1.Long-term results of organ sparing surgical treatments of precancerous cervical lesions
Avirmed D ; Amarsanaa J ; Amarsanaa E ; Angarmurun D
Mongolian Medical Sciences 2010;153(3):31-35
Background: Cervical cancer is the most common cancer in female reproductive system. Since introduction of diagnostic modalities like Pap-tests, the detection pre-cancerous cervical lesions CIN1, CIN2 and CIN3 have increased dramatically. Early detection of pre-cancerous lesions enables performance of organ sparing treatments like LEEP, conization and cryotherapy.Aim: Since there are no studies in the field of organ sparing treatment of cervical cancer, we decided analyze the results of such treatments and calculate the:1. Five year survival of patients underwent organ sparing surgical procedures2. Fertility and reproductive function of these patientsMethod: LEEP (n-63), knife conization (n-22) and trachelectomy (total removal of cervix) (n-15) was performed in women of reproductive age (25-35 years old) at National Cancer Center. The treatment results were followed for 5 years and statistical analysis of survival and reproductive function were analyzed.Results: 87.7% of patients with CINI lesions had LEEP, 12.3 % had knife conization and 0% had trachelectomy. 44.4% of patients with CINI lesions had LEEP, 55.6 % had knife conization and 0% had trachelectomies respectively. For CINIII 6.2% of patients had LEEP, 0% had knife conization and 93% had trachelectomy.We performed organ sparing treatment in 100 patients, out of which 10% had cancer recurrence in LEEP treatment, 9.1% in knife conization and 0% in trachelectomy. Complications of hemorrhage were observed in 14% of patients, cervical tube obstruction in 3% and deterioration of chronic inflammations in 13% respectively. After the organ sparing treatment, menstrual cycle was normal in 75% of the all patients, 65% reached pregnancy. 9.2% of patients who reached pregnancy had stillbirth, 12.3% had abortion, and 78.5% had normal delivery. 80.4% of patients with pregnancy had natural labors, while19.6% of patients had ceasarean sections respectively. Conclusion: in Mongolia, LEEP, knife conization and trachelectomy methods are used since 2000. But the treatment results were not reported so far. 10% of patients treated by LEEP and 9.1% of patients treated by knife conization had tumor recurrence. Thus our treatment efficiency is above 90%. Up to 20% of patients had complications ranging from bleeding to cervical tube obstruction. We conclude that organ sparing cancer treatment allows better QOL (quality of life) for the patients and provides opportunity to have children.
2. LUNG DEVELOPMENT OF LOW BIRTH WEIGHT INFANT
Erdenetsetseg B ; Oyuntsetseg A ; Naranchimeg TS ; Solongo E ; Amarsanaa J
Innovation 2015;9(3):84-85
Neonatal mortality is declining in our FIRST MATERNAL HOSPITAL last few years but the number of preterm babies are increasing. Globally, the main causes of neonatal deaths are preterm birth complications (35 per cent), intrapartum-related complications (complications during labor and delivery) (24 per cent), and sepsis (15 per cent). Together, these three causes account for almost three quarters of all neonatal deaths.We have analyzed 51 medical records who have died in neonatal intensive care unit of Urgoo maternal hospital. 23 questionnaries were analyzed.Premature infant deaths basis of the mother’s birth disorders and mother abnormality. Furthermore, abruption placenta 25.1%, caesarian section 57.1%, hypertonus–21.4%.Prevention of fetal lung under development treatment did not affect 67.8% mortality. Chronic hypoxia is 46.4%, not a day mortality 25.4%, treating was 1–3 days mortality rate is 57.1% is the ability to live shows children die. Compared treated for complications premature infant mortality is 14.2%, causes premature infant mortality is ischemia of brain.Based on the study of maternal hospital mortality in the treatment of premature infants most important thing is CPAP machine it is premature to reduce infant mortality 30.7per cent. Is necessary to use with respiratory distress syndrome infant most important thing is surfactant treatment.
