[fd8900]: / processing / MACCROBAT / 27842605.ann

Download this file

537 lines (536 with data), 19.0 kB

T1	Age 2 13	76-year-old
T2	Sex 14 19	woman
T3	Clinical_event 20 29	presented
E1	Clinical_event:T3 
T4	Nonbiological_location 37 45	hospital
R1	MODIFY Arg1:T4 Arg2:E1	
T5	Sign_symptom 65 78	epigastralgia
E2	Sign_symptom:T5 
T6	Date 85 96	a day prior
E3	Date:T6 
T7	Diagnostic_procedure 111 126	Laboratory data
E4	Diagnostic_procedure:T7 
T8	Diagnostic_procedure 165 181	aminotransferase
E5	Diagnostic_procedure:T8 
T9	Diagnostic_procedure 183 207	alanine aminotransferase
E6	Diagnostic_procedure:T9 
T10	Diagnostic_procedure 209 233	ɤ-guanosine triphosphate
E7	Diagnostic_procedure:T10 
T11	Diagnostic_procedure 239 259	alkaline phosphatase
E8	Diagnostic_procedure:T11 
R6	SUB_PROCEDURE Arg1:E5 Arg2:E4	
R7	SUB_PROCEDURE Arg1:E6 Arg2:E4	
R8	SUB_PROCEDURE Arg1:E7 Arg2:E4	
R9	SUB_PROCEDURE Arg1:E8 Arg2:E4	
T13	Activity 4808 4812	died
E9	Activity:T13 
T14	Disease_disorder 4816 4835	progressive disease
E10	Disease_disorder:T14 
R10	CAUSE Arg1:E10 Arg2:E9	
T15	Date 4836 4850	8 months after
E11	Date:T15 
T16	Diagnostic_procedure 267 282	total bilirubin
E12	Diagnostic_procedure:T16 
T17	Diagnostic_procedure 287 300	tumor markers
E13	Diagnostic_procedure:T17 
T18	Detailed_description 261 266	Serum
R11	MODIFY Arg1:T18 Arg2:E12	
T12	Lab_value 152 161	elevation
E14	Lab_value:T12 
R2	MODIFY Arg1:E14 Arg2:E5	
R3	MODIFY Arg1:E14 Arg2:E6	
R4	MODIFY Arg1:E14 Arg2:E7	
R5	MODIFY Arg1:E14 Arg2:E8	
T19	Clinical_event 100 109	admission
E15	Clinical_event:T19 
T20	Diagnostic_procedure 302 326	carcinoembryonic antigen
E16	Diagnostic_procedure:T20 
T21	Diagnostic_procedure 328 331	CEA
E17	Diagnostic_procedure:T21 
R12	IDENTICAL Arg1:E17 Arg2:E16	
T22	Diagnostic_procedure 334 359	carbohydrate antigen 19-9
E18	Diagnostic_procedure:T22 
T23	Diagnostic_procedure 361 367	CA19-9
E19	Diagnostic_procedure:T23 
R13	IDENTICAL Arg1:E19 Arg2:E18	
T24	Diagnostic_procedure 370 376	SPan-1
E20	Diagnostic_procedure:T24 
T25	Diagnostic_procedure 382 405	neuron-specific enolase
E21	Diagnostic_procedure:T25 
T26	Diagnostic_procedure 407 410	NSE
E22	Diagnostic_procedure:T26 
R14	IDENTICAL Arg1:E22 Arg2:E21	
T27	Lab_value 422 442	within normal ranges
E23	Lab_value:T27 
R15	MODIFY Arg1:E23 Arg2:E12	
R16	MODIFY Arg1:E23 Arg2:E13	
R17	MODIFY Arg1:E23 Arg2:E16	
R18	MODIFY Arg1:E23 Arg2:E18	
R19	MODIFY Arg1:E23 Arg2:E20	
R20	MODIFY Arg1:E23 Arg2:E21	
T28	Diagnostic_procedure 454 473	computed tomography
E24	Diagnostic_procedure:T28 
T29	Diagnostic_procedure 475 477	CT
E25	Diagnostic_procedure:T29 
R21	IDENTICAL Arg1:E25 Arg2:E24	
T30	Diagnostic_procedure 483 526	magnetic resonance cholangiopancreatography
E26	Diagnostic_procedure:T30 
