Biochemical, Biomechanical & Morphological Properties of Quantitative Ultrasound

生物化学、生物力学

• 批准号: 7738734
• 负责人: BARBARA L MCFARLIN
• 金额: $ 28.17万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-20 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7738734
• 关键词: 3-Dimensional; Acoustics; Address; Affect; African American; Anatomy; Animal Model; Animals; Biochemical; Biomechanics; Birefringence; Birth; Birth Rate; Cerebral Palsy; Cervical; Cervical Dilatations; Cervical Ripening; Cervix Uteri; Collagen; Contracts; Data; Data Set; Detection; Etiology; Experimental Designs; Extracellular Matrix; Fetus; Frequencies; Gestational Age; Goals; Gold; Healthy People 2010; Hispanics; Histology; Hospital Mortality; Human; Incidence; Infant; Infant Mortality; Intervention; Lead; Length; Life; Maps; Measures; Methods; Modeling; Native Americans; Parents; Pathway interactions; Phase; Pregnancy; Premature Birth; Premature Infant; Premature Labor; Process; Property; Radio; Rattus; Research; Role; Sample Size; Savings; Smooth Muscle; Stress; Techniques; Testing; Thick; Three-dimensional analysis; Tissue Model; Tissues; Translating; Ultrasonics; Ultrasonography; United States; Uterine Contraction; Uterine cavity; Water; Woman; Work; base; electric impedance; expectation; improved; in vivo; infant death; innovation; instrumentation; novel; pregnant; premature; programs; prospective; public health relevance; quantitative ultrasound; research study; respiratory distress syndrome

DESCRIPTION (provided by applicant): Background. Globally,1.1 million infants die each year during the first four weeks of life due to prematurity.In the United States, prematurity is the second leading cause of infant mortality and the leading cause of infant mortality for African Americans. If birth could be delayed from 30 to 34 weeks gestation, the incidence of: inhospital mortality could be reduced from 8.1% to 0.4%; cerebral palsy could be reduced from 6.3% to 0.7%; and respiratory distress syndrome could be decreased from 44% to 3%. Delaying the birth of an infant <29 weeks gestation to term (= 37 weeks) is estimated to result in at least $122,000 savings/case. Treatment of preterm labor has focused on treating contractions rather than the long process of cervical ripening that precedes preterm labor. Pharmacologic agents to arrest preterm labor have functions to modify contracting smooth muscle not cervical ripening,5 and have failed to reduce preterm birth rates in the last 40 years. The long-term goal of this research program is to develop a noninvasive quantitative ultrasound (QUS) technique that will: detect early cervical ripening in humans; and lead to scientific interventions to modify preterm birth. The goal of this R21 application is to validate the biochemical, biomechanical and biostructural properties of cervical ripening with QUS, as an essential step to detect cervical ripening in humans. Aim 1. Determine the relationship among frequency-dependent QUS-derived parameters in the rat cervix as ripening occurs, with cervix tissue biochemical (collagen and water), biostructural (birefringence, histology, 3-D impedance map) biomechanical (stress-strain) properties. Aim 2. Determine the form factor that appropriately models pregnant cervix tissue. Methods. This is a prospective longitudinal repeated-measures experimental design consisting of 2 experiments to achieve aim 1 consisting of: a preliminary experiment (1) to determine sample size and a more definitive experiment (2). Experiment 3 will use 3-dimensional impedance modeling of a 3-dimensional histological data set to determine the form factor that appropriately models pregnant cervix tissue. Conclusion. We anticipate that the successful completion of this research will have furthered our goal of translating quantitative ultrasound of the cervix for use in humans by validating the biochemical (collagen and water), biostructural (birefringence, histology, 3-D impedance map) biomechanical (stress-strain) basis of quantitative ultrasound in the in vivo animal model. PUBLIC HEALTH RELEVANCE STATEMENT: The birth of a healthy baby at term is a universal expectation of prospective parents. However, 500,000 infants were born preterm in 2006. The underlying mechanisms preceding labor are not yet fully understood. The 21% increase in the incidence of preterm birth (to 12.8% of all births in 2006) in the United States between 1990 and 2006 is an indication of the seriousness of this problem. In 2006, 18.4% of African-American women, 14.2% of Native American women and 12.2% of Hispanic women delivered a preterm infant compared to 11.7% of White women. Preterm birth is the second leading cause (after congenital anomalies) of infant mortality in the United States and the leading cause of infant death among African-American infants.2 Compared with infants born full-term, premature infants born = 28 weeks gestation, have a one hundred-fold increase in the incidence of cerebral palsy (1/1000 infants born at term versus 100/1000 born premature). Delaying the birth of an infant <29 weeks gestation to term (= 37 weeks) is estimated to result in at least $122,000 savings/case. Reducing the preterm birth rate to 7% in the United States is a goal of the Healthy People 2010 initiative, and it is only by reducing the incidence of preterm birth that infant mortality in the United States can be addressed.

