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Do&cced= il;. Dr Yusuf AKCAN
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quoted-printable Content-Type: text/html; charset="us-ascii" Slayt 1
=
¨Sirkülasyonda otoantikorlar ve hiperglobunemi = ile giden sebebi bilinmeyen kronik nekroinflamatuar bir kc hastalığıdır.
¨Diğer kc hastalıklarından ayrılmalıdır. Çünkü;
¡%80 antiinflamatuar ve immunosupresif tedav= iye cevap verir
¨Eski isimleri
¡Lupoid hepati= t, plasma cell hepatiti, otoimmun kroan= ik aktif hepatit
¨10-20 yaşları ve 45-70 yaşlarda zirve yapar.
¨PBS den daha az görülür.
¡[ Pbs insidans:5/100 000, prevalans 65/100 000]&= #13;
¨Dolaşan antikorlar organ spesifik değildi= r. Patogenezde rolleri yoktur.
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=
¨TİP I
¡klasik tiptir.
¡Vakaların %80 ini oluşturur
¡%70 i kadın ve  < 40 yaş altındadır
¡Tanı anında
ú%25 siroz
ú%40 akut başlangıç dönemindedir.
¡ANA, ASMA, AAA (Anti actin anti-asiloglycoprotein)&= #13;
¡AAA, tip I e spesifik tir. Laboratuar ve histolojik aktivite ile korroledir. Varlığı tedaviyi kesince relapsı gösterir.
¡P-anca diğer antikorların olmadığı durumlarda tanı için kullanılabilir. %90 +dir.
¡Sebebi bulunamayan akut hepatitlerde akılda tutulmalıdır.
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=
¡= TİP II-
<= span style=3D'font-family:Verdana;font-size:109%'>úÇocuk ve Gençlerde
<= span style=3D'font-family:Verdana;font-size:109%'>ú kadınlarda =
<= span style=3D'font-family:Verdana;font-size:109%'>úanti LKM1, A-LC-1 (liver cytosol 1)
<= span style=3D'font-family:Verdana;font-size:109%'>úAnti LKM1 pozitifliği, kronik HCV de de görülebilir.
<= span style=3D'font-family:Verdana;font-size:109%'>úAPECED (autoimmune poliendocrinopatyhy disorder),
­mukokutanöz kandidiaziz, multipl  endokrin bez yetmezliği, antkor üretimi = ve OIH)
<= span style=3D'font-family:Verdana;font-size:120%'>­<= span style=3D'font-family:Verdana;font-size:120%'>­
<= ![endif]>
¡TİP III
<= span style=3D'font-family:Verdana;font-size:127%'>úAz tanınır,
<= span style=3D'font-family:Verdana;font-size:127%'>úAnti-SLA (anti liver solueble antigen)/ LP (liver-pancreas)
<= span style=3D'font-family:Verdana;font-size:127%'>úBazen ASMA da + olabilir.,
<= span style=3D'font-family:Verdana;font-size:127%'>úKlinik olarak tip I den farklı değildir.
<= span style=3D'font-family:Verdana;font-size:127%'>úSteroide iyi cevap verir
<= span style=3D'font-family:Verdana;font-size:127%'>úTarget antigenler:
<= span style=3D'font-family:Verdana;font-size:140%'>­  s transferaza <= /div>
<= span style=3D'font-family:Verdana;font-size:140%'>­¨
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=
=
¨Overlap with PBS
¡Zayıf AMA pozt
¡Hangisi hakimse onun tedavisi daha etkilidir. <= /span>
¨Overlap with PSC in adults
¡No response to steroid
¨Aotuimmune sclerosing cholangitis in children
¡Responsive to steroid
¨Autoimmune cholangitis
¡Asma pozt
¡Histolojik olarak ise AMA- PBS veya small suct dise= ase var
¡Glu+urso
¨Cryptogenic chronic hepatitis
¡Bir kısım vaka otoimmun marker gmstermeden birçok noktasında AIH benzer ve steroide iyi cevap verebilir.
¡Bunlarda anti-SLA/LP bakılmalı, takiplerde diğer antikorlarda çıkabilir.
