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Yuan Y, Huang J, Yu J, Tan JKS, Chng KZ, Lee J, Kim S. Application of machine learning algorithms for accurate determination of bilirubin level on in vitro engineered tissue phantom images. Sci Rep 2024; 14:5952. [PMID: 38467676 PMCID: PMC10928098 DOI: 10.1038/s41598-024-56319-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/05/2024] [Indexed: 03/13/2024] Open
Abstract
Neonatal Jaundice is a common occurrence in neonates. High excess bilirubin would lead to hyperbilirubinemia, leading to irreversible adverse damage such as kernicterus. Therefore, it is necessary and important to monitor neonates' bilirubin levels in real-time for immediate intervention. However, current screening protocols have their inherent limitations, necessitating more convenient measurements. In this proof-of-concept study, we evaluated the feasibility of using machine learning for the screening of hyperbilirubinemia in neonates from smartphone-acquired photographs. Different machine learning models were compared and evaluated to gain a better understanding of feature selection and model performance in bilirubin determination. An in vitro study was conducted with a bilirubin-containing tissue phantom to identify potential biological and environmental confounding factors. The findings of this study present a systematic characterization of the confounding effect of various factors through separate parametric tests. These tests uncover potential techniques in image pre-processing, highlighting important biological features (light scattering property and skin thickness) and external features (ISO, lighting conditions and white balance), which together contribute to robust model approaches for accurately determining bilirubin concentrations. By obtaining an accuracy of 0.848 in classification and 0.812 in regression, these findings indicate strong potential in aiding in the design of clinical studies using patient-derived images.
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Affiliation(s)
- Yijia Yuan
- Advanced Innovation in Micro/Nanoengineering (AIM) Laboratory, Department of Biomedical Engineering, National University of Singapore, Singapore, 119276, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore, 119276, Singapore
| | - Jiayao Huang
- Advanced Innovation in Micro/Nanoengineering (AIM) Laboratory, Department of Biomedical Engineering, National University of Singapore, Singapore, 119276, Singapore
| | - Jiachen Yu
- Advanced Innovation in Micro/Nanoengineering (AIM) Laboratory, Department of Biomedical Engineering, National University of Singapore, Singapore, 119276, Singapore
- College of Biomedical Engineering and Instrument, Zhejiang University, Hangzhou, 310027, China
| | - Justin Kok Soon Tan
- Advanced Innovation in Micro/Nanoengineering (AIM) Laboratory, Department of Biomedical Engineering, National University of Singapore, Singapore, 119276, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore, 119276, Singapore
| | | | - Jiun Lee
- Department of Neonatology, National University Health System, Singapore, 119228, Singapore
- Department of Paediatrics, National University of Singapore, Singapore, 119228, Singapore
| | - Sangho Kim
- Advanced Innovation in Micro/Nanoengineering (AIM) Laboratory, Department of Biomedical Engineering, National University of Singapore, Singapore, 119276, Singapore.
- N.1 Institute for Health, National University of Singapore, Singapore, 119276, Singapore.
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Jo Y, Yim D, Park CE, Yong I, Lee J, Cho W, Ahn KH, Yang C, Chang JB, Park YG, Kim TS, Kim T, Kim P. Bi-directional crosstalk between cells and extracellular matrix leads to network morphogenesis in multi-layered tissues. RESEARCH SQUARE 2023:rs.3.rs-2294818. [PMID: 36778230 PMCID: PMC9915997 DOI: 10.21203/rs.3.rs-2294818/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cell-generated mechanical forces drive many cellular and tissue-level movements and rearrangements required for the tissue or organ to develop its shape1, 2, 3, 4, 5. The prevalent view of tissue morphogenesis relies on epithelial folding resulting in compressed epithelial monolayers, overlooking the involvement of stroma in morphogenesis1, 4, 6, 7. Here, we report a giant web-like network formation of stromal cells in the epithelium-stroma interface, resulting from a multi-scale mechano-reciprocity between migrating cells and their extracellular environment. In multi-layered tissues, surface wrinkles form by a stromal cell-mediated tensional force exerted at the basement membrane. The topographical cue is transmitted to the stromal cell, directing its protrusion and migration along the wrinkles. This inductive movement of the cells conveys traction forces to its surrounding extracellular matrix, remodeling the local architectures of the stroma. In this manner, stromal cells and wrinkles communicate recursively to generate the cellular network. Our observation provides a rational mechanism for network formation in living tissues and a new understanding of the role of cellular-level tensional force in morphogenesis.
