Are paraspinal muscle quantity, lumbar indentation value, and subcutaneous fat thickness related to disc degeneration? An MRI-based study.

INTRODUCTION: The aim of the study was to investigate the relationship between lumbar disc herniation and Goutallier classification (GC), lumbar indentation value, and subcutaneous adipose tissue thickness. METHODS: 102 consecutive patients (59 female and 43 male) with lumbar back pain, numbness, tingling, or pain in the lower extremity indicating radiculopathy who had undergone lumbar magnetic resonance imaging (MRI) and had an intervertebral disc herniation in the L4-5 level, were included in the study. 102 patients who have undergone lumbar MRI in the same time period and have no disc herniation were chosen to be the control group and were selected so as to match the herniated group for sex and age. All these patients' scans were re-interpreted regarding paraspinal muscle atrophy (using the GC), lumbar indentation value, and subcutaneous adipose tissue thickness in the L4-5 level. RESULTS: The Goutallier score was higher in the herniated group, compared with the non-herniated group (p < 0.001). There was no statistical difference between herniated and non-herniated groups regarding lumbar indentation value (LIV) and subcutaneous adipose tissue thickness (SATT). A Goutallier score of 1.5 provided the highest sensitivity x specificity value to indicate the disc herniation according to the statistical results. The individuals with a Goutallier score of 2, 3, and 4 have 2.87 times more likely to have disc herniation in their MRIs than the ones with a score of 0 and 1. CONCLUSION: Paraspinal muscle atrophy seems to be related to the presence of disc herniations. The cut-off value of GC to indicate the disc herniation in this study might be useful to predict the risk for disc herniation regarding the Goutallier score. The LIV and SATT measured in magnetic resonance images were randomly distributed between individuals with herniated and non-herniated groups, and statistically, no relationship was observed between these groups regarding these parameters. IMPLICATIONS FOR PRACTICE: The effect of the parameters studied in this research on disc herniations are expected to be an added value to the literature. The awareness of risk factors for intervertebral disc herniations might be used in preventive medicine to predict the risk and understand the tendency of an individual for disc herniations to occur in the future. Further investigations are needed to establish whether there is a causal relationship or correlation between these parameters and disc herniation.

PGDIS position statement on the transfer of mosaic embryos 2021.

Chromosome testing strategies, such as preimplantation genetic testing for aneuploidy (PGT-A), improve initial IVF outcomes by avoiding unwitting transfer of aneuploid embryos in morphology-based selection practices. Newer technologies have revealed that some embryos may appear to have intermediate whole chromosome (or parts of a chromosome termed segmental) copy number results suggesting trophectoderm mosaicism. An embryo with a trophectoderm mosaic-range result may be the only option for transfer for some patients. Recent data suggest that such mosaic embryos can be transferred without added risk of abnormal birth outcomes but may be associated with increased implantation failure and miscarriage rates, with higher values of mosaicism appearing to be less favourable for producing good outcomes. In this Position Statement, we provide guidance to laboratories, clinics, clinicians and counsellors to assist in discussions on the utility and transfer of mosaic embryos.

Dynamic evolution of hyperuniformity in a driven dissipative colloidal system.

Hyperuniformity is evolving to become a unifying concept that can help classify and characterize equilibrium and nonequilibrium states of matter. Therefore, understanding the extent of hyperuniformity in dissipative systems is critical. Here, we study the dynamic evolution of hyperuniformity in a driven dissipative colloidal system. We experimentally show and numerically verify that the hyperuniformity of a colloidal crystal is robust against various lattice imperfections and environmental perturbations. This robustness even manifests during crystal disassembly as the system switches between strong (class I), logarithmic (class II), weak (class III), and non-hyperuniform states. To aid analyses, we developed a comprehensive computational toolbox, enabling real-time characterization of hyperuniformity in real- and reciprocal-spaces together with the evolution of several order metric features, and measurements showing the effect of external perturbations on the spatiotemporal distribution of the particles. Our findings provide a new framework to understand the basic principles that drive a dissipative system to a hyperuniform state.

