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Development of altered taste preferences in tumor-bearing rats.

Experimental tumors induce a decline in food intake that may derive from changes in taste or the development of taste aversions. The preferences of tumor-bearing (TB) and non-tumor-bearing (NTB) rats for five chemicals (three palatable and two aversive taste stimuli) were studied in an animal model of experimental cancer employing the methylcholanthrene (MCA) sarcoma. In protocol 1, five groups of Fischer 344 rats were given 23-h, two-bottle preference tests (taste solution vs. water) daily from day 3 after tumor implantation until spontaneous death occurred. Both NTB and TB rats avoided quinine hydrochloride and hydrochloric acid solutions throughout the experiment indicating that tumor growth produced no disruption in the animals' perception of these normally aversive tastes. In both groups, preference for sucrose (88% to 97%) and saccharin (75% to 93%) remained high until days 22 and 17 respectively, but tended to decline with advanced tumor growth. In both cases, a reduction in total calorie intake preceded the changes in sucrose or saccharin preference by several days. With or without a tumor, rats exhibited approximately 50% preference for NaCl at all times. In protocol 2, a four-bottle preference test (sucrose vs. saccharin vs. NaCl vs. water) was administered before tumor implantation and again 3 weeks later when a decline in food intake was evident. Both TB and NTB rats displayed a dominant preference for sucrose over saccharin, NaCl, and water at the pre- and posttests. However, a comparison of the difference scores (pre- minus postimplantation) of NTB and TB rats showed a small but significant suppression of TB animals' preference for sucrose. The altered preferences for sweet but not salt taste stimuli suggest that food-related taste cues may be more susceptible to the development of taste aversions during cancer. However the contribution of taste changes to the anorexia of cancer remains unclear and it is possible that the changes in taste preference may be secondary to the reduction in food intake.

Animals↗

Effects of atrial natriuretic factor on anterior pituitary hormone secretion in normal man.

The effects of intravenous human atrial natriuretic factor ANF(99-126) administration on anterior pituitary hormone secretion have not been extensively investigated in humans. We repeatedly studied 10 healthy volunteers (5 female, 5 male, aged 28 +/- 2 years) on 2 occasions, 3 days apart. In randomized, single blind order, subjects received pretreatment with either placebo or intravenous ANF(99-126) (bolus 100 micrograms/kg, 30-min infusion of 0.1 micrograms/kg.min). Subsequently on both occasions subjects received a combined intravenous bolus injection of pituitary releasing hormones (200 micrograms thyrotropin releasing hormone, 100 micrograms gonadotropin releasing hormone and 100 micrograms human adrenocorticotropin releasing hormone; Bissendorf, Hannover, FRG). Plasma concentrations of adrenocorticotropic hormone (ACTH), cortisol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), growth hormone (GH), thyrotropin (TSH), prolactin, ANF and cyclic guanosine monophosphate (GMP) were determined by radioimmunoassay. ANF(99-126) treatment induced a significant reduction in basal ACTH plasma concentrations and tended to decrease basal plasma cortisol. The TSH response to combined releasing hormone administration was significantly diminished after ANF(99-126) pretreatment. In women, the releasing hormone induced prolactin increase was reduced after ANF(99-126) pretreatment. With the present study design, ANF(99-126) did not alter the basal or releasing hormone stimulated plasma concentrations of cortisol, LH, FSH and GH. Releasing hormone administration did not affect ANF and cyclic GMP plasma levels. In humans, effects of natriuretic peptides on anterior pituitary hormone secretion may have to be considered with investigational or therapeutic administration of ANF analogues or agents interfering with the ANF metabolism.

Adult↗

Ipsilateral disturbance of taste due to pontine haemorrhage.

A patient with haemorrhage in the right tegmentum of the pons demonstrated ipsilateral disturbance of taste on both the anterior two-thirds and posterior one-third of the tongue. The contralateral medial lemniscus was not disturbed, contrary to the early descriptions that the secondary gustatory neurons from the nucleus of the solitary tract cross and turn upwards in the pons through the contralateral medial lemniscus. This finding would accord with the concept of the pontine taste area which receives ipsilaterally the secondary gustatory neurons from the anterior pole of the nucleus of the solitary tract.

Cerebral Hemorrhage↗

Predisposing factors in Bell's palsy: a case-control study.

The frequency of diabetes mellitus reported in subjects affected by Bell's palsy varies widely. In this investigation, a case-control study, we encountered a frequency of 24.8%. In addition, arterial hypertension and lipid disturbances were found to affect subjects with Bell's palsy more frequently than controls. These findings appear to suggest a primarily ischaemic pathogenesis for most cases of idiopathic peripheral facial paralysis. Furthermore, the finding of significantly lower taste impairment in diabetics than in non-diabetics with Bell's palsy may support the hypothesis of a vascular rather than a metabolic pathogenesis in these cases also. In fact, the vessels supplying the distal portion of the facial nerve, probably more affected in the diabetic patients in order to preserve taste sensation, have such a particular anatomical configuration that this might favour the onset of a diabetic small vessel disease which, in turn, would represent a factor of easier decompensation.

