Search Results (52)

The recommended surgery for pancreatic tumors is dependent on the diagnosis. For pancreatic adenocarcinoma, duodenal, and ampullary adenocarcinoma, a Whipple pancreaticoduodenectomy with lymph node dissection is recommended. For small < 2 cm or non-imageable gastrinomas, duodenal transillumination, duodenotomy, duodenal tumor excision and adjacent lymphadenectomy is recommended. For large > 3 cm gastrinomas, a Whipple pancreaticoduodenectomy with adjacent lymph node dissection is recommended. For small 1–2 cm insulinomas, intraoperative ultrasound with enucleation is recommended. If the patient with gastrinoma, insulinoma, or multiple nonfunctional NETs occurs in the setting of MEN-1, a subtotal pancreatectomy with or without splenectomy with enucleation of pancreatic head tumors is recommended, with adjacent lymph node dissection. The detail of each procedure is described with illustrations. Full article

Ground-penetrating radar surveys on structures have a wide range of applications, and they are very useful in solving engineering problems: from detecting reinforcement, studying concrete characteristics, unfilled joints, analyzing brick elements, detecting water content in building bodies, and evaluating structural deformation. They generally pursued small investigation areas with measurements made in direct contact with target structures and for small depths. Detecting deep piles presents specific challenges, and surveys conducted from the ground level may be unsuccessful. To reach great depths, medium-low frequencies must be used, but this choice results in lower resolution. Furthermore, the pile signals may be masked when they are located beneath massive reinforced foundations, which act as an electromagnetic shield. Finally, GPR equipment looks for differences in the dielectric of the material, and the signals recorded by the GPR will be very weak when the differences in the physical properties of the investigated media are modest. From these weak signals, it is difficult to identify information on the differences in the subsurface media. In this paper, we are illustrating an exploration on plinth foundations, supported by drilled piles, submerged in soil, extensive, deep and uninformed. Pulse GPR prospecting was performed in common-offset and single-fold, bistatic configuration, exploiting the exposed faces of an excavation around the foundation. In addition, three velocity tests were conducted, including two in common mid-point and one in zero-offset transillumination, in order to explore the range of variation in relative dielectric permittivity in the investigated media. Thanks to the innovative survey on the excavation faces, it is possible to perform profiles perpendicular to the strike direction of the interface. The electromagnetic backscattering analysis approach allowed us to extract the weighted average frequency attribute section. In it, anomalies emerge in the presence of drilled piles with four piles with an estimated diameter of 80 cm. Full article

Background: Venous blood collection in pediatric patients is a critical procedure for diagnostic and monitoring purposes, yet it remains considerably more challenging than in adults. Factors such as small vein size, limited cooperation, and heightened sensitivity to pain contribute to technical difficulties and increased error rates. Objectives: This mini-review aims to provide a concise synthesis of current clinical practices and emerging technologies that support safer, more efficient venipuncture in children. Results: Key findings include the anatomical and procedural considerations relevant to pediatric venipuncture, age-specific recommendations for technique and positioning, as well as evidence-based strategies to reduce pain and anxiety. Common preanalytical errors, particularly hemolysis and insufficient sample volumes, are also addressed, along with their implications for clinical outcomes. Recent advances in medical digitalization, including the use of venous ultrasound, near-infrared projection, and transillumination, offer valuable support in overcoming procedural challenges. These technologies are not meant to replace human expertise but to complement it, improving vein visualization and increasing first-attempt success rates when integrated into a child-centered approach. Conclusions: Venous blood collection in pediatric patients requires a delicate balance between technical proficiency and human-centered care. Emphasis is placed on the importance of a child-centered approach, combining technical skill with empathy and clear communication. Enhancing the quality and safety of venous sampling in children requires not only training and standardization, but also a deeper understanding of the psychological dimensions involved in pediatric care. Full article

