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Dieser Aufsatz möchte dem Deutschunterricht nicht noch einen weiteren Stoff - die latein-amerikanische Literatur - hinzufügen, um damit eine beliebig erweiterbare >Konkurrenz der Texte< zu eröffnen. Vielmehr wird lateinamerikanische Literatur für den Deutschunterricht vorgeschlagen und in Beispielen vorgestellt, weil sie besonders geeignet erscheint, im Zeitalter eines überall spürbaren Kulturwandels den Deutschunterricht zum Ort bewußter Auseinandersetzung mit >Kultur< zu machen. In den 20er Jahren schon wurde in einer Epoche ähnlich tiefgreifender kultureller Krisen über Deutschunterricht als >Kulturkunde< diskutiert. Damals lief die Absicht von Germanisten und Lehrplanautoren aber in der Hauptsache hinaus auf eine Festigung des Bewußtseins nationaler >deutscher Kultur<, auf eine Abschließung des >deutschen Wesens< nach außen. Die >Erziehung zum bewußten Deutschtum< gipfelte in der Formulierung des preußischen Ministerialrats im Kultusministerium, Hans Richert, aus dem Jahr 1924: >Im deutschen Unterricht sollen die Schüler lernen, deutsch zu reden und zu schreiben, deutsch zu fühlen, zu denken und zu wollen.<
Yin und Yang im Klassenzimmer? : China-Moden der 80er Jahre – mit einem kurzen Rückblick auf Brecht
(1985)
In zwei Beiträgen der Zeitschrift Diskussion Deutsch (Heft 84/1985) wurde ein Denkmodell ins Licht der Diskussion gestellt, das bis dahin eher in kleinen Zirkeln sich verborgen hatte: die Sucht, Rettung beim >Uralten< zu finden. Es war nicht, wie bei gestandenen Konservativen, das >Klassische<, es waren nicht >die Alten<, nein, das UR-Alte musste es sein, nämlich die Geheimnisse des Fernen Ostens, das Tao und Yin und Yang. Nun, zwanzig Jahre später, sind Tai Chi, Qi Gong, Bachblüten, Gaia, Heilenergien, Rebirthing, Reiki, Karmaarbeit etc. pp. zum esoterischen Alltag bzw. ist Esoterik alltäglich geworden. Das war ein Anlass, diese Miszelle wieder hervorzuholen, die damals – offensichtlich vergeblich – versuchte, jenes Denkmodell ins Licht der Kritik und damit in seiner Unreflektiertheit bloß zu stellen: westliches Denken spiegelt hier das Licht des Ostens gleichsam blind, nämlich ohne es zu reflektieren.
Rezepte gegen Rührseligkeit waren die Figuren nostalgischer Mythen nicht. Denn das hieße, sie pauschal zu verstehen im Sinne von Handlungsanweisungen, Gegengiften, Vorbildfiguren gegen das zu häufige Gerührtsein, gegen die Auflösung der hergebrachten Affektkontrolle, gegen zunelunende Gefühlsintensität, gegen die Tränen, die meist aus Ergriffenheit über moralische Konflikte, über besonders tugend- oder lasterstarke Situationen oder Menschen vergossen wurden. Die nostalgischen Mythen werden vielmehr, wie viele andere literarische Motive, seit den 60er Jahren des 18. Jahrhunderts in den Rahmen empfindsamer Denk-, Handlungsund Gestaltungsmuster gestellt, ordnen sich also einer Zeitströmung unter. "Rezepte" gegen das zu häufige Weinen sind diese Figuren nicht per se - weder der arkadische oder idyllische Schäfer und Hirte, der Landmann und Bauer, der physiokratische Musterbauer, der leidende Negersklave, der passiv-edle, aber moralisch überlegene gute Wilde, der (statt eines besseren Ausdrucks sei dieser Pleonasmus gestattet) "wilde" Wilde oder der "nordische" Wilde (sprich: der Kelte oder Germane), noch schließlich der Südseeinsulaner, wie er aus den Berichten nach der Entdeckung Tahitis in Europa literarisch Furore und Mode machte, sind als Gegenfiguren konzipiert. Eine gewisse Ausnalune - und mit diesem Vorbehalt werden sie in die Diskussion einbezogen - stellen allenfalls der aufständische Negersklave, der melancholische, barbarische Wilde und der von moralischen Tabus (scheinbar) unbelastete Südseeinsulaner dar. Man kann an diesen Figuren die Durchdringung literarischer Topoi mit Mustern der empfindsamen Strömung studieren. In den nostalgischen Mythen, in jenen vemeintlich archetypischen Formen "natürlichen" Lebens, die mit trauernder Sehnsucht als Gegenstand von Hoffnung oder Kritik (mit Blick auf die eigene Gegenwart) beschrieben werden, finden sich allerdings eine ganze Anzahl von Situationen und Figuren, in denen das rührselige Weinen umgedeutet wird. Man kann an solchen Figuren auch andere Tränen als die bloß moralisch rührenden entdecken und in diesen nostalgischen Vorstellungen von Natürlichkeit Verschreibungen von Widerstandskraft, ja sogar Auflehnung gegen handlungslose Weinerlichkeit finden.
