Journal articles: 'Bloc-or'

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Johal, Kavan S., and David Floyd. "To Bloc or Not to Bloc: Challenges in the Management of Patients Requesting “En-Bloc Capsulectomy”." Aesthetic Surgery Journal 40, no. 9 (June 15, 2020): NP561—NP563. http://dx.doi.org/10.1093/asj/sjaa115.

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Bowman, Chakriya. "Yen bloc or koala bloc? Currency relationships after the East Asian crisis." Japan and the World Economy 17, no. 1 (January 2005): 83–96. http://dx.doi.org/10.1016/j.japwor.2003.09.002.

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Dubuisson, J. B., and C. Chapron. "Le bloc opératoire endoscopique OR 1." Gynécologie Obstétrique & Fertilité 31, no. 4 (April 2003): 382–87. http://dx.doi.org/10.1016/s1297-9589(03)00060-2.

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Shirono, Kazuko. "Yen Bloc or Yuan Bloc: An Analysis of Currency Arrangements in East Asia." IMF Working Papers 09, no. 3 (2009): 1. http://dx.doi.org/10.5089/9781451871500.001.

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Türkoğlu, Ahmet, Abdullah Oğuz, Gizem Yaman, Mesut Gül, and Burak Veli Ülger. "Laparoscopic splenectomy: clip ligation or en-bloc stapling?" Turkish Journal of Surgery 35, no. 4 (December 16, 2019): 273–77. http://dx.doi.org/10.5578/turkjsurg.4276.

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Grimberg, Dominic C., Ankeet Shah, and Brant A. Inman. "En Bloc Resection of Bladder Tumors: Style or Substance?" European Urology 78, no. 4 (October 2020): 570–71. http://dx.doi.org/10.1016/j.eururo.2020.05.019.

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Kamusella, Tomasz. "The Jewess Hana, or Antisemitism in the Soviet Bloc." Narracje o Zagładzie, no. 1(7) (May 18, 2021): 261–71. http://dx.doi.org/10.31261/noz.2021.07.17.

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The article is devoted to the first novel of the Sorbian writer Jurij Koch entitled Židowka Hana [The Jewess Hana], published in 1963. Curiously, it contains in its title the ethnonym “Jewess,” which breached the antisemitic line then adopted across the Soviet bloc. Perhaps, this ideological transgression explains why this novel was not translated into German or the bloc’s other languages during the communist period. Sorbian-language novels were (and still are) few and apart, so the East German authorities, for the sake of the official promotion of minority cultures, supported thetranslation of them into German and other “socialist languages.” But not in this case. The important work languished half-forgotten in its Upper Sorbian original and in the 1966 Lower Sorbian translation. Only three decades after the fall of communism and the reunification of Germany, the author prepared and successfully published the German-language version of this novel in 2020.

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Cao, Liangliang, and Jie Ma. "EMBR-05. THE TENTATIVE APPLICATION OF EN BLOC CONCEPT IN THE PEDIATRIC BRAIN TUMOR: EXPERIENCE FROM A LARGE PEDIATRIC CENTER IN CHINA." Neuro-Oncology 23, Supplement_1 (June 1, 2021): i6. http://dx.doi.org/10.1093/neuonc/noab090.023.

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Abstract Background The less allowable blood loss and tolerance of intraoperative blood loss of children lead to the high rate of massive blood transfusion in the treatment of brain tumor. The surgical concepts of en bloc resection may contribute to the improvement of brain tumor resection. Objective To investigate the effects of en bloc concept on short outcomes of pediatric brain tumors and factors associated with the application of en bloc concept. Methods According to the surgical concept involved, the patients were divided into three subgroups-complete en bloc concept, partial en bloc concept and piecemeal concept. The matching-comparison (piecemeal group and en bloc group formed from the first two subgroups) was conducted based on age, tumor location, lesion volume, and pathological diagnosis to investigate effect of the en bloc concept on the short-term outcomes. Then the patient data after January 2018, when the en bloc concept was routinely integrated into brain tumor surgery in our medical center, were reviewed and analyzed to find out the predictors associated with the application of en bloc concept. Results In the en bloc group, the perioperative outcomes, including hospital stay (p=0.001), PICU stay (p=0.003), total blood loss(p=0.015), transfusion rate(p=0.005) and complication rate(p=0.039), were all significantly improved. The multinomial logistic regression analysis showed that tumor volume and imaging features, like bottom vessel, encasing nerve or pass-by vessel, finger-like attachment, ratio of “limited line” and ratio of “clear line” remained independent factors for the application of en bloc concept in our medical center. Conclusion This study supports the application of complete or partial en bloc concept in the pediatric brain tumor surgery referring to the preoperative imaging features, and compared with piecemeal concept, en bloc concept can improve the short outcomes without significant increases in neurological complication. Large series and Additional supportive evidence are still warranted.

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Salazar, G., B. Craige, M. L. Styers, K. A. Newell-Litwa, M. M. Doucette, B. H. Wainer, J. M. Falcon-Perez, et al. "BLOC-1 Complex Deficiency Alters the Targeting of Adaptor Protein Complex-3 Cargoes." Molecular Biology of the Cell 17, no. 9 (September 2006): 4014–26. http://dx.doi.org/10.1091/mbc.e06-02-0103.

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Mutational analyses have revealed many genes that are required for proper biogenesis of lysosomes and lysosome-related organelles. The proteins encoded by these genes assemble into five distinct complexes (AP-3, BLOC-1-3, and HOPS) that either sort membrane proteins or interact with SNAREs. Several of these seemingly distinct complexes cause similar phenotypic defects when they are rendered defective by mutation, but the underlying cellular mechanism is not understood. Here, we show that the BLOC-1 complex resides on microvesicles that also contain AP-3 subunits and membrane proteins that are known AP-3 cargoes. Mouse mutants that cause BLOC-1 or AP-3 deficiencies affected the targeting of LAMP1, phosphatidylinositol-4-kinase type II alpha, and VAMP7-TI. VAMP7-TI is an R-SNARE involved in vesicle fusion with late endosomes/lysosomes, and its cellular levels were selectively decreased in cells that were either AP-3- or BLOC-1–deficient. Furthermore, BLOC-1 deficiency selectively altered the subcellular distribution of VAMP7-TI cognate SNAREs. These results indicate that the BLOC-1 and AP-3 protein complexes affect the targeting of SNARE and non-SNARE AP-3 cargoes and suggest a function of the BLOC-1 complex in membrane protein sorting.

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Suki, Dima, Mustafa Aziz Hatiboglu, Akash J. Patel, Jeffrey S. Weinberg, Morris D. Groves, Anita Mahajan, and Raymond Sawaya. "COMPARATIVE RISK OF LEPTOMENINGEAL DISSEMINATION OF CANCER AFTER SURGERY OR STEREOTACTIC RADIOSURGERY FOR A SINGLE SUPRATENTORIAL SOLID TUMOR METASTASIS." Neurosurgery 64, no. 4 (April 1, 2009): 664–76. http://dx.doi.org/10.1227/01.neu.0000341535.53720.3e.

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Abstract OBJECTIVE To test the hypothesis that differential risks of developing leptomeningeal disease (LMD) exist in patients having a single supratentorial brain metastasis resected via a piecemeal or en bloc approach or treated with stereotactic radiosurgery (SRS). METHODS Between 1993 and 2006, 827 patients with a supratentorial brain metastasis underwent resection or SRS at The University of Texas M.D. Anderson Cancer Center. The primary outcome was the incidence of LMD. RESULTS Resection was performed piecemeal in 191 patients and en bloc in 351 patients; 285 patients received SRS. LMD occurred in 33 patients, 29 in the resection group and 4 in the SRS group. Risk of LMD was significantly higher with piecemeal tumor resection than with other procedures (SRS: hazard ratio [HR] for piecemeal, 5.8; 95% confidence interval [CI], 1.9–17.2; P = 0.002; en bloc, HR for piecemeal, 2.7; 95% CI, 1.3–5.6; P = 0.009). The difference between piecemeal and en bloc was particularly pronounced in patients with a melanoma primary (HR, 8.4; 95% CI, 1.8–39.2; P = 0.007). The risk of LMD was not significantly different between en bloc resection and SRS (HR for en bloc, 2.1; 95% CI, 0.7–6.4; P = 0.21). Similar results were obtained when comparing effects of SRS and both resection approaches after limiting the sample to patients with tumors in a specific volume range. CONCLUSION Piecemeal resection of a supratentorial brain metastasis carries a higher risk of LMD than en bloc resection or SRS. Further assessment of the role of the 2 surgical resection approaches and SRS in a controlled prospective setting with large numbers of patients is warranted.

