Use of evergreen and deciduous plants by nocturnal-roosting birds:A case study in Beijing

With continually increasing urbanization,the land cover in urban areas continues to change,resulting in the loss of biodiversity.Birds are highly sensitive to changes in habitat.Most forest birds perch on plants that provide increased safety to reduce the risk of predation,and small birds may also consider insulation when using roosting plants in winter because of cold weather.Landscaping plants thus shape the nocturnal roosting environment of urban birds,and proper planting is essential for the survival of birds at night.The use of roosting plants by urban birds should therefore be studied to provide a reference for landscaping.In the current study,we observed 1865 nocturnal roosting birds in Beijing from 2021 to 2022,with 23 species of birds from 12 families and 45 species of plants from 22 families recorded.Juniperus chinensis exhibited the highest bird rarity-weighted richness,followed by Fraxinus pennsylvanica,Phyllostachys propinqua,Pinus tabuliformis,and Ulmus pumila.The diameter at breast height,tree height,and crown width of plants used by birds was largest in summer and smallest in winter,and the perch height of birds was the highest in spring and summer and the lowest in winter.Birds used the highest proportion of deciduous plants in summer and the highest proportion of evergreen plants in winter.A significant seasonal difference in the use of evergreen and deciduous plants by small birds was noted,with a preference for deciduous plants in summer and evergreen plants in winter,while this preference was not found in large birds.These findings indicate that evergreen plants provide a vital nocturnal roosting environment for small birds in winter.To provide a better nocturnal roosting habitat for urban birds,we recommend paying attention to the combination of evergreen and deciduous plants when carrying out landscape construction.

Cat scratch disease in children with nocturnal fever:A case report

BACKGROUND Cat scratch disease(CSD)is the most common human infection caused by Barto-nella henselae(B.henselae).The main manifestation is self-limited lymphaden-opathy that primarily affects adolescents,and typically resolves without treat-ment within 2-4 months.However,individuals with compromised immune systems or immunodeficiency require specific antibacterial therapy following diagnosis.Due to its low incidence,nonspecific clinical manifestations,and diagnostic limitations,this condition often poses challenges for clinicians in terms of missed diagnoses and misdiagnoses.CASE SUMMARY The child was ultimately diagnosed with CSD.The primary manifestations included nocturnal fever,enlargement of lymph nodes in the neck,axilla and groin,and suspected brucellosis;however,both brucellosis tests conducted during the course of the illness yielded negative results.Bone marrow cytology indicated stimulated proliferation.Lymph node biopsy indicated hyperplasia of lymphoid tissue in the cervical lymph nodes(right),with combined immunohisto-chemical findings indicating reactive hyperplasia.Immunohistochemical analysis revealed CD20 B(+),CD3 T(+),BCL-6(+),and BCL-2(-).CD21 FDC networks were present and Ki67 expression in the germinal center was~80%.Blood next-generation sequencing indicated B.henselae sequence number was 3.Serological test results demonstrated positive antibody response to B.henselae IgG(+),B.henselae IgM(+),Bartonella quintana(B.quintana)IgG(-)and B.quintana IgM(-),and the final diagnosis was CSD.CONCLUSION In patients presenting with fever at night and swollen lymph nodes of unknown origin,CSD should be considered.

Mean nocturnal baseline impedance in gastro-esophageal reflux disease diagnosis:Should we strictly follow the Lyon 2 Consensus?

Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux disease(GERD)is the one produced by the Lyon Consensus.Recently an updated second version has been released.Mean nocturnal baseline impedance(MNBI)was proposed by the first Consensus to act as supportive evidence for GERD diagnosis.Originally a cut-off of 2292 Ohms was proposed,a value revised in the second edition.The updated Consensus recommended that an MNBI<1500 Ohms strongly suggests GERD while a value>2500 Ohms can be used to refute GERD.The proposed cut-offs move in the correct direction by diminishing the original cut-off,nevertheless they arise from a study of normal subjects where cut-offs were provided by measuring the mean value±2SD and not in symptomatic patients.However,data exist that even symptomatic patients with inconclusive disease or reflux hypersensitivity(RH)show lower MNBI values in comparison to normal subjects or patients with functional heartburn(FH).Moreover,according to the data,MNBI,even among symptomatic patients,is affected by age and body mass index.Also,various studies have proposed different cut-offs by using receiver operating characteristic curve analysis even lower than the one proposed.Finally,no information is given for patients submitted to on-proton pump inhibitors pH-impedance studies even if new and extremely important data now exist.Therefore,even if MNBI is an extremely important tool when trying to approach patients with reflux symptoms and could distinguish conclusive GERD from RH or FH,its values should be interpreted with caution.

Effects of nocturnal snacks on body composition in patients with liver cirrhosis

BACKGROUND Patients with liver cirrhosis are universally malnourished and the nocturnal snacks intervention is the currently recommended nutritional intervention for patients with liver cirrhosis.Body composition is an important indicator for the assessment of nutritional conditions.We investigated the effects of nocturnal snacks(200 kcal/day)for 3 months on body composition in patients with liver cirrhosis.Seventy patients with liver cirrhosis and 30 healthy controls were enrolled,and differences in body composition were detected using InBody 720,a body composition analyzer.The patients were further randomized into a normal diet group(three meals a day)and nocturnal snacks group(three meals a day+nocturnal snacks).The effect of nocturnal snacks on the body composition of patients with cirrhosis was assessed after 3 months of intervention.RESULTS Body fat mass(BFM),skeletal muscle mass(SMM),fat free mass,visceral fat area(VFA),and body cell mass(BCM)were significantly lower in the liver cirrhosis patients than in the healthy controls.After 3 months’intervention,BFM,VFA and BCM were significantly higher in the nocturnal snacks group than in the normal diet group,with no significant differences in total caloric intake and daily activity.However,there was no significant difference in SMM between the nocturnal snacks and normal diet groups.CONCLUSION Long-term nocturnal snacks may improve body composition indices such as BFM,VFA and BCM in patients with cirrhosis.However,the improvement was minor for SMM.

DEFECTIVE LYMPHOCYTES SUPPORTING HEMATOPOIESIS IN PATIENTS WITH PAROXYSMAL NOCTURNAL HEMOGLOBINURIA

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired hemo-lytic disease in which there is a stem cell disorder of clonal nature. Previous studies have demonstrated that the numbers of burst-forming units-erythroid (BFU-E) and colony-forming units-granulocyte / macrophage (CFU-GM) from bone marrow of PNH patients growing in the medium containing PHA-LCM from the normai donors were more reduced than those of normai bone marrow. The purpose of present study was to investigate if PNH lymphocytes are defective in supporting hematopoiesis in vitro. PHA-LCM from PNH blood was added to the culture medium for the growth of PNH and normai BFU-E and CFU-GM. The numbers of PNH bone marrow BFU-E and CFU-GM in the medium containing PHA-LCM from PNH blood were less than those from normai blood; the numbers of normai bone marrow BFU-E and CFU-GM grown in the medium containing PHA-LCM from PNH blood were more decreased than those from normai blood. The results suggest that diminished numbers of PNH bone marrovv BFU-

Effect of domperidone therapy on nocturnal dyspeptic symptoms of functional dyspepsia patients

AIM:To investigate the incidence of nocturnal dyspeptic symptoms in patients with functional dyspepsia(FD) and whether prokinetic drugs can alleviate them. METHODS:Eighty-five consecutive Chinese patients with FD were included in this study.One week after single-blinded placebo run-in treatment,baseline nocturnal intragastric pH,bile reflux and nocturnal dyspeptic symptoms of eligible patients,including epigastric pain or discomfort,abdominal distention and belching, were investigated with questionnaires.Patients exhibiting nocturnal dyspeptic symptoms were randomly and double-blindly assigned to domperidone group or placebo group.Nocturnal intragastric pH and percentage of duodenogastric bile reflux time were determined after treatment. RESULTS:Of the 85 FD patients,2 females withoutnocturnal symptoms,who responded to placebo run-in treatment,were excluded from the study,30(36.1%) exhibited nocturnal dyspeptic symptoms with increased duodenogastric bile reflux time(intragastric bilirubin absorbance>0.14)and mean gastric pH(confirming the existence of bile reflux)(P=0.021,0.023) at night were included in the study.Of these 30 patients,21(70%)had overt nocturnal duodenogastric bile reflux,which was significantly higher than that of those without nocturnal symptoms(P=0.026).The 30 patients were allocated to domperidone group or placebo group(n=15).The nocturnal duodenogastric bile reflux and gastric pH were significantly decreased after domperidone treatment(P=0.015,0.021).The severity score of nocturnal dyspeptic symptoms was also significantly decreased after domperidone treatment (P=0.010,0.015,0.026),which was positively correlated with the reduced nocturnal bile reflux or gastric pH(r=0.736,0.784,0.753 or r=0.679,0.715,0.697, P=0.039,0.036,0.037 or P=0.043,0.039,0.040). CONCLUSION:A subgroup of Chinese FD patients show overt nocturnal dyspeptic symptoms,which may be correlated with the excessive nocturnal duodenogastric bile reflux.Domperidone therapy can alleviate these symptoms.

