Persius/hicric huggingface dataset:
Impedance phlebography

# Overview
Impedance phlebography, or impedance plethysmography, is a non-invasive medical test that measures small changes in electrical resistance of the chest, calf or other regions of the body. These measurements reflect blood volume changes, and can indirectly indicate the presence or absence of venous thrombosis. This procedure provides an alternative to venography, which is invasive and requires a great deal of skill to execute adequately and interpret accurately.
For the chest area, the technique was developed by NASA to measure the split second impedance changes within the chest, as the heart beats, to calculate both cardiac output and lung water content. This technique has progressed clinically (often now called BioZ, i.e. biologic impedance, as promoted by the leading manufacturer in the US) and allows low cost, non-invasive estimations of cardiac output and total peripheral resistance, using only 4 skin electrodes, oscillometric blood pressure measurement and lung water volumes with minimal removal of clothing in physician offices having the needed equipment.
For leg veins, the test measures blood volume in the lower leg due to temporary venous obstruction. This is accomplished by inflating a pneumatic cuff around the thigh to sufficient pressure to cut off venous flow but not arterial flow, causing the venous blood pressure to rise until it equals the pressure under the cuff. When the cuff is released there is a rapid venous runoff and a prompt return to the resting blood volume. Venous thrombosis will alter the normal response to temporary venous obstruction in a highly characteristic way, causing a delay in emptying of the venous system after the release of the tourniquet. The increase in blood volume after cuff inflation is also usually diminished.

# Limitations
- Patient must lie still.
- Patient must be positioned correctly: to avoid obstruction of venous outflow, Thus, this procedure can be difficult to perform in
paraplegic
patient with plaster cast (It cannot be performed over the cast).
- paraplegic
- patient with plaster cast (It cannot be performed over the cast).
- In patient with arterial diseases, due to there poor filling, can give a false positive tests.
- In patient with prior venous diseases and venous outflow obstruction, there is an increased venous pressure, which can give a false negative result.

# Accuracy
Despite the above mentioned limitations, impedance plethysmography is useful for the diagnosis and clinical management of patients suspected of having deep vein thrombosis.
Incongruent transition
Incongruent transition, in chemistry, is a mass transition between two phases which involves a change in composition.  This is contrasted with congruent transition, for which the composition remains the same.
The transition may be that of melting, vaporization or allotropism. The concept is also often extended to related phenomena, for example, incongruent dissolution of a solid by a liquid solvent, which is often encountered in geology.
The term "phase decomposition" is sometimes used to describe incongruent transition. However, it has to be kept in mind that incongruent transition is described by an equilibrium.
For an example, see incongruent melting.
Indinavir how supplied

# How Supplied
CRIXIVAN Capsules are supplied as follows:
No. 3755  100 mg capsules: semi-translucent white capsules coded "CRIXIVANTM 100 mg" in green. Available as:
NDC 0006-0570-62 unit-of-use bottles of 180 (with desiccant).
No. 3756  200 mg capsules: semi-translucent white capsules coded "CRIXIVANTM 200 mg" in blue. Available as:
NDC 0006-0571-43 unit-of-use bottles of 360 (with desiccant).
No. 3758  400 mg capsules: semi-translucent white capsules coded "CRIXIVANTM 400 mg" in green. Available as:
NDC 0006-0573-40 unit-of-use bottles of 120 (with desiccant)
NDC 0006-0573-62 unit-of-use bottles of 180 (with desiccant)
NDC 0006-0573-54 unit-of-use bottles of 90 (with desiccant)
Storage
Bottles:  Store in a tightly-closed container at room temperature, 15-30C (59-86F). Protect from moisture.
CRIXIVAN Capsules are sensitive to moisture. CRIXIVAN should be dispensed and stored in the original container. The desiccant should remain in the original bottle.
Inferior cardiac nerve
The inferior cardiac nerve arises from either the inferior cervical or the first thoracic ganglion.
It descends behind the subclavian artery and along the front of the trachea, to join the deep part of the cardiac plexus.
It communicates freely behind the subclavian artery with the recurrent nerve and the middle cardiac nerve.
Inferior rectal artery
The inferior rectal artery (inferior hemorrhoidal artery) is an artery that supplies blood to the rectum.

