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PubMed1978

Smell and taste acuity in epileptic syndromes.

Taste and smell acuity were determined in 50 normal subjects and 48 epileptic patients by means of Henkin's method. Smell detection thresholds are greatly reduced in epileptic patients, mainly those suffering from partial seizures with complex symptomatology. Epileptic patients show also a reduced threshold for sweet and bitter taste. Age, sex and antiepileptic drugs do not affect taste and smell acuity. The significance of these findings in the pathogenesis of epileptic seizures is discussed.

Adult↗
PubMed1980

Taste, smell and zinc metabolism in patients with chronic renal failure.

Taste and smell acuity, and zinc concentrations in blood, plasma, red blood cells, and hair were determined in male patients with end stage renal disease (n = 7), male (n = 20) and female (n = 6) patients on maintenance hemodialysis (HD), and male (n = 23) and female (n = 25) control groups. Taste acuity for salt (NaCl), sweet (sucrose), acid (HCl) and bitter (urea) in all 3 patient groups was lower than in the appropriate control group. These differences were significant only for sucrose (male dialysis, p < 0.05), HCl (male uremics not on dialysis, p < 0.01; male dialysis, p < 0.01; and female dialysis, p < 0.05) and urea (male dialysis, p < 0.01). Smell perception was impaired (not significantly) for the male patient groups, but slightly improved (not significantly) for the female patient group. Red blood cell and hair Zn++ concentrations were elevated for the male HD group (p < 0.001). THe plasma zinc concentration was significantly lowered for the male patient groups (p < 0.05). Age showed a negative correlation with pyridine, NaCl, sucrose, and HCl mean detection levels for both male HD patients and control groups. Sensitivity to urea also decreased with age for male HD patient groups, but increased for the male control group. Blood and RBC Zn++ concentrations increased and plasma and hair Zn++ decreased with age for the male HD patients and the male control group. No correlation was observed between Zn++ concentrations and taste and smell mean detection levels.

Adult↗
PubMed1998

Scratch density differentiates microsmic from normosmic and anosmic subjects on the University of Pennsylvania Smell Identification Test.

During assessment of smell function using the University of Pennsylvania Smell Identification Test, we observed that some persons with diminished smell perception seemed to perserverate in their attempts to release the odorant from the microencapsulated odorant strips. In this study we quantified the marked area of 1680 such strips from tests administered to 42 anosmics, normosmics, and microsmics. The density of pixels on the microencapsulated labels from the microsmic patients was greater than that from the other two groups, which did not differ significantly from one another. These data suggest (i) that persons with diminished olfactory ability attempt to increase the perceived intensity of the stimulus by marking the test's scent strips more vigorously and (ii) that the density of such marking may prove useful in detecting malingerers attempting to feign microsmia.

Aged↗
PubMed1988

Assessment of patients with taste and smell disorders.

The evaluation of patients with taste and smell complaints is difficult without standardized quantitative methods of assessment. This paper summarizes recent developments in the evaluation of chemosensory patients. Evaluation must begin with a careful medical history, since certain questions can help in establishing an etiology. Several recent advances have been made in the development of standardized tests for the assessment of taste and olfactory function. Smell can be evaluated with a combination of butanol threshold and odor identification (University of Connecticut test battery) and with the University of Pennsylvania Smell Identification Test (UPSIT). Scores obtained from 91 patients show good correlation between these two testing procedures. Both tests provide normative data for comparison, with the UPSIT including both age- and sex-related norms. Traditional evaluation of taste deficits with threshold procedures has been questioned. Measures of suprathreshold taste intensity require the anchoring of taste judgements to another, presumably normal, modality. This has been approached using magnitude matching, in which taste and auditory loudness are judged on the same scale. Spatial testing of the tongue and soft palate can reveal pathology of the gustatory nerves or their central connections. Further understanding of taste and olfactory dysfunction will be facilitated by the development of standardized methods of evaluation.