The impact of TFPI on coronary atherosclerotic burden.

OBJECTIVES: We aimed to associate a coronary artery disease (CAD) presence and severity with endothelial dysfunction (ED), carotid intima media thickness (CIMT) and Tissue Factor Pathway Inhibitor (TFPI). BACKGROUND: ED has a central role in atherosclerosis. CIMT and TFPI activity are also related with atherosclerosis and CAD. METHODS: In our prospective observational study, 50 patients had CAD and 30 had normal coronary arteries. Endothelial function was evaluated by endothelium-dependent flow-mediated dilatation (FMD) and nitroglycerine-mediated dilatation (NMD) measurements. CIMT and Serum TFPI levels were also measured. RESULTS: TFPI was a statistically significant determinant between the two groups with an increased level in CAD (+) group (84.9 ± 19.3 vs 70.2 ± 14.7, p = 0.001). There was a positive correlation between CIMT and Gensini (r = 0.34, p = 0.014). There was a strong negative correlation between Gensini and FMD-NMD, statistically significant (FMD: r = -0.715, p < 0.001; NMD: r = -0.718, p < 0.001). CONCLUSION: We observed that ED, increased CIMT and TFPI levels were associated with CAD. Additionally, increased CIMT measurements and decreased FMD and NMD values had a positive correlation with GSS (Tab. 4, Fig. 6, Ref. 50).

Maxillomandibular advancement for obstructive sleep apnea.

Objective: : We aimed to present our clinical experience with maxillomandibular advancement (MMA) for the treatment of obstructive sleep apnea (OSA) syndrome and to compare our results with literature data. Materials and Methods: : The patients who were operated for OSA in the last 10 years were included in the study. A detailed patient's charts review was retrospectively performed. Inclusion criteria were to be available with preoperative and postoperative polysomnography data. Results: : There were totally 7 cases who underwent MMA procedure for OSA in our clinic. The mean age was 38.6 ± 8.1 years. Surgical success was achieved in all cases (100%). The mean preoperative and postoperative apnea-hypopnea indexes were 63.3 ± 35.2 and 7.5 ± 3.4, respectively (P < 0.05). The most common complication was inferior alveolar nerve deficit following bilateral sagittal split osteotomy. The facial numbness was temporary in 4 (57.1%), and permanent in one case (14.3%). Conclusion: Our surgical results in MMA is compatible with literature data. MMA is the choice of treatment in severe OSA in case of positive airway pressure therapy intolerance.

The clinical utility of PGD with HLA matching: a collaborative multi-centre ESHRE study.

