00±0.22

vs.0.54±0.17, p<0.05). In PBS-treated mice, M1 R deficiency did not alter TRAIL-R2 expression. However, in Chrm1-/- mice AOM treatment stimulated a large increase in TRAIL-R2 expression compared to WT mice (32.24±7.12 vs. 1.82±0.37, p<0.001). Consistent with this observation, there was a significant increase in the proportion of TUNEL-positive HSC in AOM-treated Chrm1-/- compared to WT mice (48.4% ± 5.3% vs. 22.46% ± 3.10%, p<0.001). Conclusion: In AOM-treated mice, M1 R deficiency is associated with up-regulated TRAIL-R2 expression check details and enhanced HSC apoptosis. These findings provide mechanistic insight into the effect of M1 R ablation on hepatic fibrosis resolution. Disclosures: The following people have nothing to disclose: Vikrant Rachakonda, Nathalie H. Urrunaga, Ravirajsinh Jadeja, Daniel Ahmad, Leon McLean, William S. Twaddell, Kunrong Cheng, Neeraj K. Saxena, Jean-Pierre Raufman, Sandeep Khurana Progression and Regression of liver fibrosis have been linked with the innate immune system, especially macrophages. Depending on stimulation by different cytokines or LPS, macrophages can differentiate into M1 (classically activated) and a spectrum of M2 (alternatively activated) macrophages. The roles of M1 and M2 in liver fibrosis progression selleck kinase inhibitor or regression are largely unexplored. We used the models of liver fibrosis progression (6 weeks of CCl4 by oral gavage) and spontaneous regression

after withdrawal of the toxin for 4 weeks in C57BL6 mice, and the model of Mdr2KO mice (spontaneous biliary fibrosis progression) to assess the role of M2 and their manipulation in liver fibrosis progression and reversal. In mice with CCL4-induced liver fibrosis, expression of the M2-inducing, IL-4/IL-13

responsive IL-4Ralpha1 was increased during progression, but strongly decreased after 2 weeks of spontaneous fibrosis regression. In Mdr2 KO mice, expression of the IL-4Ralpha1 gradually increased until age 6-wk, and decreased thereafter. For functional characterization of M2 macrophages, neutralizing PJ34 HCl IL-4Ralpha antisense oligonu-cleotide (ASO) was tested in vitro (murine RAW macrophages) and in vivo via the intraperitoneal route. The specific ASO but not an irrelevant control ASO suppressed IL-4Ralpha expression in RAW macrophages by 90% at 2μg/ml. When given to CCL4-treated mice twice weekly at 40 mg/kg i.p. from wk-2 to w-4 during the regression phase, the ASO suppressed hepatic expression of IL-4Ralpha1 by 47%, and collagen deposition as determined by Sirius Red staining by 30%. Concomitantly, ASO treatment decreased the M2 markers Arg1 and Mrc1 and increased the M1 markers CCL3, MMP-8 and MMP-9, and profibrogenic procollagen alpha1 (I) RNA. Serum ALT was increased 4-fold in ASO-treated vs untreated mice. Mdr2 KO mice that received the ASO from week 6 to week 10 also showed a similar shift from the M2 to the M1 phenotype, a similar regulation of the above genes and a significant increase in ALT.

61; 95% CI: 13.51–27.77)

and odds of non-home discharge (OR: 2.94; 95% CI: 2.42–3.57.) Conclusions: Inpatient orthopedic procedures in patients with cirrhosis result in high short-term postoperative mortality and high rates of non-home discharge. More advanced degrees of liver disease resulted in overall worse outcomes. Careful consideration should be taken when considering orthopedic procedures in patients with cirrhosis. Disclosures: Josh Levitsky – Grant/Research Support: Salix, Novartis; Speaking and Teaching: Gilead, Salix, Novartis The following people have nothing to disclose: Neehar D. Parikh, Michael Stover, Brittany Lapin Background: Demand for hepatologists will likely exceed capacity with the predicted burden of viral hepatitis in the US. Facilitating appropriate referrals from primary care providers (PCPs) can help optimize limited specialist capacity. MG-132 molecular weight We hypothesized that a structured referral template with recommended tests