Humans↗
PubMed2002

Assessing olfactory abilities with the University of Pennsylvania smell identification test: a Rasch scaling approach.

The strategy of delaying or retarding the progression of Alzheimer's disease requires early diagnosis and treatment. Previous research indicates that measurement of changes in olfaction and cognition will play an important role in the early detection of AD and in the monitoring of therapy effectiveness. Using the data of 177 subjects, our objective was to study the measurement properties of the University of Pennsylvania Smell Identification Test (UPSIT) using a Rasch scaling framework. The results indicate that the UPSIT can yield a linear, unbiased, and unidimensional Rasch measure of human smell recognition abilities. As expected, olfactory recognition ability decreased with age, and at the rate of about 0.05 Logits per year. Also, Alzheimer's patients showed a decrease in smell recognition equivalent to that experienced by healthy subjects over the course of 30 years. Hormone replacement therapy was not found to affect healthy women's olfactory recognition ability. Additional diagnostic information can be extracted from the analysis of incorrect responses patterns that is relevant to group membership.

Aged↗
PubMed2001

[Genetic determination of smell].

The recent study of olfactory receptor genes sheds new light on the significance of this receptor not only for smell recognition but also in human embryogenesis. In this work current data concerning the role of olfactory receptors in human as well as their genetic determination are presented. Olfactory receptors are encoding approximately by 1000 hOR genes. The hOR gene family is most likely the largest in human genome. Among 1000 hOR genes, 347 are functional, the rest 70% being pseudogenes are not expressed. HOR genes reside at 25 locations in human genome in multiple clusters on all human chromosomes, except 2, 4, 18, 20, 21, and Y. Each receptor recognizes single as well as multiple odorant, and each odorant binds to multiple receptors to generate specific activation patterns for each of a great number of distinct smells. There is more and more evidence showing close correlation between HLA complex and smell recognition, which influence mating behavior in animals, consequently leading to increase immune response to various pathogens. The last investigations showed hOR expression in germinal cells and in developing embryo, suggest that hOR may play functional role in cell recognition in organogenesis.

Animals↗
PubMed2005

Incorporating the sense of smell into haptic surgical simulators.

It is widely recognized that the sense of smell plays an important role in the field of medicine. The sense of smell not only assists the physician in the diagnosis of certain disorders, but it also plays a surgical role as well. Historically, learning this skill was contingent upon some level of clinical exposure to medically related odors. The advent of computerized scent production devices could change this. This article proposes a hypothetical surgical simulation model that incorporates olfactory technologies into existing, haptic, surgical simulators. If incorporated into virtual educational settings such as these, computerized scent production devices could be used not only as a novel way to enhance the virtual experience, but also as a way for medical students to begin to recognize the important role that the sense of smell can play during surgery.

Clinical Competence↗
PubMed2006

Olfaction in rhinology--methods of assessing the sense of smell.

Olfactory disorders frequently occur in rhinological disease. Different subjective and objective test methods are available to assess the sense of olfaction. Among the subjective methods, screening tests and threshold measurements are commonly used to quantify hyposmia or anosmia. Qualitative methods are available using discrimination and identification tests. Objective methods are used in research and in some medicolegal situations. Objective tests include olfactory evoked potentials, functional Magnetic Resonance Imaging and functional Positron Emission Tomography. The measurement of the sense of smell helps to assess the whole spectrum of the effects of nasal disease. This is especially important before rhinological surgery, because a non-detected smell disorder in patients with rhinological disease is common. The assessment of a pre-existing hyposmia or anosmia helps to avoid a postoperative claim that this was caused by surgery. A variety of validated screening tests for olfaction is available and they are a useful tool to document whether a patient is able to smell.

Diagnostic Techniques, Respiratory System↗
PubMed1989

Initial otolaryngologic assessment of patients with taste and smell disorders.