¨
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text/html; charset="us-ascii" Slayt 1
TABLE 75-2 -- Subclassifications of Autoimmune Hepatitis Based on Autoantibodies * † 
Clinical Features
Type 1
Type 2
Type 3
Conventional = autoantibodies
Smooth muscle
Nuclear
Liver/kidney microsome type 1
None
Novel autoantibodies
pANCA
Actin=
Asialoglycoprote= in receptor
Liver cytosol type 1
Soluble liver antigen/liver-pancreas
Putative autoantigen
Unknown
Asialoglycoprote= in receptor possible
CYP2D6
Transfer ribonucleoprotein = (tRNP) involved in s= elenocysteine metabolism
Age (years)
Bimodal (10–20 and 45–70)
Pediatric (2–14)
Adults (30–50)
Women (%)
78
89
90
Concurrent immune = diseases (%)
41
34
58
Organ-specific = antibodies (%)
4
30
Uncertain
Gamma globulin = elevation
Marked
Mild
Moderate
Low IgA
No
Occasional
No
HLA associations
-B8, -DR3, -DR4
-B14, -DR3, <= i>-C4A-Q0, -DR7
Uncertain
Allelic risk factors
DRB1 * 0301<= span style=3D'font-family:"Times New Roman";mso-ascii-font-family:"Times New Ro= man"; mso-bidi-font-family:"Times New Roman";mso-hansi-font-family:"Times New Ro= man"; font-size:78%'> and † 0401<= span style=3D'font-family:"Times New Roman";mso-ascii-font-family:"Times New Ro= man"; mso-bidi-font-family:"Times New Roman";mso-hansi-font-family:"Times New Ro= man"; font-size:78%'>
(White North Americ= ans and northern Europeans)=
DRB1 * 07
(Germans and Brazilians)
Uncertain
Glucocorticoid responsive <= /span>
+++
+++
+++
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<= span style=3D'font-family:Verdana'>¨Tip I Bütün yaşlarda, Tip II ise genç ve erişkin bayanlarda daha sıktır. =
<= span style=3D'font-family:Verdana'>¨Klinikte asemtomatik vakalar ve uzun s&uum= l;reli subklinik seyir görülebileceği gibi, hızlı ilerleyici fulminan hepatitde görülebilir.
¨Semptomatik olanlarda,
<= span style=3D'font-family:Verdana;font-size:117%'>¡İştahs= 5;zlık, bulantı , kusma,  sarılık, yorgunluk
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¨Asemptomatik vakalar sadece transaminaz yüksekliği ile tesadüfen farkedilebilir.
¨Enzimler dalgalı bir seyir izleyebilir.
¨Akut tabloda (tranasaminazlar 1000 lerde) gelen bir çok hastanın kc biopsisinde siroz bulunmaktadır.
¨Buda subklinik olarak uzun bir süre geçirildiğini göstermektedir.
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¨Diğer otoimmun hastalıkların eş= lik etmesi tanıda şüphe uyandırmalıdır
¡Hemolitik anemi,
¡İTP,
¡Tip I DM
¡Tiroiditler
¡Ulseratif kolit (primer sclerozan kolanjitde daha <= /span>fazladır)
¡Polyglandular otoimmun sendrome (tip II otoimmun hepatitde özellikle)
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=
=
¨Viral hepatitler
¡HBV
¡HCV
¡HDV
<= span style=3D'font-family:Verdana;font-size:64%'>¨NASH
¨alkol
¨ilaçlar ve toksinler
¡metil dopa
¡nitrofurantoin
¡amiodoron
¡INH
¨Otoimmün
¨PBS
¨PSC
¨genetik hastalıklar
¡hemokromatosis
¡alfa-1 antitripsin eksikliği
¡wilson hastalığı <= /div>
¨idiopatik
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<= span style=3D'font-family:Verdana;font-size:64%'>¨FM normal olabileceği gibi hepatomegali, splenomegali, diğer kc hastalığı bulguları, ve derin sarılık olabilir.
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=
¨ALT ve AST daha fazla yükselir.
¨ALP ve bilirübinler daha az etkilenirler
¨Serum globulinleri (özellikle = gama globulinler) çoğunlukla yükselir.
¨seroloji
¡ANA, ASMA, anti-LKM-1, a-LC-1, anti-= LSA
¡Gamaglobulin yükselmesi ve otoantikorlar chronic viral hepatitlerdede olabilir.
¡Nadiren AMA + liği olabilir. Buda overlap sendromunu gösterir.
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¨Bazen, Bütün özellikleri otoimmun hepatite uyduğu halde seroloji negatif olabilir.
¨Bazen antiinflamatuar tedaviye cevap tek başına otoimmun hepatit tansını koydurabilir.
¨OIH de uluslarası bir = skorlama sistemide mevcuttur. Muhtemel veya kesin OIH demek için kullanılabilir.
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¨Portal alanlar tutulur
¨Mononukler hücrler, plasma hücrelerinden = oluşabilir.
¨İleri aşamalarda fibroziz ve regenerasyon nodulleri olabilir.
¨İnfiltrasyon bilyer kanaliküllere genelde zarar vermez
¨Patolojik bulgular tamamen spesifik <= span style=3D'position:absolute;top:37.2%;left:4.45%;width:95.54%;height:26.74%= '>olmadığından serolojik çalışmalar tanı açısından önemli hale gelir.
¨
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file:///C:/D1325D94/otoimmunehepatit_dosyalar/slide0013.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slayt 1
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¨Azothiopürine (1-2 mg /kg) steroid azaltıcı olarak veya uzun dönem remisyon idamesi için tek başınada kullanılabilir.
