om:
31
13 and 18 years of age and in a 41-year-old
woman, thefirst adult case. Two cases of hypothyroidism in growth-retarded boys were also
noted atthis time. In September 1965 a further
examination wascarried out by two of us (R.A.C.
and J.E.R.), and 5 more exposed people were
found with nodules varyingin size from 2 to 8 mm.
One of these was a 45-year-old woman in the
group that received only an estimated 69 rads.
The cases up to this point were recently reviewed.”
In March 1966 nodules of the thyroid gland were
detected in 5 additional exposed children. Table
17 gives some pertinent data on all these cases.
Table 18 showsthedistribution of the thyroid abnormalities (nodules and hypothyroidism) by age.
In Table 19 results are presented on the various
populations studied along with the estimated radi-
ation dose to the thyroid gland. It is noteworthy
a
that the preponderanceof thyroid abnormalities
have occurred in children exposed at <10 years of
age and only in the more heavily exposed group
(15 of 19 children, 78.9%). No cases with thy¥@id
abnormalities weredetected in the children in the|
decided that 5 such cases should be broughtto the
United States. These cases had not shown reduction in nodule size, though presumably they had
been on the hormone therapy for the 6-month
period. Four children with thyroid nodules who
were not considered to have had an adequatetrial
therapy with thyroid hormone wereleft in the
Islands to be re-evaluatedlater. In one 40-year-old
man a nodule had disappeared, presumably as a
result of therapy.
Surgical Cases
Of the 16 cases with nodules, a total of 11 have
had surgery. In 1964, the first 3 cases in teen-age
girls were operated upon* at the U.S. Naval Hospital, Guam.'°** In July 1965, 3 cases were brought
to the Medical Research Center at Brookhaven
National Laboratory (Figure 22) and later taken
to the New England Baptist Hospital, Boston, for
surgery.** In May 1966, 5 additional cases were
brought to Brookhaven for further examinations
(Figure 23
takentpthe-New Eng-
land Desert
icealin Bostdi-for s& urgery.**
lower exposure groupsof the same age ranged® . =:, At Brookhaveg, detailed thyroidstudies wereCar132] ahd "Tic.saptake studies
Ailingnae children, 40 Utirik childreg)}or in the +~ # ried out, ingluding?
andscansbefore aj aftez TSH¥dmigistrationt
61 unexposed Rongelap children. Two adults with and measuregyent offpasalmetaboliem sate, serum
thyroid nodules were noted in the mote heavil#"
protein- boutidjoding, sem deine
thie
(7, ) level,
exposed Rongelap group and onein the Ailingnae
group. In the Utirik and unexposed populations a
low incidence of thyroid |nodules was found, and
these océurred only in+
Ider age group.
and serunmancithyrdglobglin a#igibolly
iter. Brief
roid abnérmalities in the Marshallese, it was de-
upon, the-@ignd&
In viewofthe}‘potellabteriousness of the thy-
cided thatthecxpoas.pgpple should receive thyroid hormone Ege mesit r the remainder of,
lives in order $@ sy
RISH secretions,
treatment mightpf
her development of
nodules and posgibly Sigime regression ofexilting
hospital summary-reports on thse casts are presented in Appendix§.
Gross Appearg
In all 9 childreni operated
were found at surgery to be
multinodullggralthoughiin some casga
atic nodules
had appeagedr@fmically to be solitarge?Bee nodules
varied in ciggeter from a few gg
in consist
x
eral cm,
gtively hard
r red. Cyst
nodules. The ttgales ami
growthin ret
Chile
timeof the Septsinber 19
the more heavggexposed
thyroxine afi laily dose‘of 0. 3 mg to all people
<50 years of age and 0.2 mgto all people >50.
mal. In therother adult (No..4§§
ideathat,if at the time of the next survey (March
two firm, yellow, malignant nodules|‘about | cm
in diameter (Figure 26).
The new cases with thyroid nodules wereleft in
the Islands under hormonetreatment, with the
1966) the nodules had not regressed or further
nodules had developed, consideration would be
given to bringing them to the United Statesfor
study and possible surgery. In March 1966 it was
did not show multiple nocisdér4 aut:
“Surgery was performed by Captain C.A. Broaddus, MC,
USN.
**Surgery was performed by Dr. B.P. Colcock of the Lahey
Clinic.
{Weare grateful to Dr. H.L. Atkins for these analyses.