Patients are often referred to otolaryngologists to evaluate dysfunctions of taste or smell. A history and physical examination focused on signs and symptoms of chemosensory disorders, in combination with screening tests for taste and smell function, can quickly and easily delineate the general type and cause of the dysfunction. Several centers for chemosensory disorders referred to in this issue are available for referral to patients who need detailed testing and evaluation. Although treatment options for most taste and smell dysfunctions are limited, by categorizing disorders, we can give the patient an idea of the probable cause and prognosis of the dysfunction.

Humans↗
PubMed1978

Decreased taste and smell acuity in cirrhosis.

The sensory modalities of taste and smell were evaluated in eight patients with cirrhosis that was proved by biopsy specimens and in 13 control subjects. Additionally, the following serum levels were determined in these same subjects: zinc, copper, magnesium, calcium, manganese, and selenium. Fourteen concentrations each of sucrose, sodium chloride, urea, and hydrochloric acid were used to evaluate taste acuity. Smell was evaluated with 11 concentrations each of nitrobenzene, thiophene, and pyridine. These studies show that decreased acuity of taste and smell occurred in conjunction with cirrhosis in the patients who were tested. There were no trace element abnormalities that consistently correlated with decreased acuity in perception of the individual test substances.

Adult↗
PubMed1984

[Occupational damage of the sense of smell].

Workers occupationally exposed to synthetic lacquers vapours and wood dust underwent olfactometric and laryngological examinations. The findings indicated that the synthetic lacquers vapours induced neurotoxic lesions of the smell sense. The wood dust causes only nasal cavity mucous membrane lesions inhibiting smell stimuli access to the smelling area. It was suggested olfactometric tests should be included into the preemployment examinations.

Adolescent↗
PubMed1993

[Smell and taste in patients with chronic renal failure treated by hemodialysis].

In 30 patients with chronic renal failure, who were treated by hemodialysis, we investigated smell and taste function. We compared these functions before and up to 6 months following hemodialysis. We also estimated the correlation of the level of urea in the patients' blood with taste and smell. We found a positive (though temporary) influence of hemodialysis upon taste and smell.

Adolescent↗
PubMedDate not supplied

Taste and smell. Neglected senses that contribute to the malnutrition of AIDS.

Taste and smell loss (due to medications, oral pathology such as candidiasis, and peripheral or central nervous system disease) are well documented in HIV-infected people. These chemosensory abnormalities can impair food intake and contribute to wasting. An understanding of the how medications affect the senses of taste and smell may allow clinicians to choose medications based in part on these side effects. Meanwhile, the use of flavor enhancers to improve food intake may help the nutrition of patients who have suffered taste and smell losses.

Female↗
PubMed1980

Fat cell number, resting metabolic rate, mean heart rate, and insulin elevation while seeing and smelling food as predictors of slimming.

The explanatory value of total fat cell number, resting metabolic rate, mean heart rate during sleep, and peripheral insulin while seeing and smelling food were examined in relation to weight reduction in 19 obese women on a 1100-kcal/day diet. The insulin response while seeing and smelling food was expressed as the insulin area (mU x min x 1(-1)) over the baseline level. Food was presented in front of the patient for 5 min. Insulin was determined in short intervals 20 min before and 20 min after start of food presentation. Fat cell number, resting metabolic rate, and mean heart rate during sleep were determined with standard techniques. All patients went through a period of weight loss, a plateau phase, and a period of weight regain. Body weight, fat cell number, resting metabolic rate, and/or heart rate correlated significantly with degree and rate of weight loss, duration of plateau phase, and rate of regain. In multiple regression analysis fat cell number and resting metabolic rate explained 81% of the variance for weight loss, 66% for rate of regain, and 29% for duration. For duration, only fat cell number contributed significantly. The variance of rate of weight loss was explained up to 49% by metabolic rate and insulin response while seeing and smelling food. The possibility of predicting weight reduction to a certain target weight is of great practical importance since the patients can obtain a realistic goal for their efforts to reduce body weight. Hopefully systematic investigations of factors associated with the inability of obese subjects to maintain weight reduction will improve treatment in the future.