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Spies, Claryn. "Reading Black Bloc Aesthetically." Theory in Action 14, no. 1 (January 31, 2021): 39–62. http://dx.doi.org/10.3798/tia.1937-0237.2103.

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While black bloc has been persistently misunderstood and maligned by the mainstream media and leftist intellectuals alike, rereading this tactic as an aesthetic practice opens new and more interesting methods of appraisal. This paper considers three ways of reading black bloc: first, how participation in a black bloc can be an ontologically transformative experience for its participants; second, how property destruction associated with black blocs can have transformative effects on its spectators; and third, how black bloc is particularly well-suited to what Jacques Rancière calls the redistribution of the sensible. These accounts provide alternative lenses through which black bloc can be brought into focus, and suggest that the bloc’s lack of concrete demands or fixed membership, its fleeting temporality, and its refusal to either identify itself with a particular party or class, or to engage with “politics as usual”—the very things that frustrate its critics—can be read as its greatest strengths. In entertaining a multiplicity of ways of seeing black blocs, we may loosen ourselves from the prevailing criticisms that eschew nontraditional forms of demonstrations, and shift the horizon of what we find to be politically possible. [Article copies available for a fee from The Transformative Studies Institute. E-mail address: journal@transformativestudies.org Website: http://www.transformativestudies.org ©2021 by The Transformative Studies Institute. All rights reserved.] KEYWORDS: Aesthetics, Direct Action, Anonymity, Subjectivity, Jacques Rancière.

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Handoyo, Rossanto Dwi, Lilik Sugiharti, and Miguel Angel Esquivias Padilla. "TRADE CREATION AND TRADE DIVERSION EFFECTS: THE CASE OF THE ASEAN PLUS SIX FREE TRADE AREA." Buletin Ekonomi Moneter dan Perbankan 24, no. 1 (April 14, 2021): 93–118. http://dx.doi.org/10.21098/bemp.v24i1.1163.

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This study examines whether trade agreements promoted under the ASEAN+6 over the period 2007-2017 supported trade creation and/or trade diversion effects within three export product groups, namely, manufactured goods, primary products, and natural resources-based goods. Using a gravity model, we note that primary products offer pure trade creation (greater intra-bloc and extra-bloc trade). Manufactured products experienced trade creation in intra-bloc and extrabloc exports, while natural resources-based goods show trade creation in intraregional exports and trade creation in imports from extra-bloc.

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John Peter, Arun T., Jens Lachmann, Meenakshi Rana, Madeleine Bunge, Margarita Cabrera, and Christian Ungermann. "The BLOC-1 complex promotes endosomal maturation by recruiting the Rab5 GTPase-activating protein Msb3." Journal of Cell Biology 201, no. 1 (April 1, 2013): 97–111. http://dx.doi.org/10.1083/jcb.201210038.

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Membrane microcompartments of the early endosomes serve as a sorting and signaling platform, where receptors are either recycled back to the plasma membrane or forwarded to the lysosome for destruction. In metazoan cells, three complexes, termed BLOC-1 to -3, mediate protein sorting from the early endosome to lysosomes and lysosome-related organelles. We now demonstrate that BLOC-1 is an endosomal Rab-GAP (GTPase-activating protein) adapter complex in yeast. The yeast BLOC-1 consisted of six subunits, which localized interdependently to the endosomes in a Rab5/Vps21-dependent manner. In the absence of BLOC-1 subunits, the balance between recycling and degradation of selected cargoes was impaired. Additionally, our data show that BLOC-1 is both a Vps21 effector and an adapter for its GAP Msb3. BLOC-1 and Msb3 interacted in vivo, and both mutants resulted in a redistribution of active Vps21 to the vacuole surface. We thus conclude that BLOC-1 controls the lifetime of active Rab5/Vps21 and thus endosomal maturation along the endocytic pathway.

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Setty, Subba Rao Gangi, Danièle Tenza, Steven T. Truschel, Evelyn Chou, Elena V. Sviderskaya, Alexander C. Theos, M. Lynn Lamoreux, et al. "BLOC-1 Is Required for Cargo-specific Sorting from Vacuolar Early Endosomes toward Lysosome-related Organelles." Molecular Biology of the Cell 18, no. 3 (March 2007): 768–80. http://dx.doi.org/10.1091/mbc.e06-12-1066.

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Hermansky-Pudlak syndrome (HPS) is a genetic disorder characterized by defects in the formation and function of lysosome-related organelles such as melanosomes. HPS in humans or mice is caused by mutations in any of 15 genes, five of which encode subunits of biogenesis of lysosome-related organelles complex (BLOC)-1, a protein complex with no known function. Here, we show that BLOC-1 functions in selective cargo exit from early endosomes toward melanosomes. BLOC-1–deficient melanocytes accumulate the melanosomal protein tyrosinase-related protein-1 (Tyrp1), but not other melanosomal proteins, in endosomal vacuoles and the cell surface due to failed biosynthetic transit from early endosomes to melanosomes and consequent increased endocytic flux. The defects are corrected by restoration of the missing BLOC-1 subunit. Melanocytes from HPS model mice lacking a different protein complex, BLOC-2, accumulate Tyrp1 in distinct downstream endosomal intermediates, suggesting that BLOC-1 and BLOC-2 act sequentially in the same pathway. By contrast, intracellular Tyrp1 is correctly targeted to melanosomes in melanocytes lacking another HPS-associated protein complex, adaptor protein (AP)-3. The results indicate that melanosome maturation requires at least two cargo transport pathways directly from early endosomes to melanosomes, one pathway mediated by AP-3 and one pathway mediated by BLOC-1 and BLOC-2, that are deficient in several forms of HPS.

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Sharda, Anish V., Alexandra M. Barr, Joshua A. Harrison, Adrian R. Wilkie, Chao Fang, Lourdes M. Mendez, Ionita C. Ghiran, Joseph E. Italiano, and Robert Flaumenhaft. "VWF maturation and release are controlled by 2 regulators of Weibel-Palade body biogenesis: exocyst and BLOC-2." Blood 136, no. 24 (December 10, 2020): 2824–37. http://dx.doi.org/10.1182/blood.2020005300.

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Abstract von Willebrand factor (VWF) is an essential hemostatic protein that is synthesized in endothelial cells and stored in Weibel-Palade bodies (WPBs). Understanding the mechanisms underlying WPB biogenesis and exocytosis could enable therapeutic modulation of endogenous VWF, yet optimal targets for modulating VWF release have not been established. Because biogenesis of lysosomal related organelle-2 (BLOC-2) functions in the biogenesis of platelet dense granules and melanosomes, which like WPBs are lysosome-related organelles, we hypothesized that BLOC-2–dependent endolysosomal trafficking is essential for WPB biogenesis and sought to identify BLOC-2–interacting proteins. Depletion of BLOC-2 caused misdirection of cargo-carrying transport tubules from endosomes, resulting in immature WPBs that lack endosomal input. Immunoprecipitation of BLOC-2 identified the exocyst complex as a binding partner. Depletion of the exocyst complex phenocopied BLOC-2 depletion, resulting in immature WPBs. Furthermore, releasates of immature WPBs from either BLOC-2 or exocyst-depleted endothelial cells lacked high-molecular weight (HMW) forms of VWF, demonstrating the importance of BLOC-2/exocyst-mediated endosomal input during VWF maturation. However, BLOC-2 and exocyst showed very different effects on VWF release. Although BLOC-2 depletion impaired exocytosis, exocyst depletion augmented WPB exocytosis, indicating that it acts as a clamp. Exposure of endothelial cells to a small molecule inhibitor of exocyst, Endosidin2, reversibly augmented secretion of mature WPBs containing HMW forms of VWF. These studies show that, although BLOC-2 and exocyst cooperate in WPB formation, only exocyst serves to clamp WPB release. Exocyst function in VWF maturation and release are separable, a feature that can be exploited to enhance VWF release.

