The study aimed to compare the histological features of Leydig cells and macrophages in the testicular interstitium of obstructive versus nonobstructive azoospermia. Thirty-nine azoospermic men undergoing testicular sperm extraction during intracytoplasmic sperm injection were allocated into obstructive azoospermia group (GI) and nonobstructive azoospermia group (GII) which was subdivided into Sertoli cell-only syndrome (GIIA), germ cell arrest (GIIB) and hypospermatogenesis (GIIC) subgroups. Serum LH, FSH and testosterone levels were measured. Ultrastructural changes and the mean number of CD68-positive cells were estimated in the different groups. In GIIA, Leydig cells' processes came in contact with macrophages and showed smooth endoplasmic reticulum dilatation. In GIIB, Leydig cells showed apoptotic changes. Macrophages were commonly encountered in their vicinity demonstrating large number of lysosomes. In GIIC, Leydig cells showed euchromatic nuclei. Macrophages showed expulsion of their lysosomal contents in the interstitium surrounded by apoptotic bodies. The mean count of total CD68-positive macrophages was higher in cases of obstructive azoospermia with nonsignificant differences compared to nonobstructive azoospermia groups. Significant increase in FSH level was detected in GIIA compared to GI. It is concluded that structural interactions might take place between Leydig cells and macrophages in the interstitial tissue of azoospermic men.

The study aimed to compare the histological features of Leydig cells and macrophages in the testicular interstitium of obstructive versus nonobstructive azoospermia. Thirty-nine azoospermic men undergoing testicular sperm extraction during intracytoplasmic sperm injection were allocated into obstructive azoospermia group (GI) and nonobstructive azoospermia group (GII) which was subdivided into Sertoli cell-only syndrome (GIIA), germ cell arrest (GIIB) and hypospermatogenesis (GIIC) subgroups. Serum LH, FSH and testosterone levels were measured. Ultrastructural changes and the mean number of CD68-positive cells were estimated in the different groups. In GIIA, Leydig cells' processes came in contact with macrophages and showed smooth endoplasmic reticulum dilatation. In GIIB, Leydig cells showed apoptotic changes. Macrophages were commonly encountered in their vicinity demonstrating large number of lysosomes. In GIIC, Leydig cells showed euchromatic nuclei. Macrophages showed expulsion of their lysosomal contents in the interstitium surrounded by apoptotic bodies. The mean count of total CD68-positive macrophages was higher in cases of obstructive azoospermia with nonsignificant differences compared to nonobstructive azoospermia groups. Significant increase in FSH level was detected in GIIA compared to GI. It is concluded that structural interactions might take place between Leydig cells and macrophages in the interstitial tissue of azoospermic men.

The study aimed to compare the histological features of Leydig cells and macrophages in the testicular interstitium of obstructive versus nonobstructive azoospermia. Thirty-nine azoospermic men undergoing testicular sperm extraction during intracytoplasmic sperm injection were allocated into obstructive azoospermia group (GI) and nonobstructive azoospermia group (GII) which was subdivided into Sertoli cell-only syndrome (GIIA), germ cell arrest (GIIB) and hypospermatogenesis (GIIC) subgroups. Serum LH, FSH and testosterone levels were measured. Ultrastructural changes and the mean number of CD68-positive cells were estimated in the different groups. In GIIA, Leydig cells' processes came in contact with macrophages and showed smooth endoplasmic reticulum dilatation. In GIIB, Leydig cells showed apoptotic changes. Macrophages were commonly encountered in their vicinity demonstrating large number of lysosomes. In GIIC, Leydig cells showed euchromatic nuclei. Macrophages showed expulsion of their lysosomal contents in the interstitium surrounded by apoptotic bodies. The mean count of total CD68-positive macrophages was higher in cases of obstructive azoospermia with nonsignificant differences compared to nonobstructive azoospermia groups. Significant increase in FSH level was detected in GIIA compared to GI. It is concluded that structural interactions might take place between Leydig cells and macrophages in the interstitial tissue of azoospermic men.

