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Glycoside toxicity, a common and potentially fatal complication among patients taking digoxin, is treated basically by managing cardiac arrythmias until the patient can excrete enough drug to decrease the intoxication. Patients with renal failure, however, are particularly difficult to manage. We describe a case of advanced digoxin toxicity in an elderly man with severe renal failure, treated with a charcoal hemoperfusion device.

The action of triiodothyronine on the production of alpha-fetoprotein and albumin in serum-free cultures of Hep G2 human hepatoma cells was examined. Our data showed that a marked inhibition (up to 8-fold) of alpha-fetoprotein secretion and an increase in albumin (up to 4-fold) are produced by 10(-8) M triiodothyronine. These effects were slow in their onset and for completion required 20-25 days of treatment with the hormone. However, an exposure of the cells to triiodothyronine for only the first 4 h was sufficient to affect, in a similar way, the secretion of alpha-fetoprotein and albumin when measured 15 days after treatment. The secretion of the two proteins parallels their intracellular levels. The decrease in alpha-fetoprotein production can be explained by a reduction of the RNA coding for the protein. The same is essentially true also for albumin increased secretion and related mRNA expression.