fil.ion.ucl.ac.uk/spm). For each subject, EPI images were reoriented, realigned, and unwarped, correcting for movement and normalized into standardized Montreal Neurological Institute (MNI) space. To make sure that the results were not induced by an inadequate warping of the brainstem, we used the unified segmentation algorithm available in SPM to perform normalization during preprocessing. This has been shown to achieve good intersubject

coregistration for brain areas, such as the striatum and the brainstem (Klein Inhibitors,research,lifescience,medical et al. 2009). Next, linear detrending was carried out using a software package named Resting-State fMRI Data Analysis Toolkit (REST, by SONG Xiao-Wei et al., http://resting-fmri.sourceforge.net). Regional spontaneous Inhibitors,research,lifescience,medical activity was assessed in the left dorsal ACC by

calculating the fractional BVD-523 chemical structure amplitude of low frequency fluctuation (fALFF: Zou et al. 2008), as implemented in the REST toolkit. The ACC mask was defined by merging the individually placed spectroscopy voxel position in normalized space to correspond to the size and placement of the MRS voxel that was used for obtaining MRS spectra in the left dACC. The fALFF Inhibitors,research,lifescience,medical was calculated by transforming the time series for each voxel to a frequency domain (without bandpass filtering) using fast Fourier transform to obtain the power spectrum. As the power of a given frequency is proportional Inhibitors,research,lifescience,medical to the square of its amplitude in the original time series, the square root

was calculated at each frequency of the power spectrum. The sum of the amplitude across Inhibitors,research,lifescience,medical 0.01–0.08 Hz was divided by that across the entire frequency range (0–0.25 Hz). The fALFF of each voxel was divided by the global mean fALFF value to standardize data across subjects and then a spatial smoothing transformation was conducted with an 8 mm Gaussian kernel. For functional connectivity from analyses, the preprocessed fMRI data were temporal bandpass filtered (0.01–0.08 Hz) and spatially smoothed with an 8 mm Gaussian kernel. To remove physiological nuisance, the global volume intensity, the global white matter, and cerebral spinal fluid (CSF) temporal signals were regressed from the time series (Fox et al. 2005). In addition, motion parameters were treated as nuisance and removed via regression. For functional connectivity (rs-FC) of the dACC with other brain regions, we defined a priori ROIs based on a literature review of neuroimaging studies using delay discounting paradigms.

To stretch the gastrocnemius, participants were instructed to stand facing a wall or bench with feet shoulder width apart and perpendicular to the wall. They were then instructed to lean forward, keeping the back knee straight and the heel grounded. To stretch the soleus, participants were instructed to bend both knees, keeping both feet flat on

the floor. Participants were asked to hold each stretch for one minute and to perform each stretch three times daily. The control group did not receive any intervention for the duration of the study. All participants were asked to avoid additional stretches or other specific exercises of the foot and ankle for the duration of the study. At the completion of the study, participants selleck chemicals in the Selleck Fasudil control group were offered the serial night casting and stretching. Participants and their caregivers recorded compliance with the casting and stretching regimen in a daily diary. The primary outcome was ankle dorsiflexion range

Libraries measured using the Lunge Test (Bennell et al 1999, Burns et al 2009a). Participants stood with one foot perpendicular to a wall and were asked to lunge forward towards the wall. The foot was progressively moved further away from the wall until the maximum range of ankle dorsiflexion was obtained without the heel lifting off the ground. The angle of the tibial shaft from vertical was measured in degrees using a digital inclinometer (Bennell et al 1999). The more involved ankle (ie, with lesser dorsiflexion range) was measured (Menz 2005). The validity of this test is supported by ultrasonography, which shows elongation of the gastrocnemius and soleus fascicle lengths during the lunge (Hallet et al 2005). Additionally, since ankle dorsiflexion range is assessed in weight bearing, it more closely approximates the range of ankle dorsiflexion during activity. Secondary outcomes included foot deformity, mobility, balance, falls, and self-reported activity limitations. Foot deformity was measured with the Foot Posture Index – a multi-segmental screening tool that allocates

a score between −2 and +2 to each of six criteria related to foot structure (Redmond et al 2006). Mobility was measured as the speed of three motor tasks: standing up from a chair (stands/s), walking (both preferred speed and fast speed in m/s), Mephenoxalone and ascending and descending stairs (stairs/s). Balance was measured as the maximum time (up to 30 s) to maintain three tasks from the Berg Balance Scale (Berg et al 1992): standing with the medial borders of the feet touching, standing with the big toe of one foot beside the heel of the other foot and standing with the toes of one foot placed directly behind the heel of the other foot (tandem stance). Falls and adverse events were recorded daily in a diary. Falls were reported as the number of falls to the ground in the week prior to scheduled visits.

