Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 218 219 EN Mojtaba Kamali Aghdam Department of Pediatric, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Kambiz Davari Department of Pediatric, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Kambiz Eftekhari Department of Pediatric, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 12 08 2016 01 09 Severe thrombocytopenia with bleeding is rarely reported in children with brucellosis, and recurrent epistaxis is extremely rare. Brucellosis with hemorrhage should be differentiated from viral hemorrhagic fever, malignancy, and other blood disorders. Bone marrow aspiration (BMA) is mandatory to differentiate from other blood diseases. An 8-year-old boy was admitted with recurrent epistaxis, petechiae and purpura on face and extremities and bleeding from the gums. During the hospitalization, he was febrile and complained of muscle pain. Leukopenias associated with thrombocytopenia were observed. BMA showed to be normal. Among the multiple tests requested, only serum agglutination test (SAT) and 2-MercaptoEthanol test (2-ME) were positive. He was treated with Intravenous immunoglobulin (IVIG) associated with co-trimoxazole and rifampin. Finally, fever subsided, and he was discharged with good condition and normal platelet count. Brucellosis should be a differential diagnosis in patients with fever and bleeding disorders and a history of consumption of unpasteurized dairy, in endemic areas. https://acta.tums.ac.ir/index.php/acta/article/view/5251 https://acta.tums.ac.ir/index.php/acta/article/download/5251/4769

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 165 172 EN Mahshid Attari Department of Biology, Islamic Azad University, Qom Branch, Qom, Iran. AND Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Jamaloo Department of Biology, Islamic Azad University, Qom Branch, Qom, Iran. Sahar Shadvar Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Nahid Fakhraei Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Reza Dehpour Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. AND Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 04 05 2016 04 05 Withania somnifera (WS) possess anti-inflammatory and antioxidant properties. WS preparations have a potential therapeutic role in the central nervous system (CNS) related disorders in animal models. In this study, the possible protective effect of acute aqueous WS root extract on behavioral despair was explored and compared with fluoxetine, an antidepressant with selective serotonin (5-HT) reuptake inhibitor activity (SSRI). Further, the probable involvement of nitric oxide (NO) determined to measure immobility time in forced swimming test (FST) and tail suspension test (TST) in male mice. Immediately after assessment of locomotor activity, the immobility time was evaluated. WS was administered intraperitoneally (200, 400 mg/kg; i.p.) 60 min before the behavioral tests. To assess the involvement of NO in the possible protective effect of WS, a non-specific NO synthase inhibitor, NG-L-arginine methyl ester (L-NAME, 10 mg/kg, i.p.) was administered 30 min before the extract administration (400 mg/kg, i.p.), 90 min before the tests. Acute WS extract (200, 400 mg/kg, i.p.) dose-dependently decreased the immobility time in FST, P<0.05, P<0.001, respectively and 400 mg/kg proved the most effective dose and this dose was comparable to fluoxetine (20 mg/kg, i.p. WS (400 mg/kg, i.p.) also lowered the immobility measure in TST (P<0.05). However, these effects were not related to change in locomotor activity. Moreover, L-NAME (10 mg/kg, i.p.) did not influence the effect of the extract on the behavioral tests. As a consequence, the immobility time was virtually constant between the group received the extract (400 mg/kg) alone, and the group received L-NAME (10 mg/kg) before the extract. It is probable that NO does not mediate this beneficial effect, and WS may affect other neurochemical systems and pathways. https://acta.tums.ac.ir/index.php/acta/article/view/5549 https://acta.tums.ac.ir/index.php/acta/article/download/5549/4761

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 220 221 EN Farzaneh Motamed Department of Pediatric Gastroenterology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran. Gholamhossein Fallahi Department of Pediatric Gastroenterology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran. Faezeh Ahmadi Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Bazvand Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Maedeh Ahmadi Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Kambiz Eftekhari Department of Pediatric Gastroenterology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran. Nima Rezaei Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Immunology, School of Medicine, Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Universal Scientific Education and Research Network (USERN), Tehran, Iran. 2015 12 15 2016 03 04 Cystic fibrosis (CF) is a hereditary disease of mucous and sweat glands, which affects the respiratory and gastrointestinal systems. Herein, we describe a 3-month-old girl with a history of recurrent episodes of urinary tract infections that required hospitalization. She was referred to our center at the age of three months, with massive gastroesophageal variceal bleeding. In physical examination, she had clubbing, hepatosplenomegaly, and mild ascites. Laboratory studies revealed high serum levels of liver enzymes and low level of Albumin. As of suspicious to CF, sweat tests were performed twice which confirmed the diagnosis of CF. Gastrointestinal bleeding due to gastroesophageal varices is a rare complication of CF, which could result as a consequence of hepatobiliary involvement of disease. Early diagnosis of CF could prevent severe complications and even death in this group of patients. https://acta.tums.ac.ir/index.php/acta/article/view/5269 https://acta.tums.ac.ir/index.php/acta/article/download/5269/4770

