{\rtf\ansi\deff0\ansicpg1252

{\fonttbl
{\f0\froman times new roman;}{\f1\fswiss helvetica;}}
{\colortbl\red0\green0\blue0;}
{\info{\author Perpus-lt5}}
\jexpand\viewkind1\viewscale100
\paperw12240\paperh15840\margl666\margr133\margt666\margb386
\cols2\colno1\colw4520\colsr-0\colno2\colw6920\pard\li1493\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li1493\ri0\sl-413\slmult0 \*\tx1853\fs24\cf0\f0\charscalex
100\b {A.}\b0 \tab \fs24\cf0\f0\charscalex100\b {Pengertian }\b0 \par\column\par
d\li560\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li560\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li560\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li560\ri0\sl-413\slmult0 \
fs24\cf0\f0\charscalex100\b {BAB II}\b0 \par\pard\li0\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-320\slmult0 \fs
24\cf0\f0\charscalex100\b {KONSEP DASAR }\b0 \par\pard\sect\sectd\sbknone\pard\
li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0
\f0\charscalex100 {Sirosis hati adalah penyakit hati}\fs24\cf0\f0\charscalex100
{ menurun yang difus ditandai dengan}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li1853\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {adanya pembent
ukan jaringan ikat disertai nodul. Biasanya dimulai dengan}\par\pard\li1853\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs22\cf0\f0\charsca
lex100 {adanya proses peradangan nekrosis sel }\fs22\cf0\f0\charscalex100 {hati
yang luas. Pembentukan jaringan ikat}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li1853\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {dan usaha rege
nerasi nodul. }\fs22\cf0\f0\charscalex100 {Distorsi arsitektur hati ak}\fs22\cf0
\f0\charscalex100 {an menimbulkan perubahan}\par\pard\li1853\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {sirkula
si mikro dan makro menjadi tidak te}\fs22\cf0\f0\charscalex100 {ratur akibat pen
ambahan jaringan ikat}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1
853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {dan nodul tersebut. (Suzanne
C. Sm}\fs24\cf0\f0\charscalex100 {eltzer & Brenda G. Bare. 2001)}\par\pard\li257
3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs22\cf0\f0\c
harscalex100 {Sirosis hati adalah penyakit yang di}\fs22\cf0\f0\charscalex100 {t
andai oleh adanya peradangan difus}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li1853\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {dan menahun pada
hati, diikuti dengan pr}\fs22\cf0\f0\charscalex100 {oliferasi jaringan ikat, de
generasi dan}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\s
l-346\slmult0 \fs22\cf0\f0\charscalex100 {regenerasi sel hati sehingga timbul ke
kacauan dalam susunan parenkim hati. (Arif}\par\pard\li1853\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Mansjoer
,FKUI. 1999)}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\s
l-346\slmult0 \fs22\cf0\f0\charscalex100 {Sirosis hati adalah penyakit hati kron
}\fs22\cf0\f0\charscalex100 {is yang tidak diketahui penyebabnya}\par\pard\li185
3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs22\cf0\f0\c
harscalex100 {dengan pasti, merupakan stadium terakhir dari penyakit hati kronis
yang tidak}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl
-333\slmult0 \fs22\cf0\f0\charscalex100 {diketahui penyebabnya dengan pasti, mer
}\fs22\cf0\f0\charscalex100 {upakan stadium terakhir dari penyakit}\par\pard\li1
853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0
\charscalex100 {hati kronis dan terjadinya pengera}\fs24\cf0\f0\charscalex100 {s
an dari hati. (Sujono Hadi, 1991)}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li2573\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {Dari beberapa pen
gertian diatas da}\fs22\cf0\f0\charscalex100 {pat disimpulkan bahwa sirosis hati
}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult
0 \fs22\cf0\f0\charscalex100 {adalah penyakit hati kronis yang ditandai }\fs22\

cf0\f0\charscalex100 {oleh adanya peradangan nekrosis sel}\par\pard\li1853\ri0\s

l-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs22\cf0\f0\charscal
ex100 {hati, diikuti dengan proliferasi jaringan }\fs22\cf0\f0\charscalex100 {ik
at, degenerasi dan regenerasi sel hati}\par\pard\li1853\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {disertai nod
ul sehingga terj}\fs24\cf0\f0\charscalex100 {adi pengerasan dari hati.}\par\pard
\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-346\slmult0 \*\tx185
3\fs24\cf0\f0\charscalex100\b {B.}\b0 \tab \fs24\cf0\f0\charscalex100\b {Anatomi
dan Fisiologi}\b0 \par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853
\ri0\sl-333\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {1.}\tab \fs24\cf0\f0\ch
arscalex100 {Anatomi }\par\pard\sect\sectd\sbknone\pard\sect\sectd\sbkpage{\shp
{\*\shpinst
\shpleft1800\shptop1440\shpright5400\shpbottom4440
\shpfhdr0\shpwr3\shpwrk0\shpfblwtxt1\shplid2028\shpz0\shpbxpage\shpbypage
\absh15840\absw12240{\sp{\sn shapeType}{\sv 75}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn pibFlags}{\sv 2}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn fEditedWrap}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn pib}{\sv {\pict
\jpegblip
FFD8FFE000104A46494600010100000100010000FFDB004300080606070605080707070909080A0C
140D0C0B0B0C1912130F141D1A1F1E1D1A1C1C20242E2720222C231C1C2837292C30313434341F27
393D38323C2E333432FFDB0043010909090C0B0C180D0D1832211C21323232323232323232323232
3232323232323232323232323232323232323232323232323232323232323232323232323232FFC0
001108013F01B903012200021101031101FFC4001F00000105010101010101000000000000000001
02030405060708090A0BFFC400B5100002010303020403050504040000017D010203000411051221
31410613516107227114328191A1082342B1C11552D1F02433627282090A161718191A2526272829
2A3435363738393A434445464748494A535455565758595A636465666768696A737475767778797A
838485868788898A92939495969798999AA2A3A4A5A6A7A8A9AAB2B3B4B5B6B7B8B9BAC2C3C4C5C6
C7C8C9CAD2D3D4D5D6D7D8D9DAE1E2E3E4E5E6E7E8E9EAF1F2F3F4F5F6F7F8F9FAFFC4001F010003
0101010101010101010000000000000102030405060708090A0BFFC400B511000201020404030407
05040400010277000102031104052131061241510761711322328108144291A1B1C109233352F015
6272D10A162434E125F11718191A262728292A35363738393A434445464748494A53545556575859
5A636465666768696A737475767778797A82838485868788898A92939495969798999AA2A3A4A5A6
A7A8A9AAB2B3B4B5B6B7B8B9BAC2C3C4C5C6C7C8C9CAD2D3D4D5D6D7D8D9DAE2E3E4E5E6E7E8E9EA
F2F3F4F5F6F7F8F9FAFFDA000C03010002110311003F00F7FA28A2800A28A2800A28A2800A28A280
0A28A2800A28A2800A28A2800A28A2800A4240192714B450014514500145417579159A07944A4138
02285E43F92826882F23B962235986067F790BA0FCD80A009E8AA579AB69FA7EF37B7B0DB2C6BBDD
E67088A3D4B1E07E75359DE5ADFDAC77367730DCDBC83292C2E1D587A823834013D1451400514514
00514514005145140051451400514514005145140051451400514514005145140051451400514514
005145140051451400521CF6A5A2800A28A39A0028A28A0028A28A0039A28A2800A28A2800A28A28
00A28A31CE6800A28A2800A4A5240192702A8CFA95BA594B75F6A86DE18416965B90516351D4B6EC
607B934016DE68E3203B852C70A09C64FA0F5AC8BDD56FD487B6B4821B300F9B797F2988478EE136
E587D4A7D6B9896E2D615BAD73C3D069FB6421A5F106B374CD104CF22224962063850513D09E6B91
D47C45A16A979E58B7BEF134AA32B79AD48F069E79380A889B1B9E84A7A7CC78A00ED53C41733199
F46D4EFB5CB8655F96DF4D536606464C52168D49E7BCCE78E3D2AACF7367A65DC5ABEA1E1AD0EC2F
84996BFD76EED6D672718CA344B2E78C8E581E2B9DBDBAD624B3125F6B73C7A5C6AA8DA669507D9D
13FDD950870A3D391ED5CD68BE1BF0DCDAD65ED6E6E23D45B65A3C900862C119CACA3E7661C9CE07
D6803BFD43C75A146ACF6DE24D19A6249DE96371A96C5EE0EC71B7EB903DAA8DB7C46F0FADBB4B37
8BA217072125B6F0E4F1C647A32B0666FC18562369DA5D85F2E97AA2DBEA9771C8637F2F4D5BC314
1FC2CCEFBCA9F72CBF4A84E8ED3CB0AB5D78C46972136E1C5945E5007A068954AED3FDE65C0F5A00
EBF4DF19CB756E834DF1E783EEE5247976B7164F68CFFECF3392BFF7C1C7A1ADD96E75EB98164D43
C37617807FAB9749BF49A58CFAA89D2351F5DC4FB570E3C3165736D3D99BCD560B878CAC493496F1
F0BD43361CAA9F4071CF415CF8D2A7B2D4AD8585AFF66C8AA7F7BE19941195EA269594027FD9C8EF
C5007ADCBE23B8D3362EA1245610055F325D511A210E7A13329685D89C0DA194D68CBE28D32C0BAE
A7771DA22852B733298E1973D3639F949F60C4F4F5AF315F14F8B2C60B7BAB9B287C4362642845DC
31452C07A10660DE5E7DB1935BDE18D77C29AB5CCD67A287F0FEAE50A0B09F8849C9248855FCA7C9
CF230DEE2803D0ECEFAD350804D677314F1FF7A370C3F4AB15C66A3A3DCDB3A30D3A4B89CA7FC7DD

88D890B776F2FCE5900F64739F4AB5A5EB514E8D6967AD417FA804DC2CB50536D383EEA57CC55F76
463EE6803A9A2B3A2D42E9084BCD32689B682D242C268B77A0230E7EA50530788B443A80D3FF00B6
34F17C7FE5D8DCA097FEF8CE7F4A00D4A29064FA6296800A28A2800A28A2800A28A2800A28A2800A
28A2800A28A2800A28A2800A28A2800A28A2800A28A2800CF3452151BB76391DE96800A28A2800A2
8A2800A28AAB36A16D05DC76AECE669395548D9F03D4E01C0F738A00B5454335D4304B0C523E1E66
DA8304E4FE15350018A28A2800A28A28013038E3A52D14500150DCCAD6F6D24A90493B229611458D
CE7D064819FA914DBBBC86CA20F33850CDB14907058F4048071F5AE7B5ED56E6D65D3ED6D2CA1B8D
76F1B6C4A5CBC56CBFC5330E0ED1EC01270323AD0054D6B5CF2ED608352B79DB52BA60D6BA559963
301C7FAC642C0019E5BEE8F535CFEBB7F1E8B751FF0069C57BABEA6B1F99068D6876D85A7190D231
DAAC723AB9273D14567EB1E2D8F43BEB9F0F786A54BCF11DDCBFF131D5642B1AC6D8E42E73960380
A0103BE6B134F96F3C3E2F34E925D485E5E334E934F10B977CFF00132C4ACD8E9CE53D314011CFF6
9F165B26ADE31B7BD95189F222B68E7486CC818051563756F7673F4AB9690DC5AE8B019E5BBBB8AE
B290C9E595671C801D7CA185FF006852B789EEF4B8228EE122D3DE424F9B7714D610CAE738658F63
64F7C89173CE40A86DB50B87D32E2DB5217F6C44C24B97B7D45543AF51F3A220DBFEF3671FC54011
A69B7361AE4D75A968B6456DADC193508EE9A59A31CFC82260AC78F44FC4D47A2C097122FD974D85
20BF91945ADCDA6F671FDEF25F626DE992A18F3D7BD4B77A92B6B16F1DD6BD7F0CE8CC2DE0B7D244
B34808E047288F2C3039E24FAD4AF7FA5489268F64245B59E50B7977ABD9492049783E588BCA1C9E
BB9CE067BF4A00AB791DD786F5C8EC6E2DAEF491708CB01B7862B7806324B315924CAFBEC047A526
D6B5D4E31A5DD3450CBF33DD410C5E7DD719FDDCD858A44E7A30CF07AD5E89AC74BD0A696C2CA099
ED1A436D770EAB2471C5231236E5618E3073FC009C7D79AD0D6B54317862CBED16493EA334211755
8D983839CECC012C99E3A38DA7F4A00E6E2D23EDAF2C52681A65D4A939984D70ED6F332FF79E2588
071EA79153C52DC6AB7386F33528AC58859E0B386EFC86EDE5884B0451FED296E7922AEE87ABE929
2C96D6D679B99A13E74082DADAF0B8E72C1634F5CE71BB9A48BC45E1EB7B6BB7BDB1D5A3880DA6CA
F11A591DF9E44CC0F5CFF1BE38FBA2802BDF5F4B05F4A754B45BC8A5B5C5C15B6486DD71D03B3E07
E4C7FDD15CF5DC69AB1B4834EB2D363B7807C8F05C42D22F7C8F2A4FBC3B715DB437AD737B77731E
AB2C3A7436E8B1599B40F3467BBC68B80C39192076E2A9C96D06B972F6ABE26B3BC964237C7731DB
DC2B803BA89032FD19B8A005F0AFC53BCD02EE0D3359F3EEF492E214BDBA9079B076F9CE06E1F5C1
15ED7716B63ABD988EEADEDAF2D5F0E1654122377070722BC161D3B4CBA8A7B1BBB88EE2054644D3
ED6DA18D60939E4491B3839F4049E6BB1F831E229AEB4AB8F0FDE481A6D38E2224B6E319E80EE553
C74CE3B50076FA868ED123DCE9FA9DFD8BC7FBC2B1C8258DC01F77CB932AABFEE6D3EE2B02FBC770
5C69AB649E1FBAD5B5296DFCC9F4E5440A89D332331280123A02C7AF5C56EF89FC49A7F8574F4BCB
A867B87B8952DE2B5B7C1926663801558807D4FB571F1DE785BE0F5A5F4975792CF79AB5DB5CADA4
68A67F9B9DA17380A3D4902802936B5A769508B79FE16F8874B92550CC7418147FE45B7743FC8D6A
47AF5945A58FB3378DB4724839BBB1B9B87C67A6E9629C0FA572D7DF19BC457170A349D0F4CB188B
6145FDC092490762115D0FE037555D47E2578D6C2471777D649202088AD74C72A01EE59CE3F0DC0F
BD0075FF00F099DA599013C75B5643B565D6F4EDAAAE3AAE1238074F56CFB55A1E33DDD3E22F827F
1B6C7F3BCAF3F3F187C6502C4CF6DA5DCC2ED94692C995DBF059B03F5AD37F8C57F7132DBDCF822D
16F18650DDDEF979F701E21C7E3401D6FF00C262D9E7E22F81B1FF005C39FF00D2BA8D7C6ACC5D7F
E16078354A9C2E2D376FFA01784D70DA9FC53F14BA79165AB69105C671E55B58EED83DD9A461FA56
31F88DE3A8A70973E2C9A346E15869D6BC9FC5401F5245007AB278935B13FEFF005856456F985A78
4AFA4565F670EC3F119153DDF8AAE148962D77EC16CAA4BCBAA786AED107D64668D57F1AF247F883
E3686D0CCFE2F7DE1B1E5082C8B38F541D5BF0CFD6B4A4F18F8F34DB4B5B8D57C573DB8B8702253A
542E2407B6F8D1C06FF64F26803D334FF175CDDCDF66D3F5EF0AEBB76DCAC305C7D938F6C3CEC4FF
00C040F7AD7B8F144B671C4F3E83AA306E2468511F611D70A5848FFF0000424FA578C5EFC47D7679
24B3D6F47D1B59B180EE5FED1D35A267F42431C29F7D953E9BF107C2B114592CB59F0B33B7CAFA4D
E79F6ABEBFB8605307D3CA3D73EF401EE567ACD95EC51BA3CB09958AA477703DBC8C47A24815BF4A
BF5E55168C755D37EDFE1FD623D534B6421A3D3716F719EA5BCB626DCC84E7398A33CF514DD22EF5
CD2A45B0B4D5E769D23327D8EFDBED1708BEB2DB976948030034321049FB9401EAF4573DA178A63D
4A28A3BE892CAEE43B117CCCC7330193E592036473956556183C77AE86800A28A2800A28A2800A28
A2800A39A2939EC07E7400B45141A0028A28A0028A28A002B96B7F04DA5B6A32DE46D0233B97DC96
88B2393FF3D1FAC87EB5D41E3DE8C71DE80390B7F0242905D457135A4AB3CAF2612C84606E3CF1B8
824F39C633E94EBEF09C8B7571796DF65318B61147690D8AAB3819F959BCC50CA73F74E31CF35D69
E074268E68038CD3BC2124DA2DBA5D88ACE60800861465100FEEA859085FA063F5AD4B5D0B51875A
86EE5D53CCB78E13118954AEEF424924E47AE7F0ADFE71D2824E40C1FAD0065AE830C618477DA926
E62C737B23FE5B89C0F614368D310026B5A9C641CE4346D9F6F990D6A529E940180FE1DD44C8CCBE
2FD71031FBA23B3207D3301351CBA16A3044D249E34D74220C93E4591FFDB6AE887419EB5CFEAF7D
1C976EB2C92C76760BE75C3045F2E561D10B1CF7EDC1A00C9633D9410196FE7D5B5BBA761A6B5E5A
C692C0840C9C08D368039248F6AE6BC49AD3787278F40D15EF6EF52BB71FDAFAB4307DA268C11D80
C00C7B0C61476A9BC51E27BAF0C68D26AD7296F3789F54CC5616A84334111E98C61B038271DFBD79
1E9D6D6F63652CD3EA5A55C6A93C8565B4955E795C93966DC8DF8FCCB9A00EFBFB3D6C2C2280C29F

D92D76919375A5F952CA4E37348D314F3189E77056FC6B7EF742D38EA6FA9C1324764A025B43A6DB
BDA88DB1F334AE83E627D38AE120486F24B3B17361AACA4891089D00B371D18C2363E3D7E6DDC56E
DDB5D35DBE9CBAC6893C898699EEF5033FD8D579247EF395ED82AADEE6802FFF0062C76CB21B2D2C
C7673A34D35E41019732E73990332F07DB2727B557D674A4B49A0D52E2EA5B3CA2E6EB512B098467
8542AB1BED27F85DBF3AA03598B57D4E4D32DB5CB0D3E5B70AF1BDA5A1582EB23EEE016DCA7FBA59
0FA7AD6E417765696BF6AB292CE19E58D62BF2A92840A38C25BB16309CF7E07734015346D1E2D6EE
2EAE25BBD4EE622C2586F22B59638318EA80B92DEB9F9873C52ADB25FB2EA175AB3DCDA41BA26D46
19398141C153E528F41C327183934F8AC24FF847BEDE92DACB656E0CB26A377AA9BA9632091B5793
1C631DC367AFCB50DEB1BD8ACAE15C5BC862571731EB66181573C90230CAD9FF006DB9F4C50059D5
346363A7456D731C49A2B9020BB82FE769245FF6A0894090FB1623DBB561DEE9DA7DD4D6BA1E877B
71A73CD2799B6DE66B729FEDB42CCB273ED1B7D475ADE4B7BEB4D0EFFEC1A2DAC114E726FD8C525B
DD237577F2E4400E7A9C13ED5837B1BC3A325B69910D36D4168E688DA4B1C32498E0A4C8071EFC13
401661B04B1F10BF87F56D6ACB57BE86DC8373E4490DCDB0618C8930D9F72181F6AD47D17FB3D60B
8BC696CE4D823B5D4112390E73C6E9240DF7B8C8D84F3599752C90786ACFC4F0E9E65D56CA25B5D4
6DB6BCB3042460AB07CF1D7E62463B53EE3C530BD9477B7971AA99E44114162EF243316EFE66D8CB
153E8032D003355B2B7D3340BF48F50B71AD483CE92EEE9E179B6E790A028F2C1030318C75C556D2
7648966DA65C59D8C68989A086E85E4B1823965F31A443D73C2AD476378F6C965A66936F6F16AD73
3916B6D1F99BAD81FBCE4CA8A540E4EDC283D054BABDD41A26B971A6F871DAE6F6D3F79AA49757F1
C225661C84DCA78EA485C01E940199A868874C9A79E0B76D574F6FDF35CBE8D6B2641F555742E7AF
39C7B568FC25880F88571244D69042F01C40B6CB0C99F4DAA3E5C7A126A9A4F048B16A363A75FC5F
2102E34FB9B7922EBC8F3644DDD7B7CA2B5BE18EA31DCFC456308631496849616E130F9E43391BA4
3EFD28035FC63E229D3C43A95F8B591FFB09445636E0B309EE5C7DEDAA0838C8033D326BCCCE93A8
450CFAA6B92DA4B3EA0F995AF9F648D291D10B45938E802B638AEAFC5975AF6A5F15AFF4C8564B5B
581566890AA81330C7CC0B3296EB8E1BB74AA53F8A67B28458CFA87D84FCC6EADEED242A1BD0A051
9CFD4D0063D9E8F73636096CDA44824B86DCF15D5A44F1919E0876DC54FF00DB304FEB4C6B45488D
BC9A5C76D15A1DBE6DCDA1452CC7A7314A8DDB04EDF6A7BCFA1CB1C314767A35C6A00899CDAC6AB0
05CF47C90C4E3B138F6AB171AAC979A84B7CD7135F5922159D74D0FB5140F955C2045C7B920D0067
34B6F64A2C534AD2A6D4501CE6CFED0190FF007F2F907E8A31EC2AEAF86DC68F6D7B67A15DCB3839
96D60B885A38FF00DB5E18FD0122AA4D72752B08A38AC7C3CD3CAFFBB2F379778A49E07CCE5893EC
C455F9ACF4CB4B41A76B16DA94970CEAE6C6CE6322443AE644FB432907AF1B4FD2802A6A511C477B
A9DB6BB144C445B6F21843E4FF0075481B87D147D6A193426B049ED574BD4E595F12C3771662017D
1D02B0C0F6E7E957C5EADC5DC36BA3E996D02C1F2991B49711263B9577979FA9AAB15C68DAA789E7
B9D5F7ADC22ED496DE32D1330E9BA3605C7E07140135968F71F6313324ACD2DC22FD9ED2D278D581
FE23F3271EADE5B1AA3AC24F6375A9E9AF6F7AB6258395B399258D1B1D5DCA96EBD8EDABD6F6D6DA
8E9773773CF68F711C997852189EE4AE7030CD39D83D8A82714D375AA698B6E90AEA727D9E4F31E2
6B7730A29E9BD63B86427D8853401912C3A4E9FA76953A4D6C92B0CCB27DA8C9838E8F12C476FE75
6EDA58FA7DA522B650D22C7A5DDB33B1F5914B6154FB007E95A56FAA5ABEA733CFA95D2B91F69664
B8B6B743273F2049A4F97000E8CC7DAA3BFD4AE4D90BED7E187505BA522DE298DB48117FBC190E49
C7F105A00C9D075A97C39E2CD275AB74F28CB3849D816DD2A39C15625CE4743D33C57D37E22F0DDB
78AAC608E5BDBBB30AC2459ACFCB597DB0EC8C57EAA41F7AF9D23B396FFC43E1BD35A6BA916E6646
852551E52A29DC76B1442780380A3EA6BEA645088AA3A28C50079F6A9E10BFB7B9596573AD58F960
4AF3C719BAF97A6F0142CA0718236BAE382D9A6E9DE334D0E78ACEE8DDDE593F11BC71C93B42071C
BE32E3D41F9C77CD7A2D73DAAF8563D4F53FB7B5FDE2E14016C86348CB0E8DB826F0DEFBBF0A00DB
B4BBB7BFB58EEAD2649A095432488721854D5E789AEDF6877D25D491DC4966809D4A295479B0E3A4
816353BB3DCFCA08E7AD779657B6DA8D9437967324F6D3A078E44395653D08A009E8A28A0028A28A
0028A28A0028A28A0043D4734B45140051451400514514005145140051451400514514015AFE4B88
AC666B448DEE769F29647DAACDD8135CCD8E9F258982D7ED32C50DA9379A94CA2365B8908CED63BB
78C75FBB8200E6B635991217864BB6B64B5523CB695D8379D9C2F4E08AF3BF88097DA7786A0F0A58
1B8BFD4F5895E6BD65650FE4E73210C4051D94668038B9EF21F1AF892E7C4F7F79653462636DA7E9
E524958460E03FC92288C9EBF38F4E2B5752B9B78EDA1D1ADBFB4AE6EA07F37F7375095553E91CE4
A9238E8A3FDEA8B48D034EB0D3DEC2D3473ACD9CE36C575095B675604EE5797CF5DC47B051C62B58
58DDADB8B687C4A2248DC1588D9C5E7A8FF9E6250CEB81EBE59FAF7A00A8B67AACB2DAAC56178908
62F713CF71028987A3888707FD80873C7CD52D9C36D158492691E1FB0D4AEE69B718A18DB4D78947
4DC66565771D7A29F6A8ADEC34DD5659967D63C6FE45B3FCDA6CB6F24CC5F2479A0E08643D86D03D
456E5A5AE986FEC74CB64BBB0BDB6DE9BF51D3D6299C119021951443B8F07073D3A75C0053BD3AD6
ABAD417B0A5A496D796C6D2E3CB9582E572363481C956073C88947BD545B6FEDED0992DAE6E5E6D2
AE0349B6C0CCE0A920A2490AA3647A82C7D7AD69FD95A5F1EE9F7571A15FBDEACA2069A5B69F62C7
B49DE4AA08830E99563D6A592DB56D035EBDB6D45A69AC669CBDACECB2B9911B92AD311208F6E785
C4638EB401592E3FB2B556D6CEAD29B13062654D1AE2423DDE611B371CF0D8C7AD5537B6B7BA3AAC
BAE426C2EDDC492C976F3C6880F4D824031F8E47A1AB4DA69FB5DA1B2D7FF71339794C576C4BA8E4

0212555C678E0393DC54687547D467963D76C6E0DB027CFB49F02CCF6492DC0677CF39C95F603AD0
042F0681AC6962D63D5EDAF0DBAE04965A2CFA8C217B093CB5DA0FB0DA4715989E0DB2BDD2DCD8F8
A3C317421F91E3BFD296D0DB96FF006189DA4FFB499F7AD6921BB7D417579F50B7BC3691B07B3B2B
C7821248E03C723498EB9CA608F4AAFAA785AD8FD8AE2FACF48812E482C45F624121FBAA844659C7
B647D28035FC03F0F355D1E7D53FB6EFB4D9ADEFAD560852C652401CE4ED0880F51CF26BCFD51FC0
3AFCBA46B961773DA2EEF204D2EF5B88FB18F7E6327FD908187F78D5E5F8717FA74B7979A8E97A25
B6968A1CDCC85A265C6482ACCC195BD4E7E82B6746D4A0D6CC5E06F1EA25D062B369FA819554BAE7
E550E7059874C81923AFB8056368BE1FF04DFEB9AB25C5ADE6AE4C36504B046F2C111E876A01938E
71C71DFBD676822DACADACDA086EAF2224BBC760BB82478E4CB99242A7D94E4E2ADF89C6A371F137
50B17B39A496D6C956C8B5C830C517F7CA128771231C30A926BBD46F27B4D3BFB4A7B7B88213E759
DBCB1BE73D24DD3824AFA8553D68032354B18EFEC56E2CD6F354864B8648D8DB624B44F421E3790E
39E72BF85749F08ED566F1C6A7750DC2DD416F6A9089D2291416C9CA92E58647FB27F0AC1D6F4C5B
1D2ADED24B3696639924B848E34684FB130C6841F5DC1B9EF5BDF030EFBFD7EEA203CACA82D93852
074393FA8E280394D5A7975DF89FE209D27C491C8B6F0048E099CED073813B6547BA8C53EDA482C3
4FB848F4B91D6372B730DCB8856EDF3824CB22BA301E991D0D6335FBC7E2CD76FE79ADE6B68B522F
2DAC6EF28719C1213386E3AE7A115DA5D780B5AB8D4E6BAD3EFADB4EF08CC8B72F3B95062520EF58
D0EEDA7BE703AD0073D6B6B71E2DD42DB44D3A2B8B6D3722E2EA49242045167247CB88D7DB033C66
B4B5AD52DB5FBA8B4CB1D5EE349B1B3B858ECA0B2B175FB57406479B85F5C6339EB83591A9F8B639
ACA5F0E782DBEC1A22926E2E5E655BABF3DCE490C47D066AB477B7FAEDB5AE9104177ABC25805B6B
3243C6ABD327736DE7FBC17F0A00D4D63CFD12F2E6312451D8BC8B9B98E34B50C71925D99544ADD7
808DF5ADBB2F0F68777A3CDE2FD6350D4F4DD3319F345C6DFB68FE12A03315F60369F614FD37E18F
89AEB511AB5DA5C58D945F3358457B21BABB03A23334ACABFF007D01CF41DA3F16E91E3FF13EA0A9
77E19BEB4D1ED47FA1D959DDC0738E8D2112727D85007276D669E29996FAC3480968252A9A8DCCB7
17534583C6EF9D473E84103D6A7D6F5084EA912C161A759C6A0A35F49613FCC4756011594FE21AB4
468FE34D7A1874E6D235CBA1036443A85A411C1176C879D1B3DFA6692FE393C35AA269C975A6EABA
82C7BEF2D6E6D4CD0D80C74528BE586FFB65F5A00C39E47B87B2D3A4D76C6F6CB779B1C5A7989CA9
F4C34698739E06DA2731C1AB98631702D10AB3C7A9CB6F6D72E4739DECAAC147AE08F7AB7AACB6B7
9636115B6AD2EAD6E859E24B530B4D071D3ECEA012BF5DB8F4AAB036A1A7D99B89FED7A7E96195FC
CFB0949253C6D639063EBDB7FE1401B96F61F6C17B2432DF5B5A5DC24DCDD5EA5B4D11503811BACC
19FEBB9BE9583A4D80BFD2A5D46DAE74BB1B00FE5A47A9AAB34807752371563FDD017EBDEB634ED2
B51F88ED25DC305CEAB6BA6FDEB7BABB758AE1F1C797B4A2C67E99EBF8D635AD8EABE25D762D12C6
091752B76648D247E2C90751E6A1C903FDA273401269DE30BDD3FC4767A8684AB34D1A1B78ACEF37
34458E07EE6256DC9D3B9AF419BE217C44B21723544F09E97240A24921B88EE6592343D19840D205
1FEF11D0F15D9780FE1B58F826D2699A48EFF5898967BC9220A4647DD53C90BF9E6ACBF84757613C
917896EAD9EE5CBDC42B6B66EB2678C16FB38278E32C09A00E65FC75E2683499751B0D4BC37E2530
A0792CF4A86532007DC3B6DFC579C76A8F40F8F7A0DF4DF66D76C6E7469F382ED99A2073D0900329
FAAE073CD7A0586909A3C1047A75A5869F6C8C4CF0DB5A8FDE0C7F0EC0B839E7EEFE15E71E3CF0B5
BDC5EDE5E9F0C5AEB2FA9292BF6695ACEFE0DA3EF7EF19838E3B2AE3B83401E937B6767AE59477F6
7224D27964C13C3270EA47DD247054D705E1993FE106D61AC22999B42BB6677827701EC27CF2AA33
CC67D871EF9E387F0BF885BC0BA7594FA4B6B8AAEDB6EB42D4E02CB31CF2D6D2850370F4C73CF4AF
5AD534ED3BC55A545AD5B38B62532ED2C411C7B36F53B48F71401D88704290410DC839A75727E0ED
564266D12F16E45C5A00D13DC26D33467F894E0060338C8FCABACA003348082323A52D140051451D
FAD0014514846680168A28A0028A28A004CF38A5A28A0028A00C74A303D2800A339A28A0033484F1
9033F4A5E955B509045A7CCC60F3F2A47941D537E78C658803F3A00E4A5BDB8D5BC736FA75CCFA2F
D8618DA63677014DE06078C21761B7BEE001E2BCCF539878AFE2AEAF78CB7920D30ADB409A75D451
BBA8E5B7EE20EDCF7276F15EA16165A6E8F16B32E9F691C1E45B6D7897CB541C1382E14367EACC3D
2BCC3C2D25A58E9F6577A5E4F9AAF25D49716931976BFCC56DB64619B923E666231401B4F3208D6E
66F0D5C49A936E4D361168974D6DC6327CBD8A99F5DC6A392F0E9C6C2E35083526D463518B4B3B06
9EE118900B1915F6A0FF0067249FC2B36D869D69A938BAF0D4715E5D3178C79820B9009F977B4B31
520E39C30CF75ADC4D5AEE29C28B45B3BA11E5AF10C2F1038E03AAC80B01FEC803DE802281B52BAD
4BFB2E7B9D5A7B413095D2649A2BA8C12482D2A80DB7B003A7F78F4ABF25A8325E698F78358D19B1
27D8AF754513C6D9C8D8C577364F7760463834E0166B38F538350489A50435D6972C73CAE3F89923
CB86F4C005876AB034CD0F55B4FECBBD6B1BD8E201CDA4CD1F9CE1BA48DBD84887DBE4EF400DB9B7
BB3A54169A4EABA9C113382F6F777FBA70A4F45984C381E8189C0AAF753DEE836092DB78DA173E6F
94F63AA86B88A6639FDD82434C58E7B123D8D6B9923D26FD6D9248D9E15023B389D498411D7CB964
E7D3284D51B09508B8796EA682F656DA618268F7C04F40CB10F901EBCC9DE8033747B5861BB9E7D1
B4B6F0CEB4F98DF4EBC4912C35038CE616F970700E0A80477538A75BEB2BA8C777A5CF1EA49AC842
1ACAE268DA7B551D4C5B810D93C87F9BAF5AA9AA4D717F6863D5A0BD9E74957743A5C3308D640786
69566285BA1F99D6B46CE75F15EBEBA4C97A7FB4EC62F32D759B29628EE6007868E588B316078CF0
41F6201A00CFBE6BCD63C37691E9779A93CD63B4DD45737E82F6341C1225428379F467C7FB3DAB3F

