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At least 883 records · Page 49Linked to original sources
PubMed1989

Laser surgery in lingual tonsil hyperplasia.

Modern techniques have reduced the long existing reluctance to perform lingual tonsillectomy. The results of treatment of hyperplasia of the lingual tonsil with the carbon dioxide laser in 32 patients are presented. After exposure with a special endoscope the lingual tonsil can be vaporized or excised under microscopic control with promising results, far superior to the results obtained with other surgical techniques. Since the success rate of the surgery depends on the diagnostic criteria for applying this therapy, a careful selection of patients is essential.

Adult↗
PubMed1981

Influence of tonsillar disease on the expression of J chain by immunoglobulin-producing cells in human palatine and nasopharyngeal tonsils.

A significant reduction of the percentage of J-chain-positive intra- and extra-follicular IgA immunocytes was found in inflamed palatine tonsils. There was a tendency to similar alterations in hypertrophied adenoids. Tonsillar disease apparently enhances local maturation of the B-cell system, perhaps on the basis of intensified proliferation of memory clones. Alternatively, there may be a disease-associated defect in the mechanism(s) that normally induced switchover to the IgA isotype early in clonal development. It is speculated that, by decreasing the J-chain expression during local B-cell differentiation, tonsillar disease may jeopardize the potential of the tonsils as a putative precursor source for the secretory immune system of the upper aero-digestive tract.

Adenoids↗
PubMed2005

Palatine tonsils in smoker and non-smoker patients: a pilot clinicopathological and ultrastructural study.

BACKGROUND: Tobacco smoke is a well-known source of toxic, mutagenic and carcinogenic agents. The aim of the present preliminary study was to investigate the effects of cigarette smoking on lymphoid and non-lymphoid tonsillar tissue. METHODS: The study group consisted of 12 smoker and 10 non-smoker patients complaining recurrent tonsillitis. Clinical data, histological findings and scanning electron microscopic analyses were considered. To the best of our knowledge, such an approach has not been previously adopted in a similar experimental model. RESULTS: Smoker patients showed a longer history of recurrent tonsillitis, difficulties in clinical management and evident morphostructural changes than non-smokers. CONCLUSIONS: These preliminary results suggest a possible interference of cigarette smoking with the therapy response as well as a possible role of tobacco smoke in impairment of inflammatory response. Results are critically analysed and discussed. Literature data on this subject are reviewed.

Adolescent↗
PubMed2002

Distribution of azithromycin in plasma and tonsil tissue after repeated oral administration of 10 or 20 milligrams per kilogram in pediatric patients.

Azithromycin concentrations in the tonsils of 56 pediatric patients, treated with 10 or 20 mg of the drug per kg of body weight for 3 days, were compared. Azithromycin levels in plasma and tonsil samples were determined up to 8.5 days after the last dose. The 20-mg/kg regimen resulted in an improved tonsillar distribution of azithromycin, suggesting the achievement of enhanced therapeutic concentrations at infective sites of the upper respiratory tract.

Administration, Oral↗
PubMed1976

Alkaline phosphatase activity in the human tonsils and its relation to tonsillar diseases.

Alkaline phosphatase activity was examined in the human tonsils in fetal life and after repeated attacks of acute tonsillitis and in quinsy. Gomori's metal precipitate technique was used to demonstrate the phosphatase activity using four different substrates: sodium beta-glycerophosphate and adenosine triphosphate at pH 9, riboflavin 5-phosphate at pH 9.2 and 5-monophosphoric acid at pH 8.3. (2) The phosphatase activity differs somewhat according to the phosphate ester used as a substrate illustrating an example of 'substrate specificity'. (3) Alkaline phosphatase activity was increased in the case of both acute and chronic inflammation. This increase has been discussed in relation to such phenomena as transformation of lymphocytes into macrophages and antibody formation.

Acute Disease↗
PubMed1989

Recurrent tonsillitis: histologic and bacteriologic evaluation.

Histologic and bacteriologic evaluations of tonsils removed at surgery from ten patients with a diagnosis of recurrent tonsillitis were performed. The bacteriology was complex, with an average of 6.3 aerobic bacteria and 3.3 anaerobic bacteria isolated from each patient. Histologic sections revealed chronic cryptitis, with intact tonsillar architecture. These findings provide a possible explanation for the failure of commonly used antibiotic regimens to eradicate recurrent infection from this site.

