1.Immunohistochemical diagnostics in stomach cancer
Gerelee Kh ; Avirmed D ; Tuul M ; Batbold Ts
Mongolian Medical Sciences 2014;169(3):73-80
Although stomach cancer immunohistochemistry is similar tothe immunohistochemistry of other organ, it
has great impact on diagnosis and treatment, such as its ability to reveal whether the cancer is primary
or metastatic and which treatment model would be more effective in individual case.
Lately, CK7, CK20 and CDX-2 immunohistochemical markers are commonly used in stomach cancers.
Stomach cancer prognosis is different in each patient, depending on several factors, patients’ health
status, cancer cell differentiation, and cancer cell growth. To evaluate these factors,immunohistochemic
al analysis is more effective and for this purpose they use Ki-67, CD 34, BCL-2, p53, Cyclin D1, andHer-
2 markers.The evaluation of HER-2 expression should be carefully carried out, as following:
1. HER-2 expression should be evaluated on minimum 5 positive stained cells. The evaluation criteria
aremicroscopic magnification and cytoplasmic membrane-stained pattern.
2. Other than the membrane-stained pattern must be excluded. HER2 gene evaluation (FISH) can
confirm the HER2 IHCexpression.
3. Usage of FDA approved antibody (4B5) has the advantageof increased sensitivity.
4. The algorithm for the evaluation of HER-2 expression used for breast cancer has 50% possibility of
false negativity if it is used for stomach cancer. Therefore, it is needed to beevaluated with another
specific algorithm. Because HER-2 2+ and 3+ cases can improve outcome with usingTrastizumab
treatment.
2.Result of stereometric research study of cardiomyocytes in cardiovascular diseases
Tuul G ; Odgerel TS ; Gerelee KH ; Batbayr KH ; Lhkaga L ; Zevgee T
Mongolian Medical Sciences 2011;172(2):27-32
In 2006, by the news of National Center of Health Development, morbidity of cardiovascular disease was 501.84 per 10000 people. It’s increased by 2 times than over 10 years.Goal: To study and to determine stereometric research, mathematic modeling and histologicalcharacteristic on cardiomyocyte of arterial hypertension (AH), acute myocardial infarction (AMI) and chronic rheumatoid fever (CRF).Materials and Methods: It was prepared sections for histometric materials from muscular of left ventricle. Linear measurement and number of cardiomyocyte per area of materials were carried out by computermicroscope “Leica” with program Diskus 3.2 version from German. On linear measurement of AH, AMI and CRF were processed by mathematic modeling. On ratio of cytoplasm and nucleus and histological characteristics were analyzed by chi-square testResults: Results of stereometric research on cardiomyocyte On AH volume of cardiomyocyte was 5788.22±40.99mkm3, volume of the nucleus - 806.47±12.86mkm3, ratio cytoplasm and nucleus 1:7 and number of cells per area was 10.On AMI volume of cardiomyocyte was 3240.94±48.96mkm3, volume of the nucleus - 693.85±12.76mkm3, ratio cytoplasm and nucleus 1:5 and number of cells per area was 16. On CRF volume of cardiomyocyte was 5341.06±63.4mkm3, volume of the nucleus - 801.5±15.96mkm3, ratio cytoplasm and nucleus 1:7 and number of cells per area was 11. In comparatively healthy condition at 20 to 30 years old population of Mongolia the volume of cardiomyocyte was determined 1063.17mkm3, volume of nucleus 406.69mkm3, ratio cytoplasm and nucleus 2.6 and number of cells per area was 31. Result of histological research of myocardial muscle. By the research of the difference between histological characteristic was confirmed that all of this characteristics have real main difference. Conclusions: It was confirmed difference with statistical probability by that determined volume of the cardiomyocyte 5788.22±40.99mkm3 in AH, 3240.94±48.96mkm3 in AMI and 5341.06±63.4mkm3 in CRF. Quantity of cells per area was in AH - 10, in AMI – 16 and in CRF 11, but in comparatively healthy condition it was 31.
