About all

What is glandular system: You and Your Hormones from the Society for Endocrinology

An Overview of the Endocrine System – Anatomy & Physiology

The Endocrine System

OpenStaxCollege

Learning Objectives

By the end of this section, you will be able to:

  • Distinguish the types of intercellular communication, their importance, mechanisms, and effects
  • Identify the major organs and tissues of the endocrine system and their location in the body

Communication is a process in which a sender transmits signals to one or more receivers to control and coordinate actions. In the human body, two major organ systems participate in relatively “long distance” communication: the nervous system and the endocrine system. Together, these two systems are primarily responsible for maintaining homeostasis in the body.

The nervous system uses two types of intercellular communication—electrical and chemical signaling—either by the direct action of an electrical potential, or in the latter case, through the action of chemical neurotransmitters such as serotonin or norepinephrine. Neurotransmitters act locally and rapidly. When an electrical signal in the form of an action potential arrives at the synaptic terminal, they diffuse across the synaptic cleft (the gap between a sending neuron and a receiving neuron or muscle cell). Once the neurotransmitters interact (bind) with receptors on the receiving (post-synaptic) cell, the receptor stimulation is transduced into a response such as continued electrical signaling or modification of cellular response. The target cell responds within milliseconds of receiving the chemical “message”; this response then ceases very quickly once the neural signaling ends. In this way, neural communication enables body functions that involve quick, brief actions, such as movement, sensation, and cognition.In contrast, the endocrine system uses just one method of communication: chemical signaling. These signals are sent by the endocrine organs, which secrete chemicals—the hormone—into the extracellular fluid. Hormones are transported primarily via the bloodstream throughout the body, where they bind to receptors on target cells, inducing a characteristic response. As a result, endocrine signaling requires more time than neural signaling to prompt a response in target cells, though the precise amount of time varies with different hormones. For example, the hormones released when you are confronted with a dangerous or frightening situation, called the fight-or-flight response, occur by the release of adrenal hormones—epinephrine and norepinephrine—within seconds. In contrast, it may take up to 48 hours for target cells to respond to certain reproductive hormones.

Visit this link to watch an animation of the events that occur when a hormone binds to a cell membrane receptor. What is the secondary messenger made by adenylyl cyclase during the activation of liver cells by epinephrine?

In addition, endocrine signaling is typically less specific than neural signaling. The same hormone may play a role in a variety of different physiological processes depending on the target cells involved. For example, the hormone oxytocin promotes uterine contractions in women in labor. It is also important in breastfeeding, and may be involved in the sexual response and in feelings of emotional attachment in both males and females.

In general, the nervous system involves quick responses to rapid changes in the external environment, and the endocrine system is usually slower acting—taking care of the internal environment of the body, maintaining homeostasis, and controlling reproduction ([link]). So how does the fight-or-flight response that was mentioned earlier happen so quickly if hormones are usually slower acting? It is because the two systems are connected. It is the fast action of the nervous system in response to the danger in the environment that stimulates the adrenal glands to secrete their hormones. As a result, the nervous system can cause rapid endocrine responses to keep up with sudden changes in both the external and internal environments when necessary.

Endocrine and Nervous Systems
Endocrine systemNervous system
Signaling mechanism(s)ChemicalChemical/electrical
Primary chemical signalHormonesNeurotransmitters
Distance traveledLong or shortAlways short
Response timeFast or slowAlways fast
Environment targetedInternalInternal and external

The endocrine system consists of cells, tissues, and organs that secrete hormones as a primary or secondary function. The endocrine gland is the major player in this system. The primary function of these ductless glands is to secrete their hormones directly into the surrounding fluid. The interstitial fluid and the blood vessels then transport the hormones throughout the body. The endocrine system includes the pituitary, thyroid, parathyroid, adrenal, and pineal glands ([link]). Some of these glands have both endocrine and non-endocrine functions. For example, the pancreas contains cells that function in digestion as well as cells that secrete the hormones insulin and glucagon, which regulate blood glucose levels. The hypothalamus, thymus, heart, kidneys, stomach, small intestine, liver, skin, female ovaries, and male testes are other organs that contain cells with endocrine function. Moreover, adipose tissue has long been known to produce hormones, and recent research has revealed that even bone tissue has endocrine functions.

Endocrine System

Endocrine glands and cells are located throughout the body and play an important role in homeostasis.

The ductless endocrine glands are not to be confused with the body’s exocrine system, whose glands release their secretions through ducts. Examples of exocrine glands include the sebaceous and sweat glands of the skin. As just noted, the pancreas also has an exocrine function: most of its cells secrete pancreatic juice through the pancreatic and accessory ducts to the lumen of the small intestine.

In endocrine signaling, hormones secreted into the extracellular fluid diffuse into the blood or lymph, and can then travel great distances throughout the body. In contrast, autocrine signaling takes place within the same cell. An autocrine (auto- = “self”) is a chemical that elicits a response in the same cell that secreted it. Interleukin-1, or IL-1, is a signaling molecule that plays an important role in inflammatory response. The cells that secrete IL-1 have receptors on their cell surface that bind these molecules, resulting in autocrine signaling.

Local intercellular communication is the province of the paracrine, also called a paracrine factor, which is a chemical that induces a response in neighboring cells. Although paracrines may enter the bloodstream, their concentration is generally too low to elicit a response from distant tissues. A familiar example to those with asthma is histamine, a paracrine that is released by immune cells in the bronchial tree. Histamine causes the smooth muscle cells of the bronchi to constrict, narrowing the airways. Another example is the neurotransmitters of the nervous system, which act only locally within the synaptic cleft.

Career Connections

Endocrinologist
Endocrinology is a specialty in the field of medicine that focuses on the treatment of endocrine system disorders. Endocrinologists—medical doctors who specialize in this field—are experts in treating diseases associated with hormonal systems, ranging from thyroid disease to diabetes mellitus. Endocrine surgeons treat endocrine disease through the removal, or resection, of the affected endocrine gland.

Patients who are referred to endocrinologists may have signs and symptoms or blood test results that suggest excessive or impaired functioning of an endocrine gland or endocrine cells. The endocrinologist may order additional blood tests to determine whether the patient’s hormonal levels are abnormal, or they may stimulate or suppress the function of the suspect endocrine gland and then have blood taken for analysis. Treatment varies according to the diagnosis. Some endocrine disorders, such as type 2 diabetes, may respond to lifestyle changes such as modest weight loss, adoption of a healthy diet, and regular physical activity. Other disorders may require medication, such as hormone replacement, and routine monitoring by the endocrinologist. These include disorders of the pituitary gland that can affect growth and disorders of the thyroid gland that can result in a variety of metabolic problems.

Some patients experience health problems as a result of the normal decline in hormones that can accompany aging. These patients can consult with an endocrinologist to weigh the risks and benefits of hormone replacement therapy intended to boost their natural levels of reproductive hormones.

In addition to treating patients, endocrinologists may be involved in research to improve the understanding of endocrine system disorders and develop new treatments for these diseases.

The endocrine system consists of cells, tissues, and organs that secrete hormones critical to homeostasis. The body coordinates its functions through two major types of communication: neural and endocrine. Neural communication includes both electrical and chemical signaling between neurons and target cells. Endocrine communication involves chemical signaling via the release of hormones into the extracellular fluid. From there, hormones diffuse into the bloodstream and may travel to distant body regions, where they elicit a response in target cells. Endocrine glands are ductless glands that secrete hormones. Many organs of the body with other primary functions—such as the heart, stomach, and kidneys—also have hormone-secreting cells.

Visit this link to watch an animation of the events that occur when a hormone binds to a cell membrane receptor. What is the secondary messenger made by adenylyl cyclase during the activation of liver cells by epinephrine?

cAMP

Endocrine glands ________.

  1. secrete hormones that travel through a duct to the target organs
  2. release neurotransmitters into the synaptic cleft
  3. secrete chemical messengers that travel in the bloodstream
  4. include sebaceous glands and sweat glands

C

Chemical signaling that affects neighboring cells is called ________.

  1. autocrine
  2. paracrine
  3. endocrine
  4. neuron

B

Describe several main differences in the communication methods used by the endocrine system and the nervous system.

The endocrine system uses chemical signals called hormones to convey information from one part of the body to a distant part of the body. Hormones are released from the endocrine cell into the extracellular environment, but then travel in the bloodstream to target tissues. This communication and response can take seconds to days. In contrast, neurons transmit electrical signals along their axons. At the axon terminal, the electrical signal prompts the release of a chemical signal called a neurotransmitter that carries the message across the synaptic cleft to elicit a response in the neighboring cell. This method of communication is nearly instantaneous, of very brief duration, and is highly specific.

Compare and contrast endocrine and exocrine glands.

Endocrine glands are ductless. They release their secretion into the surrounding fluid, from which it enters the bloodstream or lymph to travel to distant cells. Moreover, the secretions of endocrine glands are hormones. Exocrine glands release their secretions through a duct that delivers the secretion to the target location. Moreover, the secretions of exocrine glands are not hormones, but compounds that have an immediate physiologic function. For example, pancreatic juice contains enzymes that help digest food.

True or false: Neurotransmitters are a special class of paracrines. Explain your answer.

True. Neurotransmitters can be classified as paracrines because, upon their release from a neuron’s axon terminals, they travel across a microscopically small cleft to exert their effect on a nearby neuron or muscle cell.

autocrine
chemical signal that elicits a response in the same cell that secreted it
endocrine gland
tissue or organ that secretes hormones into the blood and lymph without ducts such that they may be transported to organs distant from the site of secretion
endocrine system
cells, tissues, and organs that secrete hormones as a primary or secondary function and play an integral role in normal bodily processes
exocrine system
cells, tissues, and organs that secrete substances directly to target tissues via glandular ducts
hormone
secretion of an endocrine organ that travels via the bloodstream or lymphatics to induce a response in target cells or tissues in another part of the body
paracrine
chemical signal that elicits a response in neighboring cells; also called paracrine factor

3.

5 The Endocrine System – Psychology 2e

Learning Objectives

By the end of this section, you will be able to:

  • Identify the major glands of the endocrine system
  • Identify the hormones secreted by each gland
  • Describe each hormone’s role in regulating bodily functions

The endocrine system consists of a series of glands that produce chemical substances known as hormones (Figure 3.30). Like neurotransmitters, hormones are chemical messengers that must bind to a receptor in order to send their signal. However, unlike neurotransmitters, which are released in close proximity to cells with their receptors, hormones are secreted into the bloodstream and travel throughout the body, affecting any cells that contain receptors for them. Thus, whereas neurotransmitters’ effects are localized, the effects of hormones are widespread. Also, hormones are slower to take effect, and tend to be longer lasting.

Figure
3.30

The major glands of the endocrine system are shown.

Hormones are involved in regulating all sorts of bodily functions, and they are ultimately controlled through interactions between the hypothalamus (in the central nervous system) and the pituitary gland (in the endocrine system). Imbalances in hormones are related to a number of disorders. This section explores some of the major glands that make up the endocrine system and the hormones secreted by these glands (Table 3.2).

Major Glands

The pituitary gland descends from the hypothalamus at the base of the brain, and acts in close association with it. The pituitary is often referred to as the “master gland” because its messenger hormones control all the other glands in the endocrine system, although it mostly carries out instructions from the hypothalamus. In addition to messenger hormones, the pituitary also secretes growth hormone, endorphins for pain relief, and a number of key hormones that regulate fluid levels in the body.

Located in the neck, the thyroid gland releases hormones that regulate growth, metabolism, and appetite. In hyperthyroidism, the thyroid secretes too much of the hormone thyroxine, causing agitation, bulging eyes, and weight loss. One cause of hyperthyroidism is Graves’ disease, an autoimmune disease in which one’s own body attacks itself. In hypothyroidism, reduced hormone levels cause sufferers to experience tiredness, and they often complain of feeling cold. Fortunately, thyroid disorders are often treatable with medications that help reestablish a balance in the hormones secreted by the thyroid.

The adrenal glands sit atop our kidneys and secrete hormones involved in the stress response, such as epinephrine (adrenaline) and norepinephrine (noradrenaline). The pancreas is an internal organ that secretes hormones that regulate blood sugar levels: insulin and glucagon. These pancreatic hormones are essential for maintaining stable levels of blood sugar throughout the day by lowering blood glucose levels (insulin) or raising them (glucagon). People who suffer from diabetes do not produce enough insulin; therefore, they must take medications that stimulate or replace insulin production, and they must closely control the amount of sugars and carbohydrates they consume.

The gonads secrete sexual hormones, which are important in reproduction, and mediate both sexual motivation and behavior. The female gonads are the ovaries; the male gonads are the testes. Ovaries secrete estrogens and progesterone, and the testes secrete androgens, such as testosterone.