Background: The iliotibial band (ITB) is an anatomically complex structure with multiple proximal and distal attachments, making its mechanical behavior difficult to interpret. In the study of iliotibial band syndrome (ITBS), prior research has often considered the underlying lateral femoral epicondyle (LFE) as a fixed reference to describe ITB movement during knee flexion, potentially misrepresenting true tissue dynamics. This proof-of-concept study introduces the musculoskeletal advanced transillumination technique (MATT) to visualize and measure LFE displacement relative to the ITB and the tubercule of the ITB (tITB) on the tibia during passive knee flexion. Methods: Un-embalmed donor knees (n = 8) were dissected to expose the ITB and positioned on a device allowing standardized passive motion from 0° to 30°. A trocar was inserted between the femoral epicondyles, and a 300-watt xenon light source illuminated the LFE. Video was recorded with an iPhone 15, and key frames were analyzed using ImageJ Version 1.54i, and a custom Python (Version 3.12.5) script to quantify LFE displacement relative to the ITB and to the tITB. Results: Median absolute LFE displacement from 0° to 30° was 9.18 mm (IQR 7.23–10.95). Between 0° and 30°, the LFE shifted anteriorly by −1.76 mm (IQR −10.28 to −8.72) relative to the anterior border of the ITB, and by 11.26 mm (IQR 8.27 to 26.33) relative to its posterior border. The LFE-tITB distance increased from 51.98 mm (IQR 49.13–52.36) at 0° to 53.66 mm (IQR 50.08–60.11) at 30°, with a median displacement of 3.92 mm (IQR: 2.48–5.73). Conclusions: Musculoskeletal Advance Transillumination Technique (MATT) is a straightforward and reproducible technique that offers direct visualization of the dynamic relationship between a skeletal landmark and myofascial structures, such as the LFE and the ITB. By challenging the assumption that the LFE is a fixed reference point, MATT opens new perspectives for investigating the biomechanical mechanisms underlying conditions like iliotibial band syndrome. Full article

We report a case of herpes simplex virus type 1 (HSV-1) anterior uveitis evolving into an acute iris transillumination-like syndrome with secondary pigmentary glaucoma, highlighting diagnostic challenges and treatment considerations. A 61-year-old immunocompetent woman presented with unilateral anterior uveitis characterized by keratic precipitates and mild anterior chamber inflammation. The condition was initially treated with topical and subconjunctival corticosteroids without antiviral therapy. After an initial resolution of symptoms, upon the cessation of treatment, the patient developed features resembling unilateral acute iris transillumination (UAIT) syndrome with elevated intraocular pressure, diffuse pigment dispersion, and progressive iris transillumination defects. Aqueous polymerase chain reaction (PCR) testing confirmed the presence of HSV-1. Despite the initiation of antiviral therapy, the condition progressed to severe pigmentary glaucoma, with unreliable intraocular pressure measurements due to prior LASIK surgery. Cataract extraction, pars plana vitrectomy, and Ahmed valve implantation were performed, with only partial recovery of visual acuity. This case illustrates that HSV-1 uveitis can mimic or transition into a UAIT-like syndrome, possibly due to steroid use without concurrent antiviral treatment, which may exacerbate viral replication and damage to the iris pigment epithelium. Aqueous PCR testing aids in differential diagnosis, but indicative medical history and clinical findings should remain instrumental. Clinicians should maintain a high index of suspicion for herpetic etiology in anterior uveitis cases and initiate prompt antiviral treatment to prevent potentially sight-threatening complications. Full article

Background: Migration of the peritoneal end of the ventriculoperitoneal shunt (VPS) into the scrotum is a rare but recognized complication. Inguinoscrotal migration typically occurs as a result of increased intra-abdominal pressure combined with a patent processus vaginalis. A 14-month-old pediatric patient presented to the emergency department with abdominal pain, vomiting, and swelling of the right scrotum that had persisted for two days. The patient had a history of a head injury that had resulted in a large secondary arachnoid cyst for which a VPS had been placed at eight months of age. Examination of the inguinoscrotal region revealed a swollen and painful right side of the scrotum with a hydrocele and a palpable distal portion of the ventriculoperitoneal catheter in the right groin extending to the scrotum. After a brief preoperative preparation, the patient underwent laparoscopic abdominal emergency exploration, during which shunt repositioning and laparoscopic closure of the patent processus vaginalis were performed. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: A total of 30 case reports and six case series were included, analyzing 52 pediatric patients with scrotal migration of the VPS. The median age at presentation was 24 months (range: 1–169 months). The indication for VPS placement was hydrocephalus. Migration of the VPS catheter occurred on the right side in 34 cases. The median interval from VPS placement to the onset of symptoms was 9.0 months (range: 1 day–72 months). The most frequently reported symptoms were scrotal/inguinoscrotal swelling (n = 50), vomiting (n = 7), and fever (n = 3). Diagnostic methods included abdominal X-ray (n = 43), ultrasound (n = 5), scrotal transillumination test (n = 5), and computed tomography (n = 1). Regarding treatment, surgical repositioning of the VPS catheter into the peritoneal cavity was performed in 47 patients (90.4%), with no intraoperative or postoperative complications reported. Conclusions: Laparoscopic repositioning of the VPS into the peritoneal cavity, combined with closure of the processus vaginalis, appears to be a safe and effective treatment option for scrotal migration of the VPS. However, further well-designed studies are warranted to provide more comprehensive, generalizable, and unbiased evidence regarding this complication in the pediatric population. Full article

