en_test.json

[
    {
        "text_id": "100310",
        "sentence_id": 1,
        "text": "We present a case of a 32-year-old woman with a history of gradual enlargement of the anterior neck.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 2,
        "text": "The medical history was unremarkable and no comorbidities existed.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 3,
        "text": "There was no history of radiation exposure.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 4,
        "text": "Clinical examination revealed a multinodular goiter.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 5,
        "text": "Computed tomography showed a thyroid nodule of the left lobe extended to the isthmus and the right lobe with anterior and posterior capsular rupture contracting close contact with the vascular axis left carotid-jugular plunging into the cervicothoracic away from the hole aortic arch.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 6,
        "text": "There was no evidence of lung lesions.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 7,
        "text": "The patient underwent a surgical exploration.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 8,
        "text": "There was a hard left lobe nodule of 5 cm infiltrating the adjacent muscles and partially infiltrates the trachea.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 9,
        "text": "The intraoperative consultation pathology diagnosis was: undifferentiated carcinoma.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 10,
        "text": "A total thyroidectomy was realized.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 11,
        "text": "Histological examination showed a proliferation of elongated spindle-shaped cells, arranged in interweaving fascicles of varying sizes, intersected at right angles.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 12,
        "text": "Tumor cells are atypical with strange nuclei.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 13,
        "text": "Chromatin is distributed inhomogeneously.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 14,
        "text": "The cytoplasmic membrane is irregular and thick.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 15,
        "text": "The nucleolus is very large.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 16,
        "text": "The tumor realize a pushing against thyroid parenchyma which is separated with a fibrous capsule.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 17,
        "text": "The mitotic rate was extremely high (19 mitosis/10 high power field), and atypical mitotic figures were also present.",
        "relations": [
            [
                "high",
                "rate"
            ],
            [
                "19 mitosis/10 high power field",
                "rate"
            ]
        ]
    },
    {
        "text_id": "100310",
        "sentence_id": 18,
        "text": "The neoplasia showed invasion of the peri-glandular fat tissue.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 19,
        "text": "Immuno-histochemical staining of the slides with caldesmon, desmin, PanCK, CK5-6, CK7, myogenin, epithelial membrane antigen (EMA), CEA, thyroid transcription factor (TTF-1), pancytokeratin, smooth muscle actin (SMA), MelanA, S 100 protein, CD 45, CD3, CD30, CD 20, CD 15, CD34, ALK, calcitonin and KI 67 protein was performed.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 20,
        "text": "The tumour was strongly positive for caldesmon, SMA, desmin, and negative for pancytokeratin and other epithelial, lymphoid and melanocytic markers.",
        "relations": [
            [
                "negative",
                "markers"
            ],
            [
                "negative",
                "pancytokeratin"
            ]
        ]
    },
    {
        "text_id": "100310",
        "sentence_id": 21,
        "text": "On the basis of the clinical, radiographic, histopathological and immunohistochemical features, the final diagnosis was primary thyroid leiomyosarcoma, FNCLCC grade 3.",
        "relations": []
    },
    {
        "text_id": "100310",
        "sentence_id": 22,
        "text": "In multidisciplinary tumour board, it was decided that adjuvant loco regional RT and chemotherapy by ifosfamide and doxorubicin.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 1,
        "text": "A 21-year-old male was referred to the gastroenterology clinic for incidental findings of severe chronic pancreatitis on cross-sectional imaging but no associated symptoms of pancreatitis.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 2,
        "text": "He had presented to the emergency department for abdominal pain consistent with prior episodes of renal colic.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 3,
        "text": "Computed tomography scan confirmed the presence of renal calculi that passed with conservative management.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 4,
        "text": "An incidental finding on the imaging showed marked pancreatic atrophy with multiple sub-centimeter calcifications consistent with severe chronic pancreatitis.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 5,
        "text": "Remarkably, he did not report having any symptoms associated with pancreatic insufficiency including epigastric pain, vomiting, steatorrhea and weight loss.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 6,
        "text": "He denied having any prior episodes of acute pancreatitis and had no history of alcohol use.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 7,
        "text": "His laboratory tests were all within normal range, including complete blood count, liver function tests, amylase and lipase.",
        "relations": [
            [
                "normal range",
                "tests"
            ],
            [
                "normal range",
                "tests"
            ],
            [
                "normal range",
                "count"
            ],
            [
                "normal range",
                "lipase"
            ],
            [
                "normal range",
                "amylase"
            ]
        ]
    },
    {
        "text_id": "100339",
        "sentence_id": 8,
        "text": "His family history was significant as his father had an isolated episode of pancreatitis which required abdominal surgery.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 9,
        "text": "Magnetic resonance cholangiopancreatography (MRCP) showed severe parenchymal atrophy and pancreatic ductal stones with ductal dilation to 9mm.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 10,
        "text": "Due to his young age and atypical presentation, he was referred for genetic testing and counselling.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 11,
        "text": "He underwent genetic testing for various genes known to cause hereditary pancreatitis: CASR, CFTR, CTRC, PRSS1, SPINK1.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 12,
        "text": "He tested positive for homozygous variant of SPINK1 (N34S) mutation.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 13,
        "text": "Reflex testing of at-risk relatives confirmed that both of his parents were heterozygous carriers of the same SPINK1 (N34S) mutation and a review of their extended pedigree revealed that they were distant cousins.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 14,
        "text": "Given his asymptomatic clinical course, he remains under close follow-up without requiring any specific treatment for pancreatic insufficiency.",
        "relations": []
    },
    {
        "text_id": "100339",
        "sentence_id": 15,
        "text": "Due to the severity of pancreatitis noted on imaging and long expected lifespan, he was counselled about the increased risk of pancreatic malignancy and is undergoing regular cross-sectional imaging for the detection and prevention of cancer.",
        "relations": []
    },
    {
        "text_id": "100345",
        "sentence_id": 1,
        "text": "A 20-year-old right-handed female factory worker with no medical history is consulting in the emergency ward with an open trauma of the left hand resulting from an occupational accident.",
        "relations": []
    },
    {
        "text_id": "100345",
        "sentence_id": 2,
        "text": "Her hand was crushed under a heavy object.",
        "relations": []
    },
    {
        "text_id": "100345",
        "sentence_id": 3,
        "text": "Physical examination found an important swelling and obvious distortion at the dorsum of the hand associated with wounds of the ulnar and radial edges of the left hand.",
        "relations": []
    },
    {
        "text_id": "100345",
        "sentence_id": 4,
        "text": "The neurovascular examination was normal; in particular no sensitive deficit in the median nerve area was noted.",
        "relations": [
            [
                "normal",
                "examination"
            ]
        ]
    },
    {
        "text_id": "100345",
        "sentence_id": 5,
        "text": "Plain radiographs with front and lateral views showed a dislocation of the three lesser fingers associated with fractures of the hamatum and the second metacarpal.",
        "relations": []
    },
    {
        "text_id": "100345",
        "sentence_id": 6,
        "text": "The three lesser metacarpals and the distal fragment of the hamatum were medially displaced.",
        "relations": []
    },
    {
        "text_id": "100345",
        "sentence_id": 7,
        "text": "The patient was immediately brought to the operating theatre.",
        "relations": []
    },
    {
        "text_id": "100345",
        "sentence_id": 8,
        "text": "The treatment consisted of a reduction and stabilisation using a multiple carpo-metacarpal and cross inter-metacarpal pinning.",
        "relations": []
    },
    {
        "text_id": "100345",
        "sentence_id": 9,
        "text": "The wound was cleaned up trimmed and sutured.",
        "relations": []
    },
    {
        "text_id": "100345",
        "sentence_id": 10,
        "text": "The had and the wrist were immobilized with a splint for six weeks.",
        "relations": []
    },
    {
        "text_id": "100345",
        "sentence_id": 11,
        "text": "The patient had an intense and regular rehabilitation program.",
        "relations": []
    },
    {
        "text_id": "100345",
        "sentence_id": 12,
        "text": "At one year follow-up, the outcome is good: the patient is painless with good bone consolidation in right position, strictly normal range of motion (metacarpophalangeal 90°, proximal interphalagienne 100° and distal interphalageal 90°) and a 80% grip strength compared to the right side.",
        "relations": [
            [
                "90°",
                "metacarpophalangeal"
            ],
            [
                "100°",
                "interphalagienne"
            ],
            [
                "90°",
                "interphalageal"
            ],
            [
                "80%",
                "strength"
            ]
        ]
    },
    {
        "text_id": "100385",
        "sentence_id": 1,
        "text": "A 45 year old female with history of sickle cell disease presented with abdominal pain.",
        "relations": []
    },
    {
        "text_id": "100385",
        "sentence_id": 2,
        "text": "A CT scan revealed an exophytic renal mass measuring 2.9cm x 2.0cm x 2.1cm located on the antero-lateral aspect of her right kidney and an unremarkable spleen.",
        "relations": [
            [
                "2.9cm x 2.0cm x 2.1cm",
                "measuring"
            ]
        ]
    },
    {
        "text_id": "100385",
        "sentence_id": 3,
        "text": "She was evaluated by urology and a right partial nephrectomy was planned, however on the day of the procedure, the patient's preoperative pregnancy test was positive.",
        "relations": [
            [
                "positive",
                "test"
            ]
        ]
    },
    {
        "text_id": "100385",
        "sentence_id": 4,
        "text": "The procedure was post postponed until after she delivered and interval ultrasounds were obtained throughout her pregnancy to monitor the renal mass.",
        "relations": []
    },
    {
        "text_id": "100385",
        "sentence_id": 5,
        "text": "The lesion increased minimally in size.",
        "relations": []
    },
    {
        "text_id": "100385",
        "sentence_id": 6,
        "text": "Two months after caesarian section delivery, patient underwent an unremarkable right laparoscopic partial nephrectomy with individual artery and vein vascular occlusion at the level of the renal hilum.",
        "relations": []
    },
    {
        "text_id": "100385",
        "sentence_id": 7,
        "text": "A superficial liver laceration caused by the Veress needle was noted at the beginning of the procedure and effectively managed using bipolar cautery.",
        "relations": []
    },
    {
        "text_id": "100385",
        "sentence_id": 8,
        "text": "The patient's post-operative course was notable for marked thrombocytosis with her platelet count increasing for her baseline of 300,000 to a zenith of 1.3 million.",
        "relations": [
            [
                "300,000",
                "count"
            ],
            [
                "1.3 million",
                "count"
            ]
        ]
    },
    {
        "text_id": "100385",
        "sentence_id": 9,
        "text": "She was started on aspirin therapy and splenomegaly was noted on abdomen ultrasound.",
        "relations": []
    },
    {
        "text_id": "100385",
        "sentence_id": 10,
        "text": "Her platelet count normalized to 334,000.",
        "relations": [
            [
                "334,000",
                "count"
            ]
        ]
    },
    {
        "text_id": "100385",
        "sentence_id": 11,
        "text": "On pathology, the renal mass was classified as a papillary renal neoplasm consistent with a translocation carcinoma.",
        "relations": []
    },
    {
        "text_id": "100385",
        "sentence_id": 12,
        "text": "There was no splenic tissue in the specimen.",
        "relations": []
    },
    {
        "text_id": "100385",
        "sentence_id": 13,
        "text": "It was noted that the complete lack of staining of any keratins or epithelial membrane antigens was not consistent with a usual renal cell carcinoma and hence the diagnosis of a translocation tumor was made.",
        "relations": []
    },
    {
        "text_id": "100385",
        "sentence_id": 14,
        "text": "The patient was lost to follow up presenting 2 years later and a follow-up CT scan noted marked splenic atrophy with several splenules.",
        "relations": []
    },
    {
        "text_id": "100385",
        "sentence_id": 15,
        "text": "The patient was completely asymptomatic and at the time received all the post-splenectomy vaccination and her platelet count remained within normal limits.",
        "relations": [
            [
                "within normal limits",
                "count"
            ]
        ]
    },
    {
        "text_id": "100415",
        "sentence_id": 1,
        "text": "A 57 year old lady presented to a peripheral hospital with complaints of penetrating epigastric pain of a week’s duration.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 2,
        "text": "There was no vomiting or weight loss.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 3,
        "text": "Bowel movements were normal.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 4,
        "text": "Clinical examination at the time was unrevealing.",
        "relations": [
            [
                "unrevealing",
                "examination"
            ]
        ]
    },
    {
        "text_id": "100415",
        "sentence_id": 5,
        "text": "An abdominal ultrasound examination was reported as normal.",
        "relations": [
            [
                "normal",
                "examination"
            ]
        ]
    },
    {
        "text_id": "100415",
        "sentence_id": 6,
        "text": "The patient’s insistence on full investigation of the persistent epigastric pain led to a computed tomographic examination and discovery of a pancreatic tumour subsequent to which she was referred to our institution.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 7,
        "text": "The CT scan showed a large tumour (6cm in largest diameter) in the body and tail of pancreas with no evidence of metastasis.",
        "relations": [
            [
                "6cm",
                "diameter"
            ]
        ]
    },
    {
        "text_id": "100415",
        "sentence_id": 8,
        "text": "She was prepared for exploratory laparotomy.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 9,
        "text": "The pancreas was explored through the gastrocolic omentum.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 10,
        "text": "The body and tail of the pancreas including the tumour were resected.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 11,
        "text": "The spleen was also removed.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 12,
        "text": "The end of the pancreas was suture ligated.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 13,
        "text": "Her post-operative recovery was uneventful.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 14,
        "text": "Histological examination of the specimen showed a well circumscribed ovoid tumour 60mm x 50mm across.",
        "relations": [
            [
                "60mm x 50mm across",
                "tumour"
            ]
        ]
    },
    {
        "text_id": "100415",
        "sentence_id": 15,
        "text": "Sections revealed islands and trabeculae of regular cells with variable amounts of eosinophilic cytoplasm, mostly regular nuclei with indistinct nucleoli.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 16,
        "text": "Areas of necrosis were present with hemorrhage.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 17,
        "text": "A fibrous pseudo-capsule was noted around the tumour and the resection of the tumour appeared complete.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 18,
        "text": "No capsular of vascular invasion was seen.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 19,
        "text": "Immuno-peroxidase staining was positive for chromogranin A.",
        "relations": [
            [
                "positive",
                "staining"
            ],
            [
                "positive",
                "chromogranin"
            ]
        ]
    },
    {
        "text_id": "100415",
        "sentence_id": 20,
        "text": "Synaptophysin was strongly positive, CD10 was negative, Ki-67 was less than 2% positive and the mitotic count was between 2-20 per 10 hpf.",
        "relations": [
            [
                "strongly positive",
                "Synaptophysin"
            ],
            [
