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Interna) Medicine
61
Unexposed (Reongelap,
Uturik)
among those exposed at an age greater than
10 years, there have been 3 adults with
thyroid nodules (5.5%). In the smaller
Ailinginae group there was 1 case that
represents 12.5%. It should be notedthat
several nodules have been detected in older
people of the Utirik and Rongelap comparison populations. These latter cases were
in people over 50 years of age, whereas in
the Rongelap exposed adults, the nodules
occurred before the age of 50 years.
In view of the seriousness of this development, the highest exposure group on Ron-
gelap was started on thyroid hormone
therapy in order to protect the glands
against further thyroid-stimulating hormone
(TSH) stimulation and hopefully to reduce
the possibility of further development of
nodules as well as to cause regression of
existing nodules. Accordingly, in September
of 1965 daily treatment was begun with
synthetic thyroxine, 0.3 mg to those under
50 years of age and 0.2 mg to those over 50
years.
Surgery has been performed on 11 subjects. Three were taken to Guam in 1964,
where thyroidectomy was carried out at the
Naval Hospital. Eight other cases were
taken back to the United States to Brookhaven National Laboratory where we carried out a numberof thyroidstudies before
surgery was done in Boston. These studies
included iodine uptake, serum TSH level,
thyroid scan, basal metabolic rate, PBI, and
serum thyroxine level. Thyroglobulin antibody tests were made, but no increase was
seen. Dr. Robbins will speak further about
these studies. Subtotal thyroidectomy was
carried out in Boston by Dr. Bentley Colcock. Total thyroidectomy was carried out
on the patient who showed a mixed papillary and follicular carcinoma of the thyroid.
Clinically these nodules have appeared in
some cases to be single nodules, but at surgery they were nearly all found to be multi-
nodular. They were usually soft to firm in
reEre eee ke
6.4
49
48
0.0
36
0.0
y ld
16
0.0
Utirikt
40
14
T 35-110
1
+ 69
6
Ajlinginaet
*T
dose from external gamma radiation.
dose from beta and gamma radionuclides, +
{ Dosage in this group was the same as in the 20- to 40-year group.
t In estimating the thyroid doses to the Ailinginae and Utirik exposed groups it was assumed that such doses were proportional to the thyroid doses of the
Rongelap exposed group, based on relative whole-body gamma dose received.
194
48
21
22
0.0
I 175-300
0.0
I 16
y ld
0.0
0.0
3
4.5
{).0
Yo
rads
0.0
rads
I 350-600
y 175
12
Yo
rads
19
Rongelap
Group
ICAL STAFF
:
\
A
malities have been noted. On Rongelap,
10
Group
Dose*
mated
Group Thyroid
in
Group
1
geeks
7
x
*
_+ same.age. range, again no thyroid abnor-
2.0
7.1
td
30.9
Abnormalities
No.
No. Alnorin malities
Abnormalities
Esti-
Age (1954) 20-40 years Age (1954) >40 yearst
No.
in
Abnormalities
[stimated
Thyroid
Dose*
Age (1954) 10-19 years
No.
Abnormalities
I'stimated
Thyroid
Dose*
Age (1954) <10 years
No.
Island Group
TABLE4,
Thyroid Abnormalities (Nodules and Hypothyroidism )—Marshallese Populations Examined 1964 Through 1966
All Ages
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