sentence
stringlengths 20
553
| entities
listlengths 0
5
|
|---|---|
The Ki- 67 labeling index was : 40 % ( estimated on 10 HPF ) , Estrogen receptor status were 90 % , progesterone receptor 10 % ( both using Allred score ) and the human epidermal growth factor was negative . | [] |
Based on the histopathological and immunohistochemical findings the case has been reported as lymphoepithelioma-like carcinoma of the breast and staged as pT 1 N 1 M 0 . | [
{
"offsets": [
94,
126
],
"text": "lymphoepithelioma-like carcinoma",
"type": "CLINENTITY"
}
] |
The post-operative pet scan showed no distant metastasis . | [
{
"offsets": [
38,
56
],
"text": "distant metastasis",
"type": "CLINENTITY"
}
] |
The laboratory data showed a normal level of carbohydrate antigen 15-3 ( CA 15 -3 : 39 . 8 U / ml ) . | [] |
Following surgery , the patient underwent four cycles of doxorubicin and cyclophosphamide and twelve cycles of paclitaxel chemotherapy . | [] |
She declined endocrine therapy and was treated with radiotherapy commencing 3 weeks after chemotherapy . | [] |
The radiation dose was 50 Gy in 25 fractions using a 6 MV photon tangent pair followed by a boost of 10 Gy in 5 fractions using 6 MV photon tangent pair . | [] |
Regular follow up consists of physical examination every three months . | [] |
At her 1 year follow-up , the patient was doing well with no evidence of recurrent disease . | [] |
A 60 year-old man presented to an outside institution for septic shock with hematesis . | [
{
"offsets": [
58,
70
],
"text": "septic shock",
"type": "CLINENTITY"
}
] |
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 . | [
{
"offsets": [
28,
45
],
"text": "diabetes mellitus",
"type": "CLINENTITY"
},
{
"offsets": [
48,
60
],
"text": "hypertension",
"type": "CLINENTITY"
},
{
"offsets": [
134,
146
],
"text": "arteriopathy",
"type": "CLINENTITY"
},
{
"offsets": [
190,
207
],
"text": "venous thrombosis",
"type": "CLINENTITY"
}
] |
Home medications included daily pioglitazone , atenolol , furosemide and anticoagulant with poor compliance . | [] |
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 . | [
{
"offsets": [
51,
63
],
"text": "septic shock",
"type": "CLINENTITY"
},
{
"offsets": [
249,
265
],
"text": "amputation stump",
"type": "CLINENTITY"
}
] |
Patient was given immediately oxygen , fluids , antibiotics , and drugs to increase blood pressure . | [] |
Six hours later , the patient presented a single episode of hematemesis . | [
{
"offsets": [
60,
71
],
"text": "hematemesis",
"type": "CLINENTITY"
}
] |
There was no associated melena or abdominal pain . | [
{
"offsets": [
24,
30
],
"text": "melena",
"type": "CLINENTITY"
},
{
"offsets": [
34,
48
],
"text": "abdominal pain",
"type": "CLINENTITY"
}
] |
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 . | [
{
"offsets": [
35,
48
],
"text": "liver disease",
"type": "CLINENTITY"
},
{
"offsets": [
51,
58
],
"text": "varices",
"type": "CLINENTITY"
},
{
"offsets": [
61,
81
],
"text": "peptic ulcer disease",
"type": "CLINENTITY"
},
{
"offsets": [
153,
166
],
"text": "gastroparesis",
"type": "CLINENTITY"
},
{
"offsets": [
181,
192
],
"text": "GI bleeding",
"type": "CLINENTITY"
}
] |
Physical examination was unremarkable . | [] |
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 ) . | [] |
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 . | [
{
"offsets": [
321,
337
],
"text": "diffuse bleeding",
"type": "CLINENTITY"
}
] |
Gastric mucosa was strictly normal in direct vision and in retrovision , the bulb and duodenum were normal . | [] |
Biopsie specimens were showed necrotic debris , mucosal submucosal necrosis with a local inflammatory response . | [
{
"offsets": [
30,
45
],
"text": "necrotic debris",
"type": "CLINENTITY"
},
{
"offsets": [
48,
75
],
"text": "mucosal submucosal necrosis",
"type": "CLINENTITY"
}
] |
The treatment of this condition was based continuous high dose omeprazole ( 8 mg / h ) after bolus of 80 mg and total parenteral nutrition . | [] |
The patient experienced no further hematemesis or melena . | [