Adipose Tissue↗
PubMed2004

Smell and taste disorders.

Disorders of taste and smell can present a challenge to the facial plastic surgeon. Obtaining a detailed history and examination is the key to the diagnosis and work-up of olfactory and gustatory dysfunction. Easy-to-administer tests are available for olfactory evaluation(University of Pennsylvania Smell Identification Test) and gustatory (taste sticks, tasting tablets) evaluation. The prognosis and management of olfactory and gustatory disease depend on its etiology. Despite ongoing research, the treatment of the disorders of smell and taste is limited.

Chemoreceptor Cells↗
PubMedDate not supplied

Deficient dietary intake of vitamin E in patients with taste and smell dysfunctions: is vitamin E a cofactor in taste bud and olfactory epithelium apoptosis and in stem cell maturation and development?

OBJECTIVES: We reviewed dietary intake of several nutrients in a large group of patients with taste and smell dysfunction, compared intake of these nutrients with standard values, and recognized that intake of vitamin E was significantly less than that of most other nutrients. Based on this observation we attempted to develop an hypothesis of the possible role vitamin E might play in these sensory disorders. METHODS: Vitamin E intake was measured in 250 patients with taste and smell dysfunctions. RESULTS: Intake of the vitamin was 3.2 +/- 0.2 mg/d (mean +/- standard error of the mean), or 36 +/- 2% of the recommended daily allowance, an intake significantly below that considered adequate. This diminished intake occurred with normal intake of total calories; protein; fat; carbohydrate; several vitamins, including thiamin, niacin, and pyridoxine; and the trace metals zinc, copper, and iron. CONCLUSIONS: Although specific relations between vitamin E intake and smell and taste dysfunctions are unclear, the non-antioxidant roles of vitamin E indicate that it is a factor in apoptosis, cellular signaling, and growth of various cell lines, suggesting that this vitamin may play a role in growth and development of stem cells in taste buds and olfactory epithelium.

Adolescent↗
PubMed1997

[Disorders of smell and taste. Standard and recent methods in diagnosis and therapy].

Compared to disorders of the ears and eyes, diseases of smell and taste seem to be far less outstanding: however, the unimpaired perception of odours and flavours comprises an important part of our well-being, as can be seen in the perfume industry or in drinking and eating habits. The ENT-specialist covers organic causes of these senses, as he has the tools to explore and treat in the depth of the nasal and oral cavities. The "Arbeitsgemeinchaft Olfaktologie/Gustologie der Deutschen Gesellschaft für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie" therefore is in process of establishing a new set for a standardised smell and taste test, which is based in part on the sniffin'sticks, which were developed by Prof. Kobal, Erlangen. The examination procedure of nasal and oral chemosensory performance requires a high test-retest reliability and an efficiency comparable to internationally established measurements in order to render valid results in diagnostic and therapeutic procedures. The new test kit with the sniffin'sticks is presented in this paper, followed by an overview on some disorders of smell and taste perception and proposals for actual therapeutic procedures.

Ageusia↗
PubMed1995

Workplace, age, and sex as mediators of olfactory function: data from the National Geographic Smell Survey.

Certain medications and environmental agents are known to adversely affect chemosensation. We report data from 712,000 respondents aged 20 to 79 to the National Geographic Smell Survey that suggest that exposure to the factory workplace adversely affects the sense of smell, and that these effects interact with age. Men and women with histories of factory work reported poorer senses of smell relative to other workers. They also demonstrated objective evidence of greater impairment in odor detection. These effects were greater for men. Factory workers of all ages more frequently reported olfactory loss secondary to chemical exposure and head injury than did workers in other environments. The highest relative risk of olfactory problems secondary to head injury was in the oldest women factory workers. Thus, olfaction may behave as other senses do: Age, sex, and exposure to noxious events or agents interact to produce sensory deficits.

Adult↗