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PubMed1993

Distribution of lectin receptors in the human hyperplastic tonsil: histochemical and flow cytometric analyses.

The distribution of lectin receptors in the human tonsil was studied using 16 biotinylated lectins. The avidin-biotin-peroxidase complex (ABC) method was used on frozen and paraffin-embedded tissue sections. Cell suspensions were also analysed by dual flow cytometry using respective fluorescein isothiocyanate-conjugated lectins and phycoerythrin-labeled anti-CD3 and anti-human immunoglobulin. Frozen sections fixed with acetone and paraffin-embedded materials fixed in three solutions were compared for lectin affinity; ethanol-fixed sections gave best results followed by frozen and buffered formalin-fixed ones, then nonbuffered formalin. Con-A, RCA-1, LcH, WGA, MPA, PHA, PSA, PNA, SJA and GSA-1 reacted with all tissue components of the tonsil in immunohistochemical studies, but binding intensity was fixative dependent. Binding of Lotus and BPA to lymphocytes was limited to germinal center lymphocytes. Other tissue components were also reactive but staining intensity was weaker in Lotus compared with BPA. SBA and DBA did not react with lymphocytes, but reacted with macrophages/histiocytes, vascular endothelia, and epithelial cells. LBA and LPA were constantly negative with all tissue components irrespective of fixatives. Flow cytometric analyses showed that all but three (DBA, LBA and LPA) partially or totally stained lymphocyte surfaces. Lotus receptors were expressed exclusively on B-lymphocytes.

Acetone↗
PubMed2001

M cells and associated lymphoid tissue of the equine nasopharyngeal tonsil.

The aim of this study was to characterise the morphological and histochemical features of equine nasopharyngeal tonsillar tissue. Nasal and oropharyngeal tonsillar tissue has been described as the gatekeeper to mucosal immunity because of its strategic location at the entrance to the respiratory and alimentary tracts. A combination of light, scanning and transmission electron microscopy has revealed the presence of follicle-associated epithelium (FAE) overlying lymphoid tissue of the equine nasopharyngeal tonsil caudal to the pharyngeal opening of the guttural pouch. Membranous microvillus (M) cells were identified in the FAE on the basis of short microvilli, an intimate association with lymphocytes, cytoplasmic vimentin filaments and epitopes on the apical surface reactive with lectin GS I-B4 specific for alpha-linked galactose. CD4-positive lymphocytes were scattered throughout the lamina propria mucosae as well as forming dense aggregates in the subepithelial part. The central follicular area was heavily populated with B lymphocytes and the dome and parafollicular areas contained both CD4- and CD8-positive lymphocytes. CD8-positive lymphocytes were also present in the epithelium and, together with B lymphocytes, in small numbers in the lamina propria mucosae. These observations indicate that the nasopharyngeal tonsil is potentially an important mucosal immune induction site in the horse and an appropriate target for intranasally administered vaccines.

Animals↗
PubMedDate not supplied

Studies on difference in cellular immune-response between the human tonsil and blood lymphocytes.

Tonsillar and blood lymphocytes in a viable state were separated from tuberculin-sensitive tonsillectomized patients. The difference in the response to various cellular immunological stimulation between both lymphocyte groups was studied. Tonsillar lymphocytes without adherent cells could not respond well to PPD, while blood lymphocytes responded far better than tonsillar lymphocytes did to PPD when adherent cells were absent. PHA and PWM stimulated tonsillar and blood lymphocytes irrespective of the presence of adherent cells. However, in case of PWM stimulation, 3H-TdR incorporation was more remarkable in tonsillar lymphocytes than in blood lymphocytes. Furthermore, the lymphocytes which react to homologous cells also existed in the tonsils as in blood. These results suggest that there might be lymphocyte-subpopulations showing a difference of functional roles or of maturing-process between tonsil and blood lymphocytes.

B-Lymphocytes↗
PubMed1988

Otitis media with effusion and tubal tonsil (video).

