Geoffrey Block

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Scholarly Contributions

Chapters

• Block, G. (2000). Hereditary Hemochromatosis.. In NORD Guide of Rare Disorders. Lippincott, Williams and Wilkins.
• Block, G. (2000). Wilson's Disease. In NORD Guide of Rare Disorders. Lippincott, Williams and Wilkins.

Journals/Publications

• Loveland, M., Ibrahim, R., & Block, G. (2024). The prevalence and characteristics of misinformation on "TikTok" related to cirrhosis and liver disease: A comparative analysis of accurate and misleading content. Journal of investigative medicine : the official publication of the American Federation for Clinical Research, 72(4), 383-386.
• Morrill, K., Wightman, P., Cruz, A., Batai, K., Block, G., Hsu, C., & Garcia, D. (2024). Disparities in hepatocellular carcinoma incidence among Hispanic and non-Hispanic adults in Arizona: Trends between 2009-2017. Annals of Epidemiology, 96. doi:10.1016/j.annepidem.2024.05.012
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  Background: Hepatocellular carcinoma (HCC) is a highly lethal cancer with few treatment options available to patients. Most HCC cases in Arizona, a state with a high proportion of Hispanic adults, have not been included in recent reports of HCC incidence. This study describes trends in HCC incidence and stage at diagnosis among Arizona residents between 2009–2017 and reports on racial and ethnic disparities for these outcomes. Methods: The Arizona Cancer Registry was used to identify Arizonans aged 19 or older diagnosed with liver cell carcinoma diagnosed between 2009–2017. A total of 5043 cases were examined. Adjusted annual and 3-year HCC incidence rates (per 100,000) were examined for non-Hispanic White (NHW) and Hispanic adults. Results: The total age-adjusted HCC incidence rate increased significantly between 2009–2012 and then declined significantly between 2012–2017. Across nearly all years, age-adjusted HCC incidence in Hispanic adults was twice that of NHW adults. Hispanic adults were more likely to be diagnosed at a later stage across all time periods. The disparity in 3-year age-adjusted HCC incidence rate between NHW and Hispanic adults decreased between 2009–2017. Conclusion: Whe total age-adjusted HCC incidence rate increased significantly between 2009–2012 and then declined significantly between 2012–2017. Across nearly all years, age-adjusted HCC incidence in Hispanic adults was twice that of NHW adults. Hispanic adults were more likely to be diagnosed at a later stage across all time periods. The disparity in 3-year age-adjusted HCC incidence rate between NHW and Hispanic adults decreased between 2009–2017.
• Desai, A., Duzdar, S., Stump, T., Orman, E., Nephew, L., Patidar, K., Ghabril, M., Block, G., Fallon, M., Chalasani, N., & Monahan, P. (2023). Measuring Medication Use, Obstacles, and Knowledge in Individuals With Cirrhosis. Clinical Gastroenterology and Hepatology, 21(7). doi:10.1016/j.cgh.2022.08.025
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  Background & Aims: Although patient knowledge is modifiable, there are no widely accepted tools to measure patient understanding during cirrhosis care. We aimed to develop and validate “My Cirrhosis Coach” (MCC), a personalized, self-administered questionnaire to evaluate cirrhosis-related medication use, obstacles, and understanding. Methods: Adults with cirrhosis were prospectively enrolled at 3 tertiary centers from July 2016 through July 2020. Psychometrics including confirmatory factor analysis was used to develop and validate a final questionnaire. Content validity was measured via the content validity index and expert performance. Discriminant validity was assessed by comparing scores between groups hypothesized to have varying performance. Results: The MCC was tested in a diverse cohort (n = 713) with cirrhosis and its complications including ascites (45%) and hepatic encephalopathy (33%) with median Model for End-Stage Liver Disease-Sodium 10 (interquartile range, 9–15). A 6-factor model of the MCC fit the data well (root mean square error of approximation, 0.22; comparative fit index, 0.96; standardized root mean squared residual, 0.104; final domains: Medication Use & Accessibility, Medication Obstacles, Lactulose Use, Diuretic Use, Beta Blocker Use, and Dietary Sodium Use). The MCC had excellent content validity (content validity index, 81%–94%) and accuracy (91%–100%) ratings by experts. Mean domain scores ranged from 1.1 to 2.6 (range, 0–3; 3 indicating better performance). Those with a cirrhosis complication scored higher in the relevant medication domain (ie, diuretic use score in ascites). Compared with outpatients, inpatients scored higher in all knowledge domains except salt use and reported more medication obstacles. Scores differed by income, education level, and having an adult at home. Conclusions: In a large, diverse cohort, we validated the MCC, which can serve to standardize medication use and knowledge measurement in clinical practice and education-based studies in cirrhosis.
