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.Measurements of esophageal diseases and distribution
Gerelee G ; Tuul M ; Baikov V.V
Mongolian Medical Sciences 2011;172(2):8-16
Incidence rate of esophageal cancer is not similar in each country, for example higher incidence in Central Asia, North America and northern Africa. An esophageal cancer in Mongolia is 4th most common cancer after liver, stomach and lung cancers. At first to determine the structure and functional tendency we need to formulate mathematic analysis, processing and reference values of measurements. Formulation consists of 2 main parts that are quantitative and qualitative methods.Goal: By this research study we have aimed to determine pathological types and morphometric indices in esophageal cancer.Materials and Methods: Materials and samples for research study were chosen from biopsies, which were taken for diagnosis of esophageal disease in national center of cancer, Ulaanbaatar city among 1998-2002. These materials were diagnosed by international classification, 2006 of WHO. Totally 286 samples were prepared, here 184 (64.5%) samples were squamous cell carcinoma (well differentiated- 55, moderate differentiated-103, poorly differentiated-26), adenocarcinoma 20 (7%), undifferentiated carcinoma 7 (2.4%), intraepithelial neoplasia 74 (25.9%), low grade neoplasia 9 (3.1%) and high grade neoplasia was 65 (22.8%). Measurement was done by Video test 5.0 of Russia and software SPSS 17.0 was used for statistical analysis.Results: From the result of the study concluded the average indices are increased by 1.5 times in neoplasia cases of squamous epithelium, 2.1 times in well differentiated squamous cell carcinoma cases, 3.2 times in moderate differentiated squamous cell carcinoma cases, 2 times poorly differentiated squamous cell carcinoma cases, 2.1 times in adenocarcinoma cases and 1.7 times in the undifferentiated carcinoma cases in compare with relatively healthy average volume indices. But in the performed study was not observed a real difference between average volume indices of variable cancer cases. The most high rate of cell volume indices and square indices of nucleus were observed in moderate differentiated squamous cell carcinoma cases while in undifferentiated carcinoma and poorly differentiated squamous cell carcinoma cases were lowest rate of cell volume indices were observed.Conclusions: There are considerable signification on caryometrical and stereometrical research of differentiation between esophageal cancer and precancerous diseases.
3.Results of the research study on influencing factors for mortality and morbidity rate of cardiovascular diseases
Tuul M ; Baasanjav N ; Purevsuren D
Mongolian Medical Sciences 2011;172(2):70-77
Background: According to statistics from National Center of Public Health Development of Mongolia morbidity rate of cardiovascular diseases was 501.84 cases per 10000 population in 2006, which demonstrates increase of 2 times compare to 1996 and 50% increase compare to 2000. Goal: To study bio-ecological factors influencing on mortality and morbidity rate of prevalent cardiovascular diseases among Mongolians.Materials and Methods: We have chosen arterial hypertension, acute myocardial infarction, and chronic rheumatoid fever according 10th classification of WHO. Indices of morbidity, mortality of diseases were calculated per 1000 population.Result: Average atmospheric temperature t0С (χф2=1494); atmospheric pressure (χф 2=36.07); precipitation (χф 2=704); and mineralization of rivers (χф 2=532) have statistically significant effect on morbidity rate of arterial hypertension among the population of Uvurkhangai, Gobi-Altai, Darkhan-Uul, Gobisumber aimags and UB city. Average atmospheric temperature t0С (χф 2=241); atmospheric pressure (χф2=88.62); precipitation (χф 2=62.18); and mineralization of rivers (χф2=86.28) have statistically significant effect on morbidity rate of chronic rheumatoid fever among the population of Arkhangai, Bayankhongor, Umnugobi, Gobisumber aimags.Conclusions:1. Geographical distribution of arterial hypertension is prevailed in Uvur-Khangai, Gobi-Altai, Darhan-Uul, Gobi-Sumber aimags and UB city, distribution of acute myocardial infarction is prevailed in Hovd, Hubsgul, Arkhangai, Selenge, Gobi-Sumberaimags and geographical distribution of chronic rheumatoid fever is prevailed in Bayankhongor, Arkhangai, Umnugobi, Gobisumber aimags. 2. Ecological factors have statistically significant (χF 2=23.1-161.1) influence on the distribution of morbidity and mortality of arterial hypertension, acute myocardial infarction and chronic rheumatoid fever. Influencing ecological factors in regions covered with this study, such as temperature, atmospheric pressure, wind speed and mineralization of water sources have weaker and reverse correlations each separately (r=-0.1-0.2) but in combination they have medium and reverse correlations (r =-0.45- 0.52).3. The result of the research study established that morbidity and mortality of cardiovascular diseases (arterial hypertension, acute myocardial infarction and chronic rheumatoid fever) distributed in 3 regions on the territory of Mongolia depending on ecological factors.
