LO
and feet. Marked improvement was notedin the
case of an 80-yr-old man whohadsuffered a cerebral accident 2 years previously; muchof the unilateral paralysis had disappeared. Three other
aged exposed people, two females, one supposedly
101 years of age and one 75, and one male 79,
were obviously becoming moreinfirm. They rarely
left the seclusion of the mats beneath their houses.
Only one unexposed person was in this same age
range, a male aged 84 whowas still able to move
aboutfairly well.
In April 1958, after the March survey, a death
occurred in a 36-yr-old male from the Ailingnae
group, which had received about 69 r of gamma
irradiation from thefallout in 1954. He had complained in Marchofepigastric pain, anorexia, and
loss of vigor. Physical examination at that ume
was essentially negative except for epigastric tenderness. A tentative diagnosis of peptic ulcer was
made, although it could not be substantiated
since x-rays were not available. He improved on
an ulcer diet including canned milk. About 3
weeks later, after the survey team hadleft, he becameacutely ill and was transferred to the Naval
Hospital at Kwajalein, where he died the following day. The entire skin and mucous membranes
of the mouth were covered with uniocular vesicles
and bullae. Autopsy revealed acute bilateral
pneumonia of unknownorigin and passive congestion of the liver. A diagnosis of varicella was
made. Microscopic examinationofthe skin lesions
showed inclusion bodies typical of varicella.*
Thestriking thing about the physical examinations in both the exposed and unexposed peopie
was therelative paucity offindings associated with
degenerative diseases. While the group under
observation is too small to permit any valid statistical analysis, the clinical impression was that
diseases such as atherosclerosis and hyptertension
were considerably less common and of lesser
severity than in a comparable group of our population. Among the 114 people 50 years old orless,
none had a biood pressure greater than 140/90.
Among the 23 persons older than 50 years, 6 had
pressures ranging from 160 to 220 systolic and 90
to 110 diastolic, and 2 had systolic elevations of
160 to 170 but diastolic pressures of 75 to 80. The
groups were too small for these findings to be
"Weare grateful to Capt. B.E. Bassham, (MC) USN, for
doing the autopsy, and to Dr. S.W. Lippincort and Dr. H.A.
Johnson of Brookhaven National Laboratory for the histological
examination,
evaluated relative to American statistics, butit
can be said that theblood pressures do not exceed
those commonly found and probably are lower.
There was a generalfeeling that conditions like
hernia, varicose veins, hemorrhoids, and vaginal
prolapse were much less common than one might
anticipate in examining a random groupof people
of similar age in our society. Oneinteresting finding was a relatively high incidence of kyphosis.
While this is commonin older people in our own
population, it was particularly striking in the
Marshallese, because it appeared to be localized
to the lower thoracic and lumbar region. Fungus
infections of the skin, partcularly Tenia versicolor,
were widespread.
Growth and Development Studies
Cross sectional data on height and weight and
bone age determinationsfor the 2- and 3-year
surveys gave an impression oflag in growth and
development in the exposed children compared
with unexposed children of the same age. However, in an attempt to obtain moreaccurate birth
dates of the children for the 4-year survey, the
ages of some of the children, previously thoughtto
be well established, were found to be questionable.
The absenceof recorded birth information seriously complicates the determination of the accuracy of given chronological ages and dates of
birth. More definitive evaluation of data will be
possible when verification of birth dates is completed. Detailed geneological and biological histories are being compiled to establish the most
probable birth date of each child. (Unfortunately,
the 1958 roentgenogramsof the wrist and knee,
intended for assessment of osseous maturation,
were lost at sea. )
In addition to cross sectional studies, longitudinal studies of incremental growth data and bone
maturation studies over the period since exposure
will be undertaken when the ages of the children
are better established.
Ophthalmological Examinations
Table 2 shows the major ophthalmological
findings. Generally the Rongelap people, exposed
and unexposed, showed superior vision and accommodation. The majority of disorders were
found in the conjunctiva, cornea, andlens. Irrita-
tion of the eyes from bright tropical sunlight and
exposure to coral dust probably play a part in the
high incidence of conjunctival and corneal detects.