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Dariusz Marek Lebensztejn

Publications and source records attributed to Dariusz Marek Lebensztejn.

11 recordsLinked to original sources
PubMed2006

Ultrastructure of Kupffer cells and hepatocytes in the Dubin-Johnson syndrome: a case report.

Ultrastructure of Kupffer cells and hepatocytes in liver bioptate was evaluated in a 17-year-old boy with Dubin-Johnson syndrome (DJS). The liver tissue obtained by needle biopsy was fixed in glutaraldehyde and paraformaldehyde and routinely processed for electron microscopic analysis. The ultrastructural examinations of liver bioptate revealed the accumulation of membrane-bound, electron-dense lysosomal granules within the cytoplasm of hepatocytes, characteristic of DJS. They were located mainly in the vicinity of the biliary pole, and preferentially in the centrilobular region that corresponded to the pigment deposits seen under light microscope. The presence of the granules was accompanied by dilated elements of the granular endoplasmic reticulum and paracrystalline mitochondrial inclusions as well as dilation of the bile canaliculi. The changes in hepatocytes co-existed with marked stimulation and enhanced phagocytic activity of Kupffer cells. This was manifested in the accumulation of pigment deposits within their cytoplasm that corresponded to those observed in hepatocytes. Hyperactive pericentral Kupffer cells which are involved in the response to pigmentary material originating from disintegrated hepatocytes may play an essential role in the development of DJS.

Adolescent↗
PubMed2005

Diagnostic accuracy of serum biochemical fibrosis markers in children with chronic hepatitis B evaluated by receiver operating characteristics analysis.

AIM: To investigate the diagnostic accuracy of potent serum biochemical fibrosis markers in children with chronic hepatitis B evaluated by receiver operating characteristics (ROC) analysis. METHODS: We determined the serum level of apolipoprotein A-I (APO A-I), haptoglobin (HPT) and a-2 macroglobulin (A2M) with an automatic nephelometer in 63 children (age range 4-17 years, mean 10 years) with biopsy-verified chronic HBeAg-positive hepatitis B. Fibrosis stage and inflammation grade were assessed in a blinded fashion according to Batts and Ludwig. We defined mild liver fibrosis as a score < or =2 and advanced fibrosis as a score equal to 3. ROC analysis was used to calculate the power of the assays to detect advanced liver fibrosis (AccuROC, Canada). RESULTS: Serum concentrations of APO A-I, HPT and A2M were not significantly different in patients with chronic hepatitis B compared to controls. However, APO A-I level of 1.19 ng/L had a sensitivity of 85.7% and a specificity of 60.7% (AUC = 0.7117, P = 0.035) to predict advanced fibrosis. All other serum biochemical markers and their combination did not allow a useful prediction. None of these markers was a good predictor of histologic inflammation. CONCLUSION: Apolipoprotein A-I may be a suitable serum marker to predict advanced liver fibrosis in children with chronic hepatitis B.

Adolescent↗
PubMed2005

[The evaluation of hyaluronic acid and laminin concentration in serum in children with chronic hepatitis B treated with lamivudine, unresponsive to previous interferon-alpha therapy].

UNLABELLED: THE AIM OF THE STUDY was to evaluate prospectively serum hyaluronic acid (HA) and laminin (LAM) concentration in children with chronic hepatitis B (chB) during lamivudine treatment. MATERIAL AND METHODS: The observation was carried out on 40 children (29 boys and 11 girls), aged 4-17 yrs with biopsy proven chB who were nonresponders to previous IFN alpha therapy. Lamivudine was given in the dose of 3-4mg/kg/day up to 100 mg/day. The concentration of HA and LAM were measured with EIA technique in serum (CORGENIX and TAKARA kits respectively) before and after 12 months of therapy. RESULTS: After 12 months of therapy mean serum concentration of HA and LAM were lower then before treatment (20.3 +/- 13.3 vs 26.1 +/- 18.2 ng/ml, p=0.0112; 430 +/- 93 vs 455 +/- 161 ng/ml, p=NS respectively). The decrease of HA concentration was observed in subgroups of both responders and nonresponders (21.9 +/- 10.9 vs 26.1 +/- 10.6, p=NS; 20.1 +/- 13.7 vs 26.1 +/- 19.0, p=0.01 resp.). CONCLUSION: The decrease of HA and LAM serum concentration may suggest that lamivudine treatment inhibits liver fibrosis. Further studies with liver morphology evaluation are needed to confirm antifibrotic effect of lamivudine in children with chB.

Adolescent↗
PubMed2005

[Serum gamma-glutamyl transpeptidase activity in children with chronic hepatitis B].

UNLABELLED: THE AIM OF THE STUDY was evaluation of serum activity of chosen enzymes (ALT, AST, GGT and ALP) in assessment of fibrosis degree in children with chronic hepatitis B. MATERIAL AND METHODS: We determined serum activity of liver enzymes in 47 children aged 4-16 with biopsy-verified chronic hepatitis B, prior to interferon alpha treatment. Fibrosis stage was assessed in a blinded fashion according to Batts and Ludwig. We defined advanced fibrosis as a score =3. Receiver operating characteristics (ROC) analysis was used to calculate the power of the assays to detect advanced liver fibrosis (AccuROC, Canada). RESULTS: Serum GGT activity of 19 IU/I had a sensitivity of 50% and a specificity of 90% (AUC=0.7324, p=0.0391) to predict advanced fibrosis. All other enzymes did not allow a useful prediction. CONCLUSION: GGT is suitable serum marker to predict advanced liver fibrosis in children with chronic hepatitis B.