Increased GLUT3 expression may meet this demand, as has been demonstrated in response to chronic increases in neuronal glucose requirements

(Vannucci 1994). However, Choeiri et al. (2005) found that acutely increased demand associated with cognitive activity and training tasks was associated with increased hippocampal GLUT1 expression, Inhibitors,research,lifescience,medical thus allowing increased glucose uptake from the circulation to the interstitial fluid. GLUT3, however, did not increase. Therefore, additional transport mechanisms may need to be inducted to meet acute increases in neuronal glucose requirement during cognitive activity. Insulin-mediated glucose uptake occurs by promoting rapid and substantial translocation of GLUT4 from sequestered intracytoplasmic pools to the plasma membrane (Mueckler 1994) within minutes of insulin binding to the receptor. Insulin signaling therefore provides a mechanism able to rapidly stimulate high-affinity Inhibitors,research,lifescience,medical additional glucose uptake. These kinetic characteristics would fit with a role for neuronal insulin signaling in facilitating rapid stimulated glucose Inhibitors,research,lifescience,medical uptake according to neuronal activity. This is also

consistent with Hori’s demonstration of excitatory neurotransmitter-induced insulin signaling cascade protein expression in the postsynaptic density (Hori et al. 2005). We propose that this insulin-stimulated transport may EGFR cancer provide a mechanism for meeting the increase in glucose requirement during cognitive activity. To investigate this link between cognitive impairment

and insulin Inhibitors,research,lifescience,medical resistance, we applied a lipid infusion model of insulin resistance (Dresner et al. 1999; Roden et al. 1999) to study hippocampal tissue energetics in healthy volunteers. Tissue energetics were investigated by assessing high-energy phosphate levels using phosphorus magnetic resonance spectroscopy (31P MRS). Intracellular energy Inhibitors,research,lifescience,medical is produced and transported in the form of adenosine triphosphate (ATP). A reduction in glucose supply would result in reduced ATP production. The ATP molecule is readily converted to phosphocreatine (PCr) to provide an intracellular buffer store, which can be readily hydrolyzed to produce Farnesyltransferase ATP. The PCr/ATP ratio therefore provides an index of cellular energy availability, and a reduction in the PCr/ATP ratio reflects reduced ATP production relative to concurrent energy consumption. Aim Inhibition of the insulin signaling mechanisms that putatively facilitate increased glucose uptake during cognitive activity would lead to relative insufficiency of neuronal energy substrate. This energy deficit would be reflected as a reduction in the hippocampal PCr/ATP ratio. The aim of this study was to determine whether hippocampal energetics during cognitive activity were impaired in a human experimental model of insulin resistance.

In organ culture, also, some

BPs can inhibit the generation of mature osteoclasts, possibly by preventing the fusion of osteoclast precursors [5]. In contrast to their ability to induce apoptosis in osteoclasts, which contributes to the inhibition of selleck screening library resorptive activity, some experimental studies suggest that BPs may protect osteocytes and osteoblasts from apoptosis induced by glucocorticoids [9]. Since the early 1990s there has been a systematic effort Inhibitors,research,lifescience,medical to elucidate the molecular mechanisms of action of BPs, and, not surprisingly, it has been found that they could be divided into 2 structural subgroups [10, 11]. The first group comprises the nonnitrogen-containing bisphosphonates, such as CLO and ETI, that perhaps most closely resemble pyrophosphate. These Inhibitors,research,lifescience,medical can be metabolically incorporated into nonhydrolyzable analogues of adenosine triphosphate (ATP) methylene-containing (AppCp) nucleotides, by reversing the reactions of aminoacyl-transfer RNA synthetases [12]. The resulting metabolites contain the P–C–P moiety in place of the β,γ-phosphate groups of ATP [13]. Intracellular accumulation Inhibitors,research,lifescience,medical of these metabolites within osteoclasts inhibits their function and may cause osteoclast cell death, most likely by inhibiting ATP-dependent enzymes, such as the adenine nucleotide