would lead to a more complete pre-referral workup and productive first specialty visit. Aim: 1) To assess PCP uptake/completion of a HBV/HCV template; 2) To determine PCP preference for co-management vs. consultation; 3) To BMN-673 assess association of template use with treatment recommendation during the first specialist visit. Methods: For all internal referrals at a single center, we implemented HBV/HCV referral templates with laboratory workup recommendations developed by hepatology faculty within the electronic health record. New PCP referrals for HBV/HCV treatment from Jun-Dec 201 2 were included (n=24 HBV; n=35 HCV). Referral and visit notes (n= 16 HBV;n=20 HCV) were reviewed to assess template use, completeness

of workup, and specialist treatment recommendations based on first visit information. Results: Templates were used in 55% of referrals by 28 different PCPs, with 44% requesting co-management and 25% requesting consultation. PCPs choosing co-management asked to be the primary patient contact in 66% of those referrals. Users following the template were more likely to order HIV testing (81% vs. 38% non-users; p<0.01), but there was no difference in orders for liver enzyme tests, viral serologies, Edoxaban or HCV genotyping which were high at baseline. Serum fibrosis testing (FibroSURETM) was low (6%) in HCV referrals, regardless of template use. Among HCV referrals, first visit treatment decisions were made 55% of the time. Treatment was deferred in other cases, to gain information on disease stage/fibrosis. Among HBV referrals, despite complete workup, treatment was deferred in 50% (ALT range 1 8–39) to establish disease course via key serial labs (e.g. ALT/HBV DNA). Conclusions: Voluntary PCP uptake of the HBV/HCV template was good, with considerable interest in patient comanagement. PCPs ordered most recommended labs, except HIV and fibrosis testing.

This chapter will discuss the epidemiology, diagnosis and management of patients with recurrence of their primary liver disease in the hepatic allograft, specifically hepatitis C, hepatitis B, autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis and nonalcoholic fatty liver. “
“Background and Aim:  Tumor recurrence after liver resection occurs in the majority of patients with hepatocellular carcinoma (HCC). This study was conducted to clarify the safety and effectiveness of repeated liver resection as a curative option for intrahepatic HCC recurrence. Methods:  Between July 1990 and January

2009, 483 patients underwent 514 curative hepatic resections for HCC in our institution. Among this collective, 27 patients underwent 31 repeated resections due to recurrent HCC (27 s resections, three third resections and one forth resection). The outcome of these patients was retrospectively reviewed PD-0332991 datasheet using a prospective database. Results:  Perioperative morbidity and mortality was 11% (three of 27) and 0%. Six patients showed multiple liver lesions, 23 underwent minor liver resections (fewer than three segments) and five patients underwent major resections (three or more segments).

The majority of the patients showed no signs of chronic liver disease (16 of 27). The median tumor free margin was 1.5 mm (range: 0 to 20 mm). The median tumor diameter was 40 mm (range: 10 to 165 mm). Tumor dedifferentiations selleck compound at time of tumor recurrence were not observed. The 1-, 3- and 5-year overall survival rates after second liver resection were 96%, 70% and 42%. Conclusions:  Repeated liver resection is a valid and safe curative therapy option for

recurrent HCC and results in significant prolongation of survival Molecular motor in comparison to interventional treatment strategies in selected patients. However, due to impaired liver function, multifocal intrahepatic or extrahepatic recurrence repeated resection is only feasible in a minority of patients. “
“Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in industrialized countries and may proceed to steatohepatitis (NASH). Apoptosis and free fatty acid (FFA)-induced lipotoxicity are important features of NASH pathogenesis. We have shown a hepatoprotective effect of adiponectin in steatotic livers of hepatitis C virus (HCV) patients and recent data links bile acid (BA) metabolism to the pathogenesis of NAFLD. The aim of this study was to identify potential interactions between BA and FFA metabolism in NAFLD. Liver biopsies and serum samples from 113 morbidly obese patients receiving bariatric surgery, healthy individuals, and moderately obese NAFLD patients were studied. Serum FFA, BA, and M30 were increased in NASH versus simple steatosis, while adiponectin was significantly decreased. The NAFLD activity score (NAS) score correlated with BA levels and reversely with adiponectin.

