Persius/hicric huggingface dataset:
UC Davis School of Medicine

# History
Founded in 1966, the UC Davis School of Medicine graduated its first class of physicians in 1972. The school maintains research facilities on the Davis campus while the majority of the school's teaching and clinical space is located in Sacramento, 17 miles to the east of the Davis campus.  With the December 2006 opening of its new Education Building, the school recently transitioned all medical school classes to the Sacramento campus. Research activities will continue at both campuses for the foreseeable future.

# Admissions and Ranking
As a result of UC Davis School of Medicine's small class size, desirable location in Northern California and relatively affordable tuition, admissions is highly competitive. In 2005 the school received 4,109 applications. The school offered interviews to 392 applicants and 93 matriculated. This yields an acceptance rate of approximately 6 percent. For 2007, US News and World Report ranks UC Davis School of Medicine #30 based on primary care methodology and #49 based on research methodology.

# Hospitals
UC Davis Medical Center, located in Sacramento, is one of five teaching hospitals in the University of California system.  It ranks among the top 50 hospitals in America, according to an annual survey published by U.S. News and World Report. Other hospitals affiliated with UC Davis school of medicine include:
- UC Davis Children's Hospital
- UC Davis Cancer Center
- Shriners Hospitals for Children-Northern California
- Sacramento VA Medical Center

# Research
Faculty in the School of Medicine specialize in a wide range of basic and applied research, including those related to neuroscience, cancer biology, vascular biology, genetic diseases and functional genomics, health services, infectious diseases, nutrition, telemedicine, and vision science. The school receives approximately $90 million in NIH funding annually. About half of UC Davis medical students conduct research during their training.

# Student Clinics
UC Davis School of Medicine is known for the quality of its student-run clinics, which offer free primary care to the uninsured, low-income and other underserved population of Sacramento and surrounding areas. These clinics provide patients quality health care and allow UC Davis medical students to gain real world clinical experience during the early stages of their training.
- Clinica Tepati
- Imani Clinic at Oak Park
- Joan Viteri Memorial Clinic
- Paul Hom Asian Clinic
- Shifa Community Clinic

# See Also
- List of Medical Schools in the United States
- Medical School
- University of California
- UC Davis
Uridine diphosphate glucose
Uridine diphosphate glucose (uracil-diphosphate glucose, UDP-glucose) is a nucleotide sugar. It is involved in glycosyltransferase reactions in metabolism.

# Functions
It is used in nucleotide sugars metabolism as an activated form of glucose as a substrate for enzymes called glucosyltransferases.
It is a precursor of glycogen and can be converted into UDP-galactose and UDP-glucuronic acid, which can then be used as substrates by the enzymes that make polysaccharides containing galactose and glucuronic acid.
UDP-glucose can also be used as a precursor of sucrose lipopolysaccharides, and glycosphingolipids.

# Components
UDP-glucose consists of the pyrophosphate group, the pentose sugar ribose, glucose, and the nucleobase uracil.
UDP-glucose 6-dehydrogenase
UDP-glucose 6-dehydrogenase is a cytosolic enzyme that in humans is encoded by the UGDH gene.
The protein encoded by this gene converts UDP-glucose to UDP-glucuronate and thereby participates in the biosynthesis of glycosaminoglycans such as hyaluronan, chondroitin sulfate, and heparan sulfate. These glycosylated compounds are common components of the extracellular matrix and likely play roles in signal transduction, cell migration, and cancer growth and metastasis. The expression of this gene is up-regulated by transforming growth factor beta and down-regulated by hypoxia.
This enzyme participates in 4 metabolic pathways: pentose and glucuronate interconversions, ascorbate and aldarate metabolism, starch and sucrose metabolism, and nucleotide sugars metabolism.

# Nomenclature
This enzyme belongs to the family of oxidoreductases, specifically those acting on the CH-OH group of donor with NAD+ or NADP+ as acceptor. The systematic name of this enzyme class is UDP-glucose:NAD+ 6-oxidoreductase.
Other names in common use include:
- UDP-glucose dehydrogenase,
- uridine diphosphoglucose dehydrogenase,
- UDPG dehydrogenase,
- UDPG:NAD oxidoreductase,
- UDP-alpha-D-glucose:NAD oxidoreductase,
- UDP-glucose:NAD+ oxidoreductase,
- uridine diphosphate glucose dehydrogenase,
- UDP-D-glucose dehydrogenase, and
- uridine diphosphate D-glucose dehydrogenase.

# Biochemistry
In enzymology, a UDP-glucose 6-dehydrogenase (EC 1.1.1.22) is an enzyme that catalyzes the chemical reaction
The 3 substrates of this enzyme are UDP-glucose, NAD+, and H2O, whereas its 3 products are UDP-glucuronate, NADH, and H+
References:
Ubiquitin-activating enzyme
Ubiquitin-activating enzymes, also known as E1 enzymes, catalyze the first step in the ubiquitination reaction that targets a protein for degradation via the proteasome. The ubiquitination process covalently attaches ubiquitin, a short protein of 76 amino acids, to a lysine residue on the target protein. Once a protein has been tagged with one ubiquitin molecule, additional rounds of ubiquitination form a polyubiquitin chain that is recognized by the proteasome's 19S regulatory particle, triggering the ATP-dependent unfolding of the target protein that allows passage into the proteasome's 20S core particle, where proteases degrade the target into short peptide fragments for recycling by the cell.
The E1 reaction is itself ATP-dependent and begins with ATP hydrolysis coupled to adenylation of a molecule of free ubiquitin. The adenylated ubiquitin is transferred to the E1's active site cysteine residue in concert with the adenylation of a second molecule of ubiquitin, which is then transferred to the active-site cysteine residue of the next enzyme in the ubiquitination catalytic chain, the ubiquitin-conjugating enzyme or E2. The reaction in which the ubiquitin is attached to the target protein is performed by the third class of molecules in the chain, the ubiquitin ligases or E3s.
In most cells there are only a few different types of E1 and E2 enzymes, but many different types of E3s. It is the E3 that binds the substrate and therefore confers substrate specificity.
Uniform Anatomical Gift Act

# Overview
The Uniform Anatomical Gift Act (UAGA), and its periodic revisions, is one of the uniform acts that attempt to harmonize the law in force in the fifty U.S. states. It provides a template for the creation and amendment of legislation to adjust public policy and align it with developments in medical practice.
This law governs organ donations for the purpose of transplantation, and it also governs the making of anatomical gifts of one's cadaver to be dissected in the study of medicine. The law prescribes the forms by which such gifts can be made. It also provides that in the absence of such a document, a surviving spouse, or if there is no spouse, a list of specific relatives in order of preference, can make the gift. It also seeks to limit the liability of health care providers who act on good faith representations that a deceased patient meant to make an anatomical gift.
The proposed law has been recently revised to make the process of making an anatomical gift more streamlined.  Formerly, anatomical gifts had to be executed with testamentary formalities, including the creation of a written instrument with two witnesses.  The latest version of the statute eliminates the requirement of the witnesses.  This change is to encourage the practice of allowing an anatomical gift to be made by a notation on a driver's license.
The act also prohibits trafficking in donated human organs for profit.
The history of the UAGA shows the limits of legislation to achieve certain social goals.
Valproate sodium overdosage

# Overdosage
Overdosage with valproate may result in somnolence, heart block, and deep coma. Fatalities have been reported; however patients have recovered from valproate serum concentrations as high as 2120 mcg/mL.
In overdose situations, the fraction of drug not bound to protein is high and hemodialysis or tandem hemodialysis plus hemoperfusion may result in significant removal of drug. General supportive measures should be applied with particular attention to the maintenance of adequate urinary output.
Naloxone has been reported to reverse the CNS depressant effects of valproate overdosage. Because naloxone could theoretically also reverse the antiepilepsy effects of valproate, it should be used with caution in patients with epilepsy.
Vertebral artery dissection

# Overview
Vertebral artery dissection is the development of dissection (a flap-like tear) in the vertebral artery. It is commonly associated with physical trauma but may also develop spontaneously. It is a major cause of ischemic stroke in young people.

# Epdidemiology and Demographics
The annual incidence is about 1 per 100,000 in America and 1.5 per 100,000 in France.

# Diagnosis

## Symptoms
Typical features are pain in the neck associated with stroke-like symptoms of the "posterior circulation": cranial nerve palsies, ataxia, and cortical visual loss. It can also cause subarachnoid hemorrhage (bleeding into the area around the brain); dissecting aneurysms of the vertebral artery represent about 4% of all aneurysms.

## CT
- Vertebral artery dissection 1
- Vertebral artery dissection 2
- Vertebral artery dissection 3
- Vertebral artery dissection 4
- Vertebral artery dissection 5
- Vertebral artery dissection 6
- Vertebral artery dissection 7

# 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS: Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease (DO NOT EDIT)

## Management of Patients with Cervical Artery Dissection (DO NOT EDIT)

# Related Chapters
- Vertebral artery disease
- Ischemic stroke
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2-Hydroxyglutaric aciduria
2-hydroxyglutaric aciduria is a rare, autosomal recessive neurometabolic disorder characterized by the significant elevation of urinary levels of hydroxyglutaric acid.

# Forms
2-hydroxyglutaric aciduria is an organic aciduria, and has two distinct isometric variants:

## L-2-hydroxyglutaric aciduria
The L-2 form is more common, severe, and mainly affects the central nervous system. The basal ganglia are affected, and cystic cavitations in the white matter of the brain are common, beginning in infancy. This form is chronic, with early symptoms such as hypotonia, tremors, and epilepsy declining into spongiform leukoencephalopathy, muscular choreodystonia, mental retardation, and psychomotor regression.
It is associated with L2HGDH.

## D-2-hydroxyglutaric aciduria
The D2 form is rare, with symptoms including macrocephaly, cardiomyopathy, mental retardation, hypotonia, and cortical blindness.
Oxoglutarate dehydrogenase

# Overview
Oxoglutarate dehydrogenase (aka -ketoglutarate dehydrogenase) is an enzyme complex most commonly known for its role in the citric acid cycle.

# Units
Much like pyruvate dehydrogenase complex, this enzyme forms a complex composed of three components:
In fact, three classes of these multienzyme complexes have been characterized, one specific for pyruvate, a second specific for 2-oxoglutarate and a third specificbranched-chain -keto acids.

# Properties

## Nomenclature and classification
The official name of this enzyme is oxoglutarate dehydrogenase (OGDC) although it is also commonly known as -ketoglutarate dehydrogenase (AKGDH).
- CAS: 9031-02-1

## Metabolic pathways
This enzyme participates in three different pathways:
- Citric acid cycle (KEGG link: MAP00020)
- Lysine degradation (KEGG link: MAP00310)
- Tryptophan metabolism (KEGG link: MAP00380)

## Kinetic properties
The following values are from Azotobacter vinelandii (1):
- KM: 0.14  0.04 mM
- Vmax : 9  3 mol.min-1.mg-1

# Citric acid cycle

## Reaction
The  reaction catalyzed by this enzyme in the citric acid cycle is:
This reaction proceeds in three steps:
- decarboxylation of -ketoglutarate,
- oxidation,
- and subsequent transfer to CoA, which forms the end product, succinyl CoA.
G' for this reaction is -7.2 kcal mol-1.  The energy needed for this oxidation is conserved in the formation of a thioester bond of succinyl CoA.

## Regulation
Oxoglutarate dehydrogenase is a key control point in the citric acid cycle. It is inhibited by its products, succinyl CoA and NADH. A high energy charge in the cell will also be inhibitive.