                "negative",
                "CD10"
            ],
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                "less than 2% positive",
                "Ki-67"
            ],
            [
                "2-20 per 10 hpf",
                "count"
            ]
        ]
    },
    {
        "text_id": "100415",
        "sentence_id": 21,
        "text": "The staining reactions were confirmatory of a neuroendocrine carcinoma of the pancreas.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 22,
        "text": "The final staging of the completely excised tumour was T3 N0 M0.",
        "relations": [
            [
                "T3 N0 M0",
                "staging"
            ]
        ]
    },
    {
        "text_id": "100415",
        "sentence_id": 23,
        "text": "Following discharge, she was followed up regularly and remains symptom free.",
        "relations": []
    },
    {
        "text_id": "100415",
        "sentence_id": 24,
        "text": "A CT Scan performed 2 years after surgery showed no evidence of tumour recurrence.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 1,
        "text": "A 64-year-old woman was admitted to our institution with palpable lump in her left breast.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 2,
        "text": "Patient had not any previous medical and family story of cancer and denied any use of alcohol and cigarettes.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 3,
        "text": "She took oral contraception for 5 years.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 4,
        "text": "Her menarche was at age 12.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 5,
        "text": "Physical examination revealed a 3 cm tumor located on the left breast adhere to deep plans.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 6,
        "text": "There was no retraction of the nipple, skin ulceration or inflammatory changes.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 7,
        "text": "The right breast exam was negative and there was no clinical evidence of axillary lymph node involvement.",
        "relations": [
            [
                "negative",
                "exam"
            ]
        ]
    },
    {
        "text_id": "100432",
        "sentence_id": 8,
        "text": "Mammography revealed a 2.6 cm round hyperdense mass with irregular and speculated margins in the subareolar area with associated microcalcifications within the mass.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 9,
        "text": "The mass was categorized as Breast Imaging Reporting and Data System category 5.",
        "relations": [
            [
                "5",
                "category"
            ]
        ]
    },
    {
        "text_id": "100432",
        "sentence_id": 10,
        "text": "Fine needle aspiration and a core biopsy of the lesion were performed and the diagnostic was tubular carcinoma of the breast.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 11,
        "text": "The patient underwent left lumpectomy with axillary node dissection.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 12,
        "text": "The macroscopic (gross) examination of specimens revealed the presence of a nodule measuring 1.5 cm in its largest diameter.",
        "relations": [
            [
                "1.5 cm",
                "measuring"
            ],
            [
                "1.5 cm",
                "diameter"
            ]
        ]
    },
    {
        "text_id": "100432",
        "sentence_id": 13,
        "text": "The histology showed that tumor cells were arranged in a rare trabecular pattern with a prominent lymphoid stroma.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 14,
        "text": "Carcinomatous cells were polygonal with granular amphophilic cytoplasm and a nucleus with fine chromatin.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 15,
        "text": "Nucleoli were generally inconspicuous.",
        "relations": [
            [
                "Up to 8 mitoses per 10 HPF",
                "counted"
            ]
        ]
    },
    {
        "text_id": "100432",
        "sentence_id": 16,
        "text": "Up to 8 mitoses per 10 HPF were counted.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 17,
        "text": "No lympho-vascular component or intraductal component was noted.",
        "relations": [
            [
                "grade II",
                "Scarf"
            ]
        ]
    },
    {
        "text_id": "100432",
        "sentence_id": 18,
        "text": "The tumor was grade II of Scarf Bloom Richardson.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 19,
        "text": "Surgical margin was clear.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 20,
        "text": "The resected axillary lymph nodes contained metastases, including one/19 N level I lymph nodes.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 21,
        "text": "The immunohistochemistry study showed an expression of the following antibodies Ck (AE1/AE3) on the carcinomatous component, CD3 and CD20 with homogenous distribution in the stroma.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 22,
        "text": "The Ki-67 labeling index was: 40% (estimated on 10HPF), Estrogen receptor status were 90%, progesterone receptor 10% (both using Allred score) and the human epidermal growth factor was negative.",
        "relations": [
            [
                "40%",
                "index"
            ],
            [
                "90%",
                "receptor"
            ],
            [
                "10%",
                "receptor"
            ],
            [
                "negative",
                "factor"
            ]
        ]
    },
    {
        "text_id": "100432",
        "sentence_id": 23,
        "text": "Based on the histopathological and immunohistochemical findings the case has been reported as lymphoepithelioma-like carcinoma of the breast and staged as pT1N1M0.",
        "relations": [
            [
                "pT1N1M0",
                "staged"
            ]
        ]
    },
    {
        "text_id": "100432",
        "sentence_id": 24,
        "text": "The post-operative pet scan showed no distant metastasis.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 25,
        "text": "The laboratory data showed a normal level of carbohydrate antigen 15-3(CA15-3: 39.8 U/ml).",
        "relations": [
            [
                "a normal level",
                "antigen"
            ],
            [
                "39.8 U/ml",
                "CA15-3"
            ]
        ]
    },
    {
        "text_id": "100432",
        "sentence_id": 26,
        "text": "Following surgery, the patient underwent four cycles of doxorubicin and cyclophosphamide and twelve cycles of paclitaxel chemotherapy.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 27,
        "text": "She declined endocrine therapy and was treated with radiotherapy commencing 3 weeks after chemotherapy.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 28,
        "text": "The radiation dose was 50Gy in 25 fractions using a 6MV photon tangent pair followed by a boost of 10Gy in 5 fractions using 6MV photon tangent pair.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 29,
        "text": "Regular follow up consists of physical examination every three months.",
        "relations": []
    },
    {
        "text_id": "100432",
        "sentence_id": 30,
        "text": "At her 1 year follow-up, the patient was doing well with no evidence of recurrent disease.",
        "relations": []
    },
    {
        "text_id": "100453",
        "sentence_id": 1,
        "text": "A 3 years old girl born from non-consanguineous parents, without any neonatal suffering; with good psychomotor development, from a popular district in one of our cities, without any obvious contact with dogs; presented with exophthalmia associated with unilateral blindness evolving rapidly within 3 months.",
        "relations": []
    },
    {
        "text_id": "100453",
        "sentence_id": 2,
        "text": "Clinical examination showed a non-pulsatile, painless, axial, irreducible exophthalmia with no sign of conjunctivitis or keratitis, and right monocular blindness, right ptosis; and fundal examination had objectified right papillary oedema.",
        "relations": []
    },
    {
        "text_id": "100453",
        "sentence_id": 3,
        "text": "The rest of the clinical examination was normal.",
        "relations": [
            [
                "normal",
                "examination"
            ]
        ]
    },
    {
        "text_id": "100453",
        "sentence_id": 4,
        "text": "Brain and orbital magnetic resonance imaging (MRI) revealed an extra-connal right orbital lesion near the orbital apex, measuring 28 x 18mm, of oval shape, it appeared hypo-signal in T1 and hyper-signal in T2, limited by a thin wall which took contrast product, this lesion compressed the optic nerve towards the nasal region.",
        "relations": [
            [
                "28 x 18mm",
                "measuring"
            ]
        ]
    },
    {
        "text_id": "100453",
        "sentence_id": 5,
        "text": "Chest x-ray and abdominal ultrasound did not reveal any other localization.",
        "relations": []
    },
    {
        "text_id": "100453",
        "sentence_id": 6,
        "text": "The patient was operated by performing a right extra-dural frontal approach, a cyst puncture was done in the first intention because the cyst was adherent to the neighbouring structures making its complete removal impossible, then a microscopic extirpation of the cystic membrane, combined with abundant washing by hypertonic serum to sterilize the cystic sit and reduce chances of dissemination.",
        "relations": []
    },
    {
        "text_id": "100453",
        "sentence_id": 7,
        "text": "Histological examination was in favour of intra-orbital hydatidosis.",
        "relations": []
    },
    {
        "text_id": "100453",
        "sentence_id": 8,
        "text": "Postoperatively, the patient was given an antihelminthic treatment of albendazole at a dose of 10mg per kilogram per day in 3 doses separated by 2 weeks; the evolution was marked by the significant regression of the exophthalmia and the gradual improvement of the visual acuity.",
        "relations": []
    },
    {
        "text_id": "100453",
        "sentence_id": 9,
        "text": "The patient however still retains a right unilateral nasal hemianopia after two years of follow-up.",
        "relations": []
    },
    {
        "text_id": "100453",
        "sentence_id": 10,
        "text": "An MRI done in the same period shows a cure of the patient by a complete disappearance of the cyst.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 1,
        "text": "We received a boy 3-year-old boy with autistic disorder on hospital of pediatric ward A at university hospital Mohammed VI of Marrakesh.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 2,
        "text": "He has no family history of illness or autistic spectrum disorder.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 3,
        "text": "The history revealed that at 2 years of age.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 4,
        "text": "The child was diagnosed with a ‘‘severe communication disorder,'' with social interaction difficulties and sensory processing delay.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 5,
        "text": "A composite follow-up of all previous assessments and investigations was undertaken.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 6,
        "text": "Blood work was normal (thyroid-stimulating hormone (TSH), hemoglobin, mean corpuscular volume (MCV), and ferritin).",
        "relations": [
            [
                "normal",
                "work"
            ]
        ]
    },
    {
        "text_id": "100490",
        "sentence_id": 7,
        "text": "Genetic testing was unremarkable (normal karyotype, negative for fragile X) and the magnetic resonance imaging (MRI) in search of a demyelinating attack of the white matter, electroencephalography (EEG), optometry assessment were also normal.",
        "relations": [
            [
                "normal",
                "karyotype"
            ],
            [
                "negative",
                "X"
            ],
            [
                "normal",
                "imaging"
            ],
            [
                "normal",
                "MRI"
            ],
            [
                "normal",
                "assessment"
            ],
            [
                "normal",
                "EEG"
            ],
            [
                "normal",
                "electroencephalography"
            ]
        ]
    },
    {
        "text_id": "100490",
        "sentence_id": 8,
        "text": "At the conclusion of this composite assessment, the boy was given a primary diagnosis of autistic spectrum disorder.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 9,
        "text": "A plan was instituted including speech-language therapy, intensive individualized educational programming, and contact was encouraged with the Autism Society.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 10,
        "text": "For that purpose, the parents moved to morocco to be surrounded by family without any huge improvement.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 11,
        "text": "Upon direct questioning at initial presentation, the 3-year-old child was reported by the parents to have unexplained fatigue, Gastrointestinal symptoms included bloating, constipation and diarrhea.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 12,
        "text": "Psychiatric symptoms included a frequently depressed mood, disproportionate anger, and emotional lability.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 13,
        "text": "On exploring his history, the child was born from yemenite father and Moroccan mother in Germany at-term weighing 3500 g with an Apgar score of 9 at 1 minute and 10 at 5 minutes after an uneventful pregnancy and delivery.",
        "relations": [
            [
                "3500 g",
                "weighing"
            ],
            [
                "9",
                "Apgar"
            ],
            [
                "10",
                "Apgar"
            ]
        ]
    },
    {
        "text_id": "100490",
        "sentence_id": 14,
        "text": "No concerns were present in the neonatal period.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 15,
        "text": "Development in the first 24 months of life appeared fine according to the parents-his motor skills seemed to progress normally and he achieved expected milestones.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 16,
        "text": "After 2 years of age, however, his language skills slowly began to regress.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 17,
        "text": "He also demonstrated a change in temperament as he started to whine repeatedly and to scream without provocation.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 18,
        "text": "Physical examination revealed a height and weight normal for age.",
        "relations": [
            [
                "normal",
                "weight"
            ],
            [
                "normal",
                "height"
            ]
        ]
    },
    {
        "text_id": "100490",
        "sentence_id": 19,
        "text": "He was uncommunicative, restless, and somewhat agitated.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 20,
        "text": "General examination was unremarkable other than dark rings around the eyes.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 21,
        "text": "There were no dysmorphic features evident.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 22,
        "text": "He had difficulty maintaining eye contact, and he appeared disinterested in what was taking place.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 23,
        "text": "No abnormality was found on abdominal assessment.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 24,
        "text": "Anti-tissue transglutaminase antibodies levels were 76 U (normal < 10).",
        "relations": [
            [
                "76 U",
                "levels"
            ]
        ]
    },
    {
        "text_id": "100490",
        "sentence_id": 25,
        "text": "The patient underwent upper endoscopy as duodenal biopsy to confirm a celiac disease diagnosis.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 26,
        "text": "It shows a total villous atrophy corresponding to a stage 4 of Marsh classification.",
        "relations": [
            [
                "stage 4",
                "classification"
            ],
            [
                "stage 4",
                "atrophy"
            ],
            [
                "positive screen",
                "disease"
            ]
        ]
    },
    {
        "text_id": "100490",
        "sentence_id": 27,
        "text": "Given the positive screen for celiac disease (positive anti-tissue transglutaminase antibodies and results of duodenal biopsy), dietary intervention was immediately commenced.",
        "relations": [
            [
                "positive",
                "results"
            ],
            [
                "positive",
                "antibodies"
            ]
        ]
    },
    {
        "text_id": "100490",
        "sentence_id": 28,
        "text": "All gluten was eliminated from the boy's diet.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 29,
        "text": "Within 1 month, the boy's gastrointestinal symptoms were relieved and his behavior had changed.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 30,
        "text": "The mother reported that her boy became progressively more communicative.",
        "relations": []
    },
    {
        "text_id": "100490",
        "sentence_id": 31,
        "text": "The child has continued on the gluten-free diet and has progressed well and remained healthy over the following 6 months.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 1,
        "text": "A 12-year-old girl was referred to Department of Oral Surgery, with a complaint of pain and swelling in the left of maxilla that appeared 3 months ago.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 2,
        "text": "The swelling was slowly progressive, associated with pain.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 3,
        "text": "However, the patient did not refer any motor or sensory deficit.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 4,
        "text": "There was no family history of similar swelling.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 5,
        "text": "Physical examination revealed a left maxillary swelling.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 6,
        "text": "There was no facial palsy.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 7,
        "text": "No cervical lymph node enlargement was seen.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 8,