53D6D346B892CED6F974EBFB80268D6D6C20B8927FFAEC61F9D89E79E3F1AB7A87FC237A2DECEBAB
78B750D52700A49A578759E05C672CD22472124F5C92C3AF4A96CBC48D6F646C7C09A6787ECEDE46
F9A5B2B95B9B88971C3C89B4283C7F131E9DE802AE9875A68E193FB2BC576965B8CF72AF14AB2CD2
7645F288263F621474F7AC1F186B4974634BCB8974ABA688985EFAC6EADE6461C84DCAC8A474E5B7
E3D6BB05D635B46894F8E2E662C844ED8B18FC97CE14143131C13D0F4F7AAB0F8E3C7FA3C86DF5AB
3B59A350732496A53E51D09746EFED1E28020D43566F19782F4BF16685288354D2D960D49A350F22
4271E6004A9CF1F357392CBA7B49776D69797777A6469E70993ECF750F98724BCA6552AA73E98FA5
76967F14D629245D73C246CAC9805B8BAB499674DA7BC89B4305FD6B33C47E1EB8F0769375A9F87C
1BAF0A5F6679A2B3DE935B67182AC8C0B479EA3231F4E280398BAD7278AD6C1AEAC74937017F797B
0B4776CFC7058602A7E008AEF3E09451C9A06B776C891CB2DC3079522118231D70001F9015C8F833
C39A878E94C7657BF60D32DC8F32F2DF1B99FD13E4521B1D49247D6BD1FC1969A1E83E2DD5BC3FA4
5F4B7370B0A4B77E6CAD2399318CBB371920741ED401E2DA1E91E22F11EA1A8687A29B89EC3EDF29
92ED6478E255CFCDB9F9073E9C93D6B77C67ACDBC315AF803C3B796D0E8B6400BF99A7244B275285
87CDB7239DA0F6F7AE9E4F157876C74AD43C25E24BDD4F47B95BB90C89671392F116CAFCEA8DF2B0
EB8C1EB5976BE14F843A9A83A7F8A67D3C67634125D08B77D04E99FCA8030F41D2B50D63C41FD85A
23FD8177ACF7334321611463AB2CC537127B035A9A978E21D27558BC35E15924B6B2F30C579AB411
46F7577377E7000E7AB119FA537C67AB45E0088F84BC37E1D6D3ED2F80965BEBA9B79BB5EE15831F
A7504761C83580906942C920B7B785750B91FBE8112FADD61E060AAAA90C3DC919A0081B4F89AFA5
D4EE2EAEADAF6C2E1577B5E34F73719F590CB184183DB9ADC87C61E3DD575A960D3F50D4ED61550D
E4C10C17E1063A97620738CF2DC5674BA958D95840E34DD1DA4890C53B5DDC937531E99556538E7F
BF9FC2AE69BA5CB3CE96A6CF51B19A521044D6D7320954FA904C3B7DF18F614005F6A7E31D5A268F
58BFF106A3A6825658B4F4891C91C7CCB0E481EA0E45578FECDA5C31E856B68DA8BC804B0DA5E45F
6986D973CB37CAAEA793D16BB3B8B68F4D67F0FCB6DA4D9662CC76F7CEE913B1EC9E5855727FBBBC
1E6B93D43546D4D34FD12DF4A2D269F2F991432DE8B5746038658DCF98547240127E3401B7AA6ABA
7DEDCD8DB69F3A5BDD5A67C9992E96382360BFC71A3C7220EDB8AF15C7EAE3C41637371A7EA1ACA3
C775019E458F51925B5994F607CCCB1AD8D4EDF4B3AB5A2DC5CF99717EBB9E5D56D99ADE06031B76
3C80A93EAC5BDAA3D6DB44F084B2D869D6D749A9CB18C4F6B0279534ADC615260CDB73FF003CC0EB
D6802F6966C6D3E1F0D7357B9B94B4C045B092E246378C0602989A7C327B7CA78E95D1FC2EBFF0D6
85A0CDAFB47E55C5F4C4DCCCBA74B1C168A3F8032875551FED30FAD739A37816E350B1BEBBF1979B
6D736506FB1D36F75431428A472FE6658A0CE78E3A547E1CB67F086832DE7DBE783C4A66CCFA0ACC
9225EDB96E81369DDF2E7E7527A1CFA5007B769BE32D3357D425B7B074BB86300FDAAD2E22B8439E
C56372EA7EAA07BD6EBCD1C70B4AEDB23404B3302302BE59F18F8234BD2FC417A16F2CB4F8AE235B
AB3B594929B4FDE5F336E1707A0ACFF0FE89AAEA16EDFD93AD476D29E0C49AA14623D4AC60803D0B
15FC2803EB4B5BAB7BDB64B9B49E29E090652489C32B0F504706AB6A3A5C7A8B425E575F29B25701
91C770CAC083F5EA3D6BE6ED0614D213503A4F8EE583C42A7315B99E3812794FF0C80EF8E539FE22
FF00CABB6D3BC57F15340B53AA78A34EB69F49B4C35D9458FCE68C8FBE8D1B6C38FF0022803AED77
C1AB6DE238BC49A62B49706336D2DB4F20781633DD2238C9C81C065F6E6B8CD3ACBC49E02D6EF2FE
EF4F81340DFB752F2EE1DA29D1CFCB2A47213B0AE7046EE99E0F15EC30CBA778834849545BDED85D
4618060B2248A4771C835CC3F84B4988DC68B6B6325B68F7D932C10B5C2A6E3D400B858D4FD719ED
CD00656B6E741F116973D83451AC4C02AC97AEAB35BB7DE0A8432B30ED8DA47AF26BD2118488AEA7
2AC322BCFBC29F6806F7C13AB4D7104FA60DF692C33FCD3DA312133C7247DD39CF4F7AE8FC21AA5B
EA5A3BA5B4B34AB6933DB6F96231B1DA719C103F3C5007414514500145145001451450014983EB4B
450014519C514005231DAA5BD066969080C083C83D680306DFC5BA7BE9AF7B749716AB1B6D903C12
1DBCE01CEDE57DFA55BB7D72DEE6EE6891595225DC5D81CB0C672A00391F91F6A74DA06953AA892C
A2F9780465481F51CD4B6FA558DADDB5D430EC999761218E31F4CE28020FF848B49DBB8DEA28FF00
6D4AFF003155A7F1AF85AD64F2EE3C47A540FF00DD96ED10FEA6B768A00E7FFE13BF07FF00D0D7A1
FF00E0C61FFE2AA86ADE31F0ADE5B47045E28F0F3832A993CCD4A30028E7F85C1CD75F585AEDF456
FA869D6FFF001316B994BB411DA01B5D80CE1C9E00F4DD81401C1F8B3C556F2781B56B1B4F16F87E
F752BE98C500B4BB8E3F2A2638FE1666240EA7F95731E1AF03690913D8F9BE14BE4C02B732309248
DFBA95129073FA7A5741F16EED5EF7C256B716A935CBCE6536D25C2432642E3FD6FDDEA7A0EB54AE
7C87D346917FE1EBEC5C10D208F4EFB5C48B9E09669898F1C7CDB80EE076A00A7716777A7DAD869D
7DA9CB6496D785915E3436461E72A5C2206C8EC4B63DF153F97A46A1ABCD3E9F7F657BAE05CDA88E
F21962441C6D486370A7FE0583CD4FA2EAF6736937563A65DEAB241632F94D7D642D91ADD71D1510
AB151ECAFF00435A06349E19FF00B42FAE2FC5F1F2CC90DAB3F97101FF002D088C264F70E40E7A1A
00A961E1996CA290A1D36D2696E3CC9EC4CD188A4F561BDA50ADDF0A10E47515B106953CB770EA9F
D973DBB5A0C6207B4F35B3DCB0DE5B38E06E150C9711DBCDA758224F3E9ECBFE8C96D24032FD3F78
778E31D9138C55C6B5B7D3B48D4CE9F0DCC92C055A53791B4285BAFCB2C8A5881EAA08A00A97573A
A4925C6A974BA169F6D70A60B492F888AEA26E987DAF87C9E70181F6ACF96D3FB3745B9579639219
515E49A7D4EE239507724B619178E00639ABF7F730C90584F38BA9770CC5FEB6E43B9E7319465E47
66207D2A8EA9235DE9D6F6DAC3C9A9C8C0C6B692D85CA4C84F466994FCA077240FAD00623E8DA24D

6E211A5436524A8C6EB51D4879F83FC26299AE11C13D862B465D1A4D2FC362C2C219A0D4B5984ADC
5DCD77E408E151D467CC396F6F5EB4CB5D3B48D756613C5A6359E9A00BFBCB969AE63B6DA32514CB
2142C7B91823B8AD086E63D5238B555B7D3ADF5077274F370E6D9CC4BC06C18E46231CFDDC73D680
322C868B65E10B98258AFAD2D587970CB20782DBD18870415C9EE719CF19A6496772D66C7C471DC0
D0AC943C57325CC5FB9C74F2C2A2484FFB5D7D09AD1BE6B795ED6F21BCBCFED3BDCA491437E260C4
7DEF251C85C7B9400567DBD859DAC091E8B06816FA8A48D03C6DAC7CD7800395628046D20EE0A9C7
34011DE0D26DAD27B697C3D25DB188C91DFDEC1E6EDEE0892E14A8FA316FA561DDE8CE7408F558B4
ED5AFD0206FDFA5BBC702FFD334559540E9D23418EF5A9649A542935D5E6AB0596A849B69AD75194
3A4883B2C6638460678D8483EA6960BCB486658D36DDC10112451C77A9081FED25A040703D3CC27E
B401CEC5642F74ABCF3631A3DC2A7992F9F6314971347EAAAB123AAFB8E2B63C07E37D77C39A85B6
937765797DA56A0E238EDEE11D9E2C8EABC1CAE3A8ED53EA5770789AC435DEBCF7902CFB7174A144
5EA142B46DDFF88B7D0D5EF09DA25CFC47D26E6D6395F4C585D524336417040E8497C7D401401B3E
3DD493C25E1F87C23E11B37B3BED499A409007296F193976C91F2F5EDD335C97C1A95347F8977BA6
C3334D1DC5B7EF1F70932E0FF7D4FA9EE297E22BC371F182E619D7CE8C5A469B443920E491FC0C7F
118AD1F052CE3E2B595A4EE0CF0DABC8C222080848C6E3B54E7F13F850073BF12749BAD0FE27DDCF
717FE545AA21911E146030001B194673DB9E9ED5CBB585BBDBDC4933C509F2B72059D1C3FD514064
FC40AEF7E22AB41F1817C98A6BC95A046F26E1DB6C4A4E0B447CCE0F1D0281C66B2F55BC3673CD04
6CD6D6A5B9B969D65943FA33094617D03934015F42F880745D1ED748D76C2C75BD033C417A03CB17
FB84F181D8633EE2AD5D5CFC30D414AAEB1E28D0E090E52D245F36043EA130E71F4352E8B776D25A
79D6F35EA5DC8E76B5BDACACBE9CECF95F3FF02FAD473C7ACAD8DC99259A28EE8989963B7F31A45E
859D519FA74C649F614013E8DE18B9478AEFC35E38F0CDF5B85CEFB999ED651ECD1E18A8FAE3E955
75CFB32DBAA5FF00C43D2F50BC66DEBA7D8E92BA8C4A7FD976E07E42A85D9B3D2EDACF4DFF004779
550E1751B1568F69FE300CAC43FD541F6AB963A841716F1E976FE26599215DDB2577B65888ED95B7
607F3FC280123D6D61B5F2B4C8E6B42CC0C970F7282171DC2094B2C2DCF419FA567D84EB7FA95C5E
DCEA1791FD8D7F7774CAF7922F5CAF9D16D4507D48C57450F892F350B59228EE20BD9501FF0042B3
8E302451C7CED348B2918FEEC43AF7AA56F7BE20F1F789ADA1F0F69B2431DA26C7CDCCBE4C3EBBCE
F2BFF010A0D007357327DB7538574E696FEF2EFEE42F134CE1BFBAA5C61BFDE038F5AF69F86BF0AF
FB1E54F10F8957ED1ADC8018E291FCC16A3D3249CB7BF6E82BA4F04FC3DB0F0979B7B2C9F6ED66E0
7EFEF1D718FF006507F0AFEB5D9500705F119750B39F49D5349B7171782436A62F204C5D1C740A5D
41E40EA6B98B3F22FBC45A4DFEBD7D776BE2485BCBB5B23A35D44A918FBE1511CAB7BB862BD38AEA
7E2E493DA78165D4AD608669AC678E70B32EE4C06E491C678A54F0FF0087758D0EC2D469F0878D92
FA3B5895D55642721B7142C833FCE8038CD734E7FB6DCDA0F115ADA6B9752BC9A65D5C5A842F1E41
36EC4A2EDE4F47DDEBF4E8348F87BA63E93249637179A76A41B6DC4A6C6DA06271CAF106D64EE0A8
39F5AC7F16E8EBE26BABEFB7E99C9062B1DD74C218D9461A42831BCF240CFA76AD2D3EEE4F0BDBC7
E1CD260592E74DD396E607BD2D23484E77441CF09903803A67A605006769BAC59F843C4375A6CBAE
DA6A92C4CA15B5CD4CC0605EFB092E87D82AA718CD6A2E9AB06BA7C41E16D17ED76D727CBBDB0B5B
9B448A6C8FF5A8C1B9392410C467AE292EB56D33E25786D6E7458AC2EEF6DA3125C69975651CDB58
F054990A608E790CBF5A2CF4CD2ED2D345B5D4ADBC244C8A4AD9DDAADB4D0639630312E4E38E33FF
0003A005F0BEBB75E18B897426F066AB6905C5C49269F6E8F6C00079650CD30527249001E95D3DCE
BDA86E8E66F04EBC6443F2949AD33F43B6E3A7B1E2B9F4F03E910E8FAB5FCF6FA434CCE5EC751BDB
A7BA31003E5633390CB823385231EA6B7BC13E23BCD574E8AD7598A087558D325A0B849A2B94E825
8CAB1E0FA1E4500733E309AF2E6F74BF132784B5CB5BCD1A432B4CED6A41808FDE290273DBBE322B
43C3FE24497C457B343A1F88ADE2BE812E5639ACA3119FF695D5CE49C8E0D75F797304970FA55CC6
7FD26261197FBB2F1CA8F715C6E9BA8DE69B6FE190CCA2CE1B9934EB9452D2B2BF2132C0E31C7719
E9401D13F8BA085B13E91AF46C064AAE992CBFAC6181FC0D54D77C500787BFB42CE5BCB1459D6377
BAB46B76C1F41327EB835D6D1401C3FF00C265A9C4F1245A659DC5B8DBBE797512B27B9D8B0ED3F9
8CFB53D3E20C046A92489A72C5651EF05750DEEB80789955098BA707E6CD76B50C16B0DB2BAC3185
0EC5DBBE49EA68028F8775A8FC43A0D9EAB0AAA47731870AAC580FA120123EA07D2B5290000600C0
F414B400514514005262968A0031EF4514500273477A5A28010000F41462968A006807DAB9AD725B
8B6D6D2790ABDA7D9B62442E3CA6690B75273903DEBA7ACDD4ED627786768D59C3AAE4A83C67BE58
0FE7401E53E31D125F137C57B3B4697C8FECED3BCE28D1B3F9B9E0843B959CFB8AC1D363B28F741A
2C77967A9BBB078268DB4C90A0FE22F1AC8E17DD9949F515B3F12350B8FF00859515B25CDC5AAC16
0250D1A3BEE3BBB2AE40C7AB29156238C9D52DAF649EE75212C3E70B94863C5C3631B5C5BA724762
CAD4015FEC7AAEBE1EDACB48B7D227863DB25CDBF9737DA33C960C30E07FB5BB93FC26A95A86B7BF
B0B7874EB636F333C52C4A37ED6E72EBBCA143DF263C1CF5E6BA2D12DAEF5BBF4BFBCB3D57430929
58DE2D49E41718EED1AAA10BC71918F51560DE9D5352BF86FAD5AEA1B79310DC6E8A285140E92ABB
296E73FC2474E68031F4BB5B8D3C5E45629A84D133F9124F6B3C9712A67A168DD3CBC0CF51BF1DF1
CD362B07BDF11FFA5F8AF531BA3DB1DEFD920B7385E4C1BD54173C1FB8DF955217AFA82DB46233F6
780B18DAC964B1491C9E02B420A118EE26232795ADA175777E2229E18956E07C8E96DE23BF46538C
FEF1E3876B1F7C9FAD00635869D05F6AAF6FA75DC96ECC8CF6E97114A664238326F9E46318F5C263

9EF56A4B8D22EF479A337761E204D3DF17179AAC891DB46D81F2AAC718F371FED91D783E95E5966D
593FB3F51D16C6C347B370F3453999EE59813C34B7301F301F4519F4351B6B3A77DA63BBF0EC79BC
92436CBA5ADD48D2B823F855999211C0392A303B0A00B4FABEBBAE782352D3750B4D2ECD2CA68824
1690CB14660C8386197DA08CF183F8D5CB98EFE7B8823874F63A7BA6C8215B269158A8C9747257F0
562A38AC6B9D520F0DE95A969515D40B7575728F762E350F396391BFE59A3280E48E3A05C67AD47A
F2259DF69D676568979E22993CCB48ADAE5DF2C719F31B70257FDE3D8D0055BBB8BF4BDB7BDD6175
4D12D94B27DB56C1AD662A3A06911A562BEC36D66CE927886D6E13C37657F76D2CA045359C0F3473
38CE5A59A789590F6CF9871E9EBE9F61E09D39752866F13409A9EB6D0996DAC8AB0B3888EAA8ACCC
A4FA96273D40ACCD4FC71A45C433583496969ACE9B130FB2C1A84A2D15FB29453189BE9838E45006
3D9F83FC15E07B6826F1D5FA5E6AAEBB869E3322027FBB1A8CBFD4F15AD0699F0CBC4B7206952E9F
61A82A158FEC464B0B84623FB9950D8EFC1EF5E6B2EA33DD16D6359B9D34EAF29023B3BA8F7AC29D
8247BB2BEBC8FC6A6161FDA1A9CF2AEA4C2ED6319F22DE2503B82A3793C7A804D00686B7A46A7E12
9E1D3754D3EC617790B41AFCD3858E46EB929B586EC76C64FAD278475054F89DA54F36A304A8A5A3
F3E02E23909EC14AF19F6C0E2BACF06F8860F1BE9179E01F15233DEAC388EE1D8B34CBD9C7030471
DEBCF7538AFB43D726D16FDAEEE754D3A40D6D3432A84900FB84A6D2C7D0E081401D1FC59B3BED2B
E240BA8F6C769AB5B88D9D5073B7A82C738FA8F4EF47C338AFE3F8A1631CF731CF0A58BF95B24DC8
8991F779CFE6074ABFF11F58D27C55F0B74ED7B7DA41AB5B48A3CB9D42CC581C3A2EE193D3380307
1563E0FE83AA5E6A13F89445259DB322C70477108DB20EECA30081E98C0FAD0053F8D1E75CF8CF48
9B4E9DE79A0568DE0B60CB327A92C0671F4AE6998DA3DB4D3B2CF70CC7F7B7243C63D83189DB23DE
51F415E87E35F86ABE2BD7F51BD83ED56BAD1843DABC8AC6060BFC25802A327B641F6AF373A078E6
C6EDE16F0BDF452850AE2D6C90A7D564453CFB839A00AB3A4F15C0B986FBCBDAC42DD888AFCDDC2B
22E481EE69D2ADE6A166DA908E5BACA6C9A6960CF9A01C70CDB547D4166F6AD7B4F0DF8E44CD37FC
231A94B1CA009E399A33E728ECC6425BF3ABEDE10F1FCFA79D3EC7C2F716767270609AF6D1A1DB9F
E240A0FE239FAD007356FA45DC8822B7B0D62CEDF21A50F7588A21FDE6CA0CFF009E69F7DABEA6A6
2D1E0BDFED9955B75B79113CD229F6424AB0FC1ABB8D1FE056A37AB18F11EA56B6B6F19CA41A726F
907FDB471C1FC1BEB5EA9E1BF05787FC271B0D234F48A571FBC9DC9795FEAED93F874A00F29F0F7C
24D7FC4AF15FF8D2EC5ADBE73F62862459645F47640027D0027DC57B3E93A3D8685A7C5A7E976715
ADA4630B1C7DBFC4FB9ABF45001451450079EEBDAEEB3E201ABE91A5F845357D29775B4B703578E0
667C7CCA060918E3938A5D32E3C7F3E96969368BA66891C51889AE2F6FFED5841FC412303271FDE7
1EBED53F8EF49B5B1B3975AB44367752488B75769777104691E70649161923DF81DC9FC6B81B8B9F
865A3C06F7C41E23BFF16DC29DC913CB35C401F1F75016283AF491D8FBF7A00B7ACDEE94D736D71A
25FF009DE1FF000E2335FCB1AC4D14F31C15456761B8E4E7E52473EB55FC2D71A47C434BE961D635
07D70A9B996DC5B456E9807E58FCD4432818C0E24FC3B562DFFC5BD5AEAC43685A25A691E1CB43B1
43D8FDA2263D1558A8089DB8078F5AD9D06FAFFE2069A75C87C23A7DA4D6AEB1B5E41A9CB64B7807
58F6A21DE33FDE240CE3D6800D05BC691CCE9E1FF105B2D8594B8BCB2BB22EE1B6524EE5F34812B1
1C1DB85C7F7AB79B52D0FC5FAEDBF85B514D0AE9A3845CD95FE9B72AD1B383F3050AC2485C1E400C
C08EB9AD2B8D43C4779A94F18B7D234ABAD32D772DAB5EBCAB2A30EA59155D40C74DA7EB589E21B9
BAD43C3BA678E34A6D2A14D15BCD9D6DA4F30DD6DC07559463E5C678619C81C0A00D4B0D5F54F0B6
BCD69E23D46486DA52145D5F2C696EC39C159E38954BE0005640A7D09EFADE38D182E82FAE6836A0
EB768CB3DB5C42A1A46191B97279284672A0D5AD76FF0051FEC986EAD3493ADD95EECF32CE5441E5
A36339CF2C307A05635CE78B3489FC3DE1ABAB9F0CC32C1BA32CFA7B19A7B4283938524085876036
8E3047A00753E22921BBB0D36C25934E8AFAEE457863BDB67914B28DC76ED652AC3B1CD652C7FD92
9ADDB43FBB582E62BB568ADBCDDC5B1B80524F3C75EBCD5CD521D17C4DE0DB287518C6A1617B6EBB
24DA7607DB90CCE8A7CBE7F8BA5715F0F85D5D697E2DD0B5E51AA0D3CAC4891C9B95A30B9540EA10
B63D7033401EC80E541C119EC696ABD8CA26B0B79046D1868D4846EABC74AB140051451400514514
005145140051451400514521E475C5002D149C803A9A5A0028A2933CE28016A86AD6AF770448B249
181323168CF2003E9B483F88ABC68CFAD0078478DF50B6B7F8B1A91BC8AC24823B1833F69B88E193
3938F2CB150DEE0B01FD68DDD8C9A5EB126AFA768DAA4497F1AA992CA686E88CF5629197DBED8DC3
DC54DF102EA4B0F8A9A8C4650A973631B8188A376209F9564914AFE7C541A7DABEA971F6F124123C
11EE8D6E5A0D519587380C88AC84760AD8F6A00DC96C3586BD875016BA6DDA243B44FA8F982FBB67
00E0C27AF2370F61516B31B4374FAA32790618D04714D2FCCC09E54C802AB1FAC8DFEEFAE0E97E25
D535C922B69CDADD5DA891A3B892CA58E788F4DBB87C8A074C0561C7356DB5DB9984423D4AC74FBA
B5E2F1AE2792281C03F74136D90C7D8FE7401D158CF0ACF6FA9BDB2E9A97119599CC7E6DC22F6613
46A5CAF1D32A0564D8EA2B7FAEEAD63098AEA583F7E5A4B56637098E1BCD192A474FB99F426AA49E
2792DA517BA75CF9F6F743CA5B7BA0B6FB1BB9495C2175FF00B66C7DE9E9A9DCCB7D20D46E2DAE27
68C0FB449AB2A46A87B44BF674491BEBBA8023B9D5AF2608F7FA4C1616738F26178F51432BFA6C32
48AE33C7057345ECB71A6BC7A4E8F0DDDD5D491B35CDE3B3CAD6F19FF9668ED32EC278E847D2A8DB
CF1690B3DC2F911BA92B248BA5849047E9E65AA81F52DF91A4862D43C3F61F6B4D1E45334DFB8845
E932DC190F542610DB4E79C90783C50068457D6FA4E90FA6C4D323DC388ADF4BB49E279A62DD4CD1
BB30EA49DDF371C935D25AD847F0FAD52FE4B686E35470237B9BBBB58ADF4F8CE3F76BC003B7DC41

93D6A1D2B4F97C0F6A25BB8A1D43C4371F3DB6956F316168A4F2EA19491F7B2D2107BFD2B0355D67
59D5F535D20BADFCA99951A5BB82358D4F5C93B8CB8391FEAD3A743401BDA749A64125EEBF79A9C1
A85BCB218DAE25BBCB2BF758C91F2A71DD8FD2B3E20CDAC2789AE34FB5B1D082B962B04427908CFE
F049B0314C0E319CE7A7355FC49AD68B75716B0DCDACD25BDB2FCAD29786E772F24DBFF11E4751B0
7D6B9AF13EB706A1E238E4592D668268549B932A34F163A21772027BAB1E7D6802E91A85EC17B7D1
DC5DDCE99752F9B0A9B69A44D9FC390762B7D3045169A3DA5DAB5DED8D2DF88E46812DFF00D67A04
4575239EEA31EF5461D4F5CD5AE09B1B1D5355F2D8057B384F94AE3B37925948F7F305763A7FC37F
1AEBAFE76A97561A35B3AE45B147BA727D594B919FAB1C500725ACFDAAD23B3D464BEB5B79B4D71F
66115C1123807A7CA88A01C60E171537883C5B67E3B5B47D33C3F78FE20824467B9899AE2145CF3B
C0CE17F0C57A4C7F0F7C1BE16B28AEB5CBA93589E26C431DFDDA04321FE18E26654C9EC0E6B5BC41
A6697AEDB5AEBF6BA58D4A4B08DA27B060177C4C06F4D8D801801C67D28039097E1FC7E1986DBC53
757E97E77A9B9885A2C90C4ADC1789086C30E39FAD767E1299745D6AEFC2B35FA5D2AC6B7766EC50
48D1B75055555460F4C0E9542D66B5D13C34D131BAD4FC25768CB13AC0267B0523EE3A8CB3A03C0C
292B8E78E6B21F4AD2B55F0EF86F5F8EC348D5D60B816F733BDB2379F6E495C9DC9D47070718E79A
00F5BC1FF26900C2618E7EB583FF00082F83FF00E855D0BFF05D0FFF001353D9F84FC37A65C0BBB2
F0FE95693A8204B0D9C68C077E40A00AB6DE34D12F3579F4D86EBE683EFCAEA56327BAAB1FBD8EE4
640FAD3E5F17E910ADDB493B8FB39190ABBCB83D19554938F7E2A95B782BC39771BDD594F7DB2662
CB241A94DB579E427CF80339E055A3E0BD1E2B996EE1FB45BCD2C6B1CD2473106455CE03673D3268
03427F10E8D6D6A2E6E357B2B78719DF35C220FF00C78D4779E25D1F4CB1B5BEBCD4AD63B2BA60B1
5D34CA22391907767183598BE12D364B7BC906AB752DADCC5B5773C4E9001D590943CFFBC48AD6FE
C8B5B8D2ED6D45C4D2430A80926F0C5C631927183F8500589357D3622449A8DA2111F9A774CA3E4F
EF75E9EF50A78834592DEDEE23D5F4F686E58A4122DCA1595867214E70C783D3D2B9AB9F861A3BDF
9BFB395AD2EF3B9641696B290FD9B74913367F1AB777E054BE4B713F88359DF149E63B46F0A099BF
DA511EDFC80A00D583C4FA3DCA2CB05F45240CFE589518150C0E083DC631DC01579751B1742EB796
ECA392C255207EB5CE4FE00D3AF20782F6FAFEE636956555768D361520A81B106464679CD3A5F044
33DCDC4936A9772C33445040F0C05118FF0010FDDE73C7AD007490CF6F7D6AB3412C5716F2AE55D1
83A38F623822AA6B1A1E9DAEE8F36957F6EB25A4AB8283E5DBE8548E847622ABE9B6B6DE12F0CC70
5EEAAF25BD9C7F3DE5EBAA9C7AB1E057396BF106DFC61A8BE95E0BBFB179635DD3DE5DA3E235FF00
A6717CAD21F7CAA8EB93D2803335EBCF11F8324F2EDBC5D0EA71BAAA2D8DE69DE64F047D0C80DBA8
271FED281EF59D9F09470DC5B36B7ADD9D930FB44CEF2DCDB4B2DD31E1A34601989EA154119ED517
87A0D4EF353F15E8BA82699324327977FE219A211CCEA57230A55E33B73F74B0C03D2B1E7D586B32
5C78D2EAD88D33C3503D9E9B7316435F4D9DA1C10718EC3191F31A00D7F0EEBFE25D575775D56489
AC2CE17572B6F711EA7343FC2CCB11223627A7DD27D3D381F15EBCF2D9EA9E1DB2F07DF2B5DCA268
5B55125C5E444819203062A4807F8B3D6BD46D743D4B48F08E9961657F712EA1A9CA26D564B754FB
5CCCF825848E408D57A125588038C1AE33C5296BA678BECB49B986D2D20556B992092FEEF558EF58
701658B1956EA776C6E47538A00F4F1E55E7813466FEC07D4B6C51E1658A3736ACA3EFB2C8412463
F8416F6A7F87ECFC33AC4D73A968935AC17EC3CABF160D80C7BACB13003775E4A861C8CD67F80E5B
4B74D3E6D22D56C34AD563791AD0DD8748A61C9F2D4E08CF39185C7F741CD776F6E15A66818C73CA
BF7C8DC33D8E0FA5007923C5E1DB4D3352D0358BAB5D16F74995D60B9490C72340FF003288DCB28E
71828491C74C62A0F83D61A6CCBAFDBE95A8CF77A65DC43724B6F1C2E8E460E15588E9EA16B81F16
6A9E22B6F16EB16DAEDFBB5D02B1CB696F014B5BB8BF859B0E0E71EA0F4C66BD1BE06D939935BD4D
C429E63A448902C2AA140C80447D0F3D0F3401EB3A741F65D36DADF6B2F97184DAD8C8C0C762455A
A28A0028A28A0028A28A0042483ED49BBD8FE469D4500145145001456178BB5C93C3BA11D4638669
CA4A8A628537BB8270401FE78AC9BCF8896367AD5BE98638659A784488229C921BFBA7E5C0FCF3ED
401D9D15C7DE78E0476EA2DED516E7784713CCAAAA7FD9C906438FEED5A9BC696C91A7D9B4FBBBC9
9BFE58C0F0A91EBCBC8A3F5A00E9A8AC283C5115CEA16F6D0E9D7AF0CC76FDA8188468D8276905F7
E78EA148E7AD6B5DDD47656B25C4AB33220C910C2F2B9FA2A02C7F014013D15CF1F1969BC6DB3D75
89E31FD85783F9C55249E239B66EB6F0F6B373ECB0C711FF00C8AE9401E41F156CD53E2A5A5D3C2B
26FB0DCA65BC8EDD4156EA1D87CA467D734C6B5B56B29AF5E4D5B55D3199635BEB8BDB3B85594F1B
55DDA37383800AB8A87C7D7E937C4EB59B5BF0DEB3B65B558EDAD4184485B3CB068D9BB91C865231
5AC2E6EADF576D28F86E1B89AF22092D96A1ACDB79B20C654880CCC19801F788078F6A0075EEA50E
929041A92AC704F1F948B71701441D7E6138F306E3FDD12E69B6F61A8ADA28D2E782C6D1804B5D46
FEF84A2318E520578D4B6EE3869587E58A8AC6CEFAC45FE9F77E1ED0D6E1D0C8D0EA1AAA4B7017B3
3EC8DCB1ECA3381D00E2A8DBDFDCD8A5BD8E89A7F87626B9C196DE4BC9124503A9787CB8403C7DED
84E2802FAEA6BAEEB863BCD56E4DCDA44634D2A091BECD3903FE5A9111894F3D1777D6B1259ED6DE
CE7935DBCD7B4AB8965671610CE220141EA24B9319753E919E32318AE8EEAF2E2676BA823B6BB91A
1F2D6EA3FB7CF046BFC4B1B44AA8C3DF78358EDAD58689A624369E23D064024DAB69FD9D7124EAE7
F8433CE587E2E07D28033F54C59D869F72A9776709CCE88D14971B076692479B603CE4719CF426B4
F47BBB1B373E299A2D627B7B0530C13DE2832CB70E40E0B61428C80323D79A9BFB535682D24D5A5D
412DEEC8FB3450FF006323310C7EEA9699B713EC4AD64E8B75AADCDA5DE95717F0D9456CDE6324B6

