The aim of this study was to evaluate the effect of increasing postnatal age on soluble intercellular adhesion molecule-1 (sICAM-1), a very early and sensitive marker of immune activation and response in the serum of newborn infants. Serum sICAM-1 was measured by EIA (T Cell Diagnostics) in 20 healthy adults (controls) and in 43 (24 females/19 males) healthy neonates, of whom 28 were full term, and 15 were born at a gestational age between 35 and 38 weeks of pregnancy, on the 1st, 5th and 30th day of life. Neonatal serum sICAM-1 values showed a very significant increase (P < 0.01) from the 1st day (137.3 ± 62.0 ng/ml) to the 5th day (259.3 ± 124.0 ng/ml) and then to the 30th day of life (415.0 ± 114.0 ng/ml), being significantly lower on the 1st day (P < 0.01), whereas significantly higher on the 30th day of life (P < 0.05), than those in healthy adults (305 ± 195 ng/ml). Serum sICAM-1 values on the 1st day of life depended on both the mode of delivery (significantly higher in neonates born vaginally) and the gestational age at birth (significantly lower in those born at a gestational age over 38 weeks). A significant strong correlation was found in sICAM-1 values between the 1st and the 5th day following delivery (r(p) = 0.77, P < 0.009). Conclusion: The results of this study demonstrate a significant rise of serum sICAM-1 during the 1st month of life in healthy neonates suggesting a progressively increased activation of the neonatal immune system.

The purpose of this prospective study was to determine the incidence of any form of 21α-hydroxylase deficiency among Greek women with hyperandrogenic symptoms, and to test the predictive value of basal serum 17-hydroxyprogesterone (17-OHP) in the early follicular phase as a screening index for patient preselection to adrenocorticotropic hormone (ACTH) testing. Eighty-eight unselected women with hyperandrogenic symptoms were examined in the Gynecological Endocrinology Unit of the Second Department of Obstetrics and Gynecology of Athens University. Using the ACTH-stimulated 17-OHP values at 60 minutes (17-OHP60) the study population was divided into four groups (A, B, C and D). Clinical and basal hormonal parameters as well as serum 17-OHP60 values and human leukocyte antigens were studied. Both clinical and basal hormonal parameters could be used to distinguish only patients with severe 21α-hydroxylase deficiency (group A). In contrast, patients with moderate non-classical congenital adrenal hyperplasia (NC-CAH; group B), heterozygotes for NC-CAH (group C), and unaffected females (group D) can be diagnosed and classified only by serum 17-OHP60 values. In conclusion, the incidence of NC-CAH in Greek females with hyperandrogenic symptoms is 3.4%. The positive predictive value of basal 17-OHP is only 13% for this disease. Only 17-OHP60 helps to diagnose and classify moderate and mild forms of NC-CAH. Thus, it seems that ACTH testing is imperative in every subject suspected of this enzymatic disorder.

Objective - To determine the degree of hypophyseal deficiency in Kallmann's syndrome, and the effects of Gn-RH priming and HRT. Patients and Methods - Seven female patients with complete Kallmann's syndrome were subjected to dynamic tests (chlorpromazine, TRH and double Gn-RH provocation test) immediately after their first admission to the hospital. In five patients the diagnosis was established for the first time (unprimed patients), while in the other two cases the diagnosis has been established earlier and the patients were already receiving hormonal replacement therapy (HRT-primed patients). In the 5 unprimed patients, 100 μg Gn-RH s.c. were administered daily for 28-32 days and the double Gn-RH test was repeated immediately after. Results - The gonadotropic response of the unprimed patients in the administration of Gn-RH was insufficient, mainly in the second stimulation, with secretory dominance of FSH (ratio LH/FSH <1), while after the monthly Gn-RH priming, the gonadotropic response to Gn-RH had improved, with a considerable increase in the peak values of plasma FSH and LH after both stimulations, and the LH/FSH ratio was reversed to >1. In the two primed patients, the gonadotropic response to Gn-RH administration was better in both stimulations than that of the unprimed patients. Conclusions - Both the short-term Gn-RH and the long-term HRT priming improve the secretory promptitude of the hypophyseal cells for both gonadotropins, while after long-term Gn-RH priming the LH-secreting cells are capable of both release and synthesis of the hormone, as can be seen by the results of the second stimulation in the Gn-RH primed patients. Consequently, for women with Kallmann's syndrome who wish to become pregnant, ovulation induction and conception can be achieved sooner and with less cost if they are previously primed.