STUDY QUESTION: Has PGD-HLA been successful relative to diagnostic and clinical efficacy? SUMMARY ANSWER: The diagnostic efficacy of PGD-HLA protocols was found lower in this study in comparison to published PGD-HLA protocols and to that reported for general PGD by ESHRE (78.5 vs 94.1% and vs 92.6%, respectively), while the clinical efficacy has proven very difficult to assess due to inadequate follow-up of both the ART/PGD and HSCT procedure outcomes. WHAT IS KNOWN ALREADY: The first clinical cases for PGD-HLA were reported in 2001. It is now a well-established procedure, with an increasing number of cycles performed every year. However, PGD-HLA is still offered by relatively few PGD centres, the currently available data is fragmented and most reports on PGD-HLA applications are limited in number and scope. Published systematic details on methodology, diagnostic results, overall ART success and haematopoietic stem cell transplantation (HSCT) outcomes are limited, precluding an evaluation of the true clinical utility of PGD-HLA cycles. STUDY DESIGN, SIZE, DURATION: This retrospective multi-centre cohort study aimed to investigate the diagnostic and clinical efficacy of the PGD-HLA procedure and the aspects of PGD-HLA cycles influencing positive outcomes: birth of genetically suitable donor-baby (or babies) and HSCT. In April 2014, 32 PGD centres (Consortium members and non-members) with published/known PGD-HLA activity were invited to participate. Between February and September 2015, 14 centres submitted their data, through a custom-designed secure database, with unique login access for each centre. Data parameters covered all aspects of PGD-HLA cycles (ART, embryology and genetic diagnosis), donor-babies born and HSCT. PARTICIPANTS/MATERIALS, SETTING, METHODS: From 716 cycles submitted by 14 centres (performed between August 2001 and September 2015), the quality evaluation excluded 12 cycles, leaving 704, from 364 couples. The online database, based on REDCap, a free, secure, web-based data-capture application, was customized by Centre for Clinical Epidemiology and Outcomes Research (CLEO), Athens. Continuous variables are presented using mean, standard deviation, median and interquartile range, and categorical variables are presented as absolute and relative frequencies. MAIN RESULTS AND THE ROLE OF CHANCE: The data included 704 HLA-PGD cycles. Mean maternal age was 33.5 years. Most couples (81.3%) requested HLA-typing with concurrent exclusion of a single monogenic disease (58.6% for beta-thalassaemia). In 92.5% couples, both partners were fertile, with an average 1.93 HLA-PGD cycles/couple. Overall, 9751 oocytes were retrieved (13.9/cycle) and 5532 embryos were analysed (7.9/cycle). Most cycles involved fresh oocytes (94.9%) and Day 3 embryo biopsy (85.3%). In 97.5% of cycles, the genotyping method involved PCR only. Of 4343 embryos diagnosed (78.5% of analysed embryos), 677 were genetically suitable (15.4% of those analysed for HLA alone, 11.6% of those analysed for HLA with exclusion of monogenic disease). Of the 364 couples, 56.6% achieved an embryo transfer (ET) and 598 embryos were transferred in 382 cycles, leading to 164 HCG-positive pregnancies (pregnancy rate/ET 41.3%, pregnancy rate/initiated cycle 23.3%) and 136 babies born (live birth rate/ET 34.3%, live birth rate/initiated cycle 19.3%) to 113 couples. Data analysis identified the following limitations to the overall success of the HLA-PGD procedure: the age of the mother undergoing the treatment cycle, the number of oocytes collected per cycle and genetic chance. HSCT was reported for 57 cases, of which 64.9% involved combined umbilical cord-blood and bone marrow transplantation from the HLA-identical sibling donor; 77.3% of transplants reported no complications. LIMITATIONS REASONS FOR CAUTION: The findings of the study may be limited as not all PGD centres with PGD-HLA experience participated. Reporting bias on completion of the online database may be another potential limitation. Furthermore, the study is based on retrospective data collection from centres with variable practices and strategies for ART, embryology and genetic diagnosis. WIDER IMPLICATIONS OF THE FINDINGS: This is the first multi-centre study evaluating the clinical utility of PGD-HLA, indicating variations in practice and outcomes throughout 15 years and between centres. The study highlights parameters important for positive outcomes and provides important information for both scientists and couples interested in initiating a cycle. Above all, the study underlines the need for better collaboration between all specialists involved in the ART-PGD/HLA procedure, as well as the need for comprehensive and prospective long-term data collection, and encourages all specialists to aim to properly evaluate and follow-up all procedures, with the ultimate aim to promote best practice and encourage patient informed decision making. STUDY FUNDING/COMPETING INTEREST(S): The study wishes to acknowledge ESHRE for funding the customization of the REDCap database. There are no competing interests. TRIAL REGISTRATION NUMBER: N/A.

Association of serum betatrophin with fibroblast growth factor-21 in women with polycystic ovary syndrome.

