Suicidal digoxin poisoning: conventional treatment and antibody therapy.

A 66-year-old mand suffering from severe coronary heart disease took digoxin with suicidal intent an was treated for the ensuing complete atrioventricular block with digoxin-specific antibody fragments. Two and a half hours after intravenous infusion of the antibody fragments, the signs of intoxication passed off, and atrial fibrillation with a normal ventricular rate was reinstated. Antibody therapy is capable of permanently abolishing the signs of symptoms of digitalis poisoning after a matter of hours. Such a rapid or complete response cannot be achieved by any conventional form of treatment. This advantage must be weighed against the risks (immunologic reactions, loss of the therapeutic effect of the cardiac glycoside if an overdose of antibody is given). Moreover, antibody therapy does not take effect immediately, as is understandable in view of the mechanism of action. It should therefore be instituted in good time in potentially life-threatening cases of intoxication.

[Bronchiolo-alveolar cell carcinoma]. / Das Bronchioloalveolarzellkarzinom.

15 cases of bronchiolo-alveolar cell carcinoma were observed at the Dept. of Surgery of the University Hospital of Zurich from 1961 to 1976. The mean age of these patients was 56 years. The sex distribution was 13 males and 2 females. Five cases were discovered accidentally; the symptoms of the remaining 10 were uncharacteristic. Cytology, bronchoscopy and mediastinoscopy were negative at early stages. Diagnosis was made by histologic examination of the specimens only. Needle biopsy, performed routinely over recent years, proved helpful in 4 cases. In 12 out of 14 patients, lobectomy was considered 'radical'; nevertheless, only 2 survived more than 5 years. The disseminated form of the bronchiolo-alveolar cell carcinoma is characterized by a particularly poor prognosis. According to our experience and to the literature, only the solitary, nodular type shows a more favourable outlook.