16 None was positive for malignantcells. It was noted Table 4 that the secretions were scanty in most of the women, and the smears were consequently some- what dry. Inflammatory reaction with the presence of blood in the smears was common. Endocervical atypia was noted in a numberofcases. ‘The results ofthese examinations are reportedin Appendix 6. Rectal examinations were carried out on all adults, and proctoscopic examinations whenindicated. Several cases of prostatic enlargement were noted, but no evidence of malignancy was appar- ent. An ulcerating lesion was noted in a 66-yearold female in the exposed group (No. 30) in the upper rectum. Scrapings from this area indicated that it was an inflammatorylesion and not malignant. PEDIATRIC EXAMINATIONS During the 1961 survey, 155 children were examined (Table 4). All exposed subjects in the pediatric age group (< 20 years) were seen except for two (No. 67 and No. 76) who had moved to other atolls. The increase in number of nonex- posed children of exposed parents represents new babies born since the previous survey. New babies also increased the total of nonexposed Rongelap controls, even though a numberof children either becameold enoughto be transferred to the adult study or were lost to the study because of migration. The exposed and nonexposed group at Majuro wereall 6 years of age or older. All nonexposed children of exposed parents were <6 vears old. Of the 88 nonexposed Rongelap children, 38 were <6 years of age. The incidence of various physical findingsis summarized in Table 5. Adenopathy wasdefined for the purposesof this tabulation as the presence of (a) nodes 0.5 cm orlargerin all areas (cervical, axillary, and inguinal), or (b) nodes 1.0 cm or larger in the axillary regions, or (c) nodes 2.0 cm or larger in either the cervical or inguinal areas. The term “active chronic impetigo” includes several types of superficial skin infections. Many of these lesions probably represented secondaryinfections of lacerations and abrasions. The incidencesof otitis media and adenopathywererelated to age, both being more commonin younger children. Clinically active chronic impetigo was also found moreoften in the younger children; Children Examined at at at 22 2 2 0 2 2 26 + 19 2? 3 24 67 0 8 13 13 0 388 13 110 25 20 155 Rongelap Majuro Kwajalein Total Exposed Exposed in utero Nonexposed (exposed parents) Control Rongelapseries Majuroseries Total however, its incidence was higher in the exposed children (although the group wasolder) than in nonexposed Rongelap children of comparable ages. Its incidence was also higher amongthe nonexposed Majuro children, whowereall in the older group. As in 1959, the pattern of physical findings seemed unrelated to exposure to radiation. Growth and Development During the past several surveys considerableeffort has been expended to establish as firmly as possible the accuracy of the date ofbirth for each child. The medical survey records provided reliable written data for children born atter March 1954 and for some born immediately before the fallout. For the other children, however, the task of determining birth dates proved to be difficult, frustrating, and unsatisfactory. The reconstruction of the birth chronology was based on an intensive study and evaluation of very frequently contradictory information derived from the following sources: 1. Dates of birth as reported by parents. 2. Dates of birth as recorded occasionally in the village ledgers used for various purposes. 3. Limited numberof birth certificates on file at the court house on Majuro. 4. Birth order of children within each family unit. 5. Ranking of childhood population in termsof age by parents. 6. Ranking of childhood population in terms of age by children. 7. Correlation with memorable environmental events.