Carbon dioxide laser surgery was performed on children aged 5 to 11 years, on whom either adenoidectomy or tonsilloadenoidectomy had been performed to restore their hearing. We examined 177 ears 18 to 24 months after surgery. Thirty ears (17%) were diagnosed as having otitis media with effusion. Analysis of the endoscopic findings revealed 51% marked tubal tonsil hypertrophy and 33% adenoid tissue hypertrophy. Subjects were operated upon in the dorsal position for a duration of point one second at an amplitude of 15 watts. Six months after surgery, most patients' hearing had returned to almost normal. The tympanograms which were taken 6 months after surgery showed good results in almost every case. Otitis media with effusion was found to have recurred in 3 ears. The effect of adenoidectomy is apparently dependent upon age, the size of adenoids, and the influence of allergies and sinusitis. Furthermore, our cases suggested that tubal tonsil hypertrophy was one of the factors found in recurrent otitis media with effusion in older children. It can thus be inferred that endoscopic examination of the postnasal space is recommended in children with recurrent otitis media with effusion after adenoidectomy, and that carbon dioxide laser surgery is a reliable therapeutic method in the topical treatment of this disease.

Adenoidectomy↗
PubMed1988

Immunological studies on the relation between tonsil and pustulosis palmaris et plantaris.

In order to clarify the relationship between the tonsils and pustulosis palmaris et plantaris (PPP), immunological investigations were performed focusing on keratin and antikeratin antibody. As materials, the tonsils, plantar skins and peripheral blood from the patients with PPP undergoing tonsillectomy were used. The results were summarized as follows: 1) Common keratin polypeptides reacting with monoclonal anti-keratin antibody were found both in the tonsillar epithelium and in the plantar skin. 2) High molecular weight keratin polypeptides were predominant in the tonsillar epithelium of the patients with PPP as in the plantar skin. 3) The antikeratin antibody titers in the sera of the patients with PPP were on a high level, and tended to decrease after tonsillectomy. 4) The antibody in the sera of the patients with PPP reacted with 67, 63 and 56 kd bands of keratin polypeptides. 5) The antikeratin antibody titers in the culture medium of the patients with PPP, especially in the tonsillar lymphocyte cultures, were on a high level. These results suggest the possibility that the keratin of the tonsillar epithelium and the antikeratin antibody in the serum may play an important role for pustule formation.

Antibodies↗
PubMed1988

A study on the adjuvant activity of palatine tonsil.

The involvement of non-specific factors in the onset of focal infection should never be ignored. We pay attention to the adjuvant activity of tonsil as one of various kinds of nonspecific factors. We confirmed the presence of such substances with adjuvant activity as lipopolysaccharides and muramyl dipeptide in the lacunar debris of tonsil. Then, using experimental animals with adjuvant induced arthritis, the study was made to determine whether the lacunar debris actually exerts adjuvant activity. We demonstrated the presence of adjuvant activity in the lacunar debris.

Adjuvants, Immunologic↗
PubMed1988

Indication of tonsillectomy for recurrent tonsillitis.

The indication of tonsillectomy for recurrent tonsillitis was discussed from the standpoint of clinical immunology. Elevated serum IgG was observed in 29.8% of the patients under 8 years of age preoperatively. In contrast, in 25% of patients between 9-15 years of age, serum IgG was low preoperatively. In the patients over 16 years of age no abnormal serum IgG was found, and the elevated serum IgG returned to normal after tonsillectomy. The patients with normal serum IgG preoperatively retained normal values postoperatively. The low preoperative IgG level group still remained low postoperatively. As to postoperative improving symptoms, high and low grade fever improved most (100%), followed by cervical lymphadenopathy (93%), frequent absence from school (93%), sore throat (88%) and recurrence of bronchitis (85%). The patients with recurrent tonsillitis for 8 years showing high serum IgG had indications for tonsillectomy.

Adolescent↗
PubMed1992

Penicillin tolerance in group A streptococci and treatment failure in streptococcal tonsillitis.

Penicillin tolerance in Streptococcus pyogenes has been suggested as a possible cause of therapeutic failure in streptococcal phryngitis treated with penicillin. In 144 patients with acute group A streptococcal tonsillitis treated with phenoxymethyl penicillin 12.5 mg per kg body weight b.i.d. for 10 days the same T-type was recovered after treatment in 21%. The recovery rate was higher for non-tolerant strains, 23%, than for tolerant strains, 10% (p greater than 0.05). Of patients with a non-tolerant strain 17% had both clinical and bacterial treatment failure in comparison with 5% infected with a tolerant strain (p greater than 0.05). Reinfection with a new serotype occurred in altogether 3%. The present data did not indicate that penicillin tolerance in group A streptococci is of significance in acute tonsillitis treated with phenoxymethylpenicillin for 10 days.

