T1  Age 2 13    63-year-old

T2  Sex 14 18   male

T3  History 27 62   without smoking or drinking history

T4  Date 76 92  on June 11, 2014

E1  Date:T4 

T5  Clinical_event 67 75    admitted

E2  Clinical_event:T5 

R1  MODIFY Arg1:E1 Arg2:E2  

T6  Sign_symptom 141 150    dysphagia

E3  Sign_symptom:T6 

T7  Sign_symptom 155 162    fatigue

E4  Sign_symptom:T7 

T8  Disease_disorder 180 199    obstructive disease

E5  Disease_disorder:T8 

A1  POLARITY E5 UNCERTAIN

T9  Occupation 229 248  had been an athlete

T10 Biological_structure 203 224    upper digestive tract

R2  MODIFY Arg1:T10 Arg2:E5 

T11 History 266 297 retired in good physical status

T12 History 316 372 His family and social history indicated nothing abnormal

T13 Diagnostic_procedure 383 403    physical examination

E6  Diagnostic_procedure:T13 

T14 Biological_structure 411 415    skin

T15 Biological_structure 417 428    oral mucosa

T16 Biological_structure 430 434    eyes

T17 Biological_structure 440 453    genital areas

R3  MODIFY Arg1:T14 Arg2:E6 

R4  MODIFY Arg1:T15 Arg2:E6 

R5  MODIFY Arg1:T16 Arg2:E6 

R6  MODIFY Arg1:T17 Arg2:E6 

T18 Sign_symptom 489 496    lesions

E7  Sign_symptom:T18 

A2  POLARITY E7 NEG

T19 Diagnostic_procedure 512 528    laboratory tests

E8  Diagnostic_procedure:T19 

T20 Diagnostic_procedure 539 555    hepatic function

E9  Diagnostic_procedure:T20 

T21 Diagnostic_procedure 557 571    renal function

E10 Diagnostic_procedure:T21 

T22 Diagnostic_procedure 577 596    serum tumor markers

E11 Diagnostic_procedure:T22 

T23 Diagnostic_procedure 605 629    carcinoembryonic antigen

E12 Diagnostic_procedure:T23 

T24 Diagnostic_procedure 631 654    cytokeratin 19 fragment

E13 Diagnostic_procedure:T24 

T25 Diagnostic_procedure 656 679    squamous cell carcinoma

E14 Diagnostic_procedure:T25 

T26 Diagnostic_procedure 681 704    neuron-specific enolase

E15 Diagnostic_procedure:T26 

T27 Diagnostic_procedure 710 734    carbohydrate antigen 125

E16 Diagnostic_procedure:T27 

R7  SUB_PROCEDURE Arg1:E9 Arg2:E8   

R8  SUB_PROCEDURE Arg1:E10 Arg2:E8  

R9  SUB_PROCEDURE Arg1:E11 Arg2:E8  

R10 SUB_PROCEDURE Arg1:E12 Arg2:E11 

R11 SUB_PROCEDURE Arg1:E13 Arg2:E11 

R12 SUB_PROCEDURE Arg1:E14 Arg2:E11 

R13 SUB_PROCEDURE Arg1:E15 Arg2:E11 

R14 SUB_PROCEDURE Arg1:E16 Arg2:E11 

T28 Lab_value 744 759   in normal range

R15 MODIFY Arg1:T28 Arg2:E16    

R16 MODIFY Arg1:T28 Arg2:E15    

R17 MODIFY Arg1:T28 Arg2:E14    

R18 MODIFY Arg1:T28 Arg2:E13    

R19 MODIFY Arg1:T28 Arg2:E12    

R20 MODIFY Arg1:T28 Arg2:E10    

R21 MODIFY Arg1:T28 Arg2:E9 

T29 Diagnostic_procedure 808 820    examinations

E17 Diagnostic_procedure:T29 

T30 Detailed_description 795 807    radiological

T31 Detailed_description 780 790    endoscopic

R22 MODIFY Arg1:T30 Arg2:E17    

R23 MODIFY Arg1:T31 Arg2:E17    

T32 Diagnostic_procedure 862 884    Endoscopic examination

E18 Diagnostic_procedure:T32 

T33 Sign_symptom 926 930    mass

E19 Sign_symptom:T33 

T34 Detailed_description 916 925    irregular

T35 Color 896 914   slightly pigmented