Adolescent↗
PubMed2005

[Reversibility of advanced liver fibrosis--therapeutic possibility and biochemical monitoring of the disease].

The advanced liver fibrosis and cirrhosis had been regarded irreversible until quite lately. However, experimental and clinical studies confirmed possibility of stopping or even decreasing the stage of liver fibrosis through causal factor elimination and application of pharmacological preparation of potential antifibrotic activity. The morphological examination of liver bioptate is a "gold standard" in assessment of liver fibrosis stage. However it is an invasive procedure and has several limitation such as "sampling error". Therefore several biochemical blood tests for liver fibrosis have been evaluated which are less invasive and give possibility of long-term monitoring of the course of disease and possible changes caused by treatment. The non-invasive markers of liver fibrosis include extracellular matrix components (ECM) as well as non-ECM biochemical panels (FibroTest, Forns index, APRI). Significant progress in diagnostics and treatment confirmed the reversibility of liver fibrosis. However, reversibility of cirrhosis still becomes controversial. Further investigations of antifibrotic drugs and settlement of proper biochemical blood panel for better monitoring of possible disease regression are needed.

Antiviral Agents↗
PubMed2004

[The HBeAg/antiHBe seroconversion as a result of lamivudine treatment in children with chronic hepatitis B unresponsive to previous interferon alpha therapy].

UNLABELLED: The aim of the study was evaluation the HBeAg/antiHBe seroconversion frequency as a result of lamivudine treatment in children who are nonresponders to previous IFN-alpha therapy. MATERIAL AND METHODS: The observation was carried out on 41 children, aged 4-17 years, with biopsy-proven chronic hepatitis B (HBeAg+) treated with lamivudine 3-4 mg/kg/d (max. 100 mg/d) for 12 months. RESULTS: After 6 months of lamivudine therapy 59.3% children normalized GPT activity and only 1 child (2.5%) lost HBeAg. At the end of 12 months of therapy 81.5% normalized GPT activity and 4 of them (10%) lost HBeAg and seroconverted to antiHBe. None of treated children lost HBsAg. The age, sex, pretreatment GPT activity and active histological disease were not predictors of lamivudine-induced HBeAg loss. There were no side effects of lamivudine therapy except one boy who had severe thrombocytopenia. CONCLUSIONS: The HBeAg/antiHBe seroconversion rate after one year trial of lamivudine in children with chronic hepatitis B unresponsive to previous IFN alpha therapy was 10%. The age, sex, pretreatment GPT activity and active histologic disease were not predictors of lamivudine-induced HBeAg loss.

Adolescent↗
PubMed2003

[The serum concentration of transforming growth factor beta1, interleukin 12 and interleukin 5 in children with chronic hepatitis B].

The aim of the study was to evaluate the serum TGF-beta 1, IL-12 and IL-5 concentration in children with chronic hepatitis (ChH) B. The study included 62 children with histopathologically diagnosed chh B. The stage of fibrosis and inflammation grade were assessed according to Batts and Ludwig and Ishak et al. The control group consisted of 9 children without clinical signs of infectious and chronic diseases. Serum TGF-beta 1 concentration was significantly elevated in patients with chronic hepatitis B (p = 0.0077) as compared to controls; there were no significant differences in serum concentrations of IL-12 and IL-5 between the examined groups of children. There was also no correlation between serum concentration of the studied cytokines and the degree of fibrosis, inflammation, activity of GPT, GOT, ALP, GGTP and concentrations of bilirubin, proteins or immunoglobulins (G, A, M).

Adolescent↗
PubMed2002

[SEN virus--novel hepatotropic agent causing hepatitis?].

The author presents the review of world literature on infection of novel discovered SEN virus (SENV) after the initials of the infected patients, a human immunodeficiency virus-infected injection drug user. This single-stranded DNA virus, distantly related to the TT virus (TTV) has been announced as a major cause of non-A-E hepatitis. Genotypes SENV-D and SENV-H were more prevalent in the serum samples of patients with transfusion-associated hepatitis and were of lesser prevalence in serum samples from healthy blood donors.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Serum concentration of transforming growth factor (TGF)-beta 1 does not predict advanced liver fibrosis in children with chronic hepatitis B.

BACKGROUND/AIMS: The aim of the study was to evaluate if measurement of TGF-beta1 has clinical usefulness as a marker of liver fibrosis using ROC analysis and to assess its serum concentration during IFN alpha treatment. METHODOLOGY: Fibrosis stage and inflammation grade were assessed according to Batts and Ludwig and Ishak et al. before and 12 months after the end of IFN alpha treatment of 30 children with chronic hepatitis B. TGF-beta1 was measured by means of the quantitative sandwich enzyme immunoassay technique using recombinant human TGF-beta soluble receptor type II as a solid phase pre-coated onto a microplate (R&D System Inc., Minneapolis, USA). RESULTS: There was no significant correlation between serum TGF-beta1 level and the stage of liver fibrosis. However TGF-beta1 levels in patients before IFN alpha therapy were significantly higher than in controls. IFN alpha treatment did not improve histological fibrosis during 18 months of observation and it did not cause any significant changes in serum TGF-beta1 levels although there was a tendency to decrease its level during therapy and follow-up. CONCLUSIONS: Serum concentration of TGF-beta1 does not predict advanced liver fibrosis in children with chronic hepatitis B.

Adolescent↗