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ATOMIC; LINERGY COMMISEIION Joint Conn it tee on Atomic Energy Congress of the United States W e wish to report the latest information concerning the medical status of the 1-Inrshallese exposed to the fallout from the March 1, 1954, test Diagnoses made by Dr, Robert Conard of Broolcliaven National Laboratory athis annual medical reexamination this spring prompted bringing five Marshallese and an interpreter stateside for definitive treatment. They arrived week before last,received their pre operative medical work-up a t t h e 14edicP1 Center of Broolthaven Ncltional Laboratory, and transferred to the Cleveland lle tro polit an General Hospital for surgery Details of the present status of the affected14a ~ s halles care shovrn i n the following tabulation which recapitulates past medical thyroid I, Young Rongelapese exposed to fallout Plarch 1, 1954, when they were 600 t o 1400 rem internal irradiation.) 175 rad s external gainma plus 1, Currently normal by clinical and biochemical tests.2 (11%) 3. Have undergone surgery in the U. S. because of Currently hypothyroid vith minimal nodular it y. Responding satisfactorily to oral thyroid hormone nodulas thyroids ; his to logic diagnoses of adenomatous goiter and HGzthle cell tunor. Responding satisfactorily to oral th yr cid hormone
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4 . Development during the past year of nodules i n the th yr cid requiring definitive diagnosis and Two young adults had the primary benign adenomatous goiter essentially identical with those i n 1.3, above. They were treated by subtotal thyroidectomy and a r eI The third Rongelapese, agirl nbw 21-22 years of age, was found t o have a papillary adenona with invasion by neo plastic cell so € the lymph nodes of the left side of the neck. Since the frozen sections and invasive ness radical dissection of the left side of the neck plus complete thyroidectomy were carried 1 suggested a serious degree of malignancy, a The patient is recovering with a minor (Ronc of six Ailing in a e children exposed t o an estimated external dose of 70 rads have shown thyroid dysfunction.) 11, Surviving adult Rongclapcse exposed 'to fallout, (Estimated dose: 175 rad s external plus 160 rem internal irradiation,) 1. Papillary carcinoma removed'. surgica1l.y a t age 41. No recurrence. Taking oral thyroid 2. Small nodule a t age 40 which disappeared under oral thyroid hormoiic therapy. 1 3, This patient was exposed as an adult at the age found on physical examination proved tobe an invasive adenoma involving the capsule of the plastic ce il s only a subtotal thyroidectomy was The rough mass i n one lobe of the thyroid Since the lymph nodes were free of neoThe patient is recovering satisfactorily with minimal signs of hypoparathyroidism. 1
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111. Surviving adult Ailingiiiae people exposed to fallout. (Estimated dose: 70 rad s external gamma irradiation.) 1. Adcnomatous goiter removed a t age 45.. .Recovered b and was on thyroid therapy; died of influenza fV. Surviving adult Uti rik people exposed to fallout. (Estimated dose : 14 rad s external gnnima plus 15 rem This pati cnt was included when she vas found t o have developed a nodular enlargement of the thyroid gland; she was 22 atthe time of exposure.In frozen section the tissue resembled a follicular adenoaa and therefore a total his to logic sections have confirnied the diagnosis and upgraded the est in a ted degree o f malign?.ncy, To summarize, a12 but2 of the19children exposed on Rongclap have now exhibited thyroid dysfunction, some of a serious degree o A small but probably significant number o f people exposed as adults OR Rongelap and other islands are experiencing serious thyroid problem. This first case of neo plastic thyroid disease in a person on Uti rik suggests closer medical surveillance of the Marshallese living on Uti rik.Dr Conard proposes visit iq Uti rik during his mid-winter medical survey o i the Marshallese, Consideration is being given to issuance of a public announcement dealing with the above findings Comrnissi oner Jdhnson