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Introduction: Sympathetic stimulation and pressor responses including tachycardia, hypertension and tachyarrhytmias caused by laryngoscopy and tracheal intubation may result in severe complications in susceptible patients. Opioid anesthetics are one of the several drugs used to attenuate this response but prolonged postoperative respiratory depression is the major complication distracting from their high dose administration which is nceded for complete amelioration of pressor response. In this study Alfentanyl, as a rapid acting and short duration opioid (without prolonged respiratory depression), was used in two different dosages for controlling of pressor response.
Materials and Methods: In a single blind, controlled clinical trial, 236 patients in the range of 18 to 70 years old), whom needing laryngoscopy and tracheal intubation were selected and randomly divided into two equal groups. First group received low (current) dose (15u gr/kg) Alfentanyl, and the other received high dose (450gr/kg), prior to laryngoscopy and tracheal intubation. Type and dosage of induction drugs were the same and matched in both groups. Blood pressure and heart rate were measured before intravenous induction and after intubation of the tracheal in all patients. Mercurial sphygmomanometer and pulse oximeter were used for these measurements. Incidence of such
complications as hypotention, muscle stiffness and neurologic hyper reactivity, were also measured. Data were analysed by Z distribution and Chi square tests.
Results: Alfentanyl was cffective in controlling pressor response in both groups. In the case of heart rate, the mean difference between two groups was not significant. There was a significant difference mean arterial pressure between two groups (p<0.05). In high dose group, incidence of complications was higher for severe hypotension (p<0.05), stiff chest syndrome (p<0.05), and neurologic hyperreactivity (p<0.05).
Conclusion: High dose of Alfentanyl is more efficient in controlling of pressor response than low dose of the drug. High dose administration also may results in some complications. In this study current dose of Alfentanyl is recommended for controlling of pressor response, but high dose may be used with some modification in the dose of induction agents.

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Introduction: Sympathetic skin response (SSR) is a central, polysynaptic process which is attributed to sympathetic sudomotor activity. The descinding pathway presents spinal sympathetic system to sweat glands of hands and feets skin. The glands which are affected in reflex sympathetic dystrophy (RSD).
Materials and Methods: In present study, SSRs were recorded from left hands of 62 adult healthy subjects and 12 affected hands of RSD patients in relaxed, supine position at room temperature. Recording were performed by a pair of silver cup electrodes (1cm2) after stimulation of contralateral median nerve at volar aspect of wrist, all connected to a polygraph (physiograph, Narco, USA) to record at least five stimulation recording prosedure in each subject.
Results: Comparison of mean latency, amplitude, duraion and shape of responses in RSD 'patients with normal control group showed significant differences between duration and amplitudes (P=0.0007 and P=0.0001) while the latencies were not different and the shape of responses were mostly biphasic in both RSD and normal group.
Conclusion: Hyperactivities of SSRs in RSD patients are due to sudomotor changes of skin resistance, the SSR may also play a role in the quantitive evaluation of patients with suspected RSD.

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Introduction: The phone's sound beams are known to be a valid test that reflects the activity of foreign hair cells, and are therefore very useful for assessing cochlear changes, such as those that occur after exposure to noise.
method: In one clinical trial, 74 volunteers aged 18-25 were examined by simple random sampling. The results of audiometric tests of the participants' pure sounds and tympanometry were within the norm on the day of the experiment. In this study, the phonetic tests of the phone were spontaneous, transient, and distorted from both ears of the subject, which was considered as a basic level of evaluation for us. Then a person's ear was selected and in the intensity of SPL 100 decibels and for 5 minutes in his ear was given a turn. After 2 minutes after the end of the presentation, the previous evaluations were repeated in both ears and the range of responses in both ears was compared.
Results: In 34 participants, submucosal nostrils led to a decrease in amplitude or SOAE responses. One of the interesting findings in this study was the emergence of new peaks in SOAE responses in the opposite ear after the presentation of the sound. The proposed noise created a significant statistical decrease in the range of TEOAE response both in the affected ear and in the opposite ear. Comparing the mean amplitude of DPOAE responses before and after exposure to shift-induced noise in the ear was significant in the Hertz range of 1699-6299, but this comparison was not significant in the opposite ear. The mean time of DPOAE incubation before and after exposure to shingles did not show a statistically significant difference in both the affected ear and the opposite ear.
Conclusion: The findings show that the phone's sound beams are a good tool for tracking hearing damage caused by noise. TEOAEs are also more sensitive to tracking than other tests, and can even be used as a very fast screening tool to assess susceptibility to hearing damage caused by noise before entering high-end industrial environments. And considered sound.

