MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_01C64A8B.85E00B00" This document is a Single File Web Page, also known as a Web Archive file. If you are seeing this message, your browser or editor doesn't support Web Archive files. Please download a browser that supports Web Archive, such as Microsoft Internet Explorer. ------=_NextPart_01C64A8B.85E00B00 Content-Location: file:///C:/D809C636/Menopause_Bianchi_2006.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" The menopause (here and today) - Grace P. Bianchi Movarekhi

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The menopause (here and today)
Grace P. Bianchi Movarekhi  MD, PD
Training in Reproductive Health Research
Geneva - March 17, 2006
------=_NextPart_01C64A8B.85E00B00 Content-Location: file:///C:/D809C636/Menopause_Bianchi_2006_files/slide0002.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" The menopause (here and today) - Grace P. Bianchi Movarekhi
What is menopause ?
<= ![if !ppt]>
l
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lThe= end of periods
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lThe= end of the ovarian activity
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lThe= end of reproductive capacity
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lThe=   transition from childbearing years to = non-chi= ldbearing years
l
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>l= The term derives the Greek words menos (month) = and pausis (pause)
l
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Perimenopause
lThe term defines the period that precedes (pre-menopause) a= nd follows menopause (post-menopause)
lIs characterised by progressive decrease in ovarian function = and the appearance of the clinical and biological signs associated to this event
lCan last  s= everal years and must be related to the concept of life expecta= ncy
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Epidemiology of menopause
lMean age of menopause varies according = to stu= dies
lMWHS : 51.3 years
lMostly between 48 and 52 years
l90% of women are menopaused between 45 = and= 55 years of age
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lMea= n age at perimenopause : 47.5 years of age
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lDur= ation of postmenopause : life expectancy is 33 years after t= he age of 50.
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Where does the aging process = start?
lEndocrine mechanisms
lOvarian reserve
lOocyte quality
lImplantation
l =
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Change= s
–Already 10 years before menopause slight <= /span>changes in menstrual cycles can b= e discerned. =
lFollicular phase shortens and hence does the menstrual cycle.
–A progressive rise in FSH secretion has been described throughout reproductive life and accelerates approximately a decade before = menopause and therefore concedes wit= h a phase of accelerated follicle deplet= ion.
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Changes
<= span class=3DBB style=3D'position:absolute;left:-5.12%;top:.22em'>lAging of oocytes (starts in uterus)
lDecrease of the oocyte reserve
l   (25000) by the age of 37.5y old =
lCritical threshold 1000 oocytes (51 y)
lAging of the granulosa cells
<= span class=3DBB style=3D'position:absolute;left:-5.2%;top:.22em'>lAging of ovarian vascular system
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Changes
lThe post-menopausal ovary ( at 6-12 months= of amenorrhea) is constituted mainl= y of hyperplasic connective tissue lSome follicles will still be present and will disappear progressively between 24 and 48
l months of amenorrhea<= /div>
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= From Klein et al. JCE 85, 4518-25,2000
Mean follicular fluid concentrations for older sub= jects (40-45)
and younger control (20-25)
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Bianchi Movarekhi
From Klein et al. JCE 85, 4518-25,200= 0
Older subjects had significantly higher concentrations
of  total follistatin and activin A
No significant difference in concentrations of  Inhibin A and B
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Bianchi Movarekhi
Genetic factors?
lIn contrast to the timing of onset of= the menstrual cycle= for which a considerable genetic influence has been shown data are not so clear for menopause.
lAttempts to relate menopause with dif= ferent behavioural, reproductive and anthropometrical factors failed to show a consistent and replicable = influence.
lOnly smoking advances menopause of ~1= .5-2 years
l
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l= «Genes control the cessation of a woman’s reproductive life: a twin study of = hysterectomy and age at menopause»&#= 13;
–classical twin study
–628  twin pairs
–h2 =3D 63%
Snider H., MacGregor J., Spector T.D.
J Reprod Endocrinol Metab 1998
Genetic factor= s? II
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Factors = known to modify the age of menopause<= /span>
lSmoking (early onset)
lEthnic origin and climate (early)
lMalnutrition (early)
lHysterectomy (early)
lFibroids ? (late)
lAlcohol (late)
lObesity (late)
l =
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Factors = known not to modify the age of menopa= use
lAge at puberty
lOral contraception
lOvari= an stimulation
lNumbe= r of pregnancies
lAge a= t last pregnancy
lLifes= tyle
lHeigh= t
lWeigh= t
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What happens at menopause ?<= /div>
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lIn post-menopausal women estrogen levels are dow= n to one tenth than their level during reproductive years
l
lPro= gesterone is nearly absent  
l                    
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lThe= small amounts of circulating hormones are produced not by = the ovaries but by the adrenal glands and the f= at cells
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Target organs
lBone
lCardiovascular system
lBreast
lUterus
lOvary
lAnd muscle, skin, brain, etc.
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Symptoms of menopause
lAbsence of period
lHot flashes
lNight sweats
lSleeplessness
lVaginal dryness <= /div>
lMood changes
lSkin and hair modifications
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lFat= igue
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HRT today
Still an option?
<= span class=3DBB style=3D'position:absolute;left:-5.64%;top:.22em'>lShort and long term treatments
lDifferent indications and possibly
l different risks
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Steroid hormones effects on cells
lThey can have different effects in different tissues
l
l Estrogens are extra and intra cellular messengers and stimulate cell growth= 3;
l In general they have a proliferative effect
l
l Progesterone has a trophic effect
l Progestins have mostly an at= rophic effect
l on the endometrium
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Hormones used for HRT
• Estradiol <= /b>
• (17 = b es= tradiol, estrogen valerate)
• oral, transdermal, vaginally,i.m.
