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At least 649 records · Page 36Linked to original sources
PubMed2003

Redefining the magnetic resonance imaging reference level for the cerebellar tonsil: a study of 170 adolescents with normal versus idiopathic scoliosis.

STUDY DESIGN: Magnetic resonance imaging (MRI) was used to compare quantitatively the position of the cerebellar tonsil in neurologically normal adolescents with that in idiopathic scoliosis (AIS) patients and age-matched healthy controls. OBJECTIVES: To redefine the normal reference level of the cerebellar tonsil in healthy adolescents and to compare the differences in tonsillar level with AIS of different severities. SUMMARY OF BACKGROUND DATA: Asymptomatic Chiari I malformation has been reported not infrequently in children and adolescents with AIS. The definition of tonsillar herniation and its variations with sex, age, and curve severities have not been clarified. METHODS: Sagittal MRI of hindbrain was performed on 170 adolescents, including 117 patients with AIS and 53 age-matched healthy controls. RESULTS: The cerebellar tonsillar tip in healthy patients was found at an average of 2.8 mm above the basion-opisthion reference line (BO line) (range, 0-10.5 mm), in contrast to the finding that 17.9% of the AIS patients had tonsillar tip below the BO line. The position of tonsil in the AIS group was lower than that in the healthy controls (P < 0.05), and the differences also increased with the severity of the curve (P = 0.027). CONCLUSIONS: Using the current MRI reference standards, the incidence of tonsillar herniation could be significantly underestimated. According to our experience, any inferior displacement of a tonsil below the BO line in adolescents should be regarded as abnormal. Scoliosis could be an important manifestation of subclinical tonsillar herniation.

Adolescent↗
PubMed2006

[Clinical features of 89 patients with primary non-Hodgkin's lymphoma of the tonsil].

BACKGROUND & OBJECTIVE: Head and neck lymphoma develops predominantly in the tonsil. This study was to investigate the clinical features of primary non-Hodgkin's lymphoma (NHL) of the tonsil, and to explore possible ways to improve the prognosis and quality of life of the patients after treatment. METHODS: Clinical data of 89 naive patients with NHL of the tonsil, treated from May 1990 to Jan. 2003, were retrospectively reviewed. All patients were confirmed pathologically and classified according to revised European-American Lymphoid Neoplasms and World Health Organization Classification, and staged according to the Ann Arbor classification. Stage I-II patients received radiochemotherapy-predominant treatment, whereas stage III-IV patients received chemotherapy-predominant treatment. RESULTS: Of the 89 cases, 60 (67%) were diffuse large B-cell subtype, 11 (12%) were peripheral T-cell subtype, 5 (6%) were indolent lymphoma, 1 was anaplastic large T-cell lymphoma, and 1 was T lymphoblastic lymphoma; 81 (91%) were stage I-II disease. Of the 89 patients, 58 (72%) received radiochemotherapy, 19 (21%) received radiotherapy alone, 3 received chemotherapy alone, and 1 received radiochemotherapy combined with rituximab. The 5-year overall survival rate was 80%, that of stage I-II patients was 84%. Cox regression multivariate analysis showed that the survival rate was correlated to the value of international prognostic index (IPI), and whether the patient had primary refractory or relapsed disease, but was not correlated to sex, age, pathologic subtype, B symptoms, and bulky disease. CONCLUSIONS: Most patients with NHL of the tonsil are at early stages, with good prognosis. Diffuse large B-cell lymphoma is the most common pathologic subtype. Primary refractory, relapse, and IPI>1 are independent prognostic factors.

Adolescent↗
PubMedDate not supplied

[The development of the human lingual tonsil in the prenatal period].

Morphofunctional regularities in the development of the lingual tonsil were examined in 120 human embryos and fetuses of gestation age of 5 weeks to 9 months with the use of a complex of histologic and injection methods and transmission electron microscopy. Lingual tonsil development was found to start at gestation age of 9 weeks. By the end of gestation period the lingual tonsil represents a complex of cryptolymphatic units, each of them consisting of cryptal epithelial wall, lymphoid parenchyma, and connective-tissue capsule. The role of postcapillary venules with parafollicular zone high endothelium of lingual tonsil follicles is discussed.

Gestational Age↗
PubMed1998

Features of spontaneous improvement in syringomyelia with low-situated cerebellar tonsils.