3.Results of research study of mathematic model on hepatocytes in Mongolians
Tuul M ; Odmaa B ; Gerelee KH ; Batbayr KH ; Suhbaatar TS ; Amgalanbaatar D
Mongolian Medical Sciences 2011;172(2):36-40
Background: Research of histo and cytometry in comparative healthy and pathological condition is not so much in our country. Therefore, it is making a demand to do stereometrical research study on tissues, cells and nucleus.Goal: To study and to determine stereometrical indices, mathematic model of hepatocytes and nucleus in condition of comparatively healthy, acute intoxication, chronic inflammation and cancer of Mongolians.Materials and Methods: It was prepared sections for histometric materials. Linear measurements of hepatocytes and nucleus were carried out by computer-microscope “Leica” with program Diskus 3.2 version from German. On linear measurement in condition of comparatively healthy, acute intoxication, chronic inflammation and cancer were processed by mathematic modeling.Results: Volume distribution of hepatocyte’s cytoplasm χ2st=15.51>χ2 F=4.31; (P<0.001), and hepatocyte’s nucleus χ2 st=12.59>χ2 F=10.74 in comparatively healthy (normal) conditions pursues normal distribution formula, however, the volume of hepatocyte’s cytoplasm and nucleus follows Maxwell formula of abnormal distribution χ2 st=23.68>χ2 F=10.44; (P<0.001), χ2 st=15.51>χ2 F=6.90; (P<0.001) in a condition of acute intoxication and volume of hepatocyte’s cytoplasm and nucleus χ2 st=23.68>χ2 F=8.03; (P<0.001), χ2 st=15.51>χ2 F=4.32; (P<0.001) in a condition of chronic inflammation. And volume distribution of hepatocyte’s cytoplasm χ2 st=8.27>χ2F=19.68; (P<0.001), and hepatocyte’s nucleus χ2st=3.41>χ2F=3.82 incondition of cancer. There is no statistically significant difference (P<0.001) between observation and theoretical frequencies of average values of hepatocyte’s cytoplasm and nucleus volume, which confirms that the result is true and accurate.Conclusions:1. Volume of hepatocyte’s cytoplasm is 2184.18±36.98 mkm3 in comparatively healthy (normal) conditions, 4153.17±84.18 mkm3 in a condition of acute intoxication, 4887.84±75.51 mkm3 in a condition of chronic inflammation and 13143.88±4.29 mkm3 in a cancer condition. Volume of nucleus is 299.94±36.98 mkm3 in comparatively healthy (normal) conditions, 873.59±13.86 mkm3 in a condition of acute intoxication, 888.65±13.51 mkm3 in a condition of chronic inflammation and 2924.57±2.12 mkm3 in a cancer condition.2. Volume of hepatocyte’s cytoplasm was increased 2 times, volume of hepatocyte’s nucleus was increased 3 times in a condition of acute intoxication and volume of hepatocyte’s cytoplasm was increased 2.2 times, volume of hepatocyte’s nucleus was increased 2.9 times (P< 0.001) in a condition of chronic inflammation. However volume of hepatocyte’s cytoplasm was increased 6.5 times, volume of hepatocyte’s nucleus was increased 9.7 times in a condition of cancer.
4. The comparative study of thyroid isotope scanning and FNA cytology in the nodular lesion of thyroid gland
Suren O ; Tuul B ; Puregmaa KH ; Sаyamaa L ; Ulzii-Orshikh N ; Enkhtuya B ; Bayarmaa E ; Ganzorig B
Innovation 2016;10(3):32-36
Thyroid nodular lesions are the common clinical problem in the world. A variety of tests have been employed to separate benign from malignant thyroid nodules. These tests include isotope scanning and fine needle aspiration cytology (FNAC). Our research was based on the fact that the comparison of FNAC and thyroid isotope scan in thyroid nodule was not researched in Mongolia. Therefore, we want to evaluate the specimen adequacy of FNAC, and compare its result to thyroid isotope scanning in patients with thyroid nodule. The research was conducted on archive materials of FNAC and thyroid isotope scanning of patients with thyroid nodule who were treated in surgical department of The First Central Hospital from 2012 to 2015, and the statistic analyze was done by using SPSS 20 under the auspices of School of Pharmacy and Bio-Medicine,Department of pathology, Mongolian National University of Medical Sciences. We have collected the FNAC of 807 patients, including 34 patients (4.2%) were males and 773 patients (95.8%) were females. FNA cytology results were interpreted as benign in 495 cases (61.3%), follicular lesion of undetermined significance in 31 cases (3.8%), follicular neoplasm in 9 cases (1.1%) suspicious in 17 cases (2.1%), malignant in 3 cases (0.4%), and unsatisfactory in 252 cases (31%). We have got the result of thyroid isotope scanning of 43 (5.32%) patients out of 807 cases. On thyroid scan, 18 patients (41.9%) having cold nodule were labeled as suspicious for malignancy, 25 patients (58.1%) had hot nodule. The FNA diagnosis of 25 patients with a hot nodule following: 1 patient (4%) with neoplasm, 17 patients (68%) with benign results, 6 patients (24%) had non-diagnostic. The FNA diagnosis of 18 patients (41.9%) with cold nodule following: 1 patient (5.5%) with follicular lesion of undetermined significance, 10 patient (55.5%) with benign, 5 patient (27.7%) with non-diagnostic, 2 patient (11.1%) had malignant. The FNAC results were interpreted as benign in 495 cases (61.3%), malignant in 3 cases (0.4%), and unsatisfactory in 252 cases (31%). Two patients out of 18 patients with cold nodule diagnosed as malignancy by FNAC. The sensitivity and specificity of thyroid isotope scanning was 96% and 16.6%, respectively.