R24 MODIFY Arg1:T34 Arg2:E19    

R25 MODIFY Arg1:T35 Arg2:E19    

T36 Biological_structure 953 968    lower esophagus

R26 MODIFY Arg1:T36 Arg2:E19    

T37 Area 980 995    5.0 cm × 3.0 cm

R27 MODIFY Arg1:T37 Arg2:E19    

T38 Diagnostic_procedure 1017 1023  biopsy

E20 Diagnostic_procedure:T38 

T39 Detailed_description 1005 1016  Fine needle

R28 MODIFY Arg1:T39 Arg2:E20    

T40 Coreference 1031 1037   lesion

E21 Coreference:T40 

R29 IDENTICAL Arg1:E21 Arg2:E19 

R30 MODIFY Arg1:E21 Arg2:E20    

T41 Disease_disorder 1058 1066  melanoma

E22 Disease_disorder:T41 

T42 Biological_structure 1047 1057  esophageal

R31 MODIFY Arg1:T42 Arg2:E22    

T43 Diagnostic_procedure 1091 1105  histopathology

E23 Diagnostic_procedure:T43 

T44 Diagnostic_procedure 1133 1152  computed tomography

E24 Diagnostic_procedure:T44 

T45 Diagnostic_procedure 1154 1156  CT

E25 Diagnostic_procedure:T45 

R32 IDENTICAL Arg1:E25 Arg2:E24 

T46 Biological_structure 1125 1132  abdomen

T47 Biological_structure 1115 1120  chest

R33 MODIFY Arg1:T46 Arg2:E24    

R34 MODIFY Arg1:T47 Arg2:E24    

T48 Diagnostic_procedure 1176 1200  magnetic resonance image

E26 Diagnostic_procedure:T48 

T49 Biological_structure 1168 1175  cranial

T50 Detailed_description 1159 1167  enhanced

R35 MODIFY Arg1:T50 Arg2:E26    

R36 MODIFY Arg1:T49 Arg2:E26    

T51 Diagnostic_procedure 1202 1205  MRI

E27 Diagnostic_procedure:T51 

R37 IDENTICAL Arg1:E27 Arg2:E26 

T52 Diagnostic_procedure 1216 1244  emission computed tomography

E28 Diagnostic_procedure:T52 

T53 Diagnostic_procedure 1246 1249  ECT

E29 Diagnostic_procedure:T53 

R38 IDENTICAL Arg1:E29 Arg2:E28 

T54 Biological_structure 1211 1215  bone

R39 MODIFY Arg1:T54 Arg2:E28    

T55 Sign_symptom 1258 1266  enlarged

E30 Sign_symptom:T55 

T56 Biological_structure 1295 1306  lymph nodes

R40 MODIFY Arg1:T56 Arg2:E30    

T57 Biological_structure 1267 1278  mediastinal

T58 Biological_structure 1288 1294  celiac

R41 MODIFY Arg1:T58 Arg2:T56    

R42 MODIFY Arg1:T57 Arg2:T56    

T59 Sign_symptom 1333 1344  involvement

E31 Sign_symptom:T59 

A3  POLARITY E31 MAYBE_NEG

T60 Biological_structure 1364 1375  lymph nodes

T61 Biological_structure 1348 1363  supraclavicular

R43 MODIFY Arg1:T61 Arg2:T60    

R44 MODIFY Arg1:T60 Arg2:E31    

T62 Diagnostic_procedure 1395 1397  CT

E32 Diagnostic_procedure:T62 

T63 Sign_symptom 1438 1443  tumor

E33 Sign_symptom:T63 

T64 Biological_structure 1428 1437  pulmonary

T65 Detailed_description 1418 1427  irregular

T66 Detailed_description 1408 1416  isolated

R45 MODIFY Arg1:T64 Arg2:E33    

R46 MODIFY Arg1:T65 Arg2:E33    

R47 MODIFY Arg1:T66 Arg2:E33    

T67 Diagnostic_procedure 1454 1482  Positron emission tomography

E34 Diagnostic_procedure:T67 

A4  POLARITY E34 NEG

T68 Diagnostic_procedure 1596 1613  clinically staged

E35 Diagnostic_procedure:T68 

T69 Lab_value 1617 1624 cT3NxM1

R48 MODIFY Arg1:T69 Arg2:E35    

T70 Detailed_description 1642 1710  7th edition of American Joint Committee on Cancer TNM staging system

