Persius/hicric huggingface dataset:
Thoracic nerves
The thoracic nerves are the spinal nerves emerging from the thoracic vertebrae.

# Anterior divisions
- The intercostal nerves come from thoracic nerves T1-T11, and run between the ribs ("costae"). At T2 and T3, it further branches into the intercostobrachial nerve.
- The subcostal nerve comes from nerve T12, and runs below the twelfth rib.

# Posterior divisions
The medial branches (ramus medialis; internal branch) of the posterior divisions of the upper six thoracic nerves run between the Semispinalis dorsi and Multifidus, which they supply; they then pierce the Rhomboidei and Trapezius, and reach the skin by the sides of the spinous processes.
The medial branches of the lower six are distributed chiefly to the Multifidus and Longissimus dorsi, occasionally they give off filaments to the skin near the middle line.

# Additional images
- Nervous system
- Areas of distribution of the cutaneous branches of the posterior divisions of the spinal nerves.
- Diagram of the course and branches of a typical intercostal nerve.
- Intercostal nerves, the superficial muscles having been removed.
To Err is Human
"To Err is Human: Building a Safer Health System" is a groundbreaking report issued in 2000 by the U.S. Institute of Medicine which resulted in an increased awareness of U.S. medical errors. The push for patient safety that followed its release currently continues. The report was based upon analysis of multiple studies by a variety of organizations and concluded that between 44,000 to 98,000 people die each year as a result of preventable medical errors. For comparison, fewer than 50,000 people died of Alzheimer's disease and 17,000 died of illicit drug use in the same year.
The report called for a comprehensive effort by health care providers, government, consumers, and others. Claiming that the knowledge of how to prevent these errors already existed, it a minimum goal of a 50 percent reduction in errors over the next five years. Though not currently quantified, as of 2007 this ambitious goal has yet to be met.
The report was followed in 2001 by another widely cited Institute of Medicine report, "Crossing the Quality Chasm," which furthers many of the points from the original study. Both are widely referenced. "To Err is Human" was the inspiration for the Institute for Healthcare Improvement's 100,000 Lives Campaign, which in 2006 claimed to have prevented an estimated 124,000 deaths in a period of 18 months through patient-safety initiatives in over 3,000 hospitals.
Tolfenamic acid

# Overview
Tolfenamic acid (TA) is one of the class of non-steroidal anti-inflammatory drugs (NSAIDs). It is used to treat the symptoms of migraine.

# Other possible uses
A study concludes, "TA was found significantly better than placebo in the subjective evaluation of drug efficacy (p<0.001) and in reducing the reported hangover symptoms in general (p < 0.01). In the TA group, significantly lower symptom scores were obtained for headache (p<0.01), and for nausea, vomiting, irritation, tremor, thirst and dryness of mouth (all p < 0.05)."

# Commercial names
Commercial names for tolfenamic acid include Clotam Rapid, Migrex and Tufnil for use in humans and Tolfedine for veterinary use in cats and dogs. This drug should not be confused with Tolmetin.
Torus palatinus

# Overview
Torus palatinus (pl.  palatal tori) is a bony growth on the palate.  Palatal tori are usually present on the midline of the hard palate.  Most palatal tori are less than 2 cm in diameter, but their size can change throughout life.
The prevalence of palatal tori ranges from 9% - 60% and are more common than bony growths occurring on the mandible, known as torus mandibularis.  Palatal tori are more common in Asian and Inuit populations, and twice more common in females.  In the United States, the prevalence is 20% - 35% of the population with similar findings between blacks and whites.
Although some research suggest palatal tori to be an autosomal dominant trait, it is generally believed that palatal tori are caused by several factors.  They are more common in early adult life and can increase in size.  In some older people, the size of the tori may decrease due to bone resorption.  Consequently, it is believed that mandibular tori are the result of local stresses and not solely on genetic influences.
Sometimes, the tori are categorized by their appearance.  Arising as a broad base and a smooth surface, flat tori are located on the midline of the palate and extend symmetrically to either side.  Spindle tori have a ridge located at their midline.  Nodular tori have multiple bony growths that each have their own base.  Lobular tori have multiple bony growths with a common base.
Palatal tori are usually a clinical finding with no treatment necessary.  It is possible for ulcers to form on the area of the tori due to repeated trauma.  Also, the tori may complicate the fabrication of dentures.  If removal of the tori is needed, surgery can be done to reduce the amount of bone present.

