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T1 Age 2 13 24-year-old T2 Personal_background 14 19 Malay T3 Sex 20 24 male T4 Clinical_event 37 45 referred E1 Clinical_event:T4 T5 Nonbiological_location 53 71 respiratory clinic R1 MODIFY Arg1:T5 Arg2:E1 T6 Diagnostic_procedure 116 126 radiograph E2 Diagnostic_procedure:T6 T7 Biological_structure 110 115 chest R2 MODIFY Arg1:T7 Arg2:E2 T8 Lab_value 86 94 abnormal E3 Lab_value:T8 R3 MODIFY Arg1:E3 Arg2:E2 T9 Detailed_description 95 109 pre-employment R4 MODIFY Arg1:T9 Arg2:E2 T10 Activity 140 147 smoking E4 Activity:T10 T11 Detailed_description 154 173 10 cigarettes a day R5 MODIFY Arg1:T11 Arg2:E4 T12 Duration 174 202 since he was 21 years of age E5 Duration:T12 R6 MODIFY Arg1:E5 Arg2:E4 T13 History 140 202 smoking about 10 cigarettes a day since he was 21 years of age T14 History 207 323 stopped smoking 10 months ago after he noticed he had being having reduced effort tolerance for the past three years T15 Occupation 335 348 office worker T16 History 353 417 did not have a history of exposure to organic or inorganic dusts T17 Activity 215 222 smoking E6 Activity:T17 A1 POLARITY E6 NEG T18 Date 223 236 10 months ago E7 Date:T18 T19 Duration 307 323 past three years E8 Duration:T19 T20 Sign_symptom 274 298 reduced effort tolerance E9 Sign_symptom:T20 T21 Family_history 423 453 two siblings were asymptomatic T22 Subject 423 435 two siblings T23 Sign_symptom 441 453 asymptomatic E10 Sign_symptom:T23 R7 MODIFY Arg1:T22 Arg2:E10 T24 Diagnostic_procedure 458 469 examination E11 Diagnostic_procedure:T24 T25 Sign_symptom 491 502 tachypnoeic E12 Sign_symptom:T25 A2 POLARITY E12 NEG T26 Sign_symptom 527 542 finger clubbing E13 Sign_symptom:T26 T27 Disease_disorder 556 568 hypertension E14 Disease_disorder:T27 T28 Detailed_description 546 555 pulmonary R8 MODIFY Arg1:T28 Arg2:E14 T29 Diagnostic_procedure 574 591 oxygen saturation E15 Diagnostic_procedure:T29 T30 Detailed_description 595 603 room air T31 Detailed_description 604 611 at rest R9 MODIFY Arg1:T30 Arg2:E15 R10 MODIFY Arg1:T31 Arg2:E15 T32 Lab_value 616 619 94% E16 Lab_value:T32 R11 MODIFY Arg1:E16 Arg2:E15 T33 Lab_value 624 631 dropped E17 Lab_value:T33 T34 Lab_value 635 638 92% E18 Lab_value:T34 R12 MODIFY Arg1:E17 Arg2:E15 R13 MODIFY Arg1:E18 Arg2:E15 T35 Activity 645 653 climbing E19 Activity:T35 T36 Detailed_description 657 679 four flights of stairs R14 MODIFY Arg1:T36 Arg2:E19 R15 CAUSE Arg1:E19 Arg2:E17 T37 Diagnostic_procedure 681 699 Spirometry testing E20 Diagnostic_procedure:T37 T38 Disease_disorder 734 746 lung disease E21 Disease_disorder:T38 T39 Diagnostic_procedure 754 790 forced expiratory volume in 1 second E22 Diagnostic_procedure:T39 T40 Diagnostic_procedure 792 796 FEV1 E23 Diagnostic_procedure:T40 T41 Diagnostic_procedure 804 825 forced vital capacity E24 Diagnostic_procedure:T41 T42 Diagnostic_procedure 827 830 FVC E25 Diagnostic_procedure:T42 R16 IDENTICAL Arg1:E23 Arg2:E22 R17 IDENTICAL Arg1:E25 Arg2:E24 T43 Detailed_description 711 730 restrictive pattern R18 MODIFY Arg1:T43 Arg2:E21 T44 Lab_value 835 840 2.7 L E26 Lab_value:T44 R19 MODIFY Arg1:E26 Arg2:E22 T45 Lab_value 864 869 3.2 L E27 Lab_value:T45 R20 MODIFY Arg1:E27 Arg2:E24 T46 Diagnostic_procedure 908 922 FEV1/FVC