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At least 19 recordsLinked to original sources

Quantitative bacteriology of tonsils removed from children with tonsillitis hypertrophy and recurrent tonsillitis with and without hypertrophy.

The aerobic and anaerobic bacterial species and their numbers were studied in tonsillar specimens from children who had undergone elective tonsillectomy: 6 patients with recurrent tonsillitis (RT), 9 with recurrent tonsillitis with hypertrophy (RTH), and 8 with obstructive tonsillar hypertrophy (OTH). Mixed flora were present in all tonsils, yielding an average of 6.7 isolates (5.6 aerobic or facultative and 1.1 anaerobic bacteria). The highest recovery rate of organisms per tonsil was in patients with OTH (7.7 per tonsil), compared to 6.3 per tonsil in RT and 5.9 per tonsil in RTH. The predominant aerobic and facultative organisms were Haemophilus influenzae (22 isolates), Neisseria sp (16), Staphylococcus aureus (14), and Eikenella corrodens (14), and the predominant anaerobic bacteria were Fusobacterium sp (8), Bacteroides sp (7), and Prevotella melaninogenica (5). The number of bacteria per gram of tonsillar tissue varied between 10(4) and 10(8). A higher concentration of S aureus and H influenzae was found in hypertrophic tonsils (RTH and OTH) as compared to RT. These findings suggest the presence of an increased bacterial load and supports an etiologic role for H influenzae and S aureus in hypertrophic tonsils with and without inflammation (RTH and OTH). Further studies to elucidate the effect of selective antimicrobial therapy directed at these organisms may offer an alternative management of hypertrophic tonsils.

Bacterial Infections↗

Immunohistological studies on tonsils with recurrent tonsillitis and focus-tonsil with pustulosis palmaris et plantaris.

By use of monoclonal antibodies and anti-immunoglobulin antibodies, the distributions of 15 adult tonsils with recurrent inflammation and palmoplantar pustulosis as focus-tonsil were investigated. The avidin-biotin-peroxidase complex (ABC) method was utilized throughout the experiment. Monoclonal antibodies of the Leu and OKT series revealed the location of T and B cell subsets characteristic in the tonsils with chronic inflammation and the focus tonsils with pustulosis palmaris et plantaris (PPP). In vitro sensitization of tonsil tissues was performed with crude antigen from tonsillar epithelium. Tonsil tissues with PPP demonstrated a significant increase in S-IgD-bearing lymphocytes and esterase-positive cells in the mantle zones of follicles, although the tissues of recurrent tonsillitis showed no such effects. It was speculated that tonsils with focal infections are usually standby for the production of antibodies against tonsillar epithelial antigens.

Adult↗

Immunohistological studies on tonsils of recurrent tonsillitis and tonsils with focal infections.

In this study, two experiments were made to investigate the immunological pathogenesis of PPP, a skin disease of so-called focal infections. One was the immunohistological study on tonsils with PPP and recurrent tonsillitis. In the investigation, monoclonal antibodies against T lymphocytes and anti-immunoglobulin antibodies were used to reveal the distribution of T and B cell subsets on frozen sections of tonsils. But no difference between tonsils with focal infection and recurrent tonsillitis was observed in the distribution of T and B cell subsets. The other was the identification of a common antigen between tonsillar epithelium of PPP and hand-sole skin by use of one monoclonal antibody against PPP-tonsillar epithelium, which was made in our laboratory. Monoclonal antibody ATE-3 was in IgM, and recognized about 35 kilo dalton molecular weight protein of a tonsillar epithelium of PPP. This antibody reacted with the basal layer cells of the tonsillar epithelium and the suprabasilar cells of plantar skins of PPP. But ATE-3 did not react with normal tonsillar epithelium and normal plantar skin.

Adult↗

[Palatine tonsils and immunity. III. T- and B-lymphocytes in the palatine tonsils of patients with chronic tonsillitis].

Both B- and T-cells are contained in the palatine tonsils of patients suffering from chronic tonsillitis. The former respond by blast-transformation to the in vitro stimulation by the streptococcus and staphylococcus antigens and the latter--to PHA, and produce soluble substances inducing blast-transformation reaction of lymphoid cells of the palatine tonsils under the effect of streptococcus and staphylococcus antigens.