Die Literatur der Bundesrepublik hat zwei Ursprünge: einen legitimen in Gestalt der während des Dritten Reiches verbotenen, verschlüsselten oder in der Emigration entstandenen Literatur und einen illegitimen, verleugneten in Gestalt von damals wie heute gelesenen, immer wieder aufgelegten und teilweise massenhaft verbreiteten Werken. Um einige der letzteren soll es im folgenden gehen. Dabei ist in der Frage der Kontinuität ein Trennungsstrich notwendig. Für die Literaturwissenschaft ist die Infragestellung des "Nullpunkts", des "Kahlschlags" nach 1945 in der belletristischen Literatur noch immer ein Thema, das emotional geführte Kontroversen auslöst. Im Bereich der Sachliteratur begann erst Ende der siebziger Jahre das Bewußtsein davon zu erwachen, daß ein Nullpunkt hier gar nicht vorhanden war. Für die Sekundärliteratur der fünfziger und sechziger Jahre scheint die Sachbuchproduktion des Dritten Reiches innerhalb der Gattungstradition entweder nicht zu existieren oder unbefragt-selbstverständlich zu sein! Sicher hängt dies damit zusammen, daß die Literaturwissenschaft insgesamt sich mit Sachliteratur nur marginal befaßt hat und dann meist nur als heftige Kritik an der literarischen Qualität. Typologisierungs- und Definilionsfragen, Probleme der Abrenzung von und in "Trivialliteratur" hatten den Vorrang vor inhaltlichen Analysen. Es erscheint manchmal auch nicht abwegig zu vermuten , daß die Beschränkung auf typologische Probleme auch eine Reduktion biographischer Art darstellt, etwa bei Autoren wie C. W. Ceram oder Erwin Barth von Wehrenalp.s Generell scheint es aber so zu sein, daß das Selbstverständnis von Sachbuchautoren und -lesern für bestimmte ideologische Implikationen blind blieb. Auch in dem 1978 als Teil von Kindlers Literaturgeschichte der Gegenwart erschienenen voluminösen Band "Die deutschsprachige Sachliteratur" wird nur in wenigen Artikeln (z. B. "Medizin", "Geographie") auf die ja für fast alle Gebiete vorhandene Tradition des Dritten Reiches wertend zurückgegriffen. Hervorzuheben ist allerdings, daß Ulf Diederichs in seiner Einleitung zu diesem Band sich ausführlich mit diesem Abschnitt der Gattungsgeschichte auseinandersetzt. Diese Einleitung gehört ebenso wie die Literaturgeschichte von Schütz/Vogt zu den Texten, die die oben angedeuteten Sicht blenden aufzureißen beginnen.
