مجله دانشگاه علوم پزشکی گرگان
سال شانزدهم شماره 1 (پیاپی 49، بهار 1393)

Previous studies have reported inconsistent findings about the effect of endurance training on level of interleukin-18 (IL-18) and high-sensitivity C-reactive protein (hsCRP) in obese individuals. This study was performed to determine the effect of resistance training on serum level of IL-18 and hsCRP in obese men. In this clinical trial، eighteen obese men were randomly divided into training and control groups. After 12-hours fasting، height، weight، body mass index، body fat percent، serum level of IL-18 and hsCRP were assessed before and after training period. Resistance training protocol consisted of twelve weeks training، 3 sessions training per week، each session for 60 minutes. Mean±SD of IL-18 were 323. 34±46. 57 pg/ml and 239. 43±53. 75 pg/ml in training and control groups، respectively. Mean±SD of hsCRP was 3. 83±3. 65 µg/ml and 3. 03±2. 98 µg/ml in training and control groups، respectively. This difference was not significant. Performing resistance training for twelve weeks did not significantly reduce IL-18 and hsCRP in obese men.

Nausea and vomiting are common complications after surgery which creates spasm، hypoxia and pulmonary aspiration. This study was done to determine the effect of ondansetrone، metoclopramide associated with dexamethasone on postoperative nausea and vomiting in cholecystectomy surgery using Laparoscopic method. In this double blind clinical trial study، 100 patients with ASA class I and II undergoing laparoscopic cholecystectomy divided randomly into two groups. The patients in the first group were received metoclopramide (10mg/kg/bw) with dexamethasone (8mg/kg/bw) and the second group were received ondansetron (4mg/kg/bw) with dexamethasone (8mg/kg/bw) intravenously 5 min before the final stage of surgery. Premedication and induction of anesthesia in patients were equal 5 minutes to 4 hours after surgery، postoperative nausea and vomiting were recorded for each patient. The rate of nausea in the first and the second groups were recorded 38% and 28%، respectively. The rate of vomiting in the first and the second groups were recorded 30% and 16%، respectively. These values were not significant. Ondansetron with dexamethasone non significantly reduced postoperative nausea and vomiting after laparoscopic cholecystectomy in comparison with metoclopramide with dexamethasone.

Temporal lobe epilepsy is the most common type of epilepsy in human. Patients suffer from spontaneous seizures and memory deficiency. This study was done to assess the effect of Co-enzyme Q10 (CoQ10) administration on seizure، short-term spatial memory and stress oxidative indices in hippocampus of kainic acid-induced epilepsy. In this experimental study، 48 male rats were randomly allocated into six groups: sham-operated; CoQ10 (10 mg/kg/bw) -treated SH; kainate; CoQ10 (2، 5 and 10 mg/kg/bw) treated kainic acid. CoQ10 was intraperitoneally administered daily for one week before intra-hippocampal injection of kainic acid (4µg/kg/bw) in animals. Kainic acid induced chronic and acute spontaneous seizures in animals. Also، kainic acid administration caused a reduction in alternational behavior rate (consecutive or serially entrance into all of arms in triplet set)، increasing of malondialdehide، nitrite level and decreasing of superoxide dismutase activity compared to sham group (P<0. 05). Pre-treatment of kainate rats with CoQ10 decreased rate of spontaneous seizures (P<0. 05). CoQ10 increased alternational behavior rate، decreased malondialdehide and nitrite serum level (P<0. 05). But it had no significant effect on superoxide dismutase activity. Pre-treatment of kainic acid exposed rats with CoQ10 reduced rate of seizures and improved short-term spatial memory and oxidative stress indices in rats.

Agricultural toxins including organochlorine and organophosphorus families cause damages in the various tissues in humans. Diazinon is a non-systemic organophosphate insecticide. This study was carried out to determine the effect of Diazinon on sex hormone، interferon gamma، interleukin-4 and 10 in male rats. In this experimental study 24 adult male Wistar rats were randomly allocated into four groups. Three experimental groups were received Diazinon 5 days per week for one month at 0. 3، 3 and 30 mg/kg/bw intraperitoneally، while controls received nothing. Seven days after the last injection، blood samples were obtained and the serum testosterone، FSH، LH، interferon gamma، interleukin-4 and interleukin-10 were measured. Serum level of Interleukin-10 significantly increased in experimental group (30 mg/kg/bw of Diazinon) compared to controls (P<0. 05). Serum level of Interleukin-10 significantly decreased in 0. 3 mg/kg/bw and 3mg/kg/bw of Diazinon groups compared to controls (P<0. 05). Interleukin-4 level was only significant in the group receiving 30 mg/kg/bw of Diazinon (P<0. 05). Reduction in interferon-gamma level was not significant between control and experimental groups. FSH significantly reduced in the three experimental groups in comparison with controls (P<0. 05). Testosterone level was significantly increased in experimental groups compared to control (P<0. 05). Diazinon increases interleukin-10 and testosterone and reduces FSH hormone in the rat.

