Persius/hicric huggingface dataset:
Animal testing on frogs
Frogs have been used in animal tests throughout the history of biomedical science.
Eighteenth-century biologist Luigi Galvani discovered the link between electricity and the nervous system through studying frogs. The African clawed frog or platanna, Xenopus laevis, was first widely used in laboratories in pregnancy assays in the first half of the 20th century. When human chorionic gonadotropin, a hormone found in substantial quantities in the urine of pregnant women, is injected into a female X. laevis, it induces them to lay eggs. In 1952 Robert Briggs and Thomas J. King cloned a frog by somatic cell nuclear transfer, the same technique that was later used to create Dolly the Sheep, their experiment was the first time successful nuclear transplantation had been accomplished in metazoans.
Frogs are used in cloning research and other branches of embryology because frogs are among the closest living relatives of man to lack egg shells characteristic of most other vertebrates, and therefore facilitate observations of early development. Although alternative pregnancy assays have been developed, biologists continue to use Xenopus as a model organism in developmental biology because it is easy to raise in captivity and has a large and easily manipulatable embryo. Recently, X. laevis is increasingly being displaced by its smaller relative X. tropicalis, which reaches its reproductive age in five months rather than one to two years (as in X. laevis), facilitating faster studies across generations. The genome sequence of X. tropicalis is scheduled to be completed by 2015 at the latest.
Ankle pain and swelling
Contributors:  Cafer Zorkun M.D., PhD.

# Overview
- Common problem that occurs secondary to a chronic or an acute injury or degenerative disease.
- Ankle sprains are the most common cause of ankle pain.
Ankle sprain are generally a traumatic inversion injury
- Ankle sprain are generally a traumatic inversion injury
- Bilateral ankle swelling can be indicative of cardiac or vascular etiologies rather than intrinsic foot/ankle disease

# Differential Diagnosis
- Avulsion fracture of the distal fibula
- Bimalleolar fracture
- Degenerative joint disease
- Diabetic arthropathy (Charcot's)
- Inversion sprain
- Inversion/eversion injury of subtalar joint
- Neoplasm
- Peroneal nerve entrapment
- Poor shoe alignment
- Repetitive injury with disruption of the ankle retinaculum
- Syndesmosis injury
- Trimalleolar fracture

# Physical Examination
- Complete physical including ankle, foot, lower leg examination
- Pulses
- Neurovascular status
- Color
- Capillary refill

## X-Ray
- Ottawa ankle rules determine necessity of ankle x-ray following trauma
Tender proximal fifth metatarsal
Tenderness of distal 6 cm of the fibula or tibia
Tender navicular area
Cannot bear weight (at least 4 steps)
- Tender proximal fifth metatarsal
- Tenderness of distal 6 cm of the fibula or tibia
- Tender navicular area
- Cannot bear weight (at least 4 steps)
- Lateral x-rays if needed
- Three-view ankle x-rays
- Stress views
- Foot series
- Lower leg series
Images courtesy of RadsWiki
- Normal ankle; Lateral
- Normal ankle; Oblique
- Normal ankle; AP

## MRI and CT
- CT and MRI if indicated

## Other Diagnostic Studies
- Anterior/posterior drawer test
- Range of motion and muscle strength

# Treatment
Mnemonics for treatment of ancle pain and swelling.
- PRINCE
Protection
Rest
Ice
NSAIDs (nonsteriodal anti-inflammatory drugs)
Compression
Elevation
- Protection
- Rest
- Ice
- NSAIDs (nonsteriodal anti-inflammatory drugs)
- Compression
- Elevation
- Casting if necessary
- To improve range of motion and muscle strength, physical therapy is often recommended

# Surgery and Device Based Therapy
- Bracing ankle/foot may prevent reinjury
- Surgery may be necessary for certain fractures
Anterior border of lung
The anterior border of the lung is thin and sharp, and overlaps the front of the pericardium.
The anterior border of the right lung is almost vertical, and projects into the costomediastinal sinus; that of the left lung presents, below, an angular notch, the cardiac notch, in which the pericardium is exposed.
Opposite this notch the anterior margin of the left lung is situated some little distance lateral to the line of reflection of the corresponding part of the pleura.
Anticipation (genetics)
In medicine, anticipation is a phenomenon whereby the symptoms of a genetic disorder become apparent at an earlier age as it is passed on to the next generation. In most cases, an increase of severity of symptoms is also noted. It is common in trinucleotide repeat disorders like Huntington's disease, myotonic dystrophy and fragile X syndrome, where triplet repeat mutations in DNA are implicated. Rather strangely, all of these diseases produce neurological symptoms.

