20 shownin Figure 8. Because of language barriers, Table 13 such tests are difficult to carry out. Cultural, Assay for Human Growth Hormone (HGH) in Exposed Marshallese Children Subject No. Timeafter insulin, min Blood glucose, mg/100 ml HGH, ng, ml* 2 25 31.6 4.0 3 30 89.6 < 2.0 33 25 34.0 6 8 54 a+ 65 65 83 25 23 15 30 i5 27 30 26.9 29.0 67.1 35.6 33.6 22.6 38.1 < 2.0 5.0 <2.0 <2.0 3.0 4.0 2.0 3.0 *Assayed by Dr. J. Roth, National Institutes of Health, Bethesda, Maryland. The normalfasting level is 0 to 3.0 nanograms/mi, with at least a 3- to 5-fold rise 60 min after insulin injection. tosplenomegaly. Another child (No. 1055), also born to nonexposed parents, had diagnosticstigmata of mongolism. The results of examinations of the neck and thyroid gland are summarizedelsewhere in this report. With the exception of the thyroid nodules, no correlation between the devel- opment of abnormalities in children and exposure to radiation could be suggested. In 1965 assays for human growth hormone levels were done on blood specimens obtained from 8 exposed Marshallese children. After an over- night fast, crystalline insulin was injected intravenously at a dose of 0.1 mg/kg body weight. Blood was drawnat 15 and 30 min. Theexisting circumstancesin the field precluded the continuation of the hypoglycemic state beyond 30 min. The hormone values were determined by the method of Glick et al.'® The results are summarized in Table 13. Even thougha higherlevel of growth hormonesecretion might have occurred ifhypoglycemia had been prolonged, measurable amounts of human growth hormonewere found in all children tested. The 2 markedly physically retarded boys were amongthe8 studied. Whenit is noted that TSH secretion is also adequate in these chil- dren (see section on thyroid gland), the results qualitatively document the existence of anterior pituitary gland function. Goodenough “Draw a Man” tests*® were taken by a numberofchildren. Someof the drawings are social, and educationalvariables also complicate the scoring. The figures are being analyzed with the hope that numerical scores may provide some measure of mental development in the growthretarded children. A detailed analysis of the growth and development data on the Marshallese children during the period 1958 through 1963 has been published.” The analysis has been extended to include the growth measurements for 1964 and 1965. In 1966 the unexposed (control) children were not exam- ined. The trends revealed previously have con- tinued. Amongthe girls, there is no significantdif- ference between exposed and unexposed children in either the statural or weight curves (Figures 9 and 10). Thereis no significant difference in body weight between exposed and unexposed boys(Figure 11). Among the boys only, the statural growth of the exposed lags below that of the unexposed subjects (Figures 12 and 13). This difference in stature is better delineated when age at expo- sure is considered (Figure 13}. Thus, boys exposed at ages >6 years show nodifference in statural growth from that of unexposed boys. Boys exposed at ages 2 years and younger show the most prom- inent retardation. Analysis this year indicates that boys exposed at 3 to 5 years of age are also show- ing somelag in statural growth. Children born to exposed parents have demonstrated nosignificant difference in statural and weight growth as com- pared with children born to unexposed parents (Figures 14 to 17). Skeletal age assessmrents by the method of Greulich and Pyle’? have been plotted against chronological age in boys (Figure 18) and in girls (Figure 19). The lines represent the best fitting linear relationships by the least-squares method. While the curves for the exposed group (both boys and girls) fall to the right of the curves for the unexposed, the differences are not statistically signifi- cant. The points representing the markedly growthretarded boys are immediately apparent from inspection. The graphsalso indicate that the skeletal age assessments at given chronological ages for the Marshallese boys andgirls are lower (by about 6 to 12 months) than the Greulich-Pyle standardsfor Americanchildren. Since September 1965 the exposed children have been given courses of thyroid hormone.