        "text": "The oral examination showed a 4 cm x 5 cm, tender, compressible mass in the left maxilla, from the lateral incisor to the second premolar teeth.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 9,
        "text": "The tumor surface was smooth and red-purple.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 10,
        "text": "Several teeth were involved and displaced in the tumor mass.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 11,
        "text": "We noted the absence of canine.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 12,
        "text": "Vitality tests proved negative on the central and lateral incisor.",
        "relations": [
            [
                "negative",
                "tests"
            ]
        ]
    },
    {
        "text_id": "100600",
        "sentence_id": 13,
        "text": "Hight mobility of lateral incisor was noted.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 14,
        "text": "Orthopantomography and occlusal radiography showed a wide osteolytic area of the anterior left maxilla, extending from the first permanent molar to the central incisor.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 15,
        "text": "The canine was impacted.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 16,
        "text": "No root resorption was observed.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 17,
        "text": "The radiolucency was closely related to maxillary sinus and involving the nasal cavity.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 18,
        "text": "Haematological investigations showed normal serum calcium, phosphorus and parathormone (PTH) levels.",
        "relations": [
            [
                "normal",
                "levels"
            ]
        ]
    },
    {
        "text_id": "100600",
        "sentence_id": 19,
        "text": "The provisional diagnosis of benign tumor of the maxilla was made.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 20,
        "text": "The patient underwent excision and curettage of the mass with extraction of the canine and lateral incisor tooth.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 21,
        "text": "The wound was closed with interrupted sutures.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 22,
        "text": "The post-operative histopathological report revealed multinuclear giant cells scattered randomly throughout the cellular and fibrous vascular-rich tissue.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 23,
        "text": "New bone formation and granulation tissue rich in mononuclear inflammatory cells was revealed.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 24,
        "text": "The giant cells were multinucleated with bland-appearing nuclei, and the background stromal cells displayed no evidence of atypical mitoses.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 25,
        "text": "A diagnosis of giant cell tumor was established.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 26,
        "text": "During a 1-year serial clinical and radiological follow-up, there was no evidence of recurrence.",
        "relations": []
    },
    {
        "text_id": "100600",
        "sentence_id": 27,
        "text": "The facial contour and masticatory function were well-preserved.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 1,
        "text": "A 43-year-old non-diabetic Indian male reported to our outpatient department with chief complaints of cough with expectoration, chest pain, reduced appetite, fever with chills, and night sweats for two weeks.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 2,
        "text": "He also complained of breathlessness on exertion and had two episodes of blood in his sputum.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 3,
        "text": "The patient explained that the cough was continuous and was relieved after taking cough syrup.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 4,
        "text": "He also mentioned that the episodes of fever were initially intermittent and then daily for the last two weeks and were relieved after taking Paracetamol.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 5,
        "text": "The chest pain was localized to the middle of the chest and was aggravated on exertion.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 6,
        "text": "He was a businessman by profession with no history of smoking, alcoholism, or any other substance abuse.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 7,
        "text": "Also, there was no history of any contact of TB or COVID-19 in the family or close contacts.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 8,
        "text": "And there was no history of foreign travel in the recent past.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 9,
        "text": "But he had reported having traveled by a domestic airline about twenty days back.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 10,
        "text": "There was no history of weight loss or any other major illness in the past.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 11,
        "text": "On examination his vitals were-pulse-108/minute, arterial BP-130/80 mm of Hg, respiratory rate of 30 breaths/minute, Sp02-899% on room air, temperature- 101-degree centigrade.",
        "relations": [
            [
                "108/minute",
                "were-pulse"
            ],
            [
                "130/80 mm of Hg",
                "BP"
            ],
            [
                "30 breaths/minute",
                "rate"
            ],
            [
                "899%",
                "Sp02"
            ],
            [
                "101-degree centigrade",
                "temperature"
            ]
        ]
    },
    {
        "text_id": "100606",
        "sentence_id": 12,
        "text": "His Sp02 fell by 70% on room air after waking.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 13,
        "text": "On auscultation, there was crepitation on the bilateral middle lobes of the lungs.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 14,
        "text": "Also, dyspnea on exertion was noted.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 15,
        "text": "The rest of the systemic examination was within normal limits.",
        "relations": [
            [
                "normal limits",
                "examination"
            ]
        ]
    },
    {
        "text_id": "100606",
        "sentence_id": 16,
        "text": "Considering this as a probable case of TB with COVID-19 he was advised a chest radiograph with sputum microscopy (Ziehl Neelsen (ZN) staining for acid-fast bacilli), Cartridge-based nucleic acid amplification test (CBNAAT) of the sputum and other routine investigations.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 17,
        "text": "To check for the COVID-19 he was advised qualitative polymerase chain reaction (PCR) test from the oropharyngeal swab.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 18,
        "text": "The results were surprising with Mycobacterium tuberculosis detected on sputum fluorescent microscopy and were also confirmed by the CBNAAT.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 19,
        "text": "However, there was no resistance to Rifampicin.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 20,
        "text": "The results of the PCR were positive for RNA specific to SARS-CoV-2.",
        "relations": [
            [
                "positive",
                "SARS-CoV-2"
            ]
        ]
    },
    {
        "text_id": "100606",
        "sentence_id": 21,
        "text": "Besides, the chest radiograph PA-view was suggestive of bilateral consolidations on the middle lobes of lungs with ill-defined borders.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 22,
        "text": "The other investigations revealed a low lymphocyte count (1x 10 9 /L) and increased levels of C-reactive protein (CRP) (57 mg/L), lactate dehydrogenase (LDH) (580 U/L), and erythrocyte sedimentation rate (ESR) (70 mm in the 1 st hour).",
        "relations": [
            [
                "1x 10 9 /L",
                "count"
            ],
            [
                "57 mg/L",
                "CRP"
            ],
            [
                "57 mg/L",
                "protein"
            ],
            [
                "580 U/L",
                "dehydrogenase"
            ],
            [
                "580 U/L",
                "LDH"
            ],
            [
                "70 mm",
                "ESR"
            ],
            [
                "70 mm",
                "rate"
            ]
        ]
    },
    {
        "text_id": "100606",
        "sentence_id": 23,
        "text": "Also, a sample for liquid culture (MGIT BACTEC) was sent to the Intermediate Reference Laboratory (IRL) which revealed the growth of Mycobacterium tuberculosis.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 24,
        "text": "Computed tomography was not performed as the diagnosis was established by other cheaper and faster methods and also the patient was unwilling for the same.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 25,
        "text": "All the other routine investigations were within normal limits.",
        "relations": [
            [
                "normal limits",
                "investigations"
            ]
        ]
    },
    {
        "text_id": "100606",
        "sentence_id": 26,
        "text": "He was referred to the nearest designated COVID-19 management center, where he was managed as per national guidelines.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 27,
        "text": "Besides, he was also started on an antitubercular treatment of four drugs as per the National Tuberculosis Elimination Program (NTEP) guidelines.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 28,
        "text": "He was advised follow-up post completion of his stay at the designated COVID-19 center, but he has not yet reported back for follow-up.",
        "relations": []
    },
    {
        "text_id": "100606",
        "sentence_id": 29,
        "text": "Written informed consent was obtained from the patient for using clinical data and images for publication in this study.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 1,
        "text": "A 31-year-old woman with no pathological history was admitted to our hospital for chest pain, bone and joint pain, hair loss and asthenia for the last 3 months.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 2,
        "text": "On physical examination, we found fever at 38°C, polypnea at 32 cycles/min, arterial hypertension at 160/90 mmHg, malar rash, synovitis of wrists, elbows and ankles, and edema on both legs.",
        "relations": [
            [
                "38°C",
                "fever"
            ],
            [
                "32 cycles/min",
                "polypnea"
            ],
            [
                "160/90 mmHg",
                "hypertension"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 3,
        "text": "Diagnostic assessment: laboratory tests disclosed the following values: Increase level of erythrocyte sedimentation rate 120 mm/1 st hour, C reactive protein was 20 mg/l.",
        "relations": [
            [
                "120 mm/1 st hour",
                "rate"
            ],
            [
                "20 mg/l",
                "protein"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 4,
        "text": "The blood count showed hemoglobin at 9g/dl, MCV at 85 µ 3, lymphopenia at 400/mm 3, while platelets were normal 450 000/mm 3.",
        "relations": [
            [
                "9g/dl",
                "hemoglobin"
            ],
            [
                "85 µ 3",
                "MCV"
            ],
            [
                "400/mm 3",
                "lymphopenia"
            ],
            [
                "450 000/mm 3",
                "platelets"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 5,
        "text": "Direct coombs test was negative.",
        "relations": [
            [
                "negative",
                "test"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 6,
        "text": "Serum Albumin was 25g/l; proteins level was low at 50g/l and proteinuria at 3.2g/day.",
        "relations": [
            [
                "25g/l",
                "Albumin"
            ],
            [
                "low",
                "level"
            ],
            [
                "50g/l",
                "level"
            ],
            [
                "3.2g/day",
                "proteinuria"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 7,
        "text": "Creatinine was normal.",
        "relations": [
            [
                "normal",
                "Creatinine"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 8,
        "text": "Anti-nuclear antibody ANA were positive 1/320 with homogeneous pattern, anti-dsDNA level was 160U/ml.",
        "relations": [
            [
                "positive 1/320",
                "antibody"
            ],
            [
                "positive 1/320",
                "ANA"
            ],
            [
                "160U/ml",
                "level"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 9,
        "text": "Anti-cardiolipin IgG antibodies were positive 25UGPL.",
        "relations": [
            [
                "positive 25UGPL",
                "antibodies"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 10,
        "text": "Rheumatoid Factor was negative.",
        "relations": [
            [
                "negative",
                "Factor"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 11,
        "text": "C3 and C4 complement fractions were low (0.2 g/l and 0.05 g/l).",
        "relations": [
            [
                "low",
                "fractions"
            ],
            [
                "0.2 g/l",
                "fractions"
            ],
            [
                "0.05 g/l",
                "fractions"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 12,
        "text": "Chest x-ray, electrocardiogram and echocardiography were normal.",
        "relations": [
            [
                "normal",
                "electrocardiogram"
            ],
            [
                "normal",
                "x-ray"
            ],
            [
                "normal",
                "echocardiography"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 13,
        "text": "Chest computed tomography (CT) scan showed proximal pulmonary embolism.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 14,
        "text": "Renal ultrasound was normal.",
        "relations": [
            [
                "normal",
                "ultrasound"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 15,
        "text": "Renal biopsy reveals immunocomplex nephritis, lupus nephritis, segmental mesangial proliferation, mild activity lupus nephritis class III (A/C).",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 16,
        "text": "Before starting corticosteroids, we analyzed electrolytes.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 17,
        "text": "Serum calcium was elevated 132 mg/l with hyper-calciuria 479 mg/24 h. 25 OHD was normal.",
        "relations": [
            [
                "elevated",
                "calcium"
            ],
            [
                "132 mg/l",
                "calcium"
            ],
            [
                "479 mg/24 h",
                "hyper-calciuria"
            ],
            [
                "normal",
                "OHD"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 18,
        "text": "Alcaline phosphatase was 420 UI/l. the patient did not have any symptoms of hypercalcemia.",
        "relations": [
            [
                "420 UI/l",
                "phosphatase"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 19,
        "text": "Serum protein Electrophoresis showed polyclonal hypergammaglobulinaemia.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 20,
        "text": "Serum and urine immunofixation as well as Bence-Jones proteinuria were negative.",
        "relations": [
            [
                "negative",
                "proteinuria"
            ],
            [
                "negative",
                "immunofixation"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 21,
        "text": "Intact parathyroid hormone (iPTH) was high 628 pg/ml.",
        "relations": [
            [
                "high",
                "hormone"
            ],
            [
                "high",
                "iPTH"
            ],
            [
                "628 pg/ml",
                "hormone"
            ],
            [
                "628 pg/ml",
                "iPTH"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 22,
        "text": "CT scan and ultrasound of parathyroid imaging revealed a lower left parathyroid nodule measuring 2cm x 1 cm.",
        "relations": [
            [
                "2cm x 1 cm",
                "measuring"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 23,
        "text": "Femoral and lumbar bone mineral density (BMD) showed osteoporosis (T-score: -2.6).",
        "relations": [
            [
                "2.6",
                "T-score"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 24,
        "text": "In addition, we found multiple pelvic osteolytic lesions at CT scan.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 25,
        "text": "Other causes of hypercalcemia and bone lysis were excluded.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 26,
        "text": "The diagnosis in this case was SLE with lupus nephritis class III and anti-phospholipid syndrome, complicated by pulmonary embolism associated to primary hyperparathyroidism causing severe hypercalcemia, osteoporosis.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 27,
        "text": "Therapeutic intervention: the patient was given a pulse of methyl-prednisolone 15 mg/kg/day for 3 days followed by oral prednisone 1 mg/kg/day, associated with intravenous cyclophosphamide 750 mg/m 2 /month for 6 months.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 28,
        "text": "Mycophenolate mofetil 2 g/day was prescribed as a maintenance therapy of lupus nephritis with hydroxychloroquine at a dose of 400 mg/day.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 29,
        "text": "Treatment of pulmonary embolism was initiated with subcutaneous low molecular weight heparin (enoxaparin 0.1 ml/10 kg/12h) followed by antivitamin K.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 30,
        "text": "For Hypercalcemia, patient has received intravenous fluid with furosemide.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 31,
        "text": "She also required Alendronate 70 mg/week with Vitamin D 400u/day for osteoporosis.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 32,
        "text": "The left parathyroid gland was surgically removed.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 33,
