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Endogenously formed cytokines may play an important role in the development of meningitis, and it is necessary to understand in more detail inflammatory cascades involved in the disease process. We were interested to investigate biochemical changes which are inducible by interferon gamma. Therefore, we exa­mined concentrations of neopterin, tryptophan, kynurenine and interferon gamma in cerebrospinal fluid (CSF) of 11 children with bacterial or viral meningitis and of 20 children with febrile convulsions, who suffered from viral or bacterial disease not involving the central nervous system. Concentrations of neopterin (mean ± S.D.: 43.9 ± 34.6 nmol/l) kyunrenine (0.41 ± 0.56 μmol/l) and interferon gamma (0.64 ± 0.81 U/ml) levels were higher in CSF of children with meningitis than in those with febrile convulsions (all p

Background and Aims: Surgical resection is currently the cornerstone of liver tumor treatment in children. In adults radiofrequency ablation (RFA) is an established minimally invasive treatment option for small focal liver tumors. Multiprobe stereotactic RFA (SRFA) with intraoperative image fusion to confirm ablation margins allows treatment for large lesions. We describe our experience with SRFA in children with liver masses., Methods: SRFA was performed in 10 patients with a median age of 14 years (range 0.5-17.0 years) suffering from liver adenoma ( n  = 3), hepatocellular carcinoma ( n  = 1), hepatoblastoma ( n  = 2), myofibroblastic tumor ( n  = 1), hepatic metastases of extrahepatic tumors ( n  = 2) and infiltrative hepatic cysts associated with alveolar echinococcosis ( n  = 1). Overall, 15 lesions with a mean lesion size of 2.6 cm (range 0.7-9.5 cm) were treated in 11 sessions., Results: The technical success rate was 100%, as was the survival rate. No transient adverse effects higher than grade II (Clavien and Dindo) were encountered after interventions. The median hospital stay was 5 d (range 2-33 d). In two patients who subsequently underwent transplant hepatectomy complete ablation was histologically confirmed. Follow-up imaging studies (median 55 months, range 18-129 months) revealed no local or distant recurrence of disease in any patient., Conclusions: SRFA is an effective minimal-invasive treatment option in pediatric patients with liver tumors of different etiologies.

Background: Homeostatic mechanisms to maintain the T cell compartment diversity indicate an ongoing process of thymic activity and peripheral T cell renewal during human life. These processes are expected to be accelerated after childhood thymectomy and by the influence of cytomegalovirus (CMV) inducing a prematurely aged immune system. The study aimed to investigate proportional changes and replicative history of CD8+ T cells, of recent thymic emigrants (RTEs) and CD103+ T cells (mostly gut-experienced) and the role of Interleukin-(IL)-7 and IL-7 receptor (CD127)-expressing T cells in thymectomized patients compared to young and old healthy controls., Results: Decreased proportions of naive and CD31 + CD8+ T cells were demonstrated after thymectomy, with higher proliferative activity of CD127-expressing T cells and significantly shorter relative telomere lengths (RTLs) and lower T cell receptor excision circles (TRECs). Increased circulating CD103+ T cells and a skewed T cell receptor (TCR) repertoire were found after thymectomy similar to elderly persons. Naive T cells were influenced by age at thymectomy and further decreased by CMV., Conclusions: After childhood thymectomy, the immune system demonstrated constant efforts of the peripheral CD8+ T cell compartment to maintain homeostasis. Supposedly it tries to fill the void of RTEs by peripheral T cell proliferation, by at least partly IL-7-mediated mechanisms and by proportional increase of circulating CD103+ T cells, reminiscent of immune aging in elderly. Although other findings were less significant compared to healthy elderly, early thymectomy demonstrated immunological alterations of CD8+ T cells which mimic features of premature immunosenescence in humans.