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PubMedDate not supplied

Aerobic and anaerobic bacteria in tonsils of children with recurrent tonsillitis.

Tonsils were obtained from 50 children suffering from recurrent tonsillitis. Patients' ages ranged from 2.5 to 17 years (mean 6 years); 29 were males and 21 females. The tonsils were sectioned in half after heat searing of the surface and the core material was cultured for aerobic and anaerobic microorganisms. Mixed aerobic and anaerobic flora was obtained in all patients, yielding an average of 7.8 isolates (4.1 anaerobes and 3.7 aerobes) per specimen. There were 207 anaerobes isolated. The predominant isolates were 101 Bacteroides sp (including 10 B fragilis group, and 47 B melaninogenicus group), 29 Fusobacterium sp, 34 Gram-positive anaerobic cocci (25 Peptococcus sp and 9 Peptostreptococcus sp) and 16 Veillonella sp. There were 185 aerobic isolates. The predominant isolates were 41 alpha-hemolytic streptococci, 24 Staphylococcus aureus, 19 beta-hemolytic streptococci (11 group A, 4 group B, and 2 each group C and F), 14 Haemophilus sp (including 12 H influenzae type B) and 5 H parainfluenzae. Beta-lactamase production was noted in 56 isolates recovered from 37 tonsils. These were all isolates of S aureus (24) and B fragilis (10), 15 of 47 B melaninogenicus (32%), 5 of the 12 B oralis (42%), and 2 of 12 H influenzae type B (17%). Our findings indicate the polymicrobial aerobic and anaerobic nature of deep tonsillar flora in children with recurrent tonsillitis, and demonstrate the presence of many beta-lactamase-producing organisms in 74% of the patients.

Adolescent↗
PubMed1991

[Antibody-producing ability of mononuclear cells from human tonsils: a consideration for immunological pathogenesis and operative indication of recurrent tonsillitis].

Antibody-production of mononuclear cells from human tonsils was examined by enzyme-linked immunosorbent assays in the culture system following polyclonal stimulations with pokeweed mitogen. The results were summarized and discussed as follows; 1) Age-related changes were not observed. 2) Antibody-producing ability in the intermittent phase of recurrent tonsillitis was significantly impaired. 3) Antibody-production in the recrudescent phase of recurrent tonsillitis was increased and might be reactivated probably by stimuli of the recent infection in vivo. 4) It was suggested that the recurrent tonsillitis was due to the low antibody-production ability of tonsillar mononuclear cells. 5) These results gave an immunological basis on the operative indication of recurrent tonsillitis.

Adolescent↗
PubMed2004

[Electrophoretic lymphocyte motility in tonsils of patients with chronic tonsillitis].

The changes in the electrophoresis motility (EPM) of lymphocytes in the tonsils of patients with chronic tonsillitis were assessed using the method of microelectrophoresis. Tonsil lymphocytes of healthy volunteers were used as controls of these experiments. During this investigation it was shown that the average value of EPM of lymphocytes in the control group was -0.98 +/- 0.02 mumol.cm.V-1.S-1. The absolute value of TPM of lymphocytes of the patients with chronic tonssillitis in average dropped 16% to a value of -0.82 +/- 0.02 mumol.cm.V-1.S-1. The percent composition of lymphocytes, whose EPM was close to 0, is higher in the group of patients with chronic tonsillitis, then in the control group. Mathematical analysis were conducted on the experimental data and on the basis of the results it was proposed that the drop of the absolute value of EPM during chronic tonsillitis is connected with the drop in the amount of active lymphocytes.

Cell Membrane↗
PubMed2006

[The activity of chronic inflammation of palatine tonsils mucosa in chronic tonsillitis before and after treatment using UZOL-01-Ch device].

A low-frequency ultrasound device UZOL-01-Ch was applied for therapy of chronic tonsillitis (CT). The activity of chronic inflammation was followed up under action of 0.05% dioxidine solution coming through the device UZOL-01-Ch on the tissues of palatine tonsils in CT at a clinical remission phase in 34 CT patients. CT activity degrees were proposed which were defined by the presence and distribution of polymorphonuclear neutrophils in inflammatory cellular infiltrate of palatine tonsil mucosa in CT. These degrees help assessed the results of therapeutic effect of the device UZOL-01-Ch on tonsil tissue in CT. Use of the device provided depression of inflammation activity in tonsil mucosa in CT patients at a clinical remission phase.

