Fibrosis correlates with a ductular reaction in hepatitis C: Roles of impaired replication, progenitor cells and steatosis

The mechanisms for progressive fibrosis and exacerbation by steatosis in patients with chronic hepatitis C (HCV) are still unknown. We hypothesized that proliferative blockade in HCV-infected and steatotic hepatocytes results in the default activation of hepatic progenitor cells (HPC), capable of differentiating into both biliary and hepatocyte lineages, and that the resultant ductular reaction promotes portal fibrosis. To study this concept, 115 liver biopsy specimens from subjects with HCV were scored for steatosis, inflammation, and fibrosis. Biliary epithelium and HPC were decorated by cytokeratin 7 immunoperoxidase, and the replicative state of hepatocytes was assessed by p21 and Ki-67 immunohistochemistry. A ductular reaction at the portal interface was common. There was a highly significant correlation between the area of ductular reaction and fibrosis stage (r = 0.453, P < .0001), which remained independently associated after multivariate analysis. HPC numbers also correlated with fibrosis (r = 0.544, P < .0001) and the ductular area (r = 0.624, P < .0001). Moreover, steatosis correlated with greater HPC proliferation (r = 0.372, P = .0004) and ductular reaction (r = 0.374, P < .0001) but was not an obligate feature. Impaired hepatocyte replication by p21 expression was independently associated with HPC expansion (P = .002) and increased with the body mass index (P < .001) and lobular inflammation (P = .005). In conclusion, the strong correlation between portal fibrosis and a periportal ductular reaction with HPC expansion, the exacerbation by steatosis, and the associations with impaired hepatocyte replication suggest that an altered regeneration pathway drives the ductular reaction. We believe this triggers fibrosis at the portal tract interface. This may be a stereotyped response of importance in other chronic liver diseases.

In utero and postnatal maternal smoking and asthma in adolescence

Background: Asthma in early childhood has been associated with maternal smoking during pregnancy and parental smoking soon after birth. However, less is known about these exposures and the development of asthma symptoms in adolescence. Methods: Data were taken from the Mater University Study, of Pregnancy, a large birth cohort study of mothers and children enrolled in Brisbane, Australia, beginning in 1981. Smoking was assessed at 2 stages during pregnancy and at the 6-month and 5-year follow-up visits. Asthma was assessed from maternal reports that were provided when the child was age 14 years. We conducted multivariable multinomial logistic regression analyses to assess the effect of maternal smoking on asthma symptoms. Results: There was a strong sex interaction such that girls whose mothers had smoked heavily (20 or more cigarettes per day) in pregnancy and at the 6-month follow up had increased odds of experiencing asthma symptoms at age 14 (odds ratio = 1.96; 95% confidence interval = 1.25-3.08). The contribution of heavy smoking during pregnancy appeared to be stronger than heavy smoking after the birth. No similar associations were seen for boys. Conclusion: Female adolescents whose mothers smoked heavily during the fetal period and the early months of life have increased risk of asthma symptoms in adolescence. In utero exposure to heavy smoking was found to have a stronger effect than postnatal environmental tobacco exposure.

Socio-economic distribution of environmental risk factors for childhood injury

Objective: Childhood injury remains the single most important cause of mortality in children aged between 1-14 years in many countries. It has been proposed that lower socio-economic status (SES) and poorer housing contribute to potential hazards in the home environment. This study sought to establish whether the prevalence of observed hazards in and around the home was differentially distributed by SES, in order to identify opportunities for injury prevention. Methods: This study was a cross-sectional, random sample survey of primary school children from 32 schools in Brisbane. Interviews and house audits were conducted between July 2000 and April 2003 to collect information on SES (income, employment and education) and previously identified household hazards. Results: There was evidence of a relationship between prevalence of household environmental hazards and household SES; however, the magnitude and direction of this relationship appeared to be hazard-specific. Household income was related to play equipment characteristics, with higher SES groups being more likely to be exposed to risk. All three SES indicators were associated with differences in the home safety characteristics, with the lower SES groups more likely to be exposed to risk. Conclusion:The differential distribution of environmental risk factors by SES of household may help explain the SES differential in the burden of injury and provides opportunities for focusing efforts to address the problem.

Embedded progressive-three-layered fiber long-period gratings for respiratory monitoring

A long-period grating (LPG) was written into a progressive three-layered single-mode fiber that was embedded into a flexible platform as a curvature sensor. The spectral location and profile of the LPGs were unaltered after implantation in the platform. The curvature sensitivity was 3.747 nm m with a resolution of ± 1.1 × 10-2 m-1. The bend sensor is intended to be part of a respiratory monitoring system and was tested on a resuscitation training manikin. © 2003 society of Photo-Optical Instrumentation Engineers.

