Skin Careful exam with color photography of any suspicious lesions particularly in the area of previous beta burns. Biopsies if indicated. Other Special Studies Diabetes —- There is a high incidence of middle-age onset type hypdglycemia and/or. diabetes and it is the subject of a special study under the direction of Dr. James Field. Computerized data .will be available soon. Evaluation of the vascular and neurological status of diabetic cases should be attempted. Blood Sugars (Pre- and Postglucola) have already been studied in most of the.Rongelap and Utirik people, but a few additional tests may be necessary. Intestinal Parasite Survey and Treatment — During the past 18 months an intestinal parasite survey was completed at Rongelap Island by Drs. Krotoski and Knudsen. Studies include stool exams and serological studies (Immunofluor-— escence). The Rongelap people received mebendazole anthelmintic therapy (generosity of Ortho Pharmaceuticals) every three months. A similar study is currently underway on Utirik using pyrantal pamoate. Studies of Polymorphism and rare protein variance in blood of some children of exposed and unexposed parents as an index of genetic effects of exposure will be repeated by Dr. J. Neel at the University of Michigan. He has expanded his battery of tests which he is carrying out on the descendents of exposed Japanese. Laboratory & X-Ray Exams are outlined in Enclosure V. Clinical Reviews - The findings on physical examinations will be reviewed ‘in conjunction with laboratory and x-ray findings every few days and at the end of an island stay. Recommendations for further diagnostic procedures or treatment with possible referrals will be made to the Trust Territory. Treatment Every effort should be made to treat all conditions, even minor ailments, on the completion of the physical exam. Also at the outer islands every morning (usually 8~9 AM) Sick call will be held and treatment given when possible. An adequate supply of common drugs, that from experience are likely to be ap- propriate, will be available.. , Rapport In the past there have been some misunderstandings among the people regard- ing medical exams which have largely stemmed from communication difficulties. It is hoped that we can improve rapport by: having frank question/answer discus- sions at the village meetings, by educational talks by the staff, by patient/doctor conferences at the time of the physical exam, and by treatment of ailments wherever possible. In addition, at Rongelap and Utirik, gifts brought to the people will include food, clothing donations and eyeglasses for reading. The latter, based on previous years' experience, is particularly appreciated by the people. hoped to show movies at night and have a party before leaving the island. It is Personal Data Informal summer clothing (shorts and sport shirts) are all that are needed in the Marshalls. Don't forget bathing suit, sneakers, old shoes, face masks, and snorkel, hat, sun lotion, photographic equipment, writing material, etc. om gts ji JUQEGRnt has Physicians may wish to bring their own stethoscope but physical exam equipment