Acute Disease↗
PubMed1993

Chronic tonsillitis and IgA nephropathy. Clinical study of patients with and without tonsillectomy.

To determine whether tonsillectomy is a significantly effective treatment in the clinical course of IgA nephropathy, we did a comparative study on 50 patients with IgA nephropathy and chronic tonsillitis. We divided the patients into two groups: 35 patients with and 15 without tonsillectomy (control group). With or without tonsillectomy, renal function became progressively worse during the follow-up period in most patients with a serum creatinine level of > 1.4 mg/dl at the time of renal biopsy. In patients with a serum creatinine level of < or = 1.4 mg/dl, renal function remained normal in all subjects with tonsillectomy, but worsened in 3 patients out of 13 without tonsillectomy. Improvement in proteinuria/hematuria was found more frequently in the tonsillectomized group than in the controls. Furthermore, the serum IgA level was significantly reduced after tonsillectomy, especially in patients showing improvement. From these results we conclude that tonsillectomy was effective for patients with IgA nephropathy complicated by tonsillitis when the operation was performed before deterioration of renal function.

Adult↗
PubMed1995

The rabbit M-cell marker vimentin is present in epithelial cells of the tonsil crypt.

The epithelium of the rabbit palatine tonsil was studied with vimentin immunohistochemistry, using cryosections and paraffin sections labelled with three monoclonal antibodies. Vimentin-positive epithelia[ cells were detected in crypt regions overlying lymphoid follicles but were absent from the surrounding stratified pharyngeal epithelium. The cells lay in close contact with intra-epithelial lymphocytes and their apical cytoplasm had a membranous shape. Since vimentin is a sensitive, specific marker for M-cells of the rabbit intestine, the present findings indicate that M-cells similar to those in the gut-associated lymphoid tissue occur in the tonsil.

Animals↗
PubMed1984

Acute tonsillitis in children: microbial pathogens in relation to age.

Tonsil swabs were collected from 248 children (1 through 10 yr) who presented with acute tonsillitis. A beta-hemolytic streptococcus was grown from 129 (53%) of 244 cases and as the sole pathogen from 83 (47%) of 178 cases. Beta-Hemolytic streptococci were especially common over the age of 6 yr (68% of children) relatively uncommon under the age of 4 yr (18%); most (90%) streptococci belonged to group A; 18 streptococcal T types were represented amongst 88 group A strains; the potentially nephritogenic serotypes 4 and 12 were prominent and accounted for 42 (47%) of typable isolates. Eight (8%) of 96 unmatched children (1 through 10 yr) who served as controls were found to be carrying beta-hemolytic streptococci, 5 of which belonged to group A. A virus was grown from 52 (29%) of 182 children and as the sole pathogen from 40 (22%) of 178 children. Only echoviruses (8 serotypes) and adenoviruses (5 serotypes) were common; younger children showed a higher isolation rate of viruses. The clinical picture in children yielding a virus was indistinguishable from that of cases who yielded a beta-hemolytic streptococcus.

Acute Disease↗
PubMed1987

Penicillin tolerance in beta-streptococci isolated from patients with tonsillitis.

Beta-streptococci isolated from patients with acute tonsillitis were tested for penicillin tolerance defined as an MBC/MIC ratio greater than or equal to 16. 11/18 strains recovered from patients with clinical treatment failure were tolerant to penicillin in comparison with 0/15 strains from successfully treated patients. The MBC/MIC ratio was less than 16 for all strains versus cefadroxil but above that ratio for many strains versus clindamycin, doxycycline and erythromycin. We suggest that penicillin tolerance may be one reason to treatment failures in individuals with streptococcal tonsillitis and that other antibiotics could be used to treat these patients since penicillin tolerance is not correlated to a general increase in antibiotic resistance.

