Tonsilar Tissue Research Articles

Clinical and histopathological correlation in patients with chronic tonsillitis

<p class="abstract"><strong>Background:</strong> Chronic tonsillitis is diagnosed when an individual has 7 episodes of tonsillitis in 1 year, 5 episodes in 2 consecutive years, or 3 episodes each year for 3 years consecutively. There is correlation of clinical and histopathological findings in patients with chronic tonsillitis.</p><p class="abstract"><strong>Methods:</strong> It is prospective study which is aimed at correlation of clinical and histopathological findings in chronic tonsillitis patients underwent tonsillectomy. This was carried out in tertiary care hospital, Pune, Maharashtra, India. In our study, 25 patients of chronic tonsillitis underwent tonsillectomy were included. In this we have examined the histopathology of tonsillar tissue section in correlation with the clinical manifestations of tonsillar diseases that were due to infection. </p><p class="abstract"><strong>Results:</strong> In pathological examination of palatine tonsil, underlying subepithelial tissue showed many lymphoid follicles with prominent germinal centres comprising of centrocytes, centroblasts, immunoblasts, small and large lymphocytes in 19 patients (76%). 13 patients (52%) showed prominent germinal centres with bites of salivary gland and muscle tissue. 6 patients (24%) showed prominent germinal centre with mild lymphoplasmocytic inflammatory cell infiltrate. In 4 patients (16%), tissue lined by stratified squamous epithelium showed focal ulceration. 3 patients (12%) showed stratified squamous epithelium with granulation tissue. Crush artifact were noted in 3 patients (12%). 2 patients (8%) had small granules with actinomycotic species colonies within the palatine tonsilar crypts. Only 1 patient (4%) showing keratin impacted in tonsilar tissue.</p><p class="abstract"><strong>Conclusions:</strong> There is strong correlation between histopathological examination suggestive of lymphoid hypertrophy and grading of palatine tonsil hypertrophy.</p>

ORTHODONTIC-ORTHOPEDIC and OTOLYRNGOLOGICAL treatment of “facial insufficiency” and hyperdivergence

In treating children who have a significant lack of space both for the correct placement of their teeth, in what is called an arch length discrepancy, as well as for proper accommodation of their airways resulting in the Obstructive Sleep Apnea Syndrome, it seems to us to be indispensable for specialists in dentofacial orthopedics and otolaryngology to share and combine their philosophies and treatment approaches. The three clinical cases that we are presenting in a virtually documentary cinemaphotographic fashion, dealing simultaneously with the skeletal, dental, and breathing aspects of the disorder, will, we hope, give an improved view of the landmarks and architecture of “facial insufficiency” and the ways in which it can be treated. Patients with “facial insufficiency” suffer from simultaneous impairment of the correct growth off the two maxillae. In addition, the failure of the two jaws to develop sagittally makes the problem difficult to detect. Patients with Class I bimaxillary retrusions make up the majority of patients seeking orthodontic treatment who have facial insufficiency. And it is only the oral examination the orthodontist makes about the lack of space for teeth that uncovers the accompanying problem of lack of space for the airways. It should be pointed out that not all patients with bimaxillary retrusions have insufficient airway space. Still orthopedic treatment of the dental problem, enlarging available space in the dental arches, also automatically increases available airway space. This procedure must await the restart of vertical posterior growth under the influence of upward pressure from the tongue against palatal supports that stimulate the mandibular condyles. It is understandable, then, that any blockage of nasal breathing, from, for example the inferior turbinates or enlarged adenoidal tissue or impediment to vertical tongue thrusts, from excess tonsilar tissue or tight lingual frenums would be a primary hindrance to the desired growth process. So the first orthodontic objective is freeing the tongue, the second is adjusting occlusion. Ramus growth, in fact, unlocks a verticotransverse “raising” action of the lower lateral sectors needed for occlusal recovery and advancement of the maxilla. The “mandibular lock” blocking maxillary advancement is thus opened vertically.

CD4(+) and CD8(+) T cell death during human immunodeficiency virus infection in vitro.

