Persius/hicric huggingface dataset:
Lateral vestibular nucleus

# Overview
The lateral vestibular nucleus (Deiterss nucleus) is the continuation upward and lateralward of the principal nucleus, and in it terminate many of the ascending branches of the vestibular nerve.
It consists of very large multipolar cells whose axons form an important part of the posterior longitudinal bundle of the same and the opposite side.
The axons bifurcate as they enter the posterior longitudinal bundle,
- the ascending branches send terminals and collaterals to the motor nuclei of the abducens, trochlear and oculomotor nerves, and are concerned in coordinating the movements of the eyes with alterations in the position of the head;
- the descending branches pass down in the posterior longitudinal bundle into the anterior funiculus of the spinal cord as the vestibulospinal fasciculus (anterior marginal bundle) and are distributed to motor nuclei of the anterior column by terminals and collaterals.
Other fibers are said to pass directly to the vestibulospinal fasciculus without passing into the posterior longitudinal bundle.
The fibers which pass into the vestibulospinal fasciculus are intimately concerned with equilibratory reflexes.
Other axons from Deiterss nucleus are supposed to cross and ascend in the opposite medial lemniscus to the ventro-lateral nuclei of the thalamus; still other fibers pass into the cerebellum with the inferior peduncle and are distributed to the cortex of the vermis and the roof nuclei of the cerebellum; according to Cajal they merely pass through the nucleus fastigii on their way to the cortex of the vermis and the hemisphere.
Deiter's nucleus was named after German neuroanatomist Otto Friedrich Karl Deiters (1834-1863).
Descending palatine artery
The descending palatine artery descends through the pterygopalatine canal with the anterior palatine branch of the sphenopalatine ganglion, and, emerging from the greater palatine foramen, runs forward in a groove on the medial side of the alveolar border of the hard palate to the incisive canal; the terminal branch of the artery passes upward through this canal to anastomose with the sphenopalatine artery.

# Branches
Branches are distributed to the gums, the palatine glands, and the mucous membrane of the roof of the mouth; while in the pterygopalatine canal it gives off twigs which descend in the lesser palatine canals to supply the soft palate and palatine tonsil, anastomosing with the ascending palatine artery.
According to Terminologia Anatomica, the descending palatine artery branches into the "greater palatine artery" and "lesser palatine arteries".
- The greater palatine artery goes through the greater palatine foramen, and supplies the hard palate
- The lesser palatine arteries go through the lesser palatine foramina, and supply the soft palate
Desensitization (medicine)

# Overview
For medical purposes, desensitization is a method to reduce or eliminate an organism's negative reaction to a substance or stimulus.
For example, if a person with diabetes mellitus has a bad allergic reaction to taking a full dose of beef insulin, the doctor gives the person a very small amount of the insulin at first. Over a period of time, larger doses are given until the person is taking the full dose. This is one way to help the body get used to the full dose and to avoid having the allergic reaction to beef-origin insulin. (See Hyposensitization.)
At the cellular level, administration of small doses of toxin produces an IgG response which eventually overrides the hypersensitive IgE response.
In pharmacology, desensitization is the loss of responsiveness to the continuing or increasing dose of a drug. Also termed tachyphylaxis, down-regulation, fade or drug tolerance. This may be an important area to consider for the future design of safer drugs.

