1.Endometrial hyperplasia treatment with the levonorgestrel-impregnated intrauterine system or oral progestogens
Khaliun U ; Munkhtsetseg D ; Bolorchimeg B
Innovation 2021;15(1):24-27
Background:
To investigate relapse rates after the successful treatment of patients with non-atypical endometrial hyperplasia (EH) either a levonorgestrel impregnated intrauterine system
(LNG-IUS; MIRENA®) or two regimens of oral dydrogesterone (DGS) after primary histological
response. Currently, the incidence of EH is indistinctly reported to be around 200,000 new EH cases
per year in Western countries.
Methods:
Patients were at their choice assigned to one of the following three treatment arms:
LNG-IUS; 10 mg of oral DGS administered for 10 days per cycle for 6 months; or 10 mg of oral DGS
administered daily for 6 months. The women were followed for 6 months after ending therapy.
[Figure2] Women aged 25-55 years with low or medium risk endometrial hyperplasia met the
inclusion criteria, and 35 completed the therapy.
Results:
Histological relapse was observed in 55/ (41%) women who had an initial complete
treatment response. The relapse rates were similar in the three therapy groups (P = 0.66). In our
study involved 25-55 (mean 42.2±1.61) aged 35 women. Among them had reproductive aged
31.43% (n= 11) premenopausal women 42.86 % (n= 15) postmenopausal women 25.71% (n= 9).
Their mean body mass index had 28.8±1.15 kg/m², and normal weight 34.29% (n=12), overweight
34.29% (n=12), obese 17.14% (n=6), extremely obese 14.29 % (n=5). [Figure3] Types of obesity had
normal 37.14% (n=13), android 25.71% (n=9), gynecoid 37.14% (n=13). Mean parity had 1.8±0.19 to
nulliparous 14.29% (n=5), primiparous 60% (n=21), multiparous 25.71% (n=9). Smoke 17.14% (n=6).
Non combined disease had 65.7% (n=23), diabetes mellitus 17.14% (n=6), PCOS 14.29% (n=5),
cardiovascular disease had 2.86% (n=1). [Table1] Mean endometrial thickness of TVUS had (
16.0±0.91mm). Smoke (p=0.0391), types of obesity (p=0.0436) and myoma of the uterus (p=0.0187)
seen affected the endometrial thickness. LNG-IUD group had after treatment’s menstrual period
11.11% heavy 80ml (n=1), 88.89% light 5ml (n=8). DGS (5-25 day) group had after treatment’s
menstrual period 9.09% heavy =80ml (n=1), 90.91% light5ml (n=10), DGS (16-25 day) group after
treatment menstrual period 40% heavy 80ml (n=6), 46.67% normal 5-80ml (n=7), 13.33% light 5ml
(n=2) байв. Therefore between the three treatment groups had no differences. But treatment’s
before and after result had statistics probability differences (P= 0.4064). [Figure4]
Conclusions
Finally, given the long natural history of menorrhagia, study outcomes need to be
assessed over a period that is longer than 2 years. In conclusion, our study showed that both the
LNG-IUD, oral progestin treatment reduced the adverse effect of menorrhagia on women’s lives
over the course of two years. LNG-IUD was the more effective first choice, as assessed impact of
bleeding on the women’s quality of life.
2.A new diagnostic biomarker in early detection of Hepatocellular Carcinoma
Batchimeg B ; Baljinnyam T ; Khulan U ; Khaliun M ; Bilguun E ; Munkhtsetseg B ; Terguunbileg B ; Chinzorig M ; Gan-Erdene B ; Bilegtsaikhan Ts ; Erkhembulgan P ; Batbold B ; Munkhbat B ; Munkhtuvshin N ; Munkhbayar S
Mongolian Medical Sciences 2021;197(3):10-16
Background and Aims:
Hepatocellular carcinoma (HCC) is a common cause of cancer related death
in Mongolia. Early diagnosis is the very important management to increase successful treatment
and survival rate. Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC)
tissue and in serum of HCC patients. Recent studies have been conducted and suggested as a
diagnostic biomarker for detecting HCC in the early stage. Therefore, we investigated the diagnostic
value of the serum GPC3 level and compared it to the alpha-fetoprotein (AFP) level as a diagnostic
biomarker of HCC.
Methods:
We enrolled a total of 90 participants and divided into 3 groups with HCC (30), with liver
cirrhosis (LC/30) and healthy (30) as the control group (30). GPC3 and AFP serum (sGPC-3, sAFP)
levels were measured using commercially available enzyme-linked immunosorbent assay kits. The
diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve and
estimated sensitivity and specificity of each biomarker.
Results:
sGPC3 was significantly elevated in the HCC group as compared to liver cirrhosis and
healthy subjects (658±138.2 pg/ml, 378±25.5 pg/ml, 356.3±29 pg/ml) respectively. sGPC-3 sensitivity
was 96.6% and specificity was 100%. The area under the ROC curve (AUC) for GPC3 was 0.999
(0.996- 1.0).
In comparison, the mean of AFP was significantly higher in HCC (16.9±11.7 ng/ml) than in LC (6.7±7.6
ng/ml) and in healthy subject (3.3±2.1 ng/ml) and AFP sensitivity was 43,3 %, specificity was 95 %
with an AUC of 0.808 (0.696- 0.921).
The combination of GPC-3 with AFP achieved the highest sensitivity (97.1%) and specificity (97%).
Conclusion
Serum GPC3 has a higher sensitivity than AFP for the early diagnosis of HCC.