29 HCCs were defined by topography code C22.0 (primary liver cancer) and morphology codes 8170-1875. ICCs were identified by topography code C22.0 (primary liver cancer) and morphology codes 8160 and 8161, or by topography code C22.1 (intrahepatic bile duct cancer) and morphology codes 8010, 8020, 8140, 8160, and 8161. Only persons enrolled in Medicare parts A and B for at least 3 years before diagnosis of HCC or ICC were eligible for inclusion

to insure adequate time for prior diagnoses to be recorded. This criterion resulted in a minimum age of 68 years for the study participants. The following groups were excluded: persons younger than age 65 years at diagnosis, persons enrolled in Medicare because of disabilities or end-stage renal disease, Ibrutinib clinical trial persons with unspecified diagnostic confirmation of HCC or ICC, persons with HCC or ICC identified solely by autopsy or death certificate, and persons enrolled in a health maintenance organization

during the study period, because Medicare health maintenance organization plans are not required to submit individual claims to Medicare. To minimize the possibility of erroneously including cancer metastatic to the liver, persons with prior diagnoses of stomach, colon, lung, pancreatic, breast, prostate, or rectal cancers were excluded. Individuals with no prior cancer diagnoses were selected as controls from a 5% random sample of Medicare beneficiaries residing in the geographic regions of selleck compound the SEER-13 registries. Roflumilast Controls had to have at least 3 years of enrollment in Medicare parts A and B. Control selection was based on the same inclusion and/or exclusion criteria as used for case selection. Controls

were assigned a pseudo-diagnosis date using a random number generator. Cases and controls were matched on the year of search for risk factors to minimize possible diagnostic trends. Metabolic syndrome was defined, as suggested by the U.S. National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), as the presence of at least three of the following conditions: elevated waist circumference/central obesity, dyslipidemia (elevated triglycerides, lowered high-density lipoprotein), hypertension, and impaired fasting glucose.30 The corresponding medical conditions were selected using the following ICD-9-CM codes: Overweight, obesity: 278.0, 278.1, 278.01, 278.00, V77. Dyslipoproteinemia: 272.0, 272.1, 272.2, 272.4, 272.5, 272.9; Hypertension: 401, 401.0, 401.1, 401.9, 402.0, 402.1, 402.9, 403.0, 403.1, 403.9, 404, 404.0, 404.1, 404.9, 278.0, 278.00, 278.01, 278.02, 278.1, V77.8, 783.1, 278.02; Impaired fasting glucose/diabetes mellitus: 250, 790.2, 790.21, 790.22, 790.29.31 Because there is no specific ICD-9-CM code for elevated waist circumference, obesity served as the proxy variable.

Regarding baseline eGFR in more detail, 73% (212/292) Selleck RAD001 of pts had an eGFR >90, while 27% (80/292) showed an eGFR of 60-90. The latter occurred more frequent in female patients (33.6% vs. 23.6, p=0.041) and elder patients >50 years (46.2% vs. 12.4%, p<0.0001). At TW12 46.2% (37/80) of pts with baseline eGFR of

60-90 experienced anemia in contrast to only 20.3% (43/212) with baseline eGFR >90 (p<0.0001). When eGFR remained >90 from baseline until TW12 the frequency of anemia was 17.4% (25/144) while an eGFR decline from >90 to ≤90 until TW12 was associated with a trend towards a higher rate of anemia (27.1%, 16/59), but the difference did not reach significance (p=0.116). No influence on the frequency of anemia was observed in pts who had an eGFR decline from 60-90 to <60 (53.8%, 21/39) in comparison to pts with stable eGFR of 60-90 from baseline until TW12 (53.3%, 8/15; p=0.973). Conclusions: The present interim analysis of the NOVUS study demonstrates a strong association between renal function at baseline and the frequency of anemia caused by BOC triple therapy. As a consequence RBV dose reductions should be considered in pts with impaired renal function. Disclosures: Gerlinde Teuber - Advisory Committees or Review Panels: MSD, Gilead; Grant/ Research Support: MSD, Roche Pharma; Speaking and Teaching: FK506 cell line MSD, Gilead, Janssen, BMS Peter Buggisch

