Persius/hicric huggingface dataset:
Dextromoramide

# Overview
Dextromoramide (Palfium, Palphium, Jetrium, Dimorlin) is the right-handed isomer of the moramide molecule. The left handed molecule is called levomoramide, and a mixture of the two is called racemoramide. Its full chemical name is  (+)-1-(3-Methyl-4-morpholino-2,2-diphenylbutyryl)pyrrolidine, and its molecular formula: C25H32N2O2, with an atomic weight of ~392.5. It is one of a group of molecules known as substituted ,-Diphenyl--Amino-Butyramides.
It is a powerful opioid analgesic, and as such is subject to drug prohibition regimes, both internationally through UN treaties, and by the criminal law of individual states.
It was discovered and patented in 1956 by Dr Paul Janssen at Janssen Pharmaceutica, who also discovered fentanyl, another important synthetic opioid, widely used to treat pain and in combination with other drugs as an anaesthetic. It has the proprietary name Palfium, though as of mid 2004 the drug was discontinued in the UK due to limited supplies of precursor chemicals.
As is the case with so many drug discoveries, dextromoramide was discovered by accident during research into almost identical compounds, namely ,-Diphenyl--Dialkyamino-Butyramides, which show no analgesic activity, but are extremely active physiologically as inhibitors of gastric secretions in man.
In many countries dextromoramide is unused, for example the USA, where it is considered a Schedule 1 drug, alongside cannabis and LSD, as having no medicinal uses. It is still rarely used in Australia, but prescription is avoided due to its abuse potential and so use of Palfium is now mainly limited to terminal care.
The typical dose is 5mg four hourly for cancer pain - the drug has a short half life comparable with pethidine. Dextromoramide is also used as a short-acting analgesic for minor surgical procedures. In this case it is administered sublingually and reaches a therapeutic concentration after around 12 minutes.
Dextromoramide was much favoured by drug abusers in Australia in the 1970s. A single case report and a review of the subject appears in the Australian Journal of Pharmacy 1980;61:641-644
Dextrorotation
Dextrorotation  is the property of rotating plane polarized light clockwise. Laevorotation is the opposite of  dextrorotation.
Compounds with these properties are said to have optical activity and consist of chiral molecules. Chiral centers that have opposite configurations rotate polarized light the same number of degrees, but in opposite directions. If one molecule that has a chiral center with an "R" configuration rotates plane polarized light 25 degrees clockwise, its enantiomer with the corresponding chiral center having the "S" configuration will rotate plane polarized light 25 degrees counter-clockwise. However it is not possible to determine whether any chiral center will be laevorotatory or dextrorotatory directly from its configuration. Enantiomers have equal and opposite optical rotation, but both "R" and "S" stereocenters have the ability to be dextrorotatory or laevorotatory.
The prefixes D- or (+)- and L- or (-)- are applied in the naming of a compound.
D-glucose is dextrorotatory.

# Notes and references
-  The first word component dextro- comes from Latin word for right (as opposed to left).  Laevo or levo comes from the Latin for "left."
Diiodotyrosine

# Overview
Diiodotyrosine (DIT) is a precursor in the production of thyroid hormone, and results from iodization of monoiodotyrosine at the other meta- position on the phenol ring.

# Function
DIT is a modulator of the enzyme thyroid peroxidase (which is involved in the production of thyroid hormones).
Triiodothyronine is formed, when diiodotyrosine is combined with monoiodotyrosine (in the colloid of the thyroid follicle).
Two molecules of DIT combine to make the thyroid hormone thyroxine ('T4' and 'T3').
Disaffectation

