at Utirik Leland, the treatment would have to be re-evaluated. -, “ene Chron ta RAC: bwa Dice: 6/27/73 Typed: 6/29/73 Om 720A obert A, Conard, KD.