2.4 Introduction Wen THe Exposes groups were first seen at Kwajalein after evacuation from their native atolls. the amount of radiation they liad. re ceived was not known wth certamty It was Kor desions epilation. granuloevtopenia and The skin lesions were first reerved between the i2th and 14th post-exposare days. These lesions were most prevalent Hh Onbocs topenia. known, however, from. nstrument readings taken at the sites of "he farlont and from: moni toring all individuals, that a significant amount of penetrating irradiation to the entire bods had been received and that extensive contamina »orroups [und (1 but were present to a slight extent oa Crroup TET. Details of the skin svmp- tion of radioactive materiais nad occurred. “Che levree developed i many individuals of Groups evaluation of dosage isee ntroduction). Even if the precise dose nad heen known it would lnrapeutic neasares for potential sequelae of hese cellular deficiencies, 5 view of the conflicting opinions about the ane of prophylactic and therapeutic measures ah as antibiotics and whole blood transfusions tion of the skin and possible mrernal deposi nature of the irradiating matertal and the cir cumstances of exposure orevented i. prec se not have been possible ro predict the viological effects since the quantitative response of man isnot known. According!y, x complete medical history and physical examination Was obtained on each individual and sumerous follow ay examinations were carried out. In addition, routine sick-cail was hele twice daily and on spection of the skin ef ail ndividuals was made aut frequent intervals. Medical care was avail able at all times. Hospira facilities were avail able at the Kwajalein Nava Dspensary, and support by the more »xtensive snedical facriities of the TS. Pacific Fleer had seen oromised if needed. From description: of the umount of faliou' material and from radioa rivity measurements it was apparent that Crroup | Rongelapy bad received the highest doses of radiation, Group IT (.Ailinginae) ane Grreup T1f > Americans in intermediate amount and Croup TY i Ue mk the least. From physical sios:metry re waslater estimated that Group I } ad reeerved approX mately 175 r of gamma radiation: Crroup 1, 69 rz Group TIT. Ts round Group iV. ier The most serious clinieai tnd Jaboratery nia i festations of irradiation appeared on Group and TT. The only apnormal tres that could be attributed with certat cy te re adertion wore opis and desions and their treatment are re- jocted at Chapter 3. Details of hematologic tidies are presented in Chapter TV. Granuoostopera ind thromboevtopenia of marked ind TE and was of sufficient severity to warait serigus consideration of prophylactic and che treatment of radiation disease (1-5), it vas ctecided that therapy would be instituted ms ois indteated clinically for specific condi- lois as they arose. In order to determine the effect of che internal deposition of radioactive natemadon the course of the externally induced acdation onyursy, if Was necessary to determine he aegree cf internal radioactive contamina10, Detans of the measurement of internal lepos,. tion of radionuclides are considered in } peter " opftrc bert on acienuchides It is sutficient to state here that the from the internally deposited to the total acute dose was rs ore runt 2.' Symptoms and Signs Related to Radiation Injury sh opkaAr Syoproms Tirvr developed during the ist reve days could be attributed to radiation. Phose svniptoms were associated with the skin rot fhe @ostrommfestinal tract, tehing ard barning of the skin occurred in ~oercen oof Croup | Rongelapo, 20 percent lo