•    Conjugated estrogens = ;
•    (50% es= trone sulfate, 23% equiline)
• oral, vaginal
• Estriol
• oral, vaginal
•
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Hormones used for HRT
<= span style=3D'font-size:88%;color:yellow;mso-color-index:7;text-shadow:auto'>lNatural progesterone
<= span style=3D'font-size:88%;color:yellow;mso-color-index:7;text-shadow:auto'>lProgestins derived from progesterone
<= span style=3D'color:#00CC00;text-shadow:auto'>–Acetate of medroxiprogesterone
<= span style=3D'color:#00CC00;text-shadow:auto'>–Medrogestone,
<= span style=3D'color:#00CC00;text-shadow:auto'>–Cyproteron acetate
<= span style=3D'color:#00CC00;text-shadow:auto'>–Dihydrogesterone
<= span style=3D'font-size:88%;color:yellow;mso-color-index:7;text-shadow:auto'>lProgestins derived from nortestosterone
<= span style=3D'color:#00CC00;text-shadow:auto'>–Norethisterone
<= span style=3D'color:#00CC00;text-shadow:auto'>–Norgestrel, desogestrel, levonorgestrel, desogen, dienoges= t
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Possible therapeutic  schemes
lEstrogens only&#= 13;
l 1__________ 14 _____________= 28
l&#= 13;
l<= b>Gestogens as= cyclic monotherapy
l   1     14<= b>_____________ 28 <= /b>
l<= b>Cyclic combined HRT
l   1= __________ 14=  ____________ 28
l<= b>       <= b>_____________  28= 3;
l<= b>Continuous combined HRT
l   1= = __________ 14=  _____________28
l<= b>   1__________ 14= _____________28&= #13;
l
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Epidemiology of HRT
lAbout 8 million women in the USA take <= /b>est= rogen alone and about 6 million are on the combined hormone regimen
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>l45%= of US women born between 1897 and 1950 used HRT for at = least one month and 20% for 5 or more years= 3;
<= span class=3DBB style=3D'position:absolute;left:-4.71%'>l
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HRT effects on t= otal circulating levels
lHormone replacement therapy ( HRT ) onl= y dou= bles the estrogen  and progesterone levels = of a post-menopausal woman thus by no means it res= tores the previous hormone environment of that woman or is capable of restoring any ovarian activity=
l
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The WHI study
l <= /span>
l <= /div> lAim of the study was to define risks and benefits of strat= egies that could reduce the incidence of heart disease, breast and colon cancer and fractures in post-menopausal women
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The WHI study (2)
l161 809 women aged between 50 and 79 years old were enrolled betwee= n 1993 and 1998 for a set of clinical studies on low-fat dietary patterns,= Calcium and Vit D supplementation, 2 trials of post-menopausal hormon= e use and an observational study at 40 USA clinical centres <= /span>
l =
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The WHI study (3)
l Type of studied HRT
–Continuous combin= ed HRT
–Conjugated equine estrogens administered orally <= /div>
–Type of study = ;
lDouble blind<= /span>
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WHI report : JAMA 7-17-2002  (1)
l16 608 women with no history of hysterectomy had been enrolled for a randomised tria= l on continuous hormonal replacement treatment wit= h equine estrogens and acetate of medroxiprogester= one lThe= trial was stopped early because evidence of  hea= lth risks exceeding health benefits over an ave= rage follow-up of 5.2 years
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WHI report : JAMA 7-17-2002  (2)
–The arm of the study on combined HRT
–was stopped after 5,2 years instead of  8
–as intermediate monitoring of results
–showed that the risks outweighted the
–benefits
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WHI report : JAMA 7-17-2002  (3)
lRisk included small but significant incre= ase in
–
–breast cancer
–coronary heart disease<= span lang=3DEN-GB style=3D'text-shadow:auto;color:yellow;mso-color-index:7'>=
–stroke
–blood clots
l
–Be= nefits included lower risk for
–
–hip fractures
–colon cancer
–
–<= span lang=3DEN-GB style=3D'text-shadow:auto;mso-special-format:lastCR;display:n= one'>
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NHI alert
 3 /3/ 2004=
lWHI completely stopped
<= span class=3DBB style=3D'position:absolute;left:-4.21%;top:.22em'>lNo benefits for the cardiovascular system
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Heart disease risk <= /b>
lThe risk was 29% higher for the group taking  com= bined HRT than the group  on placebo = ;
lThe annual increased risk for an indivi= dual women was still relatively small
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lIn = 1 year 37 heart disease events per 10.000 women were repor= ted in the combined HRT protocol versus 30 in the placebo group=
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Breast cancer risk
lRis= k was 26% higher in the treated group
lOn = average in one year 8 additional cases were observed in this group lThe increase was apparent after 4 years and the= risk appeared to be cumulative
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Stroke and blood clots risk<= /div>
l41% of increased risk for the group on HRT lOn average 29 cases per 10000 women v= s. 20 cases = lThe risk appeared in the 2nd year of <= /b>treatment
<= span style=3D'visibility:hidden'>l =
l2 fold greater rates of blood clots than the group on placebo&= #13;lOn average 34 cases per 10000 women v= s. 16 cases =
<= span style=3D'color:#00CC00;text-shadow:auto;visibility:hidden'>l
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Benefits shown b= y the = com= bined HRT study –WHI
lCol= on cancer
–Reduction of 37% = in the HRT group
–On average 10 cas= es per 10000 women vs 16 cases in the placebo group
–Benefit appeared = after 3 years of use and became  more significant with time
l
l
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Benefits shown b= y the com= bined HRT study –WHI
lBone fractures= 3;
–First study to sh= ow a decreased  risk of vertebral  and other osteoporotic fractures <= /b>
–24% reduction in = total fractures  and 34% reduction in hip fractures
–10 vs. 15 cases (= 5 fewer cases per 10000 per year)
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Uterine cancer and HRT
lProlonged exposure of the uterus to estrogens in the absence of progesterone increases the risk of endometrial cancer lPro= gesterone or progestins must be used for at least 10 days to provide protection statistically
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Ovarian cancer and HRT=
lOne recent study suggested that combined  HRT= do not increase the risk if Progesterone is used at least fo= r 15 days a month lEstrogens increases the risk of ovarian cancer = and= the risk increase with time  of use (l= ess or more than 20 y of treatment)
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Osteoporosis and HRT
lHRT reduces  of 30% the risk of hip fractures <= /span>and= 50% those of vertebrae
lOne of the women= over 80 will suffer of fractures
lA protective eff= ect seems to exist and is time dependent (less = and over 10 y)
lThe time of trea= tment seems also to play a role
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Alzheimer and HRT
lJAM= A Nov. 2002
l41% reduction in risk of AD (26 cases out of 106= 6 women who had used HRT  vs  58 cases out= of 800 non users) lWomen who had used HRT for 10 or more yea= rs  has a risk comparable with the risk obs= erved in men
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Other substances= used for relief of menopausal symptoms
l
lPhyto – hormon= es 
–Black cohosh (cimifuga racemosa), lignins
–(flaxseeds), coumestans (sunflower seeds, red clover),
– isoflavones (soya), yam (extracts)
–
lAndrogens =
–Dehydroepiandrosterone
–Testosterone
l
–
–
l<= span lang=3DEN-GB style=3D'mso-special-format:lastCR;display:none'> =
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Other substances= used for relief of menopausal symptoms
l(Selective estro= gen receptors modulators)
lRaloxifene <= /b>
lSSRI and NRI
lSERM =
lModulators of the serotonin levels and 5-HT 2a rec= eptors
lFluoxitine =
l =
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Tibolone=
(C19, derived from Norethisterone)
capable of interacting with estrogen, progestin and
androgen receptors
l
lHot flashes
lSweating
lDizziness
lHeadaches
lVaginal dryness
lDyspareunia
lDecreases FSH
lIncreases libido
= l
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Tibolone II
l= No estrogenic activity on endometrium ??
