Persius/hicric huggingface dataset:
Galactocele
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Galactocele
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# Overview

# Epidemiology and Demographics

# Risk Factors

# Screening

# Pathophysiology & Etiology

# Molecular Biology

# Genetics

# Natural History

# Diagnosis

# Differential Diagnosis
For differentiating galactocele from other causes of breast lump, click here.

# History and Symptoms

# Physical Examination

## Appearance of the Patient

## Eyes

## Ear Nose and Throat

## Heart

## Lungs

## Abdomen

## Extremities

## Neurologic

## Other

# Laboratory Findings

## Electrolyte and Biomarker Studies

## Electrocardiogram

## Chest X Ray

## MRI and CT

## Echocardiography or Ultrasound

## Other Imaging Findings

## Other Diagnostic Studies

# Risk Stratification and Prognosis

# Treatment

# Pharmacotherapy

## Acute Pharmacotherapies

## Chronic Pharmacotherapies

# Surgery and Device Based Therapy

## Indications for Surgery

## Pre-Operative Assessment

## Post-Operative Management

## Transplantation

# Primary Prevention

# Secondary Prevention

# Cost-Effectiveness of Therapy

# Future or Investigational Therapies

# Suggested Revisions to the Current Guidelines
Garenoxacin

# Overview
Garenoxacin (INN) is a quinolone antibiotic for the treatment of Gram-positive and Gram-negative bacterial infections.
Garenoxacin was discovered by Toyama Chemical Co., Ltd. of Tokyo, Japan, and is currently being marketed in Japan under the tradename Geninax. Schering-Plough holds worldwide rights for garenoxacin, except for Japan, South Korea, and China.
On February 13, 2006, Schering-Plough announced that the United States Food and Drug Administration has accepted the New Drug Application (NDA) for garenoxacin, and has been granted a 10-month review.
Schering-Plough later withdrew its application to the United States Food and Drug Administration, FDA, (August 20, 2006) for approval of the antibiotic Garenoxacin.
The European Medicines Agency (EMEA) had also been formally notified by Schering-Plough Europe (July 28 2007) of its decision to withdraw the application for a centralized marketing authorization for garenoxacin as well.  Based on the CHMP review of the data regarding safety and efficacy (risk/benefit), the CHMP considered the application for garenoxacin to be unapprovable.
Gastrectomy
A gastrectomy is a partial or full surgical removal of the stomach.  The first successful gastrectomy was performed by Theodor Billroth in 1881 for cancer of the stomach.  Gastrectomies are performed to treat cancer, severe cases of peptic ulcer disease, and perforations of the stomach wall. This procedure is becoming less common as peptic ulcers are now often treated with antibiotics for Helicobacter pylori or by endoscopy. 
In severe duodenal ulcers it may be necessary to remove the lower portion of the stomach called the pylorus and the upper portion of the small intestine called the duodenum.  If there is a sufficient portion of the upper duodenum remaining a Billroth I procedure is performed, where the remaining portion of the stomach is reattached to the duodenum before the bile duct and the duct of the pancreas.  If the stomach cannot be reattached to the duodenum a Billroth II is performed, where the remaining portion of the duodenum is sealed off, a hole is cut into the next section of the small intestine called the jejunum and the stomach is reattached at this hole.  As the pylorus is used to grind food and slowly release the food into the small intestine, removal of the pylorus can cause food to move into the small intestine faster than normal, leading to gastric dumping syndrome.
In the past a gastrectomy for peptic ulcer disease was often accompanied by a vagotomy, where the vagus nerve is cut to reduce acid production in the stomach. Nowadays, this problem is managed with proton pump inhibitors.

# Polya's operation
A type of posterior gastroenterostomy which is a modification of the Billroth II operation. Resection of 2/3 of the stomach with blind closure of the duodenal stump and retrocolic anastomosis of the full circumference of the open stomach to jejunum
See also Finsterer-Hofmeister operation under Hans Finsterer, German surgeon, 18771955.
Gentianales
Gentianales are an order of flowering plants, included within the asterid group of dicotyledons.
The circumscription of Gentiales in the Cronquist system included a broadly defined Loganiaceae (since broken up into several families), Retziaceae, Gentianaceae, Saccifoliaceae, Apocynaceae, and Asclepiadaceae.  The circumscription recognized by the Angiosperm Phylogeny Group (APG) includes Apocynaceae (including Asclepiadaceae), Gelsemiaceae (segregated from Loganiaceae), Gentianaceae (including Saccifoliaceae), Loganiaceae, and Rubiaceae.
Under the APG definition some well-known members of Gentianales are coffee, gardenias, and frangipani.
APG includes Retziaceae in Stilbaceae (order Lamiales).
Hinge joint