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Futter, Clare E., and Daniel F. Cutler. "Coming or going? Un-BLOC-ing delivery and recycling pathways during melanosome maturation." Journal of Cell Biology 214, no. 3 (August 1, 2016): 245–47. http://dx.doi.org/10.1083/jcb.201607023.

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Melanosome biogenesis requires successive waves of cargo delivery from endosomes to immature melanosomes, coupled with recycling of the trafficking machinery. Dennis et al. (2016. J. Cell Biol. http://dx.doi.org/10.1083/jcb.201605090) report differential roles for BLOC-1 and BLOC-3 complexes in delivery and recycling of melanosomal biogenetic components, supplying directionality to melanosome maturation.

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Nazarian, Ramin, Marta Starcevic, Melissa J. Spencer, and Esteban C. Dell'Angelica. "Reinvestigation of the dysbindin subunit of BLOC-1 (biogenesis of lysosome-related organelles complex-1) as a dystrobrevin-binding protein." Biochemical Journal 395, no. 3 (April 11, 2006): 587–98. http://dx.doi.org/10.1042/bj20051965.

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Dysbindin was identified as a dystrobrevin-binding protein potentially involved in the pathogenesis of muscular dystrophy. Subsequently, genetic studies have implicated variants of the human dysbindin-encoding gene, DTNBP1, in the pathogeneses of Hermansky–Pudlak syndrome and schizophrenia. The protein is a stable component of a multisubunit complex termed BLOC-1 (biogenesis of lysosome-related organelles complex-1). In the present study, the significance of the dystrobrevin–dysbindin interaction for BLOC-1 function was examined. Yeast two-hybrid analyses, and binding assays using recombinant proteins, demonstrated direct interaction involving coiled-coil-forming regions in both dysbindin and the dystrobrevins. However, recombinant proteins bearing the coiled-coil-forming regions of the dystrobrevins failed to bind endogenous BLOC-1 from HeLa cells or mouse brain or muscle, under conditions in which they bound the Dp71 isoform of dystrophin. Immunoprecipitation of endogenous dysbindin from brain or muscle resulted in robust co-immunoprecipitation of the pallidin subunit of BLOC-1 but no specific co-immunoprecipitation of dystrobrevin isoforms. Within BLOC-1, dysbindin is engaged in interactions with three other subunits, named pallidin, snapin and muted. We herein provide evidence that the same 69-residue region of dysbindin that is sufficient for dystrobrevin binding in vitro also contains the binding sites for pallidin and snapin, and at least part of the muted-binding interface. Functional, histological and immunohistochemical analyses failed to detect any sign of muscle pathology in BLOC-1-deficient, homozygous pallid mice. Taken together, these results suggest that dysbindin assembled into BLOC-1 is not a physiological binding partner of the dystrobrevins, likely due to engagement of its dystrobrevin-binding region in interactions with other subunits.

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Yuan, Yefeng, Teng Liu, Xiahe Huang, Yuanying Chen, Weilin Zhang, Ting Li, Lin Yang, et al. "A zinc transporter, transmembrane protein 163, is critical for the biogenesis of platelet dense granules." Blood 137, no. 13 (April 1, 2021): 1804–17. http://dx.doi.org/10.1182/blood.2020007389.

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Abstract Lysosome-related organelles (LROs) are a category of secretory organelles enriched with ions such as calcium, which are maintained by ion transporters or channels. Homeostasis of these ions is important for LRO biogenesis and secretion. Hermansky-Pudlak syndrome (HPS) is a recessive disorder with defects in multiple LROs, typically platelet dense granules (DGs) and melanosomes. However, the underlying mechanism of DG deficiency is largely unknown. Using quantitative proteomics, we identified a previously unreported platelet zinc transporter, transmembrane protein 163 (TMEM163), which was significantly reduced in BLOC-1 (Dtnbp1sdy and Pldnpa)–, BLOC-2 (Hps6ru)–, or AP-3 (Ap3b1pe)–deficient mice and HPS patients (HPS2, HPS3, HPS5, HPS6, or HPS9). We observed similar platelet DG defects and higher intracellular zinc accumulation in platelets of mice deficient in either TMEM163 or dysbindin (a BLOC-1 subunit). In addition, we discovered that BLOC-1 was required for the trafficking of TMEM163 to perinuclear DG and late endosome marker–positive compartments (likely DG precursors) in MEG-01 cells. Our results suggest that TMEM163 is critical for DG biogenesis and that BLOC-1 is required for the trafficking of TMEM163 to putative DG precursors. These new findings suggest that loss of TMEM163 function results in disruption of intracellular zinc homeostasis and provide insights into the pathogenesis of HPS or platelet storage pool deficiency.

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Larimore, Jennifer, Karine Tornieri, Pearl V. Ryder, Avanti Gokhale, Stephanie A. Zlatic, Branch Craige, Joshua D. Lee, et al. "The schizophrenia susceptibility factor dysbindin and its associated complex sort cargoes from cell bodies to the synapse." Molecular Biology of the Cell 22, no. 24 (December 15, 2011): 4854–67. http://dx.doi.org/10.1091/mbc.e11-07-0592.

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Dysbindin assembles into the biogenesis of lysosome-related organelles complex 1 (BLOC-1), which interacts with the adaptor protein complex 3 (AP-3), mediating a common endosome-trafficking route. Deficiencies in AP-3 and BLOC-1 affect synaptic vesicle composition. However, whether AP-3-BLOC-1–dependent sorting events that control synapse membrane protein content take place in cell bodies upstream of nerve terminals remains unknown. We tested this hypothesis by analyzing the targeting of phosphatidylinositol-4-kinase type II α (PI4KIIα), a membrane protein present in presynaptic and postsynaptic compartments. PI4KIIα copurified with BLOC-1 and AP-3 in neuronal cells. These interactions translated into a decreased PI4KIIα content in the dentate gyrus of dysbindin-null BLOC-1 deficiency and AP-3–null mice. Reduction of PI4KIIα in the dentate reflects a failure to traffic from the cell body. PI4KIIα was targeted to processes in wild-type primary cultured cortical neurons and PC12 cells but failed to reach neurites in cells lacking either AP-3 or BLOC-1. Similarly, disruption of an AP-3–sorting motif in PI4KIIα impaired its sorting into processes of PC12 and primary cultured cortical neuronal cells. Our findings indicate a novel vesicle transport mechanism requiring BLOC-1 and AP-3 complexes for cargo sorting from neuronal cell bodies to neurites and nerve terminals.

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Hsieh, Patrick C., Khan W. Li, Daniel M. Sciubba, Ian Suk, Jean-Paul Wolinsky, and Ziya L. Gokaslan. "Posterior-Only Approach For Total En Bloc Spondylectomy For Malignant Primary Spinal Neoplasms: Anatomic Considerations and Operative Nuances." Operative Neurosurgery 65, suppl_6 (December 1, 2009): ons173—ons181. http://dx.doi.org/10.1227/01.neu.0000345630.47344.17.

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Abstract MALIGNANT PRIMARY SPINAL tumors are rare tumors that are locally invasive and can metastasize. The majority of these tumors have a poor response rate to chemotherapy and conventional radiotherapy. Studies have shown that long-term survival and the potential for cure is best achieved with en bloc surgical excision of these tumors with negative surgical margins. Total en bloc spondylectomy involves removal of vertebral segment(s) in whole to achieve wide tumor excision. Total en bloc spondylectomy can be performed through staged or combined anterior and posterior approaches, or from a posterior-only approach. The posterior-only approach offers the advantage of achieving complete tumor excision and circumferential spinal reconstruction in a single setting. In this report, we discuss the operative management of malignant primary vertebral tumors using the posterior-only approach for total en bloc spondylectomy. The oncological considerations and surgical nuances that allow for safe but aggressive surgical excision of primary spinal tumors to achieve favorable oncological and neurological outcomes are highlighted.