l= 12% of cases irregular bleeding (unexpl= ained)
l= Endometrium has showed to be atrophic at US and biopsy
lNo impact on fibroids
l= Can be associated to LHRH analogues to limit hypoestrogenic symptoms
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Tibolone= III
lEffective on bone <= /span>
lReduces by 50% bone remodelling= 3;
l but increases thromboembolic events  (Thebes study data presented in Buenos Aires 2005)=
lless effects on breast
l Until the  One million women study (Lancet 2003) showed that this was not = the case
lHas an inotropic effect on heart a= nd no impact on = blood pressure
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Alternatives to hormone replacement therapy
Osteoporosis
l Adequate calcium= and vitamin D intake (1000 to 1500 and exercise
l = = If at risk:
l Livi= al ??
l rece= nt results showed that as it increases bone density it increases <= /span>also thromboembolic risk in older women (LIFT study)  and that it cou= ld cause endometrial cancer (THEBES study)
l Evista ??
l important  vasomotor side effects
l Fosamax ??
l Mandibular osteodistrophy
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Raloxife= ne
lDerived from tamoxifene and mainly us= ed for = prevention of breast cancer recurrenc= y
lEffec= ts: agonists or antagonists on different tissues
lUsed essentially for prevention and treatment of osteoporosis lEffec= ts also on the vascular system and metabolism
lOngoi= ng studies  (Ruth, More)
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Biphosphonates
lThey decrease osteoclasts activity
lThey are fixed by the bone
lVery little absorption
lSome side effects
lThe effect last on bone up to one year after end of treatment
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Alternatives to hormone replacement therapy
General advise
lDon’t smoke
lEat a healthy diet
lMaintain a healthy weight
lGet adequate exercise
lReduce stress
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Alternatives to hormone replacement therapy
Hot flashes
lLifestyle changes
lSoy foods
lAntidepressants
l (Effexor, Prozac, Paxil) = ;
lHypotensive drugs
l (Catapresan)
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Alternatives to hormone replacement therapy
Vaginal dryness
lVaginal lubricants
lVaginal estrogen products
l (cre= ams, gels, ovules, vaginal ring)
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Alternatives to hormone replacement therapy Heart disease
<= span class=3DBB style=3D'position:absolute;left:-4.71%'>l
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lCon= trol and maintain low cholesterol levels
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lCon= trol and maintain low blood pressure levels
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Questions left open
<= span style=3D'color:#00CC00;text-shadow:auto'>lWill low doses of estrogens and progestin have lower risks?
<= span style=3D'color:#00CC00;text-shadow:auto'>lDo other types of estrogens an= d progestins or oth= er ways of administering them have different risks?
<= span style=3D'color:#00CC00;text-shadow:auto'>lWhich place for physiological HRT?
lWhat is the best method to stop taking estrogens and progestins
l
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Conclusions
lMore research is needed and welcomed= 3;
lA standard, perfect and safe dose for a= ll women probably does not exist
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lThe= best dose is the lowest capable of treating the symptoms in each patient
<= span style=3D'font-size:88%;color:#00CC00;text-shadow:auto'>lGen= etic and personal risks must be carefully evaluated
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Content-Transfer-Encoding: quoted-printable Content-Type: application/javascript; charset="windows-1252" function LoadSld() { var sld=3DGetObj("SlideObj") if( !g_supportsPPTHTML ) { =09 sld.style.visibility=3D"visible" return } if( MakeNotesVis() ) return runAnimations =3D _InitAnimations(); =09 if( IsWin("PPTSld") ) parent.SldUpdated(GetSldId()) g_origSz=3DparseInt(SlideObj.style.fontSize) g_origH=3Dsld.style.posHeight g_origW=3Dsld.style.posWidth g_scaleHyperlinks=3D(document.all.tags("AREA").length>0) if( g_scaleHyperlinks ) InitHLinkArray() if( g_scaleInFrame||(IsWin("PPTSld") && parent.IsFullScrMode() ) ) document.body.scroll=3D"no" _RSW() if( IsWin("PPTSld") && parent.IsFullScrMode() ) FullScrInit(); =09 MakeSldVis(); ChkAutoAdv() if( runAnimations ) { if( document.all("NSPlay") ) document.all("NSPlay").autoStart =3D false; if( sld.filters && sld.filters.revealtrans ) setTimeout( "document.body.start()", sld.filters.revealtrans.duration * = 1000 ); else document.body.start(); } } function MakeSldVis()=20 { var fTrans=3Dg_showAnimation && SldHasTrans() if( fTrans )=09 { if( g_bgSound ) { idx=3Dg_bgSound.indexOf(","); pptSound.src=3Dg_bgSound.substr( 0, idx ); pptSound.loop=3D -(parseInt(g_bgSound.substr(idx+1))); } SlideObj.filters.revealtrans.Apply()=09 } SlideObj.style.visibility=3D"visible" if( fTrans ) SlideObj.filters.revealtrans.Play() } function MakeNotesVis()=20 { if( !IsNts() ) return false=20 SlideObj.style.display=3D"none" nObj =3D document.all.item("NotesObj") parent.SetHasNts(0) if( nObj ) {=20 nObj.style.display=3D"" parent.SetHasNts(1) } return 1 } function ChkAutoAdv() { if(SldHasTrans()) SlideObj.onfilterchange=3DAutoAdv else AutoAdv() } function AutoAdv() { if(!IsWin("PPTSld") || !gUseSldTimings )return var sld=3DGetCurSld() if( (sld.mAdvDelay>0) && !parent.IsFramesMode() ) setTimeout("parent.GoToNextSld()",sld.mAdvDelay) } function GetObj(id) { if(g_supportsPPTHTML) return document.all(id); else return document.getElementById(id); } function SldHasTrans() { return SlideObj.style.filter !