# Overview
In the hinge joint (ginglymus), the articular surfaces are moulded to each other in such a manner as to permit motion only in one plane, forward and backward, the extent of motion at the same time being considerable.
The direction which the distal bone takes in this motion is seldom in the same plane as that of the axis of the proximal bone; there is usually a certain amount of deviation from the straight line during flexion.
The articular surfaces are connected together by weak collateral ligaments, which form their chief bond of union.
The best examples of ginglymus are the interphalangeal joints and the joint between the humerus and ulna; the knee- and ankle-joints are less typical, as they allow a slight degree of rotation or of side-to-side movement in certain positions of the limb.
Mitiglinide

# Overview
Mitiglinide (INN, trade name Glufast) is a drug for the treatment of type 2 diabetes.
Mitiglinide belongs to the meglitinide class of blood glucose-lowering drugs and is currently co-marketed in Japan by Kissei and Takeda.  The North America rights to mitiglinide are held by Elixir Pharmaceuticals.  Mitiglinide has not yet gained FDA approval.

# Pharmacology
Mitiglinide is thought to stimulate insulin secretion by closing the ATP-sensitive K(+) K(ATP) channels in pancreatic beta-cells.

# Dosage
Mitiglinide is delivered in tablet form.
Goblet cell

# Overview
Goblet cells are glandular simple columnar epithelial cells whose sole function is to secrete mucus. They secrete using both apocrine and merocrine methods of secretion.
The majority of the cell's cytoplasm is occupied by mucinogen granules, except at the bottom.  Rough endoplasmic reticulum, mitochondria, the nucleus, and other organelles are concentrated in the basal portion.  The apical plasma membrane projects microvilli to increase surface area for secretion.

# Locations
They are found scattered among the epithelial lining of many organs, especially the intestinal and respiratory tracts. In the respiratory tract, they are found inside the trachea, bronchus, and larger bronchioles.

# Histology
In mucicarmine stains, goblet cells can be easily identified by the deep red mucin found within their cell bodies.
The nuclei of goblet cells tend to be displaced toward the basal end of the cell body, close to basement membrane, leading to intense basophilic staining.

# Etymology
The term goblet refers to these cells' goblet-like shape.  The apical portion is shaped like a cup, as it is distended by abundant mucinogen granules; its basal portion is shaped like a stem, as it is narrow for lack of these granules.
There are other cells which secrete mucus (as in the fundic glands of the stomach), but they are not usually called "goblet cells" because they do not have this distinctive shape.

# Basal secretion
This is the normal base level secretion of mucus. The continuous secretion is accomplished by cytoskeletal movement of secretory granules.

