Protocol

1974

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may be important in cases that might develop cardiac problems.

Four

Therefore

this group will be taken off thyroxine prophylactic treatment beginning
(The 23 people who have had
January 15, 2 months before the survey.
atrophy, will not be
thyroid
with
boys
2
the
thyroidectomys including
that their thyroid function
known
already
included in this study since it is
great importance in this
of
is
is ‘abnormal and continued thyroid treatment

group.)

In order to test thyroid function in this study it is planned

to measure thyroxine (T-4 and T-3) and TSH levels on an initial blood sample

followed by administration of 10 units of TSH and another blood sample
drawn 24 hrs later for measurement of thyroxine levels and clinical
exam of the thyroid. About 10 unexposed Rongelap people will be similarly
tested.

Dietary Iodine and Iodine Excretion Levels: Iodine in the diet may
by testing the level of this element in representative meals
evaluated
be
which will include local fruits and marine life. It has always been
thought that the iodine level in their diet should be high and this will
test this assumption. Urinary excretion of iodine, tested some years
ago, was in the low-normal range and this test will be repeated on aliquots
of 24-hr urine samples being collected for radiochemical analyses. These
studies may also be done in some of the Utirik population since their

diet is presumably less “westernized".

There are two other thyroid studies which may require some
supplementary information:
(1) excretion rate of iodine in children
using 129] is in progress. Activation analysis for measurement of urinary
iodine on urines from 2 children given this isotope is being measured up
to 16 days. This study is designed to help evaluate the thyroid dose
received by children which has been based on an excretion rate of 0.1% of
thyroid burden being excreted in the urine at 15 days after exposure
(the time of the first urine collections).
The other study (2) is an
evaluation of iodoprotein levels which are unusually high in the Marshallese
people. Jack Robbins, Ed Rall and I are particularly interested in
investigating the environmental and genetic aspects of this finding.
Other ethnic groups are under study.
One study in progress concerns the
use of orally administered 1297 with plasma collection before and at 2 and
4 days to determine possible incorporation of orally ingested iodine in the
various serum iodine fractions.
This study is of a preliminary nature
and depending on the outcome, further sampling of the population may be
indicated,
Diabetic Study: Diabetes in the Marshall Islands, along with cataracts.
is considered to be of unusually high incidence.
The Trust Territory
Medical Personnel at the district centers have been quite concerned about
the problem and have requested our help in any way possible.
In response
to this request, although we have not seen any connection between diabetes
and radiation exposure in the Rongelap people, we are anxious to help if
possible.

We are therefore fortunate in having Dr. James Field, an expert

in this field, participate in the survey and perhaps suggest further
procedures for evaluation and therapy of this disease in the Marshalls.

Select target paragraph3