• Block, G. (2022). Measuring Liver Disease Knowledge in Individuals with Cirrhosis. Clinical Gastroenterology and Hepatology.
• Block, G., & Junno, S. (2021). NON-ALCOHOLIC FATTY LIVER DISEASE: DO NON-INVASIVE FIBROSIS SCORES STILL HAVE A ROLE IN PREDICTING EARLY STAGE HEPATIC FIBROSIS? Submission Type: AASLD Oral or Poster Submissions. Hepatology.
• Alger, J., Amiridis, M., Assanis, D. N., Barron, E. J., Becker, M. P., Blank, R. M., Block, G. D., Bollinger, L. C., Brown, R. A., Burwell, S. M., Cassidy, C. M., Clements, J. P., Crow, M. M., Currall, S. C., Degioia, J. J., Frenk, J., Fuchs, W. K., Gabel, J. T., Gallagher, P. D., , Gee, E. G., et al. (2020). Support U.S. research during COVID-19.. Science (New York, N.Y.), 370(6516), 539-540. doi:10.1126/science.abf1225
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  Colleges and universities are critical components of the U.S. innovation ecosystem. These institutions are called upon to play ever-evolving roles in building talent for a changing workforce; achieving scientific breakthroughs; creating new technologies, products, and companies; and contributing to local economic development. Yet, as the pace of change accelerates across our economy, federal and state budget constraints have made meeting these expectations increasingly challenging. The federal commitment to research and development stands at a multidecadal low as a percentage of GDP ([ 1 ][1]). Now, the coronavirus disease 2019 (COVID-19) pandemic has disrupted almost all aspects of higher education, including the ability to keep laboratories open, conduct research in a timely manner, collect and process data, and collaborate with colleagues and students. As colleges and universities across the nation make difficult decisions to advance their vital missions this fall, the $55 billion in federal support for university-performed R&D (i.e., on-campus research) is at risk ([ 2 ][2]). Maintaining the strength of the U.S. research enterprise—the same research enterprise that has enabled the rapid sequencing of the COVID-19 genome and launched numerous treatment and vaccine studies—must be a national priority. Laboratories must remain open, and researchers must be allowed to continue data collection and analysis, with all the necessary health protocols in place. We cannot afford to shut down critical projects with long-term national benefits or to postpone projects that provide the hands-on graduate and undergraduate student research experiences necessary to train the next generation of scientists and engineers. In these difficult times, we call upon the federal government to provide the leadership, critical funding, and programmatic flexibility necessary to enable the nation's colleges and universities to continue the U.S. commitment to research, exploration, and new knowledge creation that will power our economy and provide opportunity for all. 1. [↵][3]AAAS, “Federal RD [www.aaas.org/sites/default/files/2020-07/RDGDP.png][4]. 2. [↵][5]AAAS, “RD [www.aaas.org/programs/r-d-budget-and-policy/rd-colleges-and-universities][6]. [1]: #ref-1 [2]: #ref-2 [3]: #xref-ref-1-1 "View reference 1 in text" [4]: http://www.aaas.org/sites/default/files/2020-07/RDGDP.png [5]: #xref-ref-2-1 "View reference 2 in text" [6]: http://www.aaas.org/programs/r-d-budget-and-policy/rd-colleges-and-universities
• Block, G. (2020). COVID-19 Prevalence and complications in chronic liver disease and liver transplant. j hep.
• Block, G. (2020). Quality of Life in Cirrhotic Patients post hospital admission. Hepatology.
