Brain, cerebellum--Sarcoidosis Why is this cerebellum? Arteriosclerosis is a particular morphological pattern of vascular pathology observed in arterioles most often encountered as a result of chronic hypertension. Definition. Arteriosclerosis, often described as a thickening and hardening of the arteries, appears in various forms and can be related to a number of different causes. Study free Science flashcards and improve your grades. Individuals with recent onset of severe hypertension, if they manifested changes in the arterioles, would have fibrinoid necrosis, or, hyperplastic arteriolosclerosis. Stage II Hypertension is classified as BP >160/100. with narrowing of the lumen Hyperplastic arteriolosclerosis - onionskin, concentric, laminated thickening of the walls of arterioles with progressive narrowing of the lumina - in malignant hypertension hyperplastic changes are accompanied by deposits of fibrinoid and acute necrosis of the vessel walls. I am a bit confused about how these two findings are linked with malignant hypertention. hyperplastic arteriolosclerosis + fibrinoid arteriolitis . We examined the influence of chronic treatment with ANG-(1–7) on development of hypertension and end-organ damage in spontaneously hypertensive rats … Hyaline arteriolosclerosis. (Ci012) 19. Even the acute blood pressure elevations that are observed in malignant hypertension may induce acute pathological vascular remodeling that include hyperplastic arteriolosclerosis and fibrinoid necrosis. Ans. In malignant hypertension these hyperplastic changes are often accompanied by fibrinoid necrosis of the arterial intima and … Theodore L. Goodfriend, Kristin M. Lyerly, in Pathophysiology of Kidney Disease and Hypertension, 2009 3 Small Arteries and Arterioles. 74%. One complication of hyperplastic arteriolosclerosis with malignant hypertension is fibrinoid necrosis, as seen here in a renal arteriole. The “fibrinoid” part of the name seems to imply that fibrin has a central role in the mechanism of this type of necrosis. [4] The term "onion-skin" is sometimes used to describe this form of blood vessel[8] with thickened concentric smooth muscle cell layer and thickened, duplicated basement membrane. 6. is ‘d’ i.e., Fibrinoid necrosis [Ref : Robbin’s 7Th/e p. 1006, 1007 & 6e p. [snip],[snip] p. [snip] Whether it is “essential” or of known etiology, hypertension results in development of intrinsic lesions of the renal arterioles (hyaline arteriolosclerosis) ... *Fibrinoid necrosis in walls of small arteries and afferent arterioles. 6). The term "onion-skin" is sometimes used to describe this form of blood vessel with thickened concentric smooth muscle cell layer and thickened, duplicated basement membrane. Flea Bitten Kidney. (general) Results in reduced vessel caliber with end-organ ischemia. arteriolar nephrosclerosis. nephrosclerosis. hardening of the kidney, usually associated with hypertension and disease of the renal arterioles. It is characterized as benign or malignant depending on the severity and rapidity of the hypertension and arteriolar changes. Five of 12 cases had cardiomegaly, with concentric hypertrophy of the left ventricular myocardium. 7.8) that slowly progresses to chronic renal failure C. Hyperplastic arteriolosclerosis involves thickening of vessel wall by hyperplasia of smooth muscle ('onion-skin' appearance, Fig. Hyperplastic arteriolosclerosis: It is characterized by thickening of the arteriolar wall due to the concentric proliferation of smooth muscle cells, giving the arterioles an “onion skin” appearance. These changes represent an adaptive response of arterioles to severe (“malignant”) hypertension. Definition. What causes hyperplastic arteriosloclerosis? Atlectasis and its Types. ie benign DM. Characteristic Disease type of amyloid that appears in inflammation (chronic infection, RA) AA amyloid edema + frothy urine nephrotic syndrome concentric, laminated thickening of arterioles due to smooth mm proliferation ("onion-skinning") hyperplastic arteriolosclerosis first step in th Pregnancy-induced Hypertension (preeclampsia-eclampsia) Pre-eclampsia is the triad of . (10) References: 1. Asthma and its Types. Learn faster with spaced repetition. The end result is a The end result is a Necroptosis (1,528 words) [view diff] exact match in snippet view article find links to article Hyperplastic arteriolosclerosis is the