INTRODUCTION:Uterine leiomyomas are the common smooth muscle tumors of female genital tract. Usually theirdiagnosis poses no problem. On the other hand leiomyosarcomas are highly malignant tumors.Distinction between the two poses no problem if the leiomyosarcoma shows significant dysplasia,however at times it may become a serious problem to differentiate between leiomyoma and well–differentiated leiomyosarcoma. Under such circumstances the mitotic count per 100 high powerfields considered by many as the most important criterion of distinction.MATERIAL AND METHODS:To investigate the role of mitotic activity in the growth of uterine leiomyomas, the mitotic count per100 high-power fields and the relation of this to the patient’s age (30 to 54 years) were examined intissue sections of leiomyomas from 130 surgically removed leiomyomatous uteri.RESULTS:The mean mitotic count in submucosal uterine leiomyoma was significantly higher (42.3%) than thatof the other location such as intermural and subserosal leiomyoma. We found the highest mitoticcount in a leiomyoma at the late reproductive aged women (46.1%) at early secretory phase. But therewas not a statistical correlation between women’s age and mitotic activity of uterine leiomyoma.CONCLUSION:Increased mitotic activity in leiomyomas under the late reproductive aged women suggests that thegrowth of these tumors is affected by progesterone level

Aim was to investigate expression of tumor suppressor P53 gene, proliferating Ki-67 protein inordinary and proliferating uterine leiomyomato establish possible usefulness of these two parametersin distinguishing between ordinary leiomyoma and proliferating leiomyoma. Retrospective study of49uterine leiomyoma (25 ordinary leiomyoma, 24 proliferating leiomyoma) technically acceptable foranalysis from years 2010–2013 department of Obstetrics and Gynecology and department of Pathology,Mongolian National University of Medical Science, Ulaanbaatar, Mongolia.MethodAll tissue specimens were obtained from surgically removed tumors. Tissue was fixed in formalinand cut to thickness of 5 mm from paraffin-embedded blocks. All haematoxylineosin slides and allimunohistochemical slides for each case were reviewed by two experienced pathologist.ImmunohistochemistryParaffin-embedded tumor sections were deparaffinized and stained in automated platformDakoCytomationusing monoclonal mouse anti-human Ki-67 antigen (Dako,Glostrup, Denmark), monoclonal mouse anti-humanP53 protein (Dako, Glostrup, Denmark).Immunohistochemicalanalysis of P53 and Ki67 expression was performed. Every nuclei stained brown,regardless of shade intensivity, was considered positive. The interpretation of immunohistochemicalstaining was expressed as number of positive cells in 100 cell count in most active area of the slide.Non-parametric analysis of variance Kruskal-Walistest was performed.P53 expressionExpression of P53 was negative in 24/24 ordinary uterine leiomyoma, 2/10 mitotic activity leiomyoma,11/15 cellular leiomyoma. Expression of P53 in 1–10% of cells showed 3/10(30%) mitotic activeleiomyoma and 1/15(6.6%) cellular leiomyoma. Expression in 10-70% of cells showed 5/10(50) mitoticactivity leiomyoma, 3/15(20%) cellular leiomyoma. A significant difference in expression of P53 wasseen between ordinary and proliferative (mitotic activity and cellular) uterine leiomyoma (p<0.007, Table1).Ki-67 expressionExpression of Ki67 was negative in 20/20 (100%) ordinary leiomyoma, 4/11(36.3%) mitotic activityleiomyoma and 7/18(38.8%) cellular uterine leiomyoma. 1–10% of cells were positive in 4/11 (36.6%)mitotic activity leiomyoma, and 5/18% cellular leiomyoma. Expression was positive in 10-70%of cellsof 3/11(27.2%) mitotic activity leiomyoma and 6/18(33.3%). Statistically significant differences in Ki67expression was found between ordinary leiomyoma and proliferating leiomyoma (p<0.014, Table 2) andbetween LM and LMS (p=0.000, Table 1).Conclusion:The findings of our study in concordance with other study results are helpful information establishingmore diagnostic criteria and parameters for diagnosis in doubtful cases between two entities.Immunoassaying for Ki-67 and P53 are such parameters. The panel of their expression in specific caseeases diagnosis.