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Introduction: Different strains of Echinococcus Granulosus have been found in endemic areas of Iran. This variation has a significant aspect in the field of medical parasitology and veterinary and also in epidemiology, pathology, control and prevention of Hydatid cyst infection. Morphology, epidemiology and biochemical studies can be carried out to determine Hydatid cyst strains in human and animal origins as host. This study was done to measure different biochemical compositions of liver Hydatid cyst fluids in human, sheep, goat, cattle and camel in 2004.
Materials and Methods: In a cross sectional-analytical study, 112 samples of Hydatid fluids were collected from the liver cysts of different hosts: 16 sheeps, 64 cattles, 12 goats and 10 camels in slaughter houses of Sari and Ghaemshahr and 10 human in Imam hospital. All cyst fluids were centrifuged at 4500 rpm at 4˚C for 45 minutes and the supernatants were analyzed for various biochemical parameters.
Results: Quantitative differences were observed in the levels of Sodium, Glucose, Urea, Alanin Aminotransferase (AST) in liver cystic fluids obtained from different hosts, although these differences were not statistically insignificant. However, differences in the levels of Potassium, Calcium, Triglycerides, Cholesterol, Uric acid, Creatinin, Albumin, Gamma Glutamyl Transferase, Aspartat Aminotransferase (AST) and Creatinine Phosphokinase (CPK) in different Hydatid cyst fluids were statistically significant (P<0.05).
Conclusion: Differences in biochemical composition of different Hydatid cyst fluids suggest the possible existence of more than one strain of Echinococcus Granulosus in human and other intermediate domestic animal hosts in Mazandaran.

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Introduction: Considering the increasing incidence of atherosclerosis and cardiovascular disorders in diabetes mellitus, this study was conducted to evaluate the beneficial effect of two-month administration of Plantago Psyllium (PP) seed on the contractile reactivity of isolated aorta in diabetic rats. Materials and Methods: In this experimental study, 32 male Wistar rats were randomly divided into four control, PP-treated control, diabetic and PP-treated diabetic groups. To induce diabetes, Streptozotcin (STZ) was intraperitoneally administered (60mg/Kg). PP-treated groups received PP mixed with standard pelleted food at a weight ratio of 6.25%. After 2 months, contractile reactivity of thoracic aortic rings to KCl and Noreadrenaline were determined using isolated tissue setup. Data was analyzed using ANOVA and Tukey tests. Results: Serum glucose level showed a significant increase in diabetic group after one and two months (p<0.001), but it,s decrease in PP-treated diabetic group was not significant in comparison to diabetic group. Also PP-treated diabetic group showed a lower contraction to KCl (p<0.05) and noreadrenaline (p<0.01) as compared to diabetic group. Meanwhile, there was no significant difference between control and PP-treated control groups regarding contractile reactivity. Conclusion: It can be concluded that oral administration of PP for 2 months can decrease the contractile responsiveness of vascular system and this may prevent the development of hypertension in diabetic rats.

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Introduction: Chest wall in children is more compliant, slow twitch muscle fibers are less than adults and the alveolus are smaller in size and lesser in number. Airways are more expandable and smaller in diameter. In the other hand the inhalational anesthetics can cause respiratory depression and rapid shallow ventilation. These changes can cause microatelectasia, low respiratory system compliance and increase in work of breathing. Controlled ventilation probably will prevent these events. This study is going to compare behaviors of respiratory system under inhalational anesthesia. Materials and Methods: In a clinical trial, 60 pediatric patients between 6 months to 6 years of age, ASA I & II, who were candidates of elective surgery on extremities and lower abdomen, entered to study. Patients were randomly allocated in two groups of spontaneous and controlled ventilation. In the first group inhalational and in the second group intravenous inductions was performed. Both groups were given halothane (0.8-1%) in a 50% mixture of N2O and O2 for maintenance of anesthesia. HR, RR, BP, SPO2 and T before induction and all of these plus EVT and peak and plateau APs, 5 minutes after induction and every 15 minutes thereafter were measured and dynamic and static compliance were calculated by using measured data. Data was analyzed by ANOVA, T student and Chi square tests. Results: Patients in spontaneous ventilation group had significantly more RR and EtCO2 and less awakening time (p<0.05).Total mean of HR, SBP, DBP, SPO2, T, PIP, PltIP, dynamic and static compliance after induction of anesthesia had no statistical differences between the two groups. Conclusion: There are no constant significant differences between the two groups in respiratory system compliance, airway pressures and T and this study can not prove the development of significant changes in respiratory system indices between the two groups. Thus microatelectasis (if developed) is not clinically important during less than one hour surgeries.