T31	Diagnostic_procedure 528 532	MRCP
E27	Diagnostic_procedure:T31 
R22	IDENTICAL Arg1:E27 Arg2:E26	
T32	Sign_symptom 543 547	mass
E28	Sign_symptom:T32 
T33	Sign_symptom 554 562	enlarged
E29	Sign_symptom:T33 
T34	Biological_structure 563 574	gallbladder
R23	MODIFY Arg1:T34 Arg2:E29	
R24	MODIFY Arg1:T34 Arg2:E28	
T35	Sign_symptom 579 584	bulky
E30	Sign_symptom:T35 
T36	Biological_structure 585 604	hepatic lymph nodes
R25	MODIFY Arg1:T36 Arg2:E30	
T37	Biological_structure 621 634	hepatic hilum
R26	MODIFY Arg1:T37 Arg2:T36	
T38	Sign_symptom 677 684	lesions
E31	Sign_symptom:T38 
A1	POLARITY E31 NEG
T39	Diagnostic_procedure 704 730	gastrointestinal endoscopy
E32	Diagnostic_procedure:T39 
T40	Detailed_description 698 703	lower
T41	Detailed_description 688 693	upper
R27	MODIFY Arg1:T40 Arg2:E32	
R28	MODIFY Arg1:T41 Arg2:E32	
T42	Diagnostic_procedure 732 783	Endoscopic ultrasound-guided fine-needle aspiration
E33	Diagnostic_procedure:T42 
T43	Diagnostic_procedure 785 792	EUS-FNA
E34	Diagnostic_procedure:T43 
R29	IDENTICAL Arg1:E34 Arg2:E33	
T44	Diagnostic_procedure 1017 1053	endoscopic naso-gallbladder drainage
E35	Diagnostic_procedure:T44 
T45	Diagnostic_procedure 1055 1060	ENGBD
E36	Diagnostic_procedure:T45 
R30	IDENTICAL Arg1:E36 Arg2:E35	
T46	Therapeutic_procedure 1844 1859	cholecystectomy
E37	Therapeutic_procedure:T46 
T47	Therapeutic_procedure 1875 1890	lymphadenectomy
E38	Therapeutic_procedure:T47 
T48	Biological_structure 1861 1874	hepatic hilar
R31	MODIFY Arg1:T48 Arg2:E38	
T49	Therapeutic_procedure 1918 1927	resection
E39	Therapeutic_procedure:T49 
T50	Biological_structure 1892 1917	extrahepatic biliary duct
R32	MODIFY Arg1:T50 Arg2:E39	
T51	Therapeutic_procedure 1933 1952	hepaticojejunostomy
E40	Therapeutic_procedure:T51 
T52	Sign_symptom 2044 2051	lesions
E41	Sign_symptom:T52 
A2	POLARITY E41 NEG
T53	Diagnostic_procedure 1150 1178	positron emission tomography
E42	Diagnostic_procedure:T53 
T54	Diagnostic_procedure 1179 1198	computed tomography
E43	Diagnostic_procedure:T54 
T55	Diagnostic_procedure 1200 1203	PET
E44	Diagnostic_procedure:T55 
T56	Diagnostic_procedure 1204 1206	CT
E45	Diagnostic_procedure:T56 
R33	IDENTICAL Arg1:E44 Arg2:E42	
R34	IDENTICAL Arg1:E45 Arg2:E43	
T57	Biological_structure 834 850	hilar lymph node
R35	MODIFY Arg1:T57 Arg2:E33	
T58	Diagnostic_procedure 852 880	Immunohistochemical staining
E46	Diagnostic_procedure:T58 
T59	Diagnostic_procedure 931 938	keratin
E47	Diagnostic_procedure:T59 
T60	Diagnostic_procedure 940 944	CD56
E48	Diagnostic_procedure:T60 
T61	Diagnostic_procedure 950 963	synaptophysin
E49	Diagnostic_procedure:T61 
T62	Lab_value 916 926	positivity
E50	Lab_value:T62 
R36	MODIFY Arg1:E50 Arg2:E47	
R37	MODIFY Arg1:E50 Arg2:E48	
R38	MODIFY Arg1:E50 Arg2:E49	
