Elevated protein~bound iodine levels, characteristic of the Marshallese,
have been further evaluated,
The finding of an increased iodoprotein fraction
in the serum of these people is believed to part ly explain the increase in PBI
levels,
Urinary excretion of iodine was in the normal range in the Marshallese,
1327 thyroidal uptake studies showed a puzzling depression in uptake of the
thyroid to the isotope to about one-half normal levels,
There was also a
decreased excretion of the isotope,
Definite nodules of the thyroid were noted in 11. people, minimal
changes in five others, and hypothyroidism in two cases,
All but one case
occurred in the more heavily exposed population (55 living of the original 64
persons) who received about 175 rads of whole body gamma radiation, fallout
burns of the skin, and internal absorption of fission products.
One case
with a nodule was noted in an adult woman in the smaller Rongelap group (16
of 18 living) that had received less than half the exposure of the other group.
In the more heavily exposed group thyroid pathology developed in 58% of
children exposed at less than five years of age,
(the first six cases) have had surgery.
Five children and one adult
The nodules in the children proved to
be benign adenomatous goiters, closely resembling goiter of iodine deficiency,
The one adult case had a mixed papillary and follicular carcinoma with localized metastasis,
She had a thyroidectomy (surgical plus radioiodine).
The radiation etiology in these cases appears to be reasonably certain
in view of the following facts,
(1) The thyroid glands received a substantial
dose of radiation from radioiodines and external gamma radiation (adults about
300 rads, children about 700-1,400 rads).
(2) The high incidence of thyroid
pathology in the exposed group and lack of it in the unexposed people is most
SoG TUES