translocase, a component of the mitochondrial permeability transition pore [14]. Induction of osteoclast apoptosis seems to be the primary mechanism by which the simple BPs inhibit bone resorption, since the Inhibitors,research,lifescience,medical ability of CLO and ETI to inhibit resorption in vitro can be overcome when osteoclast apoptosis is prevented using a caspase inhibitor [15]. In contrast, the second group, comprising the nitrogen-containing bisphosphonates (N-BPs), which are several orders of magnitude more potent at Inhibitors,research,lifescience,medical inhibiting bone resorption in vivo than the simple bisphosphonates, is not metabolized to toxic analogues of ATP [16]. N-BPs act by inhibiting farnesyl diphosphate (FPP) synthase, a

key enzyme of the mevalonate pathway (Figure 3). Figure 3 Isoprenoids are synthesized from the mevalonate pathway that starts from reaction catalyzed by the 3-hydroxy-3-methylglutaryl CoA (HMG-CoA) reductase (the rate-limiting reaction in cholesterol biosynthesis) which catalyzes the conversion of out HMG-CoA to … This enzyme is inhibited by nanomolar concentrations of N-BPs. ZOL and the structurally similar MIN are extremely potent inhibitors of FPP synthase [6] and inhibit the enzyme even at picomolar concentrations. Importantly, studies with recombinant human FPP synthase revealed that minor modifications to the structure and conformation of the R2 side chain that are known to affect antiresorptive potency also affect the ability to inhibit FPP synthase. These studies strongly suggest that FPP synthase is the major pharmacologic target of N-BPs in osteoclasts in vivo and help to explain the relationship between bisphosphonate structure and antiresorptive potency [6].

Evidence for IDO in depression is supported bystudies demonstrating that decreased levels of tryptophan and increased kyneurenin is associated with inflammation and depression.185 Increased IDO has also been positively correlated with depression, although a direct causal relationship has not been demonstrated. A recent study has now provided direct evidence that induction of IDO underlies the depressive behaviors caused by inflammation/activated immunologic conditions. This work was conducted using a bacterial immune activation model, Bacille Calmette-Guerin (BCM), which induces a long-lasting induction of interferon

and results in depressive behaviors in animal models.185,186 The results Inhibitors,research,lifescience,medical demonstrate that BCM-mediated immobility in the forced swim test is reversed by an IDO inhibitor, 1-methyltryptophan, and in mice that are deficient in IDO.185 In addition, BCM also increases the expression of a downstream enzyme, Inhibitors,research,lifescience,medical 3-hydroxyanthranilic acid oxygenase (3-HAO) that is involved in the synthesis of quinolinic acid. These studies indicate that an IDO inhibitor, and possibly an inhibitor of 3-HAO, could have efficacy for the treatment of depression and related mood disorders. Summary and future directions Significant advances have been made in characterizing the neuronal and glial damage, or structural Inhibitors,research,lifescience,medical alterations, at the cellular and anatomical levels in stress-related mood disorders and

other Screening Library supplier psychiatric illnesses, and in elucidating the molecular signaling pathways and mechanisms that underlie these changes. However, this work Inhibitors,research,lifescience,medical is still at a relatively early stage, and a more complete characterization of these complex alterations and signaling mechanisms will require extensive resources and time. Moreover, identification of genetic polymorphisms that impact these pathways and systems and that influence Inhibitors,research,lifescience,medical susceptibility or resilience to illness is a major area of research that will continue to develop and unfold. When combined with studies of environmental risk factors and lifetime history

of stress, this work will define and describe the mechanisms underlying individual variations of illness. Together, the results of this next work can be used to formulate a comprehensive approach for the prevention and treatment of psychiatric illnesses. Changes in lifestyle and behavior can reduce stress and exposure to environmental factors that influence cellular risk and damage and prevent illness. These approaches, as well as behavioral interventions that enhance the activity and function of specific neural circuits, and thereby provide protection, can also be used once a person has become ill. Development of therapeutic agents that target neuroprotective mechanisms, combined with genetic information will ultimately provide tailored approaches for highly specific and efficacious treatments for depression and other illnesses.