most common lesion in hypertension. Hypertensive emergency is defined as elevated blood … What does hyperplastic arteriolosclerosis lead to? Hyperplastic arteriolosclerosis, appears with fibrinoid necrosis in severe malignant hypertension -> diastolic BP >120 mmHG. Flutamide-treated female TGR(mREN2)27 have a completely normal histological aspect of the kidney (B). It is common in the immune-mediated vasculitides which are a result of type III hypersensitivity. Clinical features in Emphysema. Well, it doesn’t. PTH indirectly stimulates proximal tubule cells to make 1,25-(OH) 2 vit D which ↑ intestinal absorption of both Ca2+ and phosphate. Arteriosclerosis. Microcalcifications may rarely be so extensive and closely packed as to produce a “brain stone.”. Histopathologically, these petechiae are revealed to represent perivascular microhemorrhage and are associated with hyperplastic arteriolosclerosis and fibrinoid necrosis of parenchymal vessels [22, 23]. IV-G had lower CH50 levels. Yokoyama . HEMOLYTIC UREMIC SYNDROME (FIBRINOID NECROSIS OF HILAR ARTERIOLE). Hyaline arteriolosclerosis is a major morphologic characteristic of benign nephrosclerosis, in which the arteriolar narrowing causes diffuse impairment of renal blood supply, with loss of nephrons. 2) and distinguished from the Reading time: 3 minutes. Although the terms neural retina and sensory retina are proper, in this chapter, because of “customary” usage, the terms retina, neural retina, and sensory retina are often used interchangeably. (L) areas of black hemorrhage & chalky, yellow/white fat necrosis with soft, gray/white necrotic parenchyma (R) acute inflammation with necrosis & fibrinoid necrosis of vessel --> hemorrhage ; chronic pancreatitis (L) fibrous replacement, atrophy of exocrine pancreatic glands (central) some preserved islets within atrophy The following classification was used for deTABLE termining the severity of renal vascular lesions: -, no or a slight thickening of the arterioles; t, a mild thickening a focal necrosis of the arterioles, ++, an extensive fibrinoid necrosis /or proliferative arteriolosclerosis. Narrowing of the arteriolar lumens (afferent and efferent) can be due to hyperplastic arteriolosclerosis (not to be confused with arteriosclerosis or atherosclerosis) or hyalinosis. Title: No Slide Title Author: J. Matthew Velkey Last modified by: J. Matthew Velkey Created Date: 5/3/2002 12:05:02 PM Document presentation format Fibrinoid necrosis, concentric wall thickening of arterioles, and hyperplastic arteriolosclerosis is observed in the kidney of untreated rats (A). Malignant HTN may lead to _____ of the vessel wall. Identify the major risk factors for atherosclerosis. Pathoma says that HA can lead to Fibrinoid necrosis whilst RR describes these two as indipendent conditions. Arteriolosclerosis : morphologic forms of vascular disease affecting arterioles and small muscular arteries. Due to Fibrinoid Necrosis Raimund Kottke1 Marius Horger1 Heiko Schimmel2 Manfred Wehrmann2 Kottke R, Horger M, Schimmel H, Wehrmann M ... cytologic atypia, and mixed hyperplastic and adenomatous FNH, the last being the least common subtype, accounting for … proximal tubule cells convert 25-OH vit D to 1,25-(OH) 2 vit D, which ↑ intestinal absorption of Ca2+ and phosphate. In humans, the most common cause of arteriolosclerosis is systemic hypertension which can occur via primary or secondary means. If you are viewing this on the new Reddit layout, please take some time and look at our wiki (/r/step1/wiki) as it has a lot of valuable information regarding advice and approaches on taking Step 1, along with analytical statistics of study resources. Malignant (accelerated) hypertension can damage the kidney, causing fibrinoid necrosis of arterioles, glomerulitis, and hyperplastic arteriolosclerosis. 46. Raimund Kottke 1, Marius Horger 1, Heiko Schimmel 2 and Manfred Wehrmann 2 ... although a preexisting arterial malformation or vascular injury with subsequent hyperplastic response and proliferation of vessels and bile ducts has been suggested . Hyperplastic arteriolosclerosis - thickening of vessel wall by hyperplasia - hyperplasia of s.m. No difference. This banner text can have markup.. web; books; video; audio; software; images; Toggle navigation Hyperplastic arteriolosclerosis occurs more often in patients with hypertension; typically, laminated, concentric thickening and luminal narrowing occur, sometimes with fibrinoid deposits and vessel wall necrosis (necrotizing arteriolitis). arteriolosclerosis from the hypertension, focal segmental GN; 6 Fibromuscular dysplasia. Note laminar arrangement in vascular wall, “onion skin lesion”. One complication of hyperplastic arteriolosclerosis with malignant hypertension is fibrinoid necrosis, as seen here involving a renal arteriole.fibrinoid necrosis, as seen here involving a renal arteriole. 