# Trinucleotide Repeats and Expansion
Trinucleotide repeats are apparent in a number of loci on the human genome, including introns, exons and 5' or 3' UTR's. They consist of a pattern of three nucleotides (e.g. CGG) which is repeated a number of times.  During meiosis, they undergo triplet expansion (see later section); thus, the germ cells produced have a greater number of these repeats.  For many of the loci, this expansion is harmless, but in some areas expansion can eventually affect the expression of a gene, causing symptomatology. To cause this effect, the number of repeats needs to cross a certain threshold; for example, normal individuals have between 5 and 30 CTG repeats at the disease loci for myotonic dystrophy. If the number of repeats becomes greater than 50, the person is only mildly affected - perhaps having only cataracts; also, the locus is meiotically unstable, meaning the number of repeats will grow (dynamic mutations).  Once the number of copies reaches over 100, the disease will manifest earlier in life (although the individual will still reach adulthood before the symptoms are evident) and the symptoms will be more severe - including electrical myotonia. As the number progresses upwards past 400, the symptoms show themselves during childhood.

# Triplet Expansion
The mechanism behind the expansion of the triplet repeats is not well understood. One theory is that the increasing number of repeats influence the overall shape of the DNA, which can have an effect on its interaction with DNA polymerase and thus the expression of the gene.

# Diseases with Anticipation and their Repeats
Click on section title for internal link to a thorough list
- Autosomal Dominant
Several spinal cerebellar atrophies
Huntington's Disease - CAG
Myotonic Dystrophy - CTG
- Several spinal cerebellar atrophies
- Huntington's Disease - CAG
- Myotonic Dystrophy - CTG
- Autosomal Recessive
Friedreich Ataxia - GAA
- Friedreich Ataxia - GAA
- X-Linked
Fragile X syndrome - CGG
- Fragile X syndrome - CGG
Antimicrosomal antibody
Synonyms and Related Keywords: Thyroid antimicrosomal antibody; Antimicrosomal antibody; Microsomal antibody; Thyroid peroxidase antibody; TPOAb

# Overview
Antithyroid microsomal antibody is a test to measure antithyroid microsomal antibodies in the blood. Microsomes are found inside thyroid cells. The body produces antibodies to microsomes when there has been damage to thyroid cells.   

# Differential diagnoses
A negative test is normal. A positive test may be due to:
- Autoimmune hemolytic anemia
- Granulomatous thyroiditis
- Hashimoto's thyroiditis
- Nontoxic nodular goiter
- Rheumatoid arthritis
- Sjogren syndrome
- Systemic lupus erythematosus
- Thyroid cancer
High levels of these antibodies have also been linked to an increased risk of:
- Miscarriage
- Preeclampsia
- Premature birth
- In vitro fertilization failure
Other risks associated with having blood drawn are slight but may include:
- Excessive bleeding
- Fainting or feeling light-headed
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Anton-Babinski syndrome
Synonyms and keywords: Anton's blindness

# Overview
Anton-Babinski syndrome, more frequently known as Anton's blindness, is a rare symptom of brain damage occurring in the occipital lobe.  People who suffer from it are "cortically blind," but affirm, often quite adamantly and in the face of clear evidence of their blindness, that they are capable of seeing.  Failure to see is dismissed by the sufferer through confabulation. It is mostly seen following a stroke, but may also be seen after head injury. It's believed that the cause is damage to two areas; the portion of the brain responsible for eyesight, and the portion responsible for detecting the presence of vision.

# Historical Perspective
This condition is named after Gabriel Anton and Joseph Babinski. It is well described by the neurologist Macdonald Critchley:
The sudden development of bilateral occipital dysfunction is likely to produce transient physical and psychical effects in which mental confusion may be prominent. It may be some days before the relatives, or the nursing staff, tumble to the fact that the patient has actually become sightless. This is not only because the patient ordinarily does not volunteer the information that he has become blind, but he furthermore misleads his entourage by behaving and talking as though he were sighted. Attention is aroused however when the patient is found to collide with pieces of furniture, to fall over objects, and to experience difficulty in finding his way around. He may try to walk through a wall or through a closed door on his way from one room to another. Suspicion is still further alerted when he begins to describe people and objects around him which, as a matter of fact, are not there at all.
Thus we have the twin symptoms of anosognosia (or lack of awareness of defect) and confabulation, the latter affecting both speech and behaviour. ("Modes of reaction to central blindness", in The Divine Banquet of the Brain, Raven, New York, 1979, p. 156)
The syndrome may be conceptualised ideally as the converse of blindsight: a syndrome in which part of the visual field is experienced as completely inoperative, but some reliable perception does in fact occur.

