Masanori Umemoto

Clinical study of flavor disturbance.

Objective We have observed that, in cases of smell loss, patients often complain of taste loss as well even though they actually have normal gustatory acuity according to gustatory tests; we have defined such symptoms as “flavor disturbance”. The clinical features of flavor disturbance are reported in this paper. Material and Methods A total of 297 patients (99 males, 198 females; mean age 55.5 years) were treated for olfactory disturbance at the hospital of Hyogo College of Medicine between July 1995 and August 2001. Sixty-six out of 297 patients (22.5%) also experienced taste disturbance, and 49 of these 66 cases were evaluated by means of smell and taste tests. These 49 patients who complained of taste and smell loss were classified into two groups according to the results of their smell and taste tests. Patients who only complained of olfactory disturbance were also reviewed. Results There was no relationship between the severity of olfactory disturbance and the degree of flavor disturbance. The incidence of flavor disturbance was high in patients with sudden olfactory disturbance after upper respiratory tract infection or head trauma and low in those with slowly progressive olfactory disturbance. The symptoms of flavor disturbance improved regardless of whether smell was improved or not. Conclusions The patients with flavor disturbance tended to misrecognize that they had taste loss because of sudden smell loss, and there were more of these cases than we expected. When patients with smell and taste loss are treated, flavor disturbance should also be considered.

Expression of Activating Transcription Factor 3 and Growth-associated Protein 43 in the Rat Geniculate Ganglion Neurons after Chorda Tympani Injury

The purpose of this study was to evaluate the degree of damage in the geniculate ganglion and its target organ as a result of chorda tympani (CT) injury. We performed unilateral transection of the rat CT and examined expression of the activating transcription factor 3 (ATF3), a neuronal injury marker, and the growth-associated protein 43 (GAP-43), a regeneration-associated molecule. The mean proportion of ATF3-immunoreactive (ir) neurons in the geniculate ganglion was: 32% at 3 days after CT injury, but these neurons were never detected in the naive ganglion. Using in situ hybridization, the mean percentage of GAP-43 mRNA-labeled neurons (signal: noise ratio S 10) was observed to have increased significantly to 60% for 1-7 days after CT injury, while that in the naive ganglion was <15%. The results of morphological studies using scanning electron microscopy and immunohistochemistry indicated that atrophic change and reduction of protein gene-product 9.5-ir fibers in the denervated papillae, mainly in the intragemmal region, were observed after CT injury. Increase in GAP-43 mRNA, suggesting CT axonal regeneration, may have a role in recovery from taste disorders. However, this regenerative process may be involved in abnormal activity in the axotomized neurons or the adjacent intact neurons and so one must not disregard the existence of injured geniculate ganglions when considering the treatment of diseases that cause CT injury.

Blood Boil of the Maxillary Sinus; A Three-Case Report.

We describe three cases of blood boils of the maxillary sinus that were suspected to be malignant tumors. The patients were a 27-year-old female, a 52-year-old male and a 24-year-old male. The chief complaints in all cases were unilateral nasal obstruction and nasal bleeding. CT examination showed that the tumors occupied the entire unilateral maxillary sinus, and expanded with maxillary bone thinning. Biopsies performed through the nasal cavity revealed the tumorous masses to be benign. Ultimately, the tumorous masses were surgically extirpated without any transfusion, and the histopathological diagnosis turned out not to be the more typical hemangioma, but rather so called blood boil.

Regeneration of epithelial cells of the maxillary sinus mucosa in chronic sinusitis

The maxillary mucosae of chronic sinusitis patients were observed by transmission and scanning electron microscopy. Although the epithelium was severely damaged by the chronic inflammation and the ciliated cells and goblet cells were degraded and had peeled off, most of the basal cells survived at the surface of the mucosa. The surviving basal cells extended their cytoplasmic processes toward each other and finally covered the bare surface of the mucosa. Cells having a few cilia and many microvilli were occasionally observed. Immunohistochemistry for PCNA (proliferating cell nuclear antigen) was also performed. The nuclei of many basal cells in the nonciliated area and those of a few ciliated cells were positive for PCNA. These findings suggest that the maxillary mucosa of chronic sinusitis has the ability to regenerate and that basal cells play the role of precursors to ciliated cells.