inations (for occult blood and parasites), and bacteriologic cultures (aerobic and anaerobic) with antibiotic sensitivity testing are available. Hemoglobin Ai. determinations, syphilis testing, and erythrocyte sedimentation rates are also provided. Serum is routinely separated and frozen for thyroid function tests and other studies which must be sent to commercial or university laboratories. Fingerstick techniques are used on young children wheneverpossible. An x-ray machine is available for most commonly required roentgenograms. Electrocardiograms are also available. Referral laboratories for studies mentioned in this report include: BioScience Laboratories in Honolulu (special chemistries, serologic tests); ‘Pathologists’ Laboratories, Inc., in Honolulu (Papanicolaou smear readings); the Endocrinology Laboratory at Brigham and Women’s Hospital, Boston (thyroid function tests); Hazleton Laboratories American, Inc., Immunoassay Department, Vienna, VA (prolactin levels); Hepatitis Branch, Division of Viral Diseases, Centers for Disease Control, Atlanta, GA(hepatitis B serology), Brookhaven National Laboratory, Clinical Chemistry .Laboratory (serum cholesterol, high-density lipoproteins, triglycerides); and Hematopathology Laboratory, University of California, Irvine Medical Center (free erythrocyte protoporphyrin assays). Medical Findings Recent Mortality The following seven deaths occurred during 1983-84: Rongelap Subject No. 80. At the time of his last medical examination in 1982, this 72-year-old man gave clinical evidence of chronic obstructive pulmonary disease. His cigarette smoking history exceeded 60 pack-years. Congestive heart failure was not considered to be the cause of chronic dyspnea. His electrocardiogram showed atrialfibrillation in 1981. It had been present since at least 1965, but his pulse rate was not rapid in 1982. He died in January 1983. Ailingnae None Utirik Subject No. 2194. When examined in March 1983 this 64-year-old woman had proteinuria, a serum creatinine of 2.3 mg/dl, a hemoglobin of 10.8 g/dl, and diabetic retinopathy. Proteinuria, anemia, and hyperglycemia had been noted as early as 1979, and diabetic retinopathy and a serum creatinine of 2.2 mg/dl were present in 1976. A papillary carcinoma of the thyroid was removed in 1976. A thyroid scan in January 1983 showed minimal residual thyroid in the region of the isthmus; no evidence of metastatic disease waspresent, although the thyroglobulin level was elevated at 64 ng/ml. The patient was advised to take thyroid hormone replacement, but compliance was poor. In January 1984 she died of a “massive cerebro-vascular accident” in the Majuro hospital following outpatient care of cellulitis. Subject No. 2157. Diabetes mellitus, mild urinary retention compatible with benign prostatic hypertrophy, and dyspnea on exertion associated with normal lung markingson chest x-ray were noted on this man’s 1983 examination when he was 55 years old. He died in January 1984 while residing on Utirik. The cause of death, as diagnosedbythe local health aid, was diabetic ketoacidosis. Subject No. 2168. This patient, a 47-yearold man, had chronic low back pain, a 1-cm left axillary lymph nede, and possible hepatomegaly noted in March 1983. His hemoglobin was 15.5 g/dl, and liver function tests were normal except for a slightly elevated serum aspartate aminotransferase level. He had no history of excessive ethanol intake. He died in March 1984 after being admitted to the Majuro Hospital for massive gastrointestinal bleeding. The death certificate identified bleeding from esophageal varices secondaryto liver cirrhosis as the cause of death. Serologic tests for hepatitis B, performed on stored serum from his 1983 examination, revealed a positive test for hepatitis B surface antigen. Subject No. 2185. In March 1983, at age 61, this man had achronic cough associated witha positive tuberculin skin test and a chest x ray showing no pulmonary disease. He was a cigarette smoker, and cardiology consultation indicated no evidence of cor pulmonale. His weight had remained stable. In January 1984, while returning to Utirik atoll from a fishing