Carpal Tunnel Syndrome Associated with Bifid Median Nerve and Palmaris Profundus - Case Report and Literature Review

The anatomic variations of the median nerve and of the muscles of the wrist have been widely reported in literature. It is essential for the surgeon to be familiar with these variations in order to avoid accidental injury to the nerve during surgery. We report a rare case of bifid median nerve accompanied by an anomalous tendon of palmaris profundus discovered during the surgical release of carpal tunnel. The transverse carpal ligament was dissected and the anomalous tendon was left in situ because any direct compression over the median nerve was noticed intraoperatively. The patient was evaluated one year postoperatively clinically and radiologically (with MRI). At the follow up the resolution of symptoms was complete and the sleep disturbance was solved. The patient achieved a postoperative QuickDASH score of 9.1 and a Michigan Hand Questionnaire outcome score of 90 points

The X-Ray Halo Scaling Relations of Supermassive Black Holes

We carry out a comprehensive Bayesian correlation analysis between hot halos and direct masses of supermassive black holes (SMBHs), by retrieving the X-ray plasma properties (temperature, luminosity, density, pressure, and masses) over galactic to cluster scales for 85 diverse systems. We find new key scalings, with the tightest relation being M-Tx, followed by M-Lx. The tighter scatter (down to 0.2 dex) and stronger correlation coefficient of all the X-ray halo scalings compared with the optical counterparts (as the M-se) suggest that plasma halos play a more central role than stars in tracing and growing SMBHs (especially those that are ultramassive). Moreover, M correlates better with the gas mass than dark matter mass. We show the important role of the environment, morphology, and relic galaxies/coronae, as well as the main departures from virialization/self-similarity via the optical/X-ray fundamental planes. We test the three major channels for SMBH growth: hot/Bondi-like models have inconsistent anticorrelation with X-ray halos and too low feeding; cosmological simulations find SMBH mergers as subdominant over most of cosmic time and too rare to induce a central-limit-theorem effect; the scalings are consistent with chaotic cold accretion, the rain of matter condensing out of the turbulent X-ray halos that sustains a long-term self-regulated feedback loop. The new correlations are major observational constraints for models of SMBH feeding/feedback in galaxies, groups, and clusters (e.g., to test cosmological hydrodynamical simulations), and enable the study of SMBHs not only through X-rays, but also via the Sunyaev-Zel dovich effect (Compton parameter), lensing (total masses), and cosmology (gas fractions)

The ASY-EOS experiment at GSI: investigating the symmetry energy at supra-saturation densities

The elliptic-flow ratio of neutrons with respect to protons in reactions of neutron rich heavy-ions systems at intermediate energies has been proposed as an observable sensitive to the strength of the symmetry term in the nuclear Equation Of State (EOS) at supra-saturation densities. The recent results obtained from the existing FOPI/LAND data for $^{197}$Au+$^{197}$Au collisions at 400 MeV/nucleon in comparison with the UrQMD model allowed a first estimate of the symmetry term of the EOS but suffer from a considerable statistical uncertainty. In order to obtain an improved data set for Au+Au collisions and to extend the study to other systems, a new experiment was carried out at the GSI laboratory by the ASY-EOS collaboration in May 2011.Comment: Talk given by P. Russotto at the 11th International Conference on Nucleus-Nucleus Collisions (NN2012), San Antonio, Texas, USA, May 27-June 1, 2012. To appear in the NN2012 Proceedings in Journal of Physics: Conference Series (JPCS

Peri-Operative Management of Patients Undergoing Fenestrated-Branched Endovascular Repair for Juxtarenal, Pararenal and Thoracoabdominal Aortic Aneurysms: Preventing, Recognizing and Treating Complications to Improve Clinical Outcomes

