Acute Rheumatic Fever

Acute Rheumatic Fever
Julia Martino, M.D.
Pediatrics, Palo Alto Medical Clinic, Palo Alto, California
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Brief Description
An overview of the etiology, pathophysiology, clinical features, diagnosis and treatment of acute rheumatic fever.
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References
Da Silva N, Faria Pereira B. Acute rheumatic fever: still a challenge. Pediatric Rheumatology. 1997; 23: 545-562
Groves AM. Rheumatic fever and rheumatic heart disease: an overview. Tropical Doctor. 1999; 29: 129-132
Pichichero ME. Group A beta-hemolytic streptococcal infections. Pediatrics in Review. 1998; 19(9): 291-302
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Mar 13, 2010	1350	VA:03:13:2951:2010
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														<td width="6%"><strong>9</strong></td>
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														<td width="6%"><strong>10</strong></td>
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						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide11.JPG" id="image_11"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>11</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281973"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_12" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(12);">
			<span style="display:none;" id="span_12">|~|/files/powerpoints_images/node281949/Slide12.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide12.JPG" id="image_12"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>12</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281975"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_13" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(13);">
			<span style="display:none;" id="span_13">|~|/files/powerpoints_images/node281949/Slide13.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide13.JPG" id="image_13"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>13</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281977"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_14" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(14);">
			<span style="display:none;" id="span_14">|~|/files/powerpoints_images/node281949/Slide14.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide14.JPG" id="image_14"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>14</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281979"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_15" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(15);">
			<span style="display:none;" id="span_15">|~|/files/powerpoints_images/node281949/Slide15.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide15.JPG" id="image_15"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>15</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281981"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_16" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(16);">
			<span style="display:none;" id="span_16">|~|/files/powerpoints_images/node281949/Slide16.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide16.JPG" id="image_16"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>16</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281983"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_17" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(17);">
			<span style="display:none;" id="span_17">|~|/files/powerpoints_images/node281949/Slide17.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide17.JPG" id="image_17"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>17</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281985"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_18" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(18);">
			<span style="display:none;" id="span_18">|~|/files/powerpoints_images/node281949/Slide18.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide18.JPG" id="image_18"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>18</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281987"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_19" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(19);">
			<span style="display:none;" id="span_19">|~|/files/powerpoints_images/node281949/Slide19.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide19.JPG" id="image_19"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>19</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281989"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_20" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(20);">
			<span style="display:none;" id="span_20">|~|/files/powerpoints_images/node281949/Slide20.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide20.JPG" id="image_20"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>20</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281991"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_21" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(21);">
			<span style="display:none;" id="span_21">|~|/files/powerpoints_images/node281949/Slide21.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide21.JPG" id="image_21"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>21</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281993"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_22" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(22);">
			<span style="display:none;" id="span_22">|~|/files/powerpoints_images/node281949/Slide22.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide22.JPG" id="image_22"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>22</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281995"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_23" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(23);">
			<span style="display:none;" id="span_23">|~|/files/powerpoints_images/node281949/Slide23.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide23.JPG" id="image_23"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>23</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281997"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_24" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(24);">
			<span style="display:none;" id="span_24">|~|/files/powerpoints_images/node281949/Slide24.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide24.JPG" id="image_24"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>24</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_281999"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_25" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(25);">
			<span style="display:none;" id="span_25">|~|/files/powerpoints_images/node281949/Slide25.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide25.JPG" id="image_25"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>25</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_282001"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_26" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(26);">
			<span style="display:none;" id="span_26">|~|/files/powerpoints_images/node281949/Slide26.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide26.JPG" id="image_26"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>26</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_282003"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_27" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(27);">
			<span style="display:none;" id="span_27">|~|/files/powerpoints_images/node281949/Slide27.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide27.JPG" id="image_27"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>27</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_282005"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_28" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(28);">
			<span style="display:none;" id="span_28">|~|/files/powerpoints_images/node281949/Slide28.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide28.JPG" id="image_28"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>28</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_282007"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_29" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(29);">
			<span style="display:none;" id="span_29">|~|/files/powerpoints_images/node281949/Slide29.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide29.JPG" id="image_29"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>29</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_282009"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_30" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(30);">
			<span style="display:none;" id="span_30">|~|/files/powerpoints_images/node281949/Slide30.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide30.JPG" id="image_30"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>30</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_282011"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_31" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(31);">
			<span style="display:none;" id="span_31">|~|/files/powerpoints_images/node281949/Slide31.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide31.JPG" id="image_31"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>31</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_282013"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_32" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(32);">
			<span style="display:none;" id="span_32">|~|/files/powerpoints_images/node281949/Slide32.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide32.JPG" id="image_32"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>32</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_282015"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_33" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(33);">
			<span style="display:none;" id="span_33">|~|/files/powerpoints_images/node281949/Slide33.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide33.JPG" id="image_33"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>33</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_282017"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_34" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(34);">
			<span style="display:none;" id="span_34">|~|/files/powerpoints_images/node281949/Slide34.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide34.JPG" id="image_34"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>34</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_282019"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_35" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(35);">
			<span style="display:none;" id="span_35">|~|/files/powerpoints_images/node281949/Slide35.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide35.JPG" id="image_35"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>35</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_282021"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_36" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(36);">
			<span style="display:none;" id="span_36">|~|/files/powerpoints_images/node281949/Slide36.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide36.JPG" id="image_36"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>36</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_282023"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_37" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(37);">
			<span style="display:none;" id="span_37">|~|/files/powerpoints_images/node281949/Slide37.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node281949/Slide37.JPG" id="image_37"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
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														<td width="6%"><strong>37</strong></td>
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