1.Mitotic activity in uterine leiomyoma
Jargalsaikhan B ; Yanjinsuren D ; Tegshjargal S ; Erdenetsogt D
Mongolian Medical Sciences 2014;167(1):27-29
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
2.Diagnostic value of tumor suppressor P53gene and proliferative Ki67 marker expression in uterine leiomyomas
Jargalsaikhan B ; Yanjinsuren D ; Galtsog L ; Erdenetsogt D ; Tegshjargal S
Mongolian Medical Sciences 2014;169(3):33-37
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.
3.Issue in late diagnosis of gastric cancer
Tulgaa L ; Ganchimeg D ; Chinzorig M ; Erkhembayar E ; Tegshjargal B ; Nasanjargal T ; Dashmaa A ; Bayar D ; Tsegmed S ; Bolor-Erdene T ; Otgonbayar I ; Batbold B
Mongolian Medical Sciences 2019;187(1):42-47
Introduction:
Gastric cancer is still one of the most leading causes of mortality in the world. The highest mortality rate of gastric cancer is estimated in Mongolia. South Korea and Japan, where leading the incidence of gastric cancer, mortality rates are observed in 51th and 31nd rank respectively. In Mongolia, gastric cancer is the second leading site, after liver cancer.
Goal:
We aimed to determine the cause of late diagnosis of gastric cancer and to evaluate supply of upper endoscopy devices and human resource for gastric cancer in the general hospital of provinces and districts.
Materials and Methods:
In this study, 84 patients suffering from gastric cancer (42 patients in III, IV TNM stage; 42 patients in I, II TNM stage)were investigated in National Cancer Center, Mongolia. A survey questionnaire which included age, gender, education, income, risk factors and clinical questions was detected from all patients. And we conducted study of supply of upper endoscopy devices and human resource for gastric cancer in general hospitals of from 21 provinces and general hospitals of 6 districts by questionnaire.
Results:
Seventy three(86.9%) patients were over 50 years old and the highest rates of gastric cancer were in group of 61-70 years (40.5%). From the results, the reason to visiting hospital was significantly different between two groups. 55.1% of patients suffering from early-stage gastric cancer were voluntarily diagnosed by upper endoscopy. In contrary, 55.8% of patients suffering from late-stage gastric cancer have visited the hospital due to worsening symptoms or dysphagia and vomiting. Factors such as age, gender, education, employment status and income had no significant effect on late diagnosis of gastric cancer. In totally 24(89%)general hospitals out of 27 had upper endoscopy devices and 22 (81.5%) hospitals had endoscopist. Although 75% of total general hospitals conduct
annual cancer screening, 64% of them do not perform the endoscopy in annual screening.
Conclusion
In our country, late diagnosis of gastric cancer is related to the attitudes of patients for preventing and screening disease. Therefore, it is important to improve the health education of the population and to develop healthy, right attitudes and practices. And the study revealed that general hospitals have insufficient for upper endoscopy devices and human resource.
4.Study of influencing factors of the maternal, infant and placenta weight
Jargalsaikhan B ; Otgonbayar L ; Gandolgor B ; Uurtiintuya B ; Oyunsuren E ; Otgontsetseg B ; Tsolmon G ; Amarjargal B ; Tegshjargal S
Mongolian Medical Sciences 2017;181(3):10-14
Introduction :
In the last years other country scientists told about not only determine infant weights, need to interest
correlation between maternal weight, height and infant weight. In our country few research articles posted
about anthropometry of obstetrics and gynecology. Our study aim is determine maternal weight, infant
weight, placenta weight and assess factors affecting roles on maternal story of “Amgalan” Maternity
Hospital in 2014-2015.
Goal:
The current study aimed at assessing maternal weight, infant weight, placenta weight and evaluating the
effect of factors leading to it.
Materials and Methods:
The data was already collected from “Amgalan” Maternity Hospital using maternal history and record and
it was collected measuring general physical characteristics such as body weight and height, infant weight,
placenta weight and body circumferences. We used retrospective method and collected statistical data
was analyzed using SPSS 21.0 software.
Results:
Of total 964 study participants aged 18-45. The average age of participants was 29.6 ± 5.8 years old and
49.7% (n=479) was working during pregnancy, 45.7% (n=441) hadn’t works, 4.6% (n=44) was student.
The average weight of mothers was 75.4±11.5, weight of infants was 3439.5±456, weight of placenta
was 685±129. The following factors affected maternal and infant weights: lower education, working, early
and late pregnancy complication. Maternal weight had a low direct correlation with infant weight (r=0.267,
p<0.01) and placenta weight (r=0.208, p<0.01). In our study maternal height had a low direct correlation
with infant weight(r=0.173, p<0.01) and infant weight had a moderate direct correlation with placenta
weight (r=0.376, p<0.01).
Conclusions
1. The average maternal weight was 75.4±11.5, infant weight was 3539.5±456, placenta weight was 685±129.
2. The following factors affected maternal and infant weights: lower education, working status, early and late pregnancy complications.
3. Maternal weight had a little direct correlation with infant weight (r=0.267, p<0.01) and placenta
weight (r=0.208, p<0.01).
