Mapping the Mechanical Properties of the Diabetic Foot

描述(由申请人提供)：截肢是糖尿病患者护理中最严重的问题之一，无论是患者的成本还是医疗保健系统的成本都是如此。足部感染占糖尿病患者入院人数的20%。1999年，大约有86,000例截肢与糖尿病有关。1997年，疾病控制中心估计，这一群体中截肢者的年度治疗费用为12亿美元。这一数字将会上升，因为糖尿病的总体患病率正在接近流行规模，目前涉及1600万美国人。重点是早期干预和预防，而这反过来又取决于及早发现和了解足部感染的发展。 糖尿病发展到感染和截肢很难跟踪，因为有许多因素导致感染。然而，神经病通常会导致溃疡和感染。我们的假设是，脚的内在机械特性的变化导致了导致骨痂形成和溃疡的变化。我们将开发在活体内成像足部软组织内在机械特性的方法。目前的方法不能将固有特性与形状和结构分开，而固有特性更直接地与糖尿病等代谢性疾病的进展有关。我们将在整个足底软组织中映射的内在力学特性包括：剪切弹性系数、泊松比和阻尼系数。临床医学有几个潜在的好处：糖尿病损害导致溃疡的早期特征和萎缩脂肪垫的定量特征。对基础科学的潜在益处包括为行走过程中的足部数值模型确定正常和异常脂肪垫的特征，以及了解糖尿病通过其降解足底脂肪垫和其他软组织的机制。

DESCRIPTION (provided by applicant): Amputation of the foot is one of the most serious problems in the care of diabetics both in terms of the cost to the patient and in terms of the cost to the health care system. Foot infection accounts for 20% of hospital admissions in diabetic patients. There were approximately 86,000 amputations related to diabetes in 1999. The annual treatment cost of amputees within this group was estimated at $1.2 billion by the Center for Disease Control in 1997. This number is going to escalate because the overall prevalence of diabetes, now involving 16 million Americans, is approaching epidemic scale. The emphasis is on early intervention and prevention that in turn, depends on early detection and understanding the development of foot infections. The progression of diabetes to infection and amputation is difficult to follow because there are many factors contributing to infection. However, neuropathy generally leads to ulcers and infection. Our hypothesis is that changes in the intrinsic mechanical properties of the foot contribute to the alterations that lead to callus formation and ulceration. We will develop methods to image the intrinsic mechanical properties of the soft tissues of the foot in vivo. Current methods can not separate the intrinsic properties from the shape and structure and the intrinsic properties are more directly tied to the progression of a metabolic disease like diabetes. The intrinsic mechanical properties we will map throughout the plantar soft tissues include the: shear modulus, Poisson's ratio, and damping coefficient. There are several potential benefits to clinical medicine: early characterization of diabetic damage leading to ulceration and quantitative characterization of atrophic fat pads. The potential benefits to basic science include characterization of normal and abnormal fat pads for numerical models of the foot during ambulation and understanding the mechanisms through which diabetes degrades the plantar fat pads and other soft tissues.