Adolescent↗
PubMed1985

Treatment of patients with a history of recurrent tonsillitis due to group A beta-hemolytic streptococci. A prospective randomized study comparing penicillin, erythromycin, and clindamycin.

Forty-five patients with a history of recurrent tonsillitis associated with Group A beta-hemolytic streptococcal (GABHS) infection participated in a prospective, randomized study comparing penicillin, erythromycin, or clindamycin therapy. Surface tonsillar cultures were obtained before therapy, 10 days after termination of therapy, and once a month for a period of 12 to 18 months. The specimens were processed for aerobic and anaerobic bacteria. Beta lactamase-producing aerobic and anaerobic bacteria were present in 43 of the 45 (96%) tonsillar cultures. GABHS colonization was eradicated in two of 15 patients treated with penicillin, in six of 15 treated with erythromycin, and in 14 of the 15 treated with clindamycin. In long-term follow-up, 12 of 14 patients treated with penicillin, eight of 14 treated with erythromycin, and one of 15 treated with clindamycin (p less than 0.0001 when compared to penicillin and p = 0.002 when compared to erythromycin) continued to suffer from recurrent tonsillitis.

Adolescent↗
PubMedDate not supplied

Fine-needle aspiration as a diagnostic tool for recurrent tonsillitis.

Acute tonsillitis is a common childhood disease, but repeated antibiotic treatment may fail, leading to tonsillectomy. Superficial swab cultures do not sufficiently represent the core bacteria present, but fine-needle aspiration may be a promising diagnostic method. We evaluated 58 patients undergoing tonsillectomy, and took superficial and core swabs, and fine-needle aspirations. Staphylococcus aureus was the most common bacterial pathogen identified, present in 26 out of 50 (52%) positive core cultures, followed by Haemophilus influenza in 13 positive core cultures (26%), and group A beta-haemolytic streptococci in 10 positive core cultures (20%). Fine-needle aspiration detected 33 out of 50 positive core cultures (66%), whereas superficial swab culture detected 18 of 50 (36%); the difference being statistically significant. All pathogens detected by superficial swabs and fine-needle aspiration were detected in core cultures. The sensitivity and specificity of fine-needle aspiration were 66% and 100%, respectively, compared with 36% and 100% for superficial swabs. Fine-needle aspiration is therefore a promising method for detecting core bacteria in patients with recurrent tonsillitis.

Bacteria↗
PubMed2004

Differential gene expression profile of human tonsil high endothelial cells: implications for lymphocyte trafficking.

Lymphocyte recirculation is dependent on the interactions of adhesion and signaling molecules expressed on lymphocytes and their partners on high endothelial cells (HEC). Many of the events in this process have yet to be molecularly characterized. To identify novel HEC-specific proteins with potential function in the recruitment cascade, we sequenced a normalized human tonsil HEC cDNA library (generated from an inflamed tonsil) from which lymphocyte and human umbilical vein endothelial cell cDNAs had been subtracted. One-thousand forty-nine sequences were analyzed. All but three mapped to known cDNAs or genomic DNAs. The two most abundant transcripts encoded alpha2-macroglobulin and hevin. The next-abundant transcripts encoded several other protease inhibitors, making this protein class the most prominent in HEC. Several endothelial-specific transcripts were also identified, including those encoding E-selectin, vascular cell adhesion molecule-1, vascular endothelial-junctional adhesion molecule, and platelet-endothelial cell adhesion molecule-1. The library contains a great diversity of transcripts, and studies of the encoded proteins will provide further insight into the complex biology of these specialized endothelial cells.

Base Sequence↗
PubMedDate not supplied

Colonization by Haemophilus influenzae and group A streptococci in recurrent acute tonsillitis and in tonsillar hypertrophy.

One hundred patients subjected to tonsillectomy because of recurrent acute tonsillitis or tonsillar hypertrophy were evaluated bacteriologically both with ordinary throat culturing and cultures from tonsillar cores. In 26% of the patients H. influenzae was isolated and in 20% beta-haemolytic group A streptococci. Growth of B. catarrhalis was obtained in 10% and group C-, group G streptococci or pneumococci in less than 5% each. None of the group A streptococcal strains proved tolerant to penicillin. A much higher isolation rate of H. influenzae was found in cultures obtained from tonsillar core tissue (23%) than from ordinary throat cultures (2%). This was also the fact, though to a lower extent, regarding group A streptococci. H. influenzae and group A streptococci were isolated as often in patients with tonsillar hypertrophy as in patients suffering from recurrent acute tonsillitis, suggesting a role of these bacteria in both conditions.

