Summary In order to determine whether low plasma levels of retinol and its carrier (retinol binding protein) are related to increased risk of cancer recurrence, these were measured in 103 patients who had had colorectal cancer surgically removed. According to the modification of the Dukes' classification, 66 had B2 tumours (with no nodal involvement' and 37 had C tumours (with lymph-node metastases). These patients were part of the Cross Cancer Institute Adjuvant GI Cohorts who were on the control arms receiving no further treatment. At the time of blood sample collection, they were believed to be free of neoplastic disease. The post-operative patients were found to be associated with subnormal circulatory levels of retinol (43.3 pg dl-1 vs 65.3 pg dl-1) and its carrier protein (4.6mg dl-1 vs 5.7 mgdl-1), when compared with apparently healthy subjects. The latter being more markedly depressed in patients with "C" type tumour (3.8 mgdl-1) than that in those with "B2" type tumour (5.0mg dl-1). These findings appeared to be persistent during the follow-up study when a second blood sample was collected, one to four months later from 40 patients. Furthermore, the initial plasma retinol level in conjunction with RBP was found to be even lower in 12 patients (35.1 pg dl-1, 3.7 mg dl -1) who subsequently had cancer recurrence than in those who remained free of apparent cancer (44.5 g dl -1, 4.6 mg dl -1). The lowest initial values of retinol (19.3 pg; 18.8 pg dl-1) and RBP (2.4; 1.6 mg dl -1) recorded in the study were seen in the only two patients who died of the disease at the time of follow-up.

The findings in this study indicate that therapy with a combination of ACTH and antithymocyte globulin (ATG) should be strongly considered for patients with multiple sclerosis who are in acute relapse, who have an elevation in the ratio of gamma globulin to total protein in cerebrospinal fluid, and who are not responsive to ACTH or corticosteroid alone. Twenty-one patients with acute bouts of multiple sclerosis were randomly allocated and treated under controlled conditions with ACTH alone or ACTH and ATG. While patients in both groups improved significantly for four months after treatment, the patients remaining in the ACTH/ATG group are significantly better than the ACTH group for seven of the first eight posttreatment months.

SummarySerum There is considerable evidence from case-control studies that a low serum level of vitamin A is an important risk factor for the development of a variety of human cancers of epithelial cell origin [1][2][3][4][5][6][7][8]. Several of these studies [1,[4][5][6]8 ] have also indicated that the presence of an established cancer is associated with low serum concentrations of the vitamin A transport proteins, which include retinol-binding protein (RBP) and prealbumin. Furthermore, in our recent study [9] where serum vitamin A and RBP levels were measured in patients with surgically resected cancers of the colon and rectum, those who subsequently had recurrent disease showed lower levels of vitamin A and RBP compared with those who remained free of recurrence. Low RBP levels in plasma have also been reported in patients with recurrence of breast tumors, when compared with the

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