Surgical management of lobar cerebral cavernous malformations in children: a single-center experience.

PURPOSE: We aimed to determine the surgical indications and postoperative outcomes among pediatric patients with lobar cerebral cavernous malformations (CCMs). METHODS: We retrospectively reviewed pediatric patients operated on for lobar CCM between March 2010 and August 2021. Indications for surgery included (1) intracranial hemorrhage, (2) symptomatic superficially located lesion, and (3) asymptomatic CCM in non-eloquent area in case of strong parental preferences. Patients presenting with seizures were assessed using Engel Epilepsy Surgery Outcome Scale. RESULTS: Twenty-one patients were included. The predominant symptoms were seizures (57.1%), headaches (33.3%), and focal neurological deficits (23.8%). Patients were qualified for surgery due to symptomatic intracranial hemorrhage (47.6%), drug-resistant epilepsy (28.6%), and focal neurological deficits (9.5%). Three patients (14.3%) were asymptomatic. A gross total resection of CCM with the surrounding hemosiderin rim was achieved in all patients. The mean follow-up was 52 months. No patient experienced surgery-related complications. In all individuals with a preoperative first episode of seizures or focal neurological deficits, the symptoms subsided. All six patients with drug-resistant epilepsy improved to Engel classes I (67%) and II (33%). CONCLUSION: Surgical removal of symptomatic lobar CCMs in properly selected candidates remains a safe option. Parental preferences may be considered a sole qualifying criterion for asymptomatic lobar CCM excision.

[Blatant rejection- unexpected appreciation- silent neglect : On the discussion of psychoanalysis in the psychiatric/neurologic literature during the Nazi period]. / Offene Ablehnung ­ unerwartete Anerkennung ­ schweigendes Übergehen : Zur Behandlung der Psychoanalyse in der psychiatrisch/neurologischen Literatur des "Dritten Reichs".

In textbooks of psychiatry and/or neurology which appeared during the Nazi period, psychoanalysis is mostly treated unkindly, although they avoid antisemitic reasoning. Kurt Kolle accords Freud merely a historical role and favors the comprehensive psychotherapy cultivated from 1936 onwards at the "Göring Institute". There is however a remarkable contribution by Josef Reinhold (Jeseník/Czechoslovakia) showing considerable knowledge and demonstrating to which degree psychoanalysis could be acknowledged under the Nazi regime in an academic text written by a non-German author. Oswald Bumke who emerged in the 1920s as the most vehement critic of Freud expressed his rejection of psychoanalysis by completely deleting its discussion in the 1943 edition of his textbook. In a polemic pamphlet of 1938 he extended his fight to Adler and Jung in whom he found still too much Freud, albeit in disguise. His deputy Max Mikorey buttressed this attack by racist arguments. Both statements were part of the ongoing conflict of academic psychiatry with a Nazi psychotherapy increasingly gaining an independent standing. Prior to 1933, the Zeitschrift für die gesamte Neurologie und Psychiatrie had been the major forum of discussing psychoanalysis in psychiatric circles. This discussion petered out in 1934 after the Journal had published the first scholarly paper, which connected the profile of Freud's teachings with their being rooted in the Viennese upper Jewish bourgeoisie. There was a parallel process in the journal Der Nervenarzt.

Gate Spacer Investigation for Improving the Speed of High-Frequency Carbon Nanotube-Based Field-Effect Transistors.

Carbon nanotube (CNT)-based field-effect transistors have demonstrated great potential for high-frequency (HF) analog transceiver electronics. Despite significant advancements, one of the remaining challenges is the optimization of the device architecture for obtaining the highest possible speed and linearity. While most studies so far have concentrated on symmetrical top gated FET devices, we report on the impact of the device architecture on their HF performance. Based on a wafer-level nanotechnology platform and device simulations, transistors with a buried gate having different widths and positions in the FET channel have been fabricated. Analysis of several FETs with nonsymmetrical gate electrode location in the channel revealed a speed increase of up to 18% measured by the external transit frequency fT and maximum frequency of oscillation fmax. Although only randomly oriented CNTs with a density of 25 CNTs/µm and 280 nm long channels were used in this study, transit frequencies up to 14 GHz were obtained.

Comparison of Pantoprazole Concentrations in Simultaneous Cerebrospinal Fluid and Serum Samples.