Conflict of Interest: None declared
Spinal Cord Injury (SCI) is a damage to the spinal cord that results in the loss of mobility and sensation below the level of injury. The disorder is characterized according to the amount of functional loss,

sensational loss, and inability to stand and walk.1-3 The incidence of SCI varies amongst countries. For example there are 12.7 and 59 new cases per million in France and the United States of America, respectively.4,5 It may be the result of trauma, especially Inhibitors,research,lifescience,medical motor vehicle accident, penetrating injuries, or diseases. As a result of this type of disability, most individuals with SCI rely on a wheelchair for their mobility. They can transport themselves from one place to another using a manual wheelchair with a speed and energy expenditure similar to normal subjects.6,7 Although, the use wheelchair provides mobility to such patients, it is not without problems. The main problems

are the restriction to mobility from architectural features Inhibitors,research,lifescience,medical in the landscape, and a number of health issues due to prolonged sitting. Decubitus ZD6474 price ulcers, osteoporosis, joint deformities, especially hip joint adduction contracture, can result from prolonged wheelchair use.8 Individuals with SCI often undergo various rehabilitation programmes Inhibitors,research,lifescience,medical for walking and exercises. It has been suggested that by decreasing urinary tract infections, improving cardiovascular and digestive systems functions and psychological health walking Inhibitors,research,lifescience,medical is a good exercise for paraplegics in order to maintain good health.8 In contrast, most patients prefer not to use an orthosis, or use it occasionally. They have mentioned some problem associated with use of orthoses. The main problem with orthosis use is the high energy demands it places on the users during ambulation. In Inhibitors,research,lifescience,medical contrast to mobility speed with a wheelchair, the mobility speed of a SCI patient with an orthosis

is significantly less than that of normal walking.9-13 Donning and doffing of the orthosis is another important problem associated with the use of an orthosis.14 The high amount of the force applied on the upper limb musculature is another issue, which affects the use of an orthosis. about Depending on the style of walking, between 30% and 55% of body weight is applied on the crutch during walking.15-17 The high extent of the force, which is transmitted to the upper limb joints, increases the incidence of some diseases as well as shoulder pain.18,19 Fear to fall, especially during hand function performances, is another problem of using an orthosis. Although standing with an orthosis may have some benefits for the patients, it has a number of problems. Therefore, the main question that remains is wether or not walking and standing with an orthosis can fulfil the afore-mentioned benefits. Unfortunately, the information mentioned in some textbooks regarding the benefits of using an orthosis for SCI individuals are based on the survey studies.

In PD-Off, the relation between the PFC BOLD activity and DAT-BPND values follows a U-shaped model; in contrast, the same relation follows an inverted-U shape model in PD-On. The color bars represent T statistics. For display purposes, maps are thresholded at P < 0.005, uncorrected, but results are significant at P < 0.05, familywise error (FWE), small volume correction (svc). Coordinates (x, y, and z) are in the Montreal Neurological Institute (MNI) space. BOLD, blood oxygenated level dependent. Click Inhibitors,research,lifescience,medical here to view.(1003K, tif)
Crucifixion as a means of state-sponsored torture and execution likely began in the Persian

Empire five centuries Inhibitors,research,lifescience,medical before the birth of Christ. It was originally “designed” as a means of executing condemned

criminals without allowing their feet to touch “holy ground” (Jackson 1909; Barbet 1953; Tenney 1964). This practice spread rapidly throughout the Persian Empire (Friedrich 1971; Shrier 2002), and was adopted by nearby Indian, Scythian, Taurian, and Assyrian societies (Holoubek and Holoubek 1995). In the 4th century B.C., Alexander the Great adopted crucifixion from the Persians, introducing it to Inhibitors,research,lifescience,medical Egypt, Carthage, and the Roman Empire. In Rome, the practice rapidly flourished, evolving into a brutal means of executing revolutionaries, slaves, and foreign criminals (Roman citizens were protected from the torture except in cases of deserting soldiers) (Depasquale and Burch 1963; Hengel 1977). In the centuries that Inhibitors,research,lifescience,medical followed, many mass crucifixions were performed in the Roman Empire, often adjacent