Background: This study aimed to analyze and compare the translucency and marginal adaptation of five resin-based materials used as occlusal sealants, both before and after simultaneous fatigue and thermocycling. Two null hypotheses were tested: (1) All tested materials allow the transillumination of sealed occlusal carious lesions. (2) There are no differences in marginal adaptation before and after simultaneous fatigue and thermocycling. Methods: Forty extracted human molars with early occlusal caries lesions were randomly divided into five equal groups. Near-infrared transillumination images of cleaned occlusal surfaces were captured before and after applying the following sealants: (I) OptiBond FL (adhesive alone), (II) OptiBond FL (primer and adhesive) (Kerr Corp., Brea, CA, USA), (III) Scotchbond Universal (3M, St. Paul, MN, USA) combined with OptiBond FL adhesive, (IV) Fissurit (VOCO GmbH, Cuxhaven, Germany), (V) Helioseal Clear (Ivoclar Vivadent AG, Schaan, Liechtenstein). A scanning electron microscope was used to assess marginal adaptation before and after simultaneous fatigue and thermocycling. The percentages of continuous margins (CMs) were quantified before and after the fatigue test and statistically compared (Shapiro–Wilk Normality test, two-way ANOVA with Fisher’s post hoc test). Results: Helioseal Clear and Fissurit were fully transparent under near-infrared transillumination. The percentage of closed margins significantly decreased after loading in one group: OptiBond FL primer application before adhesive application significantly reduced marginal adaptation. Conclusion: OptiBond FL (adhesive), Scotchbond Universal with OptiBond FL (adhesive), Fissurit, and Helioseal Clear provided excellent marginal adaptation. However, using OptiBond FL primer on enamel negatively impacted adaptation. Helioseal Clear and Fissurit, as transparent sealants, may allow lesion monitoring using an 850 nm transillumination camera. Full article

Background/Objectives: The aim of this in vitro study was to determine the optimal combinations of wavelengths for short wavelength infrared (SWIR) multispectral transillumination and reflectance imaging of caries lesions on proximal and occlusal surfaces. Methods: The contrasts of (n = 76) caries lesions on the occlusal and proximal surfaces of extracted teeth were measured at 1050, 1300, and 1550 nm for occlusal transillumination and 1058, 1300, 1450, and 1675 nm for occlusal reflectance. All teeth were also imaged using radiography and microcomputed tomography (μCT) to verify lesion presence. A custom-fabricated handheld imaging probe suitable for clinical use and for the simultaneous acquisition of SWIR occlusal transillumination and reflectance (SWIR-OTR) images was used. Three high-power superluminescent diode lasers were used for transillumination, and a fiber-optic switch was used to switch between the transillumination wavelengths. Optical bandpass filters coupled with a tungsten halogen lamp were used for reflectance. All images were acquired at the same position and with the same field of view for comparison. Results: The highest contrasts in reflection were at 1450 and 1675 nm for occlusal and interproximal lesions, and the highest contrasts for transillumination were at 1050 and 1300 nm. Conclusions: This study suggests that the best wavelengths for SWIR-OTR are between 1000 and 1300 nm for transillumination and greater than 1400 nm for reflectance. Wavelengths beyond 1400 nm are advantageous for reflectance and yield significantly higher contrast. Wavelengths beyond 1300 nm are not promising for occlusal transillumination since internal water absorption leads to contrast inversion. Full article

