21 Sacraductiom Ween Tee Param groups were tirt wen at Kwajslem after everustien from their native atalla, the amount of radiation they had recorved was nat known with certainty. It wes known, however, fram instrument readings taben at the sites of the fallowt and from nemi- tering all individuala, that a significant amee::t of peactrating irradiation to the entire body had bern received and that extensive contaminstren of the skin and posible internal depositren of radinactive materials had ocrurred. The nature of the irradiating material and the cir- shin tenons, eprintinn, granulurytnprnss sad thrambersinpenie. The shin enone were tent cteerved between the ith and 1th pret-cape sure days, Therur irons were mont provelent in Ciroupe | and [0 but were prearnt to 2 slight extent in Groep LIT. Details of the shm symptoms and fences aad their treatment are re ported in Chapter 3. Details of hematolagr studive are prevented in Chapter [V. (iranekeytopenia and thromborytopenia of marbed degree developed in many individuals of Girnup= not have been possible to predict the biological I and I] and was of sufficient severity to warrant sericus consideration of prophylectir and therapeutic measures for potential sequelae of these cellular defirienries. In view of the conflicting opinions show the snot known. Accordingly, a complete medica! such as antibiatics and «hole blumd transfeionn commfances of exposere prevented a precise evaization of dmage (sre introduction). Even if the preciss dose had been known it would effects since the quantitative response of man history and physical examination was obtained «om each individual and numerous follow-up examinations were carmed out. In additiun, routine sck-call was held twice daily and inspetion of the shun of all individuals was made at frequent intervals, Medical care was avail- able at all times. Hanpital facilities were avail- able at the Kwajalein Naval Dispensary. and support by the more extensive medical facilities of the U.S. Pacitic Fleet had been promixed f needed. From dearriptions of the amount of fallout material and from radivectivity measurements, it was apparent that Giroup f ¢ Rongelap) had received the highest dewes of radiation, Giroup Tf (Ailinginae) and Ciroup TE ( Americans) value of prophylactic amd therapeutic meresures in the treatment of radiation dimpase (1-5), 1t wan decided that therapy would be insiteted only as indicated clinically for specifir conditions as they arune. In order to determine the effect of the internal depauthm of radiwertive material on the course of the externally induced radiation injury, it was necewary to determine the degree of internal radioactive contamimatien. Pletails of the measurement of internal depmution of radionuclides are considered in Chapter V. It is sufficient to state here that the contribution from the internally deposited radhonuclides to the total acute dow was neignitieant. an intermediate amount and Giroup LV ( Utirik) 2.2 mately 175 r of gamma radiation: Giroup U1, Sevraat Svsprows Tat developed dunng the The most serious clinical and laboratory manifeatations of irradiation appeared in Group I and I]. The only abnormalities that could be There symptums were aworiated with the skin the least. From physical dosimetry it was later estimated that Giroup | had received approxi69 or: Group TLL, 1 6: and Group IV. 14 r. attributed with certainty to irradiation were Symptoms and Signs Related to Radiation Injury fire two days coukl be attnbuted to radiation. and the gastromtestinal tract. ftching and burning of the skin oceurred 1... 2 pervent of Group | ( Rongelap), 2) percent oy 15

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