--- a
+++ b/processing/MACCROBAT/24518095.ann
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+T1	Age 2 13	44-year-old
+T2	Personal_background 14 21	Chinese
+T3	Sex 22 25	man
+T4	History 33 60	7 pack-year smoking history
+T5	Clinical_event 65 73	referred
+E1	Clinical_event:T5 
+T6	Nonbiological_location 77 104	Shanghai Pulmonary Hospital
+R1	MODIFY Arg1:T6 Arg2:E1	
+T7	Date 108 121	February 2013
+E2	Date:T7 
+T8	Sign_symptom 149 153	mass
+E3	Sign_symptom:T8 
+T9	Biological_structure 144 148	lung
+T10	Biological_structure 128 143	left upper lobe
+R2	MODIFY Arg1:T9 Arg2:E3	
+R3	MODIFY Arg1:T10 Arg2:E3	
+T11	Sign_symptom 193 203	metastases
+E4	Sign_symptom:T11 
+T12	Biological_structure 178 192	intrapulmonary
+T13	Detailed_description 168 177	bilateral
+T14	Detailed_description 159 167	multiple
+R4	MODIFY Arg1:T12 Arg2:E4	
+R5	MODIFY Arg1:T13 Arg2:E4	
+R6	MODIFY Arg1:T14 Arg2:E4	
+T15	Disease_disorder 210 226	pleural effusion
+E5	Disease_disorder:T15 
+T16	Detailed_description 205 209	left
+R7	MODIFY Arg1:T16 Arg2:E5	
+T17	Disease_disorder 246 261	lymphadenopathy
+E6	Disease_disorder:T17 
+T18	Lab_value 232 245	2R/4R/10L/11L
+R8	MODIFY Arg1:T18 Arg2:E6	
+T19	Diagnostic_procedure 277 285	cytology
+E7	Diagnostic_procedure:T19 
+T20	Biological_structure 263 276	Pleural fluid
+R9	MODIFY Arg1:T20 Arg2:E7	
+T21	Disease_disorder 295 309	adenocarcinoma
+E8	Disease_disorder:T21 
+T22	Diagnostic_procedure 314 363	Scorpion Amplification Refractory Mutation system
+E9	Diagnostic_procedure:T22 
+T23	Detailed_description 365 390	AmoyDx Co., Xiamen, China
+R10	MODIFY Arg1:T23 Arg2:E9	
+T24	Sign_symptom 414 455	epidermal growth factor receptor mutation
+E10	Sign_symptom:T24 
+A1	POLARITY E10 NEG
+T25	Medication 470 482	chemotherapy
+E11	Medication:T25 
+T26	Medication 488 499	gemcitabine
+E12	Medication:T26 
+T27	Medication 504 513	cisplatin
+E13	Medication:T27 
+R11	SUB_PROCEDURE Arg1:E12 Arg2:E11	
+R12	SUB_PROCEDURE Arg1:E13 Arg2:E11	
+T28	Sign_symptom 550 558	symptoms
+E14	Sign_symptom:T28 
+A2	TREND E14 INC
+T29	Disease_disorder 602 609	disease
+E15	Disease_disorder:T29 
+T30	Detailed_description 590 601	progressive
+R13	MODIFY Arg1:T30 Arg2:E15	
+T31	Clinical_event 613 641	second opinion was requested
+E16	Clinical_event:T31 
+T32	Nonbiological_location 651 673	University of Colorado
+R14	MODIFY Arg1:T32 Arg2:E16	
+T33	Diagnostic_procedure 707 713	biopsy
+E17	Diagnostic_procedure:T33 
+T34	Detailed_description 680 706	computed tomography–guided
+R15	MODIFY Arg1:T34 Arg2:E17	
+T35	Sign_symptom 737 743	lesion
+E18	Sign_symptom:T35 
+R16	MODIFY Arg1:E10 Arg2:E9	
+T36	Biological_structure 721 736	left upper lobe
+R17	MODIFY Arg1:T36 Arg2:E18	
+R18	MODIFY Arg1:E18 Arg2:E17	
+T37	Medication 836 846	pemetrexed
+E19	Medication:T37 
+T38	Medication 851 861	nedaplatin
+E20	Medication:T38 
