PATIENT NO. 2 (continued) ry L and X-Ray Thyroid Workup: Data: PBI 6.2 we%, iodine fractionation, 167 meh with LTi LBze » chyronine fraction (T4+T3) 4.2 pg%. Cholesterol Thyroid -23%. BMR 1:16. 143 mg% esters. Thyroid autoantibodies titer under 132 lesser a to and scan (39m) showed possible nodularity of the right lobe, extent cf the lower lobe. Chest x-ray showed no diseases or abnormalities. uptake st.udy showed an uptake of 39% at 6 hours. PBI 5.4. I Following TSH stimula- tion for three days, the uptake showed a slight decrease at 5-1/2 hours over the value before TSH stimulation. Blood Electrocardiogram normal; sed rate slightly elevated (21 mm). count within normal limits except slightly low RBC (4,100,000) and hemoglobin 12.7 gm. Alkaline phosphatase was slightly low (4.5 units). slightly elevated (8.5 gm with globulins up to 4.5 gm). Total proteins These are typical Normal values were found for prothrombin time, values for Marshallese people. bilirubin, cephalin flocculation, transaminase, calcium, P, thymol turbidity, Urinalysis and stools for ova and parasites were both FBS, BUN, CO2, Cl, Na, K. negative. The patient’s hospital course here was uneventful, and he was Unspital Course: ‘transferred to New England Baptist Hospital, Boston, for surgical exploration of Dr. Bentley P. Colcock, under general anesthesia, removed his neck on July 5. a 1.2 cm diameter nodule from the right lobe of the thyroid gland, including some surrounding thyroid tissue which contained multiple small nodules. nodules varied in color from pale gray to deep red. The From histological examina- tion of the tissues, a pathological diagnosis of adenowatous goiter was made. His recovery from the operation was rapid and subsequent course was uneventful. He was returned to this hospital on 7-13-65 and was discharged on 7-18-65, fit to travel back tc Diagi is: he Marshall Islands. Adenomatous goiter. Discharge Medication: No immediate drug therapy. It is anticipated that he will be put on thyroid 180 mg daily for life in September along with the other exposed Rongelap people. Follow-'Ip: Patient has remained in good health and apparently euthyroid on 3 mg levothyroxine daily. In March, 1966, he was taken off thyroid therapy for three weeks for test purposes. At that time he showed good thyroidal function by 1327 uptake though his TSH Level was slightly elevated (26 mg/ml}. No recurrence of nodules has been noted, PATIENT NO, 20 AGE 18 SEX M HOSPITAL Hospital of Medical Research Center, BNL DATE June, 1965 This 18 year old Marshallese male was admitted to this Hospital for evaluation of a thyroid nodule which was discovered during this past March. History of Present Illness: During the annual physical examination in March, 1965, this 18 year old boy was found to have a small i cm nodule of the right lobe of the thyroid gland. He was one of the group of 64 people who had been accidentally exposed to fallout in 1954. It was estimated that he had received a whole body 100