Persius/hicric huggingface dataset:
Isotopomers

# Overview
Isotopomers (isotopic isomers) are isomers having the same number of each isotopic atom but differing in their positions. For example, CH3CHDCH3 and CH3CH2CH2D are a pair of constitutional isotopomers. An isotopomer should not be confused with an isotopologue.

# 13C NMR
The peaks seen in a 13C NMR spectra are a result of different Isotopomers. For example consider ethanol (CH3CH2OH). Ethanol will have 2 simple isotopomers one in which the 13C atom is on the methyl group i.e. 13CH3CH2OH and one isotopomer in which the 13C atom is on the methylene i.e. CH313CH2OH.
This gives rise to 2 peaks in the 13C NMR spectrum.
Note the 12C atoms do not show up in the 13C NMR.
Also given that 13C is only present in 1% abundance, there is a very small chance of also seeing the isotopologue in the 13C NMR, wherein both carbon atoms are 13C atoms (i.e. 13CH313CH2OH). These atoms would couple, giving satellites off the main peaks in a normal 13C-NMR spectrum and forming the basis for INADEQUATE (13C13C correlation) experiments.

# Uses
Isotopmers have been used to determine reaction pathways e.g. A m-Benzyne to o-Benzyne Conversion Through a 1,2-Shift of a Phenyl Group. Blake, M. E.; Bartlett, K. L.; Jones, M. Jr. J. Am. Chem. Soc. 2003, 125, 6485
Junin virus

# Morphology and Genome Structure
The Junin virus virion is enveloped with a variable diameter of between 50 and 300nm. The surface of the particle encompasses a layer of T-shaped glycoprotein extensions, extending upto 10nm from the envelope, which are important for mediating attachment and entry into host cells.
The Junin virus genome comprises two single stranded RNA molecules, each encoding two different genes in an ambisense orientation. The two segments are termed 'short (S)' and 'long (L)' due to their respective lengths. The short segment (around 3400 nucleotides in length) encodes the nucleocapsid protein and the glycoprotein precursor (GPC). The GPC is subsequently cleaved to form two viral glycoproteins, GP1 and GP2 which ultimately form the T-shaped glycoprotein spike which extends from the viral envelope. . The long segment (around 7200 nucleotides in length) encodes the viral polymerase and a zinc binding protein.

# Epidemiology and Disease
A member of the genus Arenavirus, Junin virus characteristically causes Argentine hemorrhagic fever (AHF). AHF leads to major alterations within the vascular, neurological and immune systems and has a mortality rate of between 20 and 30%. Symptoms of the disease are conjunctivitis, purpura, petechia and occasional sepsis. The symptoms of the disease are relatively indistinct and may therefore be mistaken for a different condition.
Since the discovery of the Junin virus in 1958, the geographical distribution of the pathogen, although still confined to Argentina, has risen. At the time of discovery, Junin virus was confined to an area of around 15,000km2. At the beginning of 2000, the distribution had risen to around 150,000km2.. The natural hosts of Junin virus are rodents, particularly Mus musculus, Calomys spp and Akodon azarae. Direct rodent to human transmission only transpires when contact is made with excrement of an infected rodent. This commonly occurs via ingestion of contaminated food or water, inhalation of particles within urine or via direct contact of broken skin with rodent excrement.
KARS (gene)
Lysyl-tRNA synthetase is an enzyme that in humans is encoded by the KARS gene.

# Function
Aminoacyl-tRNA synthetases are a class of enzymes that charge tRNAs with their cognate amino acids.  Lysyl-tRNA synthetase is a homodimer localized to the cytoplasm which belongs to the class II family of tRNA synthetases.  It has been shown to be a target of autoantibodies in the human autoimmune diseases, polymyositis or dermatomyositis
Besides its role in translation, Lysyl-tRNA synthetase is involved in a signaling pathway leading to gene activation. Following physiological stimulation of a variety of cells, Lysyl-tRNA synthetase binds to the transcription factors MITF and USF2 and can then influence their transcriptional activities. Such physiological stimulation includes immunological activation of mast cells, so this pathway maybe relevant to the allergic response.

