422
8 years post exposure it was noted that two boys
the thyroid gland. Development of thy rot abaor-
2720-08 They had been exposed at one year af age
and gradually developed atrophy of the thyroid
quens years 43 At present (197 b) 20 of Bo ex.
posed people of Rongelap are allected, including
were particularly stunted in growth (Figure
malities in other subjects continued during subse-
dry shin, sluggish reflexes, and bony dysgenesis of
gland and signs of myxedema with pully faces,
the twa stunted bors who developed thyrocl
atrophy without modularity, Qe of b children es-
younger and had been exposed anatea, bn boos, a
sutistactory thethou for serui thy conte aescaly sia
romaining af risk (persons living ie btd, at the
tine of appeanimce of the tive absarenatities |,
the Geen is for continued developanedt of besicais
the humerus and femur (sce Figure 26). Phew beo
bovs (Nos. 3 and 3) were considerably shorter
than heir brothers (Nos. 83 and Bb) who were
by ion exchange column beeane available. Stud:
ies Dv this method stowed that some of the chil
deen did indeed have law serum thyroxine levels.
Control studies on ner tual Marshallese revealed
that ounaf them had unusually high jodopre-
tia levels, leading tofale inter pretadion of por
tein bound iodine (PM determinations. dt became
apparentonty then that low thyrosine (V,) levels
in seme of the children lad probably Deva muuskea
by high levels of iodoprotein.!’"*4 Several children
with slight growth tehirdaton did lowered Tb,
levels. The hypothyroidism appeared tube fron
plumary thyroid damage and net secondary to
pituitary damage, since levt for grawth hari
in several growtheretarded children were nocnal,
and their serum thyroid-stimulatiog bormnenue
CUSIE) levels were clevisted,
B. DEVELOPMENT OF THYROID NOOULES
In 19603, 0 veary after exposure, a Tl-year-old
Wirl wats found to have an asyinptosnatic nodule af
posed ueatery developed tivroid nodules an lb.
Figure 20 shows that, considering the population
WIth Tecct nereases eng the loweree s posiae
Silognae group. Palbbe 2 lists the tharoid status
WMallesposced Kenueclap people abd of people with
postive fnuiiais an certain other pepuliatietis,
The thyroid nodules were usually multiple.
were not tender, aud varied in size frou several
nullimeters to several ccatiineters in disnieter, br
some ofthe children nodular ghinds were joss
ated with low chyrosineg levels and slight grows
retardation. The two stunted boys (Nus, band 31
showed markedly reduced thyroxine levels, None
of the adualis with nedublarity toad low thytuare
fevels prior to surgical exploration. Uhe growth re-
Liordanon with reduced disroxine level appears to
be the result of cadiation iajury to Che thvroid ina
the children (see Section Ey below),
Vable 25 fists the rncidence of beniun and miss
Vigtisttot lesscuas sored thie estionteal clewer ad risckietion
to the chyroid glands athe vartous populstions,
The bighest ineddence of lesions (So) lias been
noted among these in the heavily exposcd group
who were UW vears old at the tie of the aceident. The albscace of lesions aan those of corre:
sponding aves an tlic less expescd Codd grep acl
the unexpescd groups is autable, but Loaf tox.
T
posed children ia the Milingnae group lave ree
cently developed lesions. “Phe dacidence of chivas
lesions aniong the cxapeacd Kaagelap acelts is con
siderably lower than that amoung the childern but
Penecaet Uavecl
be naas (erandalive |
Ko aige lige
Nabirngriae
Uuak
Ca ntatenad
higher than amen the Ciik or aaes paused
groups, Phe Utirsk group docs not appear te hive
hada higher incideae|r of thyroid bestons tia the
~_
ee dana cb nn aop van arene de TNE Om
ae
Wa
gt
ob
TED
ee aa te
Year alter expeaure
Figure 29. Cuniulative percentages of persans with thy-
roid lesan in exspamed Kongelap, \ddingnac, and Utirik
groups end ib unexpuacd Rangeiip contral group since
Dh, based on aibens of perenne ia the groups in bare,
Ihe Gane when tadiation-tiducer) lesions were first noted.
uncsapescd geaups, butione Uiaik individual de-
velaped cancer ol the thyresed.
C. SURGICAL EXPLORATION
Ta viewof the posibly malignant tatare af ihe
thyroid nodules is ihe expescd population, suru:
cal exploration of the affected tiyraids, with retneval of tuxdules, was coasidercd necessary. Thy: