No abstract

We describe 6 unrelated patients affected by infantile spinal muscular atrophy with respiratory distress type 1 (SMARD1) with prolonged survival upon mechanical ventilation (4.5-11 years), which has not been reported before. Biallelic mutations in the IGHMBP2 gene proved the diagnosis of SMARD1 in all patients. Disease onset was in the first 2 months in the described patients, starting with generalised hypotonia, failure to thrive, and early breathing difficulties. Diaphragmatic palsy was diagnosed and permanent ventilation was initiated 2-8 months after onset. Within months a more distal muscular atrophy became evident associated with joint contractures (talipes), hand drops, and fatty finger pads. Motor development remained minimal, loss of function was observed within the first year after which no further progression was recorded. Voiding dysfunction with reflux nephropathy was observed in 3 patients and has not been reported before. Further evidence of autonomic nerve dysfunction resulting in cardiac arrhythmia, hypertension, and excessive sweating was given in 2 patients. Investigative results were largely compatible with those obtained in classic SMA. However, neurogenic atrophy muscle was more pronounced in distal muscles, if examined, and there was evidence of peripheral nerve involvement at least in some patients.

No abstract

0 The photostability of the fluoroquinolones ciprofloxacin (CPX), ofloxacin (OFX), and fleroxacin (FLX) toward ultraviolet irradiation (UVA) and room light was investigated in dilute aqueous solutions. A series of photoproducts was observed by high-performance liquid chromatography (HPLC) for all three drugs. As little as 1 h of exposure to room light was enough for the formation of detectable amounts of CPX photoproducts. The major CPX photoproduct was characterized as a dimer by liquid secondary ion mass spectrometry, but its structure was not determined. Since irradiation of CPX results (as cited in ref/ 11) in a loss of antibacterial activity and since all substances, parent drugs as well as their photoproducts, are potential candidates for undesired drug effects, quinolone drugs should be strictly protected from all light during storage and administration.

For 11 drugs it was investigated whether tissue distribution in vivo can be predicted by use of binding data obtained in vitro. The selection of drugs represented a broad spectrum of physicochemical and pharmacokinetic properties thought to be important for distribution of drugs in vivo. The extent of binding to plasma and to tissue-homogenates of rabbits was determined in vitro. The drug concentrations in plasma, liver, lungs, kidneys, and skeletal muscle of rabbits were determined in vivo after i.v. administration of the drug. The tissue-plasma partition ratios measured in vivo were compared with the theoretical tissue-plasma partition ratios calculated from the in vitro binding data. For all drugs investigated the muscle-plasma partition ratio could be reasonably well predicted by the in vitro binding data. In liver, lungs, and kidneys good agreement was found between measured and predicted tissue-plasma ratio for anionic drugs; marked differences, however, were observed between measured and predicted tissue-plasma ratios of lipophilic cationic drugs. A significant correlation was found between binding of drugs to muscle tissue in vitro and the volume of distribution of the unbound drug (Vf), opening the possibility to approximate Vf from in vitro binding studies with rabbit muscle tissue.