Measurement of polarization observables T, P, and H in π0 and η photoproduction off quasi-free nucleons.

The target asymmetry T, recoil asymmetry P, and beam-target double polarization observable H were determined in exclusive π0 and η photoproduction off quasi-free protons and, for the first time, off quasi-free neutrons. The experiment was performed at the electron stretcher accelerator ELSA in Bonn, Germany, with the Crystal Barrel/TAPS detector setup, using a linearly polarized photon beam and a transversely polarized deuterated butanol target. Effects from the Fermi motion of the nucleons within deuterium were removed by a full kinematic reconstruction of the final state invariant mass. A comparison of the data obtained on the proton and on the neutron provides new insight into the isospin structure of the electromagnetic excitation of the nucleon. Earlier measurements of polarization observables in the γp→π0p and γp→ηp reactions are confirmed. The data obtained on the neutron are of particular relevance for clarifying the origin of the narrow structure in the ηn system at W=1.68GeV. A comparison with recent partial wave analyses favors the interpretation of this structure as arising from interference of the S11(1535) and S11(1650) resonances within the S11-partial wave.

Observation of the pη

Data on the beam asymmetry Σ in the photoproduction of η mesons off protons are reported for tagged photon energies from 1130 to 1790 MeV (mass range from W=1748 MeV to W=2045 MeV). The data cover the full solid angle that allows for a precise moment analysis. For the first time, a strong cusp effect in a polarization observable has been observed that is an effect of a branch-point singularity at the pη^{'} threshold [E_{γ}=1447 MeV (W=1896 MeV)]. The latest BnGa partial wave analysis includes the new beam asymmetry data and yields a strong indication for the N(1895)1/2^{-} nucleon resonance, demonstrating the importance of including all singularities for a correct determination of partial waves and resonance parameters.

Photon-electron coincidence experiments at synchrotron radiation facilities with arbitrary bunch modes.

We report the adaptation of an electron-photon coincidence detection scheme to the multibunch hybrid mode of the synchrotron radiation source BESSY II (Helmholtz-Zentrum Berlin). Single-event-based data acquisition and evaluation, combined with the use of relative detection times between the coincident particles, enable the acquisition of proper coincidence signals from a quasi-continuous excitation pattern. The background signal produced by accidental coincidences in the time difference representation is modeled using the non-coincident electron and photon spectra. We validate the method by reproducing previously published results, which were obtained in the single bunch mode, and illustrate its usability for the multibunch hybrid mode by investigating the photoionization of CO2 into CO2 + B satellite states, followed by subsequent photon emission. The radiative lifetime obtained and the electron binding energy are in good agreement with earlier publications. We expect this method to be a useful tool to extend the versatility of coincident particle detection to arbitrary operation modes of synchrotron radiation facilities and other excitation sources without the need for additional experimental adjustments.

Robust hepatitis B virus genotyping by mass spectrometry.

Genotyping of hepatitis B virus (HBV) is important for tracking HBV infections, prognosticating the development of severe liver disease, and predicting outcomes of therapy. Current genotyping methods can be laborious and costly and rely on subjective data interpretation. To identify less expensive but equally reliable alternatives, we compared "gold standard" sequencing to a novel mass spectrometry approach. Sera from individuals with acute or chronic HBV infection (n = 756), representing all genotypes, were used to PCR amplify the HBV S gene. All amplicons were subjected to base-specific cleavage and matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS). The resulting mass peak patterns were used to identify HBV genotype by automated comparison to peak patterns simulated from reference sets of HBV sequences of known genotypes. The MALDI-TOF MS data and phylogenetic analysis of HBV sequences produced completely concordant results. Several parameters such as genetic relatedness of tested HBV variants to the reference set, chronic infections, and the quality of PCR products can lower the MS score but never affected the accuracy of the genotype call. This new streamlined MS-based method provides for rapid and accurate HBV genotyping, produces automated data reports, and is therefore suitable for routine use in diagnostic settings.

A transpulmonary contrast medium enhances the transcranial Doppler signal in humans.

BACKGROUND AND PURPOSE: Transtemporal insonation in transcranial Doppler sonography is often impaired by an insufficient signal-to-noise ratio, especially in elderly patients. A transpulmonary stable air microbubble suspension was injected intravenously in humans as an intracranial ultrasonic contrast agent. METHODS: In a clinical phase II study, 20 patients (15 women, 5 men; mean age, 65.5 +/- 11.5 years) presenting with clinical indications for transcranial Doppler investigation were examined. A total of 97 intravenous injections with different concentrations (200, 300, and 400 mg/mL of suspension) of air microbubbles bound to galactose microparticles as a carrier were performed. The signal enhancement of color-coded pulse curves of basal cerebral arteries was evaluated off-line in comparison to an integrated color-coded decibel scale, considering quality, quantity, and time course of enhancement requiring a 3-dB level above the native signal. The overall diagnostic information was assessed according to a reliability score. RESULTS: The first acoustic signal increase was registered after an average of 21 seconds. Time intervals for a dose-dependent peak intensity and maximal duration were 41.3 +/- 17.1 seconds and 118.0 +/- 69.8 seconds (200 mg/mL); 55.5 +/- 27.7 seconds and 237.0 +/- 112.3 seconds (300 mg/mL); and 66.1 +/- 31.8 seconds and 293.0 +/- 122.0 seconds (400 mg/mL), respectively. Duration of signal enhancement increased significantly (P < .05) with higher concentrations. The extent of signal enhancement during the whole pulse curve reached an average of 9.1 +/- 5.0 dB for 200 mg/mL, 12.0 +/- 5.4 dB for 300 mg/mL (significant on P < .05 level), and 13.1 +/- 5.6 dB for 400 mg/mL concentration (P = NS). Respective maximal intensity spots reached 17.5 +/- 6.0, 20.7 +/- 5.5, and 22.7 +/- 5.9 dB for increasing concentrations, respectively. Overall visual assessment of enhanced pulse curves for diagnostic reliability showed a sufficient result in 38.1% of all injections with 200 mg/mL, in 88.6% with 300 mg/mL, and in 84.2% with 400 mg/mL concentration. Minimal side effects occurring in 12.4% of all injections were all reversible. CONCLUSIONS: Transpulmonary stable air microbubbles bound to a galactose carrier represent a useful and safe contrast agent in case of an insufficient native signal in transcranial Doppler investigation.