¨Kombinasyon tedavisi ile 3 yıl içinde hastaların %65 inde remisyon sağlanır.
¨Relaps sık olur %50 si altı ayda %70-80 üç yılda.
¨İki kez relaps olanlarda sürekli tedavi verilmelidir. Ya mümkün olan en düşük streoidle (7.5 mg /gün) veya azothiopurine 2 mg/kg/gün
¨Mycophenolate mofetil, azothiopurine dirençli veya intolerant olanlarda faydalı olabilmektedir.
¨Cyclosporine ilk yatıştırmada etkin olabilir.
¨Hepatitis A vaccine (Havrix) bu hastalara da önerilir.
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=
¨6 –MP azothiopurine etkisiz olduğu durumlarda verilebilir.
¨İlk remisyon %80 dir. % 20 vaka tedaviye reziztan olabilir. =
¨OIH medikal tedaviye aktif siroz aşamasın= da bile olsa iyi cevap verir.
¡(inaktif siroz da tedavi endikasyonu yoktur)
¨Tedaviye rağmen ilerleyen veya cevap vermeyen lerde OLT (karaciğer nakli yapılmalıdır).
¨AST düzeyleri tedavi endikasyonunu belirlemede= de önemli, tedavi dozlarını titre etmede de
¡Remisyon saymak için < 2 foldolmalı&= #13;
¡Steroid minimum dozunu ayarlarken AST< 5 fold ol= acak şekilde en az doz aranmarlı
¨OLT de 5 yıllık yaşam %80-90 dı= r. Post tranplant dönemde rekürens olabilmektedir.
¨ =
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=
¨Histolojinin ciddiyeti her ne kadar klinikle korole değilsede, önemli bir prognostik faktördür.
¡Aktif Sirotik hastalar ilaçsız remisyon= da kalamazlar.
¨Çoğu hasta uzun vadede idame tedaviye ihtiyaç duyarlar.
¨Tedaviye cevapsızlık en çok; <= /span>
¡Siroz
¡Genç yaşta başlangıç&#= 13;
¡Tedaviye başlamadan önce uzun süre geçmiş olması
¡HLA-B8 ve DR3
¨(LKM-1 positive hastalarda prognoz daha kötüdür. Tedaviye rağmen siroza ilerleme daha çok olur.) bu bilgi değişti. Diğer= leri kadar tedaviye iyi cevap verirler.
¨Nakilden sonra da hastalık tekrarlayabilir. (%= 17)
¡genelde immunsüpresyonun azalanlarda beklenir.
¨OIH başka nedenle OLT yapılan hastalarda = post tx dönemde oluşabilir.
¨ =
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<= span style=3D'font-family:Verdana;font-size:83%'>¡Anti Asialoglikoprotein Ab; tedaviyi takip ve relapsın= az olacağını kestirmede faydalıdır.
<= span style=3D'font-family:Verdana;font-size:83%'>¡Tedavi ile miktarı azalır. İlacları kesmeden önce serumda kaybolursa daha az relaps riski var demektir.
<= span style=3D'font-family:Verdana;font-size:71%'>¨Antibodies to actin
¡SMA dan daha spesifik ancak oldukça düş&uu= ml;k sensitivitesi var.
<= span style=3D'font-family:Verdana;font-size:71%'>¨Anti-LC1
¡Tip 2 de
¡Erken başlangıç
¡Kötü prognozu gösterir
¡İnflamasyna paralellik gösterir
<= span style=3D'font-family:Verdana;font-size:71%'>¨P-ANCA
<= span style=3D'font-family:Verdana;font-size:71%'>¨HLA özellikleri
<= span style=3D'font-family:Verdana;font-size:71%'>¨TNF –alfa promotor gene polimorfizmi,
<= span style=3D'font-family:Verdana;font-size:71%'>¨Cytotoksik T lenfocyte antigen-4 gene polimorfizmi
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TABLE 75-6 -- Treatment Indications * 
Findings <= /div>
Indications
mutlak
nisbi
yok
Clinical <= /div>
Incapacitating symptoms
Mild or no symptoms
Asymptomatic with mi= ld laboratory changes
Relentless clinical = progression
Previous intolerance= to prednisone and/or azathioprine
Laboratory <= /div>
AST ≥ 10-fold normal<= span style=3D'font-family:Arial;mso-ascii-font-family:Arial;mso-hansi-font-fami= ly: Arial;font-size:222%;color:#575F6D;mso-color-index:2;mso-special-format:la= stCR; display:none'>
AST 3- to 9-fold normal
AST < 3-fold normal
AST ≥ 5-fold normal and <= b>gamma globulin ≥ 2-fold <= b>normal
AST < 5-fold norm= al and gamma globulin <= span style=3D'position:absolute;top:61.0%;left:46.25%;width:24.15%;height:4.0%'= >< 2-fold normal
Severe cytopenia
Histologic <= /div>
Bridging necrosis
Interface hepatitis
Inactive cirrhosis
Multilobular necrosis
Portal hepatitis
Decompensated cirrhosis with variceal bleeding
=
=
= ¨