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Bohinski, Robert J., and Laurence D. Rhines. "Principles and techniques of en bloc vertebrectomy for bone tumors of the thoracolumbar spine: an overview." Neurosurgical Focus 15, no. 5 (November 2003): 1–6. http://dx.doi.org/10.3171/foc.2003.15.5.7.

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Oncological principles for en bloc resection of bone tumors were initially developed for tumors of the long bone by orthopedic surgical oncologists. Recently, spine surgeons have adopted these principles for the treatment of vertebral column tumors. The goal of en bloc resection is to establish a surgical margin that can be designated marginal or wide. In this article, the principles of surgical oncology for bone tumors of the spine are briefly reviewed and the different surgical approaches used to remove these tumors in an en bloc fashion are described in detail.

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Tomita, K., N. Kawahara, H. Baba, H. Tsuchiya, S. Nagata, and Y. Toribatake. "Total en bloc spondylectomy for solitary spinal metastases." N.N. Priorov Journal of Traumatology and Orthopedics 3, no. 2 (June 15, 1996): 11–18. http://dx.doi.org/10.17816/vto64216.

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We have developed a technique for total en bloc spondylectomy through a posterior approch and now report our experience of 20 patients with a solitary or localised metastasis in the thoracic or lumbar vertebrae. There are two steps: an en bloc laminectomy, followed by en bloc resection of the vertebral body with an oncological wide margin and the insertion of a vertebral prosthesis. Pain was relieved in the 17 patients who could be assessed; 11 of the 15 patients with a neurological deficit were much improved, impending paralysis being prevented in 5 patients. There have been no local recurrences. Nine patients are at present alive with a mean follow up of 17,4 months.

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Evans, Malkanthi, Abdul M. Sulley, David C. Crowley, Jamie Langston, and Najla Guthrie. "Pain Bloc-R Alleviates Unresolved, Non-Pathological Aches and Discomfort in Healthy Adults—A Randomized, Double-Blind, Placebo-Controlled, Crossover Study." Nutrients 12, no. 6 (June 19, 2020): 1831. http://dx.doi.org/10.3390/nu12061831.

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The lack of effective treatment for chronic discomfort without negative side effects highlights the need for alternative treatments. Pain Bloc-R is a natural health product composed of vitamins B6, B12, D, white willow bark extract, Angelica root extract, acetyl L-carnitine HCl, caffeine, L-theanine, Benfotiamine, and L-tetrahydropalmatine. The objective of this study was to compare the effects of Pain Bloc-R, acetaminophen, and placebo on unresolved aches and discomfort as assessed by the brief pain inventory (BPI) and modified Cornell musculoskeletal discomfort questionnaires. This randomized, double-blind, placebo-controlled, crossover study consisted of three 7-day periods with Pain Bloc-R, acetaminophen, or placebo, each separated by a 7-day washout. Twenty-seven healthy adults (ages 22–63 years) were randomized to receive the three interventions in different sequences. The BPI “pain at its worst” scores were significantly lower when participants took Pain Bloc-R than when they took acetaminophen (21.8% vs. 9.8% decrease, p = 0.026) after seven days of supplementation. Pain Bloc-R achieved a significant improvement in the “pain at its least” score, significantly decreased the interference of discomfort in walking, and significantly decreased musculoskeletal discomfort total scores (34%, p = 0.040) after seven days. In a post hoc subgroup analysis based on age and gender, male participants ≤45 years taking Pain Bloc-R reported significant reductions in pain severity and pain interference vs. acetaminophen. Pain Bloc-R performed as well as acetaminophen in managing unresolved non-pathological pain in otherwise healthy individuals.

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Suchy, Christian, Moritz Berger, Ingo Steinbrück, Tsuneo Oyama, Naohisa Yahagi, and Franz Ludwig Dumoulin. "Long-term follow-up after colorectal endoscopic submucosal dissection in 182 cases." Endoscopy International Open 09, no. 02 (February 2021): E258—E262. http://dx.doi.org/10.1055/a-1321-1271.

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Abstract Background and study aims We previously reported a case series of our first 182 colorectal endoscopic submucosal dissections (ESDs). In the initial series, 155 ESDs had been technically feasible, with 137 en bloc resections and 97 en bloc resections with free margins (R0). Here, we present long-term follow-up data, with particular emphasis on cases where either en bloc resection was not achieved or en bloc resection resulted in positive margins (R1). Patients and methods Between September 2012 and October 2015, we performed 182 consecutive ESD procedures in 178 patients (median size 41.0 ± 17.4 mm; localization rectum vs. proximal rectum 63 vs. 119). Data on follow-up were obtained from our endoscopy database and from referring physicians. Results Of the initial cohort, 11 patients underwent surgery; follow-up data were available for 141 of the remaining 171 cases (82,5 %) with a median follow-up of 2.43 years (range 0.15–6.53). Recurrent adenoma was observed in 8 patients (n = 2 after margin positive en bloc ESD; n = 6 after fragmented resection). Recurrence rates were lower after en bloc resection, irrespective of involved margins (1.8 vs. 18,2 %; P < 0.01). All recurrences were low-grade adenomas and could be managed endoscopically. Conclusions The rate of recurrence is low after en bloc ESD, in particular if a one-piece resection can be achieved. Recurrence after fragmented resection is comparable to published data on piecemeal mucosal resection.

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Sciubba, Daniel M., Rory J. Petteys, Sophia F. Shakur, Ziya L. Gokaslan, Edward F. McCarthy, Michael T. Collins, Matthew J. McGirt, Patrick C. Hsieh, Clarke S. Nelson, and Jean-Paul Wolinsky. "En bloc spondylectomy for treatment of tumor-induced osteomalacia." Journal of Neurosurgery: Spine 11, no. 5 (November 2009): 600–604. http://dx.doi.org/10.3171/2009.6.spine08120.

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En bloc spondylectomy represents a radical resection of a spinal segment most often reserved for patients presenting with a primary extradural spine tumor or a solitary metastasis in the setting of an indolent, well-controlled systemic malignancy. The authors report a case in which en bloc spondylectomy was conducted to control a metabolically active spine tumor. A 56-year-old woman, who suffered from severe tumor-induced osteomalacia, was found to have a fibroblast growth factor-23–secreting phosphaturic mesenchymal tumor in the T-8 vertebral body. En bloc resection was conducted, leading to resolution of her tumor-induced osteomalacia. This case suggests that radical spondylectomy may be beneficial in the management of metabolically or endocrinologically active tumors of the spine.

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Rohländer, Maike, Henning Otzen, Kristina Rode, Klaus Jung, Marion Schmicke, Teresa Harborth, Marion Langeheine, Ralph Brehm, and Árpád Csaba Bajcsy. "Histological Comparison of Testicular Needle Biopsy and En Bloc Samples in Abattoir Calves." Animals 10, no. 5 (May 25, 2020): 918. http://dx.doi.org/10.3390/ani10050918.

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The aim of this study was to test whether a single testicular needle biopsy could provide histological results comparable to en bloc resection histology and whether one biopsy was sufficient to reflect the histology of an entire pair of testicles. Two methods of sample collection were tested on 32 bull calves aged five to eight months to compare histological parameters of needle biopsy with those of en bloc resection samples. One testicular needle biopsy of the right and three en bloc samples of both testicles were collected and compared for the number of tubular cross sections, tubules with elongated spermatids (ES), outer/inner diameter of tubules, thickness of tubular wall, and number of Sertoli cells (SC). Additionally, animal data were considered. No significant differences were found between the left and right testis or among the individual locations of en bloc samples. However, histologically significant differences (Bonferroni-adjusted significance level: p < 0.05/6 = 0.0083) were found between the needle biopsy and en bloc resection regarding the tubular cross sections per visual field (p < 0.05), the outer (p = 0.01) and inner diameter and the thickness of the tubular wall (both p < 0.01). In the SOX9 immunohistochemical staining, no significant differences (p > 0.05) could be observed for SC numbers between needle biopsy and en bloc samples. In conclusion, results of testicular needle biopsy do not have the same validity as the en bloc resection histology. Furthermore, one biopsy is insufficient to reflect the histology of the entire testicular pair.