=3D ""; } function GetSldId() { return sId=3Dlocation.href.substring(location.href.la= stIndexOf('/')+1) } function HideMenu() { if( frames["PPTSld"] && PPTSld.document.all.item("ctx= tmenu") && PPTSld.ctxtmenu.style.display!=3D"none" ) { PPTSld.ctxtmenu.styl= e.display=3D'none'; return true } return false } function IsWin( name ) { return window.name =3D=3D name } function IsNts() { return IsWin("PPTNts") } function IsSldOrNts() { return( IsWin("PPTSld")||IsWin("PPTNts") ) } function SupportsPPTAnimation() { return( navigator.platform =3D=3D "Win32"= && navigator.appVersion.indexOf("Windows")>0 ) } function SupportsPPTHTML() { var appVer=3Dnavigator.appVersion, msie=3DappVer.indexOf("MSIE "), ver=3D0 if( msie >=3D 0 ) ver=3DparseFloat( appVer.substring( msie+5, appVer.indexOf(";",msie) ) ) else ver=3DparseInt(appVer) return( ver >=3D 4 && msie >=3D 0 ) } function _RSW() { if( !g_supportsPPTHTML || IsNts() || ( !g_scaleInFrame && (!IsWin("PPTSld") || !parent.IsFullScrMode()) ) ) return var padding=3D0; if( IsWin("PPTSld") && parent.IsFramesMode() ) padding=3D6 cltWidth=3Ddocument.body.clientWidth-padding cltHeight=3Ddocument.body.clientHeight-padding factor=3D(1.0*cltWidth)/g_origW if( cltHeight < g_origH*factor ) factor=3D(1.0*cltHeight)/g_origH newSize =3D g_origSz * factor if( newSize < 1 ) newSize=3D1 s=3DSlideObj.style s.fontSize=3DnewSize+"px" s.posWidth=3Dg_origW*factor s.posHeight=3Dg_origH*factor s.posLeft=3D(cltWidth-s.posWidth+padding)/2 s.posTop=3D(cltHeight-s.posHeight+padding)/2 if( g_scaleHyperlinks ) ScaleHyperlinks( factor ) } function _InitAnimations() { animRuntimeInstalled =3D ''+document.body.localTime !=3D 'undefined'; isFullScreen =3D (window.name =3D=3D "PPTSld") && !parent.IsFramesMode(); g_animUseRuntime =3D g_showAnimation && animRuntimeInstalled && !(isFullSc= reen && parent.IsSldVisited()); if( g_animUseRuntime ) { collSeq =3D document.all.tags("seq"); if( collSeq !=3D null ) { for(ii=3D0;ii numSlds ) gSldJumpIdx =3D numSlds; if ( gSldJumpIdx >=3D 0 ) { if ( gSldJumpIdx =3D=3D 0 ) gSldJumpIdx =3D 1; var jumpTo =3D parseInt(gSldJumpIdx); gSldJump =3D 0; gSldJumpIdx =3D ""; win.GoToSld( parent.GetSldList().mList[jumpTo-1].mSldHref ) } } } function _KDH() { if( event.keyCode =3D=3D 8 ) { event.returnValue =3D 0; parent.GoToPrevSld(); } } function PlaySound( href, loop ){ href=3D unescape(href); if( window.event ) window.event.cancelBubble =3D true; pptSound.src =3D href; pptSound.loop =3D loop ? -1 : 0; } function DocumentOnClick() { if( IsNts() || parent.HideMenu() ) return; if( ( g_allowAdvOnClick && (window.name=3D=3D"PPTSld") && !parent.IsFrames= Mode() ) || (event && event.keyCode=3D=3D32) ) { =09 if( g_animUseRuntime && g_animMainSequence && g_animMainSequence.cangonex= t ) return; parent.GoToNextSld(); } } var g_supportsPPTHTML =3D SupportsPPTHTML(), g_scaleInFrame =3D 1, gId=3D""= , g_bgSound=3D"", g_scaleHyperlinks =3D false, g_allowAdvOnClick =3D 1, g_showInBrowser = =3D 0, gLoopCont =3D 0, gUseSldTimings =3D 1; var g_showAnimation =3D g_supportsPPTHTML && SupportsPPTAnimation() && ( (w= indow.name=3D=3D"PPTSld" && !parent.IsFramesMode()) || g_showInBrowser );va= r g_animManager =3D null; var g_animUseRuntime =3D false; var g_animItemsToHide, g_animInteractiveItems, g_animSlideTime; var g_animMainSequence =3D null; var ENDSHOW_MESG=3D"End of slide show, click to exit.", SCREEN_MODE=3D"Fram= es", gIsEndShow=3D0, NUM_VIS_SLDS=3D54, SCRIPT_HREF=3D"script.js", FULLSCR_= HREF=3D"fullscreen.htm"; var gCurSld =3D gPrevSld =3D 1, g_offset =3D 0, gNtsOpen =3D gHasNts =3D gO= tlTxtExp =3D 0, gHasNarration =3D 0, gOtlOpen =3D true window.gPPTHTML=3DSupportsPPTHTML() var gMainDoc=3Dnew Array(new hrefList("slide0001.htm",1,-1,1),new hrefList(= "slide0002.htm",1,-1,1),new hrefList("slide0003.htm",1,-1,1),new hrefList("= slide0011.htm",1,-1,1),new hrefList("slide0050.htm",1,-1,1),new hrefList("s= lide0048.htm",1,-1,1),new hrefList("slide0058.htm",1,-1,1),new hrefList("sl= ide0062.htm",1,-1,1),new hrefList("slide0043.htm",1,-1,1),new hrefList("sli= de0044.htm",1,-1,1),new hrefList("slide0049.htm",1,-1,1),new hrefList("slid= e0045.htm",1,-1,1),new hrefList("slide0051.htm",1,-1,1),new hrefList("slide= 0052.htm",1,-1,1),new hrefList("slide0007.htm",1,-1,1),new hrefList("slide0= 010.htm",1,-1,1),new hrefList("slide0009.htm",1,-1,1),new hrefList("slide00= 53.htm",1,-1,1),new hrefList("slide0023.htm",1,-1,1),new hrefList("slide003= 2.htm",1,-1,1),new hrefList("slide0034.htm",1,-1,1),new hrefList("slide0035= .htm",1,-1,1),new hrefList("slide0019.htm",1,-1,1),new hrefList("slide0008.