3.Study on peripheral nerves and location of the moxibustion points on vertebra
Choijamts G ; Amarsanaa J ; Uuvanbaatar B
Diagnosis 2024;110(3):30-34
Background:
According to the theory of traditional medicine, there are 19 active veins that pierce down from the brain stem like a root, through which the lhung runs and performs the movement of the body. It is believed that the water veins or white veins exist in all four limbs and solid organs and play an important role in regulating the body's activities by lhung action, while in traditional medicine, the nervous system regulates the activities of all organ systems and ensures the unity of the body's activities and adapts to the external environment. It is considered as a system that creates conditions for the body to interact as a whole, and moxibustion is a treatment that provides beneficial therapeutic changes to the diseased organ through the arc of reflection. Purpose
Purpose :
Establishing importance of moxibustion treatment and coherence of moxibustion points and peripheral nerve fibers.
Survey Methodology:
Data collection method: 31 pairs of neurological terms from European and traditional medical books and texts, judge which organs to go to for innervation and the degree of branching of white veins and summarize the translated material
Comparative method:
To develop results by comparing the data collected from the literature and sources of traditional medicine and European medicine which are the main materials of this research
Research results:
The 13 inner and 6 outer veins from the white vein were filtered from traditional medical commentaries and compared with the peripheral nerve branches of the spinal cord medicine. Compared with nerve, nerve branches from the anterior horn of the spinal cord, including the shoulder, lumbar were compared with 6 fibers running outside, and from the nerve branches from the shoulder where N. medialis, N. radialis, and N. ulnaris nerves were located and branched. According to the comparison of jajid, and Radna veins, the N. femoralis nerve coming from the lumbar with internal branches of the Vugujin vein, and the N. sciaticus or sciatic nerve coming from the lumbar were compared depending on the location of the outer branches of the Vugujin nerve and the end of the branching.
Studied how the nerves branching out from the main 20 junctions located in the posterior confluence of moxibustion therapy, and in doing so, compared the spinal nerve and vegetative nerve branches that exit from the confluence separately and assigned their locations. It is considered the feature of forming a network and separating from it to go to the innervation organ.
Conclusion
The white veins have 13 inner veins, outer veins 6, and the inner veins are 4 lhung veins, 2 heart, 2 in the small intestine, the 4 tripa (tiba) veins are in the lungs, colon, liver, and gallbladder, and the 4 badkan veins are in the stomach, spleen, kidney, bladder veins connects with vesicle of regeneration. It is mentioned in the majority of texts that it will connect with also vesicle of regeneration, but there are differences in two sources saying that 2 veins of lhung 2 in large intestine, 1 vein of badkan connects with lungs, and the 13 branches of white veins correspond to the organs innervating the vagus nerve in the medical theory. The branch of the nerve that connects with the back points of moxibustion is connected with the branch of the nerve from the anterior horn of the spinal cord, the ganglion of the sympathetic nerve from the external horn and its branches. It is considered more important to consider the branching of nodes.
4.Top aspects of strategies on prevention and control of mycotoxins in foods
Tserendolgor U ; Ganzorig D ; Unursaikhan S ; Amarsanaa J ; Gerelmaa L ; Narandelger B ; Odonchimeg M
Mongolian Medical Sciences 2016;175(1):74-82
Afl atoxins are a type of mycotoxin produced by Aspergillus species of fungi, such as A. fl avus andA.parasiticus. Afl atoxins are the most potent hepatocarcinogen and mutagen among mycotoxins.Afl atoxins can effects a wide range of commodities, including crops, cereals, peanuts, maize, beans,and milk and fruits. Thus, we carried out a monitoring surveillance survey on the afl atoxins level in somefood commodities. In early stage of this survey we tested a total of 112 samples of foods including fl our,rice, peanuts, maize, dried fruits, milk, and cereals. According to the preliminary results of this survey,59 (52.7%) samples of foods including fl our, rice, peanuts, maize, dried fruits, milk, and cereals’ sampleswere positive for a total afl atoxins (AFB1+AFB2+AFG1+AFG2). Although levels of total afl atoxins in allsamples were at permissible limits by the commission regulation of EU, the strategies for the preventionand control of mycotoxin are required in Public health system and Agricultural organization in Mongolia.Since afl atoxins is the most well-known mycotoxin ever thoroughly studied and its prevention and controlhas been most successfully practiced in various countries, therefore, this paper will focus on the strategyfor the prevention and control of afl atoxins’s mycotoxin contamination food in Mongolia.