# Pencillin desentization
- Patients who have a positive skin test to one of the penicillin determinants can be desensitized.
- This is a straightforward, relatively safe procedure that can be performed orally or IV.
- Although the two approaches have not been compared, oral desensitization is regarded as safer and easier to perform.
- Patients should be desensitized in a hospital setting because serious IgE-mediated allergic reactions can occur.
- Desensitization usually can be completed in approximately 4-12 hours, after which time the first dose of penicillin is administered.
- After desensitization, patients must be maintained on penicillin continuously for the duration of the course of therapy.
Diazepam binding inhibitor
Acyl-CoA-binding protein in humans belongs to the family of Acyl-CoA-binding proteins.
This gene encodes diazepam binding inhibitor, a protein that is regulated by hormones and is involved in lipid metabolism and the displacement of beta-carbolines and benzodiazepines, which modulate signal transduction at type A gamma-aminobutyric acid receptors located in brain synapses. The protein is conserved from yeast to mammals, with the most highly conserved domain consisting of seven contiguous residues that constitute the hydrophobic binding site for medium- and long-chain acyl-Coenzyme A esters. Diazepam binding inhibitor also mediates the feedback regulation of pancreatic secretion and the postprandial release of cholecystokinin, in addition to its role as a mediator in corticotropin-dependent synthesis of steroids in the adrenal gland. 
Three pseudogenes located on chromosomes 6, 8 and 16 have been identified. Multiple transcript variants encoding different isoforms have also been described for this gene.
Dicarboxylic aminoaciduria
Dicarboxylic aminoaciduria is a rare form of aminoaciduria (1:35 000 births) which is an autosomal recessive disorder of urinary glutamate and aspartate due to genetic errors related to transport of these amino acids. Mutations resulting in a lack of expression of the SLC1A1 gene,  a member of the solute carrier family, are found to cause development of dicarboxylic aminoaciduria in humans. SLC1A1 encodes for EAAT3 which is found in the neurons, intestine, kidney, lung, and heart. EAAT3 is part of a family of high affinity glutamate transporters which transport both glutamate and aspartate across the plasma membrane.

# Symptoms
Dicarboxylic aminoaciduria involves excretion of urinary glutamate and aspartate, resulting from the incomplete reabsorption of anionic amino acids from the glomerular filtrate in the kidney.  This has an impact on a diseased individual's amino acid pool, as they will have to spend additional resources to replenish the amino acids which would have otherwise been present. Additionally, glutamate transporters are responsible for the synaptic release of the glutamate (neurotransmitter) within the interneuronal synaptic cleft. This hindrance of functionality in individuals with dicarboxylic aminoaciduria may be related to growth retardation, intellectual disability, and a tendency toward fasting hypoglycemia and ketoacidosis . Dicarboxylic aminoaciduria is diagnosed by finding the increased presence of glutamate and aspartate in the urine.

# Transport
Glutamate transporters are proficient at pumping glutamate into cells due to their ability to couple with inorganic ions. Transport of glutamate into the cell requires the coupling of three sodium ions as well as a proton, whereas transport out of the cell requires a single potassium ion. This transport results in two positive charges being displaced across the membrane per cycle. Moreover, this process is dependent on a pH gradient, due to glutamate needing to be protenated prior to transport.

# Mutations
Dicarboxylic aminoaciduria is the result of a point mutation of tryptophan to arginine at position 445 and a deletion mutation of isoleucine at position 395. EAAT3 is found in location 9p24, it is primarily expressed in the brain and kidneys.

# Metabolism
In the gastrointestinal tract, protein digestion and absorption are key to establishing and maintaining amino acid pools. In the case of dicarboxylic aminoaciduria, where glutamate and aspartate transport are impaired, the alanine, aspartate and glutamate metabolism are impacted. Enterocytes in the intestines break up peptides into residual amino acids where they would normally use charge-specific amino acid transporters to get across the epithelial cells. In dicarboxylic aminoaciduria, the anionic amino acid transporter, EAAT3, cannot bring glutamate and aspartate across epithelial cells, leading to them being excreted via the urine.