to heavily traveled passageways to serve as warnings to foreigners and potential invaders (Edwards et al. 1986; Hoare 1994). In its earliest Persian form, the condemned were tied with rope or impaled to an upright post or tree and left to die. In Rome, however, crucifixion selleck chemicals llc developed into a lengthy, torturous ceremony Inhibitors,research,lifescience,medical (Edwards et al. 1986). The condemned were initially stripped of their clothing, tied to a pole, and publicly ridiculed while flogged with a flagrum consisting of leather bands attached to metal balls or small bones (Holoubek and Holoubek 1995). After the flogging, the victim was forced to carry Carnitine palmitoyltransferase II a 75–125 pound patibulum across his shoulders to the site of crucifixion, typically located outside the city walls in view of travelers-by (Barbet 1953; Edwards et al. 1986; Hoare 1994; Holoubek and Holoubek 1995). Suffering from significant blood loss and physical exhaustion, the condemned was then offered a mild analgesic drink of wine and myrrh and thrown back upon the patibulum to be secured. Various types of crosses were developed in Rome for this practice, including the “T-shaped” tau and “┼-shaped” Latin crosses (Barbet 1953; Davis 1965, 1976; Hengel 1977; Lumpkin 1978; Edwards et al. 1986).

Out of the 50 eyes SB431542 clinical trial with retinal hemorrhages, only 1 (2%) lacked either a subdural or intrascleral hemorrhage. Within these, 33 (66%) had both subdural and intrascleral hemorrhages, while 15 (30%) had a subdural without intrascleral hemorrhage, and 1 (2%) had an intrascleral without subdural hemorrhage. Subdural inhibitors hemorrhage was present in 58 eyes (97%), of which 33 (57%) also had retinal and intrascleral hemorrhages. Only 6 of these eyes

(10%) positive for subdural hemorrhage had neither retinal nor intrascleral hemorrhages, while 15 (26%) had retinal hemorrhage of any kind without intrascleral hemorrhage, and 4 (6.9%) had intrascleral hemorrhage without retinal hemorrhage. Therefore, 10 eyes (17%) had subdural hemorrhage without retinal hemorrhage, of which 6 had unilateral retinal hemorrhages and 4 lacked retinal hemorrhages bilaterally. Intrascleral hemorrhage was present in 38 eyes (63%): Vorinostat manufacturer 33 of those eyes (87%) also had subdural and retinal hemorrhages, 4 (11%) had subdural without retinal hemorrhages, and 1 (2.6%) had retinal without subdural hemorrhage. Intrascleral hemorrhage always accompanied a retinal or subdural hemorrhage. Vitreoretinal interface abnormalities were seen in 51 abusive head trauma eyes (85%) (Figure 1, Right panel). ILM tear in isolation was the most common observation in 22 eyes (37%). The incidence of ILM tear with a perimacular ridge and cherry hemorrhage

was 20 (33%), while incidence of only ILM tear and a perimacular ridge was 5 (8%) and of only cherry hemorrhage with ILM tear was 4 (6.7%). Every eye with a perimacular ridge or cherry hemorrhage had a torn ILM. In eyes with ILM tear, 20 (39%) also had a cherry hemorrhage and a perimacular ridge, 5 (10%) had a perimacular ridge without a cherry hemorrhage, 4 (7.8%) had a cherry hemorrhage without a perimacular ridge, and 22 (43%) did not have an accompanying perimacular ridge

or a cherry hemorrhage. In total, 24 (40%) eyes had a cherry hemorrhage: 20 (83%) also had ILM tears and a perimacular ridge, while either 4 (17%) had an ILM tear without a perimacular ridge. There were 25 (42%) eyes out of 60 with perimacular ridges: 20 (80%) also had both cherry hemorrhages and ILM tears, while 5 (20%) had a torn ILM without a cherry hemorrhage. Subdural hemorrhage at the optic nerve has a bluish hue externally. In cross-section, the blood is visible inside the dura (Figure 2, Left). Microscopically, intrascleral hemorrhage is found surrounding ruptured intrascleral vessels at the junction of the optic nerve and sclera (Figure 2, Right). Intrascleral bleeding is often continuous with the subdural space. Typical perimacular ridges are elevated, circular retinal folds with a canopy of ILM above, torn away from retina, with fibrin-hemorrhage debris below. Often a portion of the perimacular ridge can be seen clinically, surrounding hemorrhage at the macula (Figure 3, Top left).

