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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 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.
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.
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.
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.
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.
Transillumination of the neonatal chest is described as an aid in the diagnosis of pneumothorax or pneumomediastinum. Sudden severe tension pneumothorax or pneumomediastinum can be localized for immediate treatment and the success of therapy can be immediately assessed using transillumination.
Filtration of the light used for transillumination of neonates is employed to reduce heat buildup in the skin during transillumination. Clinical and experimental evaluation of the effects of filtration are presented.
We studied the structure of the normal iris as seen in infrared transillumination photographs of variously pigmented eyes in subjects of different age and sex. To transilluminate the iris infrared light was passes via a fiber-glass optic through the lateral wall of the globe and photographs were taken with a Zeiss stereo slit-lamp camera. The photographs showed that the structural pattern of the iris was similar in both blue and brown eyes of either sex. The iris was rather dense in children, well developed in adults and somewhat atrophic in the elderly. On the posterior surface of the iris the radial contraction folds and the structural folds of Schwalbe and circular contraction folds were seen; they were delicate in children and more pronounced in adults and the elderly. The pupillary part of the iris ballooned forward in young people whereas in the elderly the whole iris had this configuration.
A consecutive series of 38 eyes of 35 glaucoma patients treated with transillumination guided cyclocryotherapy (CCT) either to obtain pain relief or to achieve IOP control was studied at Helsinki University Eye Hospital. Transillumination was used to guide the applications to the correct site. The follow-up range was 1-43 months (mean 9 months). Pretreatment IOP was 39 +/- 13 mm Hg and postoperative 26 +/- 16 mm Hg (mean +/- SD). Twenty-three eyes underwent one and 15 eyes 2-5 procedures. IOP control (IOP 9-23 mm Hg) was achieved in 50%. The response was more favorable in eyes without iris neovascularisation (59% achieved IOP control) than in eyes with neovascular glaucoma (38% achieved IOP control). The best response was achieved in eyes with chronic uveitis (5/7 eyes achieved IOP control). Repeated procedures improved the IOP control rate. Hypotony (IOP < 9 mm Hg) without clinical signs of phthisis occurred in three eyes (8%). Thirteen eyes needed primarily pain relief and 92% achieved it. Postoperatively vision was better in 8%, unchanged in 37% and worse in 55%. Visual acuity was 0.05 or better in nine eyes pretreatment and in eight eyes after treatment.
A fiber optic sleeve that fits over a Goldmann three-mirror lens, as well as an independent cable used in conjunction with the Goldmann lens, are described for transillumination biomicroscopical examination of the anterior chamber angle and the uvea. High-intensity retroillumination is provided to the anterior and posterior segments of the globe without production of heat to the eye. Present clinical uses as well as possible future research with the instruments are discussed.
Transillumination is shown to be an effective device in the early diagnosis of enlarging skull fractures in children.