We have evaluated the death of CD4(+) and CD8(+) T cells during in vitro human immunodeficiency virus (HIV) infection of peripheral blood mononuclear cells (PBMC) and tonsilar tissue. Acute infections with several X4 and R5 HIV isolates induced a decrease in cell viability that was higher in infections with X4 viruses and correlated with an increased rate of CD4(+) T-cell death. In CD4(+) T cells, the primary X4 isolate AOM induced higher levels of death than the laboratory X4 isolates IIIB and NL4-3 or the R5 isolates BaL and MDM. An effect on CD8(+) T-cell viability was exclusively observed in infections by X4 viruses, including the NL4-3 strain, in both PBMC and tonsilar tissue. This effect was dependent on the env gene of the infecting isolate and required productive HIV replication in CD4(+) but not in CD8(+) T cells. Our results suggest that X4 and R5 HIV isolates depleted CD4(+) T cells to a different extent and that CD8(+) T-cell viability may also be affected by mechanisms other than those acting in CD4(+) T cells.

Cytokine-enhanced expression of glycoprotein Ib alpha in human endothelium.

Platelet glycoprotein Ib is a major platelet membrane protein composed of two disulfide-linked chains, termed the alpha and beta chains. The larger alpha chain (GpIb alpha), a platelet receptor for von Willebrand factor, plays a major role in mediating platelet adhesion to the subendothelium. Our laboratories have previously reported synthesis of a protein in human endothelial cells that is immunoprecipitated with polyclonal and monoclonal antibodies to platelet GpIb alpha. Lopez et al. (Lopez, J. A., Chung, D. W., Fujikawa, K., Hagan, F. S., Papayannopoulou, T., and Roth, G. J. (1987) Proc. Natl. Acad. Sci. U.S.A. 84, 5615-5619) have reported the cloning of GpIb alpha from a human erythroleukemia (HEL) cell cDNA library. Using this clone as probe, we have isolated two partial GpIb alpha clones from a human umbilical vein endothelial cell lambda gt11 cDNA library. These clones were localized within HEL-derived GpIb alpha cDNA by sequence and restriction enzyme analysis. Additionally, they detected the same message species in HEL and tonsilar RNA that was detected with the HEL GpIb alpha cDNA. Low level GpIb alpha mRNA expression was detected in cultured human umbilical vein endothelial cells, which was increased by treatment of the cells with tumor necrosis factor-alpha. This effect was enhanced by pretreatment with interferon-gamma. Additionally, localization of GpIb alpha in endothelium of fresh tonsilar tissue was demonstrated by immunohistochemistry and in situ hybridization. GpIb alpha may play a role in mediating platelet or other effector cell adhesion to activated endothelium.

Chronic pneumonia in a child with primary ciliary dyskinesia.

This is the ninth in a continuing series of Radiologic-Pathologic Correlation Conferences held at the State University of New York (SUNY) Health Science Center at Syracuse. Dr. Jack Westcott, Professor and Chairman of Radiology at the Hospital of St. Raphael, New Haven, CT, and Clinical Professor of Diagnostic Imaging, Yale University College of Medicine, is the guest radiologic consultant. Dr. David Panicek, Chief of the Abdominal Imaging Section at the SUNY Health Science Center at Syracuse, is the moderator. Dr. E. Mark Levinsohn is coordinator of the series. Dr. Panicek: A 31/2-year-old girl was admitted for evaluation of recurrent pneumonia and persistent cough that had begun when she was 3 years old. Over a 6-month period, she was hospitalized twice for bilateral pneumonia that responded to antibiotic therapy. In addition, she had a chronic, hacking, nonproductive cough; clear nasal discharge; and an intermittent erythematous rash. Her travel and environmental histories were unremarkable. The patient had had several episodes of otitis media and persistent middle ear effusions that resulted in delayed speech and language development. She was known to have a small, asymptomatic ventricular septal defect. Her family history included a cousin who died at the age of 8 years from respiratory disease. Physical examination showed the right tympanic membrane to be erythematous and immobile, with fluid behind the membrane. The lungs were clear to auscultation and percussion. A grade Il/VI systolic murmur at the left lower sternal border was consistent with the known ventricular septal defect. Mild digital clubbing was present without cyanosis. Laboratory findings included a WBC count of 30,100/mI, 73% due to polymorphonuclear leukocytes (some with Dohle bodies) and 4% to bands (normal values: 5000-1 5,000/mI; 21 %-63%; 0%-7%, respectively). The erythrocyte sedimentation rate was elevated. An arterial blood gas determination with the patient breathing room air showed Po2 61 mm Hg, Pco2 31 mm Hg, CO2 21 mmol/l, and 02 saturation 91% (normal values: 95-1 00 mm Hg, 35-40 mm Hg, 24-30 mmol/ I, 94%-i 00%, respectively). Dr. Westcott: Frontal and lateral radiographs of the chest (Figs. 1 A and 1 B) show diffuse bronchial wall thickening, scattered patchy infiltrates, and linear atelectasis bilaterally. The lungs are mildly hyperexpanded, consistent with obstructive airway disease. A radiograph of the chest taken 1 month later (Fig. 1 C) shows slightly more density in the lung bases, particularly on the left side. The apparent dilated bronchi within some of these infiltrates suggest bronchiectasis and diffuse chronic lung disease. Sinus radiographs were unremarkable. Normal adenoid and tonsilar tissue was evident on the lateral view, excluding those forms of congenital immunodeficiency syndromes, such as congenital hypogammaglobulinemia, that are characterized by a lack of lymphoid tissue [1-3].