Glasgow is the largest city in Scotland. It has high concentrations of poverty, disadvantage and poor health. There are stark

area-based health inequalities with life expectancy in the most disadvantaged areas estimated to be at least 15 years less than in the least disadvantaged (Hanlon et al., 2006, Palmer et al., 2006, Walsh, 2008 and WHO Commission on Social Determinants of Health, 2008). Glasgow’s socially disadvantaged areas include: • post-second world war housing estates situated on the edges of Glasgow city (referred to as peripheral estates). These largely comprise low-rise and medium-rise tenement flats (large buildings divided into flats off a common stairwell) and houses. Social or council housing remains a dominant form of housing in Glasgow with about 40% of housing being socially rented. (This compares to about 17% socially rented UK-wide). ZD1839 In 2003, over 80,000 socially rented homes in the city were transferred BYL719 from public ownership to Glasgow Housing Association (GHA), a third sector social landlord. Most of these 80,000

homes needed improvement to meet the Scottish Housing Quality Standard (Communities Scotland, 2007)1 and a major regeneration program was developed which included housing improvements, building new socially rented and private sector homes, demolition (approximately 20,000 homes), improvements to the physical neighborhood environment, new/improved amenities and services, and community interventions (see Box 1 for details). Housing improvement: including repairs or replacements to roofs, external cladding, doors, windows, kitchens, bathrooms, electrics,

heating, common areas, etc., based on surveyor’s assessments of each property. In GoWell we are studying this large, multi-faceted program of housing investment and area regeneration in 15 areas across Glasgow. The GoWell Program began in 2005 and was a planned 10-year evaluation aimed at exploring the links between regeneration and the health and wellbeing of individuals, families and communities. It also aimed to establish the nature and Libraries extent of these impacts and the processes that isothipendyl have brought them about, to learn about the relative effectiveness of different approaches, and to inform policy and practice. GoWell is a research and learning program comprising multiple components, and multiple research methods and uses a pragmatic comparative design and mixed methods. The components of the evaluation are shown in Box 2. GoWell also has a strong focus on dissemination and community engagement activities including: regular community newsletters to residents and presentations of local data to community resident groups, briefing papers primarily for policymakers and practitioners, website, blogs and twitter and an annual event with participation from housing associations, Glasgow City Council, Scottish Government, community and voluntary sector organizations, residents and academics.

A large body of E7080 mouse research states that with a drop in hematocrit levels to below 17%, the patient will have serious complications; and if the hematocrit level drops below 14%, the patient might be at risk of death.9-13 In our study, the lowest hematocrit level was not below 22%; consequently, we found no significant relationship

between the hematocrit level before surgery, lowest hematocrit level on pump, and changes in the liver function tests. Mc Sweeny et al.14 stated that a history of myocardial infarction, revascularization, and ejection fraction below 40% were the independent factors affecting postoperative gastrointestinal complications. Moreover, the authors Inhibitors,research,lifescience,medical found that a history of renal failure was effective in the occurrence of gastrointestinal complications. Also, Raman et al.15 reported that a history of diabetes mellitus and heart failure Inhibitors,research,lifescience,medical could cause severe liver ischemia after cardiac surgeries. In our study, a history of diabetes had a significant relationship with direct bilirubin changes, and not with the other liver function tests. Also, myocardial infarction and preoperative creatinine levels did not have a significant relationship with any of the liver function tests, while the ejection fraction had a reverse significant relationship with the changes in the ALP levels and the CVP pressure had a direct and significant relationship with the changes in the liver enzymes. The Inhibitors,research,lifescience,medical results of the present study

Inhibitors,research,lifescience,medical are not in agreement with that of in some previous studies. Conflicting results can also be found between the previous investigations; this is because different studies employ different markers for detecting hepatocellular injury such as alcohol dehydrogenase (AD) and glutathione S-transferase (GST). It is worthy of note that we used conventional transaminases, which are, albeit a lesser Inhibitors,research,lifescience,medical indicator of hepatic damage, more practical than the others. Holmes showed that using inotrope and vasopressors could increase visceral vascular resistance

and cause ischemia by vascular contracture. For instance, while infusion of epinephrine could increase cardiac output, it would reduce visceral perfusion.16 In our study, inotrope and vasopressors were infused for all the patients until the first postoperative day. Therefore, we could not assess their effect on the changes in the liver function tests. Some researchers have reported that the use of intra-aortic balloon pumps could reduce tissue perfusion and cause gastrointestinal complications, especially liver Thymidine kinase complications.8 In our study, only AST had a considerably significant increase in the patients for whom intra-aortic balloon pumps were used. Another study showed that inadequate venous drainage caused liver congestion and increased postoperative liver damage. Venous drainage during CPB depends on multiple factors.17 However, during CPB, the amount of the pump flow directly correlates with the amount of systemic venous return. In our study, the pump flow was maintained at 2.4-2.