9696EAEB9C9DA1A23B9FBE06073D4D0047FD9979A85EC925FBEA924A64678E3B8821924248E704AB
211D3A2AA8F5AB315EDB6836135C3DBC2F1CA0AAB5D4314CC84707114330546ED95503D7359F6A35
0F11417D6BE11D2AEF5812B8335ECD6F14411BD379DAA7A7DDDABEB9A96EFC1BABDA69936A7E24D6
61B56B41CC57B1C93220F4420E73FEEA91EF4018F3F89B51783CA8F51BA8E1881304B32C72CD1FB6
E0BDFD063DC9AF56F869F0E742B8F0FDA6BFABD9AEA3A95E2F9ACD704B4633CFFAB276E7DC835CA5
8787341D47E1CD8A3E9714BAB6AF3F976132CCC6723392FC28DAAA32704B0C7535EEF616B1E99A5C
16C0848ADE20A49C01803934012916F636BC2A4304438545C051EC05656AE9AA6A31082C52DD6DA7
1B646B988300BEBB49E7E8715069DA9DEEA97F3DD47B974C6F92CD8216598F7761B72067A1DC01A8
EE7C50DF697D3F47B56D5B555F965489F6DBDBB63FE5ACA7213B7CA37373F7680313E23784AD352F
8657961045140F65179908862102065E7EE81802B85F87BAB6BFBAC6DEC637135CC604DA8EA4DBDD
13B7EEB21E41D70C7007BF7F538FC386FDD8F8A6EE2D624939FB09880B48476DB11CEE3C0F99C93E
9B7A579F5D78535641ADF86EC6DE0965B6996EF4D9269DA371031C98976A8F90118DA1BA6071C500
762DF0F0D86A6DAE787F54FB2EB728FF00489EEAD9268EE78E8540529FF6CCAFBE6ABEA57379E2CF
87FAD5A6ADA5A5B6A762C56485260D1B3A6195D1BA8538C8CF23BD4DF0DB58B8974E9344D5217B6D
52C89DF6E2DA548D133C6D661823FE046ABDD48C6CBC797113C678D8BB0648223C72450076FA6486
E34AB394E4178509FAE2ACBA1789D370058100E3A7E159FE1D12AF86F4D139CCA2D9371F7DA2B443
83D08FC0D0079D5B7C37D56C6D560B7D7E3914DCB4EED3C32646589C295906319E33915623F01EA9
0EA42F535999A5072CEF7773F39E99D81F60FA6D22BBE524F5AE7357F1FF00853429658B52D7EC21
9A2E1E1136F914FA145CB7E9401976DE11D72DEEA4BB6D62596E1890375F5C6C0A7B6CDDB7F1C55A
D0BC3BADE99E25B8BCBAD48DCD84B0802392F2E24657EF8466D8074E833D6B2E6F8B368D776D0E9D
E19F115F4574C16DEE8597930CC4F4DAD215FD7156BFE136F102EB10E953782E7B6B9B905ADDE7BF
8BCA2075DEC9B8AFE01A803B8A4AE02FFC6DE2BB4D51F4DB6F075BEA3771A79928B5D464548D7D77
CB02213EC189AC5D63C49E2BBCD0A0D76C7C43A75B68E2731DCAC166D05D29DDB4A2894481D81E30
02EE2063AD007A7EA5A959E9162F797D308A04EA7696249E802804B13D80049AE2EFFE26AA5DFD82
D341D5219E53B2DEEB5688585ABB9E8374A43139FE10A58F606B97BDD146A5A8E9B3368FA85C25B4
A6E1B59F11BC90646324650E63038C294453B7E84E2EA9F10346D3A2B8B2D28EADE2274FDE5EBC17
B3C76118049C2EF691828C7404291DF1C5006D6A714C6E6D6E758BEF12CBA879C185C6E8A7D2A175
E794405427381BC07E33918CD6878875964D3F4FF16789A5D10D9D96E92CF4C4977FDA26C7CB22C8
41E700E142F1DCD71369F11FC7BAFDB9B4F08E8965144728ADA6E9EE7CAE3A348FFBB071DF02B64F
833C3DE0E487C59F10F569B53D70A799F639A612EF97B045EAD8FF00BE450036D2CF59F8891C9E2A
F126A12691E0DC190693F6A282555FEF12114A923393EB567C277569E35D6EDB5AD6BC8D3741D3A5
30E83A448CAB0C8EA3FD667A3B0C1E80E31C74C9C1D2E4F1A7C5EF110985E5D697E19E6364B594AC
4231D5081C3391DCF02BD23C437E7C23A8E8DA645AC59E9DA4984C76D69169AD7371B94750AA4923
DC2F1F8D0062EAFE251A4DC5F78A5F46F086A46702C8B5B6B5FBC2A0F28CCF104F4C8E3A77AE4FC2
9E05BDD4BE220D5EFB41B7D234B9AD9AEADAD14C734678000DA8B823A9C103AF156BC21E1793E237
8E6F759F10CE755D36C18471DC3DA9B75B8707EE79671B42F7C824FAF6AF62D5ADA78755D1AE6CC1
D914A619215645063618CF2474C741CD00798FC3ABED3DF448B7B5BC33D8EB92A1896031AC7B98FD
D072573BBA678CE2BD575AF105868D6774F35D5B8B986DDE716ED2A876503A804E719EF5C05A7C39
B58353F1343A8E8D6A6DA595AF6C75654334F13373B42952495619EBCF1C552BAD53C4FAA689A978
7FC42DA7AE90B029975B0CD0BCB6E472C2301C07E0E431503D2803C7F48BD9FC53E3B8752D5D0DD4
9A85C179A084BAB3201C28F2FE6EC3B7D6BE85F863A7A416FAB5F5BE992699677777FB9B3981F310
280A59B773CE3382322BCFB4AB7D0FC37146FE119F509F54BC1F63B39D6C5D44CA7BF98CAF1391C9
C8C74E95EDBA1695168BA35BD8C4065173236002EE79663800649C9E050068D14514005145140066
901CE7A52D2605002075662A0F23AD3A8C52607A5002D1DA8EB450067EAFAD58683606F753B816F6
E182962ACDC9E070A09AA4FE2FD016E6385AFD77BE361F29F69CFA3631FAD5FD5748B2D6AD3ECB7D
1BBC7B83031CAF13A91DC3A10C3F0355C786F4B55C08653C63735C48CC7EA4B64FE3400D7D6F4195
A5696EED49B4F999A41F73DC13FD2A9BEADE15B6BD8951B4E3717A77931F97B98631B9B907D06696
2F0669CD6B3437A5EEFCC271BD8ED8C760AA491FE3491F8274CB758A2B492E2D2D1412F6B6E51229
5CFF001B0DBF7BE840E7906802CA68BA2DEEB90EB11A432DDDA218A3642A4440FA6391F4CD6DD66E
8DA42E8D6AF08BCB9BB6772ED2DCECDC7DBE45518FC2B4A800271451462803C57C7F791DBFC64D2E
497519F4FF002AC1B6490C734AD2127EEEC8C648EE79ACDD512EA7B8F3A4D1FC372DA4F30C6B41C4
6B7126400AEBB9A6570780BBC67F4A5F89B7D0DBFC60B132DF456C91D8FF00AC94C6C1096F4911D4
74EE07D4557D3EFF0040B7D5AFB569DBED7AA46825497415906E6C11F32461E2078EA5C67D050068
EAB7112C5E5EA16DA75C6E1B2092E34DB9B56864FEF47398A424E40C15D8063A9ACAB7B8BABFD752
D60B5FB42DAC69F69D467B928723276B48100993EA07BE2AD3A6993CB6F7579A5DBFDA645374FBF4
D13DD9E9862D186E871D41FC2A3B7D2C4B72BAF5ADB34B2DCAED7974DB978A59971D251247E5C5D3
AEE5E9D73C5004778F61A7B4F7C93B1B76E23FB3DD5E2DB44F9E4911B11B7DB20545A86A1A54D297
D3FC436125ABF33D93EA92DA0F37D46CC16CFBEEAA76B69F6BB8B3B85D5EC98D8B33BC97F7915C8B
7539F94C88A01CE7A1987E3518B9D57C4BAC5A695A45CD86A1761987916F04C90DBA1EAEF30972C3
1DB2C280331B5358E6BA4BA492EA59D44569F67BA338663D170CCAC47B3024D5AD5FE1FF008B74FF

000FAEB17DA3C2B115DB25BD9203320ECCF12284C7AE3F1AF6CF03FC34D2FC1D0F9CCDF6ED4DC00F
752281B3D5631FC233F8D76C010319CD0078A781FE25F85BC25E02D36CE69269AED949FB3DAAA492
331ED8520293D8360D62C1A7C37BE22BBF136BF26B3A6FDAE6FF0044D1A43B6F2F8760888CA50678
39523B96C57B06B5F0F7C27E229A49B54D0ACE69A43B9A6453148C7DDD0863F9D4FA77877C33E0EB
396E6CB4FD3F4C8634CCD7240521477791B923EA68029F85B42BF8E73AC6B7E5A5DB27976B6510C4
76517F73A9DCE7F89BBF6E2ADF8A35DB7D261B7B779D966B97DAB15BB1372E3BF9518462FEFD001C
E45556D5B5BF10C9E5E8100B1D3B386D56ED01328F5822CE4FFBCF81D080C2ACE95E1BB5D2AEAE6E
821B8BA900125FCF2799712FA866230ABFECAE00EC050042BA6EB1AFAA9D566934CD3BF86C2D65FD
F4A3FE9B4A3A7FB89FF7D30E2B76D34EB2B0B04B1B2B68ADAD5176AC502F96AA3DB18C5711E31F89
09E1E22CF4BB04D42F4F11C0F2B0697FEB9AAAB33E3E807BD72F6BE3CF8912D99BB5D0B4D9A1DC00
8A184ED5F58E4669C346FDB050F26803D8A6261850470993040033D3DEA86ABA61BE31DC413FD92E
EDC1686E8AEE0BEA19723729EE322B98F0EEB979E20B06BA8EC7508AE8308EEB4F9C4482D5F1C8F9
91495EF9E6A96AF3BEB1A908EEA595B46B33B0697A6CA249B5297D1802B88C77070A7B902802F687
AF4DADEA47578E6B596CACD658EE2F6DA3916195573C297037104672B903A64D50BD467F0188A375
8EEBC417E0A2A6149577CFFE80B56FC417BE24D4B409B4AD37C19A85AA481631FE9768A4479E70A2
5C0E323AD67EAD67E33D4F51D1A5B6D2E7D1748D381595527B796E9815C65146E418FAE7AE07A807
55AA78C34CD11A3D36DA29F52D414AC22CEC143946E0012312123EA3EF91C74CD7357BE27D6EEEE7
EC9E266FF8416CB04ADC0BC86692EBAFCAB21529191D7182C7B74AA369A6DFDC5E43A2FDABC49168
3E689A0BCB8D3E39A5926193F3BB212AA0F42D1F240F9BA03AFE225BD86EEDDFC47E231A7D85ACC2
7B4BCB53F65591C748E70DBC1FA82B9CF00628032F5EF09DBCD7D61F62D43579A3688CFE5EB37D2C
F617498E5245762E1B0720E001D79E951E9BE1ABD9B46874F9EDF4FD2345D4A56DB616F6A2EA5849
39F9647564DA793F320C678AA5A878DEE564BF93C2F617FE2696E21DA64BC887D92DC720EC765532
293C91D0F635CB6BBA0788BC4D650A6A37F7A96D045E6C96D208628557F856086172A48E9FBC6068
03BBBDB182433697E2EF1359A6856202DBDA48B6D6D25CED1D5F278C1E9B4273DAB0F484F01D869F
2EA169E2BB5D375C9B72437D2EA1F6A9A08F3C295DDB4FD31F89AE7E2F0DF87AE34CB5BCD27C3B14
5A7B46EF7977A9CB3406DA54231FBC42E63279F94E455AF0FBDF78F357B78F4FD12163638F275F37
12A98B0791BC449E675E148E7B9E68034F50BAF01DADCC37F0FC41B97BD99C0D42717B71BAE900E9
8848098EDC62897C49E0836F2695E18B5BEF12B5C93BAD6F7CC92DF7019CB3CE46CFAAF3577C51A4
782342D61350F1CF89750D5759F2C08A38B313AA8F458002BF566ED55D75DF056B5A1C5A4A7833C6
77FA6C9309028129591C9E0B399B9FC4FF002A00E3B53D47C5FF0011B5A8BC376F716D2DB29F9AC2
066686D429C66590805C8EDC91C57A5E82BE15F86262F0BE9D716F73E2ABE41932ABFEF64EC1D955
B62F5C0C56643E27D4C5DAF873C33E15B8F0CD8B39496EAD6C92EE689B03878D0E222770F99C9F5C
7A3F44F036A9629A8896192D46A9360DDEA3A9B5C5C193270C16DD542E7FEBA6474CFA002CFE23F8
B2D248D736DE1DD3238EE4C0B15C09105C0F54724E463BE54FB5642F82D6E348BCD5A5B08EC56EE5
3E6ACB62F7F76CE38FF4690B8739C70703D726BA997C3979E1ED363862B93ADDE8BD410C0D0C71DB
24848C49200FE6C85473FBC9189C67D28D7358D43C3D2C5A96A566D73A858CDBA69FED8D05AB44C3
9D88CE403E8083CF7A0076A3A9791E179F5097478E3F0CC3029B9B59635178CC31B84D136D19FF00
81E7D8E6B94F0FF87A4F887E31FF00848F43B23E18F0E451983CFB02209EF3D40DBF77A7271F89ED
AB65A1EB9F17657D5758BA7D37C2333A3DBE9B1C604972AA7EF3360100E3AF71D31D6BD7AC6C6D74
DB286CACA1482DA15091C6830140ED4011E97A5D9E8DA74361610886DA21855049FA924F249EE4D4
5AD68763AFD87D92FA362A183C7221DAF138E8CA7B115A34500797F883C15E3DBA8BC9B6F12D86AD
0862553538E4836AFF00759613E5CC38FE343D4D6458689F10A7BEB983C41E1CB2D4D2689AD9656B
F4B7B48A2F458E304B0FF7909F7AF67A280389F05FC3F5F0DC514BA8DEBDF5CC400B787CC95ADECC
631889647623FDEEBF4AEDA8A2800A28A2800A28A2800A28A28013073D6979A4CF3D296800A28A28
00A28A2800A28A2800A28A2800A28A2803C43C6F2DADC7C6A8AD26B4B47C6980F9F711E444D92436
4A3018C63381D7AD45FF00085DFBDCDDFDBE4BD2F2B0B96BBD34C6F803A05051E451803EE86CF3F2
8CE2BD0FC77E0DB8F125A4777A45F369FADDA83E45C292048A7AC4F8EA871FFD6AF25FEC8F8A2FA3
B787E1F0DFD92DA294B6FB368E019CE7319122A8FA81F5A00E93ED77F1E9F34D7BAE592E84D6E56E
DEEFC962E391B6301524DE08E44883D8572D75E3CF0B5947BB48D1C5D490DB2DB2CF2C490C32A7FB
6BC67E9E5FD0F356F4AF839E2ABB0B7579069F697AEF992E7519C5E4A17FEB9ED6427A757AF43F0F
7C1FF0F6913C579A8EFD5EFE360E1EE142428DEA90AFCA07A67763D6803C9FC3FE11F157C48B9F3F
71D2742C8DAD1A325BA803810C44FCDF5E9FCABDF7C2DE12D27C21A5AD96976EA848CCB31199266E
ECC7BD6E00140000007000A5A0028AA1A96AF69A5A2F9ECCF349C456F12EF9653E8AA393F5E83B91
5952697A9F88955B569A6D3AC0E0FF00675ACDB647F6965539F4F95081EACC0D003EF3C4DE65DC9A
76836BFDA97E84AC8436CB7B76F4965C100FFB2A19B91C639A4B5F0C9B9B88EFBC4572BAA5E236E8
E3D856DA03DB644491B87F7DB2DD7040E2B6ECECEDB4FB48ED2CEDE3B7B78942A451285551E800A9
E80239F779126C386DA707D0FE63F9D79FF8D3E21C1E07D23ECCF38975548BE58DA2622463D3E6DC
76FE39AEDF546B45B075BD911207C29DE4E0FB7041AF10F1BF88B4ED4B4E8EDAF74C9351D5E1BD1B
1A1B79609AD610DF2BA46C089060633F758D0073BE08D4A6D77C5E26D5E2BA9359D40931EAB6BA97
D924897D23566D92818FBA14FB835ED7A2E8771677D79773CB15C5F3001EEED61FB2DD4A070A268F

26391B1FC7C0F402B16C752F075E597D9F5EF15D9DD630638354F2ECA7B7EFCAAECC3770768238E6
BB3D2EDAC4AC774B05B4891A7956B7C67F3E49233FF4D08CF3FEF1CD0061EBFA78B7F13595DA25CB
26A5035ADEC71398DE4503208642086192383DEBC7355F1098E0D434CF0169771E1FB18DDBFB4AFE
EA6F2EE249338DA65773B464F4DD939E9EBED7AF6996F6BE21D1752B78256BB46921590BB3AC6ACB
C92A4E3B75AF11B296E27F194BA46997D63A9EADA8EA464B9BCBCD3CE2DCA1CE06E620F4C7CBFF00
7D0EB401E85A4783FC2DE0BF87726B7E24D32CB53BC68BED3713DE4227777238552E33FA0AF3DB1D
5B5E4974FB84D5BC4362FA9C85A28EDAF566B5446248882C9811B63A72DEC3B57A67C5FBE363F0E6
3D3B5031DE6A3772C7122DBC7B03B0392C10EF380074E6BCE60F11683A26A16F69A47886EF51B4B8
558A5D27EC2DB22909C330568F68239E234524D0059BBD3BE25EB1AC4B0DBEB1AF58E9C0EC4BBBD9
E585770FEF6C8D0807FBDB76FF00B558FA5695A65EF89134D790DD789A09C79F3317BE5B8551F360
B0DAA7D0F38E3BD76D7BE17BA875E834CD0340D7AF619ACC7997979AB5D5A431139FE5FDDC9FA574
3A57867C2DF08348935BD52ECCF7CCA23FB44A8A5C9FF9E712819E4FE3EB401CD5B7C3DF11EADA85
CEADA9EA89A3698AC4ACBA85BC52DDAC60608048DB1275C60F7C915A70681F0DB53BED32D34EF15D
C7DB34A859631A7DE8579811F37CCAB963C74422B366B1D63E2ECB25F6AD75258786EDD774163681
92499873C99955188F5E9F966A4F0FF87B4A8AD523D3B4FB3B4BC0C66DFAC471BBBA2F0648A289B7
B11FDE568D79C8CF7007BF8CFE12D8E9C3464B0BAD5192E0BFD8E4B3966964989E73E6E32D927826
A6BAF893AE5E5C49A568DE0C6D374DB68B75C7F6ADD0D36448B0795E57CB1C7DE05AB52CE0FB669F
6D71A0EA30F88E643B6EEC7CEB7811410725F7C724A0E7F84BE78EBEB62D27D2DF548A1D37C25E21
BBB88C131DEDE6F686D5BEE931BDCBE00EBFEAC1C8E80D0071DA6F842C8A7F68DAE997D1C979FBF9
5EE21B3D523DB9F98C574EFE58073D64CB1E702B6AD356D06265B3D3B743A7BCE22B9B6F0CC25A2F
98E3CCB8BB8D005E31958C8C67A915A32EA3A26A3343A078C7C55A46AB72B2031D8440A2B38E8267
52558F4FE1419FE1AC7B9F19689A4CD71E09B7417964E592E5AD63DC2D430CF971C4A374A00E32A3
8EE6803A2D52D353D2AFAFECB44D56CF4ED0A3B3DF2C034C6B874739C9411ED662C0E49258E6B9E3
75E1B8E2F0E68C93DBF89BCA5665D1B4BB78446081CC8CA5BE561CF0CFD49E33577C3D75A896B6D2
3C2DE13BB834BB7932B3EA70B5AC6898237AB37EF19BBE307DC8ADCD37E1A6D5035BF10EA5A880EE
E2181CDA460B1CF2633E6363A7CCE680383B1BD975292FE5F871E1ED6D2EE2BC3F6C7BBB88D1236C
FCCA034C41FA2ED3FED0E2BA3F0F78521D2EEA6D4B53F02EABAAEAF3C8256B9B86B371191D04624B
A72B8F5DC4FF002AF4BD374BB0D1EC92CF4DB282CED93EEC50461147BE077F7AB7401CE9F126A4A0
7FC519AF7E12591FFDB8A43E26D487FCC99AFF00FDF767FF00C915D1D1401CC8F16DEEEC3F83BC44
9EE52D88FD2634E4F16C9B6479BC33E208523E771B6472DF4547663F9574945007329E39D3DDB0DA
5F88907AB687778FD2335660F14DA5EACCB6D6DAA472A44D20375A5DCC09C0FEF3A28FC335BB4D74
491192440E8C30CAC3208F7A00F39B6F1FEAE74882E5EC8DDB4B32AACD0699710C6CA4F230E7B7F7
B247B54FA9F8CB5A8217686C918970D0AC192EC33CAB6E040FAD77B0C115B4090C11245120DA888A
02A8F40053F9C71FAD00711A878F2EAD34ABED42D34EB3BD86D4A2122F8420313F307675C281EA4D
432FC4A549EF225B4B076B7B4FB4ED3A9046E99F9B720017FDA0587B577BCF1814B40199E1ED6135
FD02CB55458D56EA212011B3328CFA165527F215A749DE96800A28A2800A2933DA96800A690DFC24
0FA8CD3A8A003B51480E49E3A52D002639E941CF603F134B499F6A0006ECF2463DAA26B8892E12DD
9FF7B202CAB83D075A941C8CD71F2F82A63AC5E6A305DE9B1CD292D1CC74DCCE0F1812C824064518
E985E31CD007526F20174D6E64C4889E630EC17D49A911D268D2489D5D0F2195B208FAD7289E0990
DDC37571A8C72BA44F1C907D907D9E42D8CB18CB13918E3E638C9EB4E8BC1F73149E50BFB4163B48
F2E3B378E40D8C70CB28007B6DFC6803ACFCE915D59D9030257191E95CAAF856FD3C0AFA0FF69C7F
6BC1F2EE6184C2ABF3647CAAC7A77E79A49BC39AD4D656692EA7149710CB1BB18CCB0210BD7E50EC
4FE62803A47BEB48A5F2E5BA811F38DAD2006A704F39F5AE3AFF00C2FABDC9BF8AD6EE0B38E73BA3
96395CB6E3FC4508C647D4D3A7D0BC42645861BA44B7923C4B2A5FCA922B01D546C3D7D7231401D6
5C4F15ADBBCF3CB1C3146BB9E49180551EA49AC2FED4D4B5C3E5E8B11B6B338CEA570990E33CF951
9E5BFDE6C2F423753743F0EC8BA05AD9F886382F6E2094CABBEE25BA5077654EF979623D4818EC05
7494019BA668967A5C924D1879AEE5004B773B6F96400E402C7B7270A3007602B48D145001480E49
F6ED4B450073FE2FBBB2D2FC2B76D7492F932E220210C58B39C0C6DE41C9EB5E79E279B50B8D66D7
40BEB1D3AFAD1A20127D4ACEE200870308D70036FC927EEEDF726BD0FC6F62FA9783354B54884ACF
01F90A16DD8E7180CA7FF1E15C0DF6FB0B0D3E5BBD7D64867895EDF4FD52C16F98B01FF2C6042242
578F9998E3BFAD0076BE168352B0D35F4FBBD36D63F2CFEED63D565BB0EA7BE655DCA3DAA2D4BC5F
0D95DBE93A659B6A7AB230C595861845E8667C6D887D793D81AE7ACFFB57C497E969A98BBD0AD36E
D44B2B3DB25DA0C643DCC6CE912F628086F7AEDF43D3F4BD0F4F874FD2B4D5B3879F9228582E4752
CC4024FB9E4FBD00799F892E3EDB05EEA5E33B98EFEC2CD962874AB4B6716FF6927017CC077CCC32
073B573DBD2E7C27F0A6A163A85EEB971A5A68F633A85B3D3FC9092AAF7321C6E3EC18923357F5CF
0EA3595D0D43553A3E9571725CDA5B2C53BCB2E72AD048CBB918919C6D241E84753C9786FC5DA6F8
2350BDD1ED2F756D5B53D4275F2ED6EB37125B61704C8C99DEDDF6A027F9D0077BAFF823C3D7BAD3
6BDE2ED49AEED63C2DBDB5F4CB15B5B9F6030189FF006B39AA5AE7C51F07782AF17475B3B85982AA
AC5696CB126D23821D8A2EDF70703F0AE035FD025F144F24DAFEB3AB6A4F1CC3CC234BBCB64B28F0
4FCB08B77527AFCCC4718C9AEE3C33E1AD3EF74182C5267B9D174D3BA0BC7BB63F6818CE55A39BE5

03A60803DB1401CFE9DF13BC413DF341682DD34AF3189BC9EDE6D49E207A2B35B909DF8F98903A9A
BFA3E81AB5FA6ACBAB4B7FA9096E3CD63ABDBAC5041CE564801690631EFC639C1AD3D4750D1A3D22
EC6A371A86ABA432AAB2DD471431421B81E54EFE52C83A7DD32374AE3F5DBABFD2F4C8AD353B7BBB
4F010086179E55B879D8F211FE7597CBC91C019E3D2803A299746F105A15B1F11456B63A5388DE78
218FCFBAB818E03C83695C9C6D19C9C73DAABDCC0FAB6B965A40D35ADB5C9A2FB48D63C41696D777
08AA460471459551CF7298F7354E3D36CBC35A6DA4DA7686F3EBBA95CA6E92C6DE4B58ED50F46405
5B728E338CE73CD7AA68DE1EB6D2A59EF0B3CF7F738335C4AECCC7D002C4955F6181D78A00C66F86
DA15DDB95BD3732CB292D7524129B5172C4609758B68238E957B50F02787356B2D3EC751D38DCDAE
9FFF001ED14B732B2AF18F9816F98E3FBD9AE8954F25BA9ED9C81485D15C217018F404F268039BBB
F00E857F3D98BA8A5974FB34D90698CF9B45EC098F1C903A67207A56C69BA2693A2A3AE95A5D958A
B9CB8B5B748831F7DA066AFD64EBBE23D1BC3562D75AC6A105AC40701DBE67F655EAC7D803401AD4
5793699F1BECF55F1345A458F87AE8C1312904F24E919620F5287EE8C73D49F6AF58524A82C3071C
807A5002D14514005145140051451400519A29368CE7033EB400B480E47FF5A96936819F7F7A005A
28C52119F5FCE80168A28A0040D919E9F5A32338EF4B4847BE280168A28A0028A28A0028A28A0028
C514500145145001451450014628A2801314B45140051451400514556BEBFB3D32CE4BCBFBA86DAD
A319796670AABF89A00B3CE7DAA96A5AB5868F6E27BFB948558ED4079691BFBA8A3966F6009AC71A
B6B5AE929A2D93585991FF00211D46220B8FFA6706431EFCBECC70406157F4DF0FD969F71F6C7DF7
7A932ED7BEBA21A561DC0380114FF75405F6A00A17075EF105BC91DA96D0ED1C11E74D1AC97320E7
A2125631D0FCD93D8AA9AF3FB1D0ECFC3FE1D927D28D8E93E22B0B9DB77A96A9BA24957782C0CB86
53B8761D0F618AF65AF34F11E94E758D72DDEDB53BA827816EE3823D55E08DC80438C2E71D3A302A
680331FC7F6B3932D9F8DAE2CB4F79963F364D0A5B9CBE70C229F1B304F03729FC6BBAD3AF2FEDE5
FECF5B6D5F55F977FF0068DE2C10C583FC3F28563F821FAD794782BC75649A4258E97E30D3B46452
CE967AB6963E5E791E746D1C6467D141AEDB44F1FAEA7AA9B15BBD33539E28C173A441713998E0FF
0011511C3D0F576FA8A00D2F1C4D7167A2A34F6CE74D28C974D63B8CF092303CA0003ED9E315CB68
3E18D5D74C81B44D2F477D1E422436D7F36CBADE3182CE9070DC73BFCC3EFC57A4B5B2EB1A6CF69A
8D82C56F3A60C324A19F07AEEDBC03F463F5AE1343D4F557BABBD37C3F7D608F0C6EAB15FD9DC664
65E038938DD8E338DD401A36A75BB9D52431C3A2417963198A691B569AE3C90C323742228D5BA0EA
C38CF3589AA4705FE9D7D74936BDADEAEABFB9CE9D2C56513A9C6E8E390085803C8DCCE78E09E293
ECB3C705B4F73A9DEF88751D526CDE69310896DE551C300B22232A2F180CC07D7357351D674DB8F1
15FF00877C537563A2E997164856CA4BADA6553907739C221EDB50E78CE680398D7341F11E8DA2FF
00C24BAFCFE1EBABC81123B69A4B7D92333600695DC02B8C9F954A8193544E9975E22BCB7F0E5E78
B749D5747D3A2FED1BC10C4028E788FCC5639EFDC76EB9ABB7361E18D43C03ACE93A1C167AE5EE9F
33436325ADBBC9340ACC369DCA19B68FEF03838F6AD9BDD4349D675DF07E909AE45757B0A347786C
6F0468EA13051D436FCE47DDCF63401574AD62EA1D7B4F68345D66C3C266DFCD8ED59E2DAA472192
3505CAFB67BF4AF5987ECF771457917953EF1BA295572707D0F515E61A3DF78BB54F1BDF68D65769
63A769126EB6F374B7F2E44C6046CC5D5B1EE01FE95D85C45AB687325FE9D0C73DB38DD7FA6A7DE5
3DE587DFD54F5ED83D4036E5901D4E188C93AC814B6040E508F4DE005FC09FC2AF82493D47B1AE7E
FF005C825D3ED2EEDAF5A1B5B97110BA48D99E3627A14F2D80E9825B18A7C57FA99F173D94D6DB34
E5815A2B86963CCAFDC05FBDE9ED4013789FC456FE18D126D4268DE7907CB05BC60979E43F751400
4E49F6E2BCAAF34182FB50B4FF00848A681FC55AA3FDA6582E3CC94E9F6A0FDC465951632381BB23
249AF4593CDD57C78B1496D7096BA641E6249240C23795F8CAB918240F427AD55F126AB61E11D36E
A6BF36FA84D74088EDEEE68925B93E859CAAED1E807D013C500796695E0CB5BDF8901BFB3ADD1D5C
4F6D6D2DD49BD6353813386DE1C923B4BD31C66BE8503000E3F0AE2FC07E1D30C07C49AAD94106BB
A8203208B705862EAB1804E06075C019AED6800A28A2800A29ACC415C216C9C1231C53A800A28A28
00A28A2800C5145140098C52D145001451450014514500277A5A28A0028A28A0064B2C7046D24B22
C71AF5673803F1A702194329041190477A474591191D432B0C1523208A48A28E0896286348E34185
4450028F4005003E8A28A0028AE56EFC43A845E21FB2ADB4A208B2CF1AD9CC4BAFF7BCDDA63C7FB2
0E691FC497CD7F68D159CDF639D1F74AD1308E323A16257773E82803ABA2B97B4F144EC238268609
2E5F3B763B207C7A654E3F3A8A1F174F7DE0BBFD6A1B3C5C5AB3AF916C5A62C55B1852CA9B89F6E3
3DCD0075B4572B1F8C448F691F956C925C425C42D3B79F9C0E162D996C67E6E463DE991F8DA24B99
ED6786212410891C99D6323AFCCC8DCAA71F7B9A00EB68AE374FF1CADCDB2BCDF606776214DB5DAB
C6C3B796C7065F72A0549A5F8E60BBD316EAE2DE48CF9AD110CBE5B120919D8C7201EC4F5A00EBA9
AEEB1A33BB05451966638007A9AC1B2F137F6B4D7D6BA7D9B0BBB600AA5D48B1AC80F4395DC40F7C
76A9574037B289F5CB9FB7B02196D76EDB68CE72309FC447AB93EA3140119D72EF54631E816A258F
8FF898DC82B6E07AA01F34BFF01C29FEF8A96D3C376C97A9A86A32C9A96A08731CF720110F5FF548
3E54EA4640DC475635B20003006052D001451450015CF78B95AD74B6D5E1B76B892C94BBDBC76EB2
B5C47FC518C8279F6AE86908C820E707D0E2803C4ED3C6B25AEA16F2DBD8E99A5453A89AD00D4A0B
78648BA797222AB1DC3DB24575361E3C9353BA8534ED1E6BBB79DF64B2E971CECBBFA12659618E3D
A3D7764E2B5B52B1D2B53BEB6D135FFB3F99967B2467C1940FE24627CC5917D55862A1FF00842EFA
09648EDF5ED68D916C8B697556200C74DFE5F9C077C0947D68027D4359B4B694E8DA427DA6FA76F2

