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1. 主症状、随伴症状、疾病などの関係を図化した例（その1）
1.の自動作図時に参照したCase Report
A 48 year-old nonsmoking man with a long-standing diagnosis of asthma presented with a 2-week history of worsening shortness of breath, productive cough, and pleuritic chest pain. Chest X ray confirmed right-middle lobe consolidation suggestive of pneumonia. His symptoms resolved with a 6-day course of antibiotics, but a follow-up chest X ray demonstrated worsening of the consolidation. Bronchoscopy revealed a right middle-lobe tumor, and the biopsy was posi- tive for small-cell lung carcinoma.
The patient was born in Hong Kong and immigrated to England around 1990 at 35 years of age. According to his medical his- tory, at 4 years of age he was diagnosed with asthma, which was treated with Chinese tradi- tional medicine (CTM) pills known to con- tain arsenic until he was 14 years of age, when he was diagnosed with Bowen's disease. In 1988, a skin biopsy of a lesion on his right elbow was positive for squamous cell carci- noma in situ. He had never smoked cigarettes, and he drank alcohol only once a month. He had no other known exposures to arsenic through drinking water, diet, or occupation.
When seen by the medical oncologist, he complained of a cough that produced clear sputum and dull pain over the right costal margin, but he denied constitutional symp- toms. A physical exam revealed an afebrile Asian male with no palpable lymphade- nopathy. Chest examination was consistent with right middle lobe consolidation. The liver edge was palpable 3 cm below the costal margin but was neither nodular nor tender. Multiple 3-8 cm scaly, purple-brown, well- demarcated tear-drop-shaped patches were distributed over the skin of his trunk and extremities; these patches were consistent with his history of Bowen's disease. His neurologic examination was normal.
Computed tomography of the patient's chest and abdomen confirmed a right hilar mass completely obstructing the right mid- dle-lobe bronchus with distal pneumonitis and large mediastinal nodes. Multiple hypo- dense liver lesions suggestive of metastatic dis- ease were also found.
A diagnosis of extensive stage small-cell lung cancer was made. The patient entered a phase III clinical trial comparing cisplatin and etoposide to cisplatin and irinotecan and was randomized to the latter arm. Because more than 37 years had passed since the cessation of his known arsenic exposure, direct testing to confirm a diagnosis of arsenic exposure would probably have served little purpose. He achieved a complete remission but died of complications of progressive disease 8 months later.
2. 主症状、随伴症状、疾病などの関係を図化した例（その2）
2.の自動作図時に参照したCase Report
A 28-year-old man with lepromatous leprosy presented with one month of diffi- culty with writing and right hand/finger numbness in the ulnar distribution, four years after completion of MDT.
He had been diagnosed by skin biopsy six years prior and completed two years of MDT with rifampin, dapsone, and clofazimine. His treatment course had been compli- cated by concomitant development of numerous erythematous and tender lesions on bilateral arms and legs consistent with ENL beginning one year into MDT. For ENL, he was treated with thalidomide 100mg daily during MDT with several failed attempts to discontinue secondary to recurrence of lesions on his upper and lower extremities (ENL relapse). He had subsequently been restarted on thalidomide 100mg daily after three month thalidomide-free period due to ENL relapse one month prior to presenting with right hand numbness/weakness.
Formal nerve conduction studies were obtained of the right arm to elucidate the underlying eti- ology of his weakness as well as potential burden of nerve impairment, which demonstrated right ulnar neuropathy at the elbow involving focal demyelination and severe (75% - 85%) axo- nal loss. A right elbow MRI was obtained to assess for presence of nerve compression, which demonstrated focal area of ulnar nerve inflammation within the cubital fossa without mass effect.
The patient was diagnosed with ulnar neuritis thought secondary to immune-mediated neuritis related to infiltration of M. leprae into the nerve and was treated with prednisone taper consisting of 1mg/kg for two weeks followed by 20mg for three months upon demonstration of clinical stability of right hand numbness.
Prednisone was then discontinued after completion of a five-week taper. He remained on thalidomide 100mg daily throughout corticosteroid treat- ment as well as one year after completion of steroid taper, due to his history of frequent ENL relapses. The patient was followed monthly after completion of prednisone taper for monitoring of neuritis, as well as to manage his thalidomide treatment and monitor for ENL relapse.
At three months following steroid treatment, he reported no difficulty in gross motor and ADL tasks but continued to have some residual difficulty with fine instrumented tasks with right hand. At one year after completion of the prednisone taper, the patient's right hand numbness and weakness had resolved, with the patient demonstrating full strength, sensation, and range- of-motion on neurologic examination.
