9 and hand for bone development studies); studies of aging criteria; special examinations of the skin with color photography ofselected lesions; ophthalmological studies including slit-lamp observa- tions, visual acuity, and accommodation; audio- metric examinations; cardiovascular survey; and X-ray examinations as deemed necessary. In 1959, 96 exposed people, including their children, and 166 unexposed people were examined on Rongelap. Cardiovascular Survey. In view ofthe possible association oflate effects of radiation with cardiovasculardisease, the following cardiovascular survey was carried out. 1. Clinical histories recorded present and past health and illnesses, especially cadiac and pulmonary symptoms. 2. Physical examinations included the usual observations in the cardiovascular system in regard to the rhythm andrate of the hear; the nature of the heart sounds and murmurs, if present; the size and shape ofthe heart by clinical indications, changes in the arterial walls as observed by inspection of the retinal arteries and bypalpationofthe radial, brachial, and dorsalis pedis arteries; and the appearance ofthe veins. 3. Instrumental procedures: Systolic and diastolic blood pressures were obtained with the cuff-type aeronoid sphygmomanometer. Oscillometry readings were obtained from both legsat calf level by the Collins type of oscillometer. The highest of the readings obtainedat different pressure levels was used as a single reading for each subject. Electrocardiograms were taken on people 20 years of age and over (84 unexposed and 38 exposed individuals). The electrocardiogramswere taken by a Sanborn Direct Writing apparatus which had been specially shock mountedfor field use.*’ In almost all subjects the electrocardiograms were taken with 12 leads, to include three standard bi- polar limb leads, three augmented unipolar limb leads. and six unipolar or V chest leads in accord with the standard 1 2-lead procedure recommended by the American Heart Association. The tech- nical quality of the electrocardiogram was in most instances relatively good, but there were two handicaps. The electric power for the instruments was obtained from a generator on the LST byrunning a cable ashore to outlets in the various build*We are most grateful to the Medical Equipment Research Deparment, U.S. Army, Fort Totten, N.Y.. for use of this instra- ment on a permanent loan basis. ings used for the medical examinations. Induction currents often caused interference, and grounding of the instruments at times was difficult. There were also technical variations because of variable line voltage and amperage. X-rayfilms of the chest were taken on selected subjects when indicated. The number taken was kept to a minimum to avoid additional radiation of the exposed people, even though the dose involved was extremely small. The films were used chiefly for the study of the lungs and, to someextent, for measurement of heart size and shape. Chest films were obtained on 11 subjects in the unexposed group and 7 in the exposed group. It should be pointed out that there was no standardized basal or adjusted level of physical activity, such as resting for one hour before taking the tests. The patients were seen in the course of the usual examination, as might occur in the outpatient department of a hospital. DOE ARCHIVES Arthritis Survey. During the course of other studies on the Rongelap population, it was possible to obtain information on the prevalence of arthritis and allied phenomena. Sincelittle is known of the prevalence of these diseases in trop- ical populations, any such data would be a contribution to the “geographic pathology”of the arthritides’ besides being of interest in connection with the possible adverse influence of radiation ex- posure on degenerative diseases. X-rays of the hands and wrists were graded for osteoarthritis on a scale of 1+ to 4+ bythe method of Kellgren and Laurence® as modified by Blumberg et al.° The same x-rays were used to detect any cases of rheumatoid arthritis, other arthritides, or bony abnormalities.* A small aliquot of serum (0.3 to 0.5 ml) was used to deter- mine the presence of “rheumatoid factor” bythe bentonite flocculation test of Bozicevich et al.’* In this test, a titer of 42 or greater is considered positive, “46 doubtful, and anytiter below “6 negative.* A joint examination on each of the Rongelapese was performed bythe medical examiners, and anyindividual with significant joint findings was re-examined byone of the physicians experienced in the diagnosis ofJoint disease. Treatment of the joint disease was undertaken where indicated. *We are indebted to the following personnel of the National Institutes of Health: Drs. R.L. Black, J.J. Bunim, and E.G.L. Bywaters for reviewing the x-rays: and Dr. K. Bloch for performing the bentonite flocculation test. 1S