SESSION I] , 125 Eleven cases were operated on, nine children and two adults. Figure 17 shows the nodules at surgery. Note the hemorrnagic nodules. It turned out at surgery that practically all of these glands had multiple nodules whereas at the clinical examination we had only been able to feel one or two; at surgery in most cases the glands were pretty well shot with nodules. FREMONT-SMITH: Does this mean that a lot of other cases where you didn't feel anything also probably had multiple invisible nodules? CONARD: Yes, it's quite possible that we were unable to palpate minute nodules in some cases, | can't deny that. FREMONT-SMITH: Yes. CONARD: Figure 18 shows one of the glands in one of the children WARREN: Is that pigment or extravasated blood? that was sliced up just to show you the consistent nature, the multiple nature, of these nodular changes in the gland. CONARD: A lot of that is hemorrhagic blood pigment. The histological examination of these nodules showed that they wereall benign; they were of the type usually seen with iodine deficiency but, of course, we know that on Rongelap there's no iodine deficiency. The iodine level in the foods is .ormal and the urinary excretion of iodine, checked in quite a few of these people, has been within the normal range. Furthermore, we don't know of any goitrogenic foods on the Island. The evidence seems overwhelming that this is a radiationinduced phenomenon in these people. There was one case in a 40-year-old woman in which the nodule was malignant. Now, one can argue that this may be just a normal occurrence. A lot of people believe that cancer of the thyroid is not easily produced by radiation exporure, but certainly in a small group like this heavily-exposed one it has to be considered as a possibility anyway. MILLER: You said that there is overwhelming evidence that this is radiation-induced. You didn't mention yet that part of this evidence is observations made in other radiation-exposed groups. CONARD: Yes, that is certainly true. ; , ; yc