        "text": "Histopathological examination revealed parathyroid adenoma.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 34,
        "text": "Her immediate postoperative parathyroid hormone level was 64 pg/ml with a calcium level of 98 mg/l.",
        "relations": [
            [
                "64 pg/ml",
                "level"
            ],
            [
                "98 mg/l",
                "level"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 35,
        "text": "Follow-up and outcomes: forty-eight hours after the surgery she developed oral paresthesia.",
        "relations": [
            [
                "72 mg/l",
                "hypocalcemia"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 36,
        "text": "She had hypocalcemia at 72 mg/l.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 37,
        "text": "She required oral supplementation for few months.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 38,
        "text": "Additional investigations for multiple endocrine neoplasia were negative.",
        "relations": [
            [
                "negative",
                "investigations"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 39,
        "text": "The patient remained asymptomatic.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 40,
        "text": "Her SLE was calm without any relapse.",
        "relations": [
            [
                "negative",
                "Control"
            ]
        ]
    },
    {
        "text_id": "100653",
        "sentence_id": 41,
        "text": "Control of proteinuria was negative.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 42,
        "text": "Corticosteroids was dropped.",
        "relations": []
    },
    {
        "text_id": "100653",
        "sentence_id": 43,
        "text": "The follow-up was 4 years.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 1,
        "text": "A 35-year-old mentally ill man was transferred from a local psychiatric hospital after attempted suicide by fire 3 days before admission.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 2,
        "text": "He acquired full-and partial-thickness injury in approximately 38% of his TBSA, including face and neck (5%), both upper extremities (8%), right thigh (4%), left thigh and leg (3%), and most of his anterior and posterior trunk (16%).",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 3,
        "text": "The patient was hospitalized for 66 days and underwent five debridement surgeries.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 4,
        "text": "The psychiatric diagnosis was schizophrenia type ICD 10 F20.3, treated with Haloperidol 1.5 mg and Diazepam 5 mg daily.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 5,
        "text": "The patient was occasionally restrained due to rebellious and self-destruction behavior.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 6,
        "text": "The nutrition management of this patient was started after a week of hospitalization, which is considered late.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 7,
        "text": "In the initial nutrition assessment, the patient was 40 kg weight and 150 cm tall thus the body mass index (BMI) was 17,57 kg/m 2 or underweight.",
        "relations": [
            [
                "40 kg",
                "weight"
            ],
            [
                "150 cm",
                "tall"
            ],
            [
                "17,57 kg/m 2",
                "index"
            ],
            [
                "17,57 kg/m 2",
                "BMI"
            ]
        ]
    },
    {
        "text_id": "100658",
        "sentence_id": 8,
        "text": "Gastrointestinal symptoms and signs were not found.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 9,
        "text": "Information regarding the patient's dietary intake in the last two weeks and weight change within the last 6 months could not be obtained, but his mother claimed that the patient seemed to lose weight because he refused any food that had been offered to him; he only smoked and drank coffee.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 10,
        "text": "Albumin level was 3.6 gr/L with imbalanced electrolyte levels.",
        "relations": [
            [
                "3.6 gr/L",
                "level"
            ]
        ]
    },
    {
        "text_id": "100658",
        "sentence_id": 11,
        "text": "Signs of fluid accumulation were not found.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 12,
        "text": "According to the subjective global assessment (SGA) tool, the patient belonged to group C (severely malnourished).",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 13,
        "text": "Energy and protein were given starting from 30 kcal/kg, increasing gradually to 50 kcal/kg, and 2 gp/kg divided into oral nutrition and oral nutrition supplements (ONS) with a 50:50 ratio.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 14,
        "text": "The patient was also given micronutrient supplementations, specifically vitamin A 100,000 units for the first week, vitamin C 100 mg 3 times a day, and zinc 20 mg once a day.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 15,
        "text": "During the early weeks of hospitalization, the patient's weight loss continued.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 16,
        "text": "At the end of the second week, his body weight was 36 kilograms while his serum albumin level was 2.7 gr/L.",
        "relations": [
            [
                "36 kilograms",
                "weight"
            ],
            [
                "2.7 gr/L",
                "level"
            ]
        ]
    },
    {
        "text_id": "100658",
        "sentence_id": 17,
        "text": "On the 28 th day, the patient's body weight was 33 kilograms while his serum albumin level was 2.1 gr/L.",
        "relations": [
            [
                "33 kilograms",
                "weight"
            ],
            [
                "2.1 gr/L",
                "level"
            ]
        ]
    },
    {
        "text_id": "100658",
        "sentence_id": 18,
        "text": "Energy and protein intake was maintained, but the ratio of oral intake and ONS was modified to 70:30.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 19,
        "text": "During the treatment, the patient's appetite was unstable.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 20,
        "text": "The patient was also hardly cooperative with enteral access.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 21,
        "text": "The patient often writhed in pain and became more aggressive.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 22,
        "text": "The patient did not respond well to analgesics and sedations.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 23,
        "text": "Partially parenteral nutrition (PN) enriched with branched-chain amino acid (BCAA) was administered to support protein needs.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 24,
        "text": "However, his BMI continued to decline, and on the 42 nd day, his body weight dropped to 32 kilograms with a serum albumin level of 2 gr/L.",
        "relations": [
            [
                "32 kilograms",
                "weight"
            ],
            [
                "2 gr/L",
                "level"
            ]
        ]
    },
    {
        "text_id": "100658",
        "sentence_id": 25,
        "text": "On the 66 th day, granulation tissues appeared on the wound bed.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 26,
        "text": "Considering the mental and nutrition status of the patient, it was decided not to continue with the skin graft surgery.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 27,
        "text": "The patient had lost 24% of body weight (BMI 11.96 kg/m 2) and the serum albumin level was 2.5 gr/L.",
        "relations": [
            [
                "11.96 kg/m 2",
                "BMI"
            ],
            [
                "2.5 gr/L",
                "level"
            ]
        ]
    },
    {
        "text_id": "100658",
        "sentence_id": 28,
        "text": "The patient displayed severe muscle wasting and subcutaneous fat loss.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 29,
        "text": "However, the general and mental condition was relatively better.",
        "relations": []
    },
    {
        "text_id": "100658",
        "sentence_id": 30,
        "text": "The patient was discharged from the hospital.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 1,
        "text": "A 19-year-old healthy man was admitted to our cardiology department following a syncopal episode.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 2,
        "text": "His past medical history was unremarkable.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 3,
        "text": "He no family history of heart disease or sudden death.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 4,
        "text": "Two-days prior the syncope, he developed chest pain and an influenza-like illness consisting of fevers, rhinorrhea, and sore throat.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 5,
        "text": "At the physical exam, the patient was febrile at 39°C.",
        "relations": [
            [
                "39°C",
                "febrile"
            ]
        ]
    },
    {
        "text_id": "100682",
        "sentence_id": 6,
        "text": "He had an inflamed throat, bradycardia at cardiac auscultation and there were no signs of heart failure.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 7,
        "text": "The electrocardiogram (EKG) showed grade III atrioventricular (AV) bloc with a ventricular rate of 38 beats per minute.",
        "relations": [
            [
                "38 beats per minute",
                "rate"
            ]
        ]
    },
    {
        "text_id": "100682",
        "sentence_id": 8,
        "text": "Laboratory studies were remarkable for a HS-troponin level 181ng/L, a white blood cell count of 14270/mm³ with 48% lymphocytes, and elevated C-reactive protein at 90mg/L.",
        "relations": [
            [
                "181ng/L",
                "level"
            ],
            [
                "14270/mm³",
                "count"
            ],
            [
                "48%",
                "lymphocytes"
            ],
            [
                "90mg/L",
                "protein"
            ]
        ]
    },
    {
        "text_id": "100682",
        "sentence_id": 9,
        "text": "Serum electrolytes, kidney and liver functions were within normal limits.",
        "relations": [
            [
                "normal limits",
                "functions"
            ]
        ]
    },
    {
        "text_id": "100682",
        "sentence_id": 10,
        "text": "A chest X-ray showed an appropriate cardiac size.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 11,
        "text": "The initial transthoracic echocardiography (TTE) showed a normal global left ventricular function (left ventricular ejection fraction (LVEF) 60%) and wall motion abnormalities (anteroseptal hypokinesia), with reduced left ventricular global longitudinal strain (LV GLS= -14.1%).",
        "relations": [
            [
                "60%",
                "LVEF"
            ],
            [
                "60%",
                "fraction"
            ],
            [
                "-14.1%",
                "GLS"
            ],
            [
                "-14.1%",
                "strain"
            ]
        ]
    },
    {
        "text_id": "100682",
        "sentence_id": 12,
        "text": "Cardiac magnetic resonance (CMR) showed increased signal intensity at the mid-lateral wall on T2-weighted images.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 13,
        "text": "Late enhancement revealed a patchy subepicardial hyperenhancement of the medio-distal segments of the anterior and anterolateral walls which confirm the diagnosis of myocarditis.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 14,
        "text": "The patient was treated with cefotaxime and doxycycline.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 15,
        "text": "All serological tests (chlamydia, coxiella, mycoplasma, rickettsia, lyme and bartonella) obtained during the hospitalization were negative.",
        "relations": [
            [
                "negative",
                "mycoplasma"
            ],
            [
                "negative",
                "coxiella"
            ],
            [
                "negative",
                "bartonella"
            ],
            [
                "negative",
                "rickettsia"
            ],
            [
                "negative",
                "lyme"
            ],
            [
                "negative",
                "tests"
            ],
            [
                "negative",
                "chlamydia"
            ]
        ]
    },
    {
        "text_id": "100682",
        "sentence_id": 16,
        "text": "Five days later, the patient was asymptomatic.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 17,
        "text": "The 24 hours ECG monitoring showed a sinus rhythm.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 18,
        "text": "The TTE revealed a normal LVEF and an improvement in the LVGLS with segmental reduced values concordant with the CMR abnormalities.",
        "relations": []
    },
    {
        "text_id": "100682",
        "sentence_id": 19,
        "text": "At one-month follow-up the patient made a full recovery without any recurring cardiovascular symptoms or abnormal electrocardiographic or echocardiographic findings.",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 1,
        "text": "We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago.",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 2,
        "text": "He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before.",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 3,
        "text": "Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria.",
        "relations": [
            [
                "12/15",
                "GCS"
            ],
            [
                "12/15",
                "Glasgow"
            ],
            [
                "5",
                "opening"
            ],
            [
                "2",
                "response"
            ],
            [
                "5",
                "response"
            ],
            [
                "24 cycles/min",
                "polypneic"
            ],
            [
                "97%",
                "SpO"
            ],
            [
                "97%",
                "saturation"
            ],
            [
                "115 bpm",
                "tachycardic"
            ],
            [
                "160/95 mmHg",
                "hypertensive"
            ],
            [
                "2.24 g/L",
                "glucose"
            ],
            [
                "without ketonuria",
                "glycosuria"
            ]
        ]
    },
    {
        "text_id": "100705",
        "sentence_id": 4,
        "text": "The patient was apyretic.",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 5,
        "text": "Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L.",
        "relations": [
            [
                "normal",
                "acidosis"
            ],
            [
                "3 mmol/L",
                "hypokalaemia"
            ],
            [
                "normal",
                "lactatemia"
            ],
            [
                "0.43 mmol/L",
                "lactatemia"
            ]
        ]
    },
    {
        "text_id": "100705",
        "sentence_id": 6,
        "text": "Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test.",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 7,
        "text": "After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition.",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 8,
        "text": "A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities.",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 9,
        "text": "An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks.",
        "relations": [
            [
                "normal",
                "echocardiography"
            ],
            [
                "normal",
                "ultrasound"
            ]
        ]
    },
    {
        "text_id": "100705",
        "sentence_id": 10,
        "text": "Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers.",
        "relations": [
            [
                "elevated",
                "CRP"
            ],
            [
                "elevated",
                "protein"
            ],
            [
                "45.5",
                "CRP"
            ],
            [
                "45.5",
                "protein"
            ],
            [
                "negative",
                "procalcitonin"
            ],
            [
                "0.04 ng/ml",
                "procalcitonin"
            ],
            [
                "12,500",
                "cells"
            ],
            [
                "9280",
                "PNN"
            ],
            [
                "normal",
                "lymphocytes"
            ],
            [
                "2140",
                "lymphocytes"
            ],
            [
                "normal",
                "ferritinemia"
            ],
            [
                "5.37",
                "levels"
            ],
            [
                "negative",
                "D-dimers"
            ]
        ]
    },
    {
        "text_id": "100705",
        "sentence_id": 11,
        "text": "Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal.",
        "relations": [
            [
                "normal",
                "assessment"
            ]
        ]
    },
    {
        "text_id": "100705",
        "sentence_id": 12,
        "text": "SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative.",
        "relations": [
            [
                "negative",
                "reaction"
            ],
            [
                "negative",
                "RT-PCR"
            ],
            [
                "negative",
                "serology"
            ]
        ]
    },
    {
        "text_id": "100705",
        "sentence_id": 13,
        "text": "Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours.",
        "relations": [
            [
                "0.58g/l",
                "proteinorachia"
            ],
            [
                "0.58",
                "ratio"
            ]
        ]
    },
    {
        "text_id": "100705",
        "sentence_id": 14,
        "text": "Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy.",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 15,
        "text": "Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures.",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 16,