5.The incidence of stomach and esophageal cancer in Mongolia: a data from 2009-2018
Tulgaa L ; Nasanjargal T ; Ulziisaikhan B ; Ganchimeg D ; Tegshjargal B ; Tsegmed S ; Batbold B
Mongolian Medical Sciences 2020;192(2):27-36
Introduction:
Cancer is a major public health issue both in Asia and in Mongolia. The most prevalent cancer related
deaths in Mongolia are registered for the stomach, esophagus and liver.
Purpose:
We aimed to investigate the incidence of stomach and esophageal cancer in Mongolian population.
Materials and Methods:
Epidemiologic data were collected from 2009 to 2018 through the oncology cabinet of all hospitals and
medical centers from all provinces, soums (the smallest unit of provinces) and major districts of the
capital city. The incidence of stomach and esophageal cancer was calculated by appropriate methods
and it was presented by ArcGIS Pro 9.2 software. A P-value of less than 0.05 was considered to be
statistically significant and based on two side hypotheses. All calculations were performed in the IBM
SPSS Statistics software. The study design in concordance with ethical guidelines was approved
by the Ethics Committee of Ministry of Health Mongolia. All clinical investigations were conducted
according to the principles laid down in the Declaration of Helsinki.
Results:
The incidence of esophageal cancer in last ten years (2009-2018) was 10.09 in 100000 populations
and the highest incidence were registered in Uvs (38.13), Bayan-Ulgii (24.15) and Zavkhan (18.18)
provinces, respectively. The incidence of stomach cancer was 20.33 in 100000 populations and the
highest incidences were registered in Uvs (53.01), Khovd (46.02) and Darkhan-Uul (40.50) provinces,
respectively.
Conclusion
1. Incidence rates for esophageal and stomach cancer are high among the Mongolian population.
In the last decade, the incidence of esophageal cancer had not decreased significantly, but it’s
constant.
In our study, the esophageal cancer incidence was 10.09 per 100’000 people, which includes
one of the high incidence rate countries according to the WHO classification. More than 10
aimags incidence rate of esophageal cancer was higher than the National average. Most of them have occurred in the western region of the country. Most of the Western, some of Khangai and
Eastern soums have had the highest incidence of esophageal cancer what we have shown on
the mapping.
2. The incidence rates of stomach cancer were registered as 20.33 per 100’000 people in the last
10 years at the national level. It has shown that according to the WHO classification, our country
is also one of the countries with the highest incidence of stomach cancer. The stomach cancer
incidence trend was increased in the last 10 decades. Therefore, some of aimag’s soums has
included the highest rate classification. In addition, some soums in the Western, Khangai, and
Eastern aimags had have a very high incidence of stomach cancer.
According to results in the above, the nationwide targeted prevention program is needed
especially where the highest incidence rates. Also there is a lack of cooperation between national
organizations to accurate registration of gastrointestinal cancer and to fight against these harmful
cancers.
6.The effect of nutrition risk factors for esophageal and gastric cancer
Enkhmyagmar D ; Tulgaa L ; Nasanjargal T ; Batbold B ; Ganchimeg D ; Tegshjargal B ; Bolor-Erdene T ; Bayar D ; Erkhembayar E ; Chinzorig M ; Dashmaa A ; Tsegmed S
Mongolian Medical Sciences 2019;187(1):80-86
Gastric and esophageal cancer is a significant global health issue. The epidemiology of these tumors has significantly increased over the past several years especially in developing and developed countries. Many dietary exposures have been proposed to protect against or increase risk for esophageal and gastrointestinal (GI) cancers, including poor diets, foods, individual nutrients, methods of food preparation, and habits of consumption. Overweight/obese status is associated with an increased risk for many cancer types such as esophageal, gallbladder, kidney, pancreatic and
gastric cancer. The association between obesity and cancer is strong. Nowadays there is a recognized decrease in incidence and mortality of distal gastric cancer and an increase in incidence and mortality of proximal esophageal cancer. In Mongolia, gastric cancer is the second most common cancer in males and the third most common in females. It is very important to understand how diet and nutrition affect to gastric and esophageal cancers. In this review we will discuss the effect of diet in locally advanced gastro-esophageal cancer. Although we tried to conclude all published articles about gastric and esophageal cancers in Mongolia.
In this survey, is considered dietary risks into 5 groups as following;
• Insufficient nutrition education(don’t know food and nutrients significance and food hygiene, don’t know right consumption of food)
• Bad habits (hot tea and meals, salty tea and food, low consumption of fruits and vegetables, sometimes eating breakfast, most of daily energy of food in the night, high amount of sugar, a drink of caffeine, overweight and etc.)
• Food processing technology (such as overcooking, pickling, preserving, frying, excessive salt in tea fried and etc).
• Chemical contaminants in food products (various inorganic fertilizers, heavy metals and etc.)
• Household economic capacity is influencing
Diet can be used as a tool to evoke the positive/desirable biological responses of an organism aiming to maximize health and protection against diseases (chronic/non-communicable diseasesparticularly cancer) by mostly means of prevention.