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PubMed1983

Guanylate cyclase activity of human lymphocytes from peripheral blood, thymus, and tonsils. A comparative study.

The subcellular repartition and the distinctive properties of guanylate cyclase (EC 4.6.1.2) vary according to the lymphocyte population studied and according to the presence of detergent. Guanylate cyclase of non-adherent peripheral lymphocytes and of thymus lymphocytes is recovered by more than 90% in the soluble fraction of the homogenate. Kinetics according to the substrate (5'-GTP-Mn2+) is Michaelian, the Ca2+ ion acts as an activator, especially in the case of blood lymphocytes, and the detergent has no effect on the enzyme activity. On the other hand, the guanylate cyclase of tonsil lymphocytes reside in the particulate fraction. It has non-Michaelian kinetics for the substrate, a strong stimulating effect of detergent, and an inhibitory effect of Ca2+. A comparison of the enzymatic activities of unseparated and of non-adherent tonsil lymphocytes obtained from the same donor points to a correlation between their T and B properties: predominant soluble activity in the T population and particulate guanyl cyclase activity in the B subset.

B-Lymphocytes↗
PubMed2000

Nasopharyngeal tonsil's provision of the surface secretions with immunocytes, a property additional to antigen processing.

As we recently found that IgA, IgM, and IgG are produced and secreted by immunocytes present in nasopharyngeal secretions, we tested the hypothesis that B- and T-lymphocytes in the surface secretions are derived from the nasopharyngeal tonsil in an active process. By immunohistochemistry, we found that numerous B- and T-lymphocytes were often accumulated in restricted areas in the epithelium, and some of these cells were demonstrated just beneath the epithelial surface or could be observed protruding into the lumen. A portion of these cells were Ki-67+, indicating clonal expansion and/or immunoglobulin class switching. Analyses of the surface secretions by immunocytochemistry also demonstrated B- and T-lymphocytes, as well as Ki-67+ cells--a finding that indicates that immunologically active cells are transported into the surface secretions. The results imply that there is a substantial migration from the nasopharyngeal tonsil of immunologically active cells into the surface secretions.

Adenoidectomy↗
PubMed2002

Acute tonsillitis as the first manifestation of post-transplant lymphoproliferative disorder.

Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication that may follow orthotopic liver transplantation (OLT) in children. The first symptoms are often in the ear, nose, or throat (ENT) area. This abnormal proliferation of lymphoid cells is related to Epstein-Barr virus (EBV) infection in immunocompromised children. The incidence of PTLD, EBV status before OLT and at the diagnosis of PTLD, delay between OLT and PTLD, localization, pathological investigations, and the treatment and evolution of PTLD were prospectively evaluated in 77 pediatric liver transplant recipients. Eight patients (10%) developed PTLD, all with an ENT presentation. Seven had acute nonbacterial tonsillitis (with a negative throat swab), and 1 had a pharyngolaryngeal localization at the time of the diagnosis. Four patients had associated involvement outside the ENT area. All patients were EBV-seronegative at the time of OLT; 6 underwent seroconversion at the time of diagnosis, and 2 within 9 and 20 months of diagnosis. All patients presented with low-grade PTLD. All patients with acute tonsillitis associated with EBV seroconversion underwent immediate tonsillectomy, and immunosuppression was decreased as much as tolerated. This therapeutic protocol led to complete recovery in all patients. After OLT in children, nonbacterial tonsillar inflammation or hypertrophy associated with an EBV infection is often the first manifestation of PTLD. Tonsillectomy combined with tapering of immunosuppression offers the best chance for a complete recovery.

Acute Disease↗
PubMed1990

Severe upper airway obstruction in children secondary to lingual tonsil hypertrophy.

Lingual tonsil hypertrophy in children is a rarely reported disorder. Two cases of severe upper airway obstruction in pediatric patients secondary to marked lingual tonsil enlargement are reported. Both children were effectively treated with lingual tonsillectomy. The surgical technique, using an insulated Bovie tip, is described.