AEA44DF29B4CAE774CCA0E0E3A0623DAA8C367AC689E1DBB4D244177A95BA15B5F32CDCA90073966
60CC4FFBC7F1AEA2D342D3EC4C6F1DBA868BE650B9DA0F72067927D4E4FBD5A8EE4CAB1B2C132EF2
47CEA14AFB904E7F2A00F2CD1E06F0DF87750F14786EEEDEFAF2E24F37574D5D444F0BE32C0B001A
30A4E76B6EE3D3AD68DF5ADB5BF82750D6B5AD76DAFB50D5E002291597C8248CA45046490DFF008F
13EFD2BA4D4FC1FA56A0B2C96B0CDA75ECAC1DEEAC4F90F295E82423FD629F46C8C565DB5B5FC7AA
DBEAB6DA30923D8D1DCD919A48596443C3C313011127FBC48ED86A00CF835DBA7D4744BBB4D2E0B4
D4AF6C4DBFD9B55B996D65257FE99AC4C303FBC40EB58FA1C0F6B6DE24B78F4AB4D4F572E779D2EE
446B213CEC3334680C80E738048FA9AECF51D29E6F1459EB16BA36A89A8346616BCFB5C463B78C91
9063690839FF00654F4EB5BBA6E93F6495EE66D42EEFEE1F204B70CB851FDD5540AA07E19F526802
87837405F0F787ADED5A27FB4CBFBDB97924F31CB9E7E673CB11D33EDDAB6D6EA121BCB7F3150ED6
29F3E0FA6064E6A619C9C918EDC52F6A00E5B5AF0F913CD7DA7471C8972BB6FF004D948115DAFA8F
EEC83B377E87B1187A0F86A3BA026D17C61AF436F6EECAB693AC52B5BBF752658D9B1E99278E86BA
DD6757B7D3A0F246A767677B2F16CB72A1B7B7A04DE85CFB022B3B4FD0BCCD524D7962B8B4D5DA31
14923CCC619D474062DEC147A7719A00A1145E3DB6D625824BCB4B9B723297434B8F6E3D0FFA523E
EFF80915B76FE1A8C5FC77F797B75757080E448F8424FAA8E38EC3A0AD1B4D423B899ADA41E55DA0
CBC2C79C7A8F51EF572800A28A2800A28A2800A28A2800A28A2800A28A2800A28A280131EE6968A2
80100EBCD02968A0043473EB4B450014514500145145001451450014514500145145001451450014
5145003762654ED5CAFDD38E9514B676B367CDB6864CE3EFA03D3A54F450043159DB413CB3436F0C
72CB8F31D10067C74C91D6A6A28A0028A28A0028A28A0028A28A00CED6747835AB1304A5A3950EF8
274037C320E8EA482323E86ABE857F772432596A714B1DF5A00B24926DDB38ED22950060F7E060F6
A92EF5DB78AEDEC6D11EFAFD402D6F060F979EEEC7E541F5393D81AA177E1A7F12448BE267596DD5
838D3AD6475873E9237065C1F50ABEAB4015EE7C5B36A32C965E13B11AB4E0957BC91F659427FDA9
70779FF6630C7D715D159433A59DB8BD36EF7489F3B411144DDDF6824903F1AAB6CD756F7C6C8D92
4163181F677B6E54A81F75863E5F603F3AD30314011987123BA315671863927F100F00FE1515B59C
70B0712DCC8EB904CB2B9CFF00C0738FC85592C01009C67A6696801A110485C22873C16C7247D694
10C320E4504E0669B2BF96858024F40307AFE00D003EB36EBEDEB788A97B1C76EC795168CEFF00F7
DEEDA3F15A96FF00501A7DA79F3432B0009630A993671E83E661F404FB554B5BA3A8592DDACEAF20
1B944464407D994FCC3F1140181E21D59B52BD4F0EE9C2E2FDCB817BF649E20F1467FBC77A94FC06
7D2BADD3B4FB5D2AC21B1B288456F0A8544049C0FA9E4D4B6EB22C0BE6AC6B2119611E719FC6B3FC
41ABB68BA6B5D8FB100A402F7D746DE15E7F89C2363DB8A00B57D6297B1AE59A39A33BA2950E0A37
F51EA3BD57B2D4665B8163A8A2C777CF96E99D9381DD7D0FAAF6F7AE7A0F8836F71A7EE55B07D419
0BADA5B5FACACEBD9D010A594FAE05553E37B3BBB6D3AEF52B4D2E3B274F3996F2E95678241DCC6C
B8523D7771401DF515C9DBF8FB4DB9D574DB24098D477FD9E613A147DBFDDC1F98F3DAAD5E78BAD6
C3569ACAE6DE4448D46D99A689448D8CED0ACE1BA77C62803A2A2B92B4F1E5B5F247E56997D11756
DCF31842C2C3380C049B8E7FD9069DA5F8DEDF51D3E2B98ACAEE753BC4D244A8AB1EC241243386C6
460704D007574572B178EECE5B2B3BBFECAD5A38EE5CA859E0589E3C7765760483EAA0D41278EA3B
6B78EEAF6DFECD134AB118DD816059B68C302412491C71D7AD0076345614DE2AB48209A57B3BFCC4
A58A2C39638FA1FD4F1EF5AB65771DFD8C17710212640EA0904807E848FC8D0058A28A2800A28A28
00A28A2800A28A2800A28A2800A28A2800A2933ED4B40051451400514526E1EFF95002D145140051
4514005149B8671919F4A5A0028A28A0028AE53C43A9EB76FAC5B5AD823888E1F0BA7CD379B8E483
2AB048FE8C0E7B51278935378165874F9D079C23064D3AE09739E46D00151FED9F97BD0075745719
2F88B5C5D466D9A75C3AA263C81633058CFA9908DB27D13A77ABCDAF6AF1B167D27F778007CB206C
FAFDDE9F91A00E968AE42EBC5FA90456D3F48B7B85CE19E7BA9215FC0885B35AE0DFEB5A55AC90DD
AE9DE68CCFE4A895F1D308ED8039EE54FD01A00B17FACD9E9F2AC0EED2DDBAEE8ED201BE571D3214
741FED1C01DC8AA6B6DAC6AD837F2FF665A9FF00975B5933338FF6E51F77E89C83FC66B434FD2ED3
4C8992D62219C8324AEC5E494FABB9C963F535728020B5B4B7B180436D0AC51839DAA3A9EE4FA9F7
353D1450045716F0DDDBBC1711AC9138C3230C822AB2DA4B616E63D3D21F2D23C45039651BBDDF9C
0FC0D5EA280238BCCF250CDB449805B6E719EF8A78208C8391ED4B50A5AC111CC512C796DC7CBF97
71F538EBF8D00579F56B3B5768AE2EA049D4063107DCC149E0E00CE3F0A7CD1492B3B3CE45B80195
61560F9FF781E47B01F9D5BA280334D999AEE3970E60DB905E59032B7BA938C7E157A15956202675
793BB226D07F0C9FE7525201818249F73400B451450014628A2801BB132A76AE57EE9C74FA552874
5D32DEF2EEF23B1805CDE605C4BB016940E0024F51EDD2AFD14014E2D274E8221143A7DAC71AF011
215007E0050BA569CB726E56C2D44E53CB32885776DFEEE719C7B55CA2803217C2DE1E54811741D2
C2DBB17840B38F11B1392578E0E7D2A68FC3FA343E6F95A458279ADBA4DB6C8379F53C726B468A00
C85F0AF8754CE5741D314DC27973116918F317D1B8E47D6B46D6D2DAC2D63B5B3B78ADEDE25DB1C5
1205551E800E054D4500145145001451450014514500145145001451450014514500145159B6DAA3
5CCF8090243E6320324D890EDEB85DBFD68034A8E6B1C6BF135925DC711788DCF91210DF739C6E3E
DD3F3A64FE238E0B679CDB48C8B70611861F363F8A8036E939F51F95531A9C1F6C5B521C4AD079F8
38C63D3AF5A6695AB45AB42D2C31BAAA9C64B2B027EA09E7DA802F9DDD88FCA8E7D4565C7AFDA3CF
0404324B3C8D1A2164392BD790C47BE3AD5E37482F85A6D7F30C7E6671C6338A009E8EF54EEF515B

5BAB6B6104B34B393808506D03A93B9867F0C9F6AB1E7C40A83220663800B0C93E940125273E82A2
9AEEDADD82CD71146CDD03B804FE7449756F14914724D1A3CA7118660379F6F5A009B9A424F619FC
682C01009009E83D6A392E228D58B3E768DC428DC71EB81CD004B4531268E4844C8D98CAEE07DA88
6549E259636DC8C32A718C8A007D14C3346B2796586FDBBB6F7C5321B98672C236CB2FDE041057EA
0F4A009A8A28A002933F5FCA968A002932071914B450027E34B9E68A2800A28A2800A28A2800A293
6804900734B400514518A0028A4C718A8671721505AF95B8B0DC6524E17BE00EA68027A2931CE696
800A4CFB1A5C7BD260E7EF1A005A2931CF5340047727EB400B4521CF623F2A39C751F95002D149CF
A8FCA8F9BD47E5400B451CD14005145273E83F3A005A28A2800A28A2800A2933EC4519FAFE5400B5
50E9B67E779C2DD049CF2A31C9EA78EFEF56E8A00ABFD9B69BE46F217F7872E3276B1F71D0D31F49
B292331B44DB37EFC2C8C003ED83C7D3A55DA280299D2ECF746C21DAD18215958820631D41A75AE9
F6D651B25B466256EB8627F1E7BD5AA28028BE93693797E72194A1CFCE73B8FAB0E86A44B0B78983
40BE4E13CB5117CAAA339E17A67F0AB5450055BBB08EF422CCEE63539F2F0B827D791907E84546DA
540EAE0B4837F0C548191E870307F1CD5EA28033EDB4A8ED136C3332023076C512E7F24152CF6097
1E56F95FF76A547CA8739EFCAFF2AB74500628F0DD9097718E2E47CCE2145763DB2540071EE2A41E
1EB5104D1196622520B1F9723E985E2B5A8A00CC3A327F64AE9E2E662A872B23E19BF1E306ABFF00
C2370939798B1DBB788917FF0041033F8D6DD140193A8E850EA335ACAE630F6EA42398F2EB9EEAD9
F96AB37876711158B5031B1EE8244CFD7648A7F5CD6FD1401474FB06B15933379AD236E24EE3C63A
7CCC4FEB57A8A2800A28A2800A28A2800A28A2800A28A2800A28A2800A28A2800A28A2800A28A280
0A28A2800A28A2800A28A2800A28A2800A28A2801A91A44BB634545F451814EA28A0028A28A0028A
28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A
28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A
28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A28A0028A
28A00FFFD9}
}}}}{\shp
{\*\shpinst
\shpleft6440\shptop1626\shpright9120\shpbottom3240
\shpfhdr0\shpwr3\shpwrk0\shpfblwtxt1\shplid2029\shpz1\shpbxpage\shpbypage
\absh15840\absw12240{\sp{\sn shapeType}{\sv 75}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn pibFlags}{\sv 2}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn fEditedWrap}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn pib}{\sv {\pict
\jpegblip
FFD8FFE000104A46494600010100000100010000FFDB004300080606070605080707070909080A0C
140D0C0B0B0C1912130F141D1A1F1E1D1A1C1C20242E2720222C231C1C2837292C30313434341F27
393D38323C2E333432FFDB0043010909090C0B0C180D0D1832211C21323232323232323232323232
3232323232323232323232323232323232323232323232323232323232323232323232323232FFC0
001108007100BB03012200021101031101FFC4001F00000105010101010101000000000000000001
02030405060708090A0BFFC400B5100002010303020403050504040000017D010203000411051221
31410613516107227114328191A1082342B1C11552D1F02433627282090A161718191A2526272829
2A3435363738393A434445464748494A535455565758595A636465666768696A737475767778797A
838485868788898A92939495969798999AA2A3A4A5A6A7A8A9AAB2B3B4B5B6B7B8B9BAC2C3C4C5C6
C7C8C9CAD2D3D4D5D6D7D8D9DAE1E2E3E4E5E6E7E8E9EAF1F2F3F4F5F6F7F8F9FAFFC4001F010003
0101010101010101010000000000000102030405060708090A0BFFC400B511000201020404030407
05040400010277000102031104052131061241510761711322328108144291A1B1C109233352F015
6272D10A162434E125F11718191A262728292A35363738393A434445464748494A53545556575859
5A636465666768696A737475767778797A82838485868788898A92939495969798999AA2A3A4A5A6
A7A8A9AAB2B3B4B5B6B7B8B9BAC2C3C4C5C6C7C8C9CAD2D3D4D5D6D7D8D9DAE2E3E4E5E6E7E8E9EA
F2F3F4F5F6F7F8F9FAFFDA000C03010002110311003F00E9FC2FA45EDB6BDA45E5CD848D6B3BB189
8818242921B93C63EF0CF240C8CD7A3EABA35A6AFF0066FB5A6E16F2895781CE3AA9C83F29E323BE
0555F0D89A6F0EE96F750C6248E2063E338182AAC3AE0943FA9FA579F7C5BF15DD065F0EE9124CB7
036CD73244D8C2F65C8E7AF27F0A4DD95D9518B93B222F895F10A4B0BF874BF0F5C5B12E7CCBAB88
D55CEEC6D0BD319C0E4F27803B5795D978A758D2EF4DDE9F77B2656C10F0A90467273C7B567A9799
EDD677F2E0E72D8C9CFA9FAD2CF6D3B42E628B865DC307A0AE77393773D18E1E0A3667B1F867E39D
9DD016DE21B436D3AE035C5B8DD191EA4751F419AEF2C6F3C2FE3374BEB536D7D2DB82B861F3283F
DE43D475C647D2BE500BE45C866DB87008007F5ADAB76BED0EE46A3A75E5C5AA9215E68188603B8E
3E95A2A9DCE7961BF94FA2BC79159C3E19457B75DE922C76C5171E59EA47B0DAA463E9C71C797D7A
BF8475FB4F1B78523BB9218DCE7CAB985D772875C1E41FC1BF1153F8AA6B6B1F0ADDA1862F2CC621

8A2385009E06D1FECFDE007F77B56BB9C8D5B43C868A28A0028A28A0028A28A0028A28A0028A28A0
028A28A0028A28A0028A28A00F64B2BE8B4DF075ADECD9F2E0B0491B033C08C1FE95F346B3AA36AD
AADCDFADC4F25D5CC85A55C600EF81DF8E07E15ED1E2FD467B0F84F690CCFB1EF628EDF7403388C8
CF39FF006060FB9E2BC674D922D36496675F370729228C95CFA8ACAA3D6C7661236F7849E0B7B7B7
B69A467CA2E2458D4F047463EDCD56C4892156568D5F90D8C0C1E46455F8E28679A669E678E5901D
C2220866ECA07D7159A6EA7FB682855CB80A53048518F7F4C560CEE26D421371206DE8ACA14A4483
EFFAF3DAACDAB1B9B696DB68C104919E95243A84BA5C2F768B148A48019C6EEBC71E95505C1D3EF4
36005380D839383DEA96A886ED2B99B0DF6A5A34E23B4B89A2676E551C807DF1EB5EEBE15F88369E
27897C33AFC1E45ECF1792B3020ACAC00E791C3F7E9D6BC6FC4164CB776734286442C090839E0D48
D73751EA497E86E60308DF134ABCEF073D4738AA52699954A2A57B1EF1E33F0C69D6DA27DBACE15B
77B50A8550712292179F7E73BBA9EF9E31E755E856DE208BC69F0FEF2433411DDAC1E74D0C44929B
4EEC107A67691DFD7DABCF6BA11E7356760A28A281051455AD3AC27D52FE1B2B60A6594E06E38038
C927E801340156A482092E6E22B785774B2B8445CE3249C01CD7A4E8BE06874DBEB1BC96E7CD9A1C
B4A850142D8E36F718273939C903A5686B37FE15D1AE0EA7AACD610DC10AC1E4DA5CED3C151D7233
D473C0F414059B39093E1D6B291B32CD64E541211646CB7B0CA81F99AE46BBFD43E327846C6DFCD8
EEE7BA3B82ED8A120FD72D815CBDCFC61D1F4CBFD9A2F86E142506E965D909C1E71F283C74353CC8
B5093E86456D7873C393F88AEA444956186200C9291BB19CE001919CE0FE5F40635F8D3A56A17D0C
1AB6816EF18380E58485723B061EC2BB1F0E789BC14649EE6C2E23B09A450668E791A3519E70013B
4E39FBBD33EF4D4931384974323FE15C6B1FF3F363FF007F1FFF0089AE7F59D1AEB43BEFB25DF965
CA07568DB2AC0F71DFA82391DABDAA0992E2259A2915E371956520823D735E5DF1021922F1317795
9C4B0A3AA9FE01CAE07E209FC699272D45145004DE37F12C3ADF87748D16D86D6B400CCD28DBCA20
50179E7A9FD2B907B06B5DC85D99401BB77463EC6B4BC51E1D9B4D86C6FEEE7D8976C648761DC40E
0E48F51B8567DC113CA2294DD206C9425B7138FBDC0ED93584B73D1A1651D0AF716B8F2ED2D6244C
0329766C1C81DCFD69BE7987CBB730C0CE3B9C83D0F520D286BA74D93A2C3202196575F959091F29
F4CD2C7E617D93C244433800038C562DD8E95A8CB8859A1D862456283E6CE4293E9E9511B7892369
2EF7B232908570707D08AB9719B68963F91D9C865DC7803D71549AD64BA90B6D9255C679E0E00E68
5307127D1AE60B097EC1AAB49E5B00237521B69381CFB53B59B7974DCCCAE5ADFAEC5EB83FE4564D
BDBEF2B1B8764560DF20CE07B56A2DF4735BA8499E78F791FBEE19579EDE955BB057377E1D6A9FD9
1E29B55BC0AB6B7E3ECF302D95756FBBB80EBCE07E26BDAB58F0569B736F7935ADA6CBA68BF74B13
6C50E01C607419E01FE8726BE78784465F0018C0E02F515EA5E0FF008BB6915A5BD878859908FDDA
5E63208E00DE3B7D7DAB5A6EDA338B1345FC51228FC29AA49A2CDAA6C448A2DFBA376C498538638C
718C1E090783C74CE1D7B7DADEE99E21D2DDAD6EA2BCB4990AB18DFA8390471C8EF592741F095B43
3C2F159A06C6FDF392CBB7D096CAFBE319EF5B1C471BE03B1B5BED7E44BB812744B767549065776E
51C8E87827AD69FC46F135EF84ED2C6D7448E1B556DCEE5634C01D82AFB9249E3FAD627883E24E89
A17991784B4C867BC862317DAF695880E3AF773F283939E879E4D78F2EAB7F7DA8996FEE6E259A67
F31A590E7A9C9C67F1359549E9A1D146936EF24747AB7C43F146A91C36979AC49040C0B318104449
1D3257F957137A50CE2DE38F72EEC95438E3F1EB5ABF688AF22906762C642B338C73D7207E759372
B0C726234E5B0AAC9D318FE75926DBD4EC5049688A914B34F1BDBA2878D4B3E08C703D6ADD949235
BBB4A4A02061C81CF1C62A58ADA2CC7226D90B0C4A8AB80ABD09CF4CFF008D6C9D2AC2389619F7B6
E2A44A0FCA01F5FC29B689506B532608ADA6B589DE55C8970FBBA8F4238E9524539B6BA925F39F6E
0296947DEC7715AF3E8A20936AB21B7954F96E38191DBF3AC8D46DE6B748813971C383C9FA9A4B60
69EE7AC7C21F1DDADBCD368F7D2796B3B878DF6E115B1839F40703DB22BA3F88F1BAEBB6D2146D8D
6C14311C1219B233ED91F98AF0A92EADE1D3F742C52567F2C9504291D4E7DABE8EF877AE2F887C3F
6725CC0AF776318413B20C9CEE5F97B8E1467D6B5A72E872D785BDE479AD15DD78C74D8350F13D9E
9DA6DAAC77D286699CAEC47CF3BB3DF18624807D3923038FD474F9F4BD426B2B90A2588E0ED39072
3208FA820D6A739D378FA3D35BE1A6906EC66E112DDADD54E198ED50DF860FE78AF24BABF82CEF23
B9B7BB11C8030E808504F20FBF4AFA27ECB6379E0282DF5158DED5AC10B090E00C2020E7B118CE7D
ABE651649A8C100BD67F2557019000D9EB8FF6BEB594D6A76E165A343FCC17DB05B4B31B7C1694B3
12A46738DB52C774CB222F932ECDB92C4E2A4B2D323B548E23202CE0EE3BC9518E9903D454173E6C
97E41712C013712C73F813584D5CEC8966EEEC4B18F344601DA73D481D38A7010B0E1CA0EA4648C0
E99ACA983485D6408F961B1946DC0FF0AB1E5C661D8F2A16CE724E0935CFCB66684F77E5A4627895
9483B768240C63353BA42D7105C08360C65F6E1837AD57B8F3E7B684A08C28072164C8144768F121
D877275650F92C3DBD29A6C08FC89ADA47B9498C89D557B11F5A91E18648D2E59E425B0D247F2918
3FCAABDC595EC90B8D8522E38C166C7B8AAE11ED18C4708738F2D41357CCDF515BA1B5A538845CC7
6B7D35A79BCAF95215DD8F5C1AA373F65B4BA74B98663799C969493BCFAFE35341756D142B23280C
5C216F418F4A5D5DE286E64BB7B9DE66887968A0330C0C73D71D688CA4DBB90E105D0A93C87ED119
B99D238653B6331AF4C7538EFE95645ACCBA73DF08BCE8633B03123E5CE3961E98A834FBDB468D62
9ED2579769F2A41CAAFAFD3EB5665F157D8AC65B2B6B65C4C811D940E9D3B5572A7A05DEE654F6CE
D03CD2B2BBA60A4712E7209EFED52D9E9ED7FA6FDB0DB3C6A48560DE9DCA9F6AAB653DD2DDC60076
4DA70AA7A0F7AECEC35286E74DBBB3544492256CAE7EE71E9FE14A5CCB42925BF430A0B7BE8DA6D3

A316CB18396629FC231C83EBD2AEC0E750B916E2D879717CAEB2F2F27A63DF8ACA6B82234E635B82
E13838C0F73DC57491AC50A29BA788997E547F33CBDB2638C9F4EF46A0D22A4B6B06B13CD1B492C3
6B047E6089782ADEE3BFAD635F3DBDA0104C4C92BA70CFC63D315A535DC9670896D0929F72671974
393D07734BABDCD8DD5BC012543712100EE8F01723A027A60F7AB466F6D0E69AF1A3B8921883087A
B1451DFD3D6BE80F8333A4DA1DC852CC1420CB0E4FCD27F857CED34C2D898C8901058076390C3B76
AFA33E1878B7C2175A659689A4CEB1DFC70AF9892204799864B1CFF1609247B115BC56A725797BB6
3D0A5B2B79EF2DEEE58F74F6DBBCA6DC46DDC30DC743C7AD79478DBFE46FBEFF00B67FFA2D6BABF1
56AD71A3F8A349BA9448FA7A231F2D580CBE1958E3B90ACB8CFE18C9AE1B5FD49358D72E6FA38DA3
4948DAAC79C050A33F966B5EA719E83A92492FC2F9238943336940631927F75DBF1C57CEEB7A217B
4963DD288A33F23A9D8A4F6EBCFAF6AFA3D52FFF00E15F20B374FB59D3BF76C06DC7EEFE5EA4F3D3
9FAF4E95F30C2924CC8BB0ED624FCC48526B2A876613A9B16B65777B2DC5EC50B38894B4918E8A48
FD00145CDABF96CF843B102951C65F6E3F3AD78E2BD86D66DD08963B9504857C92703D3AF15853CD
34EB20D8461890A7A96AE7A8F43BA0915623244D1AB2040A319618DDED8A73793223164F35A4F941
FEEFE1CFF3A4FB5ADCAAF98E01C1CEFEC69F145096091CAD173C11DCD73F5342DC568D0A16310681
1303039CF5E462A9A895EE5CC4853E7C8627BF1C55DB1909CED95902AED386CEE39EF55EF2429E68
30B797F312632071DE8E6D6C3B7535ACEF24B3763759DF3719009C1F73E958F7091DF5F3C9239811
38DFDDCE7A01496FA84C21590B2C642654927F2A8DF506844697506C6C868F2B82DFE4D34A5706D1
75B4F8AEB4EB88A0B9C1550CFE60DA491D31CF354F54922B9582DF62236C0A1930CCDD3EF55496FD
6E8CD2CAFE5F9606C50719E7A56D4D0C1369AB736096B7180A256873946E383EFCD6B18B8ABB326D
376462D9D9CB64642F24AA84600EC7EBCD5196DBECECC642E549EC2B7F50B2921B57579865B8D8DE
BD7AD300862B306F47998C058BAD542A27ABDC52A525A2337C3ACF3EA525AB48521C1CB9F6E8319A
B69617573E2B38B816D05C3EDF365055429E84F3D7DA99A1EAF6D6B7B2C291473171FC5D07D0FE15
3DFCCC675B7BA546451945DE7701DAAB9ACC9E4E68EE69DDE89736E5B50686330449B4BC646588E3
3B7AF615997708FED0B7B9923925E9234520C27039EBD4D6B43A90BA8E0825431CC4AA2B3C9F2AAE
7FFD7F9D335931AEBB01273682251BA76CFCDCF353CE997CBD0886AEEB348DF620D0CB88C4487007
7CF4C75158DAB5E4135D0FDE86D990485381939A9E456B92F1C37812073C86185181D41F5AC69222
91A44B2A64E58E4648E68493D452BAD0CDB972ADE632B1DE3E556E94CD2AF66D3B55B5BD88957865
5752091920E71C73DAACCB6E66930AAEE8A4649A856DCC52EF23233D87F3AE84F438A74DB95CFABB
C777C971E17D337E167B8759C2007A6C39E7D8B0FCEBCEABD074EF0D8F13F827419A5BE9229A3B65
E4AEF52368078C839F94739F5AE12EED9ECEF27B590A9786468D8AF4241C1C7E55A2D8E46ACCF64D
246FF0BD827F7ACA31FF008E0AF98259ADF44D46FAD6E224B87825789D393B886EA3E98AFA33C3FE
24D20E89611497B1432246B0324AC148655E4FD0E383D39C75E2BCC3E32E8AD06AD6BADDBC96EB61
7A806F5518F300FBC48EBB94FE95335746D87972CAC72B6BF67BAD3238E3BBB884DBB90C8EE36853
DB8E71D6AACB67F6C57C663453F2AA37240C6307AE7BD50B6BE79C89E6226642CA108EAB8EA0D5FD
22ED52D4B968E1876956DC3F780E3B5734AF63D38D8CF48FC82E1E354E73D77648EB4D9A57631E4C
9E5E73B82E3F0AD422209BDDC619772B6724835550796C3E57113838E7935CB7BEE6B6196DBD3616
3F2B1C80139FAE6A392CAE9A477F3BCD4738DADC6CF5E9ED56218666909F9589C10A0E31568DCCD1
2F993C6FE502124E3248A149A0B1424B5B94BF86DE5F9A071B63709D78079AAD2431A5E2BDC5F3FC
848650A430F4DBEB5A3E6594E5D62790C63B6E3903F1A6CD6C85217701C839054649F7354A6EF713
8DD198F2D998AF2D97CE9269976AC92AF453FCAA8E846E74C92584DD08D9DF06DC8E5BD3F9D6F416
915B5EBDCC8198B8EC40D83B715DADFC1E1EBAB4BAD45D10DD2C2BB4A81C36DE3F5AD3DB251B7733
F61CD252EC719AC3DDDC34104476DBC9B4CA382C3E99A86E2DD6EAC84508985C0F943C8C02818EA6
AFCF1C91A287B679CBAE07CC7720EA4FB8ACE9AF56E6016D6B1FCCEC14A4A32DF5FA5446FA2468FA
F993E87E12D2447B2FA59649DC6E592138C7A819AA7358476BAB48B712B5C2C4305FD47AD58B6B86
B591AD991D0A2F9792795C7240F5A975590DC5B22C43CB90385F300E4FA0AAE79395990A9C62AE8C
75907DA2364126E8CE543124103D45693C9148BB259A09A6DCA4306C2FD39E4F150E9122C1AF46D7
7048D1B651C1ED91D6AD5EDA4658C8BB5E3898154461B831EDEBDA9B293B09AC69AF0D9A46B6E215
2DB82C6D91E9C67E95405B4E6D44CD68CAA38F314E081D7E61F855CBFD4AFB55B784341B6546C076
3C32F5C7BF35621796E6D1D1ED9CEE423EF0E0F4E7DB9A1E8095CE7664507CB217713C143F293F5A
A6219559978C83C80739AD811B476FCC0A25893E5208233599E691869B686246E2B9C8AD62CC671D
4FA87E156A2750F0158C6C70F683C92BB48200E84E7AE4115CAF8CA348FC597CA88A809462146392
8A49FC4926B5FE0CC6E3C3D74C1BF762E085058B6E5D8B83EDD2B17C5B72975E2AD4248C300B208F
E6F54014FEA0D74C1DE28F32AAB4DA23F0F686FE20D48DA2CEB0858CC8CE57760020703BF2477156
BE2C5BC3A27C30B4D099BED13C9703CB936631862E4E3271D71D6B3F45D5A6D13548AF611BB6E43C
65880EA7A838FCFEA01ADAF895A8C5E21F858B7A238E36374A0A6E0E632188C678C12307E869CB61
53F8D1E31A4C32D8B58DD48C985F98AB1FF58B9C11F9FAD6F5C44F2C6EB0DB1FB36E0ACD818C8238
07F2AA896F0EA9E1DBE631AC4F65E5EC6503E604E39FCEA2B5B9992D6DEDC48DB25F94F278033D3F
EF9FD6B959EB47416E825AEA2D02C681210A1A2CFE3FAD57245C3B4B1A98D7002C6DFC07D78CD5BB
8B702F76EE2C59090CFC91D2A268DA1B39242FB8630462B9E4AC6CB51C3CB59544A1B79500900E33
9E2AD19845237DD650080413B7F9545A75CFD91FE65F37730FBC7A55EBB9C48AD1A461188C337AF3