26%. In malignant hypertensionthese hyperplastic changes are often accompanied by fibrinoid necrosis of the arterial intima and media. Adrenal gland --Polyarteritis Find some involved arteries. Fibrinoid necrosis --> may cause acute renal failure: Term. What is the major complication of a thoracic aneurysm? Of the various serum enzymes, which is the first to be elevated after an acute myocardial infarction: A. Hypertensive urgency is defined as having a systolic blood pressure over 180 mmHg or a diastolic blood pressure over 110 mmHg. The pathologies thought to be secondary to uncontrolled hypertension include hyaline arteriolosclerosis (figure 1A), hyperplastic arteriolosclerosis, segmental arterial disorganization, and microaneurysm (figure 1B). IV-S had more fibrinoid necrosis and lower C4. Peter Nelson 1, Erin Abner 1, Richard Kryscio 1, ... Foci of necrosis were present, and proliferative activity was brisk (up to 17 mitoses identified per 10 high-power fields). In 5% of cases the fibrinoid necrosis was present with ... (Hyaline change) was seen in 80.00% renal biopsies whereas; arteriolosclerosis (Hyperplastic myointimal changes) was present in 66.66% of cases. Hyperplastic arteriolosclerosis. Hyperplastic Arteriolosclerosis. 6. arteriolosclerosis: Monckeberg's sclerosis (medial calcinosis): For atherosclerosis, describe the gross and microscopic appearances of the lesions, their distribution within the arterial tree, major known predisposing factors and complications. 17 Arterio- and arteriolosclerosis (kidney) 18 In malignant hypertension these hyperplastic changes are often accompanied by fibrinoid necrosis of the arterial intima and media. -Arteriosclerosis can be Hyaline ( protein-DM,HT) or hyperplastic (smooth ms hyperplasia, fibrinoid necrosis-malignant HT) or Monckeberg (medial calcific sclerosis) 4. How HA can lead to FN? Proteinuria was associated with increased severity of tubular degeneration, inflammation, fibrosis, tubular epithelial single-cell necrosis, and decreased normal parenchyma. GENETICS • In black people, HN occurs earlier, is more severe, and more often causes ESRD (36.8% vs 26% in white patients). 33%. Larger renal vessels such as renal interlobular arteries often display a concentric proliferation of the vascular wall's cellular elements, termed "Hyperplastic Arteriolosclerosis". d)Fibrinoid necrosis. Arterial damage caused by the sudden onset of malignant hypertension can cause fibrinoid necrosis. In malignant hypertension these hyperplastic changes are often accompanied by fibrinoid necrosis of the arterial intima and media. This is a type of arteriolosclerosis involving a narrowed lumen. Pathogenesis of Emphysema. Ans. . Study 404 Renal flashcards from Rebecca B. on StudyBlue. • Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, is characterized by intimal changes (smooth muscle proliferation and concentric fibrosis, AKA “onion skinning”) with fibrinoid necrosis of the tunica media. A tutorial of blood vessel pathology for 5th year medical students at Cambridge University. Hyperplastic arteriolosclerosis is a type of arteriolosclerosis involving a narrowed lumen. Fibromuscular dysplasia leads to … Comparison of Chronic Bronchitis and Emphysema. 7.9). Medical emergency . Theodore L. Goodfriend, Christine M. Lyerly, in the pathophysiology of kidney disease and hypertension, 2009Hipeperplasty arteriolosclerosis is the most common lesion in hypertension. Abdominal bruits are commonly heard. 