Background: Given the lack of standardization in stimulus types for assessing accommodation, we aimed to evaluate accommodative response (AR) and Zernike coefficients using four different stimuli. Methods: Sixteen healthy subjects aged 22–32 years participated. Four black transilluminated stimuli (Snellen 6/12 “E”, 6/6 “e”, Maltese Cross 6/12 “X”, 6/6 “x”) were used to stimulate accommodation from 0 D to 5 D, in 1 D increments, using the irx3 aberrometer. From the results, AR was calculated with Seidel defocus and the change in Zernike coefficient value between the non-accommodative state and the fully accommodative state (5 D) was determined. Results: Larger pupils were observed with stimulus “E” (p-value < 0.05). The mean AR at the maximum accommodative level (5 D) for the different stimuli was −1.88 ± 1.00 for “E”, −2.60 ± 1.44 for “X”, −2.00 ± 1.32 for “e”, and −2.40 ± 1.27 for “x”. No statistically significant differences were found between AR and Zernike coefficients with the four different accommodative stimuli (p-value > 0.05, one-way ANOVA). Conclusions: The study evaluated accommodative stimulus design and size on AR and Zernike coefficients and found no significant differences. However, stimuli with higher spatial frequencies (“e” and “E”) provided larger ARs compared to the other stimuli. Full article

Technological improvements have introduced significant innovations in dentistry and broadened the array of tools and techniques in dental care. One technological development that has been widely researched over the past 20 years is the use of Near-Infrared Transillumination (NIRT) imaging for the diagnosis of dental caries. This paper aims to introduce a comprehensive collection of NIRT images, intended as a reference tool for routine dental examinations, dental research, pedagogical activities, and forensic odontology. The collection presents pairwise clinical and NIRT images categorized as follows: (a) healthy teeth, (b) carious teeth, (c) restored teeth, (d) enamel defects, and (e) diverse findings. This atlas could be a valuable tool for the dental community as it is designed as an identification guide of NIRT illustrated dental features. Full article

Recent studies in transillumination imaging for developing an optical computed tomography device for small animal and human body parts have used deep learning networks to suppress the scattering effect, estimate depth information of light-absorbing structures, and reconstruct three-dimensional images of de-blurred structures. However, they still have limitations, such as knowing the information of the structure in advance, only processing simple structures, limited effectiveness for structures with a depth of about 15 mm, and the need to use separated deep learning networks for de-blurring and estimating information. Furthermore, the current technique cannot handle multiple structures distributed at different depths next to each other in the same image. To overcome the mentioned limitations in transillumination imaging, this study proposed a pixel-by-pixel scanning technique in combination with deep learning networks (Attention Res-UNet for scattering suppression and DenseNet-169 for depth estimation) to estimate the existence of each pixel and the relative structural depth information. The efficacy of the proposed method was evaluated through experiments that involved a complex model within a tissue-equivalent phantom and a mouse, achieving a reconstruction error of $2.18$% compared to the dimensions of the ground truth when using the fully convolutional network. Furthermore, we could use the depth matrix obtained from the convolutional neural network (DenseNet-169) to reconstruct the absorbing structures using a binary thresholding method, which produced a reconstruction error of $6.82$%. Therefore, only one convolutional neural network (DenseNet-169) must be used for depth estimation and explicit image reconstruction. Therefore, it reduces time and computational resources. With depth information at each pixel, reconstruction of 3D image of the de-blurred structures could be performed even from a single blurred image. These results confirm the feasibility and robustness of the proposed pixel-by-pixel scanning technique to restore the internal structure of the body, including intricate networks such as blood vessels or abnormal tissues. Full article