Goal: The purpose of this study is to identify issues of current situation of the health information system in the health care facilities of Mongolia.Materials and Methods: A total 362 users as hospital directors, physicians, nurses, statisticians and IT workers of 105 health care facilities at primary, secondary and tertiary level participated in this study. Data collection methods were generated using a combination of questionnaires and in-depth interview of the users. The statistical analysis was carried out using the SPSS. Outcome measures were calculated with 95% confidence intervals (CI).Results: The survey results were shown that a vertical health information flow regulates in the health sector, internal networks set up and H-info 2.0 software as routine data processing and insurance claims are used in the hospitals of Mongolia. Regarding of e-health software as Computerized Physician Order Entry (CPOE), Drug Information System (DIS), Laboratory Information System (LIS) and Radiology Information System (RIS), 82.6% of the health care facilities used only CPOE. There 50% of the existed e-health software is not integrated in the health care facilities. In the data management, 27.0% of the health care facilities that used e-health applications had no backup solution. 45.5% of total users said that the information technology human resource is insufficient. 70.0% of users responded as there did not any continues training program in health information technology. The study was determined lack of functions and difficulty of using the existed software and inadequate software operation and not user-friendliness are the causes of the most of dissatisfactions. Conclusions: A vertical health information flow, internal networks, routine statistic processing set up and mainly CPOE used in the health care facilities. However there is no integration of e-health software and lack of its capacity. It is required modern integrated health information system in the health sector of Mongolia.

Introduction: Pancreatic cancer in young patients is usually correlated with chronic alcohol consumption and hereditary factor. Chronic pancreatitis, pancreatic trauma, pancreatic cyst, alcoholism, and diabetes mellitus are the most clearly established etiological factors (T.Y Flanders., W.S Foulkes., 1996). The cancer was located to the pancreatic head in 75% to the body in 15-20% and to the tail in 5-10% of cases (A.E Richard., 2005). Goal: Determination of the US signs in pancreatic cancer and establishment standard (control) US diagnostic criteria. Objectives: 1. To reveal direct and indirect US signs of pancreatic cancer. 2. To establish standardized US diagnostic criteria. Materials and Methods: A prospective study was carried out in 35 patients with pancreatic cancer in a 4 years period between 2006-2010 (Shastin Central Hospital, Achtan Clinical Hospital). To each patient has being filled special investigation chart. Diagnosis was confirmed on the result of physical examination, laboratory investigation, abdominal conventional radiography, upper gastrointestinal contrast radiography, CT, MRI, ERCP and biopsy. The results of the measurements were compared with the standardized control evaluation of Mongolian people (Ts.Badamsed.B.Tserendash). Results: Our sample represents US signs in 35 patients with pancreatic cancer. On the basis of our study US sign were divided into two categories: direct and indirect signs. Direct signs: a) irregular shape, b) irregular tumour edge, c) hypodensity, d) tumour size more than 2.1cm, e) different location. Indirect signs: a) CBD distends, b) gallbladder distends, c) intra hepatic bile duct distend, d) pancreatic pseudo cyst, e) near-aortic limp node enlargement, f) splenomegaly. We consider that the upper mentioned US abnormality can be as control standard criteria for the US diagnosis of the pancreatic tumour. According to the study of V.N.Demidov and G.P.Sidorov (1987), the pancreatic cancer is located to head in 50-80%. In our series it was about 45.7%± 8.4. Irregular tumour shape in 60.0%±8.3, tumour hypodensity 80.0%±7.2, irregular tumour edge 68.6%±7.8, tumour clear definition 71.4%±7.6 which are the same with N.M. Mukharllyamov (1987). Conclusions: 1. Were described direct and indirect US diagnostic signs in pancreatic cancer 2. The tumor location, shape, size, edge, consistency, intra and extra hepatic bile duct distend, gallbladder distend, near-aortic limp node enlargement are the basic control criteria for the diagnosis of pancreatic cancer.

PurposeThe aim of our study is to investigate the relationship between cognitive status, depression level,functional status and quality of life in elderly people living at home and in Batsumber.Methods158 voluntary elderly subjects, older than 60 ages were included in the study. The data was obtained byface to face interviews. The questionnaire covered socio-demographic characteristics, administrationof the standardized Mini mental test (SMMT), Geriatric Depression scale (GDS), Lawton instrumentalactivities of daily living (IADL) scale and World health organization Quality of life instrument-olderadults module (WHOQOL-OLD). Data analysis was performed using SPSS 22 software.ResultsThe living at their own home subjects (77.4%) had a high cognitive level and the living in nursing homesubjects (88.2%) low cognitive level. In both groups appeared in high levels of depression. Therewas a positive correlation between IADL, cognitive status and quality of life (p<0.05) and a negativecorrelation between cognitive status, quality of life and depression status.Conclusion: Our results suggest that elderly are more susceptible to the risk of developing psychiatricproblems especially depression. And this study indicated importance of the relationship betweenfunctional level, cognitive status, depression level and quality of life of elderly people living at homeand in Batsumber.

