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Maple syrup urine disease (MSUD) is an autosomal recessive inherited metabolic disorder caused by mutations in any of the genes encoding for the branched-chain keto dehydrogenase (BCKDH) components. This study screened MSUD patients throughout the whole Upper Egypt describing their symptoms, clinical and laboratory findings, genetic studies, and their treatment, with a 6-month follow-up for their responses. Screening identified three children with MSUD. Homozygous mutation in R195Q single nucleotide polymorphism (SNP) within the BCKDHA gene was found with the second MSUD patient. Follow-up for 6 months to assess the treatment regimens and progression of cases demonstrated that early treatment regimens including a dietary restriction of branched-chain amino acids with L-Carnitine administration could prevent MSUD-associated intellectual disabilities. It was concluded that R195Q SNP is pathogenic, and it may cause inherited forms of MSUD in some patients. MSUD cases have rarely been reported; so these findings will be highly useful for future cases of MSUD in the Upper Egyptian population.

Maple syrup urine disease (MSUD) is an autosomal recessive inherited metabolic disorder caused by mutations in any of the genes encoding for the branched-chain keto dehydrogenase (BCKDH) components. This study screened MSUD patients throughout the whole Upper Egypt describing their symptoms, clinical and laboratory findings, genetic studies, and their treatment, with a 6-month follow-up for their responses. Screening identified three children with MSUD. Homozygous mutation in R195Q single nucleotide polymorphism (SNP) within the BCKDHA gene was found with the second MSUD patient. Follow-up for 6 months to assess the treatment regimens and progression of cases demonstrated that early treatment regimens including a dietary restriction of branched-chain amino acids with L-Carnitine administration could prevent MSUD-associated intellectual disabilities. It was concluded that R195Q SNP is pathogenic, and it may cause inherited forms of MSUD in some patients. MSUD cases have rarely been reported; so these findings will be highly useful for future cases of MSUD in the Upper Egyptian population.

Maple syrup urine disease (MSUD) is an autosomal recessive inherited metabolic disorder caused by mutations in any of the genes encoding for the branched-chain keto dehydrogenase (BCKDH) components. This study screened MSUD patients throughout the whole Upper Egypt describing their symptoms, clinical and laboratory findings, genetic studies, and their treatment, with a 6-month follow-up for their responses. Screening identified three children with MSUD. Homozygous mutation in R195Q single nucleotide polymorphism (SNP) within the BCKDHA gene was found with the second MSUD patient. Follow-up for 6 months to assess the treatment regimens and progression of cases demonstrated that early treatment regimens including a dietary restriction of branched-chain amino acids with L-Carnitine administration could prevent MSUD-associated intellectual disabilities. It was concluded that R195Q SNP is pathogenic, and it may cause inherited forms of MSUD in some patients. MSUD cases have rarely been reported; so these findings will be highly useful for future cases of MSUD in the Upper Egyptian population.

Background Infertility continues to be a highly prevalent condition. Although assisted reproduction technology has been significantly effective, it is relatively costly and may yield disappointing clinical outcomes. There is still an unexplained correlation between the substantial contribution of the testicular somatic cells such as the peritubular cells and interstitial immune cells such as mast cells. Aim The aim of this work was to study the histological, immunohistochemical, and morphometric profiles of peritubular cells and mast cells in azoospermic men that might be a clue for male infertility therapy. Patients and methods This study was carried out on 39 infertile azoospermic men attending the Andrology Outpatient Clinic in Assiut University Hospital. Patients were divided into two groups. Group I (GI), which included patients with obstructive azoospermia (n=9), and group II (GII), which included patients with nonobstructive azoospermia. GII was subdivided as follows: Subgroup A, which included patients with Sertoli cell-only syndrome (n=9); subgroup B, which included patients with germ cell arrest (n=10); and subgroup C, which included patients with hypospermatogenesis (n=11). Testicular biopsies were obtained and processed for light, immunohistochemical, morphometric analysis, and electron microscopic examinations. Results The testicular interstitium of GI showed an apparently normal pattern of organization as regards cellular and fibrous components. GIIA showed the highest mast cell number, which established cytoplasmic projections toward peritubular cells. The mean count of tumor necrosis factor α-positive cells showed a significant increase in GIIA compared with GI. The mean area% of collagen fibers increased significantly in GIIA, GIIB, and GIIC compared with GI. In GIIB, bundles of microfibrils were most evident between the basement membrane and the first layer of peritubular cells. In GIIC, they appeared flattened with slender interlacing processes forming bridges. Mast cells bore long cytoplasmic projections, which extended toward the neighboring fibroblasts. Conclusion The present data signify complex cell interactions in cases of testicular dysfunction within the interstitial compartment.