# Interactions
KARS (gene) has been shown to interact with Multisynthetase complex auxiliary component p38. Physiological trigger such as immunological activation results in the phosphorylation of LysRS is on serine residues. It separates from the multisynthetase complex and initiates Ap4A production.
Kehr's sign
Kehr's sign is the occurrence of acute pain in the tip of the shoulder due to the presence of blood or other irritants in the peritoneal cavity when a person is lying down and the legs are elevated. Kehr's sign in the left shoulder is considered a classical symptom of a ruptured spleen. May  result from diaphragmatic or peridiaphragmatic lesions, renal calculi, splenic injury or ectopic pregnancy.
Kehr's sign is a classical example of referred pain: irritation of the diaphragm is signalled by the phrenic nerve as pain in the area above the collarbone.
The discovery of this is often attributed to a German gall bladder surgeon named Hans Kehr, but extensive studies into research he conducted during his life shows inconclusive evidence as to whether or not he actually discovered it.
Kidney bean

# Overview
The kidney bean is a variety of the common bean (Phaseolus vulgaris). It is named for its visual resemblance in shape and color to a kidney. Red kidney beans can be confused with other beans that are red, such as adzuki beans.

# Classification
There are different classifications of kidney beans, such as:
- Red kidney bean (also known as: common kidney bean, Rajma in India,  Surkh(Red) Lobia in Pakistan).
- Light speckled kidney bean (and long shape light speckled kidney bean).
- Red speckled kidney bean (and long shape light speckled kidney bean).
- White kidney bean (also known as cannellini or Lobia in India or Safaid (White) Lobia in Pakistan).

# Dishes
Red kidney beans are commonly used in chili con carne and are an integral part of the cuisine in northern regions of India, where the beans are known as rajma and are used in a dish of the same name. Red kidney beans are used in New Orleans and much of southern Louisiana for the classic Monday Creole dish of red beans and rice. The smaller, darker red beans are also used, particularly in Louisiana families with a recent Caribbean heritage. Small kidney beans used in La Rioja, Spain, are called caparrones.

# Toxicity
Raw kidney beans contain relatively high amounts of phytohemagglutinin, and thus are more toxic than most other bean varieties if not pre-soaked and subsequently heated to the boiling point for at least 10 minutes. The US Food and Drug Administration recommends boiling for 30 minutes to ensure they reach a sufficient temperature long enough to completely destroy the toxin. Cooking at the lower temperature of 80 C (176 F), such as in a slow cooker, can increase this danger and raise the toxin concentration up to fivefold. Canned red kidney beans, though, are safe to use immediately.
Kininogen 1
Kininogen-1 (KNG1), also known as alpha-2-thiol proteinase inhibitor, Williams-Fitzgerald-Flaujeac factor or the HMWK-kallikrein factor is a protein that in humans is encoded by the KNG1 gene. Kininogen-1 is the precursor protein to high-molecular-weight kininogen (HMWK), low-molecular-weight kininogen (LMWK), and  bradykinin.

# Expression
The KNG1 gene uses alternative splicing to generate two different proteins: high-molecular-weight kininogen (HMWK) and low-molecular-weight kininogen (LMWK).  HMWK in turn is cleaved by the enzyme kallikrein to produce bradykinin.
- KNG1 gene   low-molecular-weight kininogen (LMWK) protein (contains 427 amino acids) or high-molecular-weight kininogen (HMWK) protein (644 amino acids)
- HMWK protein  bradykinin peptide (9 amino acids)

# Function
HMWK is essential for blood coagulation and assembly of the kallikrein-kinin system. Also, bradykinin, a peptide causing numerous physiological effects, is released from HMWK. In contrast to HMWK, LMWK is not involved in blood coagulation.
Kininogen-1 is a constituent of the blood coagulation system as well as the kinin-kallikrein system.
Left atrium
The left atrium is one of the four chambers in the human heart. It receives oxygenated blood from the pulmonary veins, and pumps it into the left ventricle.

# Structure
Blood is pumped through the left atrioventricular orifice, which contains the mitral valve. A normal left atrium may be up to 5.5cm in maximum diameter; any larger than this is a sign of cardiac failure. This may occur in cases of mitral regurgitation.
The left atrium of a human faces more or less posteriorly. It is named 'left' based on the chamber's embryological and (putative) evolutionary origin. The term 'base' of the heart sometimes refers to the left atrium, though 'base' is an ambiguous term.
Attached to the left atrium is the left auricular appendix (auricle). This auricle is a common site for formation of thrombi, which may embolise causing stroke or ischemic gut. Atrial fibrillation makes this more likely.

# Foramen ovale
There is a foramen ovale (oval hole) between the right and left atrium in the fetus. After birth, this should close over and become the fossa ovale. If it does not, this is an atrial septal defect (hole in the heart). In the fetus, the right atrium pumps blood into the left atrium, bypassing the pulmonary circulation (which is useless in a fetus). In an adult, a septal defect would result in flow in the reverse direction - from the left atrium to the right - which will reduce cardiac output, potentially cause cardiac failure and in severe or untreated cases, death.

