cardio vas cul er

8/17/2019 Cardio Vas Cul Er

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DEPARTEMEN PATHOLOGY ANATOMIC

MEDICAL FACULTY

USU – MEDAN

2008

CARDIOVASCULER


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1. IHD

2. Hypertensive HD (systemic & pulmonary)

3. Valvular HD 4. Nonischemic (primary) myocardial

disease

. !on"enital HD

#ypes o$ Heart Disease

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HEART

DISEASE

ISCHAEMIC HEART DIASEASE803

HYPERTENSIVE HEART

DIASEASE 43

RHEUMATIC HEART DIASEASE 2) 3

CONGENITAL HEART DIASEASE

2 3

ENDOCARDITIS ACTERIALIS 1)2 3

SYPHILLIS HEART DIASEASE

13

COR PULMONALE DIASEASE 13

OTHERS 53 5/16/16Depa!e"e# Pa!$%&%'( A#a!%"( )Ca*+%,a-.&a


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CORONARY HEART DISEASE

ARTERIOSCLEROTICHEART DISEASE

ANGINA PECTORISMYOCARDIALINFARCTION

5/16/165Depa!e"e# Pa!$%&%'( A#a!%"( )Ca*+%,a-.&a


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A!$e%-.&e%!+. .%%#a( a!e(D+7-e "(%.a*+a& 9%!+. %..a-+%#a&&(

.a*+a. ,a&,e 9%!+.

ARTERIOSCLEROTIC HEARTDISEASE

MORPHOLOGY

%:#+-$)(e&&%: 'a#&a *+7-e&( a.."&a!e- +# !$e $ea!"-.&e3 .%#!a+#e* &+p%;-.+# .%"p&e


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ARTERIOSCLEROTIC HEART DISEASE

T$e $ea! +- 9e.%"e?S"a&&

N%"a&

E#&a'e*

D+-%*e %; .a*+a. ,a&,e ?

M+!a& ,a&,e 9%!+.

C$%*ae !e#*+#eae 9%!+. % .a&.+.a!+%#

5/16/16@Depa!e"e# Pa!$%&%'( A#a!%"( )Ca*+%,a-.&a


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Gross appearance of heavilybrotic and calcied cardiac valve

5/16/168Depa!e"e# Pa!$%&%'( A#a!%"( )Ca*+%,a-.&a


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ANGINA PECTORIS

I#!e"+!!e#! .$e-! pa+# .a-e* 9( !a#-+e#!e,e-+9&e "(%.a*+a& +-.$ae"+.

TYPICAL /

STALEANGINA

PECTORIS

PRINBMETAL /VARIANT

ANGINA

UNSTALE

ANGINAPECTORIS

cressendoangina 3

5/16/164Depa!e"e# Pa!$%&%'( A#a!%"( )Ca*+%,a-.&a


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5/16/1610 Depa!e"e# Pa!$%&%'( A#a!%"( )Ca*+%,a-.&a


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Pathogenesis

H(p%


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MYOCARDIAL INFARCTION

De,e&%p"e#! %; a# aea %; "(%.a*+a& #e.%-+-

.a-e* 9( &%.a& +-.$ae"+a

P%p&a&( .a&&e* $ea! a!!a.>

Coronary atherosclerosis(99%)

Thrombosis & Emboliasc!lar diseases

"ste!m occl!sion ca!sed bysyphillis

#rteriosclerosis occl!sion &

$ypotension

C%%#e +#-.+e#.( .a-e* 9( ?