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Muelleman, Thomas, Naweed I. Chowdhury, Daniel Killeen, Kevin Sykes, J. Walter Kutz, Brandon Isaacson, Hinrich Staecker, and James Lin. "Effect of Piecemeal vs En Bloc Approaches to the Lateral Temporal Bone on Survival Outcomes." Otolaryngology–Head and Neck Surgery 158, no. 4 (February 20, 2018): 716–20. http://dx.doi.org/10.1177/0194599818758994.

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Objectives Lateral temporal bone resection (LTBR) has traditionally been performed en bloc in accordance with oncologic principles. Occasionally, this is not possible due to a low tegmen or lateralized vasculature. We sought to determine if outcomes of piecemeal and en bloc LTBR are comparable. Study Design Retrospective review. Setting Two academic medical centers. Subjects and Methods Multi-institutional retrospective cohort study. Current Procedural Terminology codes were used to identify patients with T1 to T3 squamous cell carcinoma of the external auditory canal (EAC) who underwent LTBR from 2005 to 2015. Kaplan-Meier curves were constructed to compare total survival between the 2 treatment approaches. Pairwise comparisons were performed using χ2 and Fisher exact tests (significance at P = .05), as appropriate. Results Twenty-five patients were identified. Ten patients underwent en bloc LTBR; 15 underwent piecemeal LTBR. Median follow-up time was 11 months (range, 1-60 months). There was not a significant difference in overall survival between en bloc (38.9 months; 95% confidence interval [CI], 22.7-55.2) compared to piecemeal (37.5 months; 95% CI, 21.1-53.9) procedures ( P = .519). Estimates of disease-free survival also did not reveal statistically significant differences: estimated mean disease-free survival was 48.1 months (95% CI, 33.7-62.6) in en bloc patients and 32.5 months (95% CI, 17.1-47.8) in piecemeal patients ( P = .246). Conclusion These data suggest that piecemeal resection can be considered for cases of squamous cell carcinoma involving the external auditory canal where anatomic constraints preclude a safe en bloc resection. Larger studies or studies with a longer follow-up time may provide improved insight into survival comparisons.

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Alsafi, Bayan. "The regional counter-blocs strategy in the context of the Middle East Second Cold War." International Journal of Scientific Research and Management 9, no. 06 (June 13, 2021): 652–57. http://dx.doi.org/10.18535/ijsrm/v9i6.sh01.

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Iranian Shiite geopolitical theories aimed at forming a transnational ideological project in order to unite the Islamic world and the formation of Iran military and ideological strategically allies in addition to Iran’s nuclear ambitions have shaken the regional alliances system. Adapting to a radical change in regional policy and security requires the use of a counter-bloc strategy with account for questions regarding the structure, formation, motivation, and risk involved with counter-bloc to Iran. For countries with a Sunni ideology, this stage requires reformulating and upgrading their strategy with a regional ally characterized by hostility to Iran and loyalty to USA, in addition to military, nuclear and cyber capabilities and global support to form a counter-bloc. Israel, a historical enemy of the Arab nation became the best option. Turkey’s absence within this structure may impede the success or continuity of the strategy of the counter-Iran bloc.

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CHANG, YUAN-CHING. "Economic Interdependence and Third-Party International Interactions: A 30-Country Third-Party Bloc Case Study." Japanese Journal of Political Science 9, no. 1 (April 2008): 63–87. http://dx.doi.org/10.1017/s1468109907002824.

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AbstractThe trade–conflict model claims that one state, designated ‘actor’, is deterred from initiating conflict against a trading partner, designated ‘target’, for fear of losing the welfare gains associated with trade. This paper extends the trade–conflict model to garner implications concerning trade and conflict interactions where third-party blocs are involved. The theoretical propositions supported by proofs are: (1) if the actor increases trade with a third-party who is a friend of the target, then the actor will decrease conflict toward the target; (2) if the actor increases trade with a third-party who is a rival of the target, then the actor will increase conflict toward the target. A 30-country sample from the Conflict and Peace Data Bank (COPDAB) is used and divided into three blocs, namely a Western bloc, a Middle Eastern bloc, and an Eastern bloc. The empirical analysis supports the hypotheses. A similar relationship is also discussed and tested for situations in which conflict increases or decreases between the actor and third-party bloc. In addition, the evidence shows that Western bloc countries play a central role in world political and economic relationships.

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Choudhry, S., A. Abu-Bakar, and P. Wylie. "A yen bloc in Pacific Asia: natural economic symbiosis or overblown rhetorics?" Applied Economics Letters 7, no. 4 (April 2000): 215–18. http://dx.doi.org/10.1080/135048500351537.

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Kabuli, Hamit Ahmet, Serkan Teksoz, Akif Enes Arikan, Yusuf Bukey, Murat Ozcan, and Ates Ozyegin. "Total thyroidectomy en bloc or not? prospective, randomized clinical trial: Cerrahpasa experience." Hellenic Journal of Surgery 86, no. 1 (January 2014): 5–9. http://dx.doi.org/10.1007/s13126-014-0086-0.

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SANJAY, B. K. S., G. A. RAJ, and D. A. YOUNGE. "Giant Cell Tumours of the Hand." Journal of Hand Surgery 21, no. 5 (October 1996): 683–87. http://dx.doi.org/10.1016/s0266-7681(96)80161-6.

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A study of seven cases of giant cell tumours of the hand is reported. All tumours were treated by an en bloc excision of the tumour or by whole ray resection. En bloc resection of the tumour and reconstruction with a fibular graft where necessary should be considered as the treatment of choice in giant cell tumour of the hand.

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Bailey, Christopher S., Charles G. Fisher, Michael C. Boyd, and Marcel F. S. Dvorak. "En bloc marginal excision of a multilevel cervical chordoma." Journal of Neurosurgery: Spine 4, no. 5 (May 2006): 409–14. http://dx.doi.org/10.3171/spi.2006.4.5.409.

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✓ The purpose of this case report is to demonstrate that an en bloc resection with negative surgical margins can be successfully achieved in a case of a seemingly unresectable C-2 chordoma if appropriate preoperative staging and planning are performed. The management of chordomas is controversial and challenging because of their location and often large size at presentation. Because chordomas are malignant and will aggressively recur locally if intralesional resection is conducted, wide or true en bloc resection is generally recommended. The literature indicates, however, that surgeons are reluctant to perform wide or even marginal resections because of the lesion’s complex surrounding anatomy and the risk of significant neurological compromise when a tumor abuts the dura mater or neural tissues. In this report the authors outline the successful en bloc resection of a large C1–3 chordoma and discuss the importance of preoperative staging and planning.

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Jimenez-Garcia, Victoria, Masayoshi Yamada, Hiroaki Ikematsu, Hiroyuki Takamaru, Seiichiro Abe, Taku Sakamoto, Takeshi Nakajima, Takahisa Matsuda, and Yutaka Saito. "Endoscopic submucosal dissection in management of colorectal tumors near or involving a diverticulum: a retrospective case series." Endoscopy International Open 07, no. 05 (May 2019): E664—E671. http://dx.doi.org/10.1055/a-0848-8048.