R39	SUB_PROCEDURE Arg1:E49 Arg2:E46	
T63	Detailed_description 971 982	tumor cells
R40	MODIFY Arg1:T63 Arg2:E46	
T64	Disease_disorder 1009 1012	NEC
E51	Disease_disorder:T64 
#1	AnnotatorNotes E51	neuro endocrine carcinoma
T65	Detailed_description 1062 1070	catheter
R41	MODIFY Arg1:T65 Arg2:E35	
T66	Diagnostic_procedure 1091 1104	bile cytology
E52	Diagnostic_procedure:T66 
T67	Sign_symptom 1114 1137	class V malignant cells
E53	Sign_symptom:T67 
T68	Sign_symptom 1274 1281	lesions
E54	Sign_symptom:T68 
A3	POLARITY E54 UNCERTAIN
T69	Sign_symptom 1321 1328	lesions
E55	Sign_symptom:T69 
A4	POLARITY E55 NEG
T70	Diagnostic_procedure 1370 1392	18F fluorodeoxyglucose
E56	Diagnostic_procedure:T70 
T71	Diagnostic_procedure 1394 1397	FDG
E57	Diagnostic_procedure:T71 
R42	IDENTICAL Arg1:E57 Arg2:E56	
R43	SUB_PROCEDURE Arg1:E56 Arg2:E42	
T72	Lab_value 1354 1366	accumulation
E58	Lab_value:T72 
R44	MODIFY Arg1:E58 Arg2:E56	
T73	Biological_structure 1410 1421	gallbladder
T74	Biological_structure 1439 1450	lymph nodes
R45	MODIFY Arg1:T73 Arg2:E58	
R46	MODIFY Arg1:T74 Arg2:E58	
T75	Diagnostic_procedure 1423 1429	SUVmax
E59	Diagnostic_procedure:T75 
T76	Diagnostic_procedure 1452 1458	SUVmax
E60	Diagnostic_procedure:T76 
T77	Lab_value 1430 1433	7.8
E61	Lab_value:T77 
T78	Lab_value 1459 1463	13.4
E62	Lab_value:T78 
R47	MODIFY Arg1:E61 Arg2:E59	
R48	MODIFY Arg1:E62 Arg2:E60	
R49	SUB_PROCEDURE Arg1:E59 Arg2:E42	
R50	SUB_PROCEDURE Arg1:E60 Arg2:E42	
T79	Disease_disorder 1554 1557	NEC
E63	Disease_disorder:T79 
T80	Biological_structure 1542 1553	gallbladder
R51	MODIFY Arg1:T80 Arg2:E63	
T81	Biological_structure 1592 1617	hepatic hilar lymph nodes
R52	MODIFY Arg1:T81 Arg2:E63	
T82	Disease_disorder 1618 1628	metastasis
E64	Disease_disorder:T82 
T83	Detailed_description 1252 1259	primary
T84	Detailed_description 1263 1273	metastatic
R53	MODIFY Arg1:T83 Arg2:E54	
R54	MODIFY Arg1:T84 Arg2:E54	
T85	Therapeutic_procedure 1661 1679	surgical resection
E65	Therapeutic_procedure:T85 
T86	Medication 1689 1701	chemotherapy
E66	Medication:T86 
T87	Disease_disorder 1769 1780	obstruction
E67	Disease_disorder:T87 
T88	Detailed_description 1758 1768	mechanical
R55	MODIFY Arg1:T88 Arg2:E67	
T89	Biological_structure 1788 1801	hepatic hilum
R56	MODIFY Arg1:T89 Arg2:E67	
T90	Sign_symptom 1809 1817	enlarged
E68	Sign_symptom:T90 
T91	Biological_structure 1818 1828	lymph node
R57	MODIFY Arg1:T91 Arg2:E68	
T92	Sign_symptom 1958 1963	bulky
E69	Sign_symptom:T92 
T93	Biological_structure 1964 1975	lymph nodes
R58	MODIFY Arg1:T93 Arg2:E69	
T94	Therapeutic_procedure 1989 1997	resected
E70	Therapeutic_procedure:T94 
R59	MODIFY Arg1:T93 Arg2:E70	
T95	Detailed_description 2002 2009	en bloc
R60	MODIFY Arg1:T95 Arg2:E70	
