20 potentially available total of 41 children from the 1959 survey, 29 were re-examined in 1963 (Table 10). In the group of 60 children examined in 1959, there were 12 who because of their ages could not have been exposed either directly or : utero to the fallout radiation; two of these 12 were re-exam- ined in 1963. More than one-fourth of the ¢» -osed pediatric sample on Utirik was lost to follow-up between the two examinations. The fluctuations between examinations in the numbers of control children and of offspring of exposed parents are shown in Tables 11 and 12. The 29 children added to the control group were randomly selected from the Ebeye school population to provide an additional group comparablein ages to those Rongelap children who were exposed during infancy and early childhood vears to the fallout radiation. Unfortunately, a study of the biographical information on these new subjects indicated the existence of the same uncertainties regarding actual chronological ages that had been encountered before. Verification or correction of the birth date on eachof the children will be required before the data can be utilized for comparative purposes. Children Examined 1964. During the 1964 survey, 22 exposed children, 41 children of exposed parents, and 101 control children were ex- amined. The decrease in the numberof exposed children examined in the Rongelap series from 1958 through 1964 results from temporary movement of subjects to other atolls and to graduation of children from the pediatric to the adult study. The increase in number ofchildren of exposed parents examined results from new births. Results of Physical Examinations. The incidence of abnormal physical findings in the exposed and control groups of children is summarized in Table 13. In general the health of the children seen during both surveys was good. Respiratory infections and skin infections were infrequent. The nutritional status ofall children was adequate, the growth patterns were consistent with those seen in previous years, and the height increments for the period were consistent with the previous group trends. Duringthe epidemic on these atolls, 24 children in the study developed poliomyelitis. Residual weakness of muscle groups was evident in 11 of these children at the time of the 1963 examination (Table 14). Seven children continued to show residual paralysis of varying degree at the time of Table 14 History of Poliomyelitis Among Children of Study Population, Rongelap and Ebeve Subjects with positive history but no residual involvement at ume of examination": Now. 102, 105, 113, 120, 126, 127, 930, 1012, 1025, 1031, 1040, 1504 Subjects with positive history and with residual! involvement at ume of examination: Nos. 96, 98, 103, 106, 110, 870, 901, 903, 1030, 1037 *One subject, No. 84, who had a history of poliomyelius was not examined. the 1964 survey (Nos. 95, 96, 98, 106, 870, 901, 903). In several instances, the degree of involve- ment appeared less than in the previous year. The increase in palpable livers in exposed and control groups during the 1964 examinationsis thoughtto result from variation between pediatric examiners. Liver enlargement exceeded 2 cm below the right costal margin in only two children, and in the remainderthe liver was palpable ac the costal margin only. In all but one additionalcate- gory in Table 13, variation was considered to be within limits expected in sequential examinations of any pediatric age population. Thyroid Nedules. Of particular interest was the development of thyroid nodules in threegiris 9 and [0 years after exposure; two were 13 and one was 14 years of age at the time of detection. These girls were in the higher dose group in which there were 29 children (<< 18 years of age} exposed; 17 of the 29 were girls, with 6 girls in the 10 to 15- year range. Of 75 unexposed comparison children, 37 were girls, and 2! of the girls were in the age range of 10 to 15 years. No thyroid nodules were noted in this group (only one diffuse thyroid enlargement has been detected in an unexposed aduit). A small nodule was first detected in one of the girls in 1963, and nodules in the other two were first detected in March 1964. No lymph node involvement was grossly evident. The individuals were hospitalized and two had complete thyroidectomies and thethird a partial thyroidectomy .* Grossly the glands had a ‘“‘bobblestone” appearance with multiple hard nodules and wereat first “Captain C.A. Broaddus (MC} U.S.N. at the U.S. Naval Hospital in Guam performed the surgery.