Major Endocrine Glands and Associated Hormone Functions

Endocrine GlandAssociated HormonesFunction
PituitaryGrowth hormone, releasing and inhibiting hormones (such as thyroid stimulating hormone)Regulate growth, regulate hormone release
ThyroidThyroxine, triiodothyronineRegulate metabolism and appetite
PinealMelatoninRegulate some biological rhythms such as sleep cycles
AdrenalEpinephrine, norepinephrineStress response, increase metabolic activities
PancreasInsulin, glucagonRegulate blood sugar levels
OvariesEstrogen, progesteroneMediate sexual motivation and behavior, reproduction
TestesAndrogens, such as testosteroneMediate sexual motivation and behavior, reproduction

Table
3. 2

Dig Deeper

Athletes and Anabolic Steroids

Although it is against Federal laws and many professional athletic associations (The National Football League, for example) have banned their use, anabolic steroid drugs continue to be used by amateur and professional athletes. The drugs are believed to enhance athletic performance. Anabolic steroid drugs mimic the effects of the body’s own steroid hormones, like testosterone and its derivatives. These drugs have the potential to provide a competitive edge by increasing muscle mass, strength, and endurance, although not all users may experience these results. Moreover, use of performance-enhancing drugs (PEDs) does not come without risks. Anabolic steroid use has been linked with a wide variety of potentially negative outcomes, ranging in severity from largely cosmetic (acne) to life threatening (heart attack). Furthermore, use of these substances can result in profound changes in mood and can increase aggressive behavior (National Institute on Drug Abuse, 2001).

Baseball player Alex Rodriguez (A-Rod) spent the latter part of his playing career at the center of a media storm regarding his use of illegal PEDs. Rodriguez excelled while using the drugs; his success played a large role in negotiating a contract that made him the highest paid player in professional baseball. A subsequent scandal and suspension tarnished his reputation and, according to a statement he made once retired, cost him over $40 million. Even lower-profile athletes, particularly in cycling and Olympic sports, have been revealed as steroid users. What are your thoughts on athletes and doping? Why or why not should the use of PEDs be banned? What advice would you give an athlete who was considering using PEDs?

Breast hyperplasia – treatment breast hyperplasia in Kiev, breast hyperplasia treatment in the clinic

Synonymization of concepts

The name “hyperplasia of the glandular tissue of the mammary glands” is familiar to few. This is explained by the fact that the disease has many synonyms that are well known. The most recognizable:

Dyshormonal hyperplasia Breast glandular dysplasia Breast epithelial hyperplasia
Diffuse dyshormonal fibrocystic disease Focal hyperplasia Ductal fibrocystic disease
Atypical ductal hyperplasia Nodular fibrocystic disease -cystic changes Lobular hyperplasia of the mammary gland
Fatty hyperplasia Benign tumors

Symptoms of the disease

If with the question “What is hyperplasia?” we figured out, you need to understand how to diagnose the disease. As a rule, it proceeds secretly and for a long time the woman does not even know about the problem. A mammologist can diagnose the disease after a palpation examination and examination using an ultrasound scanner or mammograph. On self-examination, the following symptoms may be a cause for concern:

  • presence in the mammary glands of fixed nodular seals ranging in size from 0. 5 to 1.5 mm in diameter;
  • breast tenderness and tenderness during the first days of the menstrual cycle;
  • increase in bust size for no apparent reason, swelling in certain areas;
  • clear, watery or milky discharge from the nipple that is not associated with pregnancy or lactation;
  • swollen lymph nodes near the chest, pain in the shoulder and armpit.

Please note that these are common features that accompany the processes of deformation of the breast tissue. Each form of the disease has its own symptoms. For example, glandular dysplasia of the breast is accompanied by a painless course, and tumor neoplasms are disc-shaped and mobile.

Make an appointment with a mammologist for an examination

Causes of hyperplasia

The disease occurs in women over 20 years old. Predisposing factors for the development of the inflammatory process are hormonal disorders in the body, genetic predisposition, experienced stress and diseases of the endocrine system. Also, the disease develops against the background of a long period of breastfeeding, contact with harmful chemicals, due to mechanical injuries of the chest and taking hormonal drugs.

The indicated reasons for the development of breast hyperplasia to the patient at first glance do not seem to be related and serious chest diseases. In practice, this is a cause for concern on the part of the mammologist. Treatment of hyperplasia of the mammary glands of varying complexity will not be effective if the root cause is not qualitatively eliminated. Otherwise, a relapse is possible.

Photo 1. Well recognized – well treated

Cancer risk

Most types of hyperplasia do not require radical treatment. Taking into account the type and stage of the disease, the doctor draws up a plan of action. If this is an early phase, it identifies and eliminates the causes of breast compaction. If a large neoplasm is found in the mammary gland or a woman has atypical hyperplasia, surgery may be necessary.