T96	Diagnostic_procedure 2068 2088	postoperative course
E71	Diagnostic_procedure:T96 
T97	Lab_value 2093 2103	uneventful
E72	Lab_value:T97 
R61	MODIFY Arg1:E72 Arg2:E71	
T98	Clinical_event 2116 2126	discharged
E73	Clinical_event:T98 
T99	Date 2134 2149	tenth day after
E74	Date:T99 
T100	Therapeutic_procedure 2150 2157	surgery
E75	Therapeutic_procedure:T100 
T101	Diagnostic_procedure 2159 2174	Macroscopically
E76	Diagnostic_procedure:T101 
T102	Sign_symptom 2180 2185	tumor
E77	Sign_symptom:T102 
T103	Area 2190 2200	58 × 42 mm
R62	MODIFY Arg1:T103 Arg2:E77	
T104	Biological_structure 2232 2238	fundus
R63	MODIFY Arg1:T104 Arg2:E77	
T105	Sign_symptom 2268 2277	gallstone
E78	Sign_symptom:T105 
T106	Color 2258 2267	yellowish
R64	MODIFY Arg1:T106 Arg2:E78	
R65	MODIFY Arg1:T104 Arg2:E78	
T107	Therapeutic_procedure 2353 2360	excised
E79	Therapeutic_procedure:T107 
R66	MODIFY Arg1:E77 Arg2:E76	
T108	Biological_structure 2305 2330	hepatic hilar lymph nodes
T109	Area 2332 2342	71 × 37 mm
R67	MODIFY Arg1:T109 Arg2:E79	
R68	MODIFY Arg1:T108 Arg2:E79	
T110	Diagnostic_procedure 2382 2405	Microscopic examination
E80	Diagnostic_procedure:T110 
T111	Biological_structure 2413 2424	gallbladder
R69	MODIFY Arg1:T111 Arg2:E80	
T112	Disease_disorder 2476 2490	adenocarcinoma
E81	Disease_disorder:T112 
T113	Detailed_description 2436 2467	moderate to well differentiated
R70	MODIFY Arg1:T113 Arg2:E81	
T114	Detailed_description 2468 2475	tubular
R71	MODIFY Arg1:T114 Arg2:E81	
T115	Biological_structure 2513 2519	mucosa
T116	Biological_structure 2527 2541	muscular layer
R72	MODIFY Arg1:T116 Arg2:E81	
R73	MODIFY Arg1:T115 Arg2:E81	
T117	Biological_structure 2547 2570	not the serosal surface
R74	MODIFY Arg1:T117 Arg2:E81	
T118	Disease_disorder 2584 2587	NEC
E82	Disease_disorder:T118 
A5	POLARITY E82 NEG
T119	Sign_symptom 2617 2622	tumor
E83	Sign_symptom:T119 
T120	Biological_structure 2636 2647	gallbladder
R75	MODIFY Arg1:T120 Arg2:E83	
T121	Diagnostic_procedure 2674 2687	synaptophysin
E84	Diagnostic_procedure:T121 
T122	Diagnostic_procedure 2692 2696	CD56
E85	Diagnostic_procedure:T122 
T123	Diagnostic_procedure 2715 2729	chromogranin A
E86	Diagnostic_procedure:T123 
T124	Lab_value 2652 2669	slightly positive
E87	Lab_value:T124 
R76	MODIFY Arg1:E87 Arg2:E84	
R77	MODIFY Arg1:E87 Arg2:E85	
T125	Lab_value 2702 2710	negative
E88	Lab_value:T125 
R78	MODIFY Arg1:E88 Arg2:E86	
R79	MODIFY Arg1:E83 Arg2:E84	
R80	MODIFY Arg1:E83 Arg2:E85	
R81	MODIFY Arg1:E83 Arg2:E86	
T126	Diagnostic_procedure 2746 2762	resection margin
E89	Diagnostic_procedure:T126 
T127	Sign_symptom 2799 2804	tumor
E90	Sign_symptom:T127 
A6	POLARITY E90 NEG
T128	Biological_structure 2772 2781	liver bed
R82	MODIFY Arg1:T128 Arg2:E89	
R83	MODIFY Arg1:E90 Arg2:E89	
