Introduction. Cervical cancer is one of the most common cancers among women worldwide. Its mortality exemplifies health inequity, as its rates are higher in low & middle income countries (LMICs ), and in low socio-economic groups within countries. Around 80% of global cervical cancer cases are in LMICs. (WHO, 2008 ) Goal. To determine the prevalence, incidence and mortality for cervical cancer among Mongolian population Objectives: 1. To determine the trends of incidence and mortality for cervical cancer by regions among Mongolian population during 2000-2009 2. To estimate DALYs for cervical cancer in 2009 Materials and Methods: Data for this study were abstracted from Annual Reports of the National Cancer Registry for 2000-2009.I ncidence and mortality rates were calculated as mean annual numbers per 100,000 residents. Age-standardized incidence rates (ASRs) and age-standardized mortality rates (ASMRs) were calculated by the direct method by weighting age-specific incidence and mortality rates to the World Population. The DALY combines in one measure the time lived with disability and the time lost due to premature mortality: DALY = YLL + YLD YLL – years of life lost due to premature mortality YLD – years lived with disability. Results: last ten years, the trends have been increasing of the prevalence, incidence and mortality rate for cervical cancer in Mongolia. The cervical cancer incidence rates are the highest in Central and Eastern regions than other regions. The average burden of cervical cancer across all regions in 2009 was 2868 DALYs per 100000 population, of which about 30,9% was due to premature death and 69% non-fatal health outcomes. Conclusion: The incidence of cervical cancer is generally low in China, moderate in Japan and somewhat higher in Korea and Mongolia [11]. Need to estimate the DALYs for common cancers in Mongolia.

Introduction: Hysterectomy is second mostfrequent gynecological operation. Historicallythe uterus has been removed by either theabdominal or vaginal route. The vaginaloperation is preferable when there are nocontraindications because of lower morbidityand quicker recovery. Since it was first reportedby Reich et al in 1989 laparoscopically assistedvaginal hysterectomy (LAVH) has gainedwidespread acceptance. To compare totallaparoscopic hysterectomy (TLH), laparoscopicassistedvaginal hysterectomy(LAVH), vaginalhysterectomy (VH) and total abdominalhysterectomy(TAH).Materials and methods: A prospective,randomized study was performed atGynecologic Surgery Department of NationalCancer Center of Mongolia between March2013 and January 2014. A total of 120 womenindicated to undergo hysterectomy for cervixcancer stage 0-1, uterine myoma, uterinecancer were randomly assigned to fourdifferent groups (30 VH, 30 LAVH,30 TLH and30 TAH). Operating time, blood loss, rate ofcomplications, consumption of analgesics andlength of hospital stay were measured in eachgroup.Results: In our research the groups weresignificantly different for mean intraoperativeblood loss were TLH:119+/-54.7mL, LAVH:127.5+/-52.7 mL, VH; 145+/-57.8 mL andTAH: 210+/-77.4mL (P=.007) and operativetime were TLH 115+/-16.6 minutes LAVH:112.5 +/-18.5 minutes; VH: 51.6 +/-16.9minutes;TAH:69+/-18.2 (P = .001). Theaverage weight of uterine were from 95.1+/-27.6mg (range 58-140) in the VH group ,to 181.2+/-97 (range 76-400g) in the LAVHgroup through to 122.3+/-64 for the TAHgroup. Postoperative pain on day 0 and thetotal abdominal group were 5.5+/-0.7 days ofanalgesic request it was higher than other threegroups (TLH: 3.0+/-0.8days, LAVH: 3.08+/-0.7days, VH: 3.0+/-0.86 days P<.001). LAVHwas associated with a reduced hospital stay(TLH: 3.3+/- 0.7, LAVH: 3.3 +/- 0.6 days;VH: 3.7 +/- 0.6 days;TAH:6.5+/-0.7 P <.001). Total Laparoscopic hysterectomy hadlongest operating time (115+/- 16.6min), a lowcomplication rate, lack of severe post-operativecomplications. Vaginal hysterectomy had theshortest operating time (51.6+/-16.9min).However, there were technical problems withsalpingo-oophorectomy from the vaginalapproach and this group had a significantlyhigher rate of febrile complications (20%)compared to LAVH (2.3%) and TAH (16%).Conclusion: Even though operative timefor VH is less than TLH, there is a technical problem known as salpingo-oophorectomy.TLH and LAVH have number of advantagesincluding less interaoperative blood lose, lesspostoperative analgesic requirement, andshorter duration of postoperative hospitalstays.