– Advisory Committees or Review Panels: Janssen, AbbVie, BMS, Siemens; Speaking and Teaching: Roche, MSD, Gilead Michael R. R. Kraus – Advisory Committees or Review Panels: Merck/MSD, Roche, Gilead, BMS, Janssen, ABBVIE; Consulting: Merck/MSD, Roche; Speaking and Teaching: Merck/MSD, Gilead, BMS, Janssen, ABBVIE Bernd Weber – Advisory Committees or Review Panels:

Molteni Farmaceutici, Bristol Myers Squibb, AbbVie; Speaking and Teaching: Roche Pharma AG, Janssen Cilag, Reckitt Benckiser, Sandoz, Lundbeck Pharma, Sanofi-Aventis, MSD, Gilead Sciences Uwe Naumann – Speaking and Teaching: MSD, Roche, BMS, Abbott, VIIV, Jans-sen, Boehringer Ingelheim, Gilead Dagmar Hartmann – Employment: MSD Germany Bernd Dreher – Employment: MSD Manfred Bilzer – Consulting: MSD Germany Carnitine palmitoyltransferase II The following people have nothing to disclose: Hanns F. Loehr, Hermann Stef-fens, Christine John, Peter R. Geyer, Thomas Witthoeft, Andreas Herrmann, Mark Hoesl, Elmar Zehnter Objectives: Chronic hepatitis C (CHC) is no longer a challenging clinical state with newer DAA’s achieving SVR within a shorter duration of therapy. Pegylated Interferon Alfa 2a with Ribavirin was the main stay of therapy. Interferon is con-traindicated in psychiatric population (Schizophrenic. major depression, bipolar and schizoaffective disorder). These population have a majority of co morbidities, substance abuse and advanced fibrosis along with a poor QOL score.

pylori infection (detected by stool antigen) and venous blood ammonia concentration. Exclusion criteria: clinical hepatic encephalopathy, illiteracy, ongoing alcohol consumption, ongoing or recent gastrointestinal bleeding or spontaneous bacterial peritonitis, proton pump inhibitors or psychotropic drugs use and recent H. pylori therapy. Statistical Navitoclax significance was established at p < 0.05. Results: RESULTS: From the 102 patients who were evaluated, 41 were included: 31 men, mean age of 57 years, 81% with alcoholic cirrhosis, 31 in class A and 10 in class B (Child-Pugh), mean MELD of 6. SHE was diagnosed in 34% of patients. The prevalence of H. pylori infection was

22%. Hyperammonemia was found in 98% of patients. Levels of blood ammonia were not significantly different between patients with or without H. pylori infection (49.8 ± 18.8 vs 45.7 ± 13.6 μmol/L; p = 0.468) nor between patients with or without Fostamatinib manufacturer SHE (48.50 ± 13.3 vs 45.6 ± 15.6 μmol/L; p = 0.555). The rate of SHE was higher in patients with H. pylori infection (56% vs 28%), although without statistical significance. There was a significant positive correlation between ammonia levels and MELD (p = 0.009). Conclusion: About one-third of cirrhotic patients have SHE. H. pylori infection was not associated with the presence of SHE. Patients

with more severe liver disease have higher levels of ammonia, which are not related with H. pylori infection. Key Word(s): 1. encephalopathy; 2. H. pylori; 3. hyperammonemia; Presenting Author: ATSUSHI MITSUNAGA Additional Authors: TOMOKO TAGATA, TETSUYA HAMANO, HONAMI TERAMOTO, YUTAKA MITSUNAGA, IZUMI SHIRATO, MIHO SHIRATO, MASAHIKO SHIMADA, TAKAYOSHI NISHINO Corresponding Author: ATSUSHI MITSUNAGA