T129	Disease_disorder 2838 2847	carcinoma
E91	Disease_disorder:T129 
T130	Biological_structure 2816 2826	epithelium
R84	MODIFY Arg1:T130 Arg2:E91	
T131	Sign_symptom 2866 2876	metaplasia
E92	Sign_symptom:T131 
T132	Biological_structure 2855 2865	intestinal
R85	MODIFY Arg1:T132 Arg2:E92	
T133	Biological_structure 2886 2898	goblet cells
R86	MODIFY Arg1:T133 Arg2:E92	
T134	Diagnostic_procedure 2935 2946	alcian blue
E93	Diagnostic_procedure:T134 
T135	Biological_structure 2980 3005	hepatic hilar lymph nodes
T136	Sign_symptom 3035 3040	tumor
E94	Sign_symptom:T136 
T137	Detailed_description 3023 3028	small
T138	Shape 3029 3034	round
R87	MODIFY Arg1:T138 Arg2:E94	
R88	MODIFY Arg1:T137 Arg2:E94	
T139	Diagnostic_procedure 3067 3073	nuclei
E95	Diagnostic_procedure:T139 
T140	Diagnostic_procedure 3084 3093	cytoplasm
E96	Diagnostic_procedure:T140 
T141	Lab_value 3052 3066	hyperchromatic
E97	Lab_value:T141 
T142	Lab_value 3078 3083	scant
E98	Lab_value:T142 
R89	MODIFY Arg1:E98 Arg2:E96	
R90	MODIFY Arg1:E97 Arg2:E95	
R91	MODIFY Arg1:E94 Arg2:E95	
R92	MODIFY Arg1:E94 Arg2:E96	
R93	MODIFY Arg1:T135 Arg2:E94	
T143	Sign_symptom 3116 3121	tumor
E99	Sign_symptom:T143 
T144	Detailed_description 3104 3108	Some
R94	MODIFY Arg1:T144 Arg2:E99	
T145	Qualitative_concept 3133 3138	large
R95	MODIFY Arg1:T145 Arg2:E99	
T146	Diagnostic_procedure 3157 3163	nuclei
E100	Diagnostic_procedure:T146 
T147	Texture 3147 3156	vesicular
R96	MODIFY Arg1:T147 Arg2:E100	
R97	MODIFY Arg1:E99 Arg2:E100	
T148	Sign_symptom 3169 3174	tumor
E101	Sign_symptom:T148 
T149	Disease_disorder 3517 3520	NEC
E102	Disease_disorder:T149 
T150	Disease_disorder 4506 4509	NEC
E103	Disease_disorder:T150 
T151	Detailed_description 3198 3204	sheets
T152	Detailed_description 3206 3211	cords
T153	Detailed_description 3221 3231	trabecular
T154	Detailed_description 3235 3242	rosette
T155	Sign_symptom 3284 3292	necrosis
E104	Sign_symptom:T155 
T156	Detailed_description 3278 3283	focal
R98	MODIFY Arg1:T156 Arg2:E104	
R99	MODIFY Arg1:T151 Arg2:E101	
R100	MODIFY Arg1:T152 Arg2:E101	
R101	MODIFY Arg1:T153 Arg2:E101	
R102	MODIFY Arg1:T154 Arg2:E101	
R103	MODIFY Arg1:E101 Arg2:E104	
T157	Diagnostic_procedure 3304 3325	immunohistochemically
E105	Diagnostic_procedure:T157 
T158	Lab_value 3326 3334	positive
E106	Lab_value:T158 
T159	Diagnostic_procedure 3339 3343	CD56
E107	Diagnostic_procedure:T159 
T160	Diagnostic_procedure 3345 3358	synaptophysin
E108	Diagnostic_procedure:T160 
T161	Diagnostic_procedure 3364 3378	chromogranin A
E109	Diagnostic_procedure:T161 
R104	MODIFY Arg1:E106 Arg2:E107	
R105	MODIFY Arg1:E106 Arg2:E108	
R106	MODIFY Arg1:E106 Arg2:E109	
R107	SUB_PROCEDURE Arg1:E107 Arg2:E105	
R108	SUB_PROCEDURE Arg1:E108 Arg2:E105	
R109	SUB_PROCEDURE Arg1:E109 Arg2:E105	