# Diagnosis

## Physical Examination

### Oral cavity
- Torus palatinus. Adapted from Dermatology Atlas.

# Differential diagnosis
Torus palatinus must be differentiated from other mouth lesions such as oral candidiasis and aphthous ulcer
Tosylchloramide

# Overview
Tosylchloramide or  N-chloro tosylamide, sodium salt, sold as chloramine-T, is a N-chlorinated and N-deprotonated sulfonamide used as a biocide and a mild disinfectant. It is a white powder that gives unstable solutions with water. Trade names of chloramine-T products include Chloraseptin, Chlorazol, Clorina, Disifin, Halamid, Hydroclonazone, Trichlorol, Minachlor, and generic Chloramin T or Tosylchloramide Sodium, among others.

# Uses

## Iodination and radioiodination
Hypochlorite released from chloramine-T acts as an effective oxidizing agent for iodide to form iodine monochloride (ICl). ICl rapidly undergoes electrophilic substitution predominantly with activated aromatic rings, such as those of the amino acid tyrosine. Thus, chloramine-T is widely used for the incorporation of iodine to peptides and proteins. Chloramine-T together with iodogen or lactoperoxidase is commonly used for labeling peptides and proteins with radioiodine isotopes (123I, 125I or 131I).

## Biocide
Chloramine-T is available in tablet or powder form and has to be dissolved before use. It is sprayed on a surface and allowed to stand for at least 15 minutes before being wiped off or allowed to dry. It used in areas such as hospitals, laboratories, nursing homes, funeral homes, medical, dental and veterinary facilities, where control of pathogens is required, for disinfecting surfaces and soaking medical and dental equipment. The substance is also used for parasite control and for drinking water disinfection.
Chloramine-T is as an algicide, bactericide, virucide, fungicide (including spores), germicide. It is also effective against mycobacteria such as tuberculosis, foot-and-mouth disease and avian influenza. The molecular structure of toluenesulfonylamide is similar to para-aminobenzoic acid, an intermediate in bacterial metabolism, which is disrupted by this sulfonamide (in the same way as by a sulfa drug). Therefore, chloramine-T is capable of inhibiting with bacterial growth with two mechanisms, with the phenylsulfonamide moiety and the hypochlorite, which destroys the DNA structure via oxidation and thereby prevents microbes from reproducing and reforming.

## Protective agent
Chloramine-T reacts readily with mustard gas to yield a harmless crystalline sulfimide; chloramine-T derivatives are being studied as protective agents against poison gas.

# Certifications
- EN 13713 Bactericidal
- EN 14675 Virucidal
- EN 14476 Virucidal Norovirus
- EN 1650  Fungicidal
- EN 13704 Sporicidal Clostridium difficile
Tourniquet test

# Overview
A tourniquet test (also known as a Rumpel-Leede Capillary-Fragility Test or simply a capillary fragility test) determines capillary fragility. It is a clinical diagnostic method to determine a patient's haemorrhagic tendency. It assesses fragility of capillary walls and is used to identify thrombocytopenia (a reduced platelet count).  The test is defined by the WHO as one of the necessary requisites for diagnosis of Dengue fever.

# Methodology
A blood pressure cuff is applied and inflated to a point between the systolic and diastolic blood pressures for five minutes.  The test is positive if there are more than 20 petechiae per square inch (a petechia is  a small red or purple spot on the body, caused by a minor hemorrhage).  If the test is positive, a patient with sufficient pre-test probability may have dengue haemorrhagic fever.