Background Infertility continues to be a highly prevalent condition. Although assisted reproduction technology has been significantly effective, it is relatively costly and may yield disappointing clinical outcomes. There is still an unexplained correlation between the substantial contribution of the testicular somatic cells such as the peritubular cells and interstitial immune cells such as mast cells. Aim The aim of this work was to study the histological, immunohistochemical, and morphometric profiles of peritubular cells and mast cells in azoospermic men that might be a clue for male infertility therapy. Patients and methods This study was carried out on 39 infertile azoospermic men attending the Andrology Outpatient Clinic in Assiut University Hospital. Patients were divided into two groups. Group I (GI), which included patients with obstructive azoospermia (n=9), and group II (GII), which included patients with nonobstructive azoospermia. GII was subdivided as follows: Subgroup A, which included patients with Sertoli cell-only syndrome (n=9); subgroup B, which included patients with germ cell arrest (n=10); and subgroup C, which included patients with hypospermatogenesis (n=11). Testicular biopsies were obtained and processed for light, immunohistochemical, morphometric analysis, and electron microscopic examinations. Results The testicular interstitium of GI showed an apparently normal pattern of organization as regards cellular and fibrous components. GIIA showed the highest mast cell number, which established cytoplasmic projections toward peritubular cells. The mean count of tumor necrosis factor α-positive cells showed a significant increase in GIIA compared with GI. The mean area% of collagen fibers increased significantly in GIIA, GIIB, and GIIC compared with GI. In GIIB, bundles of microfibrils were most evident between the basement membrane and the first layer of peritubular cells. In GIIC, they appeared flattened with slender interlacing processes forming bridges. Mast cells bore long cytoplasmic projections, which extended toward the neighboring fibroblasts. Conclusion The present data signify complex cell interactions in cases of testicular dysfunction within the interstitial compartment.

Background Infertility continues to be a highly prevalent condition. Although assisted reproduction technology has been significantly effective, it is relatively costly and may yield disappointing clinical outcomes. There is still an unexplained correlation between the substantial contribution of the testicular somatic cells such as the peritubular cells and interstitial immune cells such as mast cells. Aim The aim of this work was to study the histological, immunohistochemical, and morphometric profiles of peritubular cells and mast cells in azoospermic men that might be a clue for male infertility therapy. Patients and methods This study was carried out on 39 infertile azoospermic men attending the Andrology Outpatient Clinic in Assiut University Hospital. Patients were divided into two groups. Group I (GI), which included patients with obstructive azoospermia (n=9), and group II (GII), which included patients with nonobstructive azoospermia. GII was subdivided as follows: Subgroup A, which included patients with Sertoli cell-only syndrome (n=9); subgroup B, which included patients with germ cell arrest (n=10); and subgroup C, which included patients with hypospermatogenesis (n=11). Testicular biopsies were obtained and processed for light, immunohistochemical, morphometric analysis, and electron microscopic examinations. Results The testicular interstitium of GI showed an apparently normal pattern of organization as regards cellular and fibrous components. GIIA showed the highest mast cell number, which established cytoplasmic projections toward peritubular cells. The mean count of tumor necrosis factor α-positive cells showed a significant increase in GIIA compared with GI. The mean area% of collagen fibers increased significantly in GIIA, GIIB, and GIIC compared with GI. In GIIB, bundles of microfibrils were most evident between the basement membrane and the first layer of peritubular cells. In GIIC, they appeared flattened with slender interlacing processes forming bridges. Mast cells bore long cytoplasmic projections, which extended toward the neighboring fibroblasts. Conclusion The present data signify complex cell interactions in cases of testicular dysfunction within the interstitial compartment.