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 173 175 EN Alborz Salavati Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Abdolrasoul Mehrsai Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Farzad Allameh Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Farimah Alizadeh Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Farshad Namdari Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Hosseinian Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Elaheh Salimi Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Fariba Heidari Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Gholam Reza Pourmand Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 04 05 2016 04 05 Coronary artery disease (CAD) and vascular insufficiency are consequences of modern lifestyle, and vasogenic erectile dysfunction (ED) is one of the leading causes of sexual dysfunction which could be prevented like ischemic heart disease if the risk factors are discovered and managed. Seventy-five men scheduled for coronary angiography were asked to fill out the IIEF5 questionnaire and underwent serum lipoprotein-a, uric acid, lipid profile, testosterone, Sex Hormone Binding Globulin (SHBG), dehyderoepiandrostendion sulfate (DHEAS) tests; and the results were compared with those of erectile dysfunction patients with and without coronary artery disease. Ten out of 32 CAD patients (30%) and 6 of 43 normal coronary men had ED Prevalence (P=0.04). The average serum uric acid in ED patients with normal coronary was 5.6 (± 0.68) 6.5 ±078 mg/dl in ED patients of CAD group P=0.034. Men with both ED and CAD had significantly higher levels of lipoprotein-a compared to those CAD patients with normal sexual function. Higher uric acid and lipoprotein-a levels are correlated with the presence of ED in patients with CAD. https://acta.tums.ac.ir/index.php/acta/article/view/5550 https://acta.tums.ac.ir/index.php/acta/article/download/5550/4762

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 222 225 EN Marino Marčić Department of Neurology, University Hospital Split, Split, Croatia. Ljiljana Marčić Department of Radiology, University Hospital Split, Split, Croatia. Krešimir Kolić Department of Radiology, University Hospital Split, Split, Croatia. Marina Titilić Department of Neurology, University Hospital Split, Split, Croatia. 2015 11 30 2016 04 03 We presented the case of a patient with internal watershed infarction with a nonspecific clinical presentation including hemiplegia, hemisensory deficit, and speech disturbance. Neuroimaging and ultrasound diagnostic procedure are important tools for diagnosis of these rare ischemic events that count for about 6% of all strokes.  Specific therapy is mandatory for the diagnosis of watershed infarction and different from the therapeutical measures than can be taken for embolic and atherothrombotic strokes. Our patient was a 69-year-old, right-handed Caucasian woman who presented to our facility with acute right side weakness and speech disturbance. He had hypothyroidism, permanent atrial fibrillation, diabetes mellitus and she was hypotensive. She reported dizziness few days before the accident. Imaging studies revealed internal watershed infarction. Therapeutic procedures were taken to restore low cerebral blood flow. Internal watershed infarction is rare (less than 10% of all strokes) but well recognized a clinical feature of stroke. Specific pathophysiology generally is connected with hypoperfusion and hemodynamic mechanisms. Specific therapy is mandatory for these conditions. https://acta.tums.ac.ir/index.php/acta/article/view/5225 https://acta.tums.ac.ir/index.php/acta/article/download/5225/4771

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 176 184 EN Mohammad Reza Abassi Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Amin Safavi Department of Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Masoumeh Haghverdi Department of Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Babak Saedi Department of Otolaryngology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2016 04 05 2016 04 05 Kidney failure affects different aspects of normal life. Among different manifestations, sleep problem can be considered as a common complaint of ESRD (End Stage Renal Disease) patients. In this study, we aimed to investigate the interrelationship between sleep disorders in ESRD patients and their characteristics. Through a cross-sectional study (2010-2011), 88 ESRD patients undergoing maintenance hemodialysis thrice weekly were recruited to enter the study. We used a self-administered questionnaire into which the data were reflected. The patients selected their specific sleep disorders using a nine-item scale while the Epworth Sleepiness Scale (ESS) determined both the presence and severity of sleep disorders. The data was finally analyzed with their baseline characteristics, dialysis characteristics, medication/stimulants use, and clinical and biochemical parameters. Over 95% of the patients had, at least, one specific sleep disorder while the ESS revealed 36.36% of patients as normal, 59.09% as having mild sleep disorders, and 4.54% as having moderate to severe sleep disorders. Sleep disorders were significantly correlated with older ages (P=0.035), dialysis dose (P=0.001), blood creatinine levels (P=0.037), upper airways obstruction (P=0.035), hepatomegaly (P=0.006), hepatic failure (P=0.001), higher blood TSH levels (P=0.039), history of hypothyroidism (P=0.005), and the use of levodopa (P=0.004), anti-hypertensive medications (P=0.006), benzodiazepines (P=0.006), Eprex (Erythropoietin) (P=0.001), Venofer (Iron Sucrose Injection) (P=0.013), and phosphate-binders agents (P=0.018). Sleep disorders are common findings among ESRD patients and seem to be a more complicated issue than a simple accumulation of the wastes products in the body. Whatever the causes of sleep disorders are, disorder-specific treatments should be considered. https://acta.tums.ac.ir/index.php/acta/article/view/5551 https://acta.tums.ac.ir/index.php/acta/article/download/5551/4763