Affiliations: Tokyo Women’s Medical University Yachiyo Medical Center Objective: The fact that stomach cancer under occurs the circumstances of chronic inflammation from Helicobacter Pylori (HP)infection is common knowledge. It is also becoming clear that stomach cancer occurrence is suppressed by eradication of HP. However, there is a limit to the results of suppressing stomach cancer by HP eradication, and it is a fact that even after HP eradication stomach cancer occurs at a fixed rate. As far as we could search in Ichushi (Japan Medical Abstracts Society), in cases of early gastric cancer treated Orotidine 5′-phosphate decarboxylase with endoscopy, in metachronous cancer which occurred after successfully eradication via HP eradication treatment, 11.2 years after HP eradication was the longest observed period. On this occasion, in spite of HP eradication being carried out after treatment of early gastric cancer with endoscopy, we experienced a case of metachronous repeated cancer occurrences over a period of 13 years following and we therefore make this report. Methods: Case: 56 year old male. In March of 1998, Endoscopic Mucosal Resection (EMR)was performed on IIa type early gastric cancer (12 mm) in the posterior wall of the antrum.

pylori infection (detected by stool antigen) and venous blood ammonia concentration. Exclusion criteria: clinical hepatic encephalopathy, illiteracy, ongoing alcohol consumption, ongoing or recent gastrointestinal bleeding or spontaneous bacterial peritonitis, proton pump inhibitors or psychotropic drugs use and recent H. pylori therapy. Statistical selleck compound significance was established at p < 0.05. Results: RESULTS: From the 102 patients who were evaluated, 41 were included: 31 men, mean age of 57 years, 81% with alcoholic cirrhosis, 31 in class A and 10 in class B (Child-Pugh), mean MELD of 6. SHE was diagnosed in 34% of patients. The prevalence of H. pylori infection was

22%. Hyperammonemia was found in 98% of patients. Levels of blood ammonia were not significantly different between patients with or without H. pylori infection (49.8 ± 18.8 vs 45.7 ± 13.6 μmol/L; p = 0.468) nor between patients with or without this website SHE (48.50 ± 13.3 vs 45.6 ± 15.6 μmol/L; p = 0.555). The rate of SHE was higher in patients with H. pylori infection (56% vs 28%), although without statistical significance. There was a significant positive correlation between ammonia levels and MELD (p = 0.009). Conclusion: About one-third of cirrhotic patients have SHE. H. pylori infection was not associated with the presence of SHE. Patients

with more severe liver disease have higher levels of ammonia, which are not related with H. pylori infection. Key Word(s): 1. encephalopathy; 2. H. pylori; 3. hyperammonemia; Presenting Author: ATSUSHI MITSUNAGA Additional Authors: TOMOKO TAGATA, TETSUYA HAMANO, HONAMI TERAMOTO, YUTAKA MITSUNAGA, IZUMI SHIRATO, MIHO SHIRATO, MASAHIKO SHIMADA, TAKAYOSHI NISHINO Corresponding Author: ATSUSHI MITSUNAGA

Affiliations: Tokyo Women’s Medical University Yachiyo Medical Center Objective: The fact that stomach cancer under occurs the circumstances of chronic inflammation from Helicobacter Pylori (HP)infection is common knowledge. It is also becoming clear that stomach cancer occurrence is suppressed by eradication of HP. However, there is a limit to the results of suppressing stomach cancer by HP eradication, and it is a fact that even after HP eradication stomach cancer occurs at a fixed rate. As far as we could search in Ichushi (Japan Medical Abstracts Society), in cases of early gastric cancer treated Racecadotril with endoscopy, in metachronous cancer which occurred after successfully eradication via HP eradication treatment, 11.2 years after HP eradication was the longest observed period. On this occasion, in spite of HP eradication being carried out after treatment of early gastric cancer with endoscopy, we experienced a case of metachronous repeated cancer occurrences over a period of 13 years following and we therefore make this report. Methods: Case: 56 year old male. In March of 1998, Endoscopic Mucosal Resection (EMR)was performed on IIa type early gastric cancer (12 mm) in the posterior wall of the antrum.