Antigens, Bacterial↗

[Cellular composition of palatine tonsil imprints in the differential diagnosis of uncomplicated chronic tonsillitis with a tonsillo-cardiac syndrome and chronic tonsillitis with rheumatism].

The authors studied imprints of tonsillar sections stained both by the method of Pappeneheim and that of Stockinger and Kellner taken from 205 patients with chronic non-complicated tonsillitis, chronic tonsillitis with tonsillocardiac syndrome and chronic tonsillitis with rheumatism, the rheumatic process being of various stages of activity. A comparison of the preparations received shows that the organism's immunologic reformation resulting from the rheumatic process is characterised by growing reticulolymphoblastic, plasmocellular and macrophage reactions and vivification of sinuslymphocytopoiesis which proved to be in strict correlation with the extent of rheumatic activity.

Chronic Disease↗

A scanning electron microscope study of the caecal tonsil: the identification of a bacterial attachment to the villi of the caecal tonsil and the possible presence of lymphatics in the caecal tonsil.

A scanning electron microscope (SEM) was used to compare the proximal region (PR) and distal region (DR) of the caecum. The caecal tonsil (CT) occupied the initial 4-10 mm of the PR. Villi were present in the PR and absent from the DR. Segmented structures were attached to the surface of PR. Transmission electron microscopy (TEM) revealed these structures to be bacteria. No difference in surface morphology could be discerned between the CT and the remainder of the PR. Lymphatic vessels were observed in the CT by employing TEM.

Animals↗

[Infection of herpes simplex virus (HSV) and Epstein-Barr virus (EBV) in acute tonsillitis--histopathological assessment by optical and electron microscopic observation of biopsy specimens of tonsils].

Infection with HSV or EBV was studied by measuring serum antiviral antibody titers in adults with acute tonsillitis, and results were compared to light and electron microscopy findings of tonsil biopsy specimens. The clinical and laboratory features of acute tonsillitis caused by HSV or EBV were also studied. Subjiects were 42 patients with acute tonsillitis treated at the Department of Otorhinolaryngology at Tokyo Women's Medical University Daini Hospital between August 1997 and March 2000. They had failed to respond to antimicrobial agents prescribed by a physician, and had severe oropharyngeal mucosal lesions, liver dysfunction, skin eruptions, or cervical lymphadenopathy, with hospitalization required because of impaired food intake due to sore throat or deterioration in general condition. Subjects were 24 men (mean age: 30.8 years) and 18 women (mean age: 28.3 years) aged 16 to 78 years (mean: 29.8 years). A underwent, bacteriological and hematology tests and palatine tonsil biopsy specimens were obtained to examine tissue changes by light microscopy and electron microscopy due to detect HSV antigen by immunohistochemistry and EBV nucleic acids by EBV-encoded small nuclear RNA 1 and 2 (EBER) in situ hybridization (ISH). Among patients, the serum antiviral antibody profile indicated that 4 (9.5%) had acute tonsillitis due to primary HSV infection and 5 (11.9%) had acute tonsillitis due to primary EBV infection. The findings characteristic of acute tonsillitis due to primary HSV infection included stomatitis, skin eruptions, atypical lymphocytes, and liver dysfunction. Findings characteristic of acute tonsillitis due to primary EBV infection included petechiae of the soft palate, an increase of lymphocytes, atypical lymphocytes, and liver dysfunction. At the initial test, serum anti-HSV antibody was positive in 14 patients (33.3%), and more than half had no history of prior infection. Anti-EBNA antibody was positive in 32 (76.2%), and many had been infected previously. It should be noted that a decrease in positive HSV antibody means that acute tonsillitis due to primary HSV infection is not uncommon in adults and is expected to increase steadily. Light microscopy revealed histological changes in 2 patients. HSV antigen was positive in 2 (50%) with acute tonsillitis due to primary HSV infection, while EBER cells were positive in 5 (100%) with acute tonsillitis due to primary EBV infection, so special staining of the tissues was found to be useful. Electron microscopy failed to detect viral particles in ultrathin sections and no differences were seen in morphological changes or tissue damage between patients with positivity for HSV antigen and with EBER-positive cells. Detection of HSV antigen and EBV nucleic acids in pathological specimens from patients with acute tonsillitis requires careful judgment, but is considered useful for making an early diagnosis and for making a diagnosis in patients without an increase of the antiviral antibody titer and in those with reinfection or reactivation. Pathological examination (including special staining) and careful observation of clinical features may help to identify HSV or EBV infection and allow decisions to be made with regard to the therapeutic strategy and prevention of complications.