# Structure
The inferior rectal artery arises from the internal pudendal artery as it passes above the ischial tuberosity.
Piercing the wall of the pudendal canal, it divides into two or three branches which cross the ischioanal fossa, and are distributed to the muscles and integument of the anal region, and send offshoots around the lower edge of the gluteus maximus to the skin of the buttock.
They anastomose with the corresponding vessels of the opposite side, with the superior and middle rectal arteries, and with the perineal artery.
Inferior rectus muscle
The inferior rectus muscle is a muscle in the orbit.

# Actions
It depresses, adducts, rotates laterally, and extorts the eye.

# Innervation
As with most of the muscles of the orbit, it is innervated by the oculomotor nerve (Cranial Nerve III).

# Additional images
- Dissection showing origins of right ocular muscles, and nerves entering by the superior orbital fissure.
- The right eye in sagittal section, showing the fascia bulbi (semidiagrammatic).
Inferior thyroid veins
The inferior thyroid veins two, frequently three or four, in number, arise in the venous plexus on the thyroid gland, communicating with the middle and superior thyroid veins.
They form a plexus in front of the trachea, behind the Sternothyreoidei.
From this plexus, a left vein descends and joins the left innominate trunk, and a right vein passes obliquely downward and to the right across the innominate artery to open into the right innominate vein, just at its junction with the superior vena cava; sometimes the right and left veins open by a common trunk in the latter situation.
These veins receive esophageal tracheal, and inferior laryngeal veins, and are provided with valves at their terminations in the innominate veins.

# Additional images
- The arch of the aorta, and its branches.
- The fascia and middle thyroid veins.
- The thymus of a full-time fetus, exposed in situ.
Information processing

# Overview
Information processing is the change (processing) of information in any manner detectable by an observer.  As such, it is a  process which describes everything which happens (changes) in the universe, from the falling of a rock (a change in position) to the printing of a text file from a digital computer system. In the latter case, an information processor is changing the form of presentation of that text file.
Information processing may  more specifically be defined in terms by Claude E. Shannon as the conversion of latent information into manifest information. Latent and manifest information is defined through the terms of equivocation (remaining uncertainty, what value the sender has actually chosen), dissipation (uncertainty of the sender what the receiver has actually received) and transformation (saved effort of questioning - equivocation minus dissipation).
Practical Information Processing can be described as a cycle, where data (which may have no inherent meaning to the observer) is converted into information (which does have meaning to the observer). This conversion takes one of three forms:
- Computation utilizes mathematics (specifically arithmetics) to create the information from data. Example: a cash register (either mechanical or digital) uses addition to convert the individual item prices (data) into the total amount owed to the store (information).
- Transduction is the conversion of one type of energy into another type. Example: A mechanical speaker converts an electric signal (data) into sound waves (information).
- Translation is the conversion of a string of symbols from one set into another. Example: a person fluent two languages could rewrite a document that is written in a language that the observer does not understand (data) into a language that the observer does understand (information). Note that translation is the only Information processing form that can not yet be performed purely by a machine. It requires an organic brain (some electronic computer programs can 'translate' but in reality they are using complex programs, which actually rely solely on computation to complete the process).
Within the field of cognitive psychology, information processing is an approach to the goal of understanding human thinking. It arose in the 1940s and 1950s. The essence of the approach is to see cognition as being essentially computational in nature, with mind being the software and the brain being the hardware. The information processing approach in psychology is closely allied to cognitivism in psychology and functionalism in philosophy although the terms are not quite synonymous. Information processing  may  be sequential or parallel, either of which  may be centralized or decentralized (distributed). The parallel distributed processing approach of the mid-1980s became popular under the name connectionism. In the early 1950s Friedrich Hayek was ahead of his time when he posited the idea of spontaneous order in the brain arising out of decentralized networks of simple units (neurons). However, Hayek is rarely cited in the literature of connectionism.
Intercavernous sinuses
The intercavernous sinuses are two in number, an anterior and a posterior, and connect the two cavernous sinuses across the middle line.
The anterior passes in front of the hypophysis cerebri, the posterior behind it, and they form with the cavernous sinuses a venous circle (circular sinus) around the hypophysis.
The anterior one is usually the larger of the two, and one or other is occasionally absent.
Interleukin-3 receptor
The interleukin-3 receptor (CD123) is a molecule found on cells which helps transmit the signal of interleukin-3, a soluble cytokine important in the immune system.
The gene coding for the receptor is located in the pseudoautosomal region of the X and Y chromosomes.
The receptor belongs to the type I cytokine receptor family and is a heterodimer with a unique alpha chain paired with the common beta (beta c or CD131) subunit.
The gene for the alpha subunit is 40 kilobases long and has 12 exons.