Differentiation of multi-infarct and Alzheimer dementia by intracranial hemodynamic parameters.

BACKGROUND AND PURPOSE: The differentiation between the Alzheimer and multi-infarct types of dementia may still be equivocal considering clinical criteria, neuropsychological tests, and imaging techniques. Cerebral microangiopathic alterations underlying multi-infarct dementia should allow the characterization of dementia subgroups. METHODS: Patients with a diagnosis of multi-infarct dementia (n = 17; mean age, 69.1 +/- 8.5 years) or Alzheimer dementia (n = 24, mean age, 65.8 +/- 9.0 years) according to standard testing criteria, clinical findings, and neuroimaging techniques (computed tomography and magnetic resonance imaging) were investigated prospectively by transcranial Doppler sonography and compared with a normal reference group (n = 64; mean age, 61.0 +/- 11.1 years). Transcranial Doppler sonography allows an indirect evaluation of peripheral flow resistance in the microcirculatory bed by quantifying pulsatility characteristics, as reflected in the effective pulsatility range (time-averaged mean blood flow velocity minus the peak-systolic to end-diastolic amplitude, in centimeters per second). RESULTS: A total of 204 vessels were investigated in 105 subjects. Mean and diastolic blood flow velocities as well as the effective pulsatility range were significantly lower in the multi-infarct dementia group compared with the Alzheimer and the normal reference groups (p < 0.001). By using receiver operating characteristic analysis, a cutoff point for effective pulsatility range values of -5 cm/sec gives a side-dependent sensitivity of 90.48-95.24% and a specificity of 64.71-70.59% in diagnosing Alzheimer-type dementia; the corresponding sensitivity and specificity for a value of -2 cm/sec are 82.35-88.24% and 80.95-90.48%, respectively. CONCLUSIONS: Pulsatility changes as reflected by the effective pulsatility range are a noninvasive additional criterion in the differential diagnosis of dementia.

[Multimodal carotid occlusion test for determining risk of infarct before therapeutic internal carotid artery occlusion]. / Multimodaler Karotisokklusionstest zur Bestimmung des Infarktrisikos vor therapeutischem Karotis-interna-Verschluss.

UNLABELLED: In patients with head and neck carcinoma and extensive cervical metastasis, the topographic and functional relationship of the tumor to the carotid artery is highly important. In case of suspected carotid infiltration, the possibility of a carotid resection or a prosthetic replacement has to be considered preoperatively. Treatment of cavernous carotid aneurysms may also require sacrificing the internal carotid artery (ICA). An interdisciplinary test occlusion of the ICA was performed to assess cerebral collateral circulation prior to permanent carotid occlusion. MATERIALS AND METHODS: Fifty-two patients with cervical tumors (n = 45) or inoperable aneurysms (n = 7) were examined. The endovascular balloon test occlusion (BTO) of the ICA was combined with monitoring of the neurological status, cardiovascular status (EKG, blood pressure), cortical function (EEG), and single photon emission CT (SPECT) imaging of the regional cerebral blood flow (rCBF) with 99mTechnetium-HMPAO. In the last 24 patients, transcranial Doppler sonography (TCD) of the ipsilateral middle cerebral artery (MCA) was added for direct hemodynamic monitoring during BTO. In order to improve the diagnostic value of the test results and to simulate hemodynamic crisis, the cerebrovascular reserve capacity was then evaluated with acetazolamide (Diamox). RESULTS: BTO could be performed without neurological complications or carotid dissection. In eight (15%) patients BTO had to be interrupted previously due to neurological symptoms or a delta-EEG. These patients and patients with highly pathological test results in SPECT imaging (n = 9) or TCD (n = 3) were excluded from permanent carotid occlusion. Ten (19%) patients were definitely occluded without hemodynamic complications, but two patients suffered embolic infarctions, which can not be predicted by this procedure. In two patients with a severe hypoperfusion in SPECT imaging, the ICA had to be ligated under emergency conditions following a carotid rupture. Predictably, a hemodynamic infarction occurred postoperatively in both patients. CONCLUSIONS: The multimodal BTO with brain perfusion imaging (HMPAO-SPECT) and quantitative blood flow monitoring (TCD) allows a hemodynamic stroke risk assessment prior to permanent occlusion of the ICA. The procedure is important for planning of the therapeutic strategy and for the preoperative dialogue with the patient. Embolic ischemic complications can not be predicted.