Adolescent↗
PubMed1996

Bacterial adherence to the surface and isolated cell epithelium of the palatine tonsils.

Bacterial adherence to the oropharyngeal epithelium is a significant factor in normal microecology, etiopathogenesis of diseases (tonsillitis, gingivitis) and possibly also induction of immune response. Bacterial adhesion to human tonsillar epithelium of whole tonsils and swabs was studied by fluorescence, scanning, and transmission electron microscopy. The epithelial cell borders were well demarcated. On the apical surface of the cells there were irregular microridges. All forms of microscopy visualized epithelial cells with attached bacteria, often forming microcolonies on the free surface. Some bacteria formed excavations on the cell surface. Most attached bacteria were coccoid, but variously sized rods were also visible. In transmission electron microscopy, epithelial cells with intracellular bacteria were regularly observed.

Adolescent↗
PubMed1996

In situ localization of Streptococcus pyogenes during acute tonsillitis: an immunocytochemical study with gold markers.

Epithelial cells were harvested from the surface of the palatine tonsils of seven patients with current acute tonsillitis, proven culture-positive for Streptococcus pyogenes. The epithelial cells harboured attached bacteria, which expressed positive affinity to gold-labelled antiserum to S. pyogenes. The gold particles adhered selectively to the bacterial capsules. The microorganisms were held in place by projections protruding from the epithelial cells, which were in close contact with the pili of the bacteria. In some areas, positive immunogold-labelled bacteria intermingled with bacteria lacking such labelling. None of the culture-negative controls harboured epithelial cells with positive immunogold-labelled bacteria. Orally administered phenoxymethylpenicillin caused a significant reduction in both culture-positive S. pyogenes and bacteria displaying positive coating with specific gold-labelled antiserum to S. pyogenes.

Acute Disease↗
PubMed1991

In vivo attachment of group A streptococci to tonsillar epithelium during acute tonsillitis.

The attachment of group A beta-hemolytic streptococci (GABHS) to the tonsillar epithelium during current acute tonsillitis (AT) was studied by means of fluorescence microscopy and electron microscopy in 5 patients. Conventional cultures from the tonsils showed massive growth of GABHS and tonsillar epithelial cells were heavily infested with GABHS, which proved positive for FITC-labelled antibodies against beta-hemolytic streptococci. The bacteria were firmly attached to the epithelial cell membranes by cell projections, which grasped the microorganisms from various directions. A 24 h course of oral treatment with phenoxymethylpenicillin radically affected bacterial adherence to the epithelial cells.

Acute Disease↗
PubMed2003

Cost-effective workup for tonsillitis. Testing, treatment, and potential complications.

Despite increased strictness in surgical criteria, tonsillectomy continues to be one of the most common outpatient surgical procedures performed in the United States. The primary care physician is integrally involved in the diagnosis and treatment of tonsillitis, the chief reason for tonsillectomy. This article gives guidelines for diagnosis and management of tonsillitis and provides an overview of its potential complications.

Acute Disease↗
PubMed1999

[A study of cytokine in palatine tonsil--flow cytometric analysis of cytokine production in tonsillar mononuclear cells].