5.Dietary exposure and liver cancer risk assessment of aflatoxins in foods consumed in Mongolian people
Tserendolgor U ; Gerelmaa L ; Ganzorig D ; Amarsanaa J ; Unursaikhan S ; Narandelger B ; Odonchimeg M
Mongolian Medical Sciences 2016;176(2):36-46
This cross-sectional survey was conducted in seven district of the capital city Ulaanbaatar ofMongolia, and border post in Zamiin-Uud, and Altanbulag province from March to December 2015.A total of 380 samples including 70 flours, 114 rice’, 41 various peanuts, 15 maize and maizeproducts, 24 milks, 6 yoghurts, 39 beers, 27 dried fruits and 44 herbal teas were randomly collectedfrom supermarkets, hypermarkets, department stores, factories, and bazaars in Ulaanbaatar city,and Zamiin-Uud, and Altanbulag province.HPLC (High performance liquid chromatography), and enzyme-linked immunosorbent assay (ELISA)were used for the total aflatoxins (B1+B2) and aflatoxin M1 detection.The survey found that (148) 38.9% of all analysed food samples were contained aflatoxins (B1+B2),and aflatoxin M1 were ranging from 0.0094 μg kg-1to 2.4μg kg-1. The levels of aflatoxins (B1+B2)were below the maximum tolerance limit in EU and worldwide regulations. Mean concentrationlevel of aflatoxins (B1+B2) was 0.17 μg kg-1 in all positive samples. Mean daily low and high foodintake were respectively, 63 g and 245 g. Based on the daily food consumption data, estimatedexposure dose of aflatoxins (B1+B2) was 0.16734 mg kg-1bw day-1 in individuals with a daily low foodintake, and 0.65078 mg kg-1bw day-1 in individuals with a daily high food intake (95th percentile). Theexposure dose of aflatoxins from daily high food intake exceeds the estimated provisional maximumtolerable daily intakes, 0.4 μg kg-1 body weight day-1 for adults with hepatitis B (Kuiper-Goodman,1998). Furthermore, estimated excess cancer risk values to liver cancer incidence by ingestion ofthese foods for aflatoxins (B1+B2) and aflatoxin M1were calculated to be 0.0448 mg kg-1bw day-1forindividuals negative for hepatitis Band 1.344 mg kg-1bw day-1 for individuals positive for hepatitis B.Thus, the findings of our survey showed that the potential hazard associated with aflatoxin in foodin Mongolia has not been serious. However, most researchers suggested that no level of aflatoxinexposure is considered safe.Conclusion: Currently, the levels of the total aflatoxins and aflatoxin M1 were lower than the maximumpermissible levels in UE and the USFDA, and worldwide regulations. Currently, estimated exposuredose of the total aflatoxins and M1aflatoxin through daily high food intake was risked in populationwith hepatitis B virus. However, in Mongolian population has not been excess liver cancer risk.
6.Total Aflatoxin Contamination of Various Peanuts
Gerelmaa L ; Tserendolgor U ; Burmaajav B ; Ganzorig D ; Amarsanaa J ; Unursaihkan S ; Odonchimeg M ; Narandelger B
Mongolian Medical Sciences 2016;178(4):51-57
ObjectiveThis study aimed to assess the prevalence of the total aflatoxin in peanuts, and their concentration level.Material and MethodThis cross-sectional survey was conducted in seven district of Ulaanbaatar, the capital city of Mongolia,from March to December 2015.A total of 41 samples of peanuts were randomly collected from the survey area, from March to December2015. An ELISA test was used for detection the total aflatoxins(B1+B2). The relative humidity andtemperatures of the storage areas were measured at the time of sampling the peanut.ResultsThe Frequency statistics analysis showed that 61% of all analyzed peanut samples had detectablelevels of the total aflatoxinat 0.05 μg kg-1. The prevalence of samples contaminated with the totalaflatoxins(B1+B2) were higher among analysed samples of the tree nuts, peanuts imported from China,and canned nuts (P<=0.01). Levels of the total aflatoxins were less than the maximum permissible limitsof 15 μg kg by the regulation of European Union and worldwide. The mean values of the storage relativehumidityat the time of sampling peanuts were higher than the recommended storage relative humidity incorn cereals (<13%). Furthermore, the mean values of the storage temperatures at the time of samplingpeanuts were higher in groundnut peanuts, cedar’s nut and peanuts imported from China than therecommended level of the storage temperature in corn cereals (10°C-21°C).Conclusion:The prevalence of the total aflatoxin in peanuts was higher. The level of the total aflatoxins were less thanthe maximum permissible limits of 15 μg kg-1 by the regulation of European Union and worldwide. Thestorage relative humidity and temperatures of peanuts may encourage the growth of fungi-producingaflatoxins. Thus, a national strategy for the elimination of aflatoxin in foods is needed in Mongolia.