T162	Diagnostic_procedure 3396 3409	mitotic count
E110	Diagnostic_procedure:T162 
T163	Lab_value 3414 3453	24 per 10 high-power microscopic fields
E111	Lab_value:T163 
R110	MODIFY Arg1:E111 Arg2:E110	
T164	Diagnostic_procedure 3463 3488	Ki-67 proliferation index
E112	Diagnostic_procedure:T164 
T165	Lab_value 3493 3499	70–80%
E113	Lab_value:T165 
R111	MODIFY Arg1:E113 Arg2:E112	
T166	Biological_structure 3560 3579	hepatic lymph nodes
T167	Therapeutic_procedure 3600 3610	cauterized
E114	Therapeutic_procedure:T167 
T168	Detailed_description 3584 3599	microscopically
T169	Biological_structure 3526 3552	surgical dissection margin
R112	MODIFY Arg1:T166 Arg2:T169	
R113	MODIFY Arg1:T169 Arg2:E114	
R114	MODIFY Arg1:T168 Arg2:E114	
T170	Sign_symptom 3622 3627	tumor
E115	Sign_symptom:T170 
R115	MODIFY Arg1:E115 Arg2:E114	
T171	Sign_symptom 3648 3656	invasion
E116	Sign_symptom:T171 
A7	POLARITY E116 NEG
T172	Biological_structure 3664 3689	extrahepatic biliary duct
R116	MODIFY Arg1:T172 Arg2:E116	
T173	Diagnostic_procedure 3717 3743	pathological re-evaluation
E117	Diagnostic_procedure:T173 
T174	Diagnostic_procedure 3747 3765	total segmentation
E118	Diagnostic_procedure:T174 
R117	SUB_PROCEDURE Arg1:E118 Arg2:E117	
T175	Disease_disorder 3788 3802	adenocarcinoma
E119	Disease_disorder:T175 
T176	Biological_structure 3823 3834	lymph nodes
T177	Severity 3769 3784	negligible area
R118	MODIFY Arg1:T177 Arg2:E119	
R119	MODIFY Arg1:T176 Arg2:E119	
T178	Disease_disorder 3853 3867	adenocarcinoma
E120	Disease_disorder:T178 
T179	Biological_structure 3886 3919	intestinal metaplastic epithelium
T180	Biological_structure 3927 3938	gallbladder
R120	MODIFY Arg1:T180 Arg2:T179	
T181	Diagnostic_procedure 3962 3966	CDX2
E121	Diagnostic_procedure:T181 
T182	Lab_value 3949 3957	positive
E122	Lab_value:T182 
R121	MODIFY Arg1:T179 Arg2:E122	
R122	MODIFY Arg1:E120 Arg2:E122	
R123	MODIFY Arg1:E122 Arg2:E121	
T183	Diagnostic_procedure 4048 4052	CDX2
E123	Diagnostic_procedure:T183 
T184	Lab_value 4035 4043	negative
E124	Lab_value:T184 
R124	MODIFY Arg1:E124 Arg2:E123	
T185	Biological_structure 4013 4030	hilar lymph nodes
R125	MODIFY Arg1:T185 Arg2:E124	
T186	Medication 4117 4128	carboplatin
E125	Medication:T186 
T187	Dosage 4101 4113	three cycles
R126	MODIFY Arg1:T187 Arg2:E125	
T188	Medication 4193 4202	etoposide
E126	Medication:T188 
T189	Dosage 4204 4255	80 mg/m2 on days 1 through 3 repeated every 21 days
R127	MODIFY Arg1:T189 Arg2:E126	
T190	Dosage 4130 4187	area under the curve of 5 on day 1 repeated every 21 days
R128	MODIFY Arg1:T190 Arg2:E125	
T191	Sign_symptom 4291 4302	neutropenia
E127	Sign_symptom:T191 
T192	Severity 4283 4290	grade 4
R129	MODIFY Arg1:T192 Arg2:E127	
T193	Medication 4349 4365	fluoroquinolones
