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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 49-year-old woman had a six-week history of increasing shortness of breath and fatigue. X-ray films and pulmonary scans showed multiple areas of emboli, especially in the right lung. Treatment with heparin was unsuccessful, and although a repeat scan showed only slight changes, the patient's condition deteriorated. Acute pulmonary edema and ventricular tachycardia preceded her death. Autopsy revealed a primary intimal sarcoma with osteogenic elements arising in the posterior leaflet of the pulmonary valve and obstructing the main pulmonary artery and its right branch.
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PMID:Primary intimal sarcoma of pulmonary valve and trunk with osteogenic sarcomatous elements. Report of a case considered to be pulmonary embolus. 106 72

Bone is a dynamic tissue whose functional mass is controlled by the balance between the endocrine drive towards bone resorption and the mechanically-engendered drive towards bone formation. Strain is the key intermediate variable between loading forces and bone remodelling. Animal studies have shown that static loading of bone has no osteogenic effect; bone loss occurs as if there were no loading at all. However, dynamic loading, that is, cyclic change in internal strain, is strongly osteogenic, with relatively few cycles required for maximum effect. However, if a sufficient number of cycles is applied, repetitive loading can cause stress fractures. This number decreases as internal strains increase. Thus strain redistribution within bone, as caused by muscle fatigue or improper sports equipment, is a significant cause of fracture.
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PMID:Bone dynamics: stress, strain and fracture. 332 49

In this study the authors examined the capacity of gels of reconstituted basement membrane, laminin, and type I collagen to mediate repair of critical size defects in rat calvaria. Although autografts are widely used to repair bone defects caused by trauma or surgical treatment of congenital malformations, neoplasms, and infections, an adequate quantity of graft is not always available. Allogenic bone is readily available, but its use is associated with an increased incidence of nonunion, fatigue fracture, and rejection. Biologically active, purified components of basement membranes, which have been shown to promote osteogenic differentiation and angiogenesis in vitro and type I collagen (the major constituent of bone extracellular matrix) can be formed into native isotonic space-filling gels. In this study critical size calvarial defects were created in retired male Sprague-Dawley rats. Thirty-six animals were divided into seven groups. Group 1 (control) received no treatment for the defects. Group 2 animals were implanted with methylcellulose. Groups 3, 4, 5, and 6 were implanted with gels of type I collagen, reconstituted basement membrane, or laminin, respectively. The last group of three animals (Group 7) was implanted with 100 micrograms of type I collagen gels (identical to Group 3) and sacrificed at 20 weeks following a single CT scan to determine if complete healing could be obtained with this method given sufficient time. Except for rats in the type I collagen group that was evaluated by multiple computerized tomography (CT) scans biweekly from 2 to 12 weeks, bone repair was evaluated using CT at 12 weeks. Healing was quantified using three-dimensional reconstruction of CT. Following the final CT scan in each experimental group, animals were sacrificed, and a sample of tissues was evaluated by conventional histology. Animals treated with type I collagen gels showed 87.5% repair of the area of the defects at 12 weeks and 92.5% repair by 20 weeks. Increasing the gel volume 1.5 x accelerated complete repair to 3 months. Murine-reconstituted basement membrane and laminin gels induced 55.5% and 46.3% repair, respectively, at 3 months. In untreated control animals 7% repair of the area of the defects showed at 3 months. Histological analysis confirmed new bone formation in partial and completely healed defects. Bioengineered native collagen gels may have wide applicability for bone repair as an alternative bone graft material alone, in combination with autograft or marrow aspirate, or as a delivery system for osteogenic growth factors.
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PMID:Repair of critical size rat calvarial defects using extracellular matrix protein gels. 754 44

Fatigue loading triggers bone resorption and is associated with stress fractures. Neither the osteogenic response nor the changes in bone mechanical properties following in vivo fatigue loading have been quantified. To further characterize the skeletal response to fatigue loading, we assessed bone formation, mechanical properties, density and resorption in the ulnae of 72 adult rats subjected to a single bout of in vivo loading followed by 0, 6, 12 or 18 days of recovery. Axial, compressive loading (peak force 13.3 N, 2 Hz) was applied to the right forelimb until the ulna was fatigued to a pre-determined level. The left forelimb served as a contralateral control. The primary osteogenic response to fatigue loading was woven bone formation that occurred on the periosteal surface of the ulnar diaphysis and was significantly greater in loaded limbs versus controls at 6, 12 and 18 days (p <.0.05). Ultimate force of the ulna in three-point bending decreased by 50% and stiffness decreased by 70% on day 0 (p < 0.01 vs. control), indicative of acute fatigue damage. By day 12, ultimate force and stiffness had returned to control levels (p > 0.05) and by day 18 had increased 20% beyond controls (p < 0.01). Bone cross-sectional area, moment of inertia, and mineral content increased with recovery time (p < 0.01), consistent with the increases in woven bone formation and mechanical properties. Intracortical resorption space density and osteoclast density also increased with recovery time (p < 0.05), indicating activation of intracortical remodeling. In summary, our findings demonstrate the remarkable ability of the adult skeleton to rapidly form periosteal woven bone and thereby offset the negative structural effects of acute fatigue damage and subsequent intracortical resorption.
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PMID:In vivo fatigue loading of the rat ulna induces both bone formation and resorption and leads to time-related changes in bone mechanical properties and density. 1216 65