Adult↗

A gustatory mutant of Drosophila defective in pyranose receptors.

Mutations in an X-linked gene, gust-A, block the responses of Drosophila melanogaster to a group of pyranose sugars. It is shown that the behavioural effects of this mutation are correlated with a loss of electrical responses in taste receptors. The mutation affects the chemoacceptors for pyranose sugars leaving the furanose acceptors intact.

Animals↗

Prognosis of facial palsy in Borrelia burgdorferi meningopolyradiculoneuritis.

Out of 72 patients treated for Borrelia burgdorferi meningopolyradiculoneuritis facial palsies occurred in 22 (12 unilateral, 10 bilateral). Eleven of the 32 pareses were initially complete. By the follow-up examination patients had recovered well with slight sequelae in 22% without cosmetically disfiguring pareses or synkinesias. Electrophysiological studies revealed axonal damage of the nerve as the underlying mechanism.

Adult↗

[Captopril in congestive heart failure (author's transl)].

Captopril (Lopirin, Squibb, von Heyden) is an inhibitor of the angiotensin-I converting enzyme. In congestive heart failure angiotensin mediated vasoconstriction and aldosterone secretion is reversed by captopril. Both effects of captopril induce reduction of cardiac preload and afterload. The clinical state of patients with congestive heart failure therefore improves since cardiac output increased and pulmonary pressures decrease. Captopril acts orally and the dosage used for the treatment of congestive heart failure ranges from 50 to 150 mg daily. After oral ingestion of a single dose the maximum haemodynamic effect is observed after 45-90 min. No tolerance induction or tachyphylaxis has been observed during maintenance therapy over a period of 18 months. There are some reversible adverse reactions like pruritus, skin rash and partial or complete taste loss which are dose related. Serious side effects include leucopenia, agranulocytosis, renal failure and membranous glomerulonephritis. Therefore regular urinary and blood analysis is necessary during captopril therapy.

Acute Kidney Injury↗

Trace elements in human parotid saliva.

Although various proteins and some electrolytes have been measured in human saliva, little systematic data about the major and minor elemental components of this body fluid have been obtained. In order to obtain such data, concentrations of C, Na, P, Cl, K, Ca, Sc, Cr, Fe, Co, Zn, Se, Br, Rb, Sb, I, and Cs in human parotid saliva were measured by instrumental nuclear methods. The data obtained confirmed the relative lack of Zn in saliva of patients with hypogeusia (decreased taste acuity) and suggested that concentrations of Na, Cl, Br, and Ca followed the order: normals greater than hypogeusia greater than hyposmia (decreased smell acuity). To compare concentrations of elements in saliva with those in blood and urine, absolute concentrations were normalized to that of Na through the use of a concept called an enrichment factor. On this basis, parotid saliva is relatively depleted in Se, Zn, and Fe and enriched for most other elements relative to blood plasma indicating that the fluid is not simply a transudate of blood plasma. Using this same technique, saliva composition was found more similar to urine than blood plasma, being relatively depleted in Se, Cs, and Co, being enriched in I, Br, and Cr and having about the same relative concentrations of P, Cl, Zn, Fe, Ca, K, and Rb. As the total body concentrations of many of the enriched elements in saliva are extremely small, their enrichment in saliva suggests special roles for these elements in the oral cavity. Because of its accessibility, ease of collection, and interaction with some body constituents, saliva represents a useful, albeit neglected, tool in the diagnosis of some physiological and pathological changes in body function and in understanding important aspects of trace metal metabolism.

Adult↗

Epidural test dose: lidocaine 100 mg, not chloroprocaine, is a symptomatic marker of i.v. injection in labouring parturients.

The authors studied the sensitivity (SN) and specificity (SP) of an epidural test dose containing either lidocaine 100 mg or 2-chloroprocaine 100 mg as symptomatic markers of intravascular injection in labouring parturients. In a prospective, double-blind and randomized fashion 48 unmedicated and labouring parturients were equally divided into three groups. After placement of a lumbar epidural catheter the normal saline group (NS) received 5 ml normal saline i.v., the lidocaine group (LD) received lidocaine 100 mg i.v., and the 2-chloroprocaine group (CH) received 2-chloroprocaine 100 mg i.v. All injections were given during uterine diastole. Within the next one to two minutes a blinded observer recorded the patient's perception of the presence of metallic or funny taste, dizziness, and tinnitus. We then calculated SN and SP of each symptom (alone and in combination) along with their positive (+) and negative (-) predictive value (PV). In both groups no symptom alone reached clinically acceptable levels of SN (< 87%). Only in the LD group, tinnitus+taste and dizziness+taste reached a SN of 100% with a SP of 81% and 69% respectively. While the -PV was 100% for both groups of symptoms, the +PV reached 42% for tinnitus+taste and 30% for dizziness+taste. We conclude that lidocaine 100 mg is a sensitive marker of intravascular injection in labouring parturients, and that tinnitus+taste is the most reliable indicator of intravenous injection.

Anesthesia, Epidural↗

Age-related changes in unstimulated salivary function and composition and its relations to medications and oral sensorial complaints.