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Content-Type: application/javascript; charset="us-ascii" function LoadSld() { var sld=3DGetObj("SlideObj") if( !g_supportsPPTHTML ) { sld.style.visibility=3D"visible" return } if( MakeNotesVis() ) return runAnimations =3D _InitAnimations(); 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() { var fTrans=3Dg_showAnimation && SldHasTrans() if( fTrans ) { 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() } SlideObj.style.visibility=3D"visible" if( fTrans ) SlideObj.filters.revealtrans.Play() } function MakeNotesVis() { if( !IsNts() ) return false SlideObj.style.display=3D"none" nObj =3D document.all.item("NotesObj") parent.SetHasNts(0) if( nObj ) { 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 DocumentOnClick() { if( IsNts() || parent.HideMenu() ) return; if( ( g_allowAdvOnClick && (window.name=3D=3D"PPTSld") && !parent.IsFrames= Mode() ) || (event && event.keyCode=3D=3D32) ) { 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"Slayt gösterisi bitti, çıkmak iç= ;in tıklatın.", SCREEN_MODE=3D"Frames", gIsEndShow=3D0, NUM_VIS_S= LDS=3D30, 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("slide0002.htm",1,-1,1),new hrefList(= "slide0003.htm",1,-1,1),new hrefList("slide0004.htm",1,-1,1),new hrefList("= slide0030.htm",1,-1,1),new hrefList("slide0031.htm",1,-1,1),new hrefList("s= lide0032.htm",1,-1,1),new hrefList("slide0027.htm",1,-1,1),new hrefList("sl= ide0028.htm",1,-1,1),new hrefList("slide0029.htm",1,-1,1),new hrefList("sli= de0033.htm",1,-1,1),new hrefList("slide0018.htm",1,-1,1),new hrefList("slid= e0005.htm",1,-1,1),new hrefList("slide0006.htm",1,-1,1),new hrefList("slide= 0007.htm",1,-1,1),new hrefList("slide0008.htm",1,-1,1),new hrefList("slide0= 017.htm",1,-1,1),new hrefList("slide0009.htm",1,-1,1),new hrefList("slide00= 10.htm",1,-1,1),new hrefList("slide0023.htm",1,-1,1),new hrefList("slide001= 1.htm",1,-1,1),new hrefList("slide0012.htm",1,-1,1),new hrefList("slide0013= .htm",1,-1,1),new hrefList("slide0014.htm",1,-1,1),new hrefList("slide0015.= htm",1,-1,1),new hrefList("slide0021.htm",1,-1,1),new hrefList("slide0024.h= tm",1,-1,1),new hrefList("slide0025.htm",1,-1,1),new hrefList("slide0026.ht= m",1,-1,1),new hrefList("slide0034.htm",1,-1,1),new hrefList("slide0020.htm= ",1,-1,1)); 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 ) { 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(); function CalculateMHTMLPrefix() { if ( document.location.protocol =3D=3D 'mhtml:') { href=3Dnew String(document.location.href) Start=3Dhref.indexOf('!')+1 End=3Dhref.lastIndexOf('/')+1 if (End < Start) return href.substring(0, Start) else return href.substring(0, End) } 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() { if (PPTSld.pptSound) PPTSld.pptSound.loop =3D 0; } function FullScreen() { 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() { obj=3DGetHrefObj(gCurSld) if( obj.mOrigVis =3D=3D 1 ) return obj.mSldIdx else return gCurSld } function GetNumSlds() { 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; 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(); 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 } } function _IBSetP() { if( this.mIsOn ) { obj=3Dthis.ChgState( gShadowClr,gHiliteClr,2 ) obj.style.posLeft+=3D1; obj.style.posTop+=3D1 } } function _IBSetD() { obj=3Dthis.ChgState( gFaceClr,gFaceClr,0 ) obj.style.posTop=3D0 } 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() } } 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() { 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 ) { if( t.UserAction !=3D null ) t.UserAction() if( !t.GetState ) return if( t.GetState() ) t.SetPressed() else t.SetActive() } } 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 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() { b =3D gBtnArr[this.mBorderId] if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _BSetI_BorderImg() { 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 var sNext=3D"Sonraki",sPrev=3D"Önceki",sEnd=3D"Gösteriyi Bitir",s= Font=3D"Arial",sArrow=3D"Ok",sFreeform=3D"Serbest Form",sRect=3D"Dikdö= rtgen",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 ) 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(); 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