The synthesis and properties of carbonated apatite materials have received considerable attention due to their importance for medical and dental applications. Such apatites closely resemble the mineral phase of bone, exhibiting superior osteoconductive and osteogenic properties. When formed at physiological temperature they present significant potential for bone repair and fracture fixation. The present study investigates the mechanical properties of a carbonated apatite cancellous bone cement. Flexural strength was measured in three and four point bending, and the fracture toughness and fatigue crack-growth behaviour was measured using chevron and disc-shaped compact tension specimens. The average flexural strength was found to be approximately 0.468 MPa, and the fracture toughness was approximately 0.14 MPa radical m. Fatigue crack-growth rates exhibited a power law dependence on the applied stress intensity range with a crack growth exponent m=17. The fatigue threshold value was found to be approximately 0.085 MPa radical m. The mechanical properties exhibited by the carbonated apatite were found to be similar to those of other brittle cellular foams. Toughness values and fatigue crack-growth thresholds were compared to other brittle foams, bone and ceramic materials. Implications for structural integrity and longer term reliability are discussed.
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PMID:Mechanical properties of carbonated apatite bone mineral substitute: strength, fracture and fatigue behaviour. 1534 8

It was recently claimed that titanium metal and its alloys can bond to the living bone, without being coated by apatite (VPS coatings), but by being chemically and heat-treated. The bioactivity of treated titanium is of interest because of the opportunity to obtain orthopaedic or dental implants presenting, at the same time, high toughness, strength and fatigue resistance as well as bone-bonding ability. The bioactive behaviour of the treated implants is due to the presence of a modified surface, which, during soaking in body fluid, promotes the precipitation of apatite. The apatite formed is strongly bonded to the substrate and promotes living bone bonding. In this work were characterised samples of Ti-6Al-7Nb alloy with surfaces presenting a different chemical and mechanical state. The aim of the research was twofold. The first objective was to characterise chemically and heat-treated samples with different surface topography, in order to define the best conditions for osteogenic integration. The second aim was to assess the corrosion behaviour of the bioactive implants, because they expose a microporous and quite thin modified surface layer. No-treated and passivated samples, with a surface state closed to that nowadays used on implants, were used as reference. The surface structure, morphology, electrochemical behaviour and bioactivity of the different samples were assessed by means of XRD, SEM-EDS, anodic polarizations, open circuit measurements and in-vitro tests. Results evidence that it is possible to modify the surface of the Ti-6Al-7Nb alloy in order to obtain the formation of a bioactive layer and that the substrate roughness influences the characteristics of the surface layer formed. It was also evidenced that the as treated surfaces present inadequate corrosion behaviour, so a new two-step chemical treatment has been developed in order to obtain a bioactive material with good corrosion resistance.
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PMID:New chemical treatment for bioactive titanium alloy with high corrosion resistance. 1574 11

In this issue, we would complete the conclusions of the systematic revision with the results from the major clinical and experimental studies. First of all, we outline that the use of bone mineral density is controversial and opposed of the major studies in the field that show that the bone density is only one of the factors which describe bone resistance, and not the bone quality. In fact, often, a dramatic variation of bone strength is linked to the fact that the newly bone is located in the only in the surfaces where mechanical stress is greatest and this doesn't change completely the density. To study the optimal exercises program we have to remember that the ideal timing in the remodelling unit of the bone was estimated at 4-6 months: therefore any treatment which has the aim of preventing bone loss should last at least 2-3 times this period to ensure that the registered effect on bone density is evaluated in a period of balance. According to Frost, the strength of the bone is determined by 4 factors: the mechanical property characteristic of bony tissue, the amount of micro damage from fatigue, bone mass factors (amount and type of bone in the bone) and the size and shaper of the bone (architectural factors). Moreover, it is very important the role of muscular strength on the bone: the muscles work like a lever in such a manner that to move every kilo of body weight, the muscular force is usually over 2 kg. This explains why strong muscles are usually associated with strong bones. About the specific role of the strain on the bone, from studies of the past 10 years there seems to be more precise and useful information for our queries: new formation of bone took place in rabbits only with dynamic stimuli and not static, and it is very important also the frequency of the stimulus and the speed. Moreover, some authors have shown that the stimuli of ostegoenesis depends on the fluid shear stresses though the lacunar-canalicular network system. So: exercises at high impact which can produce significant deformation of the bone matrix, better carry the fluid through the canalicular network and furthermore the strains applied at high frequency stimulate in a effective manner osteogenesis. Therefore, the mechanical strain necessary to begin osteogenesis decreases with the increase of the frequency of the strain. Rubin and Lanyon have shown that the prolongation of the stimulation with strain the osteogenic response did non increase if the regimen is prolonged more. In fact, Turner demonstrated that the bone presents a phenomenon of desensitisation following a prolonged strain stimulus. He proposed the osteogenic index of exercises like the osteogenic response to exercise which could be increased in a regimen of exercises which foresee also a period of rest between brief sessions of significant strain. So, concerning the effects of exercises, the stimulus produced by the strain must be such that it exceeds a threshold of a minimum effective stimulus, must be applied in a intermittent and dynamic manner, should produce a stimulus which is distributed differently to the norm, should be applied with high speed and few repetitions.
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PMID:The conclusions of the systematic revision with the results from the major clinical and experimental studies. 1617 92