4.Мathematical modeling of reference values of internal organs of mongolians and comparative assessment with ultrasound measurements
Tuul M ; Lkhagva L ; Sukhbaatar TS ; Amgalanbaatar D ; Enkhjargal M
Mongolian Medical Sciences 2010;153(3):39-43
Objective: Mathematical modeling of reference values of internal organs of Mongolians (in vitro) and compare them with results of two and three-dimensional ultrasound measurements.Materials and Methods: Mathematical modeling was done with the methods of interpolation. Ultrasound measurements of internal organs were made with common methods of standard planes and results were analyzed. The basis of mathematical modeling to convert reference values of organs to values of organs in live conditions (in vitro) was elaborated. For example: Heart was modeled with double cylindrical volume with convex surface. Liver was modeled with triangle pyramid (tetrahedron) with concave and convex surface. Kidney was modeled with the shape of rotating ellipse with convex and hollow surface. Spleen was modeled with the shape of cutting pyramid with concave and convex surface. Pancreas was modeled with the shape of cylinder with convex surface. Gallbladder was modeled with the shape of cutting cone with spherical bottom. Following formulas were defined and used for modeling:Where: V-volume, r-modelled average value of 3 dimensions radius of rotation, k-coefficient for converting volume of mathematical models to original volume, P-perimeter, S-calculated bottom square with formula Guron, ϱ- density of tissue, h - height, a - length, b - width, c -thickness, r 1; r2 ;r3 – average value of radius, m - mass, I- total length. Results: Comparative analysis of the volume of internal organs of adult Mongolians determined with the help of mathematical modeling with the volume established with 2D ultrasound linear measurements revealed no statistically significant difference between parenchymal organs and revealed statistically significant difference between other organs (P<0.001).
5.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.
6.To explain results of hepatocellular modeling in mongolians by non linear theory
Odmaa B ; Tuul M ; Аmgalanbaatar D
Mongolian Medical Sciences 2012;161(3):11-16
Bacground: Liver cancer is the 5th most common cancer worldwide with 500,000 cases diagnosed per year. It is a disease with a high death rate (14000-15000 per year). By the last news of national center of health development, liver cancer is first most common cancer in our country. Goal: To study and to compare volumetric modeling of hepatocyte’s cytoplasm, nucleus and stereometric indices in condition of comparatively healthy, acute intoxication, chronic inflammation, cancerous condition and clear cell tumor, and to explain by non linear theory.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 GermanOn linear measurement in condition of comparatively healthy, acute intoxication, chronic inflammation, cancerous condition and clear cell tumor were processed by mathematic modeling. Results: In comparatively healthy condition the volume of the hepatocyte’s cytoplasm was determined 2140.73±19.97 mkm3, the volume of the hepatocyte’s nucleus was 295.19±2.60 mkm3, ration between hepatocyte’s cytoplasm and nucleus was 7:1 (P<0.001). In condition of acute intoxication the volume of the hepatocyte’s cytoplasm was determined 4281.36±77.83 mkm3, the volume of the hepatocyte’s nucleus was 895.00±13.42 mkm3, ratio between hepatocyte’s