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 185 190 EN Laleh Eslamian Department of Obstetrics & Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Imam Hospital, affiliated with Tehran University of Medical Sciences; a total of 195 female patients with breast cancer met the inclusion criteria. All of the patients had a complete blood count with leukocyte differential performed before chemotherapy. Medical records including pathology reports were also available. Data for all patients were collected prior to any surgical intervention. Exclusion criteria included clinical evidence of active infection, presence of hematological disorders, acute as well as chronic inflammatory or autoimmune diseases, or prior steroid therapy. Higher platelet count was significantly associated with the higher stage. The stage was not associated with the hemoglobin level. There was no association between the tumor size and age of patients with NLR. There was a significant relationship between NLR and IDC. There was a significant relationship between IDC and NLRs of less than 8.1 and greater than 3.3. There was a significant relationship between NLR and vascular invasion. There was no association between NLR and estrogen receptor and HER2. There was no significant relationship between the PLR and the cancer stage. In this study, NLR showed a significant relation with the disease staging. As the NLR increases the stage increases as well. Therefore, this ratio may be helpful in the preoperative evaluation of patients with breast cancer. https://acta.tums.ac.ir/index.php/acta/article/view/5704 https://acta.tums.ac.ir/index.php/acta/article/download/5704/4921

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 268 271 EN Bahram Mofid Department of Clinical Oncology, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zeinab Shankayi Department of Medical Physics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Kambiz Novin Department of Clinical Oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sadegh Dehghani Department of Medical Physics, Tehran University of Medical Sciences, Tehran, Iran. Morteza Shankayi Department of Mechanic, School of Engineering, Tarbiat Modares University, Tehran, Iran. Hamidreza Haghighatkhah Department of Radiology, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. S. Mohammad Firoozabadi Department of Medical Physics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. 2015 10 04 2016 09 05 Electrochemotherapy (ECT) is a new local treatment method for solid and superficial tumors. During this new technique, patients experience an unpleasant sensation and slight edema. Most unpleasant and painful is mainly attributed to muscle contractions provoked by high amplitude and low repetition frequency pulses. Recently, we showed that electrochemotherapy using low voltage and higher repetition frequency (LVHF ECT) is an effective tool for inhibiting tumor growth and inducing cell permeabilization. Low voltage high-frequency electrochemotherapy was developed and optimized in vitro and in vivo which and can be used in the clinic. In the present study, we report a case of cervical lymph node metastasis of breast cancer treated by the technique. In our case, LVHF ECT was successful in reducing the size and palliating the symptoms of cervical lymph node metastasis in clinical conditions, whereas other approaches were inefficient. Our electrochemotherapy technique shows good clinical results. However, more studies on this new method are necessary to prove that LVHF ECT can be considered as a standard treatment modality. https://acta.tums.ac.ir/index.php/acta/article/view/4259 https://acta.tums.ac.ir/index.php/acta/article/download/4259/4932

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 233 240 EN Mehrnaz Rasooli-Nejad Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Maryam Khazaee-Pool Department of Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran. Ladan Abbasian Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Zahra Bayat Jozani Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Sara Ahsani-Nasab Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Banafsheh Moradmand Badie Discipline of Public Health, School of Medicine, Flinders University, Flinders, South Australia. Afsaneh Pargar Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Esmaeeli Djavid Academic Member of Academic Center for Education, Culture and Research, Tehran, Iran. 2015 10 25 2016 03 04 There are limited documents about HIV patients switched to second-line antiretroviral therapy (ART) in resource-limited countries. We aimed to assess the efficacy of second-line ART for HIV patients following first-line ART failure. This was a cohort study of HIV/AIDS patients with first-line ART treatment failure switched to second-line ART between January 2004 and March 2014, who followed for at least 12 months after switching. Fifty of studied patients (85%) were treated with regimens containing lopinavir/ritonavir (Kaletra) and nine of them (15%) treated with other regimes. Seven patients were experienced opportunistic infections in accordance with stage III and IV WHO classification. In this way, 11.8% of patients had aclinicalfailure, and 37 of them (62%) had immunological responses. Weight gain was evident in these patients, and there was a significant correlation between theincrease in CD4 and weight gain (P=0.007). Only 13 patients achieved HIV viral load testing that 6 of them had avirological response after 12 months on second-line ART. No significant associations were found between virological or immunological response and gender, age, and lopinavir/ritonavir regimens (P>0.05).With counselling and supporting in those failing first-line ART, inessential switching to more costly second-line ART can be prevented in the majority of patients. However, patients' need to second-line ART drugs has increased, for which national ART programmes and regular follow-up should be organized. The high cost of these drugs and limited access to viral load testing are main barriers to proper management of patients switched to second-line ART regimens. https://acta.tums.ac.ir/index.php/acta/article/view/5060 https://acta.tums.ac.ir/index.php/acta/article/download/5060/4922