Adolescent↗
PubMed1977

[Role of the microbial flora of the palatine tonsils in the pathogenesis of chronic tonsillitis].

Species composition and the potency of a microbial focus of the microorganisms on the surface and in the lacunae of the palatine tonsils were studied in 51 patients suffering from chronic tonsillitis and in 52 healthy indivisuals. The species composition of the microorganisms was identical in the groups under study. However, its quantitative indices displayed significant differences. The potency of the microbial focus of the beta-hemolytic streptococci in the tonsillar lacunae of healthy individuals averaged 0.010 +/- 0.02 million, in patients with simple chronic tonsillitis-0.16 +/- 0.05, and in toxicoallergic tonsillitis of the I degree-1.03 +/- 0.8 million microbial cells. The constancy and a marked increase of all the species of microorganisms in the tonsillar lacunae of patients suffering from chronic tonsillitis, and also a marked dependence of this phenomenon on the extent of decompensation of the pathological process led to the conclusion that all of them played a definite role in the pathogenesis of this disease. It is supposed that the pathogenic influence of the mentioned microbes on human organism was realized both on account of summation of the antigenic-allergic and the infectious action, and by its other possible mechanisms.

Adult↗
PubMed1982

[Concentrations of erythromycin and amoxicillin in tonsil and sinus tissues of patients with tonsillitis and sinusitis. A comparison (author's transl)].

Thirty male patients with chronic tonsillitis and 30 male patients with chronic Sinusitis maxillaris were pre-treated for four days with either 2 X 1 g erythromycin daily per os or 3 X 0.75 g amoxicillin daily per os in an open and randomised comparative study. MIC values for the relevant bacteria were determined beforehand. The intended tonsillectomy or radical operation was performed on the third day of pre-treatment, circa 1.5 h after the final administration of antibiotics. The tonsils or the sinus membrane were examined bacteriologically; the concentrations of erythromycin or amoxicillin were determined. At the same time, the concentration of the antibiotic administered was determined in the serum. The average concentration of erythromycin in the tonsil tissue was 1.24 micrograms/g; it was 1.21 micrograms/g in the sinus membrane. Amoxicillin was found at a concentration of 0.17 microgram/g in the tonsil tissue, and 0.1 microgram/g in the sinus membrane. While the levels of erythromycin in the tissue generally equalled or exceeded the MIC value for the pathogen in question, the levels of amoxicillin only reached the relevant MIC value for the given pathogen in a few cases since the concentration in the tissue was insufficient. The clinical tolerance of both antibiotics was good.

Administration, Oral↗
PubMed2004

Detection of the archetypal regulatory region of JC virus from the tonsil tissue of patients with tonsillitis and tonsilar hypertrophy.

The regulatory regions of JC virus (JCV) DNAs in the brain of patients with progressive multifocal leukoencephalopathy (PML) (designated as PML-type regulatory regions) are hypervariable, whereas those in the urine and renal tissue of individuals without PML have the same basic structure, designated as the archetype. It is thought that JCV strains with the archetypal regulatory region circulate in the human population. Nevertheless, Monaco et al (J Virol 70: 7004-7012, 1996) reported that PML-type regulatory regions occur in human tonsil tissue. The purpose of this study is to confirm their findings. Using nested polymerase chain reaction (PCR), the authors detected the regulatory region of JCV DNA in the tonsil tissue from 14 (44%) of 32 donors with tonsillitis and tonsilar hypertrophy. Sequencing of the detected regulatory regions indicated that they were identical with the archetypal regulatory regions detected previously or, in a few cases, slightly deviated from the archetype. This finding suggests not only that tonsil tissue is the potential site of initial JCV infection but also that archetypal JCV strains circulate in the human population.