• Block, G. A., Bolon, M. K., Cheung, A. K., Flessner, M. F., Fox, P., Fried, L., Gassman, J. J., Hodakowski, A., Isakova, T., Ix, J. H., Kulik, L., Kusek, J. W., Martinez, C. A., Mehta, R., O'brien, M. J., Raj, D., Raphael, K. L., Souma, N., Sprague, S. M., , Wagener, E. D., et al. (2018). A Patient With CKD Develops Cholestatic Liver Injury During a Clinical Trial.. Kidney international reports, 3(1), 5-10. doi:10.1016/j.ekir.2017.07.012
• Bellin, M. D., Freeman, M. L., Gelrud, A., Slivka, A., Clavel, A., Humar, A., Schwarzenberg, S. J., Lowe, M. E., Rickels, M. R., Whitcomb, D. C., Matthews, J. B., Amann, S., Andersen, D. K., Anderson, M. A., Baillie, J., Block, G., Brand, R., Chari, S., Cook, M., , Cote, G. A., et al. (2013). Total pancreatectomy and islet autotransplantation in chronic pancreatitis: recommendations from PancreasFest. Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 14(1), 27-35.
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  Total pancreatectomy with islet autotransplantation (TPIAT) is a surgical procedure used to treat severe complications of chronic pancreatitis or very high risk of pancreatic cancer while reducing the risk of severe diabetes mellitus. However, clear guidance on indications, contraindications, evaluation, timing, and follow-up are lacking.
• Patzer, J. F., Block, G. D., Khanna, A., Yin, W. Y., Molmenti, E., Gerber, D., Kramer, D. J., Scott, V. L., Aggarwal, S., Wagner, R. A., Fulmer, M. L., Amiot, B. P., & Mazariegos, G. V. (2002). D-galactosamine based canine acute liver failure model. Hepatobiliary & pancreatic diseases international : HBPD INT, 1(3), 354-67.
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  Appropriate preclinical evaluation of a bioartificial liver assist device (BAL) demands a large animal model, as presented here, that demonstrates many of the clinical features of acute liver failure and that is suitable for clinical qualitative and quantitative evaluation of the BAL. A lethal canine liver failure model of acute hepatic failure that removes many of the artifacts evidenced in prior canine models is presented.
• Block, G. (2001). Procreation for Donation: The Moral and Political Permissibility of “Having a Child to Save a Child”. Cambridge Quarterly of Healthcare Ethics, Volume 10(Issue 4), 408 - 419. doi:https://doi.org/10.1017/S0963180101004030
• Clark, D. B., Lynch, K. G., Donovan, J. E., & Block, G. D. (2001). Health problems in adolescents with alcohol use disorders: self-report, liver injury, and physical examination findings and correlates. Alcoholism, clinical and experimental research, 25(9), 1350-9.
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  Although adolescent alcohol consumption has been found to be positively correlated with self-reported health problems, few studies have examined other health indicators. This study compared adolescents with alcohol use disorders (AUDs) and a community reference group on self-reported health problems, serum liver enzymes, and physical examination findings. The relevance of negative emotionality to understanding these health problems was also investigated.
• Block, G. D., & Aulisio, M. I. (2000). Will genetics revolutionize medicine?. The New England journal of medicine, 343(20), 1496; discussion 1498.
• Block, G. (1999). ANALYTIC OPTIMIZATION OF BIOHYBRID LIVER REACTION KINETICS WITH DIFFERENTIAL-ALGEBRAIC EQUATIONS. ASAIO.
• Block, G. (1999). High Efficiency Genomic Transduction of Intact Pancreatic Islets In Long Term Culture with Recombinant Adeno-Associated Virus Vectors (rAAV). Transplantation, 67(7), 207.
• Patzer, J. F., Mazariegos, G. V., Lopez, R., Molmenti, E., Gerber, D., Riddervold, F., Khanna, A., Yin, W. Y., Chen, Y., Scott, V. L., Aggarwal, S., Kramer, D. J., Wagner, R. A., Zhu, Y., Fulmer, M. L., Block, G. D., & Amiot, B. P. (1999). Novel bioartificial liver support system: preclinical evaluation. Annals of the New York Academy of Sciences, 875, 340-52.