Isolation of functional polyclonal TsF from MRL-lpr spleens using monoclonal antibody absorbance

We have previously described a monoclonal antibody, B16G, which has been found to be specific for T-cell derived suppressor factors (TsF). B16G has been shown to react with T-suppressor cells, TsF in the spleens of normal or tumor-bearing mice, the TsF produced by a tumorspecific T-cell hybridoma, and with polyclonal whole human TsF isolated from tonsilar tissue. This panreactivity inherent to the B16G MAb has made it clear that it recognizes some common, shared epitope of the TsF molecule. In this study we have used B16G as a probe to isolate TsF from the spleens of MRL-lpr mice and compare the activity with these factors isolated from the spleens of an MHC compatible nonautoimmune strain, CBA. We find that equivalent quantities of functional TsF are isolable from both strains and thus, it can be concluded that the associated oligoclonal B-cell activation characteristic of MRL-lpr mice is not due to a polyclonal T-suppressor cell deficit, nor to the ability of TsC in these mice to produce soluble, functional TsFs. The molecular and biochemical characteristics of these TsFs are discussed.

Different fixative-resin combinations and the immunocytochemical demonstration of immunoglobulins (kappa light chains) in semi-thin sections.

The effect of six different epoxy resins on the immunostaining of kappa light chains in tonsilar tissue which had been fixed by one of three fixing variants is described. The results show that not only may a specific resin influence the reaction but this may be enhanced by adopting a particular fixative-resin combination.

Studies on redox substances in tonsil.--Relation between thiol compounds and vitamin C in tonsils- (author's transl)

In the series of investigation on the function of tonsils, the authors have reported in details on the individual redox substances in tonsilar tissue. In this study, the relationship between each component has been discussed. Each redox substance was measured as follows:glutathione and the thiol compound by the enzyme-spectrophotometrical method and the DTNB colorimetry; vitamin C by nitrophenyl hidrazine (DNP) method.The reduced glutathione and reduced vitamin C exhibited the positive correlation in palatine and pharyngeal tonsils. When the age of the patients was considered, the positive partial correlation was observed between these two substances. Positive correlation was also found in inflammatory stage or in chronic tonsillitis. Furthermore, the positive partial correlation existed with the degree of hypertrophy of palatine tonsils and the fluctuation of blood ASO titers, and the multiple correlation was found with ages in tubal tonsils.The oxidative glutathione and oxidative vitamin C revealed the negative correlation in hypertrophied tonsils, and in the non-inflammatory stage. The multiple correlation was found with ages particularly in palatine tonsils and in tubal tonsils, and the positive partial correlation was also shown with ages in tubal tonsils.When evaluating the ratio between oxidative and reduced glutathione and that of oxidative and reduced vitamin C, the multiple correlation with ages in palatine tonsils was indicated.No relations were found between the thiol compounds except glutathione and total vitamin C.

Percent distribution of T- and B-cells in tonsils of children, juveniles and adults

The percent distribution of T- and B-lymphocytes in tonsilar tissue of 122 patients from 2--68 years and both sexes was investigated. T-cells were determined by the E-rosetting technique and B-cells by immunofluorescence. We found 50.3% B-cells and 30.6% T-cells in tonsilar tissue. There was a significant decrease of IgM-receptor carrying cells with increasing age and with a converse behavior of the sum of IgA-, IgD-, IgE-receptor B-cells. In tonsils with acute inflammation and with hyperplasia IgM cells were also increased significantly when compared to cell counts in chronic tonsillitis. The results are discussed and compared to data from the literature.

CYTOLOGICAL STUDY OF TONSILS

Using the tonsils with various pathological conditions removed from the patients, the author has investigated the percentage of every kind of cells contained in the tonsilar tissue, Golgi's apparatus and mitochondria in the cells. The results obtained were as follows. It would be considered that the plasmacells might have the closest relation with the immunity function of tonsils.