5.Diagnosis of intraoperative squash cytology in brain tumors
Enkhee O ; Tsetsegdelger M ; Bolortuya B ; Enkhbat TS ; Khusyan KH ; Tuul B ; Bayarmaa E
Mongolian Medical Sciences 2014;170(4):14-18
Background: The intraoperative smear cytology (squash preparation) is fairly accurate, simple, reliabletool for rapid intraoperative diagnosis of neurosurgical biopsies [1]. In the early 1930s, Dr Eisenhardtand Cushing introduced intraoperative cytological investigations for rapid examination of neurosurgicalspecimens and guidance of surgical treatment [2]. Besides rapid decision making during neurosurgicalprocedures, it is also to be ensured that minimum injury is caused to the normal brain structuressurrounding the intracranial neoplasm. It has become necessary for pathologists to train themselves inthe interpretation of cytomorphological features of various central nervous system lesion and used inmany neurosurgical units of all over the world [3]. Thus, to begin doing intraoperative squash cytology inour practice is the aim of this study.Aim: To study the diagnostic accuracy of squash cytology in the intraoperative diagnosis of centralnervous system tumorsMaterials and Methods: The material for this study was obtained from 30 cases of nervous systemneoplasms sent for intraoperative consultation from State Third Central Hospital, Shashtin to the thirdsection of National Center for Pathology between 7th of November 2013 to 28th of March 2014. Squashpreparation was performed on all cases and stained with hematoxylin and eosin. The diagnosis given onsquash cytology was then compared with final diagnosis given on paraffin-embedded sections.Results: Of total 30 cases of primary central nervous system tumors, neuroepithelial tumors are thelargest category of tumors (50%). The accuracy of squash cytology was 82.1%.Conclusion: This is the first study in our country where intra-operative squash cytology in brain tumorwas done and diagnostic accuracy was 82.1% as very good category. There were 4 cases had diagnosticdiscrepancy.
6. ANALYSIS OF DISTRIBUTION & STUDY OVERVIEW OF THE GENUS POLYGALA & LANCEA IN MONGOLIA
Tuul KH ; Tseversuren N ; Munkhjargal N
Mongolian Pharmacy and Pharmacology 2013;2(1):55-
Introduction: In recent times, human tend use natural drugs which have low toxicity effect. We found out many drugs used in Mongolian and Tibetan traditional medicine.The genus Polygala (Polygalaceae) is represented in Mongolia by only three species (P.tenuifolia Willd, P.sibirica L, P.hybrida DC). These are well- known traditional Mongolian herbs, especially Tibetan medicine and modern medicine used for treatment of many diseases, such as prevent dementia and brain protection effects, antitumor activity and influenza, pneumonia, pharyngitis, heart disease and dysentery, and used as an antiphlogistic and for detoxification, expectoration. Some researchers have reported [4] phenols and triterpenes from this plant.In Mongolia, P.tenuifolia Willd, P.sibirica L, P.hybrida DC are distributed widely in various areas such as khangai, khentii, khubsgul at al.These plants are substituted by Tibetan lanceta (Lancea tibetica Hook.f.et Thoms. Scrophulariaceae. The Tibetan medicinal plant used for many disease in oriental medicine such as Tibetan, Chinese and Mongolian.Furthermore, this plant grows only in Tibetan autonomic region of China and Mongolia.The flowers, leaves and fruit are used in Tibetan and Mongolian medicine, they are said to have a sweet and bitter taste with a cooling potency. They are used in the treatment of pulmonary disorders. The fruit is used to treat heart disorders and retention of the menses, whilst the leaves are used for healing wounds.General Description of Lancea tibetica; Herbs, 3-10 cm tall, glabrous except for petioles. Rhizomes to 10 cm long, with a pair of membranous scales on each node. Leaves 6-10, rosulate; leaf blade obovate, obovate- ob-long, or spatulate, 2-8 cm long, subleathery, base tapering, margin entire or obscurely and sparsely toothed, apex obtuse and usually apiculate. Flowers in fascicles of 3-5 or in a raceme; bracts subulate- lanceolate. Calyx, leathery; lobes subulate-triangular. Corolla dark blue to purple, 1.5-2.5 cm long, tube 1-1.3 cm long; throat yellowish and/or with purple dots; lower lip middle lobe entire; upper lip erect, deeply 2-lobed. Stamens inserted near middle of tube; filaments glabrous. Fruit red to dark purple, ovoid, included in persistent calyx. Seeds numerous, brownish yellow, oblong.Future our experimental purpose is comparative study in chemical and biological activities these two plants, Polygala Hybrida DC & Lancea tibetica Hook.f.et Thoms which are grow in Mongolia.