# Cell types and function
The receptor, found on pluripotent progenitor cells, induces tyrosine phosphorylation within the cell and promotes proliferation and differentiation within the hematopoietic cell lines. It can be found on basophils and pDCs as well as some cDCs among peripheral blood mononuclear cells.
CD123 is expressed across acute myeloid leukemia (AML) subtypes, including leukemic stem cells.

# Possible drug target
An experimental antibody-drug conjugate SGN-CD123A targets CD123 as a possible treatment for AML.
Interleukin-4 receptor
The interleukin 4 receptor is a type I cytokine receptor. IL4R is its human gene.

# Function
This gene encodes the alpha chain of the interleukin-4 receptor, a type I transmembrane protein that can bind interleukin 4 and interleukin 13 to regulate IgE antibody production in B cells. Among T cells, the encoded protein also can bind interleukin 4 to promote differentiation of Th2 cells.  A soluble form of the encoded protein can be produced by an alternate splice variant or by proteolysis of the membrane-bound protein, and this soluble form can inhibit IL4-mediated cell proliferation and IL5 upregulation by T-cells. Allelic variations in this gene have been associated with atopy, a condition that can manifest itself as allergic rhinitis, sinusitis, asthma, or eczema. Two transcript variants encoding different isoforms, a membrane-bound and a soluble form, have been found for this gene. Interactions of IL-4 with TNF promote structural changes to vascular endothelial cells, thus playing an important role in tissue inflammation.
The binding of IL-4 or IL-13 to the IL-4 receptor on the surface of macrophages results in the alternative activation of those macrophages. Alternatively activated macrophages (AAM) downregulate inflammatory mediators such as IFN during immune responses, particularly with regards to helminth infections.

# Interactions
Interleukin-4 receptor has been shown to interact with SHC1.

# Structure
The N-terminal (extracellular) portion of interleukin-4 receptor is related in overall topology to fibronectin type III modules and folds into a sandwich comprising seven antiparallel beta sheets arranged in a three-strand and a four-strand beta-pleated sheet. They are required for binding of interleukin-4 to the receptor alpha chain, which is a crucial event for the generation of a Th2-dominated early immune response.
Interleukin-5 receptor
The interleukin-5 receptor is a type I cytokine receptor. It is a heterodimer of the interleukin 5 receptor alpha subunit and CSF2RB.
The IL-5 receptor (IL-5R) belongs to the type I cytokine receptor family and is a heterodimer composed of two polypeptide chains, one  subunit, which binds IL-5 and confers upon the receptor cytokine specificity, and one  subunit, which contains the signal transduction domains.

# -subunit
The IL-5R chain is exclusively expressed by eosinophils, some basophils and murine B1 cells or B cell precursors.  Like many other cytokine receptors, alternative splicing of the -chain gene results in expression of either a membrane bound or soluble form of the b-chain.  The soluble form does not lead to signal transduction and therefore has an antagonistic effect on IL-5 signaling.  Both monomeric forms of IL-5R are low affinity receptors, while dimerization with the -chain produces a high affinity receptor. In either case, the -chain exclusively binds IL-5 and the intra-cellular portion of IL-5R is associated with Janus kinase (JAK) 2, a protein tyrosine-kinase essential in IL-5 signal transduction.

# -subunit
The -subunit of the IL-5 receptor is responsible for signal transduction and contains several intracellular signaling domains.  Unlike the -chain, the -chain does not bind IL-5, is not specific to this cytokine, and is expressed on practically all leukocytes.  In fact, the -subunit of the IL-5 receptor is also found in IL-3 and GM-CSF receptors where it is associated with IL-3R and GM-CSFR subunits respectively. Therefore, it is known as the common  receptor or c.  As with the IL-5R subunit, the  subunits cytoplasmic domain is constitutively associated with JAK2, as well as LYN, another tyrosine kinase, which are both essential for IL-5 signal transduction.