E128	Medication:T193 
T194	Detailed_description 4336 4348	prophylactic
R130	MODIFY Arg1:T194 Arg2:E128	
T195	Date 4258 4281	During the first course
E129	Date:T195 
T196	Date 4367 4381	After 4 months
E130	Date:T196 
T197	Sign_symptom 4392 4403	recurrences
E131	Sign_symptom:T197 
T198	Detailed_description 4383 4391	multiple
R131	MODIFY Arg1:T198 Arg2:E131	
T199	Biological_structure 4411 4434	para-aortic lymph nodes
R132	MODIFY Arg1:T199 Arg2:E131	
T200	Diagnostic_procedure 4492 4499	EUS-FNA
E132	Diagnostic_procedure:T200 
T201	Medication 4545 4557	chemotherapy
E133	Medication:T201 
T202	Detailed_description 4533 4544	second-line
R133	MODIFY Arg1:T202 Arg2:E133	
T203	Medication 4563 4572	amrubicin
E134	Medication:T203 
R134	SUB_PROCEDURE Arg1:E134 Arg2:E133	
T204	Dosage 4574 4625	24 mg/m2 on days 1 through 3 repeated every 21 days
R135	MODIFY Arg1:T204 Arg2:E134	
T205	Sign_symptom 4636 4647	neutropenia
E135	Sign_symptom:T205 
T206	Sign_symptom 4652 4658	anemia
E136	Sign_symptom:T206 
T207	Severity 4628 4635	Grade 4
R136	MODIFY Arg1:T207 Arg2:E135	
T208	Medication 4725 4762	granulocyte colony-stimulating factor
E137	Medication:T208 
T209	Detailed_description 4715 4724	pegylated
R137	MODIFY Arg1:T209 Arg2:E137	
T210	Therapeutic_procedure 4782 4793	transfusion
E138	Therapeutic_procedure:T210 
T211	Detailed_description 4767 4781	red blood cell
R138	MODIFY Arg1:T211 Arg2:E138	
R139	AFTER Arg1:E1 Arg2:E2	
*	OVERLAP E2 E3
R140	BEFORE Arg1:E3 Arg2:E15	
*	OVERLAP E15 E4 E12 E13 E16 E18 E20 E21 E24 E26 E28 E29 E30 E31 E32 E33
R141	BEFORE Arg1:E33 Arg2:E46	
R142	SUB_PROCEDURE Arg1:E47 Arg2:E46	
R143	SUB_PROCEDURE Arg1:E48 Arg2:E46	
*	OVERLAP E46 E51
R144	BEFORE Arg1:E51 Arg2:E35	
*	OVERLAP E35 E52 E53 E42 E43 E54
R145	BEFORE Arg1:E54 Arg2:E55	
*	OVERLAP E55 E63 E64
R146	BEFORE Arg1:E64 Arg2:E65	
R147	BEFORE Arg1:E65 Arg2:E66	
R148	CAUSE Arg1:E68 Arg2:E67	
R149	AFTER Arg1:E66 Arg2:E67	
*	OVERLAP E67 E68
R150	BEFORE Arg1:E68 Arg2:E37	
*	OVERLAP E37 E38 E39 E40 E69 E70
R151	BEFORE Arg1:E70 Arg2:E41	
R152	BEFORE Arg1:E41 Arg2:E71	
R153	BEFORE Arg1:E71 Arg2:E73	
*	OVERLAP E73 E74
R154	AFTER Arg1:E74 Arg2:E75	
R155	BEFORE Arg1:E75 Arg2:E76	
*	OVERLAP E76 E77 E78
R156	AFTER Arg1:E78 Arg2:E79	
R157	BEFORE Arg1:E79 Arg2:E80	
*	OVERLAP E80 E81 E82 E83 E84 E85 E86 E89 E90 E91 E92 E93 E94 E95 E96 E99 E100 E101 E104 E105 E110 E112 E102
R158	BEFORE Arg1:E102 Arg2:E114	
*	OVERLAP E114 E115 E116
R159	BEFORE Arg1:E116 Arg2:E117	
*	OVERLAP E117 E119 E120 E121 E123
R160	BEFORE Arg1:E123 Arg2:E125	
*	OVERLAP E125 E126 E129 E127 E128
R161	BEFORE Arg1:E128 Arg2:E130	
*	OVERLAP E130 E131 E132 E103 E133 E135 E136
R162	BEFORE Arg1:E136 Arg2:E137	
*	OVERLAP E137 E138
R163	BEFORE Arg1:E138 Arg2:E9	
*	OVERLAP E9 E10 E11