Previous studies have shown the adverse effects of gestational diabetes on hippocampal neuron density in animal model. This study was conducted to determine the effect of gestational diabetes on number of motor neuron in the ventral horns of spinal cord in 4, 8 and 12 weeks rat offspring. In this experimental study, 30 Wistar dams were randomly allocated in control and diabetic groups. Dams in diabetic group were received 40 mg/kg/bw of streptozotocin (STZ) at the first day of gestational day (GD) and control group were received an equivalent volume normal saline, intraperitoneally. Six offspring of cases and controls were randomly selected at the 4, 8, 12 postnatal weeks. Postnatal rats were scarified and sections (6 micrometer) were taken from the cervical part of spinal cord, stained by cresyl violet. A photograph of sections was produced using an Olympus BX51 microscope and a DP12 digital camera. The number of motor neurons in the right ventral horns of spinal cord was evaluated in 100000 μm2 area of spinal cord using OLYSIA Autobioreport software. The number of motor neurons in 4 weeks rat offspring were reduced (24.90%) in gestational diabetics compared to controls (17.16±0.5 vs22.85±2.1, P<0.05). The motor neurons in 8 weeks rat offspring were reduced (32.95%) in gestational diabetics in comparison with controls (17.70±1.7 vs26.40±2.0, P<0.05). Also, the number of motor neurons in 12 weeks rat offspring were reduced (24.38%) in gestational diabetics in comparison with controls (17.83±0.7 vs23.58±1.4, P<0.05). The uncontrolled gestational diabetes reduces the number of motor neurons in the ventral horn of spinal cord in rat offspring.

Trophic factor family plays a key role for neuromuscular system healthy. This study was carried out to determine the effect of one session of resistance exercise on protein content and mRNA expression of NT4/5 in rat slow and fast muscles. In this experimental study, sixteen adult male rats randomly were allocated into resistance exercise (T) and control groups. The resistance training protocol consisted of climbing a 1-meter–long ladder, with a weight attached to a tail sleeve. Quantitative Real time RT-PCR for NT-4/5 expression and ELISA Kit for protein assay were used. Resistance training significantly decreased mRNA expression and increased protein of NT4/5 in soleus muscle (P<0.05). Significant alteration was not detected in flexor hallucis longus muscle. One session of resistance training can alter protein and mRNA of NT-4/5 in skeletal muscle and this alteration was dependent on muscle type.

Diabetes induces motor dysfunctions, Palmatine is an isoquinoline alkaloid, with anti-diabetic and antioxidant activities. This study was conducted to evaluate the effect of Palmatine on motor dysfunction in STZ-induced diabetic rats. In this experimental study, 32 male wistar rats were randomly allocated into control, Palmatine-treated non-diabetic, diabetic and Palmatine-treated diabetic groups. Diabetes was induced by STZ administration at the dose of 55 mg/kg/bw, intraperitoneally. Palmatine hydrochloride was administered subcutaneous at doses of 10 mg/kg/bw per day for a period of 6 weeks, one week after induction of diabetes. Blood glucose level was measured 1, 3, 5, 7 weeks after STZ injection. Locomotor activity tests including Y maze, grip-traction and inclined plane tests were performed to determining locomotor activity. In Y maze test, the number of arms entered significantly increased in Palmatine-treated diabetic group compared to diabetic group (P<0.05). Grip traction and inclined plane tests significantly increased in Palmatine-treated diabetic group compared to diabetics animals (P<0.05). Palmatine hydrochloride administration for 6 weeks improves motor dysfunctions in streptozotocin-induced diabetic rats.

