Persius/hicric huggingface dataset:
Base of the heart

# Overview
The base of the heart, directed upward, backward, and to the right, is separated from the fifth, sixth, seventh, and eighth thoracic vertebr by the esophagus, aorta, and thoracic duct.
It is formed mainly by the left atrium, and, to a small extent, by the back part of the right atrium.
Somewhat quadrilateral in form, it is in relation above with the bifurcation of the pulmonary artery, and is bounded below by the posterior part of the coronary sulcus, containing the coronary sinus.
On the right it is limited by the sulcus terminalis of the right atrium, and on the left by the ligament of the left vena cava and the oblique vein of the left atrium.
The four pulmonary veins, two on either side, open into the left atrium, while the superior vena cava opens into the upper, and the anterior vena cava into the lower, part of the right atrium.
Basement membrane
The basement membrane is a structure that supports overlying epithelial or endothelial cells.

# Composition
The basement membrane consists of an electron-dense membrane called the lamina densa, about 3070 nanometers in thickness, and an underlying network of reticular collagen (type IV) fibrils (its precursor is fibroblasts) which average 30 nanometers in diameter and 0.12 micrometers in thickness. This type IV collagen is of the reticular type, in contrast to the fibrillar collagen found in the interstitial matrix.   In addition to collagen, this supportive matrix contains intrinsic macromolecular components.
The Lamina Densa (which is made up of type IV collagen fibers; perlecan (a heparan sulfate proteoglycan) coats these fibers and they are high in heparan sulfate) and the Lamina Lucida (made up of laminin, integrins, entactins, and dystroglycans) together make up the basal lamina. Lamina Reticularis attached to basal lamina with anchoring fibrils (type VII collagen fibers) and microfibrils (fibrilin) is collectively known as the basement membrane. 

# Function and importance
The primary function of the basement membrane is to anchor down the epithelium to its loose connective tissue underneath. This is achieved by cell-matrix adhesions through cell adhesion molecules (CAMs).
The basement membrane acts as a mechanical barrier, preventing malignant cells from invading the deeper tissues. Early stages of malignancy that are thus limited to the epithelial layer by the basement membrane are called carcinoma in situ.
The basement membrane is also essential for angiogenesis (development of new blood vessels). Basement membrane proteins have been found to accelerate differentiation of endothelial cells. 
It also plays an important role in glomerular filtration in the kidney.
Noncollagenous domain basement membrane collagen type IV is autoantigen (target antigen) of autoantibodies in the autoimmune disease Goodpasture's syndrome.
Cerebral peduncle

# Overview
The cerebral peduncle, by most classifications, is everything in the mesencephalon except the tectum. The region includes the midbrain tegmentum, crus cerebri, substantia nigra and pretectum. The peduncles are also known as the crus cerebri. There are numerous nerve tracts located within this section of the brainstem. Of note, in the cerebral peduncular loop fibers from motor areas of the brain project to the cerebral peduncle and then project to various thalamic nuclei.
Inasmuch as the peduncles are an anatomic landmark, for details regarding the function of this area interested readers are referred to the individual referenced articles. On a broad scale, though, this area contains many nerve tracts conveying motor information to and from the brain to the rest of the body.

# Additional images
- Scheme showing the connections of the several parts of the brain.
- Superficial dissection of brain-stem. Lateral view.
- Dissection of brain-stem. Lateral view.
- Deep dissection of brain-stem. Lateral view.
- Dissection showing the projection fibers of the cerebellum.
- Median sagittal section of brain.
- The left optic nerve and the optic tracts.
- Upper part of medulla spinalis and hind- and mid-brains; posterior aspect, exposed in situ.
Batista procedure
The Batista procedure was an experimental open-heart surgical technique that aimed to reverse the effects of remodeling in cases of end-stage dilated cardiomyopathy, which is refractory to conventional medical therapy. In spite of promising initial results, the method was soon found to be of little if any benefit, and it is no longer considered a recommended treatment for the disease.
The procedure involves removal of a portion of left ventricular free wall reducing the volume of the enlarged left ventricle towards normal. The patient had to be connected to a heart-lung machine during surgery to ensure adequate circulation while bypassing the heart.
Despite the positive benefits of such a procedure, the mortality percentage still remains to be 60% or less.

