a D. HORMONE TREATMENT J 1905, the seriousness of the development of Vayreid lesions in dhe Rongelap people was recog: nized, and a panel of experts was called together loceviewthe findings and make recommendations tegarding the passibility af initiating preventive therapy! 24 Phe concensus was that the more heavily exposed Rengelap group should be placed ob epiicement Unyraxine for lle sn order ta tre 4 SED secretion by the pituiary ghind, bt was Raped that nullifying the stanutanig aciivity of this losin onthe thyroid would ailabit devel. opment of benign adh matigiant nedules, acd are sagtap Haat geowal snd development te the hota detcient children would be riproved. Phe passt lite af development of pituitary tumors, whieh his bern noted ia hypothyroid woinals®? aod hue dian betas. ight be prevented. Etlieal cons siderations ruled out randomized dinical trials of therapy. Syuthede t-thyraxine (Svathroud, Flint Drug Cra.) which aight be mare stable than dessicated thvroid ander trapieal coucitivns, wis recom. mended ata dase af (os ig, dav for peaple od sears of age and O.2 aig /day for those > 0. VreatHint wats supervised by the denleh aide, lat dit. culties i inaintaniig a strictly rewular treaties Figure 37. Same comparison as in Figure Mi, for subject No. J and bis younger brother (No. #4) regimen soon became apparent. Enoan effort to overcame this problem it was found that giving the entire weekly dose at one time was etlective and safe, and resulted in maintenance of aormal fevels of thyroxine"? Even on this simplified treat. ment schedule a few of he peaple, iieluding same whe had undergone thyeatdectoay, showed law thyroxine levels indicating that they were nat cote wstonthy taking the medication, CPhis wis ane of the reasons dur establishing the post of resident plvsiciau tothe Istands in BU 2 re mentor the tritiaent programas well as other healih care.) Foe 1 people aathis regimen who developed above. hormal Vy levels, awociited with comptabiis of nervousness and pulpitatasn. the dose wa reduced, Tn view of the recent appearance of thyroid nod: ules wong dhe Nilingaae group and ina subject exposed aeuters. all persons exposed on the atoll are now diebuded inthe treatuent progran. The hormone therapy has unquestionably enhanced growth and development is the wrowt le retarded Rongelap children (Figures 21. 36, and 47 show the taiprovement in dhe two niost stunted Figuie 3G. feft: Subject Naw S$ (shortens and his vounger Voccthwer (Noo Uo b aan 1Mb, Beek: Sac two bays in 1974 alee Nooo had been given thread horde for i years. bows. However. the benetit of such treatnent re: garding development of nodularities inthe thyroid uncertain. OF the children exposed at age < 10 yearn in the more highly exposed Rongelap greup, ouly twe have not developed lesions. The less ex- poscd Ailinggroup, in whieh development of