BACKGROUND: Pantoprazole is a proton pump inhibitor drug mainly used for treating peptic diseases. Adverse effects of pantoprazole in the occasional central nervous system (CNS) include headache, vertigo and sleep disturbances. Data in rats suggest that proton pumps are expressed in the inner ear and in the epithelium of the choroid plexus, which would be a potential target to mediate such proton pump inhibitor effects. METHODS: To assess the distribution of pantoprazole into the human CNS despite its low lipophilicity (log p = 0.5), we quantified pantoprazole concentrations by liquid chromatography/tandem mass spectrometry in serum and cerebrospinal fluid retain samples withdrawn simultaneously. Twenty-six sample pairs were obtained from 23 neurological patients with therapeutic administration of pantoprazole prior to sampling. RESULTS: Median (interquartile range) serum concentration of total pantoprazole was 142 ng/ml (30.8-622). Cerebrospinal fluid concentration of total pantoprazole was 2.79 ng/ml (1.59-7.3) and reached 2.0% (1.0-4.5%) of simultaneous serum concentrations. CONCLUSION: This value corresponds to the unbound fraction of pantoprazole in serum reported previously and indicates that pantoprazole CNS concentrations are high enough to exert some effects on possible CNS targets.

Towards an optimal contact metal for CNTFETs.

Downscaling of the contact length Lc of a side-contacted carbon nanotube field-effect transistor (CNTFET) is challenging because of the rapidly increasing contact resistance as Lc falls below 20-50 nm. If in agreement with existing experimental results, theoretical work might answer the question, which metals yield the lowest CNT-metal contact resistance and what physical mechanisms govern the geometry dependence of the contact resistance. However, at the scale of 10 nm, parameter-free models of electron transport become computationally prohibitively expensive. In our work we used a dedicated combination of the Green function formalism and density functional theory to perform an overall ab initio simulation of extended CNT-metal contacts of an arbitrary length (including infinite), a previously not achievable level of simulations. We provide a systematic and comprehensive discussion of metal-CNT contact properties as a function of the metal type and the contact length. We have found and been able to explain very uncommon relations between chemical, physical and electrical properties observed in CNT-metal contacts. The calculated electrical characteristics are in reasonable quantitative agreement and exhibit similar trends as the latest experimental data in terms of: (i) contact resistance for Lc = ∞, (ii) scaling of contact resistance Rc(Lc); (iii) metal-defined polarity of a CNTFET. Our results can guide technology development and contact material selection for downscaling the length of side-contacts below 10 nm.

[Biographical discoveries and supplements around the 3rd psychoanalytic congress in Weimar 1911, Part II: Maria von Stach, Georg Wanke ? and the photographer Franz Vältl]. / Biografische Neuentdeckungen und Ergänzungen zum III. Psychoanalytischen Kongress in Weimar (1911). Teil II: Maria von Stach, Georg Wanke ­ und der Photograph Franz Vältl.

In the first section of this paper Andreas Peglau presents new material on the vicissitudes of the life of publicist and feminist Maria v. Stach. Of particular interest is her longtime relationship to Karen Horney, both as patient and as friend. ? Michael Schröter adds new information about Georg Wanke, director of a sanatorium in Thuringia, who came to psychoanalysis from hypnotism. In September/October 1911 he (1) visited the Weimar Congress, (2) presented a paper on psychoanalysis to his psychiatric colleagues, and (3) joined the Berlin Psychoanalytic Association. His 1924 book contains some remarkable ideas on euthanasia which seem to have been directly approved by Freud. ­ Last but not least A. Peglau provides a portrait of the man who created the Weimar photo, Franz Vältl.

Max Eitingon's rise and decline: the Berlin years.

Max Eitingon's main achievement was the foundation of the Berlin psychoanalytic Poliklinik that served both as an outpatient center and a training institute. Another area of his responsibility was the Verlag, the International Psychoanalytic Press. By 1926, he occupied several leading positions, including presidency of the International Psychoanalytical Association and editorship of the major psychoanalytic journal of the time. The basis of his power was his personal relationship with Freud, as well as his monetary wealth, which he put into the service of the Freudian cause. By 1932, he had suffered an overall setback, however, with the Berlin Institute losing its best teachers, the Verlag barely escaping bankruptcy, and the journal's editorship returning to Vienna.

[Organisation and funding of the Berlin Psychoanalytic Polyclinic. The role of Max Eitingon]. / Organisation und Finanzierung der Berliner psychoanalytischen Poliklinik. Die Rolle Max Eitingons.

