[The research ethics committees].
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Biomedical subjects
Publications and source records attributed to F O Winther.
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This survey is based on our own experiences and a study of the literature. The CO2 laser has certain advantages in the surgical treatment of otosclerosis, both in the primary operation and in reoperation. In rhinal surgery the argon laser has been used with good results in Osler's disease. Laser surgery is not recommended for vasomotoric rhinitis and polyposis. The CO2 laser has improved the quality of treatment of laryngeal papilloma. With high precision and minimal bleeding the postoperative voice is better than with conventional surgery. The CO2 laser can also be used to exstirpate small malignant tumours of the tongue and leukoplasia of the oral mucosa. Healing is rapid and involves relatively little pain. The postoperative functional result is usually good, due to moderate formation of scars.
543 persons over 70 years of age and living in Akershus county near Oslo were offered a hearing test at the local health centre. 495 (91%) were tested. The test revealed that 111 (22.4%) needed a hearing aid. 52 (10.5%) of these already had a hearing aid. Most of those who required a hearing aid (97.3%) belonged to the group with subjective hearing problems. It is concluded that good health care for the elderly also includes a hearing test for persons with a hearing problem, and provision of a hearing aid if necessary. It is important that also this part of the health care is provided locally.
The daily use of hearing aids was investigated in two groups of persons over 70 years of age. One group received only initial instruction in the use of the hearing aid. In this group only six of the 35 patients used their hearing aid every day or on most days. In the other group, which received a further audiopedagogical follow-up, the corresponding figure was 48 out of 61. Better cooperation between the primary health care and ear-nose-and throat-departments/specialists may lead to a better audiopedagogical follow-up of these patients.
Impairment of vocal cord function is a threat to patients with thyroid carcinoma; either due to the tumor having infiltrated the larynx or the recurrent nerve, or to accidental damage to the laryngeal nerves during thyroid surgery. We have reviewed 1,245 patients' records which were filed under the diagnosis of thyroid carcinoma at Det Norske Radiumhospital from 1956 to 1978. Pareses of vocal cords were noted in 465 patients (37.3%) during the course of their illness. In 135 patients (10.8%) the pareses were due to infiltration by the tumor, most commonly seen in anaplastic carcinoma. In 267 patients (21.4%) the pareses followed surgery; planned resections of the recurrent nerves were performed in 48 patients (3.9%). Transient pareses with normal vocal cord movements within months were experienced in 137 cases (11%). Permanent paralysis caused accidentally during surgery was seen in 82 patients, representing 6.6% of all patients and 4.7% of the surgically exposed nerves. We stress the need for pre- and postoperative evaluation of vocal cord movement as an aid to future diagnosis and optimal surgical planning.
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In a 14 year old boy, a ruptured spleen was removed. Two months after the splenectomy he developed recurrent infections of the respiratory tract. A deficiency of IgA and IgE in his blood serum was found. His impaired resistance to respiratory tract infections responded well to substitution therapy with IgA. Spontaneous clinical recovery occurred during 3 years after the splenectomy, and was parallelled by a slow return of IgA to normal levels, whereas the absence of IgE persisted. The identical twin brother of the patient, who had his spleen intact, had normal levels of serum IgA and did not suffer from frequent respiratory tract inflammations.
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