9CD65B32BA15BCF824889F2C2843F3211D3E94D31AAA24F9C288F690719727B8E6A0485CCA966653
B9F29E663A67BE33FD692E6C14DDED790B6E50071D00E29A498876C612894A31FEE80324AFBD5854
56F30385280FCF1B1E706A19EF1745B7598C3E7A05312A6EDB8C82739C1F4F4ACAD335C69ADD5A48
0332B15396C822854DC95D09D451766750228A586E23690FDD568987381E9C1AC39B49115C8BCB90
DE5CBF22F96A7B9EA4F18EA2B574A8FCBB7B885588F3DC4808FE019FBB536B332C9E1760102F9AC1
3AF4E01CFD78AB5A75076673D7B0C96F7296D733A6D8D33FBBE703B1278F6EE6A3BCD3C425245B96
9EDBD62048563D3BFB56F49A79B8D374E904880C9160EE8F71E3D7919AA1769F62956E010D1AA853
081852DCFCDFE7F3AA5214974213AADA4F6B3DA9808676CA3B0C60E00CFE79ACF6B44748EEE3B88C
4C32246C9196038AD7B409A869A6EE440277F9370ED8E98EFDAA8D93AB288CC6A3692A08EFCE727D
69B9D85CBCC16F702EAC96378DA47818B3BA9C8C123156A691A632081FCADA800561D700D3CE8C24
B32E93F9610B332AA7DEC0FAD60595D486EE7DDC94C60E695B9B5457C3A172550D6B35BAA932328C
15E73549200D2A42A048BC64EDE2ADDF5D6215BA8D363C5B50E0FDEC83CD52D2435D4F1C68ED1820
8E0E6B48DD2B99C926CF76F8457496FA8EA9A72CC3C92AB2C51E7EF9E8580F4E9553C5E9B3C557E3
CB48FE75384E872A0E7A0E4F53EE4F5EB557E174061F18C70B32B8166C7257FDDC77AB1E2BBA82F7
C4D7B3DBC8B2444A80EBC838500E3D79079AEAA5F09E66257EF198D4514568738514514005145140
0514514005145140051451400514514005145140051451400514514005145140051451401FFFD9}
}}}}{\shp
{\*\shpinst
\shpleft6600\shptop3213\shpright9093\shpbottom3293
\shpfhdr0\shpwr3\shpwrk0\shpfblwtxt1\shplid2030\shpz2\shpbxpage\shpbypage
\absh15840\absw12240{\sp{\sn shapeType}{\sv 75}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn pibFlags}{\sv 2}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn fEditedWrap}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn pib}{\sv {\pict
\jpegblip
FFD8FFE000104A46494600010100000100010000FFDB004300080606070605080707070909080A0C
140D0C0B0B0C1912130F141D1A1F1E1D1A1C1C20242E2720222C231C1C2837292C30313434341F27
393D38323C2E333432FFDB0043010909090C0B0C180D0D1832211C21323232323232323232323232
3232323232323232323232323232323232323232323232323232323232323232323232323232FFC0
001108000600A003012200021101031101FFC4001F00000105010101010101000000000000000001
02030405060708090A0BFFC400B5100002010303020403050504040000017D010203000411051221
31410613516107227114328191A1082342B1C11552D1F02433627282090A161718191A2526272829
2A3435363738393A434445464748494A535455565758595A636465666768696A737475767778797A
838485868788898A92939495969798999AA2A3A4A5A6A7A8A9AAB2B3B4B5B6B7B8B9BAC2C3C4C5C6
C7C8C9CAD2D3D4D5D6D7D8D9DAE1E2E3E4E5E6E7E8E9EAF1F2F3F4F5F6F7F8F9FAFFC4001F010003
0101010101010101010000000000000102030405060708090A0BFFC400B511000201020404030407
05040400010277000102031104052131061241510761711322328108144291A1B1C109233352F015
6272D10A162434E125F11718191A262728292A35363738393A434445464748494A53545556575859
5A636465666768696A737475767778797A82838485868788898A92939495969798999AA2A3A4A5A6
A7A8A9AAB2B3B4B5B6B7B8B9BAC2C3C4C5C6C7C8C9CAD2D3D4D5D6D7D8D9DAE2E3E4E5E6E7E8E9EA
F2F3F4F5F6F7F8F9FAFFDA000C03010002110311003F00D1F8C161043E24B7BD5C892E2DB13311BB
0AB9FBA3A66BCF3F7B730CBA42395689FCCF398927206303DB14515CD2DD9E9D0F811746953E9BA7
8860B90F03C61DB782186579C73423896E490CEB20E43673CE3FCE28A2B9EAF43AE2451013CB246D
C2A1C8C7739EF56F6AC36EDF2AFEEC90BC7F9E28A2B9BB1A91DA402E2EE60ED89204F3060705BD7D
6B2EEEFE6FB411FC29202BF5FEB4515B456A4322B7B77D4ED2E25BA7DE2246217DFEB8ACAF0EC4B2
DF5C345948E3940453C9033EB4515BAFE1B39AA7F16277B34C192D429645595D5541C83C0E0FB572
7ABDEDD596AF0DC4FE5CD22B139008C9C77A28ACA9A563A5F53615E40E8A269161B9E5D07527EB55
634DB2BA447689641F3FF10C7BD1454012B46B31265C3103218A8DD9AAB7172D6B2DA98C9DA4F207
1FD68A2A5EE8B8F533AE6CC8D56E243290E33861497F2A59416B2EC2C193E55CF00E7F9514575477
473CB663FC1F18BABDB8763B36C6D22EDEC706BD07E1CEA9E7F8E6DADECA3F222462921EEE3078E3
DC0A28AB5F198D4FE1B3FFD9}
}}}}{\shp
{\*\shpinst
\shpleft6480\shptop3293\shpright6493\shpbottom3306
\shpfhdr0\shpwr3\shpwrk0\shpfblwtxt1\shplid2031\shpz3\shpbxpage\shpbypage
\absh15840\absw12240{\sp{\sn shapeType}{\sv 75}}
{\sp{\sn fFlipH}{\sv 0}}

{\sp{\sn fFlipV}{\sv 0}}

{\sp{\sn pibFlags}{\sv 2}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn fEditedWrap}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn pib}{\sv {\pict
\jpegblip
FFD8FFE000104A46494600010100000100010000FFDB004300080606070605080707070909080A0C
140D0C0B0B0C1912130F141D1A1F1E1D1A1C1C20242E2720222C231C1C2837292C30313434341F27
393D38323C2E333432FFDB0043010909090C0B0C180D0D1832211C21323232323232323232323232
3232323232323232323232323232323232323232323232323232323232323232323232323232FFC0
0011080001000103012200021101031101FFC4001F00000105010101010101000000000000000001
02030405060708090A0BFFC400B5100002010303020403050504040000017D010203000411051221
31410613516107227114328191A1082342B1C11552D1F02433627282090A161718191A2526272829
2A3435363738393A434445464748494A535455565758595A636465666768696A737475767778797A
838485868788898A92939495969798999AA2A3A4A5A6A7A8A9AAB2B3B4B5B6B7B8B9BAC2C3C4C5C6
C7C8C9CAD2D3D4D5D6D7D8D9DAE1E2E3E4E5E6E7E8E9EAF1F2F3F4F5F6F7F8F9FAFFC4001F010003
0101010101010101010000000000000102030405060708090A0BFFC400B511000201020404030407
05040400010277000102031104052131061241510761711322328108144291A1B1C109233352F015
6272D10A162434E125F11718191A262728292A35363738393A434445464748494A53545556575859
5A636465666768696A737475767778797A82838485868788898A92939495969798999AA2A3A4A5A6
A7A8A9AAB2B3B4B5B6B7B8B9BAC2C3C4C5C6C7C8C9CAD2D3D4D5D6D7D8D9DAE2E3E4E5E6E7E8E9EA
F2F3F4F5F6F7F8F9FAFFDA000C03010002110311003F00F7EA28A29907FFD9}
}}}}{\shp
{\*\shpinst
\shpleft6600\shptop3293\shpright9093\shpbottom3346
\shpfhdr0\shpwr3\shpwrk0\shpfblwtxt1\shplid2032\shpz4\shpbxpage\shpbypage
\absh15840\absw12240{\sp{\sn shapeType}{\sv 75}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn pibFlags}{\sv 2}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn fEditedWrap}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn pib}{\sv {\pict
\jpegblip
FFD8FFE000104A46494600010100000100010000FFDB004300080606070605080707070909080A0C
140D0C0B0B0C1912130F141D1A1F1E1D1A1C1C20242E2720222C231C1C2837292C30313434341F27
393D38323C2E333432FFDB0043010909090C0B0C180D0D1832211C21323232323232323232323232
3232323232323232323232323232323232323232323232323232323232323232323232323232FFC0
001108000300A003012200021101031101FFC4001F00000105010101010101000000000000000001
02030405060708090A0BFFC400B5100002010303020403050504040000017D010203000411051221
31410613516107227114328191A1082342B1C11552D1F02433627282090A161718191A2526272829
2A3435363738393A434445464748494A535455565758595A636465666768696A737475767778797A
838485868788898A92939495969798999AA2A3A4A5A6A7A8A9AAB2B3B4B5B6B7B8B9BAC2C3C4C5C6
C7C8C9CAD2D3D4D5D6D7D8D9DAE1E2E3E4E5E6E7E8E9EAF1F2F3F4F5F6F7F8F9FAFFC4001F010003
0101010101010101010000000000000102030405060708090A0BFFC400B511000201020404030407
05040400010277000102031104052131061241510761711322328108144291A1B1C109233352F015
6272D10A162434E125F11718191A262728292A35363738393A434445464748494A53545556575859
5A636465666768696A737475767778797A82838485868788898A92939495969798999AA2A3A4A5A6
A7A8A9AAB2B3B4B5B6B7B8B9BAC2C3C4C5C6C7C8C9CAD2D3D4D5D6D7D8D9DAE2E3E4E5E6E7E8E9EA
F2F3F4F5F6F7F8F9FAFFDA000C03010002110311003F00D9F8EF0465741930773CED1B104F2B8CE0
D790DB4AF6C2D6589B6C8D3B2B375C8C0E0E68A2B9A7F11E861FE0474FA7137DA044F727CC65CE33
DB038ACFB7E35160381E4B714515CF54EEA64EF231DA09E3C95E00C54B73120860C2E32884E3B9DD
4515CECD7A8FB472D6BE61C6F2D82D8E7F3A5D3D16270A8A02C9B778C641EB45156886233945F2D7
010924A81C76AE574991975BD5083CEFEBF8D1456B0F8599D4F8A274B67349240CAEE59402C01E70
78E6A39A18EEC59CD70A249091966E7B5145631DCD5F52E6ABFE8F6F03C5F23676E475C73C55494E
64527AE07238A28A960589957CAE83A9ED59D76ABE5C87032338E3A514552029E9A827FB51972E7E
CE4F27DC567CE0496526F1BB6A7CB9E71F4A28ADA1F111536659D32344D15CAAED3BC0C8EB5DCFC3
9454F1AE98554024F240EBF29A28ADE3F1A39EAFF099FFD9}
}}}}{\shp
{\*\shpinst

\shpleft6533\shptop3306\shpright9120\shpbottom4160
\shpfhdr0\shpwr3\shpwrk0\shpfblwtxt1\shplid2033\shpz5\shpbxpage\shpbypage
\absh15840\absw12240{\sp{\sn shapeType}{\sv 75}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn pibFlags}{\sv 2}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn fEditedWrap}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn pib}{\sv {\pict
\jpegblip
FFD8FFE000104A46494600010100000100010000FFDB004300080606070605080707070909080A0C
140D0C0B0B0C1912130F141D1A1F1E1D1A1C1C20242E2720222C231C1C2837292C30313434341F27
393D38323C2E333432FFDB0043010909090C0B0C180D0D1832211C21323232323232323232323232
3232323232323232323232323232323232323232323232323232323232323232323232323232FFC0
001108003800A703012200021101031101FFC4001F00000105010101010101000000000000000001
02030405060708090A0BFFC400B5100002010303020403050504040000017D010203000411051221
31410613516107227114328191A1082342B1C11552D1F02433627282090A161718191A2526272829
2A3435363738393A434445464748494A535455565758595A636465666768696A737475767778797A
838485868788898A92939495969798999AA2A3A4A5A6A7A8A9AAB2B3B4B5B6B7B8B9BAC2C3C4C5C6
C7C8C9CAD2D3D4D5D6D7D8D9DAE1E2E3E4E5E6E7E8E9EAF1F2F3F4F5F6F7F8F9FAFFC4001F010003
0101010101010101010000000000000102030405060708090A0BFFC400B511000201020404030407
05040400010277000102031104052131061241510761711322328108144291A1B1C109233352F015
6272D10A162434E125F11718191A262728292A35363738393A434445464748494A53545556575859
5A636465666768696A737475767778797A82838485868788898A92939495969798999AA2A3A4A5A6
A7A8A9AAB2B3B4B5B6B7B8B9BAC2C3C4C5C6C7C8C9CAD2D3D4D5D6D7D8D9DAE2E3E4E5E6E7E8E9EA
F2F3F4F5F6F7F8F9FAFFDA000C03010002110311003F00EC3E1F5A69D797B7B1DE5B453CC23568D6
54DC02E7E6383C752BEFFAD703E2CD3351F0D6B3A8D9CA6636EEED716B36FEA84F0A07B1E315D969
32EBFE19B06D561B25FB15C8505A55C8EFB5B0086039383D0E47A8AEC751D0B4CF1EE836935FC661
765DD1CB6B28678F3D54315C7B104707353257D8D294D425767CD56977A94722CB35E5C13210C88D
2B118CF4233F5FCAB52D2FA779B12DEB1CC6762AB364B13C03CF6ABFAD7862E7C3FE21B8B1780CBE
41CA33FCAB344790DD7AF0738E8456142B2E9DA844EF0722418C8DE832323A77AE59735DA3D58283
49A4747347702756FB4B88D86D18723E6C74AA79BB640BF6998312413B8E07EB55EEF509A0511960
D16E251987AFA66B3E2D4663BE28A3676B80586E6DA378EB8FC3B561CB37D4DB961D8DBBB99A2883
49792C591C00C493F80AAF737B35BAC132DCC921900C4418E7F1F4AAB15CB6624370CF246B932C6B
C2E7F8483C9A8A1D48C53CD1C8AB13870E6471C91DC1CD38A92DD89C63D8E86417101883492FEF58
0405F39CFBFD6B1BC4BAAC96BA4490C571289176813C521043671827BF43D2ABDD6A2B6C8922CC6E
02B0C2F23603D703D3F1AA10F87F51F14EB96F61A7433491CAE1A52AA48854F27F10327DEB5A716E
5B98D7718C1E86F40D33496931BCB968BCB1B80739638CE7157A19AE8DD6198FEF415550C484CF20
9F7AABA9473685AB4FA448493632F95B9BAB0EC78E3A62AFDCDE5AAD92429271380032F18E3E63EB
9AE7939A958DE31838A924431C97690892E24D918767DE58F2076348249B692D3480B9240F333807
9AA035082589EDA3491E3638DCE7A8F5F6AAB26AE90B792B9DE17194C714B96A0ED4CD56BA9CAEE8
E590BAB72993822A8DF6A1776F12B096561BB04AB9E3EBCD64DDEAACF2C0CCEB1AEFDAD81F31F734
D37721FB4ED5F35957CC649463E51CF4AD1426B7645E9ED63452FEE67599BED73A3119402538F6A8
64D4AEDF045DCEBB502B2F984107F3EB59E3518656406DCC6ECD97D9C018E98ABE8B36A371208622
E8ADBC1DB9048F5FCEAAD217B8FA17ADEDF557B4170D79719552447E69CB52FF006C49716F146CD3
C52282AEC8C4F39EB59B6DABDFC2A6290F9AB8C03907071DBD3AD757E14F879E29D525DCF67259D9
4C7E6B898EDE0F3B82E72723D2B48C64CCE73A705767A05A68F047F09A2BCB88237BC21664B8C7CE
4338032DD4FCA7A1FE945759E2E856DBC117302636C69128C0C7475A2BAD6C790DDDDCF36975CD4E
7D2D34D92F246B34C62338E83A027A903D09C703D0576BE1D9359B2F03B5EDBDC59B45109258E196
26276A93B86E0C3B862383DB9F4F3AAD6D3F51D6A7B51A1D8CF2BC5392A205039CF2467A81D73C81
D73D4D311D5EA7E1D5F887E15B3BF964165AA287F2E7854E31B88DA413C8207AF5AF21D5ACAEB4CB
9823D42DBEC733E6168A552BB88FE304F18F715E83FF001547842DFF00E5A5AC13BFFB122EE03F10
0E3E99C7B577F7361A578CB40B66BFB58E68668C3801B2626239DAC39041C8FC2B39D3E63A28E21D
3D1EA8F9D75AD51AF2D52D0B2F9514652311E1863BE0FAFBD61BB245125B9612B8501181CED18CF5
1DF39AF5DBFF0081D2BCB30B1D5A15B76626349A324A83EE2B36FF00E10F88D9CC68D657485C3998
4863CF1D369AE7F6525D0EF8E2693EB6380B08A0745B8BB32621E3CA20AB49F56ABBFE893171348E
A1FE432003807D477AF47D17E0BB18C1D52F9A165FBAB090E4FD49E315D7695F0BFC37A64F0DCBC1
25DDC44DBC34CD9527B654707154A949EE13C6528EDA9E6DE15F871AA6A932437510834B59B7B5C3
C7891C0E8133D8FE5F5AF63F0EF8774EF0CD81B4D3E220139795FEFC87B64FB741579EF248F578EC
DEDF10491164B82E30640798F1EBB7E6FA03E86B9BF177898DA79363A3DCEED41A5C3885164C0E46

D3D7E62D8E3AF1DB8CEF18289E6D5AD2A8F5390F89DF0C351D63517D7FC3F206B9651F68B3638F34
F40549E338EC6B8FD13E16F8BB51993ED76BF6011820BCEE39238E304E7F91AF44B9F1278B740B94
1A9AC6DE621D8B2C6A54F3D414C723D33DFA74ACE9FC75AFCD3174BA8E153D238E152A3E9B813FAD
0E9C5BB846BD48AB266AE95F08349B58E26BFBA96E9D24DE550048D87F748E4E3F1AE33E23FC3ABD
B5F141D47C3BA5DC4B6B7516654B688308E4190405519008C7E39AF48F08F89D2EACAE1B58D5A217
0240152629180B8E08E0672739E4F41D3BF41A96A42DAE6DED608E5B8BB73BFECF09504C6382CC5B
80076E4658019EB4F955AC25566A57B9F205DE957104D3457F14969728E098E58CA3AAFF00BA69C1
5E61F6969B73CC3040EBB40C027DB8AFADB5FF000BE91E24B27B7D52CE397285565DA37C79E32A7D
7F31ED5C1DD7C0AF0FCA07D9B51BEB6C31E5486F909E179F4F5EB50E9BE87447131FB48F9EBEC979
6B208995658D88F9979C7E35BFA3E8B7DAC43E5697657575740F290296087381BBB283EA4D7D01A5
7C26F0B694B18FB2B5E385DB21BA6F30483E9D07383C57472C563E19D02E9F4FB5B6B48E1899D102
8552DCE01F5C938FC68F677DC4F136F84F2FF03FC2140FFDA1E23B7788AB9D963BF3B8E0619994F4
CE7E5F6AF43F156BD71E1DB0B63696E8E5DF665D098D540E9C118278C7B035CC59EA7E38D42C5AF6
D5A492DC67E611440B63AE01193F803CF15CE5F6B7A96A76F0C17976F3450FDC56C75C63271D4FB9
C9E4FA9AD124B639A72727765BD63C57AA6B50F913BA47071BA28570188EE72493F4CE381C515894
53242BD01AF2D742F8723C43A6E9F6BF6CB6841124F16496DFB1C920E7072D8E7A63E95E7F5DC6A3
A50BCF83D3416664B9778FCCDA199416DFF32E09C600DDED91BBAF340237356F13CBA7689A6CCB3D
84F7D3DCDB5BCE9192532EC15CA0C86F5C67F1AAADE2BF0C7872F6E955AE628C98D6E3ECF6B23DBC
3291C0CAAE1598150477C0EF589A97C38D2B4EB5D3B50D3F470BAB8BDB5333A3EE08A1D7795002A0
E149C8504F3C0CE2B9ED7A2D67527D6ACA6B5D5BCD8E7468608556384C0B271249900B0C2B1C9272
738000CD033BA97C7B12EA7AF58BB2DA3E9B2411A4B35ACCE84B805B76D1F80E7B83CD74375ACC1A
568DFDA3A94A2285225795CC6CBC9C7453F30249E01E7B75AF31D5ED6E2EF53F13595BDA34B733DB
5A346AAECED8061DC031C161FBB392C32700FAD6F6BF16A9A9FC3AB07BEB0BB59AC66825BA84CC7C
D9D62601886072370CB64904119CFF001502B176D7E20DB5E78A26B2564B7D3EDAD7CF9DAEA09239
5080EC720F41B541E474079E82B46C7E20F872FCDC2A5F3C7240ACCF1CF03C6FB554B92148CB6141
3C738FA8AF36F1007F186A17971A5D88B6824B08A38D8BA2798EBE631518E4750A09EE7D2AE25BA6
A56F7572B61AECF72BA5CC1A4BEBB568E0664C955DD8DE3207CC07A11EA10EC77B61E3FF000EEA77
D15A5B5F3033605BC92C2F1C739E384660031F9978EA72319A645F10BC3735EC16CB7B28372E52DE
67B7748A6C67715723040C1E7A715C66B3E16BFF00EC3F065B69E82CE559CC9757108C796ACB83B8
A28CE54ED39C8E7E66232D5876C655B0F0BE99F61BE96586E9D85CBB47728C8B1107C90BC3A67760
1CE01C16EC0B8247A05FF88BC2536B6F26A735CCEB048D6E92CF6EE6CE29003B9036DDA58F7CE791
EC2AC9F1F78545DBDC47334CD1C82D66BC86D99E38B2C301A5C6029241EB8EF5E7FE21B2F116BDA7
BC52596B377A8457E5A4D380115A469BDB6E0823729047CD9CF5E94D8ACEE74EF00F88F49B8D227D
3EE6E43BC50B4FBC2FCC308727A8033BBF8877E0640B23D9753D4ED749D3E6BEBE94436B08DCEFB4
B11CE3803249C903005723A9F893447B19F5CB4B9934EBBB39E386E6696D1D6440CCA0AC88464E57
18C83EA3A53EEBECFA97C2BDDFF132D56DBC8566F3E644B9654704EE7002EE5DA79EA76FDE24EEAE
12E63D5FC47E12D661B192F754B6FDC2DA35C6C33B90CA5C1618DC17039383C9EB4C123D3C78D343
59EF617BD909B0DCB7730B690451329C302D8C03ED93C54961E31D1AFD2E59669A036D09B8952E6D
DE2611633E661864AF079AF3F87C3BA9DC7877C5567069B6EAB2DE33C36F048CCA592556F2D4602E
D2176E70A781918C6165B4D575DB892F0C1A9DDDB5B6913D84EF2A25BB4A4B9DC987663B8052A58E
EF980E3A9A4163A4BCF18E977134D7B65ABDF594D6D10261B9B293CA910E583142A0F3FDEE090303
9ABD178F7C3D746185A69E559248C194D8C8B123B1063DCCC30A4F0464FA11D4579EC965AD5C69B7
5A6E9505FC9A59840D9AA44A2686425BE48DB866CFCA32738278279A76A969A8E90F0DEDB58DF58E
A31D940CC05BACB6B74E12304B0FBB1EDDAE1B001E148F4A0763D635DBC9ECB42BBBAB59628A648F
72B4BD07E1FDEF41EB8AF16AF67BCB87B4F0BCB3DDC700952D33246E80465F6FDDDBB8F04F18DC7A
E327AD78C532428A28A002B42C75BD4B4CB79A0B3BB78629BEFAAE3AE31919E87DC60F03D0514500
591E2CD73118FED072235DABB954F1C75C8E4F1D4F3D7D4D1278B35C95DDDB507DCC9E592154607B
60707DC73D3D051450051B7D4EF6D6FBEDB0DCC82E4AED3231DC4AFA1CF51F5AB57FE24D5F53B536
D7778D2424825022AE71EB8033F4A28A00CC8E492140913B228C6029C018E9569F55BF78F61BB942
952842B6DDCA7A838EBF8D145007A65BF8B7488B47B4BA9EE205959111E2847CC87B8DBD428E7F01
C672339B0695E0CD3F5697518EEAD55E538D914E8AAA598720260F5EE4F19268A2803235FF00115D
E9FAEDC1D275659A2980662B1A3053FDD071838F5F7C1E41AE6F50D4EF755B833DEDC3CD211B79E0
018C6001C01F4A28A00B9078A35AB5B05B286FDD2054D8A02AE557D0363231DB9E3B554D3355BDD1
95974F9CC08DD51402BF5DA4633EF4514016ECFC51AD584262B7BF70858B90EAAE72793CB02793CF
D49F5A49FC4FAD5C446393519B6962C4A90A7273C6460E39E9D3A7A0A28A008CEBFAAF9E930BD916
44390530A0FD40E08F63525CF89B58BC40B3DE160010311AA919F7028A28029DCEA57D79188EEAF6
E674077059656600FAE09F7AAB45140051451401FFD9}
}}}}\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\margbsxn506\par
d\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmul

t0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2
573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li2573\ri0\sl-453\slmult0 \fs24\cf0\f0\charscalex100 {Hati terletak
dibelakang tu}\fs24\cf0\f0\charscalex100 {lang-tulang iga (}\fs24\cf0\f0\charsca
lex100 {kosta) dalam rongga abdomen
}\par\pard\li1853\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {daerah kana
n atas, hati memiliki berat sekitar 1500 g dan dibagi menjadi empat}\par\pard\li
1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f
0\charscalex100 {lobus. Setiap lobus hati te}\fs24\cf0\f0\charscalex100 {rbungku
s oleh lapisan tip}\fs24\cf0\f0\charscalex100 {is jaringan ikat yang}\par\pard\l
i1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\
f0\charscalex100 {membentang kedalam lobus itu sendiri dan membagi masa hati men
jadi unit-unit}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0
\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {yang lebih kecil, yang disebut lobul
us.}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slm
ult0 \fs24\cf0\f0\charscalex100 {Sirkulasi darah kedalam dan keluar hati sangat
penting dalam}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\
sl-333\slmult0 \fs24\cf0\f0\charscalex100 {penyelenggaraan fungsi hati. Darah ya
ng me}\fs24\cf0\f0\charscalex100 {ngalir ke dalam hati berasal dari dua}\par\par
d\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\c
f0\f0\charscalex100 {sumber. Kurang lebih 75% suplai darah da}\fs24\cf0\f0\chars
calex100 {tang dari vena porta yang mengalirkan}\par\pard\li1853\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {dar
ah yang kaya akan nutrien dari traktu}\fs24\cf0\f0\charscalex100 {s gastrointest
inal. Bagian lain suplai}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {darah tersebut masuk kedal
am hati lewa}\fs24\cf0\f0\charscalex100 {t arteri hepatika dan banyak mengandung
}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult
0 \fs24\cf0\f0\charscalex100 {oksigen. Cabang-cabang terminalis ke}\fs24\cf0\f0\
charscalex100 {dua pembuluh darah ini bersatu untuk}\par\pard\li1853\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100
{membentuk capillary beds bersama yang merupakan sinusoid hepatik. Dengan}\par\p
ard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24
\cf0\f0\charscalex100 {demikian, sel-sel hati (hepatosit) akan }\fs24\cf0\f0\cha
rscalex100 {terendam oleh campuran darah vena dan}\par\pard\li1853\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {a
rterial. Sinusoid mengosongkan isinya ke}\fs24\cf0\f0\charscalex100 {dalam venul
e yang berada pada bagian}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {tengah masing-masing lobu
lus hepatik da}\fs24\cf0\f0\charscalex100 {n dinamakan vena sentralis. Vena }\pa
r\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \f
s24\cf0\f0\charscalex100 {sentralis bersatu membentuk vena hepatik}\fs24\cf0\f0\
charscalex100 {a yang merupakan drainase vena dari}\par\pard\li1853\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {
hati dan akan mengalirkan isinya kedalam ve}\fs24\cf0\f0\charscalex100 {na kava
inferior didekat diafragma. }\par\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn1584
0\marglsxn666\margrsxn133\margtsxn666\margbsxn440\pard\li1853\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex1
00 {Jadi terdapat dua sumber yang mengalirkan darah masuk kedalam hati dan hanya
}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult
0 \fs24\cf0\f0\charscalex100 {terdapat satu lintasan keluarnya.}\par\pard\li2573
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs22\cf0\f0\ch
arscalex100 {Disamping hepatosit, sel-sel fagositik yang termasuk dalam sistem}\

par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0
\fs22\cf0\f0\charscalex100 {retikuloendotelial juga te}\fs22\cf0\f0\charscalex10
0 {rdapat dalam hati. Organ }\fs22\cf0\f0\charscalex100 {lain yang mengandung se
l-sel}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\s
lmult0 \fs22\cf0\f0\charscalex100 {retikuloendotelial adalah limpa, sumsum tulan
g, nodus limfatikus (kelenjar limfe)}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {dan paru-paru.
Dalam hati, sel-sel ini }\fs24\cf0\f0\charscalex100 {dinamakan sel kupfer. Fung
si utama sel }\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\
sl-333\slmult0 \fs24\cf0\f0\charscalex100 {kupfer adalah memakan benda partikel
(s}\fs24\cf0\f0\charscalex100 {eperti bakteri) yang}\fs24\cf0\f0\charscalex100 {
masuk kedalam hati}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li185
3\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {lewat darah portal.}\par\pard\l
i1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \*\tx2213\
fs24\cf0\f0\charscalex100 {2.}\tab \fs24\cf0\f0\charscalex100 {Fisiologi: }\par
\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\
tx2573\fs24\cf0\f0\charscalex100 {a.}\tab \fs24\cf0\f0\charscalex100 {Metabolism
e glukosa}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-3
46\slmult0 \fs24\cf0\f0\charscalex100 {Sesudah makan glukosa diambil dari darah
vena portal oleh hati dan}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {diubah menjadi glikogenya
ng disimpan dalam hepatosit. Selanjutnya }\par\pard\li2573\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {glikogen
diubah kembali menjadi glukosa dan jika diperlukan dilepaskan}\par\pard\li2573\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\char
scalex100 {kedalam aliran darah untuk mempertahankan kadar glukosa yang normal.}
\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0
\fs24\cf0\f0\charscalex100 {Glukosa tambahan dapat disintesis oleh}\fs24\cf0\f0
\charscalex100 { hati lewat proses yang dinamakan}\par\pard\li2573\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {g
lukoneogenesis. Untuk pr}\fs24\cf0\f0\charscalex100 {oses ini hati menggunakan a
sam-asam amino}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0
\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {hasil pemecahan protein atau laktat
yang diproduksi oleh otot yang}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {bekerja.}\par\pard\l
i2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {b.}\tab
\fs24\cf0\f0\charscalex100 {Konversi amonia}\par\pard\li2573\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Penggun
aan asam-asam amino untuk glukoneogenesis akan membentuk}\par\pard\li2573\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscale
x100 {amonia sebagai hasil sampingan. Hati mengubah amonia yang dihasilkan }\par
\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs
24\cf0\f0\charscalex100 {olehproses metabolik ini menjadi }\fs24\cf0\f0\charscal
ex100 {ureum. Amonia yang diprodukdi oleh}\par\pard\li2573\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {bakteri d
alam intestinum juga akan }\fs24\cf0\f0\charscalex100 {dikeluarkan dari dalam da
rah portal}\par\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\marg
rsxn133\margtsxn666\margbsxn480\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li2573\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex100 {untuk sintesis
ureum. Dengan cara ini hati mengubah amonia yang}\par\pard\li2573\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {m
erupakan toksin berbahaya menjadi ureum yaitu senyawa yang dapat}\par\pard\li257
3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\c
harscalex100 {diekskresikan kedalam urin.}\par\pard\li2213\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\
slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {c.}\tab \fs24\cf0\f0\charscalex100
{Metabolisme protein}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li25
73\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {Organ ini mensintesis hampir s

elur}\fs22\cf0\f0\charscalex100 {uh plasma protein termasuk albumin,}\par\pard\l

i2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs22\cf0\
f0\charscalex100 {faktor-faktor pembekuan darah prot}\fs22\cf0\f0\charscalex100
{ein transport yang spesifik dan}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li2573\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {sebagian besar lip
oprotein plasma. }\fs22\cf0\f0\charscalex100 {Vitamin K diperlukan hati untuk}\p
ar\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \
fs22\cf0\f0\charscalex100 {mensintesis protombin dan sebagian}\fs22\cf0\f0\chars
calex100 { faktor pembekuan lainnya. Asam-}\par\pard\li2573\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {asam ami
no berfungsi sebagai unsur }\fs24\cf0\f0\charscalex100 {pembangun bagi sintesis
protein. }\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \*\tx2573\fs24\cf0\f0\c
harscalex100 {d.}\tab \fs24\cf0\f0\charscalex100 {Metabolisme lemak}\par\pard\li
2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs22\cf0\f
0\charscalex100 {Asam-asam lemak dapat dipecah untuk memproduksi energi dan bada
n}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmul
t0 \fs22\cf0\f0\charscalex100 {keton. Badan keton merupakan senyaw}\fs22\cf0\f0\
charscalex100 {a-senyawa kecil yang dapat masuk}\par\pard\li2573\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {ked
alam aliran darah dan menjadi sumber}\fs22\cf0\f0\charscalex100 { energi bagi ot
ot serta jaringan}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\
ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {tubuh lainnya. Pemecahan asam lem
ak menjadi bahan keton terutama }\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li2573\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {terjadi ketika ket
ersediaan glukosa untuk metabolisme sangat terbatas }\par\pard\li2573\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100
{seperti pada kelaparan atau di}\fs24\cf0\f0\charscalex100 {abetes yang tidak t
erkontrol.}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0\c
harscalex100 {e.}\tab \fs24\cf0\f0\charscalex100 {Penyimpanan vitamin dan zat be
si}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmu
lt0 \*\tx2573\fs24\cf0\f0\charscalex100 {f.}\tab \fs24\cf0\f0\charscalex100 {Met
abolisme obat}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\
sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Metabolisme umumnya menghilangkan akt
ivitas obat tersebut meskipun}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {pada sebagian kasus,
aktivasi obat da}\fs24\cf0\f0\charscalex100 {pat terjadi. Salah satu lintasan }\
par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0
\fs24\cf0\f0\charscalex100 {pentinguntuk metabolisme obat melip}\fs24\cf0\f0\cha
rscalex100 {uti konjugasi (p}\fs24\cf0\f0\charscalex100 {engikatan) obat }\par\p
ard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24
\cf0\f0\charscalex100 {tersebut dengan sejumlah senyawa, }\fs24\cf0\f0\charscale
x100 {untuk membentuk substansi yang lebih}\par\pard\sect\sectd\sbkpage\pgwsxn12
240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\margbsxn386\pard\li2573\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\l
i2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-413\slmult0 \fs24\cf0\
f0\charscalex100 {larut. Hasil konjugasi tersebut dapa}\fs24\cf0\f0\charscalex10
0 {t diekskresikan ke}\fs24\cf0\f0\charscalex100 {dalam feses atau}\par\pard\li2
573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0
\charscalex100 {urine seperti ekskresi bilirubin.}\par\pard\li2213\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0
\sl-320\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {g.}\tab \fs24\cf0\f0\charsc
alex100 {Pembentukan empedu}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Empedu dibentuk oleh he
patosit dan dikumpulkan dalam kanalikulus serta }\par\pard\li2573\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {sa
luran empedu. Fungsi empedu adalah }\fs24\cf0\f0\charscalex100 {ekskretorik sepe
rti ekskresi }\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0
\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {bilirubin dan sebagai pembantu prose

