PATIENT NO. 69 (continued) day. She was discharged back to her island home on 10-27-64 with the recommendation that she take thyroid extract, grains 2 daily for an indefinite period. Follow-Up: Following release from the hospital the patient has remained asymptomatic and apparently euthyroid on 3.0 mg of levothyroxine daily. No recurrence of thyroid nodules has been detected. In March, 1966, three weeks after stopping thyroid hormone (temporarily for test purposes) her 1327 uptake showed little, if any, thyroid function. PATIENT NO. AGE 2 12. SEX -M HOSPITAL Hospital of Medical Research Center, BNL DATE June, 1965 This 12 year old Marshallese boy who was exposed to radioactive fallout in 1954 was admitted to this hospital to evaluate a nodule of the thyroid gland which was discovered this past March. History of Present Illness: During the annual physical examination (March, 1965) of the Rongelap people who were exposed to fallout radiation in 1954, this boy was found to have a small nodule of the thyroid gland about 2 cm in diameter. He was about 1 year of age at the time of exposure to radioactive fallout. He received an estimated dose of 175-200 rads whole body gamma radiation from the fallout and an undetermined dose of radiation (largely beta) to the skin along with some internal absorption of radioactive materials. It was estimated that the thyroid gland of a child this age had received roughly 700-1400 rads largely from the radioiodines absorbed. He experienced some nausea and vomiting during the first day or so which was believed related to his radiation exposure. His peripheral blood elements dropped to about one-half of the level of unexposed Marshallese people, but recovered to about normal by one year. Beginning about two weeks after exposure, he developed lesions of the skin from fallout deposition. These lesions were confined largely to the anterior neck folds, axillary, scalp and perianal regions. He also had extensive epilation. These lesions healed within several weeks and the hair began regrowing with complete regrowth by six months. He showed no other acute effects from his exposure. However, during the 10-year period since exposure he was found to show some degree of lag in growth, based on anthropometric studies as well as bone age studies. He has lagged a year to a year and one-half behind the unexposed children of the same age. This inhibition in his growth is believed to have been due to his fallout exposure, though the mechanisms involved have not been clear. There has been no evidence of thyroid malfunction. Two PBI readings taken in the past few years were in the normal range for the Marshallese people. Six years ago his cholesterol was 150 mg%Z and he remained in good health. Physical Examination: No enlargement of the thyroid was noted. A 2 cm diameter nodule, oval in shape, finely moveable, nontender but firm, was noted in the right lobe. The nodule moved on swallowing. No other nodules and no lymphadenopathy was palpated. The remainder of the physical examination was essentially negative. There were a few scars on the anterior neck region and in the perianal region, residual of previous beta burns. 9008383 OY