Cefadroxil↗
PubMed1987

Twice-a-day regimen of erythromycin base is effective in the treatment of acute streptococcal tonsillitis.

A multicenter clinical trial on the efficacy and safety of a twice-a-day administration of erythromycin base was performed on 261 adolescent or adult patients with acute tonsillitis. The patients were randomized for each doctor separately into q.i.d. (4 x 250 mg) and b.i.d. (2 x 500 mg) groups. Throat swabs were cultured for group A beta-haemolytic streptococci before the treatment and, in positive cases (100 patients), 2-3 days after completing the treatment of at least 7 days. No significant difference in the efficacy between the two regimens was observed as judged by clinical evaluation or bacteriological examination. About 90% of patients were completely healed by both criteria in both treatment groups. Side-effects were reported in 40 and 44% respectively, in the treatment groups. However, only 9/244 (3.7%) had to stop the treatment because of side-effects. Six of these belonged to the b.i.d. group and 3 to the q.i.d. group. This difference is not statistically significant (p greater than or equal to 0.05). Our results suggest that twice-a-day regimen of erythromycin base is an effective and well-tolerated treatment of streptococcal tonsillitis.

Adolescent↗
PubMed1991

Phenoxymethylpenicillin two or three times daily for tonsillitis with beta-haemolytic streptococci group A: a blinded, randomized and controlled clinical study.

In relation to compliance problems it was investigated whether phenoxymethylpenicillin dosed twice or 3 times daily was equally effective in tonsillitis due to beta-haemolytic streptococci group A. In a randomized, controlled and single blind multicentre study 206 patients older than 5 years with a positive culture of group A streptococci were treated with phenoxymethylpenicillin for 7 days. 101 patients received the daily dosage divided in 2 doses and 105 patients divided in 3 doses a day. The cure rate (a combination of bacteriological and clinical cure) was 82.0% in the 2-dosage regimen, and 88.2% in the 3-dosage regimen. The difference was not statistically significant. In conclusion, phenoxymethylpenicillin dosed 2 or 3 times daily seems to be equally effective in tonsillitis due to group A streptococci.

Adolescent↗
PubMed1991

Fusobacterium pyomyositis of the shoulder after tonsillitis. Report of a case of Lemierre's syndrome.

A case of nontropical pyomyositis is reported in a young male without predisposing factors. The disease was preceded by a tonsillitis, and the presentation initially suggested a septic arthritis of the shoulder. Fusobacterium, a highly unusual pathogen in pyomyositis, was isolated from an abscess in the infraspinatus muscle. The increasing frequency of the disease in areas with a temperate climate and the pathogenesis are discussed. Our case had the classic features of Lemierre's syndrome: invasion of the bloodstream by Fusobacterium species from a tonsillitis.

Abscess↗
PubMed1998

[The role and expression of CD27/CD70 in tonsil].

We studied the expression and function of CD27 and CD70, which are reported to play an important role in the T-B cell interaction in tonsillar lymphocytes of patients with chronic tonsillitis. In comparison of CD27 and CD70 in peripheral lymphocytes of each patients, no significant difference was found. Furthermore, CD27 and CD70 in T-B cell interaction and antibody production in the tonsil was studied. Our findings was confirmed that CD27 and CD70 are involved in interactions between T/T, T/B and B/B cells. A comparative study of CD27- CD4+ cells and CD70+ CD4 cells, so-called memory cells in the T cell subset, was made in tonsillar lymphocytes and peripheral lymphocytes. No significant difference was found in the presence of CD27+ CD4+ cells, but the CD27- CD4+ cells increased in tonsillar lymphocytes. This suggests recurrent antigenic stimulation and the presence of memory cells in tonsillar lymphocytes. Localization of CD27 and CD70 in tonsillar tissue was also investigate.

Antibody Formation↗
PubMed1998

[The influence of sleep breathing disorder on growth hormone secretion in children with tonsil hypertrophy].