Georg Büchner ist ein schwieriger Autor - nicht nur für Literaturwissenschaftler. Im Deutschunterricht existierte Büchner bis 1945 praktisch überhaupt nicht - und neuerdings gibt es Stimmen, denen er wohl zu oft im Unterricht präsent ist. 1986 wird über Einseitigkeit im heutigen Deutschunterricht geklagt und als Beispiel angeführt: " ... wenn Oberstufenunterricht fast ausschließlich von Brecht, Böll und Büchner lebt". Die Schwierigkeiten des Deutschunterrichts mit Büchner sind eigentlich eher Schwierigkeiten des Deutschunterrichts mit sich selbst, d.h. mit der besonderen Aufgabe, die er für sich beansprucht. Denn es gibt im Deutschunterricht eine lange Tradition, mehr als Sprache und Literatur vermitteln zu wollen: eine Lebenshaltung, eine Einstellung, eine Ideologie, eine Weltanschauung, wie immer man es nennen will oder genannt hat: Lebenshilfe oder Bildung.
Intensive land use is a driving force for biodiversity decline in many ecosystems. In semi-natural grasslands, land-use activities such as mowing, grazing and fertilization affect the diversity of plants and arthropods, but the combined effects of different drivers and the chain of effects are largely unknown. In this study we used structural equation modelling to analyse how the arthropod communities in managed grasslands respond to land use and whether these responses are mediated through changes in resource diversity or resource quantity (biomass). Plants were considered resources for herbivores which themselves were considered resources for predators. Plant and arthropod (herbivores and predators) communities were sampled on 141 meadows, pastures and mown pastures within three regions in Germany in 2008 and 2009. Increasing land-use intensity generally increased plant biomass and decreased plant diversity, mainly through increasing fertilization. Herbivore diversity decreased together with plant diversity but showed no response to changes in plant biomass. Hence, land-use effects on herbivore diversity were mediated through resource diversity rather than quantity. Land-use effects on predator diversity were mediated by both herbivore diversity (resource diversity) and herbivore quantity (herbivore biomass), but indirect effects through resource quantity were stronger. Our findings highlight the importance of assessing both direct and indirect effects of land-use intensity and mode on different trophic levels. In addition to the overall effects, there were subtle differences between the different regions, pointing to the importance of regional land-use specificities. Our study underlines the commonly observed strong effect of grassland land use on biodiversity. It also highlights that mechanistic approaches help us to understand how different land-use modes affect biodiversity.
Objectives: To compare radiation dose and image quality of single-energy (SECT) and dual-energy (DECT) head and neck CT examinations performed with second- and third-generation dual-source CT (DSCT) in matched patient cohorts. Methods: 200 patients (mean age 55.1 ± 16.9 years) who underwent venous phase head and neck CT with a vendor-preset protocol were retrospectively divided into four equal groups (n = 50) matched by gender and BMI: second (Group A, SECT, 100-kV; Group B, DECT, 80/Sn140-kV), and third-generation DSCT (Group C, SECT, 100-kV; Group D, DECT, 90/Sn150-kV). Assess- ment of radiation dose was performed for an average scan length of 27 cm. Contrast-to-noise ratio measure- ments and dose-independent figure-of-merit calcu- lations of the submandibular gland, thyroid, internal jugular vein, and common carotid artery were analyzed quantitatively. Qualitative image parameters were evalu- ated regarding overall image quality, artifacts and reader confidence using 5-point Likert scales. Results: Effective radiation dose (ED) was not signifi- cantly different between SECT and DECT acquisition for each scanner generation (p = 0.10). Significantly lower effective radiation dose (p < 0.01) values were observed for third-generation DSCT groups C (1.1 ± 0.2 mSv) and D (1.0 ± 0.3 mSv) compared to second-generation DSCT groups A (1.8 ± 0.1 mSv) and B (1.6 ± 0.2 mSv). Figure-of- merit/contrast-to-noise ratio analysis revealed superior results for third-generation DECT Group D compared to all other groups. Qualitative image parameters showed non-significant differences between all groups (p > 0.06). Conclusion: Contrast-enhanced head and neck DECT can be performed with second- and third-generation DSCT systems without radiation penalty or impaired image quality compared with SECT, while third-generation DSCT is the most dose efficient acquisition method. Advances in knowledge: Differences in radiation dose between SECT and DECT of the dose-vulnerable head and neck region using DSCT systems have not been evaluated so far. Therefore, this study directly compares radiation dose and image quality of standard SECT and DECT protocols of second- and third-generation DSCT platforms.