The advent and refinement of complex endovascular techniques in the last two decades has revolutionized the field of vascular surgery. This has allowed an effective minimally invasive treatment of extensive disease involving the pararenal and the thoracoabdominal aorta. Fenestrated-branched EVAR (F/BEVAR) now represents a feasible technical solution to address these complex diseases, moving the proximal sealing zone above the renal-visceral vessels take-off and preserving their patency. The aim of this paper was to provide a narrative review on the peri-operative management of patients undergoing F/BEVAR procedures for juxtarenal abdominal aortic aneurysm (JAAA), pararenal abdominal aortic aneurysm (PRAA) or thoracoabdominal aortic aneurism (TAAA). It will focus on how to prevent, diagnose, and manage the complications ensuing from these complex interventions, in order to improve clinical outcomes. Indeed, F/BEVAR remains a technically, physiologically, and mentally demanding procedure. Intraoperative adverse events often require prolonged or additional procedures and complications may significantly impact a patient’s quality of life, health status, and overall cost of care. The presence of standardized preoperative, perioperative, and postoperative pathways of care, together with surgeons and teams with significant experience in aortic surgery, should be considered as crucial points to improve clinical outcomes. Aggressive prevention, prompt diagnosis and timely rescue of any major adverse events following the procedure remain paramount clinical needs

Deep sub-threshold Ξ−\Xi^- production in Ar+KCl reactions at 1.76A GeV

We report first results on a deep sub-threshold production of the doubly strange hyperon $\Xi^-$ in a heavy-ion reaction. At a beam energy of 1.76A GeV the reaction Ar+KCl was studied with the High Acceptance Di-Electron Spectrometer (HADES) at SIS18/GSI. A high-statistics and high-purity $\Lambda$ sample was collected, allowing for the investigation of the decay channel $\Xi^- \to \Lambda \pi^-$. The deduced $\Xi^-/(\Lambda+\Sigma^0)$ production ratio of $(5.6 \pm 1.2 ^{+1.8}_{-1.7})\cdot 10^{-3}$ is significantly larger than available model predictions.Comment: 4 pages, including 4 figure

In-Medium Effects on K0 Mesons in Relativistic Heavy-Ion Collisions

We present the transverse momentum spectra and rapidity distributions of $\pi^{-}$ and K$^0_S$ in Ar+KCl reactions at a beam kinetic energy of 1.756 A GeV measured with the spectrometer HADES. The reconstructed K$^0_S$ sample is characterized by good event statistics for a wide range in momentum and rapidity. We compare the experimental $\pi^{-}$ and K$^0_S$ distributions to predictions by the IQMD model. The model calculations show that K$^0_S$ at low tranverse momenta constitute a particularly well suited tool to investigate the kaon in-medium potential. Our K$^0_S$ data suggest a strong repulsive in-medium K$^0$ potential of about 40 MeV strength.Comment: 10 pages, 10 figures, accepted by Phys. Rev.

Temperatures of Exploding Nuclei

Breakup temperatures in central collisions of 197Au + 197Au at bombarding energies E/A = 50 to 200 MeV were determined with two methods. Isotope temperatures, deduced from double ratios of hydrogen, helium, and lithium isotopic yields, increase monotonically with bombarding energy from 5 MeV to 12 MeV, in qualitative agreement with a scenario of chemical freeze-out after adiabatic expansion. Excited-state temperatures, derived from yield ratios of states in 4He, 5Li, 6Li, and 8Be, are about 5 MeV, independent of the projectile energy, and seem to reflect the internal temperature of fragments at their final separation from the system. PACS numbers: 25.70.Mn, 25.70.Pq, 25.75.-qComment: 10 pages, RevTeX with 4 included figures; Also available from http://www-kp3.gsi.de/www/kp3/aladin_publications.htm

Study of dielectron production in C+C collisions at 1 AGeV

The emission of e+e- pairs from C+C collisions at an incident energy of 1 GeV per nucleon has been investigated. The measured production probabilities, spanning from the pi0-Dalitz to the rho/omega! invariant-mass region, display a strong excess above the cocktail of standard hadronic sources. The bombarding-energy dependence of this excess is found to scale like pion production, rather than like eta production. The data are in good agreement with results obtained in the former DLS experiment.Comment: submitted to Physics Letters