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[Potentials of thermography in the diagnosis and characterization of chronic tonsillitis].

Thermography was done to 131 patients with chronic tonsillitis (simple form in 46, toxico-allergic in 85). The main thermographic sign of this disease is temperature lowered by more than 1 degree C (2.2 degrees C on an average) in the proximal third of the phalanx as compared to that in the dorsal surface of the hand at the level of metacarpophalangeal articulations. Hyperthermia in the shoulder girdle area an in the neck up to the submaxillary line with clear contours is characteristic of patients with the toxico-allergic form of chronic tonsillitis. A thermographic picture in the zone of hyperthermia has the shape of a "collar". Thus thermography makes it possible to distinguish between the main clinical forms of chronic tonsillitis and to specify indications to a therapeutic method.

Adult↗

Alpha-streptococci as supplementary treatment of recurrent streptococcal tonsillitis: a randomized placebo-controlled study.

Recurrences are a common finding after antibiotic treatment of acute group A streptococcal tonsillitis. This has been attributed to several factors, among others a disturbed normal throat flora and especially a lack of alpha-streptococci. It thus seems logical in patients with recurrent streptococcal tonsillitis, to restore the normal alpha-streptococcal flora by reimplantation of alpha-streptococci. This was performed in a double blinded, randomized, placebo-controlled study. 36 patients with recurrent streptococcal group A tonsillitis were treated with antibiotics followed by either placebo (19 patients) or a pool of 4 selected alpha-streptococcal strains (17 patients) with good interfering activity against clinical isolates of beta-streptococci. No patient recurred during the first 2 months of follow-up in the alpha-treated group, but 7 in those treated with antibiotics and placebo. After 3 months 1 in the patient group treated with antibiotics and alpha-streptococci and 11 in the placebo-treated group recurred. These results are statistically highly significant and show that recolonisation with alpha-streptococci seems to offer a new way to lower the rate of recurrence in streptococcal throat infections.

Adolescent↗

Nickel content of human palatine tonsils: analysis of small tissue samples by flameless atomic absorption spectrophotometry.

We describe a method for determining the nickel content of small tissue samples by flameless atomic absorption spectrophotometry in this case biopsy specimens from human palatine tonsils. Contact between tissue samples and metallic objects was avoided, except for the use of biopsy forceps (Type No. 8150.00 Wolf, stainless steel) for collecting samples, to imitate the actual procedure when small biopsy specimens are removed from the nasal mucosal membranes in nickel workers for histopathological and chemical investigations. Nickel contamination from this instrument was insignificant at the precision of the present procedures. The mean concentration of nickel in 15 tonsils was 13.5 +/- 7.0 (SD) microng/100g (wet wt). The mean nickel concentration in eight different samples of the same tonsil was 5.6 +/- 2.7 (SD microng/100 g.

Adolescent↗

Profile of immunoglobulin production in adenoid and tonsil lymphocytes.

The adenoids and tonsils are thought to be essential parts of the system protecting against pathogens invading the upper respiratory tracts. We have examined IgA-spot forming cells (SFC) as well as IgG- and IgM-SFC in human adenoid and tonsil lymphocytes. The majority of SPC were revealed to be IgG type in adenoid and tonsil lymphocytes. However, when the changes in the number of SFC were examined following 6 days of incubation in the presence of LPS and Con A, an increase in IgA-SFC was noted in both adenoid and tonsillar lymphocytes, suggesting that adenoid and tonsillar lymphocytes differentiate into IgA forming cells under appropriate conditions.

Adenoids↗

[Evaluation of granulocyte (PMNL) function in patients with chronic inflammation of the middle ear and palatine tonsils].

The evaluation of granulocytes function (PMN) in patients with chronic inflammation of middle ear and palatine tonsils. There were 39 people examined and divided into: 28 patients with chronic inflammation of middle ear and palatine tonsil, 11 healthy persons. The function of granulocytes in patients with chronic inflammation of middle ear and palatine tonsil were changed more in comparison with the healthy people.

Adult↗

[Morphofunctional organization of the palatine tonsils as a lymphoepithelial organ].

The paper considers compartment structure of the tonsils reflecting cooperative interactions of the cells in immune response. A special emphasis is laid on the lymphoepithelial relations at the level of criptal epithelium the area of which serves as an immunoregulatory compartment of the palatine tonsils. Similarity of the regions of lymphoepithelial symbiosis in the zone of the criptal epithelium and lymphoepithelial pattern in the thymus is discussed as well as the role of the palatine tonsils as a secondary organ of immunogenesis in the general hierarchy of the immune system.

