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Nonmelanocytic Lesions
Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Nicole Nagrani, Natalie M. Williams, Natalia Jaimes
Both types of hemangiomas demonstrate similar dermoscopic features. The archetypal dermoscopic structures in hemangiomas are lacunae or lagoons, which are round to oval or angulated, well-defined areas that may vary in size and color. Lacunae may be tightly clustered or scattered throughout the lesion and are often separated by fibrous septae. Based on their location and depth within the skin, their color can range from red, red-white, or red-blue to maroon, blue, blue-black, or even black if thrombosis is present (Figures 6f.1–6f.7).
Structural and Functional Aspects of Brain Damage
Published in Giuseppe Mancia, Guido Grassi, Konstantinos P. Tsioufis, Anna F. Dominiczak, Enrico Agabiti Rosei, Manual of Hypertension of the European Society of Hypertension, 2019
Cristina Sierra, Miguel Camafort, Antonio Coca
Lacunar infarction is the infarct subtype most closely and directly associated with hypertension due to its high prevalence among clinical lacunar syndromes and the hypertensive lipohyalinotic changes seen in small penetrating vessels at necropsy (11). In other types of infarct, the effect of hypertension is less direct and is mediated by its effects on atherogenesis in large extracranial or intracranial vessels. Lacunae are small infarcts, or occasionally, haemorrhages related to Charcot-Bouchard microaneurysms.
IVIM MRI: A Window to the Pathophysiology Underlying Cerebral Small Vessel Disease
Published in Denis Le Bihan, Mami Iima, Christian Federau, Eric E. Sigmund, Intravoxel Incoherent Motion (IVIM) MRI, 2018
Jacobus F. A. Jansen, Sau May Wong, Walter H. Backes
Current therapies of lacunar stroke, one of the most common clinical manifestations of cSVD [33], include antiplatelet therapy, blood pressure reduction, and statin therapy [34]. Quantitative IVIM imaging measures were associated with WMHs and may act as potential surrogate markers for structural damage in cSVD [17, 18, 20]. Tissue injury, including lacunae and WMHs, is linked to cognitive decline and physical and psychiatric disabilities [3]. Since the imaging measures may be potential surrogate markers of structural damages in cSVD, these measures can be employed as a neurobiological readout of treatment for patients with cSVD in the short term. For example, vascular risk factors (e.g., smoking, blood pressure, and diabetes) are known to be correlated with WMH severity and the occurrence of lacunae [35]. It can be investigated whether an intervention to improve the vascular condition could lead to less tissue injury in the future. However, prior to conducting this intervention study, which will likely require a long follow-up time, the effect of this intervention on the imaging measures can be studied in the shorter term to gain an early insight into biological responses. For this purpose, longitudinal studies are required to explore the role of imaging measures as surrogate markers of cSVD in more detail. These studies could evaluate whether functional impairment (e.g., abnormal microvasculature and/or parenchyma as shown through IVIM) indeed precedes morphological abnormalities.
Neo-Fetishism: Toward an Epistemological Hybrid at the Crossroads Between Psychoanalysis and the Social Sciences
Published in Studies in Gender and Sexuality, 2023
In 2010, a book was published presenting research on fetishism by several eminent psychoanalysts (Bouchet-Kervella, Bouhsira, and Janin-Oudinot, 2012). With the exception of already-old texts by Freud and Glover5Who, we should note, saw alcoholism as a fetishism, which shows how far some authors will denature the concept in order to “make their case.” republished in this volume, none of the texts in this collection presented any clinical case illustrating fetishistic behavior. One of the patients we encounter in this book is a homosexual whose fetish is “backroom” sex. Another happens to be an analysand in whom the author detects a fetishistic transference bond. Both cases are far removed from the imperious use of an object for sexual ends that is the very essence of fetishism. I wonder about the signification of this clinical lacuna. Have fetishists disappeared? Have they stopped seeking professional help? For that matter, did they ever seek it? We have long taken comfort from the maxim that says “The pervert is the one who doesn’t seek professional help,” even more so in the case of the fetishist enamored of a magical object he has no desire to give up since it seems to fulfill him and help him overcome his psychic conflicts. However, a number of analysts, led by Joyce McDougall (1978/2005), have shown that this is certainly not the case, and that the many fetishists in analysis are evidently capable of requesting psychoanalysis and investing the psychoanalytic setting.
The role of extracranial carotid duplex in predicting functional outcome in first time lacunae strokes
Published in Neurological Research, 2023
Ting-Wei Jiang, Ying-Lin Hsu, Ju-Lan Yang, Yin-Tzer Shih, Chih-Ming Lin
Clinical first-time stroke presentations vary a lot, and this is particularly evident when first-line clinicians encounter various types of strokes. Lacunae stroke is the most common type of stroke classification. The cause of lacunae is an uncontrolled human body hypertensive state, elevated blood sugar, and lipid deposition causing small intracranial obstructions leading to a cerebral parenchyma ischemic state, thus presenting clinical stroke symptoms) [17]. However, prevention and long-term outcome predictions are yet to be investigated. The current study, though not large in scale, looked at the longitudinal retrospective nature and followed up for one year or more on each patient and discovered that the baseline carotid duplex parameter could effectively predict the long-term physical functional ability of lacunae stroke patients. Upon reviewing current published literature and case reports, it was clear that none of the related research emphasized lacunae stroke outcome prediction through use of baseline carotid duplex variables. We therefore believe that this research could serve as important information in filling the gaps in this arena.
Retinal Vascular Patterns and Capillary Plexus Reflectivity of Intraocular Tumors; an Optical Coherence Tomography Angiography Study
Published in Current Eye Research, 2022
Busenur Gönen, Mustafa Hepokur, Ümit Yaşar Güleser, Hüseyin Yetik, Ahmet Murat Sarıcı
Four different patterns have previously been described in choroidal osteoma. These are the absence of vascular flow (6.25%), a dark background compatible with decalcification (12.5%), the presence of a vascular network (25%) and a neovascular membrane (18.75%).17 We observed a vascular network (42.9%) within the tumor only in cases with CNV. We did not observe the absence of vascular flow within the tumor in any cases. Actually, there was blood flow because there was a normal choriocapillaris structure in areas except the spaces compatible with the lacunae. Toledo et al. showed the presence of a hyporeflective plexus in a lesion and an intense signal on the en-face image in evaluating the choriocapillaris plexus.11 Similarly, we detected these findings in our cases with choroidal osteoma. It should be kept in mind that choroidal osteoma has the appearance of mature bone tissue, based on histopathological examination. This may cause deviations (e.g. pigmented lesions) on OCTA images compared to reality by affecting light transmission.