# Stimulated secretion
Secretion may be stimulated by dust, smoke, etc.
Other stimuli include viruses, bacteria, etc.

# Additional images
- An intestinal gland from the human intestine.
- Goblet cell in ileum
Gonadotrope

# Overview
Pituitary gonadotropes are one of the 6 major cell types in the anterior pituitary.
They produce two hormones called gonadotropins which stimulate the ovaries. One of these is follicle stimulating hormone (FSH) which stimulates the development of the ovarian follicle in which the ova (egg) matures. The other is luteinizing hormone (LH) which is secreted in a peak just before ovulation.
LH stimulates the development of the corpus luteum which prepares the uterus for pregnancy.
These hormones are secreted in parallel and non-parallel patterns during the reproductive cycle. Secretion is stimulated by neuroendocrine mechanisms
The secretory neurons are cells scattered in a special region of the brain (gonadotropin releasing hormone-GnRH). These nerve cells originally migrated from the olfactory bulb during fetal development and then became specialized to control the reproductive system.
The GnRH is secreted into the blood stream in the pituitary stalk.
Goose bumps
Goose bumps, also called goose pimples, goose flesh, chill bumps, chicken skin, or the medical term cutis anserina, are the bumps on a person's skin at the base of body hairs which involuntarily develop when a person is cold or experiences strong emotions such as fear or awe. The reflex of producing goose bumps is known as horripilation, piloerection, or the pilomotor reflex. It occurs not only in humans but also in many other mammals; a prominent example are porcupines which raise their quills when threatened.
Goose bumps are created when tiny muscles at the base of each hair, known as arrectores pilorum, contract and pull the hair erect. The reflex is started by the sympathetic nervous system, which is in general responsible for many fight-or-flight responses.
Goose bumps are often a response to cold: in animals covered with fur or hair, the erect hairs trap air to create a layer of insulation.  Goose bumps can also be a response to anger or fear: the erect hairs make the animal appear larger, in order to intimidate enemies. This can for example be observed in the intimidation displays of chimpanzees, in stressed mice and rats, and in frightened cats. In humans, it can even extend to piloerection as a reaction to hearing nails scratch on a chalkboard or listening to awe-inspiring music.
Piloerection as a response to cold or fear is vestigial in humans; as humans retain only very little body hair, the reflex (in humans) now serves no known purpose.
In humans, goose bumps are strongest on the forearms, but also occur on the legs, back, and other areas of the skin that have hair. In some people, they even occur in the face or on the head.
Piloerection is also a (rare) symptom of some diseases, such as temporal lobe epilepsy, some brain tumors, and autonomic hyperreflexia. Goose bumps can also be caused by heroin withdrawal. A skin condition that mimics goose bumps in appearance is keratosis pilaris.
Goose bumps can occur only in mammals, since other animals do not have hair. The term "goose bumps" is therefore misleading: the bumps on the skin of a plucked goose technically do not qualify as piloerection even though this is where the term comes from. Birds do however have a similar reflex of raising their feathers in order to keep warm.
The Latin horrere is the root of words such as "horrific" or "horror"; it means "to tremble".
In other languages, the "goose" may be replaced by other kinds of poultry. For instance, "hen" is used in French (la chair de poule), Dutch (kippenvel), Spanish (la carne de gallina) and Chinese ().
Gossypiboma
Gossypiboma is the technical term for a surgical sponge accidentally left inside a patient's body.  It is derived from the Latin "gossypium" (cotton) and the Swahili "boma" (place of concealment).
Actual occurrences are difficult to come by since nearly all cases are settled out of court.  Statistical studies by researchers however put the number of occurrences between 3,000 and 5,000 cases a year.
Sponges are counted by hand before and after surgeries.  This method was codified into recommended guidelines in the 1970's by the A.O.R.N.

# Computerized Solutions
No significant and successful advancements had been made in the field until late 20th century.
The first break through came in 1997 when an UCLA MBA student and his urologist father co-developed and patented a turn-key system that would require the adherence of special labels at the manufacturing level to the sponges a hospital uses.  These sponges then could easily be read by a handheld scanner while the nursing staff followed their established sponge counting protocols and procedures, much like at a grocery store checkout counter.
Since each item has a unique code, the system will assist the nurse in keeping an accurate count by not letting the same sponge be counted twice accidentally.  Ohio University's Center For Auto Identification recent studies had compelling results: data matrix tags had at worst a 1 in 10 million scan error rate and at best a 1 in 612 million scan error rate.
After sustained testing, development, and studies while operating under an FDA exemption, the developer, SurgiCount Medical, received 510(k) clearance by the FDA for the system in March of 2006 to commercially roll out the system.  Currently the Safety Sponge System is the only FDA approved system and is the only system that is market ready.

# Radio Frequency Identification Technology
In 2004, Gautam Gandhi and Steve Fleck, MBA students from Carnegie Mellon won several national business plan competitions for ClearCount Medical Solutions.  RFID technology is used instead of the line-of-sight approach to lost sponges.  RFID is an appealing concept because it requires just waving a wand over an area to communicate wirelessly with a tag.  The company obtained FDA clearance in 2007.

# The Future
Using the high of the range (5,000) of retained sponges per year with the 30 million relevant surgeries per annum, an accuracy rate of 99.98% is the norm of hospitals.
PMEL (gene)
Melanocyte protein PMEL also known as premelanosome protein (PMEL) or silver locus protein homolog (SILV) is a protein that in humans is encoded by the PMEL gene. Its gene product may be referred to as PMEL, silver, ME20, gp100 or Pmel17.

# Structure and function
PMEL is a 100 kDa type I transmembrane glycoprotein that is expressed primarily in pigment cells of the skin and eye. The transmembrane form of PMEL is modified in the secretory pathway by elaboration of N-linked oligosaccharides and addition and modification of O-linked oligosaccharides. It is then targeted to precursors of the pigment organelle, the melanosome, where it is proteolytically processed to several small fragments. Some of these fragments form non-pathological amyloid that assemble into sheets and form the striated pattern that underlies melanosomal ultrastructure. PMEL cleavage is mediated by several proteases including a proprotein convertase of the furin family, a "sheddase" that might include members of the a disintegrin and metalloproteinase (ADAM) family, and additional proteases in melanosomes or their precursors. After the amyloidogenic region is cleaved, the small remaining integral membrane fragment is digested by -secretase.
The expression of the PMEL gene is regulated by the microphthalmia-associated transcription factor (MITF).
Granularity
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Granulocyte

# Overview
Granulocytes are a category of white blood cells characterised by the presence of granules in their cytoplasm. They are also called polymorphonuclear leukocytes (PMN or PML) because of the varying shapes of the nucleus, which is usually lobed into three segments. In common parlance, the term polymorphonuclear leukocyte often refers specifically to neutrophil granulocytes, the most abundant of the granulocytes. Granulocytes or PMN are released from the bone marrow by the regulatory complement proteins.