cytoplasm and nucleus was 5:1 (P<0.001). In condition of chronic inflammation the volume of the hepatocyte’s cytoplasm was determined 4887.84±75.72 mkm3, the volume of the hepatocyte’s nucleus was 888.65±12.46 mkm3, ration between hepatocyte’s cytoplasm and nucleus was 5:1 (P<0.001). In cancerous condition the volume of the hepatocyte’s cytoplasm was determined 3852.63±116.06 mkm3, the volume of the hepatocyte’s nucleus was 463.09±12.95 mkm3, ratio between hepatocyte’s cytoplasm and nucleus was 8:1 (P<0.001). In clear cell tumor the volume of the hepatocyte’s cytoplasm was determined 15062.69±348.41 mkm3, the volume of the hepatocyte’s nucleus was 801.05±22.56 mkm3, ratio between hepatocyte’s cytoplasm and nucleus was 19:1 (P<0.001). Conclusions:1. We have determined volume of hepatocyte’s volume and nucleus, ratio between cytoplasm and nucleus in condition of comparatively healthy, acute intoxication, chronic inflammation, cancerous and clear cell tumor.2. Volume of hepatocyte’s cytoplasm was increased 2.28 times, volume of hepotocyte’s nucleus was increased 3.01 times in condition of chronic inflammation and volume of hepatocyte’s cytoplasm was increased 1.99 times, volume of hepotocyte’s nucleus was increased 3.03 times in condition of acute intoxication. Also volume of hepatocyte’s cytoplasm was increased 1.79 times, volume of hepotocyte’s nucleus was increased 1.5 times in cancerous condition and volume of hepatocyte’s cytoplasm was increased 7.03 times, volume of hepotocyte’s nucleus was increased 2.7 times in condition of clear cell tumor.3. By the comparison between volumes of hepatocyte’s cytoplasm and nucleus in condition of comparatively healthy, acute intoxication, chronic inflammation, cancerous was determined medium direct correlation rather by the comparison between volumes of hepatocyte’s cytoplasm and nucleus in condition of clear cell tumor wasn’t determined correlation.
7.Health status scores of mountain regions’ population (30-69 years) of Mongolia
Enkhjargal М ; Tuul M ; Lkhagva L ; Odgerel TS ; Darjaa TS
Mongolian Medical Sciences 2012;162(4):7-13
BackroundTerritory of Mongolia is spread over seven natural ecological zones and it has harsh continental climate. Mongolia is one of the most sparsely populated country on the World. The study was done among residents of the Khovd province and its subprovinces as representations of Altai mountain region. The study was focused on clarifying relavance of health status scores of a population with geographical and ecologicalspecifics of the places they live.Goal:To determine BA, grades of aging and health status scores among population (30-69 years) of mountain regions.Materials and Methods:In total 1119 persons were chosen for the research study, which was conducted in 2011. Quantative data of the study has been processed with the use of statistical data processing software SPSS-19.Results14.4% - 94.1% of male in all age groups had health problems. In all age groups 55.9%-85.5% of male and 43.9%-78.4% of female had adaptation functional tension. Conclusions: Aging for women of all age groups was significantly slowed or slowed. Aging for men of 30-49 ages it was accelerated, for men of 50-69 years aging was normal or slightly slowed. The portion of people with adaptation functional tension was greater in all age groups. Most of the women in the age group of 60-69 years had unsatisfactory adaptation. Health status of male is significantly at a lower level compare to female.