## Reliability
This test does not have high specificity.  Factors that interfere with this test are women who are premenstrual, postmenstrual and not taking hormones, or those with sun damaged skin, since all will have increased capillary fragility.(Pagana, & Pagana, 1998; Tsai, 2000).  At least one insurance company, Aetna, has determined that the Rumpel-Leede test is obsolete or unreliable and has been replaced by more advanced procedures.
Training effect
Training effect is the elevation of metabolism through physical exercise.  This effect was discovered by Dr. Kenneth H. Cooper for the United States Air Force in the late 1960s.  Dr. Cooper coined the term "Training Effect" for this.
The measured effects were that muscles of respiration were strengthened, the heart was strengthened, blood pressure was sometimes lowered and the total amount of blood and number of red blood cells increased, making the blood a more efficient carrier of oxygen. VO2 Max was increased.
The exercise necessary can be accomplished by any aerobic exercise in a wide variety of schedules - Dr. Cooper found it best to award "points" for each amount of exercise (as laid out in the detailed tables in his classic 1968 book "Aerobics" ISBN 0-553-20992-2, reprinted and expanded several times) and require 30 points a week to maintain the Training Effect.
Dr. Cooper instead recommended a "12-minute test" (the Cooper test) followed by adherence to the appropriate starting-up schedule in his book.  As always, he recommends that a physical exam should precede any exercise program.  (A newly-recognized effect is that of Exercise hypertension, for which there is a medical test.)
The physiological effects of training have received much further study since Dr Cooper's original work.  It is now generally considered that effects of exercise on general metabolic rate (post-exercise) are comparatively small and the greatest effect occurs for only a few hours. However, all exercise components (summarised perhaps as general endurance - as reflected to a degree by VO2 max, strength, local muscular endurance, and flexibility) are significantly trainable at all ages in many people, and the Cooper Points System still gives overall guidance on this.
Transmetalation

# Overview
Transmetalation (alt. spelling: transmetallation) is a general chemical reaction type in organometallic chemistry describing the exchange of ligands between two metal centers.
The metal centers need not be the same. The ligands R and R' can be organic or inorganic. The double displacement reaction is conceptually related.
Transmetalation is important in the synthesis of various organometallic compounds. Silver N-heterocyclic carbene complexes are easily formed, and are often used to transfer the carbene ligands to other metals containing labile ligands such as acetonitrile or 1,5-cyclooctadiene. Where L-H+ denotes the ligand precursor:
This reaction type also appears frequently in the catalytic cycle of various metal catalysed organic reactions such as the Stille reaction and the Negishi coupling.
Treacle protein
Treacle protein is a protein that in humans is encoded by the TCOF1 gene.
This gene encodes a nucleolar protein with an LIS1 homology domain. The protein is involved in ribosomal DNA gene transcription through its interaction with upstream binding factor (UBF). Mutations in this gene have been associated with Treacher Collins syndrome, a disorder which includes abnormal craniofacial development. Alternate transcriptional splice variants encoding different isoforms have been found for this gene, but only three of them have been characterized to date.
TCOF1 is a gene that provides instructions for making a protein called treacle.  This protein is active during early embryonic development in structures that become bones and other tissues in the face. Although the precise function of this protein is unknown, researchers believe that it plays a critical role in the development of facial bones and related structures.
Studies suggest that treacle is involved in the production of a molecule called ribosomal RNA (rRNA) within cells. Treacle is active in the nucleolus, which is a small region inside the nucleus where rRNA is produced. As a major component of cell structures called ribosomes, rRNA is essential for the assembly of proteins.
Aside from its interaction with UBF, treacle has been implicated in the methylation of the precursor to mature ribosomal RNA by interaction with the nucleolar protein pNop56.
The TCOF1 gene is located on the long (q) arm of chromosome 5 between positions 32 and 33.1, from base pair 149,717,427 to base pair 149,760,047.

# Related diseases
More than 120 mutations in the TCOF gene have been identified in people with Treacher Collins syndrome. Most of these mutations insert or delete a small number of DNA building blocks (base pairs) in the TCOF1 gene. TCOF1 mutations lead to the production of an abnormally small, nonfunctional version of treacle or prevent the cell from producing this protein. Researchers speculate that a loss of treacle reduces the production of rRNA in parts of the embryo that develop into facial bones and tissues. It is not known how loss of the treacle protein causes the specific problems with facial development found in Treacher Collins syndrome. For instance, mutations in the TCOF gene of these individuals often result in a cleft palate.

# Model organisms
Mutations in this gene in Jindo dogs have been associated to the observed cranial differences between Jindo and boxer dogs.
Trenonacog alfa

# Overview
Turoctocog alfa (trade name NovoEight) is a recombinant antihemophilic factor VIII used for the treatment of and prophylaxis of bleeding patients with haemophilia A. It is marketed by Novo Nordisk. It was first launched in Germany in January 2014 and has been approved in the US, EU and Japan.