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  Preclinical safety and efficacy evaluation of a novel bioartificial liver support system (BLSS) was conducted using a D-galactosamine canine liver failure model. The BLSS houses a suspension of porcine hepatocytes in a hollow fiber cartridge with the hepatocytes on one side of the membrane and whole blood flowing on the other. Porcine hepatocytes harvested by a collagenase digestion technique were infused into the hollow fiber cartridge and incubated for 16 to 24 hours prior to use. Fifteen purpose-bred male hounds, 1-3 years old, 25-30 kg, were administered a lethal dose, 1.5 g/kg, of D-galactosamine. The animals were divided into three treatment groups: (1b) no BLSS treatment (n = 6); (2b) BLSS treatment starting at 24-26 h post D-galactosamine (n = 5); and (2c) BLSS treatment starting at 16-18 h post D-galactosamine (n = 4). While maintained under isoflurane anesthesia, canine supportive care was guided by electrolyte and invasive physiologic monitoring consisting of arterial pressure, central venous pressure, extradural intracranial pressure (ICP), pulmonary artery pressure, urinary catheter, and end-tidal CO2. All animals were treated until death or death-equivalent (inability to sustain systolic blood pressure > 80 mmHg for 20 minutes despite massive fluid resuscitation and/or dopamine administration), or euthanized at 60 hours. All animals developed evidence of liver failure at 12-24 hours as evidenced by blood pressure lability, elevated ICP, marked hepatocellular enzyme elevation with microscopic massive hepatocyte necrosis and cerebral edema, elevated prothrombin time, and metabolic acidosis. Groups 2b and 2c marginally prolong survival compared with Group 1b (pairwise log rank censored survival time analysis, p = 0.096 and p = 0.064, respectively). Since survival times for Groups 2b and 2c are not significantly different (p = 0.694), the groups were combined for further statistical analysis. Survival times for the combined active treatment Groups 2b and 2c are significantly prolonged versus Group 1b (p = 0.047). These results suggest the novel BLSS reported here can have a significant impact on the course of liver failure in the D-galactosamine canine liver failure model. The BLSS is ready for Phase I safety evaluation in a clinical setting.
• Block, G. (1998). PRECLINICAL EVALUATION OF A NOVEL BIOARTIFICIAL LIVER USING A CANINE D-GALACOSAMINE LIVER FAILURE MODEL. Transplantation.
• Block, G. (1997). D-GALACTOSAMINE CANINE LIVER FAILURE MODEL. ASAIO Journal.
• Block, G. (1997). Effect of Growth Factors and Defined Medium on Primary Hepatocyte Culture on Polyester Carriers with Varying Surface Treatment. Tissue Engineering.
• Block, G. (1997). PRELIMINARY CANINE STUDIES OF A NEW HOLLOW-FIBER-BASED BIOARTIFICIAL LIVER SYSTEM. ASAIO Journal.
• Block, G. (1996). HGF, EGF, and TGF stimulate transition to hepatoblasts, population expansion and clonal growth in primary cultures of hepatocytes in a chemically defined (HGM) medium. The Journal of Cell Biology.
• Block, G. D., Locker, J., Bowen, W. C., Petersen, B. E., Katyal, S., Strom, S. C., Riley, T., Howard, T. A., & Michalopoulos, G. K. (1996). Population expansion, clonal growth, and specific differentiation patterns in primary cultures of hepatocytes induced by HGF/SF, EGF and TGF alpha in a chemically defined (HGM) medium. The Journal of cell biology, 132(6), 1133-49.
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  Mature adult parenchymal hepatocytes, typically of restricted capacity to proliferate in culture, can now enter into clonal growth under the influence of hepatocyte growth factor (scatter factor) (HGF/SF), epidermal growth factor (EGF), and transforming growth factor alpha (TGFalpha) in the presence of a new chemically defined medium (HGM). The expanding populations of hepatocytes lose expression of hepatocyte specific genes (albumin, cytochrome P450 IIB1), acquire expression of markers expressed by bile duct epithelium (cytokeratin 19), produce TGFalpha and acidic FGF and assume a very simplified morphologic phenotype by electron microscopy. A major change associated with this transition is the decrease in ratio between transcription factors C/EBPalpha and C/EBPbeta, as well as the emergence in the proliferating hepatocytes of transcription factors AP1, NFkappaB. The liver associated transcription factors HNFI, HNF3, and HNF4 are preserved throughout this process. After population expansion and clonal growth, the proliferating hepatocytes can return to mature hepatocyte phenotype in the presence of EHS gel (Matrigel). This includes complete restoration of electron microscopic structure and albumin expression. The hepatocyte cultures however can instead be induced to form acinar/ductular structures akin to bile ductules (in the presence of HGF/SF and type I collagen). These transformations affect the entire population of the hepatocytes and occur even when DNA synthesis is inhibited. Similar acinar/ductular structures are seen in embryonic liver when HGF/SF and its receptor are expressed at high levels. These findings strongly support the hypothesis that mature hepatocytes can function as or be a source of bipotential facultative hepatic stem cells (hepatoblasts). These studies also provide evidence for the growth factor and matrix signals that govern these complex phenotypic transitions of facultative stem cells which are crucial for recovery from acute and chronic liver injury.