Sphingosine‐1‐phosphate (S1P) regulates pathophysiological processes, including liver regeneration, vascular tone control, and immune response. In patients with liver cirrhosis, acute deterioration of liver function is associated with high mortality rates. The present study investigated whether serum S1P concentrations are associated with disease severity in patients with chronic liver disease from compensated cirrhosis (CC), acute decompensation (AD), or acute‐on‐chronic liver failure (ACLF). From August 2013 to October 2017, patients who were admitted to the University Hospital Frankfurt with CC, AD, or ACLF were enrolled in our cirrhosis cohort study. Tandem mass spectrometry was performed on serum samples of 127 patients to assess S1P concentration. Our study comprised 19 patients with CC, 55 with AD, and 51 with ACLF, aged 29 to 76 years. We observed a significant decrease of S1P according to advanced liver injury from CC and AD up to ACLF (P < 0.001). S1P levels further decreased with progression to ACLF grade 3 (P < 0.05), and S1P highly inversely correlated with the Model for End‐Stage Liver Disease score (r = −0.508; P < 0.001). In multivariate analysis, S1P remained an independent predictor of 7‐day mortality with high diagnostic accuracy (area under the curve, 0.874; P < 0.001). Conclusion: In patients with chronic liver disease, serum S1P levels dramatically decreased with advanced stages of liver disease and were predictive of early mortality. Because S1P is a potent regulator of endothelial integrity and immune response, low S1P levels may significantly influence progressive multiorgan failure. Our data justify further elucidation of the diagnostic and therapeutic role of S1P in ACLF.
Alcoholism is one of the leading and increasingly prevalent reasons of liver associated morbidity and mortality worldwide. Alcoholic hepatitis (AH) constitutes a severe disease with currently no satisfying treatment options. Lipoxin A4 (LXA4), a 15-lipoxygenase (ALOX15)-dependent lipid mediator involved in resolution of inflammation, showed promising pre-clinical results in the therapy of several inflammatory diseases. Since inflammation is a main driver of disease progression in alcoholic hepatitis, we investigated the impact of endogenous ALOX15-dependent lipid mediators and exogenously applied LXA4 on AH development. A mouse model for alcoholic steatohepatitis (NIAAA model) was tested in Alox12/15+/+ and Alox12/15−/− mice, with or without supplementation of LXA4. Absence of Alox12/15 aggravated parameters of liver disease, increased hepatic immune cell infiltration in AH, and elevated systemic neutrophils as a marker for systemic inflammation. Interestingly, i.p. injections of LXA4 significantly lowered transaminase levels only in Alox12/15−/− mice and reduced hepatic immune cell infiltration as well as systemic inflammatory cytokine expression in both genotypes, even though steatosis progressed. Thus, while LXA4 injection attenuated selected parameters of disease progression in Alox12/15−/− mice, its beneficial impact on immunity was also apparent in Alox12/15+/+ mice. In conclusion, pro-resolving lipid mediators may be beneficial to reduce inflammation in alcoholic hepatitis.
Background and aims: Spontaneous bacterial peritonitis (SBP) is a severe complication of decompensated cirrhosis. The prevalence of multidrug-resistant organisms (MDROs) in patients with cirrhosis is increasing. Identification of patients at risk for SBP due to MDROs (ie, SBP with the evidence of MDROs or Stenotrophomonas maltophilia in ascitic culture, MDRO-SBP) is crucial to the early adaptation of antibiotic treatment in such patients. We therefore investigated whether MDROs found in ascitic cultures can also be found in specimens determined by noninvasive screening procedures.