Analysis of the CHRNA7 gene mutation and polymorphism in Southern Han Chinese patients with nocturnal frontal epilepsy

Objective:To detect the CHRNA7 gene mutation and polymorphism in Southern Han Chinese patients with nocturnal frontal lobe epilepsy(NFLE).Methods:Blood samples were collected from 215 Southern Han Chinese patients with NFLE and 200 healthy Southern Han Chinese control subjects.Genomic DNA was extracted,and CHRNA7 whole genome exons were amplified by the polymerase chain reaction and subjected to Sanger sequencing.Results:No CHRNA7 gene mutation was detected in all of the NFLE patients.However,five single nucleotide polymorphisms(SNPs)in sporadic cases were found,located in exons 5,6.and 7 of the CHRNA7 gene.Among them,c.690G>A and c.698A>G are known SNPs,while c.370G>A,c.654C>T,and c.497-498delTG were newly discovered SNPs.These SNPs were also found in some of the healthy controls.Conclusions:No CHRNA7 gene mutation was identified in Southern Han Chinese patients with NFLE.The CHRNA7 gene is probably not responsible for NFLE in this population.

Role of the Nocturnal Low-level Jet in the Formation of the Morning Precipitation Peak over the Dabie Mountains

The diurnal variation of precipitation over the Dabie Mountains(DBM) in eastern China during the 2013 mei-yu season is investigated with forecasts of a regional convection-permitting model. Simulated precipitation is verified against surface rain-gauge observations. The observed morning precipitation peak on the windward(relative to the prevailing synoptic-scale wind) side of the DBM is reproduced with good spatial and temporal accuracy. The interaction between the DBM and a nocturnal boundary layer low-level jet(BLJ) due to the inertial oscillation mechanism is shown to be responsible for this precipitation peak. The BLJ is aligned with the lower-level southwesterly synoptic-scale flow that carries abundant moisture.The BLJ core is established at around 0200 LST upwind of the mountains. It moves towards the DBM and reaches maximum intensity at about 70 km ahead of the mountains. When the BLJ impinges upon the windward side of the DBM in the early morning, mechanical lifting of moist air leads to condensation and subsequent precipitation.

Effects of Reduced Nocturnal Temperature on Performance and Behavior of Nursery Pigs

Previous studies suggested that pigs prefer lower environmental temperatures during nighttime compared to daytime. So reducing nocturnal temperature in nursery barns may not jeopardize performance or welfare of pigs, but can save energy for heating the barn. A study was conducted to investigate growth performance and behavioral response of nursery pigs to reduced nocturnal temperature. This study was conducted in four replicates, each utilizing 270 newly weaned pigs and lasting for 5 wk. Temperature setpoint in the control room （CON） was started at 30℃ and decreased by 2℃ per week. In the treatment room （RNT）, temperature setpoint was maintained same as in CON between 7：00 h and 19：00 h, and reduced by 8~C between 19：00 h and 7：00 h starting from d 5. Growth performance （15 pens/room, 9 pigs/pen, BW=（6.3±0.61） kg） was monitored for 5 wk, and behaviors in 6 pens in each room were video-recorded for 24 h 3 d after being exposed to the experimental temperature. Instantaneous scan sampling was performed to determine time budgets for standing, sitting, eating, drinking, belly nosing, three postures of lying, and huddling. Two focal pigs were continuously viewed to record duration and occurrence of eating and drinking. Reduced nocturnal temperature did not affect the growth performance of the pigs, time spent standing, sitting, total lying and eating or duration and frequencies of eating and drinking （all P〉0.10）. However, RNT increased time spent lying sternal （83 vs. 72%, P〈0.001） and number of pigs that were huddling （70 vs. 50% of lying pigs, P〈0.001）, and decreased time spent lying laterally （0.8 vs. 4.6%, P〈0.001）, lying half laterally （5.3 vs. 11.0%, P〈0.001）, and belly nosing （0.9 vs. 1.7%, P=0.01） during nighttime. These results indicate that nursery pigs adopted the posture of lying sternal and huddled together to reduce heat loss from their body surface to maintain thermal balance and growth performance in RNT. Such mild reduction in nocturnal temperature in the nursery barn can save energy for heating the barn without negative effects on performance and behavior of nursery pigs.