PURPOSE: Betatrophin and fibroblast growth factor-21 (FGF-21), which are recently discovered members of hepatokine/adipokine family, have been proposed to be associated with some metabolic disorders in which insulin resistance plays a major role. METHODS: We aimed to investigate serum betatrophin and FGF-21 concentrations in women with polycystic ovary syndrome (PCOS). In this cross-sectional study, we recruited 31 women with PCOS and 34 women as healthy controls. Serum betatrophin level and its relationship with serum FGF-21 level as well as metabolic parameters were examined. RESULTS: Serum betatrophin level was significantly higher in women with PCOS than the control group [1.10 (0.20-4.20) vs 0.70 (0.20-3.50) ng/ml, p = 0.004], whereas FGF-21 did not differ between the groups [74.80 (7.80-435.90) vs 119.30 (10.50-443.40) pg/ml, p = 0.13]. Serum betatrophin correlated positively with LH levels (r = 0.26, p = 0.03). After controlling BMI, there was a significant positive correlation between betatrophin and FGF-21 (r = 0.25, p = 0.04). Multivariate regression analysis revealed that FGF-21 and presence of PCOS were the significant predictors of betatrophin concentrations (R2 = 0.22, F = 2.56, p = 0.03). CONCLUSIONS: Our results indicate that betatrophin levels are increased and associated with LH and FGF-21 levels, but not with insulin resistance, in women with PCOS.

Effects of closure versus non-closure of the visceral and parietal peritoneum at cesarean section: does it have any effect on postoperative vital signs? A prospective randomized study.

OBJECTIVE: To investigate the effect of peritonization at cesarean section on postoperative vital signs which was thought to be an indirect finding secondary to increased sympathetic activity originated from pain caused by stretched peritoneum. METHODS: One hundred and thirty-three pregnant women were randomized to four groups; Closure of parietal peritoneum only (group 1; n = 32), closure of visceral and parietal peritoneums (group 2; n = 32), no closure of peritoneums (group 3; n = 32) and closure of the visceral peritoneum only (group 4; n = 32). All participants were monitored for blood pressure, pulse activity and hourly urinary output during the first postoperative 24 h. Postoperative pain was measured using a Visual Analogue Scale 6th and 24th hours after surgery. Return of bowel function was measured from the end of the operation to the first passage of flatus. Operating time, pre- and postoperative hemoglobin, postoperative complications, length of hospital stay and postoperative urine osmolarity were noted. RESULTS: The mean surgery duration was significantly longer in group 2. Diuresis was found significantly decreased in group 2. Pulse rate and systolic and diastolic blood pressure were significantly higher in group 2. Closure of both peritoneums was associated with higher post-operative pain as assessed using Visual analogue scale score analyses in group 2. CONCLUSION: Both visceral and parietal membrane closure in cesarean section should be avoided in women with hypertensive disorders, renal function abnormalities and autonomic dysfunction because of increased postoperative pain and associated sympathetic overactivity.

Comparison of the result of consolidative technique otoplasty and incisionless otoplasty in the repairs of prominent ears.

We aimed to compare the long-term results of complications of consolidative technique otoplasty (CTO) and incisionless otoplasty (IO). The study consists of 156 patients who were operated between 2006 and 2015. According to surgical techniques, these patients were divided into two groups as IO group and CTO group. The distance between the head and the ear was assessed by measuring the four points preoperatively and postoperatively (SUP: most superior helical point, SCA: superior conchal attachment, ICA: inferior conchal attachment, and lobule). Early and late postoperative complications, operative time were recorded. 128 ears in IO group, 163 ears in CTO group were prominent. When postoperative SUP, SCA, ICA, lobule values for right and left ears in both groups were statistically evaluated, it was found that CTO technique has led to significantly greater improvement compared to the IO technique (p < 0.001). The success rate in IO technique and CTO technique was 72 and 96 %, respectively. Early complications were similar in both groups. The late period complication determined much more frequently was seen in the IO group. Concerning operative time, it was identified as significantly lower in the IO group (p < 0.001). The early-term outcomes of both techniques were similar; however, the complication rates due to suture material and needed for revision in IO technique were higher whereas CTO technique was more permanent with lower complication risks.