{
"offsets": [
35,
46
],
"text": "hematemesis",
"type": "CLINENTITY"
},
{
"offsets": [
50,
56
],
"text": "melena",
"type": "CLINENTITY"
}
] |
Due to the severity of the necrosis , and with deterioration of his condition and persistent sepsis he died later in the same day . | [
{
"offsets": [
27,
35
],
"text": "necrosis",
"type": "CLINENTITY"
},
{
"offsets": [
93,
99
],
"text": "sepsis",
"type": "CLINENTITY"
}
] |
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 . | [
{
"offsets": [
58,
96
],
"text": "familial hyperinsulinemic hypoglycemia",
"type": "CLINENTITY"
}
] |
The patient was treated with injections of Sandostatin LAR ® ( octreotide ) during the first four pregnancies . | [] |
Her first pregnancy in 1999 was unknown until approximately 25 th gestational weeks with fatal intrauterine growth retardation . | [
{
"offsets": [
95,
126
],
"text": "intrauterine growth retardation",
"type": "CLINENTITY"
}
] |
The following two pregnancies were terminated on parental request after a chorion villus biopsy revealed the mutation causing late familial hyperinsulinemic hypoglycemia . | [
{
"offsets": [
131,
169
],
"text": "familial hyperinsulinemic hypoglycemia",
"type": "CLINENTITY"
}
] |
During the fourth pregnancy , in which the fetus also had the mutation , serial ultrasound examinations showed a small fetus with appropriate growth . | [] |
At birth the girl was small for gestational age . | [] |
She was admitted to the neonatal special care unit due to low blood glucose and intravenous glucose and early feeding was initiated . | [
{
"offsets": [
58,
75
],
"text": "low blood glucose",
"type": "CLINENTITY"
},
{
"offsets": [
80,
99
],
"text": "intravenous glucose",
"type": "CLINENTITY"
}
] |
One day old , her condition deteriorated with signs of an abdominal catastrophe indicating necrotizing enterocolitis . | [
{
"offsets": [
58,
79
],
"text": "abdominal catastrophe",
"type": "CLINENTITY"
},
{
"offsets": [
91,
116
],
"text": "necrotizing enterocolitis",
"type": "CLINENTITY"
}
] |
After two laparotomies - both confirming necrotizing enterocolitis - the child died 8 days after birth . | [
{
"offsets": [
41,
66
],
"text": "necrotizing enterocolitis",
"type": "CLINENTITY"
}
] |
In the following two pregnancies Sandostatin LAR ® was stopped before pregnancy and the patient was treated only with diet restriction and intensive glucose monitoring . | [] |
Both pregnancies ended successfully . | [] |
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 . | [
{
"offsets": [
39,
64
],
"text": "small for gestational age",
"type": "CLINENTITY"
},
{
"offsets": [
131,
150
],
"text": "normal birth weight",
"type": "CLINENTITY"
}
] |
A 37 - year-old Arabian woman presented with 12 months of progressive Cushing ' s syndrome-like symptoms . | [
{
"offsets": [
70,
95
],
"text": "Cushing ' s syndrome-like",
"type": "CLINENTITY"
}
] |
Biochemical evaluation confirmed adrenocorticotropic hormone -dependent Cushing ' s syndrome . | [
{
"offsets": [
33,
92
],
"text": "adrenocorticotropic hormone -dependent Cushing ' s syndrome",
"type": "CLINENTITY"
}
] |
However , the anatomical site of her excess adrenocorticotropic hormone secretion was not clearly delineated by further investigations . | [] |
Magnetic resonance imaging of our patient ' s pituitary gland failed to demonstrate the presence of an adenoma . | [
{
"offsets": [
103,
110
],
"text": "adenoma",
"type": "CLINENTITY"
}
] |
Spiral computed tomography of her chest only revealed the presence of a non-specific 7 mm lesion in her left inferobasal lung segment . | [] |
Functional imaging , including a positron emission tomography scan using 18 - fluorodeoxyglucose and gallium- 68 - DOTA-D-Phe 1 - Tyr 3 - octreotide , also failed to show increased metabolic activity in the lung lesion or in her pituitary gland . | [] |
Our patient was commenced on medical treatment with ketoconazole and metyrapone to control the clinical features associated with her excess cortisol secretion . | [] |