SVR rates are comparatively lower in ITF2357 in vitro patients who have majority preponderance of negative predictors. Further strategies focused on addressing these hardest to cure populations are now required. A DEV,1 J MITCHELL,2 K POLKINGHORNE,3 R SKOIEN,4 K STUART,5 W CHENG,6 A LEE,7 M LEVY,8 J LUBEL,9 S NAZARETH,6 S WARNER,1 A WIGG,10 S ROBERTS2 1Department of Gastroenterology, Monash Medical Centre, Melbourne, Australia, 2Department of Gastroenterology, Alfred Hospital, Melbourne,

Australia, 3Department of Epidemiology, Monash Medical Centre, Melbourne, Australia, 4Department of Gastroenterology, Royal Brisbane and Women’s Hospital, Brisbane, Australia, 5Department of Gastroenterology, Princess Alexandra Hospital, Brisbane, Australia, PF 2341066 6Department of Gastroenterology, Royal Perth Hospital, Perth, Australia, 7Department of Gastroenterology, Concord Hospital, Sydney, Australia, 8Department of Gastroenterology, Liverpool Hospital, Sydney, Australia, 9Department of Gastroenterology, Eastern Health, Melbourne, Australia, 10Department of Gastroenterology, Flinders Medical Centre, Adelaide, Australia Introduction: In Australia, and many other countries, the standard treatment for HCV genotype 1 is triple therapy with Pegylated

interferon-α-2a/2b, ribavirin (PR) and a first generation direct-acting antiviral (DAA), such as boceprevir (BOC). Uncertainty over the timing of regulatory approval and reimbursement for newer DAAs has led to increasing impetus to treat now to reduce disease progression, especially in advanced liver disease. Current BOC treatment experience data to date is mostly from the northern Rapamycin hemisphere. Thus, we aimed to evaluate

the efficacy and safety of BOC based triple therapy in a large Australian cohort reflective of real-world clinical practice. Methods: A retrospective, observational analysis was conducted in 1026 patients enrolled in an early access program in 65 hepatitis treatment centers. Patients received a PR 4 week lead in followed by either response-guided or fixed-dose duration of BOC for 44 weeks according to standard guidelines. Demographic, clinical and virological data were entered into a central database. Cirrhosis was characterized by a composite of radiological imaging, histology (METAVIR 4) and/or transient elastography (median stiffness >12.5 kPa). Virological response (VR) was defined as undetectable HCV RNA using a sensitive quantitative PCR assay. Results: 407 patients were included in this interim analysis, of whom 308 patients had end of treatment data and 157 had week 12 follow up data. The majority were male (68%) and Caucasian (90%), with mean age of 51 years. Cirrhosis was present in 24% (Child-Pugh A) and 55% had prior PR treatment. HCV genotype 1 distribution was 53% 1a, 16% 1b, 3% 1a/1b, and 28% undifferentiated. IL28B genotype distribution was 20% CC, 35% CT, 7% TT and 38% unknown.

(2) To investigate the influence of teprenone and pantoprazole on the anti-platelet effect of clopidogrel and aspirin in patients with

CVD. Methods: A total of 105 patients with coronary heart disease, who needed to receive dual anti-platelet therapy of asprin and clopidogral were randomly divided into three groups. Each group contained 35 patients. The patients with peptic ulcer or digestive haemorrhage history, prescribing other NSAIDs, anticoagulant drugs or glucocorticoid simultaneously were excluded to the study. On the base of their own therapy, the control group didn’t receive any gasric protective therapy. The teprenone group were prescribed teprenone (50 mg tid) for 30 days and the pantoprazole group were prescribed pantoprazole SAR245409 concentration beta-catenin inhibitor (40 mg qd) for 30 days. TXB2, 6-Keto-PGF1α,

