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ANALYTICAL MODEL OF PHOTOTHERAPY FOR NEONATAL JAUNDICE—I. THE INITIAL Z‐E TRANSIENT
Author(s) -
Pratesi Riccardo,
Ronchi Laura,
Locchi Fabrizio
Publication year - 1986
Publication title -
photochemistry and photobiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.818
H-Index - 131
eISSN - 1751-1097
pISSN - 0031-8655
DOI - 10.1111/j.1751-1097.1986.tb04717.x
Subject(s) - isomerization , irradiation , transmittance , exponential decay , exponential function , chemistry , photochromism , materials science , molecular physics , optics , physics , photochemistry , mathematics , nuclear physics , catalysis , mathematical analysis , biochemistry
A simple model of phototherapy (PT) for neonatal jaundice is presented. Two coupled systems are considered: the “skin” (upper skin layers and vascular network where phototherapy light may penetrate) and the “body” (i.e. the “dark” ensemble of blood vessels and organs where circulation and metabolization of biliribin (BR) and its photoisomers occur). The mathematics necessary to analyze the PT process is presented together with an appropriate optical model of skin based on a multilayered system to which the theory of radiation transfer in isotropically scattering and absorbing media is applied. A simple matrix formalism is introduced to determine analytically the light distribution in the multilayer skin. The results are. then, used to analyze the initial transient of PT, i.e. configurational isomerization up to photoequilibrium in the superficial skin layers under blue (450 nm) and green (500 nm) light irradiation within a time interval sufficiently short to neglect diffusion of pigments and formation of structural isomers of BR. Strong coupling among the various BR layers due to the time variation of diffuse transmittance and reflectance is found, resulting in complicated time patterns with initial and final single‐exponential behavior. The initial decay constant of BR concentration depends sensibly on the depth of the layer, while the final one is independent of it. As expected the amount of BR conversion at photoequilibrium is larger with blue than with green light. However, at sufficiently larger depths green light is more efficient than blue light to produce the initial conversion of ZZ to ZE isomers of BR. The present analysis has some relevance for the understanding of the different efficiencies of coloured fluorescent lamps in clinical PT. The application of the complete model (“skin”+“body”) requires the knowledge of the diffusion constants and absorption coefficients of pigments and of the optical parameters of deep cutaneous tissues.