Patients and methods: This retrospective study was conducted at the liver center of the University Hospital Frankfurt, Germany. Between 2011 and 2016, patients with cirrhosis were included upon diagnosis of SBP and sample collection of aerobic/anaerobic ascitic cultures. Furthermore, the performance of at least one complete MDRO screening was mandatory for study inclusion.
Results: Of 133 patients diagnosed with SBP, 75 (56.4%) had culture-positive SBP and 22 (16.5%) had MDRO-SBP. Multidrug-resistant Escherichia coli (10/22; 45.5%) and vancomycin-resistant enterococci (7/22; 36.4%) resembled the major causatives of MDRO-SBP. Rectal swabs identified MDROs in 17 of 22 patients (77.3%) who developed MDRO-SBP with a time-dependent sensitivity of 77% and 87% after 30 and 90 days upon testing, while negative predictive value was 83% and 76%, respectively. The majority of patients were included from intensive care unit or intermediate care unit.
Conclusion: MDRO screening may serve as a noninvasive diagnostic tool to identify patients at risk for MDRO-SBP. Patients with decompensated cirrhosis should be screened for MDROs from the first day of inpatient treatment onward.
Der folgende Text entstand aus einem Vortrag, der am Germanistischen Seminar der Universität Heidelberg am 30.1. 1992 gehalten wurde. Er erschien im Druck in: Dietrich Harth (Hg.): Fiktion des Fremden. Erkundung kultureller Grenzen in Literatur und Publizistik. Frankfurt: Fischer Taschenbuch Verlag 1994, S. 83-112. In der deutschen literarischen Emigration nach Frankreich ab 1933 wird eine ganze Generation von Autoren gezwungen, ihr Denkmodell >Frankreich< mit der Realität zu konfrontieren. Das ist nicht nur ein imagologischer >Praxistest< im Vergleich von >Bild< und >Realität<, sondern es geht in diesem Ineinander von Selbst- und Fremddefinition im Grunde um die politische, geistige, psychologische Selbstfindung. Denn das positive Heteroimage >Frankreich< ist ganz eng an das sehr kritisch besetzte Autoimage >Deutschland< gebunden. Die in den images steckenden >imagotypen Makrostrukturen< werden sowohl in politische Hoffnungen und Erwartungen wie in literarische Phantasien umgesetzt. In Texten aller Gattungen - fiktionalen, journalistischen wie essayistischen - findet sich eine >fiktionale Sehweise< von Frankreich, die auf ihre Strukturen, auf Statik und Prozeßhaftigkeit befragt werden soll.
Background: Liver cirrhosis is associated with profound immunodysfunction, i.e. a parallel presence of chronic systemic inflammation and immunosuppression, which can result in acute-on-chronic liver failure (ACLF). Omega-3 fatty acids are precursors of pro-resolving mediators and support the resolution of inflammation.
Objective: The aim of this study was to determine plasma levels of omega-3 fatty acids in patients with liver cirrhosis and ACLF.
Methods: Patients with liver cirrhosis with and without ACLF were enrolled in a prospective cohort study and analyzed post-hoc for the present sub-study. Clinical data and biomaterials were collected at baseline and at day 7, 28 and after 3 months of follow-up. Plasma concentrations of arachidonic acid (ARA) and docosahexaenoic acid (DHA), which represent key omega-6 and -3 fatty acids, respectively, were quantified and associated with markers of systemic inflammation and severity of liver cirrhosis.
Results: A total of 117 patients were included in the present analyses. Of those, 26 (22.2%), 51 (43.6%) and 40 (34.2%) patients had compensated or decompensated liver cirrhosis, and ACLF. Plasma levels of ARA and DHA were similar in patients with compensated cirrhosis, decompensated cirrhosis, and ACLF. Furthermore, no significant association between plasma ARA or DHA and C-reactive protein or peripheral blood leukocytes were observed (P>0.05).
Conclusion: In our study plasma levels of key omega-3 and omega-6 fatty acid are neither associated with the severity of liver cirrhosis nor with liver-cirrhosis-associated systemic inflammation.
