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.