7.Outcomes of Mandibular Reconstruction Using Free Flap After Head and Neck Cancer Resection and Approaches for Improvement
Unubold E ; Denis S ; Odontungalag Ts ; Yanjinlkham M ; Amarsanaa G ; Tsetsegkhen N ; Gantsetseg G ; Battsengel B ; Gan-Erdene B ; Bat-Erdene M ; Bulganchimeg S ; Ganbaatar Yu ; Odkhuu J ; Enkh-Orchlon B
Mongolian Journal of Health Sciences 2025;87(3):82-89
Background:
Reconstruction of mandibular and maxillary defects resulting
from malignant tumors has remained a complex challenge in recent years. Defects
caused by tumors—as well as trauma, inflammatory diseases, and congenital
anomalies—lead to impaired essential functions such as mastication,
swallowing, and speech. Prior to the 1950s, reconstruction of maxillofacial
hard tissue was not commonly performed. Instead, metal plates were used to
reestablish bony continuity, and surrounding tissues were utilized to close soft
tissue defects, without effectively restoring function.
With modern advances in three-dimensional (3D) virtual planning, it is now possible
to accurately plan free bone flaps for reconstructing jaw defects. During
surgery, manually bending reconstruction plates to fit donor bone precisely is
often not feasible. Preoperative 3D planning allows for precise fabrication of
surgical guides and fixation plates, improving accuracy and significantly reducing
operative time. Additionally, incorporating dental implant planning into
the reconstruction process facilitates restoration of both structural and functional
outcomes.
Aim:
To evaluate the outcomes of mandibular defect reconstruction using
scapular free flaps in Mongolia and explore potential approaches to optimize
the technique.
Materials and Methods:
This was a case study series. Data from reconstructive
surgeries performed at the National Cancer Center of Mongolia, Central
Dental Hospital, and the Mongolia-Japan Hospital were collected. Variables
included patient age and sex, etiology of the mandibular defect, size of the
scapular bone segment, operative time, ischemia time of the free flap, number
of vascular anastomoses performed, and pedicle length.
For 3D planning, CT scans of the patient's head and lower limb (slice thickness
<1 cm) were used to generate 3D models via the 3D Slicer software. Cutting
guides for the mandible and scapula (ASIGA), as well as the reconstruction
models (AMS), were printed using a 3D printer.
Results:
A total of 400 free flap reconstructions were performed during the
study period. Of these, 29 cases involved reconstruction of mandibular defects
using scapular free flaps. The mean age of patients was 40.0 ± 18.3 years,
with 52% (15 patients) being female. The etiologies of the defects included
malignant tumors (13 cases, 45%), benign tumors (6 cases, 21%), and pre-existing
defects (10 cases, 34%).
In one case, tumor resection and mandibular reconstruction were performed
using 3D planning. The total operative time was 9 hours and 30 minutes, and
the ischemia time was 2 hours and 40 minutes.
Conclusion
Between 2012 and 2025, a total of 29 mandibular reconstructions
using scapular free flaps were performed in Mongolia. Traditional reconstruction
methods were associated with prolonged ischemia time. The use of
3D surgical planning has shown potential in significantly reducing ischemia
time and improving surgical outcomes.