7.Healthy live guidance based on human characteristic types by traditional Mongolian medicine
Tuul Kh ; Munkhdelger D ; Sosorbaram L ; Lkhagvasuren Ts
Mongolian Pharmacy and Pharmacology 2018;13(2):14-17
Introduction:
Traditional Mongolian medicine contents a whole idea of preventive medicine.
Traditional Mongolian medicine main theory is “Rlung-Mkhris-Badgan” which is composed human
body. These elements confirm human healthy during metabolite balance but when any of these
lacks or exists in an excessive amount, then there is an illness. Understanding on the theory “Rlung-Mkhris-Badgan” by modern medicine there are called cell universal regulation system.[1] A striking
feature of metabolism is the similarity of the basic metabolic pathways and components of “Rlung-Mkhris-Badgan” even vastly different metabolic pathways. Human has own Rlung-Mkhris Badgan`s
portion differently when they were born, during all life must obey their attribute manner. There are
seven individualities which expressed human characters.
Furthermore in traditional Mongolian medicine have richness experience of concerning with
three elements unbalanced time to come disease early diagnosis and remedy them effectively. Accordingly organic body must adaption four seasons` biological accommodation and follow up four
seasons` suitable food technology and climate condition.
Purpose:
1. To determine human characteristic types by traditional Mongolian medicine main theory.
2. To suggest healthy live advice for people who participate randomized in preventive medical examination by used modern and traditional medical diagnostic methods.
Method:
Biomedicine and Clinical Pharmacy Department doctor teachers were organized “Healthy
life starts every day right habit” topic preventive medical examination for all students of Mongolian
University of Pharmaceutical Sciences 09-29 days of September, 2016. Participant by diagnosed
medical basic physical examination methods and filled out questionnaire in human characteristics
based traditional Mongolian medicine main theory.
Results:
There had 513 participants, 29 of them were “rlung” characteristic personality, 26 of
“mkhris” characteristic personality, 22 of them “badgan” characteristic personality, 163 of them “rlung
and mkhris” combined characteristics, 118 of them “rlung and badgan” combined characteristics”, 68
of them “Badgan and Mkhris” combined characteristics, 87 of them were composite characteristic
personalities.
Conclusion
1. Determined 85% of participants are respectively combined and composed types of characteristic personalities, and these participants supposed to be better metabolism balance. Determined 15% of
participants are one element dominantly personalities.
2. We made a Healthy Life Guidance depending on human characteristics.
8.ЭС СУДЛАЛЫН ШИНЖИЛГЭЭНИЙ ЧАНАРЫН ГАДААД ХЯНАЛТЫН АСУУДАЛД
Bolorchimeg Kh ; Tuul B ; Narantuya N ; Bolormaa O ; Tserenpil B ; Bayarmaa E ; Sayamaa L
Innovation 2017;11(2):26-28
BACKGROUND. Uterine cervical cancer is the fourth leading cause of cancer deaths
in women worldwide. In our country, cervical cancer is second most common cancer
in women. Uterine cervical smear (Papanicolaou test) remains an effective and widely
used method for early detection of precancerous and cancerous lesions. Since 2002,
the cervical smear was introduced to the clinical practice of our country. However,
there is no study to performed external quality assurance of cervical smear until now.
MATERIALS AND METHODS. We selected 20 glass slides of uterine cervical smear, the
diagnosis was approved by histopathology. Each chosen slides were evaluated by four
cytologists of A, B, C, D hospitals with hidden clinical information, independently.