We analysed six patients who showed spontaneous improvement among the 19 nonsurgically treated cases of syringomyelia with low-situated cerebellar tonsils who visited our outpatient clinic. MR images both before and after improvement were available for two of these patients; CT-myelography before improvement and MR images after improvement were used for two patients; and in the remaining two patients, MR images after improvement only were used. Consequently, we were able to abstract several features from detailed and precise neurological and radiological evaluations of these patients. These features consisted of mild (rather than severe) disability, as well as four radiological features--a rounded shape of the lower edge of the cerebellar tonsils, a low tightness of the foramen magnum, an elevation of the tonsils during the course of the disease. Results of our radiological analyses were consistent with the theories proposed for the pathogenesis of syringomyelia in the light of the CSF flow around the foramen magnum. We propose that the features we have isolated are useful in determining treatment policies and prognoses of patients with syringomyelia accompanied by low-situated cerebellar tonsils.

Adult↗
PubMed1998

Features of spontaneous improvement in syringomyelia with low-situated cerebellar tonsils.

We analysed four patients who showed spontaneous improvement among the 19 nonsurgically treated cases of syringomyelia with low-situated cerebellar tonsils who visited our outpatient clinic. MR images both before and after improvement were available for two of these patients; CT-myelography before improvement and MR images after improvement were used for two patients. Consequently, we were able to abstract several features from detailed and precise neurological and radiological evaluations of these patients. These features consisted of mild (rather than severe) disability, as well as three radiological features--a rounded shape of the lower edge of the cerebellar tonsils, a low tightness of the foramen magnum, an elevation of the tonsils during the course of the disease. Results of our radiological analyses were consistent with the theories proposed for the pathogenesis of syringomyelia in the light of the CSF flow around the foramen magnum. We propose that the features we have isolated are useful in determining treatment policies and prognoses of patients with syringomyelia, accompanied by low-situated cerebellar tonsils.

Adult↗
PubMed1998

Detection of Epstein-Barr virus infection in the epithelial cells and lymphocytes of non-neoplastic tonsils by in situ hybridization and in situ PCR.

Non-neoplastic tonsils were analyzed for detection of Epstein-Barr virus (EBV)-positive cells by in situ hybridization and in situ PCR. EBV-encoded small nuclear RNA 1(EBER1)-positive cells were found in 28.2% of the tonsils and were evenly localized in the extrafollicular area and within germinal centers. Latent membrane protein 1 (LMP1)-positive cells were also dispersed in the extrafollicular and germinal center. Using in situ DNA-DNA hybridization, the EBV-positive signals were observed in the upper epithelial cell layers of the tonsils. In addition, in situ PCR detected EBV DNA-positive cells in the lower epithelial cell layers and lymphoid cells.

Chronic Disease↗
PubMed1995

The role of the middle ear and tonsil in the etiology of febrile convulsions.

The middle ear and tonsil are thought to be important sources of infection in children with febrile seizures. However, these patients are rarely examined by an otolaryngologist in the acute phase and we are unaware of any previous studies where otolaryngologists have documented the presence of acute suppurative otitis media (ASOM) and tonsillitis in a series of children with febrile convulsions. We carried out a prospective study on 47 children admitted to two Dublin hospitals with a diagnosis of simple febrile convulsion. All children were examined by an otolaryngology resident within 6 h of admission. Nine children were noted to have ASOM and 18 had acute tonsillitis. The otolaryngology resident's opinion of the condition of the ears and throat often differed from that of the admitting pediatric resident, as documented in the clinical records. We review the recent literature on febrile convulsions and discuss the possible role of the otolaryngologist in the prevention of seizure recurrence.

Child, Preschool↗
PubMed1976

Mycotic flora in tonsils and adenoids. A microbiological and histological evaluation.

The tonsils of 147 patients with chronic tonsillitis and the adenoids of 134 children with recurrent respiratory infections were cultured for fungal organisms and studied microscopically. A control group consisted of 68 healthy persons. Positive cultures were obtained in 64% of patients with chronic tonsillitis, in 21% of children treated with adenoidectomy, and in 69% of the control group. Candida albicans, Saccharomyces sp. and Aspergillus were the most common organisms. The histological investigations revealed no evidence of pathogenecity in these organisms. They were found in the tonsillar crypts, and no granulomatous inflammation was seen surrounding them.