Adult↗
PubMed2004

Histopathological evaluation in biopsies of palatine tonsils submitted to cryptolysis by coagulation with CO2 laser for treatment of chronic caseous tonsillitis.

OBJECTIVE: To perform histopathological evaluation in biopsies of palatine tonsils in a group of patients, with symptoms of chronic caseous tonsillitis, treated with an innovative and conservative method, using CO(2) laser. BACKGROUND DATA: In general, the treatment of chronic caseous tonsillitis with CO(2) laser, as described in the literature, refers to the clinical experience of the authors and, the technique used for criptolysis encourages tissue vaporization, which leads to the consequent reduction of the tonsillar parenchyma. MATERIALS AND METHODS: The individuals were submitted to cryptolysis coagulation with only 6 W of CW, CO(2) laser power, in scanned and unfocused mode, over a mean area of 2.2 mm diameter, leading to energy doses from 18 to 54.5 joules/cm(2). Biopsies were performed at the beginning and end of each treatment. A comparative analysis was performed between the initial and final biopsies taking into consideration possible alterations in the following: germinal centers, lymphoid tissue, sub-epithelial fibrosis, and parenchyma fibrosis. RESULTS: The histopathological analysis of these biopsies showed that the laser, used at a specific energy density, could relieve the symptoms of the disease causing neither increase of the fibrotic content nor decrease of the lymphoid structure. The action of the laser, following the proposed technique, is superficial, causing only epithelial coagulation, which enables a weakening of the tension forces in the crypt borders, causing them to open. This effect results in the reduction and even disappearance of caseous retention. CONCLUSION: We, therefore, conclude that the proposed method of treatment with CO(2) laser, called laser cryptolysis by coagulation (LCC) is an effective and conservative method, causing no significant morphological alterations to the tonsils.

Adolescent↗
PubMed2006

[Morphological radioautographic study of the palatine tonsils in chronic tonsillitis and healthy subjects].

A pilot morphological (radioautographic) study of healthy and affected palatine tonsils (in hypertrophy and toxic-allergic form of chronic tonsillitis) in children and adults has shown that intensity of biosynthetic processes (protein-synthetic -- RNA synthesis and proliferative activity -- DNA synthesis) in the cells of palatine tonsils and structural changes of their tissues depend on characteristics of pathological process. Microbial penetration into the tonsils with formation of an active focus of chronic infection is traced.

Adolescent↗
PubMed1989

[Morphology of the palatine tonsil lymphocytes in chronic tonsillitis using data of electron microscopic radioautography].

Electron-microscopic and electron-radioautographic examinations of the palatine tonsil lymphocytes in 20 patients with chronic decompensated tonsillitis, aged 21-50, have revealed the proliferation of poorly differentiated T- and B-lymphocyte pools in the lymphoid tissue of the tonsils; these processes manifest by an intensive 3H-thymidine incorporation into the minor lymphocytes of different types. A high level of the RNA radioactive precursor incorporation in B-lymphocytes indicates a constant differentiation of this lymphocyte population. The biological essence of intensive incorporation of protein radioactive precursors in B-lymphocytes appears to consist in the maximal production of active protein substrates mediating the humoral immunity in chronic tonsillitis.

Adult↗
PubMed1978

Immunoglobulin systems of human tonsils. II. Patients with chronic tonsillitis or tonsillar hyperplasia: quantification of Ig-producing cells, tonsillar morphometry and serum Ig concentrations.

Patients suffering from recurrent tonsillitis (RT), hyperplastic tonsillitis (HT) or idiopathic tonsillar hyperplasia (ITH) were compared in immunological studies with subjects showing clinically normal palatine tonsils. Serum concentrations of immunoglobulins, particularly IgG, were increased in association with tonsillitis. Conversely, the number of IgG-, IgA- and IgM-producing immunocytes was reduced per tonsillar tissue unit. The density of such cells was decreased in the germinal centres of the lymphoid follicles, in the extrafollicular areas and in the reticular parts of the crypt epithelium. However, only small changes in immunocyte class ratios were observed, excepting a significantly raised proportion of IgD-producing cells. The immunohistochemical results indicated a defect in the tonsillar immunological function associated with disease, perhaps as a result of inadequate stimulatory signals for local maturation of B-cell clones. An influence of low age on this result in the HT and ITH groups could not be excluded. In the RT group there was a significant negative correlation between the tonsillar density of IgA-producing cells and the rate of synthesis of serum IgA. This may indicate that compensatory mechanisms are reflected in inversely related levels of local and systemic IgA synthesis.

