21
parents. It was interesting that the boys born soon
after the fallout had more retarded skeletal ages
than those born more recently, and that the skeletal ages of all boys were slightly more retarded in
1962 than in 1961 (15 months as compared with
13 months). However, the differences were not
Statistically significant, and the data available at
this time would not support any conclusion concerning factors related to the retardation of skeletal maturity in these boys.
CANCER DETECTION, LEUKEMIA SURVEY
Examinations as thorough as possible under
field conditions were carried out for the detection
of malignancy. All rumors were recorded. Most of
the tumors seen were of the benign type of the skin
and subcutaneous tissues. One exposed woman
(No. 64) had a tumorof the fourth left phalanx;
this was surgically removed, and histological examinations showedit to be a benign giantcell type.
No malignant lesions were detected in either the
exposed or unexposed groups. Pelvic examinations
were carried out on the sexually mature females
(except when pregnant). Cervical erosions, lacerations, and prolapse were noted with great frequency. Papanicolaou’s staining was carried out
on vaginal and cervical smears in those women
that had not had the procedure done during the
past survey. None was positive for malignant
cells. As noted last year, the secretions were scanty
in most of the women, and the smears were
consequently somewhat dry. Inflammatory reaction with the presence of blood in the smears was
common. A numberof cases of endocervical atypia
and trichomonas infection were noted. The resuits
of the individual examinations are reported in Appendix 5.
Rectal examinations were carried out on all
adults, and proctoscopic examinations were done
when indicated, Several cases of prostatic enlargement were noted but no evidence of malignancy
was apparent.
In view of the increased incidence of leukemia
reported in the Japanese and others exposed to
radiation, careful examinations for this blood dyscrasia are carried out annually on the Marshallese.
On physical examination, no evidence of lymphadenopathy, splenomegaly, or other signs of leukemia were detected. Hematological examinations
showed no excessive leukocytosis or increased
numbers of immature leukocytes. Basophil counts
on 4000 leukocytes on each individual showed no
elevation except in one 9-yr-old exposed boy who
has shown about a 3% basophil countover the past
few years. However,in this case no other evidence
of incipient leukemia has been apparent. Alkaline
phosphatase studies on the blood smears show that
although some people had low levels, this finding
was not associated with any other findings suggestive of leukemia (see Appendix 4).
RESIDUAL BETA BURNS
Table 9 lists those cases that showed residual
skin changes in areas previously exhibiting beta
burns. Variation in pigmentation, hyperkeratosis,
atrophy, and scarring in varying degrees were
noted in these cases. The development of pigmented macular and papular (nevus-like) lesions
in areas of the skin that had sustained beta burns
wasfirst observed several years ago. These lesions
appear to be increasing slightly in number. Similar
lesions are also occasionally seen in the unexposed
group. Figure 16 shows the appearance of acute
beta burns in an exposed woman several weeks
after exposure and Figure 17 shows development
of pigmented nevus-like lesions at 8 yrs post exposure in the skin area previously involved with beta
burns. A nevus was removed in one case because
of a complaint of irritation by clothing. The histological report on this lesion was as follows: ‘“Fragment of skin with abundant pigment in the epithelium. In a small area, there is a superficial
infiltration of dermis composed of nevustype cells
and pigmentary cells. No evidence of malignancy.
Diagnosis: nevus pigmentosus.”
None of the residual changes noted in the skin
showed any tendency to chronic radiation derma-
titis or ulceration and none showed any gross evi-
dence of malignant change. During the next survey
it is planned to carry out an extensive biopsy program with histological study of skin lesions.
STUDIES OF AGING CRITERIA,
DENTAL SURVEY
Studies of aging criteria and a dental survey were
not carried out during this annual examination.