R49 MODIFY Arg1:T70 Arg2:E35    

T71 Disease_disorder 1715 1732  esophageal cancer

E36 Disease_disorder:T71 

T72 Diagnostic_procedure 1767 1773  biopsy

E37 Diagnostic_procedure:T72 

T73 Biological_structure 1757 1766  pulmonary

T74 Detailed_description 1744 1756  percutaneous

T75 Detailed_description 1734 1743  CT-guided

R50 MODIFY Arg1:T73 Arg2:E37    

R51 MODIFY Arg1:T74 Arg2:E37    

R52 MODIFY Arg1:T75 Arg2:E37    

T76 Therapeutic_procedure 1858 1867 resection

E38 Therapeutic_procedure:T76 

T77 Sign_symptom 1900 1907  lesions

E39 Sign_symptom:T77 

T78 Biological_structure 1875 1885  esophageal

T79 Biological_structure 1890 1899  pulmonary

R53 MODIFY Arg1:T79 Arg2:E39    

R54 MODIFY Arg1:T78 Arg2:E39    

T80 Detailed_description 1845 1857  Single-stage

R55 MODIFY Arg1:T80 Arg2:E38    

T81 Clinical_event 1961 1973    consultation

E40 Clinical_event:T81 

T82 Therapeutic_procedure 2239 2252 esophagectomy

E41 Therapeutic_procedure:T82 

T83 Therapeutic_procedure 2269 2278 lobectomy

E42 Therapeutic_procedure:T83 

T84 Therapeutic_procedure 2117 2136 targeted antibodies

E43 Therapeutic_procedure:T84 

A5  POLARITY E43 NEG

T85 Detailed_description 2257 2268  right upper

R56 MODIFY Arg1:T85 Arg2:E42    

T86 Detailed_description 2228 2238  Ivor-Lewis

T87 Detailed_description 2215 2227  simultaneous

R57 MODIFY Arg1:T86 Arg2:E41    

R58 MODIFY Arg1:T87 Arg2:E41    

R59 MODIFY Arg1:T87 Arg2:E42    

T88 Medication 2314 2332    general anesthesia

E44 Medication:T88 

T89 Therapeutic_procedure 2366 2376 intubation

E45 Therapeutic_procedure:T89 

T90 Detailed_description 2353 2365  endotracheal

T91 Detailed_description 2340 2352  double-lumen

R60 MODIFY Arg1:T90 Arg2:E45    

R61 MODIFY Arg1:T91 Arg2:E45    

T92 Therapeutic_procedure 2399 2409 dissection

E46 Therapeutic_procedure:T92 

T93 Detailed_description 2390 2398  systemic

T94 Biological_structure 2413 2424  lymph nodes

R62 MODIFY Arg1:T94 Arg2:E46    

R63 MODIFY Arg1:T93 Arg2:E46    

T95 Biological_structure 2436 2447  mediastinum

T96 Biological_structure 2452 2459  abdomen

R64 MODIFY Arg1:T95 Arg2:T94    

R65 MODIFY Arg1:T96 Arg2:T94    

T97 Duration 2542 2553  290 minutes

E47 Duration:T97 

T98 Sign_symptom 2571 2579  bleeding

E48 Sign_symptom:T98 

A6  POLARITY E48 NEG

T99 Diagnostic_procedure 2614 2635  pathological staining

E49 Diagnostic_procedure:T99 

T100    Sign_symptom 2661 2678  pleomorphic cells

E50 Sign_symptom:T100 

T101    Sign_symptom 2692 2708  melanin granules

E51 Sign_symptom:T101 

T102    Diagnostic_procedure 2727 2752  immunohistochemical tests

E52 Diagnostic_procedure:T102 

T103    Diagnostic_procedure 2789 2812  human melanoma black 45

E53 Diagnostic_procedure:T103 

T104    Lab_value 2766 2785 positive expression

R66 MODIFY Arg1:T104 Arg2:E53   

T105    Diagnostic_procedure 2814 2819  HMB45

E54 Diagnostic_procedure:T105 

R67 IDENTICAL Arg1:E54 Arg2:E53 

T106    Diagnostic_procedure 2822 2858  microtubule-associated protein tau 1

E55 Diagnostic_procedure:T106 

T107    Diagnostic_procedure 2860 2865  MAPT1

E56 Diagnostic_procedure:T107 

R68 IDENTICAL Arg1:E56 Arg2:E55 

R69 MODIFY Arg1:T104 Arg2:E55   

T108    Diagnostic_procedure 2868 2875  melan A

E57 Diagnostic_procedure:T108 

T109    Diagnostic_procedure 2880 2884  S100

E58 Diagnostic_procedure:T109 

R70 MODIFY Arg1:T104 Arg2:E58   

R71 MODIFY Arg1:T104 Arg2:E57   

T110    Lab_value 2890 2909 negative expression

T111    Diagnostic_procedure 2913 2919  desmin

E59 Diagnostic_procedure:T111 

T112    Diagnostic_procedure 2921 2934  synaptophysin

E60 Diagnostic_procedure:T112 

T113    Diagnostic_procedure 2940 2967  epithelial membrane antigen

E61 Diagnostic_procedure:T113 

T114    Diagnostic_procedure 2969 2972  EMA

E62 Diagnostic_procedure:T114 

R72 IDENTICAL Arg1:E62 Arg2:E61 

R73 MODIFY Arg1:T110 Arg2:E59   

R74 MODIFY Arg1:T110 Arg2:E60   

R75 MODIFY Arg1:T110 Arg2:E61   

T115    Disease_disorder 3001 3009  melanoma

E63 Disease_disorder:T115 

T116    Biological_structure 3036 3057  dissected lymph nodes

T117    Biological_structure 3015 3031  resection margin

T118    Sign_symptom 3078 3083  tumor

E64 Sign_symptom:T118 

A7  POLARITY E64 NEG

R76 MODIFY Arg1:T116 Arg2:E64   

R77 MODIFY Arg1:T117 Arg2:E64   

T119    Diagnostic_procedure 3107 3122  molecular study

E65 Diagnostic_procedure:T119 

T120    Sign_symptom 3148 3206  mutation of V-raf murine sarcoma viral oncogene homolog B1