5/16/1612 Depa!e"e# Pa!$%&%'( A#a!%"( )Ca*+%,a-.&a


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Types

5/16/16Depa!e"e# Pa!$%&%'( A#a!%"( )Ca*+%,a-.&a1

A#( a'e +-> ↑ a'e ↑

♀ ? p%!e.!e* *+#' ep%*.!+,e a'eE-!%'e# ↓ (a;!e "e#%pa-e3 HD ↑

Ta#-"a&;&&/#ea&(

;&&3

S9)e#*%.a*+a&#%#)!a#-"a&3

nner ' * +all

ncidence & ,is- .actor


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5/16/16

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a1


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5/16/16

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a15


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5/16/16

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a16


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Pathogenesis

• a-+. ? C%%#a( A!e+a& O..&-+%#• Se,ee .%%#a( a!$e%-.&e%-+-• A.!e a!$e%-.&e%!+. p&ae .$a#'ep!e3• Spe+"p%-e* p&e!e&e! a.!+,a!+%#• T$%"9%-+- = ,a-%-pa-"

Conse/!ence0

M(%.a*+a& Re-p%#-e• Ce--a!+%# %; ae%9+. '&(.%&(-+- a#ae%9+.'&(.%&(-+-

• I#a*ea!e p%*.! %; p$%-p$a!eCea!+#e p$%- = ATP3

• a.. &a.!+* a.+*


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5/16/1618

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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1istrib!tion of infarcts

R+'$!

.%%#a(a!e(0)0 3

Le;! a#!e+%

*e-.e#*+#'a!e(0)50 3

Le;!.+."e<

a!e(15)20 3

5/16/1614

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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5/16/1620

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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E,%&!+%# O; M%p$%&%'+. C$a#'e- +#M(%.a*+a& I#;a.!+%#

Time Gross .eat!re 2ight3icroscopic.indings

Electron3icroscopic.indings

Re,e-+9&eI#(

J $ N%#e N%#e Re&a


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Time Gross .eat!re 2ight 3icroscopic.indings

18 – 2 $ Da> "%!!&+#' C%a'&a!+%# #e.%-+-K.%#!a.!+%# 9a#*#e.%-+- a! pe+p$e( %;+#;a.!K #e!%p$+&+.

+#&!a!e

1 ) *a(- M%!!&+#' :+!$ (e&&%:)!a#+#;a.! .e#!e

C%"p&e!e .%a'&a!+%##e.%-+- %; "(%9e-K$ea,( #e!%p$+&+.+#&!a!e

) @ *a(- H(pee"+. 9%*eK .e#!a&(e&&%:)!a# -%;!e#+#'

e'+##+#' *+-+#!e'a!+%#%; *ea* "(%9e- :+!$*(+#' #e!%p$+&-K ea&(p$a'%.(!%-+- %; *ea*.e&&- 9( "a.%p$a'e- a!+#;a.! 9%*e

@ ) 10 *a(- Ma


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5/16/16

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a2

Time Gross .eat!re 2ight 3icroscopic.indings

10 ) 1 *a(- Re*)'a( *epe--e*+#;a.! 9%*e-

e&&)e-!a9&+-$e*'a#&a!+%# !+--e :+!$ #e:9&%%* ,e--e&- = .%&&a'e#*ep%-+!+%#

2 – 8 :> Ga():$+!e -.ap%'e--+,e ;%" 9%*e!%:a* .%e %; +#;a.!

I#.ea-e .%&&a'e#*ep%-+!+%# :+!$ *e.ea-e*.e&&&a+!(

2 "%#!$ S.a+#' .%"p&e!e De#-e .%&&a'e#%- -.a


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5/16/162

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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C%"p&+.a!+%#-

Pap+&&a( "-.&e *(-;#.!+%# +#;a.!e* pap+&&a("-.&e "a( p!e3

E

Ma& !$%"9+ p%!e#!+a& -%.e- ;% -(-!e"+. e"9%&+

Ve#!+.&a 9%!+. = a#e(-"-

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Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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HYPERTENSIVE HEART DISEASE


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HYPERTENSIVE HEARTDISEASE

A%!+. -!e#%-+-

P+"a( $(pe!%p+.

.a*+%"(%pa!$(

D+a'#%-+- 9a-e* %#?