ratio E28 Diagnostic_procedure:T46 T47 Lab_value 927 930 85% E29 Lab_value:T47 R21 MODIFY Arg1:E29 Arg2:E28 T48 Diagnostic_procedure 936 947 haemoglobin E30 Diagnostic_procedure:T48 T49 Lab_value 949 956 168 g/L E31 Lab_value:T49 R22 MODIFY Arg1:E31 Arg2:E30 T50 Diagnostic_procedure 965 984 parathyroid hormone E32 Diagnostic_procedure:T50 T51 Detailed_description 959 964 serum R23 MODIFY Arg1:T51 Arg2:E32 T52 Lab_value 986 996 2.9 pmol/L E33 Lab_value:T52 T53 Diagnostic_procedure 1020 1027 calcium E34 Diagnostic_procedure:T53 T54 Lab_value 1029 1040 2.34 mmol/L E35 Lab_value:T54 T55 Lab_value 1054 1060 normal E36 Lab_value:T55 R24 MODIFY Arg1:E36 Arg2:E30 R25 MODIFY Arg1:E36 Arg2:E32 R26 MODIFY Arg1:E36 Arg2:E34 R27 MODIFY Arg1:E35 Arg2:E34 R28 MODIFY Arg1:E33 Arg2:E32 T56 Diagnostic_procedure 1076 1083 calcium E37 Diagnostic_procedure:T56 T57 Detailed_description 1070 1075 urine T58 Detailed_description 1062 1069 24-hour R29 MODIFY Arg1:T57 Arg2:E37 R30 MODIFY Arg1:T58 Arg2:E37 T59 Lab_value 1093 1099 normal E38 Lab_value:T59 T60 Lab_value 1100 1108 6.9 mmol E39 Lab_value:T60 T61 Diagnostic_procedure 1124 1136 urine volume E40 Diagnostic_procedure:T61 T62 Detailed_description 1116 1123 24-hour R31 MODIFY Arg1:T62 Arg2:E40 R32 MODIFY Arg1:E39 Arg2:E37 R33 MODIFY Arg1:E38 Arg2:E37 T63 Lab_value 1140 1145 2.8 L E41 Lab_value:T63 R34 MODIFY Arg1:E41 Arg2:E40 T64 Diagnostic_procedure 1157 1167 radiograph E42 Diagnostic_procedure:T64 T65 Biological_structure 1151 1156 chest R35 MODIFY Arg1:T65 Arg2:E42 T66 Sign_symptom 1205 1214 opacities E43 Sign_symptom:T66 T67 Detailed_description 1192 1204 micronodular T68 Detailed_description 1186 1191 dense R36 MODIFY Arg1:T67 Arg2:E43 R37 MODIFY Arg1:T68 Arg2:E43 T69 Detailed_description 1215 1240 distributed symmetrically R38 MODIFY Arg1:T69 Arg2:E43 T70 Biological_structure 1266 1301 middle to lower zones of both lungs R39 MODIFY Arg1:T70 Arg2:E43 T71 Texture 1313 1345 classical "sandstorm" appearance R40 MODIFY Arg1:T71 Arg2:E43 T72 Sign_symptom 1398 1407 opacities E44 Sign_symptom:T72 T73 Texture 1388 1397 sand-like R41 MODIFY Arg1:T73 Arg2:E44 T74 Sign_symptom 1372 1380 obscured E45 Sign_symptom:T74 T75 Biological_structure 1351 1366 cardiac borders R42 MODIFY Arg1:T75 Arg2:E45 T76 Diagnostic_procedure 1448 1452 HRCT E46 Diagnostic_procedure:T76 T77 Diagnostic_procedure 1411 1446 high-resolution computed tomography E47 Diagnostic_procedure:T77 R43 IDENTICAL Arg1:E46 Arg2:E47 T78 Biological_structure 1466 1471 lungs R44 MODIFY Arg1:T78 Arg2:E47 T79 Sign_symptom 1504 1523 microcalcifications E48 Sign_symptom:T79 T80 Detailed_description 1499 1503 tiny T81 Detailed_description 1488 1498 widespread R45 MODIFY Arg1:T80 Arg2:E48 R46 MODIFY Arg1:T81 Arg2:E48 T82 Biological_structure 1539 1544 lungs R47 MODIFY Arg1:T82 Arg2:E48 T83 Sign_symptom 1569 1579 microliths E49 Sign_symptom:T83 T84 Biological_structure 1587 1598 lower lobes R48 MODIFY Arg1:T84 Arg2:E49 T85 Sign_symptom 1644 1661 septal thickening E50 Sign_symptom:T85 T86 Sign_symptom 1666 1686 ground-glass changes E51 Sign_symptom:T86 #1 AnnotatorNotes E51 ground glass opacity T87 Biological_structure 1631 1643 interlobular R49 MODIFY Arg1:T87 Arg2:E50 R50 MODIFY Arg1:T87 Arg2:E51 T88 Sign_symptom 1699 1713 