Introduction Cervical cancer is one of the most common types of cancer in women worldwide. It can be prevented by identifying pre-cancer lesions at early stages using Pap smear screening and treating these lesions. Knowledge and attitude on cervical cancer and Pap smear tests are associated with actual participation in cervical cancer screening. Therefore, our study aimed to investigate cervical cancer and Pap smear knowledge and attitudes among Mongolian women. Materials and Methods A total of 671 women aged 30 to 60 years from urban and rural areas participated in the study. The multiple clusters sampling method was used. We examined the relations of socio-demographic characteristics with lack of knowledge and negative attitude towards Pap smear tests by using a multilogistic regression analysis. Result The response rate was 89% (671/750). 62% of the participants correctly answered less than 4 out of 8 questions about cervical cancer risk factors. Also 47,2% and 79,3% of the total number of the women had never heard of Pap Smear and HPV. Only 16,4% of the respondents have some knowledge about them. Almost all (93%) participants agreed that there is a defficiency of information about cancer and its screening.58% and 28% of respondents said that they would participate in Pap smear tests voluntarily and agree to vaccinate their daughters. Positive attitude on Pap smear tests was higher among women living in rural areas and those who have had a Pap smear test. Conclusions Cervical cancer and Pap smear knowledge and attitude among the women in Mongolia are low. Having higher education and higher income level did not ensure positive attitude to cervical cancer screening. Strategies for communicating accurate information about cervical cancer, prevention, and detection as well as risk and treatment of cervical cancer are needed.

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.

Goal: Thoracic surgery usually used for anesthesia double lumen endotracheal tubes, then ventilatedone lung.Methods: The clinical records of the 160 cases patients who had double-lumen endotracheal tubes toplace in National Cancer Center of Mongolia (this structure starts from the inferior part of the larynxin the neck, opposite the 6th cervical vertebra, to the intervertebral disc between Th4-5 vertebrae inthe thorax, where it divides at the carina into the right and left bronchi). Inpatients during one lunganesthesia done 2012- and 2014 were reviewed. All cases were performed high Level thoracic epiduralcatheterization and put double lumen tube for jugularinternal vena. Double-lumen endotracheal tubesare not meant for postoperative ventilation. In addition, because of their significantly larger size andstiffness, they have a higher propensity for trauma after insertion, which may result in postoperativehoarseness or vocal cord lesions.Results: We are reporting 2012- 2014 anesthesia department at National Cancer Center. In our studyinvolved all 160 open thoracic surgery cases with DLT. In study had anesthesia tidal volume7.77+1.07ml/kg, one lung volume 5.87+0.46 ml/kg, the women DLT size 33.43+7.25Fr, deep 27.68+2.47 cm, manDLT size 37.09+7.69cm, deep 28.43+2.6 cm. During anesthesia monitored averageSaO2-95%+1.07,in analyzed arterial blood average SpO2- 92.605 %+5.69 (p<0.032).Conclusion: One lung anesthesia separating two lungs by double lumen tube (DLT) – the advantagesof the method are allowing surgeons to operate safely in collapsed side of lung; there are a few reportsof airway damages. The bronchoscopy procedure is in need to use during the alloperations. Other typesof separation tube are required to be (especially in children) introduced.

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.

Thoracic surgery usually used for anesthesia double lumen endotracheal tubes, then ventilated one lung in NCC of Mongolia The clinical records of the 160 cases patients who had double-lumen endotracheal tubes to place in NCC of Mongolia. In patients during one lung anesthesia done 2012- 2014 were reviewed. All cases were performed high level thoracic epidural catheterization and put double lumen tube for jugular internal vena We are reporting 2012- 2014 anesthesia department at National Cancer Center of Mongolia. In our study involved all 160 open thoracic surgery cases with DLT. In study had anesthesia tidal volume 7.77+1.07ml/kg, one lung volume5.87+0.46 ml/kg, the Mongolian women DLT size 35.43+2.25Fr, deep 27.68+2.47 cm, Mongolian man DLT size 37.09+4.69cm, deep 28.43+2.6 cm. During anesthesia monitored average SpO2-95%+ 1.07,in analyzed arterial blood average SaO2- 92.65 %+ 5.69. (p<0.032) One lung anesthesia separating two lungs by double lumen tube (DLT) – the advantages of the method are allowing surgeons to operate safely in collapsed side of lung; there are a few reports of airway damages. The bronchoscope procedure is in need to use during the all operations in Mongolia. Other types of separation tube are required to be (especially in children) introduced. In the future lungs, esophagus, mediastinal tumors and heart, spine and vascular surgery need double lumen tube to global standards anesthesia widely available in Mongolia. The thoracic anesthesia use double lumen tube outside the epidural anesthesia decided that it can be combined with postoperative pain control. Correct technique of placing the double lumen tube one lung anesthesia surgical team and the shortness of time and the surgical risk patients with post-surgical complications and reduce mortality is of high importance in Mongolia. In our study is a dominant decided that it was linked to smoking habits