The interrogation and multiplexing of long period grating curvature sensors using a Bragg grating based, derivative spectroscopy technique

A long period grating is interrogated with a fibre Bragg grating using a derivative spectroscopy technique. A quasi-linear relationship between the output of the sensing scheme and the curvature experienced by the long period grating is demonstrated, with a sensitivity of 5.05 m and with an average curvature resolution of 2.9 × 10-2 m-1. In addition, the feasibility of multiplexing an in-line series of long period gratings with this interrogation scheme is demonstrated with two pairs of fibre Bragg gratings and long period gratings. With this arrangement the cross-talk error between channels was less than ± 2.4 × 10-3 m-1.

Bending and orientational characteristics of long period gratings written in D-shaped optical fiber

Long period gratings (LPGs) were written into a D-shaped single-mode fiber. These LPGs were subjected to a range of curvatures, and it was found that as curvature increased, there was increasingly strong coupling to certain higher order cladding modes without the usual splitting of the LPGs stopbands. A bend-induced stopband yielded a spectral sensitivity of 12.55 nm·m for curvature and 2.2×10-2 nm°C-1 for temperature. It was also found that the wavelength separation between adjacent bend-induced stopbands varied linearly as a function of curvature. Blue and red wavelength shifts of the stopbands were observed as the sensor was rotated around a fixed axis for a given curvature; thus, in principle, this sensor could be used to obtain bending and orientational information. The behavior of the stopbands was successfully modeled using a finite element approach.

Bend and index insensitive long period grating in progressive three layered optical fibre

A long period fibre grating written in a progressive three-layered optical fibre is shown to exhibit an attenuation band that has a very low bending sensitivity (5.1×10 –2 nm m) compared to normal step-index fibre, and is also insensitive to changes in the refractive index of the surrounding medium. Applications to sensing and telecommunications are discussed.

Sensing characteristics of a novel two-section long-period grating

The behavior of a temperature self-compensating, fiber, long-period grating (LPG) device is studied. This device consists of a single 325-µm-period LPG recorded across two sections of a single-mode B-Ge-codoped fiber—one section bare and the other coated with a 1-µm thickness of Ag. This structure generates two attenuation bands associated with the eighth and ninth cladding modes, which are spectrally close together (~60 nm). The attenuation band associated with the Ag-coated section is unaffected by changes in the refractive index of the surrounding medium and can be used to compensate for the temperature of the bare-fiber section. The sensor has a resolution of ±1.0 × 10-3 for the refractive index and ±0.3 °C for the temperature. The effect of bending on the spectral characteristics of the two attenuation bands was found to be nonlinear, with the Ag-coated LPG having the greater sensitivity.

Simultaneous refractive index and temperature measurement using cascaded long-period grating in double-cladding fibre

A compact scheme for simultaneous temperature and surrounding refractive index (SRI) measurement using two long-period gratings (LPGs) of different periods inscribed side-by-side in a single piece of a double-cladding fibre is presented. One of the LPGs is sensitive to both SRI and temperature, whilst the second is sensitive to temperature only.

Discrimination between strain and temperature effects using first and second-order diffraction from a long period grating

We study the effects of temperature and strain on the spectra of the first and second-order diffraction attenuation bands of a single long-period grating (LPG) in step-index fibre. The primary and second-order attenuation bands had comparable strength with the second-order bands appearing in the visible and near-infra red parts of the spectrum. Using first and second-order diffraction to the eighth cladding mode a sensitivity matrix was obtained with limiting accuracy given by cross-sensitivity of ~1.19% of the measurement. The sensing scheme presented as a limiting temperature and strain resolution of ±0.7 °C and ~±25 µ.

A comparison of the sensing characteristics of long period gratings written in three different types of fiber

This paper compares the environmental sensing behaviour of long period gratings written in three fibers with different refractive index profiles: step, W and a progressive three layered fiber. The measurands considered are temperature, refractive index, axial strain and bending, and the spectral behaviour of individual attenuation bands were observed and, where possible, compared to theoretical predictions. Significant differences in the behaviour of the three fiber types were found.

Embedded progressive-three-layered fiber long-period gratings for respiratory monitoring

A long-period grating (LPG) was written into a progressive three-layered single-mode fiber that was embedded into a flexible platform as a curvature sensor. The spectral location and profile of the LPGs were unaltered after implantation in the platform. The curvature sensitivity was 3.747 nm m with a resolution of ±1.1×10–2 m–1. The bend sensor is intended to be part of a respiratory monitoring system and was tested on a resuscitation training manikin.