1
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Toro C, Markarian B, Mayrovitz HN. Breast Cancer-Related Lymphedema Assessed via Tissue Dielectric Constant Measurements. Cureus 2024; 16:e59261. [PMID: 38813316 PMCID: PMC11135004 DOI: 10.7759/cureus.59261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 04/29/2024] [Indexed: 05/31/2024] Open
Abstract
This review describes the use of tissue dielectric constant (TDC) measurements mainly in the assessment of breast cancer-related lymphedema (BCRL). PubMed, Web of Science, and EMBASE databases were initially searched using criteria that included the terms "dielectric" and "lymphedema." The initial search yielded a total of 131 titles. After removing studies not focused on upper extremity lymphedema, 56 articles remained. These articles, together with relevant articles from their bibliographies, formed the basis of the review. The findings show the potential utility and applications of TDC measurements to help detect and track BCRL, whether present in limbs, breasts, or trunks. It is reported as a non-invasive, simple-to-use method, with each measurement requiring less than 10 seconds, suggesting its practicality and useability as an in-office or in-clinic screening and tracking method. Although there are various ways to quantitatively evaluate lymphedema, most, if not all, are restricted to measurements on limbs. Thus, one significant advantage of the TDC approach is that almost any local region of interest can be effectively measured and tracked, which, for BCRL, could include specific regions of arms or hands, breasts, and truncal areas.
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Affiliation(s)
- Carel Toro
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Biura Markarian
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Harvey N Mayrovitz
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, USA
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2
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Finnegan M, Fitzgerald S, Duroux R, Attia J, Markey E, O’Connor D, Morrin A. Predicting Chronological Age via the Skin Volatile Profile. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2024; 35:421-432. [PMID: 38326105 PMCID: PMC10921460 DOI: 10.1021/jasms.3c00315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 02/09/2024]
Abstract
Skin volatile emissions offer a noninvasive insight into metabolic activity within the body as well as the skin microbiome and specific volatile compounds have been shown to correlate with age, albeit only in a few small studies. Building on this, here skin volatiles were collected and analyzed in a healthy participant study (n = 60) using a robust headspace-solid phase microextraction (HS-SPME) gas chromatography-mass spectrometry (GC-MS) workflow. Following processing, 18 identified compounds were deemed suitable for this study. These were classified according to gender influences and their correlations with age were investigated. Finally, 6 volatiles (of both endogenous and exogenous origin) were identified as significantly changing in abundance with participant age (p < 0.1). The potential origins of these dysregulations are discussed. Multiple linear regression (MLR) analysis was employed to model age based on these significant volatiles as independent variables, along with gender. Our analysis shows that skin volatiles show a strong predictive ability for age (explained variance of 68%), stronger than other biochemical measures collected in this study (skin surface pH, water content) which are understood to vary with chronological age. Overall, this work provides new insights into the impact of aging on the skin volatile profiles which comprises both endogenously and exogenously derived volatile compounds. It goes toward demonstrating the biological significance of skin volatiles and will help pave the way for more rigorous consideration of the healthy "baseline" skin volatile profile in volatilomics-based health diagnostics development going forward.
