Course of Testicular Injury Following Accidental Exposure to Nuclear Radiations; Report of a Case

Radiological Society of North America, Incorporated, 1952. Reprinted from Radiology, Vol. 59, No. 5, pages 737-43, November, 1952. Wraps. Good. Pages 737-743, [1]. Illus. References. Summary in Spanish. Marks on front page. Back page as a date stamp and states "Distributed by University of California Los Alamos Scientific Laboratory, Los Alamos, New Mexico". The two authors were with the Los Alamos Medical Center and the Bio-Medical Research Group at LASL. This information was presented at the meeting honoring the occasion of the retirement of Evarts A. Graham, M.D., as Bixby Professor of Surgery, Washington University, St. Louis, Nov. 29, 1951. It was accepted for publication in January 1952. Dr. Oakes had been associated with the Manhattan Project, the United States Air Force, and Washington University. He became Chief of Staff of the Los Alamos Medical Center before he retired from the Laboratory. Dr. Clarence C. Lushbaugh was former chairman of the Medical Division at Oak Ridge Associated Universities and a founding member of the Radiation Research Society. He became pathologist at the Los Alamos Medical Center and a staff member in the Biomedical Research Group of the Los Alamos Scientific Laboratory. His research interest shifted to the problem of radiation dermatitis in humans and experimental animals, and he focused much of his attention on biochemical changes in irradiated skin. He also became involved in the study of radiation accident victims. This interest continued throughout his career, and he became recognized internationally as an authority on the subject. He was involved not only in the investigation of radiation accidents in the U. S., but also in Brazil, El Salvador and the Soviet Union. Format is approximately 7.75 inches by 10.5 inches. Previous owner's name, Donald J. Kimeldorf stamped on front page. Dr. Kimeldorf was a renowned expert on ionizing radiation. Although cases of testicular atrophy following exposure to ionizing radiations have been known since 1904 and were common in the Hiroshima and Nagasaki bombings, little is as yet known of the ultimate fate of this lesion in man. The Joint Commission for the Investigation of the Effects of the Atomic Bomb in Japan is investigating this problem, but as yet no reports have been published. Experimental investigations of the effects of ionizing radiations on the testes of animals were begun in 1903 and have been reviewed by Heller. Regeneration of the atrophic testis following irradiation has been studied in animals but not definitively in man, although many isolated case reports are to be found. Regeneration of human "germinal aplasia" from causes other than irradiation has been studied carefully, with the aid of testicular biopsies along with sperm counts. One case of irradiation testicular atrophy has been similarly studied. Sequential testicular biopsies along with sperm counts following exposure to radiation would seem to be the best investigative method available for determining the progress of testicular regeneration in man and allowing comparison with the results obtained from experimental animals. This technic was used in studying the following case of testicular atrophy due to ionizing radiations. The patient, aged :34, married and the father of one child, arrived ambulatory at the hospital shortly after an accidental exposure to nuclear radiations composed of slow and fast neutrons and gamma and beta rays of various intensities and energies. The dosage received was estimated to be equivalent to 390 r of 80-kv.x-rays and 26.4 r of gamma rays to the total body. The dosage is described in this manner inasmuch as this particular combination of more familiar types of radiation best represents the dosage distribution produced by the original complex mixture of radiations. Appropriate factors for the varying biological effectiveness of the original radiations have been included. On admission the patient's blood pressure was at its usual level of 136/96 mm. Hg. His pulse was 100 per minute; respirations 20 per minute; oral temperature 99.4 0 F. He appeared in good physical condition, calm and well oriented, and without any signs of recent injury. After several hours he became nauseated and vomited once. The nausea disappeared and the appetite returned twelve hours after exposure. Diarrhea did not develop. The blood pressure fell to 120/80 mm. Hg in fourteen hours and returned in twenty-four hours to 140/90. The patient was weak, tired, and prostrated for several ensuing days. On the fifth day his temperature began to rise and on the sixth day reached 102.6 0 F. At this time he was drowsy, anorexic, and constipated. The authors concluded that "On the basis of this case, the usual dismal prognosis for regeneration of the accidentally acutely irradiated human testis should be modified toward a more hopeful prospect."