Lead as an environmental pollutant can damage the immune system. This study was done to determine the effect of moderate-intensity exercise and Curcumin supplement on serum level of immunoglobulin A in rats exposed to lead acetate. In this experimental study, 46 male rats were allocated into six groups including; Control (C), vehicle (V), lead (L), lead and exercise (LE), lead and curcumin (LC), Lead+exercise+curcumin (LEC). Animals in training groups ran on treadmill for 8 weeks (25- 64 minutes per daily, 15-22 meter/minute and 0% grade). Animals in Lead, LE, LC and LEC groups were received lead acetate (20 mg/kg/bw) and vehicle animals were received ethyl oleat (30 mg/kg/bw) Intraperitoneally for 3 days per week for 8 weeks. Rats in curcumin and LEC groups were received Curcumin (30mg/kg/bw), for 3 day per week for 8 weeks. IgA level were measured by single radial immuno diffusion method. Lead acetate significantly increased MDA levels at P<0.05 in animals. IgA level was 0.2, 0.41 and 0.47 mg/dL in Lead, LE and LEC groups (P<0.05). The simultaneous use of endurance exercise training and curcumin due to increased IgA activity has beneficial effects against lead poisoning.

Onosma dichroanthum Boiss. is one of the most important mountainous medicinal plants in Iran. This study was done to determine the biomechanical evaluation of root extract ointment of Onosma dichroanthum Boiss. on wound healing in rats. In this experimental study, 18 male adult Wistar rats were randomly allocated into control (I), vehicle (II) and treated group with ointment containing of extract 1% of root of Onosma dichroanthum Boiss., (III). 20 mm vertical skin incision wound were made on rats back side. The assessment of the wound healing was carried out at day 14. At the end of study, rats were sacrificed, skin sample were extracted and evaluated by biomechanical method (maximum force, elastic stiffness, energy absorption). There was no significant difference in biomechanical parameters among the treated, vehicle and control groups. Topical application of Onosma dichroanthum Boiss. root have no effect on healing of skin wound in animal model.

Children constipation is one of the common causes of abdominal pain. Cow´s milk in children diet is suggested to be one of the main cause of chronic constipation. This study was performed to determine the effect of cow´s milk elimination from children diet with chronic constipation. This quasi-experimental study, was performed on 80 children with chronic constipation. Rome-III criteria were considered for disease diagnosis. Cow’s milk was eliminated for three weeks from children’s diet and the clinical symptoms in children were surveyed, subsequently. Constipation was cured in 33.8% of children as result of cow's milk free diet. The rate of treatment response in affecting children whom their disease in began under 2 years of age (52.6%) was significantly higher than others (16.6%) (P<0.05). Children treatment was not significantly related to child’s gender and amount of milk consumption. Eliminating of cow's milk from the diet improves the chronic constipation in children.

The vertebra is the most common site of bone metastases. Diagnosis of metastases particularly in the early stages can improve patients’ prognosis and therapy. This study was done to compare the diagnostic value of magnetic resonance imaging and bone scan for the diagnosis of vertebral metastases. This descriptive study was done on 43 patients with any types of primary cancer. Patients underwent spinal magnetic resonance imaging and nuclear scan. Bone scan results were considered as the gold standard. The sensitivity and specificity were calculated for magnetic resonance imaging and nuclear scan. The magnetic resonance imaging diagnosed 19 cases of thoracic vertebral metastases which previously diagnosed as negative by bone scan. Sensitivity and specificity of magnetic resonance imaging compared to bone scan was 90.7% and 95.6%, respectively. The magnetic resonance imaging diagnosed 4 cases of lumbar vertebral metastases which were reported negative in bone scan. Sensitivity, specificity and accuracy of magnetic resonance imaging in compare to bone scan were 97.6%, 97% and 97.2%, respectively. In diagnosis of vertebral metastases, the magnetic resonance imaging is more sensitive than bone scan.

Cholelithiasis have concomitant with biliary tract stones (BTS) in about 10-15% of the affected patients. This study was carried out to compare the specificity and the sensitivity of ultrasonography and computed tomography (CT scan) with the endoscopic retrograde cholangio pancreatography (ERCP) for detecting of the biliary tract stones and to evaluate the efficacy of the ERCP therapy. In this descriptive study, 135 patients suspected of BTS whom were candidate for the ERCP were gone under investigation. Ultrasonography of the gallbladder, liver, biliary tract, oral and IV contrast of abdominal CT scan and the ERCP were conducted for each patient. ERCP was considered as key critria to define BTS. The specificity and sensitivity of the ultrasonography and CT scan and the success rate of the therapeutic ERCP was estimated. BTS were observed in 112 patients by ERCP method. The specificity and sensitivity of the ultrasonography was 72.3% and 73.9%, respectively. The specificity and sensitivity of the CT scan was 50.8% and 91.3%, respectively. The success rate of the therapeutic ERCP was estimated as 76.9%. Ultrasonography as a non-invasive, non-expensive and well sensitivity method which is recommended in patient screening of biliary tract stones in compare to ERCP and CT scan.

