NAME UNI NO. SOT ATE "Aye i “Ke HOSPITAL of che> MEDICAL RESEARCH CENTER UPTON, NEW YORK 08-22-57R (Rongelap 15) DISCHARGE SUMMARY PAVILION ADMITTED: Aug. 26, 1969 DISCHARGED: . 1 OPD Sept. 22, 1969 This 22-year-old Marshallese lady was admitted to the Hospital for evaluation of a nodular thyroid gland believed to result from radioactive fallout in 1954. The patient was 7 years old at the time of exposure to fallout and she received an estimated 175 rads of whole body ganma radiation, beta radiation of the skin, and internal absorption of radioisotopes. The dose to the thyroid gland from radioiodines is estimated to have been between 500-1000 rads in addiction to the 175 rads of gamma radiation. She developed transient mild beta burns of the scalp and slight epilation, Her leukocytes and platelets fell to about half normal levels within several weeks,but she had no signs or symptoms related to this depression. By one year she had largely recovered from these acute effects and her subsequent medical history is generally negative up to the present developments. Go Not Write In Binding Margin HISTORY OF PRESENT ILLNESS: In 1967 several small nodules were palpated in the left upper lobe of the thyroid. In addition fn 1968 a 1 cm. nodule was palpated in the right lobe. This past March,1969, examination of the thyroid revealed three distinct nodules, the largest one 2 cm, in the tight-lower lobe and the other smaller in size in the left. lobe, She has remained completely euthyroid and has shown no evidence of any retardation of growth and development. Her PBI and cholesterol levels have always been in the normal range. She had been taking thyroid-hormone medication fairly regularly since September 1965. PHYSICAL EXAMINATION: The patient was alert, and appeared to be completely euthyroid with no major complaints. The findings on physical examination were largely confined to the thyroid gland. The three nodules were noted as described above except that perhaps the nodule in the left lobe of the gland had enlarged slightly. No lymphadenopathy was detectable. The only other finding on physical examination that might be noted was slight leukorrhea, LABORATORY AND X-RAY FINDINGS: PREOPERATIVE HOSPITAL COURSE: The patient was asymptomatic “~ BNL 720A al uo tod Cc” i cn - 76 - “<uuaepeppaneteaeetaties, Thyroid studies revealed the following: PBI 8.1 pg.%, total Lodine 8.2 upg.%, Llodoprotein 2.6 -f1g.%, and T-4 5.3 wg.%; BMR -15; cholesterol 153 mg.Z, esters 119 mg.%; thyroid scan showed a functioning nodule in the right lobe; uptake of radioiodine was normal but response to TSH stimulation was only fair;a test for thyroid antibodies was negative. The hemogram and other blood chemistry findings were normal. The chest X-ray was normal. Vaginal discharge was positive for monilia, ea"|A BROOKHAVEN NATIONAL LABORATORY