cystic changes E52 Sign_symptom:T88 T89 Biological_structure 1688 1698 Subpleural R51 MODIFY Arg1:T89 Arg2:E52 T90 Biological_structure 1732 1748 both lower lobes R52 MODIFY Arg1:T90 Arg2:E52 T91 Sign_symptom 1769 1786 black pleura sign E53 Sign_symptom:T91 T92 Disease_disorder 1805 1817 pneumothorax E54 Disease_disorder:T92 A3 POLARITY E54 NEG T93 Disease_disorder 1821 1837 pleural effusion E55 Disease_disorder:T93 A4 POLARITY E55 NEG T94 Diagnostic_procedure 1919 1923 size E56 Diagnostic_procedure:T94 T95 Lab_value 1954 1960 normal E57 Lab_value:T95 T96 Diagnostic_procedure 1860 1876 bronchial system E58 Diagnostic_procedure:T96 R53 MODIFY Arg1:E57 Arg2:E56 T97 Biological_structure 1931 1948 pulmonary vessels R54 MODIFY Arg1:T97 Arg2:E56 T98 Biological_structure 1892 1909 small bronchioles R55 MODIFY Arg1:T98 Arg2:E58 R56 MODIFY Arg1:E57 Arg2:E58 T99 Disease_disorder 1974 2006 diffuse parenchymal lung disease E59 Disease_disorder:T99 T100 Therapeutic_procedure 2008 2039 videoassisted thoracic surgical E60 Therapeutic_procedure:T100 A5 POLARITY E60 NEG T101 Therapeutic_procedure 2041 2045 VATS E61 Therapeutic_procedure:T101 R57 IDENTICAL Arg1:E61 Arg2:E60 T102 Diagnostic_procedure 2052 2058 biopsy E62 Diagnostic_procedure:T102 T103 Biological_structure 2047 2051 lung R58 MODIFY Arg1:T103 Arg2:E62 A6 POLARITY E62 NEG T105 Therapeutic_procedure 2110 2126 mini-thoracotomy E64 Therapeutic_procedure:T105 T104 Other_event 2145 2187 difficulty in manoeuvering the endostapler E63 Other_event:T104 T106 Disease_disorder 2210 2222 pneumothorax E65 Disease_disorder:T106 T107 Severity 2201 2209 moderate R59 MODIFY Arg1:T107 Arg2:E65 T108 Therapeutic_procedure 2227 2243 mini-thoracotomy E66 Therapeutic_procedure:T108 T109 Outcome 2273 2282 recovered E67 Outcome:T109 T110 Duration 2289 2295 5 days E68 Duration:T110 T111 Nonbiological_location 2303 2307 ward R60 MODIFY Arg1:T111 Arg2:E67 T112 Diagnostic_procedure 2318 2324 biopsy E69 Diagnostic_procedure:T112 T113 Biological_structure 2313 2317 lung T114 Disease_disorder 2368 2371 PAM E70 Disease_disorder:T114 #2 AnnotatorNotes E70 pulmonary alveolar microlithiasis T115 Sign_symptom 2387 2401 calcospherites E71 Sign_symptom:T115 T116 Biological_structure 2413 2428 alveolar spaces R61 MODIFY Arg1:T116 Arg2:E71 T117 Sign_symptom 2476 2485 congested E72 Sign_symptom:T117 T118 Biological_structure 2455 2470 alveolar septae R62 MODIFY Arg1:T118 Arg2:E72 T119 Sign_symptom 2502 2510 fibrosis E73 Sign_symptom:T119 T120 Severity 2497 2501 mild R63 MODIFY Arg1:T120 Arg2:E73 R64 MODIFY Arg1:T113 Arg2:E69 T121 Sign_symptom 2516 2527 infiltrates E74 Sign_symptom:T121 R65 MODIFY Arg1:T118 Arg2:E73 R66 MODIFY Arg1:T118 Arg2:E74 T122 Detailed_description 2538 2561 lymphoplasmacytic cells R67 MODIFY Arg1:T122 Arg2:E74 R68 AFTER Arg1:E1 Arg2:E2 R69 AFTER Arg1:E2 Arg2:E4 R70 BEFORE Arg1:E4 Arg2:E6 * OVERLAP E6 E7 R71 AFTER Arg1:E7 Arg2:E9 * OVERLAP E9 E8 E10 R72 BEFORE Arg1:E10 Arg2:E11 * OVERLAP E11 E12 E13 E14 E15 E19 E20 E21 E22 E24 E28 E30 E32 E34 E37 E40 E42 E43 E45 E44 E47 E48 E49 E50 E51 E52 E53 E54 E55 E58 E56 E59 E60 E62 E64 E63 R73 BEFORE Arg1:E63 Arg2:E65 R74 AFTER Arg1:E65 Arg2:E66 R75 BEFORE Arg1:E66 Arg2:E67 R76 MODIFY Arg1:E68 Arg2:E67 * OVERLAP E67 E69 E70 E71 E72 E73 E74