Glycodelin expression in normal and cancerous human breast tissue and its relation with age, tumor type, microscopic grade and metastasis to axillary lymph nodes recently were noticed. This study was done to evaluate the glycodelin expression in breast cancer. In this descriptive study, 96 Paraffin-embedded blocks of malignant breast cancer by immunohistochemistry method were considered to evaluate the expression of glycodelin. Patients age,tumor size, tumor type, microscopic grade and metastasis to axillary lymph nodes were recorded for each subject. Glycodelin was found in 30.45% of invasive carcinoma of the breast with axillary lymph node metastasis. Glycodelin was expressed in 72.7% of carcinoma of the breast without lymph nodes metastasis (P<0.05). There was a significant relation between glycodelin expression with microscopic grade 1 of tumor and metastasis to less than 4 of lymph nodes (P<0.05). Glycodelin expression can be evidence for lack of axillary lymph node metastasis of breast cancer.

Different coagulants including aluminum sulfate (Alum) and Polyaluminum Chloride (PAC) are used for water clarification process and deposition of colloidal particles. The use of coagulants causes some residual aluminum in water. The residual aluminum higher than 0.2 mg/l, has adverse effects on human health and environment. This study was conducted to determine the amount of residual aluminum by applying Polyaluminium chloride and aluminum sulfate for turbidity removal from turbid water. In this laboratory study, the experiments were run by using synthetic water having low (10-30 NTU), medium (100-130 NTU) and high (200-230 NTU) initial turbidities. Synthetic turbid water was prepared by adding stock kaolin suspension into distilled water. Samples of 1 liter of water were poured on 6 Jars. After adjusting of pH, coagulant was added into each beaker at various doses and agitated at 100 rpm for 30s. The mixing speed was then reduced to 20 rpm and kept for another 15 minutes. The suspensions were left for sedimentation and after 30 minutes of sedimentation, clarified samples were collected from the top of the beakers. Residual turbidity and residual aluminum was measured. The residual turbidity was measured using a Turbidimeter according to Nephlometric method. The residual aluminum was determined by Eriochrome cyanine R method. Residual alminium in low, medium and high turbidities was 0.006 mg/l, 0.05 mg/l and 0.07 mg/l by applying Polyaluminum Chloride and 0.065 mg/l, 0.15 mg/l and 0.22 mg/l by applying alum, respectively. There was a significant correlation between dosage of Alum and Polyaluminum Chloride with residual aluminium (P<0.05). Polyaluminum Chloride due to low sensitivity to pH variation and less residual aluminum in treated water is more suitable than alum coagulant and could be used as a recommended water coagulant.

Insulin resistance (IR) is one of the factors affecting dyslipidemia in type 2 diabetes which increases the risk of cardiovascular diseases. This study was done to determine the association of homeostasis model assessment of insulin resistance with lipid profiles in type 2 diabetes. This descriptive study was conducted on 72 patients with type 2 diabetes in Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran during 2011. Anthropometric indces, fasting serum glucose, serum insulin and lipid profiles were measured and IR index and atherogenic lipid parameters were calculated. The mean of lipid profiles and parameters were compared across the IR tertiles. The association of homeostasis model assessment and insulin resistance in each tertile with lipid profiles was determined. The mean±SD of IR index was 0.9±0.3, 2.1±0.4 and 4.4±1.6 in the 1th, 2th and 3th tertiles, respectively. In the 3th tertile, serum triglyceride and atherogenic lipid parameters were significantly high and serum HDL-C level was non-significantly low than normal reference range. IR index in the 2th and 3th tertiles was significantly related to serum Triglyceride (P<0.05). IR index in level of >2.8, was inversely associated with HDL-C and directly associated with atherogenic lipid parameter. There is association between Insulin resistance with lipid metabolic abnormality in type 2 diabetic patients.

