{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:19:52Z","timestamp":1790839192033,"version":"4.1.0"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T00:00:00Z","timestamp":1640908800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"national research foundation of korea","doi-asserted-by":"crossref","award":["2020R1A5A8018367"],"award-info":[{"award-number":["2020R1A5A8018367"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003725","name":"national research foundation of korea","doi-asserted-by":"crossref","award":["2020R1A5A8018367"],"award-info":[{"award-number":["2020R1A5A8018367"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003725","name":"national research foundation of korea","doi-asserted-by":"crossref","award":["2020R1A5A8018367"],"award-info":[{"award-number":["2020R1A5A8018367"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003725","name":"national research foundation of korea","doi-asserted-by":"crossref","award":["2021R1A2C3008169"],"award-info":[{"award-number":["2021R1A2C3008169"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003725","name":"national research foundation of korea","doi-asserted-by":"crossref","award":["2021R1A2C3008169"],"award-info":[{"award-number":["2021R1A2C3008169"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003725","name":"national research foundation of korea","doi-asserted-by":"crossref","award":["2021R1A2C3008169"],"award-info":[{"award-number":["2021R1A2C3008169"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Phosphate-buffered saline (PBS) and Alsever\u2019s solution (AS) are frequently used as media in blood-related studies, while 0.9% normal saline (NS) is frequently used in transfusion medicine. Despite the frequent use, the effects of these solutions on the shape and volume of red blood cells (RBCs) have not been reported. We collected blood samples from five healthy adults and used three-dimensional refractive index tomography to investigate the changes in the morphology of RBCs caused by changes in osmolality and solutes at the single-cell level. After diluting 2 \u03bcL of RBCs 200-fold with each solution (PBS, AS, and 0.9% NS), 40 randomly selected RBCs were microscopically observed. RBC shape was measured considering sphericity, which is a dimensionless quantity ranging from 0 (flat) to 1 (spherical). RBCs in plasma or AS showed a biconcave shape with a small sphericity, whereas those in 0.9% NS or PBS showed a spherical shape with a large sphericity. Moreover, we confirmed that sodium chloride alone could not elicit the biconcave shape of RBCs, which could be maintained only in the presence of an osmotic pressure-maintaining substance, such as glucose or mannitol. Although 0.9% NS solution is one of the most commonly used fluids in hematology and transfusion medicine, RBCs in 0.9% NS or PBS are not biconcave. Therefore, as the debate on the use of NS continues, future clinical studies or applications should consider the effect of glucose or mannitol on the shape of RBCs.<\/jats:p>","DOI":"10.1371\/journal.pone.0262106","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T18:43:42Z","timestamp":1640976222000},"page":"e0262106","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":32,"title":["Effects of osmolality and solutes on the morphology of red blood cells according to three-dimensional refractive index tomography"],"prefix":"10.1371","volume":"16","author":[{"given":"Minkook","family":"Son","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye Sung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahn Jae","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YongKeun","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hae-Rahn","family":"Bae","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2851-1112","authenticated-orcid":true,"given":"Seung Yeob","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myung-Geun","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6050-0993","authenticated-orcid":true,"given":"Sung","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,31]]},"reference":[{"issue":"5","key":"pone.0262106.ref001","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1557\/mrs2010.571","article-title":"Shape and biomechanical characteristics of human red blood cells in health and disease","volume":"35","author":"M Diez-Silva","year":"2010","journal-title":"MRS Bull"},{"key":"pone.0262106.ref002","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1007\/978-1-4757-2257-4","volume-title":"Biomechanics: Mechanical properties of living tissues","author":"YC Fung","year":"1993"},{"issue":"3","key":"pone.0262106.ref003","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/0304-4157(91)90017-Q","article-title":"Shapes and shape changes in vitro in normal red blood cells","volume":"1071","author":"A Elgsaeter","year":"1991","journal-title":"Biochim. 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