# Overview
The term 'disaffectation' was coined by noted French psychoanalyst Joyce McDougall as a strictly psychoanalytic term for alexithymia. McDougall felt that alexithymia had become too strongly classified as a neuroanatomical defect and concretized as an intractable illness leaving little room for a purely psychoanalytic explanation for this phenomenon. In coining the term McDougall hoped to indicate the behavior of people who had experienced overwhelming emotion that threatened to attack their sense of integrity and identity. Such individuals, unable to repress the ideas linked to emotional pain and equally unable to project these feelings delusionally onto representations of other people, simply ejected them from consciousness by "pulverizing all trace of feeling, so that an experience which has caused emotional flooding is not recognized as such and therefore cannot be contemplated". They were not suffering from an inability to experience or express emotion, but from "an inability to contain and reflect over an excess of affective experience."
'Disaffectation' conveys a deliberate double meaning. The Latin prefix dis-, indicates separation  or loss and suggests, metaphorically, that certain people are psychologically separated from their emotions and may have "lost" the capacity to be in touch with interior psychic reality. Also included in this prefix is the secondary meaning from the Greek dys- with its implication of illness.
According to Professor of Psychiatry of the University of Toronto Graeme Taylor this psychoanalytic conceptualization departs from older, less applicable theories which emphasized the role of unconscious neurotic conflicts, and instead facilitates a psychoanalytic model of physical illness and disease based on the operation of primitive pre-neurotic pathology that has failed to achieve psychic representation. Henry Krystal Professor of Psychiatry at Michigan State University agreed, adding that it is useful to separate the consideration of psychotherapy for the "disaffected" individual from that of the classical psychosomatic neuroses. To Krystal this consideration is important because "since these patients may develop serious, even occasionally fatal exacerbations of illness during psychotherapy, treating them with psychotherapy for psychosomatic illness is not indicated". This distinction has allowed the field of psychoanalysis to contribute constructively to the field of psychosomatic medicine.
Discodermolide

# Overview
(+)-Discodermolide is a recently discovered polyketide natural product found to be a potent inhibitor of tumor cell growth.  The molecule's carbon skeleton is made up of eight polypropionate and four acetate units with 13 stereocenters.

# History
Discodermolide was first isolated in 1990 from the Caribbean marine sponge Discodermia dissoluta by chemist Dr. Sarath Gunasekera and biologist Dr. Ross Longley,  scientists at the Harbor Branch Oceanographic Institution.  The sponge contained 0.002% of discodermolide (7 mg/434 g of sponge).  Since the compound is light-sensitive, the sponge must be harvested at a minimum depth of 33 meters. Discodermolide was initially found to have immunosuppressive and antifungal activities.

# Mechanism of action
Discodermolide has been shown to inhibit the proliferation of human cells by arresting the cell cycle in G2- and M-phase.  It hyper-stabilizes microtubules, especially prevalent during cell division, and competes with paclitaxel for microtubule binding, but with higher affinity.  Over a variety of cell lines, activity has been measured at IC50 = 3-80 nM.
Hyper-stabilization of the mitotic spindle causes cell cycle arrest and cell death by apoptosis.
Discodermolide is effective in paclitaxel- and epothilone-resistant cancer cells.

# Total syntheses
Several total syntheses have been published to date by Schreiber, Smith, Paterson, Marshall, and Myles.  A review of the various synthetic approaches has also been published.

# Clinical development
The Harbor Branch Oceanographic Institution licensed (+)-discodermolide to Novartis, which began a phase 1 clinical trial in 2004.  Patient accrual was halted due to drug toxicitiy.  The Amos B. Smith's research group (in collaboration with Kosan Biosciences) has a preclinical drug development program ongoing.
The compound supply necessary for complete clinical trials cannot be met by harvesting, isolation, and purification.  As of 2005, attempts at synthesis or semi-synthesis by fermentation have proven unsuccessful.  As a result, all discodermolide used in preclinical studies and clinical trials has come from large-scale total synthesis.
Vaginal septum
A vaginal septum is a congentital partition within the vagina; such a septum could be either longitudinal or transverse.

# Longitudinal septum - double vagina
A longitudinal vaginal septum develops during embryogenesis when there is an incomplete fusion of the lower parts of the two mullerian ducts. As a result there is a double vagina. There may be associated duplications of the more cranial parts of the mullerian derivatives, a double cervix, and either a uterine septum or uterus didelphys (double uterus).
The person with a longitudinal vaginal septum may be asymptomatic and not aware of the condition. If dyspareunia is a problem a simple resection of the septum could be performed.