BACKGROUND AND AIMS: The purpose of the current study was to examine the salivary flow rate and composition in relation to drug consumption and idiopathic oral sensorial complaints (OSC). OSC cover xerostomia, disturbed sense of taste, or burning mouth sensitivity with no established classical etiology (e.g., Sjogren's syndrome, or a response to radiotherapy). METHODS: A thorough sialometrical and sialochemical analysis was performed for all subjects who were healthy non-hospitalized individuals ranging in age from 18-89 years. Saliva samples were all collected in unstimulated conditions. RESULTS: The three most significant observations were: a) Elderly people have significantly reduced and altered salivary secretion. Whereas specific concentrations increased, the total values of most salivary components were found to be decreased in the elderly. b) Fifty percent of the elderly make OSC. c) OSC were made mainly by elderly individuals who use drugs. CONCLUSIONS: Reduction in salivary function and altered composition are age-related. However, when drugs are not involved, a compensatory capacity which avoids OSC apparently exists. In contrast, the effect of drugs on OSC is extensive. The finding that the total amount of salivary components and not only salivary flow rates are reduced in the elderly is of great clinical importance, since such a reduction is expected to be reflected in compromising various salivary functions.

Administration, Oral↗

To divide or manipulate the chorda tympani in stapedotomy.

The objective of this study is to determine the nature, duration and severity of chorda tympani symptoms in post-stapedotomy patients when the nerve has been known to have either sustained surgical manipulation or division. The study design was retrospective and blind, based at a tertiary Otology Referral Center (Gloucestershire Royal Hospital). All successive patients undergoing stapedotomy operated upon by the senior author (JMR) between November 1991 and October 1998 were included. The main outcome measures were postoperative graded dysgeusia (questionnaire) and post operative electrogustometry score, comparing the chorda tympani cut group and the chorda tympani preserved group. Sixty stapedotomies were performed in the study period. After a minimum interval of 8 months, questionnaire data were obtained in 55/60 (92%), and electrogustometry studies were carried out in 48/60 (80%). Symptoms of dysgeusia were experienced in the chorda tympani nerve cut (CC) group in 95% and in the chorda preserved (CP) group in 52%. For those with symptoms, duration was 6.7 months (+/-4.9 SD) and 3.4 months (+/-3.7 SD) for the CC and CP groups, respectively. From the electrogustometry data, after 8 months, the risk of total loss of response is significantly higher in CC patients (94%) than in CP patients (25%) (P = 0.0001). Also at 8 months, 54% of CP patients had normal ipsilateral electrogustometry responses compared with 6% in the CC group. In conclusion, cutting the chorda tympani results in significantly greater symptoms than when subjected to manipulation only, and these symptoms are likely to be more long lasting. Therefore, it is our recommendation that where possible the chorda be preserved. The risk of severe chorda symptoms when the chorda is cut is small (<5%). Preoperative consent to include dysgeusia is advised.

Adult↗

Perceived taste disturbance in adults: prevalence and association with oral and psychological factors and medication.

Taste disturbance may cause subjective discomfort and impair appetite and food intake. The aim of this study was to estimate the prevalence of perceived taste disturbance and analyze its association to age, gender, whole salivary flow rate, subjective oral dryness, burning mouth, medication, and psychological factors. Five hundred forty-seven men and 656 women aged 20 to 69 years were randomly selected from the Public Dental Health Service register in northern Sweden. Oral complaints were registered and whole salivary flow rate measured. Medication, anxiety, depression, and stress were assessed. Thirty individuals (2.5%), five men (0.9%) and 25 women (3.8%), reported perceived taste disturbances (distorted taste or loss of taste). In men, no individual with taste disturbance was found in the youngest and oldest age groups. The prevalence in the 30-39-year age group was 1.9% and in the 40-49-year group 1.8%. In women, one individual (1%) with taste disturbance was found in the youngest age group. In the 30-39-year group, the prevalence was 3.8%, increasing to 5.1% in the oldest age group. Illness, subjective oral dryness, state anxiety, perceived stress, depression, use of antiasthmatics, and trait anxiety were associated with taste disturbance. It was concluded that perceived taste disturbance might be an interaction of various health factors such as illness and mental condition.

Adult↗

Influence of early high-dose steroid treatment on Bell's palsy evolution.

The objective of this double-blind, randomized, placebo-controlled study was to test the efficacy of high-dose prednisone, administered as early as possible, in modifying the natural progression of Bell's palsy. Sixty-two consecutive patients, enrolled within 72 hours of facial palsy onset, were assigned to high dose intravenous prednisone in combination with intramuscular polyvitaminic therapy (group A) or polyvitaminic therapy alone (group B). Clinical grading of facial muscle strength and length of absence from work were evaluated. An early worsening of facial muscle strength was observed in controls, leading to the divergence in the trends of the grading scores in the two groups; this result was not confirmed in the long-term follow-up. Treated patients returned to work earlier than controls. In conclusion, early treatment based on high-dose corticosteroids slightly accelerates spontaneous improvement in Bell's palsy.

Adolescent↗