60 FALLOUT EFFECTS—MARSHALL ISLANDERS which is not reported to be radiation induced in the exposed Japanese people (5). One death from cancer of the stomach in a Rongelap man exposed to 175 rads gamma radiation may have been related to his exposure. Acute myelogenous leukemia developed in a 19-year-old Rongelap male who was exposed to 175 rads of gamma radiation at | year of age (12) and had a subtotal thyroidectomy for removal of benign nodules at age 13. He was treated for leukemia at the National Cancer Institute but responded poorly and died 6 monthslater. Retrospective studies of his hemogramsindicated that he had had a relative neutropenia compared with other exposed and unexposed peers over a numberof years prior to his death. THYROID ABNORMALITIES It has been clearly demonstrated that the most widespread late effects of fallout exposure in the Marshallese have been related to radiation injury to the thyroid gland. With the development of thyroid hypofunction and benign and malignant nodules in the Rongelap population in the 2nd decade after exposure, extensive thyroid studies by thyroid experts have been carried out in both exposed and unexposed Marshallese.? Hypofunction A number of tests of thyroid function have been carried out by methods previously published (35,36). Serum samples have been analyzed for thyroxine (T,), thyroxine-binding globulin index (TBGI), triiodothyronine (T3), and thyroid stimulating hormone (TSH). Stimulation tests with thyrotropin-releasing hormoneand TSHandtests for iodine uptake, scans, etc., were done on patients hospitalized for surgery. In view of improved radioimmunoassay and othertechniques, retrospective analyses were done on stored frozen serum samples taken in earlier years. Thefirst indication of functional impairment of the thyroid was the observation, toward the end of the Ist decade, of growth retardation in some of the exposed Rongelap children. Numerous data have been collected on statural growth and osseous maturation in the exposed and control children over the years (13,54,55). In 1964 it was noted that two boys exposed at 1 year of age were stunted in growth and became myxedematous, and a number of other children exposed at less than 10 years of age had a slight degree of growth retardation. This was particularly true of the Rongelap boys exposed at less 2Some of the physicians who have been more actively involved in the thyroid examinations include Drs. D. E. Paglia (UCLA); B. Dobyns (Cleveland Metropolitan General Hospital, Cleveland); B. R. Larsen (Peter Bent Brigham Hospital, Boston); W. W. Sutow (deceased) (M. D. Anderson Hospital, Houston); J. E. Rail, J. Robbins, and J. Wolff (NIH, Bethesda); J. T. Nicoloff (University of Southern California, Los Angeles); B. Colcock (Lahey Clinic, Boston); W. Adams, H. Pratt, and K. Knudsen (Brookhaven National Laboratory); C. S. Hill, Jr. (M. D. Anderson Hospital, amr tos faos ad Pea ri at Houston); and D. D. Becker (Cornell Medical Center, New York).