s}\fs24\cf0\f0\charscalex100 { pencernaan melalui emulsifikasi }\par\pard\li2573

\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\ch
arscalex100 {lemak oleh garam-garam empedu.}\par\pard\li2213\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-21
3\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-360\slmult0 \*\tx
2573\fs24\cf0\f0\charscalex100 {h.}\tab \fs24\cf0\f0\charscalex100 {Ekskresi bil
irubin}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\
slmult0 \fs24\cf0\f0\charscalex100 {Bilirubin adalah pigmen yang berasal dari pe
mecahan hemoglobin oleh }\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {sel-sel pada sistem retiku
loendotelial yang mencakup sel-sel kupfer dari}\par\pard\li2573\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {hati
. Hepatosit mengeluarkan bilirubin dari dalam darah dan melalui reaksi}\par\pard
\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf
0\f0\charscalex100 {kimia mengubahnya lewat konjugas}\fs24\cf0\f0\charscalex100
{i menjadi asam glukuronat yang}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {membuat bilirubin l
ebih dapat larut }\fs24\cf0\f0\charscalex100 {didalam larutan ya}\fs24\cf0\f0\ch
arscalex100 {ng encer. Bilirubin}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {terkonjugasi disek
resikan oleh he}\fs24\cf0\f0\charscalex100 {patosit kedal kanalikulus empedu}\pa
r\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \f
s24\cf0\f0\charscalex100 {didekatnya dan akhirnya diba}\fs24\cf0\f0\charscalex10
0 {wa dalam empedu ke duodenum. }\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Konsentrasi biliru
bin dalam darah da}\fs24\cf0\f0\charscalex100 {pat meningkat jika terdapat penya
kit}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slm
ult0 \fs24\cf0\f0\charscalex100 {hati, bila aliran empedu terhalang atau bila te
rjadi penghancuran sel-sel}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {darah merah yang berlebi
han. Pada }\fs24\cf0\f0\charscalex100 {obstruksi saluran empedu, bilirubin}\par\
pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs2
4\cf0\f0\charscalex100 {tidak memasuki intestinum dan se}\fs24\cf0\f0\charscalex
100 {bagai akibatnya, urobilinogen tidak}\par\pard\li2573\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {terdapat d
alam urin.}\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl333\slmult0 \*\tx1853\fs24\cf0\f0\charscalex100\b {C.}\b0 \tab \fs24\cf0\f0\char
scalex100\b {Etiologi}\b0 \par\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\m
arglsxn666\margrsxn133\margtsxn666\margbsxn426\pard\li1853\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex100
{Menurut FKUI, 1999, penyebab siro}\fs24\cf0\f0\charscalex100 {sis hepatis antar
a lain :}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-21
3\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-320\slmult0 \*\tx2213\fs24\cf0\f0\cha
rscalex100 {1.}\tab \fs24\cf0\f0\charscalex100 {Malnutrisi}\par\pard\li1853\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \*\tx2213\fs24\cf0\f
0\charscalex100 {2.}\tab \fs24\cf0\f0\charscalex100 {Alkoholisme }\par\pard\li22
13\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-346\slmult0 \fs24\cf0\f0\
charscalex100 {Alkohol adalah salah satu penyebab terj}\fs24\cf0\f0\charscalex10
0 {adinya sirosis hepa}\fs24\cf0\f0\charscalex100 {tis karena sifat}\par\pard\li
2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs22\cf0\f
0\charscalex100 {olkohol itu sendiri yang merupakan zat}\fs22\cf0\f0\charscalex1
00 { toksik bagi tubuh yang langsung}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {terabsorbsi ol
eh hati yang dapat ju}\fs24\cf0\f0\charscalex100 {ga mengakibatkan perlemakan ha
ti.}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \*\tx2213\fs24\cf0\f0\charscal
ex100 {3.}\tab \fs24\cf0\f0\charscalex100 {Virus hepatitis}\par\pard\li2213\ri0\

sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs22\cf0\f0\charsca

lex100 {Hepatitis virus yang telah menginfek}\fs22\cf0\f0\charscalex100 {si sel
hati semakin lama akan}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
2213\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {berkembang menjadi sirosis h
epatis.}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-320\slmult0 \*\tx2213\fs24\cf0\f0\char
scalex100 {4.}\tab \fs24\cf0\f0\charscalex100 {Kegagalan jantung yang menyeba}\f
s24\cf0\f0\charscalex100 {bkan bendungan vena hepatika}\par\pard\li1853\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \*\tx2213\fs24\cf0\f0\ch
arscalex100 {5.}\tab \fs24\cf0\f0\charscalex100 {Hemokromatosis (kelebihan zat b
esi)}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\sl
mult0 \fs22\cf0\f0\charscalex100 {Kelebihan zat besi juga akan semaki}\fs22\cf0\
f0\charscalex100 {n memperberat kerja hati sehingga hati}\par\pard\li2213\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs22\cf0\f0\charscale
x100 {tidak dapat mengolah zat besi yang dapat }\fs22\cf0\f0\charscalex100 {diab
sorbsi tubuh teta}\fs22\cf0\f0\charscalex100 {pi zat besi akan}\par\pard\li2213\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-346\slmult0 \fs24\cf0\f0\cha
rscalex100 {tertimbun dalam jumlah banyak yang }\fs24\cf0\f0\charscalex100 {dapa
t menyebabkan sirosis hepatis.}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-320\slmult0 \*\
tx2213\fs24\cf0\f0\charscalex100 {6.}\tab \fs24\cf0\f0\charscalex100 {Penyakit w
ilson (penumpukan tembaga yang berlebihan)}\par\pard\li1853\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100
{7.}\tab \fs24\cf0\f0\charscalex100 {Zat toksik}\par\pard\li1493\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li1493\ri0\sl-346\slmult0 \*\tx1853\fs24\cf0\f0\charscale
x100\b {D.}\b0 \tab \fs24\cf0\f0\charscalex100\b {Patofisiologi }\b0 \par\pard\
li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs22\cf0
\f0\charscalex100 {Adanya faktor etiologi menyebabkan }\fs22\cf0\f0\charscalex10
0 {peradangan dan nekrosis meliputi}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {daerah yang lua
s (hapatos}\fs24\cf0\f0\charscalex100 {eluler), terjadi }\fs24\cf0\f0\charscalex
100 {kolaps lobulus hati dan ini memacu }\par\pard\li1853\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {timbulnya
jaringan parut disertai terben}\fs24\cf0\f0\charscalex100 {tuknya septa fibrosa
}\fs24\cf0\f0\charscalex100 {difus dan nodul sel}\par\pard\li1853\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {ha
ti. Septa bisa dibentuk dari sel }\fs24\cf0\f0\charscalex100 {retikulum penyangg
a kolaps dan berubah}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li18
53\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {menjadi jaringan parut. Jaring
an pa}\fs24\cf0\f0\charscalex100 {rut ini dapat menghubungkan daerah portal}\par
\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsx
n666\margbsxn493\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1
853\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex100 {yang satu dengan yang lain at
au porta}\fs24\cf0\f0\charscalex100 {l dengan sentral (bridging necrosis).}\par\
pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs2
2\cf0\f0\charscalex100 {Beberapa sel tumbuh kembali dan membentuk nodul dengan b
erbagai ukuran, dan}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li185
3\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {ini menyebabkan distorsi percab
angan }\fs22\cf0\f0\charscalex100 {pembuluh hepatik dan gangguan aliran}\par\par
d\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs22\c
f0\f0\charscalex100 {daerah portal dan menimbulkan hiperten}\fs22\cf0\f0\charsca
lex100 {si portal. Tahap berikutnya terjadi}\par\pard\li1853\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {peradan
gan dan nekrosis pa}\fs22\cf0\f0\charscalex100 {da sel duktules, sinusoid, }\fs2
2\cf0\f0\charscalex100 {retikulo endotel, terjadi}\par\pard\li1853\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {f
ibrogenesis dan septa aktif}\fs24\cf0\f0\charscalex100 { jaringan kologen beruba
h }\fs24\cf0\f0\charscalex100 {dari reversibel menjadi }\par\pard\li1853\ri0\sl213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex

100 {irrevensibel bila telah terbentuk septa pe}\fs24\cf0\f0\charscalex100 {rman

en yang aseluler }\fs24\cf0\f0\charscalex100 {pada daerah portal}\par\pard\li185
3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\c
harscalex100 {dan parenkhim hati sel limfosit T dan }\fs24\cf0\f0\charscalex100
{makrofag menghasilkan limfokin dan}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {monokin sebagai
mediator fibrinogen, septal }\fs24\cf0\f0\charscalex100 {aktif ini berasal da}\
fs24\cf0\f0\charscalex100 {ri portal menyebar}\par\pard\li1853\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {kepar
enkim hati. Kolagen sendiri terdiri }\fs24\cf0\f0\charscalex100 {dari 4 tipe yai
tu de}\fs24\cf0\f0\charscalex100 {ngan lokasi daerah}\par\pard\li1853\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100
{sentral, sinusoid, jaringan }\fs24\cf0\f0\charscalex100 {retikulin (sinusoidpo
rtal), }\fs24\cf0\f0\charscalex100 {dan membrane basal. Pada}\par\pard\li1853\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\chars
calex100 {semua sirosis terdapat peningkatan pert}\fs24\cf0\f0\charscalex100 {um
buhan semua jenis kologen tersebut.}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Pembentukan jar
ingan kologen dirangsang }\fs24\cf0\f0\charscalex100 {oleh nekrosis hepatoselulu
er dan}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\
slmult0 \fs24\cf0\f0\charscalex100 {asidosis laktat merupakan faktor pera}\fs24\
cf0\f0\charscalex100 {ngsang. Dalam hal mekanisme terjadinya}\par\pard\li1853\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\chars
calex100 {sirosis secara mekanik dimulai dari ke}\fs24\cf0\f0\charscalex100 {jad
ian hepatitis viral akut, timbul}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {peradangan luas, n
ekrosis luas dan pembentukan jaringan }\fs24\cf0\f0\charscalex100 {ikat yang lua
s disertai}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl346\slmult0 \fs24\cf0\f0\charscalex100 {pembentukan jaringan ikat yang luas di}\
fs24\cf0\f0\charscalex100 {srtai pembentukan nodul regenerasi oleh}\par\pard\li1
853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0
\charscalex100 {sel parenkim hati, yang masih baik. Jadi }\fs24\cf0\f0\charscale
x100 {fibrosis pasca nekrotik adalah dasar}\par\pard\li1853\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {timbulny
a sirosis hati. Pada mekanisme }\fs24\cf0\f0\charscalex100 {terjadinya sirosis s
ecara imunologis}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\r
i0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {dimulai dengan kejadian hepatitis
vira}\fs24\cf0\f0\charscalex100 {l akut yang menimbulkan peradangan sel}\par\par
d\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\c
f0\f0\charscalex100 {hati, nekrosis / nekrosis bridging dengan }\fs24\cf0\f0\cha
rscalex100 {melalui hepatitis kronik agresif diikuti}\par\pard\li1853\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100
{timbulnya sirosis hati. Perkembangan si}\fs24\cf0\f0\charscalex100 {rosis deng
an cara ini memerlukan waktu}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {sekitars 4 tahun sels
yang nengandung vi}\fs24\cf0\f0\charscalex100 {rus ini merupakan sumber rangsang
an}\par\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\
margtsxn666\margbsxn466\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li1853\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex100 {terjadinya proses imun
ologis yang berl}\fs24\cf0\f0\charscalex100 {angsung terus menerus sampai terjad
i}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmul
t0 \fs24\cf0\f0\charscalex100 {kerusakan hati.}\par\pard\li1493\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li1493\ri0\sl-346\slmult0 \*\tx1853\fs24\cf0\f0\charscalex
100\b {E.}\b0 \tab \fs24\cf0\f0\charscalex100\b {Manifestasi Klinis}\b0 \par\par
d\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li1853\ri0\sl-320\slmult0 \fs22\cf0\f0\charscalex100 {Manifestasi kl
inis atau tanda gejala ya}\fs22\cf0\f0\charscalex100 {ng menyertai dari penyakit
sirosis hepatis}\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\r
i0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {ini diantaranya adalah sebagai ber

ikut: }\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-213

\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-320\slmult0 \*\tx1853\fs24\cf0\f0\char
scalex100 {1.}\tab \fs24\cf0\f0\charscalex100 {Pembesaran hati}\par\pard\li1853\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\cha
rscalex100 {Nyeri abdomen dapat terjadi sebagai akib}\fs24\cf0\f0\charscalex100
{at dari pembesaran hati yang cepat.}\par\pard\li1493\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-320\slmul
t0 \*\tx1853\fs24\cf0\f0\charscalex100 {2.}\tab \fs24\cf0\f0\charscalex100 {Obst
ruksi portal dan asites}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\l
i1853\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {Pasien dengan keadaan semac
am ini cender}\fs22\cf0\f0\charscalex100 {ung menderita dispepsia
kronis ata
u}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmul
t0 \fs24\cf0\f0\charscalex100 {diare}\par\pard\li1493\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-320\slmul
t0 \*\tx1853\fs24\cf0\f0\charscalex100 {3.}\tab \fs24\cf0\f0\charscalex100 {Vari
ses gastrointestinal}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li18
53\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {Distensi pembuluh darah akan m
emb}\fs22\cf0\f0\charscalex100 {entuk varises/hemoroid tergantung}\par\pard\li18
53\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs22\cf0\f0\
charscalex100 {lokasinya. Adanya tekanan yang ti}\fs22\cf0\f0\charscalex100 {ngg
i dapat menimbulkan ruptur dan}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {pendarahan. Kurang l
ebih 25% pasi}\fs24\cf0\f0\charscalex100 {en akan mengalami hematemesis }\par\pa
rd\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\
cf0\f0\charscalex100 {ringan/varises pada lambung dan esofagus.}\par\pard\li1493
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li1493\ri0\sl-320\slmult0 \*\tx1853\fs24\cf0\f0\charscalex100 {4.}\tab \fs24
\cf0\f0\charscalex100 {Edema}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Kosentrasi albumin pla
sma menurun, pr}\fs24\cf0\f0\charscalex100 {oduksi aldosteron yang berlebihan ak
an}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmu
lt0 \fs24\cf0\f0\charscalex100 {menyebabkan retensi natrium serta air dan kalium
.}\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li1493\ri0\sl-333\slmult0 \*\tx1853\fs24\cf0\f0\charscalex
100 {5.}\tab \fs24\cf0\f0\charscalex100 {Defisiensi Vitamin dan Anemia}\par\pard
\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs24\cf
0\f0\charscalex100 {Defisiensi vitamin dan anemia Karena pembentukan, penggunaan
dan}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\sl
mult0 \fs24\cf0\f0\charscalex100 {penyimpanan vitamin tertentu yang tidak}\fs24\
cf0\f0\charscalex100 { memadai (terutama vitamin A, C dan}\par\pard\sect\sectd\s
bkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\margbsxn440\p
ard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-413\slm
ult0 \fs24\cf0\f0\charscalex100 {K), maka tanda-tanda defisiensi vitami}\fs24\cf
0\f0\charscalex100 {n tersebut sering }\fs24\cf0\f0\charscalex100 {dijumpai, khu
susnya}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\
slmult0 \fs22\cf0\f0\charscalex100 {sebagai fenomena hemoragik yang berk}\fs22\c
f0\f0\charscalex100 {aitan dengan defisi}\fs22\cf0\f0\charscalex100 {ensi vitami
n K.}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\sl
mult0 \fs22\cf0\f0\charscalex100 {Gastritis kronis dan gangguan fungsi gastro}\f
s22\cf0\f0\charscalex100 {intestinal bersama-sama asupan diet}\par\pard\li1853\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs22\cf0\f0\char
scalex100 {yang tidak adekuat dan gangguan fungsi ha}\fs22\cf0\f0\charscalex100
{ti turut menimbulkan anemia yang}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li1853\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {sering menyertai
sirosis hepatis. Gejala an}\fs22\cf0\f0\charscalex100 {emia dan status nutrisi s
erta kesehatan}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0
\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {pasien yang buruk akan mengakibatkan
kelelahan hebat yang mengganggu}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li1853\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {kemampuan untuk me

lakukan aktiv}\fs24\cf0\f0\charscalex100 {itas rutin sehari-hari.}\par\pard\li14

93\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li1493\ri0\sl-320\slmult0 \*\tx1853\fs24\cf0\f0\charscalex100 {6.}\tab \fs
24\cf0\f0\charscalex100 {Kemunduran mental}\par\pard\li1853\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {Kemundur
an fungsi mental dengan en}\fs22\cf0\f0\charscalex100 {sefalopati dan koma hepat
ik yang}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333
\slmult0 \fs22\cf0\f0\charscalex100 {membakat. Karena itu, pemeriksaan ne}\fs22\
cf0\f0\charscalex100 {urologi perlu dilakukan pada sirosis}\par\pard\li1853\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \fs22\cf0\f0\charsca
lex100 {hepatis dan mencakup perilaku umum }\fs22\cf0\f0\charscalex100 {pasien,
kemampuan kognitif, orientasi}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {terhadap waktu serta
tempat, dan pola }\fs24\cf0\f0\charscalex100 {bicara. (Suzanne, C. Smeltzer, 200
1)}\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-333\slmu
lt0 \*\tx1853\fs24\cf0\f0\charscalex100\b {F.}\b0 \tab \fs24\cf0\f0\charscalex10
0\b {Penatalaksanaan klinis}\b0 \par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-413\slmult0 \f
s22\cf0\f0\charscalex100 {Penatalaksanaan pada pasien dengan }\fs22\cf0\f0\chars
calex100 {sirosis hepatis dapat dilakukan dengan}\par\pard\li1493\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li1493\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {be
berapa cara berikut sesuai de}\fs24\cf0\f0\charscalex100 {ngan kondisi yang dial
ami klien:}\par\pard\li1506\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1506\ri0\sl213\slmult0 \fs18\cf0\par\pard\li1506\ri0\sl-400\slmult0 \*\tx1866\fs22\cf0\f0\c
harscalex100 {1.}\tab \fs22\cf0\f0\charscalex100 {Pasien dalam keadaan kompensas
i }\fs22\cf0\f0\charscalex100 {hati yang cukup dilakukan kontrol yang}\par\pard\
li1866\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1866\ri0\sl-346\slmult0 \fs22\cf0
\f0\charscalex100 {teratur, istirahat yang cukup, susunan diet}\fs22\cf0\f0\char
scalex100 { tinggi kalori tinggi protein, lemak}\par\pard\li1866\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li1866\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {sec
ukupnya}\par\pard\li1506\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1506\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li1506\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1506\
ri0\sl-466\slmult0 \*\tx1866\fs24\cf0\f0\charscalex100 {2.}\tab \fs24\cf0\f0\cha
rscalex100 {Pasien sirosis dengan penyebab yang diketahui, seperti :}\par\pard\l
i1880\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1880\ri0\sl-333\slmult0 \*\tx2253\
fs24\cf0\f0\charscalex100 {a.}\tab \fs24\cf0\f0\charscalex100 {Alkohol dan obatobatan di anjurk}\fs24\cf0\f0\charscalex100 {an menghentikan penggunaanya }\par
\pard\li1880\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1880\ri0\sl-346\slmult0 \*\
tx2253\fs24\cf0\f0\charscalex100 {b.}\tab \fs24\cf0\f0\charscalex100 {Hemokromat
osis}\par\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn13
3\margtsxn666\margbsxn533\pard\li2253\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li22
53\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2253\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li2253\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex100 {Di hentikan pemakaia
n preparat }\fs24\cf0\f0\charscalex100 {yang mengandung besi/terapi kelas 1 }\p
ar\pard\li2253\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2253\ri0\sl-333\slmult0 \
fs24\cf0\f0\charscalex100 {(desferioxamine)}\par\pard\li1880\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1880\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1880\ri0\sl-32
0\slmult0 \*\tx2253\fs24\cf0\f0\charscalex100 {c.}\tab \fs24\cf0\f0\charscalex10
0 {Pada hepatitis kronik autoim}\fs24\cf0\f0\charscalex100 {un diberikan kortiko
steroid}\par\pard\li1506\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1506\ri0\sl-346
\slmult0 \*\tx1866\fs24\cf0\f0\charscalex100 {3.}\tab \fs24\cf0\f0\charscalex100
{Terapi terhadap komplikasi yang timbul}\par\pard\li1853\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {a
.}\tab \fs24\cf0\f0\charscalex100 {Asites}\par\pard\li2213\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Diberikan
diet rendah garam, bila perlu dikombinasikan dengan furosemid}\par\pard\li1853\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li1853\ri0\sl-333\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {b.}\tab \fs24\
cf0\f0\charscalex100 {Perdarahan varises esofagus (hematemesis, melena)}\par\par
d\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx25

73\fs24\cf0\f0\charscalex100 {1)}\tab \fs24\cf0\f0\charscalex100 {Lakukan aspira

si cairan lambung ya}\fs24\cf0\f0\charscalex100 {ng berisi darah untuk mengetahu
i}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmul
t0 \fs24\cf0\f0\charscalex100 {apakah perdarahan sudah berhenti/masih berlangsun
g.}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmu
lt0 \*\tx2573\fs24\cf0\f0\charscalex100 {2)}\tab \fs24\cf0\f0\charscalex100 {Bil
a perdarahan banyak, berikan dextrosa/salin dan }\fs24\cf0\f0\charscalex100 {tra
nsfusi darah}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\s
l-333\slmult0 \fs24\cf0\f0\charscalex100 {secukupnya.}\par\pard\li1853\ri0\sl-21
3\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \*\tx2213\fs24\cf0\f0\cha
rscalex100 {c.}\tab \fs24\cf0\f0\charscalex100 {Ensefalopati}\par\pard\li2213\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0
\f0\charscalex100 {1)}\tab \fs24\cf0\f0\charscalex100 {Dilakukan koreksi faktor
pencetus}\fs24\cf0\f0\charscalex100 { seperti pemberian KCl pada}\par\pard\li257
3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\c
harscalex100 {hipokalemia.}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {2)}\tab \fs24\c
f0\f0\charscalex100 {Mengurangi pemasukan protein maka}\fs24\cf0\f0\charscalex10
0 {nan dengan memberi diet sesuai.}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {3)}\tab
\fs24\cf0\f0\charscalex100 {Aspirasi cairan lambung bagi pasi}\fs24\cf0\f0\char
scalex100 {en yang mengalami perdarahan pada}\par\pard\li2573\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {varise
s.}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmu
lt0 \*\tx2573\fs24\cf0\f0\charscalex100 {4)}\tab \fs24\cf0\f0\charscalex100 {Pem
berian antibiotik campisilin/sefalosporin pada keadaan infeksi}\par\pard\li2573\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\cha
rscalex100 {sistemik.}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2
213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {5)}\tab \fs24\cf0\f0
\charscalex100 {Transplantasi hati}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li1853\ri0\sl-333\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {d.}\tab
\fs24\cf0\f0\charscalex100 {Peritonitis bakterial spontan}\par\pard\li2213\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-346\slmult0 \fs24\cf0\f0\charsca
lex100 {Diberikan antibiotok pilihan seperti }\fs24\cf0\f0\charscalex100 {cefota
xim, amoxicilin, aminoglikosida.}\par\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn
15840\marglsxn666\margrsxn133\margtsxn666\margbsxn360\pard\li1853\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-413\slmult0 \*\tx2213\fs24\cf0\f
0\charscalex100 {e.}\tab \fs24\cf0\f0\charscalex100 {Sindrom hepatorenal/nefropa
ti hepatik}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl333\slmult0 \fs24\cf0\f0\charscalex100 {Keseimbangan cairan dan garam diatur den
gan ketat}\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-333\slmult0 \*\tx1853\fs24\cf0\f0\ch
arscalex100\b {G.}\b0 \tab \fs24\cf0\f0\charscalex100\b {Komplikasi }\b0 \par\pa
rd\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\
cf0\par\pard\li1853\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {Bila penyakit
sirosis hati be}\fs24\cf0\f0\charscalex100 {rlanjut progresif, maka gambaran kl
inis, prognosis dan}\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li149
3\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {pengobatan tergantung pada 2 ke
lompok besar komplikasi: }\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-400\slmult0 \*\tx18
53\fs22\cf0\f0\charscalex100 {1.}\tab \fs22\cf0\f0\charscalex100 {Kegagalan hati
(hepatoseluler);}\fs22\cf0\f0\charscalex100 { timbul spider nevi, eritem}\fs22\
cf0\f0\charscalex100 {a palmaris, atropi testis,}\par\pard\li1853\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {gi
nekomastia, ikterus, ensefalopati, dll.}\par\pard\li1493\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li1493\ri0\sl-333\slmult0 \*\tx1853\fs22\cf0\f0\charscalex100 {2.
}\tab \fs22\cf0\f0\charscalex100 {Hipertensi portal; dapat menimbulkan splenomeg
ali, pemekaran pembuluh vena}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li1853\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {esophagus/cardia, capu

t medusa, hemoro}\fs24\cf0\f0\charscalex100 {id, vena kolateral dinding perut.}\

par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-333\slmult0
\*\tx1853\fs24\cf0\f0\charscalex100 {3.}\tab \fs24\cf0\f0\charscalex100 {Asites}
\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-333\slmult0
\*\tx1853\fs24\cf0\f0\charscalex100 {4.}\tab \fs24\cf0\f0\charscalex100 {Ensefa
lopati }\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-34
6\slmult0 \*\tx1853\fs24\cf0\f0\charscalex100 {5.}\tab \fs24\cf0\f0\charscalex10
0 {Peritonitis bacterial spontan}\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li1493\ri0\sl-333\slmult0 \*\tx1853\fs24\cf0\f0\charscalex100 {6.}\tab \
fs24\cf0\f0\charscalex100 {Sindrom hepatorenal}\par\pard\li1493\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li1493\ri0\sl-346\slmult0 \*\tx1853\fs24\cf0\f0\charscalex
100 {7.}\tab \fs24\cf0\f0\charscalex100 {Transformasi ke arah kanker hati primer
(hepatoma)}\par\pard\li1493\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li1493\ri0\sl-400\slmult0 \*\tx1853\fs24\cf0\f0\
charscalex100\b {H.}\b0 \tab \fs24\cf0\f0\charscalex100\b {Pengkajian Fokus}\b0
\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1853\ri0\sl-320\slmult0 \*\tx2213\fs24\cf0\f0\charscalex10
0 {1.}\tab \fs24\cf0\f0\charscalex100 {Aktifitas / istirahat}\par\pard\li2213\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-346\slmult0 \fs24\cf0\f0\chars
calex100 {Gejala : kelemahan, kelelahan}\par\pard\li2213\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-320\sl
mult0 \fs24\cf0\f0\charscalex100 {Tanda : letargi, penurunan masa otot/ tonus}\p
ar\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100
{2.}\tab \fs24\cf0\f0\charscalex100 {Sirkulasi}\par\pard\li2213\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {Geja
la : riwayat perikarditis, penyakit jantung rematik, kanker (malfungsi hati}\par
\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs
24\cf0\f0\charscalex100 {menimbulkan gagal hati), disrit}\fs24\cf0\f0\charscalex
100 {mia, distensi vena abdomen.}\par\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn
15840\marglsxn666\margrsxn133\margtsxn666\margbsxn453\pard\li1853\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-413\slmult0 \*\tx2213\fs24\cf0\f
0\charscalex100 {3.}\tab \fs24\cf0\f0\charscalex100 {Eliminasi}\par\pard\li2213\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\cha
rscalex100 {Gejala : flatus}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \fs24\
cf0\f0\charscalex100 {Tanda : distensi abdomen (hepatosple}\fs24\cf0\f0\charscal
ex100 {nomegali, ascites), penurunan bising}\par\pard\li2213\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2213\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {urus,
feses warna tanah liat, }\fs24\cf0\f0\charscalex100 {melena, urine gelap dan pek
at}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li1853\ri0\sl-320\slmult0 \*\tx2213\fs24\cf0\f0\charscale
x100 {4.}\tab \fs24\cf0\f0\charscalex100 {Makanan/cairan}\par\pard\li2213\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscale
x100 {Gejala : anoreksia, tidak toleran terhadap}\fs24\cf0\f0\charscalex100 { m
akanan/tidak dapat mencerna,
}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li2213\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {dan mual muntah}
\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {Tanda
: penurunan berat badan / peningka}\fs24\cf0\f0\charscalex100 {tan cairan, kulit
ke}\fs24\cf0\f0\charscalex100 {ring, furgor buruk}\par\pard\li2213\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li2213\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {
edema umum pada jaringan, ikteri}\fs24\cf0\f0\charscalex100 {k, nafas berbau, pe
rdarahan gusi}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-320\slmult0 \*\tx2213\fs24\cf0\f
0\charscalex100 {5.}\tab \fs24\cf0\f0\charscalex100 {Neurosensori}\par\pard\li22
13\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\
charscalex100 {Gejala : orang terdekat dapat melapor}\fs24\cf0\f0\charscalex100
{kan perubahan kepribadian, penurunan}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\

cf0\par\pard\li2213\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {mental}\par\p

ard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li2213\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {Tanda : peru
bahan mental, bicara lambat/tak jelas}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\
cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmu
lt0 \*\tx2213\fs24\cf0\f0\charscalex100 {6.}\tab \fs24\cf0\f0\charscalex100 {Nye
ri/kenyamanan}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\m
argrsxn133\cols2\colno1\colw3293\colsr-0\colno2\colw8146\pard\li2213\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100
{Gejala}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-33
3\slmult0 \fs24\cf0\f0\charscalex100 {: nyeri tekan abdomen}\fs24\cf0\f0\charsca
lex100 {/nyeri kuadran kanan atas}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsx
n15840\marglsxn666\margrsxn133\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \*\tx329
3\fs24\cf0\f0\charscalex100 {Tanda }\tab \fs24\cf0\f0\charscalex100 {: perilaku
berhati-hati/distraksi pada diri sendiri}\par\pard\li1853\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\
slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {7.}\tab \fs24\cf0\f0\charscalex100
{Pernafasan}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl
-333\slmult0 \fs24\cf0\f0\charscalex100 {Gejala : dispnea}\par\pard\li2213\ri0\s
l-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Tanda : takipnea, pernafasan
dongkal, hipoksia, bunyi nafas tambahan, }\par\pard\li2213\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {ekspans
i paru terbatas (asites) }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\m
arglsxn666\margrsxn133\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn6
66\margrsxn133\margtsxn666\margbsxn426\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1853\ri0\sl-413\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100
{8.}\tab \fs24\cf0\f0\charscalex100 {Keamanan}\par\pard\li2213\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Geja
la : pruritus}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \*\tx3293\fs24\cf0\f
0\charscalex100 {Tanda }\tab \fs24\cf0\f0\charscalex100 {: demam, ikterik, ekim
osis, ptekie}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\s
l-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-333\slmult0 \*\tx2213\fs24\cf0\f0
\charscalex100 {9.}\tab \fs24\cf0\f0\charscalex100 {Seksualitas }\par\pard\li22
13\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx3293\fs2
4\cf0\f0\charscalex100 {Gejala }\tab \fs24\cf0\f0\charscalex100 {: gangguan men
struasi, impoten}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx3293\fs24\cf
0\f0\charscalex100 {Tanda }\tab \fs24\cf0\f0\charscalex100 {: atropi testis, gi
nekomastia
}\pa
r\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li1853\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {10.}{ }\f
s24\cf0\f0\charscalex100 {Pemeriksaan Penunjang}\par\pard\li2213\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0\charscale
x100 {a.}\tab \fs24\cf0\f0\charscalex100 {Pemeriksaan laboratorium }\par\pard\l
i2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \*\tx2933\
fs24\cf0\f0\charscalex100 {1)}\tab \fs24\cf0\f0\charscalex100 {Darah lengkap : h
emoglobin (Hb)/hem}\fs24\cf0\f0\charscalex100 {atokrit (Ht) dan sel darah merah}
\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\slmult0
\fs24\cf0\f0\charscalex100 {(sdm) mungkin menurun karena perdarahan}\par\pard\l
i2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \*\tx2933\
fs24\cf0\f0\charscalex100 {2)}\tab \fs24\cf0\f0\charscalex100 {Kenaikan kadar se
rum glutamic ok}\fs24\cf0\f0\charscalex100 {saloasetic transaminase (SGOT),}\par
\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-346\slmult0 \fs
24\cf0\f0\charscalex100 {serum glutamic piruvic transaminase (SGPT)}\par\pard\li
2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \*\tx2933\f
s24\cf0\f0\charscalex100 {3)}\tab \fs24\cf0\f0\charscalex100 {Albumin serum menu