Management of nocturnal enuresis-myths and facts

Nocturnal enuresis often causes considerable distress or functional impairment to patient and their parents necessitating a multidisciplinary approach from paediatrician, paediatric nephrologist, urologists and psychiatrist. Mechanisms of monosymptomatic nocturnal enuresis are mainly nocturnal polyuria, bladder overactivity and failure to awaken from sleep in response to bladder sensations. Goal oriented and etiology wise treatment includes simple behavioral intervention, conditioning alarm regimen and pharmacotherapy with desmopressin, imipramine and anticholinergic drugs. Symptoms often recurs requiring change over or combination of different modes of treatment.

Effects of forest fragmentation on nocturnal Asian birds:A case study from Xishuangbanna,China

Owls have the potential to be keystone species for conservation in fragmented landscapes, as the absence of these predators could profoundly change community structure. Yet few studies have examined how whole communities of owls respond to fragmentation, especially in the tropics. When evaluating the effect of factors related to fragmentation, such as fragment area and distance to the edge, on these birds, it is also important in heterogeneous landscapes to ask how ＇location factors＇ such as the topography, vegetation and soil of the fragment predict their persistence. In Xishuangbanna, southwest China, we established 43 transects （200 mx60 m） within 20 forest fragments to sample nocturnal birds, both visually and aurally. We used a multimodel inference approach to identify the factors that influence owl species richness, and generalized linear mixed models to predict the occurrence probabilities of each species. We found that fragmentation factors dominated location factors, with larger fragments having more species, and four of eight species were significantly more likely to occur in large fragments. Given the potential importance of these birds on regulating small mammal and other animal populations, and thus indirectly affecting seed dispersal, we suggest further protection of large f ragments and programs to increase their connectivity to the remaining smaller fragments.

Successful treatment of noncirrhotic portal hypertension with eculizumab in paroxysmal nocturnal hemoglobinuria: A case report

BACKGROUND Idiopathic non-cirrhotic portal hypertension(INCPH)is mainly associated with thrombophilia in Western countries.Paroxysmal nocturnal hemoglobinuria(PNH)is a rare hematologic disease that manifests with hemolytic anemia,thrombosis,and peripheral blood cytopenias.Portal and hepatic venous thrombosis were reported in PNH.A rare case of INCPH complicating PNH is described.CASE SUMMARY A 63-year old woman with a 2-year past medical history of PNH without treatment was admitted because of jaundice and refractory ascites requiring large volume paracentesis.Liver histology revealed portal venopathy with portal fibrosis and sclerosis,nodular regenerative hyperplasia,parenchymal ischemic changes,and focal sinusoidal and perivenular fibrosis without bridging fibrosis or cirrhosis,all indicative of INCPH.The flow cytometry confirmed PNH diagnosis and eculizumab treatment was initiated.Her condition was improved gradually,bilirubin was normalized 6 months following initiation of eculizumab,and 1 year later diuretics were stopped.CONCLUSION Eculizumab improved intravascular hemolysis and reversed clinical manifestations of INCPH in a patient with paroxysmal nocturnal hemoglobinuria.

Relationship between Occurrence and Progression of Lung Cancer and Nocturnal Intermittent Hypoxia, Apnea and Daytime Sleepiness