The study aimed to compare the histological features of Leydig cells and macrophages in the testicular interstitium of obstructive versus nonobstructive azoospermia. Thirty-nine azoospermic men undergoing testicular sperm extraction during intracytoplasmic sperm injection were allocated into obstructive azoospermia group (GI) and nonobstructive azoospermia group (GII) which was subdivided into Sertoli cell-only syndrome (GIIA), germ cell arrest (GIIB) and hypospermatogenesis (GIIC) subgroups. Serum LH, FSH and testosterone levels were measured. Ultrastructural changes and the mean number of CD68-positive cells were estimated in the different groups. In GIIA, Leydig cells' processes came in contact with macrophages and showed smooth endoplasmic reticulum dilatation. In GIIB, Leydig cells showed apoptotic changes. Macrophages were commonly encountered in their vicinity demonstrating large number of lysosomes. In GIIC, Leydig cells showed euchromatic nuclei. Macrophages showed expulsion of their lysosomal contents in the interstitium surrounded by apoptotic bodies. The mean count of total CD68-positive macrophages was higher in cases of obstructive azoospermia with nonsignificant differences compared to nonobstructive azoospermia groups. Significant increase in FSH level was detected in GIIA compared to GI. It is concluded that structural interactions might take place between Leydig cells and macrophages in the interstitial tissue of azoospermic men.

The study aimed to compare the histological features of Leydig cells and macrophages in the testicular interstitium of obstructive versus nonobstructive azoospermia. Thirty-nine azoospermic men undergoing testicular sperm extraction during intracytoplasmic sperm injection were allocated into obstructive azoospermia group (GI) and nonobstructive azoospermia group (GII) which was subdivided into Sertoli cell-only syndrome (GIIA), germ cell arrest (GIIB) and hypospermatogenesis (GIIC) subgroups. Serum LH, FSH and testosterone levels were measured. Ultrastructural changes and the mean number of CD68-positive cells were estimated in the different groups. In GIIA, Leydig cells' processes came in contact with macrophages and showed smooth endoplasmic reticulum dilatation. In GIIB, Leydig cells showed apoptotic changes. Macrophages were commonly encountered in their vicinity demonstrating large number of lysosomes. In GIIC, Leydig cells showed euchromatic nuclei. Macrophages showed expulsion of their lysosomal contents in the interstitium surrounded by apoptotic bodies. The mean count of total CD68-positive macrophages was higher in cases of obstructive azoospermia with nonsignificant differences compared to nonobstructive azoospermia groups. Significant increase in FSH level was detected in GIIA compared to GI. It is concluded that structural interactions might take place between Leydig cells and macrophages in the interstitial tissue of azoospermic men.

Background/Purpose: Early assessment of the severity of acute pancreatitis (AP) is a highly challenge for a physicians’ practice to improve the management and decrease the mortality. We aimed to determine early prognostic factors for AP related in-hospital mortality. Methods: Upon hospital admission, predictors of AP related in-hospital mortality were prospectively assessed using regression analysis over 129 consecutive AP patients. Predictive abilities of these prognostic factors were compared using the area under receiver operating characteristic curve (AUC). Results: AP related in-hospital mortality was 10.9%. Red cell distribution (RDW), serum creatinine, glucose and albumin were associated with AP mortality. RDW had the highest AUC followed by serum creatinine and albumin (AUC: 914, 95% CI: 0.797 - 0.975; 0.797, 95% CI: 0.695 - 0.878; 0.798, 95% CI: 0.677 - 0.865 respectively). The cut-off with the best ability to predict in-hospital mortality was 14.2 for RDW. By coupling RDW and serum creatinine, AUC was improved to 0.940, 95% CI: 0.839 - 0.986. Conclusion: RDW, serum creatinine, albumin, and glucose even with borderline level changes may predict AP related in-hospital mortality, where, RDW has the highest prognostic accuracy. Coupling RDW and serum creatinine model significantly improves their predictive accuracy that may aid in further improvement of the quality of care of AP patients.

Background/Purpose: Early assessment of the severity of acute pancreatitis (AP) is a highly challenge for a physicians’ practice to improve the management and decrease the mortality. We aimed to determine early prognostic factors for AP related in-hospital mortality. Methods: Upon hospital admission, predictors of AP related in-hospital mortality were prospectively assessed using regression analysis over 129 consecutive AP patients. Predictive abilities of these prognostic factors were compared using the area under receiver operating characteristic curve (AUC). Results: AP related in-hospital mortality was 10.9%. Red cell distribution (RDW), serum creatinine, glucose and albumin were associated with AP mortality. RDW had the highest AUC followed by serum creatinine and albumin (AUC: 914, 95% CI: 0.797 - 0.975; 0.797, 95% CI: 0.695 - 0.878; 0.798, 95% CI: 0.677 - 0.865 respectively). The cut-off with the best ability to predict in-hospital mortality was 14.2 for RDW. By coupling RDW and serum creatinine, AUC was improved to 0.940, 95% CI: 0.839 - 0.986. Conclusion: RDW, serum creatinine, albumin, and glucose even with borderline level changes may predict AP related in-hospital mortality, where, RDW has the highest prognostic accuracy. Coupling RDW and serum creatinine model significantly improves their predictive accuracy that may aid in further improvement of the quality of care of AP patients.