Le;! ,e#!+.&a $(pe!%p$( :+!$ a $+-!%( %;$(pe!e#-+%#

E


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3orphology

C%#.e#!+. $(pe!%p$( -("e!+..+.";ee#!+a& 50 '"3

S+e?Ea&(? N%"a& *+&a!e*

3icroscopic

•

M(%.(!e- • N.&e+? &a'e $(pe.$%" 9%


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5/16/1624


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VALVULAR HEART DISEASE


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RHEUMATIC HEART DISEASE

A.!e +""#%&%'+.a&&( "e*+a!e* "&!+-(-!e"+#a""a!%( *+-ea-e '%p A -!ep!%.%..a&

p$a(#'+!+- a;!e a# +#!e,a& %; a ;e: :ee>-

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Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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O#&( '%p A -!ep!%.%..a& p$a(#'+!+- RFI#+!+a& ↑ ea.!+,a!+%# :+!$ -9-ee#! p$a(#'ea&+#;e.!+%#-

A9 M p%!e+# .%-- ea.!+%# :+!$ '&(.%p%!e+# ?

Hea! %+#!- = %!$e-

O#-e! ? 2) :ee>- a;!e +#;e.!+%# S!ep!%.%..+ )3 +#&e-+%#

C$%#+. ,a&,&a*e;%"+!+e-

HD +# a.!e p$a-eA.!e $e"a!+.

.a*+!+-3

R$e"a!+. Fe,e "a( .a-e

5/16/162

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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5/16/16

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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5/16/16

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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5/16/16

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a5


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5/16/16@

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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Pericardial


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Pericardialinvolment

F+9+#%-

pe+.a*+!+-Se%-/Se%)

-a#'+#e%-e7-+%#

Ma#+;e-!e* '%--&( ="+.%-.%p+.a&&( ?

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Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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Endocardi!m

Va&,&a +#a""a!+%# !e#*- !% ? mitral =aortic ,a&,e-

T$e ,a&,e pe*+-p%-e- ?

S"a&& ,e'e!a!+%#- ,a&,e .&%-e3 Q ,e.%-

e#*%.a*+!+-

5/16/160

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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S9.!a#e%- #%*&e- / e(!$e"a

"a'+#a!"

P!lmonary

Ma#+;e-!e* 9( .$%#+. +#""a!+%# = 9+#%-+#a""a!+%# %; p&ea& -;a.e

5-in

#rthritis of the large 6ointsSe&; &+"+!e* *%e- #%! .$%#+. *e;%"+!(

5/16/161

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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5/16/162

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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I#;e.!+,e E#*%.a*+!+-

Ca-e* 9( 9a.!e+a

A.!e S9)a.!e

H+'$ ,+&e#.eS!ap$ Ae-3

Pe,+%-&( a9#%"a& ,a&,e

L%: ,+&e#.eα)He"%&(!+. S!ep!%.%..-3

I#;e.!+%# %; !$e .a*+a. ,a&,e /"a& -;a.e %;!$e e#*%.a*+" !$%"9%!+.

*e9+-%'a#+-"3 term vegetation

5/16/16

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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Etiology

a.!e+e"+a

IV D' A9-e

De#!a& S'e(

Ca!$e!e

-$#' !ee!$

,is- Pee


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3orphology

Ve'e!a!+%#- ?a.!e+a % %!$e %'a#+-"

S+#'&e / "&!+p&e

Ma( +#,%&,e* ? 1 ,a&,eM%-! .%""%# ? A%!+. = M+!a

RV ,a&,e *' a9-e

F#'a& ↑↑

5/16/165

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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#c!te Endocarditis

C&a--+. ,e'e!a!+%#

e'+#- ? -"a&& e

abscess)

M+.%-.%p+. ?a.!e+a& 9+# 9&%%*E+*#e( "(%.a* +#;a.!

a9-.e--e-

5/16/166

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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5/16/16@

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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PERICARDIAL DISEASE


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PERICARDITIS

V+- p(%'e#+. 9a.!e+a

"(.%9a.!e+a ;#'+Se.%#*a( !% ?A.!e "(%.a* +#;a.!Ca*+a. -'e(

Ra*+a!+%# !% !$e "e*+a-!+#"Ue"+aRF SLE "e!a-!a!+. "a&+'#a#.+e-

Ca-

e ?