Cell Movement↗

[The evaluation of granulocyte function before and after surgical treatment in patients with chronic inflammation of the middle ear and palatine tonsils].

The aim examinations was the evaluation of granulocytes (PMNL) pre- and postsurgical treatment in patients with chronic inflammation of middle ear and palatine tonsils. The examined 40 persons and divided into three groups: I--18 patients with chronic inflammation of middle ear, II--10 ones with chronic tonsillitis and III--12 healthy persons. There were evaluated: "in vivo" and "in vitro" migration, bactericidal index and absorption of S. aureus labeled 14C isotope (phagocytic index) in the own modification. Preoperative treatment in patients with chronic inflammation of middle ear and palatine tonsils in comparison to the healthy were noticed: characteristic increase of the migration area, the MIF liberation and the phagocytic index, decrease in the bactericidal index (but more in group II). After a year postsurgical treatment the function of granulocytes in patients of group II was more similar to the healthy than in group I.

Adolescent↗

Immunohistochemical study of tonsils from newborn infants with emphasis on follicular dendritic reticulum cells.

The origin of follicular dendritic reticulum cells (FDRCs) is still debated in the literature, although their derivation from local transformed mesenchymal cells is now generally accepted. The purpose of this immunohistochemical study was to further define the nature of the FDRC, for which an endothelial cell derivation was proposed in previous papers. Palatine tonsils were removed at autopsy from eight newborn infants ranging from a few hours to four days of age. Paraffin embedded tonsil specimens were stained by current histochemical methods and immunohistochemically processed with a panel of antibodies against follicular dendritic reticulum cells (CD21 and CD35), endothelial cells (Factor VIII R. Ag, CD31, CD34), B lymphoid cells (L26, LN1, MB2), T lymphoid cells (UCHL1, DF-T1, OPD4, CD8, CD3), monocytic cells (PGM1 and KP1), interdigitating dendritic cells (S100 Protein, PGM1), intercellular adhesion molecule (ICAM-1 (CD54). Double immunostainings for endothelial markers and for FDRCs were performed. In newborn infant tonsils, lymphoid follicles are absent. T lymphocytes appear to represent the largest component whereas B lymphocytes are seen in small aggregates between blood capillary vessels. Monocytes and interdigitating dendritic cells are also present. The capillary endothelial cells within the B lymphoid aggregates are positive for endothelial and FDRCs markers; double immunostaining for Factor VIII R Ag (or other endothelial markers) and CD21 was present within the same capillary endothelial cells. Further they were positive for ICAM-1. These observations lend further evidence that the derivation of FDRCs may be from transformed endothelial cells and on this way they act as enhancing microenvironment for B lymphocyte expansion.

Animals↗

Recurrent lingual tonsil hyperplasia.

Clinically significant lingual tonsil hypertrophy is a rare entity in children. We describe a child, status postadenotonsillectomy, with recurrent hypertrophy of the lingual tonsil after carbon dioxide laser ablation. Workup was negative for immunodeficiency, cystic fibrosis, and allergies. The findings of examination of multiple biopsy specimens of the tissue suggested follicular hyperplasia, and cytometery showed no evidence of a lymphoproliferative disorder. Empiric treatment with a histamine2-receptor blocker after the sixth carbon dioxide laser ablation prevented lingual tonsil hypertrophy.

Adenoids↗

Appearance and development of lymphoid cells in the chicken (Gallus gallus) caecal tonsil.

BACKGROUND: We have analyzed by electron microscopy, immunohistochemistry, and flow cytometry the development of chicken caecal tonsil, the largest lymphoid organ of avian gut-associated lymphoid tissue (GALT). METHODS: White Leghorn chickens of different ages obtained from a local supplier were routinely processed by transmission electron microscopy. For both immunohistochemistry and flow cytometry, we tested a battery of specific monoclonal antibodies (mAbs) to chicken cell markers on caecal cryosections or cell suspensions, respectively. RESULTS: A rudimentary caecal tonsil occurs at the end of incubation. The organ grows just after birth, reaching the adult condition 4 days later. Firstly (4 days to 2 weeks), it contains predominantly T lymphocytes, principally TcR alphabeta+ and CD4+ cells, which occupy largely the named caecal diffuse lymphoid tissue. In adult tonsils (6-week-old chickens) however, B lymphocytes, mainly expressing either IgM or IgA, predominate. They occur in both the subepithelial zone and the germinal centers, in which there are also a few T cells. After 2 weeks the CD8+ lymphocytes gradually become more numerous than CD4+ cells. In the tonsillar epithelium CD8+TcRgammadelta+ T cells, CD8+TcRgammadelta-alphabeta-, presumably NK cells, and a few B lymphocytes are the main cell subpopulations. CONCLUSIONS: Chicken caecum grows fast after hatching. The diffuse lymphoid tissue largely contains TcR alphabeta CD4+ or CD8+ cells. CD8+ cells of caecal epithelium represent gammadelta T cells or NK cells. B lymphocytes which occur in the subepithelial zone, germinal centers, and, in few numbers, the caecal epithelium predominantly express either IgM or IgA.