The Hebrew Scroll, catalogued as Magliabekian Manuscript III 43 and belonging to the National Central Library of Florence (BNCF), is a membranous richly decorated scroll, with colorful depictions of sacred sites through the Holy Land to Lebanon along with handwritten texts in Hebrew and notes in Italian. Despite the fact that the manuscript was originally catalogued as an “object of no artistic or scientific value”, recent paleographic studies dated it to the XIV century and highlighted it as the oldest scroll still available, depicting holy places from Egypt to Lebanon. Nevertheless, precise dating, authorship, and the interpretation of its original function are still uncertain. A suite of complementary techniques was used, including photographic documentation in visible (VIS) light in diffuse light, grazing light, and transillumination, luminescence induced by ultraviolet (UV) radiation, imaging spectroscopy (IS), Macro Area X-ray Fluorescence (MA-XRF), and spot analyses such as fiber-optic reflectance spectroscopy (FORS) in the UV, VIS, and near-infrared (NIR) regions, Fourier transform infrared spectroscopy (FT-IR) in external reflectance mode (ER), and micro-Raman spectroscopy. The results of the non-invasive diagnostic campaign enabled the identification of several constituting materials (parchment, pigments, binder, and inks). The identified materials were consistent with the proposed dating and geographical manufacturing area of the artefact. Full article

Dental caries remains a significant global health issue. It was highlighted by the World Health Organization’s 2022 reports that despite the efforts and scientific advancements in caries detection and management, the situation has only marginally improved over the past three decades. The persistence of this problem may be linked to outdated concepts developed almost a century ago but are still guiding dentists’ approach to caries management today. There is a need to reconsider professional strategies for preventing and managing the disease. Contemporary dentistry could benefit from embracing new concepts and technologies for caries detection and management. Dentists should explore, among others, alternative methods for caries detection such as optical-based caries detection. These tools have been established for over a decade and they align with current disease understanding and international recommendations, emphasizing early detection and minimally invasive management. This narrative review presents the current state of knowledge and recent trends in caries detection, diagnosis, monitoring, and management, offering insights into future perspectives for clinical applications and research topics. Full article

The classical transillumination technique has been revitalized through recent advancements in optical technology, enhancing its applicability in the realm of biomedical research. With a new perspective on near-axis scattered light, we have harnessed near-infrared (NIR) light to visualize intricate internal light-absorbing structures within animal bodies. By leveraging the principle of differentiation, we have extended the applicability of the Beer–Lambert law even in cases of scattering-dominant media, such as animal body tissues. This approach facilitates the visualization of dynamic physiological changes occurring within animal bodies, thereby enabling noninvasive, real-time imaging of macroscopic functionality in vivo. An important challenge inherent to transillumination imaging lies in the image blur caused by pronounced light scattering within body tissues. By extracting near-axis scattered components from the predominant diffusely scattered light, we have achieved cross-sectional imaging of animal bodies. Furthermore, we have introduced software-based techniques encompassing deconvolution using the point spread function and the application of deep learning principles to counteract the scattering effect. Finally, transillumination imaging has been elevated from two-dimensional to three-dimensional imaging. The effectiveness and applicability of these proposed techniques have been validated through comprehensive simulations and experiments involving human and animal subjects. As demonstrated through these studies, transillumination imaging coupled with emerging technologies offers a promising avenue for future biomedical applications. Full article

This in vitro study aimed to investigate the diagnostic potential of short-wave infrared transillumination (SWIRT) at 1050, 1200 and 1300 nm for the detection of proximal caries in molars and premolars. It was compared to the diagnostic performance of bitewing radiography (BWR) and micro-computed tomography (µCT) as the reference standard. 250 sound or decayed proximal surfaces of permanent posterior extracted teeth were examined using (1) SWIRT at 1050, 1200 and 1300 nm with two camera systems of different resolutions, (2) BWR and (3) µCT. Thresholds were defined for both test methods and the reference standard for caries in general, enamel caries and dentin caries. All images were assessed by two examiners twice, at an interval of two weeks. SWIRT at wavelengths of 1050, 1200 and 1300 nm achieved sensitivity values more than 2.5 times higher than BWR (enamel caries 3.2–4.4 times; dentin caries 3.25–4.25 times) for the detection of proximal caries. Sensitivity values of SWIRT improved with the higher wavelength. No significant difference was found in diagnostic quality between the two camera systems. SWIRT at 1300 nm imaged proximal enamel caries with the highest accuracy, while the physical optimum for transillumination in dentin was located at a lower wavelength (<1000 nm). Full article