Airway Obstruction↗
PubMed1994

Mycoplasma and Chlamydia in adenoids and tonsils of children undergoing adenoidectomy or tonsillectomy.

The prevalence of mycoplasmal and chlamydial infection was assessed in 83 children undergoing adenoidectomy, tonsillectomy, or both procedures for recurrent adenotonsillitis or obstructive symptoms. Throat smears (surface specimens) and minced adenoids and tonsils (core specimens) were cultured for Mycoplasma spp and for Chlamydia spp. Isolation rates in adenoidal specimens were as follows: Mycoplasma hominis, surface 7.1% core 2.9%; and Ureaplasma urealyticum, surface 1.4%, core 2.9%. Mycoplasma hominis was also found in tonsillar specimens: surface 14.3%, core 20%. Chlamydia trachomatis was isolated only from a single core adenoidal specimen. The rate of mycoplasma isolation was significantly higher in children with recurrent adenotonsillitis (34.5%) than in those with obstructive symptoms (3.7%). Our findings document colonization of genital mycoplasmas in adenoids and tonsils of children with recurrent adenotonsillitis. Further studies are needed to evaluate the possible pathogenetic role of these microorganisms in adenotonsillar infection.

Adenoidectomy↗
PubMedDate not supplied

Muscular anatomy of the tonsil and tonsillar bed: a reexamination.

A study was designed to investigate the muscular relations to the tonsil and tonsillar bed in man. Twenty-one histologically prepared human fetal specimens were examined. Muscle bundles from the palatopharyngeus and stylopharyngeus muscles and the amygdaloglossus muscle were found to relate to the tonsillar capsule in such a way as to suggest that during swallow, the tonsils may be moved laterally to permit a wide and unobstructed pharyngeal port.

Glossopharyngeal Nerve↗
PubMed1989

Unsuspected sarcoidosis of the tonsil.

A case of unsuspected sarcoidosis of the tonsils and adenoids presenting as nasal airway obstruction in a child believed to have chronic tonsillitis with adenoid hypertrophy is reported. This unusual case supports the value of routine histologic analysis of all tissue removed at the time of surgery.

Adenoids↗
PubMedDate not supplied

Double-blind, placebo-controlled multicentre trial of the efficacy and tolerance of morniflumate suppositories in the treatment of tonsillitis in children.

The efficacy and tolerability of morniflumate suppositories used together with phenoxymethylpenicillin were studied in a placebo-controlled, double-blind trial in 101 children with acute tonsillitis. Patients received a suppository containing 400 mg morniflumate or placebo twice daily for 4 days; all patients also received 1,500,000 IU/day phenoxymethylpenicillin. Response to treatment was assessed by clinical examination before and after 2 and 4 days' treatment. Efficacy was evaluated by resolution of oropharyngeal pain, congestion, fever, size and sensitivity of adenopathies, quality of life and duration of sleep. Body temperature fell rapidly after the start of treatment. There was also resolution of pharyngeal pain, earache, dysphagia and adenopathy. Spontaneous pharyngeal pain was present after 4 days in significantly (P = 0.03) fewer patients receiving morniflumate than receiving placebo. It is suggested that morniflumate combined with antibiotic therapy is an effective and well-tolerated treatment for tonsillitis in children.

Administration, Rectal↗
PubMed1993

Bauhinia purpurea lectin (BPA) binding spectra in hyperplastic human tonsil and in peripheral blood: immunohistochemical, immunoelectron microscopic, and flow cytometric analyses.