5/16/164

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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1 I""e*+a!e $e"%*(#a"+..%"p&+.a!+%#-

2 Re-%&,e -ee&ae )3 P%'e-- !% .$%#+. 9%-+#'

p%.e--

Pe+.a*+!+- "a( ?

5/16/1650

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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3orphology

Pa!+e#!- :+!$ e"+a / a.!e RF ? 9+#%--$a''( bread & b!tter pericarditis3

V+a& ? 9+#%-

A.!e a.!e+a& ? 9+#%p&e#!

T9e.&%- ? .a-e%-

Me!a-!a-e- ? -$a''( 9+#%-

A.!e pe+.a*+!+-

A.!e 9+#%- / 9+#%p&e#! e-%&,e-ee&ae )3

E

5/16/1651

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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C$%#+.pe+.a*+!+-

Appeaa#.e a#'e- ?

De&+.a!e a*$e-+%#- – *e#-e 99%!+.-.a- !$a! %99&+!ea!e !$e pe+.a*+a&

-pa.e

C%#-!+.!+,e pe+.a*+!+-

5/16/1652

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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Pe+.a*+a& E7-+%#-

Se%- Se%-a#'+#e%- C$(&%-

C,HDH(p%a&9"+e"+a

&#! .$e-! !a"aMa&+'#a#.(

Me*+a-!+#a&&("p$a!+.

%9-!.!+%#

5/16/165

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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$emopericardi!m

Sepaa!e&( ;%" $e"%$a'+. pe+.a*+"e7-+%#

Pe 9&%%* ?Rp!e* a%!+. a#e+-"a

Rp!e* "(%.a +#;a.!Pe#e!a!+#' !a"a +#

.a*+a. !a"p%#a*e *ea!$

5/16/1655

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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M%e .%""%# !$a# p+"a(

10 %; *+--e"+#a!e* .a#.e

M%-! +#,%&,e- ?

Pe+.a*+" .a-e* ? pe+.a*+!+- = $e"%$a'+.

e7-+%#

Me!a-!a!+. Ne%p&a-"-

• L("p$a!+.• Ve#%-•

A!e+a&.$a##e&-

ia0• Ca.+#%"a &#' =9ea-!• Me&a#%"a• L("p$%"a&e>e"+a

3ost common primary neoplasms thatmetastasi7e 0

5/16/165@

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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La'e "e!a-!a!+. .a.+#%"a +# &e;! a!+" !$a!:a- .%#!+#%- :+!$ !"% +# &e;! p&"%#a( ,e+#

T$+- "a-- -+"&a!e*a# a!+a& "(


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Rae

M%-! .%""%#?M(


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G%-- appeaa#.e %; .a*+a. "(


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Ca*+a. "(


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T$e .%#.e#!+. aa#'e"e#! %; !"% .e&&-a%#* e#*%.a*+")&+#e* -pa.e- +-

.$aa.!e+-!+. %; !$e e#!+!(

5/16/1662

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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G&a#*&a "(


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G&a#*&a "(


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G%-- appeaa#.e %; a &a'ea#'+%-a.%"a %; !$e $ea!

5/16/1665Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a

P+"a( -(#%,+a& -a.%"a %; $ea!


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P+"a( -(#%,+a& -a.%"a %; $ea!-$%:+#' !(p+.a& 9+p$a-+. appeaa#.e

5/16/1666Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a

H+'$ 'a*e -a.%"a %; $ea! #%!


67/68

H+'$)'a*e -a.%"a %; $ea! #%!;!$e .&a--+a9&e

I! +- #%! #-a& ;% !$e-e !"%- !% -$%: a +#' %;

ep+!$e&+%+* &a'e !"% .e&&- +# a pe+,a-.&a &%.a!+%#5/16/166@

Depa!e"e# Pa!$%&%'( A#a!%"( )

Ca*+%,a-.&a


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T$#8 :";

Depa!e"e# Pa!$%&%'( A#a!%"(

cardio vas cul er

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