+T39	Sign_symptom 899 918	shortness of breath
+E21	Sign_symptom:T39 
+A3	TREND E21 INC
+T40	Diagnostic_procedure 973 978	scans
+E22	Diagnostic_procedure:T40 
+T41	Sign_symptom 946 965	further progression
+E23	Sign_symptom:T41 
+R19	MODIFY Arg1:E23 Arg2:E22	
+T42	Diagnostic_procedure 1021 1027	biopsy
+E24	Diagnostic_procedure:T42 
+T43	Diagnostic_procedure 1081 1092	PCR testing
+E25	Diagnostic_procedure:T43 
+T44	Detailed_description 1062 1080	SNaPshot multiplex
+R20	MODIFY Arg1:T44 Arg2:E25	
+T45	Sign_symptom 1049 1058	mutations
+E26	Sign_symptom:T45 
+A4	POLARITY E26 NEG
+R21	MODIFY Arg1:E26 Arg2:E25	
+T46	Diagnostic_procedure 1188 1197	FISH test
+E27	Diagnostic_procedure:T46 
+T47	Detailed_description 1172 1187	ALK break-apart
+R22	MODIFY Arg1:T47 Arg2:E27	
+T48	Lab_value 1208 1233	atypical negative pattern
+R23	MODIFY Arg1:T48 Arg2:E27	
+T49	Diagnostic_procedure 1433 1450	diagnostic assays
+E28	Diagnostic_procedure:T49 
+T50	Medication 1738 1748	crizotinib
+E29	Medication:T50 
+T51	Dosage 1750 1768	250 mg twice daily
+R24	MODIFY Arg1:T51 Arg2:E29	
+T52	Date 1795 1803	May 2013
+E30	Date:T52 
+T53	Sign_symptom 1823 1846	symptomatic improvement
+E31	Sign_symptom:T53 
+T54	Medication 1927 1937	crizotinib
+E32	Medication:T54 
+T55	Sign_symptom 1958 1969	progression
+E33	Sign_symptom:T55 
+A5	POLARITY E33 NEG
+T56	Date 1976 1990	September 2013
+E34	Date:T56 
+T57	Lab_value 1249 1309	68% of cells demonstrated single copies of the 5′ ALK signal
+R25	MODIFY Arg1:T57 Arg2:E27	
+T58	Lab_value 1314 1395	numerous cells with doublets of the 5′ ALK signal combined with one 3′ ALK signal
+R26	MODIFY Arg1:T58 Arg2:E27	
+T59	Lab_value 1464 1486	ALK protein expression
+R27	MODIFY Arg1:T59 Arg2:E28	
+T60	Diagnostic_procedure 1490 1493	IHC
+E35	Diagnostic_procedure:T60 
+#1	AnnotatorNotes E35	immunohistochemistry
+T61	Detailed_description 1504 1517	D5F3 antibody
+R28	MODIFY Arg1:T61 Arg2:E35	
+R29	SUB_PROCEDURE Arg1:E35 Arg2:E28	
+T62	Detailed_description 1519 1562	Cell Signaling Technology Inc., Danvers, MA
+R30	MODIFY Arg1:T62 Arg2:T61	
+T63	Lab_value 1595 1680	presence of an echinoderm microtubule-associated protein-like 4 (EML4)-ALK transcript
+R31	MODIFY Arg1:T63 Arg2:E28	
+T64	Diagnostic_procedure 1695 1701	RT-PCR
+E36	Diagnostic_procedure:T64 
+R32	SUB_PROCEDURE Arg1:E36 Arg2:E28	
+*	OVERLAP E1 E2 E3 E4 E5 E6 E7 E8 E9 E10 E11
+R33	BEFORE Arg1:E11 Arg2:E14	
+*	OVERLAP E14 E15
+R34	BEFORE Arg1:E15 Arg2:E16	
+*	OVERLAP E16 E17 E18 E19 E20
+R35	BEFORE Arg1:E20 Arg2:E21	
+*	OVERLAP E21 E23 E24 E26 E25 E27 E28
+R36	BEFORE Arg1:E28 Arg2:E29	
+*	OVERLAP E29 E30
+R37	BEFORE Arg1:E30 Arg2:E31	
+T65	Date 1863 1876	after 1 month
+E37	Date:T65 
+*	OVERLAP E31 E37
+R38	BEFORE Arg1:E37 Arg2:E32	
+*	OVERLAP E32 E33 E34
+T66	Activity 45 52	smoking
+E38	Activity:T66 
+R39	BEFORE Arg1:E38 Arg2:E1