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Affiliation(s)
- Melissa Finnegan
- School
of Chemical Sciences, Insight SFI Research Centre for Data Analytics,
National Centre for Sensor Research, Dublin
City University, Dublin D09 V209, Ireland
| | - Shane Fitzgerald
- School
of Chemical Sciences, Insight SFI Research Centre for Data Analytics,
National Centre for Sensor Research, Dublin
City University, Dublin D09 V209, Ireland
| | - Romain Duroux
- IFF-Lucas
Meyer Cosmetics, Toulouse, Cedex 1, 31036, France
| | - Joan Attia
- IFF-Lucas
Meyer Cosmetics, Toulouse, Cedex 1, 31036, France
| | - Emma Markey
- School
of Chemical Sciences, Insight SFI Research Centre for Data Analytics,
National Centre for Sensor Research, Dublin
City University, Dublin D09 V209, Ireland
| | - David O’Connor
- School
of Chemical Sciences, Insight SFI Research Centre for Data Analytics,
National Centre for Sensor Research, Dublin
City University, Dublin D09 V209, Ireland
| | - Aoife Morrin
- School
of Chemical Sciences, Insight SFI Research Centre for Data Analytics,
National Centre for Sensor Research, Dublin
City University, Dublin D09 V209, Ireland
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3
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Mayrovitz HN. Medical Applications of Skin Tissue Dielectric Constant Measurements. Cureus 2023; 15:e50531. [PMID: 38222165 PMCID: PMC10787628 DOI: 10.7759/cureus.50531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 12/14/2023] [Indexed: 01/16/2024] Open
Abstract
Tissue dielectric constant (TDC) values assess certain skin properties that are dependent on multiple factors but mainly on the relative amount of water content within a locally measured tissue volume. Because of the non-invasive nature of these measurements and their ease of use, the method has been widely used in various medically related applications. The goal of this paper was to review and describe the uses and findings of such TDC measurements, considering and including the wide array of medical applications. The review is in part based on information derived from an analysis of published material obtained via literature searches of four major electronic databases and, in part, based on the author's experience with the TDC measurement methods and their various applications and his professional experiences. The databases searched were PubMed, Web of Science, EMBASE, and CINAHL Complete. Based on the initial search criteria, a total of 1257 titles were identified. After removing duplicates and filtering according to relevancy, 160 remained for detailed further review. In some cases, the bibliography of these retrieved articles provided additional sources. The findings demonstrate multiple research and medical uses and applications of TDC measurements, focusing on detecting and quantifying localized edema and lymphedema in multiple target sites. These include the upper and lower extremities, breasts, and trunk as regions involved in medical conditions causing lymphedema. In addition, the findings suggest that TDC evaluations are a convenient, non-invasive method to study and evaluate other conditions impacting skin, including diabetes mellitus and skin wounds or ulcers. Its ability to detect aspects of tissue changes simply and rapidly at almost any anatomical location makes it a useful tool for investigating multiple dermatological conditions and their treatment as future applications of this method.
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Affiliation(s)
- Harvey N Mayrovitz
- Medical Education, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
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4
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Mayrovitz HN. Measuring Breast Cancer-Related Lymphedema. Breast Cancer 2022. [DOI: 10.36255/exon-publications-breast-cancer-lymphedema] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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5
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Yu Z, Liu N, Wang L, Chen J, Han L, Sun D. Assessment of Skin Properties in Chronic Lymphedema: Measurement of Skin Stiffness, Percentage Water Content, and Transepidermal Water Loss. Lymphat Res Biol 2019; 18:212-218. [PMID: 31596657 DOI: 10.1089/lrb.2018.0066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Lymphedema (LE) is a chronic progressive protein-rich edema of the soft tissues. Measurement of extracellular fluid of the affected limbs is widely used in detecting LE; however, quantification of the skin alterations and early tissue changes in LE lacks approaches. Methods and Results: Ninety-one patients with LE were assessed. Measurement of transepidermal water loss (TEWL), skin stiffness (SF), and percentage water content (PWC) was assessed on five predetermined skin sites. The value of TEWL, SF, and PWC increased significantly in lymphedematous skin compare with controls, indicating damaged function and texture of the affected skin. Both PWC ratio and SF ratio strongly correlated with LE stage. High correlations were found among instruments assessing tissue fluid. Conclusions: Assessment of the skin parameters has contributed new information about the functional and structural alterations in chronic lymphedematous skin. Quantification of skin properties changes could be a valuable supplement to diagnosis and evaluation of chronic LE.