According to destructive consequences of untreated attention deficit hyperactivity disorder (ADHD), this study was done to evaluate of the prevalence of adult ADHD and its relation with depression among Iranian students. This descriptive study was carried out on 414 students of Kerman University of Medical Sciences, Kerman, Iran during 2010-11. ADHD was screened by ADHD self report scale for adult ADHD and asking DSM-IV criteria from parents for childhood ADHD. Beck depression inventory questionnaire was used to determine depression. The prevalence of adult ADHD and childhood ADHD was 3.9% and 8.5%, respectively. Depression was more prevalent in those with adult or childhood ADHD. Depression was more prevalent in under graduate than post graduate students (P<0.05). Depression is more prevalent in students with adult ADHD or with history of childhood ADHD.

Gastroenteritis due to Salmonella is common in human and considered as a global dilemma of public health. This study was done to determine the Pattern of serotyping and antibiotic resistance of Salmonella in children with diarrhea in Iran. In this laboratory study, 306 stool samples were collected from children with diarrhea in public health centers in Robat-karim, Tehran province, Iran. The specimens were enriched in Selenite F medium and then cultured on Hekton agar. The identification of Salmonella was carried out by conventional method and antimicrobial susceptibility testing was performed according to CLSI procedures. Out of 306 stool samples, 7.2 % were identified as Salmonella species, as follow: 7 Salmonella typhi, 6 Salmonella paratyphi B, 3 Salmonella paratyphi C, 2 Salmonella paratyphi A and 4 samples were not identifiable. There was a significant relation between presence of WBC in fecal and salmonellosis (P<0.05). In drug sensitivity trends, 92.3% of Salmonella species were sensitive to chloramphenicol, ceftizoxime, Nalidixic acid and Amikacin. This study showed that Salmonella was the cause of children diarrhea in 7.2% in this region.

The generated genetic diversity in the microbial pathogens and drug resistant led to a growing interest to use herbal medicine. This study was carried out to determine the in vitro anti-bacterial activity of chloroform, ethyl acetate and hydroalcoholic extracts of Scilla persica Hausskn. In this laboratory study, chloroform, ethyl acetate and hydroalcoholic extracts were obtained from bulb of Scilla persica. The anti-microbial activity, the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of the extracts were evaluated on Staphylococcus aureus, Bacillus cereus and Escherichia coli using the disk diffusion (growth inhibition zone) and macro-dilution methods. Dimethyl sulfoxide (DMSO) was used as a negative control while nalidixic acid and ampicillin were used as positive control. The maximum inhibition zone for ethyl acetate extract was 26.3±0.1 milimetre, 23.7±0.3 milimetre and 19.5±0.4 milimetre for Staphylococcus, Escherichia coli and Bacillus, respectively. The maximum inhibition zone of chloroform extract was found to be 16.4±0.2 milimetre and 14.9±0.3 milimetre for Staphylococcus and Bacillus, respectively. Antimicrobial activity of the chloroform and ethyl acetate extracts of bulb of Scilla persica on Escherichia coli, Staphylococcus aureus and Bacillus cereus are more effective compared to nalidixic acid and it is similar to ampicillin in in-vitro condition.

Gastrointestinal polyps have pre-carcinomatous potential. In regard to increasing rate of gastrointestinal cancers and the relation between polyps with cancers, this study was done to determine the anatomical and histopathological distribution of gastrointestinal polyps in Gorgan, Iran. This cross-sectional study was conducted on 290 patients with gastrointestinal polyps were undergoing colonoscopy or endoscopy in 5th Azar teaching hospital in Gorgan, northern Iran during 1999-2008. The diagnosis was confirmed by histopathologic method. Gender and age was recorded for each patient. 56.6% of patients were males 19.3% of polyps was diagnosed in the sixth decade of patient's age. The most frequent pathological type of gastrointestinal polyps was adenoma (54.1%) followed by hyperplastic (19.7%), acute inflammatory (13.8%) and young polyps type (11.4%). Tubular type with 63% was the most common type of adenoma polyp followed by various villouses (19.1%) and tubulovillous (17.9%). 87.2% and 12.8% of polyps were in colon and stomach, respectively. The most frequent anatomical position of polyps was rectum (30%) followed by sigmoid with 26/1%. Adenoma polyp in colon was the most common type in gastrointestinal tract.