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Abstract Background and study aims Surgery is the standard treatment for colon tumors associated with diverticulum. Use of endoscopic submucosal dissection (ESD) to treat such tumors is controversial. The aim of this study was to assess the safety and feasibility of ESD in treating superficial colorectal tumors situated near or involving diverticulum. Patients and methods Consecutive patients from two referral centers who had colorectal tumors near or involving diverticulum treated by ESD were retrospectively studied. Clinicopathological characteristics and clinical outcomes were analyzed. Results Of the 12 patients studied, six had tumors near diverticulum and six had tumors involving diverticulum. The overall en-bloc R0 resection rate, median tumor size and procedure time were 67 %, 26.5 mm (range, 15 – 80 mm) and 110 minutes (range, 50 – 220 minutes), respectively. For tumors near diverticulum group, the en-bloc R0 resection rate was 100 % and no adverse events (AEs) or residual/recurrent tumors were observed. In contrast, for intradiverticular tumors group, the en-bloc R0 resection rate was low at 33 %, and one AE (perforation) was observed. The diverticula were ≥ 6 mm in diameter in the patients with incomplete resection. However, all but one diverticulum was unrecognized before ESD. Two residual tumors were detected at the 12-month surveillance and one required surgery. Conclusions This case series indicates that ESD is safe and feasible for treating colorectal tumors near a diverticulum and might be feasible for tumors involving a diverticulum smaller than 6 mm. Selection for smaller diverticulum size may contribute to higher en-bloc R0 resection rates.

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Rao, Ganesh, George J. Chang, Ian Suk, Ziya Gokaslan, and Laurence D. Rhines. "Midsacral Amputation for En Bloc Resection of Chordoma." Operative Neurosurgery 66, suppl_1 (March 1, 2010): ons—41—ons—44. http://dx.doi.org/10.1227/01.neu.0000365799.21610.c4.

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Abstract Background: En bloc resection, with adequate surgical margins, of primary malignant bone tumors of the sacrum is associated with long term disease control and potential cure. Resection of sacral tumors is difficult due to the proximity of neurovascular and visceral structures, and complete, or even partial, sacrectomy often results in functional loss for the patient. Objective: We describe the technique for en bloc resection of a sacral chordoma through a mid-sacral amputation. Results: We demonstrate successful removal of a large sacral tumor with wide surgical margins while preserving neurologic function. Conclusion: This technique for midsacral amputation to remove a sacral tumor en bloc minimizes local recurrence and maximizes neurovascular function.

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Resorlu, Berkan, Ural Oguz, Fazli Polat, Suleyman Yesil, and Ali Unsal. "Comparative Analysis of Pedicular Vascular Control Techniques during Laparoscopic Nephrectomy: En Bloc Stapling or Separate Ligation?" Urologia Internationalis 94, no. 1 (August 13, 2014): 79–82. http://dx.doi.org/10.1159/000363250.

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Objective: To compare the safety and efficacy of en bloc stapling and separate ligation techniques for renal vascular control during laparoscopic nephrectomy. Patients and Methods: Clinical data were collected from 60 patients who underwent laparoscopic nephrectomies using en bloc stapling (n = 27, group 1) or the separate ligation method (n = 33, group 2). Comparative analysis was carried out between the two groups, examining operative times, blood loss, intra- and postoperative complications and hospital stay. Results: Compared with the separate ligation method, the en bloc hilar control technique was associated with a shorter total operating time (98 vs. 121 min, p = 0.029). However, both groups were similar in terms of estimated blood loss, hemoglobin drop, changes in creatinine level and postoperative hospital stay. The total complication rates in group 1 and 2 were 3.7 and 15.1%, respectively, with a statistically significant difference. There were no complications related to the use of the endo-GIA stapler and no patients required conversion to open surgery in group 1. In group 2, 2 patients required conversion to open surgery, including 1 due to renal vein bleeding secondary to inaccurate vascular control and the other due to bleeding from the vena cava during dissection. In addition, 1 patient had a superficial bowel injury that was repaired laparoscopically and another had a superficial liver tear that was managed without conversion or transfusion. Conclusion: En bloc ligation of the renal hilum is an easy and reliable technique that allows safe and fast control of the renal pedicle.

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Clarke, Michelle J., Hormuzdiyar Dasenbrock, Ali Bydon, Daniel M. Sciubba, Matthew J. McGirt, Patrick C. Hsieh, Reza Yassari, Ziya L. Gokaslan, and Jean-Paul Wolinsky. "Posterior-Only Approach for En Bloc Sacrectomy." Neurosurgery 71, no. 2 (May 7, 2012): 357–64. http://dx.doi.org/10.1227/neu.0b013e31825d01d4.

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Abstract BACKGROUND: En bloc resection of primary sacral tumors has a demonstrated survival benefit. Total and high sacral amputations are traditionally performed by using a staged anterior and subsequent posterior approach. However, we have found that en bloc resection and biomechanical reconstruction of the spinal column is possible from a posterior-only approach in many cases. OBJECTIVE: To assess our series of posterior-only sacrectomies, emphasizing postoperative complications and overall surgical and oncologic outcome. METHODS: Sixty-nine consecutive patients underwent sacral resections for tumor at our institution between 2004 and 2009. Medical records of all patients were reviewed, and patients were excluded if they had an intentional intralesional resection, hemipelvectomy, or a previous operation. The records of the resulting 36 consecutive patients who underwent primary posterior-only en bloc sacral resections were retrospectively reviewed. RESULTS: Of the posterior-only patients, all underwent midline posterior approaches for en bloc sacral resection. Sacral amputation was defined by the by sacral root preservation: total (2 cases), high (8 cases), middle (9 cases), low (12 cases), and distal (5 cases). Chordoma was the most common tumor type (30 cases), and surgical margins were marginal in 34 cases and contaminated in 2. Overall, there were 13 complications, including 9 wound infections/revisions. The extent of sacrectomy, and thus the extent of roots sacrificed, correlated with functional outcome. CONCLUSION: It may be possible to perform a posterior-only approach to en bloc sacral resections/reconstructions in patients with tumors that do not extend beyond the lumbosacral junction or invade the bowel requiring bowel resection and diversion.

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Ryder, P. V., R. Vistein, A. Gokhale, M. N. Seaman, M. A. Puthenveedu, and V. Faundez. "The WASH complex, an endosomal Arp2/3 activator, interacts with the Hermansky–Pudlak syndrome complex BLOC-1 and its cargo phosphatidylinositol-4-kinase type IIα." Molecular Biology of the Cell 24, no. 14 (July 15, 2013): 2269–84. http://dx.doi.org/10.1091/mbc.e13-02-0088.

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Vesicle biogenesis machinery components such as coat proteins can interact with the actin cytoskeleton for cargo sorting into multiple pathways. It is unknown, however, whether these interactions are a general requirement for the diverse endosome traffic routes. In this study, we identify actin cytoskeleton regulators as previously unrecognized interactors of complexes associated with the Hermansky–Pudlak syndrome. Two complexes mutated in the Hermansky–Pudlak syndrome, adaptor protein complex-3 and biogenesis of lysosome-related organelles complex-1 (BLOC-1), interact with and are regulated by the lipid kinase phosphatidylinositol-4-kinase type IIα (PI4KIIα). We therefore hypothesized that PI4KIIα interacts with novel regulators of these complexes. To test this hypothesis, we immunoaffinity purified PI4KIIα from isotope-labeled cell lysates to quantitatively identify interactors. Strikingly, PI4KIIα isolation preferentially coenriched proteins that regulate the actin cytoskeleton, including guanine exchange factors for Rho family GTPases such as RhoGEF1 and several subunits of the WASH complex. We biochemically confirmed several of these PI4KIIα interactions. Of importance, BLOC-1 complex, WASH complex, RhoGEF1, or PI4KIIα depletions altered the content and/or subcellular distribution of the BLOC-1–sensitive cargoes PI4KIIα, ATP7A, and VAMP7. We conclude that the Hermansky–Pudlak syndrome complex BLOC-1 and its cargo PI4KIIα interact with regulators of the actin cytoskeleton.

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Costa, Sergio Renato Pais, Sergio Henrique Couto Horta, Alexandre Cruz Henriques, Jaques Waisberg, and Manlio Basílio Speranzini. "En bloc pancreaticoduodenectomy and right hemicolectomy to treat locally advanced right colon cancer: report of three cases." Einstein (São Paulo) 8, no. 1 (March 2010): 97–101. http://dx.doi.org/10.1590/s1679-45082010rc786.