= htm",1,-1,1),new hrefList("slide0020.htm",1,-1,1),new hrefList("slide0031.h= tm",1,-1,1),new hrefList("slide0036.htm",1,-1,1),new hrefList("slide0021.ht= m",1,-1,1),new hrefList("slide0022.htm",1,-1,1),new hrefList("slide0024.htm= ",1,-1,1),new hrefList("slide0060.htm",1,-1,1),new hrefList("slide0025.htm"= ,1,-1,1),new hrefList("slide0026.htm",1,-1,1),new hrefList("slide0028.htm",= 1,-1,1),new hrefList("slide0027.htm",1,-1,1),new hrefList("slide0029.htm",1= ,-1,1),new hrefList("slide0040.htm",1,-1,1),new hrefList("slide0039.htm",1,= -1,1),new hrefList("slide0041.htm",1,-1,1),new hrefList("slide0038.htm",1,-= 1,1),new hrefList("slide0033.htm",1,-1,1),new hrefList("slide0063.htm",1,-1= ,1),new hrefList("slide0055.htm",1,-1,1),new hrefList("slide0057.htm",1,-1,= 1),new hrefList("slide0056.htm",1,-1,1),new hrefList("slide0017.htm",1,-1,1= ),new hrefList("slide0059.htm",1,-1,1),new hrefList("slide0061.htm",1,-1,1)= ,new hrefList("slide0014.htm",1,-1,1),new hrefList("slide0013.htm",1,-1,1),= new hrefList("slide0016.htm",1,-1,1),new hrefList("slide0018.htm",1,-1,1),n= ew hrefList("slide0030.htm",1,-1,1),new hrefList("slide0037.htm",1,-1,1)); /********************************************* Frameset functions These functions control slide navigation and state of the frameset. **********************************************/ function FullScrInit() { g_allowAdvOnClick =3D GetCurSld().mAdvOnClk document.body.style.backgroundColor=3D"black" document.oncontextmenu=3Dparent._CM; document.onkeydown =3D _KDH; document.ondragstart=3DCancel document.onselectstart=3DCancel self.focus() } function Redirect( frmId ) {=09 var str=3Ddocument.location.hash,idx=3Dstr.indexOf('#'), sId=3DGetSldId() if(idx>=3D0) str=3Dstr.substr(1); if( window.name !=3D frmId && ( sId !=3D str) ) { obj =3D GetObj("Main-File") window.location.href=3Dobj.href+"#"+sId return 1 } return 0 } var MHTMLPrefix =3D CalculateMHTMLPrefix();=20 function CalculateMHTMLPrefix() { if ( document.location.protocol =3D=3D 'mhtml:') {=20 href=3Dnew String(document.location.href)=20 Start=3Dhref.indexOf('!')+1=20 End=3Dhref.lastIndexOf('/')+1=20 if (End < Start)=20 return href.substring(0, Start)=20 else=20 return href.substring(0, End)=20 } return ''; } function GetTags(base,tag) { if(g_supportsPPTHTML) return base.all.tags(tag); else return base.getElementsByTagName(tag); } function UpdNtsPane(){ if(frames["PPTNts"]) PPTNts.location.replace( MHTMLP= refix+GetHrefObj( gCurSld ).mNtsHref ) } function UpdNavPane( sldIndex ){ if(gNavLoaded) PPTNav.UpdNav() } function UpdOtNavPane(){ if(gOtlNavLoaded) PPTOtlNav.UpdOtlNav() } function UpdOtlPane(){ if(gOtlLoaded) PPTOtl.UpdOtl() } function SetHasNts( fVal ) { if( gHasNts !=3D fVal ) { gHasNts=3DfVal UpdNavPane() } } function ToggleOtlText() { gOtlTxtExp=3D!gOtlTxtExp UpdOtlPane() } function ClearMedia() { // Clear any sounds playing before launching another browser window. Other= wise, // in fullscreen mode, you'll continue to hear the sound in the frames mod= e. if (PPTSld.pptSound) PPTSld.pptSound.loop =3D 0; } function FullScreen() {=20 if ( PPTSld.g_animUseRuntime ) PPTSld.document.body.pause(); ClearMedia(); var href =3D ( document.location.protocol =3D=3D 'mhtml:') ? FULLSCR_HREF = : FULLSCR_HREF+"#"+GetHrefObj(gCurSld).mSldHref; if(PPTNav.event.ctrlKey) { var w =3D (window.screen.availWidth * 1.0) / 2.0 var h =3D w * (PPTSld.g_origH * 1.0) / PPTSld.g_origW win =3D window.open( MHTMLPrefix+href,null,"toolbar=3D0,resizable=3D1,top= =3D0,left=3D0," + "width=3D"+ w + ",height=3D" + h ); if( win.document.body && PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } else { win =3D window.open( MHTMLPrefix+href,null,"fullscreen=3Dyes" ); if( win.document.body && PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } } function ToggleVNarration() { rObj=3DPPTSld.document.all("NSPlay") if( rObj && !PPTSld.g_animUseRuntime ) { if( (rObj.playState =3D=3D 1)||(rObj.playState =3D=3D 0) ) rObj.Play() else if( rObj.playState =3D=3D 2 ) rObj.Pause() else return; } else if( PPTSld.g_animUseRuntime ) { narObj =3D PPTSld.document.all("narrationID") if( narObj ) narObj.togglePause() } } function GetCurSldNum() { =20 obj=3DGetHrefObj(gCurSld) if( obj.mOrigVis =3D=3D 1 ) return obj.mSldIdx else =20 return gCurSld } function GetNumSlds() { =20 if( GetHrefObj(gCurSld).mOrigVis =3D=3D 1 ) return GetSldList().mNumVisSlds; else return GetSldList().mList.length } function GetSldNum( href ) { for(ii=3D0; ii 1 ) PopSldList(); else if( !IsFramesMode() ) { if( gLoopCont ) GoToFirst() else EndShow() } } function GoToPrevSld() { ii=3DgCurSld-1 if( ii > 0 ) { obj=3DGetHrefObj(ii) while ( obj && ( obj.mVis =3D=3D 0 ) && ( ii>0 ) ) obj=3DGetHrefObj(--ii) if( ii =3D=3D 0 ) ii=3D1 GoToSldNum(ii) } } function GoToFirst(){ GoToSld( GetHrefObj(1).mSldHref ) } function GoToLast() { ii=3DGetSldList().mList.length if( ii !