E66 Sign_symptom:T120 

T121    Disease_disorder 3270 3274  PMME

E67 Disease_disorder:T121 

#1  AnnotatorNotes E67  primary malignant melanoma of the esophagus

T122    Severity 3261 3269  advanced

R78 MODIFY Arg1:T122 Arg2:E67   

T123    Lab_value 3306 3314 stage IV

T124    Lab_value 3316 3323 pT3N0M1

R79 MODIFY Arg1:T123 Arg2:E67   

R80 MODIFY Arg1:T124 Arg2:E67   

T125    Therapeutic_procedure 3458 3480 postoperative recovery

E68 Therapeutic_procedure:T125 

T126    Lab_value 3485 3502 mainly uneventful

R81 MODIFY Arg1:T126 Arg2:E68   

T127    Clinical_event 3524 3534    discharged

E69 Clinical_event:T127 

T128    Date 3535 3556  14 days after surgery

E70 Date:T128 

T129    Medication 3606 3618    chemotherapy

E71 Medication:T129 

T130    Sign_symptom 3712 3728  thrombocytopenia

E72 Sign_symptom:T130 

T131    Sign_symptom 3730 3740  leukopenia

E73 Sign_symptom:T131 

T132    Sign_symptom 3742 3748  nausea

E74 Sign_symptom:T132 

T133    Sign_symptom 3750 3758  vomiting

E75 Sign_symptom:T133 

T134    Sign_symptom 3764 3772  diarrhea

E76 Sign_symptom:T134 

T135    Dosage 3572 3580    4 cycles

R82 MODIFY Arg1:T135 Arg2:E71   

T136    Dosage 3624 3646    an interval of 3 weeks

R83 MODIFY Arg1:T136 Arg2:E71   

T137    Detailed_description 3584 3592  adjuvant

T138    Detailed_description 3593 3605  conventional

R84 MODIFY Arg1:T138 Arg2:E71   

R85 MODIFY Arg1:T137 Arg2:E71   

T139    Sign_symptom 4289 4299  leukopenia

E77 Sign_symptom:T139 

T140    Sign_symptom 4301 4317  myelosuppression

E78 Sign_symptom:T140 

T141    Severity 4280 4288  moderate

R86 MODIFY Arg1:T141 Arg2:E77   

R87 MODIFY Arg1:T141 Arg2:E78   

T142    Medication 4348 4360    chemotherapy

E79 Medication:T142 

T143    Sign_symptom 4369 4378  recovered

E80 Sign_symptom:T143 

T144    Medication 4415 4452    granulocyte colony-stimulating factor

E81 Medication:T144 

T145    Medication 4454 4459    G-CSF

E82 Medication:T145 

R88 BEFORE Arg1:E82 Arg2:E81    

T146    Medication 4488 4513    human interferon alpha-2b

E83 Medication:T146 

T147    Administration 4613 4633    hypodermic injection

R89 MODIFY Arg1:T147 Arg2:E83   

T148    Dosage 4646 4669    6000 units every 3 days

R90 MODIFY Arg1:T148 Arg2:E83   

T149    Duration 4687 4697  for 1 year

E84 Duration:T149 

T150    Clinical_event 4715 4726    followed up

E85 Clinical_event:T150 

T151    Diagnostic_procedure 4777 4779  CT

E86 Diagnostic_procedure:T151 

T152    Biological_structure 4769 4776  abdomen

T153    Biological_structure 4759 4764  Chest

R91 MODIFY Arg1:T152 Arg2:E86   

R92 MODIFY Arg1:T153 Arg2:E86   