Stress fractures can occur because of prolonged exercise and are associated with cyclic loading. Fatigue is the accumulated damage that results from cyclic loading and bone fatigue damage is of special concern for athletes and army recruits. Existing literature shows that the rates of stress fracture for female athletes and female army recruits are higher than their male counterparts. In this study, we used an ex vivo rat model to investigate the fatigue response of female and male bones. We determined the strain versus number of cycles to failure (S/N) for each sex and found that for a certain initial strain (5,000-7,000 microepsilon) female bones have shorter fatigue life. To further characterize the bone response to fatigue, we also determined the creep that occurred during the fatigue test. From the creep data, for a certain strain range, female bones accumulated greater residual strains and reached the critical strain at a faster rate. In summary, this study demonstrates that female rat bones have a lower resistance to fatigue in the absence of a physiological response such as muscle fatigue or osteogenic adaptation. From these results, we hypothesized that creep was the underlying mechanism that accounted for the fast deterioration of female bones during fatigue.
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PMID:Sex differences in long bone fatigue using a rat model. 1691 3

Bone formation in a variety of contexts depends on angiogenesis; however, there are few reports of the vascular response to osteogenic skeletal loading. We used the rat forelimb compression model to characterize vascular changes after fatigue loading. The right forelimbs of 72 adult rats were loaded cyclically in vivo to one of four displacement levels, to produce four discrete levels of ulnar damage. Rats were killed 3-14 days after loading, and their vasculature was perfused with silicone rubber. Transverse histological sections were cut along the ulnar diaphysis. We quantified vessel number, average vessel area, total vessel area, and bone area. On day 3, we observed a dramatic periosteal expansion near the ulnar midshaft, with significant increases in periosteal vascularity; total vessel area was increased 250-450% (P < 0.001). Vascularity remained elevated on days 7 and 14. Vessel number and average vessel area were not correlated (P = 0.09) and contributed independently to total vascular increases. Bone area was not increased on day 3 but on days 7 and 14 was increased significantly in all displacement groups (P < 0.01) due to periosteal woven bone formation. Vascular and bone changes depended on longitudinal location (P < 0.001), with peak increases 2 mm distal to the midshaft. Vascular and bone changes also depended on displacement level (P < 0.005), with greater increases at higher levels of fatigue displacement. We conclude that skeletal fatigue loading induces a rapid increase in periosteal vascularity, followed by an increase in bone area. The angiogenic-osteogenic response is spatially coordinated and scaled to the level of the mechanical stimulus.
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PMID:Damaging fatigue loading stimulates increases in periosteal vascularity at sites of bone formation in the rat ulna. 1755 70

Periosteal woven bone forms in response to stress fractures and pathological overload. The mechanical factors that regulate woven bone formation are poorly understood. Fatigue loading of the rat ulna triggers a woven bone response in proportion to the level of applied fatigue displacement. However, because fatigue produces damage by application of cyclic loading it is unclear if the osteogenic response is due to bone damage (injury response) or dynamic strain (adaptive response). Creep loading, in contrast to fatigue, involves application of a static force. Our objectives were to use static creep loading of the rat forelimb to produce discrete levels of ulnar damage, and subsequently to determine the bone response over time. We hypothesized that 1) increases in applied displacement during loading correspond to ulnae with increased crack number, length and extent, as well as decreased mechanical properties; and 2) in vivo creep loading stimulates a damage-dependent dose-response in periosteal woven bone formation. Creep loading of the rat forelimb to progressive levels of sub-fracture displacement led to progressive bone damage (cracks) and loss of whole-bone mechanical properties (especially stiffness) at time-zero. For example, loading to 60% of fracture displacement caused a 60% loss of ulnar stiffness and a 25% loss of strength. Survival experiments showed that woven bone formed in a dose-dependent manner, with greater amounts of woven bone in ulnae that were loaded to higher displacements. Furthermore, after 14 days the mechanical properties of the loaded limb were equal or superior to control, indicating functional repair of the initial damage. We conclude that bone damage created without dynamic strain triggers a woven bone response, and thus infer that the woven bone response reported after fatigue loading and in stress fractures is in large part a response to bone damage.
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PMID:In vivo static creep loading of the rat forelimb reduces ulnar structural properties at time-zero and induces damage-dependent woven bone formation. 1829 61


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