• Rabinovitz, M., Block, G., Finkelstein, S. D., G, B., & Sd, F. (1996). alpha-Interferon retreatment of patients with chronic hepatitis C.. The American journal of gastroenterology, 91(8), 1523-6.
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  To evaluate the effect of a second cycle of alpha-IFN treatment on patients who have not responded to a first cycle or responded and relapsed, 37 patients, 25 men and 12 women, mean age 41 yr, were retreated with alpha-interferon (IFN). Seven patients responded to the first cycle of treatment, and 30 did not. Five patients who had not responded to the second cycle received a third one. All patients received twice the dose of the first cycle unless they experienced side effects during the first cycle. Thus, nine patients received 9 mU/w, nine received 15 mU/w, and 19 received 30 mU/w for 6 months. Complete response was defined as nondetectable hepatic hepatitis C virus (HCV)-RNA at the end of therapy; sustained response was defined as normal ALT levels with negative serum HCV-RNA at > 6 months after cessation of therapy. Of the 30 nonresponders to the first cycle, eight responded to the second, but only four (13%) had a sustained response. Six of the seven responders to the first cycle responded to the second cycle, but only three had a sustained response (3/7, 43%) (p = NS). Although 33 and 21% (p = NS) of those who were treated with 15 mU/w and 30 mU/w, respectively, showed a sustained response, none of those treated with 9 mU/w had a sustained response (p = NS). Although age or sex of the patients studied had no effect on the response rate, liver histology was an important factor because only noncirrhotics showed a long term response (47 vs 0%; p < 0.02). There was no difference in response rate between patients with chronic active hepatitis and chronic persistent hepatitis. In conclusion, noncirrhotic patients who have not responded or responded and relapsed to a 6-month course of alpha-INF (3-5 mU three times per week) should try a second course at a dose of 15 mU/w. Retreatment may induce complete and long lasting response in 13% of the initial nonresponders and 43% of the initial responders. A second course of alpha-IFN in nonresponding cirrhotics appears ineffective in clearing the virus at the doses used.
• Block, G. (1995). Novel expression of a unique hepatic stellate cell-specific IGF-Binding Protein in experimental alcoholic liver disease (ALD): In vivo and ex vivo studies. Hepatology, 22(4), A284. doi:https://doi.org/10.1016/0270-9139(95)94859-7
• Whitcomb, D. C., & Block, G. D. (1995). Acetaminophen Hepatotoxicity, Fasting, and Ethanol-Reply. JAMA, 274(4), 302-302. doi:10.1001/jama.1995.03530040028026
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  Dr Bonkovsky relates an interesting case in which a man developed severe hepatotoxicity after ingesting 1 to 3 g of acetaminophen per day for an acute illness. The enhanced toxicity was assumed to be caused by chronic underlying cardiopulmonary disease. In our study, there were no patients with significant underlying chronic cardiopulmonary disease. The patients in our study with clearly enhanced toxicity (ie, hepatotoxicity after consuming The letter from Drs Nelson and Temple emphasizes the relative safety of acetaminophen when used for limited periods of time, as directed. With this, we agree. On the other hand, aspirin and NSAIDs are also relatively safe
• Block, G., & Blumberg, J. B. (1994). The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study in Finland.. Nutrition reviews, 52(7), 242-5. doi:10.1111/j.1753-4887.1994.tb01430.x
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  The U.S. National Cancer Institute and the Finnish National Public Institute jointly sponsored a large double-blind, placebo-controlled primary-prevention trial to examine the effects of vitamin E and beta-carotene supplementation on reducing the incidence of lung cancers in male smokers, ages 50-69 years. Supplementation did not result in a significant reduction in lung cancer, and a higher incidence of lung cancer was observed in the group receiving beta-carotene. These results should be examined within the context of the population studied before they are cited as definitive.