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Background: Skin Sympathetic Response (SSR) is an electrophysiological technique and a central polysynaptic process. In mood disorders there are some changes in the cortex, hypothalamus activity, limbic system and basalganglia. Therefore, we compare the SSR changes in the patients with depression, mania and healthy persons. Methods and Materials: The patients with depression and mania were chosen based on DSM IV criterion by the psychiatrist. In cross-sectional analytic study, control group was selected away healthy men and women. The SSR was written by physiograph. The stimulat electrod was fixed on the middle finger of the left hand and 5 sympathetic responses were recored for every sample. The mean of amplitude, duration and latency time were computed and compared among three groups. Results: The mean of latency in control, mania and depressed groups were not statistically difference (p=.8). There were no difference between mean of duration in latency time in three groups. The mean of amplitude were not significant in three groups. Conclusion: It seems hypothalamus has not direct effect balance of sympathy skin responses.

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  Background: Considering some evidence on anti-diabetic potential of Allium ursinum (AU) , this study was conducted to evaluate the effect of oral administration of AU on contractile responsiveness of thoracic aorta in diabetic rats.

  Materials and Methods: In this experimental study, 40 male Wistar rats were divided into control, AU-treated control, diabetic, glibenclamide-treated, and AU-treated diabetic groups. For inducing diabetes, streptozotcin (STZ) was administered (60 mg/Kg). AU-treated group received AU mixed with standard pelleted food at a weight ratio of 1% for 2 months. Serum glucose level was measured at weeks 4 and 8. Eventually, contractile responsiveness of thoracic aortic rings to KCl and noradrenaline (NA) was evaluated .

  Results: Serum glucose level, at weeks 4 and 8, in the AU-treated diabetic group was significantly lower than that in the diabetics group (p<0.01 and p<0.005, respectively). In addition, the maximum thoracic aorta contractile responsiveness to NA in the AU-treated diabetic group was significantly less than the diabetic group (p<0.05) however, such a significant reduction was not observed for KCl.

Conclusion: Oral administration of AU for 2 months is of a moderate hypoglycemic effect and attenuates the contractile responsiveness of the vascular system in diabetic rats. Background: Considering some evidence on anti-diabetic potential of Allium ursinum (AU), this study was conducted to evaluate the effect of oral administration of AU on contractile responsiveness of thoracic aorta in diabetic rats. Materials and Methods: In this experimental study, 40 male Wistar rats were divided into control, AU-treated control, diabetic, glibenclamide-treated, and AU-treated diabetic groups. For inducing diabetes, streptozotcin (STZ) was administered (60 mg/Kg). AU-treated group received AU mixed with standard pelleted food at a weight ratio of 1% for 2 months. Serum glucose level was measured at weeks 4 and 8. Eventually, contractile responsiveness of thoracic aortic rings to KCl and noradrenaline (NA) was evaluated. Results: Serum glucose level, at weeks 4 and 8, in the AU-treated diabetic group was significantly lower than that in the diabetics group (p<0.01 and p<0.005, respectively). In addition, the maximum thoracic aorta contractile responsiveness to NA in the AU-treated diabetic group was significantly less than the diabetic group (p<0.05) however, such a significant reduction was not observed for KCl. Conclusion: Oral administration of AU for 2 months is of a moderate hypoglycemic effect and attenuates the contractile responsiveness of the vascular system in diabetic rats.

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Background: Chemical weapons are among the most non-humanistic types of man-made weapons. These gases can cause problems like breathing disorders and other serious illnesses, such that nearly 80 percent of wounded people in Iran have signs of coughing, exuding, and asthma. The aim of this study is to use the results of spirometry tests that are cheap in calculating the probability of illnesses in those exposed. Materials and Methods: In this cross-sectional-analytic study, data related to 1865 individuals wounded by chemical weapons in Sardasht who had been exposed to sulfur mustard were extracted from the existing medical files in Bonyad Janbazan Office. Data analysis was done through the logistic regression method while for evaluating the validity of this model, COX- SNEL was utilized. The spirometry device used in this study was Chest HI801 which was made in Japan. Results: Women formed %23.6 of the population and the rest %76.4 were men. Also, %48.7of the participants were under 40 and %51.3 were 40 and above. Mean age of men was 45.2(11.27) while this was 48.53(14.43) for women. Totally, %48.6 of participants were ill while %51.4 were reported to be healthy. Mean of FEV1 was measured to be 81.78 (21.81) and regression model parameters were as follows: constant =0.465, sex= -0.478, age= 0/29, and FEV1= -0/128. Conclusion: Through the obtained model, the probability of disease incidence in those exposed to sulfur mustard can be computed in a more economic way which can compete with the more expensive, invasive methods.