The effect of endometrial polyps on pregnancy rates in intracytoplasmic spenn injection cycles.

OBJECTIVE: The purpose of this study was to determine reproductive results of intracytoplasmic sperm injection (ICSI) for different endometrial polyps subgroup divided according to polyp size and number. MATERIALS AND METHODS: Eighty-three primer infertile patients were retrospectively analyzed. Group A consisted of 36 patients having an endometrial polyp with a diameter ≤ one cm; whereas 47 patients were included in Group B who had a polyp with a diameter > one cm or more than one polyps. All patients underwent a hysteroscopic polypectomy and ICSI treatments were started in the following cycle. RESULTS: Pregnancy was achieved in 16 patients (44.4%) in Group A and 23 patients (48.9%) in Group B. The pregnancy ratios did not reveal a statistically significant difference between the two groups. CONCLUSION: The authors concluded that in patients who have undergone hysteroscopic polypectomy before the Intracytoplasmic sperm injection (ICSI) cycle, the pregnancy rates do not depend on the diameter of the endometrial polyps.

Diabetes-resistant NOR mice are more severely affected by streptozotocin compared to the diabetes-prone NOD mice: correlations with liver and kidney GLUT2 expressions.

Nonobese diabetic (NOD) mice are susceptible strains for Type 1 diabetes development, and Nonobese Diabetes-Resistant (NOR) mice are defined as suitable controls for NOD mice in non-MHC-related research. Diabetes is often accelerated in NOD mice via Streptozotocin (STZ). STZ is taken inside cells via GLUT2 transmembrane carrier proteins, the major glucose transporter isoforms in pancreatic beta cells, liver, kidneys, and the small intestine. We observed severe adverse effects in NOR mice treated with STZ compared to NOD mice that were made diabetic with a similar dose. We suggested that the underlying mechanism could be differential GLUT2 expressions in pancreatic beta cells, yet immunofluorescent and immunohistochemical studies revealed similar GLUT2 expression levels. We also detected GLUT2 expression profiles in NOD and NOR hepatic and renal tissues by western blot analysis and observed considerably higher GLUT2 expression levels in liver and kidney tissues of NOR mice. Although beta cell GLUT2 expression levels are frequently evaluated as a marker predicting STZ sensitivity in animal models, we report here very different diabetic responses to STZ in two different animal strains, in spite of similar initial GLUT2 expressions in beta cells. Furthermore, use of NOR mice in STZ-mediated experimental diabetes settings should be considered accordingly.

Vitamin U, a novel free radical scavenger, prevents lens injury in rats administered with valproic acid.

Valproic acid (2-propyl-pentanoic acid, VPA) is the most widely prescribed antiepileptic drug due to its ability to treat a broad spectrum of seizure types. VPA exhibits various side effects such as organ toxicity, teratogenicity, and visual disturbances. S-Methylmethioninesulfonium is a derivative of the amino acid methionine and it is widely referred to as vitamin U (Vit U). This study was aimed to investigate the effects of Vit U on lens damage parameters of rats exposed to VPA. Female Sprague Dawley rats were divided into four groups. Group I comprised control animals. Group II included control rats supplemented with Vit U (50 mg/kg/day) for 15 days. Group III was given only VPA (500 mg/kg/day) for 15 days. Group IV was given VPA + Vit U (in same dose and time). Vit U was given to rats by gavage and VPA was given intraperitoneally. On the 16th day of experiment, all the animals which were fasted overnight were killed. Lens was taken from animals, homogenized in 0.9% saline to make up to 10% (w/v) homogenate. The homogenates were used for protein, glutathione, lipid peroxidation levels, and antioxidant enzymes activities. Lens lipid peroxidation levels and aldose reductase and sorbitol dehydrogenase activities were increased in VPA group. On the other hand, glutathione levels, superoxide dismutase, glutathione peroxidase, glutathione reductase, glutathione-S-transferase, and paraoxonase activities were decreased in VPA groups. Treatment with Vit U reversed these effects. This study showed that Vit U exerted antioxidant properties and may prevent lens damage caused by VPA.