Based on unpublished archival material (Eitingon's yearly reports, account statements), this paper enriches and modifies the hitherto commonly accepted image of the Berlin Polyclinic. It highlights the fact that the indigent patients treated there contributed considerably to the budget by paying fees, albeit relatively low ones. While confirming that Eitingon largely funded the clinic, it also points out (what has hardly been known before) that he reduced his support in 1928 and stopped it altogether in 1931. Among other things, candidates were now required to pay some rent for the rooms where they analyzed their training cases. On the other hand, candidates could get stipends, funded by the course fees of the Berlin Psychoanalytic Institute. Besides a number of employed assistants, candidates did most of the treatments while the members of the psychoanalytic Society had to be repeatedly reminded of their formal obligation to take over one unpaid case from the Polyclinic. At the end, the paper discusses the "spirit" of the institution.

[From psychotherapy to psychoanalysis: Max Levy-Suhl (1876-1947)]. / Von der Psychotherapie zur Psychoanalyse: Max Levy-Suhl (1876-1947).

SUMMARY: From psychotherapy to psychoanalysis: Max Levy-Suhl (1876-1947). Levy-Suhl can be considered one of the great practising psychotherapists in early 20th century Berlin. He was active in various fields, including ophthalmology, forensic adolescent psychiatry and hypnosis. Prominent among his publications were two handbooks of psychotherapeutic methods. His attitude towards psychoanalysis shifted from initial criticism to acceptance. Ca. 1930 he experienced some kind of conversion, resulting in his training at the Berlin Institute and becoming a member of the German Psychoanalytic Society. As a Jew being forced to emigrate in 1933, Levy-Suhl turned to the Netherlands where he had a psychoanalytic children's home in Amersfoort, followed by an analyst's practice in Amsterdam. He survived the German occupation, but apparently as a broken man. After the war he committed suicide.--The paper is complemented by an appendix, containing documents and an extensive bibliography.

[IPA secretary and patron--Freud's patient, financial administrator and friend. Anton von Freund's letters to Sigmund Freud (1916-1919)]. / IPV-sekretär und Mäzen--Freuds Patient, Vermögensverwalter und Freund: Die Briefe Anton v. Freunds an Sigmund Freud (1916-1919).

Although the letters, of which numerous and lengthy excerpts are presented in this paper, have repeatedly been used by scholars, they have so far remained unpublished. There are 45 items, written between 4. 1. 1916 and 13. 7. 1919. They indicate a passionate transference to Freud, unfolding against the background of two Hungarian revolutions. After suffering a relapse of his cancer, v. Freund had several stretches of analysis with Freud. While he was better, he established two major funds: one of them allowing the foundation of the psychoanalytic publishing house, the other destined to sponsor a psychoanalytic clinic in Budapest. V. Freund helped organize the Budapest IPA congress, became a member of the "secret committee" and started to actively conduct analyses. Freud was very attached to him and felt deeply shaken by the inexorable progression of v. Freund's disease and then death in January 1920.

["Snooping" analysts and the project of a rivalling journal. Two little known aspects of the Rank crisis (1924)]. / "Berliner Schnüffeleien" und ein konkurrierendes Zeitschriftenprojekt. Zwei wenig beleuchtete Aspekte der Rank-Krise von 1924.

This paper details 1) the attempts of Berlin analysts to ferret out information about Rank's technique by interviewing one of his analysands, and 2) Berlin plans to found a new journal called Psychoanalytische Klinik.

[Freud's letters to Emil und Mira Oberholzer (1912-1936)]. / Freuds Briefe an Emil und Mira Oberholzer (1912-1936). Edition mit Zwischentexten.

The 36 letters edited in this contribution touch on Emil O.'s analysis with Freud, on referrals of patients, small favors and Emil O.'s presidency of the Swiss psychoanalytical society (SGPsa) 1919-1928. Some complementing passages about background subjects are incorporated, viz. Emil O.'s analysis with Oskar Pfister, Mira O.'s analysis with Freud and especially several crises of the SGPsa caused by Emil O., culminating in his founding a rival society restricted to doctors in January 1928.

[Kurt Goldstein - Albert Moll. Two snapshots of the interaction of Freudians with their scientific and professional environment in the 1920's]. / Kurt Goldstein - Albert Moll: Zwei Momentaufnahmen zur Interaktion der Freud-Schule mit ihrer fachlichen Umwelt in den 1920er Jahren.