Despite initial normalization of her urinary free cortisol excretion rate , levels began to rise eight months after commencement of medical treatment . | [] |
Repeated imaging of her pituitary gland , chest and pelvis again failed to clearly localize a source of her excess adrenocorticotropic hormone secretion . | [
{
"offsets": [
108,
152
],
"text": "excess adrenocorticotropic hormone secretion",
"type": "CLINENTITY"
}
] |
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 . | [
{
"offsets": [
128,
137
],
"text": "granuloma",
"type": "CLINENTITY"
}
] |
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 . | [] |
Subsequently , our patient had the bronchial nodule resected . | [] |
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 . | [
{
"offsets": [
72,
87
],
"text": "carcinoid tumor",
"type": "CLINENTITY"
}
] |
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 . | [
{
"offsets": [
29,
40
],
"text": "lung lesion",
"type": "CLINENTITY"
},
{
"offsets": [
179,
196
],
"text": "hypercortisolemia",
"type": "CLINENTITY"
}
] |
A 17 months girl have been consulted in our service for colicky abdominal pain often associated with constipation and loss of appetite , since she was six months old . | [
{
"offsets": [
56,
78
],
"text": "colicky abdominal pain",
"type": "CLINENTITY"
},
{
"offsets": [
118,
134
],
"text": "loss of appetite",
"type": "CLINENTITY"
}
] |
Parents kept her at home until they remarked visible peristalsis on the abdominal wall , which lead them to consult our service . | [
{
"offsets": [
45,
64
],
"text": "visible peristalsis",
"type": "CLINENTITY"
}
] |
She was born from a full-term and uncomplicated pregnancy during which the mother had no prenatal ultrasound ( US ) . | [] |
Her neonatal period was unremarkable . | [] |
Clinical findings : on physical examination , she was colored and active . | [] |
Her vitals were within normal limits as well as her anthropometric parameters ( weight : 10 kg ) . | [] |
Her abdomen had moderate distension and peristaltic waves were visible on the abdominal wall . | [] |
Abdomen was soft on palpation and tympanic on percussion . | [] |
The digital rectal examination was unremarkable . | [] |
Symptomatic treatment was initiated with lactulose ( five mL bid ) and an antispasmodic , trimebutine ( five mL bid ) . | [] |
Timeline : our patient experienced first symptoms since August 2019 . | [] |
Parents brought her at our service only on 27 th July 2020 two days after they remarked visible peristalsis on her abdominal wall . | [
{
"offsets": [
88,
107
],
"text": "visible peristalsis",
"type": "CLINENTITY"
}
] |
The patient has been treated and discharged in August 2020 and pathology results were available 11 days later . | [] |
Diagnostic assessment : blood results were within normal range . | [] |
Abdominal X-ray showed distension of an intestinal loop in the left lumbar region . | [] |
Abdominal US identified a misleading colonic dilatation containing heterogeny echoic substance , with no other additional features . | [] |
Contrast enema was unremarkable . | [] |
Due to financial constraints , upper gastro-intestinal ( GI ) series and abdominal computed tomography ( CT ) could not be performed . | [] |
An exploratory laparotomy has been indicated with presumptive diagnosis of intestinal duplication . | [
{
"offsets": [
75,
97
],
"text": "intestinal duplication",
"type": "CLINENTITY"
}
] |
Therapeutic intervention : after the median laparotomy , a dilatated segment of the jejunum was identified at approximately ten cm from the Treitz ' s angle . | [] |
Its diameter was fourfold greater than of the adjacent bowel , to which the dilatation was connected abruptly , without any identified obstructive cause . | [] |
It measured ten cm in length and had prominent serosal vessels . | [] |
Adjacent mesentery was thickened . | [
{
"offsets": [
9,
18
],
"text": "mesentery",
"type": "CLINENTITY"
}
] |
No further anatomic anomaly was identified . | [] |
