effect of cigarette smoking on the standard semen parameters and leukocyte contamination in infertile men

To investigate sperm quality and levels of seminal leukocytes in a group of infertile men with history of cigarette smoking. A prospective clinical study. Sohag University Hospital. Fifty two infertile men were enrolled in this study during the period from June, 2004 to December, 2005. After thorough history taking and examination, they were allocated to 4 groups. Infertile smokers [n = 20] divided into 2 groups, group 1[n=12] who had normal genital examination and group 3 [n=8] who had varicocele and infertile men who were non-smokers [n = 32] divided into 2 groups, group 2 [n=21] who had normal genital examination and group 4 [n=l 1] who had varicocele. A healthy fertile non-smokers [n = 13] as a control group. Genital examination, Scrotal Doppler Ultrasound when needed and standard semen analysis. Sperm parameters [concentration, motility and normal forms] and seminal leukocytic counts. Smoking was associated with 48% increase in seminal leukocyte concentrations [P < 0.0001], On the other hand, abnormal genital examination was associated with 29% decrease in sperm concentration, a correlation which was statistically significant [P = 0.005], Differences in standard sperm variables between infertile smokers and non-smokers men were not statistically significant. Our study demonstrates a strong correlation between smoking and increased seminal leukocytic counts. Smoking metabolites may cause sub-clinical inflammation of the male reproductive tract and recruitment of leukocytes. Activation of these leukocytes may result in oxidative stress and damage to the sperm

Cylokines balance and leukocytic changes in the early post-operative period after open cardiac surgery

Cardiopulmonary bypass [CPB] exposes blood to large areas of synthetic materials that trigger the production and release of numerous ehemotactic and vasoactive substances. This ensuing abnormal whole-body inflammatory response that can complicate the postoperative period. This prospective randomized controlled study aimed to assess the concept of cytokine balance in the early period after CPB. Twenty adult patients subjected for open heart surgery for valve replacement or repair were included, surgical approach, anesthetic regimen, CPB protocol, monitoring and ICU care were standardized for all the patients. Laboratory investigations included differential leukocytic count changes, pro-inflammatory mediators; TNF-alpha IL-6, and IL-8, and anti-inflammatory mediator IL-10. The values were determined prebypass, at end of CPB, twelve and twenty four hours after end of bypass. There were significant changes in total and differential leukocytic counts after bypass. The total leukocytic count and absolute neutrophilic count increased significantly after bypass and steadily increasing parallel to each other after twelve and twenty four hours after bypass accompanied by significant decrease in the relative count of lymphocytes and monocytes. Serum levels of TNF-alpha, IL-6, IL-8 and IL-10 significantly increased at the end of bypass and after twelve hours compared with the prebypass levels, this increase was small but statistically significant compared to the prebypass levels with TNF-alpha and IL-8, at twelve and twenty four hours, the increase in IL-6 was more prominent and lasted for the 24 hours study period compared to that of IL-10 which showed a peak value immediately after CPB. Twenty four hours after the end of bypass the serum levels of TNF-alpha, IL-8 and IL-10 decreased but still significantly higher than the prebypass levels. Serum level of IL-6 remained significantly high. CPB is followed by both pro- and anti-inflammatory changes in the early 24 hours post-operatively. Marked leukocytic changes and increased serum levels of TNF-alpha, IL-6, IL-8 and IL-10 were observed