        "text": "Anticonvulsant treatment was started with sodium valproate.",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 17,
        "text": "The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset).",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 18,
        "text": "A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions.",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 19,
        "text": "Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2.",
        "relations": [
            [
                "negative",
                "serologies"
            ],
            [
                "positive",
                "SARS-CoV"
            ],
            [
                "positive",
                "RT-PCR"
            ]
        ]
    },
    {
        "text_id": "100705",
        "sentence_id": 20,
        "text": "Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6.",
        "relations": [
            [
                "positive",
                "reaction"
            ],
            [
                "38.6",
                "threshold"
            ],
            [
                "38.6",
                "CT"
            ]
        ]
    },
    {
        "text_id": "100705",
        "sentence_id": 21,
        "text": "The diagnosis of SARS-CoV-2 encephalopathy was retained.",
        "relations": []
    },
    {
        "text_id": "100705",
        "sentence_id": 22,
        "text": "The patient is still in intensive care.",
        "relations": []
    },
    {
        "text_id": "102305",
        "sentence_id": 1,
        "text": "A 32-year-old female patient with Kniest syndrome presented at our department with a painful pseudarthrosis after femoral valgisation osteotomy 8 years ago.",
        "relations": []
    },
    {
        "text_id": "102305",
        "sentence_id": 2,
        "text": "A Wagner cone stem and acetabular roof cup with a cemented Ecofit cup 2M (dual-articulation acetabular cup system) were implanted due to a dysplastic femur with a small medullary space.",
        "relations": []
    },
    {
        "text_id": "102305",
        "sentence_id": 3,
        "text": "The Ecofit cup itself is associated with a reduced risk of dislocation.",
        "relations": []
    },
    {
        "text_id": "102305",
        "sentence_id": 4,
        "text": "The patient was satisfied with the range of motion after hip endoprosthesis and reported a significant increase in quality of life.",
        "relations": []
    },
    {
        "text_id": "102305",
        "sentence_id": 5,
        "text": "The patient is still comfortable with the hip prosthesis at the most recent follow-up 4 years after implantation.",
        "relations": []
    },
    {
        "text_id": "102305",
        "sentence_id": 6,
        "text": "Follow-up radiographs over 4 years have not revealed any signs of loosening or migration, and no Trendelenburg sign was reported for the affected side.",
        "relations": []
    },
    {
        "text_id": "103220",
        "sentence_id": 1,
        "text": "Here we report a case of aggressive metastatic cholangiocarcinoma (MCC) in 72-year-old man, sequentially treated with two targeted chemotherapies.",
        "relations": []
    },
    {
        "text_id": "103220",
        "sentence_id": 2,
        "text": "Initially disease quickly progressed during best clinical practice care (gemcitabine in combination with cisplatin or capecitabine), which was accompanied by significant decrease of life quality.",
        "relations": []
    },
    {
        "text_id": "103220",
        "sentence_id": 3,
        "text": "Monotherapy with TKI sorafenib was prescribed to the patient, which resulted in stabilization of tumor growth and elimination of pain.",
        "relations": []
    },
    {
        "text_id": "103220",
        "sentence_id": 4,
        "text": "The choice of the inhibitor was made based on high-throughput screening of gene expression in the patient's tumor biopsy, utilized by Oncobox platform to build a personalized rating of potentially effective target therapies.",
        "relations": []
    },
    {
        "text_id": "103220",
        "sentence_id": 5,
        "text": "However, time to progression after start of sorafenib administration did not exceed 6 months and the regimen was changed to monotherapy with Pazopanib, another TKI predicted to be effective for this patient according to the same molecular test.",
        "relations": []
    },
    {
        "text_id": "103220",
        "sentence_id": 6,
        "text": "It resulted in disease progression according to RECIST with simultaneous elimination of sorafenib side effects such as rash and hand-foot syndrome.",
        "relations": []
    },
    {
        "text_id": "103220",
        "sentence_id": 7,
        "text": "After 2 years from the diagnosis of MCC the patient was alive and physically active, which is substantially longer than median survival for standard therapy.",
        "relations": []
    },
    {
        "text_id": "104179",
        "sentence_id": 1,
        "text": "Forty year old male presented with a huge mass in this left arm.",
        "relations": []
    },
    {
        "text_id": "104179",
        "sentence_id": 2,
        "text": "The same patient apparently was admitted three years back for excision of the arm swelling which was relatively small that time.",
        "relations": []
    },
    {
        "text_id": "104179",
        "sentence_id": 3,
        "text": "However the patient did not undergo surgery and was takin treatment from local bone setters during the last three years and tumor grew to a larger size during this period.",
        "relations": []
    },
    {
        "text_id": "104179",
        "sentence_id": 4,
        "text": "The current dimensions of tumor was 32x28 cms with circumference of 87 cms.",
        "relations": [
            [
                "32x28 cms",
                "dimensions"
            ],
            [
                "87 cms",
                "circumference"
            ]
        ]
    },
    {
        "text_id": "104179",
        "sentence_id": 5,
        "text": "X-ray showed complete destruction of the upper humerus with central calcification.",
        "relations": []
    },
    {
        "text_id": "104179",
        "sentence_id": 6,
        "text": "Biopsy releveled a chondrosarcoma.",
        "relations": []
    },
    {
        "text_id": "104179",
        "sentence_id": 7,
        "text": "Skeletal survey and bone scan did not reveal any other lesion in the body.",
        "relations": []
    },
    {
        "text_id": "104179",
        "sentence_id": 8,
        "text": "A forequarter amputation was done and a 16 kg tumor mass was excised.",
        "relations": []
    },
    {
        "text_id": "104179",
        "sentence_id": 9,
        "text": "At three years follow up, the patient has no complains with no recurrence of the tumor.",
        "relations": []
    },
    {
        "text_id": "104263",
        "sentence_id": 1,
        "text": "This case report describes the condition of a 30-year-old man involved in a motor vehicle collision.",
        "relations": []
    },
    {
        "text_id": "104263",
        "sentence_id": 2,
        "text": "Clinical examination, X-rays, and computed tomography scan revealed a posterior hip dislocation with an ipsilateral femoral head and mid-shaft fractures.",
        "relations": []
    },
    {
        "text_id": "104263",
        "sentence_id": 3,
        "text": "The patient was treated by closed reduction of hip dislocation using a temporarily applied external fixator followed by intramedullary nailing of the femoral shaft.",
        "relations": []
    },
    {
        "text_id": "104263",
        "sentence_id": 4,
        "text": "Achieving a closed reduction is a challenge with ipsilateral fractures but it should be favored over open reduction due to a lower risk of complications.",
        "relations": []
    },
    {
        "text_id": "104263",
        "sentence_id": 5,
        "text": "The type of femoral head fracture, in this case, may have aided in an easier reduction.",
        "relations": []
    },
    {
        "text_id": "105094",
        "sentence_id": 1,
        "text": "We present a case of a 77-year-old Caucasian woman with obstructive jaundice.",
        "relations": []
    },
    {
        "text_id": "105094",
        "sentence_id": 2,
        "text": "Laboratory tests revealed that she had elevated bilirubin and liver enzyme levels.",
        "relations": [
            [
                "elevated",
                "levels"
            ]
        ]
    },
    {
        "text_id": "105094",
        "sentence_id": 3,
        "text": "A computed tomographic scan showed a homogeneous 5 × 3-cm mass obstructing the common bile duct.",
        "relations": []
    },
    {
        "text_id": "105094",
        "sentence_id": 4,
        "text": "The results of brush cytology were consistent with a bile duct villous papilloma.",
        "relations": []
    },
    {
        "text_id": "105094",
        "sentence_id": 5,
        "text": "However, on the basis of the tumor's radiological features, a preliminary diagnosis of extrahepatic bile duct malignant tumor was made.",
        "relations": []
    },
    {
        "text_id": "105094",
        "sentence_id": 6,
        "text": "After discussion among the multidisciplinary team, a surgical resection of the bile duct tumor was performed.",
        "relations": []
    },
    {
        "text_id": "105094",
        "sentence_id": 7,
        "text": "Histopathological examination confirmed a villous adenoma.",
        "relations": []
    },
    {
        "text_id": "105094",
        "sentence_id": 8,
        "text": "The patient's postoperative course was uneventful.",
        "relations": []
    },
    {
        "text_id": "105223",
        "sentence_id": 1,
        "text": "A 49-year-old white Caucasian woman presented with vaginal bleeding.",
        "relations": []
    },
    {
        "text_id": "105223",
        "sentence_id": 2,
        "text": "A pelvic examination revealed a cystic lesion arising from her cervix.",
        "relations": []
    },
    {
        "text_id": "105223",
        "sentence_id": 3,
        "text": "Examination of a biopsy specimen revealed a poorly differentiated neoplasm, with sheets of small hyperchromatic cells, staining weakly for neuroendocrine markers.",
        "relations": []
    },
    {
        "text_id": "105223",
        "sentence_id": 4,
        "text": "She was diagnosed with small cell carcinoma and started on concurrent chemotherapy and radiation.",
        "relations": []
    },
    {
        "text_id": "105223",
        "sentence_id": 5,
        "text": "However, additional positive immunostaining for CD99 was strongly suggestive of Ewing's sarcoma.",
        "relations": []
    },
    {
        "text_id": "105223",
        "sentence_id": 6,
        "text": "Fluorescence in situ hybridization revealed ESWR1 gene rearrangement, confirming Ewing's sarcoma.",
        "relations": []
    },
    {
        "text_id": "105223",
        "sentence_id": 7,
        "text": "Our patient underwent surgery, which confirmed stage IIB Ewing's sarcoma.",
        "relations": []
    },
    {
        "text_id": "105223",
        "sentence_id": 8,
        "text": "She received adjuvant chemotherapy but died from progressive metastatic disease after four cycles.",
        "relations": []
    },
    {
        "text_id": "105832",
        "sentence_id": 1,
        "text": "A 35-year-old Caucasian woman known to suffer from late familial hyperinsulinemic hypoglycemia due to a well-known mutation in the insulin receptor gene has been pregnant 6 times.",
        "relations": []
    },
    {
        "text_id": "105832",
        "sentence_id": 2,
        "text": "The patient was treated with injections of Sandostatin LAR® (octreotide) during the first four pregnancies.",
        "relations": []
    },
    {
        "text_id": "105832",
        "sentence_id": 3,
        "text": "Her first pregnancy in 1999 was unknown until approximately 25th gestational weeks with fatal intrauterine growth retardation.",
        "relations": []
    },
    {
        "text_id": "105832",
        "sentence_id": 4,
        "text": "The following two pregnancies were terminated on parental request after a chorion villus biopsy revealed the mutation causing late familial hyperinsulinemic hypoglycemia.",
        "relations": []
    },
    {
        "text_id": "105832",
        "sentence_id": 5,
        "text": "During the fourth pregnancy, in which the fetus also had the mutation, serial ultrasound examinations showed a small fetus with appropriate growth.",
        "relations": []
    },
    {
        "text_id": "105832",
        "sentence_id": 6,
        "text": "At birth the girl was small for gestational age.",
        "relations": []
    },
    {
        "text_id": "105832",
        "sentence_id": 7,
        "text": "She was admitted to the neonatal special care unit due to low blood glucose and intravenous glucose and early feeding was initiated.",
        "relations": []
    },
    {
        "text_id": "105832",
        "sentence_id": 8,
        "text": "One day old, her condition deteriorated with signs of an abdominal catastrophe indicating necrotizing enterocolitis.",
        "relations": []
    },
    {
        "text_id": "105832",
        "sentence_id": 9,
        "text": "After two laparotomies - both confirming necrotizing enterocolitis - the child died 8 days after birth.",
        "relations": []
    },
    {
        "text_id": "105832",
        "sentence_id": 10,
        "text": "In the following two pregnancies Sandostatin LAR® was stopped before pregnancy and the patient was treated only with diet restriction and intensive glucose monitoring.",
        "relations": []
    },
    {
        "text_id": "105832",
        "sentence_id": 11,
        "text": "Both pregnancies ended successfully.",
        "relations": []
    },
    {
        "text_id": "105832",
        "sentence_id": 12,
        "text": "One child carried the mutation and was small for gestational age at birth while the other child did not carry the mutation and had normal birth weight.",
        "relations": []
    },
    {
        "text_id": "106233",
        "sentence_id": 1,
        "text": "A 70yrs old Female was admitted in our institution diagnosed with severe bilateral Osteoarthritis.",
        "relations": []
    },
    {
        "text_id": "106233",
        "sentence_id": 2,
        "text": "The x-rays showed bone on bone Tricompartment OA Knee with Varus Malalignment.",
        "relations": []
    },
    {
        "text_id": "106233",
        "sentence_id": 3,
        "text": "She was posted for Single Stage Bilateral Total Knee Replacement and as planned the Left Knee Was Operated first.",
        "relations": []
    },
    {
        "text_id": "106233",
        "sentence_id": 4,
        "text": "After exposure, Proximal Tibial, Distal Femoral Cuts and measurement of extension gaps the synovium from the anterior Femur was removed and sizing was done.",
        "relations": []
    },
    {
        "text_id": "106233",
        "sentence_id": 5,
        "text": "The AP cut was then proceeded with.",
        "relations": []
    },
    {
        "text_id": "106233",
        "sentence_id": 6,
        "text": "We spotted a small Osteochondral Cyst in the Anterior Femur which was curretted to remove the cystic material, which is when we realised that the cyst was large and communicating with the medulary canal.",
        "relations": []
    },
    {
        "text_id": "106233",
        "sentence_id": 7,
        "text": "The remaining Femoral preparations was done keeping in mind the risk of iatrogenic fracture and extension Stem was used in the femur.",
        "relations": []
    },
    {
        "text_id": "106233",
        "sentence_id": 8,
        "text": "The defect was then packed cancellous bone graft.",
        "relations": []
    },
    {
        "text_id": "106841",
        "sentence_id": 1,
        "text": "Our patient was an 87-year-old African-American woman who was a nursing home resident, with a history of diabetes mellitus type 2 and subarachnoid hemorrhage leading to aphasia, hemiplegia, seizures and dysphagia requiring percutaneous gastric feeds.",
        "relations": []
    },
    {
        "text_id": "106841",
        "sentence_id": 2,
        "text": "While at the nursing home, she had recurrent aspiration pneumonia and large tube-feed residuals consistent with a diagnosis of underlying gastroparesis.",
        "relations": []
    },
    {
        "text_id": "106841",
        "sentence_id": 3,
        "text": "Her management included metoclopramide and reduced tube-feeding rates, which improved her symptoms.",
        "relations": []
    },
    {
        "text_id": "106841",
        "sentence_id": 4,
        "text": "However, within months the aspiration and increased residuals returned.",
        "relations": []
    },
    {
        "text_id": "106841",
        "sentence_id": 5,
        "text": "After trials of different medication therapies without success, she started mirtazapine and her residual volume and aspirations decreased with a dose of 15mg nightly.",
        "relations": []
    },
    {
        "text_id": "107405",
        "sentence_id": 1,
        "text": "A 37-year-old Arabian woman presented with 12 months of progressive Cushing's syndrome-like symptoms.",
        "relations": []
    },
    {
        "text_id": "107405",
        "sentence_id": 2,
        "text": "Biochemical evaluation confirmed adrenocorticotropic hormone -dependent Cushing's syndrome.",
        "relations": []
    },
    {
        "text_id": "107405",
        "sentence_id": 3,
        "text": "However, the anatomical site of her excess adrenocorticotropic hormone secretion was not clearly delineated by further investigations.",
        "relations": []
    },
    {
        "text_id": "107405",
        "sentence_id": 4,
        "text": "Magnetic resonance imaging of our patient's pituitary gland failed to demonstrate the presence of an adenoma.",
        "relations": []
    },
    {
        "text_id": "107405",
        "sentence_id": 5,
        "text": "Spiral computed tomography of her chest only revealed the presence of a non-specific 7 mm lesion in her left inferobasal lung segment.",
        "relations": [
            [
                "7 mm",
                "lesion"
            ]
        ]
    },
    {
        "text_id": "107405",
        "sentence_id": 6,
        "text": "Functional imaging, including a positron emission tomography scan using 18-fluorodeoxyglucose and gallium-68-DOTA-D-Phe1-Tyr3-octreotide, also failed to show increased metabolic activity in the lung lesion or in her pituitary gland.",
        "relations": []
    },
    {
        "text_id": "107405",
        "sentence_id": 7,
        "text": "Our patient was commenced on medical treatment with ketoconazole and metyrapone to control the clinical features associated with her excess cortisol secretion.",
        "relations": []
    },
    {
        "text_id": "107405",
        "sentence_id": 8,
        "text": "Despite initial normalization of her urinary free cortisol excretion rate, levels began to rise eight months after commencement of medical treatment.",