The possible relationship between lung cancer and nocturnal intermittent hypoxia,apnea and daytime sleepiness,especially the possible relationship between the occurrence and progression of lung cancer and obstructive sleep apnea syndrome (OSAS) was explored.Forty-five cases of primary lung cancer suitable for surgical resection at the Third Affiliated Hospital of Kunming Medical University between January 2017 and December 2017 were recruited (lung cancer group),and there were 45 patients in the control group who had no significant differences in age,sex and other general data from lung cancer group.The analyzed covariates included general situation,snore score,the Epworth Sleeping Scale (ESS),Pittsburgh Sleep Quality Index (PSQI),apnea and hypopneas index (AHI),oxygen desaturation index 4 (ODk),lowest arterial oxygen saturation [LSpCh (%)],oxygen below 90% of the time [T90%(min)],the percentage of the total recorded time spend below 90% oxygen saturation (TS90%),to explore the possible relationship between lung cancer and above indicators.The participants were followed up for one year.The results showed that:(1) There was significant difference in body mass index (BMI),ESS,AHI,T90%(min),TS90%,ODh,snore score and LSpCh (%) between lung cancer group and control group (P<0.05).There was no statistically significant difference in age,gender,PSQI score,incidence of concurrent hypertension,diabetes and coronary heart disease (CHD),and smoking history between the two groups (P>0.05);(2) Patients in the lung cancer group were divided into OSAS subgroup and non- OSAS subgroup according to the international standard for the diagnosis of OSAS.There was significant difference in BMI,age,staging,incidence of concurrent hypertension and concurrent CHD,snore score,ESS score,T90%(min),TS90%,ODh and LSpCh (%) between OSAS subgroup and non-OSAS subgroup (P<0.05).There was no statistically significant difference in gender,PSQI score,incidence of concurrent diabetes,smoking history and lung cancer type between the two groups (P>0.05);(3) AHI was strongly negatively correlated with the LSpCh (%) and positively with ESS,staging,snoring score,T90%(min),TS90%,ODh and BMI (P<0.05);(4) There were 3 deaths,5 cases of recurrence,and 4 cases of metastasis in OSAS subgroup;and there was 1 death,4 cases of recurrence and 2 cases of metastasis in non-OSAS subgroup during the follow-up period of one year,respectively.There was no significant difference in mortality,recurrence rate and metastasis rate between the two subgroups,and the total rate of deterioration in OSAS subgroup was significantly increased compared to the non-OSAS subgroup (P<0.05).It was concluded that the patients with lung cancer are prone to nocturnal hypoxemia,apnea,snoring and daytime sleepiness compared to control group.The incidence of OSAS in patients with lung cancer was higher,and the difference in the hypoxemia-related indicators was statistically significant.The mortality,recurrence rate,and metastasis rate increases in lung cancer patients with OSAS during the one-year follow-up period,suggesting that OSAS may be a contributing factor to the occurrence and progression of lung cancer.

Nocturnal man biting habits of mosquito species in Serian, Sarawak, Malaysia

Knowledge of the composition and biting habits of mosquito associated with endemic areas is important in establishing sound vector control programmes and understanding the epidemiology of vector borne diseases. The biting activity cycle of several mosquito species in Serian, Sarawak was observed and described. Collections were carried out indoors and outdoors for 12 hours from 6.00 pm to 6.00 am using human landing catch techniques. A total of 7271 mosquitoes comprising 27 species belonging to sixgenera were collected. Mansonia bonneae (23.6%) was the predominant species caught in the study areas followed by Culex vishnui (22.3%), Culex pseudovishnui (19.6%) and Culex tritaenorhynchus (13.7%). A high rate of human biting activity by Ma. bonneae was detected during November but the activity was low during January.The biting activity of Ma.bonneae was found higher outdoor compared to indoorand peaked at 7.00 pm-8.00 pm.Cx.vishnui also exhibited similar biting activity peak while Anopheles letiferex-hibited biting activity peaked at 12.00 am-1.00 am.Cx.pseudovishnui showed biting patterns which were almost similar between indoor and outdoor activity and could be considered active throughout the 12 hour period.

Variability of Serum Concentration of Calcium, Phosphate and Parathyroid Hormone Depending on Time of Blood Draw for Patients on Nocturnal Home Hemodialysis

Background: Guidelines for patients treated with conventional hemodialysis patients have been written for target serum levels for calcium (Ca), phosphate (PO4) and intact parathyroid hormone (iPTH). No guidelines exist for nocturnal home hemodialysis (NHHD) patients for target values or timing of the blood sample draw. We undertook a prospective cohort study to examine the variability in pre, post and clinic (post-post) serum values for Ca, PO4, and iPTH in NHHD patients to determine if timing of blood draw could affect clinical decisions. Methods: Twenty prevalent NHHD patients collected blood pre and post their usual NHHD session with an additional blood sample drawn in clinic (post-post). Median and interquartile range of pre, post and clinic (post-post) values of iPTH, PO4 and Ca were calculated and compared with Freidman/Wilcoxon test. Serum concentrations were also categorized according to Canadian Society of Nephrology (CSN) guidelines target values for pre and clinic (post-post) samples. The proportion of patients that would be categorized differently by clinic (post-post) samples was determined. Results: There was a significant difference between pre-serum values compared to post and clinic (post-post) values. Overall, iPTH, PO4 and Ca values would be misclassified in 25%, 70% and 50% respectively if blood was drawn at the clinic visit (post-post) compared to pre-HD as per CSN guidelines. Conclusions: Although no specific guideline has been written for NHHD patients, to ensure consistency of management compared to in-centre HD patients, lab values should be drawn pre-HD until clinical evidence suggests that the recommendations should be different for NHHD.