Purpose: The etiology of Legg-Calve-Perthes disease (LCPD) remains unknown until today. A few studies have suggested passive smoke inhalation may be a risk factor, although the association is not confirmed and a causal relationship has not been established. Most mothers who smoke during pregnancy may continue smoking after giving a birth, it would be difficult to determine to what extent passive smoke inhalation adds to the risk of LCPD in these children. The causes of Legg-Calve-Perthes disease are largely unknown, but this pediatric disease seems to result from interruption of the blood supply to the proximal femur and is considered a vascular disease. Because maternal smoking during pregnancy influences fetal development and is associated with cardiovascular diseases in offspring, we hypothesized that this exposure and passive Tabaco smoke exposure are risk factors for Legg-Calve-Perthes disease and also investigated other markers of impaired fetal development and early-life exposures. Methods: We prospectively recruited total 96 patients, among those 32 patients with LCPD as a case group and 64 patients attending the hospital for other orthopedic complaints as control group. Conditional logistic regression was used to assess the association between the exposures and risk of LCPD. Results: The main risk factors for LCPD were family background, indoor use of a wood stove, having a family member who smoked indoors (passive smoke) and smoke during pregnancy. Children from the middle socioeconomic group appeared to be at a greater risk of developing LCPD. Conclusions This study provides further evidence that environmental tobacco smoke is associated with an increased risk of LCPD. Family background and exposure to wood smoke also appears to be risk factors. Maternal smoking during pregnancy and other factors indicated by impaired fetal development may be associated with an increased risk of Legg-Calvé-Perthes disease. However, it remains unclear why there are profound differences in the incidence of the disease between regions when the prevalence of smoking is comparable and why bilateral involvement is infrequent, and it needs further study.

Middle aortic coarctation (MAC), a variantof middle aortic syndrome, is a rare entity withonly ~200 cases described in the literature.It classically presents with early onset andrefractory hypertension, abdominal angina,and lower extremity claudication(1).A 30 years-old woman, Her systolic bloodpressure measures 180-200mm Hg and diastolicpressures measure 70mm Hg in both arms,lower extremity pressures are approximately70mm Hg. Her bilateral femoral pulses andpedal pulses are nonpalpable, but present onDoppler exam and CT-Angiography.We prepared diagnostic of CT-Angiographyand Aortography before operation. Wesuccessful operated abdominal aorticcoarctation by “Silver graft” Aortoaortic bypasson the middle aortic, left nephrectomy.She was discharged home on postoperativeday 7. Post operation is good. We werecontrolled CT-Angiography.

Background: Lower extremity arterial diseases are chronic stenosis of the artery and occlusive arterial diseases, which are commonly caused by atherosclerosis. Prevalence of lower extremity arterial diseases has positive proportional relationship with age of the patients. Furthermore, prevalence of lower extremity arterial disease is 16% among the males over the age of 60, whereas prevalence among same aged woman is 13%. Among the age group of 38 to 59 age, 60 to 69 age and 70-82 age group, prevalence of lower extremity arterial disease was 5.6%, 15.9%, and 33.8%, respectively. Goal: Identifying lower extremity arterial occlusive disease and chronic stenosis of arteries by CTA-TASC classification of aorta-iliac and femoral popliteal lesions. Obiective:
1. To identify age and sex of the patients with lower extremity arterial occlusive disease and chronic stenosis of arteries.
2. To identify lower extremity arterial occlusive disease and chronic stenosis of arteries by CTA-TASC classification of aorta-iliac and femoral popliteal lesions. Material and methods: Study sample consisted of 237 patients, who were diagnosed with lower extremity arterial occlusive disease and chronic stenosis of arteries from 2019 to 2020 at reference centre on Diagnostic Imaging na after R.Purev State Laureate, People’s physician and Honorary professor of the State Third Central Hospital. Computed angiogram images of lower extremity arteries were examined. Contrast agent “Ultravist” was pumped by automatic syringe. Lower extremity arterial occlusive disease and chronic stenosis of arteries are categorized by CTA-TASC classification of аorta-iliac and femoral popliteal lesions. The youngest participant was 20 years old and the oldest participant was 76 years old. Common statistical measurements such as means and standard errors were calculated. Probability of results were checked using Student’s test. Results: We have found following results: 185(78.1%±3.0) cases out of 237 diagnosed patients with lower extremity arterial occlusive disease and chronic stenosis of arteries are males and 52(21.9%±3.0) cases are female. Distribution of lower extremity arterial occlusive disease and chronic stenosis of arteries by the age group of patients are: up to 20 years of age is 3 (1.3%±0.7), 21 to 40 years of age is 14(5.9%±1.5), 41 to 60 years of age is 86(36.3%±3.1) and over the age of 61 is 134(56.5%±3.2). It is statistically highly significant that experiencing lower extremity arterial occlusive disease and chronic stenosis of arteries among the age group of over 61(P<0.001).
The result of lower extremity arterial occlusive disease and chronic stenosis of arteries by the CTA-TASC classification of aorta-iliac and femoral popliteal lesions are: CTA-TASS аorta-iliac lesions A-16(6.8%±1.8), B-8(3.4%±1.2), C-12(5.1%±1.4), D-41(17.3%±2.5), CTA-TASS femoral popliteal A-41(17.29%±2.5), B-53(22.36%±3.6), C-47(19.83%±2.6), D-96(40.5%±3.2), respectively. Conclusions
1. Lower extremity arterial occlusive disease and chronic stenosis of arteries occurs 46.5% over the age of 60 and 78.1% of the patients are males.
2. Following two categories have identified more than the rest, 17.3% CTA-TASC classification of аorta-iliac lesions, type D and 23.3% CTA-TASC classification of femoral popliteal lesions, type D.