        "relations": []
    },
    {
        "text_id": "107405",
        "sentence_id": 9,
        "text": "Repeated imaging of her pituitary gland, chest and pelvis again failed to clearly localize a source of her excess adrenocorticotropic hormone secretion.",
        "relations": []
    },
    {
        "text_id": "107405",
        "sentence_id": 10,
        "text": "The bronchial nodule was stable in size on serial imaging and repeatedly reported as having a nonspecific appearance of a small granuloma or lymph node.",
        "relations": []
    },
    {
        "text_id": "107405",
        "sentence_id": 11,
        "text": "We re-explored the treatment options and endorsed our patient's favored choice of resection of the bronchial nodule, especially given that her symptoms of cortisol excess were difficult to control and refractory.",
        "relations": []
    },
    {
        "text_id": "107405",
        "sentence_id": 12,
        "text": "Subsequently, our patient had the bronchial nodule resected.",
        "relations": []
    },
    {
        "text_id": "107405",
        "sentence_id": 13,
        "text": "The histological appearance of the lesion was consistent with that of a carcinoid tumor and immunohistochemical analysis revealed that the tumor stained strongly positive for adrenocorticotropic hormone.",
        "relations": [
            [
                "strongly positive",
                "stained"
            ]
        ]
    },
    {
        "text_id": "107405",
        "sentence_id": 14,
        "text": "Furthermore, removal of the lung lesion resulted in a normalization of our patient's 24-hour urinary free cortisol excretion rate and resolution of her symptoms and signs of hypercortisolemia.",
        "relations": []
    },
    {
        "text_id": "107424",
        "sentence_id": 1,
        "text": "Here, we present a case of unicentric Castleman's disease in a 37-year-old woman without associated neoplastic, autoimmune or infectious diseases.",
        "relations": []
    },
    {
        "text_id": "107424",
        "sentence_id": 2,
        "text": "The lesion was located in the femoral region of the right lower extremity and surgically resected after radiographic workup and excisional biopsy examinations.",
        "relations": []
    },
    {
        "text_id": "107424",
        "sentence_id": 3,
        "text": "The tumor comprised lymphoid tissue with numerous germinal centers with central fibrosis, onion-skinning and rich interfollicular vascularization.",
        "relations": []
    },
    {
        "text_id": "107424",
        "sentence_id": 4,
        "text": "CD23-positive follicular dendritic cells were detected in the germinal centers and numerous CD138-positive plasma cells in interfollicular areas.",
        "relations": []
    },
    {
        "text_id": "107424",
        "sentence_id": 5,
        "text": "The diagnosis of mixed cellularity type Castleman's disease was established and the patient recovered well.",
        "relations": []
    },
    {
        "text_id": "107559",
        "sentence_id": 1,
        "text": "A 24-year-old African-American man presented to our Emergency Department with a one-week history of fever, dyspnea, cough, and abdominal pain.",
        "relations": []
    },
    {
        "text_id": "107559",
        "sentence_id": 2,
        "text": "A computed tomography scan of his chest and abdomen revealed bilateral lower lobe pneumonia and two retained Jackson-Pratt drains in the right upper quadrant.",
        "relations": []
    },
    {
        "text_id": "107559",
        "sentence_id": 3,
        "text": "He was taken to the operating room for drain removal, a right hemicolectomy, debridement of a duodenal injury, a Roux-en-y duodenojejunostomy, and an end ileostomy.",
        "relations": []
    },
    {
        "text_id": "107559",
        "sentence_id": 4,
        "text": "He subsequently became increasing hypoxemic in the intensive care unit and a bronchoperitoneal fistula was diagnosed.",
        "relations": []
    },
    {
        "text_id": "107559",
        "sentence_id": 5,
        "text": "He required high-frequency oscillatory ventilation followed by lung isolation, and was successfully resuscitated using these techniques.",
        "relations": []
    },
    {
        "text_id": "108139",
        "sentence_id": 1,
        "text": "A 45 year old Indian female of Nordic origin presented 5 years back with a lump in the right breast and the axilla.",
        "relations": []
    },
    {
        "text_id": "108139",
        "sentence_id": 2,
        "text": "She underwent modified radical mastectomy.",
        "relations": []
    },
    {
        "text_id": "108139",
        "sentence_id": 3,
        "text": "Histophotomicrograph of the excised breast lesion showed a 2.1 cm duct carcinoma, positive for ER and PR with 1 out of 25 lymph nodes positive for metastasis.",
        "relations": [
            [
                "positive",
                "ER"
            ],
            [
                "positive",
                "PR"
            ],
            [
                "positive",
                "metastasis"
            ]
        ]
    },
    {
        "text_id": "108139",
        "sentence_id": 4,
        "text": "She received 6 cycles of chemotherapy with cyclophosphamide, epirubicin, and 5-fluorouracil.",
        "relations": []
    },
    {
        "text_id": "108139",
        "sentence_id": 5,
        "text": "This was followed by tamoxifen 20 mg per day for five years.",
        "relations": []
    },
    {
        "text_id": "108139",
        "sentence_id": 6,
        "text": "She was doing well on follow up until the completion of fifth year of her disease, when she presented with complaints of mild fever and weakness.",
        "relations": []
    },
    {
        "text_id": "108139",
        "sentence_id": 7,
        "text": "Examination revealed generalized lymph node enlargement along with hepatomegaly.",
        "relations": []
    },
    {
        "text_id": "108139",
        "sentence_id": 8,
        "text": "Hemogram showed mild anemia, normal platelet count and a leukocyte count of 1.2 x 10(11)/L.",
        "relations": [
            [
                "normal",
                "count"
            ],
            [
                "1.2 x 10(11)/L",
                "count"
            ]
        ]
    },
    {
        "text_id": "108139",
        "sentence_id": 9,
        "text": "Peripheral blood examination revealed medium sized lymphoid cells, constituting almost 75% of total nucleated cell population.",
        "relations": []
    },
    {
        "text_id": "108139",
        "sentence_id": 10,
        "text": "Immunophenotying, established a diagnosis of post thymic T-cell prolymphocytic leukemia.",
        "relations": []
    },
    {
        "text_id": "108139",
        "sentence_id": 11,
        "text": "Contrast-enhanced computed tomography of the chest and abdomen was done which revealed an anterior mediastinal mass with destruction of sternum along with multiple small nodular shadows in bilateral lung fields suggestive of lung metastasis.",
        "relations": []
    },
    {
        "text_id": "108139",
        "sentence_id": 12,
        "text": "Fine needle aspiration cytology of the mass showed atypical ductal cells with nuclear pleomorphism, which were positive for ER, PR and Her2neu protein.",
        "relations": [
            [
                "positive",
                "PR"
            ],
            [
                "positive",
                "ER"
            ],
            [
                "positive",
                "Her2neu"
            ]
        ]
    },
    {
        "text_id": "108139",
        "sentence_id": 13,
        "text": "This confirmed a co-existent metastatic breast carcinoma.",
        "relations": []
    },
    {
        "text_id": "108139",
        "sentence_id": 14,
        "text": "She was started on chemotherapy for T-PLL along with hormonal therapy with aromatase inhibitor.",
        "relations": []
    },
    {
        "text_id": "108139",
        "sentence_id": 15,
        "text": "Unfortunately, both her malignancies progressed after an initial stable disease of two months.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 1,
        "text": "A 60 year-old man presented to an outside institution for septic shock with hematesis.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 2,
        "text": "He had a medical history of diabetes mellitus, hypertension and he was amputated right leg (trans-femoral amputation) for diabetic arteriopathy six months before admission complicated by venous thrombosis.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 3,
        "text": "Home medications included daily pioglitazone, atenolol, furosemide and anticoagulant with poor compliance.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 4,
        "text": "Initial examination revealed a patient in state of septic shock, respiratory rate 28 cycles per min, his pulse was regular with an apical rate of 120 beats/min, temperature 39° C, blood pressure 70/40 mmHg, he had necrotic and suppurative amputation stump with peripheral pulse abolished.",
        "relations": [
            [
                "28 cycles per min",
                "rate"
            ],
            [
                "regular",
                "pulse"
            ],
            [
                "120 beats/min",
                "rate"
            ],
            [
                "39° C",
                "temperature"
            ],
            [
                "70/40 mmHg",
                "pressure"
            ]
        ]
    },
    {
        "text_id": "100022",
        "sentence_id": 5,
        "text": "Patient was given immediately oxygen, fluids, antibiotics, and drugs to increase blood pressure.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 6,
        "text": "Six hours later, the patient presented a single episode of hematemesis.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 7,
        "text": "There was no associated melena or abdominal pain.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 8,
        "text": "He had no history of alcohol use, liver disease, varices, peptic ulcer disease, abdominal aortic surgery, nonsteroidal anti inflammatory drug use, gastroparesis, or previous GI bleeding.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 9,
        "text": "Physical examination was unremarkable.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 10,
        "text": "Pertinent laboratory studies included a hemoglobin level of 10 g/dL, platelet count was normal, blood urea of 1,2 g/l (0,18-0,45 g/L), and a creatinine level of 68 mg/L (7-13 mg/L).",
        "relations": [
            [
                "10 g/dL",
                "level"
            ],
            [
                "normal",
                "count"
            ],
            [
                "1,2 g/l",
                "urea"
            ],
            [
                "68 mg/L",
                "level"
            ]
        ]
    },
    {
        "text_id": "100022",
        "sentence_id": 11,
        "text": "After hemodynamic stabilization, an oesophageo-gastro-duodenoscopy was performed which showed: The upper third of the esophagus was circumferentially congestive, but the middle and lower third showed circumferential black pigmentation: the mucosa was black and covered by an exudate of the same color associated with diffuse bleeding.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 12,
        "text": "Gastric mucosa was strictly normal in direct vision and in retrovision, the bulb and duodenum were normal.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 13,
        "text": "Biopsie specimens were showed necrotic debris, mucosal submucosal necrosis with a local inflammatory response.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 14,
        "text": "The treatment of this condition was based continuous high dose omeprazole (8 mg / h) after bolus of 80mg and total parenteral nutrition.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 15,
        "text": "The patient experienced no further hematemesis or melena.",
        "relations": []
    },
    {
        "text_id": "100022",
        "sentence_id": 16,
        "text": "Due to the severity of the necrosis, and with deterioration of his condition and persistent sepsis he died later in the same day.",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 1,
        "text": "A 17 year-old woman with a history of moderate persistent allergic asthma has benefited from a first desensitization protocol at age 3.",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 2,
        "text": "The protocol has been interrupted 4 years later because of a mild skin reaction.",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 3,
        "text": "Her doctor decided to stop the specific immunotherapy.",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 4,
        "text": "But another doctor restarted a new protocol of desensitization at age 16 against pollens because of a lack of control of his condition.",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 5,
        "text": "She was never hospitalized, she was receiving no medication and she was doing well one year after she received a new regimen of pneumallergens (Alustal® Stallergenes SA, France).",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 6,
        "text": "Indeed, 12 hours after initiation of treatment, she complained of abdominal pain, vomiting and diarrhea without fever.",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 7,
        "text": "Several hours after, she consulted to the emergency department where a surgical emergency was ruled out.",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 8,
        "text": "She was then admitted to the internal medicine ward.",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 9,
        "text": "Two days later, she developed an acute respiratory failure and was referred to the intensive care unit where laboratory tests revealed multiorgan failure: liver enzymes, 5000U/L (normal level, 0-37U/L); creatine phosphokinase, 59000U/L (normal level, 10-200U/L); cardiac troponin T, 21ng/ml (normal level, under 0,01ng/ml); leucopenia, 2600/mm 3 (normal level, 4000-9000/ mm 3); thrombocytopenia, 13000/ mm 3 (normal level, 150000-400000/ mm 3); prothrombin time, 38% (normal level, 70-100%).",
        "relations": [
            [
                "5000U/L",
                "enzymes"
            ],
            [
                "59000U/L",
                "phosphokinase"
            ],
            [
                "21ng/ml",
                "troponin"
            ],
            [
                "2600/mm 3",
                "leucopenia"
            ],
            [
                "13000/ mm 3",
                "thrombocytopenia"
            ],
            [
                "38%",
                "time"
            ]
        ]
    },
    {
        "text_id": "100029",
        "sentence_id": 10,
        "text": "Chest X-ray demonstrated bilateral interstitial markings with a normal cardiac silhouette.",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 11,
        "text": "Viral serology was normal for hepatitis A, B, C, D, and E, Epstein-Barr virus and Cytomegalovirus.",
        "relations": [
            [
                "normal",
                "virus"
            ],
            [
                "normal",
                "serology"
            ],
            [
                "normal",
                "Cytomegalovirus"
            ],
            [
                "normal",
                "hepatitis"
            ]
        ]
    },
    {
        "text_id": "100029",
        "sentence_id": 12,
        "text": "A skin morbilliform rash and facial edema appeared later.",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 13,
        "text": "The patient received a fluid resuscitation, platelet and erythrocyte transfusion, steroids and antibiotics.",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 14,
        "text": "A hypoxic coma occurred on day 4 leading to intubation and mechanical ventilation.",
        "relations": []
    },
    {
        "text_id": "100029",
        "sentence_id": 15,
        "text": "Rapidly, she experienced intractable shock and acute renal impairment despite inotropic agents leading to death on day 5.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 1,
        "text": "A 50-years-old woman, hypertensive, hospitalized for a large cervical mass appeared 30 years ago.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 2,
        "text": "In the family history, her mother, sisters and cousins underwent a surgery for MNG.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 3,
        "text": "Despite of the large volume of the mass, the patient never described signs of cervical compression whatsoever respiratory, digestive, laryngeal, vascular or neurologic signs.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 4,
        "text": "She never suffered from thyroid dysfunction.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 5,
        "text": "Her neck was deformed by the voluminous formation classified grade III according to the WHO modified classification.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 6,
        "text": "The mass took the front and the two sides of the neck.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 7,
        "text": "Its surface was embossed and covered by a thin normal skin.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 8,
        "text": "There were some veins of the collateral circulation limited to the neck.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 9,
        "text": "The goiter measured 18 x 11 cm.",
        "relations": [
            [
                "18 x 11 cm",
                "measured"
            ]
        ]
    },
    {
        "text_id": "100067",
        "sentence_id": 10,
        "text": "The mass was firm, painless, and mobile with the swallowing movements.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 11,
        "text": "Lymphadenopathy research was difficult and found no palpable lymph nodes.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 12,
        "text": "The laboratory tests (T 3, T 4 and TSH) were normal.",
        "relations": [
            [
                "normal",
                "tests"
            ],
            [
                "normal",
                "T"
            ],
            [
                "normal",
                "TSH"
            ],
            [
                "normal",
                "T"
            ]
        ]
    },
    {
        "text_id": "100067",
        "sentence_id": 13,
        "text": "Thoracic radiography showed a large cervical opacity roughly round and strewn with microcalcifications associated with a right eccentricity of the trachea.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 14,
        "text": "Cervical and chest CT revealed the presence of a partially calcified thyroid mass slightly plunging in the anterior mediastinum.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 15,
