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The development of transillumination of the paranasal sinuses is reviewed. A technique of transillumination with a fibre-optic source is described. In acute sinusitis there was a very significant correlation between radiography and transilluminometry.
The aim of this study was to compare the results obtained by transillumination and bitewing radiography in the diagnosis of caries affecting approximal surfaces of molar and premolar teeth for epidemiological surveys. 3960 posterior approximal surfaces on the right side of 330 patients aged 5 to 35 years were examined using a transillumination probe with a 1.5 mm diameters light source (Oralum, Rocky Mountain, Denver, Colorado) and bitewing radiographs using a portable dental apparatus (Elin, Wien, 60kV, 15mA. Transillumination detected 89% of the carious lesions reaching dentine diagnosed on radiographs and no statistically significant differences were observed in the diagnosis yield of the two systems. However, transillumination detected only 45% of these lesions diagnosed from bitewings as being confined to the enamel. Transillumination also made it possible to detect approximal caries into dentine in teeth covered by orthodontic bands. Thus comparative study gives experimental support to the use of transillumination in large epidemiological studies. The transillumination method is however not suitable for epidemiological trials including caries confined to the enamel.
The ability of operative endoscopic transillumination of the bowel wall to detect duodenal gastrinoma was evaluated prospectively in 26 patients with the Zollinger-Ellison syndrome. The results were assessed by exploratory laparotomy and compared with the results of other localization techniques. Twelve duodenal gastrinomas were resected from 10 patients. Operative endoscopic transillumination detected 10 of the 12 gastrinomas, a sensitivity of 83%, which was significantly greater (P less than 0.05) than that for either preoperative imaging (25%) or intraoperative ultrasonography and palpation (42%). The sensitivity of operative endoscopic transillumination was a result of the ability to detect focal areas that did not transilluminate on the serosal side of the duodenum, and not the mucosal appearances seen through the endoscope, which were not helpful. Operative endoscopic transillumination detected gastrinomas less than 1 cm in diameter throughout the duodenum. Of the patients in this study, 39% had duodenal gastrinomas, a greater frequency than previously reported. These results indicate that operative endoscopic transillumination is the most sensitive technique yet described for detecting duodenal gastrinomas and should be performed routinely in all patients with the Zollinger-Ellison syndrome who undergo exploratory laparotomy for cure.
Tumor size is an important prognostic factor for deaths due to uveal melanoma. The objectives of this study are: (1) to determine the association between largest tumor diameter assessed by clinical transillumination and largest tumor diameter assessed by measurement of the histologic slide; (2) to predict a clinical transillumination diameter for each enucleation specimen based on the best combination of histologic variables--diameter, height, location, and tumor shape; and (3) to use the predicted transillumination diameter in place of histologic diameter measurement as a prognostic factor for patients treated by enucleation in order to reevaluate previously reported survival outcomes for patients treated by proton beam and enucleation. Comparison of measurements on 40 eyes indicated that transillumination largest diameter measurements were larger than histologic slide measurements (mean difference, 2.87 mm). Multiple linear regression analysis yielded the following equation: transillumination diameter = [4.73 + (0.58 X histologic diameter) + (0.38 X histologic height) + (1.87 X anterior location)]. Using the actual and predicted transillumination measurements, the results of this study support a previously published report on these data: treatment type, tumor size, and location were predictive of melanoma-related deaths, metastases, and all deaths.
The transillumination-assisted isolation of segments of seminiferous tubules in defined stages of the wave of the seminiferous epithelium was investigated in Pseudomys australis and Notomys alexis. In P. australis, three different transillumination patterns (pale, spotty and dark) of the seminiferous tubules could be isolated. They corresponded to histological stages 1-2, 3-5 and 6-8 of the wave of the seminiferous epithelium. The dark pattern made up about 40% of the wave, the pale pattern about 31%, and the spotty pattern about 24%. In N. alexis, no such isolation of segments with particular cell associations was possible. In a comparison of P. australis with the laboratory rat, the dark, pale and spotty transillumination patterns of seminiferous tubule segments corresponded to the same cell associations in both species, but the length of the spotty segments in the laboratory rat made it possible to subdivide the spotty region into pale spotty and dark spotty areas and thus to isolate four different transillumination patterns. Further separation into other subgroups to isolate additional types of segments could not be performed repeatedly in any of the studied species because of the gradual change of one subgroup of transillumination pattern into another and the short length of some of the subgroups.