Thalassemias is the most common inherited disease in the world. This study was designed to assess general health of patients with beta-thalassemia major in Gorgan, northern Iran. This descriptive study was performed on 163 patients with beta-thalassemia major whom referred to Thalghani hospital in Gorgan, northern Iran. Socio-Psychosocial status of patients was assessed by using general health questionnaire-28 (GHQ-28). Socio-Psychosocial status of 44.2%, 46% and 9.8% of patients was normal, suspected and suffered from psychosocial disorders, respectively. Social dysfunction (12.9%) and depression (10.4%) were the most prevalent and anxiety was the less prevalent (4.9%) in the patients. There were significant correlations between psychosocial status and mother’s ocupation (P<0.05), patients level of education (P<0.05) and history of associated diseases (P<0.05). Social dysfunction and depression were the two major general health complications in beta-thalassemia patients in this region.

Domestic violence is the most common against women with negative effect on mother’s health, family, children and society. This study was performed to determine the prevalence of domestic violence against women in Bandar Abbas, Iran. This descriptive cross - sectional study was conducted on 500 women referred to Shahid Mohammadi hospital in Bandar Abbas, Southern Iran. Violence and physical injuries were recorded for each woman using a questionnaire. Domestic violence was reported in 460 (92 %) women. The mean age of women was 33.80±8.64 years. The mean years of marriage were 10.53±7.83 years. 389 (77.8%), 102 (20.4%) and 9 (1.8%) of women were housewive, employee and self employee, respectively. 14 (2.8%) women had addiction background. The most common type of violence against women was psychological (54%), followed by verbal (31%), physical (24.8%) and sexual (6.8%). Level of education and addiction in the families were the main factors in domestic violence. Psychological violence is the most common type of domestic violence and it is related to the level of education and addiction in the families.

Hematuria is one of the common causes of pediatric nephrology and urology diseases and is reported in 0.5-2% of children. This study was performed to determine the causes of hematuria in infants and children. This descriptive study was done on 200 infants, children and adolescents in one month to 18 year old ages with chief complaint of hematuria in Hamadan, Iran. Patients were evaluated by urinalysis, urine culture, measurement of calcium, creatinine and uric acid in random urine sample and abdominal sonography. Microscopic and gross hematuria was detected in 79.5% and 20.5% of patients, respectively. Hematuria was idiopathic in 74 (37%) of patients. Urinary tract stones (18%), urinary tract infections (15.5%), hypercalciuria (13%), hyperuricosuria (10%), urinary tract anomalies (5.5%) and glomerulonephritis (1%) were diagnosed as causes of hematuria. In 56% of patients, hematuria was caused by three common etiologies of stone, urinary tract infections and crystalluria.

Cogan's syndrome is a chronic inflammatory disorder of unknown cause affecting mostly young adults. Two main observation of the disease are bilateral interstitial keratitis and vestibuloauditory dysfunction. Association between Cogan's syndrome and systemic vasculitis as well as aortitis are exist. The diagnosis of the disease is based upon the presence of inflammatory eye disease and vestibuloauditory dysfunction. In this article, the classic Cogan's syndrome has been reported in a 47-year-old woman. Two months prior to admission, the patient had been suffering from headache, vertigo, nausea, vomiting, right leg claudication, musculoskeletal pains, bilateral hearing loss and blindness. Ophthalmologic examination revealed that visual acuity was 0.1 bilaterally and on slit lamp examination, there was a conjunctival hyperemia, bilateral cataract and interstitial keratitis. Pure tone audiogram (PTA) and auditory brain stem response (ABR) showed bilateral sensorineural hearing loss. The patient was initially treated with pulse intravenous methylprednisolone and was followed by oral prednisolone and cyclophosphamide, which in follow-up showed partial improvement.

Penetrating atheromatous ulcer is the condition in which ulceration of an aortic atherosclerotic lesion penetrates the internal elastic lamina into the media. Differentiation of penetrating atheromatous ulcer from other causes of acute aortic syndrome such as intramural haematoma and aortic dissection is difficult. The main symptom is a severe، acute chest pain radiating to the inter-scapular area، similar to classical acute aortic dissection of the thoracic aorta. In present article a case of a 52 years old woman with long- standing retrosternal chest pain and with penetrating atherosclerotic aortic ulcer in descending aorta was reported. Unlike the predominant picture of this disease،associated intramural hematoma was not seen.