        "text": "It took heterogeneously the contrast and then evocate a large MNG.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 16,
        "text": "The trachea was surrounded by the goiter, slightly narrowed and right deviated as well as the lower part of the larynx.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 17,
        "text": "The right and left vascular axes of the neck (carotid artery and jugular vein) were deviated backward.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 18,
        "text": "The patient underwent a surgery for her enormous MNG slightly plunging in the mediastinum.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 19,
        "text": "Endotracheal intubation was relatively easy by the laryngoscope.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 20,
        "text": "The incision performed was a Kocher cervicotomy.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 21,
        "text": "There was a multinodular, hypervascularized goiter.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 22,
        "text": "Its lower end plunges behind the sternal manubrium.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 23,
        "text": "The larynx was deviated towards the right side.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 24,
        "text": "The total thyroidectomy was performed in two steps: initially a right lobo-isthmectomy, then the left lobectomy.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 25,
        "text": "The retrosternal part of the goiter was released using the finger by the same incision.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 26,
        "text": "Both recurrent laryngeal nerves (RLN) were not identified because of the hemorrhage.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 27,
        "text": "One parathyroid gland was accidently devascularized and was autotransplanted to the ipsilateral sternocleidomastoid muscle.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 28,
        "text": "The operation was finished by double aspiration drainage.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 29,
        "text": "In the first hours after surgery, the patient developed a large cervical hematoma.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 30,
        "text": "She was readmitted to the operating room, and after evacuation of the hematoma there was no vessels bleeding.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 31,
        "text": "The operation was completed with a double suction drainage.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 32,
        "text": "In the immediate postoperative period, the patient developed hemodynamic collapse requiring the introduction of dobutamine.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 33,
        "text": "After 48 hours of hemodynamic support, the blood pressure stabilized and dobutamine was stopped.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 34,
        "text": "Histological study concluded in multinodular colloid goiter.",
        "relations": []
    },
    {
        "text_id": "100067",
        "sentence_id": 35,
        "text": "The patient was discharged from the hospital after 20 days in good health.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 1,
        "text": "A 13-year-old boy diagnosed with WHO diagnostic criteria of probable NS was referred from Atanga HC III in Pader district where he was enrolled and undergoing care at the nodding syndrome treatment center; he came with a history of progressive swelling and pain in the right lumbar region.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 2,
        "text": "The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 3,
        "text": "These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 4,
        "text": "The patient reported a history of falling from a tree during one of the nodding episodes in October 2012 and hit his abdomen onto a tree branch.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 5,
        "text": "On further probe on his childhood history, his mother reported that he was born normally at home by a Traditional Birth Attendant (TBA) in one of the Internally Displaced peoples (IDP) camps in 2000.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 6,
        "text": "She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD).",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 7,
        "text": "She reported that during her pregnancy, she had exclusive feeding on the relief food provided by WFP (beans, yellow posho and cooking oil) during the IDP camps and denies history of ingestion of herbs or medications which caused adverse events during and after the pregnancy.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 8,
        "text": "She reported that her child had a normal physical, cognitive and social childhood development before the onset of nodding which began in May 27th 2011 immediately after returning home from IDP camps.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 9,
        "text": "The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 10,
        "text": "She reported that in spite of these medications the child continued to have seizures and nodding at least twice a day and had since dropped out of school.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 11,
        "text": "On general examination, he was dehydrated, febrile and moderately wasted.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 12,
        "text": "There was a right lumbar region mass, tender, indurated and non-fluctuant.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 13,
        "text": "The spleen and liver were not palpable.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 14,
        "text": "There was no renal or supra-pubic tenderness.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 15,
        "text": "The rectum was full of faecal material which was of normal colour and consistency.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 16,
        "text": "The anal tone was normal and there was no blood on examining fingure.",
        "relations": [
            [
                "normal",
                "tone"
            ]
        ]
    },
    {
        "text_id": "100075",
        "sentence_id": 17,
        "text": "Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 18,
        "text": "There were immature granulocytes and atypical lymphocytes seen on the peripheral film report.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 19,
        "text": "Other laboratory results including liver function tests (ALT, AST) were elevated while serum protein levels were low; renal functions tests (serum creatinine, blood urea and nitrogen level), and serum electrolytes (K+, Na+, Cl-, HC03-) which were within normal ranges.",
        "relations": [
            [
                "elevated",
                "AST"
            ],
            [
                "elevated",
                "ALT"
            ],
            [
                "elevated",
                "tests"
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            [
                "low",
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            ],
            [
                "within normal ranges",
                "tests"
            ],
            [
                "within normal ranges",
                "level"
            ]
        ]
    },
    {
        "text_id": "100075",
        "sentence_id": 20,
        "text": "Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 21,
        "text": "The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 22,
        "text": "He received supplementary food rehabilitation and his seizure medication was changed to Sodium Valproate 200mg once a day under direct observation therapy (DOTS) and close monitoring of the vital signs.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 23,
        "text": "The patient continued to have regular follow up in the surgical ward; seizures and nodding stopped completely from the time of intervention in the hospital.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 24,
        "text": "With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life.",
        "relations": []
    },
    {
        "text_id": "100075",
        "sentence_id": 25,
        "text": "A subsequent review of the haematological and clinical chemistry findings 2 weeks later showed that renal function tests, serum electrolytes were normal except the liver enzymes level were elevated and were still high.",
        "relations": [
            [
                "normal",
                "tests"
            ],
            [
                "normal",
                "electrolytes"
            ],
            [
                "elevated",
                "level"
            ],
            [
                "high",
                "level"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 1,
        "text": "A 77-year-old Tunisian woman was hospitalized because of massive painful ascites.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 2,
        "text": "Her family history did not include any autoimmune disease.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 3,
        "text": "She denied a history of hepatitis, jaundice or alcohol use.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 4,
        "text": "She had a history of diabetes, hypertension treated by glinide and calcium blocker.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 5,
        "text": "She was explored 4 years prior to admission for exudative pleuritis of the right lung without any established diagnosis after multiple explorations including thoracoscopy with biopsies.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 6,
        "text": "On admission, blood pressure was 150/70 mmHg, her rate was 80 /mn and body temperature was 37°C.",
        "relations": [
            [
                "150/70 mmHg",
                "pressure"
            ],
            [
                "80 /mn",
                "rate"
            ],
            [
                "37°C",
                "temperature"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 7,
        "text": "The physical examination showed only abdominal distension related to the important ascites without collateral venous circulation.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 8,
        "text": "She had no skin lesions, lymphadenopathy, or hepatosplenomegaly and lower extremities showed no edema.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 9,
        "text": "Laboratory investigations showed: leucopenia with white blood cell count = 3100/mm3, lymphopenia = 840/mm3, hemoglobin = 10.5g/dL ; low serum albumin level = 29g/L, 47;-globulin = 19g/L. blood glucose levels = 180 mg/dl and hemoglobin A1c = 8.6 %.",
        "relations": [
            [
                "3100/mm3",
                "count"
            ],
            [
                "840/mm3",
                "lymphopenia"
            ],
            [
                "10.5g/dL",
                "hemoglobin"
            ],
            [
                "29g/L",
                "level"
            ],
            [
                "19g/L",
                "globulin"
            ],
            [
                "180 mg/dl",
                "levels"
            ],
            [
                "8.6 %",
                "hemoglobin"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 10,
        "text": "Urine analysis showed trace protein (0.03g/24h).",
        "relations": [
            [
                "0.03g/24h",
                "protein"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 11,
        "text": "Platelet count, activated partial thromboplastin time, liver function tests, blood urea nitrogen, serum creatinine, erythrocyte sediment rate and total cholesterol were within normal limits.",
        "relations": [
            [
                "normal limits",
                "cholesterol"
            ],
            [
                "normal limits",
                "rate"
            ],
            [
                "normal limits",
                "nitrogen"
            ],
            [
                "normal limits",
                "count"
            ],
            [
                "normal limits",
                "tests"
            ],
            [
                "normal limits",
                "creatinine"
            ],
            [
                "normal limits",
                "time"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 12,
        "text": "Tests for HBsAg and HCV were negative.",
        "relations": [
            [
                "negative",
                "Tests"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 13,
        "text": "Abdominal ultrasonography showed ascitic fluid without any sign of bowel loop thickening or enteritis.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 14,
        "text": "Neither lymphadenopathy nor liver abnormality was present.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 15,
        "text": "A chest X-ray film disclosed bilateral pleural effusion.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 16,
        "text": "Ascitic obtained by aspiration contained 170 cells mm3 (67% lymphocytes), 46g/L protein, but no malignant cells.",
        "relations": [
            [
                "170 cells mm3",
                "contained"
            ],
            [
                "46g/L protein",
                "contained"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 17,
        "text": "Cultures for bacteria and mycobacteria gave no growth.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 18,
        "text": "Tuberculosis investigation including initial tuberculin skin test and the research of Koch bacilli in sputum and urine were negative.",
        "relations": [
            [
                "negative",
                "investigation"
            ],
            [
                "negative",
                "test"
            ],
            [
                "negative",
                "research"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 19,
        "text": "Echocardiogram and electrocardiogram were normal.",
        "relations": [
            [
                "normal",
                "electrocardiogram"
            ],
            [
                "normal",
                "Echocardiogram"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 20,
        "text": "Computed tomographic scan showed massive ascites, no dysmorphic liver, and a mild bilateral pleural effusion.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 21,
        "text": "Pelvic examination was normal.",
        "relations": [
            [
                "normal",
                "examination"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 22,
        "text": "Oesogastroduodenoscopy showed hiatal hernia without oesophageal varices.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 23,
        "text": "An exploratory laparoscopy was performed, revealing a large amount of ascite, a normal liver appearance, and no granulations suggesting tuberculosis or peritoneal carcinosis.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 24,
        "text": "Histological examination of the peritoneum showed non specific chronic inflammation.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 25,
        "text": "Systemic lupus erythematosus was suspected based on pleuritis, lymphopenia and leucopenia.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 26,
        "text": "An additional serologic survey revealed markedly elevated anti-nuclear antibody (ANA) titer of 1/1600 and a significantly elevated titer of antibody to double-stranded DNA (83 IU/mL ; normal < 30 IU/mL).",
        "relations": [
            [
                "1/1600",
                "titer"
            ],
            [
                "83 IU/mL",
                "titer"
            ],
            [
                "positive",
                "serum"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 27,
        "text": "She had also positive serum antibody against the Smith antigen and low serum level of C3 complement component: 67 mg/dL (serum normal range: 84 – 151).",
        "relations": [
            [
                "67 mg/dL",
                "level"
            ],
            [
                "84",
                "serum"
            ],
            [
                "151",
                "serum"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 28,
        "text": "Relying on these findings, the patient was diagnosed with SLE since 4 of the 11 diagnostic criteria of the American College of Rheumatology were met.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 29,
        "text": "The SLEDAI score according to Systemic Lupus Erythematosus Disease Activity Index was estimated to be 7 on admission.",
        "relations": [
            [
                "7",
                "score"
            ]
        ]
    },
    {
        "text_id": "100114",
        "sentence_id": 30,
        "text": "Hydroxychloroquine 200 mg daily in combination with diuretics was initiated.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 31,
        "text": "One month later, there was no detectable ascitic fluid and no pleural effusions.",
        "relations": []
    },
    {
        "text_id": "100114",
        "sentence_id": 32,
        "text": "Five months later she remained free from symptoms while continuing to take Hydroxychloroquine",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 1,
        "text": "A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 2,
        "text": "She had a 2 year history of frequent non-pulsating headaches.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 3,
        "text": "Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 4,
        "text": "There was no nausea or aura like symptoms accompanying the headache.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 5,
        "text": "Headaches were lasting for hours.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 6,
        "text": "The pain was bilateral, generalized and pressing in quality.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 7,
        "text": "The family history for headache was negative.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 8,
        "text": "She had a history of seizures occurring in the fifteenth day of life described as attacks of tonic clonic contractions and that's when she was diagnosed with SWS.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 9,
        "text": "At the age of 6 she had a history of callosotomy to control her seizures.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 10,
        "text": "At the age of 18 during a laser treatment done in order to get rid of her port wine birthmark she had her first seizure since callosotomy.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 11,
        "text": "After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 12,
        "text": "According to the story taken from her parents even though she had a normal development at infancy she barely graduated from elementary school and she's hardly literate.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 13,