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ABSTRACT Although colorectal tumors are fairly common surgical conditions, 5 to 12% of these tumors are locally advanced (T4 tumors) upon diagnosis. In this particular situation, the efficacy of en bloc multivisceral resection has been proven. When right-colon cancer invades the proximal duodenum or even the pancreatic head, a challenging dilemma arises due to complexity of the curative surgical procedure. Therefore, en bloc pancreaticoduodenectomy with right hemicolectomy should be performed to obtain free margins. The present study reports three cases of locally advanced right-colon cancer invading the proximal duodenum. All of these cases underwent successful en bloc pancreaticoduodenectomy plus right hemicolectomy, with no death occurrence. Long-term survival was observed in two cases (30 and 50 months). In the third case, the patient did not present any recurrence twelve months after surgical treatment. Multivisceral resection with en bloc pancreaticoduodenectomy should be considered for patients who present acceptable risk for major surgery and no distant dissemination. This approach seems justified since the length of postoperative survival is longer in radically ressected groups (R0) than in palliativelly resected groups (R1-2).

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Mazzeschi, Marco, and Clayton E. Cartwright Jr. "Not Just Business as Usual in the EU: A Comprehensive Analysis of Immigration and Tax Issues Related to Business Trips in 17 Schengen Countries." International Journal of Business Administration 9, no. 2 (February 8, 2018): 46. http://dx.doi.org/10.5430/ijba.v9n2p46.

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This article undertakes a comparative analysis of doing business in the European Union’s Schengen Bloc vis-à-vis working in the Schengen Bloc. Through a critical review of what may constitute business activities vs. work in all 17 Schengen member states, the article establishes how international companies can minimize unintentional exposure to immigration noncompliance as well as possible tax liabilities. As the article observes, there is a general absence of a standard EU legal definition of ‘work’ vs. ‘business activities’ that international companies can apply when sending employees for business purposes to the Schengen Bloc. In the absence of specific criteria, the article outlines what characterizes business activities in 17 Schengen countries and then several international standards, which concerned parties can use a reference point. By examining various sources including EU, OECD and ILO frameworks, the article’s research indicates general terms of reference in distinguishing business activities from work, and how that distinction confers the need for a business visa or a work permit in the European Union’s Schengen Bloc.

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Patel, Akash J., Dima Suki, Mustafa Aziz Hatiboglu, Vikas Y. Rao, Benjamin D. Fox, and Raymond Sawaya. "Impact of surgical methodology on the complication rate and functional outcome of patients with a single brain metastasis." Journal of Neurosurgery 122, no. 5 (May 2015): 1132–43. http://dx.doi.org/10.3171/2014.9.jns13939.

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OBJECT Brain metastases are the most common intracranial neoplasms and are on the increase. As radiation side effects are increasingly better understood, more patients are being treated with surgery alone with varying outcomes. The authors previously reported that en bloc resection of a single brain metastasis was associated with decreased incidences of leptomeningeal disease and local recurrence compared with piecemeal resection. However, en bloc resection is often feared to cause an increased incidence of postoperative complications. This study aimed to answer this question. METHODS The authors reviewed data from patients with a previously untreated single brain metastasis, who were treated with resection at The University of Texas M.D. Anderson Cancer Center (1993–2012). Data related to the patient, tumor, and methods of resection were obtained. Discharge Karnofsky Performance Scale (KPS) scores and 30-day postoperative complications were noted. Complications were considered major when they persisted for longer than 30 days, resulted in hospitalization or prolongation of hospital stay, required aggressive treatment, and/or were life threatening. RESULTS During the study period, 1033 eligible patients were identified. The median age was 58 years, 83% had a KPS score greater than 70, and 81% were symptomatic at surgery. Sixty-two percent of the patients underwent en bloc resection of their tumor, and 38% underwent piecemeal resection. There were significant differences between the 2 groups in terms of preoperative tumor volume, tumor functional grade, and symptoms at presentation, among others. The overall complication rates were 13% for patients undergoing en bloc resection and 19% for patients undergoing piecemeal resection (p = 0.007). The incidences of major complications and neurological complications were also significantly different. There was a trend in the same direction for major neurological complications, although it was not significant. Among patients undergoing piecemeal resection of tumors in eloquent cortex, 24% had complications (13% had major, 18% had neurological, 9% had major neurological, and 13% had select neurological complications; 4% died within 1 month of surgery). Among those undergoing en bloc resection of such tumors, 11% had complications (6% had major, 8% had neurological, 4% had major neurological, and 4% had select neurological; 2% died within 1 month of surgery). The differences in overall, major, neurological, and select neurological complications were statistically significant, but 1-month mortality and major neurological complications were not. In addition, within subcategories of tumor volume, the incidence of various complications was generally higher for patients undergoing piecemeal resection than for those undergoing en bloc resection. CONCLUSIONS The authors' results indicate that postoperative complication rates are not increased by en bloc resection, including for lesions in eloquent brain regions or for large tumors. This gives credence to the idea that en bloc resection of brain metastases, when feasible, is at least as safe as piecemeal resection.

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Watanabe, Ko, Takuto Hikichi, Jun Nakamura, Minami Hashimoto, Tadayuki Takagi, Rei Suzuki, Mitsuru Sugimoto, et al. "Clinical Outcomes and Adverse Events of Endoscopic Submucosal Dissection for Gastric Tube Cancer after Esophagectomy." Gastroenterology Research and Practice 2019 (March 3, 2019): 1–8. http://dx.doi.org/10.1155/2019/2836860.

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Background and Aim. The clinical outcomes of endoscopic submucosal dissection (ESD) for gastric tube cancer (GTC) after esophagectomy remain unclear. The aim of this study was to evaluate the clinical outcomes and safety of ESD for GTC. Patients and Methods. Twenty GTC lesions in 18 consecutive patients who underwent ESD between February 2008 and June 2018 were included in this retrospective study. The endpoints were the treatment outcomes of ESD (i.e., en bloc resection rate, complete en bloc resection rate, and curative resection rate), the adverse events following ESD, and the long-term outcomes. Results. The en bloc resection rate was 100%, while the complete en bloc resection rate and curative resection rate were 80% each. Adverse events were observed in 16.7% (3/18) of patients: one postoperative bleeding, 1 intraoperative perforation that required emergency surgery, and 1 pyothorax that required chest drainage. The 1-, 3-, and 5-year overall survival rates were 100%, 70.9%, and 70.9%, respectively. Although local recurrence was detected in 1 case of noncurative resection, no GTC- or ESD-related deaths were observed. Conclusion. ESD for GTC was feasible and acceptable to enable en bloc resection and to prevent cancer death. However, ESD for GTC should be performed more carefully than common gastric ESD because serious adverse events specific to the gastric tube may occur.

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Yoshida, Naohisa, Ken Inoue, Osamu Dohi, Ritsu Yasuda, Ryohei Hirose, Yuji Naito, Takaaki Murakami, et al. "Efficacy of precutting endoscopic mucosal resection with full or partial circumferential incision using a snare tip for difficult colorectal lesions." Endoscopy 51, no. 09 (July 15, 2019): 871–76. http://dx.doi.org/10.1055/a-0956-6879.

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Abstract Background We analyzed the efficacy of precutting endoscopic mucosal resection (EMR), which is a method of making a full or partial circumferential mucosal incision around a tumor with a snare tip for en bloc resection. Methods We reviewed cases from 2011 to 2018 in which precutting EMR (n = 167) and standard EMR (n = 557) were performed for lesions of 10 – 30 mm. Precutting EMR was indicated for benign lesions of 20 – 30 mm or lesions of < 20 mm for which standard EMR was difficult. Through propensity score matching of the two groups, the therapeutic outcomes for 35 lesions of ≥ 20 mm and 98 lesions of < 20 mm in each group were analyzed. Results In the two sizes of lesion, there were significant differences between the precutting and standard groups in the en bloc resection rate (≥ 20 mm 88.6 % vs. 48.5 %, P < 0.001; < 20 mm 98.0 % vs. 85.7 %, P = 0.004) and the histological complete resection rate (≥ 20 mm 71.4 % vs. 42.9 %, P = 0.02; < 20 mm 87.8 % vs. 67.3 %, P < 0.001). Conclusion Precutting EMR enabled high en bloc resection rates in cases involving difficult lesions.