ET-1, palatelet aggregation(ADP revulsant) and fecal occult blood were measured before and after the treatment. The gastric-intestinal symtoms and occur of gastric-intestinal haemorrhage, cardiovascular event were recorded during and after the treatment. Results: Totally 80 patients finished the study, among which, 26 persons belonged to control group, 30 and 24 patients were teprenone and pantoprazole group, respectively. The other 25 patients were excluded as the reason of drug discontinuance, surpassing the time of follow-up visit and so on.(1) ET-1 level: In the control group, the ET-1 levels were 102.34 ± 17.00 ng/L and 103.19 ± 17.21 ng/L before and after treatment. No significance variance was found between them (t = -0.287, P = 0.777). In the teprenone group, the ET-1 levels were 96.61 ± 16.41 ng/L before and 96.61 ± 16.41 ng/L after treatment,. There was a significant difference before and after the treatment (t = 8.602, P < 0.001). (2) 6-Keto-PGF1α

level: In the SSR128129E control group, the 6-Keto-PGF1α levels were 40.88 ± 17.18 ng/L before and 39.42 ± 17.02 ng/L after treatment. No significant difference was found between them (t = 0.383, P = 0.705). In the teprenone group, these levels were 39.59 ± 13.65 ng/L and 47.05 ± 15.63 ng/L. The 6-Keto-PGF1α level increased significantly after the treatment (t = -3.268, P = 0.003). (3) TXB2 level: In the control group, the TXB2 level were 106.50 ± 28.67 ng/L before and 102.23 ± 26.55 ng/L after treatment. No significant difference was found (t = 0.934, P = 0.359). the same results were found In the teprenone group, (t = 0.719, P = 0.4787). (4) TXB2/ 6-Keto-PGF1α:In the control group, the ratio were 3.49 ± 2.19 before treatment and 3.97 ± 1.93 after treatment. No significant difference was found(Z = 0.185);In the teprenone group, the ratio were 4.09 ± 2.29 before treatment and 3.06 ± 0.96 after treatment. The ratio were significantly reduced after treatment(Z = 0.001).

In addition to the potential mating behavior described above, there is evidence that calving may be occurring north off Isla de Chiloé. A mother with a young calf was recorded nearshore on 22 October 2010 at 41º27′S, 73º51′W, about 18

nmi north of Isla de Chiloé. The video was reviewed by southern right whale experts,12 who reported that the smaller whale had the typical head shape of a calf, and that its body length appeared to be less than half of its mother’s body length. Other features that indicated that the smaller whale was a young calf were the shape of its blow holes, its wide back and its typical following behavior shown by young calves. Based on these observations, they agreed this animal was a calf born in 2010, and was probably <3 mo old. This is the southernmost record of mother-calf pair for this population. A possible birth occurred in central Chile (33º34′S, 71º48′W) in 1991, based on the sudden appearance of a small R788 in vitro calf with a female that was previously seen alone.3 Clarke (1965) also observed a female and calf pair off Cartagena (33º32′S, 71º37′W) in August 1964. Although the data are limited, one small area in southern Chile appears to be more utilized by right whales than previously thought. Sixteen sightings have been reported off Chile south of 40ºS, with six of them in a small area off northwestern

Isla de Chiloé and five of them south of Isla de Chiloé (Table 1). Isla de Chiloé is the northern limit of the Chilean fjord system and was a former whaling ground for southern ACP-196 right whales. Between 1830 and 1832, 91 British whaling vessels operated around Isla de Chiloé (Gay 1847). Today, fewer than 1,000 people live in the coastal area of northwestern Isla de Chiloé and only about 10% of

them are involved in marine activities such as fishing, making it significant that 6 (6%) of the 108 sightings off Chile and Peru since 1964 were in this small area. In addition, the fact that at least six different individuals Liothyronine Sodium were recorded between 20 September and 21 October 2011 (Fig. 3), potential reproductive behavior has been observed, and the southernmost record of a female-calf pair was just 18 nmi north of Isla de Chiloé, strongly suggest that northwestern Isla de Chiloé is an important area, although with as yet undetermined boundaries. Coastal and marine large-scale development projects may negatively impact these southern right whales, through habitat loss, marine degradation, or even direct mortality. Laist et al. (2001) suggested that right whales may be more vulnerable to ship strikes than other species because of their behavior, such as skim feeding, nursing, and mating, which occur at the surface. Mothers and calves may be the most vulnerable because they spend more time at or near the surface than other classes of right whales. Further, North Atlantic right whales did not respond to the playback of ship sounds (Nowacek et al.