Background/Purpose: Early assessment of the severity of acute pancreatitis (AP) is a highly challenge for a physicians’ practice to improve the management and decrease the mortality. We aimed to determine early prognostic factors for AP related in-hospital mortality. Methods: Upon hospital admission, predictors of AP related in-hospital mortality were prospectively assessed using regression analysis over 129 consecutive AP patients. Predictive abilities of these prognostic factors were compared using the area under receiver operating characteristic curve (AUC). Results: AP related in-hospital mortality was 10.9%. Red cell distribution (RDW), serum creatinine, glucose and albumin were associated with AP mortality. RDW had the highest AUC followed by serum creatinine and albumin (AUC: 914, 95% CI: 0.797 - 0.975; 0.797, 95% CI: 0.695 - 0.878; 0.798, 95% CI: 0.677 - 0.865 respectively). The cut-off with the best ability to predict in-hospital mortality was 14.2 for RDW. By coupling RDW and serum creatinine, AUC was improved to 0.940, 95% CI: 0.839 - 0.986. Conclusion: RDW, serum creatinine, albumin, and glucose even with borderline level changes may predict AP related in-hospital mortality, where, RDW has the highest prognostic accuracy. Coupling RDW and serum creatinine model significantly improves their predictive accuracy that may aid in further improvement of the quality of care of AP patients.

Background and objectives: Sepsis carries a poor prognosis for critically ill patients, even withintensive management. We aimed to determined early predictors of sepsis-related in-hospital mortality and to monitor levels of presepsin and high sensitivity C reactive protein (hsCRP) during admission relative to the applied treatment and the development of complications. Materials and Methods: An observational study was conducted on 68 intensive care unit (ICU) patients with sepsis. Blood samples from each patient were collected at admission (day 0) for measuring presepsin, hsCRP, biochemical examination, complete blood picture and microbiological culture and at the third day (day 3) for measuring presepsin and hsCRP. Predictors of sepsis-related in-hospital mortality were assessed using regression analysis. Predictive abilities of presepsin and hsCRP were compared using the area under a receiver operating characteristic curve. The Kaplan–Meier method was used to estimate the overall survival rate. Results: Results showed that the sepsis-related in-hospital mortality was 64.6%. The day 0 presepsin and SOFA scores were associated with this mortality. Presepsin levels were significantly higher at days 0 and 3 in non-survivors vs. survivors (p = 0.03 and p 0.001 respectively) and it decreased over the three days in survivors. Presepsin had a higher prognostic accuracy than hsCRP at all the evaluated times. Conclusions: Overall, in comparison with hsCRP, presepsin was an early predictor of sepsis-related in-hospital mortality in ICU patients. Changes in presepsin concentrations over time may be useful for sepsis monitoring, which in turn could be useful for stratifying high-risk patients on ICU admission that benefit from intensive treatment.

To compare the usefulness of a lamellar body count, a fluorescence polarization assay, and the foam stability index for predicting neonatal lung maturity in high-risk pregnancies. This study was conducted at the Department of Obstetrics and Gynecology and the Department of Pediatrics, Assiut University Hospital. A prospective clinical trail. This study was performed after recruiting 73 pregnant women, 52 with high-risk pregnancies (25 had diabetes and 27 had premature labor) and 21 with a healthy full-term singleton pregnancy as controls. All women were delivered in the Department of Obstetrics and Gynecology of Assiut University Hospital. The newborns with respiratory distress syndrome (RDS) were admitted in the neonatal intensive care unit of the Department of Pediatrics. Amniotic fluid specimens were obtained near delivery. Apgar score, vital signs, anthropometric data, and complete clinical examination results were available for all newborns, and particular emphasis was placed on signs of RDS. The incidence of RDS was 44.2% in the newborns of women who had experienced a high-risk pregnancy (of these, 82.6% were born preterm and 17.4% to diabetic mothers). We found that a lamellar body count is a good screening test for predicting neonatal lung maturity. It is as good as the fetal lung maturity assay by fluorescence polarization in some respects and better in others; moreover, it is better than the foam stability index test in all respects. A lamellar body count with cutoffs of 41 x 10(3)/microL and 18 x 10(3)/microL was a good predictor of low and high risks of RDS in newborns. Values between 19 x 10(3)/microL and 40 x 10(3)/microL were the best to predict an intermediate risk of RDS. Lamellar body count is a good screening test for predicting the degree of neonatal lung maturity.