Adolescent↗
PubMedDate not supplied

[The morphofunctional characteristics of the palatine and pharyngeal tonsils in children with chronic tonsillitis and adenoids].

22 palatine and 10 pharyngeal tonsils of 20 children, 4 to 15 years of age, with chronic tonsillitis and adenoids were studied histologically and immunohistochemically. The material was obtained at tonsillectomy, adenotomy and adenotonsillectomy. The expression of LCA, CD20, CD45 RO, CD45 RA, CD68 and HLA DR-antigen was determined immunohistochemically. Functional heterogeneity of the whole lymphoid population in the tonsil tissue is structured by dividing lymphoid tissue into T- and B-regions. However, this subdivision is relative. Interpenetration of T- and B-cells into structurally determined functional zones reflects cooperative cell relations in the immune response the obligatory participant of which are non-lymphoid cells of the microenvironment: antigen-representing macrophages of the follicle germinative centres and reticular epitheliocytes in the regions of lymphoepithelial symbiosis. HLA-DR-antigen expression of the reticulum epithelium cells and the presence of activated T-lymphocytes in the lymphoepithelial symbiosis zones allow one to consider these zones as an immunoregulatory compartment of the tonsils.

Adenoidectomy↗
PubMed2005

Pathogenesis of experimental bovine spongiform encephalopathy: preclinical infectivity in tonsil and observations on the distribution of lingual tonsil in slaughtered cattle.

The infectivity in tissues from cattle exposed orally to the agent of BSE was assayed by the intracerebral inoculation of cattle. In addition to the infectivity in the central nervous system and distal ileum at stages of pathogenesis previously indicated by mouse bioassay, traces of infectivity were found in the palatine tonsil of cattle killed 10 months after exposure. Because the infectivity may therefore be present throughout the tonsils in cattle infected with BSE, observations were made of the anatomical and histological distribution of lingual tonsil in the root of the tongue of cattle. Examinations of tongues derived from abattoirs in Britain and intended for human consumption showed that macroscopically identifiable tonsillar tissue was present in more than 75 per cent of them, and even in the tongues in which no visible tonsillar tissue remained, histological examination revealed lymphoid tissue in more than 90 per cent. Variations in the distribution of the lingual tonsil suggested that even after the most rigorous trimming of the root of the tongue, traces of tonsillar tissue may remain.

Animals↗
PubMed2003

Simultaneous, clonally identical T cell expansion in tonsil and synovium in a patient with rheumatoid arthritis and chronic tonsillitis.

In some patients with rheumatoid arthritis (RA), the disease improves following tonsillectomy. We describe a 28-year-old woman with treatment-resistant RA and chronic tonsillitis. Initially, her arthritis had been well controlled with methotrexate and corticosteroids, but the RA activity became difficult to control in spite of addition of bucillamine to the treatment regimen and repeated arthrocentesis with infusion of corticosteroid into her swollen joints. Closer examination revealed that the period of exacerbation of her chronic tonsillitis paralleled that of the systemic arthritis, and administration of antibiotics brought transient relief of the systemic symptoms. Her arthritis was ameliorated after successful tonsillectomy and synovectomy, with marked reduction of the serum rheumatoid factor concentration. Analysis of infiltrating T cell clones in tonsil and synovium using T cell receptor V(beta) repertoire and third complementarity-determining region size distribution analysis followed by nucleotide sequencing revealed common clonal T cell expansion in both tissues. This finding suggests the possible involvement of chronic focal infection in refractory RA.

Adult↗
PubMed2006

Differential proteome analysis of tonsils from children with chronic tonsillitis or with hyperplasia reveals disease-associated protein expression differences.