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Affiliation(s)
- Ziyou Yu
- Department of Plastic & Reconstructive Surgery, Lymphology Centre, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ningfei Liu
- Department of Plastic & Reconstructive Surgery, Lymphology Centre, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Wang
- Department of Plastic & Reconstructive Surgery, Lymphology Centre, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiajia Chen
- Department of Plastic & Reconstructive Surgery, Lymphology Centre, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linghua Han
- Department of Plastic & Reconstructive Surgery, Lymphology Centre, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Sun
- Department of Plastic & Reconstructive Surgery, Lymphology Centre, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Mayrovitz HN, Forbes J, Vemuri A, Krolick K, Rubin S. Skin tissue dielectric constant in women with high body fat content. Skin Res Technol 2019; 26:226-233. [DOI: 10.1111/srt.12784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/02/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Harvey N. Mayrovitz
- College of Medical Sciences Nova Southeastern University Ft. Lauderdale Florida
| | - Jessica Forbes
- KCP College of Osteopathic Medicine Nova Southeastern University Ft. Lauderdale Florida
| | - Adithi Vemuri
- KCP College of Osteopathic Medicine Nova Southeastern University Ft. Lauderdale Florida
| | - Katelyn Krolick
- KCP College of Osteopathic Medicine Nova Southeastern University Ft. Lauderdale Florida
| | - Samantha Rubin
- KCP College of Osteopathic Medicine Nova Southeastern University Ft. Lauderdale Florida
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Mayrovitz HN. Assessing Upper and Lower Extremities Via Tissue Dielectric Constant: Suitability of Single Versus Multiple Measurements Averaged. Lymphat Res Biol 2019; 17:316-321. [DOI: 10.1089/lrb.2018.0016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Harvey N. Mayrovitz
- College of Medical Sciences, Nova Southeastern University, Fort Lauderdale, Florida
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8
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Cho C, Cho E, Kim N, Shin J, Woo S, Lee E, Hwang J, Ha J. Age‐related biophysical changes of the epidermal and dermal skin in Korean women. Skin Res Technol 2019; 25:504-511. [DOI: 10.1111/srt.12679] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/09/2018] [Accepted: 01/12/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Changhui Cho
- Department of Genetic EngineeringCollege of Life SciencesGraduate School of BiotechnologyKyung Hee University Yongin‐si Korea
| | - Eunbyul Cho
- Clinical Research CenterInstitut d'Expertise Clinique (IEC) Korea Suwon Korea
| | - Nahee Kim
- Clinical Research CenterInstitut d'Expertise Clinique (IEC) Korea Suwon Korea
| | - Juhee Shin
- Clinical Research CenterInstitut d'Expertise Clinique (IEC) Korea Suwon Korea
| | - Sanga Woo
- Clinical Research CenterInstitut d'Expertise Clinique (IEC) Korea Suwon Korea
| | - Eunyoung Lee
- Clinical Research CenterInstitut d'Expertise Clinique (IEC) Korea Suwon Korea
| | - Jaesung Hwang
- Department of Genetic EngineeringCollege of Life SciencesGraduate School of BiotechnologyKyung Hee University Yongin‐si Korea
| | - Jaehyoun Ha
- Clinical Research CenterInstitut d'Expertise Clinique (IEC) Korea Suwon Korea
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Mazor M, Smoot BJ, Mastick J, Mausisa G, Paul SM, Kober KM, Elboim C, Singh K, Conley YP, Mickevicius G, Field J, Hutchison H, Miaskowski C. Assessment of local tissue water in the arms and trunk of breast cancer survivors with and without upper extremity lymphoedema. Clin Physiol Funct Imaging 2019; 39:57-64. [PMID: 30207039 PMCID: PMC6289797 DOI: 10.1111/cpf.12541] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 08/13/2018] [Indexed: 11/28/2022]
Abstract
Given the paucity of information on local tissue water (LTW) in the upper extremity and trunk of women after breast cancer surgery, the purpose of this study was to compare tissue dielectric constant (TDC) values between the affected and unaffected sides of breast cancer survivors with and without upper extremity lymphoedema (LE). Differences in LTW were assessed using the TDC method for three sites in the upper limbs, three sites in the lateral thorax and two sites on the back. Additional measures included demographic and clinical characteristics, arm circumference and bioimpedance analysis. For the 112 survivors without LE, no differences in TDC values were found between the affected and unaffected sides for the first dorsal web space, ventral forearm and upper arm, and upper and lower back. Compared to the unaffected side, TDC values were significantly higher on the affected side for the upper, mid and lower lateral thorax. For the 78 survivors with LE, compared to the unaffected side, TDC was significantly higher on the affected side for all of the sites evaluated except the hand web space. Our findings support the use of the TDC method to detect differences in upper extremity and truncal oedema in survivors with LE following breast cancer treatment. Measurement of LTW may provide a useful method to determine truncal as well as extremity LE. The ability to detect early signs of truncal oedema may lead to pre-emptive interventions in breast cancer survivors.