## Examples
Below is an example of how glutamate is used to synthesize alanine via alanine transaminase.
Another example is the conversion of aspartate to glutamate via the enzyme aspartate transaminase.
Dilated fundus examination
Dilated fundus examination(DFE) is a diagnostic procedure that employs the use of mydriatic eye drops (such as tropicamide) to dilate or enlarge the pupil in order to obtain a better view of the fundus of the eye. Once the pupil is dilated, examiners often use specialized equipment such as an ophthalmoscope or fundus camera to view the inner surfaces of the eye. DFE has been found to be a more effective method for evaluation of internal ocular health than non-dilated examination. It is frequently performed by ophthalmologists and optometrists as part of an eye examination.
- Result of Dilated fundus examination. At the beginning the eye is losing focus, but after 5-6 hours (depends on the type of the medical eye drops) it normalizes. Flash light used
- The same eye before the examination. No flash light used
Direct pathway of movement
The striatum modulates movement by two pathways: a direct pathway and an indirect pathway.
In the direct pathway, striatal neurons directly inhibit neurons in the globus pallidus internus, which reduces the inhibition of the thalamic neurons responsible for excitation of the premotor cortex.
Thus, the direct pathway facilitates movement, and anything inhibiting it (e.g. Parkinson's disease) causes akinesia.
Disorganized schizophrenia

# Overview
Disorganized schizophrenia is a subtype of schizophrenia as defined in the Diagnostic and Statistical Manual of Mental Disorders. This type is characterized by prominent disorganized behavior and speech (see formal thought disorder), and flat or inappropriate emotion and affect. Furthermore, the criteria for the catatonic subtype of schizophrenia must not have been met. This type of schizophrenia is also known as hebephrenia, and is named after the Greek goddess of youth, Hebe, in reference to the typical age of onset in puberty.
Unlike the paranoid subtype of schizophrenia, delusions and hallucinations are not the most prominent feature, although fragmentary delusions and hallucinations may be present.
The emotional responses of people diagnosed with this subtype can often seem strange or inappropriate to the situation. Inappropriate facial responses may be common and behavior is sometimes described as 'silly'. Complete lack of expressed emotion is sometimes seen, as is an apparent indifference, anhedonia (the lack of pleasure), and avolition (a lack of motivation). Some of these features are also present in other types of schizophrenia, but they are most prominent in Disorganized Schizophrenia.
This form of schizophrenia is typically associated with early onset (often between the ages of 15 and 25 years) and is thought to have a poor prognosis because of the rapid development of 'negative' symptoms and decline in social functioning.
Disorganized schizophrenia is thought to be an extreme expression of the 'disorganization syndrome' that has been hypothesised to be one aspect of a three-factor model of symptoms in schizophrenia The other factors being 'reality distortion' (involving delusions and hallucinations) and 'psychomotor poverty' (poverty of speech, lack of spontaneous movement and various aspects of blunting of emotion).
Doripenem clinical studies

# Clinical Studies

## Complicated Intra-Abdominal Infections
A total of 946 adults with complicated intra-abdominal infections were randomized and received study medications in two identical multinational, multi-center, double-blind studies comparing DORIBAX (500 mg administered over 1 hour every 8 hours) to meropenem (1 g administered over 35 minutes every 8 hours). Both regimens allowed the option to switch to oral amoxicillin/clavulanate (875 mg/125 mg administered twice daily) after a minimum of 3 days of intravenous therapy for a total of 514 days of intravenous and oral treatment. Patients with complicated appendicitis, or other complicated intra-abdominal infections, including bowel perforation, cholecystitis, intra-abdominal or solid organ abscess and generalized peritonitis were enrolled.
DORIBAX was non-inferior to meropenem with regard to clinical cure rates in microbiologically evaluable (ME) patients, i.e., in patients with susceptible pathogens isolated at baseline and no major protocol deviations at test of cure (TOC) visit, 2545 days after completing therapy. DORIBAX was also non-inferior to meropenem in microbiological modified intent-to-treat (mMITT) patients, i.e., patients with baseline pathogens isolated regardless of susceptibility. Clinical cure rates at TOC are displayed by patient populations in Table 8. Microbiological cure rates at TOC by pathogen in ME patients are presented in Table below.