The Largest Paracentric Inversion, the Highest Rate of Recombinant Spermatozoa. Case Report: 46,XY, inv(2)(q21.2q37.3) and Literature Review.

Carriers of inversions involving euchromatic regions are at risk of having unbalanced offspring due to meiotic crossover. In carriers, recombination can occur during gametogenesis and cause genetically unbalanced sperm and subsequently unbalanced embryos. Here we present segregation analysis results of an infertile male with 46,XY,inv(2) (q21.2q37.3) using fluorescent in situ hybridization (FISH) on sperm cells. This is the largest paracentric inversion (PAI) reported so far in a meiotic segregation analysis study. Sperm FISH revealed 28.0% recombinant spermatozoa rate for chromo-some 2, which was the highest rate in PAI carriers in the literature. Our results indicate a clear correlation between the size of the inverted segment and the frequency of the recombinant spermatozoa. The results of the FISH analysis with the information of unbalanced spermatozoa rate can provide accurate counseling on the genetic risk of infertility.

Growth and characterization of CuO nanostructures on Si for the fabrication of CuO/p-Si Schottky diodes.

CuO interlayers in the CuO/p-Si Schottky diodes were fabricated by using CBD and sol-gel methods. Deposited CuO layers were characterized by SEM and XRD techniques. From the SEM images, it was seen that the film grown by CBD method is denser than the film grown by sol-gel method. This result is compatible with XRD results which show that the crystallization in CBD method is higher than it is in sol-gel method. For the electrical investigations, current-voltage characteristics of the diodes have been studied at room temperature. Conventional I-V and Norde's methods were used in order to determine the ideality factor, barrier height, and series resistance values. It was seen that the morphological and structural analysis are compatible with the results of electrical investigations.

Clinical study on the insertion torque and wireless resonance frequency analysis in the assessment of torque capacity and stability of self-tapping dental implants.

Resonance frequency (RF) analysis is a non-invasive, objective and sensitive technique developed for implantology where it measures the stability of the implant in osteotomy site. Although many studies were performed by the previous electronic version of RF analyzer, a very limited number of studies were carried out with the new magnetic wireless version. The aim of the study was to evaluate the relation between insertion torques, primary and secondary stability of self-tapping tapered implant systems. Thirteen subjects were treated with 42 endosseous implants using two-stage surgical procedure. The maximal insertion torque values were recorded prior to RF analysis during surgery. Six months after surgery, the secondary stability values were measured by the RF analysis. The average maximal insertion torque and primary and secondary magnetic RF values were 33 +/- 11 N cm and 66 +/- 12 ISQ and 71.9 +/- 6 ISQ for 42 implants respectively. The correlation between insertion torque and RF values were indicated to be statistically significant (P < 0.01). Significantly higher maximal insertion torque, and primary and secondary magnetic RF values were achieved in mandibular sites compared with maxillary areas (P < 0.01). No significant differences were measured for all parameters when both systems were compared with each other (P > 0.05). There was a strong correlation between the insertion torque, primary and secondary magnetic RF values of self-tapping tapered endosseous implant used. Further studies are needed to understand the impact of the wireless magnetic RF analysis technique in clinics.

Does the use of soft or hard splints affect the short-term outcome of temporomandibular joint arthrocentesis?