We studied the binding of Bauhinia purpurea lectin (BPA) to human tonsils and peripheral blood mononuclear cells by immunohistochemical, immunoelectron microscopic, and flow cytometric techniques. The effect of several fixatives (acetone, ethanol, buffered and non-buffered formalin, B5, Bodian 11, Bouin's, Carnoy's, Zenker's, and glutaraldehyde) was also examined. BPA was reactive with germinal center lymphocytes, macrophages/histiocytes, follicular dendritic cells, squamous epithelial cells, and a subset of endothelial cells. Mantle zone and paracortical lymphocytes were non-reactive with BPA. The profile of the specific binding characteristic of BPA lectin was found to be influenced by the fixatives. Most significantly, formalin fixation greatly reduced overall binding intensity, particularly making germinal center lymphocytes totally non-reactive. The reaction intensity was most prominent in frozen sections or those fixed in Carnoy's or ethanol solution. The combination of heavy metal salt-containing fixatives with acetic acid usually did not enhance BPA binding. Glutaraldehyde solution used for immunoelectron microscopic study also preserved BPA receptors fairly well, and BPA was confined to the membrane in lymphocytes and to both the membrane and cytoplasm in macrophages/histiocytes and follicular dendritic cells. Neuraminidase treatment of tissues resulted in binding of BPA to lymphocytes that were non-reactive before treatment. Double-staining studies on cell suspensions from tonsils with FITC-BPA and PE-conjugated anti-CD3 or SIg reagents revealed that 28.4% of CD3+ cells and 61.3% or SIg+ cells were BPA reactive. In PBL, 65.6% and 81.4% of CD3+ and SIg+ cells, respectively, were BPA reactive. Neuraminidase treatment also increased the percentage of BPA-reactive lymphocytes. In conclusion, BPA is a marker for macrophages/histiocytes and germinal center lymphocytes, provided that the tissues are unfixed or fixed with suitable fixatives such as ethanol or Carnoy's solution.

Adolescent↗
PubMed2003

Integration of apoptosis and telomere erosion in virus-specific CD8+ T cells from blood and tonsils during primary infection.

Human-virus-specific CD8+ T cells that are found during primary infection have been studied almost exclusively in the peripheral blood, and it is unclear whether these cells are regulated in the same way as those in secondary lymphoid tissue. We investigated, therefore, the control of apoptosis and telomere erosion of Epstein-Barr virus (EBV)-specific CD8+ T cells found in the blood and tonsils of the same patients during acute infectious mononucleosis (AIM). Although the clonal composition of CD8+ T cells as determined by heteroduplex analysis was similar in both compartments, there was greater CD28 expression in the tonsil population, indicating that they were less differentiated. EBV-specific CD8+ T cells in both tissue types were extremely susceptible to apoptosis related to low Bcl-2 expression and were dependent on exogenous cytokines such as interleukin-2 (IL-2), IL-15, and interferon-alpha/beta (IFN-alpha/beta) for survival. In both compartments, however, these cells maintained their telomere lengths through telomerase induction. Thus, apoptosis-prone EBV-specific CD8+ T cells found during acute infection have to be rescued from death to persist as a memory population. However, signals that induce telomerase ensure that the rescued cells retain their replicative capacity. Significantly, these processes operate identically in cells found in blood and secondary lymphoid tissue.

Acute Disease↗
PubMed2002

The heterogeneity shown by human plasma cells from tonsil, blood, and bone marrow reveals graded stages of increasing maturity, but local profiles of adhesion molecule expression.

Plasma cells (PCs) are the final B-cell differentiation stage. Recent evidence reveals relevant functional differences within the PC compartment. In rodents, early PCs formed in secondary lymphoid tissues show enhanced apoptosis and short life span, whereas PCs present in a final destination organ, such as the bone marrow (BM), have reached a stable prolonged survival state. BM PCs arrive at this organ as a circulating precursor whose cellular nature remains uncertain. An initial aim of this study was to characterize this circulating cell. We hypothesized that antibody-secreting cells detectable in the human blood after immunization might be a candidate precursor. These cells were obtained from the blood of volunteers immunized 6 days earlier with tetanus toxoid (tet), and they were unambiguously identified as PCs, as demonstrated by their expression of the CD38(h) phenotype, by morphology, by immunoglobulin (Ig) intracytoplasmic staining, and by IgG-tet-secreting capacity in vitro. In addition, by using the common CD38(h) feature, human PCs from tonsil (as a possible source of early PCs), from blood from tet-immunized donors (as the putative precursors of BM PCs), and from BM (as a deposit organ) have been purified and their phenotypes compared. The results show that a variety of differentiation molecules, proteins involved in the control of apoptosis, the B-cell transcription factors, positive regulatory domain I-binding factor 1/B lymphocyte-induced maturation protein 1 and B cell-specific activating protein and, at least partially, the chemokine receptor CXCR4 were expressed by human PCs following a gradient of increasing maturity in the direction: tonsil-->blood-->BM. However, PCs from these different organs showed a local pattern of adhesion molecule expression. These observations are discussed in light of the complex physiology of the human PC compartment.