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Lee, Won-Suk, Woo Yong Lee, Ho-Kyung Chun, and Seong-Ho Choi. "En bloc Resection for Right Colon Cancer Directly Invading Duodenum or Pancreatic Head." Yonsei Medical Journal 50, no. 6 (2009): 803. http://dx.doi.org/10.3349/ymj.2009.50.6.803.

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Li, Danhui, and Yafeng Xia. "Competing for Leadership: Split or Détente in the Sino-Soviet Bloc, 1959–1961." International History Review 30, no. 3 (September 2008): 545–74. http://dx.doi.org/10.1080/07075332.2008.10415485.

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Rowlands, Dane. "Individual BRICS or a collective bloc? Convergence and divergence amongst ‘emerging donor’ nations." Cambridge Review of International Affairs 25, no. 4 (December 2012): 629–49. http://dx.doi.org/10.1080/09557571.2012.710578.

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Yoon, Joonho, Chun Kee Chung, Sunho Lee, and Chiheon Kim. "The long term surgical outcome of spinal giant cell tumor." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e22510-e22510. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e22510.

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e22510 Background: GCT is a benign and locally aggressive tumor that occur infrequently in the mobile spine. The radical excision is generally agreed for treatment of GCTs. Methods: We performed retrospective analysis of 20 GCTs in the mobile spine from 2005 to 2013. Verteberal involvement was classified with Weinstein-Boriani-Biagini grading system. Surgery types were classified into 3 groups; partial excision, gross total removal (GTR), and en-bloc resection. We analysis by GTR versus non-GTR group, and enbloc versus non-enbloc group in GTR group. The log rank test was used for comparison of factors, and a P value of less than 0.05 was deemed significant. Results: After first surgery of the 20 patients, 17 additional surgery performed for 10 (50%) patients. There were 7 (35%) local recurrences and 3 (15%) distant metastasis. The time to recurrence or progression of tumor ranged from 5 months to 39 months. Two (10%) patients had additional surgery for instrument failure. One (5%) patient died from the complication of the surgery. The follow up duration ranged from 24 months to 141 months. The local recurrence was associated with partial resection (P < 0.01) and history of recurrence (P = 0.39). There was no significant difference between non-en bloc GTR and en bloc GTR in local recurrence (p = 0.101). Conclusions: Gross total resection should be considered for GCTs of the mobile spine. The choice of en bloc resection must be balanced with risks of the procedure. En bloc resection or radical excision could be challenging in many cases. In that cases, the gross total removal by intralesional resection is considerable for local control.

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Tseng, Mei-Yu, Jung-Chun Lin, Tien-Yu Huang, Yu-Lueng Shih, Heng-Cheng Chu, Wei-Kuo Chang, Tsai-Yuan Hsieh, and Peng-Jen Chen. "Endoscopic Submucosal Dissection for Early Colorectal Neoplasms: Clinical Experience in a Tertiary Medical Center in Taiwan." Gastroenterology Research and Practice 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/891565.

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Objectives. Endoscopic submucosal dissection (ESD) is a promising technique to treat early colorectal neoplasms by facilitating en bloc resection without size limitations. Although ESD for early gastrointestinal epithelial neoplasms has been popular in Japan, clinical experience with colorectal ESD has been rarely reported in Taiwan.Methods. From March 2006 to December 2011, 92 consecutive patients with early colorectal neoplasms resected by ESD at Tri-Service General Hospital were included. ESD was performed for colorectal epithelial neoplasms with a noninvasive pit pattern which had the following criteria: (1) lesions difficult to remove en bloc with a snare, such as laterally spreading tumors-nongranular type (LST-NG) ≧20 mm and laterally spreading tumors-granular type (LST-G) ≧30 mm; (2) lesions with fibrosis or which had recurred after endoscopic mucosal resection with a nonlifting sign.Results. The mean age of the patients was66.3±12.9years, and the male-female ratio was 1.8 : 1. The mean tumor size was37.2±17.9 mm. The en bloc resection rate was 90.2% and the R0 resection rate was 89.1%. Perforations during ESD occurred in 11 patients (12.0%) and all of them were effectively treated by endoscopic closure with hemoclips. No delayed perforation or postoperative bleeding was recorded. There were no procedure-related morbidities or mortalities.Conclusion. ESD is an effective method for en bloc resection of large early colorectal neoplasms and those with a nonlifting sign. An endoscopic technique to close perforations is essential for colorectal ESD.

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49

Jameson, Kenneth P. "Latin America and the Dollar Bloc in the Twenty-first Century: To Dollarize or Not?" Latin American Politics and Society 43, no. 4 (2001): 1–35. http://dx.doi.org/10.1111/j.1548-2456.2001.tb00186.x.

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AbstractThe choice of exchange rate regime is a continuing challenge to Latin American policymakers, who currently face pressure to dollarize their economies. The constraints imposed by the “dollar bloc,” the informal but powerful currency bloc that ties Latin America to the dominant currency, are central to that choice. Current weak economic performance has called the bloc's norms and principles into question and has made the exchange rate an open issue. Ecuador's full official dollarization is one possible strategy for countries with political stability but poor economic performance to gain access to needed dollar resources. Most of Latin America, however, will continue with variants of managed floating exchange rates, and the periodic foreign exchange crises will provide access to official dollar resources and facilitate renegotiation of the terms of outstanding debt.

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50

Vasudeva, Viren S., John H. Chi, and Michael W. Groff. "Surgical treatment of aggressive vertebral hemangiomas." Neurosurgical Focus 41, no. 2 (August 2016): E7. http://dx.doi.org/10.3171/2016.5.focus16169.

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OBJECTIVE Vertebral hemangiomas are common tumors that are benign and generally asymptomatic. Occasionally these lesions can exhibit aggressive features such as bony expansion and erosion into the epidural space resulting in neurological symptoms. Surgery is often recommended in these cases, especially if symptoms are severe or rapidly progressive. Some surgeons perform decompression alone, others perform gross-total resection, while others perform en bloc resection. Radiation, embolization, vertebroplasty, and ethanol injection have also been used in combination with surgery. Despite the variety of available treatment options, the optimal management strategy is unclear because aggressive vertebral hemangiomas are uncommon lesions, making it difficult to perform large trials. For this reason, the authors chose instead to report their institutional experience along with a comprehensive review of the literature. METHODS A departmental database was searched for patients with a pathological diagnosis of “hemangioma” between 2008 and 2015. Medical records were reviewed to identify patients with aggressive vertebral hemangiomas, and these cases were reviewed in detail. RESULTS Five patients were identified who underwent surgery for treatment of aggressive vertebral hemangiomas during the specified time period. There were 2 lumbar and 3 thoracic lesions. One patient underwent en bloc spondylectomy, 2 patients had piecemeal gross-total resection, and the remaining 2 had subtotal tumor resection. Intraoperative vertebroplasty was used in 3 cases to augment the anterior column or to obliterate residual tumor. Adjuvant radiation was used in 1 case where there was residual tumor as well. The patient who underwent en bloc spondylectomy experienced several postoperative complications requiring additional medical care and reoperation. At an average follow-up of 31 months (range 3–65 months), no patient had any recurrence of disease and all were clinically asymptomatic, except the patient who underwent en bloc resection who continued to have back pain. CONCLUSIONS Gross-total resection or subtotal resection in combination with vertebroplasty or adjuvant radiation therapy to treat residual tumor seems sufficient in the treatment of aggressive vertebral hemangiomas. En bloc resection appears to provide a similar oncological benefit, but it carries higher morbidity to the patient.

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Journal articles on the topic 'Bloc-or'

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