run}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slm
ult0 \*\tx2933\fs24\cf0\f0\charscalex100 {4)}\tab \fs24\cf0\f0\charscalex100 {Hi
pokalemi (pada pemeriksaan kadar elektrolit)}\par\pard\li2573\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \*\tx2933\fs24\cf0\f0\charscalex10
0 {5)}\tab \fs24\cf0\f0\charscalex100 {Pemanjangan masa protrombin}\par\pard\li2
573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \*\tx2933\fs
24\cf0\f0\charscalex100 {6)}\tab \fs24\cf0\f0\charscalex100 {Glukosa serum : hip
oglikemi}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-34
6\slmult0 \*\tx2933\fs24\cf0\f0\charscalex100 {7)}\tab \fs24\cf0\f0\charscalex10
0 {Fibrinogen menurun}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2
573\ri0\sl-333\slmult0 \*\tx2933\fs24\cf0\f0\charscalex100 {8)}\tab \fs24\cf0\f0
\charscalex100 {Blood urea nitrogen (BUN) meningkat}\par\pard\li2213\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-346\slmult0 \*\tx2573\fs24\cf0\f0\chars
calex100 {b.}\tab \fs24\cf0\f0\charscalex100 {Pemeriksaan Jasmani Hati : }\par\
pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \*\t
x2933\fs24\cf0\f0\charscalex100 {1)}\tab \fs24\cf0\f0\charscalex100 {Hati }\par
\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs
24\cf0\f0\charscalex100 {Perkiraan besar hati, biasanya hati memb}\fs24\cf0\f0\c
harscalex100 {esar pada awal sirosis, bila hati}\par\pard\li2573\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {men
gecil artinya prognosis kurang baik. }\fs24\cf0\f0\charscalex100 {Besar hati nor
mal selebar telapak}\par\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsx
n666\margrsxn133\margtsxn666\margbsxn626\pard\li2573\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li2573\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex100 {tanga
n sendiri (7-10 cm). pada siro}\fs24\cf0\f0\charscalex100 {sis hati, konsistensi
hati biasanya}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0
\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {kenyal/firm, pinggir hati biasanya t
u}\fs22\cf0\f0\charscalex100 {mpul dan ada sakit pada perabaan}\par\pard\li2573\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\cha
rscalex100 {hati.}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\
ri0\sl-346\slmult0 \*\tx2933\fs24\cf0\f0\charscalex100 {2)}\tab \fs24\cf0\f0\cha
rscalex100 {Limpa}\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\
ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Pembesaran limpa diukur dengan 2
cara: }\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-346
\slmult0 \*\tx3293\fs22\cf0\f0\charscalex100 {a)}\tab \fs22\cf0\f0\charscalex100
{Schuffner: hati membesar ke medial dan kke bawah umbilicus (SI-}\par\pard\li32
93\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3293\ri0\sl-333\slmult0 \fs24\cf0\f0\
charscalex100 {IV) dan dari umbilicus ke SIAS kanan (SV-VIII). }\par\pard\li29
33\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\slmult0 \*\tx3293\fs2
4\cf0\f0\charscalex100 {b)}\tab \fs24\cf0\f0\charscalex100 {Hacket: bila limpa m
embesar }\fs24\cf0\f0\charscalex100 {kea rah bawah saja (HI-V).}\par\pard\li2933
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-346\slmult0 \*\tx3293\fs22\
cf0\f0\charscalex100 {c)}\tab \fs22\cf0\f0\charscalex100 {Perut dan ekstra abdom
en: pada pe}\fs22\cf0\f0\charscalex100 {rut diperhatikan vena kolateral}\par\par
d\li3293\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3293\ri0\sl-333\slmult0 \fs22\c
f0\f0\charscalex100 {dan ascites. Perhatikan spider }\fs22\cf0\f0\charscalex100
{navy pada tubuh bagi}\fs22\cf0\f0\charscalex100 {an atas, bahu,}\par\pard\li329
3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3293\ri0\sl-346\slmult0 \fs22\cf0\f0\c
harscalex100 {leher, dada, pinggang, caput medu}\fs22\cf0\f0\charscalex100 {sa,
dan tubuh bagian bawah.}\par\pard\li3293\ri0\sl-213\slmult0 \fs18\cf0\par\pard\l
i3293\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {Perlu diperhatikan adanya e
ritema palmaris, ginekomastia, dan}\par\pard\li3293\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li3293\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {atrofi testis pa
da pria. Bi}\fs24\cf0\f0\charscalex100 {sa juga dijumpai hemoroid.}\par\pard\li2
213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-346\slmult0 \*\tx2573\fs
24\cf0\f0\charscalex100 {c.}\tab \fs24\cf0\f0\charscalex100 {Pemeriksaan penunja
ng lain: }\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl333\slmult0 \*\tx2933\fs22\cf0\f0\charscalex100 {1)}\tab \fs22\cf0\f0\charscalex
100\i {Radiologi:}\i0 \fs22\cf0\f0\charscalex100 { dengan barium swallow dilihat

adanya varises esifagus}\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\

li2933\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {untuk konfirmasi hipertens
i portal.}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-3
46\slmult0 \*\tx2933\fs24\cf0\f0\charscalex100 {2)}\tab \fs24\cf0\f0\charscalex1
00\i {Esofagoskopi}\i0 \fs24\cf0\f0\charscalex100 {: dapat dilihat vari}\fs24\cf
0\f0\charscalex100 {ses esofagus sebaga}\fs24\cf0\f0\charscalex100 {i komplikasi
sirosis }\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-3
33\slmult0 \fs24\cf0\f0\charscalex100 {hati/hipertensi portal. Kelebihan endosko
pi adalah dapat melihat}\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\l
i2933\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {langsung sumber perdarahan
varise}\fs24\cf0\f0\charscalex100 {s esofagus, tanda-tanda yang}\par\pard\li2933
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\slmult0 \fs24\cf0\f0\ch
arscalex100 {mengarah akan kemungkinan terjadinya}\fs24\cf0\f0\charscalex100 { p
erdarahan berupa cherry red }\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li2933\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {spot, red whale markin
g, kemungkinan perdarahan yang lebih besar}\par\pard\li2933\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li2933\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {akan ter
jadi bila dijumpai tanda }\fs24\cf0\f0\charscalex100 {diffus redness. Selain tan
da tersubut,}\par\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\ma
rgrsxn133\margtsxn666\margbsxn626\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li2933\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex100 {dapat dieval
uasi besar dan panjang varises serta kemungkinan terjadi}\par\pard\li2933\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\slmult0 \fs24\cf0\f0\charscale
x100 {perdarahan yang lebih besar.}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li2573\ri0\sl-333\slmult0 \*\tx2933\fs22\cf0\f0\charscalex100 {3)}\tab
\fs22\cf0\f0\charscalex100\i {Ultrasonografi}\i0 \fs22\cf0\f0\charscalex100 {:
pada saat pemeriksaan USG sudah mulai dilakukan}\par\pard\li2933\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2933\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {seb
agai alat pemeriksaan rutin }\fs22\cf0\f0\charscalex100 {pada penyakit hati. Dip
erlukan}\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333
\slmult0 \fs22\cf0\f0\charscalex100 {pengalaman seorang sonografis karena}\fs22\
cf0\f0\charscalex100 { banyak faktor subjektif. Yang}\par\pard\li2933\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100
{dilihat pinggir hati, pembesaran, permukaan, homogenitas, asites,}\par\pard\li
2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\slmult0 \fs22\cf0\f
0\charscalex100 {splenomegali, gambaran vena hepatika, vena porta, pelebaran sal
uran}\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\sl
mult0 \fs22\cf0\f0\charscalex100 {empedu,atau adanya SOL (space o}\fs22\cf0\f0\c
harscalex100 {ccuping lession). Sonografi bisa}\par\pard\li2933\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li2933\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {mend
ukung diagnosis sirosis hati terutama stadium dekompensata,}\par\pard\li2933\ri0
\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\slmult0 \fs24\cf0\f0\charsc
alex100 {ikterus obstruktif batu kandung empedu dan saluran empedu.}\par\pard\li
2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \*\tx2933\*
\tx3786\fs22\cf0\f0\charscalex100 {4)}\tab \fs22\cf0\f0\charscalex100\i {Sidikan
}\i0 \tab \fs22\cf0\f0\charscalex100\i {hati}\i0 \fs22\cf0\f0\charscalex100 {: r
adionukleid yang disuntikkan secara intravena akan}\par\pard\li2933\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {
diambil oleh parenkim hati, sel re}\fs22\cf0\f0\charscalex100 {tikuloendotel dan
limpa. Bisa dilihat}\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li29
33\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {besar dan bentuk hati, limpa,
kelainan tumor hati, kista, filling defek.}\par\pard\li2933\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li2933\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {Pada sir
osis hati dan kelainan difus parenkim terlihat pengambilan}\par\pard\li2933\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\slmult0 \fs24\cf0\f0\charsca
lex100 {radionukleid secara bertumpu-tumpu (patchy) dan difus.}\par\pard\li2573\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \*\tx2933\*\tx41
06\fs22\cf0\f0\charscalex100 {5)}\tab \fs22\cf0\f0\charscalex100\i {Tomografi}\i
0 \tab \fs22\cf0\f0\charscalex100\i {komputerisasi}\i0 \fs22\cf0\f0\charscalex10

0 {: walaupun mahal sangat berguna untuk}\par\pard\li2933\ri0\sl-213\slmult0 \fs

18\cf0\par\pard\li2933\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {mendiagnos
a kelainan fokal, seper}\fs24\cf0\f0\charscalex100 {ti tumor atau kista hidatid.
Juga }\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\
slmult0 \fs24\cf0\f0\charscalex100 {dapat dilihat besar, bentuk dan homogenitas
hati.}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\s
lmult0 \*\tx2933\fs24\cf0\f0\charscalex100 {6)}\tab \fs24\cf0\f0\charscalex100\i
{Endoscopie cholangio pancreatography (ERCP}\i0 \fs24\cf0\f0\charscalex100 {):
digunakan untuk}\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri
0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {menyingkirkan adanya obstruksi ekst
rahepatik. }\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\s
l-333\slmult0 \*\tx2933\fs24\cf0\f0\charscalex100 {7)}\tab \fs24\cf0\f0\charscal
ex100\i {Angiografi}\i0 \fs24\cf0\f0\charscalex100 {: angiografi selektif, selia
}\fs24\cf0\f0\charscalex100 {gastrik atau splenotofografi}\par\pard\li2933\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-346\slmult0 \fs24\cf0\f0\charsca
lex100 {terutama pengukuran tekanan vena }\fs24\cf0\f0\charscalex100 {porta. Pad
a beberapa kasus,}\par\pard\sect\sectd\sbkpage
{\shp{\*\shpinst\shpleft2080\shptop6106\shpright2200\shpbottom7426\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2034\shpz0\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 1320}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,1226);(66,1240);(66,1240);(53,1240);(5
3,1226);(53,13);(53,0);(66,0);(66,0);(66,13);(120,1213);(66,1333);(0,1213);(66,1
3);(66,13);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2120\shptop7693\shpright2240\shpbottom7880\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2035\shpz1\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 187}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,93);(66,93);(66,93);(53,93);(53,93);(5
3,13);(53,0);(66,0);(66,0);(66,13);(120,66);(66,186);(0,66);(66,13);(66,13);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}

{\sp{\sn fBehindDocument}{\sv 1}}

{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7146\shptop8080\shpright8653\shpbottom8813\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2036\shpz2\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1507}}
{\sp{\sn geoBottom}{\sv 733}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,746);(1520,746);(1520,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 16777215}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7146\shptop8066\shpright8653\shpbottom8813\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2037\shpz3\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1507}}
{\sp{\sn geoBottom}{\sv 747}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(1520,0);(0,0);(0,746);(1520,746);(1520,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7146\shptop8066\shpright7146\shpbottom8066\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2038\shpz3\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 0}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;1;(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;4;16384;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}

{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}

{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2120\shptop8066\shpright2240\shpbottom8253\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2039\shpz4\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 187}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,93);(66,93);(66,93);(53,93);(53,93);(5
3,13);(53,0);(66,0);(66,0);(66,13);(120,66);(66,186);(0,66);(66,13);(66,13);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft6386\shptop8306\shpright6986\shpbottom8426\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2040\shpz5\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 600}}
{\sp{\sn geoBottom}{\sv 120}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(13,53);(506,53);(506,53);(520,66);(506,66);(506,6
6);(13,66);(0,66);(0,53);(0,53);(13,53);(493,0);(613,66);(493,120);(13,53);(13,5
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3520\shptop8306\shpright4120\shpbottom8426\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2041\shpz6\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 600}}
{\sp{\sn geoBottom}{\sv 120}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(13,53);(506,53);(520,53);(520,66);(520,66);(506,6

6);(13,66);(0,66);(0,53);(0,53);(13,53);(493,0);(613,66);(493,120);(13,53);(13,5
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2120\shptop8466\shpright2240\shpbottom8680\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2042\shpz7\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 214}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,106);(66,120);(66,120);(53,120);(53,10
6);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2120\shptop8893\shpright2240\shpbottom9080\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2043\shpz8\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 187}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,93);(66,93);(66,93);(53,93);(53,93);(5
3,13);(53,0);(53,0);(66,0);(66,13);(120,66);(66,186);(0,66);(66,13);(66,13);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3853\shptop9106\shpright6986\shpbottom9226\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2044\shpz9\shpbxpage\shpbypage

{\sp{\sn shapeType}{\sv 0}}

{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 3133}}
{\sp{\sn geoBottom}{\sv 120}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(13,93);(3040,53);(3053,53);(3053,66);(3053,66);(3
040,66);(13,106);(0,106);(0,106);(0,93);(13,93);(3026,0);(3146,53);(3026,120);(1
3,93);(13,93);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2080\shptop9480\shpright2200\shpbottom9866\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2045\shpz10\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 386}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,280);(66,280);(66,293);(53,280);(53,28
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,266);(53,386);(0,266);(66,13);(66,1
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7600\shptop9480\shpright7720\shpbottom10000\shpfhdr0\shp
wr3\shpwrk0\shpfblwtxt1\shplid2046\shpz11\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 520}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,413);(66,426);(66,426);(53,426);(53,41
3);(53,13);(53,0);(66,0);(66,0);(66,13);(120,400);(66,520);(0,400);(66,13);(66,1
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}

{\sp{\sn fFilled}{\sv 1}}

{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2146\shptop10520\shpright2266\shpbottom10733\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2047\shpz12\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 213}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2146\shptop10920\shpright2266\shpbottom11360\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2048\shpz13\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 440}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,333);(66,333);(66,346);(53,333);(53,33
3);(53,13);(53,0);(53,0);(66,0);(66,13);(120,306);(66,426);(0,306);(66,13);(66,1
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft8120\shptop10920\shpright8240\shpbottom11146\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2049\shpz14\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}

{\sp{\sn geoBottom}{\sv 226}}

{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7453\shptop11106\shpright7733\shpbottom11226\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2050\shpz15\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 280}}
{\sp{\sn geoBottom}{\sv 120}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(13,53);(173,53);(186,53);(186,66);(186,66);(173,6
6);(13,66);(0,66);(0,66);(0,53);(13,53);(160,0);(280,66);(160,120);(13,53);(13,5
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft6693\shptop13226\shpright7466\shpbottom13240\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2051\shpz16\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 773}}
{\sp{\sn geoBottom}{\sv 14}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;2;(0,13);(773,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;5;16384;45824;1;45824;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}

{\shp{\*\shpinst\shpleft7466\shptop11186\shpright7466\shpbottom13240\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2052\shpz16\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 0}}
{\sp{\sn geoBottom}{\sv 2054}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;2;(0,2053);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;5;16384;45824;1;45824;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3093\shptop11186\shpright5720\shpbottom11306\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2053\shpz17\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 2627}}
{\sp{\sn geoBottom}{\sv 120}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(13,53);(2520,53);(2520,53);(2520,66);(2520,66);(2
520,66);(13,66);(0,66);(0,66);(0,53);(13,53);(2493,0);(2613,66);(2493,120);(13,5
3);(13,53);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2146\shptop11506\shpright2266\shpbottom11720\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2054\shpz18\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 214}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}

{\sp{\sn fFilled}{\sv 1}}

{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft6200\shptop11506\shpright6320\shpbottom12120\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2055\shpz19\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 614}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,520);(66,520);(66,520);(53,520);(53,52
0);(53,13);(53,0);(53,0);(66,0);(66,13);(120,493);(66,613);(0,493);(66,13);(66,1
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft8120\shptop11506\shpright8240\shpbottom11840\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2056\shpz20\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 334}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,240);(66,253);(66,253);(53,253);(53,24
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,226);(66,346);(0,226);(66,13);(66,1
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7666\shptop11933\shpright8920\shpbottom12626\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2057\shpz21\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1254}}

{\sp{\sn geoBottom}{\sv 693}}

{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,693);(1266,693);(1266,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 16777215}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7666\shptop11933\shpright8920\shpbottom12626\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2058\shpz22\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1254}}
{\sp{\sn geoBottom}{\sv 693}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(1266,0);(0,0);(0,693);(1266,693);(1266,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7666\shptop11933\shpright7666\shpbottom11933\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2059\shpz22\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 0}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;1;(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;4;16384;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2160\shptop11906\shpright2280\shpbottom12120\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2060\shpz23\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}

{\sp{\sn fFlipV}{\sv 0}}

{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 214}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2026\shptop12613\shpright2146\shpbottom13040\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2061\shpz24\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 427}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,320);(66,333);(66,333);(53,333);(53,32
0);(53,13);(53,0);(53,0);(66,0);(66,13);(120,306);(66,426);(0,306);(66,13);(66,1
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3466\shptop12613\shpright3586\shpbottom13040\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2062\shpz25\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 427}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,320);(66,333);(66,333);(53,333);(53,32
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,306);(66,426);(0,306);(66,13);(66,1
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}

{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}

{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft5146\shptop12613\shpright5266\shpbottom13040\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2063\shpz26\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 427}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,320);(66,333);(66,333);(53,333);(53,32
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,306);(66,426);(0,306);(66,13);(66,1
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2080\shptop12613\shpright5200\shpbottom12613\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2064\shpz27\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 3120}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;2;(0,0);(3120,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;5;16384;45824;1;45824;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2306\shptop12373\shpright2306\shpbottom12600\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2065\shpz27\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 0}}
{\sp{\sn geoBottom}{\sv 227}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;2;(0,0);(0,226);}}
{\sp{\sn pSegmentInfo}{\sv 2;5;16384;45824;1;45824;32768}}

{\sp{\sn fFillOK}{\sv 1}}

{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft6200\shptop12586\shpright6320\shpbottom13040\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2066\shpz28\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 454}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,346);(66,346);(66,360);(53,346);(53,34
6);(53,13);(53,0);(66,0);(66,0);(66,13);(120,333);(66,453);(0,333);(66,13);(66,1
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft6200\shptop13426\shpright6320\shpbottom13853\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2067\shpz29\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 427}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,333);(66,333);(66,333);(53,333);(53,33
3);(53,13);(53,0);(53,0);(66,0);(66,13);(120,306);(66,426);(0,306);(66,13);(66,1
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3546\shptop13773\shpright3666\shpbottom13986\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2068\shpz30\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}

{\sp{\sn fFlipV}{\sv 0}}

{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 213}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2026\shptop14186\shpright2146\shpbottom14400\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2069\shpz31\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 214}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft4933\shptop14186\shpright5053\shpbottom14400\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2070\shpz32\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 214}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}

{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}

{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft6200\shptop14186\shpright6320\shpbottom14400\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2071\shpz33\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 214}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn13
3\margtsxn666\margbsxn413\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li29
33\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li2933\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex100 {prosedur ini sangat
berguna untuk }\fs24\cf0\f0\charscalex100 {melihat keadaan sirkulasi portal}\par
\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\slmult0 \fs
24\cf0\f0\charscalex100 {sebelum operasi pintas dan mendetejsi tumor atau kista.
}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult
0 \*\tx2933\fs22\cf0\f0\charscalex100 {8)}\tab \fs22\cf0\f0\charscalex100\i {Pem
eriksaan cairan asites}\i0 \fs22\cf0\f0\charscalex100 {: dengan melakukan pungsi
asites. Bisa}\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\
sl-346\slmult0 \fs22\cf0\f0\charscalex100 {dijumpai tanda-tanda infeksi (periton
}\fs22\cf0\f0\charscalex100 {itis bakterial spontan), sel tumor,}\par\pard\li293
3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\slmult0 \fs22\cf0\f0\c
harscalex100 {perdarahan dan eksudat, dilakuka}\fs22\cf0\f0\charscalex100 {n pem
eriksaan mikroskopis, kultur}\par\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li2933\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {cairan dan pemeriksaan
kadar protei}\fs22\cf0\f0\charscalex100 {n, amilase dan lipase. (Doengoes,}\par
\pard\li2933\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2933\ri0\sl-333\slmult0 \fs
24\cf0\f0\charscalex100 {Marilyn E. 1999) }\par\pard\li1493\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1493\ri0\sl-306\slmult0 \*\tx1853\fs22\cf0\f0\charscalex100
\b {I.}\b0 \tab \fs22\cf0\f0\charscalex100\b {Pathway Keperawatan}\b0 \par\pard\
li1133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1133\ri0\sl-240\slmult0 \fs18\cf0
\f0\charscalex100 {etiologi :-Malnutrisi}\par\pard\li1866\ri0\sl-400\slmult0 \fs
18\cf0\f0\charscalex100 {-Alkoholisme}\par\pard\li2560\ri0\sl-413\slmult0 \fs18\
cf0\f0\charscalex100 {-Virus Hepatitis}\par\pard\li1853\ri0\sl-400\slmult0 \fs18
\cf0\f0\charscalex100 {-Zat toksik}\par\pard\li1133\ri0\sl-413\slmult0 \fs18\cf0
\f0\charscalex100 {Peradangan
}\par\pard\li1133\
ri0\sl-400\slmult0 \fs18\cf0\f0\charscalex100 {Kerusakan hati}\par\pard\sect\sec
td\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols2\colno1\colw6626
\colsr-0\colno2\colw4813\pard\li1133\ri0\sl-360\slmult0 \fs18\cf0\f0\charscalex1
00 {Nekrosis hepatoseluler
te}\fs18\cf0\f0\charscalex100 {rputusn
ya keutuhan jaringan
}\par\pard\li1133\ri0\sl-213\slmult0 \fs18\c

f0\par\pard\li1133\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {Kolaps lobulus

hati}\par\column\pard\li0\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {Ganggu
an rasa}\par\pard\li0\ri0\sl-253\slmult0 \fs18\cf0\f0\charscalex100 {nyaman}\fs1
8\cf0\f0\charscalex100 { nyeri }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn1
5840\marglsxn666\margrsxn133\cols2\colno1\colw4733\colsr-0\colno2\colw6706\pard\
li1133\ri0\sl-413\slmult0 \fs18\cf0\f0\charscalex100 {Terbentuk jaringan parut
}\par\pard\li1133\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {Disertai septa
fibrusa }\par\pard\li1133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1133\ri0\sl-4
00\slmult0 \fs18\cf0\f0\charscalex100 {Distorsi pembuluh darah }\par\pard\li1133
\ri0\sl-400\slmult0 \fs18\cf0\f0\charscalex100 {Dan terganggunya aliran darah po
rtal }\par\pard\li1133\ri0\sl-413\slmult0 \fs18\cf0\f0\charscalex100 {Hipertens
i portal }\par\pard\li4013\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li4013\ri0\sl
-400\slmult0 \fs18\cf0\f0\charscalex100 { portal}\par\pard\li1133\ri0\sl-400\slm
ult0 \fs18\cf0\f0\charscalex100 {Sirosis hati }\par\column\pard\li1440\ri0\sl-41
3\slmult0 \fs18\cf0\f0\charscalex100 {
kelainan
}\par\pard\li1440\ri0\sl-213\slmult0 \fs18\cf0
\f0\charscalex100 { jaringan parenkim paru }\par\pard\li1440\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1440\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1440\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li1440\ri0\sl-373\slmult0 \fs18\cf0\f0\charscalex1
00 {
terganggunya }\par\pard\li1440\ri0\sl-413\slmult0 \fs18\cf0\f0\char
scalex100 {
sistem kerja paru }\par\pard\li0\ri0\sl-400\slmult0 \*\tx216
0\*\tx3600\fs18\cf0\f0\charscalex100 {
peningkatan }\fs18\cf0\f0\charsca
lex100 {system }\tab \fs18\cf0\f0\charscalex100 {
expansi
}\tab \fs
18\cf0\f0\charscalex100 { Fibrinogenesis}\par\pard\li720\ri0\sl-213\slmult0 \fs1
8\cf0\f0\charscalex100 {
terganggu}\par\pard\sect\sectd\sbknone\pgwsxn122
40\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\colw3293\colsr-0\colno2\colw
3853\colsr-0\colno3\colw4293\pard\li1133\ri0\sl-413\slmult0 \fs18\cf0\f0\charsca
lex100 {Fungsi hati terganggu}\par\column\pard\li1440\ri0\sl-413\slmult0 \fs18\c
f0\f0\charscalex100 {
peningkatan tekanan }\par\pard\li0\ri0\sl-213\slmu
lt0 \fs18\cf0\f0\charscalex100 {
hidrostatik }\par\co
lumn\pard\li0\ri0\sl-306\slmult0 \fs18\cf0\f0\charscalex100 {pola nafas}\par\par
d\li0\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {tidak efektif}\par\pard\sec
t\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\col
w2573\colsr-0\colno2\colw1440\colsr-0\colno3\colw7426\pard\li1133\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li1133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1133\ri0\
sl-386\slmult0 \fs18\cf0\f0\charscalex100 {Gangguan }\par\pard\li1133\ri0\sl-40
0\slmult0 \fs18\cf0\f0\charscalex100 {Metabolisme }\par\column\pard\li0\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\
sl-386\slmult0 \fs18\cf0\f0\charscalex100 {gangguan }\par\pard\li0\ri0\sl-400\sl
mult0 \fs18\cf0\f0\charscalex100 {sintesis vit. k }\par\column\pard\li0\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\
sl-386\slmult0 \fs18\cf0\f0\charscalex100 {gangguan
asites}\par\p
ard\li0\ri0\sl-400\slmult0 \fs18\cf0\f0\charscalex100 {metabolisme
}\par\p
ard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols2\col
no1\colw2573\colsr-0\colno2\colw8866\pard\li1133\ri0\sl-413\slmult0 \fs18\cf0\f0
\charscalex100 {bilirubin }\par\column\pard\li0\ri0\sl-413\slmult0 \fs18\cf0\f
0\charscalex100 {factor pembekuan zat besi
menekan gaster}\par\pard\s
ect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\sect\sect
d\sbkpage
{\shp{\*\shpinst\shpleft3640\shptop1666\shpright3760\shpbottom1880\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2072\shpz0\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 214}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)

;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2200\shptop2040\shpright2200\shpbottom2360\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2073\shpz1\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 0}}
{\sp{\sn geoBottom}{\sv 320}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;2;(0,320);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;5;16384;45824;1;45824;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2026\shptop2386\shpright4000\shpbottom2386\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2074\shpz1\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1974}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;2;(0,0);(1986,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;5;16384;45824;1;45824;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2920\shptop1880\shpright4546\shpbottom2240\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2075\shpz2\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}

{\sp{\sn geoRight}{\sv 1626}}

{\sp{\sn geoBottom}{\sv 360}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,360);(1626,360);(1626,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 16777215}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2920\shptop1880\shpright4546\shpbottom2240\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2076\shpz3\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1626}}
{\sp{\sn geoBottom}{\sv 360}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(1626,0);(0,0);(0,360);(1626,360);(1626,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2920\shptop1880\shpright2920\shpbottom1880\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2077\shpz3\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 0}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;1;(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;4;16384;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7733\shptop2040\shpright9893\shpbottom2706\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2078\shpz4\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}

{\sp{\sn fFlipH}{\sv 0}}

{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 2160}}
{\sp{\sn geoBottom}{\sv 666}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,666);(2160,666);(2160,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 16777215}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7733\shptop2040\shpright9893\shpbottom2706\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2079\shpz5\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 2160}}
{\sp{\sn geoBottom}{\sv 666}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(2160,0);(0,0);(0,666);(2160,666);(2160,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7733\shptop2040\shpright7733\shpbottom2040\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2080\shpz5\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 0}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;1;(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;4;16384;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}

{\shp{\*\shpinst\shpleft6200\shptop2026\shpright6320\shpbottom2253\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2081\shpz6\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 227}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft5000\shptop2026\shpright5120\shpbottom2440\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2082\shpz7\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 414}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,306);(66,320);(66,320);(53,320);(53,30
6);(53,13);(53,0);(66,0);(66,0);(66,13);(120,293);(66,413);(0,293);(66,13);(66,1
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft6773\shptop2293\shpright7586\shpbottom2413\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2083\shpz8\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 813}}
{\sp{\sn geoBottom}{\sv 120}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(13,53);(720,53);(720,53);(720,66);(720,66);(720,6
6);(13,66);(0,66);(0,66);(0,53);(13,53);(693,0);(813,66);(693,120);(13,53);(13,5
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45

824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3946\shptop2373\shpright4066\shpbottom2600\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2084\shpz9\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 227}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft1960\shptop2386\shpright2080\shpbottom2600\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2085\shpz10\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 214}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2866\shptop2386\shpright2986\shpbottom2600\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2086\shpz11\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}

{\sp{\sn rotation}{\sv 0}}

{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 214}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2320\shptop3093\shpright4000\shpbottom3093\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2087\shpz12\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1680}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;2;(0,0);(1680,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;5;16384;45824;1;45824;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3026\shptop2893\shpright3026\shpbottom3093\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2088\shpz13\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 0}}
{\sp{\sn geoBottom}{\sv 200}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;2;(0,200);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;5;16384;45824;1;45824;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}

{\shp{\*\shpinst\shpleft5573\shptop2866\shpright5693\shpbottom3093\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2089\shpz14\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 227}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7706\shptop3000\shpright9453\shpbottom3480\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2090\shpz15\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1747}}
{\sp{\sn geoBottom}{\sv 480}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,480);(1746,480);(1746,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 16777215}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7706\shptop3000\shpright9440\shpbottom3480\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2091\shpz16\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1734}}
{\sp{\sn geoBottom}{\sv 480}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(1746,0);(0,0);(0,480);(1746,480);(1746,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}

{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}

{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7706\shptop3000\shpright7706\shpbottom3000\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2092\shpz16\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 0}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;1;(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;4;16384;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3946\shptop3080\shpright4066\shpbottom3293\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2093\shpz17\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 213}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)
;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2266\shptop3106\shpright2386\shpbottom3320\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2094\shpz18\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 120}}
{\sp{\sn geoBottom}{\sv 214}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(66,13);(66,120);(66,120);(66,120);(53,120);(53,12
0);(53,13);(53,0);(66,0);(66,0);(66,13);(120,93);(66,213);(0,93);(66,13);(66,13)

;}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft6013\shptop3146\shpright6266\shpbottom3266\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2095\shpz19\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 253}}
{\sp{\sn geoBottom}{\sv 120}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(13,53);(146,53);(146,53);(146,66);(146,66);(146,6
6);(13,66);(0,66);(0,66);(0,53);(13,53);(120,0);(240,66);(120,120);(13,53);(13,5
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7133\shptop3146\shpright7586\shpbottom3266\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2096\shpz20\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 453}}
{\sp{\sn geoBottom}{\sv 120}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(13,53);(360,53);(360,53);(360,66);(360,66);(360,6
6);(13,66);(0,66);(0,66);(0,53);(13,53);(333,0);(453,66);(333,120);(13,53);(13,5
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft1840\shptop3320\shpright3106\shpbottom4040\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2097\shpz21\shpbxpage\shpbypage

{\sp{\sn shapeType}{\sv 0}}

{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1266}}
{\sp{\sn geoBottom}{\sv 720}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,720);(1266,720);(1266,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 16777215}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft1840\shptop3320\shpright3106\shpbottom4040\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2098\shpz22\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1266}}
{\sp{\sn geoBottom}{\sv 720}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(1266,0);(0,0);(0,720);(1266,720);(1266,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft1840\shptop3320\shpright1840\shpbottom3320\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2099\shpz22\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 0}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;1;(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;4;16384;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}

{\sp{\sn fLayoutInCell}{\sv 1}}}}

{\shp{\*\shpinst\shpleft6266\shptop3733\shpright8493\shpbottom4160\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2100\shpz23\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 2227}}
{\sp{\sn geoBottom}{\sv 427}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,426);(2226,426);(2226,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 16777215}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft6266\shptop3733\shpright8493\shpbottom4160\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2101\shpz24\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 2227}}
{\sp{\sn geoBottom}{\sv 427}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(2226,0);(0,0);(0,426);(2226,426);(2226,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft6266\shptop3733\shpright6266\shpbottom3733\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2102\shpz24\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 0}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;1;(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;4;16384;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 9525}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}