Adenoids↗
PubMed1993

Penetration of penicillin V to tonsillar surface fluid in healthy individuals and in patients with acute tonsillitis.

In the treatment of group A streptococcal tonsillitis, as the bacteria are located on the epithelial surface, an important determinant of outcome is the concentration of penicillin in extracellular tonsillar surface fluid. Accordingly, we investigated the concentration of penicillin in serum, and penetration to tonsillar surface fluid and saliva in nine patients with acute group A streptococcal tonsillitis and in nine healthy controls. Among the healthy subjects, despite high serum penicillin concentrations (mean, 2.04 micrograms/ml), there was no penetration to tonsillar surface fluid or to saliva, whereas erythromycin penetrated to tonsillar surface fluid in 3/6 cases. Of the nine patients with acute tonsillitis, on the first day of treatment eight manifested high concentrations of penicillin in tonsillar surface fluid (mean, 0.34 micrograms/ml--i.e. well above the minimal inhibitory concentration (MIC) for group A streptococci), but penetration to saliva was found in only two patients. On the tenth day of treatment, penicillin was not present in the saliva of any of the patients and was present in the tonsillar surface fluid of only one. The results suggest that measurable concentrations of penicillin in tonsillar surface fluid can only be obtained in the presence of inflammation with fluid exudation through the tonsillar epithelium.

Adult↗
PubMed1994

The role of Chlamydia pneumoniae in severe acute tonsillitis.

Chlamydia pneumoniae has been implicated as a cause of tonsillitis and pharyngitis, but the incidence has varied from one to 19 per cent in various studies. We investigated 51 patients admitted to University College Hospital, Galway, with severe tonsillitis. Throat swabs were examined for evidence of Chlamydia pneumoniae using a direct monoclonal antibody test. Blood was taken for serology from 45 patients. A further specimen was taken at six weeks. A control group of 32 blood bank sera was used. Mean hospital stay was three days (one to eight). Five patients (10 per cent) were monospot positive. Chlamydia pneumoniae was identified by direct immunofluorescence on a tonsillar swab from one patient who did not seroconvert. IgG antibody was identified in 13 cases (29 per cent) and in seven of the control group (22 per cent). No serological evidence of recent infection was found. Chlamydia pneumoniae was not found to be a cause of severe acute tonsillitis in our study group.

Acute Disease↗
PubMed1998

Divalent cation-activated-ATPase and ecto 5'-nucleotidase activities in chronic tonsillitis.

The activities of two ectoenzymes,Mg(2+)-ATPase (ATPase) and 5'-nucleotidase (5'-NT) from tonsillar mononuclear cells (TMC) and peripheral blood mononuclear cells (PBMC) were investigated in idiopathic tonsillar hyperplasia and recurrent tonsillitis. The ATPase activity of TMC was significantly higher in recurrent tonsillitis than in idiopathic tonsillar hyperplasia, whereas no difference was demonstrated in ATPase activity of PBMC. The activity of 5'-NT was similar in both investigated groups. However, ATPase and 5'-NT activities were significantly higher in TMC compared to PBMC. Such results suggest a possible role of ATPase in the activation of TMC during the course of chronic tonsillitis and indicate a difference in the function of TMC and PBMC.

Adenosine Triphosphatases↗
PubMed2004

IgA nephropathy and tonsils--an approach from the structure of IgA1 produced by tonsillar lymphocytes.

Human immunoglobulin A1 (IgA1), which is the predominant subtype to be deposited in glomeruli in IgA nephropathy (IgAN), has a unique mucine-like structure in its hinge region. Namely, it contains O-glycans and proline-rich peptides We previously observed underglycosylation of the hinge region in serum and deposited IgA1 in IgAN. On the other hand, clinical development and exacerbation of IgAN are frequently preceded by episodes of upper respiratory tract infection, and palatine tonsils represent the predominant immunocompetent tissue of the upper respiratory tract. Therefore, we hypothesized that tonsils were one of the origins of glomerular IgA1 in IgAN, and investigated the O-glycan structure of IgA1 produced by tonsillar lymphocytes (tonsillar IgA1). A significant increase in asialo-agalacto type O-glycans was found in the tonsillar IgA1 hinge in IgAN. These results suggest that the tonsils produce underglycosylated IgA1 molecules, which enter the bloodstream and are then deposited in the glomeruli.

Carbohydrate Conformation↗
PubMed1976

Epstein-Barr nuclear antigen (EBNA) carrying lymphocytes in human palatine tonsils.