Part 1 documents and discusses a letter, written in 1920 by Rank to Abraham, telling him of two Frankfurt neurologists, Kurt Goldstein and Walther Riese, who had applied for membership in the IPA, and adding recommendations of how to deal with them. Part 2 is concerned with a report, given by Barbara Lantos of some disparaging remarks about psychoanalysis made by Albert Moll which led Freud to withdraw his public support of the 1st International Congress of Sexual Research in 1926. It also refers to an earlier discussion in Berlin where Moll already had made the same critical comments.

[Freud as a father, reflected in his letters to his five older children]. / Freud als Vater--im Spiegel der Briefe an seine fünf alteren Kinder.

This paper is based on Freud's surviving letters to his five older children, most of them unpublished. They attest the degree of Freud's involvement in upholding his family network which for him was a crucial value. Freud as a father felt particularly responsible in the areas of money and health. His main concern for his sons and sons-in-law was their professional position, for his daughters their choice of a husband. He was not a father for every day, but rather for exceptional situations, as seen in the type of "crisis letter". Without hiding his own views, he was never reproachful or moralizing to his children, but assured them of his solidarity even in situations of conflict. Freud transferred his materialistically-solid humanism, which is reflected in these letters, to the theory and practice of psychoanalysis, thus contributing to its lasting attraction.

The Leipzig episode in Freud's life (1859): a new narrative on the basis of recently discovered documents.

This paper sheds new light on the facts and chronology of Sigmund Freud's two-month stay in Leipzig. Using material from the Leipzig city archives, the authors explore the attempts of Freud's father in 1859 to obtain a permanent residence permit in Leipzig for himself and his family. At that time, there was a ban on the immigration of foreign Jews into Saxony, lifted only for merchants whose residence was deemed beneficial to local commerce. Evidently, Jacob Freud did not meet this requirement and therefore had to move on to Vienna. The significance of these events for Freud's mental development is discussed.

[K. R. Eissler and August Aichhorn. Excerpts from their correspondence 1945-1949]. / K. R. Eissler und August Aichhorn. Aus ihrem Briefwechsel 1945-1949.

Following an introduction, which mainly provides biographical information about Eissler's years in Vienna, a considerable part (about one third) of his surviving correspondence with Aichhorn is documented. The main topics of this correspondence include: their friendship and present situation, including the experience of emigration; their current scientific work; political events; the reestablishment of the Viennese Psychoanalytical Association; and the development of psychoanalysis in the U.S. Many passages demonstrate Eissler's care for Aichhorn's material needs in post-war Vienna. Eissler, who in later years was known to be reticent about disclosing personal information, emerges from these letters as a passionately warm friend.

[Palimpsest of an early autobiography of Freud]. / Palimpsest einer Freudschen Selbstdarstellung von 1912.

The authors present an article on Freud contained in a Russian "Jewish Encyclopedia" (St. Petersburg 1906-13) and discuss to what extent it goes back to Freud who had provided a sketch for it.

[Psychoanalysis in the advanced vocational training of social workers, Berlin 1930-1933 (Verein Jugendheim)]. / Psychoanalyse im Fortbildungsangebot für Sozialberufe, Berlin 1930-1933 (Verein Jugendheim).

The Verein Jugendheim in Berlin-Charlottenburg was a holding organisation of welfare institutions and of training facilities for members of the caring professions. In 1928 it founded a Soziales Institute that offered various courses for advanced vocational training. In those courses depth psychology - mainly represented by the Adlerians, least by the Jungians and increasingly by the Freudians - had a prominent place. The role of the Freudian school was supported by the fact that two staff members of the Jugendheim (Hildegard Buder-Schenck, Ursula Graf [Laessig]) started their analytic training at that time. The main teachers of psychoanalysis at the Institute were Siegfried Bernfeld, Edith Jacobson and Steffi Bornstein; notes take by a student at one of Jacobson's seminars are documented in this paper. In general, in the psychoanalytic courses there seems to have been a shift from academic teaching of theory to case oriented supervision. The presence of psychoanalysis in the training program of the Jugendheim indicates the beginning of an institutional rapprochement between pedagogy or social work and psychoanalysis in Berlin, analogous to earlier developments in Vienna. The rise of the Nazis put a stop to this promising, yet hitherto completely unknown, chapter of history.