# Transverse septum
A transverse septum can form during embryogenesis when the mullerian ducts fuse improperly to the urogenital sinus. A complete transverse will block menstrual flow and is a cause of primary amenorrhea. The accumulation of menstrual debris behind the septum  is termed cryptomenorrhea. Some transverse septa are incomplete and may lead to dysparunia or obstruction in labor. A surgical incision will relieve the situation.
Transverse vaginal septum must be differentiated from other diseases that cause latency in secondary sexual characteristics development, such as constitutional delay of puberty, hypopituitarism, delayed puberty, and chromosomal abnormalities. Chromosomal abnormalities are Turner's syndrome, and Noonan's syndrome.
Dover's Powder
Dover's powder was a traditional medicine against cold and fever. It is no longer in use in modern medicine.
Named from Doctor Thomas Dover, an English physician of the eighteenth century who first prepared it, the powder was an old preparation of powder of ipecacuanha (which is currently used to produce syrup of ipecac), opium in powder, and sulphate of potash. The powder was largely used in domestic practice to induce sweating, to defeat the advance of a "cold" and at the beginning of any attack of fever. It was also known by the name pulvis ipecacuanhae et opii.
To obtain the greatest benefits from its use as a sudorific, it was recommended that copious drafts of some warm and harmless drink be ingested after the use of the powder.
The following excerpt from a report penned by a doctor, Doctor Sharp, employed in the British naval service in the West Indies, in this case, in Trinidad, in 1818, illustrates its use. He writes :
At this period, thirty cases of acute dysentery also occurred amongst them and although nineteen of the number were men who arrived in the island from Europe on the 1st and 12th of June, yet, the symptoms even in them were equally as mild as in the assimilated soldier, and the disease yielded to the common remedies  viz  bleeding when the state of the vascular system appeared to indicate the use of it, but in general, saline purgatives in small and repeated quantities were only necessary with small doses at bed time, of calomel and opium, infusion of ipecacuanha or Dovers powder, and this with tonics, moderate use of port wine and a light farinaceous diet generally and speedily accomplished a perfect case.
Drude particle
Drude particles are model oscillators used to simulate the effects of electronic polarizability in the context of a classical molecular mechanics force field. It is based on the Drude model of mobile electrons. Molecular mechanics models, commonly used for computational calculations such as structural minimization and molecular dynamics simulations, represent individual atoms or other particles as hard spheres that interact according to the laws of Newtonian mechanics. These methods are often used in the computational study of proteins, nucleic acids, and other biomolecules.
Most force fields in current practice use a fixed-charge model in which each atom in the simulation is assigned a single electric charge that does not change during the course of the simulation. This obviously cannot model induced dipoles or other electronic effects of a changing local environment. Drude particles are massless virtual sites carrying partial electric charge and attached to individual atoms via a harmonic spring. The spring constant and relative partial charges on the atom and associated Drude particle determine the extent to which the Drude particle responds to the local electrostatic field. The movement of the Drude particle thus serves as a proxy for the changing distribution of the electric charge associated with the corresponding atom.
The Drude particle method, and polarizable force fields in general, have not yet been widely applied due to their very high computational cost compared to the equivalent fixed-charge simulation. In the Drude model, this cost is largely due to the challenge in recalculating the local electrostatic field and repositioning the Drude particles at each time step; traditionally this is done using an iterative self consistent field (SCF) method, although a much more efficient method has been developed that assigns a very small mass to each Drude particle and applies a Lagrangian transformation. Water models incorporating Drude sites have also been developed and refined for incorporation into a polarizable force field under development.
Dual oxidase 2
Dual oxidase 2, also known as DUOX2 or ThOX2 (for thyroid oxidase), is an enzyme that in humans is encoded by the DUOX2 gene. Dual oxidase is an enzyme that was first identified in the mammalian thyroid gland. In humans, two isoforms are found; hDUOX1 and hDUOX2 (this enzyme). The protein location is not exclusive to thyroid tissue; hDUOX1 is prominent in airway epithelial cells and hDUOX2 in the salivary glands and gastrointestinal tract.