# Classification
There are three types of granulocytes, distinguished by their appearance under Wright's stain:
- Neutrophil granulocytes
- Eosinophil granulocytes
- Basophil granulocytes.
- Eosinophil granulocyte
- Basophil granulocyte
Their names are derived from their staining characteristics; for example, the most abundant granulocyte is the neutrophil granulocyte, which has neutrally-staining cytoplasmic granules.
Other white blood cells which are not granulocytes ("agranulocytes") are mainly lymphocytes and monocytes.

# Toxic materials produced or released
Examples of toxic materials produced or released by degranulation by granulocytes on the ingestion of microorganism includes:
- Low pH vesicles (3.5~4.0)
- Toxic oxygen-derived products (e.g. superoxide, hydrogen peroxide, hydroxy radicals, singlet oxygen, hypohalite)
- Toxic nitrogen oxides (nitric oxide)
- Antimicrobial agents (Defensins and cationic proteins)
- Enzymes (Lysozyme- dissolves cell walls of some gram positive bacteria, acid hydrolases- further digest bacteria).

# Pathology
Granulocytopenia is an abnormally low concentration of granulocytes in the blood. This condition reduces the body's resistance to many infections. Closely-related terms include agranulocytosis and neutropenia.
A granuloma is a tumor containing granulocytes, and a "granulomatosis" is a necrotizing granuloma.
There is usually a granulocyte chemotactic defect in individuals who suffer from insulin dependent diabetes mellitus.

# Additional images
- Blood cell lineage
- Hematopoiesis
Grey matter
Grey matter (or gray matter) is a major component  of the  central nervous system, consisting of nerve cell bodies, glial cells (astroglia and oligodendrocytes), capillaries, and short nerve cell extensions/processes (axons and dendrites).

# Composition
Grey matter is composed of unmyelinated neurons as opposed to white matter (myelinated neurons). It has a grey brown color which comes from the capillary blood vessels and the neuronal cell bodies.

# Distribution
Grey matter is distributed at the surface of the cerebral hemispheres (cerebral cortex) and of the cerebellum (cerebellar cortex), as well as in the depth of the cerebral (thalamus; hypothalamus; subthalamus, basal ganglia - putamen, globus pallidus, nucleus accumbens; septal nuclei), cerebellar (deep cerebellar nuclei - dentate nucleus, globose nucleus, emboliform nucleus, fastigial nucleus), brainstem (substantia nigra, red nucleus, olivary nuclei, cranial nerve nuclei) and spinal white matter (anterior horn, lateral horn, posterior horn).

# Function
The function of grey matter is to route sensory or motor stimulus to interneurons of the CNS in order to create a response to the stimulus through chemical synapse activity. Research has shown that the amount of gray matter in a brain is positively correlated with human intelligence. (Andreason & Others, 1994)
Grey matter structures (cortex, deep nuclei) process information originating in the sensory organs or in other grey matter regions. This information is conveyed via specialized nerve cell extensions (long axons), which form the bulk of the cerebral, cerebellar, and spinal white matter.
Griffithsin

# Overview
Griffithsin, is a protein isolated from the red algae Griffithsia.  It has a 121-amino acid sequence.   It has been shown in vitro to be a highly potent HIV entry inhibitor.  It is currently being investigated as a potential microbicide for use in the prevention of the transmission of HIV.
-  Mori T, O'Keefe BR, Sowder RC;  et al. (2005). "Isolation and characterization of griffithsin, a novel HIV-inactivating protein, from the red alga Griffithsia sp". J. Biol. Chem. 280 (10): 934553. doi:10.1074/jbc.M411122200. PMID 15613479.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link) .mw-parser-output cite.citation{font-style:inherit}.mw-parser-output q{quotes:"\"""\"""'""'"}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-lock-free a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-limited a,.mw-parser-output .cs1-lock-registration a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-subscription a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{display:none;font-size:100%}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}
-  Emau P, Tian B, O'keefe BR;  et al. (2007). "Griffithsin, a potent HIV entry inhibitor, is an excellent candidate for anti-HIV microbicide". J. Med. Primatol. 36 (45): 24453. doi:10.1111/j.1600-0684.2007.00242.x. PMID 17669213.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)