ADP-ribosyl Cyclase↗
PubMed2001

The management of severe infectious mononucleosis tonsillitis and upper airway obstruction.

Acute tonsillectomy has been advocated for severe infectious mononucleosis (IM) pharyngotonsillitis with upper airway obstruction (UAO) and not responding to corticosteroids. This paper reviews and rationalizes our management. A five-year chart review was carried out with a follow-up telephone survey. There were 36 admissions. Nine had UAO of whom 89 per cent (eight of nine patients) had a tonsillectomy. The diagnosis of UAO was not standardized. Twenty-seven patients did not have UAO and only a small proportion of these patients, 16 per cent (four of 25) went on to have an elective tonsillectomy. Corticosteroids made no significant difference to the tonsillectomy rate. UAO appears to identify patients with more severe disease who are likely to suffer recurrent tonsillitis. Acute tonsillectomy is an appropriate treatment option for this subgroup. The diagnosis of significant IM UAO is not defined and a schema is proposed. Recurrent tonsillitis is an uncommon sequela of severe IM pharyngotonsillitis without UAO.

Adolescent↗
PubMed2005

Mediastinitis: a life-threatening complication of acute tonsillitis.

Acute tonsillitis is a common condition and usually runs a benign course. However life-threatening complications do still occur, even in this postantibiotic era. Infection can spread downwards into the mediastinum through the anatomic cervical spaces, causing widespread cellulitis, necrosis, abscess formation and sepsis. We present a case of descending mediastinitis in an 18-year-old woman, arising from her first episode of tonsillitis and treated successfully by surgical drainage. We believe that an awareness of this complication, early diagnosis using computed tomography scanning, and prompt, adequate surgical drainage will reduce morbidity and mortality.

Acute Disease↗
PubMed1980

Evaluation of tonsils and adenoids in Sleep Apnea syndrome.

Peripheral Sleep Apnea syndrome has been associated with enlarged tonsils and adenoids as well as other abnormalities which may cause upper airway obstruction in children. A multidisciplinary approach is used at the Step Disorder Center of Cincinnati General Hospital to evaluate the role of tonsils and adenoids in sleep apnea. Polysomnographic techniques combined with cine sleep studies of the upper airway document the degree, site and type of obstruction. This presentation highlights the entity of obstructive sleep apnea and provides a rational clinical approach in the management of these patients.

Adenoids↗
PubMed1999

Serotyping and pathogenicity of Erysipelothrix strains isolated from tonsils of slaughter pigs in Thailand.

Erysipelothrix strains were isolated from the tonsils of 46 (15.0%) of 307 apparently healthy slaughter pigs in Thailand during the period of August to September, 1997. A total of 27 of the 46 Erysipelothrix isolates could be classified into 5 serovars but the remaining 19 were untypable in this study. Of the 25 isolates serologically identified as Erysipelothrix rhusiopathiae, 20, 4, and 1 isolates belonged to serovars 2, 12, and 17, respectively. Only 2 isolates from the tonsils belonged to Erysipelothrix tonsillarum and represented either serovar 7 or 10. Although the periods and the districts of the survey were limited, the information obtained in the present investigation demonstrates the presence of a variety of serovars in pigs in Thailand. Of 29 selected isolates belonging to serovars 2, 7, 10, 12, 17, and untypable, only 5 (17.2%) were virulent for both mice and pigs. Five of these virulent isolates belonging to serovars 2 and 12 killed less than 30% of mice immunized with a swine erysipelas bacterin commercially available in Thailand, suggesting that the vaccine elicited a sufficient immunity to these field isolates.