T154    Diagnostic_procedure 4789 4792  MRI

E87 Diagnostic_procedure:T154 

T155    Diagnostic_procedure 4799 4802  ECT

E88 Diagnostic_procedure:T155 

T156    Biological_structure 4781 4788  cranial

T157    Biological_structure 4794 4798  bone

R93 MODIFY Arg1:T156 Arg2:E87   

R94 MODIFY Arg1:T157 Arg2:E88   

T158    Diagnostic_procedure 4817 4837  physical examination

E89 Diagnostic_procedure:T158 

T159    Frequency 4855 4869 every 3 months

R95 MODIFY Arg1:T159 Arg2:E89   

R96 MODIFY Arg1:T159 Arg2:E88   

R97 MODIFY Arg1:T159 Arg2:E87   

R98 MODIFY Arg1:T159 Arg2:E86   

T160    Outcome 4898 4906   survived

E90 Outcome:T160 

T161    Sign_symptom 4929 4939  recurrence

E91 Sign_symptom:T161 

A8  POLARITY E91 NEG

T162    Sign_symptom 4950 4960  metastasis

E92 Sign_symptom:T162 

A9  POLARITY E92 NEG

T163    Detailed_description 4943 4949  remote

T164    Detailed_description 4915 4928  loco-regional

R99 MODIFY Arg1:T164 Arg2:E91   

R100    MODIFY Arg1:T163 Arg2:E92   

T165    Clinical_event 4972 4981    follow-up

E93 Clinical_event:T165 

T166    Duration 4985 5005  two and a half years

E94 Duration:T166 

T167    Medication 3823 3842    paclitaxel liposome

E95 Medication:T167 

T168    Administration 3847 3856    injection

T169    Medication 3985 3992    tegafur

E96 Medication:T169 

T170    Administration 3993 4002    injection

R101    MODIFY Arg1:T168 Arg2:E95   

R102    MODIFY Arg1:T170 Arg2:E96   

T171    Medication 4125 4137    cis-platinum

E97 Medication:T171 

*   OVERLAP E2 E3 E4 E5 E6 E7 E8

R103    BEFORE Arg1:E8 Arg2:E17 

*   OVERLAP E17 E18 E19 E20 E22 E23 E24 E26 E28 E30 E31 E32 E33 E34 E35 E36 E37

A10 POLARITY E37 NEG

R104    BEFORE Arg1:E37 Arg2:E38    

*   OVERLAP E38 E39

R105    AFTER Arg1:E39 Arg2:E40 

*   OVERLAP E40 E43

R106    BEFORE Arg1:E43 Arg2:E41    

*   OVERLAP E41 E42 E44 E45 E46 E47 E48

R107    BEFORE Arg1:E48 Arg2:E49    

*   OVERLAP E49 E50 E51 E52 E53 E55 E57 E58 E59 E60 E61 E63 E64 E65 E66 E67

R108    BEFORE Arg1:E67 Arg2:E68    

R109    BEFORE Arg1:E68 Arg2:E69    

*   OVERLAP E69 E70

R110    BEFORE Arg1:E70 Arg2:E71    

*   OVERLAP E71 E72 E73 E74 E75 E76 E95 E96 E97 E77 E78 E79 E80 E81 E83 E84 E85

R111    CAUSE Arg1:E81 Arg2:E80 

R112    MODIFY Arg1:E84 Arg2:E83    

R113    BEFORE Arg1:E85 Arg2:E86    

*   OVERLAP E86 E87 E88 E89

R114    BEFORE Arg1:E89 Arg2:E90    

*   OVERLAP E90 E91 E92 E93 E94

T172    Activity 35 42  smoking

E98 Activity:T172 

T173    Activity 46 54  drinking

E99 Activity:T173 

A11 POLARITY E98 NEG

A12 POLARITY E99 NEG

R115    BEFORE Arg1:E99 Arg2:E2 

*   OVERLAP E98 E99