Acute Disease↗

Tonsil surface and core cultures in recurrent tonsillitis: prevalence of anaerobes and beta-lactamase producing organisms.

The bacterial flora of the tonsil surface and core was compared in patients suffering from recurrent tonsillitis. Surface swabs and tonsil core tissues were received as paired samples from 50 patients admitted for elective tonsillectomy. Analysis of paired samples from individual patients revealed differences in the bacterial flora of the tonsil core and the tonsil surface. Of 366 aerobic isolates, 30% grew from the surface alone, 26% from the core only and 44% from both sites. Of 290 anaerobic isolates, 35% grew from the surface alone, 33% from the core only and 31% from both sites. The total number of isolates from surface and core samples was similar (average 9.2 and 8.8, respectively). The range of species isolated was also similar for both surface and core samples, as was the proportion of organisms producing beta-lactamase from each site (10.7% and 9.5%, respectively). Eighty-two percent of patients carried beta-lactamase-producing organisms on either the tonsil surface or in the core tissue. A surface swab does not reliably reflect the types of organisms present in the tonsil core in individual patients. Anaerobes are a major component of tonsil surface and core bacterial flora in patients with recurrent tonsillitis. The high carriage rate of beta-lactamase-producing organisms in the tonsils should be considered when selecting antimicrobial therapy for persistent or recurrent tonsillitis.

Adolescent↗

[Immunohistological study on immunocompetent cells in palatine tonsil and pharyngeal tonsil--the quantitative study by image analyzer].

Distribution of various immunocompetent cells, i.e., IgG-, IgM-, IgA-, IgD-, IgE-, CD4-, and CD8-positive cells in palatine tonsils (tonsils) and pharyngeal tonsils (adenoids) of same patients were investigated immunohistologically by using monoclonal antibodies. The proportion of Ig-positive cells and T cell subsets in both tonsils were quantitatively studied by the image analyzer (CUE-2, Olympus, USA). The results were summarized as follows: 1) There was no significant difference in proportions of Ig-positive cells and T cell subsets between tonsils and adenoids. 2) IgG- and IgD-positive cells in the tonsils were significantly increased in cases with recurrent tonsillitis than in those with simple tonsillar hypertrophy. 3) Number of IgA2-positive cells were significantly changed, i.e., decreased in the subepithelial area of tonsils and increased in the interfollicular area of adenoids in cases complicated with otitis media with effusion. 4) In cases complicated with nasal allergy, IgE-positive cells were significantly increased in the interfollicular area in both of those tonsils and adenoids. These results indicate that the image analyzer will be a breakthrough in quantitative study on the immunohistology of tonsils and adenoids and give us useful informations about roles of the tonsil and the adenoid on the local immunity of the upper respiratory airway.

Adenoids↗

Bacteriology of normal and diseased tonsils assessed by fine-needle aspiration: Haemophilus influenzae and the pathogenesis of recurrent acute tonsillitis.

The pathogenesis of recurrent tonsillitis is largely unknown. Selection of appropriate antibiotic therapy for patients with recurrent tonsillitis is difficult because of the limitations of traditional methods of sampling tonsillar microflora and the increasing incidence of beta-lactamase producing bacteria in the tonsil. In addition, little attention has been paid to the bacteriology of normal tonsils. The tonsil core bacteria was assessed in 124 patients with recurrent acute tonsillitis. Fifty-five of these patients were randomly selected for fine-needle aspiration which revealed a similar profile of bacteria in 85%. Fine-needle aspiration of 10 normal tonsils found few pathogens; the predominant organisms being normal flora. No Haemophilus influenzae were detected in this control group. This study demonstrates the accuracy of fine-needle aspiration in identifying tonsil core bacteriology and its suitability in the clinical setting. It reports on the flora of normal healthy tonsils and it highlights the association between H. influenzae and recurrent acute tonsillitis.

Acute Disease↗