Pretreatment values of CEA, CA125, SCC and TPS were measured in 130 women with 1) ovarian carcinoma (n = 25), 2) breast cancer (n = 20), 3) endometrial cancer (n = 14), 4) cervical squamous cell carcinoma (n = 20), 5) cervical adenocarcinoma (n = 9) and 6) benign gynaecological diseases (n = 42) in order to evaluate the usefulness of multiple markers in diagnosing and monitoring patients with gynaecological cancer. Antigen values were significantly higher in the cancer groups than those in the benign one (p < 0.0001). CEA values were significantly elevated in the 2nd and 5th groups, CA125 in the 1st and 5th, SCC in the 4th and 5th, and TPS in the 1st, 2nd and 5th compared to the remaining groups (p < 0.04-p < 0.0001). In advanced stage diseases, significantly higher antigen values, except for SCC, than those in limited rumours were measured (p < 0.05-p < 0.0001). In conclusion, our results suggest that, multiple markers may be more efficienti than the use of single markers in accurately identifying malignant from benign gynaecological diseases and in monitoring cancer patients.

SERUM levels of IL-1β, IL-6 and TNF-α were measured in 48 healthy, termed neonates on the 1st (N1), 5th (N5) and 40th (N40) day after birth, compared with those in maternal serum (MS), umbilical cord (UC) and adult controls. Cytokine Values in N1 and N5 were significantly elevated, than those in UC and in controls (P<0.0001). IL-1β and IL-6 declined significantly from N1 to N40 (P<0.0001), while TNF-α increased significantly from N1 to N5 and declined thereafter. MS∞IL-1β and IL-6, but not MS∞TNF- α, were significantly higher than those of controls (P<0.0001). IL-1β values depended on the mode of delivery. In conclusion, the increased concentrations of IL-1β, IL-6 and TNF-α during the perinatal period might suggest their involvement in an inflammation-like process during normal parturition, and reflect also a newborn immune response to the stress of delivery and environmental changes.

Maternal serum (MS) and amniotic fluid (AF) antigen concentrations were measured, by a microparticle EIA, in 28 pregnant women during the 2nd trimester, in 27 during the 3rd and in 34 during labor. Extremely elevated and scattered over a broad range antigen values were observed in AF, compared to those in MS samples (p < 0.0001). CEA values in both MS (100% < 5 ng/mL) and in AF did not differ significantly with advancing gestation, while CA125 in MS (6.5% > 32.5 U/mL) and in AF declined significantly with gestational age (p < 0.0001). In contrast SCC values in both MS (42.5% > 1.5 ng/mL) and in AF increased significantly with the progression of pregnancy (p < 0.0001). Amniotic fluid CA125 and less prominent SCC values were significantly higher in the 2nd trimester pregnancies, complicated by fetal anomalies, compared to those in normal pregnancies (p < 0.02 and p < 0.05 respectively). Serum CA125 was lower in the prolonged pregnancies (p < 0.05), while CEA and SCC in AF were significantly elevated (p < 0.003 and p < 0.01, respectively). A good correlation was found in CA125 and SCC values between MS and AF (r = 0.43, p < 0.0001; r = 0.32, p < 0.004 respectively), while no correlation was observed between MS and AF CEA values. In conclusion, the presence of considerable CEA, CA125 and SCC levels in amniotic fluid during pregnancy suggests their involvement in biological functions, associated with fetal development and maturation. Maternal serum CEA, in contrast to CA125 and SCC, is not influenced by pregnancy, remaining a reliable tumor marker in monitoring also pregnant cancer patients.