Sohei Endo

Sensitivity of Three Loci on the Tongue and Soft Palate to Four Basic Tastes in Smokers and Non-smokers

The filter paper disk method was used to determine the map of the 4 tastes (sweet, salty, sour and bitter) on the tongue and soft palate in 69 healthy individuals. The equipment used for testing included filter paper disks 8 mm in diameter and taste solutions, which were sequentially diluted (in 13 stages from 80% sucrose, 12 stages from 20% NaCl, 12 stages from 8% tartaric acid and 14 stages from 4% quinine hydrochloride). The threshold at which each taste was recognized in three locations (center of the tongue tip, foliate papillae on the left side and center of the soft palate) was determined by testing increasing concentrations of each solution. We found no difference by sex for sweet taste but women were more sensitive to sour taste on the tongue tip and to salty and bitter tastes on the soft palate. No difference in taste threshold was noted at the different locations for sweet, salty or bitter tastes, but both sexes were less sensitive to sour taste on the soft palate than on the tongue tip, and in men the soft palate was even less sensitive to sour taste than the tongue root. Smoking was associated with increased (worse) taste thresholds for all four tastes, for both men and women.

Double-blind, placebo-controlled trial of zinc picolinate for taste disorders.

A total of 73 patients with an idiopathic zinc-deficiency taste disorder completed a double-blind, placebo-controlled trial of the efficacy of zinc picolinate. Patients in the zinc treatment group ( n = 37) received 29 mg of zinc picolinate orally by capsule 3 times a day for 3 months. No significant difference was noted between the treatment and placebo groups in terms of improvement in subjective symptoms or whole-mouth taste sensation. However, assessment of taste using the filter paper disk method showed significantly better improvement for the group given zinc, and the serum zinc level was also significantly higher in this group than in the placebo control group.

Characteristics of 2278 patients visiting the Nihon University Hospital Taste Clinic over a 10-year period with special reference to age and sex distributions.

We investigated the incidence of taste disorders in 2278 patients (871 men, 1407 women) who visited our Taste and Smell Clinic during the 10-year period between 1981 and 1990. Although a higher proportion of our patients were women, there was a significant gender difference only in the proportion of women with mild symptoms; the proportions of men and women with moderate or severe taste disorders were not significantly different. We propose that the incidence of taste disorders is the same among men and women but that women with milder symptoms are more likely to seek treatment. The time from onset of symptoms to the first clinic visit lengthened with increasing patient age. The efficacy of treatment decreased with increasing patient age, regardless of the severity of taste disorder at the initial visit.

Taste disturbance in two patients after dental anesthesia by inferior alveolar nerve block.

We report two cases of temporary taste disturbance after inferior alveolar nerve block. The first patient to present with this rare complication of anesthesia for dental surgery was a 41-year-old woman. She lost the sense of taste on the left side of her tongue after local anesthesia for treatment of a left mandibular molar and first visited our outpatient clinic complaining of taste disorder 3 months later. Electrogustometry (EGM) and filter paper disk (FPD) testing revealed a taste disturbance in the innervation area of the left chorda tympani nerve and atrophy of the fungiform papillae on the left side of the tongue was observed. Eleven months after the dental treatment, the fungiform papillae and the results of EGM were normal. The second patient, a 22-year-old woman, received local anesthetic for extraction of a right mandibular molar and subsequently developed loss of taste on the right side of the tongue. When she visited our outpatient clinic 3 months later, atrophy of the fungiform papillae on the right side was observed. Her gustatory sense began to improve 4 months after the dental surgery and was normal at 13 months. From these findings we conclude that taste disturbance on the same side as the inferior alveolar nerve block in each case was due to direct injury to the chorda tympani and lingual nerves during administration of the local anesthetic. The results of EGM and FPD testing were diagnostic: atrophy of the fungiform papillae on the same side and disappearance of taste on the same side in the intravenous taste test provided complementary diagnostic information. The outcome was satisfactory in both cases.

Clinical Assessment of Squamous Cell Carcinoma of the Nasal Cavity Proper

The subjects were 14 patients with squamous cell carcinoma or undifferentiated carcinoma of the nasal cavity treated at Nihon University Hospital between October 1984 and November 1991, who were followed for at least 3 years. The site of the tumor origin within the nasal cavity was the lateral wall in 8 patients, the nasal septum in three patients, and unknown in three patients. Histologically, there were 13 squamous cell carcinomas in (3 well differentiated, 7 moderately differentiated, and 3 poorly differentiated) and 1 undifferentiated carcinoma. Treatment was by a combination of radiotherapy, chemotherapy, and surgery in 8 cases, a combination of radiotherapy and surgery in 5 cases, and surgery alone in 1 case. The 3-year and 5-year Kaplan-Meier survival rates were 86 and 69%, respectively. A total of 6 patients suffered a recurrence, with local recurrence occurring in 4 patients and pulmonary metastasis in 2 patients. Tumor control was achieved in 3 of the 4 cases of local recurrence by reoperation, and by surgery in 1 of the 2 cases of pulmonary metastasis. The duration of the recurrence-free interval in the patients who developed local recurrences, 18 to 46 months after the completion of the initial course of therapy, was of considerable interest.