A resection of the dilatated portion was performed , followed by end-to-end jejunal anastomosis using Vicryl 3 / 0 in separate stitches . | [] |
Follow-up and outcomes : microscopic examination revealed a lymphocytic infiltration of both layers of the muscularis propria . | [
{
"offsets": [
60,
84
],
"text": "lymphocytic infiltration",
"type": "CLINENTITY"
}
] |
The dense lymphocytic infiltration was mainly constituted of T lymphocytes CD 3 + / 8 + ( C and D ) and some B lymphocytes CD 20 + . | [
{
"offsets": [
10,
34
],
"text": "lymphocytic infiltration",
"type": "CLINENTITY"
}
] |
Locally diminished actin coloration indicated atrophy of smooth muscle fibers . | [
{
"offsets": [
46,
77
],
"text": "atrophy of smooth muscle fibers",
"type": "CLINENTITY"
}
] |
Nerve fibers and ganglion cells of myenteric and submucosal plexuses were intact with focalized absence of NK CD 56 + cells around lymphocytic infiltration . | [
{
"offsets": [
131,
155
],
"text": "lymphocytic infiltration",
"type": "CLINENTITY"
}
] |
No ectopic tissue was identified . | [] |
The postoperative period was uneventful . | [] |
The patient was on parenteral nutrition until day seven postoperatively . | [] |
She was discharged on day ten and after three months of monthly follow-up , colicky abdominal pain and chronic constipation had disappeared since the early postoperative days . | [
{
"offsets": [
76,
98
],
"text": "colicky abdominal pain",
"type": "CLINENTITY"
},
{
"offsets": [
103,
123
],
"text": "chronic constipation",
"type": "CLINENTITY"
}
] |
For the future , the follow-up will be done on a three months basis for a year and then , twice yearly . | [] |
A 34 - year-old recently diagnosed HIV positive para 4 was referred to us with a 2 - month history of abdominal pain , abdominal distension and backache which had worsened 2 weeks prior to presentation . | [
{
"offsets": [
102,
116
],
"text": "abdominal pain",
"type": "CLINENTITY"
},
{
"offsets": [
119,
139
],
"text": "abdominal distension",
"type": "CLINENTITY"
}
] |
She also had pain on defecation , night sweats and fever . | [
{
"offsets": [
13,
31
],
"text": "pain on defecation",
"type": "CLINENTITY"
},
{
"offsets": [
34,
46
],
"text": "night sweats",
"type": "CLINENTITY"
},
{
"offsets": [
51,
56
],
"text": "fever",
"type": "CLINENTITY"
}
] |
On examination she looked ill , in respiratory distress with a respiratory rate of 28 breaths per min . | [
{
"offsets": [
35,
55
],
"text": "respiratory distress",
"type": "CLINENTITY"
}
] |
She was febrile with a temperature of 38 . 2 0 C and had unilateral leg swelling . | [
{
"offsets": [
8,
15
],
"text": "febrile",
"type": "CLINENTITY"
},
{
"offsets": [
57,
80
],
"text": "unilateral leg swelling",
"type": "CLINENTITY"
}
] |
The abdomen was asymmetrically distended with an abdominopelvic mass of about 30 weeks size . | [
{
"offsets": [
4,
40
],
"text": "abdomen was asymmetrically distended",
"type": "CLINENTITY"
}
] |
The mass was firm , immobile with an irregular surface not attached to overlying skin . | [] |
There was no ascites and no hepatosplenomegaly . | [
{
"offsets": [
13,
20
],
"text": "ascites",
"type": "CLINENTITY"
},
{
"offsets": [
28,
46
],
"text": "hepatosplenomegaly",
"type": "CLINENTITY"
}
] |
The cervix looked grossly normal but was displaced anteriorly . | [] |
Digital rectal examination revealed a mass in the pouch of Douglas not involving the rectal mucosa . | [] |
Examination of the other systems was normal . | [] |
Investigations showed a haemoglobin of 6 . 5 g / dl ( NR 12 -14 g / dl ) , a slightly elevated cancer antigen 125 of 44 U / ml ( NR 0-35 ) , serum beta human chorionic gonadotropin ( HCG ) of 0 . 258 mIU / ml ( NR 0-5 ) and alpha fetoprotein of 7 ng / ml ( NR < 10 ) . | [] |
Her CD 4 count was 63 cells / mm 3 . | [] |
Her renal and hepatic function tests were normal . | [] |
An ultrasound scan showed a solid mass measuring 19 . 6 cm x 12 . 5 cm , posterior to the uterine fundus and extending to the left adnexa . | [] |
The uterus and its endometrium were normal . | [] |
Subsets and Splits