# Drug target
Three monoclonal antibodies are available to target IL-5R. Benralizumab binds to IL-5Ra, while mepolizumab and reslizumab bind to IL-5, preventing it from binding to IL-5Ra.
Interleukin-7 receptor
The interleukin-7 receptor is a protein found on the surface of cells.  It is made up of two different smaller protein chains - i.e. it is a heterodimer, and consists of two subunits, interleukin-7 receptor- (CD127) and common- chain receptor (CD132). The common- chain receptors is shared with various cytokines, including interleukin-2, -4, -9, and -15. Interleukin-7 receptor is expressed on various cell types, including naive and memory T cells and many others.

# Function
Interleukin-7 receptor has been shown to play a critical role in the development of immune cells called lymphocytes - specifically in a process known as V(D)J recombination. This protein is also found to control the accessibility of a region of the genome that contains the T-cell receptor gamma gene, by STAT5 and histone acetylation. Knockout studies in mice suggest that blocking apoptosis is an essential function of this protein during differentiation and activation of T lymphocytes. Functional defects in this protein may be associated with the pathogenesis of severe combined immunodeficiency (SCID).

# Diseases
Several diseases are associated with Interleukin-7 receptor including T-cell acute lymphoblastic leukaemia, multiple sclerosis, rheumatoid arthritis and juvenile idiopathic arthritis.
Intermaxillary segment
The rounded lateral angles of the medial process constitute the globular processes. It is also known as the intermaxillary segment It gives rise to the premaxilla.
- Head end of human embryo of about thirty to thirty-one days.
- Same embryo as shown in Fig. 45, with front wall of pharynx removed.
- The roof of the mouth of a human embryo, aged about two and a half months, showing the mode of formation of the palate.
- The head and neck of a human embryo thirty-two days old, seen from the ventral surface.
Internal fertilization

# Background
Internal fertilization is a form of animal fertilization of an ovum by spermatozoon within the body of an inseminated animal, whether female or hermaphroditic. This is distinct from external fertilization, where the union of the ova and spermatoza occur outside of the organism.
In mammals, internal fertilization is done through copulation, which involves the insertion of the penis into the vagina. Some other higher vertebrate animals (most reptiles, most birds, and some fish) reproduce internally, but their fertilization is cloacal.
The union of spermatozoon and ovum produces a zygote, which develops into an embryo, which, in turn, continues to develop inside the parent organism. At some point, the growing egg or offspring must be expelled. There are three general ways of doing this:
- Oviparous organisms, including most insects and reptiles, monotremes, and all birds lay eggs that continue to develop after being laid, and hatch later.
- Viviparous organisms, including almost all mammals (such as whales, kangaroos and humans) bear their young live. The developing young spend proportionately more time within the female's reproductive tract.  The young are later released to survive on their own, with varying amounts of help from the parent (s) on the species.
- Oviviparous organisms, like the garter snake, and the Madagascar hissing cockroach, have eggs (with shells) that hatch as they are laid, making it look like "live birth".
Intestinal malrotation

# Overview
Intestinal malrotation is a congenital anomaly of rotation of the midgut (embryologically, the gut undergoes a complex rotation outside the abdomen). As a result:
- the small bowel is found predominantly on the right side of the abdomen
- the cecum is displaced (from its usual position in the right lower quadrant) into the epigastrium - right hypochondrium
- the ligament of Treitz is displaced inferiorly and rightward
- fibrous bands (of Ladd) course over the horizontal part of the duodenum (DII), causing intestinal obstruction.
- the small intestine has an unusually narrow base, and therefore the midgut is prone to volvulus (a twisting that can obstruct the mesenteric blood vessels and cause intestinal ischemia).

# Associated conditions
This can lead to a number of disease manifestations such as:
- acute midgut volvulus
- chronic midgut volvulus
- acute duodenal obstruction
- chronic duodenal obstruction
- internal herniation

# Causes
The exact causes are not known. It is not associated with a particular gene, but there is some evidence of recurrence in families.

# Presentation
Patients (often infants) present acutely with midgut volvulus, manifested by bilious vomiting, crampy abdominal pain, abdominal distention, and the passage of blood and mucus in their stool.  Patients with chronic, uncorrected malrotation can have recurrent abdominal pain and vomiting.
Malrotation can also be entirely asymptomatic.

