roid function has been greatly improved bvthe thyroid lesions is more recent, has not been on use of radioimmunoassay techniques for measurtreatment long enoughfor evaluation. The zm utero ing T4, T3 (triiodothyronine), and TSH.88.89 Studcase was not placed on thyroxine treatmentuntil ies of serum iodoproteins, which had resulted in after nodules nad been detected. Thyroid lesions developedin several persons who were presumartifactual elevations in the serum PBI in the Marshallese, are discussed below, as are more reably taking their thyroid medication regularly cent measurements of thyroxine-bindingproteins and who appearedto be euthyroid with normal and serum thyroglobulin. thyroxine levels; on the other hand, thyroid nodules disappeared in two cases (Nos. 53 and 40) Studies of thyroid function have also included during thyroxine treatment(in thelatter case, they tests of radioiodine uptake and excretion on sevrecurred and weresurgically removed). eral occasions. In the field these were done with a beat: Bel. OE sh oe somewhatprimitive apparatus(Fig) e 38). 132] ™Folloy-up 2 MER Cl BMT Oe “Giwas used to minimize the doseto the t id. More Caréful follow-up:studies on the'su bjects whe ‘extensive and sophisticated tests were done on paThadcancer,ioclu _ whale-body.sscans at Tripler tients brought to BNL for evaluation prior to surgery elsewhere. These included tests of thyroid =e ‘MedicatGenter,havesshown.no signs ofreradioiodine uptake and scans (technetium-99m) .Socaae as been seen of before and after TSH stimulation; determination eWopmeiber a in the thyroid remnants in the henign'case#.jnecause papillary of basal metabolism rate, cholesterol, antithvrothyrgid caréinqmaprogresses very slowly, long globulin antibodylevels; and a variety ofclinical continued faligw-upobservation is necessary. chemistry tests. In a number of cases a small * Nodeaths or acute iinesses have been associ- amountof 131] was administered prior to surgery ~~ idfunction:reqgltingiin varying degrees of roundingtissues was studied by autoradiography.~'. One 48-year-old man (No. 40) briefly developed-acute thyroiditis after TSH administration. - - ated-with the thyrofa abnormalities. Morbidity Be Bigisted to thedevelopment of reduced Shypothyroidinn and $n one case of hypoparathv- roidism follawigg thyroidectomy. Thelack ofstrict + ee, _ compliance:with the thyroid treatment program in the operated cases involves the potenual danger that serious hypothyroidism may develop, particularly in patients living on the outer islands and therefore lessfrequently seen. . * + 2. Studies of Exposed Rongelap People With Thyroid Abnormalities Evidence of thyroid hypofunction and reduced reserve was seen,an a few of the children prior to surgery (Nos. 2, 20, 33, and 65) and to a greater degree ir in the two boys-who developed myxedema Measurementof circulating thyroid hormone has been an importantpart of the evaluation of thyroid function in these surveys.Duringthefirst 10 years it was done by PBI analysis and subsequently by ion-exchange chromatography(thyroxine by column). Since 1972 evaluation of thy- tae" *Ehyroid uptake studies were done at Rongelap in 1965 and FA97EbyDr. J.-E. Radi andin 1966 and 1973by Dr. J. Robbins. Ac BNL thyroid function studies were done by Dr. H.L. Atkins. PBI determinations were made by the Clinical Chemistry Section at BNL andby Bio Science Laboratories, Van Nuys, Calif., who aiso did other serum iodine analyses. T, and T3; by RIA, and dia- lyzable Ty, TSH, and TBG by reverse-flow electrophoresis were analyzed by Dr. P.R. Larsen at the University of Pittsburgh and more recently at the Peter Bent Brigham Hospital, Boston. TGB analysis by RIA was done by Drs. M. Gershengorn and J. Rob- bins, and TG analysis by Drs. M. Izuma and J.-L. Baulieu. = Figure 38. Thyroid function testing under field conditions, 1966. og 30