## Complicated Urinary Tract Infections, Including Pyelonephritis
A total of 1171 adults with complicated urinary tract infections, including pyelonephritis (49 percent of microbiologically evaluable patients) were randomized and received study medications in two multi-center, multinational studies. Complicated pyelonephritis, i.e., pyelonephritis associated with predisposing anatomical or functional abnormality, comprised 17% of patients with pyelonephritis. One study was double-blind and compared DORIBAX (500 mg administered over 1 hour every 8 hours) to IV levofloxacin (250 mg admininstered every 24 hours). The second study was a non-comparative study but of otherwise similar design. Both studies permitted the option of switching to oral levofloxacin (250 mg administered every 24 hours) after a minimum of 3 days of IV therapy for a total of 10 days of treatment. Patients with confirmed concurrent bacteremia were allowed to receive 500 mg of IV levofloxacin (either IV or oral as appropriate) for a total of 10 to 14 days of treatment.
DORIBAX was non-inferior to levofloxacin with regard to the microbiological eradication rates in microbiologically evaluable (ME) patients, i.e., patients with baseline uropathogens isolated, no major protocol deviations and urine cultures at test of cure (TOC) visit 511 days after completing therapy. DORIBAX was also non-inferior to levofloxacin in microbiological modified intent-to-treat (mMITT) patients, i.e., patients with pretreatment urine cultures. Overall microbiological eradication rates at TOC and the 95% CIs for the comparative study are displayed in Table 10. Microbiological eradication rates at TOC by pathogen in ME patients are presented in Table below.
Dorsal artery of the penis
The Dorsal Artery of the Penis ascends between the crus penis and the pubic symphysis, and, piercing the inferior fascia of the urogenital diaphragm, passes between the two layers of the suspensory ligament of the penis, and runs forward on the dorsum of the penis to the glans, where it divides into two branches, which supply the glans and prepuce.
On the penis, it lies between the dorsal nerve and deep dorsal vein, the former being on its lateral side.
It supplies the integument and fibrous sheath of the corpus cavernosum penis, sending branches through the sheath to anastomose with the deep artery of the penis.

# Additional images
- Arteries and veins of the penis (Spanish)
- The penis in transverse section, showing the bloodvessels.
Dorsal metatarsal arteries
The arcuate artery of the foot gives off the second, third, and fourth dorsal metatarsal arteries, which run forward upon the corresponding Interossei dorsales; in the clefts between the toes, each divides into two dorsal digital branches for the adjoining toes.
At the proximal parts of the interosseous spaces these vessels receive the posterior perforating branches from the plantar arch, and at the distal parts of the spaces they are joined by the anterior perforating branches, from the plantar metatarsal arteries.
The fourth dorsal metatarsal artery gives off a branch which supplies the lateral side of the fifth toe.
The first dorsal metatarsal artery runs forward on the first Interosseous dorsalis.
Dose-response relationship

# Overview
The Dose-response relationship describes the change in effect on an organism caused by differing levels of exposure (or doses) to a stressor (usually a chemical). This may apply to individuals (eg: a small amount has no observable effect, a large amount is fatal), or to populations (eg: how many people are affected at different levels of exposure).
Studying dose response, and developing dose response models, is central to determining "safe" and "hazardous" levels and dosages for drugs, potential pollutants, and other substances that humans are exposed to. These conclusions are often the basis for public policy.
When the agent is radiation instead of a drug, this is called the exposure-response relationship.

# Dose-response curve
A dose-response curve is a simple X-Y graph relating the magnitude of a stressor (e.g. concentration of a pollutant, amount of a drug, temperature, intensity of radiation) to the response of the receptor (e.g. organism under study). The response is usually death (mortality), but other effects (or endpoints) can be studied.
The measured dose (usually in milligrams, micrograms, or grams per kilogram of body-weight) is generally plotted on the X axis and the response is plotted on the Y axis. Commonly, it is the logarithm of the dose that is plotted on the X axis, and in such cases the curve is typically sigmoidal, with the steepest portion in the middle.
The first point along the graph where a response above zero is reached is usually referred to as a threshold-dose. For most beneficial or recreational drugs, the desired effects are found at doses slightly greater than the threshold dose. At higher doses still, undesired side effects appear and grow stronger as the dose increases. The stronger a particular substance is, the steeper this curve will be. In quantitative situations, the Y-axis usually is designated by percentages, which refer to the percentage of users registering a standard response (which is often death, when the 50% mark refers to LD50).  Such a curve is referred to as a quantal dose response curve, destinguishing it from a graded dose response curve, where response is continuous.
Problems exist regarding non-linear relationships between dose and response, thresholds reached and 'all-or-nothing' responses. These inconsistencies can challenge the validity of judging causality solely by the strength or presence of a dose-response relationship.
Double-balloon enteroscopy
Double-balloon enteroscopy, also known as push-and-pull enteroscopy is an endoscopic technique for visualization of the small bowel.  It was developed by Hironori Yamamoto in 2001.  It is novel in the field of diagnostic gastroenterology as it is the first endoscopic technique that allows for the entire gastrointestinal tract to be visualized in real time. 

