30 roid function has been greatly improved bythe use of radioimmunoassaytechniques for measur- thyroid lesions is more recent, has not been on treatment long enoughfor evaluation. The :n utero case was not placed on thyroxine treatment until after nodules iiad been detected. Thyroid lesions developed in several persons who were presum- ing T4, T3 (triiodothyronine), and TSH.88.89 Srudies of serum iodoproteins, which had resulted in artifactual elevations in the serum PBI in the Marshallese, are discussed below, as are morerecent measurementsof thyroxine-binding proteins and serum thyroglobulin. ably taking their thyroid medication regularly and who appeared to be euthyroid with normal thyroxine levels; on the other hand, thyroid nodules disappeared in two cases (Nos. 53 and 40) during thyroxine treatment(in the latter case, they recurred and were surgically removed). Eee -~s ~ - ae = TF L$ nad ro a . ~« Careful follow-up :studies om the-subjects who ehedcancer, inchid whale-body:sscansat Tripler Studies of thyroid function havealso included tests of radioiodine uptake and excretion on several occasions. In the field these were done with a 4Somewhat primitive apparatus (Figyye 38). 1321 was used to minimize the doseto the thyroid. More extensive and sophisticated tests were done on patients brought to BNL forevaluationprior to surgery elsewhere. These included tests of thvroid radioiodine uptake and scans (technetium-99m)} before and after TSH stimulation; determination ey MedicaGenter,haveshown,no signs ofreWo.clest-ci _Sg — as been seen of in the thyroid remnants in the benigncas ecause papillary thyrgid caréinqmaprogresses very slowly, long continued follgw-up observation is necessary. No deaths or acute tiinesses have been associ- of basal metabolism rate, cholesterol, antithyroglobulin antibody levels; and a variety of clinical chemistry tests. In a number of cases a smalt =. , amountof 1311 was administered prior to surgeryandthe function of excised thyroid lesions and surroundingtissues was studied by autoradiography.~~ - ated-withthe thyrofd abnormalities. Morbidity heagbece ted to the developmentof reduced et 2 = dfufiction-reqylting in varying degrees of =ahypothyroidism and %n one case of hypoparathy- One 48-year-old man (No. 40) briefly developed... acute thyroiditis after TSH administration. roidism follawing thyroidectomy. Thelackofstrict 2. Studies of Exposed Rongelap People With Thyroid Abnormalities compliance:with the thyroid treatment program in the operated cases involves the potential danger that serious hypothyroidism may develop, particulariy in patients living on the outer islands and therefore less frequently seen. eee i Se & “tf gb eg mA 7 . she - Pee. Measurement of caculating Ul thyroid hormone has been an important part of the evaluation of thyroid function in these surveys.-Duringthefirst 10 years it was done by PBI analysis and subsequently by ién-exchange chromatography(thyroxine by column). Since 1972 evaluation ofthy> ga *Ebyroid uptake studies were done at Rongelap in 1965 and Ti97EDr. J.-E Ral and in 1966 and 1973by Dr. J. Robbins. At BNL thyroid function studies were done by Dr. H.L. Atkins. PBI determinations were made by the Clinical Chemistry Section at BNL andbyBio Science Laboratories, Van Nuys, Calif., who also did other serum iodine analyses. T, and T3 by RIA, and dialvzable T,, TSH, and TBG by reverse-fiow electrophoresis were analvzed by Dr. P.R. Larsen at the University of Pittsburgh and more recently at the Peter Bent Brigham Hospital, Boston. TGB analvsis by RIA was done by Drs. M. Gershengorn and J. Robbins, and TG analysis by Drs. M. [zuma and J.-L. Bauheu. . = Evidence of thyroid hypofunction and reduced reserve was seenan afew of the children prior to surgery (Nos. 2, 20, 33, and 65) and to a greater degree in the two boya-who developed myxedema s _ ESFYOIES OF:BanepFFUNCTION"= ~ Figure 38. Thyroid function testing underfield conditions, 1966.