# Medical uses
In the safety and efficacy trial for prevention and treatment of bleeds, in hemophilia patients the success rate for treatment of bleeds was 84.5% (excluding bleeds for which there was no outcome reported) and out of a total of nine surgeries in nine patients performed during the trial, haemostasis was successful in all the surgeries and no treatment failures were reported. It is also used for perioperative management and routine prophylaxis to prevent or reduce the frequency of bleeding episodes. Turoctocog alfa is not indicated for the treatment of von Willebrand disease.

# Benefits and risks
In a study conducted with 150 patients aged 12 and above, adolescents after using turoctocog alfa as a treatment, had an average of 5.55 bleedings per year while the adults had an average of 6.68 bleeding per year. According to data, turoctocog alfa was considered an 'excellent' treatment for 403 out of 499 bleeding episodes.
In another study involving 63 patients aged less than 12 years, children had an average of 5.33 bleedings per year after using turoctocog alfa as hemophilia treatment. In this study too turoctocog alfa was considered as an 'excellent' treatment for 116 out of 126 bleeding episodes.
Alongside the benefits, a few of the common turoctocog alfa adverse effects would be injection site reaction, pyrexia and augmented liver enzyme levels. Rare cases of allergic reactions have been reported as well. There is a possibility of patients developing hypersensitivity to the drug since it contains traces of hamster proteins. Activity-neutralising antibodies (inhibitors) may be developed whereby expected plasma factor VIII activity levels may not be achieved and thus the bleeding would not be controlled as needed.

# Preparation
As cell culture, Chinese hamster ovary cells (CHO) are used in order to acquire proper processing of factor VIII protein, that has demonstrated good efficacy in thrombin generation and clot formation in preclinical evaluations in murine (mouse) and canine (dog) models of hemophilia A and in patient-derived whole blood.

# Difference between NovoSeven and NovoEight
Even though both treatments are plasma-derived and recombinant analogues of blood clotting factors, NovoSeven is developed as a congenital FVIIa analogue for hemophilia A and B patients while NovoEight (turoctocog alfa) is for congenital FVIII deficiency. NovoSeven is called a bypassing agent because it skips the need for factor VIII or IX in people with inhibitors and activates factor X directly.
Tricuspid valve

# Overview
The tricuspid valve is on the right side of the heart, between the right atrium and the right ventricle. The normal tricuspid valve usually has three leaflets and three papillary muscles. Tricuspid valves may also occur with two or four leaflets, and the number may change during life (Van Pragh, 1998).

# Valves
- The largest cusp is interposed between the atrioventricular orifice and the conus arteriosus and is termed the anterior or infundibular cusp.
- A second, the posterior or marginal cusp, is in relation to the right margin of the ventricle.
- A third, the medial or septal cusp, to the ventricular septum.
- The tricuspid valve prevents the blood from returning to the right atrium when the right ventricle contracts
- Anterior (frontal) view of the opened heart. White arrows indicate normal blood flow. (Tricuspid valve labeled at bottom left.)

# Pathology
A small amount of leakage or regurgitation is not uncommon in the tricuspid valve. It is a common valve to be infected (endocarditis) in IV drug users. Although it is not a common site of endocarditis, patients with a small VSD usually develop endocarditis of the tricuspid valve.
The tricuspid valve can be affected by rheumatic fever which can cause tricuspid stenosis or tricuspid insufficiency (also called tricuspid regurgitation).
Some patients are born with congenital abnormalities of the tricuspid valve. Congenital apical displacement of the tricuspid valve is called Ebstein's anomaly and typically causes significant tricuspid regurgitation.
The first endovascular tricuspid valve implant was performed by physicians at the Cleveland Clinic. 

# Images
Images shown below are Courtesy of Professor Peter Anderson DVM PhD and Published with permission.  PEIR, University of Alabama at Birmingham, Department of Pathology
- Mitral and tricuspid valves from atria. Normal valvular anatomy
- Tricuspid valve. A close look up.
- Tricuspid valve in an infant with hypoplastic right ventricle
Triethanolamine

# Overview
Triethanolamine, often abbreviated as TEA, is a viscous organic compound that is both a tertiary amine and a triol. A triol is a molecule with three alcohol groups. Triethanolamine is a strong base.  Triethanolamine can also be abbreviated as TEOA, which can help to distinguish it from triethylamine.  Approximately 150000 metric tons were produced in 1999.  It is a colourless compound although samples may appear yellow because of impurities.

