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: