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At least 397 records · Page 22Linked to original sources
PubMed2006

Detection of herpes simplex virus type 1 in addition to Epstein-Bar virus in tonsils using a new multiplex polymerase chain reaction assay.

HSV-1, HSV-2, CMV, EBV, which are the members of the herpes virus family colonize and establish latent infection in human. Although EBV is a well known virus most involved in recurrent bouts of acute tonsillitis, the role and possibility of HSV-1, HSV-2, and CMV for establishing infection in tonsils are not clear. The purpose of this study is to verify whether the tonsils might harbor the HSV-1, HSV-2, and CMV, in addition to EBV, in chronically hyperplastic nasopharyngeal lymphoid tissue. To accomplish the purpose, we developed a new Multiplex Polymerase Chain Reaction (M-PCR) assay using a single consensus forward primer and virus specific reverse primers for DNA polymerase gene of HSV-1, and 2, EBV, and CMV, and investigated its efficiency for detecting HSV1, HSV2, CMV, and EBV. The sample of 52 patients underwent tonsillectomy or adenectomy because of chronic lymphoid hyperplasia without any evidence of acute infections and were investigated for presence of HSV-1, HSV-2, CMV, and EBV. Of the 54 samples, 11 (20.4%) of them were positive for EBV, 4 of them (7.4%) were positive for HSV-1, and none of the samples were positive for HSV-2 and CMV. To the best of our knowledge, this is the first report that tonsils may be the reservoir for HSV-1 in addition to EBV, and HSV-1 may have a role in recurrent tonsillitis and systemic diseases. The MC-PCR assay presented in this study can provide a rapid, sensitive, and economical method for detection of HSV-1, HSV-2, EBV, and CMV in a single PCR tube.

Adolescent↗
PubMed1986

Long-term investigation of habitual tonsillitis in children.

The authors were in close contact with children who had indications for tonsillectomy and investigated them in both acute tonsillitis and intermittent periods of tonsil inflammation. The results obtained were as follows: Repeated attacks of acute tonsillitis clearly decreased in number. No secondary diseases due to tonsillitis were observed. When repeated attacks of acute tonsillitis occurred, the symptoms were not as serious as previously.

Adolescent↗
PubMed1991

Differences in tonsil core bacteriology in adults and children: a prospective study of 262 patients.

The tonsillar microflora of 262 patients with recurrent acute tonsillitis studied in 1989-1990 is presented. The patient population was divided into three age groups to determine any age-related features. One-hundred and forty-nine patients (57%) were in the 2-7-year-old group, 72 (28%) the 8-14-year-old age group, and the remaining 41 (15%) were over 15 years of age. H. influenzae was the single most common bacterium isolated from the centre of the tonsil (referred to as 'tonsil core'), and this was more prevalent in the 2-7-year-old age group. Staph aureus was the next most commonly isolated bacterium and was most frequently seen in the 8-14-year-old age group (29%). Anaerobic bacteriology was performed in 120 patients. Strict anaerobic species were isolated in significant numbers from the tonsil core in 5% but were present in the superficial culture in all. Anaerobes were present in moderate to heavy numbers in 32% of superficial swabs overall and this was more frequently seen in the older age groups. Mixed pathogens were found throughout all age groups and were most prevalent in the 8-14-year-old age group at 46%. The commonest mixture was H. influenzae and Staph aureus. Normal flora only was commonly found in the superficial swab and rarely in the tonsil core. The number of specimens containing a beta-lactamase producer was assessed for each group; this was similar in all of the groups ranging from 43% in the 2-7-year-old group and 53% in the 8-14-year-old group to 39% in the greater than 15-year-old group.

Adolescent↗
PubMed1977

Surface tonsillar microflora versus deep tonsillar microflora in recurrent acute tonsillitis.

One hundred patients suffering from recurrent acute tonsillitis were studied. One hundred tonsils were cultured. Surface bacteria were compared to deep bacteria. In 48 per cent of the cases a different pathogen was cultured from the interior of the tonsil as compared to the surface culture. This fact may explain recurrence of tonsillitis and makes the reliability of the conventional tonsillar culture questionable. Surgical extirpation of the tonsils seems to be the only treatment since deep bacteria remain unidentified and resist the antibiotic therapy that may affect only the surface microflora.

Acute Disease↗
PubMed1998

Restricted usage of the T-cell receptor V beta repertoire in tonsillitis in association with palmoplantar pustulosis.

Focal infections such as chronic tonsillitis or dental caries occasionally play a role in the induction or exacerbation of palmoplantar pustulosis (PPP). Arthro-osteitis is sometimes a complication in severe cases of PPP. To study the effects of bacterial infection on the exacerbation of cutaneous lesions and arthralgia, we investigated the T-cell receptor V beta repertoire in peripheral blood mononuclear cells (PBMC) and tonsil tissue after tonsillectomy in 4 cases, who had chronic tonsillitis and a history of exacerbation of cutaneous lesions following a sore throat. First, serum levels of interleukin-6 (IL-6) and IL-8 were measured before and after tonsillectomy by enzyme-linked immunosorbent assay (ELISA). Second, 3H-TdR incorporation was used to examine the effects of the culture supernatant on the PBMC of the autologous patients, other PPP patients without tonsillitis and normal controls. T-cell receptor V beta repertoire was examined by the reverse transcriptase-polymerase chain reaction method. Results showed that IL-8 was significantly high in the serum and abundantly released from tonsillar lymphocytes, which may play a role in the accumulation of neutrophils in lesional skin. T-cell receptors V beta 6 and 12 were preferentially expressed on tonsillar lymphocytes, and V beta 4, 7, 9, 17 and 18 were detected relatively frequently. These data suggest that restricted usage of T-cell receptor V beta subsets may play a crucial role in the induction of tonsillitis associated with PPP.

Adult↗
PubMed1996

IgA nephropathy with poorly developed lymphoepithelial symbiosis of the palatine tonsils.

Tonsillar abnormalities have been observed in patients with IgA nephropathy (IgAN). In addition, it has been suggested that reticulization of tonsillar crypt epithelium is important in tonsillar immunity. Therefore, we investigated reticulization of this area in patients with IgAN (14 cases) and compared results with those of control patients who exhibited recurrent tonsillitis or tonsillar hypertrophy (12 cases). Immunohistochemical staining of antikeratin antibody PKK1 was employed to visualize reticulization. Tonsils of controls showed well developed reticular crypt epithelia with lymphoepithelial symbiosis and the nonreticulated area was less than 7% of the total crypt epithelia per overall section. In IgAN tonsils, however, nonreticulated crypt epithelium was frequently observed and, in the advanced stage of IgAN, exceeded 50% of total crypt epithelia. The extent of glomerular damage in IgAN patients correlated significantly with the percentage of the area of nonreticulated crypt in palatine tonsils with a correlation coefficient of 0.91. Considered together with our finding that PKK1-positive epithelial reticular cells strongly expressed HLA-DR antigens in normal tonsils, the low level of reticulization in IgAN patients may induce the unusual immunity responsible for the pathogenesis of IgAN.

Adolescent↗
PubMedDate not supplied

Chronic bacterial tonsillitis: fact or fiction.

Chronic bacterial tonsillitis can be validly supported etiologically by quantitative bacteriologic methods. The following observations are based on a recognition that the mere presence of bacteria is much less significant than the level of bacteria present. The chronically infected adult patient may be characterized by tonsils subclinically harboring greater than 10(5) bacteria/gm as opposed to the control patient with 10(3) bacteria/gm. Useful features in predicting high bacterial levels are (1) low number of crypts, (2) presence of nodal hypertrophy, and (3) tonsils small by actual size. Estimated tonsil size, determined preoperatively, shows no statistically significant correlation with either actual size or degree of tonsil sepsis.

Adolescent↗
PubMed1984

Lingual tonsillectomy: a treatment for inflammatory lesions of the lingual tonsil.

Lingual tonsillectomy is a surgical treatment that is seldom performed because lingual tonsillitis is infrequently diagnosed. We have reviewed a group of patients with lingual tonsillitis or lingual tonsil hyperplasia who were treated with lingual tonsillectomy. Lingual tonsil lesions, the anatomy and histology of the lingual tonsil, and surgical approaches to lingual tonsillectomy are discussed.

Adult↗
PubMed1993

Effect of specific bacteria on lymphocyte proliferation in diseased and nondiseased tonsils.

Tonsillar tissue lymphocyte (TTL) function as measured by lymphocyte proliferation was assessed in vitro in 38 tonsils--30 diseased and 8 normal controls. TTLs from diseased and control tonsils were challenged with intact, heat-inactivated bacteria which may be found in the core of diseased tonsils; these bacteria were Streptococcus pyogenes and Hemophilus influenzae type B (HIB), as well as the dominant bacterium (DB) grown from that particular tonsillar core. The phytomitogen leukoagglutinin (LA) was used as a nonspecific activator. Lymphocyte proliferation was quantified and reported using a stimulation index (SI) which was based upon viable cell counts at 2, 4, and 6 days following inoculation. Overall, the greatest degree of lymphocyte proliferation in diseased TTLs (SI = .91) was produced by HIB. However, both SP and HIB produced more lymphocyte proliferation in the nondiseased TTLs than in the diseased TTLs (P < .01). H influenzae (non-B) and group A beta-hemolytic streptococci were the pathogens most frequently cultured as the dominant bacteria from the core of diseased tonsils; Streptococcus viridans was most frequently cultured in nondiseased tonsils. The DB caused greater TTL proliferation in diseased (SI = .89) versus control (SI = .63) TTLs (P < .001). These findings suggest a differential proliferative response in vitro for diseased and nondiseased TTLs in response to specific bacteria. The role of possibly pathogenic bacteria and commensals, as well as the implications for clinical disease, are discussed.

Cell Division↗
PubMed1979

Immunoglobulin-producing cells in clinically normal, hyperplastic and inflamed human palatine tonsils.

Patients suffering from recurrent tonsillitis (RT), hyperplastic tonsillitis (HT), or idopathic tonsillar hyperplasia (ITH) were compared in immunological studies with subjects showing clinically normal tonsils. Serum concentration of immunoglobulins, particularly IgG, were found to be increased in association with tonsillitis. Conversely, the number of IgG-, IgA- and IgM-producing immunocytes per tissue unit was reduced in the germinal centres of lymphoid follicles, in the extrafollicular areas, and in the reticular parts of the crypt epithelium. The overall percentage distribution of these cells was normally 65:30:3.5:1.2 for the IgG, IgA, IgM and IgD classes, respectively. In RT these figures were 53:39:4.7:4.4; in HT, 67:25:4.0:4.5; and in IHT, 50 : 33 : 7.2 : 10. Thus, there were only small alterations in the immunocyte class proportions, except for a significant relative increase in IgD-producing cells. The results indicate that there is a functional defect of the tonsils in association with disease. The relative accumulation of IgD cells is probably explained by an inadequate local maturational process in B-cell system, altough some influence of low age cannot be excluded in the HT and ITH groups.

Adolescent↗
PubMed1996

The production of immunoregulatory cytokines is localized to the extrafollicular area of human tonsils.

The localization and production at the single cell level of 19 different human cytokines, IL-1 alpha, IL-1 beta, IL-1ra, IL-2, IL-3, IL-4, IL-5, IL-6, IL-8, IL-10, IL-13, TNF alpha, TNF beta, IFN gamma, GM-CSF, G-CSF, and TGF beta 1-3, were studied in cryopreserved tonsillar tissue using immunohistochemical staining. The cytokine producing cells, with the exception of IL-1 expressing cells, had a characteristic morphology due to the accumulation of cytokine onto the Golgi organelle. The production of each cytokine was localized to specific compartments in tonsillar tissue sections from children with tonsillar hypertrophy or recurrent tonsillitis in the resting state. Immunoregulatory cytokines such as IL-2, IL-3, IL-4, G-CSF, GM-CSF and TGF beta were produced in the extrafollicular area and entrapped on the cell membranes as well as in pudels in the extracellular matrix surrounding the producer cells. The dominating cytokines both in tissues from recurrent tonsillitis and tonsillar hypertrophy were GM-CSF, G-CSF, and TGF beta 1-3 which were synthezised predominantly in the reticular crypt site. IL-1 alpha, beta and IL-1ra, on the other hand, were localized to the surface and crypt epithelium and to scattered regions in the extrafollicular area. IL-2, IL-6, IFN gamma and IL-10 were found much more often in sections obtained from recurrent tonsillitis tissue compared with those from tonsillar hypertrophy. Reversely, an excessive production of IL-4 was noted in tonsillar hypertrophy compared with that in recurrent tonsillitis. Thus, concomitant production of multiple cytokines was evident with similarities but also differences in cytokine pattern between the two groups studied. The data suggest that T-cell mediated B-cell activation and differentiation take place in the extrafollicular area. Children with recurrent tonsillitis had a higher amount of B-cells and monocytes compared with children with tonsillar hypertrophy. However, the number of CD3, CD4, CD8 or cytoplasmic Ig-positive cells did not differ between the two groups.

Cell Movement↗
PubMed2000

[Morphological study of the palatine tonsils: clinical and histopathological considerations].

This study examined 71 pediatric tonsillectomy patients through accurate case history and clinical examination, placing particular emphasis on pathologies concomitant to tonsillopathy. In an attempt to find anatomo-clinical correlations, these data were processed together with the results of a histomorphological study of thetonsil epithelium, performed on all tonsillectomy samples. The majority of these patients were females and none more than 13 years of age. Numerous pathologies were found associated with the tonsillopathy and in varying combinations, first and foremost of which was adenoid hypertrophy. Only approximately one fifth of the patients did not show any concomitant pathology of note. All patients presented a history of recurrent pharyngotonsillitis (at least 4 episodes a year) with symptoms arising from 1 to 10 years prior to surgery. The concomitant pathologies included: respiratory, cutaneous and food allergies, asthma, obstructive sleep apnea, rheumatic diseases, etc. From the histomorphological point of view, particular modifications were found in the follicle epithelium and interstitial cells of the palatine tonsil. An exasperated fibrotic interstitial reaction and chronic duration of the disease appeared to prevent tonsil filter function, facilitating chronicization of the tonsillopathy or onset of recurrent infections and concomitant allergies. In the allergic patients the tonsil epithelium was thickened and compact and showed various degrees of chorion edema, in agreement with what is found in the literature. On the contrary, few morphostructural palatine tonsil mutations were found in those subjects which did not present any concomitant pathology or were affected by tonsillopathy of brief duration. All the histomorphological modifications encountered appear related to the individual patient history, confirming the hypothesis that tonsil epithelium can not only condition the evolution of tonsillopathy--reflecting the effect of various factors--but, above all, it directs the immune response, thus playing a role in the development of various concomitant pathologies.

Adolescent↗
PubMed2001

[Relation between actinomycosis infection and the occurrence of chronic tonsillitis in adults].

Chronic tonsillitis is a frequent disease in the adult population, in which the actinomycotic infection represents a not negligible accompanying phenomenon. Data about the presence of actinomycotic granules in tonsilar crypts are controversial in the available literature sources. Likewise, evaluation of the clinical significance of actinomycetes in the tonsil is reduced to simple saprophytism by some, or is considered infective for the tonsilar tissue by others. The present study assesses the appearance of actinomycetes and the character of their invasiveness in the tonsilar tissue afflicted with chronic tonsillitis. The material consists of surgical specimens from 125 patients between the age of 15 to 78 years. Actinomycotic granules were present in 52 cases (41.6%), in 3 of those (5.8%) no tissue reaction was observed. Most frequently, in 32 of positive cases (61.5%), the granules were in crypts accompanied by abundant accumulation of inflammatory cells. In 16 cases (32.7%), actinomycetes migrated through the epithelium into the tonsilar tissue. The presence of actinomycotic granules was significantly higher in chronic lacunar tonsillitis (72.4%) if compared with chronic tonsillitis cases without dilated crypts (36.3%). Our results indicate that actinomycets may play an active role in the etiology of chronic inflammatory tonsilar disease as the causative factor, or as a factor complicating an antecedent disease.

Actinomycosis↗
PubMed1984

Functional morphology of tonsillar crypts in recurrent tonsillitis.

The cryptal epithelia contained three types of micropores (termed microcrypt) in association with free cells. Type III microcrypts appeared between ordinary epithelial cells with microridges and "specialized epithelial cells". The specialized epithelial cells consist of ciliated cells and non-ciliated cells having secretory granules and pinocytotic vesicles. Horseradish peroxidase (HRP) was taken up by phagocytes which protruded from the microcrypt and the superficial squamous epithelial cells with pinocytotic vesicles of idiopathic hypertrophic tonsils. It is suggested that Type III microcrypts have two contradictory functions. One is an active absorption of exogenous antigens; and the other is an exclusion of exogenous invasions according to mucociliary function. In recurrent tonsillitis, HRP was remarkably detected in the dilated stratified squamous epithelial clefts, epithelial tunnels, subepithelial layers and in the lumen of the high endothelial venules. The occurrence of sclerotic germinal centres in recurrent tonsillitis, and in focal infection, was greater than in idiopathic tonsillar hypertrophy, whereas the incidence in appearance of specialized epithelial cells was less frequent in acute tonsillitis than in recurrent tonsillitis, and in focal infection.

Adolescent↗
PubMed1996

Superoxide dismutases in human palatine tonsils.

In order to investigate the protective system of human palatine tonsils against the cytotoxic superoxide radicals (O(-)(2)) generated from the oxygen-related bactericidal system, immunohistochemistry and electron spin resonance (ESR) spectrometry were used to detect the distribution and activities of superoxide dismutases (SODs) in tonsils of different related systemic diseases. Immunohistochemistry showed that SODs distribute in extrafollicular lymphatic tissue and crypt epithelium. No distribution difference could be found between tonsils of different related systemic diseases. ESR revealed no significant difference between SODs activities in tonsils of different related systemic diseases. However, the mitochondrial SOD activity was found to constitute approximately 50%-60% of the total tonsillar cellular SODs activity. The results suggest: i)tonsils possess the ability to control cytotoxic O(-)(2), ii) crypt epithelium and extrafollicular lymphatic tissue may encounter more O(-)(2) threat, iii) SODs may be important in protecting germinal centers from O(-)(2) injury, and iv) systemic diseases are less related to the local expression of tonsillar SODs.

Adult↗
PubMed1996

Histopathological concept of chronic tonsillitis in children.

The purpose of this study was to ascertain to what degree the clinical entity recurrent tonsillitis (RT) is associated with a histopathological pattern of chronic tonsillitis. Cases of idiopathic tonsillar hypertrophy (ITH) not associated with recurrent infections were used for comparison. We performed a histopathological study of 126 palatine tonsils of children (57 cases due to RT and 69 due to ITH). The following features were evaluated: cryptal reticulation, the relative amount of diffuse and follicular lymphoid tissues, the intensity of parenchymal fibrosis, the papillary arrangements of the epithelium, the amount of debris in the lumen of the crypts, and the presence of keratin cysts. There was no significant quantitative difference between the two groups (RT and ITH) and we did not find a histological distinctive pattern of RT or ITH. Recurrent infection in the tonsils in children is not associated with a histopathological pattern which could be termed chronic non-specific tonsillitis and is clearly distinguishable from idiopathic tonsillar hypertrophy.

Adolescent↗
PubMed1996

Reduced reticulization of palatine tonsils with IgA nephropathy.

Tonsillar abnormalities have been observed in patients with IgA nephropathy (IgAN). In addition, it has been suggested that the reticulization of tonsillar crypt epithelium is important in tonsillar immunity. Therefore, we investigated reticulization of this area in patients with IgAN (10 cases) and compared results with those of control patients who exhibited recurrent tonsillitis or tonsillar hypertrophy (12 cases). Immunohistochemical staining of anti-keratin antibody PKK1 was employed to visualize reticulization. Tonsils of controls showed well developed reticular crypt epithelia with lymphoepithelial symbiosis, and the non-reticulated area was less than 7% (mean 1.9%, range 0-6.3%) of the total crypt epithelia per overall section. In IgAN tonsils, however, non-reticulated crypt epithelium was frequently observed and, in the advanced stage of IgAN, exceeded 50% (mean 62%, range 50-69%) of total crypt epithelia. The extent of glomerular damage in IgAN patients correlated significantly with the percentage of the area of non-reticulated crypt epithelia in palatine tonsils with a correlation coefficient of 0.91. Considering together with our finding that PKK1-positive epithelial reticular cells strongly expressed HLA-DR antigens in normal tonsils, the low level of reticulization in IgAN patients may induce the unusual immunity responsible for the pathogenesis of IgAN.

Adolescent↗
PubMed1998

Risk factors for malignancy in adult tonsils.

BACKGROUND: Tonsillectomy in adults (age 18 years and older) is performed for a variety of conditions. The palatine tonsils may harbor carcinoma or lymphoma, and this potentially unanticipated finding may follow routine tonsillectomy in the adult. The ability to preoperatively identify adult tonsillectomy patients at increased risk for tonsillar malignancy could sensitize the clinician to this possibility and the potential need for expedited rather than routine tonsillectomy scheduling. METHODS: A retrospective review of 476 consecutive adult patients who underwent tonsillectomy during the last 10 years at the University of Iowa Hospitals and Clinics was undertaken. Proposed risk factors for tonsillar malignancy included a prior history of head and neck cancer, tonsillar asymmetry, palpable firmness or visible lesion in the tonsil, neck mass, unexplained weight loss, and unexplained constitutional symptoms. These risk factors were correlated with the pathologic diagnosis in the reviewed cases. RESULTS: Of these 476 patients, 25 had malignant tonsil pathology. No patient without risk factors was found to have malignancy on pathologic evaluation of the tonsils. Of the 25 patients with malignant tonsillar pathology, 23 had two or more risk factors, and 2 patients had one risk factor. Tonsillar asymmetry, found in 20 of the 25 cases, was the risk factor most frequently associated with malignant pathology. CONCLUSIONS: These results indicate that the presence of certain preoperatively identifiable risk factors are associated with the pathologic finding of malignancy in adult tonsillectomy specimens. Based on these criteria, a model which is predictive of the presence of tonsil malignancy may be constructed.

Adult↗