21

parents. It was interesting that the boys born soon

after the fallout had more retarded skeletal ages

than those born morerecently, and that the skele-

tal ages ofall boys were slightly more retarded in

1962 than in 1961 (15 months as compared with

13 months). However, the differences were not
Statistically significant, and the data available at

this time would not support any conclusion con-

cerning factors related to the retardation of skeletal maturity in these boys.
CANCER DETECTION, LEUKEMIA SURVEY

Examinations as thorough as possible under

field conditions were carried out for the detection

of malignancy. All tumors were recorded. Most of
the tumors seen were of the benign type of the skin
and subcutaneous tissues. One exposed woman

(No. 64) had a tumorof the fourth left phalanx;

this was surgically removed, and histological ex-

aminations showed it to be a benign giant cell type.
No malignant lesions were detected in either the
exposed or unexposed groups. Pelvic examinations
were carried out on the sexually mature females
(except when pregnant). Cervical erosions, lacerations, and prolapse were noted with great frequency. Papanicolaou’s staining was carried out
on vaginal and cervical smears in those women

that had not had the procedure done during the
past survey. None was positive for malignant
cells. As noted last year, the secretions were scanty

in most of the women, and the smears were

consequently somewhat dry. Inilammatory reaction with the presence of blood in the smears was
common. A number of cases of endocervical atypia
and trichomonas infection were noted. The results
of the individual examinations are reported in Appendix 5.

Rectal examinations were carried out on all
adults, and proctoscopic examinations were done
when indicatcu. Several cases of prostatic enlargement were noted but no evidence of malignancy
was apparent.

In view of the increased incidence of leukemia
reported in the Japanese and others exposed to
radiation, careful cxaminations for this blood dyscrasia are carried out annually on the Marshallese.
On physical examination, no evidence of lymphadenopathy, splenomegaly, or other signs of Ieukemia were detected. Hematological examinations

showed no excessive leukocytosis or increased
numbers of immature leukocytes. Basophil counts
on 4000 leukocytes on each individual showed no
elevation except in one 9-yr-old exposed boy who
has shown about a 3% basophil count over the past
few years. However, in this case no other evidence

of incipient leukemia has been apparent. Alkaline

phosphatase studies on the blood smears show that
although some people had low levels, this finding
was not associated with any other findings suggestive of leukemia (see Appendix 4).
RESIDUAL. BETA BURNS
Table 9 lists those cases that showed residual
skin changes in areas previously exhibiting beta
burns. Variation in pigmentation, hyperkeratosis,
atrophy, and scarring in varying degrees were
noted in these cases. The devclopment of pigmented macular and papular (nevus-like) Icsions

in areas of the skin that had sustained beta burns
wasfirst observed several years ago. These lesions
appear to be increasing slightly in number. Similar
lesions are also occasionally seen in the unexposed
group. Figure 16 shows the appearance of acute
beta burns in an exposed woman several wecks
after exposure and Figure 17 shows development
of pigmented nevus-like lesions at 8 yrs post exposure in the skin area previously involved with beta
burns. A nevus was removed in one case because
of a complaint of irritation by clothing. The histological report on this Iesion was as follows: “Fragment of skin with abundant pigment in the epithelium. In a small area, there is a superficial
infiltration of dermis composed of nevus type cells
and pigmentarycells. No evidence of malignancy.
Diagnosis: nevus pigmentosus.”
None of the residual changes noted in the skin
showed any tendency to chronic radiation dermatitis or ulceration and none showed any gross evi-

dence of malignant change. During the next survey
it is planned to carry out an extensive biopsy program with histological study of skin lesions.
STUDIES OF AGING CRITERIA,
DENTAL SURVEY

Studies of aging criteria and a dental survey were
not carried out during this annual examination.

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