Animals↗

Dendritic cells in the bursal follicles and germinal centers of the chicken's caecal tonsil express vimentin but not desmin.

BACKGROUND: Immunohistochemical studies with anti-vimentin and anti-desmin monoclonal antibodies were designed to determine the origin of bursal secretory dendritic cells (SDC) and follicular dendritic cells. METHODS: The binding sites of anti-vimentin, anti-desmin, and anti-chicken-IgG specific monoclonal antibodies were visualized with a biotinylated anti-mouse-IgG, ABC Elite kit, and 4-chloronaphthol. Cells were double stained (anti-vimentin and rabbit anti-chicken-IgG Fc) to determine if the vimentin positive cells possessed surface IgG. RESULTS: Vimentin positive cells were observed in the cortex and medulla of the bursa and germinal center and lymphoepithelial compartment of the caecal tonsil. The mesenchymal reticular cell, the basic supporting cell of the germinal center, was stained prominently by anti-vimentin and anti-desmin. Both antibodies stained the bursal cortex but only anti-vimentin bound the bursal secretory dendritic cell of the medulla. In addition to being vimentin positive and desmin negative, the bursal secretory dendritic cell possessed and the follicular dendritic cell appeared to possess IgG on their surfaces. In all the observations, B-cells were vimentin negative. CONCLUSION: These studies suggest that follicular dendritic cells and mesenchymal reticular cells in the caecal tonsil's germinal centers may be functionally different cell populations while the bursal secretory dendritic cell and follicular dendritic cell of the caecal tonsil may have a common origin.

Animals↗

Tongue and tonsil carcinoma: increasing trends in the U.S. population ages 20-44 years.

BACKGROUND: An increasing incidence of oral carcinoma among young adults has been reported in the U.S. and Europe. Although the association between human papillomavirus infection and tonsillar carcinoma is now well established, to the authors' knowledge little is known about incidence trends in tonsillar carcinoma among younger adults. The objective of the current study was to explore the trends in both oral cavity and pharyngeal squamous cell carcinoma (SCC) in younger U.S. populations, in particular tongue and tonsillar SCC. METHODS: Using the 1973-2001 Surveillance, Epidemiology and End Results (SEER) database, we computed age, race, and site-specific trends of oral and pharyngeal (excluding nasopharynx) carcinoma incidence rates. The percent change (PC) and annual percent change (APC) were computed to explore trends in incidence rates over time. RESULTS: There were 2262 SCC of the oral cavity and 1251 SCC of the pharynx reported to the SEER program from 1973 to 2001 in adults aged 20-44 years. There was a statistically significant increase in the incidence of oral tongue SCC (APC = +2.1; P < 0.001), base of tongue SCC (APC = +1.7; P = 0.04), and palatine tonsil SCC (APC = +3.9; P < 0.001) among younger white individuals, whereas the incidence of SCC in all other oral and pharyngeal sites decreased or remained constant. CONCLUSIONS: The increase in tonsil SCC incidence from 1973 to 2001 paralleled the increase in tongue SCC, whereas SCC in all other oral and pharyngeal sites remained constant or decreased. This may suggest similar etiologic factors for SCC affecting the palatine tonsils and tongue in younger populations.

Adult↗

Definitive radiotherapy for T1 and T2 squamous cell carcinoma of the tonsil.

BACKGROUND: To assess whether survival or local control of early squamous cell carcinoma of the tonsil has been compromised by a moderate-dose approach. METHODS: Between 1970 and 1989, 185 patients with SCCa of the tonsil were seen at our institution. Fifty-three patients with T1 (30) and T2 (23) lesions treated with definitive radiotherapy were reviewed. Median follow-up was 60 months. The effects of total dose and site of the primary on survival and local regional control were analyzed. RESULTS: Three-year determinate survival was 77%. Mean total dose was 63.1 Gy. Site of the primary significantly affected survival (86% for fossa, 54% for pillars, p < 0.025). Local control at 2 years was 81% and was independent of dose > or = 63 Gy or site of the primary. Grade 4 complications defined by the RTOG/EORTC Acute Morbidity criteria occurred in three patients. CONCLUSIONS: Tumor doses on the order of 63 Gy or less result in excellent local control and survival rates for T1 and T2 carcinomas of the tonsil. Local control rates are better for fossa lesions than for pillar lesions.