RESULTS. The sensitivity of A, B, C and D hospitals were 87.5%, 93.3%, 93.3%, and 93.3%,
respectively. The specificity of A, B, C and D hospitals was 85.7%, 85.7%, 75%, and 66.6%,
respectively. The diagnostic concordance of A, B, C and D was 70%, 75%, 50%, and 55%,
respectively. The agreement of cytological diagnosis was moderate (kappa = 0.55),
moderate (kappa = 0.43), fair (kappa = 0.37), and fair (kappa = 0.33) in A, B, C, and D
hospitals, respectively. CONCLUSION: The external quality assurance in cytopathology
is needed in Mongolia. The diagnostic concordance method would be applicable in
our country to improve diagnostic agreement.
9.Research on kidney disease in the scriptures
Gunjidmaa G ; Narkhand A ; Khaliunaa S ; Oyun-Erdene B ; Tuul Kh
Mongolian Pharmacy and Pharmacology 2022;21(2):23-26
Introduction:
Kidney disease is common in our country due to the four seasons and harsh climate. This article is discussed about the kidney health, causes, pathology and kidney on the relationship of other organs in traditional medicine.
Methods:
The study was processed using analysis and synthesis methods.
Results:
1. The root nature of the five vital organs are included in the yang character organs which hot nature qualities in five elements. However, some of the five vital organs will be under the influence of that place, as they will be located in the place of the “badgan”, in the place of the “mkhris”, and in the place of the “rlung”.
2. Kidney disease is usually caused by falling from a height, hit and injured, lifting heavy things, jogging and twisting your back uncomfortably, sit for a long time in a damp place, water events excess, eating too sweets that are heavy and cold qualities. In medical practice, kidney disease is accompanied by heart disease and liver disease.
Conclusion
In according to traditional medicine main theory, kidneys are a solid vital organ that generates heat and warms the lower body because of the high blood flow through its, on the other hand they are cold character which are in the place of the “rlung”. The kidneys are functionally closely related to other organs therefore, to get sick the effects of disease on other organs.
10.Comparison study of number of bones in human body of traditional and modern medicine
Tudevdagva L ; Bold Sh ; Tuul Kh ; Ariunjargal T ; Bat-Ochir M ; Bazarragchaa S ; Enkhjin G ; Duutbayr Kh
Mongolian Pharmacy and Pharmacology 2021;18(1):11-16
Background:
During the historical development of traditional medicine, many books and manuscripts have been written in Mongolian medicine. The main textbook of traditional medicine states that: “The size of a bone consists of 23 bone species, 28 spinal joints, 24 ribs, 32 teeth, and 360 pieces of bone.”
However, modern medicine estimates that the human body has 206 bones. Therefore, this topic was chosen to study the source material of traditional medicine, including the structure of the human body, and the number of bones in the modern medical anatomy textbook.
Purpose:
Details of the number of bones in the human body in the “Four Medical Tantras”
(རྒྱུད་བཞི) of traditional medicine and its commentary, as well as compare with the number of bones in the basic textbook of anatomy of modern medicine.
Objectives:
In order to successfully implement the research objectives, the following objectives will be implemented. These include:
1. Sampling and analyzing number of bones from traditional medicine;
2. Sampling and analyzing bone numbers from modern medical textbooks;
3. Compare the names and numbers of bones in traditional medicine and modern medicine
Results:
The number, classification and features of human bones were analyzed from the main scriptures of traditional medicine such as “Explanatory Tantra”, of the “Four Medical Tantras” and the “Legs bshad gser gyi thur ma” by Blo-bzang-chos-grags. In addition, the number of bones in the human body was sampled from modern medical textbooks and prepared for comparison. The number and characteristics of bones in the human body were compared by traditional medicine and modern medicine and made a conclusion.
This study reveals that the foundations for the integrated development of traditional medicine were laid long ago in Mongolian medicine. In addition, to highlight the book “Four Medical Tantras”, which is the basis of the textbook on the structure of the human body and the research work of scientists and scholars, which is considered in Mongolian mamba datsan’s contribution to the science of human anatomy. The importance of this research is to change the extremes of Western medicine and traditional medicine and increase opportunities to use its introduction and development into training and clinical practice.
Conclusion
1. The main creature of body structure in traditional medicine is the “Four Medical Tantras” which generally assumes that the numbers of bones are 360 but does not specify it in detail. During the research, we identified 357 bone names to identify each bone. The names and locations of the three bones were not clearly marked in the medical sources.
2. The numbers of bones are 206 in modern medical textbooks. We recalculated 151 bones based on traditional medical sources without duplication of that.
3. Compared to traditional medicine and modern medicine, the number of bones and are higher than 154 bone names in traditional medicine because we included the number of teeth, small bones in the ears and small bones in the fingers and toes. Some cartilage was also counted as bones.