Introduction: In 2018, the overall colorectal cancer (CRC) incidence rate was 3.6%, according to the National Cancer Center of Mongolia (NCCM), and the incidence of colorectal cancer has increased slightly in recent years. According to cancer stages, late stage cancer has a 5-year survival rate of 51%, while early stage cancer has a 5-year survival rate of 79%. The overall survival rate of colorectal cancer in Mongolia has not been studied in precisely. In Asia, the 5-year survival rate for colorectal cancer was 60%. Therefore, this study investigated the colorectal cancer survival rate and prognostic factors at NCCM. Methods: A total of 108 patients diagnosed with CRC at NCCM’s General Surgery Department from 2013 to 2015 were used in this retrospective cohort study. The Kaplan-Meier method was used to develop the survival graphs, which were then compared using the Log-rank test. Results: The median survival time was 42 months, with a 95% CI (38.55-45.66). A 5-year period, the overall survival rate for CRC was 61.2%. Survival rates at the I, II, III, and IV stages were 100%, 75%, 65.4%, and 13.5%, respectively. There was a significant difference in CRC survival rates across all stages (p=0.0001). There was a statistically significant difference in determining the relationship between adjuvant chemotherapy and survival rate (p=0.0003). Conclusion The outcome of the surgery is determined by the CRC stage. The postoperative survival rate (61.2%) is directly related to tumor stage, peripheral glandular metastasis, distant metastasis, and chemotherapy effects.

Background: The American Heart Association estimates that more than 1 million people die each year from acute coronary heart disease and half a million from acute coronary syndrome, and that $ 115 billion a year is spent on diagnosing and treating coronary heart disease [Word Health Organization, 2013]. Goal: In this study we aimed to using coronary computed tomography angiography (CCTA) to diagnose unstable plaques in coronary artery disease. Material and methods: From 2018 to 2021, we performed a coronary computed tomography angiography (CCTA) scan with a Philips Ingenuity 64-slice computed tomography (64 MD-CT) device and examined 47 patients diagnosed with unstable coronary artery disease at the Reference centre on Diagnostic Imaging named after R.Purev State Laureate, People’s physician and Honorary professor of the State Third Central Hospital.
Common statistical measurements such as means and standard errors were calculated. Probability of results were checked using Student’s test. Result: In studying signs of coronary computed tomography angiography (CCTA) to diagnose unstable plaques in coronary artery disease that coronary artery diameters more widening to compared healthy artery 16(34.0%±6.9), low density sites clarify in plaque (lower than +30HU)- 14(29.8%±6.7), small calcification detect in plaque 36 (74.5%±6.4), ring liked additional density (lower than +130 HU) sees in edge of plaque (Halo sign)-9(19.2%±5.8), plaque edge roughness, erosion liked changes- 18 (38.3%±7.1), rupture of intima (dissection)- 8(17.0%±5.5). Conclusion We detect that computed tomography angiography (CCTA)’s specific signs of unstable plaque of coronary artery disease are coronary artery diameters widening, low density sites clarify in plaque (lower than +30HU), small calcification detect in plaque, ring liked additional density (lower than +130 HU) sees in edge of plaque (Halo sign), plaque edge roughness, erosion liked changes and rupture of intima.