# Diagnosis
With acutely ill patients, consider emergency surgery laparotomy if there is a high index of suspicion.
Plain radiography may demonstrate signs of duodenal obstruction with dilatation of the proximal duodenum and stomach but it is often non-specific. Upper gastrointestinal series is the modality of choice for the evaluation of malrotation as it will show an abnormal position of the duodeno-jejunal flexure (ligament of Treitz). In cases of malrotation complicated with volvulus, it demonstrates a corkscrew appearance of the distal duodenum and jejunum. In cases of obstructing Ladd bands, it will reveal a duodenal obstruction.
In equivocal cases, contrast enema, may be helpful by showing the caecum at an abnormal location.
It is usually discovered near birth, but in some cases is is not discovered until adulthood. In adults, the "whirlpool sign" of the superior mesenteric artery can be useful in identifying malrotation.
Patient#1
Patient#2

# Treatment
Resuscitate the patient with fluids to stabilize them before surgically
- correcting the malrotation
- cutting the fibrous bands over the duodenum.
One surgical technique is known as "Ladd's procedure", after Dr. William Ladd.
Intra-axial hemorrhage
Synonyms and keywords: Intra-axial hematoma

# Overview
Intra-axial hemorrhages, or intra-axial hematomas, are a subtype of intracranial hemorrhage that occur within the brain tissue itself.
Intra-axial hemorrhages are potentially deadly because they can increase intracranial pressure and crush delicate brain tissue or reduce its blood supply, causing ischemia.  The other category of intracranial hemorrhage is extra-axial hemorrhage, such as epidural, subdural, and subarachnoid hematomas, which all occur within the skull but outside of the brain tissue.

# Classification
There are two main kinds of intra-axial hemorrhages: intraparenchymal hemorrhage and intraventricular hemorrhages.

# Related Chapters
- Traumatic brain injury
- Intracranial hemorrhage
- Extra-axial hematoma
- Subdural hematoma
- Epidural hematoma
- Subarachnoid hemorrhage
Space occupying lesion

# Overview
Intracranial space occupying lesions are tumors or abscesses present within the cranium or skull. These lesions put pressure on the adjacent brain tissue causing its damage.

# Pathophysiology
- Tumors of brain may develop focally or can be of metastatic origin. They grow in size causing focal tissue damage by pressure and infiltration.
- Bleeding into the brain tissue causes formation of hematoma. If these hematoma's get infected they may turn into abscess.
- With increasing volume in the brain pressure increases too leading to signs of increased intra cranial pressure.

# Causes
- Primary brain tumors
- Metastatic lesion
- Hematoma
- Cerebral abscess
- Lymphomas
- Granuloma
- Tuberculoma
- Cysticercosis

# Differentiating Space occupying lesions from other diseases
Space occupying lesion should be differentiated from other diseases causing severe headache for example: 

# Risk factors
- Trauma
- HIV infection
- Diabetes
- Malignancy
- COPD (Chronic obstructive pulmonary disease)
- Tuberculosis

# History and symptoms
- Headache
- Nausea
- Vomiting
- Change in mental status
- Seizures
- Focal symptoms of brain damage
- Associated co-morbid conditions like tuberculosis, etc

# Diagnosis
Blood tests
- Total blood count, hemoglobin levels for general condition of the person.
- Electrolyte levels
- Serum BNP(Brain natriuretic peptide)
Biopsy
- Biopsy of the lesion is needed to know the nature of the lesion.
X ray
- X- ray skull is quite a non specific test, but useful if any of the lesions are calcified.
- X- ray chest may be warranted if any metastatic tumor is suspected.
CT and MRI
- These tests are of higher value to detect intracranial lesions.
- They have higher sensitivity and specificity compared to X-rays.

# Treatment
Treatment depends on the type of the lesion and associated co morbid conditions.
Medical therapy
- Pain killers to relieve the person from headache.
- Steroids to reduce cerebral edema.
- Mannitol to reduce intra cranial pressure.
- Anticonvulsant medication to cover seizures.
- Infections will need antibiotics which can cross blood brain barrier.
- Tumors will treated with chemotherapy.
Surgery
- Primary brain tumors can be surgical excised if they are amendable to surgery.
- Brain radiation is useful in radio sensitive tumors.
- Hematomas are surgically evacuated.