Background Infertility continues to be a highly prevalent condition. Although assisted reproduction technology has been significantly effective, it is relatively costly and may yield disappointing clinical outcomes. There is still an unexplained correlation between the substantial contribution of the testicular somatic cells such as the peritubular cells and interstitial immune cells such as mast cells. Aim The aim of this work was to study the histological, immunohistochemical, and morphometric profiles of peritubular cells and mast cells in azoospermic men that might be a clue for male infertility therapy. Patients and methods This study was carried out on 39 infertile azoospermic men attending the Andrology Outpatient Clinic in Assiut University Hospital. Patients were divided into two groups. Group I (GI), which included patients with obstructive azoospermia (n=9), and group II (GII), which included patients with nonobstructive azoospermia. GII was subdivided as follows: Subgroup A, which included patients with Sertoli cell-only syndrome (n=9); subgroup B, which included patients with germ cell arrest (n=10); and subgroup C, which included patients with hypospermatogenesis (n=11). Testicular biopsies were obtained and processed for light, immunohistochemical, morphometric analysis, and electron microscopic examinations. Results The testicular interstitium of GI showed an apparently normal pattern of organization as regards cellular and fibrous components. GIIA showed the highest mast cell number, which established cytoplasmic projections toward peritubular cells. The mean count of tumor necrosis factor α-positive cells showed a significant increase in GIIA compared with GI. The mean area% of collagen fibers increased significantly in GIIA, GIIB, and GIIC compared with GI. In GIIB, bundles of microfibrils were most evident between the basement membrane and the first layer of peritubular cells. In GIIC, they appeared flattened with slender interlacing processes forming bridges. Mast cells bore long cytoplasmic projections, which extended toward the neighboring fibroblasts. Conclusion The present data signify complex cell interactions in cases of testicular dysfunction within the interstitial compartment.

Background Infertility continues to be a highly prevalent condition. Although assisted reproduction technology has been significantly effective, it is relatively costly and may yield disappointing clinical outcomes. There is still an unexplained correlation between the substantial contribution of the testicular somatic cells such as the peritubular cells and interstitial immune cells such as mast cells. Aim The aim of this work was to study the histological, immunohistochemical, and morphometric profiles of peritubular cells and mast cells in azoospermic men that might be a clue for male infertility therapy. Patients and methods This study was carried out on 39 infertile azoospermic men attending the Andrology Outpatient Clinic in Assiut University Hospital. Patients were divided into two groups. Group I (GI), which included patients with obstructive azoospermia (n=9), and group II (GII), which included patients with nonobstructive azoospermia. GII was subdivided as follows: Subgroup A, which included patients with Sertoli cell-only syndrome (n=9); subgroup B, which included patients with germ cell arrest (n=10); and subgroup C, which included patients with hypospermatogenesis (n=11). Testicular biopsies were obtained and processed for light, immunohistochemical, morphometric analysis, and electron microscopic examinations. Results The testicular interstitium of GI showed an apparently normal pattern of organization as regards cellular and fibrous components. GIIA showed the highest mast cell number, which established cytoplasmic projections toward peritubular cells. The mean count of tumor necrosis factor α-positive cells showed a significant increase in GIIA compared with GI. The mean area% of collagen fibers increased significantly in GIIA, GIIB, and GIIC compared with GI. In GIIB, bundles of microfibrils were most evident between the basement membrane and the first layer of peritubular cells. In GIIC, they appeared flattened with slender interlacing processes forming bridges. Mast cells bore long cytoplasmic projections, which extended toward the neighboring fibroblasts. Conclusion The present data signify complex cell interactions in cases of testicular dysfunction within the interstitial compartment.

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.