Influence of Aging on Taste Threshold, Examined by Whole Mouth Method

The whole mouth method is a procedure that is now extensively used for comprehensively evaluating the sensitivities of taste examinations. In this study, the authors evaluated the recognition thresholds of four basic taste qualities in normal subjects (male and female) to observe the changes caused by aging; sex differences were also investigated.

A mutation at IVS1 + 5 of the von Hippel-Lindau gene resulting in intron retention in transcripts is not pathogenic in a patient with a tongue cancer?: case report

BackgroundVon Hippel-Lindau disease (VHL) is a dominantly inherited familial cancer syndrome predisposing the patient to a variety of malignant and benign neoplasms, most frequently hemangioblastoma, renal cell carcinoma, pheochromocytoma, and pancreatic tumors. VHL is caused by mutations of the VHL tumor suppressor gene on the short arm of chromosome 3, and clinical manifestations develop if both alleles are inactivated according to the two-hit hypothesis. VHL mutations are more frequent in the coding region and occur occasionally in the splicing region of the gene. Previously, we reported that the loss of heterozygosity (LOH) of the VHL gene is common in squamous cell carcinoma tissues of the tongue.Case PresentationWe describe a case of squamous cell carcinoma in the tongue caused by a point mutation in the splicing region of the VHL gene and discuss its association with VHL disease. Sequence analysis of DNA extracted from the tumor and peripheral blood of the patient with squamous cell carcinoma revealed a heterozygous germline mutation (c. 340 + 5 G > C) in the splice donor sequence in intron 1 of the VHL gene. RT-PCR analysis of the exon1/intron1 junction in RNA from tumor tissue detected an unspliced transcript. Analysis of LOH using a marker with a heterozygous mutation of nucleotides (G or C) revealed a deletion of the mutant C allele in the carcinoma tissues.ConclusionsThe fifth nucleotide G of the splice donor site of the VHL gene is important for the efficiency of splicing at that site. The development of tongue cancer in this patient was not associated with VHL disease because the mutation occurred in only a single allele of the VHL gene and that allele was deleted in tumor cells.

Changes with Age in the Electrogustometric Threshold

The clinical value of electrogustometry, which can measure taste threshold quantitatively for each innervation area, has been acknowledged for some time. Although on changes in normal values due to aging in the chorda tympani innervation area have been reported [1], to the best of our knowledge no report has been made thus far on the greater petrosal innervation area or the glossopharyngeal innervation area. We conducted electrogustometry in 516 normal men and women (all nonsmokers) in age groups ranging from teenagers to the late seventies to determine changes according to aging and sex.

Isolated oculomotor nerve palsy in malignant lymphoma

We report the clinical features of isolated oculomotor nerve palsy in patients with malignant lymphoma. A retrospective evaluation of five patients was performed. Their ages ranged from 43 to 77 years (average: 64.5 years). All histopathologic types were non-Hodgkins lymphoma, in particular B-cell type in four patients. Oculomotor nerve palsy was unilateral in all five patients and the pupil was spared in four. Leptomeningeal dissemination of malignant lymphoma was detected in three patients. However, neuroimaging could not locate the lesion responsible for the oculomotor nerve palsy in any patient. Despite chemotherapy, all patients died within nine months after the appearance of oculomotor nerve palsy. In malignant lymphoma, isolated oculomotor nerve palsy is unilateral, pupil-sparing, and a poor prognostic sign.

Complete disappearance of the nasopharyngeal cancer with intracranial extension by intra-arterial cisplatin infusion: report of two cases

Abstract Two cases of nasopharyngeal cancer with intracranial extension were treated with intra-arterial cisplatin infusion with systemic infusion of sodium thiosulfate (STS) followed by continuous IV infusion of 5-FU for 120 h. After two courses of intra-arterial chemotherapy, tumors had completely disappeared. Subsequently, full doses of external irradiation were applied. Both of them survived 5 years after the initiation of the treatment, but one died of the original cancer after just 5 years.