=3D gCurSld ) GoToSld( GetHrefObj(ii).mSldHref ) } function GoToSldNum( num ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue obj =3D GetHrefObj( num ) obj.mVis=3D1 gPrevSld=3DgCurSld gCurSld =3D num; PPTSld.location.replace(MHTMLPrefix+obj.mSldHref) if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function GoToSld( href ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue GetHrefObj( GetSldNum(href) ).mVis=3D1 PPTSld.location.replace(MHTMLPrefix+href) } function SldUpdated( id ) { if( id =3D=3D GetHrefObj(gCurSld).mSldHref ) return gPrevSld=3DgCurSld gCurSld=3DGetSldNum(id) if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function PrevSldViewed(){ GoToSld( GetHrefObj(gPrevSld).mSldHref ) } function HasPrevSld() { return ( gIsEndShow || ( gCurSld !=3D 1 && GetHrefO= bj( gCurSld-1 ).mVis =3D=3D 1 )||( GetCurSldNum() > 1 ) ) } function HasNextSld() { return (GetCurSldNum() !=3D GetNumSlds()) } function CloseWindow() { if( HideMenu() ) return; =09 var event =3D PPTSld.event; if( !IsFramesMode() && event && (event.keyCode=3D=3D27 || event.keyCode=3D= =3D32 || event.type=3D=3D"click" ) ) window.close( self ); CatchNumKeys( self, event ); } function Unload() { gIsEndShow=3D0; } function SetupEndShow() { gIsEndShow=3D1; PPTSld.document.body.scroll=3D"no"; PPTSld.document.onkeypress=3DCloseWindow; PPTSld.document.onclick=3DCloseWindow; PPTSld.document.oncontextmenu=3D_CM; } function EndShow() { if( IsFramesMode() ) return if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue doc=3DPPTSld.document var dir =3D doc.body.dir if( dir !=3D "rtl" ) dir =3D "ltr"; doc.open() doc.writeln('


' + ENDSHOW_MESG + '

') doc.close() } function SetSldVisited(){ GetSldList().mList[gCurSld-1].mVisited=3Dtrue } function IsSldVisited(){ return GetSldList().mList[gCurSld-1].mVisited } function hrefList( sldHref, visible, advDelay, advClk ) { this.mSldHref=3D this.mNtsHref =3D sldHref this.mOrigVis=3D this.mVis =3D visible this.mVisited=3D false this.mAdvDelay=3D advDelay this.mAdvOnClk=3D advClk } function SldList(arr,curSld,fEnd) { this.mCurSld =3D curSld; this.mList =3D new Array(); var idx =3D 1; for(ii=3D0;ii 0) { PushSldList(sldList,fEnd); gCurSld =3D 1; } else if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue } function PushSldList(arr,fEnd) { var ii =3D gSldStack.length; gSldStack[ii] =3D new SldList(arr,gCurSld,fEnd); GoToSld( gSldStack[ii].mList[0].mSldHref ); } function PopSldList() { if (gSldStack[gSldStack.length-1].fEndShow) EndShow() else { gCurSld =3D gSldStack[gSldStack.length-1].mCurSld; gSldStack[gSldStack.length-1] =3D null; gSldStack.length--; var sldList =3D gSldStack[gSldStack.length-1]; GoToSld( sldList.mList[gCurSld - 1].mSldHref ); } } var custShowList=3Dnew Array(); /********************************************* Navigation button implementation There are 2 types of buttons: ImgBtn, TxtBtn implemented as function objects. They share a similiar interface so the event handlers can call SetActive, for example, on a button=20 object without needing to know exactly=20 what type of button it is. **********************************************/ //---------------------------------- function ImgBtn( oId,bId,w,action ) //---------------------------------- { var t=3Dthis t.Perform =3D _IBP t.SetActive =3D _IBSetA t.SetInactive=3D _IBSetI t.SetPressed =3D _IBSetP t.SetDisabled=3D _IBSetD t.Enabled =3D _IBSetE t.ChangeIcon =3D null t.UserAction =3D action t.ChgState =3D _IBUI t.mObjId =3D oId t.mBorderId=3D bId t.mWidth =3D w t.mIsOn =3D t.mCurState =3D 0 } function _IBSetA() { if( this.mIsOn ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _IBSetI() { if( this.mIsOn ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0=20 } } function _IBSetP() { if( this.mIsOn ) { obj=3Dthis.ChgState( gShadowClr,gHiliteClr,2 ) obj.style.posLeft+=3D1; obj.style.posTop+=3D1 } } function _IBSetD() { =20 obj=3Dthis.ChgState( gFaceClr,gFaceClr,0 ) obj.style.posTop=3D0=20 } function _IBSetE( state ) { var t=3Dthis GetObj( t.mBorderId ).style.visibility=3D"visible" if( state !=3D t.mIsOn ) { t.mIsOn=3Dstate if( state ) t.SetInactive() else t.SetDisabled() } } function _IBP() { var t=3Dthis if( t.mIsOn ) { if( t.UserAction !=3D null ) t.UserAction() if( t.ChangeIcon ) { obj=3DGetObj(t.mObjId) if( t.ChangeIcon() ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-4)*t.mWidth else obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-0)*t.mWidth } t.SetActive() } =20 } function _IBUI( clr1,clr2,nextState ) { var t=3Dthis SetBorder( GetObj( t.mBorderId ),clr1,clr2 ) obj=3DGetObj( t.mObjId ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-nextState)*t.mWidth-obj= .style.posTop t.mCurState=3DnextState return obj } //----------------------------------------- function TxtBtn( oId,oeId,action,chkState ) //----------------------------------------- { var t=3Dthis t.Perform =3D _TBP t.SetActive =3D _TBSetA t.SetInactive=3D _TBSetI t.SetPressed =3D _TBSetP t.SetDisabled=3D _TBSetD t.SetEnabled =3D _TBSetE t.GetState =3D chkState t.UserAction =3D action t.ChgState =3D _TBUI t.mObjId =3D oId t.m_elementsId=3D oeId t.mIsOn =3D 1 } function _TBSetA() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gHiliteClr,gShadowClr,0,0 ) } function _TBSetI() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) } function _TBSetP() { if( this.mIsOn ) this.ChgState( gShadowClr,gHiliteClr,1,1 ) } function _TBSetD() { =20 this.ChgState( gFaceClr,gFaceClr,0,0 ) this.mIsOn =3D 0 } function _TBSetE() { var t=3Dthis if( !