77 terms. lipohyalinosis, fibrinoid necrosis, microatheroma, and charcot – bouchard aneurysms ... •Sustained HTN hyperplastic arteriolosclerosis smooth muscle cell death replacement of tunica media by collagen decreased vascular tone and poor vessel compliance Academia.edu is a platform for academics to share research papers. Occurs in Malignant hypertension, leading to hyperplasia of the intima of blood vessels. Trend to more ESRD in IV-S (P = 0.1495) Hill . Abolition of hypertension-induced kidney histopathology by Flutamide treatment in female rats. ... ‘hyalin’ denotes a glassy appearance to distinguish it from the more granular / fibrillar appearance of vascular fibrinoid necrosis. The term "onion-skin" is sometimes used to describe this form of blood vessel with thickened concentric smooth muscle cell layer and thickened, duplicated basement membrane. One complication of hyperplastic arteriolosclerosis with hypertensive emergency (malignant hypertension) when systolic pressure is ≥180 and/or diastolic pressure ≥120 mmHg along with signs of acute or ongoing end-organ damage is fibrinoid necrosis, as seen here involving a renal arteriole. Irregular pinkish areas represent fibrinoid necrosis. - HTN crisis can also cause vessel wall necrosis with fibrinoid deposits "fibrinoid necrosis"/necrotizing arteriolitis" Fibrinoid necrosis in the brain (in malignant HTN) Normal vs hyaline arteriosclerosis vs hyperplastic arteriolosclerosis. The terms refer to all the “layers” of the retina exclusive of its retinal pigment epithelium (RPE), which is discussed separately (see Chapter 17).The term neurosensory retina is redundant. Fibromuscular dysplasia is a hyperplastic disorder that is usually bilateral, occurs in females, and primarily affects the carotid and renal arteries. Hyperplastic arteriosclerosis is characterized by a pattern of thickening commonly likened to an onion skin, concentric laminations of smooth muscle cells and basement membranes being deposited one on top of the other in layers. Obstructive vs Restrictive lung diseases. Hypertension is a clinically silent pathology that is mostly defined by its late-stage pathologies. Leptomeninges. 67%. • The increased susceptibility of black patients with hypertension to Check out the pink, smudgy, inflamed vessel wall in the image above. The kidneys have a finely granular external surface and on microscopy show hyaline arteriolosclerosis, tubular atrophy, interstitial fibrosis, and glomerulosclerosis. ... and/or fibrinoid vascular necrosis). Arteriolosclerosis is a form of cardiovascular disease involving hardening and loss of elasticity of arterioles or small arteries and is most often associated with hypertension and diabetes mellitus. Histopathologic examination of the early lesion for definite diagnosis showed deposition of a homogeneous fibrinoid material within blood vessels of dermis. Primary age-related tauopathy (PART) and brain arteriolosclerosis contribute to mild cognitive impairment. onionskin lesion / hyperplastic arteriolitis: ... especially small renal arteries and arterioles, often associated with malignant hypertension and hyperplastic arteriolosclerosis. Study Exam IV: Hypertension & Vessel Diseases I flashcards from Michelle Sergi's class online, or in Brainscape's iPhone or Android app. fibrinoid necrosis . The various etiologies and pathogenic mechanisms of hypertension can be found on its own page. Hyperplastic arteriolosclerosis, in which vessel walls contain concentric layers of fusiform cells surrounding narrowed lumens. hypertensive emergency (malignant hypertension) when systolic pressure is ≥180 and/or diastolic pressure ≥120 mmHg along with signs of acute or ongoing end-organ damage leads to fibrinoid necrosis of small renal arteries as shown here. Benign nephrosclerosis is characterized by "Hyaline Arteriosclerosis " of the renal arterioles and involves a deposition of a hyaline substance in arteriolar wall that narrows the luminal diameter. The remainder of the kidney, including the glomeruli, nephrons, and renal interstitium all show diffuse atrophy with some attendant fibrosis. Go to next image in … The term "onion-skin" is sometimes used to describe this form of blood vessel with thickened concentric smooth muscle cell layer and thickened, duplicated basement membrane. is ‘d’ i.e., Fibrinoid necrosis [Ref : Robbin’s 7Th/e p. 1006, 1007 & 6e p. [snip],[snip] p. [snip] Whether it is “essential” or of known etiology, hypertension results in development of intrinsic lesions of the renal arterioles (hyaline arteriolosclerosis) The lesions do not encroach on the vessel lumen and usually are not clinically significant. - Malignant HTN - this leads to acute renal failure (ARF) and fibrinoid necrosis of vessel 13. During isolated systolic hypertension, PPs are known to exceed 80–100 mm Hg and affect cardiac and arterial tissues. 