# Further reading:
CME Category::Cardiology
Bentall procedure

# Overview
A Bentall procedure is a cardiac surgery operation involving composite graft replacement of the aortic valve, aortic root and ascending aorta, with re-implantation of the coronary arteries into the graft.  This operation is used to treat combined aortic valve and ascending aorta disease, including lesions associated with Marfan syndrome.  The Bentall procedure was first described in 1968 by Mr. Hugh Bentall and A. De Bono.

# Alternatives
The Bentall operation entails replacement of the aortic valve, aortic root and ascending aorta, but other operations may be used when all three components are not involved.
- Normal aortic root: The re-implantation of the coronary arteries is prone to complications, and aortic root replacement should be avoided when possible.  The aortic valve and ascending aorta can be replaced in separate steps, without root replacement.
- Normal aortic valve with annular dilation and ascending aneurysm (frequently found in Marfan syndrome): Artificial heart valves may wear out or require anticoagulation, and a valve-sparing aortic root replacement allows replacement of the aortic root +/- ascending aorta, while allowing a person to keep their own aortic valve and avoid the problems of aortic valve replacement.

# Indications
- Aortic aneurysm
- Aortic regurgitation
- Aortic dissection
Berberis vulgaris
Berberis vulgaris (European Barberry) is a shrub in the family Berberidaceae, native to central and southern Europe, northwest Africa and western Asia; it is also naturalised in northern Europe, including the British Isles and Scandinavia, and North America.
It is a deciduous shrub growing up to 4 m high. The leaves are small oval, 2-5 cm long and 1-2 cm broad, with a serrated margin; they are borne in clusters of 2-5 together, subtended by a three-branched spine 3-8 mm long. The flowers are yellow, 4-6 mm across, produced on 3-6 cm long panicles in late spring. The fruit is an oblong red berry 7-10 mm long and 3-5 mm broad, ripening in late summer or autumn; they are edible but very sour, and rich in Vitamin C.

# Cultivation and uses
The plant is both poisonous and medicinal. The plant, except for its fruits and seeds, is mildly poisonous. Its most potent agent is berberine, which is also known to have a number of therapeutical effects. In Europe, the berries are traditionally used for making jam. In southwestern Asia, especially Iran, the berries are used for cooking, to spice rice for example.
It is an intermediate host for Puccinia graminis (black rust), a rust disease of wheat. Wheat farmers had accused barberries of spreading rust as early as 1660, but were derided as superstitious by the jam makers. The matter was not settled scientifically until 1865. Because of the impact of this disease on wheat crops, cultivation of European Barberry is prohibited in many areas.
- Flowers
Flowers
- File:Illustration Berberis vulgaris0.jpg
Biological patent

# Overview
A biological patent is a patent relating to an invention or discovery in biology.
Some types of biological patents are considered controversial by those who feel that natural occurrences are not invented and thus should not be patentable. This is especially true if the biological matter being patented can be found in humans, such as sequences of DNA. Advocates who speak against biological patents suggest that the techniques and processes associated with the discovery could be patentable but not the actual biological matter itself.  For example, an advocate against biological patents would suggest that a gene associated with cancer should not be patented, but the test used to detect the gene could be.
On the other end of the spectrum many scientists/researchers are against patenting biological information if it comes at the cost of research. Many scientists are coming up against patent thickets, which are masses of information that they must obtain permission (and often pay large fees to utilize) before they can ever work with the information.
Whether or not patents can be validly obtained for certain parts of the DNA of an organism depends on the patent law. Modern patent law is becoming stricter about what sort of biological information can be patented. Prior to tightening, companies and organizations like the University of California were patenting whole genomes.
Biological system

# Overview
In biology, a system is a group of organs that work together to perform a certain task. Common systems, such as those present in mammals and other animals, seen in human anatomy, are those such as the circulatory system, the respiratory system, the nervous system, etc.
A group of systems composes an organism, e.g. the human body.