8. HEALTH STATUS SCORES OF ULAANBAATAR CITY POPULATION (18-25YEARS) OF MONGOLIA
Munkhjavkhaa T ; Zevgee T ; Tuul M ; Lhagva L
Mongolian Pharmacy and Pharmacology 2013;2(1):32-
background: Our country’s aging for men of 30-39, 40-49 ages it was accelerated aging process and very accelerated aging process. Aging for men of 50-59, 60- 69 ages it was normal aging and slowed aging process. Aging for women 30-39, 40-49 ages it was normal end slowed aging process. Aging for women 50-59, 60-69 ages it was slowed and significantly slowed aging process. Otherwise, aging for young groups was accelerated and very accelerated aging process, aging for old groups was normal, slowed and significantly slowed aging process. The aging process of men was more quickly than women in our country [1].Aim of the stady: To define biological aging, aging indexes and adaptation potential in population of 18- 25 years old of Ulaanbaatar city.Materials and methods: In total 537 person of 18- 25 years from Ulaanbaatar city were chosen for the research study which was conducted in 2012. Biological age levels were assessed on the basis of following standards. True biological age was determined with clinical-physiologycal indexes and biological age with chronological age. Adaptation potential have been studied with the help of special indexes and analysis were made with the use of regression method. Quantative data of the study has been processed with the use of statistical data processing software SPSS- 19.Results and discussions: Body mass index of 18-25 aged men of Ulaanbaatar city was 22.2146, cachexia 7.82%, normal weight 79.32%, more weight 10.24%, obesity 2.6%, Aging for men of 18-25 ages it was significantly slowed aging process of men was observed 0.37%, slowed aging process 0.55%, normal aging 0.93%, accelerated aging process 12.47%, and very accelerated aging process was 85.66%. The portion of men with normal adaptation potential was 55.67%, adaptation functional tension was 43.76%, unsatisfactory adaptation was 0.55%.Conciusions:1. The portion of cachexia 7.82%, more weight 10.24%, obesity 2.6% of 18-25 aged men of Ulaanbaatar city.2. Health status was abnormal 98.13% of 18-25 aged men of Ulaanbaatar city.3. The portion of 18-25 aged men of Ulaanbaatar city adaptation functional tension 43.76%, unsatisfactory adaptation was 0.55%.References:1. 1 .Tuul M., Lhagva L., Sukhbaatar Ts., AmgalanbaatarD. “Aging biology of Mongolians” III book. “Admon” puplisher. Ulaanbaatar. 2009.2. Open society forum. “Policy of young” abstract. UB. 2010.3. Leonid Kalichman, Ida Malkin, Gregory Livshigts, Oleg Pavlovsky, Valery Bathvich. Variation of Skeletal Biomarkers of biological Aging in a Chuvashian Population: A Longitudinal Stady. American journal of human biology 19:74-81. 2007.4. Apanacenco G.L, Popava L.A, “Medical Valeology”. Kiev. 2000.
9.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.
10.Health status of khangai mountain regions’ population (30-69 years)
Enkhjargal М ; Tuul M ; Lkhagva L ; Odgerel TS ; Amgalanbaatar D ; Darjaa TS
Mongolian Medical Sciences 2013;166(4):9-14
Backround: Biological age score plays an essential role in the evalution of aging process and health status. The study was focused on clarifying relavance of health status scores of a population of Khangai mountain region with geographical and ecological specifics of the places they live. Goal: To determine the grades of aging (GA) and biological age score (BAS) among population (30-69 years) of Zavkhan aimags.Materials and Methods: We examined 1901 men and women aged 30-69 years old in Zavkhan aimags in 2012 and healthy subjects were assessed with physical, physiological variable. The BAS equation was employed to compute the individual BAScores for all subjects. Quantative data has been processed with the use of statistical data processing software SPSS-19. Results: Health scores of 92.1% of male in the age group of 30-39 years, 68.7% of male in the age group of 40-49 years had health problems (in level IV, V ). In all age groups 70.3% -98.6% had normal adaptation and adaptation functional tension. 54.2- 55.1% of both sex in the ages group 60-69 years had unsatisfactory adaptation.Conclusions: Aging process for women in age groups of 50-59, 60-69 years was significantly delayed or delayed. For men of 30-49 ages aging process was accelerated, for men of 50-69 years it was normal or delayed. Health scores of men in the age group of 30-39, 40-49 years is significantly at a lower level (IV,V) and health scores of women all age groups is significantly at a high level (IIII).