We at the Specialized Breast Center provide all treatment services from diagnosis and diagnosis to surgery and post-operative care. We tell each patient in detail about the results of the study, explain complex medical terminology in simple words and answer questions of interest.

The medical center employs doctors of the highest category, who annually improve their skills at specialized conferences, forums and symposiums. In addition to mammologists and diagnosticians, we have an endocrinologist who has 10+ years of experience in solving hormonal problems in women. In order to make the only correct diagnosis and determine the necessary treatment, they can gather for medical advice.

Hardware examination is carried out using expert-class equipment. It allows us to see the slightest changes in breast tissue at an early stage.

Every woman should have a breast examination at least once a year. If you have not been to the doctor for a long time, make an appointment by calling 044-344-65-28 or leave a request on the website.

Pathophysiology of the neuroendocrine system: textbook

%PDF-1.3
%
10 obj
>
/Metadata 2 0 R
/Pages 3 0 R
/Type /Catalog
>>
endobj
40 obj
/Title
>>
endobj
20 obj
>
stream

  • Pathophysiology of the neuroendocrine system: textbook
  • Yastrebov A.P. 1.32019-01-21T15:56:16+05:002019-01-21T15:56:19+05:00

    endstream
    endobj
    3 0 obj
    >
    endobj
    5 0 obj
    >
    endobj
    6 0 obj
    >
    endobj
    70 obj
    >
    endobj
    80 obj
    >
    endobj
    90 obj
    >
    endobj
    10 0 obj
    >
    endobj
    11 0 obj
    >
    endobj
    12 0 obj
    >
    endobj
    13 0 obj
    >
    endobj
    14 0 obj
    >
    endobj
    15 0 obj
    >
    endobj
    16 0 obj
    >
    endobj
    17 0 obj
    >
    endobj
    18 0 obj
    >
    endobj
    19 0 obj
    >
    endobj
    20 0 obj
    >
    endobj
    21 0 obj
    >
    endobj
    22 0 obj
    >
    endobj
    23 0 obj
    >
    endobj
    24 0 obj
    >
    endobj
    25 0 obj
    >
    endobj
    26 0 obj
    >
    endobj
    27 0 obj
    >
    endobj
    28 0 obj
    >
    endobj
    29 0 obj
    >
    endobj
    30 0 obj
    >
    endobj
    31 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    /XObject>
    >>
    /Type /Page
    /Annots [155 0R]
    >>
    endobj
    32 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    33 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    34 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    35 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    36 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    37 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    38 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    390 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    40 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    41 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    42 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    43 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    44 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    45 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    46 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    47 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    48 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    490 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    50 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    51 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    52 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    53 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    54 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    55 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    56 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    57 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    58 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    590 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    60 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    61 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    62 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    63 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    64 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    65 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    66 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    67 0 obj
    >
    /Font>
    /ProcSet [/PDF /Text /ImageB]
    /properties>
    >>
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    68 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    690 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    70 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    71 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    72 0 obj
    >
    /Font>
    /ProcSet [/PDF /Text /ImageC]
    /properties>
    >>
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    73 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    74 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    75 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    76 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    77 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    78 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    790 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    80 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    81 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    82 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    83 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    84 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    85 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    86 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    87 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    88 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    890 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    90 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    91 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    92 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    93 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    94 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    95 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    96 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    97 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    98 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    99 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    100 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    101 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    102 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    103 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    104 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    105 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    106 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    107 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    108 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    1090 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    110 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    111 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    112 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    113 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    114 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    115 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    116 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    117 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    118 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    1190 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    120 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    121 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    122 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    123 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    124 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    125 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    126 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    127 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    128 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    1290 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    130 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    131 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    132 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    133 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    134 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    135 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    136 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    137 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    138 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    1390 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    140 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    141 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    142 0 obj
    >
    /ProcSet[/PDF/Text]
    /ExtGState>
    >>
    /Type /Page
    >>
    endobj
    143 0 obj
    >
    stream
    HUM0WN$L8 j@E qӤY!Og9@@D%Mɶx7P\~yoo[/E- g7 @8 #`ڃR)R`Ȗhxidg2qjdeQJNV;
    wk볔$bT=h?fV豎!Wn,Bn”ΝhEE:׻H+Qy
    }T[F~]I.