A proteomic approach has been used to establish a proteome map and differentiate between the protein composition of tonsils from patients with chronic tonsillitis (CT) and that of tonsils with hyperplasia (HPL). Two-dimensional gel analysis was performed with material from four patients with HPL and five patients with CT. An average of approximately 600 spots were detected in each gel. A total of 127 different proteins were identified in 158 spots analyzed by mass spectrometry. Our study revealed disease-associated differences between protein abundance for two protein spots, an HSP27 isoform and UMP-CMP kinase. Both protein spots were more abundant in the CT group. HSP27 ELISA was performed for 32 patients, 12 belonging to the HPL group and 20 to the CT group. ELISA could not be used to differentiate HSP27 isoforms nor to distinguish CT from HPL. HSP27 was found to migrate to two further protein spots in the 2D gels. The differently expressed HSP27 isoform migrated as the most acidic of all the HSP27 isoforms detected, indicating the highest degree of phosphorylation. The sum of all three HSP27 abundances in the gels from the CT group was not different from that of the HPL group, consistent with the ELISA results. Our results suggest that phosphorylation differences caused the observed migration differences of HSP27. Together with the UMP-CMP kinase abundance differences, we conclude that kinase and/or phosphatase activity are different in CT and HPL.

Child↗
PubMed2005

Tonsillitis index: an objective tool for quantifying the indications for tonsillectomy for recurrent acute tonsillitis.

This report is a preliminary exploration of the concept of a "Tonsillectomy Index" (TI) as an objective tool for quantifying the indications for tonsillectomy for recurrent acute tonsillitis (AT). The TI is derived by multiplying the number of episodes of AT by the number of years during which the episodes of AT occurred. Our objective in this study was to investigate whether there is a relationship between the natural history of AT, the immunological functions of tonsils and our proposed TI. For the natural history of AT, we medically followed 11 children with a history of AT for 5 years. When TI was equal to or greater than 8 (TI> or =8), the children suffered a significantly greater number of episodes of AT. For the immunological portion of our study, we enrolled 36 children and 46 adults undergoing tonsillectomy for either AT (study group) or tonsillar hypertrophy (control group, CG). We analyzed the co-stimulatory signals, CD80 and CD86 on tonsillar B-lymphocytes. The expression rates of CD80 and CD86 in the AT group with TI> or =8 were significantly decreased compared to those with TI was less than 8 (TI<8), as well as with those in control (tonsillar hypertrophy) group. Our preliminary findings suggest that when the TI> or =8, the tonsils have deteriorated immunologically and spontaneous resolution of recurrent AT is less likely to occur, hence tonsillectomy is appropriate. TI may be a useful tool for surgical decision making.

Acute Disease↗
PubMed1999

Tonsillar microbial flora: comparison of recurrent tonsillitis and normal tonsils.

Tonsillar microbial flora was studied in cultures of tonsillar core specimens from 34 patients tonsillectomized due to recurrent group A streptococcal pharyngotonsillitis (n = 17) or sleep apnoea (n = 17). Patients in the sleep apnoea subgroup, who had no history of recurrent tonsillitis and manifested no tonsillar hypertrophy at ENT examination, served as controls. Tonsillar core specimens were cultured for semi-quantitative estimation of growth of aerobic, anaerobic and facultative organisms. The recurrent tonsillitis and apnoea subgroups did not differ significantly in the mean number of isolates per patient, either of aerobic spp. (3.8 vs. 4.3) or anaerobic spp. (5.2 vs. 4.7). Nor did the two subgroups differ significantly in the proportion of patients whose specimens manifested beta-lactamase producers (71% vs. 59%), in the isolation frequency of viridans (alpha) streptococci, or in the occurrence of semi-quantitative growth estimates of 3-4+ for aerobic, anaerobic or beta-lactamase-producing spp. Thus, the study provided no support for the hypothesis that inactivation of penicillin V by beta-lactamase-producing bacteria in oral or throat flora, or the eradication of viridans streptococci with their GAS-inhibitory capacity, is an important factor with regard to recurrent group A streptococcal tonsillitis. Other possible explanations, such as poor antibiotic penetration at the site of infection, are discussed.

Adult↗