Dead to Rites (Occult .45 Book 2)

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Occult .45: Four Tales of Gunrunning in the Weird West, Volume 4 by Nick Carcano

East Dane Designer Men's Fashion. Shopbop Designer Fashion Brands. PCa is found on autopsy in a similar proportion of Russian and Japanese men. Our results suggest that the definition of clinically insignificant PCa might be worth re-examining. The widespread use of prostate-specific antigen PSA testing has dramatically changed the prostate cancer PCa landscape, enhancing PCa detection at a more curable stage 1.

The perverse effects of PSA testing have included the diagnosis of a considerable proportion of cancers that are probably indolent, carrying a low probability of progressing to clinically significant, lethal PCa. As a result, men may suffer debilitating side effects such as sexual impotence and urinary incontinence.

In addition to its personal toll, overtreatment of indolent PCa also carries a substantial economic burden, which is increasing because of demographic changes 5. Current strategies for detection and treatment of PCa will likely come under great scrutiny in the future. Increasing the body of knowledge regarding the prevalence of occult PCa and its characteristics is of utmost importance because the natural history of screen-detected PCa remains poorly understood. Surprisingly, the contemporary prevalence of latent PCa globally is not well known 6—9.

Autopsy studies have revealed a high prevalence of premalignant high grade prostatic intraepithelial neoplasia [HGPIN] and malignant disease mostly low grade , starting in the third and fourth decade of life and increasing steadily thereafter Autopsy studies in Asian ASI men are extremely limited, and contemporary data are lacking. Death rates from PCa in varied from the lows of less than 10 per men in Japan to highs of more than 30 per men in Scandinavia Recent reports suggest PCa incidence in Asia, although still lower than in Western nations, is increasing rapidly, possibly because of a more Westernized lifestyle 2 , Differences in PCa diagnostic practices are most likely the greatest contributor to the variation in incidence rates worldwide.

Comparative geographic—pathologic studies suggest that genetic, epigenetic, and environmental factors may be responsible for ethnic variations in the postinduction progression of PCa 1 , 11 , 12 , 15— Dietary factors have been incriminated to explain the discrepancy between incidental and clinically significant PCa in ASI populations In many ASI countries, a change in dietary habits has occurred, and its actual impact on latent and clinical PCa deserves scrutiny. We chose a specific CAU population in Russia with environmental characteristics similar to those of the Western world—reduced sun exposure and high-fat diet, both of which have been implicated in PCa risk 18 , 19 —but where there is no widespread PSA screening.

Screening is also uncommon in Japan Between and , prostate glands were prospectively collected during autopsy from men aged 20 to more than 80 years with no known history of PCa. Ethics approval from each site was obtained before collection. Patient demographics age, race, date of death, and cause of death were recorded. Consent was obtained from relatives in all cases. Analogous methodology was followed in Tokyo and Moscow. Prostate glands were removed en-block with the seminal vesicles within 24 hours of death, immediately injected with buffered formalin pH 7. Patients who died more than 24 hours before prostate harvesting were excluded.

Prostate glands were weighed and sectioned at 4-mm intervals perpendicular to the posterior surface and placed in buffered formalin for an additional 24 hours. The slices were cut in four quadrants to allow for standardized embedding in routine cassettes for further processing and for PCa and multifocality mapping. Tissue sections were embedded in paraffin, and conventional sections were stained with hematoxylin and eosin.

The number of tumor foci and spatial location peripheral, transition, anterior zone were recorded according to the criteria of McNeal et al. An area of carcinoma was considered to be a separate focus if it was separated from the nearest adjacent focus by a low-power field diameter 4.

All cancers were reviewed twice and confirmed for grade and pathological extent. Each tumor focus was outlined on the slides, and its surface measured using a standard Aperio image analyzer.

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Volume estimation for each tumor focus was calculated by measurement of tumor area in each section using virtual microscopy. Cancer volumes were calculated by multiplying the tumor area by the section thickness 4mm.

Total tumor volume was calculated as the sum of the volumes of the individual foci. GS trend was analyzed with the Cochran—Armitage test, whereas age, average number of PCa foci, average PCa volume, and average weight were analyzed as continuous variables and compared using Student t tests or Mann—Whitney—Wilcoxon tests. Multiple logistic regression was used to estimate the probability of having PCa, adjusting for possible confounders such as age, race, and prostate weight. All statistical tests were two-sided, and a P value less than. Analyses were performed using SAS version 9.

Based on estimates of PCa prevalence on autopsy from the literature 7 , 8 , 12 , we estimated the sample to include CAU prostates and ASI prostates. Characteristics of the subjects are shown in Table 1.

Median weight per block was 2. All tests were two-sided. A total of Prostate cancer prevalence distribution by age range. Table 2 presents a breakdown of pathological results according to each decade of life. The percentage of GS 7 or greater PCa increased with age. Nine of 16 Valor's Choice Confederation, 1 by Tanya Huff.

Occult .45: Four Tales of Gunrunning in the Weird West

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