# Blood supply
The left atrium is supplied mainly by the left circumflex coronary artery, though the branches are too small to be identified in a cadaveric human heart and are not named.
The oblique vein of the left atrium is partly responsible for venous drainage; it derives from the embryonic left superior vena cava.

# Animals
Many other animals, including mammals, also have four-chambered hearts, and have a left atrium. The function in these animals is similar. Some animals (amphibians, reptiles) have a three-chambered heart, in which the blood from each atrium is mixed in the single ventricle before being pumped to the aorta. In these animals, the left atrium still serves the purpose of collecting blood from pulmonary veins.

# Additional images
- Heart seen from above.
- Base and diaphragmatic surface of heart.
LIPID Study

# Objective
To assess the efficacy of pravastatin in reducing mortality in known CAD patients.

# Methods
The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) study was a randomized, double-blinded, placebo controlled trial wherein 9014 patients (young and old) with known CAD and total cholesterol levels in the range of 155 to 271 mg per deciliter were enrolled and randomly assigned to treatment with either 40 mg daily pravastatin or placebo. The patients were followed up for a mean period of 6.1 years.

# Results
- Pravastatin was associated with a lower rate of death from CAD compared with placebo (6.4% vs 8.3%)
- Overall mortality rate was lower in the pravastatin group compared with that in the placebo group (11% vs 14.1%)
- The incidence of all cardiovascular outcomes was consistently lower among patients assigned to receive pravastatin

# Conclusion
Treatment with pravastatin reduced mortality from coronary heart disease and overall mortality, as compared with the rates in the placebo group, as well as the incidence of all prespecified cardiovascular events in patients with a history of myocardial infarction or unstable angina who had a broad range of initial cholesterol levels.
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Laminectomy

# Overview
Laminectomy is a surgical procedure for treating spinal stenosis by relieving pressure on the spinal cord. The lamina of the vertebra is removed or trimmed to widen the spinal canal and create more space for the spinal nerves.
The first laminectomy was performed in 1887 by Dr. Victor Alexander Haden Horsley, a professor of surgery at the University College London. He was lauded for his breakthrough procedure.
A common type of laminectomy is performed to permit the removal or reshaping of a spinal disc as part of a lumbar discectomy.  This is a treatment for a herniated disc, bulging or degenerated disc.
Large-print
Large-print (also large-type or large-font) describes a type of book or other (paper, online or otherwise) published material in which the typeface (or font), and sometimes the medium, are considerably larger than usual, to accommodate people who have poor vision.  Often public special-needs libraries will stock large-print versions of books, along with versions written in Braille.
Among librarians Large Print is defined as print that is at least 16 points in size.
Large Print book publishing in English began in 1964 in Leicester, England when Frederick Thorpe, a retired book and magazine distributor, decided to meet the needs of elderly poor-sighted readers by reprinting older classic books in editions about twice the physical size of the original book.The type inside was enlarged to about twice the size of the original printing. The books were given plain dustjackets with type only, color-coded to indicate categories like mysteries (black), general fiction (red), romances (blue), westerns (orange) and so forth. These editions met the need but were difficult for frail elderly readers to handle because of they were oversize.
In 1969 Thorpe's company, Ulverscroft, began to retypeset the books in 16 point type and print them in normal-sized bindings, again with color-coded plain jackets. This change greatly increased the acceptance of Large Print in public libraries. Thorpe himself became a Large Print ambassador, travelling around the English-speaking world promoting the acquisition of Large Print books for seniors.
Today Large Print editions of some current books are published simultaneously with regular print editions by their publishers and usually feature the same full-color jackets and jacket designs. Many, if not most public libraries in the English-speaking world have Large Print sections and most bookstores do carry some Large Print editions.
Latent heat
In thermochemistry, latent heat is the amount of energy in the form of heat released or absorbed by a substance during a change of phase (i.e. solid, liquid, or gas),  also called a phase transition.
The term was introduced around 1750 by Joseph Black as derived from the Latin latere, to lie hidden.  The term is now dated, replaced by "enthalpy of transformation".
Two latent heats (or enthalpies) are typically described: latent heat of fusion (melting), and latent heat of vaporization (boiling).  The names describe the direction of heat flow from one phase to the next: solid  liquid  gas.
The change is endothermic, i.e. the system absorbs energy, when the change is from solid to liquid to gas. It is exothermic (the process releases energy) when it is in the opposite direction.  For example, in the atmosphere, when a molecule of water evaporates from the surface of any body of water, energy is transported by the water molecule into a lower temperature air parcel that contains more water vapor than its surroundings.  Because energy is needed to overcome the molecular forces of attraction between water particles, the process of transition from a parcel of water to a parcel of vapor requires the input of energy causing a drop in temperature in its surroundings. If the water vapor condenses back to a liquid or solid phase onto a surface, the latent energy absorbed during evaporation is released as sensible heat onto the surface. The large value of the enthalpy of condensation of water vapor is the reason that steam is a far more effective heating medium than boiling water, and is more hazardous.