# Human systems
Humans have a a variety of systems due to the complexity of the species' organism. These specific systems are widely studied in Human anatomy. "Human" systems are also present in many animals.
- Circulatory system: pumping and channeling blood to and from the body and lungs with heart, blood, and blood vessels.
- Digestive system: digestion and processing food with salivary glands, esophagus, stomach, liver, gallbladder, pancreas, intestines, rectum, and anus.
- Endocrine system: communication within the body using hormones made by endocrine glands such as the hypothalamus, pituitary or pituitary gland, pineal body or pineal gland, thyroid, parathyroids, and adrenals or adrenal glands
- Integumentary system: skin, hair and nails
- Lymphatic system: structures involved in the transfer of lymph between tissues and the blood stream, the lymph and the nodes and vessels that transport it including the Immune system: defending against disease-causing agents with leukocytes, tonsils, adenoids, thymus, and spleen
- Muscular system: movement with muscles.
- Nervous system: collecting, transferring and processing information with brain, spinal cord, peripheral nerves, and nerves
- Reproductive system: the sex organs, such as ovaries, fallopian tubes, uterus, vagina, mammary glands, testes, vas deferens, seminal vesicles, prostate, and penis.
- Respiratory system: the organs used for breathing, the pharynx, larynx, trachea, bronchi, lungs, and diaphragm.
- Skeletal system: structural support and protection with bones, cartilage, ligaments, and tendons.
- Urinary system: kidneys, ureters, bladder and urethra involved in fluid balance, electrolyte balance and excretion of urine.
Biomedical tissue

# Overview
Biomedical tissue is biological tissue used for organ transplantation and medical research, particularly cancer research.
Such tissues and organs may be referred to as: implant tissue, allograft, xenograft, skin graft tissue, human transplant tissue, implant bone. Tissue is stored in tissue establishments or tissue banks under cryogenic conditions. Fluids such as blood, blood products and urine are stored in fluid banks under similar conditions.

# Regulation
The collection, storage, analysis and transplantation of human tissue involves significant ethical and safety issues, and is heavily regulated. Each country sets its own framework for ensuring the safety of human tissue products.
The regulation of human transplantation in the United Kingdom is set out in the Human Tissue Act 2004 and managed by the Human Tissue Authority.
Tissue banks in the US are monitored by the Food and Drug Administration (FDA). The Code of Federal Regulations sets out the following topics:
- Donor Screening and Testing: the determination of donor suitability for human tissue intended for transplantation.
- Procedures and Records: the written procedures and records that must be kept
- Inspection of Tissue Establishments: the importation of tissues from abroad and the retention, recall, and destruction of human tissue.

# Notable regulation cases
- Biomedical Tissue Services, Inc. is at the heart of an investigation by the Food and Drug Administration.
Biotin deficiency

# Overview
Biotin deficiency can have a very serious, even fatal, outcome if it is allowed to progress without treatment.  Signs and symptoms of biotin deficiency can develop in persons of any age, race, or gender.  Biotin deficiency rarely occurs in healthy individuals, since the daily requirements of biotin are low, many foods contain adequate amounts, intestinal bacteria synthesize small amounts, and the body effectively scavenges and recycles biotin from bodily waste. However, deficiency can be caused by excessive consumption of raw egg-whites over a long period (months to years).  Egg-whites contain high levels of avidin, a protein that binds biotin strongly. Once a biotin-avidin complex forms, the bond is essentially irreversible.  The biotin-avidin complex is not broken down nor liberated during digestion, and the biotin-avidin complex is lost in the feces.  Once cooked, the egg-white avidin becomes denatured and entirely non-toxic.
Initial symptoms of biotin deficiency include:
- Dry skin
- Brittle nails
- Seborrheic dermatitis
- Fungal infections
- Rashes including erythematous periorofacial macular rash
- Fine and brittle hair
- Hair loss or total alopecia
If left untreated, neurological symptoms can develop, including:
- Mild depression, which may progress to profound lassitude and, eventually, to somnolence
- Changes in mental status
- Generalized muscular pains (myalgias)
- Hyperesthesias and paresthesias
The treatment for biotin deficiency is simply to start taking some biotin supplements.