        "text": "There was nothing significant on her family history except for her elder sister's port wine stain on her face.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 14,
        "text": "The elder sister had no feature of SWS and no researches were done regarding her stain.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 15,
        "text": "She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 16,
        "text": "She was also inscribed NSAID drugs.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 17,
        "text": "After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 18,
        "text": "At her physical examination a facial nevus -occurred due to choroid angioma-on the right forehead, right eyelid, nasal wing and the cheek was observed.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 19,
        "text": "Intra oral examination showed a right sided overgrowth of gingiva.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 20,
        "text": "Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 21,
        "text": "On her extremities a mild asymmetry was visible.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 22,
        "text": "Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 23,
        "text": "On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 24,
        "text": "On her psychiatric examination she showed signs of anxiety disorder.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 25,
        "text": "Her neurological examination was not remarkable except for her hemiparesis.",
        "relations": [
            [
                "not remarkable",
                "examination"
            ]
        ]
    },
    {
        "text_id": "100129",
        "sentence_id": 26,
        "text": "Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 27,
        "text": "Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 28,
        "text": "Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 29,
        "text": "In addition to that, T2 weighted MRI shows extensive venous formations around corpus of right lateral ventricle and at Gallen vein localization and widespread vascular formations are seen at perivascular space, anterior to third ventricle at Willis polygon localization and at right temporooccipital area at quadrigeminal cistern localization.",
        "relations": []
    },
    {
        "text_id": "100129",
        "sentence_id": 30,
        "text": "She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.",
        "relations": [
            [
                "75 points",
                "test"
            ]
        ]
    },
    {
        "text_id": "100129",
        "sentence_id": 31,
        "text": "Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.",
        "relations": [
            [
                "75 points",
                "test"
            ]
        ]
    },
    {
        "text_id": "100184",
        "sentence_id": 1,
        "text": "An eleven year old girl presented to the paediatric eye clinic of the University College Hospital, Ibadan, Nigeria with a history of squint and poor vision.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 2,
        "text": "Her mother had noticed a misalignment of the eyes three years previously and the patient had been complaining about poor distance vision for about a year.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 3,
        "text": "There was no history of antecedent trauma to the head or face.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 4,
        "text": "There was no history of double vision (diplopia) or pains on ocular movements.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 5,
        "text": "There was no associated headache, fever, vomiting, joint pains or skin rashes/lesions.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 6,
        "text": "The review of systems was essentially normal and she had enjoyed good health since early childhood.",
        "relations": [
            [
                "normal",
                "review"
            ]
        ]
    },
    {
        "text_id": "100184",
        "sentence_id": 7,
        "text": "Her pregnancy and delivery were uneventful; and her development was normal.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 8,
        "text": "All other family members were well and there was no family history of squint.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 9,
        "text": "Unaided visual acuity was 6/24 in the right eye and counting fingers (CF) in the left eye.",
        "relations": [
            [
                "6/24",
                "acuity"
            ]
        ]
    },
    {
        "text_id": "100184",
        "sentence_id": 10,
        "text": "During refraction, her visual acuity improved to 6/9 and 6/60 in the right and left eyes respectively.",
        "relations": [
            [
                "6/9",
                "acuity"
            ],
            [
                "6/60",
                "acuity"
            ]
        ]
    },
    {
        "text_id": "100184",
        "sentence_id": 11,
        "text": "The refractive error was a hypermetropia of +4.50 diopters in each eye.",
        "relations": [
            [
                "+4.50 diopters",
                "hypermetropia"
            ]
        ]
    },
    {
        "text_id": "100184",
        "sentence_id": 12,
        "text": "Examination revealed normal anterior and posterior segments bilaterally.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 13,
        "text": "There was about 10 prism diopters of left hypotropia with no horizontal deviation in the primary position and she did not have an abnormal head posture.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 14,
        "text": "Her palpebral fissures were normal and equal on both sides in the primary position of gaze.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 15,
        "text": "Examination of the ocular motility elicited marked limitation of elevation of the left eye when looking to the right, while elevation of the same eye was almost full on left gaze.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 16,
        "text": "The movements of the right eye were normal and there were no significant changes in the palpebral fissures of both eyes during eye movements.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 17,
        "text": "Forced duction test (performed under sedation) was positive and revealed marked restriction of passive elevation of the left eye in adduction.",
        "relations": [
            [
                "positive",
                "test"
            ]
        ]
    },
    {
        "text_id": "100184",
        "sentence_id": 18,
        "text": "Her systemic examination was completely normal.",
        "relations": [
            [
                "normal",
                "examination"
            ]
        ]
    },
    {
        "text_id": "100184",
        "sentence_id": 19,
        "text": "A diagnosis of congenital left Brown syndrome with severe amblyopia was made.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 20,
        "text": "Spectacles were prescribed and she was commenced on a trial of amblyopia therapy which consisted of patching of the right eye for a period of 3-4 hours every day (after school).",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 21,
        "text": "Her mother was counselled and educated about the condition as well as the treatment plan.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 22,
        "text": "Specifically, she was informed that surgery was necessary to correct the squint, irrespective of the outcome of the amblyopia therapy.",
        "relations": []
    },
    {
        "text_id": "100184",
        "sentence_id": 23,
        "text": "A three month follow up visit was scheduled, however, the patient defaulted after the initial visit.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 1,
        "text": "A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 2,
        "text": "Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 3,
        "text": "Pain had gradually worsened over the months with no known relieving or aggravating factors but with intermittent radiation to the chest.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 4,
        "text": "There was a history of significant weight loss but no associated early satiety, jaundice, fever, itch or spontaneous bleeding.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 5,
        "text": "No history of blood transfusion and patient was on her routine hematinic from the antenatal clinic (ANC).",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 6,
        "text": "She is not a known diabetic, Hypertensive and has no known chronic illness.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 7,
        "text": "Patient did not know her Hepatitis status.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 8,
        "text": "Denied to taking any alcohol or smoking.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 9,
        "text": "There were no cardiorespiratory nor urogenital symptoms.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 10,
        "text": "She did not store grains at home and had no known contact with chemicals or ionizing radiation.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 11,
        "text": "Clinical signs on examination included wasting, mild pallor, a tinge of jaundice but well hydrated, afebrile and no palpable lymphnodes.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 12,
        "text": "She had palmer erythema but no clubbing and parotid enlargement.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 13,
        "text": "Respiratory, cardiovascular and neurological examinations were unremarkable.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 14,
        "text": "Abdomen was grossly distended with distorted contour in the upper half and visibly distended anterior abdominal wall veins draining away from the umbilicus.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 15,
        "text": "Liver was enlarged 12cm below the costal margin with a span of 17cm.",
        "relations": [
            [
                "17cm",
                "span"
            ]
        ]
    },
    {
        "text_id": "100265",
        "sentence_id": 16,
        "text": "The liver was hard, nodular with irregular edge, mild tendernes and had a bruit on auscultation.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 17,
        "text": "The spleen was not palpable but with demonstrable mild ascites and bipedal eodema up to the mid shin.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 18,
        "text": "Symphysio fundal height was 26 cm, with longitudinal lie and breech presentation.",
        "relations": [
            [
                "26 cm",
                "height"
            ]
        ]
    },
    {
        "text_id": "100265",
        "sentence_id": 19,
        "text": "Fetal heart rate was 134 bpm and regular.",
        "relations": [
            [
                "134 bpm",
                "rate"
            ]
        ]
    },
    {
        "text_id": "100265",
        "sentence_id": 20,
        "text": "Rectal and vaginal examination were unremarkable.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 21,
        "text": "Initial diagnosis of hepatocellular Carcinoma in pregnancy was made.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 22,
        "text": "Laboratory assesment revealed HB-10.3g/dl, WBC 10200 cells/dl; Neutrophils 59.3%, lymphocytes 26.1%, Monocytes 10.1% and Eosinophils 2.7%.",
        "relations": [
            [
                "10.3g/dl",
                "HB"
            ],
            [
                "10200 cells/dl",
                "WBC"
            ],
            [
                "59.3%",
                "Neutrophils"
            ],
            [
                "26.1%",
                "lymphocytes"
            ],
            [
                "10.1%",
                "Monocytes"
            ],
            [
                "2.7%",
                "Eosinophils"
            ],
            [
                "350000/ul",
                "Platelets"
            ]
        ]
    },
    {
        "text_id": "100265",
        "sentence_id": 23,
        "text": "Platelets 350000/ul.",
        "relations": [
            [
                "Normal",
                "bilirubin"
            ]
        ]
    },
    {
        "text_id": "100265",
        "sentence_id": 24,
        "text": "Normal bilirubin but GGT and AST were raised (4 times upper limit).",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 25,
        "text": "Total protein and albumin were low, 44g/L and 29g/L respectively with INR-1.3.HBsAg was positive, HBeAg negative with HBV DNA level of 126869 IU/ml \\(Viral load).",
        "relations": [
            [
                "low",
                "albumin"
            ],
            [
                "low",
                "protein"
            ],
            [
                "44g/L",
                "protein"
            ],
            [
                "29g/L",
                "albumin"
            ],
            [
                "1.3",
                "INR"
            ],
            [
                "positive",
                "HBsAg"
            ],
            [
                "negative",
                "HBeAg"
            ],
            [
                "126869 IU/ml \\(Viral load)",
                "level"
            ],
            [
                "positive",
                "VDRL"
            ]
        ]
    },
    {
        "text_id": "100265",
        "sentence_id": 26,
        "text": "VDRL positive but TPHA not done.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 27,
        "text": "Alphafeto protein (AFP) >50000KU/L.",
        "relations": [
            [
                "negative",
                "HCV"
            ],
            [
                "negative",
                "HIV"
            ]
        ]
    },
    {
        "text_id": "100265",
        "sentence_id": 28,
        "text": "She tested negative to HIV and HCV.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 29,
        "text": "Abdominal ultrasound showed a heterogeneous coarse liver with multiple hypoechoic lessions.",
        "relations": [
            [
                "17.2cm",
                "measured"
            ]
        ]
    },
    {
        "text_id": "100265",
        "sentence_id": 30,
        "text": "The liver measured 17.2cm and there was mild ascites.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 31,
        "text": "Pelvic scan revealed a 27 week, 3 day old fetus, with active fetal movements.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 32,
        "text": "A revised diagnosis of hepatocellular carcinoma on a cirrhotic liver with decompensation in pregnancy was made.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 33,
        "text": "She was managed with analgesia, furosemide, spironolactone and lamivudine added for prevention of mother to child trasmission of the hepatitis B infection.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 34,
        "text": "The plan was to allow pregnancy to continue to at least 32 completed weeks to improve the chance of neonatal survival.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 35,
        "text": "However because of the progressive unbearable abdominal pain, pregnancy was terminated at 30 weeks 3days by successful induction of labour.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 36,
        "text": "The outcome was a fresh stillbirth weight 1.2kg.",
        "relations": [
            [
                "1.2kg",
                "weight"
            ]
        ]
    },
    {
        "text_id": "100265",
        "sentence_id": 37,
        "text": "Pain was markedly reduced post delivery and was discharged home after 5 days.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 38,
        "text": "She was booked for a follow up visit at the gastrointestinal clinic.",
        "relations": []
    },
    {
        "text_id": "100265",
        "sentence_id": 39,
        "text": "She was seen at the clinic at 2 weeks and four weeks post discharge but was lost to follow up afterwards.",
        "relations": []
    },
    {
        "text_id": "103442",
        "sentence_id": 1,
        "text": "A 62-year-old woman presented with complaints of epigastric pain and vomiting.",
        "relations": []
    },
    {
        "text_id": "103442",
        "sentence_id": 2,
        "text": "Computed tomography showed a 27-mm, hyper-enhancing tumor in the prepyloric antrum.",
        "relations": []
    },
    {
        "text_id": "103442",
        "sentence_id": 3,
        "text": "Upper endoscopy also showed a submucosal tumor causing subtotal obstruction of the gastric outlet.",
        "relations": []
    },
    {
        "text_id": "103442",
        "sentence_id": 4,
        "text": "Because a gastrointestinal stromal tumor was suspected, distal gastrectomy was performed.",
        "relations": []
    },
    {
        "text_id": "103442",
        "sentence_id": 5,
        "text": "Histopathological examination revealed spindle cell proliferation in the submucosal layer.",
        "relations": []
    },
    {
        "text_id": "103442",
        "sentence_id": 6,
        "text": "The spindle cells had invaded the muscularis propria layer and extended to the subserosal layer.",
        "relations": []
    },
    {
        "text_id": "103442",
        "sentence_id": 7,
        "text": "The tumor was finally diagnosed as an IFP based on immunohistochemical findings.",
        "relations": []
    },
    {
        "text_id": "103442",
        "sentence_id": 8,
        "text": "No mutations were identified in the platelet-derived growth factor receptor alpha (PDGFRA) gene via molecular genetic analysis.",
        "relations": []
    },
    {
        "text_id": "104891",
        "sentence_id": 1,
        "text": "A 36-year-old female showed mild swelling in the right upper eyelid.",
        "relations": []
    },
    {
        "text_id": "104891",
        "sentence_id": 2,
        "text": "She lost her RGP contact lens seven months prior to her first visit, from trauma by her child's kick to the right eye.",
        "relations": []
    },
    {
        "text_id": "104891",
        "sentence_id": 3,
        "text": "At the first examination, we felt a firm lump inferior to the right brow.",
        "relations": []
    },
    {
        "text_id": "104891",
        "sentence_id": 4,
        "text": "Eversion of the upper eyelid also revealed a firm subconjunctival mass superior to the upper tarsus.",
        "relations": []
    },
    {
        "text_id": "104891",
        "sentence_id": 5,
        "text": "After incising the conjunctiva, the RGP contact lens was found without a fibrous capsule and granulation tissue in the subconjunctival space.",
        "relations": []
    },
    {
        "text_id": "104891",
        "sentence_id": 6,
        "text": "Three years after removal of the lens, the patient did not show any complications, including ptosis.",
        "relations": []
    }
]