In 52 children between 3 and 9 years of age drainage of the maxillary sinus was performed because of chronic purulent rhinitis and opacity of the maxillary sinuses on the radiographs. The results of preoperative transillumination were compared with the drainage findings. In this selected group of children the sensitivity of transillumination for the demonstration of congestion in the maxillary sinuses was found to be limited. The authors consider transillumination to be an obsolete method for this purpose in children.
A method of curing light-cured composite resins by transillumination to cement acid-etched fixed partial dentures was adapted to bond solid mesh-backed lingual orthodontic brackets. Results of this investigation showed that the bond strengths of the orthodontic brackets bonded with light-cured composite resins were significantly less (P less than 0.05) than the bond strengths of the orthodontic brackets cemented with traditional adhesives and orthodontic composite resins. Notwithstanding, the bond strengths achieved with the transilluminated light-cured composite resins should be adequate to withstand the forces of mastication and orthodontic movements. There was no correlation of bond strengths of the brackets cemented with the transilluminated light-cured composite resins when compared to the faciolingual widths of the teeth.
Ninety-five infants from 26 to 42 weeks of gestational age were studied with a simple standardized cerebral transillumination technique utilizing a Chun gun fitted with a clear flexible disc to establish normal measurements and to test the hypothesis that transillumination is useful in differentiating "catch-up" growth from hydrocephalus. One group of infants were measured at birth; the other group were infants grown to similar gestational age and serially measured. Data from these groups were found to be similar. Transillumination was not found to be a useful technique for separating "catch-up" growth infants from the normal population, but was found to be potentially useful in separating the normal and "catch-up" population from children with hydrocephalus or serious anatomic abnormalities of the central nervous system.
Percutaneous arterial sampling was performed using transillumination. A success rate of 96% was obtained when sampling the radial, ulnar, posterior tibial, and dorsalis pedis arteries. Although small hematomas were produced despite pressure, no serious complications of infection, thrombotic obstruction, or thermal injury occurred. We conclude that the use of transillumination for arterial sampling is a safe technique that permits rapid sampling of very superficial peripheral arteries, allows visual confirmation of the Allen test for estimation of collateral flow, and would perhaps aid in arterial cannulation. Pediatrics, 59:1032-1035, 1977, TRANSILLUMINATION, ARTERIAL SAMPLING.
An account is given of the creation of an autoclavesterilisable, cold-light, transilluminating loop for surgical use following personal endoscopic experience with personally divised instruments, some of which were presented at the Turin Medical and Surgical Meetings held in 1954. It is considered that much valuable can be made of the intense luminous ray, which can be aseptically transfered into the surgery site for direct or transparent viewing. A description is given of a guided, flexible gastroduodenal sound used for obtaining material, insufflation and transillumination, and of a sterilisable, semi-rigid, metal loop used for conventional (hot light) illumination and diaphanoscopy. Lastly, the features of the new (cold-light) optical-fibre metal loop are explained. Its curvature is adaptable for the illumination and transillumination of even deep cavities. Useful employment of the new loop in the surgery of the choledochus and retro-cavities of the epiploa is referred to.
Transillumination of the skull in infants is a simple technique which can be used to detect several major abnormalities of the central nervous system. The usefulness of transillumination has been limited, however, by the lack of standard techniques for its performance and by the absence of normal values, especially in premature infants. In healthy premature infants, there is a progressive increase in transillumination with increasing gestational age over three sites--the anterior fontanelle, the frontotemporal fossa, and the parieto-occipital eminence.
We have developed a technique of detecting and recording iris transillumination defects using an infrared sensitive video camera. This method is useful for assessing the loss of posterior iris pigment in patients with the pigmentary dispersion syndrome and pigmentary glaucoma. Some patients with no transillumination defects on slit-lamp examination were noted to have discrete defects on infrared videography. This technique is a rapid, convenient, and reproducible method of permanently recording posterior iris pigment changes. These high-quality video images can then be followed to determine the natural course and the results of therapy in these patients.
