TPT as monotherapy has shown an antitumor activity in pediatric pts with various malignancies. Toxicity was mainly hematological and manageable. Further evaluation of TPT treatment is planned using combinations with other cytostatic drugs.

Children and adolescents diagnosed with ALL or NHL have a risk for accruement of BME and/or AON irrespective of the age, with an almost exclusive involvement of the lower extremities. Lesions of pedal bones and ankle joints predominantly affect children < 10 years. Lesions of knee and hip joints predominantly affect children > 10 years. In children < 10 years of age we demonstrate declining AON numbers and conversion of AON to BME thereby implicating possible beneficial effect of HBO in such patients. HBO failed to show beneficial effect on BME whether by preventing new lesions or by improving existent lesions in children > 10 years.

We conclude that other scoring systems or measures of disease severity urgently need to be established to terminate the chronic underfunding of paediatric intensive care medicine in the developed countries.

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Dive-related injuries are relatively common, but almost exclusively occur in recreational or scuba diving. We report 2 children with acute central nervous system complications after breath-hold diving. A 12-year-old boy presented with unilateral leg weakness and paresthesia after diving beneath the water surface for a distance of ∼25 m. After ascent, he suddenly felt extreme thoracic pain that resolved spontaneously. Neurologic examination revealed right leg weakness and sensory deficits with a sensory level at T5. Spinal MRI revealed a nonenhancing T2-hyperintense lesion in the central cord at the level of T1/T2 suggesting a spinal cord edema. A few weeks later, a 13-year-old girl was admitted with acute dizziness, personality changes, confusion, and headache. Thirty minutes before, she had practiced diving beneath the water surface for a distance of ∼25 m. After stepping out, she felt sudden severe thoracic pain and lost consciousness. Shortly later she reported headache and vertigo, and numbness of the complete left side of her body. Neurologic examination revealed reduced sensibility to all modalities, a positive Romberg test, and vertigo. Cerebral MRI revealed no pathologic findings. Both children experienced a strikingly similar clinical course. The chronology of events strongly suggests that both patients were suffering from arterial gas embolism. This condition has been reported for the first time to occur in children after breath-hold diving beneath the water surface without glossopharyngeal insufflation.Dive-related injuries are relatively common and mostly occur in recreational or scuba diving. Decompression illness (DCI) is a term used to describe illness resulting from a reduction in the ambient pressure surrounding the body. DCI encompasses decompression sickness (DCS) and arterial gas embolism (AGE). 1 When severe diving injury occurs, the nervous system is frequently involved. 2 We report 2 children with central nervous system complications after breath-hold diving in shallow water. CASE REPORTS Patient 1A previously healthy 12-year-old boy presented with unilateral leg weakness and paresthesia. Two days earlier, he had practiced repeated diving beneath the water surface for a distance of 25 m. He reports that, after ascent, he suddenly felt extreme thoracic pain that resolved spontaneously. During the following hours, he subsequently experienced progressive sensory changes affecting his right side. This was followed by acute right leg weakness later the same day. A cerebral and lumbar spinal MRI that was ordered by the community neurologist on the next day was reported normal and he was discharged from the hospital. Two days later, the patient was referred to our hospital with persistent right leg weakness and paresthesia and an inability to walk. Neurologic examination revealed right leg weakness and sensory deficits with