No Correlation between <i>AVPR</i>1A Promoter Polymorphisms and Prepulse Inhibition in Patients with Nocturnal Enuresis

Introduction: A correlation between AVPR1A promoter polymorphisms and prepulse inhibition (PPI) of startle reflexes has been described in healthy adults. Many children with nocturnal enuresis (NE) have a reduced PPI and treatment with desamino arginine vasopressin (dDAVP), a ligand of the arginine vasopressin receptor 1A (AVPR1A), and both improve clanical symptoms and significantly increase PPI. Methods: In 17 children (median 9.1 years, range 6.4-17.3) with NE, promoter repeats within the RS1 and RS3 regions of AVPR1A were quantified and correlated to PPI (native and age-adjusted). Results: No direct correlation was found between the number of promoter repeats at RS1 and PPI (correlation coefficient—0.240, p = 0.346) or RS3 and PPI (correlation coefficient—0.0192, p = 0.936), with no change through age-adjustment of PPI. The different RS3 length subgroups did not show differences in PPI, nor did differentiation of NE according to clinical subtype or treatment response to dDAVP show differences in the number of promoter repeats. Conclusion: The missing reproducibility of the correlation between AVPR1A promoter polymorphisms and PPI in a group with wide range of PPI suggests a more complex interaction. Therefore, further investigations are needed to analyze this very plausible interaction. Conditions with a reduced PPI, such as enuresis, schizophrenia or autism, are particularly interesting for this research.

The clinical features of idiopathic pulmonary hypertension with nocturnal hypoxemia

Objective Hypoxemia is one of the main factors of pulmonary hypertension,and it can also be a complication of pulmonary hypertension,and it is a risk factor for many cardiovascular diseases,which increases the adverse prognosis of patients.At present,there are some controversies about the diagnosis and treatment of sleep apnea disorder in patients with pulmonary hypertension.

Posthepatectomy jaundice induced by paroxysmal nocturnal hemoglobinuria: A case report

BACKGROUND Jaundice is a major manifestation of posthepatectomy liver failure,a feared complication after hepatic resection.Herein,we report a case of posthepatectomy jaundice that was not caused by liver failure but by paroxysmal nocturnal hemoglobinuria(PNH)-induced hemolysis.CASE SUMMARY A 56-year-old woman underwent right hepatectomy and biliary tract exploration surgery due to hepatic duct stones.Prior to surgery,the patient was mildly anemic.The direct antiglobulin test was negative.A bone marrow biopsy showed mild histiocyte hyperplasia.After surgery,the patient suffered a progressive increase in serum bilirubin.Meanwhile,the patient developed hemolytic symptoms after blood transfusion.She was ultimately diagnosed with PNH.PNH is a rare bone marrow failure disorder that manifests as complement-dependent intravascular hemolysis with varying severity.After steroid treatment,the patient’s jaundice gradually decreased,and the patient was discharged on the 35th postoperative day.CONCLUSION PNH-induced hemolysis is a rare cause of posthepatectomy jaundice.It should be suspected in patients having posthepatectomy hyperbilirubinemia without other signs of liver failure.Steroid therapy can be considered for the treatment of PNH in such cases.

Possible Evolution of Paroxysmal Nocturnal Hemoglobinuria into Chronic Myeloid Leukemia: A Rare Transformation

PNH is a rare acquired clonal hematopoietic stem cell disorder characterized by abnormal sensitivity of red blood cells to lysis by complement. It is caused by genetic mutation resulting in deficiency of glycosyl phosphatidylinositol anchor (GPA) for cell membrane proteins including complement regulating proteins CD55 and CD59. PNH tends to be associated with Aplastic Anemia (anemia due to failure of the bone marrow to produce red and white blood cells as well as platelets), Myelodysplastic Syndrome (a group of cancers in which immature blood cells in the bone marrow do not mature or become healthy blood cells) or rarely Acute Myeloid Leukemia (AML) (also known as acute nonlymphocytic leukemia, representing a group of clonal hematopoietic stem cell disorders in which both a block in differentiation and unchecked proliferation result in the accumulation of myeloblasts at the expense of normal hematopoietic precursors). Here we report a case and assume possible evolution of PNH into CML (a myeloproliferative malignant clonal disease characterized by presence of fusion BCR/ABL fusion oncogene).

NOCTURNAL ENHANCEMENT OF TEC INDUCED BY MAGNETIC STORM OF MARCH13,1989

The detected TEC showed nocturnal increase, which frequently occures only near the equator. In this article the nocturnal increase of TEC is emphasized.