# Applications
Triethanolamine is used primarily as an emulsifier and surfactant. It is a common ingredient in formulations used for both industrial and consumer products. The triethanolamine neutralizes fatty acids, adjusts and buffers the pH, and solubilises oils and other ingredients that are not completely soluble in water. Some common products in which triethanolamine is found are liquid laundry detergents, dishwashing liquids, general cleaners, hand cleaners, polishes, metalworking fluids, paints, shaving cream and printing inks.

## Cosmetics and medicine
Various ear diseases and infections are treated with eardrops containing triethanolamine polypeptide oleate-condensate, such as Cerumenex in the United States. In pharmaceutics, triethanolamine is the active ingredient of some ear drops used to treat impacted earwax. It also serves as a pH balancer in many different cosmetic products - ranging from cleansing creams and milks, skin lotions, eye gels, moisturizers, shampoos, shaving foams etc. TEA is a fairly strong base: a 1% solution has a pH of approximately 10, whereas the pH of skin is below pH 7, more or less 5.5-6.0. Cleansing milk/cream emulsions based on TEA are particularly good at removing makeup.

# Safety and regulation

## Allergic reactions
A 1996 study found that triethanolamine (TEA) occasionally causes contact allergy. A 2001 study found TEA in a sunscreen caused an allergic contact dermatitis. A 2007 study found TEA in ear drops caused a contact allergy. Systemic and respiratory tract (RT) toxicity was analyzed for 28 days in a nose specific inhalation 2008 study in Wistar rats; TEA seems to be less potent in regard to systemic toxicity and RT irritancy than diethanolamine (DEA). Exposure to TEA resulted in focal inflammation, starting in single male animals from 20 mg/m3 concentrations.
A 2009 study stated patch test reactions reveal a slight irritant potential instead of a true allergic response in several cases and also indicated the risk of skin sensitization to TEA seems to be very low.

## Tumors
Reports indicated that TEA causes an increased incidence of tumor growth in the liver in female B6C3F1 mice, but not in male mice or in Fischer 344 rats. A 2004 study concluded "TEA may cause liver tumors in mice via a choline-depletion mode of action and that this effect is likely caused by the inhibition of choline uptake by cells."

## Environmental toxicity
A 2009 study found that TEA has potential acute, sub-chronic and chronic toxicity properties in respect to aquatic species.

## Regulation
TEA is listed under Schedule 3, part B of the Chemical Weapons Convention as it can be used in the manufacture of nitrogen mustards.
Trimethylarsine
Trimethylarsine is the chemical compound with the formula (CH3)3As, commonly abbreviated AsMe3.  This organic derivative of arsine (AsH3) has been used as a source of arsenic in microelectronics industry.  It is known for it's distinct "garlic" like smell. Trimethylarsine had been discovered as early as 1854.

# Structure and Preparation
As predicted by VSEPR theory, AsMe3 is pyramidal with As-C distance of 1.519 A and C-As-C angles 91.83
Trimethylarsine can be prepared by treatment of arsenic oxide with trimethylaluminium:

# Properties and reactions
Trimethylarsine is pyrophoric due to the exothermic nature of the following reaction, which initiates combustion:

# History
Although poisoning events due to a gas produced by certain micobes was observed and the dependence to the arsenic in paint was assumed. It was not until 1893 that the Italian physician Bartolomeo Gosio published his results on the toxic "Gosio gas" which was subsequently shown to be trimethylarsine.. Under wet conditions mold (scopulariopsis brevicaulis was an very active species) produces significant amounts of arsenic via biomethylation of inorganic pigments especially Paris green or Scheele's Green used in indoor wallpapers which is than released into the air. Newer studies show that trimethylearsine has a low toxicity and could therefor not account for the death and the severe health problems observed in the 19th century.

# Safety
Like all organoarsenic compounds, it is considered a carcinogen.
Troisier's sign
Troisier's sign is finding a hard, enlarged, left supraclavicular lymph node. Said to be pathognomonic of abdominal cancers, in particular gastric cancer.
Virchow's node is the node commonly palpated for to elicit Troisier's sign.
Troisier's sign is named after the French pathologist Charles Emile Troisier.