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 272 276 EN Anju Bansal Department of Pathology, National Institute of Pathology (ICMR), Safdarjang Hospital Campus, New Delhi, India. Manveen Kaur Department of Pathology, National Institute of Pathology (ICMR), Safdarjang Hospital Campus, New Delhi, India. Varsha Dalal Department of Pathology, National Institute of Pathology (ICMR), Safdarjang Hospital Campus, New Delhi, India. 2015 10 13 2016 05 01 Sarcomas account for less than 1% of all primary breast malignancies, pleomorphic sarcoma of the breast being even rarer. We present two cases of pleomorphic sarcoma of the breast in a 35-year-old and a 43-year-old female. An extensive review of the available literature with evaluation of the etiology, changing terminologies and histopathologic features of pleomorphic sarcoma of the breast are discussed. The prognostic factors and treatment modalities have also been reviewed. https://acta.tums.ac.ir/index.php/acta/article/view/4970 https://acta.tums.ac.ir/index.php/acta/article/download/4970/4929

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 241 248 EN Fatemeh Pouya Department of Anatomy, Medicine Faculty, Kerman University of Medical Sciences, Kerman, Iran. AND Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran. Seyed Hassan Eftekhar-Vaghefi Department of Anatomy, Medicine Faculty, Kerman University of Medical Sciences, Kerman, Iran. Parvin Salehinejad Department of Anatomy, Medicine Faculty, Kerman University of Medical Sciences, Kerman, Iran. AND Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran. 2016 02 09 2017 01 30 The human body dimensions are affected by ecological, biological, geographical, racial, sex, and age factors. Craniofacial measurements can be considered to be one of the important tools for determination of the morphological characteristics of the head and face. In this study, which was conducted on Persian adolescents living in Kerman/Iran, different forms of head and face were determined for using in various aspects of medicine. The study was conducted on 732 participants including 366 males and 366 females in the age of 18-20-year-old. In addition to the height and weight of the participants, cephalofacial sizes of them were measured and then cephalic, facial, and brain indices were calculated. Among the cephalofacial sizes, cranial length and breadth, cranial circumference, prosopic length and prosopic breadth were significantly greater in males compared to females (P<0.005). Also, volume and weight of brain were significantly greater in male comparing to female participants (P<0.005). The predominant type of head was meso-cephal, and the predominant type of face was meso-prosopic in both sexes.  https://acta.tums.ac.ir/index.php/acta/article/view/5421 https://acta.tums.ac.ir/index.php/acta/article/download/5421/4923

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 277 279 EN Mohammad Ali Mohagheghi Department of Surgical Oncology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Ramesh Omranipur Department of Surgical Oncology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Fereshteh Ensani Department of Pathology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Alireza Ghannadan Department of Pathology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Shahriar Shahriaran Department of Radiology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Farhad Samiee Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Sedighi Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 12 2016 07 02 We present here a 32-year-old male with advanced lately diagnosed, right sided retroperitoneal mass, which had been already treated due to progressive muco-cutaneous lesions clinically consistent with psoriasis, during recent four years. The advanced retroperitoneal mass resected surgically and reported as hyaline-vascular castleman disease with a dense focus of coarse calcification, on histopathology. Association of psoriasis and castlman disease is discussed in this case report.  https://acta.tums.ac.ir/index.php/acta/article/view/4951 https://acta.tums.ac.ir/index.php/acta/article/download/4951/4930

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 249 253 EN Gholamreza Pourmand Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Shahram Gooran Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Reza Hossieni Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Fateme Guitynavard Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Majid Safavi Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Amirsina Sharifi Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ehsan Mokhtari Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 04 22 2017 01 05 Preoperative Gleason score (GS) obtained from Trans Rectal Ultra Sonography (TRUS) is the most common grading system to evaluate the appropriate treatment for patients with clinically localized prostate cancer. But this method showed upgraded and downgraded results in comparison to Gleason score obtained from radical prostatectomy. The current study aimed to determine clinical or pathological variables to reduce the differences between biopsy and radical prostatectomy Gleason scores.Through retrospective review of 52 patients with radical prostatectomy, this study examined the correlations of preoperative Gleason score