# Related Chapters
- Cortical blindness
de:Anton-Syndrom
fi:Antonin oireyhtyma
sv:Antons syndrom
Aorticopulmonary septum

# Overview
The aorticopulmonary septum (also called the spiral septum, or aortic septum in older texts) is developmentally formed from neural crest, specifically the cardiac
neural crest, and actively separates the aorta and pulmonary arteries and fuses with the interventricular septum within the heart during development. 
The actual mechanism of septation of the outflow tract is poorly understood, but is recognized as a dynamic process with contributions from contractile, hemodynamic, and extracellular matrix interactions.

# Clinical significance
The development of the aorticopulmonary septum is complex, and disorders of development are associated with several congenital heart 
defects, including:
- persistent truncus arteriosus
- double outlet right ventricle
- transposition of the great vessels
- tetralogy of Fallot
Aplasia cutis congenita
Synonyms and keywords: Cutis aplasia; congenital absence of skin; congenital scars

# Overview
Aplasia cutis congenita is the most common congenital cicatricial alopecia, and is a congenital focal absence of epidermis with or without evidence of other layers of the skin. 

# Pathophysiology

## Genetics
This dermatological manifestation has been linked to Peptidase D haploinsufficiency and a deletion in Chromosome 19. 

## Associated Conditions
It can be associated with
- Johanson-Blizzard syndrome
- Adams-Oliver syndrome
- Trisomy 13
- Wolf-Hirschhorn syndrome.
It is also seen with exposure to Methimazole and/or Carbimazole in utero.

# Diagnosis

## Physical Examination

### Skin
- Aplasia Cutis Congenita. Adapted from Dermatology Atlas.{{Cite
- Aplasia Cutis Congenita. Adapted from Dermatology Atlas.{{Cite
- Aplasia Cutis Congenita. Adapted from Dermatology Atlas.{{Cite
- Aplasia Cutis Congenita. Adapted from Dermatology Atlas.{{Cite
- Aplasia Cutis Congenita. Adapted from Dermatology Atlas.{{Cite
- Aplasia Cutis Congenita. Adapted from Dermatology Atlas.{{Cite
- Aplasia Cutis Congenita. Adapted from Dermatology Atlas.{{Cite
Internal arcuate fibers

# Overview
Internal arcuate fibers are the axons of second-order neurons contained within the gracile and cuneate nuclei of the medulla oblongata.
These fibers cross (decussate) from one side of the medulla to the other to form the medial lemniscus.
Part of the dorsal column-medial lemniscus system (second neuron), the internal arcuate fibers are important for relaying the sensation of fine touch and proprioception to the thalamus and ultimately to the cerebral cortex.
Arndt-Eistert synthesis

# Overview
The Arndt-Eistert synthesis is a series of chemical reactions designed to convert a carboxylic acid to a higher carboxylic acid homologue (ie. contains one additional carbon atom) and is considered a homologization process. Named for the German chemists Fritz Arndt (1885-1969) and Bernd Eistert (1902-1978), Arndt-Eistert synthesis is a popular method of producing beta-amino-acids from alpha-amino-acids.  Acid chlorides react with diazomethane to give diazoketones.  In the presence of a nucleophile (water) and a metal catalyst (Ag2O), diazoketones will form the desired acid homologue.
While the classic Arndt-Eistert synthesis uses thionyl chloride to convert the starting acid to an acid chloride, any procedure can be used that will generate an acid chloride.
Diazoketones are typically generated as described here, but other methods such as diazo-group transfer can also apply.
Since diazomethane is toxic and violently explosive, many safer alternatives have been developed, such as the usage of ynolates or trimethylsilyldiazomethane.

# Reaction mechanism
The key step in the Arndt-Eistert synthesis is the metal-catalyzed Wolff rearrangement of the diazoketone to form a ketene.
Heat, light, platinum, silver, and copper salts will also catalyze the Wolff rearrangement to produce the desired acid homologue.