White paper peanut allergy
(2022)
The current management of a primary IgE-mediated peanut allergy consists of the two basic pillars “exposure prophylaxis” with avoidance of the allergen and “emergency therapy” with short-term treatment of an acute allergic reaction after accidental ingestion. Accidental reactions are common despite attempted avoidance. The severity of an allergic or even anaphylactic reaction after accidental ingestion is difficult to assess prior to reaction. In addition, reaction thresholds may vary depending on the accompanying augmentation factor. Therefore, every peanut allergic patient should receive individual dietary counseling as well as instructions for the use of the emergency kit and a structured patient education program (anaphylaxis group training), if necessary. For the first time, since fall 2021 a causal treatment option with a drug for oral immunotherapy will now be available for 4‑ to 17-year-old peanut-allergic children and adolescents. The oral immunotherapy with peanut protein as defatted powder of Arachis hypogaea L., semen (peanuts) leads to desensitization with a good efficacy record and an acceptable safety profile. Other treatment options with different therapeutic approaches are also under development and will probably expand the range for treatment in the coming years.
The current management of a primary IgE-mediated peanut allergy consists of the two basic pillars “exposure prophylaxis” with avoidance of the allergen and “emergency therapy” with short-term treatment of an acute allergic reaction after accidental ingestion. Accidental reactions are common despite attempted avoidance. The severity of an allergic or even anaphylactic reaction after accidental ingestion is difficult to assess prior to reaction. In addition, reaction thresholds may vary depending on the accompanying augmentation factor. Therefore, every peanut allergic patient should receive individual dietary counseling as well as instructions for the use of the emergency kit and a structured patient education program (anaphylaxis group training), if necessary. For the first time, since fall 2021 a causal treatment option with a drug for oral immunotherapy will now be available for 4‑ to 17-year-old peanut-allergic children and adolescents. The oral immunotherapy with peanut protein as defatted powder of Arachis hypogaea L., semen (peanuts) leads to desensitization with a good efficacy record and an acceptable safety profile. Other treatment options with different therapeutic approaches are also under development and will probably expand the range for treatment in the coming years.
Background: To perform a comprehensive study on the relationship between vitamin D metabolism and the response to interferon-α-based therapy of chronic hepatitis C.
Methodology/Principal Findings: Associations between a functionally relevant polymorphism in the gene encoding the vitamin D 1α-hydroxylase (CYP27B1-1260 rs10877012) and the response to treatment with pegylated interferon-α (PEG-IFN-α) and ribavirin were determined in 701 patients with chronic hepatitis C. In addition, associations between serum concentrations of 25-hydroxyvitamin D3 (25[OH]D3) and treatment outcome were analysed. CYP27B1-1260 rs10877012 was found to be an independent predictor of sustained virologic response (SVR) in patients with poor-response IL28B genotypes (15% difference in SVR for rs10877012 genotype AA vs. CC, p = 0.02, OR = 1.52, 95% CI = 1.061–2.188), but not in patients with favourable IL28B genotype. Patients with chronic hepatitis C showed a high prevalence of vitamin D insufficiency (25[OH]D3<20 ng/mL) during all seasons, but 25(OH)D3 serum levels were not associated with treatment outcome.
Conclusions/Significance: Our study suggests a role of bioactive vitamin D (1,25[OH]2D3, calcitriol) in the response to treatment of chronic hepatitis C. However, serum concentration of the calcitriol precursor 25(OH)D3 is not a suitable predictor of treatment outcome.
Background: Vitamin D insufficiency has been associated with the occurrence of various types of cancer, but causal relationships remain elusive. We therefore aimed to determine the relationship between genetic determinants of vitamin D serum levels and the risk of developing hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC).
