PATIENT NO, 2 (continued) Laboratory and X-Ray Data: Thyroid Workup: PBI 6.2 «2%, iodine fractionation, total I 7.1 wg%, thyronine fraction (T4+T3) 4.2 ug%. Cholesterol 167 mg%, with 143 mg% esters. Thyroid autoantibodies titer under 1:16. BMR -23%. Thyroid scan (79m 6) showed possible nodularity of the right lobe, and to a lesser 132 extent of the lower lobe. Chest x-ray showed no diseases or abnormalities. I uptake study showed an uptake of 39% at 6 hours. PBI 5.4. Following TSH stimulation for three days, the uptake showed a slight decrease at 5-1/2 hours over the value before TSH stimulation, Electrocardiogram normal; sed rate slightly elevated (21 mm). Blood count within normal limits except slightly low RBC (4,100,000) and hemoglobin 12.7 gm. Alkaline phosphatase was slightly low (4.5 units). Total proteins slightly elevated (8.5 gem with globulins up to 4.5 gm). These are typical values for Marshallese people. Normal values were found for prothrombin time, bilirubin, cephalin flocculation, transaminase, calcium, P, thymol turbidity, FBS, BUN, C02, Cl, Na, K. Urinalysis and stools for ova and parasites were both negative. Hospital Course; The patient's hospital course here was uneventful, and he was transferred to New England Baptist Hospital, Boston, for surgical exploration of his neck on July 5. Dr. Bentley P. Colcock, under general anesthesia, removed a 1.2 cm diameter nodule from the right lobe of the thyroid gland, including some surrounding thyroid tissue which contained multiple small nodules. The nodules varied in color from pale gray to deep red. From histological examination of the tissues, a pathological diagnosis of adenomatous 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 to the Marshall Islands. Diagnosis; 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. 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 1 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. 5008384 It was estimated that he had received a whole body 100 st Follow-Up: 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 mig/ml). No recurrence of nodules has been noted. i