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PubMedDate not supplied

HLA-DR antigen expression in tonsillar epithelium. With special reference to focal infection.

Palmoplantar pustulosis (PPP) has long been regarded as a tonsillar focal infection because tonsillectomy is so effective in its treatment. Immune mechanisms of focal infection have been discussed mainly with regard to humoral immunity as an autoimmune disease. The present immunological study demonstrates the expression of HLA-DR antigen in tonsillar epithelium. The patterns of the HLA-DR antigen appearance in the epithelium were categorized into 4 types, and the intensity was compared between hypertrophic tonsils, recurrent tonsillitis, and tonsils with PPP. In addition, paired fluorescent staining, a combination of CD3 and anti-HLA-DR antibodies, was performed. The activity of intraepithelial T-lymphocytes was determined as an index of the HLA-DR antigen expression. In an age matching study, HLA-DR antigen appeared in high intensity in tonsils with PPP. A close correlation was found between the appearance of HLA-DR antigens and activation of infiltrating T-lymphocytes. These findings suggest that the tonsillar epithelium plays an important role in focal infection.

Child↗
PubMed1990

Topical PUVA, etretinate, and combined PUVA and etretinate for palmoplantar pustulosis: comparison of therapeutic efficacy and the influences of tonsillar and dental focal infections.

Twenty patients with palmoplantar pustulosis (PPP) were treated with topical PUVA, oral etretinate (Re), or combined PUVA and etretinate (Re-PUVA). Re and Re-PUVA treated sites improved and/or cleared more rapidly than PUVA treated sites. Complete clearance was observed in six of ten sites treated with Re-PUVA, two of ten with Re, and one of ten sites with PUVA within 12 weeks. UVA-control sites failed to be cleared within 12 weeks. Remission periods after stopping the treatment were 1.5 +/- 0.5 weeks (n = 2) with Re, 10.5 +/- 11.4 weeks (n = 6) with Re-PUVA, and one year (n = 1) with PUVA. These results overall suggested that Re-PUVA is the most effective treatment for PPP. Tonsillar focal infection (TFI) and dental focal infection (DFI) were found in 6/20 and 17/20 patients, respectively. However, the presence of focal infection (FI), TFI and/or DFI, did not appear to interfere with the therapeutic activities of Re and/or PUVA, because the complete clearance rates and remission periods in FI(+) patients were comparable with those in FI(-) patients.

Adult↗
PubMed2004

Historical review: Autointoxication and focal infection theories of dementia praecox.

The popularity of theories of autointoxication and focal infection in general medicine and dentistry in the late nineteenth and early twentieth centuries led Emil Kraepelin and others to speculate that dementia praecox was caused by a poisoning of the brain from toxins produced in other parts of the body, notably the sex glands, the intestines and the mouth. Emil Kraepelin's commitment to the autointoxication theory is ignored in the literature on the history of psychiatry due to the focus of historians and clinicians on the major contributions of Kraepelin's methods of clinical psychopathology. Besides heredity, autointoxication and focal infection were the other most dominant theories of the organic aetiology of dementia praecox in the first three decades of its existence as a nosological entity in psychiatry. Rational treatments for dementia praecox that followed logically from these aetio-logical theories were colonic irrigations and major abdominal surgeries such as appendicostomies, colectomies and the removal of presumably infected ovaries, testes and other organs associated with reproduction. Autointoxication and focal infection theories disappeared from psychiatry by the mid-1930s.

Bacterial Infections↗
PubMed2006

[Examination for focal infections: sensible or superfluous?].

Detection of focal infections aims at the identification and subsequent treatment of sources of odontogenic inflammation in order to prevent health threats in patients who are often medically compromised. Examination for dental foci often precedes medical treatment of patients with increased risks of endocarditis, patients with a joint prosthesis, patients scheduled for chemotherapy or head and neck radiotherapy or candidates for organ transplantations. Although examination for possible sources of dental inflammation is performed on a routine basis in many hospitals, the scientific basis for this policy apparently is very limited, and there is an evident need for well-designed randomized clinical trials in this field.

Focal Infection, Dental↗
PubMed1953

[Focal infection].

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Focal Infection↗