Arthrocentesis is an effective treatment modality for temporomandibular joint (TMJ) disc displacement without reduction (DDw/oR), especially in patients who do not respond to non-surgical methods, and is nowadays regarded as a first-line treatment. Soft and hard stabilizing splints have also been used to treat TMJ disorders, but no data are available regarding the use of splints following arthrocentesis. The aim of this study was to compare the effect of the use of soft or hard stabilizing splints versus no appliance following TMJ arthrocentesis on the prognosis of the treatment. Forty-five patients with DDw/oR were included in the study. Pain was measured on a visual analog scale, and maximal mouth openings, lateral jaw movements and tenderness were recorded before arthrocentesis. Following arthrocentesis hard splints were fabricated for 22 patients, soft splints for 9 patients, and 14 patients without any splint served as controls. All the measurements were repeated 1 day, 1 month, 3 months and 6 months after arthrocentesis. Improvement in mouth opening was significant as well as decrease in pain in all groups regardless of the use of splints (P<0.05). Arthrocentesis alone is a successful procedure in the treatment of DDw/oR; the use of splints as an additional therapy does not affect the short-term prognosis.

The correlations between the saturated and dry P-wave velocity of rocks.

Sometimes engineers need to estimate the wet-rock P-wave velocity from the dry-rock P-wave velocity. An estimation equation embracing all rock classes will be useful for the rock engineers. To investigate the predictability of wet-rock P-wave velocity from the dry-rock P-wave velocity, P-wave velocity measurements were performed on 41 different rock types, 11 of which were igneous, 15 of which were sedimentary and 15 of which was metamorphic. In addition to the dry- and wet-rock P-wave velocity measurements, the P-wave velocity changing as a function of saturation degree was studied. Moreover, dry-rock S-wave velocity measurements were conducted. The test results were modeled using Gassmann's and Wood's theory and it was seen that the measured data did not fit the theories. The unconformity is due to the fact that the theories are valid for high-porosity unconsolidated sediments at low frequencies. Gassmann's equation was modified for the rocks except high-porosity unconsolidated sediments. The dry- and wet-rock P-wave velocity values were evaluated using regression analysis. A strong linear correlation between the dry- and wet-rock P-wave velocities was found. Regression analyses were repeated for the rock classes and it was shown that correlation coefficients were increased. Concluding remark is that the derived equations can be used for the prediction of wet-rock P-wave velocity from the dry-rock P-wave velocity.

Gingival health status in renal transplant recipients: relationship between systemic inflammation and atherosclerosis.

Cardiovascular disease (CVD) is the leading cause of mortality in renal transplant recipients (RTR). Systemic and periodontal inflammation has been suggested to have a possible role in the development of atherosclerosis. In the present study, we aimed to investigate the relationship between gingival health status, inflammation and atherosclerosis in RTRs. Eighty-three RTR (50 male, 33 female) were enrolled in the study. Routine biochemical analyses, serum lipoproteins, C-reactive protein, fibrinogen, homocystein, parathyroid hormone (PTH) and cyclosporin A (CsA) trough levels were studied. All patients had 24-h ambulatory blood pressure monitoring and B-mode ultrasound of the common carotid arteries. Gingival status was evaluated by the Löe and Silness gingival index (GI). Mean GI value was 2.3 +/- 0.5. Fifty patients (60.3%) had GI value >or= 2.1 (severe gingivitis; group A). Thirty-three patients (39.7%) had GI value < 2.1 (no or moderate gingivitis; group B). Age, carotid intima-media thickness (CIMT) and mean time on dialysis before transplantation were significantly higher in group A than in B. Systemic inflammation markers were not different between group A and group B. Mean CIMT was positively correlated with GI (r = 0.425; p = 0.001) and negatively correlated with high-density lipoprotein cholesterol (r = -0.256; p = 0.023). After the correction for confounding variables, mean CIMT was still significantly correlated with GI (r = 0.376, p = 0.02). In RTR, gingival inflammation seems to be associated with CIMT in the absence of systemic inflammation. Thus, gingivitis may, in part, play a role in the development of systemic atherosclerosis without causing any aggravation in systemic inflammatory response.