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Affiliation(s)
- Youngmin Jo
- Department of Bio and Braine Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, South Korea
| | - Donghyun Yim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Chan E Park
- Department of Materials Science and Engineering, KAIST, Daejeon 305-701, Korea
| | - Insung Yong
- Department of Bio and Braine Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, South Korea
| | - Jongbeom Lee
- Department of Bio and Braine Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, South Korea
| | - Wonjin Cho
- Department of Bio and Braine Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, South Korea
| | - Kwang Ho Ahn
- Department of Mechanical Engineering, KAIST, Daejeon 305-701, Korea
| | - Chanhee Yang
- Department of Mechanical Engineering, KAIST, Daejeon 305-701, Korea
| | - Jae-Byum Chang
- Department of Materials Science and Engineering, KAIST, Daejeon 305-701, Korea
| | - Young-Gyun Park
- Department of Bio and Braine Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, South Korea
| | - Taek-Soo Kim
- Department of Mechanical Engineering, KAIST, Daejeon 305-701, Korea
| | - Taeyoon Kim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Pilnam Kim
- Department of Bio and Braine Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, South Korea
- Institute for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon 34141, South Korea
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3
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Abe Y, Seino S, Kurihara H, Kage M, Tokudome Y. 2-kDa hyaluronan ameliorates human facial wrinkles through increased dermal collagen density related to promotion of collagen remodeling. J Cosmet Dermatol 2023; 22:320-327. [PMID: 35587723 PMCID: PMC10084258 DOI: 10.1111/jocd.15097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/14/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND/AIMS Hyaluronan (HA) oligosaccharides are involved in several biological processes, primarily collagen remodeling and wound healing. Collagen remodeling is retarded in aging skin and causes wrinkles. The aim of this study was to evaluate the effect of 2-kDa HA oligosaccharides (HA2k) on wrinkles by permeation through the stratum corneum and promotion of collagen remodeling. METHODS A 3D skin model and excised human skin were used to evaluate the permeation of fluorescein-labeled HA2k. The effect of HA2k on collagen metabolism was evaluated by measuring the protein level of type 1 pro-collagen (COL1A1) and matrix metalloproteinase-1 (MMP-1) in the 3D skin model. 0.1% HA2k solution and vehicle control was applied to the human forearm for 8 weeks to evaluate dermal collagen density. To evaluate the effect of HA2k on depth of facial wrinkles, a randomized controlled trial was conducted with 0.1% HA2k lotion and vehicle lotion for 8 weeks. RESULTS HA2k was confirmed to permeate through the stratum corneum by fluorescent microscopy. Both COL1A1 and MMP-1 were upregulated by HA2k application in a 3D skin model culture. The collagen density was higher for the HA2k-treated forearm than for the vehicle control-treated forearm after 4 weeks. The maximum wrinkle depths in the nasolabial fold and crow's feet area were significantly shallower in the HA2k lotion group than in the control group. CONCLUSION HA2k permeated the stratum corneum, activated collagen synthesis and degradation simultaneously, and ameliorated wrinkles.
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Affiliation(s)
- Yukina Abe
- R&D Division, Kewpie Corporation, Chofu, Japan
| | | | | | - Madoka Kage
- Laboratory of Dermatological Physiology, Department of Pharmaceutical Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, Josai University, Sakado, Japan
| | - Yoshihiro Tokudome
- Laboratory of Dermatological Physiology, Department of Pharmaceutical Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, Josai University, Sakado, Japan.,Laboratory of Cosmetic Sciences, Regional Innovation Center, Saga University, Saga, Japan
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4
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Wang S, Yu RX, Fan W, Li CX, Fei WM, Li S, Zhou J, Hu R, Liu M, Xu F, Xu J, Cui Y. Detection of skin thickness and density in healthy Chinese people by using high-frequency ultrasound. Skin Res Technol 2023; 29:e13219. [PMID: 36331142 PMCID: PMC9838783 DOI: 10.1111/srt.13219] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 10/01/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Due to a recent development of high-frequency ultrasound (HFUS) systems, it is easier to realize high-resolution in vivo imaging of the biological tissues. The object of this study was to map the thickness and echo density of skin layers in healthy Chinese people and assess the influence of gender, age, and region on it. METHODS A total of 189 volunteers (85 male, 104 female) with age range of 22-75-year old (mean age of 41.2-year old) were enrolled. The thickness and density of the epidermis and dermis layer were detected by high-frequency (22 or 75 MHz) ultrasonography at 13 different anatomical sites, including the forehead, cheeks, flexor and extensor forearms, flexor and extensor upper arms, inner and outer legs, inner and outer thighs, back, and abdomen. RESULTS The thickness and density of epidermis/dermis between different anatomical sites were statistically significant (p < 0.05). The epidermis thickness of the face and trunk were less than that of the limbs, whereas the thicknesses of the dermis were on the contrary. The density of the epidermis/dermis of the face and trunk were less than that of the limbs. The thickness of dermis in most of the sites were higher in male than in female, and the density of epidermis and dermis in most of the sites were less in men than in women. The thicknesses/densities of dermis were lower in older age group in almost all sites, whereas only several sites reached statistical. The difference between the north and south regions showed the environment also influenced the thickness and density of the skin. CONCLUSION HFUS provides a simple noninvasive method for evaluating the skin thickness and echo-density, which, reflecting intradermal structure, exhibit systematic regional variation. With the establishment of Chinese phenotypic database of skin thickness and density, it will be helpful for the skin disease assessment, skin surgery, and cosmetology technology.
