Mapping the Mechanical Properties of the Diabetic Foot

绘制糖尿病足的机械特性图

• 批准号: 7009235
• 负责人: JOHN B WEAVER
• 金额: $ 32.26万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-04-01 至 2008-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7009235
• 关键词: adipose tissue; amputation; bioenergetics; biomechanics; clinical research; diabetes mellitus; diabetic neuropathy; foot; human subject; infection; magnetic resonance imaging; shear stress; ulcer

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.

描述（由申请人提供）：就患者的成本和医疗保健系统的成本而言，脚截肢是糖尿病患者护理中最严重的问题之一。足部感染占糖尿病患者住院的20％。 1999年，大约有86,000次与糖尿病有关的截肢。该组中截肢者的年度治疗成本估计在1997年，疾病控制中心估计为12亿美元。由于现在涉及1600万美国人的糖尿病的总体流行，这一数字将升级，因为糖尿病的总体患病率正在接近流行病学量表。重点是早期干预和预防，而这又取决于早期发现和理解脚部感染的发展。 糖尿病向感染和截肢的进展很难遵循，因为有许多因素导致感染。但是，神经病通常导致溃疡和感染。我们的假设是，脚的内在机械性能的变化有助于导致愈伤组织形成和溃疡的改变。我们将开发方法来成像体内脚软组织的固有机械性能。当前方法无法将固有特性与形状和结构分开，并且内在特性更直接地与糖尿病等代谢疾病的进展有关。我们将在整个足底软组织中绘制的内在机械性能包括：剪切模量，泊松比和阻尼系数。临床医学有几种潜在的好处：早期表征糖尿病损伤，导致萎缩脂肪垫的溃疡和定量表征。基础科学的潜在优势包括表征正常和异常的脂肪垫在行走过程中，对于脚的数值模型，并了解糖尿病会降解足底脂肪垫和其他软组织的机制。