# Biotin deficiency
Biotin deficiency should not be confused with biotinidase deficiency, which is not due to inadequate biotin, but rather to a deficiency in the enzymes which process it.
Pulsus bisferiens
Synonyms and keywords: Bisferious pulse, biphasic pulse, spike and dome pattern

# Overview
Pulsus bisferiens is a sign where, on palpation of the pulse, a double peak in the aortic waveform is observed with each cardiac cycle.
Bisferious means striking twice. Therefore, pulsus bisferiens is a type of aortic waveform which has two systolic peaks separated by distinct mid-systolic dip

# Pathophysiology

## Hypertrophic Cardiomyopathy
Pulsus bisferiens is due to systolic anterior motion (SAM) of the mitral valve. Because the mitral valve leaflet doesn't get pulled into the left ventricular outflow tract (LVOT) until after the aortic valve opens, the initial upstroke of the arterial pulse pressure will be normal. When the mitral valve leaflet gets pushed into the LVOT, the arterial pulse will momentarily collapse and will later be followed by a second rise in the pulse pressure, as the left ventricular pressure overcomes the increased obstruction caused by the SAM of the mitral valve. This can be seen on the physical examination as a double tap upon palpation of the apical impulse and as a double pulsation upon palpation of the carotid pulse, known as pulsus bisferiens or a "spike and dome pattern" to the carotid pulse.

# Causes Of Pulsus Bisferiens

## Overview
Pulsus bisferiens classically detected in patients with mixed aortic insufficiency and aortic stenosis, but it may also be found in isolated severe aortic insufficiency, and hypertrophic obstructive cardiomyopathy.

## Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.  Pulsus bisferiens in itself is not a life threatening condition, but in most of cases it indicate aortic insufficiency, and further investigations should be done.

## Common Causes
The most common cause of pulsus bisferiens is sever aortic insufficiency , other causes include:
- Aortic valve regurgitation Mixed with aortic stenosis
- Hypertrophic obstructive cardiomyopathy

## Causes by Organ System

## Causes in Alphabetical Order
- Aortic insufficiency
- Aortic valve regurgitation Mixed with aortic stenosis
- Hypertrophic obstructive cardiomyopathy

# Related chapters
- Hypertrophic cardiomyopathy
- Aortic regurgitation
Bladder exstrophy
Steven C. Campbell, M.D., Ph.D.

# Overview
Bladder exstrophy, more properly, the exstrophy-epispadias complex is a rare congenital anomality occurring once every 40,000-50,000 live births with a 2:1 male:female ratio.  The diagnosis involves a spectrum of anomalies of the lower abdominal wall, bladder, anterior bony pelvis, and external genitalia.  It occurs due to failure of the abdominal wall to close during fetal development and results in protrusion of the posterior bladder wall through the lower abdominal wall.
Treatment is with surgical correction of the defect, but patients can still have long term issues with urinary tract infections and sexual dysfunction.

# Pathogenesis
The cause of bladder exstrophy is maldevelopment of the lower abdominal wall, leading to a rupture which causes the bladder to communicate with the amniotic fluid.

# Spectrum of anomalies
The typical manifestation of exstrophy-epispadias complex is
- bladder everted through a midline lower abdominal wall defect
- widening of the pubic symphysis
- epispadias in males (dorsal cleft in the penis, exposing the urethral mucosa)
- bifid clitoris in females, with a short "urethral strip" indistinguishable from bladder mucosa.
The spectrum of disease extends from spade penis and epispadias on one hand, to exstrophy with cloaca (also known as cloacal exstrophy).

# Diagnosis

# Treatment
Modern therapy is aimed at surgical reconstruction of the bladder and genitalia

# Prognosis
Even with successful surgery, patients may have long-term problems with
- incontinence
- urinary reflux
- repeated urinary tract infections
- sexual dysfunction
Bleeding overview

# Overview
Bleeding is the loss of blood from the circulatory system. Bleeding can occur internally, where blood leaks from blood vessels inside the body or externally, either through a natural opening such as the vagina, mouth or rectum, or through a break in the skin.
The complete loss of blood is referred to as exsanguination, and desanguination is a massive blood loss. Loss of 10-15% of total blood volume can be endured without clinical sequelae in a healthy person, and blood donation typically takes 8-10% of the donor's blood volume.