Methodology/Principal Findings: Associations between CYP2R1, GC, and DHCR7 genotypes that are determinants of reduced 25-hydroxyvitamin D (25[OH]D3) serum levels and the risk of HCV-related HCC development were investigated for 1279 chronic hepatitis C patients with HCC and 4325 without HCC, respectively. The well-known associations between CYP2R1 (rs1993116, rs10741657), GC (rs2282679), and DHCR7 (rs7944926, rs12785878) genotypes and 25(OH)D3 serum levels were also apparent in patients with chronic hepatitis C. The same genotypes of these single nucleotide polymorphisms (SNPs) that are associated with reduced 25(OH)D3 serum levels were found to be associated with HCV-related HCC (P = 0.07 [OR = 1.13, 95% CI = 0.99–1.28] for CYP2R1, P = 0.007 [OR = 1.56, 95% CI = 1.12–2.15] for GC, P = 0.003 [OR = 1.42, 95% CI = 1.13–1.78] for DHCR7; ORs for risk genotypes). In contrast, no association between these genetic variations and liver fibrosis progression rate (P>0.2 for each SNP) or outcome of standard therapy with pegylated interferon-α and ribavirin (P>0.2 for each SNP) was observed, suggesting a specific influence of the genetic determinants of 25(OH)D3 serum levels on hepatocarcinogenesis.
Conclusions/Significance: Our data suggest a relatively weak but functionally relevant role for vitamin D in the prevention of HCV-related hepatocarcinogenesis.
Serial quantification of BCR–ABL1 mRNA is an important therapeutic indicator in chronic myeloid leukaemia, but there is a substantial variation in results reported by different laboratories. To improve comparability, an internationally accepted plasmid certified reference material (CRM) was developed according to ISO Guide 34:2009. Fragments of BCR–ABL1 (e14a2 mRNA fusion), BCR and GUSB transcripts were amplified and cloned into pUC18 to yield plasmid pIRMM0099. Six different linearised plasmid solutions were produced with the following copy number concentrations, assigned by digital PCR, and expanded uncertainties: 1.08±0.13 × 106, 1.08±0.11 × 105, 1.03±0.10 × 104, 1.02±0.09 × 103, 1.04±0.10 × 102 and 10.0±1.5 copies/μl. The certification of the material for the number of specific DNA fragments per plasmid, copy number concentration of the plasmid solutions and the assessment of inter-unit heterogeneity and stability were performed according to ISO Guide 35:2006. Two suitability studies performed by 63 BCR–ABL1 testing laboratories demonstrated that this set of 6 plasmid CRMs can help to standardise a number of measured transcripts of e14a2 BCR–ABL1 and three control genes (ABL1, BCR and GUSB). The set of six plasmid CRMs is distributed worldwide by the Institute for Reference Materials and Measurements (Belgium) and its authorised distributors (https://ec.europa.eu/jrc/en/reference-materials/catalogue/; CRM code ERM-AD623a-f).
Pathophysiological role of prostanoids in coagulation of the portal venous system in liver cirrhosis
(2019)
Background: Prostanoids are important regulators of platelet aggregation and thrombotic arterial diseases. Their involvement in the development of portal vein thrombosis, frequent in decompensated liver cirrhosis, is still not investigated.
Methods: Therefore, we used pro-thrombotic venous milieu generation by bare metal stent transjugular intrahepatic portosystemic shunt insertion, to study the role of prostanoids in decompensated liver cirrhosis. Here, 89 patients receiving transjugular intrahepatic portosystemic shunt insertion were included in the study, and baseline levels of thromboxane B2, prostaglandin D2 and prostaglandin E2 were measured in the portal and the hepatic vein.
Results: While the hepatic vein contained higher levels of thromboxane B2 than the portal vein, levels of prostaglandin E2 and D2 were higher in the portal vein (all P<0.0001). Baseline concentrations of thromboxane B2 in the portal vein were independently associated with an increase of portal hepatic venous pressure gradient during short term follow-up, as an indirect sign of thrombogenic potential (multivariable P = 0.004). Moreover, severity of liver disease was inversely correlated with portal as well as hepatic vein levels of prostaglandin D2 and E2 (all P<0.0001).
Conclusions: Elevated portal venous thromboxane B2 concentrations are possibly associated with the extent of thrombogenic potential in patients with decompensated liver cirrhosis.
Trial registration: ClinicalTrials.gov identifier: NCT03584204.