9 heart sounds and murmurs, if present; the size and shape of the heart byclinical indications; changes in the arterial walls as observed by inspection of the retinal arteries and by palpation of the radial, brachial, and dorsalis pedis arteries; and the ap- pearance of the veins. 3. Instrumental procedures: Systolic and drastolic blood pressures were obtained with the cufF-type aeronoid sphygmomanometer. Oscillometryread- ings were obtained from both legs at calf level by the Collins type of oscillometer. The highest of the readings obtained at different pressure levels was used as a single reading for each subject. Electro- cardiggrams were taken on people 20 years of age and over (84 unexposed and 38 exposed individuals). The electrocardiograms were taken bv a Sanborn Direct Writing apparatus which had been specially sock mounted for field use.* In almost all subjects the electrocardiograms were taken with 12 leads, to include three standard brpolar limb leads, three augmentedunipolar limb leads, and six unipolar or V chest leads in accord with the standard 12-lead procedure recommended by the American Heart Association. The technical quality of the electrocardiogram was in most instances relatively good, but there were two handicaps. The electric power for the instruments was obtained from a generator on the LST byrunning a cable ashore to outlets in the various build- standardized basal or adjusted level of physical activity, such as resting for one hour before taking the tests. [he patients were seen in the course of the usual examination, as might occur in the out- patient department of a hospital. Arthritis Survey. During the course of other studies on the Rongelap population, it was pos; sible to obtain information on the prevalence of arthritis and allied phenomena. Since little s knownof the prevalence of these diseases in trop- ical populations, anv such data would be a con- tribution to the “geographic pathology” of the arthritides’ besides being of interest in connection with the possible adverse influence of radiation exposure on degenerative diseases. X-rays of the hands and wrists were gradedfor osteoarthritis on a scale of 1+ to 4+bvthe method of Kellgren and Laurence® as modified by Blumberg et al.” The same x-rays were used to detect any cas: of rheumatoid arthritis, other arthritides, or bony abnormalities.* A small aliquot of serum (0.3 to 0.5 ml) was used to determine the presence ot “rheumatoid factor” by the bentontie flocculation test of Bozicevich et al.'” In this test, a titer of 42 or greater is considered positive, ‘is doubtful, and any titer below 16 nega- tive.* A joint examination on each of the Rongelapese was performed by the medical examiners, and anv individual with significant joint findings was re-examined byone of the physicians experienced in the diagnosis ofjoint disease. Treatment of the yoint disease was undertaken where indicated. h “We are indebted to the tollowing personnel of the National Institutes of Health. Drs. RL. Black, J.J. Bunim, and E.G_L. Department, US. Army, Fort Totten, NY, for use of this instru- By waters for reviewing the x-rays; and Dr. K. Bloch for pertorm- ment ona permanent loan basis. Ing the bentonite Aoccularion test. “We are most grateful to the Medical Equipment Res. ot vey was Carried out. 1. Cantal histories recorded present and past health and illnesses, especially cadiac and pulmonary symptoms. 2. Physical examinations included the usual observations in the cardiovascular system in regard to the rhythm and rate of the heart; the nature of the heart size and shape. Chest films were obtained on 11 subjects in the unexposed group and 7 in the exposed group. It should be pointed out that there was no . Awei vascular disease, the following cardiovascular sur- the lungs and, to some extent, for measurement of nea, In 1959, 96 exposed people. including their children, and 166 unexposed people were examined on Rongelap. Cardiovascular Survey. In viewof the possible association of late effects of radiation with cardio- a tions, visual acuity, and accommodation; audiometric examinations; cardiovascular survey; and X-ray emaminations as deemed necessary. Tay Th thalmological studies including slit-lamp observa- ings usec for the medical examinations. [Induction currents often caused interference, and grounding of the instruments at times was dificult. There were also technical variations because of variable line voltage and amperage. ¥-ray_fims of the chest were taken on selected subjects when indicated. The number taken was kept to a minimum to avoid additional radiation of the exposed people, even though the dose involved was extremely small. The films were used chiefly for the studyof 4, and hand for bone development studies); studies of aging criteria; speerat examinations of the skin with color photographyof selected lesions; oph-