# Definition of Multivessel Disease
For AEGIS-II inclusion criteria #5, multivessel disease criteria can be met by findings on the cardiac catheterization for the index MI, a prior cardiac catheterization, or both:
- Index MI cardiac catheterization: 50% or greater stenosis of the left main or at least 2 coronary artery territories (LAD, LCX, RCA) (prior to any interventions performed)
- Prior cardiac catheterization: 50% or greater stenosis of left main or at least 2 coronary artery territories (LAD, LCx, RCA) (prior to any interventions performed)
- Both: Index MI cardiac catheterization with 1 vessel with 50% or greater stenosis (prior to any interventions performed) AND prior PCI of at least 1 vessel different from index MI vessel
- Prior multivessel CABG
Multivessel disease requires a 50% or greater stenosis in at least 2 of the 3 major epicardial artery territories (LAD, LCx, RCA) or the left main vessel. Branch vessel disease may qualify as part of the territory of that branch vessel (for example, a diagonal vessel is considered part of the LAD territory). For the purpose of this study, the ramus is considered part of the Left Circumflex artery territory. If a branch vessel is used as a qualifying vessel, that branch should be of large enough size to potentially undergo revascularization if clinically indicated, e.g. >2mm vessel size.
Body volume index

# Overview
The Body Volume Index (BVI) has been proposed as an alternative to Body Mass Index (BMI).
Whereas BMI is based on measurement of total mass, irrespective of the location of the mass, BVI looks at the relationship between mass and volume distribution (i.e. where the body mass is located). Recent studies have highlighted the limitations of BMI as an indicator of individual health risk.  

# BVI as an application for body shape and obesity measurement
The Body Volume Index was devised in 2000 as a computer based measurement of the human body for obesity and an alternative to the Body Mass Index (BMI)
It is an application that can be used on any 3D Body Scanner, whether the scanning hardware uses visible light optical information or otherwise to determine individual health risk. BVI can differentiate between people who have the same BMI rating, but who have a different shape and different weight distribution.
Whereas the BMI of a person is measured manually by total weight and height, BVI is calculated by using 3D body data to determine volume or weight distribution.  BVI measures where the weight and the fat are located on the body rather than total weight or total fat content. There has been an increasing acceptance in recent years that abdominal fat and weight around the abdomen constitute a greater health risk.  A body surface scanner determines the three-dimensional outline of a person's exterior surface, so that computation can be used to calculate the part volumes and the part body composition of that person. BVI makes an inference as to the body's distribution of fat and weight using complex and detailed Body Composition data.
Most 3D scanners suitable for BVI require that the subject is scanned for a series of images under varying lighting conditions (various projected patterns), to determine body shape and weight distribution data for individual patient and statistical analysis.
Borrelia anserina
Borrelia anserina is a helical filiform spirochete bacteria with dimensions of approximately 8-20/0,2-0,3 m and with about 5 to 8 spirals. Their mobility is very high. B. anserina can be colored with the May Grunwald-Giemsa method.

# Cultivation
In Microbiological laboratories, B. anserina bacteria can be grown on special protein enriched mediums (rich in ovoalbumins or animal tissue (that countains Myoglobin)), in anaerobic conditions. They can also be grown in embrionated chicken eggs. The laboratory cultivation of B. anserina is rarely done and constitutes a diagnostic method in bird borreliosis and spirochetosis.

# Pathogenity
B. anserina is a pathogenic agent for birds (chickens, turkeys, ducks etc.) and causes a disease called borreliosis or spirochetosis. This bacteria is transmitted from bird to bird by ticks from the Argas and Ornitodorus genus. The major symptoms of an infection with B. anserina are: anemia, diarrhea and severe neurological disfunctions.