# Variations

## Newman-Beal modification
The addition of triethylamine to the diazomethane solution will avoid the formation of -chloromethylketone side-products.
Circulatory anastomosis
Anastomoses occur normally in the body in the circulatory system, serving as backup routes for blood to flow if one link is blocked or otherwise compromised. There are many examples of these in the body. However clinically important examples include:
- Circle of Willis (in the brain)
- scapular anastomosis (for the subclavian vessels)
- joint anastomoses - clinically very important. Almost all joints receive anastomotic blood supply from more than one source. Examples include knee (and geniculate arteries), shoulder (and circumflex humeral), hip (and circumflex iliac) and ankle. See also patellar network.
- pelvic anastomoses
- abdominal anastomoses
- hand and foot anastomoses (which include the palmar and plantar arches)
- Coronary: anterior and posterior interventricular arteries of the heart

# Coronary
Coronary anastomoses are a clinically vital subject: the coronary anastomosis is the blood supply to the heart. The coronary arteries are vulnerable to arteriosclerosis and other effects. Inadequate supply to the heart will lead to chest pains (angina) or a heart attack (myocardial infarction).
Coronary anastomoses are anatomically present though functionally obsolete. There was some suggestion that they may be helpful if a problem develops slowly over time (this will need to be verified) but in the case of the pathogenesis of CHD they do not provide a sufficient blood flow to prevent infarction.
Arthrogryposis overview

# Overview
Arthrogryposis is a rare congenital  disorder that causes multiple joint contractures and is characterized by muscle weakness and fibrosis.
The disease derives its name from Greek literally meaning 'curved or hooked joints'.
There are many known subgroups of AMC, with differing signs, symptoms, causes etc. In some cases, few joints may be affected and the range of motion may be nearly normal. In the most common type of arthrogryposis, hands, wrists, elbows, shoulders, hips, feet and knees are affected. In the most severe types, nearly every joint is involved, including the jaw and back.
It is a non-progressive disease.
Frequently, the contractures are accompanied by muscle weakness, which further limits movement.
AMC is typically symmetrical and involves all four extremities with some variation seen.
Reproductive technology
Reproductive technology is a term for all current and anticipated uses of technology in human and animal reproduction, including assisted reproductive technology, contraception and others.

# Assisted reproductive technology
Assisted reproductive technology (ART) is the use of reproductive technology to treat infertility. This is today the only application of reproductive technology to increase reproduction that is used routinely. Examples include in vitro fertilisation and its possible expansions.
- artificial insemination
- cloning (see human cloning for the special case of human beings)
- cryopreservation of sperm, oocytes, embryos
- embryo transfer
- hormone treatment
- in vitro fertilisation
intracytoplasmic sperm injection
- intracytoplasmic sperm injection
- preimplantation genetic diagnosis (PGD)
- surrogacy
- testicular sperm extraction (TESE)
- Gamete intrafallopian transfer (GIFT)

# Contraception
Contraception may also be viewed as a form of reproductive technology, as it enables people to control their fertility.

# Others
The following techniques, in contrast to ART, is not yet routinely used. In fact, most of them are even at the developmental stage:
- artificial wombs
- germinal choice technology
- in vitro parthenogenesis
- reprogenetics

# Controversy
Many issues of reproductive technology have led to bioethical issues being raised, since it often alters the assumptions that lie behind existing systems of sexual and reproductive morality.

# In fiction
Aldous Huxley's 1932 novel Brave New World was one of the earliest works to anticipate the possible social consequences of reproductive technology. Its largely negative view was reversed when the author revisited the same themes in his utopian final novel, Island, 1962.
Gattaca is a 1997 science fiction drama film drawing on concerns over technological developments which facilitate reprogenetics, and the possible consequences of such biotechnology for society. It also explores the theme of destiny and the ways in which it can and does govern lives. Characters in Gattaca continually battle both with society and with themselves to find their place in the world and who they are destined to be according to their genes.
cs:Reprodukcni technologie
Athlete's heart changes

# Overview
Athlete's heart is a term that refers to concentric and symmetric hypertrophy of the left ventricle that occurs in some athletes. It is important to distinguish Athlete's heart, which is not a true cardiomyopathy from hypertrophic obstructive cardiomyopathy (HOCM), which is a true cardiomyopathy and places the athlete at risk of sudden death.