1966;149(10):1307-11. Atypical Focal Nodular Hyperplasia with Cluster-Like Internal Cysts Due to Fibrinoid Necrosis. If the kidney has a "flea bitten" appearance to it, what does that indicate? What are consequences of hyperplastic arteriosclerosis? immune complex-related processes induce a local fibrinoid necrosis with ischemia-aggravating thrombosis in the tissue vessel walls. Proteinuria. Smaller renal vessels such as arterioles display fibrinoid necrosis and inflammatory cells may be present, yielding a picture of "Necrotizing Arteriolitis". appeared morphologically to be the counterpart of hyperplastic arteriolosclerosis as seen in the systemic vasculature in essential hypertension; other pulmonary ... of fibrinoid material in the perivascular tissue in addition to fibrinoid necrosis of the media (Fig. [1] Types include hyaline arteriolosclerosis and hyperplastic arteriolosclerosis, [2] both involved with vessel wall thickening and luminal narrowing that may cause downstream ischemic injury. ... the microscopic feature of "onion skinning" with luminal obliteration in this rat is characteristic of hyperplastic arteriolosclerosis. - … In malignant hypertension these hyperplastic changes are often accompanied by fibrinoid necrosis of the arterial intima and media. 1) fibrinoid necrosis of the arterioles, 2) hyperplastic arteriolosclerosis, also called onion-skinning of the arterioles, seen in the vessel in the center of the screen and 3) glomerulitis seen in the hypercellular glomerulus at 7 o'clock on the screen. J Am Vet Med Assoc. Eclampsia is the addition of seizures to the triad. Find "fibrinoid" necrosis. edema . Hyaline arteriolosclerosis is typically found in the kidneys of patients who have diabetes mellitus or benign arterial hypertension. Matching game, word search puzzle, and hangman also available. Proliferative factors in the plasma enters the vessel wall and causes hyperplasia of the tunica intima, causing hyperplastic arteriolosclerosis. Altera KP and Bonasch H. Periarteritis nodosa in a cat. Renal failure due to hyperplastic arteriolosclerosis due to malignant HTN: Term. Hyperplastic arteriosclerosis morphology (fibrosis) All of this inflammation does a lot of damage, and eventually, the vessel wall becomes necrotic. A. myocardial infarct vs. liver necrosis B. myocardial infarct vs. hemolytic anemia C. large vs. small myocardial infarct s D. mild vs. severe coronary atherosclerosis 92. • Fibrinoid necrosis of arterioles accompanied by an inflammatory infiltrate resulting in necrotising alveolitis and hyperplastic arteriolitis, with onionskin-like layering of fibroblasts, smooth muscle cells, and collagen. Chronic bronchitis. This is a type of arteriolosclerosis involving a narrowed lumen. I shall present a study of the microscopic changes in four cases of neurosyphilis showing hyaline degeneration of the blood vessels of the brain. Results in reduced vessel caliber with end-organ ischemia; classically produces glomerular scarring (arteriolonephrosclerosis, Fig. This is a type of arteriolosclerosis involving a narrowed lumen. Can show onion-skinning on histology causing luminal obliteration of vascular lumen May be associated with necrotizing arteriolitis and fibrinoid necrosis of the blood vessel. Discussion Which are avoidable or treatable? PAN is classically described as necrotizing vasculitis and fibrinoid necrosis affecting small and medium-sized vessels of multiple organ systems. Hyperplastic arteriolosclerosis: Characteristic of malignant hypertension. 2. Which of the three vascular layers is involved, intima, media, adventitia, or all? Is a fibrinoid necrotic area a type of hyaline too? Pathology of Hypertension Definition: Stage 1 Hypertension is classified as >140/90 BP. Secret Pathology Notes - Free download as PDF File (.pdf), Text File (.txt) or read online for free. ... - Hyperplastic arteriolosclerosis. Hyperplastic Arteriosclerosis is encountered in patients who display long-term extreme elevations of blood pressure as might be found in the context of malignant hypertension. Hyperplastic Arteriosclerosis is characterized by concentric reduplications of the arteriolar basement membrane by interspersed vascular smooth muscle cells,... … Hypertension. Fibrinoid necrosis of the glomerular tuft was seen in 22% of the glomeruli . The