# Function
Investigations into reactive oxygen species (ROS) in biological systems have, until recently, focused on characterization of phagocytic cell processes. It is now well accepted that production of such species is not restricted to phagocytic cells and can occur in eukaryotic non-phagocytic cell types via NADPH oxidase (NOX) or dual oxidase (DUOX). This new family of proteins, termed the NOX/DUOX family or NOX family of NADPH oxidases, consists of homologs to the catalytic moiety of phagocytic NADPH-oxidase, gp91phox. Members of the NOX/DUOX family have been found throughout eukaryotic species, including invertebrates, insects, nematodes, fungi, amoeba, alga, and plants (not found in prokaryotes). These enzymes clearly demonstrate regulated production of ROS as their sole function. Genetic analyses have implicated NOX/DUOX derived ROS in biological roles and pathological conditions including hypertension (NOX1), innate immunity (NOX2/DUOX), otoconia formation in the inner ear (NOX3) and thyroid hormone biosynthesis (DUOX1/2). It has been suggested that DUOX2 is the isoform to generate H2O2 utilized by thyroid peroxidase (TPO) for the biosynthesis of thyroid hormones, supported by the discovery of congenital hypothyroidism resultant from an inactivating mutation in the DUOX2 gene.
The family currently has seven members including NOX1, NOX2 (formerly known as gp91phox), NOX3, NOX4, NOX5, DUOX1 and DUOX2.
This protein is known as a dual oxidase because it has both a peroxidase homology domain and a gp91phox domain.
Duox are also implicated in lung defence system and especially in cystic fibrosis.
Schema of duox implication in human lung defence system
Duct (anatomy)

# Overview
In anatomy and physiology, a duct is a circumscribed channel leading from an exocrine gland or organ.

# Types of ducts
Examples include:

# Duct system
As ducts travel from the acinus which generates the fluid to the target, the ducts become larger and the epithelium becomes thicker. The parts of the system are classified as follows:
Some sources consider "lobar" ducts to be the same as "interlobar ducts", while others consider lobar ducts to be larger and more distal from the acinus. For sources that make the distinction, the interlobar ducts are more likely to classified with  simple columnar epithelium (or pseudostratified epithelium), reserving the stratified columnar for the lobar ducts.

# Additional images
- Section of submaxillary gland of kitten. Duct semidiagrammatic. X 200.
- Section of portion of mamma.
Gartner's duct

# Overview
Gartner's duct is a potential embryological remnant in human female development of the mesonephric ducts in the development of the urinary and reproductive organs.
The paired mesonephric ducts in the male, in contrast, go on to form the paired epididymis, ductus deferens, ejaculatory duct and seminal vesicle.
In the female they may persist between the layers of the broad ligament of the uterus and in the wall of the vagina.
These may give rise to Gartner's duct cysts.
Dye lamination

