Rongelap 51
PiAne)
MOSATAL OF Trl aniDeCat RESEARCH CENTER
BROORHAVIN NATIONAL LABOSATORS
UPTON, Miw TOK 187}
08-50-52 a
OISCHARGE SUMMARY
CIRC 63
Ares Coda 516 FAprenh 64-4167
ADMITTED:
27 May 1974
DISCHARCED:
Aral HO)
J June (974
This 65-year-old Marshallese fermle
was admitted for evaluation of her
thyroid status
in anticipation of possible surgery.
MEDICAL HISTORY:
In Seprember 1973, a small nodule
0.5 cm in diameter was noted in the
region of the lower left lobe of the thyroid.
By March 1974, the nodule
appeared to have grown slightly in elze.
She had always appeared esthyroid and
her To levels were in the normal range,
The patient was accidentally exposed
to falkouc radiacion in 1954 at age 24,
She received an estimated 69 rads of
whole body gamma radiation which caused mild depression of her blood elements
during the firsc few weeks after exposure, Fallout contamination of the skin
caused mild, transitory, beta burns of the skin during the first few weeka also,
She also absorbed internally some radionuclides, the most serious of which were
radioiodines,
She remalned generally healthy until about 1970, except that she
was somewhat underweight and had an early menopause
(age 42), after having had
one miscarriage and one child, Since 1972 she has complained of frequent bouts
of coughing, dyspnea, might sweating at times, and chest pain,
She has had
whitesto-yellowlsh sputum, but denies hemoptysis,
She claims to become dyspreic
on exertion, and during the bouts of coughing sleeps propped up on pillows,
LABORATORY & X-RAY DATA:
Thyrold scan using 123, shows a tecal
area of decreased radioactivity in
the middle and lower 1/3 of the left lobe of the thyroid laterally,
uptake was
15.8%,
Chest x ray showed Increased lung markings,
Her RAL
possible due to
chronic bronchial disease, Numerous exams for AFB of che sputum were negative,
both on smear and by culture, No other consistent pathogenle organisms were
found
In the sputum,
The EXC showed some
T-wave abnormalities, which were not
necessarily considered significant, Her hempgram was negative excepe for
increased eosinophils which may have been relaced to the finding of whip-worm and
trichuris trichura in her stools, She had slight!ty increased blood proteins,
particularly globulins, which is noc an unusual finding in the Marshallese
people,
She had a positive syphilis serology, reactive, titer If,
(tn che
Marshallese, infection with yaws, which was endemic years ago, not infrequently
results in positive serology, }
HOSPITAL COURSE:
During the first few days of hospftalizacion,
the patient
remained [n bed
a good deal of the time,
She coughed frequently and had slight increase in
resplration, bringing up a whitish-yellowish spucum,
She became dyspnete on
exertion,
She had a low-grade fever in the evenings. Her appetite was poor,
In view of possible TB infection, isolation procedures were instituted, though
subsequence
tests and
sputum findings did noc
subscancifatesuch a dlagnoasis.
Considering the posalbility of bronchial Infection, she was yiven tetracyclines
and Tedral for cough,
She improved {nm the last few days of hospitallzarion
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ONL 720A
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