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Affiliation(s)
- Melissa Mazor
- Schools of Nursing, University of California, San Francisco
| | | | - Judy Mastick
- Schools of Nursing, University of California, San Francisco
| | - Grace Mausisa
- Schools of Nursing, University of California, San Francisco
| | - Steven M. Paul
- Schools of Nursing, University of California, San Francisco
| | - Kord M. Kober
- Schools of Nursing, University of California, San Francisco
| | | | - Komal Singh
- Schools of Nursing, University of California, San Francisco
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Mayrovitz HN, Mikulka A, Woody D. Minimum Detectable Changes Associated with Tissue Dielectric Constant Measurements as Applicable to Assessing Lymphedema Status. Lymphat Res Biol 2018; 17:322-328. [PMID: 30526306 DOI: 10.1089/lrb.2018.0052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Tissue dielectric constant (TDC) measurements are increasingly being used as a tool to help characterize lymphedema features, detect its presence, and assess treatment related changes. Although the underlying physics of this technology has been well described in the literature, there has been little systematic study of in vivo reliability aspects. A central unanswered question is the minimal detectable change (MDC) that, with a given level of confidence, may be ascribed to this technology. Our goal was to address this issue using test-retest measurements from which intraclass correlations coefficients (ICC) and MDC could be estimated. Methods and Results: Forty volunteers (20 females) aged 19-61 years with body mass indices of 14.7-47 kg/m2 and body fat percentages of 12.0%-48.9% were evaluated. Two measurers (M1 and M2) used two different TDC measuring devices (multiprobe and compact) to measure TDC in triplicate sequentially and bilaterally at three locations; anterior forearm, hand palmar mid-thenar eminence, and dorsum mid-web. These measurements were made by each measurer twice constituting test-retest values (T1 and T2). From these measurements ICC2,1 and MDC at 95% confidence were determined for each site and probe for absolute TDC values and for inter-side ratios. MDC values for absolute TDC ranged from 2 to 9 TDC units, and for inter-side ratios ranged from 5.3% to 8.0% depending on site and probe. ICC2,1 values ranged from 0.765 to 0.982. Conclusions: The MDC values herein documented may be used to provide guidance to aid interpretation of measured TDC changes or differences in a clinical environment.
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Affiliation(s)
- Harvey N Mayrovitz
- College of Medical Sciences, Nova Southeastern University, Ft. Lauderdale, Florida
| | - Alexander Mikulka
- College of Medical Sciences, Nova Southeastern University, Ft. Lauderdale, Florida
| | - Don Woody
- College of Medical Sciences, Nova Southeastern University, Ft. Lauderdale, Florida
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Mayrovitz HN, Arzanova E, Somarriba S, Eisa S. Reference Values for Assessing Localized Hand Lymphedema Using Interhand Tissue Dielectric Constant Ratios. Lymphat Res Biol 2018; 16:442-445. [DOI: 10.1089/lrb.2017.0065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Harvey N. Mayrovitz
- College of Medical Sciences, Department of Physiology, Nova Southeastern University, Ft. Lauderdale, Florida
| | - Evelina Arzanova
- College of Medical Sciences, Department of Physiology, Nova Southeastern University, Ft. Lauderdale, Florida
| | - Scarlett Somarriba
- College of Medical Sciences, Department of Physiology, Nova Southeastern University, Ft. Lauderdale, Florida
| | - Samar Eisa
- College of Medical Sciences, Department of Physiology, Nova Southeastern University, Ft. Lauderdale, Florida
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12
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Mayrovitz HN, Gildenberg SR, Spagna P, Killpack L, Altman DA. Characterizing the tissue dielectric constant of skin basal cell cancer lesions. Skin Res Technol 2018; 24:686-691. [DOI: 10.1111/srt.12585] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2018] [Indexed: 02/04/2023]
Affiliation(s)