# Technique
The technique involves the use of a balloon at the end of a special enteroscope camera and an overtube, which is a tube that fits over the endoscope, and which is also fitted with a balloon.  The procedure is usually done under general anesthesia, but may be done with the use of conscious sedation.  The enteroscope and overtube are inserted through the mouth and passed in conventional fashion (that is, as with gastroscopy) into the small bowel.  Following this, the endoscope is advanced a small distance in front of the overtube and the balloon at the end is inflated.  Using the assistance of friction at the interface of the enteroscope and intestinal wall, the small bowel is accordioned back to the overtube.  The overtube balloon is then deployed, and the enteroscope balloon is deflated.  The process is then continued until the entire small bowel is visualized.
The double-balloon enteroscope can also be passed in retrograde fashion, through the colon and into the ileum to visualize the end of the small bowel.

# Indications
Double-balloon enteroscopy has found a niche application in the following settings:
- bleeding from the gastrointestinal tract of obscure cause
- iron deficiency anemia with normal colonoscopy and gastroscopy
- visualization and therapeutic intervention on abnormalities seen on traditional small bowel imaging
- ERCP in post-surgical patients with long afferent limbs

# Advantages and disadvantages
Double-balloon enteroscopy offers a number of advantages to other small bowel image techniques, including barium imaging, wireless capsule endoscopy and push enteroscopy:
- it allows for visualization of the entire small bowel to the terminal ileum
- it allows for the application of therapeutics
- it allows for the sampling or biopsying of small bowel mucosa, for the resection of polyps of the small bowel, and in the placement of stents or dilatation of strictures of the small bowel.
- it allows for access to the papilla in patients with long afferent limbs after Billroth II antrectomy.
The key disadvantage of double-balloon enteroscopy is the time required to visualize the small bowel; this can exceed three hours, and may require that patients be admitted to hospital for the procedure.   There have also been case reports of acute pancreatitis and intestinal necrosis associated with the technique.
Richard Morton (physician)
Richard Morton (1637-1698) was an English physician who was the first to state that tubercles were always present in the tuberculosis disease of the lungs. In Morton's time, this wasting disease was termed consumption, or by its Greek name of phthisis.  Recognition of the many possible symptoms of this infection belonging to a single disease was not until the 1820s and it was J.L. Schonlein in 1839 who introduced the term we use to this day of tuberculosis.
He was born in Worcestershire and, having trained at Oxford's Magdalen Hall, elected to enter the Church, becoming Vicar of Kinver in Staffordshire. With his refusal to acquiesce to the Act of Uniformity 1662 following the Restoration of Charles II, he was forced to resign. His whereabouts for the following eight years are unclear, although he probably travelled to Holland. He reappeared in 1670 when, on the sponsorship of the Prince of Orange, he was awarded doctorate of medicine by Oxford University.
His landmark paper Phthisiologia, seu exercitationes de Phthisi tribus libris comprehensae was published in Latin in 1689, with an English translation appearing in 1720. Its significance is partly due to the disease receiving little study by other doctors of the time as well as it being a major cause of death; accounting for over 18% all deaths in the City of London in 1700.
Medicine of that time was deferential to the ideas of Galen and so Morton undertandably mistook tubercles for being caused by glandular degenerations; mycobacterium tuberculosis not being identified until 1882 by Robert Koch.