Combination of two markers showed greatest diagnostic accuracy.
3.The effects of Particulate matter (PМ2.5) pollutants on cancer cells in in vitro model
Baljinnyam T ; Bilguun E ; Batchimeg B ; Zolzaya D ; Lkhaasuren N ; Oyungerel G ; Munkhtsetseg B ; Khaliun M ; Khulan U ; Batkhishig M ; Uranbileg U ; Sonomdagva Ch ; Bilegtsaikhan Ts ; Munkhbayar S ; Munkhtuvshin N ; Erkhembulgan P
Mongolian Medical Sciences 2021;197(3):17-25
Introduction:
Air pollution has become one of the major problems in socio-economic and health
issues in Mongolia. Among the various hazards of particulate matter (PM) pollutants, microorganisms
in PM2.5 and PM10 are thought to be responsible for various allergies and for the spread of respiratory
diseases. Recent studies have shown that PM2.5 particles can cause chronic heart failure, heart
arrhythmias, and strokes, as well as lung damage, cirrhosis, inflammation, cancer, cardiovascular
disease, and metabolic disorders. Furthermore, some studies have concluded that PM2.5 particles
in the environment are a risk factor for gastrointestinal, liver, colon, and lung cancer as well as it
affects the growth and metastasis of various cancer cells caused by other factors. In our country, the
health effects of air pollution and the relationship between the pathogenesis of cancer research are
scarce. Therefore, the study of the effects of PM2.5 particles on cancer cell proliferation, migration
(metastasis) can provide a significant role for cancer treatment, diagnosis, and prevention.
Purpose:
Determining the effects of PM2.5 particles on cancer cell proliferation, migration (metastasis)
in in-vitro
Material and Methods:
A human liver cancer cell line (HepG2), human gastric cancer cell line (AGS)
were obtained from the central scientific research laboratory in the Institute of medical sciences.
HepG2, AGS cells were seeded at a concentration of 1*105 cells/mL in a culture flask and cultured
in RPMI-1640 medium supplemented with 10% FBS, 1% antibiotic mix (penicillin, streptomycin) in a
humidified atmosphere of 5% CO2 at 37 °C. The cytotoxic effect of PM 2.5 in AGS, HepG2 cells were
evaluated by MTT, CCK8 assays. AGS, HepG2 cells were incubated in 96 well plates for 24h then
treated with different concentrations (0, 5, 10, 25, 50 and 100 μg ) of Bayankhoshuu, Buhiin urguu,
and Zaisan samples for 24h, respectively.
Results:
Concentrations of 10, 25, and 50 μg/ml of samples collected from the Bukhiin urguu and
Zaisan in March increased HepG2 cell growth, while doses of 25, 50 μg/ml of samples collected from
Bayankhoshuu in March and December increased HepG2 cell growth. Therefore, concentrations of
25 and 50 μg/ml of samples collected from Bayankhoshuu in March increased AGS cell growth, while concentrations of 25, 100 and μg/ml of samples collected in December increased AGS cell growth.
However, no cytotoxic effect was observed in the sample collected from Zaisan in March, whereas
the PM2.5 sample enhanced AGS cell growth in dose dependent manner in December.(p <0.05)
Conclusion
High levels of heavy metals were detected in samples collected in December from
Bayankhoshuu, Bukhiin urguu and Zaisan of Ulaanbaatar. Concentration of 25 μg/ml of samples
collected from the Bukhiin urguu and Zaisan in March increased HepG2 cell growth. Concentrations
of 25 μg/ml of PM2.5 collected from three regions around Ulaanbaatar increased HepG2 and AGS
cell migration.
4.Involvement of Vitamin D in Immune system
Baljinnyam T ; Batchimeg B ; Zolzaya D ; Ganchimeg D ; Lkhaasuren N ; Oyungerel G ; Munkhtsetseg B ; Khaliun M ; Khulan U ; Bilguun E ; Batkhishig M ; Tulgaa L ; Bilegtsaikhan Ts ; Munkhbayar S ; Munkhtuvshin N ; Munkhbat B
Mongolian Medical Sciences 2020;192(2):51-59
Research of function of vitamin D on immune system has been studying since the study revealed
that vitamin D receptor is expressed on the surface of the immune cells. 1,2-dihydroxyvitamin
D3 [1,25(OH)2D], physiologically active form, can be generated through hydroxylation of
25-hydroxyvitamin D3 [25(OH)D], inactive form of vitamin D, in a liver, connecting with specific VDR
make biological action. Vitamin D make different biological actions depends on connecting with
different immunological cells. Some studies indicated that Vitamin D plays pivotal role in antibacterial
innate immune responses through regulating reaction of the main cells as macrophages and dendritic
cells. Moreover, calcitriol, the active form of vitamin D, is connected with VDRE, modulates the innate
immune response through directly inducing expression of catelicithin and β-defensin as antimicrobial
peptides, reducing secretion of IL-1b, IL-6, TNF-a, RANKL, COX-2 as proinflammatory cytokines and
increasing production of IL-10, an anti-inflammatory cytokine. Vitamin D plays in proliferation and
differentiation of T and B cells and regulates the activities of over 500 genes. Vitamin D differently
impacts on per se stages of T cells’ proliferation. Vitamin D indirectly mitigates the differentiation from
immature B cells to plasma B cells while it directly impacts on regulation of overloaded production of
antibodies in plasma B cells. In conclusion, vitamin D modulates the innate- and adaptive immune
response through regulation on activation of APCells, proliferation and differentiation of immune cells,
secretion of some antibacterial peptides.