In vivo dual wavelength differential spectrography was performed on the hand of an adult male, using a collimated transillumination device. A pulsed laser with sufficiently high peak power and sufficiently low energy was employed so that transillumination could be realized without thermal damage. Spectrochemical analysis based on the absorbance of oxygen transporting molecules (OTM), i.e. haemoglobin in blood vessels and myoglobin in muscles, was performed along a 70 mm scanning line within the near-red infrared range. The two wavelengths used (675 and 800 nm) were chosen on the basis of the absorption spectrum of haemoglobin. The profiles computed with differential spectrography data related to the oxygen saturation of OTM are closely correlated with X-ray densitometry of the most vascularized tissues in the hand along the scanning line. In addition, at 675 nm, the profiles are rapidly modified as a function of the oxygen supply to the hand. Considering the accuracy obtained for the spatial localization of the OTM redox state, it is expected that these results could be applied to imaging.
Male sterility belongs to the recently recognized complications of cancer chemotherapy and has an increasing importance. Therefore, more information about the mode of action of anticancer drugs on mammalian spermatogenesis is needed. We have developed a technique based on transillumination of living, freshly isolated unstained rat seminiferous tubules, where the cells specifically killed by the drugs are recognized as dull zones. Early stages of cell degeneration can be rapidly analyzed by phase contrast microscopy of living cells. Because the transillumination technique, in addition, permits an accurate recognition of the segments of the seminiferous epithelial wave, the cells representing various stages of the mitotic and meiotic cell cycles during spermatogenesis can be isolated in living state for morphological analysis. Vinblastine and vincristine cause an arrest of mitotic and meiotic divisions to metaphase followed by cell death, which was more rapid after vincristine administration. Both alkaloids had a slight damaging effect on the pachytene spermatocytes. Large doses of both drugs primarily affected the Sertoli cells by destroying their microtubules and mitochondria. Vincristine specifically damaged the acrosomic system and the cytoplasmic bridges of the young spermatids.
The structural pattern of the iris in 13 patients with Fuchs's heterochromic cyclitis (FHC) was studied by infra-red transillumination stereophotography. All eyes with FHC showed atrophic changes of the iris. Extensive iris atrophy appeared as light, even translucence of the iris, associated in some cases with occasional dense small patches or pigment clumps. Moderate punctate, patchy or radiate, or extensive atrophy of the sphincter muscle was seen in all eyes with FHC. Radial contraction folds of Schwalbe, structural folds of Schwalbe, and circular contraction folds on the posterior surface of the iris were visualised in few eyes with FHC, whereas they were seen in most contralateral eyes. The results suggest that infra-red transillumination sterophotography can be used as a diagnostic method in FHC.
Transillumination of an extremity during venipuncture in infants or obese children is described. Transillumination facilitates accurate placement of the needle tip within the vein.
Prepared samples of light-activated composite were cured by transillumination of tooth tissue in healthy volunteers. Positioning of the samples and the direction of illumination was designed to simulate curing during direct bonding. The effectiveness of curing was investigated by determination of surface microhardness. The degree of polymerization of the specimens cured by transillumination was found to be reduced compared to the control samples cured by direct exposure to the light source.
Stages of the spermatogenic cycle in the horse were determined by trans-illumination of enzymically isolated, seminiferous tubules and were verified by whole-mounted tubules observed by Nomarski optics and by conventional histology. Isolated tubules were obtained from young (less than 2 years) and adult (4-10 years) horses by enzymic digestion. Dispersed tubules were separated into three different groups based on the presence, size, and intensity of a dark region in the centre of the tubules: (1) pale--homogeneously light, (2) spotty--light on the periphery with a wide spotty region in the central two-thirds, or (3) dark--an intensely dark, narrow region through the central one-third. Seminiferous tubules from young stallions separated easily, but were only of the homogeneously light pattern as they lacked mature spermatids. After observation by Nomarski optics and bright-field microscopy, pale tubules under transillumination largely contained Stages I and II, spotty tubules contained Stages V and VI, and dark tubules contained Stages VII and VIII of the spermatogenic cycle. In-vitro incorporation of [3H]thymidine in spermatogonia and preleptotene/leptotene primary spermatocytes of these tubules confirmed the viability of germ cells in isolated tubules, and ultrastructural analysis confirmed excellent preservation of normal structure of seminiferous epithelium in isolated tubules. Hence, segments of seminiferous tubules in specific stages of the spermatogenic cycle can be obtained from enzymically digested horse testes when viewed by transillumination.