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Background: Spontaneous rupture of tendon is a rare disease that often occurs following an underlying disease or drug usage. However, the association of this condition with primary hyperparathyroidism has rarely been reported. Case: In a case-study, two cases of spontaneous tendon rupture associated with primary hyperparathyroidism are reviewed. The first one is a middle-aged woman that due to bilateral patellar tendon rupture is operated for secondary repair and augmentation of tendons. The second one is a middle-aged man with unilateral triceps brachii tendon rupture who has been operated for primary tendon repair. Conclusion: Since paramount force is needed for tendon rupture, in spontaneous tendon rupture cases, patient evaluation for detecting underlying diseases and drug usage is necessary. In cases that the history of an underlying disease is not indicated, evaluation of serum level concentrations of Ca, P, ALP, and PTH is recommended for contraindication of primary hyperparathyroidism.

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Background: Adiponectin is a protein which is initially secreted exclusively by adipocytes but its secretion decreases in obese and overweight individuals. With its anti-inflammatory properties, adiponectin acts as an agent which can decrease the risk of type II diabetes and cardiovascular diseases. The aim of this study was to determine adiponectin serum levels in type II diabetic men and explore its relationship with insulin resistance following aerobic exercise. Materials and Methods: In this semi- experimental study, 30 men with type II diabetes were randomly assigned to training and control groups. The training group went through an 8-week training program which consisted of three 40-50 minute aerobic exercise sessions a week (running on treadmill at intensities corresponding to 30to 75% of maximal heart rate (35-75% HR max)). For measuring adiponectin and insulin serum levels, blood samples were obtained through ELISA technique in 2 stages, weeks zero and eight. For determining insulin resistance, insulin resistance index was utilized. In order to evaluate the results, dependent and independent t-tests and Pearson correlation coefficient were used. Results: The results did not indicate the presence of a significant relationship between adiponectin and insulin resistance following training (P=0, r=-0.14). In comparison with the control group, training induced a 39% decrease in adiponectin serum levels, a 10% decrease in BMI and bodyweight, and a 48% decrease in insulin resistance (P>0.001) Conclusions: The findings of this study showed that in response to the 8-week aerobic training program, adiponectin serum levels significantly increased while insulin resistance got decreased. In addition, there was not a significant relationship between adiponectin serum level changes following training and insulin resistance index.

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Background: The effects of acute and chronic exercises on insulin resistance index may be related to one or more factors, including morphological changes and hormonal modifications. The purpose of this study was to investigate the effects of a single session of resistance training on adiponectin levels and insulin resistance until 24 hours post-exercise. Materials and Methods: This experimental study, which followed a pretest-posttest design, was conducted on a group of 10 healthy male volunteers (23±1.4 years) with no history of participation in any regular exercise programs, weight changes more than 2 kg, special diseases, and smoking over the past 6 months that had normal body mass index (BMI) (23.7±1.6 kg.m-2). The subjects performed a single session resistance training (3 sets of 10 repetitions at 75% of 1 repetition maximum). Adiponectin, glucose, insulin, and insulin resistance index levels were measured before and 24 hours after the exercise. Results: There were no significant differences for adiponectin (μ g.ml-1) pre- (6.98±1.9) and post-exercise (8.07±1.4) and glucose (mg.dl-1) pre- (81.3±7.6) and post-exercise (80.7±6.4). However, insulin resistance index pre- (1.34±0.27) and post-exercise (1.06±0.11) and insulin concentration (UΙμ.ml-1) pre-(6.64±0.88) and post-exercise (5.37±0.43) decreased significantly 24 hours post-exercise (P<0.05). Conclusion: Based on the findings of this study, it can be suggested that a single session of resistance training with no significant changes in adiponectin level can have positive effects on glycemic indices in sedentary men.