# Pathology
2-Oxo-glutarate dehydrogrenase is an autoantigen recognized in primary biliary cirrhosis, a form of acute liver failure. These antibodies appear to recognize oxidized protein that has resulted from inflamatory immune responses. Some of
these inflamatory responses are explained by gluten sensitivity. Other mitochondrial autoantigens
include pyruvate dehydrogenase and branched-chain alpha-keto acid dehydrogenase complex, which are antigens recognized by anti-mitochondrial antibodies.
4-Androstene-3,6,17-trione
4-Androstene-3,6,17-trione (also marketed as "6-OXO" or 4-etioallocholen-3,6,17-trione) is a drug or nutritional supplement that may increase the testosterone-estrogen ratio. Its use can be detected in urine.
4-Androstene-3,6,17-trione (4-AT) is a potent irreversible aromatase inhibitor that inhibits estrogen biosynthesis by permanently binding and inactivating aromatase in adipose and peripheral tissue.  Aromatase is responsible for the conversion of testosterone to estradiol. Blocking aromatase causes the body to decrease in levels of estradiol, which then results in increase of LH and consequently, testosterone. Since testosterone has myotropic activity and estradiol does not, elevated testosterone levels increase muscle mass. However, there appear to be no human or animal studies testing the hypothesis that 4-AT will produce an anabolic effect.
4-AT is also used by steroid or prohormone users to counteract estrogen level increases caused by aromatization during their steroid cycle. This helps minimize side effects such as gynecomastia but can lead to acne. Also, after a steroid cycle, the compound may be used to shorten the recovery from the testicular suppression that can be the result of the use of steroids.
A recent United States patent application claims an 88% increase in plasma testosterone levels in men, while decreasing estrogen levels by 11%. The subjects took 300mg orally twice a day for four weeks without taking any other drugs or supplements.
An often-cited study (but only referenced as being authored by "a prestigious clinical research organization") claims an average 188% increase in total testosterone levels and an average 226% increase in free testosterone levels in six male participants. The subjects took 600mg a day for a total of three weeks.
It appears that the "prestigious clinical research organization" was Thomas Incledon's single man company "Human Performance Specialists, Inc." . Attempts to access the Inquiries page of the research section lead to a broken link.
There are no peer-reviewed studies that evaluate the safety or efficacy of 4-AT in humans. In a warning letter dated July 7, 2006, the FDA argues that marketing of 4-AT (aka, 6-OXO) violates the Federal Food, Drug, and Cosmetic Act and as such products containing it are adulterated by legal definition.

# Usage
A typical dosage regimen is 200-600mg orally once a day in the evening, for a 4-6 week cycle.
60S ribosomal protein L23a
60S ribosomal protein L23a is a protein that in humans is encoded by the RPL23A gene.

# Function
Ribosomes, the organelles that catalyze protein synthesis, consist of a small 40S subunit and a large 60S subunit. Together these subunits are composed of 4 RNA species and approximately 80 structurally distinct proteins. This gene encodes a ribosomal protein that is a component of the 60S subunit. The protein belongs to the L23P family of ribosomal proteins. It is located in the cytoplasm. The protein may be one of the target molecules involved in mediating growth inhibition by interferon. In yeast, the corresponding protein binds to a specific site on the 26S rRNA. This gene is co-transcribed with the U42A, U42B, U101A, and U101B small nucleolar RNA genes, which are located in its third, first, second, and fourth introns, respectively. As is typical for genes encoding ribosomal proteins, there are multiple processed pseudogenes of this gene dispersed through the genome.

# Clinical significance
L23a has been identified as an autoimmune target that causes a form of rheumatoid arthritis in mice and which also causes a reaction from T cells and autoantibodies from human rheumatoid arthritis patients.
Activities of daily living
Activities of daily living (ADLs),are "the things we normally do in daily living including any daily activity we perform for self-care (such as feeding ourselves, bathing, dressing, grooming), work, homemaking, and leisure."  
Health professionals routinely refer to the ability or inability to perform ADLs as a measurement  of the functional status of a person.   This measurement is useful for assessing the elderly, the mentally ill, those with chronic diseases, and others, in order to evaluate what type of health care services an individual may need. There are many tools to use for evaluation, such as the Katz ADL scale, and the Lawton IADL scale.
Most models of health care service use ADL evaluations in their practice, including the Medical(or Institutional) Models--including the Roper-Logan-Tierney model of nursing-- and Resident-Centered models--including the Program of All-Inclusive Care for the Elderly (PACE).
In the US, most medical insurance policies will not cover assistance with performing ADLs, whereas such assistance is often covered by policies specific to Long-term care.