INTRODUCTION: Recently it has been revealed that Obstructive Sleep Apnea Syndrome has an influence on the endocrine system, especially to the secretion of growth hormone (GH). It was previously reported that secretion of GH has a circadian rhythm along with a correlation with slow wave sleep. Normally in a pediatric patient, after 90 min of sleep the brain wave shows patterns of deep sleep, and a matching peak in GH secretion is observed. We have studied the effect of GH secretion in sleep breathing disorder of pediatric patients by observing the pre- and post-operative difference in GH secretion in children with tonsillar hypertrophy who had tonsillectomies. MATERIAL AND METHODS: Ten pediatric patients who complained of sleep apnea or hypopnea, and were highly suspected of having sleep breathing disorders due to tonsil hypertrophy and underwent surgery were chosen. Pre and post-operative blood somatomedin C and urinary growth hormone levels were measured. In 6 of the 10 patients blood GH levels were measured after overnight collection of blood every 30 min through a catheter placed in the vein. METHOD OF ANALYSIS: Integral blood GH calculated from GH levels of the blood samples taken every 30 min was used to express the efficacy of GH secretion during sleep, and was compared with blood somatomedin C and urinary GH levels. Pre- and post-operative somatomedin C and urinary GH measurements were compared. RESULT: 1) In 6 of the 10 patients, there was a positive correlation with integral GH and urinary GH, and no correlation with integral GH or somatomedin C. 2) Post-operatively, 7 of the 10 patients had increased urinary GH levels, 1 showed no change and 2 had decreased levels. There was a significant increase in the mean urinary GH levels from 18.6 +/- 16.1 pg/ml pre-operatively to 35.8 +/- 19.6 pg/ml post-operatively (P < 0.05). 3) Eight of the 10 patients had a post-operative increase in somatomedin C levels, 1 showed no change and the other patient had a decreased level. There was a significant increase in mean somatomedin C levels from 175.9 +/- 124.8 ng/ml pre-operatively to 226.6 +/- 134.3 ng/ml post-operatively (P < 0.01). CASE: An 8-year-old-boy was diagnosed as having habitual tonsillitis and suspected sleep breathing disorder, and was admitted to our hospital for a tonsillectomy. Apnea and hypopnea were observed during sleep in the hospital. After receiving his parents' consent, GH secretion was evaluated before and after the tonsillectomy. Integrated GH measurements, somatomedin C and urinary GH increased significantly after the operation. CONCLUSION: In this study, the improvement of sleep breathing disorder by surgery was associated with a positive effect to the GH secretion. GH secretion is important for growth of a child. Wen the cause of sleep breathing disorder is evident in the upper airway system, active treatment and cure by surgery is advised. Measurement of urinary GH in the morning is useful and simple for evaluating the ability to secrete GH.

Biomarkers↗
PubMed1994

[Anatomical study of the tonsillar bed: the topographical relationship between the palatine tonsil and the lingual branch of the glossopharyngeal nerve].

The topographical relationship between the lingual branch of the glossopharyngeal nerve (LBGN) and the muscle layer of the palatine tonsillar bed was investigated by gross and histological observation in 107 sides of 83 Japanese adult cadavers, aged 27-88yr, in order to provide anatomical data facilitating the prevention of taste disturbance caused by injury to the LBGN during tonsillectomy. The muscular composition and lamination of the tonsillar bed are thought to be unchanged by aging or pathological conditions such as inflammation, in contrast to the morphological instability of the palatine tonsil itself. In the present study, the nerve branch was often (23.4%) observed to pass along the inferior side of the styloglossus muscle and to be located lateral to the superior constrictor pharyngeal muscle, during almost its entire course to the base of the tongue, so that the palatine tonsil was clearly separated from the LBGN. In 55.1% of cases, however, the muscle lining observed at the tonsillar bed was not continuous, and instead thin muscle bundles, derived from the stylopharyngeus, palatopharyngeus or superior constrictor pharyngeal muscles, partly covered the tonsillar capsule externally. Moreover, in 21.5% of cases, the LBGN was firmly adherent to the tonsillar capsule, due to complete absence of the lining muscles at the tonsillar bed. In these cases, and also probably in a similar percentage of patients undergoing tonsillectomy, taste disturbance could occur upon removal of the hypertrophic tonsillar capsule produced by chronic inflammation. Therefore, tonsillectomy with minimal disturbance of the tonsillar bad is recommended in all cases.

Adult↗