Adult↗

Histological findings in cerebellar tonsils of patients with Chiari type I malformation.

OBJECTIVES: Cerebellar tonsillectomy is often performed for relief of symptoms associated with Chiari type I malformation (CMI). Nonetheless, the idea of removing supposedly healthy central nervous tissue has been a source of concern for neurosurgeons. The aim of this paper is to determine the histological changes in the cerebellar tonsils of patients with a wide range of symptoms and conditions related to CMI. MATERIALS AND METHODS: The cerebellar tonsils of 43 pediatric patients with CMI were sent to pathology for histological examination. CONCLUSION: The cerebellar tonsils in a great majority of CMI patients can be abnormal. We suggest that the reported histological findings are secondary to injury and ischemia.

Adolescent↗

Z-palatoplasty (ZPP): a technique for patients without tonsils.

OBJECTIVE: Patients without tonsils and with Friedman tongue position (FTP) III and IV are poor candidates for uvulopalatopharyngoplasty (UP3). Even when combined with adjunctive hyopharyngeal techniques, results are poor. We assessed a modified uvulopalatoplasty based on a bilateral Z-plasty in treating patients without tonsils who have obstructive sleep apnea/hypopnea syndrome (OSAHS). METHODS: 25 patients treated with a modified technique were matched with 25 patients previously treated with classic UP3. All patients in both groups also had radiofrequency tongue base reduction. Preoperative vs. postoperative measures of objective treatment success and subjective symptoms were compared for the 2 groups. Morbidity, including pain levels, narcotic use, and return to solid diet and normal activity, as well as complications were studied. RESULTS: Subjective improvement was good for both groups, but objective clinical improvement was significantly better for the experimental group. Morbidity and complications for the experimental group were comparable to the control group and to other published series on UP3. CONCLUSIONS: A modified technique for patients without tonsils who have OSAHS is presented. The new technique is more successful with acceptable morbidity for patients with OSAHS than classical techniques.

Adult↗

Lymphangiectatic fibrous polyp of the palatine tonsil. A report of three cases.

Three cases of lymphangiectatic fibrous polyp of the palatine tonsil are reported. The polyp arose from the upper pole of the tonsil in two cases and from the middle-to-lower part in one case. They were all asymptomatic until the polyps grew larger. The polyps were removed, with or without the tonsil. The pertinent literature is reviewed.

Adolescent↗

The association between carcinoma of the tonsil and Epstein-Barr virus--a study using radiolabelled in situ hybridization.

We reviewed 30 cases of carcinoma of the tonsil and classified them as squamous cell carcinoma, non-keratinizing differentiated carcinoma and non-keratinizing undifferentiated carcinoma. Five cases of non-keratinizing undifferentiated carcinoma were identified, and these, together with 5 cases of squamous cell carcinoma, were studied for the presence of Epstein-Barr virus by in situ hybridization using early RNA (EBERs) as probes. All cases of squamous cell carcinoma were negative for EBER and only one of the 5 cases of non-keratinizing undifferentiated carcinoma was positive. As a positive control we used a case of a primary nasopharyngeal carcinoma with extension to the tonsil. Though the tonsil and nasopharynx share similar anatomical and immunological features, we conclude that in the majority of cases EBV is not demonstrable in tonsillar carcinomas.

Carcinoma↗

Pitfalls in the use of death certificates for assessing cause of death: a study of tonsil carcinoma patients.

A study was undertaken to determine the accuracy of underlying cause of death as stated on the death certificate for patients treated at Mallinckrodt Institute of Radiology (MIR) for carcinoma of the tonsil. The sample consisted of 110 patients who were treated between 1953 and 1976 and who subsequently died; all patients were seen by a physician within 3 months of their death. Death certificate cause of death was compared with the cause of death as stated in the MIR patient record. Death certificates detected 42.5% of the deaths due to tonsil carcinoma recorded in the hospital record, and detection was found to correlate with time between treatment and death. Of the deaths reported on the death certificate as due to tonsil carcinoma, 91% were confirmed by the hospital record to be correctly reported. Overall agreement in assignment of cause of death between the hospital record and the death certificate was 59%, and was significantly affected by stage of disease at diagnosis. This review underscores the low reliability of death certificates and raises a serious question concerning the use of this information for patients who are registered in clinical trials without additional documentation of tumor extent and cause of death.

Aged↗