• Whitcomb, D. C., & Block, G. D. (1994). Association of acetaminophen hepatotoxicity with fasting and ethanol use. JAMA, 272(23), 1845-50.
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  To evaluate the association of fasting and alcohol use with hepatotoxicity from acetaminophen ingested for therapeutic reasons.
• Rabinovitz, M., Shapiro, J., Lian, J., Block, G. D., Merkel, I. S., & Van Thiel, D. H. (1992). Vitamin D and osteocalcin levels in liver transplant recipients. Is osteocalcin a reliable marker of bone turnover in such cases?. Journal of hepatology, 16(1-2), 50-5.
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  Patients with advanced liver disease are at increased risk for the development of hepatic osteodystrophy in the form of either osteomalacia or osteoporosis. The pathogenesis of these two bone diseases is multifactorial and includes, among other factors, alterations in vitamin D metabolism, malnutrition and hypogonadism. Little is known regarding vitamin D metabolism and the osteoblastic activity in liver transplant recipients. In order to clarify these issues, vitamin D metabolites and osteocalcin levels were measured prior to and 30 days following liver transplantation in 30 cirrhotic patients of various etiologies. While the mean plasma concentrations of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D of the entire group of 30 patients were significantly greater prior to orthotopic liver transplantation (OLTx) as compared to those after OLTx (11.5 +/- 8.6 vs. 7.4 +/- 5.8 ng/ml, p = 0.0066 and 41.0 +/- 34.6 vs. 20.4 +/- 11.0 pg/ml, p = 0.0003, respectively), no significant changes in osteocalcin concentrations pre- or post-transplantation could be demonstrated (5.2 +/- 3.0 vs. 6.4 +/- 4.1 ng/ml, p = 0.51). Furthermore, no correlation between the plasma concentration of osteocalcin and either vitamin D metabolite, the prothrombin time or cyclosporine levels was found. The reasons for the normal levels of osteocalcin prior to OLTx can be explained by the fact that in vitamin-K-deficient states osteocalcin is predominantly decarboxylated and, therefore, a smaller proportion is bound to bone and/or the synthesis of osteocalcin is partially modulated by 1,25-dihydroxyvitamin D, the level of which has been found to be normal.(ABSTRACT TRUNCATED AT 250 WORDS)
• Uknis, M. E., Abu-Elmagd, K., Suwan, S., Block, G., Van Thiel, D., Reyes, J., Tzakis, A., Demetris, A. J., Todo, S., & Starzl, T. E. (1992). Immunoreactivity of T lymphocytes propagated from biopsies of human cadaveric small intestine allografts: a serial study of four patients. Transplantation proceedings, 24(3), 1137.
• Wright, H. L., Bou-Abboud, C. F., Hassanein, T., Block, G. D., Demetris, A. J., Starzl, T. E., & Van Thiel, D. H. (1992). Disease recurrence and rejection following liver transplantation for autoimmune chronic active liver disease. Transplantation, 53(1), 136-9.
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  Autoimmune chronic active liver disease (ACALD), a major indication for liver transplantation, is associated strongly with antigenic determinants HLA-B8 and DR3. A retrospective analysis of 43 patients who underwent OLTx for putative ACALD and who, as well as their tissue organ donors, were typed, was performed. Disease recurrence and graft rejection episodes were determined by chart review and histopathological review of all material available. Disease recurrence was histologically documented in 11 (25.6%) of these 43 cases. Graft rejection episodes occurred in 24 (55.8%). All recurrences were in recipients of HLA-DR3-negative grafts. Nine of the recurrences were in HLA-DR3-positive recipients (odds ratio: 6.14, P less than 0.03). Two of 11 cases of disease recurrence were in recipients who were HLA-DR3-negative. Nine of these 11 had received HLA-DR3-negative grafts. Rejection occurred in 13 HLA-B8-positive recipients, 12 of whom received HLA-B8-negative grafts. Eleven HLA-B8-negative recipients experienced at least one rejection episode and 9 of these had received HLA-B8-negative grafts. Based upon these data we conclude: 1) that recurrence of putative ACALD is more likely to occur in HLA-DR3-positive recipients of HLA-DR3-negative grafts; (2) that recurrences were not seen in recipients of HLA-DR3-positive grafts; (3) that HLA-B8 status does not affect disease recurrence; and (4) that neither the HLA-B8 nor the DR3 status of the graft or recipient has an effect on the observed frequency of rejection.