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Background: Mindfulness and emotion regulation have important effects on the variables related to mental health in chemical weapons victims. The purpose of this study was to examine the effectiveness of mindfulness-based stress reduction and emotion regulation training on the affect and mood in chemical weapons victims. Materials and Methods: This interventional study was conducted with two experimental groups and a control group including 47 male chemical weapons victims with high scores on the General Health Questionnaire in Sardasht city, Iran, randomly selected and then assigned to mindfulness training, emotion regulation training, and control groups. Mindfulness-based stress reduction (MBSR) training was used with experimental group 1, emotion regulation (ER) training was implemented with experimental group 2, and the control group received no training. Data were gathered using the General Health Questionnaire, Positive and Negative Affect and Depression-Happiness scales. Analysis of variance with repeated measure was used for analyzing the data. Results: The results indicated that mindfulness-based stress reduction and emotion regulation training significantly increased positive affect and mood and decreased negative affect in chemical weapons victims. Conclusion: The results supported the effectiveness of mindfulness and emotion regulation training on affect and mood in chemical victims. Therefore, attention to the effectiveness of mindfulness and emotion regulation on variables related to mental health is important in chemical weapon victims.

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Background: ASSR is the latest threshold detection technology in pediatric audiology. The aim of this study is to investigate the degree to which ASSR thresholds correlate with click-ABR thresholds.

Materials and Methods: In this cross-sectional study, 32 children ranging in age from birth to 7 years were evaluated by ASSR and ABR in moderate to severe and severe to profound hearing loss groups.

Results: The correlation coefficients for frequencies of 500, 1000, 2000, and 4000, mean of 2-4 and mean of 1-4 kHz were between 0.68- 0.90 in moderate to severe hearing loss and 0.79-0.96 in severe to profound hearing loss.

Conclusion: Strong correlations were found between ASSR and click-ABR thresholds in all frequencies. This correlation was greater for higher degrees of hearing loss.

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Background: Paraoxonase1 activity shows decline in patients with coronary artery disease. The C to T change in the -107 position of promoter is the most important genetic determinant of serum levels of paraoxonase 1. Study of this polymorphism and its relationship with the type of fatty acid composition of phospholipids in HDL particles can be found in the common pursuit of better medicines and considered in drug treatment.

Materials and Methods: In this descriptive study 265 Patients were selected and divided in two groups based on LDL level (131 in case and 134 in control). Information of subjects were collected from questionnaire and the results of biochemistry and molecular tests. Fatty acids of HDL phospholipids were measured with Gas chromatography technic .

Results: PON1aryl esterase activity, had no significant changes after treatment with lovastatin but paraoxonase activity had more significant increases in the CC genitype of -C/T107 polymorphism. Percent of oleic acid, linoleic acid and icosapentanioc acid in HDL phospholipids were increased by lovastatin.

Conclusion: Treatment with lovastatin in the CC genotype is probably more protective effect against cardiovascular disease. Following treatment, in patients with higher paraoxanase 1 activity Oleic acid and linoleic acid have also increased in HDL phospholipids.

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Background: Physical activity and overweight both changethe body homeostasis for this purpose, in this study effect of two models of high and moderate intensity aerobic exercises on the amount of Adiponectin and Resistin were compared inobese and overweight females.

Materials and Methods: In this experimental study, 15 obese and overweight female (Mean age: 22.93±0.54 years weight: 75.15±2.07 kg hight: 160.6±1.38 Cm BMI: 29.24±0.73kg.m-2) were randomly selected as sample. Subjects were placed into high (33 min exercise, 85-90% of max hearat rate) and moderate (41 min exercise, 50-70% of max hearat rate) intensity aerobic exercise groups. Exercises lasted three days a week for eight weeks with an equal volume of consumed energy. In order to analyze data, independent-t test and Repeated Measure analysis of variance were used at a significance level of p<0.05.

Results: The results indicate a significant increase in Adiponectin after eight weeks of high-intensity aerobic exercise compared to moderate-intensity exercise (p=0.02). A significant reduction in fat mass and percentage was observed after moderate intensity exercise (p=0.03), too. In Addition, moderate intensity exercise caused a considerable decrease in Resistin after eight weeks (p=0.06).

Conclusion: High-intensity exercise appears to provide necessary metabolic stress to enhance Adiponectin, even without weight and fat loss.