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Affiliation(s)
- Shangshang Wang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Rui-Xing Yu
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Wen Fan
- Department of Dermatology, The Second People's Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Cheng-Xu Li
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.,Peking Union Medical College and Chinese Academy of Medical Sciences, Graduate School, Beijing, China
| | - Wen-Min Fei
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.,Peking Union Medical College and Chinese Academy of Medical Sciences, Graduate School, Beijing, China
| | - Shanshan Li
- Department of Dermatology and Venerology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Junfeng Zhou
- Department of Dermatology and Venerology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Ruiming Hu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Mengguo Liu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Feng Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jinhua Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yong Cui
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.,Peking Union Medical College and Chinese Academy of Medical Sciences, Graduate School, Beijing, China
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Ciprandi G, Crucianelli S, Grussu F, Spuntarelli G, Marino SFM, Urbani U, Bernaschi P, Sisto A, Rizzo MI, Zama M. Meeting the Challenges in Pediatric Wound Care: Our 15-Year Experience with Dialkylcarbamoyl Chloride-Coated Dressing Technology in Acute and Chronic Wounds. CHRONIC WOUND CARE MANAGEMENT AND RESEARCH 2022. [DOI: 10.2147/cwcmr.s376889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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de Bengy AF, Lamartine J, Sigaudo-Roussel D, Fromy B. Newborn and elderly skin: two fragile skins at higher risk of pressure injury. Biol Rev Camb Philos Soc 2022; 97:874-895. [PMID: 34913582 DOI: 10.1111/brv.12827] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 02/03/2023]
Abstract
Skin is a key organ maintaining internal homeostasis by performing many functions such as water loss prevention, body temperature regulation and protection from noxious substance absorption, microorganism intrusion and physical trauma. Skin ageing has been well studied and it is well known that physiological changes in the elderly result in higher skin fragility favouring the onset of skin diseases. For example, prolonged and/or high-intensity pressure may suppress local blood flow more easily, disturbing cell metabolism and inducing pressure injury (PI) formation. Pressure injuries (PIs) represent a significant problem worldwide and their prevalence remains too high. A higher PI prevalence is correlated with an elderly population. Newborn skin evolution has been less studied, but some data also report a higher PI prevalence in this population compared to older children, and several authors also consider this skin as physiologically fragile. In this review, we compare the characteristics of newborn and elderly skin in order to determine common features that may explain their fragility, especially regarding PI risk. We show that, despite differences in appearance, they share many common features leading to higher fragility to shear and pressure forces, not only at the structural level but also at the cellular and molecular level and in terms of physiology. Both newborn and elderly skin have: (i) a thinner epidermis; (ii) a thinner dermis containing a less-resistant collagen network, a higher collagen III:collagen I ratio and less elastin; (iii) a flatter dermal-epidermal junction (DEJ) with lower anchoring systems; and (iv) a thinner hypodermis, resulting in lower mechanical resistance to skin damage when pressure or shear forces are applied. At the molecular level, reduced expression of transforming growth factor β (TGFβ) and its receptor TGFβ receptor II (TβRII) is involved in the decreased production and/or increased degradation of various dermal extracellular matrix (ECM) components. Epidermal fragility also involves a higher skin pH which decreases the activity of key enzymes inducing ceramide deficiency and reduced barrier protection. This seems to be correlated with higher PI prevalence in some situations. Some data also suggest that stratum corneum (SC) dryness, which may disturb cell metabolism, also increases the risk of PI formation. Besides this structural fragility, several skin functions are also less efficient. Low applied pressures induce skin vessel vasodilation via a mechanism called pressure-induced vasodilation (PIV). Individuals lacking a normal PIV response show an early decrease in cutaneous blood flow in response to the application of very low pressures, reflecting vascular fragility of the skin that increases the risk of ulceration. Due to changes in endothelial function, skin PIV ability decreases during skin ageing, putting it at higher risk of PI formation. In newborns, some data lead us to hypothesize that the nitric oxide (NO) pathway is not fully functional at birth, which may partly explain the higher risk of PI formation in newborns. In the elderly, a lower PIV ability results from impaired functionality of skin innervation, in particular that of C-fibres which are involved in both touch and pain sensation and the PIV mechanism. In newborns, skin sensitivity differs from adults due to nerve system immaturity, but the role of this in PIV remains to be determined.