# Traditional Criteria for Distinguishing Athlete's Heart from HOCM
Several criteria can be used to distinguish these two entities:

## The degree of left ventricular wall thickness
- In athlete's heart the LVH is symmetric and less than or = to 12 mm
- Rarely the LV thickness can be 14-16 mm and this makes it difficult to distinguish from HOCM. Athletes who engage in strength training may develop this pattern, ahtletes who engage in endurance training do not.
- If the degree of thickening is out of proportion to the type and intensity of exercise, this suggests HOCM

## The pattern of left ventricular wall thickness
- Athleste's heart is symmetric
- HOCM is more often asymmetric, but may in some cases be symmetric

## The left ventricular cavity size
- HOCM has smaller LV cavitary dimensions in general

# Sophisticated Criteria and Testing to Distinguish Athlete's Heart from HOCM
- Doppler mitral valve inflow patterns are diagnostic of HOCM 9prolonged isovolumic relaxation time, reduced peak E velocity, prolonged deceleration time, increased peak A velocity, and decreased E/A ratio as compared to normal controls or athletes)
- Tissue doppler echocardiography
- Electrocardiogram: HOCM is favored if there are prominent q waves, large increases in voltages, and deep T wave inversions
- The presence of an LV outflow tract gradient favors the diagnosis of HOCM
- A speckled pattern on MRI favors the diagnosis of HOCM
CME Category::Cardiology
Atovaquone how supplied

# How Supplied
MEPRON Suspension (bright yellow, citrus flavored) containing 750 mg atovaquone in each teaspoonful (5 mL).
Bottle of 210 mL with child-resistant cap (NDC 0173-0665-18).
Store at 15 to 25C (59 to 77F). DO NOT FREEZE. Dispense in tight container as defined in USP.
5-mL child-resistant foil pouch - unit dose pack of 42 (NDC 0173-0547-00).
Store at 15 to 25C (59 to 77F). DO NOT FREEZE.
Atovaquone microbiology

# Microbiology

### Mechanism of Action
Atovaquone is a hydroxy-1,4-naphthoquinone, an analog of ubiquinone, with antipneumocystis activity. The mechanism of action against Pneumocystis jiroveci has not been fully elucidated. In Plasmodium species, the site of action appears to be the cytochrome bc1 complex (Complex III). Several metabolic enzymes are linked to the mitochondrial electron transport chain via ubiquinone. Inhibition of electron transport by atovaquone will result in indirect inhibition of these enzymes. The ultimate metabolic effects of such blockade may include inhibition of nucleic acid and ATP synthesis.

### Activity In Vitro
Several laboratories, using different in vitro methodologies, have shown the IC50 (50% inhibitory concentration) of atovaquone against rat P. jiroveci to be in the range of 0.1 to 3.0 mcg/mL.

### Drug Resistance
Phenotypic resistance to atovaquone in vitro has not been demonstrated for P. jiroveci. However, in 2 patients who developed Pneumocystis carinii pneumonia (PCP) after prophylaxis with atovaquone, DNA sequence analysis identified mutations in the predicted amino acid sequence of P. jiroveci cytochrome b (a likely target site for atovaquone). The clinical significance of this is unknown.
Auditory hallucinations
Auditory hallucinations are a psychological phenomenon relating to the experience of hearing voices. It is, although not always, a sign of mental disorders such as Schizophrenia. It can be treated with medication to some degree.
Auditory hallucinations, and in particular the hearing of a voice, are thought of as particularly characteristic of people suffering from schizophrenia. However, normal subjects also report auditory hallucinations to a surprising extent. For example, Bentall and Slade found that as many as 15.4% of a population of 150 male students were prepared to endorse the statement In the past I have had the experience of hearing a persons voice and then found that no one was there. They add: no less that 17.5% of the  were prepared to score the item I often hear a voice speaking my thoughts aloud as Certainly Applies. This latter item is usually regarded as a first-rank symptom of schizophrenia
Green and McCreery found that 14% of their 1800 self-selected subjects reported a purely auditory hallucination, and of these nearly half involved the hearing of articulate or inarticulate human speech sounds. An example of the former would be the case of an engineer facing a difficult professional decision, who, while sitting in a cinema, heard a voice saying, loudly and distinctly: You cant do it you know. He adds: It was so clear and resonant that I turned and looked at my companion who was gazing placidly at the screen I was amazed and somewhat relieved when it became apparent that I was the only person who had heard anything.
This case would be an example of what Posey and Losch call hearing a comforting or advising voice that is not perceived as being ones own thoughts. They estimated that approximately 10% of their population of 375 American college students had had this type of experience.

# Musical Hallucinations
Some people do not hallucinate voices or noise, they hallucinate music.

# Causes

## Drug Induced
Quazepam,