Swallow syncope, a case report and review of the literature.

Swallow syncope is a relatively rare syndrome that is treatable when diagnosed. A 66-year-old woman was referred to the department of cardiology because she had been suffering from recurrent syncopal attacks associated with swallowing. An ambulatory electrocardiogram revealed atrial and ventricular asystoles immediately after swallowing soup or tea that were reproducible (max. RR 3.5 s). An electrophysiological study did not detect sinus nodal or atrioventricular nodal dysfunction. The patient had no underlying esophageal disease or cardiac disorder. The patient's symptoms resolved after permanent pacemaker implantation. This report reviews the diagnosis, mechanism and management of swallow syncope.

[Therapy-related acute promyelocytic leukemia with a t(9;22)(q34;q11) and t(15;17)(q22;q11 to approximately 12) subclone].

The translocation (15;17) is a typical marker of acute promyelocytic leukemia, whereas t(9;22) is predominantly associated with chronic myelogenous leukemia, and seldom with acute myelogenous leukemia. Furthermore, the association between t(15;17) and t(9;22) in the same cell is extremely rare. We present a case of therapy-related acute promyelocytic leukemia (t-APL) with a subclone accompanied by karyotype 46, XX, t(9; 22)(q34;q11), t(15 ;17)(q22;11 to approximately 12) at onset. A 75-year-old woman was diagnosed as having non-Hodgkin lymphoma of the thyroid gland in July 1997. She was treated with a CHOP-like regimen, but complete remission (CR) was not achieved. She then underwent surgical resection of her thyroid gland, and was treated with etoposide (total dose 16775 mg) from February 1998 to May 2000. In June 2000, having developed t-APL, she was referred to our department. The patient attained CR following treatment with chemotherapy containing all-trans retinoic acid. Ten months later she relapsed, but lost the t(9;22), while maintaining the t(15;17).

[Successful T-cell-replete peripheral blood stem cell transplantation from an HLA 2 loci mismatched mother to her son with refractory anemia in myelodysplastic syndrome].

A 15-year-old male with refractory anemia in myelodysplastic syndrome underwent peripheral blood stem cell transplantation from his two-loci-mismatched haploidentical mother. The conditioning regimen was comprised of cyclophosphamide, busulfan, and fludarabine. Non-T-cell-depleted peripheral blood stem cells were infused with graft-versus-host disease (GVHD) prophylaxis consisting of tacrolimus and short-course methotrexate. Engraftment was confirmed on day 18, and complete chimera on day 29. Although the patient developed grade II acute GVHD following the transplantation, it responded rapidly to steroid administration. The subsequent course was uneventful, and he remains well in complete remission in 26 months after transplant. This successful experience suggests that maternal hematopoietic stem cell transplant for children, in specific immune tolerance based on the presence of microchimerism and compatibility of minor histocompatibility antigens between mother and child, may have given rise to the favorable preventing effect against severe GVHD.