# Latent heat equation
The equation for latent heat is:
where:
In other words, specific latent heat is found when energy is divided by mass.

# Table of latent heats
Lethal dose

# Overview
A lethal dose (LD) is an indication of the lethality of a given substance or type of radiation. Because resistance varies from one individual to another, the 'lethal dose' represents a dose (usually recorded as dose per kilogram of subject body weight) at which a given percentage of subjects will die.
The most commonly-used lethality indicator is the LD50 (or LD50), a dose at which 50% of subjects will die. LD measurements are often used to describe the power of venoms in animals such as snakes.
Animal-based LD measurements are a commonly-used technique in drug research, although many researchers are now shifting away from such methods.
LD figures depend not only on the species of animal, but also on the mode of administration. For instance, a toxic substance inhaled or injected into the bloodstream may require a much smaller dosage than if the same substance is swallowed.
LD values for humans are generally estimated by extrapolating results from testing on animals or on human cell cultures. One common form of extrapolation involves measuring LD on animals like mice or dogs, converting to dosage per kilogram of biomass, and extrapolating to human norms. While animal-extrapolated LD values are correlated to lethality in humans, the degree of error is sometimes very large. The biology of test animals, while similar to that of humans in many respects, sometimes differs in important aspects. For instance, mouse tissue is approximately fifty times less responsive than human tissue to the venom of the Sydney funnel-web. The square-cube law can also complicate the scaling relationships involved.
Currently, the only known LD50 values obtained directly on humans are from Nazi human experimentation.

# Relates chapters
- Lowest published lethal dose
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Leukonychia
Synonyms and keywords: Leuconychia

# Overview
Leukonychia is a medical term for white discoloration appearing on nails.  It is derived from the Greek words Leuko white and Onyx nail.  The most common cause is injury to the base of the nail (the matrix) where the nail is formed.

# Classification
Leukonychia Totalis:
This condition is a whitening of the entire nail.  This may be due to hypoalbuminaemia, a genetic condition, or a side effect of sulphonamides, a family of antibiotics.
Leukonychia Partialis:
This condition is whitening of parts of the nail.  There are several types of this condition.
Leukonychia Striata or Transverse Leukonychia:
This is a whitening or discoloration of the nail in bands or "stria".  It may be caused by cirrhosis, chemotherapy, or physical injury to the nail matrix.  (i.e. excessive nail "tapping" or slamming in a car door).
This condition looks similar to Mee's lines, a condition caused by Arsenic, Lead, or other heavy metal poisoning.
True Leukonychia:
This is the most common form of Leukonychia, small white spots on the nails. Picking and biting of the nails are a prominent cause in young children and nail biters.  
In most cases, when white spots appear on a single or a couple of fingers or toes, the most common cause is injury to the base (matrix) of the nail. When this is the case, white spots disappear after around eight months, which is the amount of time necessary for nails to regrow completely.
White spots showing up on all or nearly all nails for longer periods of time (months and years) can be due to one of several reasons. One common explanation is zinc deficiency.

# Pathophysiology

## Associated Conditions
- Kidney disease
- Liver disease

# Causes

## Causes In Alphabetical Order
- Anemia
- Arsenic poisoning
- Calcium deficiency
- Cardiac Diseases
- Cirrhosis
- Congenital isolated nail dysplasia
- Darier's disease
- Fever
- Hypoalbuminemia
- Iron deficiency
- Leprosy
- Malabsorption
- Mycosis
- Nitrate solution
- Silver solution
- Sulphonamides
- Noxa
- Steatocystoma multiplex
- Trauma
- Vitiligo
- Witkop syndrome
- Zinc deficiency

# Diagnosis

## Past Medical History
A doctor will take a thorough medical history, and may test liver and kidney function.

### Physical Examination
- Leukonychia. Adapted from Dermatology Atlas.
- Leukonychia. Adapted from Dermatology Atlas.

# Treatment

## Pharmacotherapy

### Chronic Pharmacotherapies
If a zinc deficiency is identified, a diet rich in zinc or zinc supplements may be administered.