• Uknis, M. E., Abu-Elmagd, K., Suwan, S., Block, G., Van Thiel, D., Reyes, J., Tzakis, A., Demetris, A. J., Todo, S., & Starzl, T. E. (1991). Functional analysis of graft lamina propria associated lymphocytes from a recipient of a human cadaveric small bowel allograft primarily immunosuppressed with FK 506. Transplantation proceedings, 23(6), 2943-4.
• Uknis, M. E., Block, G., Abu-Elmagd, K., Suwan, S., Van Thiel, D., Duquesnoy, R., & Zeevi, A. (1991). Sterilization of human small intestine allograft biopsies for later immunologic studies. Transplantation, 52(3), 558-9.
• Rabinovitz, M., Zajko, A. B., Hassanein, T., Shetty, B., Bron, K. M., Schade, R. R., Gavaler, J. S., Block, G., Van Thiel, D. H., & Dekker, A. (1990). Diagnostic value of brush cytology in the diagnosis of bile duct carcinoma: a study in 65 patients with bile duct strictures. Hepatology (Baltimore, Md.), 12(4 Pt 1), 747-52.
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  Malignant strictures of the extrahepatic bile ducts are difficult to distinguish from benign strictures, particularly in patients with primary sclerosing cholangitis. Because attempts at diagnosing small cancers with fine-needle aspiration biopsy are not possible in the absence of an associated mass lesion and because the sensitivity of exfoliative biliary cytology is controversial, brush cytology has been used as a potential means of establishing a specific diagnosis of bile duct carcinoma. Herein we report our experience with this technique when performed on 65 patients over a 5-yr period. Each had at least one brushing. Thirty-seven were found to have bile duct carcinoma and 28 were found to have benign strictures. Of these 37, the first brushing was positive for malignancy in 15 (40%), whereas four (11%) had cells suspected but not diagnostic of malignancy. Thirteen patients with bile duct carcinoma whose initial brushings were negative for malignancy had second brushings. Of these, five (38%) had malignant cells, whereas three (24%) yielded suspicious cells. Three of the eight whose first two brushings were negative for malignancy were found to have malignant cells on the third brushing. In contrast, of the 28 patients with benign strictures, malignant cells were never found. However, in two patients, suspicious cells were reported with the first but not the second brushing. A single negative or suspicious cytological finding decreased the probability of bile duct carcinoma to 43%. Two and three sequential negative tests reduced the probability to 32% and 0%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
• Staschak, S., Wagner, S., Block, G., Van Thiel, D. H., Jain, A., Fung, J., Todo, S., & Starzl, T. E. (1990). A cost comparison of liver transplantation with FK 506 or CyA as the primary immunosuppressive agent. Transplantation proceedings, 22(1), 47-9.
• Scott, W. J., Block, G. E., Ge, B., & Wj, S. (1989). Biliary stone disease in adults with cystic fibrosis.. Surgery, 105(5), 671-3.
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  A 27-year-old woman with cystic fibrosis had a 6-month history of fatty food intolerance and biliary colic. Ultrasonographic studies confirmed the presence of gallstones. A cholecystectomy and appendectomy were performed. An intraoperative cholangiogram showed anomalous drainage of the cystic duct into an accessory right hepatic duct. Patients with cystic fibrosis now commonly survive into adulthood and are at high risk for the development of cholelithiasis. The diagnosis may be obscured by other common gastrointestinal complications of cystic fibrosis. Optimal surgical management includes meticulous preoperative and postoperative pulmonary care. The surgeon must also have a thorough knowledge of the biliary tract anomalies that have been described in patients with cystic fibrosis.