The presence of Epstein-Barr virus (EBV) antigens in human palatine tonsilderived lymphocytes (TDL) was investigated using the indirect fluorescent antibody (FA) technique. The TDL were screened for the presence of EBV early antigen (EA), virus capsid antigen (VCA), and EBV nuclear antigen (EBNA). In 76% of the patients diagnosed as recurrent exudative tonsillitis, and in 33% diagnosed as recurrent tonsillitis and/or serous otitis media, EBNA was demonstrated in the purified TDLs. No EA- or VCA-producing cells were found in either the glass adsorbed or TDL cell preparations from all of the patients. These data suggest that in our patient sample, the tonsils may serve as a reservoir for EBV carrying lymphocytes and a basis for recurrent disease.

Adolescent↗
PubMed2000

Detection of lymphocytes productively infected with Epstein-Barr virus in non-neoplastic tonsils.

Epstein-Barr virus (EBV) persists for life in the infected host. Little is known about EBV reactivation and regulation of virus persistence in healthy individuals. We examined tonsils of chronic tonsillitis patients to detect EBV transcripts, EBV genomes and lytic proteins. LMP1 transcripts were observed in 11 of 15 specimens and BZLF1 transcripts were detected in six. Multiple copies of EBV genome equivalents per cell, and ZEBRA- and viral capsid antigen-positive cells were also detected in tonsillar lymphocytes. These results indicate that EBV productively infected cells may survive in the face of immune surveillance in the tonsils. Thus, EBV replication may occur in tonsillar lymphocytes, and tonsillar lymphoid tissues may play a role in the maintenance of EBV load in vivo.

DNA, Viral↗
PubMed1986

Tonsil flora in the very young tonsillectomy patient.

The tonsil flora of 20 children below the age of 4 years undergoing tonsillectomy, and a control group of 18 children were studied using tonsil swabs and core specimens. The study group had a significantly higher culture rate of anaerobic organisms, whereas there was no significant difference between the groups in respect of aerobic pathogens. Since most anaerobic organisms are relatively resistant to the antibiotics usually prescribed for recurring tonsillitis, the use of more appropriate antimicrobial therapy may be helpful in the prevention of early tonsillectomy.

Age Factors↗
PubMed1999

Quantitative study of germinal center area in normal and diseased tonsils using image analysis.

The aim of this study was to measure the germinal center area of secondary follicles in a consistent and unbiased manner using image analysis. Tonsil specimens were obtained from children with clinical evidence of recurrent tonsillitis and/or idiopathic tonsillar hypertrophy. Normal control biopsy specimens were obtained from children with no history of ear, nose, or throat infections. The results show a significant increase in the germinal center area in tonsils exhibiting hypertrophy when compared to normal controls (p < .002). Image analysis is an important tool for making quantitative size comparisons in lymphoid tissues.

Acute Disease↗
PubMed1996

Distribution of lymphatics in human palatine tonsils: a study by enzyme-histochemistry and scanning electron microscopy of lymphatic corrosion casts.

The distribution of lymphatics in human palatine tonsils was studied by enzyme-histochemistry for 5'-nucleotidase (5'-Nase) and scanning electron microscopy (SEM) of lymphatic corrosion casts. The palatine tonsils were found to possess lymphatics in the parafollicular area (i.e., interfollicular, interfolliculo-septal, and folliculo-septal area), in the connective tissue septa, and in the capsules, but not in the subepithelial area between the follicles and the follicle-associated epithelia or within the follicles. The tubular lymphatics originated some 200-300 microns below the epithelium and formed a three-dimensional network in the parafollicular area. Some lymphatics around the lower part of the follicle were flat, wide, and irregular in shape, and thus appeared to be lymphatic sinuses, referred to as perifollicular lymphatic sinuses. The lymphatics in the parafollicular area drained into the septal lymphatics, which ran rather straight in the connective tissue septa. The septal lymphatics finally gathered into the broader capsular lymphatics. Most of the septal and capsular lymphatics were endowed with valves. Our results indicate that lymphocytes and fluid from the follicles and the subepithelial region enter the perifollicular lymphatic sinuses and/or the interfollicular lymphatics, pass through the interfolliculo- and folliculo-septal lymphatics, and finally enter the septal and capsular lymphatics to leave the tonsil.

5'-Nucleotidase↗