We report a case of Waldenström's macroglobulinemia (WM) treated using clarithromycin (CAM) and prednisolone (PSL). An 84-year-old woman was admitted to our hospital for bleeding after a tooth extraction and hematuria. Computed tomography showed multiple ill-defined nodules in the omentum (omental cake). Although the cause of the omental cake remained unclear, the patient was diagnosed with WM, based on the detection of M-protein of immunoglobulin (Ig) M in serum and lymphoplasmacytes in bone marrow. The bleeding tendency in the patient may have been due to acquired hemophilia and/or hyper IgM-induced platelet dysfunction. The patient was treated using CAM (800 mg/day) and PSL (10 mg/day). As a result, IgM levels gradually decreased. Because the omental cake contracted along with improvement in IgM, it was thought to be lymphoplasmacytic lymphoma-like lymphoma. This case shows that treatment using CAM and PSL may be effective in some cases of WM.
Aged, 80 and over ; Blood Platelets ; Bone Marrow ; Clarithromycin* ; Female ; Hematuria ; Hemophilia A ; Hemorrhage ; Humans ; Immunoglobulin M ; Immunoglobulins ; Lymphoma ; Omentum ; Prednisolone* ; Tooth Extraction ; Waldenstrom Macroglobulinemia*

No abstract available.
Blood Platelets* ; Still's Disease, Adult-Onset*

PURPOSE: The purpose of this study was to investigate the effects of implant tilting and the loading direction on the displacement and micromotion (relative displacement between the implant and bone) of immediately loaded implants by in vitro experiments and finite element analysis (FEA). METHODS: Six artificial bone blocks were prepared. Six screw-type implants with a length of 10 mm and diameter of 4.3 mm were placed, with 3 positioned axially and 3 tilted. The tilted implants were 30° distally inclined to the axial implants. Vertical and mesiodistal oblique (45° angle) loads of 200 N were applied to the top of the abutment, and the abutment displacement was recorded. Nonlinear finite element models simulating the in vitro experiment were constructed, and the abutment displacement and micromotion were calculated. The data on the abutment displacement from in vitro experiments and FEA were compared, and the validity of the finite element model was evaluated. RESULTS: The abutment displacement was greater under oblique loading than under axial loading and greater for the tilted implants than for the axial implants. The in vitro and FEA results showed satisfactory consistency. The maximum micromotion was 2.8- to 4.1-fold higher under oblique loading than under vertical loading. The maximum micromotion values in the axial and tilted implants were very close under vertical loading. However, in the tilted implant model, the maximum micromotion was 38.7% less than in the axial implant model under oblique loading. The relationship between abutment displacement and micromotion varied according to the loading direction (vertical or oblique) as well as the implant insertion angle (axial or tilted). CONCLUSIONS: Tilted implants may have a lower maximum extent of micromotion than axial implants under mesiodistal oblique loading. The maximum micromotion values were strongly influenced by the loading direction. The maximum micromotion values did not reflect the abutment displacement values.
Dental Implants ; Finite Element Analysis* ; Immediate Dental Implant Loading ; In Vitro Techniques*

PURPOSE: This study investigated the effects of bone density and crestal cortical bone thickness at the implant-placement site on micromotion (relative displacement between the implant and bone) and the peri-implant bone strain distribution under immediate-loading conditions. METHODS: A three-dimensional finite element model of the posterior mandible with an implant was constructed. Various bone parameters were simulated, including low or high cancellous bone density, low or high crestal cortical bone density, and crestal cortical bone thicknesses ranging from 0.5 to 2.5 mm. Delayed- and immediate-loading conditions were simulated. A buccolingual oblique load of 200 N was applied to the top of the abutment. RESULTS: The maximum extent of micromotion was approximately 100 μm in the low-density cancellous bone models, whereas it was under 30 μm in the high-density cancellous bone models. Crestal cortical bone thickness significantly affected the maximum micromotion in the low-density cancellous bone models. The minimum principal strain in the peri-implant cortical bone was affected by the density of the crestal cortical bone and cancellous bone to the same degree for both delayed and immediate loading. In the low-density cancellous bone models under immediate loading, the minimum principal strain in the peri-implant cortical bone decreased with an increase in crestal cortical bone thickness. CONCLUSIONS: Cancellous bone density may be a critical factor for avoiding excessive micromotion in immediately loaded implants. Crestal cortical bone thickness significantly affected the maximum extent of micromotion and peri-implant bone strain in simulations of low-density cancellous bone under immediate loading.
Bone Density* ; Dental Implants ; Finite Element Analysis* ; Mandible

No abstract available.
Myelodysplastic Syndromes*