• Rosemurgy, A. S., Block, G. E., As, R., Ge, B., & Shihab, F. S. (1988). Surgical treatment of carcinoma of the abdominal colon.. Surgery, gynecology & obstetrics, 167(5), 399-406.
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  Eighty-eight consecutive patients with invasive, but potentially curable, carcinoma of the abdominal colon were operated upon between January 1970 through June 1974 at the University of Chicago Medical Center by a small group of senior surgeons, all of whom utilized extensive lymphadenectomy. Pathologic stage of the disease, lymph node involvement, contiguous organ involvement and degree of differentiation of the primary tumor affected survival rates. Five and ten year absolute survival rates were 71.2 and 50.0 per cent, and the relative survival rates were 78.1 and 60.9 per cent. By five years, 30.0 per cent of the patients had recurrence, and by ten years, 33.3 per cent had recurrence. The majority of recurrences occurred within three years of operation. Only 12 per cent of the recurrences were local or regional. We conclude that operation using wide anatomic resection and extended lymphadenectomy improves survival rates and limits local and regional recurrences in patients with carcinoma of the abdominal colon. Furthermore, surveillance of patients after operation for invasive carcinoma of the abdominal colon should be aggressive for at least the first three years because of the frequency of recurrence within this period.
• Sorenson, A. W., Block, G., Aw, S., & G, B. (1987). Assessment of dietary status using national guidelines.. Maryland medical journal (Baltimore, Md. : 1985), 36(2), 151-6.
• A, S., Block, G. D., Cosby, M., Dignan, M. B., Howard, G., M, C., & Steckler, A. (1986). Prevalence of health-risk behavior among seventh grade students in North Carolina.. Southern medical journal, 79(3), 295-8, 302. doi:10.1097/00007611-198603000-00009
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  Data from 386 seventh grade students, 48% male and 65% white, were collected at two sites in North Carolina. The purpose of the study was to estimate the prevalence of alcohol and drug use among adolescents as part of a continuing study of preventive health behaviors. The data were collected anonymously from self-completed questionnaires and were analyzed by race and sex to determine knowledge of and attitudes toward alcohol and smoking, self-concept, and locus of control. Black boys had the highest prevalence of alcohol (16%) and tobacco (20%) use and at the same time had the lowest amount of knowledge about the dangers of the substances. White boys, while knowing more about the potential dangers, reported similar patterns of use. In general, girls used much less alcohol and tobacco and had higher levels of knowledge and more prudent attitudes. Boys, particularly blacks, were found to be at greater risk than girls of developing patterns of behavior that are associated with abuse of alcohol and heavy smoking. The findings suggest that health education to inform adolescents of the dangers of alcohol and smoking needs to be specific to cultural and sex groups.
• Dignan, M., Steckler, A., Howard, G., M, C., A, S., Block, G. D., & Cosby, M. (1986). Locus of control and smokeless tobacco use among adolescents.. Adolescence, 21(82), 377-81.
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  Seventh-grade students from two school districts in rural North Carolina were surveyed to determine the prevalence and correlates of smokeless tobacco use. The survey was carried out as part of a larger project intended to study prevalence of "risky" behaviors, specifically alcohol and tobacco use. Data were collected from 322 students: 49% male, 36.6% nonwhite. Of those reporting use of smokeless tobacco (11.4%), virtually all were male; most reported weekly use, with a small proportion (1.3%) reporting daily use. Locus of control of "occasional" users was significantly more internal than those reporting "regular" use (p less than .05).

Others

• Block, G. (2000, October). Visceral fat is a predictor of hepatic steatosis and mass. Hepatology.
• Block, G. (2019, May). ERCP-intraductal RFA and EUS-guided RFA in Cholangiocarcinoma and Pancreatic Adenocarcinoma. DDW.
• Block, G. (2017, April). Radiofrequency ablation of pancreatic insulinomas with three year follow up.. manuscript.
• Block, G. (2017, May). Long term follow up of EUS-RFA on insulinomas. DDW Interventional EUS Conference.
• Block, G. (2016, May). EUS-RFA of pancreatic neuroendocrine tumors. DDW Interventional EUS Conference.
• Block, G. (2000, July). Tissue engineering and regenerative medicine for metabolic disorders. World Technology Center, International Technology Research Institute.