Agglutination Tests↗
PubMed1990

Isolation of Staphylococcus species from the tonsils of healthy cattle and phage patterns of isolates.

Staphylococci were found in the tonsils of 121 (75.2%) of 161 cattle. There were 15 different species, 10 belonging to novobiocin-sensitive species. The most predominant species was S. simulans (79.3% of the 121 carriers), followed by S. aureus (20.7%), S. chromogenes (10.7%) and S. epidermidis (8.3%). The other 11 species were present in 0.8 to 5.8%. Twenty-six unidentifiable isolates were isolated from 26 (21.5%) carriers. Sixty-two (51.2%) of the 121 carriers yielded two to five Staphylococcus species together while only one species could be found in each of the other 59 (48.8%). Combinations of S. simulans and other species were most frequently encountered in 50 (41.3%) of the 121 carriers. Twenty-four (96.0%) out of 25 S. aureus isolates, 3 (42.9%) of 7 S. hyicus isolates and 45 (25.4%) of 177 coagulase-negative staphylococci (13 species and unidentifiable isolates) isolates were phage typable. Most of S. aureus isolates were lysed by bovine phages 119 (n = 16) or 116 (n = 5). Thirty-three (25.4%) of 45 coagulase-negative staphylococci typable isolates with Pulverer's phage set showed the phage pattern ph5/ph9/ph10/ph12/ph13/U4/U14/U16/++ +U20/U46. The tonsils of cattle thus appear to be a suitable environment for Staphylococcus species, particularly novobiocin-sensitive species.

Animals↗
PubMed2005

Cervical necrotizing fasciitis due to bacterial tonsillitis.

Necrotizing fasciitis is a severe and potentially fatal soft tissue infection, but involvement of the head and neck is rare. We report on 4 cases of cervical necrotizing fasciitis arising from tonsillitis. One patient was diabetic and one had received steroids before disease development. One patient developed acute respiratory failure and died of septic shock. Three patients recovered, helped by early recognition, aggressive surgical intervention, appropriate broad-spectrum antibiotics, and supportive therapy. The common bacteria found in all abscess samples were Streptococcus sp., but mixed flora with anaerobic organisms was seen in all but 1 case. Tonsillitis and peritonsillar abscess must be suspected as a cause of cervical necrotizing fasciitis and a successful result can be achieved with immediate aggressive treatment.

Adult↗
PubMed1989

An immuno-electron microscopic study on interactions among dendritic cells, macrophages and lymphocytes in the human palatine tonsil.

The sites of interaction between antigen-presenting cells (dendritic cells, macrophages) and lymphocytes in the human palatine tonsil were investigated by pre-embedding immuno-electron microscopy and acid-phosphatase histochemistry. Used in this study were: an S-100 protein antiserum recognizing Langerhans cells and interdigitating cells, OKT6 monoclonal antibody reacting with surface antigens of Langerhans cells, and Leu-3a monoclonal antibody directed to surface antigens of helper-T-cells. In the stratified squamous epithelium, Langerhans cells with characteristic rod-shaped or racket-shaped Birbeck granules exhibited S-100 protein and OKT6 immunoreactivites, and frequently extended long processes to adjacent lymphocytes. The subepithelial area contained a significant number of macrophages, some of which were closely apposed to interdigitating cells with S-100 protein immunoreactivity. Occasionally, macrophages with acid-phosphatase-positive phagosomes and/or lysosomes extended short processes to neighboring lymphocytes. In the interfollicular area, some interdigitating cells and a few Langerhans cells were seen in proximity to or in contact with lymphocytes stained with the Leu-3a antibody. These findings support previous in vitro studies suggesting the induction of T-cell activation by antigen-presenting cells. They further indicate that T-cell activation by the individual antigen-presenting cells takes place in different areas of the human palatine tonsil through a variety of cell-to-cell interactions.

Cell Communication↗