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Course of Testicular Injury Following Accidental Exposure to Nuclear Radiations

1952; Radiological Society of North America; Volume: 59; Issue: 5 Linguagem: Inglês

10.1148/59.5.737

1527-1315

William R. Oakes, C. C. Lushbaugh,

Nuclear and radioactivity studies

Although Cases of testicular atrophy following exposure to ionizing radiations have been known since 1904 (1, 2) and were common in the Hiroshima and Nagasaki bombings (3, 4), 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 (5). Experimental investigations of the effects of ionizing radiations on the testes of animals were begun in 1903 (6) and have been reviewed by Heller (7). 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 (8, 9, 10). Regeneration of human "germinal aplasia" from causes other than irradiation has been studied carefully, with the aid of testicular biopsies along with sperm counts (11). One case of irradiation testicular atrophy has been similarly studied (9). 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. Case Report2 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.