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Affiliation(s)
| | - Jérôme Lamartine
- Univ. Lyon, Université Claude Bernard Lyon 1, CNRS, LBTI UMR5305, 7 Passage du Vercors, Lyon Cedex 7, F- 69367, France
| | - Dominique Sigaudo-Roussel
- Univ. Lyon, Université Claude Bernard Lyon 1, CNRS, LBTI UMR5305, 7 Passage du Vercors, Lyon Cedex 7, F- 69367, France
| | - Bérengère Fromy
- Univ. Lyon, Université Claude Bernard Lyon 1, CNRS, LBTI UMR5305, 7 Passage du Vercors, Lyon Cedex 7, F- 69367, France
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7
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de Souza IMF, Vitral GLN, Caliari MV, Reis ZSN. Association between the chronology of gestation and the morphometrical skin characteristics at childbirth: a development of predictive model. BMJ Health Care Inform 2021; 28:bmjhci-2021-100476. [PMID: 34876452 PMCID: PMC8655593 DOI: 10.1136/bmjhci-2021-100476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/10/2021] [Indexed: 12/11/2022] Open
Abstract
Objective The structural maturation of the skin is considered a potential marker of pregnancy dating. This study investigated the correlation between the morphometrical skin characteristics with the pregnancy chronology to propose models for predicting gestational age. Methods A cross-sectional analysis selected 35 corpses of newborns. The biopsy was performed up to 48 hours after death in the periumbilical abdomen, palm and sole regions. Pregnancy chronology was based on the obstetric ultrasound before 14 weeks. The dimensions of the skin layers, area of glands and connective fibrous tissue were measured with imaging software support. Univariate and multivariate regression models on morphometric values were used to predict gestational age. Results Gestational age at birth ranged from 20.3 to 41.2 weeks. Seventy-one skin specimens resulted in the analysis of 1183 digital histological images. The correlation between skin thickness and gestational age was positive and strong in both regions of the body. The highest univariate correlation between gestational age and skin thickness was using the epidermal layer dimensions, in palm (r=0.867, p<0.001). The multivariate modelling with the thickness of the abdominal epidermis, the dermis and the area of the sebaceous glands adjusted had the highest correlation with gestational age (r=0.99, p<0.001). Conclusion The thickness of the protective epidermal barrier is, in itself, a potential marker of pregnancy dating. However, sets of values obtained from skin morphometry enhanced the estimation of the gestational age. Such findings may support non-invasive image approaches to estimate pregnancy dating with various clinical applications.
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Affiliation(s)
| | | | - Marcelo Vidigal Caliari
- Department of General Pathology, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Przybysz P, Jackowska T, Wilińska M, Malinowska S, Wójtowicz J, Mlosek RK. Ultrasound image of healthy skin in newborns in the first 24 hours of life. J Ultrason 2021; 20:e242-e247. [PMID: 33500790 PMCID: PMC7830153 DOI: 10.15557/jou.2020.0043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 11/10/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction Ultrasound imaging is a safe, repeatable and easily available imaging procedure. Based on these qualities, it may become a useful tool for skin assessment in newborns. Aims: The aim of the study was to evaluate the usefulness of high-frequency ultrasound imaging for neonatal skin assessment. Another aim was to identify differences in ultrasound features of the skin in newborns depending on the examination site, sex, age, birth weight, and arterial blood gas results. Material and method A total of 72 newborns in the first 24 hours of life, without any skin lesions, were included in the study. All newborns underwent ultrasound skin examinations in three body sites (forearm, abdomen and thigh) during the first 24 hours of life. DermaMed Ultrasound Scanner with a 48 MHz probe was used for imaging. A total of three structures were identified in the ultrasound images: epidermal echo, dermis, and subcutaneous tissue. The study assessed the thickness of the epidermis and dermis, and the echogenicity of the dermis and subcutaneous tissue. Data were analysed to determine possible links with sex, post-conceptional age, body weight, birth route, and results of umbilical cord blood gas analysis. Results Depending on the body site examined, the mean epidermal thickness was 0.081 to 0.083 mm, while the mean thickness of the dermis ranged between 0.679 and 0.722 mm. The newborns with higher birth weights were shown to have a thicker epidermis regardless of the examined site [R (correlation coefficient) for the forearm: 0.47 (p <0.001), abdomen: 0.53 (p <0.001), thigh: 0.48 (p <0.001)]. A positive correlation was found between epidermal and dermal thickness (R = 0.34; p = 0.004), but a comparison of the three examined sites revealed no significant differences in the thickness of the two structures. The sex of the newborn had no significant effect on the ultrasound features of the skin. None of the ultrasound parameters under study was found to correlate with the pH level in umbilical cord blood gas analysis. Subcutaneous oedema was detected in the examined sites in all the newborns studied. Conclusions High-frequency ultrasound imaging may become a useful method for neonatal skin assessment, complementing existing diagnostic techniques for monitoring pathologically altered skin.