# Definition
Dye lamination is the noticeable retention of dye along either wall of the artery during the washout phase, which displays a characteristic churning motion, contrary to an arterial stain.
The location of dye lamination specific to the culprit lesion is recorded as being proximal remote, proximal contiguous, intralesional, distal contiguous, and/or distal remote and its persistence is recorded according to the presence of lamination remaining or ending prior to the washout of the distal landmark.
The total length of dye lamination is quantified as either 1/6th, 2/6th, 3/6th, 4/6th, 5/6th or 6/6th of the total length of the main parent vessel (from ostium to distal landmark).
EHR Resolution
July 4, 2015
We, the undersigned practicing physicians of America, do warrant the following:
Whereas the "Meaningful Use of Electronic Health Records" program, as designed by a commission, composed of 23 persons, 9 of whom were physicians, two of whom were practicing, enacted by the Hitech Act of 2009, was imposed against the will and the professional judgement of the majority of America's experienced clinicians,
Whereas, a legible, coherent, succinct and complete medical document is key and central to the safe, effective and efficient care of the patient, and physicians across this nation have found EHR systems which are compliant with this program to have significant and widespread deficits in these areas,
Whereas, we are trained and licensed medical professionals, responsible to prevent, diagnose and treat illness and injury, who sign and take personal and legal responsibility for our diagnoses and recommended courses of action,
Therefore, we hereby declare, as one profession, that as the captain of a ship is bound to avoid the reef, for his or her passengers' sake, and the pilot the mountaintop, so must physicians have the ultimate authority, and bear ultimate responsibility, for the medical care of patients who have entrusted them with their lives.
And that, along with the nation's largest nurses union, the National Nurses United, and which patients do support the premise of this resolution, we call for an IMMEDIATE moratorium on this program, including any and all penalties associated, for a minimum period of two years (with an interim report at one year), to allow for collection of feedback from physician and other end users of these systems, and experimentation, in collaboration with other experts and stakeholders, in improvement of the same.
That in the interim, America's physicians and surgeons will have both the right and obligation, to create a legible, coherent, succinct and complete medical document, to the best of their ability, and by whatever means each deems necessary, before signing said document, and assuming responsibility for its content, and that thoughtful, focused, problem solving care for the individual patient before him or her, will resume its rightful place as the prime directive of the physician, and that data collection, and all other objectives, will be assigned to others, whenever possible,
And that, any attempt by any person or entity, not the physician in attendance, to force the physician to do otherwise, and thus to violate his or her oath, shall be considered by these signatories to constitute the practice of medicine without license, or malpractice, and we call on our state legislatures to enforce the same, for the sake of all.
EXIT procedure
The EXIT procedure, or ex utero intrapartum treatment procedure, is a specialized surgical delivery procedure used to deliver babies who have airway compression due to bronchopulmonary sequestration, congenital cystic adenomatoid malformation, cervical teratoma, or other congenital disorder.

# Process
The EXIT is an extension of a standard classical Caesarean section, where an opening is made on the midline of the anesthetized mother's abdomen and uterus.  Then comes the EXIT:  the baby is partially delivered through the opening but remains attached by its umbilical cord to the placenta, while a pediatric or neonatal general surgeon establishes an airway so the fetus can breathe.   Once the EXIT is complete, the umbilical cord is cut and clamped, and the infant is fully delivered.  Then the remainder of the C-section proceeds.

# Challenges
The EXIT is much more complex than a standard C-section, as it requires careful coordination between the mother's physicians and the specialists operating on the newborn baby. The difficulty lies in preserving enough blood flow through the umbilical cord, protecting the placenta, and avoiding contractions of the uterus so that there is sufficient time to establish the airway.
Ectopia cordis
Ectopia cordis is a birth defect in which the heart is abnormally located. In the most common form, the heart protrudes outside the chest through a split sternum. Less often the heart may be situated in the abdominal cavity or neck.
Often other birth defects are also present. This condition is usually fatal in the first days of life. In some cases surgical treatment is possible. The ectopic heart is not protected by the skin or sternum.
Other organs may also have formed outside the skin. Often the heart is not formed properly and many other heart defects are associated with this condition including: Tetralogy of Fallot, pulmonary atresia, atrial and ventricular septal defects, double outlet right ventricle.
Other non cardiac malformations may be present such as cleft palate, spine malformations that can cause kyphosis.

# Occurrence
7.9 per million births. Ectopia cordis is a very rare congenital heart malformation.

# Etiology
No exact cause has been identified but this condition has also been seen more frequently in Turner Syndrome and Trisomy 18; however so far there is no evidence that it is a genetically transmissible disease.

# Prognosis
Most cases result in stillbirth or death shortly after birth. Some cases of ectopia cordis can be treated surgically but in general involve lengthy and very complicated pediatric cardiothoracic surgery.
Depending on the position of the heart from birth ectopia cordis can be classified into four different categories:
- Cervical
- Thoracic: where the heart would lie within the thoracic cavity.
- Thoracoabdominal: where the heart would lie somewhere between the thoracic and abdominal cavities.
- Abdominal: where the heart would lie in the abdominal cavity.
The malfunction happens when the sternum forms during the gestation period and the heart begins to grow in the wrong place.