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) else t.ChgState( gShadowClr,gHiliteClr,1,1 ) t.mIsOn =3D 1 } function _TBP() { var t=3Dthis if( t.mIsOn ) {=20 if( t.UserAction !=3D null ) t.UserAction() if( !t.GetState ) return if( t.GetState() ) t.SetPressed() else t.SetActive() } =20 } function _TBUI( clr1,clr2,lOffset,tOffset ) { SetBorder( GetObj( this.mObjId ),clr1,clr2 ) Offset( GetObj( this.m_elementsId ),lOffset,tOffset ) } function Offset( obj, top, left ){ obj.style.top=3Dtop; obj.style.left=3Dle= ft } function SetBorder( obj, upperLeft, lowerRight ) { s=3Dobj.style; s.borderStyle =3D "solid" s.borderWidth =3D 1=20 s.borderLeftColor =3D s.borderTopColor =3D upperLeft s.borderBottomColor=3D s.borderRightColor =3D lowerRight } function GetBtnObj(){ return gBtnArr[window.event.srcElement.id] } function BtnOnOver(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetActive() } function BtnOnDown(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetPressed() } function BtnOnOut(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetInactive() } function BtnOnUp() { b=3DGetBtnObj() if( b !=3D null ) b.Perform() else Upd() } function GetNtsState(){ return parent.gNtsOpen } function GetOtlState(){ return parent.gOtlOpen } function GetOtlTxtState(){ return parent.gOtlTxtExp } function NtsBtnSetFlag( fVal ) { s=3Ddocument.all.item( this.m_flagId ).style s.display=3D"none" if( fVal ) s.display=3D"" else s.display=3D"none" } function _BSetA_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etActive() } function _BSetI_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etInactive() } function _BSetP_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etPressed() } function _BSetA_BorderImg() {=20 b =3D gBtnArr[this.mBorderId]=20 if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _BSetI_BorderImg() {=20 b =3D gBtnArr[this.mBorderId] if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0 } } var gHiliteClr=3D"THREEDHIGHLIGHT",gShadowClr=3D"THREEDSHADOW",gFaceClr=3D"= THREEDFACE" var gBtnArr =3D new Array() gBtnArr["nb_otl"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOtlPan= e,GetOtlState ) gBtnArr["nb_otlElem"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOt= lPane,GetOtlState ) gBtnArr["nb_nts"] =3D new ImgBtn( "nb_nts","nb_ntsBorder",10,parent.ToggleN= tsPane ) gBtnArr["nb_nts"].SetActive =3D _BSetA_BorderImg; gBtnArr["nb_nts"].SetInactive =3D _BSetI_BorderImg; gBtnArr["nb_ntsBorder"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.= ToggleNtsPane,GetNtsState ) gBtnArr["nb_ntsElem"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.To= ggleNtsPane,GetNtsState ) gBtnArr["nb_prevBorder"] =3D gBtnArr["nb_prev"]=3D new ImgBtn( "nb_prev","n= b_prevBorder",30,parent.GoToPrevSld ) gBtnArr["nb_nextBorder"] =3D gBtnArr["nb_next"]=3D new ImgBtn( "nb_next","n= b_nextBorder",30,parent.GoToNextSld ) gBtnArr["nb_sldshw"]=3D new ImgBtn( "nb_sldshw","nb_sldshwBorder",18,parent= .FullScreen ) gBtnArr["nb_sldshwBorder"] =3D new TxtBtn( "nb_sldshw","nb_sldshwBorder",pa= rent.FullScreen,null ) gBtnArr["nb_sldshwBorder"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwBorder"].SetInactive =3D _BSetI_Border; gBtnArr["nb_sldshwText"] =3D new TxtBtn( "nb_sldshw","nb_sldshwText",parent= .FullScreen,null ) gBtnArr["nb_sldshwText"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwText"].SetInactive =3D _BSetI_Border; gBtnArr["nb_voice"] =3D gBtnArr["nb_voiceBorder"] =3D new ImgBtn( "nb_voice= ","nb_voiceBorder",18,parent.ToggleVNarration ) gBtnArr["nb_otlTxtBorder"] =3D gBtnArr["nb_otlTxt"]=3D new ImgBtn( "nb_otlT= xt","nb_otlTxtBorder",23,parent.ToggleOtlText ) gBtnArr["nb_ntsBorder"].m_flagId=3D "nb_nts" gBtnArr["nb_ntsBorder"].SetFlag =3D NtsBtnSetFlag gBtnArr["nb_otlTxt"].ChangeIcon=3D GetOtlTxtState /********************************************* Context menu implementation _CM() is the function that's hooked up to the oncontextmenu event. Once we're asked to show the menu, we first build it by creating DIVs on-the-fly. Then we position it=20 within the screen area so it doesn't get clipped. Creating the DIVs using createElement() means we don't have to write out any extra HTML into the slide HTML files. **********************************************/ var sNext=3D"Next",sPrev=3D"Previous",sEnd=3D"End Show",sFont=3D"Arial",sAr= row=3D"Arrow",sFreeform=3D"Freeform",sRect=3D"Rectangle",sOval=3D"Oval" function ShowMenu() { BuildMenu(); var doc=3DPPTSld.document.body,x=3DPPTSld.event.clientX+doc.scrollLeft,y= =3DPPTSld.event.clientY+doc.scrollTop m =3D PPTSld.document.all.item("ctxtmenu") m.style.pixelLeft=3Dx if( (x+m.scrollWidth > doc.clientWidth)&&(x-m.scrollWidth > 