Given an abstract, generate a keyword (a noun phrase) that best describes the focus or contribution of the paper. Such keywords can be directly from the given abstract or outside it.

Example input: Abstract: Some patients converted from ventricular fibrillation to organized rhythms by defibrillation - trained ambulance technicians(EMT - Ds) will refibrillate before hospital arrival.The authors analyzed 271 cases of ventricular fibrillation managed by EMT - Ds working without paramedic back - up.Of 111 patients initially converted to organized rhythms, 19(17 % ) refibrillated, 11(58 % ) of whom were reconverted to perfusing rhythms, including nine of 11(82 % ) who had spontaneous pulses prior to refibrillation.Among patients initially converted to organized rhythms, hospital admission rates were lower for patients who refibrillated than for patients who did not(53 % versus 76 % , P = NS), although discharge rates were virtually identical(37 % and 35 % , respectively).Scene - to - hospital transport times were not predictively associated with either the frequency of refibrillation or patient outcome.Defibrillation - trained EMTs can effectively manage refibrillation with additional shocks and are not at a significant disadvantage when paramedic back - up is not available.
Example output: Ventricular Fibrillation
Example explanation: This term is directly present in the abstract and it is one of the main topic in it. So can be chosen as the medical subject heading.
Q: Abstract: This article describes the immunologic and pulmonary abnormalities and the chemical composition of pleural effusion fluid in a patient with intestinal lymphangiectasia as they are effected by therapeutic measures during a 7-year period. Lymphedema was first noticed in the patient at 3 years of age, and pleural effusions developed 7 years later. Thoracentesis demonstrated that the right pleural fluid was yellow, clear, and had the composition of lymph. The left pleural fluid was milky and had a higher triglyceride and lymphocyte content than the right pleural fluid. Complete removal of pleural fluid transiently increased total lung capacity to a maximum of 52% predicted. Strict dietary management with a low-fat and high-protein diet resulted in a transient partial reversal of circulating lymphopenia and low T cell concentration. This was accompanied by a decrease in lymphocyte and T cell concentration in the pleural fluid. Unstimulated mononuclear cells from pleural fluid synthesized increased amounts of DNA, and added mitogens or antigens further increased DNA synthesis. Dietary therapy had a minimal effect on this DNA synthesis. Despite circulating hypogammaglobulinemia, normal antibody activity was detected. The proportion of B cells in pleural fluid was greater than that in the circulation, and dietary therapy did not alter this difference. Pulmonary physiology improved during the initial 9-month period of diet therapy, but then the rate of fluid accumulation increased, causing respiratory compromise. Stability was achieved by a right-sided pleurodesis, followed 18 months later by a left pleurodesis with the addition of a shunt to provide internal lymph drainage.
A:
Adolescence