3. 治療内容と治療結果を自動抽出し、自動図示した例
上段の各箱が治療内容
中段の各箱が治療結果
下段の各箱が治療結果を(▲良い、▼悪い、■他)で示す
3.の自動作図時に参照したCase Report
A 48 year-old nonsmoking man with a long-standing diagnosis of asthma presented with a 2-week history of worsening shortness of breath, productive cough, and pleuritic chest pain. Chest X ray confirmed right-middle lobe consolidation suggestive of pneumonia. His symptoms resolved with a 6-day course of antibiotics, but a follow-up chest X ray demonstrated worsening of the consolidation. Bronchoscopy revealed a right middle-lobe tumor, and the biopsy was posi- tive for small-cell lung carcinoma.
The patient was born in Hong Kong and immigrated to England around 1990 at 35 years of age. According to his medical his- tory, at 4 years of age he was diagnosed with asthma, which was treated with Chinese tradi- tional medicine (CTM) pills known to con- tain arsenic until he was 14 years of age, when he was diagnosed with Bowen's disease. In 1988, a skin biopsy of a lesion on his right elbow was positive for squamous cell carci- noma in situ. He had never smoked cigarettes, and he drank alcohol only once a month. He had no other known exposures to arsenic through drinking water, diet, or occupation.
When seen by the medical oncologist, he complained of a cough that produced clear sputum and dull pain over the right costal margin, but he denied constitutional symp- toms. A physical exam revealed an afebrile Asian male with no palpable lymphade- nopathy. Chest examination was consistent with right middle lobe consolidation. The liver edge was palpable 3 cm below the costal margin but was neither nodular nor tender. Multiple 3-8 cm scaly, purple-brown, well- demarcated tear-drop-shaped patches were distributed over the skin of his trunk and extremities; these patches were consistent with his history of Bowen's disease. His neurologic examination was normal.
Computed tomography of the patient's chest and abdomen confirmed a right hilar mass completely obstructing the right mid- dle-lobe bronchus with distal pneumonitis and large mediastinal nodes. Multiple hypo- dense liver lesions suggestive of metastatic dis- ease were also found.
A diagnosis of extensive stage small-cell lung cancer was made. The patient entered a phase III clinical trial comparing cisplatin and etoposide to cisplatin and irinotecan and was randomized to the latter arm. Because more than 37 years had passed since the cessation of his known arsenic exposure, direct testing to confirm a diagnosis of arsenic exposure would probably have served little purpose. He achieved a complete remission but died of complications of progressive disease 8 months later.
4. 記載内容を読みやすくするために、見出しを自動付与して全文を出力した例
赤が見出し
4.の自動作図時に参照したCase Report
A 48 year-old nonsmoking man with a long-standing diagnosis of asthma presented with a 2-week history of worsening shortness of breath, productive cough, and pleuritic chest pain. Chest X ray confirmed right-middle lobe consolidation suggestive of pneumonia. His symptoms resolved with a 6-day course of antibiotics, but a follow-up chest X ray demonstrated worsening of the consolidation. Bronchoscopy revealed a right middle-lobe tumor, and the biopsy was posi- tive for small-cell lung carcinoma.
The patient was born in Hong Kong and immigrated to England around 1990 at 35 years of age. According to his medical his- tory, at 4 years of age he was diagnosed with asthma, which was treated with Chinese tradi- tional medicine (CTM) pills known to con- tain arsenic until he was 14 years of age, when he was diagnosed with Bowen's disease. In 1988, a skin biopsy of a lesion on his right elbow was positive for squamous cell carci- noma in situ. He had never smoked cigarettes, and he drank alcohol only once a month. He had no other known exposures to arsenic through drinking water, diet, or occupation.
When seen by the medical oncologist, he complained of a cough that produced clear sputum and dull pain over the right costal margin, but he denied constitutional symp- toms. A physical exam revealed an afebrile Asian male with no palpable lymphade- nopathy. Chest examination was consistent with right middle lobe consolidation. The liver edge was palpable 3 cm below the costal margin but was neither nodular nor tender. Multiple 3-8 cm scaly, purple-brown, well- demarcated tear-drop-shaped patches were distributed over the skin of his trunk and extremities; these patches were consistent with his history of Bowen's disease. His neurologic examination was normal.
Computed tomography of the patient's chest and abdomen confirmed a right hilar mass completely obstructing the right mid- dle-lobe bronchus with distal pneumonitis and large mediastinal nodes. Multiple hypo- dense liver lesions suggestive of metastatic dis- ease were also found.
A diagnosis of extensive stage small-cell lung cancer was made. The patient entered a phase III clinical trial comparing cisplatin and etoposide to cisplatin and irinotecan and was randomized to the latter arm. Because more than 37 years had passed since the cessation of his known arsenic exposure, direct testing to confirm a diagnosis of arsenic exposure would probably have served little purpose. He achieved a complete remission but died of complications of progressive disease 8 months later.