high pressure damages the walls of small arteries and arterioles and increases their permeability to fibrinogen, causing fibrinoid necrosis of these vessels. Click for image. Why is this called "fibrinoid"? Malignant HTN classically causes what? Fibrinoid necrosis is the necrosis of immune disease and is seen in the vegetations associated with acute rheumatic fever and inflammation associated with many collagen vascular diseases. This is a type of arteriolosclerosis involving a narrowed lumen. The narrowing of the lumen can decrease renal blood flow and hence glomerular filtration rate leading to increased renin secretion and a perpetuating cycle with increasing blood pressure and decreasing … Hyaline arteriolosclerosis is a major morphologic characteristic of benign nephrosclerosis, in which the arteriolar narrowing causes diffuse impairment of renal blood supply, with loss of nephrons. Fibrinoid necrosis Hyperplastic arteriolosclerosis 6 Mönckeberg medial sclerosis Characterized by the presence of calcific deposits in muscular arteries, typically in persons older than 50. Fig - onion skin like appearance of blood vessel in hyperplastic arteriolosclerosis 12. 1. A hypertensive emergency is high blood pressure with potentially life-threatening symptoms and signs indicative of acute impairment of one or more organ systems (brain, eyes, heart, aorta, or kidneys). Fibrinoid necrosis is a specific pattern of irreversible, uncontrolled cell death that occurs when antigen - antibody complexes are deposited in the walls of blood vessels along with fibrin. USMLE Step 1 is the first national board exam all United States medical students must take before graduating medical school. IV-G had more renal insufficiency, lower C3 and CH50, more proteinuria, more immune deposits, less fibrinoid necrosis. When stained with hematoxylin and eosin, they appear brightly eosinophilic and smudged. These are: 1. hyaline arteriolosclerosis 2. hyperplastic arteriolosclerosis 3. necrotising arteriolitis All the three types are common in hypertension but may occur due to other causes as well. Early lesion consists of transmural inflammation with fibrinoid necrosis - eventually heals with fibrosis, producing a 'string-of-pearls' appearance on imaging. • Fibrinoid necrosis of arterioles accompanied by an inflammatory infiltrate resulting in necrotising alveolitis and hyperplastic arteriolitis, with onionskin-like layering of fibroblasts, smooth muscle cells, and collagen. HYALINE ARTERIOLOSCLEROSIS: Deposits of extracellular matrix leading to hyalinized wall of arterioles: HYPERPLASTIC ARTERIOSCLEROSIS: Onionskinning of vessels causing luminal obliteration: NECROTIZING ARTERIOLITIS: Hyperplastic changes accompanied with fibrinoid necrosis The damage to the arteries leads to formation of pink fibrin--hence the term "fibrinoid". Elling F. Nutritionally induced necrotizing glomerulonephritis and … Vessels are injured -> plasma proteins leak out and thrombosis occurs -> PDGF leads to intimal hyperplasia, decreasing perfusion due to vasoconstriction. The term "onion-skin" is sometimes used to describe this form of blood vessel with thickened concentric smooth muscle cell layer and thickened, duplicated basement membrane. 19. These changes are most prominent in the kidney and can lead to ischemia and acute kidney failure. Aortic dissection vs aneurysm • In persons of all age groups, ESRD is more common in black people • The rate of developing ESRD is 3.5 times higher than the rate found among whites. January (101) 2010 (100) December (57) November (11) 23. d)Fibrinoid necrosis. an adaptive reaction of arterioles to severe (malignant) hypertension. Emphysema and its Types. The narrowing of the lumen can decrease renal blood flow and hence glomerular filtration rate leading to increased renin secretion and a perpetuating cycle with increasing blood … Hyperplastic arteriolosclerosis: It is characterized by thickening of the arteriolar wall due to the concentric proliferation of smooth muscle cells, giving the arterioles an “onion skin” appearance. Hyperplastic arteriolosclerosis can also be associated with fibrinoid necrosis in the vessel walls.
What Pairs Well With Peonies, Blank Bell Shaped Curve Graph, Taleo Learning Management System, Railway Jobs Qualification And Salary 2021, Exquisite Jewelry Company, Interposition Monocular Cue, Back Of Thigh Tattoo Words,