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Affiliation(s)
- Paulina Przybysz
- Department of Paediatrics, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Teresa Jackowska
- Department of Paediatrics, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Maria Wilińska
- Department of Neonatology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Joanna Wójtowicz
- Department of Paediatrics, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Robert Krzysztof Mlosek
- Ultrasound Diagnostic Department Faculty of Medical Sciences, Medical University of Warsaw, Warsaw, Poland
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Cheng NY, Lin YL, Fang MC, Lu WH, Yang CC, Tseng SH. Noninvasive transcutaneous bilirubin assessment of neonates with hyperbilirubinemia using a photon diffusion theory-based method. BIOMEDICAL OPTICS EXPRESS 2019; 10:2969-2984. [PMID: 31259067 PMCID: PMC6583349 DOI: 10.1364/boe.10.002969] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/18/2019] [Accepted: 05/19/2019] [Indexed: 06/09/2023]
Abstract
Transcutaneous bilirubinometers are widely used to screen neonatal jaundice. However, it was reported that their accuracy is compromised at low and high bilirubin levels. We used a photon diffusion theory-based method valid in the 450-600 nm wavelength region to overcome this obstacle. Our clinical study results showed that our system could properly determine the transcutaneous bilirubin concentrations at total serum bilirubin levels higher than 14 mg/dL, where a commercial bilirubinometer failed to provide proper results in several cases. These findings suggested that photon diffusion theory could be employed to improve the core algorithm of modern bilirubinometers and enhance their applicability.
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Affiliation(s)
- Nan-Yu Cheng
- Department of Photonics, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ling Lin
- Department of Photonics, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Chien Fang
- Department of Photonics, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Hsien Lu
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chin-Chieh Yang
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Sheng-Hao Tseng
- Department of Photonics, National Cheng Kung University, Tainan, Taiwan
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10
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de-Souza IMF, Vitral GLN, Reis ZSN. Skin thickness dimensions in histological section measurement during late-fetal and neonatal developmental period: A systematic review. Skin Res Technol 2019; 25:793-800. [PMID: 31119813 PMCID: PMC6900000 DOI: 10.1111/srt.12719] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 04/28/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND The development and maturation of the skin is a process that occurs during the gestation and neonatal period. Histological skin biopsy studies are relevant to improve knowledge on the skin protective barrier during the perinatal period. The thin skin of preterm newborns is unable to maintain homeostasis, thermal regulation through the skin, and is susceptible to infections. This study systematically reviewed the evidence regarding histological thickness dimensions of the skin and its layers during the late-fetal and neonatal period. METHODS PubMed, Scopus, BVS, and e SciELO library databases, with no limits in the period of analysis or idiom. Eligibility criteria were as follows: studies describing the thickness of the entire skin or its layers during late-fetal life or the neonatal period; human being; skin biopsy analysis; and any scientific report. Two independent reviewers screened the search and extracted the following standard data: fetal or neonatal age of assessment, biopsy site, technique used for preparation and staining of histological slides, measurement techniques, and values of skin thickness. RESULTS Fifty-nine studies were screened, and eleven were identified from other sources. We recognized six studies that met the criteria for inclusion for proper extraction. Expressive differences between sites for sampling, methods of slide preparation, and number of layers measured made the thicknesses values summarization difficult. There were no reliable dimensions reported on this tissue. CONCLUSION Despite the importance of studying the human skin barrier, these findings confirmed limited evidence on skin thickness dimensions obtained by histology.
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Affiliation(s)
| | - Gabriela Luiza Nogueira Vitral
- Postgraduate Program in Pediatrics and Adolescence, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Zilma Silveira Nogueira Reis
- Postgraduate Program in Women's Health, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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