............................................................................................................... V DEDICATION ........................................................................................................... VI ACKNOWLEDGEMENTS ......................................................................................... VII LIST OF TABLES ...................................................................................................... XI LIST OF FIGURES ................................................................................................... XII LIST OF ABBREVIATIONS ...................................................................................... XV LIST OF SYMBOLS ............................................................................................... XVI Chapter

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Development and Implementation of an Ultrasonic Method to Characterize Acoustic and Mechanical Fingernail Properties

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Development, Optimization and Clinical Evaluation Of Algorithms For Ultrasound Data Analysis Used In Selected Medical Applications.

It is common knowledge in the medical field that fingernails may potentially be a useful biomarker in assessing certain disorders of the body by both their appearance and texture. With the use of a hand-held, portable ultrasonic device a user may have the ability to quantitatively assess the progression of fingernail properties on-the-spot and over the long term. This device would be applicable to both clinical and cosmetic applications alike. Its application in the medical field to chemotherapy patients in a pilot study is also introduced. No device is currently on the market to quantitatively investigate the properties of fingernails hence this would be the first of its kind. This paper outlines the hardware, software and applications of the ultrasonic probe prototype for use by certified professionals or by the general public.

Portable high-frequency device for cosmetic and clinical fingernail assessment

Background
Medical practitioners have long associated the physical appearance of human fingernails with certain underlying health conditions due to their direct connection to the vascular system. The objective of this study was to demonstrate how human fingernails can potentially be used as a biomarker to determine the severity of a patient's reaction to chemotherapy.

Methods
Quantitative investigation of fingernails in patients undergoing taxane-based chemotherapy was conducted using a high-frequency 50 MHz ultrasound device in B-mode in the form of a pilot study. Time-of-Flight (TOF) ultrasonic signal measurements were recorded longitudinally across fingernails over three time intervals; (before treatment, in the middle of treatment, and on the last day of treatment); a neuropathy assessment and photographs were also taken for comparison.

Results
A total of 17 patients were examined in this study with ages ranging from 35-69 years old with both weekly and biweekly chemotherapy regimens. Onycholysis and fingernail discoloration were observed in 8 of the 17 patients. White transverse lines and white lunula were observed on 4 of the 17 patients. Quantitative assessment revealed a TOF median decrease in fingernails during the first half of chemotherapy treatment; conversely, TOF median was found to have increased during the second half. Median TOF measurements at the end of treatment were found to return to approximately that of the baseline value.

Conclusion
This was a novel application of ultrasound in fingernails as chemotherapy biomarkers and further studies should be considered to verify and expand on the results obtained in this study.

R. A. Vacarescu

Papers

Investigation of a correlation between taxane-based chemotherapy and the ultrasonic time-of-flight of human fingernails.