0) ) m.style.pixelLeft=3Dx-m.scrollWidth m.style.pixelTop=3Dy if( (y+m.scrollHeight > doc.clientHeight)&&(y-m.scrollHeight > 0) ) m.style.pixelTop=3Dy-m.scrollHeight m.style.display=3D"" } function _CM() { if( !parent.IsFullScrMode() ) return; if(!PPTSld.event.ctrlKey) { ShowMenu() return false } else HideMenu() } function BuildMenu() { if( PPTSld.document.all.item("ctxtmenu") ) return var mObj=3DCreateItem( PPTSld.document.body ) mObj.id=3D"ctxtmenu" mObj.style.visibility=3D"hidden" var s=3DmObj.style s.position=3D"absolute" s.cursor=3D"default" s.width=3D"120px" SetCMBorder(mObj,"menu","black") var iObj=3DCreateItem( mObj ) SetCMBorder( iObj, "threedhighlight","threedshadow" ) iObj.style.padding=3D2 CreateMenuItem( iObj,sNext,M_GoNextSld,M_True ) CreateMenuItem( iObj,sPrev,M_GoPrevSld,M_HasPrevSld ) =09 CreateSeparator( iObj ) CreateMenuItem( iObj,sEnd,M_End,M_True ) mObj.style.visibility=3D"visible" } function Cancel() { window.event.cancelBubble=3Dtrue; window.event.returnVa= lue=3Dfalse } function Highlight() { ChangeClr("activecaption","threedhighlight") } function Deselect() { ChangeClr("threedface","menutext") } function Perform() { e=3DPPTSld.event.srcElement if( e.type=3D=3D"menuitem" && e.IsActive() ) e.Action() else PPTSld.event.cancelBubble=3Dtrue } function ChangeClr( bg,clr ) { e=3DPPTSld.event.srcElement if( e.type=3D=3D"menuitem" && e.IsActive() ) { e.style.backgroundColor=3Dbg e.style.color=3Dclr } } function M_HasPrevSld() { return( parent.HasPrevSld() ) } function M_GoNextSld() { if( gIsEndShow ) M_End(); else GoToNextSld() } function M_GoPrevSld() { if( gIsEndShow ) { gIsEndShow=3D0; history.back();= PPTSld.event.cancelBubble=3Dtrue; } else GoToPrevSld() } function M_True() { return true } function M_End() { window.close( self ) } function CreateMenuItem( node,text,action,eval ) { var e=3DCreateItem( node ) e.type=3D"menuitem" e.Action=3Daction e.IsActive=3Deval e.innerHTML=3Dtext if( !e.IsActive() ) e.style.color=3D"threedshadow" e.onclick=3DPerform e.onmouseover=3DHighlight e.onmouseout=3DDeselect s=3De.style; s.fontFamily=3DsFont s.fontSize=3D"9pt" s.paddingLeft=3D2 } function CreateSeparator( node ) { var sObj=3DCreateItem( node ) SetCMBorder(sObj,"menu","menu") var s=3DsObj.style s.borderTopColor=3D"threedshadow" s.borderBottomColor=3D"threedhighlight" s.height=3D1 s.fontSize=3D"0px" } function CreateItem( node ) { var elem=3DPPTSld.document.createElement("DIV") node.insertBefore( elem ) return elem } function SetCMBorder( o,ltClr,rbClr ) { var s=3Do.style s.backgroundColor=3D"menu" s.borderStyle=3D"solid" s.borderWidth=3D1 s.borderColor=3DltClr+" "+rbClr+" "+rbClr+" "+ltClr } ------=_NextPart_01C64A8B.85E00B00 Content-Location: file:///C:/D809C636/Menopause_Bianchi_2006_files/fullscreen.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" ------=_NextPart_01C64A8B.85E00B00 Content-Location: file:///C:/D809C636/Menopause_Bianchi_2006_files/buttons.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhWAESAPf4AAAAAIAAAACAAICAAAAAgIAAgACAgICAgAQEBISEBASEBISEhAQEhMTExAQE /KTM9Pz8/ERERPz8BAT8/KSkpGRkhMTcxCRkxAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAMDAwP8AAAD/AP//AAAA//8A/wD//////yH5BAEAAPgALAAAAABYARIA QAj/APEJHEiwoMGDCBMqXMiwocOHECNKnEixosWLGCEiQKCRo8YDIEHig2DxAD4LKD1avDDhgUuV GUOGbHBR5QGYFBG4fHAB58EKECJEwCfUYAWPFGAygLCRKQIIUKM6WAohKUGgCikcFWh1INWoYKVS 7SrQ41GbIhGYLAuVQVOoC+IyXUuUAkG1HE3KFDhAwkgJc5/qDZmxsOHDiBMrXsy4sePDGyP7lChT 5MULmDPnlDw5YmW6FTNrfgi0aNGEZPEtbfo2bNTUpYeeRph69dPWrqvCNFuBIGG1A59CYPAVQtwF cw0OxWdTIOiBCQAjaAB17fOFII8voGmRc+eOkilm/z9OvTtnjN4hYk1YoT3H2rnBOphPAB9skgq3 2lcaX/5YnJVt9BloAar12UEIRGCZdQghMABI1Tn32IQUVthYexhmqGGGMBHAgIfEhSiiiATAtOGJ GnYI4ogsEldicAYOGNJGZaml3Y0L3NTZUBz1xlB0PUoUI0jlVWRSVN89xBKSGB1YU1TMoRfVBEle hR9HQs1GEHxQ3RZZbveZthxt/LEmXHyp5XWABSCpaRJwbM13gAACPHVccgJFgF+NEhqUAEkQSCfc ddhVhh5dVTaEAEsTUNlkZUWKN9BNGDE6QU8OrSdbllzpxyVTTrU21Uj3scfhp7nNpyoDaTIEJ3P9 If8J2kbLNYegg9JRBwGhFvbq66+ZUiDssMQWK2yHxiZLrInKNotss8l+B5yBrr5p2UIJvortANoC 6+234IbLla/elRtZjeamh5CC3Sb0YLvixivvYkDFGlZqBNh7r4n6goVvv6/ZlCicN+kL71ALTnpQ dCIZp7CihkLA3UQmoWRBogyxtBPGCTnZncVR1rSTo5nuydC/Eo8kUH+lOoTyyvjoCuZu+PjYIKLD rZybtrM1d10C0QXKEVz48GrQkEeWdFJKlbb0UmEeV0SzyC6RvNB646LWIVjUNeC1zAFb+RDKXksM 9r531bwmpQW9+hQDDsx5pqwDRWBXcFES2hc+gEn/wJGdEEWdE6LoWcoxQweaTNmkhydkKaYMYY2Q p1unbLl/pPKbn3v7EZRvrKvqlja2ONvrtoIw9tn2g32/tQBlhtYkU+MNikZ7QYlPDPuMldpOmuJX nVo5VF3HjI+q89mteX5IDd/fVFClma5kiE4f2XUJhlz09gj2NbTDRifkmu7zXjR++RVJ/lPznuvr QH2iD6S+UewP9Dnon6d2NLwN8n90BB6hC68cFMCHoe+ACASP9c4DowUyEF0OPFcDI0ij/VXPaAKC UfhS95AKGoQ7IBRICI1HwhGaUIQoLGEKT6jCFrLwhSuMoQtlCMMZ2rCGOKShDm+4wxzy8Ic+DGIP B4cIRCKGMCAAOy== ------=_NextPart_01C64A8B.85E00B00 Content-Location: file:///C:/D809C636/Menopause_Bianchi_2006_files/frame.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" The menopause (here and today) - Grace P. Bianchi Movarekhi ------=_NextPart_01C64A8B.85E00B00 Content-Location: file:///C:/D809C636/Menopause_Bianchi_2006_files/outline.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252"
 No= tes
Slide Show
Outline
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