# Basic ADLs
The basic activities of daily living consist of these self-care tasks that are fundamental and crucial to self care.
The Katz scale defines these ADLs as: 
The ability to
- bathe
- dress (and undress)
- eat
- transfer from bed or chair, and back
- maintain continence and/or use the toilet
In the US, the Center for Medicare and Medicaid Services (CMS) also uses these five activities as the basis for their services. 
In the UK, Barthel's index  uses these ADLs for a basis of evaluation:
- Bowel Status
- Bladder Status
- Grooming
- Toilet Use
- Feeding
- Transfer
- Mobility
- Dressing
- Stairs
- Bathing

# Instrumental ADLs
Instrumental Activities of Daily Living are not necessary for fundamental functioning, but enable the individual to live independently within a community.  They are: light housework, preparing meals, taking medications, shopping for groceries or clothes, using the telephone, and managing money)
Occupational therapists also look at IADLs when completing assessments.  They include 11 areas of IADLs that are generally optional in nature, and can be delegated to others.  These areas are:
- Care of others (including selecting and supervising caregivers)
- Care of pets
- Child rearing
- Communication device use
- Community mobility
- Financial management
- Health management and maintenance
- Meal preparation and cleanup
- Safety procedures and emergency responses
- Shopping
Distal embolization case 1

# Distal Embolization

## Pre-intervention
Shown below is a pre-intervention angiogram with significant lesion in the mid RCA.

## Intervention
Shown below is an angiogram with ongoing intervention on the mid RCA.

## Post-intervention
Shown below is a post-intervention angiogram with occlusion of the right posterior descending artery due to distal embolization.
Abdominoperineal resection
Abdominoperineal resection of the rectum (AP resection) is a surgical operation to treat usually malignant disease of the rectum or anal canal, and it involves removal of the anus, the rectum, and part of the sigmoid colon along with their draining lymph nodes, through  incisions made in the abdomen and perineum. The end of the remaining sigmoid colon is brought out permanently as an opening on the surface of the abdomen, called a colostomy. Fecal matter from the colostomy is collected in a disposable bag that covers the colostomy.
This complex operation is one of the less common performed by General Surgeons, although they are specifically trained to perform this operation.  As a consequence of the complexity of this operation and its difficult execution, it has been shown that this operation is performed with fewer complications in "Centers of Excellence," such as academic hospitals where this operation is performed by Colon and Rectal surgical subspecialists in some iteration weekly, if not daily.
The principal indication for AP resection is a rectal carcinoma situated in the lower third of the rectum, within about 5cm of the anal verge.  Other indications include recurrent or residual anal carcinoma (squamous cell carcinoma) following initial, usually definitive combination chemoradiotherapy.  AP resection includes regional lymph node removal (lymphadenectomy).
Stomata are openings in the body, either natural, such as the mouth, or artificial, such as colostomy.  Any hollow organ can be manipulated into a stoma as necessary.  This includes the esophagus, stomach, duodenum, ileum, colon, pleural cavity, ureters, and kidney pelves.
Aberrant subclavian artery

# Overview
Aberrant subclavian artery, or aberrant subclavian artery syndrome refers to a rare anatomical variant of the origin of the right or left subclavian artery.  This abnormality is the most common congenital vascular anomaly of the aortic arch.  The aberrant artery usually arises just distal to the left subclavian artery and passes posterior to the mediastinum on its way to the right upper extremity.  Such course of this aberrant vessel may cause a vascular ring around a mediastinal structure.
Dysphagia due to an aberrant right subclavian artery is termed dysphagia lusoria.  Palsy of the recurrent laryngeal nerve is termed Ortner's syndrome.
The aberrant right subclavian artery frequently arises from a dilated segment of the proximal descending aorta, the so-called Diverticulum of Kummerel.

# Multi Sliced CT
Images shown below are courtesy of RadsWiki and copylefted
Accessory meningeal artery
The accessory meningeal artery (also accessory branch of middle meningeal artery, pterygomeningeal artery, small meningeal or parvidural branch) is a branch of the maxillary artery, sometimes derived from the middle meningeal artery.

# Course
It enters the skull through the foramen ovale, and supplies the semilunar ganglion and dura mater.

# Nomenclature
Only about 10% of the blood flowing through this artery reaches intracranial structures.  
Reflecting this fact, Terminologia Anatomica lists entries for both "accessory branch of middle meningeal artery" and "pterygomeningeal artery".