- H. N. Mayrovitz
- College of Medical Sciences; Nova Southeastern University; Fort Lauderdale Florida
| | - S. R. Gildenberg
- St. Joseph Mercy Livingston Dermatology Residency Program; Detroit Michigan
| | - P. Spagna
- College of Osteopathic Medicine; Nova Southeastern University; Fort Lauderdale Florida
| | - L. Killpack
- St. Joseph Mercy Livingston Dermatology Residency Program; Detroit Michigan
| | - D. A. Altman
- St. Joseph Mercy Livingston Dermatology Residency Program; Detroit Michigan
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13
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Mayrovitz HN, Wong J, Fasen M. Age and Hydration dependence of jowl and forearm skin firmness in young and mature women. J Cosmet Dermatol 2017; 17:1262-1270. [PMID: 29280546 DOI: 10.1111/jocd.12477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Quantitative assessment of possible linkages between skin's firmness and water content is useful for cosmetic and clinical purposes and to better understand features of advancing age. OBJECTIVES Our goals were to characterize age-related differential features in skin firmness in women and determine the relationship between skin firmness and indices of skin water. METHODS Skin firmness was quantified using handheld devices that measure the force to indent skin 0.3 and 1.3 mm (F0.3 and F1.3). Skin hydration was quantified using handheld devices that measured tissue dielectric constant (TDC) at 300 MHz to skin depths of 0.5 and 2.0-2.5 mm. All parameters were measured bilaterally in the jowl area and volar forearm of 60 women grouped by age <45 years (YOUNG) and ≥45 years old (MATURE). RESULTS All measured parameters were bilaterally symmetrical at jowl and forearm. Forearm and jowl indentation forces were greater in YOUNG with statistically significant declines with advancing age with regression relations most evident at shallower indentation depths (P < .001). Quantitative relations for arm and jowl were F0.3 = 0.256 × AGE + 32.7 mN and F0.3 = -0.07 × AGE + 17.7 mN. Firmness was related to TDC values only when indentation force and TDC were assessed on the arm at the shallowest skin depths, as weakly related to firmness and was observed to change with age only when measured to a depth of 0.5 mm represented by TDC5 = 0.096 × AGE + 32.7. CONCLUSIONS Experimental finding show clear differences in skin firmness between age-groups with skin hydration playing a minor role. Possible explanations and suggestions for further studies are provided.
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Affiliation(s)
- Harvey N Mayrovitz
- College of Medical Sciences, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Jennifer Wong
- College of Medical Sciences, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Madeline Fasen
- College of Medical Sciences, Nova Southeastern University, Fort Lauderdale, FL, USA
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14
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Mayrovitz HN. Diurnal changes in local skin water assessed via tissue dielectric constant at 300 MHz. Biomed Phys Eng Express 2017. [DOI: 10.1088/2057-1976/aa7d8c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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15
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Mayrovitz HN, Corbitt K, Grammenos A, Abello A, Mammino J. Skin indentation firmness and tissue dielectric constant assessed in face, neck, and arm skin of young healthy women. Skin Res Technol 2016; 23:112-120. [DOI: 10.1111/srt.12310] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Harvey N. Mayrovitz
- College of Medical Sciences; Nova Southeastern University; Ft. Lauderdale FL USA
| | - Kelly Corbitt
- College of Osteopathic Medicine; Nova Southeastern University; Ft. Lauderdale FL USA
| | - Alexandra Grammenos
- College of Osteopathic Medicine; Nova Southeastern University; Ft. Lauderdale FL USA
| | - Allen Abello
- College of Osteopathic Medicine; Nova Southeastern University; Ft. Lauderdale FL USA
| | - Jason Mammino
- College of Osteopathic Medicine; Nova Southeastern University; Ft. Lauderdale FL USA
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