Using two-color flow cytometry, we measured intracellular expression of interleukin-1 alpha (IL-1 alpha), IL-2, IL-4, IL-6, IL-8, interferon gamma (IFN-gamma) and tumor necrosis factor-alpha (TNF-alpha) in tonsillar mononuclear cells freshly isolated and stimulated by phorbol myristate acetate (PMA) and ionomycin. In freshly isolated tonsillar mononuclear cells, IL-1 alpha was produced in 0.39% of CD3 cells, 0.48% of CD4 cells, 0.66% of CD19 and 11.2% of CD14 cells; TNF-alpha was found in 5.4% of CD14 cells. After 8-hour culture without any mitogens, IL-4, IL-8, TNF-alpha and IL-1 alpha were detected in 2.1%, 0.8%, 0.55%, and 0.42% of tonsillar mononuclear cells, respectively. Flow cytometric detection of intracellular cytokines in tonsillar mononuclear cells stimulated with PMA and ionomycin revealed that CD3 cells produced IL-1 alpha, IL-2, IL-4, IL-8, IFN-gamma and TNF-alpha, and CD19 cells produced IL-1 alpha, IL-6, IL-8 and TFN-alpha. In CD3 cells, the number of cells producing IL-2 and TNF-alpha were significantly higher than those expressing other cytokines; and the number of cells producing IFN-gamma and IL-8 were significantly higher than those expressing IL-4 and IL-1 alpha. In CD19 cells, the number of cells producing IL-6 and TNF-alpha were significantly higher than those of IL-8 and IL-1 alpha; and the number of cells producing IL-8 was significantly higher than that of IL-1 alpha. There was no difference in the number of CD3 and CD19 cells producing any cytokine between the adult recurrent tonsillitis group and adult obstructive sleep apnea syndrome group. However, the number of CD3 cells producing IL-2 or TNF-alpha and CD19 cells producing IL-1 alpha, IL-6 or TNF-alpha were significantly lower in children than that of adults (p < 0.05). These findings indicate that the cytokine production in tonsillar mononuclear cells is heterogenous according to the subset and activation and that flow cytometric analysis of intracellular cytokines is a useful means to investigate the pathophysiological role of cytokines in the tonsils.

Adult↗
PubMed1999

[Results of a survey of the relationship between palatine tonsil and IgA nephropathy].

To investigate the relationship between palatine tonsil and IgA nephropathy, a survey was performed by questionnaire to 154 non-ENT medical doctors who had reported case of IgA nephropathy. The questionnaire was sent in February 1997, and answers were obtained within one month from 93 doctors (79 internal physicians, 12 pediatricians and 2 pathologists); a 60.4% response rate. A total of 72.0% of doctors answered that renal pathology was the most important prognostic factor for IgA nephropathy. A total of 73.1% of doctors thought that the administration of corticosteroid was the most effective therapy for IgA nephropathy, whereas only one doctor answered that tonsillectomy was most effective. Urine protein was the most useful factor for the estimation of the treatment, according to 37.6% of doctors. The majority of doctors who replied to the questionnaire thought that palatine tonsil seemed to be involved in the pathophysiology of IgA nephropathy in less than half of patients with IgA nephropathy. In addition, they answered that the rate of patients with IgA nephropathy to whom tonsillectomy was effective was also less than 50%. The tonsillar provocation test was rarely performed for the diagnosis of tonsillar focal infection in IgA nephropathy. Furthermore, 51.6% doctors answered that urine protein was the most important factor in any estimation of the provocation test.

Glomerulonephritis, IGA↗
PubMedDate not supplied

[The microbial cenosis of the tonsils in healthy children and in those frequently ill].

The microbial cenosis of tonsils has been studied in healthy and ailing children. It has been found out that Staphylococcus aureus and S. epidermidis, beta-hemolytic streptococcus, rarely gram-negative flora and candidae were most often isolated in the ailing children. Normal microflora of healthy children mainly included lactic acid bacteria whose level considerably decreased in ailing children that is most distinctly expressed in children with decompensated tonsillitis. To correct the disturbances in microbial cenosis during complex therapy we used lactobacteria to treat the nasopharynx with the suspension of these bacteria. Positive clinical effect with following positive results of bacteriological investigation has been obtained in all patients.

Adolescent↗
PubMed1975

[Tonsils and immunology (author's transl)].

Tonsils are lymphatic organs carrying out functions of humoral and cellular immunity. They form a local immunologic barrier; they are also involved in general immunologic defence mechanisms. Tonsillectomy or the destruction of tonsils by infections does not reduce the immunoglobulin concentration and antibody titres in peripheral blood. Only the local formation of IgA antibodies against poliomyelitis antigen seems to be impaired at least for a short time. The clinical relevance of this finding is unknown. Signs of defects in immunosurveillance, which were found in some study groups resulting from an increase of the morbidity rates of Hodgkin's disease and thyroid carcinoma, must be considered seriously although there is no statistic evidence for an increase of tumor frequency after tonsillectomy. The indication for tonsillectomy must be decided on clinical findings. Signs for a reduction of local antibody synthesis or for a possible diminuation of immunosurveillance should serve to critical indication.

Antibody Formation↗