{\sp{\sn lineType}{\sv 0}}

{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft4533\shptop3906\shpright4986\shpbottom4026\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2103\shpz25\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 453}}
{\sp{\sn geoBottom}{\sv 120}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(13,53);(360,53);(360,53);(360,66);(360,66);(360,6
6);(13,66);(0,66);(0,53);(0,53);(13,53);(333,0);(453,66);(333,120);(13,53);(13,5
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft5706\shptop3906\shpright6160\shpbottom4026\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2104\shpz26\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 454}}
{\sp{\sn geoBottom}{\sv 120}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(13,53);(360,53);(360,53);(360,66);(360,66);(360,6
6);(13,66);(0,66);(0,66);(0,53);(13,53);(333,0);(453,66);(333,120);(13,53);(13,5
3);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn13
3\margtsxn666\margbsxn626\cols3\colno1\colw2413\colsr-0\colno2\colw4813\colsr-0\
colno3\colw4213\pard\li1133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1133\ri0\sl213\slmult0 \fs18\cf0\par\pard\li1133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li11
33\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {Bilirubin tak }\par\pard\li113
3\ri0\sl-413\slmult0 \fs18\cf0\f0\charscalex100 {terkonjugasi}\par\column\pard\l
i160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li160\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li160\ri0\sl-333\slmult0 \fs1
8\cf0\f0\charscalex100 {
darah
gangguan asam
rasa penuh}\
par\pard\li1600\ri0\sl-413\slmult0 \fs18\cf0\f0\charscalex100 {
folat
pada perut}\par\pard\li0\ri0\sl-200\slmult0 \fs18\cf0\f0\charscalex100 {Res

ti }\fs18\cf0\f0\charscalex100 {p}\fs18\cf0\f0\charscalex100 {erdarahan}\par\par

d\li2320\ri0\sl-200\slmult0 \fs18\cf0\f0\charscalex100 {
anoreksia
}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-373\slmult0 \fs18\cf0\f0\charscalex10
0 {Gangguan nutrisi kurang }\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\f0\charsc
alex100 {dari kebutuhan tubuh}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn158
40\marglsxn666\margrsxn133\cols2\colno1\colw7186\colsr-0\colno2\colw4253\pard\li
1133\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {Feses pucat
ikterik
urine }\fs18\cf0\f0\charscalex100 {gelap penurunan sel darah merah }\par\p
ard\li4733\ri0\sl-400\slmult0 \fs18\cf0\f0\charscalex100 {anemia
kelemahan
}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li0\ri0\sl-320\slmult0 \fs18\cf0\f0\charscalex100 {intoler
ansi aktifitas}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\
margrsxn133\cols4\colno1\colw2573\colsr-0\colno2\colw3186\colsr-0\colno3\colw238
6\colsr-0\colno4\colw3293\pard\li1333\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex
100 {Gangguan}\par\pard\li1333\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {bo
dy image}\par\column\pard\li0\ri0\sl-400\slmult0 \fs18\cf0\f0\charscalex100 {pen
umpukan garam empedu}\par\pard\li0\ri0\sl-400\slmult0 \*\tx1440\fs18\cf0\f0\char
scalex100 {
di bawah kulit}\tab \fs18\cf0\f0\charscalex100 { }\fs18\cf0\f0\
charscalex100 {
pruritus }\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-306\slmult0 \fs18
\cf0\f0\charscalex100 {kerusakan integritas kulit}\par\column\pard\li0\ri0\sl-21
3\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\s
l-373\slmult0 \fs18\cf0\f0\charscalex100 {(Price, 2005)}\par\pard\sect\sectd\sbk
none\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\li1506\ri0\sl-480\slmu
lt0 \fs24\cf0\f0\charscalex100\b {J. Diagnosa Keperawatan}\b0 \par\pard\li1853
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-306\slmult0 \*\tx2213\fs24\
cf0\f0\charscalex100 {1.}\tab \fs24\cf0\f0\charscalex100 {Perubahan nutrisi : ku
rang dari kebu}\fs24\cf0\f0\charscalex100 {tuhan tubuh berhubungan dengan intake
}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult
0 \fs24\cf0\f0\charscalex100 {makanan kurang dari kebutuhan tubuh d}\fs24\cf0\f0
\charscalex100 {itandai dengan penurunan berat badan }\par\pard\li1853\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-346\slmult0 \*\tx2213\fs24\cf0\f0\ch
arscalex100 {2.}\tab \fs24\cf0\f0\charscalex100 {Gangguan integritas kulit berhu
bungan dengan akumulasi garam empedu}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {dibawah kulit
ditandai dengan eritema, pruritus}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li1853\ri0\sl-346\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {3.}\tab
\fs24\cf0\f0\charscalex100 {Gangguan pola nafas tak efektif be}\fs24\cf0\f0\char
scalex100 {rhubungan dengan terganggunya sistem}\par\pard\li2213\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {ker
ja paru ditandai dengan ekspansi paru}\fs24\cf0\f0\charscalex100 { terganggu, na
fas cepat dan dangkal }\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\l
i1853\ri0\sl-333\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {4.}\tab \fs24\cf0\
f0\charscalex100 {Resiko tinggi perdarahan berhubungan }\fs24\cf0\f0\charscalex1
00 {dengan gangguan faktor pembekuan}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li2213\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {ditandai denga
n penurunan hemoglobin}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
1853\ri0\sl-333\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {5.}\tab \fs24\cf0\f
0\charscalex100 {Intolerasi aktivitas berhubungan denga}\fs24\cf0\f0\charscalex1
00 {n terganggunya metabolisme penghasil}\par\pard\li2213\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li2213\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {energi dit
andai dengan kelemahan }\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li1853\ri0\sl-333\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {6.}\tab \fs24\cf0
\f0\charscalex100 {Gangguan rasa nyaman : nyeri berhubungan }\fs24\cf0\f0\charsc
alex100 {dengan proses inflamasi pada hati}\par\pard\li2213\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {ditandai
dengan adanya respon nyeri}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pa

rd\li1853\ri0\sl-346\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {7.}\tab \fs24\

cf0\f0\charscalex100 {Gangguan body image berhubungan de}\fs24\cf0\f0\charscalex
100 {ngan ikterik ditandai dengan}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {peningkatan kadar
albumin dalam darah}\par\pard\li1506\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li15
06\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100\b {K. Intervensi dan Rasional}
\b0 \par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-293\slm
ult0 \*\tx2213\fs24\cf0\f0\charscalex100 {1.}\tab \fs24\cf0\f0\charscalex100 {Di
agnosa I}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrs
xn133\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\ma
rgtsxn666\margbsxn466\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2213\ri0\sl-413\slmult0 \*\tx3293\fs24\cf0\f0\charscalex100 {Tujuan}\tab \fs
24\cf0\f0\charscalex100 {: setelah dilakukan tindakan keperawatan selama 3x24 ja
m }\par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-333\sl
mult0 \fs24\cf0\f0\charscalex100 {kebutuhan nutrisi pasien dapat terpenuhi}\par\
pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li2213\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {Kriteria ha
sil: memperlihatkan asupan}\fs24\cf0\f0\charscalex100 { makanan yang tinggi kalo
ri tinggi}\par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-3
46\slmult0 \fs24\cf0\f0\charscalex100 {protein dengan memadai, mengenali makanan
dan minuman}\par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\s
l-333\slmult0 \fs24\cf0\f0\charscalex100 {yang bergizi dan diperbolehkan dalam d
iet, pertambahan berat}\par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
3480\ri0\sl-333\slmult0 \*\tx4333\*\tx5146\*\tx7000\*\tx8506\*\tx9426\fs24\cf0\f
0\charscalex100 {badan}\tab \fs24\cf0\f0\charscalex100 {tanpa}\tab \fs24\cf0\f0\
charscalex100 {memperlihatkan}\tab \fs24\cf0\f0\charscalex100 {penambahan}\tab \
fs24\cf0\f0\charscalex100 {edema}\tab \fs24\cf0\f0\charscalex100 {dan}\par\pard\
li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-346\slmult0 \fs24\cf0
\f0\charscalex100 {pembentukan asites, melaporkan peningkatan nafsu/selera}\par\
pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-333\slmult0 \fs2
4\cf0\f0\charscalex100 {makan, turut serta dalam upaya memelihara oral hygiene}\
par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-346\slmult0
\fs24\cf0\f0\charscalex100 {sebelum makan dan menghadapi mual}\par\pard\li2213\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2213\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {Intervensi :}\par\pard\l
i2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {a.}\tab
\fs24\cf0\f0\charscalex100 {motivasi pasien untuk makan makanan dan suplemen mak
anan}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn13
3\cols3\colno1\colw4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\li25
73\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\
charscalex100 {Rasional }\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charsca
lex100 {motivasi sangat pent}\fs24\cf0\f0\charscalex100 {ing bagi penderita anor
eksia}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn1
33\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100
{b.}\tab \fs24\cf0\f0\charscalex100 { tawarkan makan makanan dengan porsi sediki
t tapi sering}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\m
argrsxn133\cols3\colno1\colw4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\
pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs2
4\cf0\f0\charscalex100 {Rasional}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li0\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\par
d\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-346\slmult0 \fs24\cf0\f0\
charscalex100 {makanan dengan porsi}\fs24\cf0\f0\charscalex100 { kecil dan serin
g lebih di}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\marg
rsxn133\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmu
lt0 \fs24\cf0\f0\charscalex100 {tolerir oleh penderita anoreksia}\par\pard\li221

3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\

pard\li2213\ri0\sl-320\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {c.}\tab \fs2
4\cf0\f0\charscalex100 { pelihara hygiene oral sebelum makan}\par\pard\sect\sect
d\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\colw4013\
colsr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Rasional}
\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-346\slmult
0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li0\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {mengurangi cita }\
fs24\cf0\f0\charscalex100 {rasa yang tidak enak dan}\par\pard\sect\sectd\sbknone
\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\li2573\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {merangs
ang selera makan}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf
0\f0\charscalex100 {d.}\tab \fs24\cf0\f0\charscalex100 { berikan obat yang dires
epkan unt}\fs24\cf0\f0\charscalex100 {uk mengatasi mual dan muntah}\par\pard\sec
t\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\col
w4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Ras
ional}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\
slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {mengurangi p
erasaan tidak enak diperut yang}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn1
5840\marglsxn666\margrsxn133\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\l
i2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {mengurangi selera makan}\
par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard
\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\
margbsxn506\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\r
i0\sl-413\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {2.}\tab \fs24\cf0\f0\char
scalex100 {Diagnosa II}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
2213\ri0\sl-333\slmult0 \*\tx3293\fs24\cf0\f0\charscalex100 {Tujuan}\tab \fs24\c
f0\f0\charscalex100 {: setelah di lakukan tindakan}\fs24\cf0\f0\charscalex100 {
keperawatan selama 3x24 jam
}\par\pard\li3466\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li3466\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {intergritas kulit
pasien tetap terjaga}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\margl
sxn666\margrsxn133\cols2\colno1\colw4013\colsr-0\colno2\colw7426\pard\li2213\ri0
\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Kriteria hasil:}\par\colum
n\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {memperlihatkan tur
gor kulit yang normal pada ekstrimitas, }\par\pard\sect\sectd\sbknone\pgwsxn122
40\pghsxn15840\marglsxn666\margrsxn133\cols2\colno1\colw3480\colsr-0\colno2\colw
7960\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li221
3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-266\sl
mult0 \fs24\cf0\f0\charscalex100 {Intervensi :}\par\column\pard\li0\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {tid
ak memperlihatkan luka pada kulit, memperlihatkan jaringan}\par\pard\li0\ri0\sl213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100
{yang normal tanpa gejala eritema, perubahan warna/peningkatan}\par\pard\li0\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-346\slmult0 \fs24\cf0\f0\charscal
ex100 {suhu.}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\ma
rgrsxn133\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0\charsca
lex100 {a.}\tab \fs24\cf0\f0\charscalex100 {batasi natrium sesuai yang diresepka
n}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\c

ols3\colno1\colw4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\li2573\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\cha
rscalex100 {Rasional }\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex
100 {meminimalkan pembentukan edema }\par\pard\sect\sectd\sbknone\pgwsxn12240\pg
hsxn15840\marglsxn666\margrsxn133\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \*\tx
2573\fs24\cf0\f0\charscalex100 {b.}\tab \fs24\cf0\f0\charscalex100 {berikan pera
watan pada kulit}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn66
6\margrsxn133\cols3\colno1\colw4013\colsr-0\colno2\colw720\colsr-0\colno3\colw67
06\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \
fs24\cf0\f0\charscalex100 {Rasional}\par\column\pard\li0\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li0\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\
pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-346\slmult0 \fs24\cf0\
f0\charscalex100 {jaringan dan kulit }\fs24\cf0\f0\charscalex100 {yang edema men
ganggu suplai}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\m
argrsxn133\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\s
lmult0 \fs24\cf0\f0\charscalex100 {nutrien rentan terhadap tekanan serta traum
a }\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0\charscale
x100 {c.}\tab \fs24\cf0\f0\charscalex100 {ubah posisi klien dengan sering}\par\p
ard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols3\col
no1\colw4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex1
00 {Rasional}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\
sl-333\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \*\tx1826\*\tx2973\*\tx3826\fs24\
cf0\f0\charscalex100 {meminimalkan}\tab \fs24\cf0\f0\charscalex100 {tekanan}\tab
\fs24\cf0\f0\charscalex100 {yang}\tab \fs24\cf0\f0\charscalex100 {lama dan}\par
\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\li
2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f
0\charscalex100 {meningkatkan mobilisasi edema.}\par\pard\li2213\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\s
l-333\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {d.}\tab \fs24\cf0\f0\charscal
ex100 {lakukan latihan gerak secara pasif,}\fs24\cf0\f0\charscalex100 { tingkatk
an ekstremitas edema}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\margls
xn666\margrsxn133\cols3\colno1\colw4013\colsr-0\colno2\colw720\colsr-0\colno3\co
lw6706\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmul
t0 \fs24\cf0\f0\charscalex100 {Rasional}\par\pard\li1853\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0
\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-440\slmult0 \*\tx2213\fs22\cf0\
f0\charscalex100 {3.}\tab \fs22\cf0\f0\charscalex100 {Diagnosa III}\par\column\p
ard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f
0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {meningkatkan mobilisasi edema}\
par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard
\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\
margbsxn466\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\r
i0\sl-413\slmult0 \*\tx3293\fs24\cf0\f0\charscalex100 {Tujuan}\tab \fs24\cf0\f0\
charscalex100 {: setelah dilakukan tindakan ke}\fs24\cf0\f0\charscalex100 {peraw
atan selama 1x30
menit,}\par\pard\li3466\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li3466\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {pola
nafas pasien me
njadi efektif}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\m
argrsxn133\cols2\colno1\colw4013\colsr-0\colno2\colw7426\pard\li2213\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\r
i0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {Kriteria hasil:}\par\column\pard\l
i0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pa

rd\li0\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {mengalami perbaika}\fs24\

cf0\f0\charscalex100 {n status pernafasan, melaporkan}\par\pard\sect\sectd\sbkno
ne\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols2\colno1\colw3466\colsr-0
\colno2\colw7973\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2
213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2213\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {Intervensi:}\par\column\
pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-346\slmult0 \fs24\cf0\
f0\charscalex100 {pengurangan gejala sesak napa}\fs24\cf0\f0\charscalex100 {s, m
emperlihatkan frekuensi}\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\
ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {pernapasan yang normal (16-24 x/m
enit) tanpa terdengarnya}\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
0\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {suara pernafasan tambahan, me}\
fs22\cf0\f0\charscalex100 {mperlihatkan gas darah yang}\par\pard\li0\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li0\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {no
rmal, tidak mengalami sianosis}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15
840\marglsxn666\margrsxn133\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\f
s24\cf0\f0\charscalex100 {a.}\tab \fs24\cf0\f0\charscalex100 {Tingkatkan bagian
kepala tempat tidur.}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\margls
xn666\margrsxn133\cols3\colno1\colw4013\colsr-0\colno2\colw720\colsr-0\colno3\co
lw6706\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmul
t0 \fs24\cf0\f0\charscalex100 {Rasional}\par\column\pard\li0\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\col
umn\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\
cf0\f0\charscalex100 {mengurangi tekanan ab}\fs24\cf0\f0\charscalex100 {dominal
pada diafragma dan}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn
666\margrsxn133\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl346\slmult0 \fs24\cf0\f0\charscalex100 {memungkinkan pengembanngan thorak da}\fs
24\cf0\f0\charscalex100 {n ekspansi paru yang maximal.}\par\pard\li2213\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li221
3\ri0\sl-320\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {b.}\tab \fs24\cf0\f0\c
harscalex100 {Hemat tenaga pasien}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsx
n15840\marglsxn666\margrsxn133\cols3\colno1\colw4013\colsr-0\colno2\colw720\cols
r-0\colno3\colw6706\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0
\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Rasional}\par\pard\li2573\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100
{pasien.}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl333\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {menguran
gi kebutuhan metabolik dan oksigen}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghs
xn15840\marglsxn666\margrsxn133\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \*\tx25
73\fs24\cf0\f0\charscalex100 {c.}\tab \fs24\cf0\f0\charscalex100 {Ubah posisi de
ngan interval}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\m
argrsxn133\cols3\colno1\colw4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\
pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs2
4\cf0\f0\charscalex100 {Rasional}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {bagian paru.}\par\
pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li1853\ri0\sl-320\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {4.
}\tab \fs24\cf0\f0\charscalex100 {Diagnosa IV }\par\column\pard\li0\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {:}\
par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0
\fs24\cf0\f0\charscalex100 {meningkatkan ekspansi dan oksigenasi pada semua }\p
ar\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\

li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-346\slmult0 \*\tx3293

\fs24\cf0\f0\charscalex100 {Tujuan}\tab \fs24\cf0\f0\charscalex100 {: setelah di
}\fs24\cf0\f0\charscalex100 {lakukan tindakan keperawatan selama 1x24 jam, }\pa
r\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-333\slmult0 \f
s24\cf0\f0\charscalex100 {terjadi pengurangan resiko perdarahan dan tidak terjad
i}\par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-333\slmul
t0 \fs24\cf0\f0\charscalex100 {perdarahan. }\par\pard\sect\sectd\sbknone\pgwsxn1
2240\pghsxn15840\marglsxn666\margrsxn133\pard\sect\sectd\sbkpage\pgwsxn12240\pgh
sxn15840\marglsxn666\margrsxn133\margtsxn666\margbsxn560\cols2\colno1\colw4013\c
olsr-0\colno2\colw7426\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li2213\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex100 {Kriteria hasil:}\par\co
lumn\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-413\slmult0 \
fs24\cf0\f0\charscalex100 {tidak memperlihatkan }\fs24\cf0\f0\charscalex100 {a
danya perdarahan yang nyata dari}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn
15840\marglsxn666\margrsxn133\cols2\colno1\colw3480\colsr-0\colno2\colw7960\pard
\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li22
13\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-266\slmult0 \fs
24\cf0\f0\charscalex100 {Intervensi :}\par\column\pard\li0\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {traktus gast
rointestinal, memper}\fs24\cf0\f0\charscalex100 {lihatkan tanda-tanda vital yang
}\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs2
4\cf0\f0\charscalex100 {normal, memperlihatkan hasil }\fs24\cf0\f0\charscalex100
{pemeriksaan yang negatif untuk}\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li0\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {perdarahan, melakukan ti
ndakan untuk mencegah trauma.}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn158
40\marglsxn666\margrsxn133\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2
213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \*\tx2573\fs
24\cf0\f0\charscalex100 {a.}\tab \fs24\cf0\f0\charscalex100 {amati feces yang di
ekskresikan untuk memeriksa warna, konsistensi dan }\par\pard\li2573\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100
{jumlah.}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrs
xn133\cols3\colno1\colw4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\
li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0
\f0\charscalex100 {Rasional}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\chars
calex100 {memungkinkan deteksi perdarahan dalam traktus}\par\pard\sect\sectd\sbk
none\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\li2573\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {gas
trointestinal}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \*\tx2573\fs24\cf0\f
0\charscalex100 {b.}\tab \fs24\cf0\f0\charscalex100 {amati manifestasi hemoragi
: ekimos}\fs24\cf0\f0\charscalex100 {is, epistaksis, ptekie, dan
}\par\pard\l
i2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\
f0\charscalex100 {perdarahan gusi.}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghs
xn15840\marglsxn666\margrsxn133\cols3\colno1\colw4013\colsr-0\colno2\colw720\col
sr-0\colno3\colw6706\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri
0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Rasional}\par\column\pard\li0\ri0\s
l-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex1
00 {:}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\
slmult0 \*\tx1706\*\tx3093\*\tx3946\fs24\cf0\f0\charscalex100 {menunjukkan}\tab
\fs24\cf0\f0\charscalex100 {perubahan}\tab \fs24\cf0\f0\charscalex100 {pada}\tab
\fs24\cf0\f0\charscalex100 {mekanisme}\par\pard\sect\sectd\sbknone\pgwsxn12240\
pghsxn15840\marglsxn666\margrsxn133\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par

\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {pembekuan darah. }\

par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-21
3\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213
\ri0\sl-440\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {c.}\tab \fs24\cf0\f0\ch
arscalex100 {catat tanda-tanda vital dengan interval waktu tertentu}\par\pard\se
ct\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\co
lw4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Ra
sional}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\
slmult0 \fs24\cf0\f0\charscalex100 {hipovolemia}\par\column\pard\li0\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {:}
\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult
0 \fs24\cf0\f0\charscalex100 {memberikan dasar dan bukti adanya syok dan}\par\pa
rd\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\li221
3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li2213\ri0\sl-320\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {d.}\tab \fs2
4\cf0\f0\charscalex100 {jaga agar klien tenang dan membatasi aktivitasnya}\par\p
ard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols3\col
no1\colw4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex1
00 {Rasional}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\
sl-346\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li0\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {memin
imalkan resiko perdarahan dan mengejan}\par\pard\sect\sectd\sbknone\pgwsxn12240\
pghsxn15840\marglsxn666\margrsxn133\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \*\
tx2573\fs24\cf0\f0\charscalex100 {e.}\tab \fs24\cf0\f0\charscalex100 {berikan vi
tamin K seperti yang diresepkan}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn1
5840\marglsxn666\margrsxn133\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\mar
glsxn666\margrsxn133\margtsxn666\margbsxn360\cols3\colno1\colw4013\colsr-0\colno
2\colw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li2573\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex100 {Rasional}\pa
r\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-413\slmul
t0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li0\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex100 {meningkatkan
pembekuan dengan memberikan}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840
\marglsxn666\margrsxn133\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li257
3\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {vitamin larut lemak yang diperl
ukan untuk mekanisme pembekuan darah}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-320\slmul
t0 \*\tx2213\fs24\cf0\f0\charscalex100 {5.}\tab \fs24\cf0\f0\charscalex100 {Diag
nosa V}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-346\
slmult0 \*\tx3293\fs24\cf0\f0\charscalex100 {Tujuan}\tab \fs24\cf0\f0\charscalex
100 { : setelah dilakukan tind}\fs24\cf0\f0\charscalex100 {akan keperawatan sela
ma 1x24 jam}\par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl
-333\slmult0 \fs24\cf0\f0\charscalex100 {pasien melaporkan peningkatan en}\fs24\
cf0\f0\charscalex100 {ergi dan partisipasi dalam}\par\pard\li3466\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li3466\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {ak
tivitas}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100
{Kriteria hasil : melaporkan peningkata}\fs24\cf0\f0\charscalex100 {n kekuatan
dan kesehatan pasien,}\par\pard\li3466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3
466\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {merencanakan aktivitas untuk
memberikan kesempatan istirahat}\par\pard\li3466\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li3466\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {yang cukup, meningk
atkan aktivitas dan latihan bersamaan}\par\pard\li3466\ri0\sl-213\slmult0 \fs18\

cf0\par\pard\li3466\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {dengan bertam

bahnya kekuatan.}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \fs24\cf0\f0\charscale
x100 {Intervensi :}\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\
cf0\f0\charscalex100 {a.}\tab \fs24\cf0\f0\charscalex100 {Tawarkan diet tinggi k
alori tinggi protein}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\margls
xn666\margrsxn133\cols3\colno1\colw4013\colsr-0\colno2\colw720\colsr-0\colno3\co
lw6706\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmul
t0 \fs24\cf0\f0\charscalex100 {Rasional}\par\column\pard\li0\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\col
umn\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\
cf0\f0\charscalex100 {memberikan kalori ba}\fs24\cf0\f0\charscalex100 {gi tenaga
dan protein bagi}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn6
66\margrsxn133\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-3
33\slmult0 \fs24\cf0\f0\charscalex100 {proses penyembuhan}\par\pard\li2213\ri0\s
l-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {b.}\tab \fs24\cf0\f
0\charscalex100 {Berikan suplemen vitamin ( A, B kompleks, C,dan K )}\par\pard\s
ect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\c
olw4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {R
asional}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-33
3\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {memberikan
nutrien bagi pasien}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\margls
xn666\margrsxn133\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\s
l-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0
\charscalex100 {c.}\tab \fs24\cf0\f0\charscalex100 {Motivasi pasien untuk melaku
kan la}\fs24\cf0\f0\charscalex100 {tihan yang diselingi istirahat}\par\pard\sect
\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\colw
4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Rasi
onal}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\s
lmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {menghemat ten
aga pasien sambil mendorong pasien}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghs
xn15840\marglsxn666\margrsxn133\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {untuk melakukan latihan
dalam batas toleransi pasien}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn1584
0\marglsxn666\margrsxn133\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\margls
xn666\margrsxn133\margtsxn666\margbsxn413\pard\li2213\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li2213\ri0\sl-413\slmult0 \*\tx2573\fs24\cf0\f0\charscalex
100 {d.}\tab \fs24\cf0\f0\charscalex100 {Motivasi dan bantu pasien untuk mela}\f
s24\cf0\f0\charscalex100 {kukan latihan dengan periode waktu}\par\pard\li2573\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\chars
calex100 {yang di tingkatkan secara bertahap}\par\pard\sect\sectd\sbknone\pgwsxn
12240\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\colw4013\colsr-0\colno2\c
olw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Rasional}\par\pard\li2573
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\ch
arscalex100 {percaya diri}\par\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-320\slmult0 \*\tx221
3\fs24\cf0\f0\charscalex100 {6.}\tab \fs24\cf0\f0\charscalex100 {Diagnosa VI}\pa
r\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \

fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\p

ar\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {memperbaiki perasaan
sehat secara umum dan}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\margl
sxn666\margrsxn133\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\
sl-333\slmult0 \*\tx3293\fs24\cf0\f0\charscalex100 {Tujuan}\tab \fs24\cf0\f0\cha
rscalex100 {: setelah dilakukan tindakan }\fs24\cf0\f0\charscalex100 {keperawata
n selama 1x 24 jam rasa }\par\pard\li3466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li3466\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {nyeri dapat terkon}\fs24
\cf0\f0\charscalex100 {trol sampai hilang.}\par\pard\sect\sectd\sbknone\pgwsxn12
240\pghsxn15840\marglsxn666\margrsxn133\cols2\colno1\colw4013\colsr-0\colno2\col
w7426\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {Krite
ria hasil:}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex10
0 {melaporkan penguranga}\fs24\cf0\f0\charscalex100 {n rasa nyeri dan gangguan r
asa}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133
\cols2\colno1\colw3480\colsr-0\colno2\colw7960\pard\li2213\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-373\slmult0 \fs24\c
f0\f0\charscalex100 {Intervensi :}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\
cf0\par\pard\li0\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {nyaman pada abdo
men, mempertahankan tirah baring dan}\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {mengurangi aktivitas
ketika nyeri }\fs24\cf0\f0\charscalex100 {terasa, ekspresi wajah rileks}\par\pa
rd\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\li221
3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li2213\ri0\sl-320\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {a.}\tab \fs2
4\cf0\f0\charscalex100 {pertahankan tirah baring ketika pa}\fs24\cf0\f0\charscal
ex100 {sien mengalami gangguan rasa nyaman}\par\pard\li2573\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {pada abd
omen}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn13
3\cols3\colno1\colw4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\li25
73\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\
charscalex100 {Rasional}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\l
i2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {hati}\par\column\pard\li0\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-346\slmult0 \fs24\cf0\f0\charsca
lex100 {:}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl346\slmult0 \fs24\cf0\f0\charscalex100 {mengurangi kebutuha}\fs24\cf0\f0\charsca
lex100 {n metabolik dan melindungi}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghs
xn15840\marglsxn666\margrsxn133\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \*\tx25
73\fs24\cf0\f0\charscalex100 {b.}\tab \fs24\cf0\f0\charscalex100 {berikan anti s
pasmodik dan sedatif seperti yang diresepkan}\par\pard\sect\sectd\sbknone\pgwsxn
12240\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\colw4013\colsr-0\colno2\c
olw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Rasional}\par\pard\li2573
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\ch
arscalex100 {nyeri}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
0\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100
{mengurangi iritabilitas }\fs24\cf0\f0\charscalex100 {traktus gastrointestinal d
an}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\
pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li2213\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {c.
}\tab \fs24\cf0\f0\charscalex100 {ajarkan manajemen nyeri}\par\pard\sect\sectd\s
bknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\colw4013\col
sr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Rasional}\pa

r\pard\li1853\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1853\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li1853\ri0\sl-320\slmult0 \*\tx2213\fs24\cf0\f0\charscalex100 {
7.}\tab \fs24\cf0\f0\charscalex100 {Diagnosa VII}\par\column\pard\li0\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {:
}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmul
t0 \fs24\cf0\f0\charscalex100 {mengurangi keluhan nyeri}\par\pard\sect\sectd\sbk
none\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\sect\sectd\sbkpage\pgw
sxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\margbsxn413\pard\li2213
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-413\slmult0 \*\tx
3293\fs24\cf0\f0\charscalex100 {Tujuan}\tab \fs24\cf0\f0\charscalex100 {: setela
h di lakukan tindakan keperawatan seama 1x24 jam, harga}\par\pard\li3480\ri0\sl213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex
100 {diri tidak terganggu}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840
\marglsxn666\margrsxn133\cols2\colno1\colw4013\colsr-0\colno2\colw7426\pard\li22
13\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li2213\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {Kriteria hasil:}\par
\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li0\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {mengatakan p
emahaman akan perubahan dan penerimaan}\par\pard\sect\sectd\sbknone\pgwsxn12240\
pghsxn15840\marglsxn666\margrsxn133\cols2\colno1\colw3480\colsr-0\colno2\colw796
0\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li2213\ri0\sl-266\slmult0 \fs24\cf0\f0\charscalex100 {Inte
rvensi :}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-3
46\slmult0 \fs24\cf0\f0\charscalex100 {diri pada situasi yang ada, mengidentifka
si perasaan dan metode}\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\r
i0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {koping terhadap persepsi diri nega
tif}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133
\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li2213\ri0\sl-320\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {a
.}\tab \fs24\cf0\f0\charscalex100 {diskusikan situasi/dor}\fs24\cf0\f0\charscale
x100 {ong pernyataan takut/m}\fs24\cf0\f0\charscalex100 {asalah, jelaskan hubunn
gan}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slm
ult0 \fs24\cf0\f0\charscalex100 {antara gejala dengan asal penyakit}\par\pard\se
ct\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\co
lw4013\colsr-0\colno2\colw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Ra
sional}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333
\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {pasien sang
at sensi}\fs24\cf0\f0\charscalex100 {tif terhadap perubahan tubuh }\par\pard\se
ct\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\li2213\ri0
\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li2213\ri0\sl-320\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {b.}\tab \fs24\cf0
\f0\charscalex100 {dukung dan dorong pasien, berikan perawatan dengan positif pe
rilaku}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\
slmult0 \fs24\cf0\f0\charscalex100 {bersahabat}\par\pard\sect\sectd\sbknone\pgws
xn12240\pghsxn15840\marglsxn666\margrsxn133\cols6\colno1\colw4013\colsr-0\colno2
\colw720\colsr-0\colno3\colw1920\colsr-0\colno4\colw1306\colsr-0\colno5\colw1266
\colsr-0\colno6\colw2213\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li257
3\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Rasional}\par\column\pard\li0\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charsca
lex100 {:}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl333\slmult0 \fs24\cf0\f0\charscalex100 {memungkinkan}\par\column\pard\li0\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex10

0 {penilaian}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\
sl-333\slmult0 \fs24\cf0\f0\charscalex100 {perasaan}\par\column\pard\li0\ri0\sl213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100
{untuk}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsx
n133\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0
\fs24\cf0\f0\charscalex100 {mempengaruhi perawatan pasien }\par\pard\li2213\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li2213\ri0\sl-320\slmult0 \*\tx2573\*\tx3626\*\tx4813\*\tx5586\*\tx6493\*\tx764
0\*\tx8560\fs24\cf0\f0\charscalex100 {c.}\tab \fs24\cf0\f0\charscalex100 {dorong
}\tab \fs24\cf0\f0\charscalex100 {keluarga}\tab \fs24\cf0\f0\charscalex100 {atau
}\tab \fs24\cf0\f0\charscalex100 {orang}\tab \fs24\cf0\f0\charscalex100 {te}\fs2
4\cf0\f0\charscalex100 {rdekat}\tab \fs24\cf0\f0\charscalex100 {untuk}\tab \fs24
\cf0\f0\charscalex100 {menyatakan,}\par\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {berkunjung/berpa
rtisip}\fs24\cf0\f0\charscalex100 {asi pada perawatan}\par\pard\sect\sectd\sbkno
ne\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\colw4013\colsr-0
\colno2\colw720\colsr-0\colno3\colw6706\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Rasional}\par\co
lumn\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-346\slmult0 \fs24
\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li0\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {partisipasi pada perawata
n membantu mereka}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn6
66\margrsxn133\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-3
33\slmult0 \fs24\cf0\f0\charscalex100 {merasa berguna}\par\pard\li2213\ri0\sl-21
3\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213
\ri0\sl-333\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {d.}\tab \fs24\cf0\f0\ch
arscalex100 {bantu pasien/orang terdekat untuk menga}\fs24\cf0\f0\charscalex100
{tasi perubahan pada penampilan }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsx
n15840\marglsxn666\margrsxn133\cols3\colno1\colw4013\colsr-0\colno2\colw720\cols
r-0\colno3\colw6706\pard\li2573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2573\ri0
\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Rasional}\par\pard\li2573\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li2573\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100
{diri}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-333
\slmult0 \fs24\cf0\f0\charscalex100 {:}\par\column\pard\li0\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {memberikan
dukungan dapat meningkatkan harga}\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsx
n15840\marglsxn666\margrsxn133\pard\sect\sectd\sbkpage}