描述（由申请人提供）：背景。在全球范围内，由于早产的前四个星期，每年有110万婴儿死亡。在美国，早产是婴儿死亡率的第二大主要原因，也是非裔美国人婴儿死亡率的主要原因。如果可以将出生从30周推迟到妊娠34周，则以下的发病率可以从8.1％降低到0.4％；脑瘫可以从6.3％降低到0.7％；呼吸窘迫综合征可以从44％降低到3％。估计，妊娠少于29周的婴儿的出生估计会导致至少储蓄$ 122,000。对早产的治疗专注于治疗收缩，而不是在早产劳动之前的长期宫颈成熟过程。逮捕早产的药理特工具有修改平滑肌而不是宫颈成熟的功能，其中5个，并且在过去40年中未能降低早产率。该研究计划的长期目标是开发一种非侵入性定量超声（QUS）技术，该技术将：检测人类早期的宫颈成熟；并导致科学干预措施改变早产。该R21应用的目的是验证颈椎成熟与QUS的生化，生物力学和生物结构特性，这是检测人类宫颈成熟的重要步骤。 AIM 1。确定大鼠子宫颈中频率依赖的QUS衍生参数之间的关系，随着子宫颈组织生化（胶原蛋白和水），生物结构（双折射，组织学，3-D障碍图）的生物力学（应激图）特性。目标2。确定适当模拟怀孕子宫颈组织的外形。方法。这是一个前瞻性纵向重复测量实验设计，该实验设计由2个实验组成，以实现目标1，该实验包括：一个初步实验（1），以确定样本量和更确定的实验（2）。实验3将使用3维组织学数据集的3维阻抗模型来确定适当模拟怀孕子宫颈组织的形状。结论。我们预计，这项研究的成功完成将进一步促进我们的目标，即通过验证生物化学（胶原蛋白和水），生物结构（双发性，组织学，3-D不良图）生物力学（压力）生物力学（应激（压力）（应力）基于Vivo动物模型的定量性超级模型，将子宫颈的定量超声转换为人类使用。 公共卫生相关性声明：学期健康婴儿的诞生是对父母的普遍期望。但是，2006年有500,000名婴儿出生于早产。劳动之前的基本机制尚未完全理解。在1990年至2006年之间，美国早产发生率增加了21％（2006年所有出生的12.8％）表明这一问题的严重性。 2006年，非裔美国人中有18.4％的妇女，14.2％的美国原住民妇女和12.2％的西班牙裔妇女提供了早产儿，而白人妇女中有11.7％。 Preterm birth is the second leading cause (after congenital anomalies) of infant mortality in the United States and the leading cause of infant death among African-American infants.2 Compared with infants born full-term, premature infants born = 28 weeks gestation, have a one hundred-fold increase in the incidence of cerebral palsy (1/1000 infants born at term versus 100/1000 born premature).估计，妊娠少于29周的婴儿的出生估计会导致至少储蓄$ 122,000。在美国，将早产率降低到7％是《健康人民2010年倡议》的目标，只有通过降低早产的发生率才能解决美国的婴儿死亡率。