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Microvascular Changes in the Diabetic Foot

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The Diabetic Foot

Part of the book series: Contemporary Diabetes ((CDI))

Abstract

Microvascular changes in diabetes are related to the presence of neuropathy and highlighted by increased vascular permeability and impaired autoregulation of blood flow and vascular tone. The functional impairment of the microcirculation has been attributed to deficiencies at the level of the nerve-axon reflex and endothelial cell dysfunction, resulting in diminished expression of endothelial nitric oxide synthetase and poly polymerase. Consequently, there is a diminished hyperemic response, resulting in failure to achieve maximal blood flow following injury. This observed functional ischemia may be a possible mechanism for the poor wound healing in diabetic foot ulcers.

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Abbreviations

PAS:

Periodic acid Schiff

ACh:

Acetylcholine

SNP:

Sodium nitroprusside

EDRF:

Endothelium-derived relaxing factor

EDNO:

Endothelial-derived nitric oxide

PKC:

Protein kinase C

PARP:

Poly ADP-ribose polymerase

AGEs:

Advanced glycosylated end products

VPF:

Vascular permeability factor

TXA2 :

Thromboxane

PGH2 :

Prostaglandin

vWF:

von Willebrand factor

CAM:

Cellular adhesion molecule

sICAM:

Soluble intercellular adhesion molecule

sVCAM:

Soluble vascular cell adhesion molecule

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Authors and Affiliations

  1. Department of Surgery, Beth Israel Deaconess Medical Center, Palmer 317, 1 Deaconess Road, Boston, MA, 02215, USA

    Francesco Tecilazich MD

  2. Division of Podiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA

    Thanh Dinh DPM (Assistant Professor in Surgery)

  3. Department of Anatomic Pathology, State General Hospital of Serres, Serres, Greece

    Antonios Kafanas MD

  4. Joslin-Beth Israel Deaconess Foot Center and Microcirculation Lab, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215-5321, USA

    Aristidis Veves MD, DSc

Authors
  1. Francesco Tecilazich MD
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  2. Thanh Dinh DPM
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  3. Antonios Kafanas MD
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  4. Aristidis Veves MD, DSc
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Correspondence to Francesco Tecilazich MD .

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Editors and Affiliations

  1. Center, Department of Surgery, Beth Israel Deaconess Medical, 1 Deaconess Road, Boston, 02215, Massachusetts, USA

    Aristidis Veves

  2. , Division of Podiatry, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Boston, 02215, Massachusetts, USA

    John M. Giurini

  3. Center, Department of Surgery, Beth Israel Deaconess Medical, 110 Francis Street, Boston, 02215, Massachusetts, USA

    Frank W. LoGerfo

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Tecilazich, F., Dinh, T., Kafanas, A., Veves, A. (2012). Microvascular Changes in the Diabetic Foot. In: Veves, A., Giurini, J., LoGerfo, F. (eds) The Diabetic Foot. Contemporary Diabetes. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-61779-791-0_10

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