INTRODUCTION:In Mongolia, The anatomists researched morphometric measurements and blood supply ofheart in adult’s liver pancreas, spleen, Ren and spinal cord and etc... The study of morphometricmeasurements of the choroid plexus is not being taught in Mongolia.GOAL:To determine the structure of the choroid plexus of adult brain ventricle.MATERIALS AND METHODS:This study obtained choroid plexus size in 84 dead bodies, which is between the adult and childrenfrom cadavers. To determine the choroid plexus morphometric measurements, the total 336specimens were evaluated. The standards deviation of choroid plexus length and thickness werecomputed in different ages.RESULT:In present study, the maximum length and thickness were determined in ages from 22-60. In presentstudy, the minimum length and thickness were determined in ages 0-10day. In adult, the meanchoroid plexus length was 8.61±0.15 cm of the lateral ventricles and 4.47±0.02 cm of the fourthventricles and 0.56±0.140 cm of the third ventricle and the choroid plexus thickness was 0.5±0.03cm of the lateral ventricles and 0.29±0.01 cm of the fourth ventricles and 0.28±0.01 cm of the thirdventricle.CONCLUSIONS:In adult, the mean choroid plexus length was 8.61±0.15 cm of the lateral ventricles and 4.47±0.02cm of the fourth ventricles and 0.56±0.140 cm of the third ventricle and the choroid plexus thicknesswas 0.5±0.03 cm of the lateral ventricles and 0.29±0.01 cm of the fourth ventricles and 0.28±0.01cm of the third ventricle.The choroid plexus weight was 0.51±0.01 gm in the lateral ventricles and 0.42±0.014 gm in thefourth ventricle.

Introduction: Pulmonary sequestration(PS) is a cystic or solid mass composed ofnonfunctioning primitive tissue that doesnot communicate with the trachea-bronchialtree and has anomalous systemic bloodsupply. Pulmonary sequestration is a raredisease, of unknown etiology, representing0.1-6% of all structural lung diseases anddevelopmental malformations. We describea case of girl with pulmonary sequestration.Result: She has been admitted in ourhospital with left lower lobe mass. Fordifferential diagnosis we did X-ray, CTscanning, MRI of chest and angiography.In the X-ray had been detected retrocardiactriangular mass. CT scanning shown us massin the left lower lobe. Due to angiography wecan’t seen arterial supply. MRI demonstratedas like as X-ray, retrocardiac triangular mass.She had been gone under the electivesurgery: Left thoracotomy, resection ofpulmonary sequestration, drainage of pleuralcavity.During and after the surgery had notcomplication and she had been dischargedafter few days of post-operative treatment.She had been fully recovered.Conclusions: Pulmonary sequestrationis rare anormaly with multiple theoreticaletiologies. Due to high technological imaginginvestigations can take right diagnosis.The patient can be fully recovered afterthe surgical treatment. Intralobular typeis more difficult to resect the pulmonarysequestration.

Introduction : The occurrence of ovarian cancer had a trend of younger in recent years. Due to no obvious clinical symptoms in the early period, most ovarian cancer was found at later period. The main screening methods are transvaginal ultrasonography, serum CA-125 and so on. About 60-70% of ovarian cancer patients are already in phase III-IV or with abdominal metastasis when diagnosed. Therefore, the early diagnosis of ovarian cancer is still in the research, and there is no definite markers, which can be used in clinical. Goal: To determine the immunohistology of ovarian tumor and perform immunohistochemical analysis Materials and Methods: A total of epithelial ovarian cancer paraffin-embedded tissue blocks 30collected. The hematoxylin and eosin stained histopathology slides of each of the cases were reviewed to confirm the original diagnosis, and to assess the histological grade of the neoplasm. Our study was performed on 30 ovarian epithelial cancer tissues obtained at the time of first surgery. The staining procedure for HER2 overexpression was performed using a monoclonal antibody. Results: Analysis histological subtypes of ovarian malignant cancer, 90% of ovarian epithelial ovarian cancer, 6.7% of sex cord-stromal and 3.3% of germ cell tumor. (G1) well differentiated, (G2) moderately differentiated, (G3) poorly differentiated were 23.3%, 40.0% and 36.7% respectively. There is statistically significant direct, medium correlation immunohistochemical examination, the HER2 protein over expression (r=0.38, р=0.022), and HER2 protein 3+ was higher in 66.7 percent were in poorly differentiated. Conclusion In our study ovarian cancer based on the morphological architecture of tissue stained by H&E histological subtypes of epithelial ovarian cancer (90%). By immunohistochemical 93.3% positive and 6.7% negative ovarian cancer in determine HER2 expression.