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Background: Hematopoietic stem cell transplants are routinely used to treat patients with cancers and other disorders of blood and immune systems. Osteoblasts constitute part of the stromal cell support system in marrow for hematopoiesis by participating in the formation of the HSC niche. It is believed that interaction between hematopoietic cells and bone forming osteoblasts regulate each other’s function. It is established that acute blood loss in animal models activates bone formation and niche development because of EPO stimulation. In this experimental study we have examined the co-culture of HSCs derived from cord blood which treated with EPO in vitro, on osteoblastic differentiation of mesenchymal stem cells.

Materials and Methods: In this experimental study MSCs isolated from bone marrow and co-cultured with CD 34+ CD38- HSCs isolated from cord blood. These co-cultured cells were treated with different doses of erythropoietin for 14 days, after that RNA were extracted from MSCs and analysed with RT-PCR to evaluate the expression of osteopontin and osteocalcin. Alizarin red and alkaline phosphatase staining were done for osteoblastic differentiation.

Results: Osteopontin and osteocalcin were expressed in MSCs. Cellular staining were positive for osteoblastic differentiation. Differentiated cells expressed osteoblastic markers.

Conclusion: These data suggest that EPO regulates the osteoblastic differentiation from bone marrow MSCs in vitro.

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Background: Infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months of regular unprotected sexual intercourse. Male infertility affecting 15% of couples. Environmental and genetic factors are involved in male infertility. Paraoxonase (PON) is an antioxidant enzyme which plays an important role in various diseases and is associated with oxidative stress and lipid metabolism. The PON gene family consists of 3 genes, PON1, PON2, and PON3, that located on the long arm of chromosome 7. In this study, the association of PON1 gene polymorphism at position 192 Q/R with idiopathic male infertility were investigated.

Materials and Methods: Blood Samples were collected from 120 patients diagnosed with idiopathic male infertility and 124 control subjects, and genotyped by PCR-RFLP method. To estimate the association between genotype and allele frequencies in cases and controls, P-values were assessed by Chi-square (&chi2) analysis.

Results: We observed a significant difference in genotype distributions of PON1 192 Q/R polymorphism between patients and controls (P= 0.0001). Our findings revealed individuals with the variant QR and RR had a significant decrease risk of idiopathic male infertility (RR: OR= 0.057, 95%CI=0.003-1.08, P= 0.05. QR: OR= 0.288, 95%CI= 0.132-0.394, P= 0.0001).

Conclusion: Our data indicate that the PON1 192 Q/R polymorphism maybe associated with decreased risk of idiopathic male infertility. Although more studies should be considered with larger number of patient and control subjects to confirm our results.

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Background: Impulsivity is a core social pathology. Therefore, the purpose of this study was to Effectiveness of group dialectical behavior therapy based on core distress tolerance and emotion regulation components on Expulsive Anger and Impulsive Behaviors.

Materials and Methods: Research method is a semi experimental socio-statistic approach consisting of experimental group (dialectical behavior therapy) and control group. Participants were patients referred to Amir Kabir Hospital in Arak. and who were Expulsive Anger and Impulsive Behaviors. Based on stratified random sampling, 16 patients (women) were placed in each group. Research tools included the structured diagnosis interview according to DSM-IV-TR (2000), Barrat impulsivity scale (1994) Distress Tolerance Scale (2005) Difficulties of Emotion Regulation Scale (2004) and dialectical behavior therapy were done for two months, 8 groups Sessions.

Results: The results of this study showed that there was significant difference between control and experimental groups after implementation of dialectical behavior therapy relying on component tolerance and regulation of emotional distress variables impulsive behavior and explosion furies (p<0.01).

Conclusion: Distress tolerance and emotion regulation components effective on Expulsive Anger and Impulsive Behaviors.

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Background: Catamenial recurrent pneumothorax is spontaneous pneumothorax in women of reproductive age, which includes 1-30% of spontaneous pneumothoraces in women and is associated with the menstrual cycle.

 Case: A 39-year-old woman with sudden onset dyspnea, respiratory distress and decreased right side respiratory sounds with a history of spontaneous pneumothorax and chest tube placement one month ago. The patient's symptoms improved after chest tube placement and within less than 24 hours after onset, she began menstruating. Treatment was performed with chemical pleurodesis with tetracycline and oral danazol.

Conclusion: Catamenial pneumothorax and thoracic endometriosis should be considered in all women of childbearing age with spontaneous recurrent pneumothorax. Early detection of this syndrome can result in reduction of morbidity and mortality with recurrence episodes.