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.The mortality and morbidity of cancer and other health events in Khongor soum, Darkhan-Uul, 2010
Suvd B ; Tuul TS ; Burmaajav B
Mongolian Medical Sciences 2011;168(1):71-82
Background: The Khongor soum has 253.3 thousand hectare square meter land which is 77 percent of Darkhan aimag from that 31.2 thousand hectare square meter land is used for plantation purpose. 12% of population is kazak. In April 2007, environment and drinking water resource of Khongor soum was polluted by dilution sewage water. Since after this incidence population were complaining about health status. Purpose of this survey was to determine cancer and general mortality of soum population. There 2 objectives: 1. To verify cancer mortality and morbidity in Khongor soum, Darkhan2. To assess excess mortality of cancer in the Khongor soumMethods: Health secondary data of 2006-2009 of Health department of Darkhan-Uul aimag was used for the assessment. The information about cause of death, number of death, population and so on were collected to caluculate crude mortality and cancer-specific mortality.Results: in 2007, the lowest or 4950 population was registered in Khongor soum and the highest number or 5628 of population was registered in 2002. The number of population gradually increased in 2009 by 5603. During 2006-2009 66 people were died in Khongor soum and this means 125.3 populations per 10000. According to the year trend mortality (66) rate was not fluctuated year by year. The leading ten causes of mortality of Khongor soum, at the first CVD (51.1 per 10000) and at the second cancer (37.8 per 10000) and it is similar with Mongolian mortality consistence. According to standardized mortality rate, mortality of Darkhan-Uul aimag was 8 per 10000 and the level of Khongor soum was 0.3 which means less than state average level. During 2006-2009 years, 24 people were died due to cancer and most of them were male (17, 70.8%). Every year of surveyed time, male mortality rate was high. The registered cancer (62.5 per 10000) of soum was similar with state average level and 1.5 times less then Darkhan- Uul aimag (92.5 per 1000) level.Conclusions: The last 5 years mortality rate of Khongor soum (124.9 per 10000) less 2.4 times from Mongolian state average level and 1.9 times less than Darkhan-uul aimag level. There are approved that cancer level of Khongor soum was not increased in last year. However, it is recommended to monitor Khongor soum’s morbidity and mortality to evaluate long-term effect of environmental pollution.
3.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.
4.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).
5.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.
6.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.
7.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).
8.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.
9.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.
10.The attack rates of the pandemic influenza infection, Ulaanbaatar, November 2009
Amarzaya S ; Altanchimeg S ; Suvd B ; Oyun M ; Enkhjargal T ; Tuul TS ; Dolgorkhand A ; Surenkhand G ; Ambeselmaa A
Mongolian Medical Sciences 2010;152(2):47-52
BACKGROUND: In Ulaanbaatar, the first case of the pandemic influenza infection has been reported on 12 October 2010.By November 9, a total of 929 cases laboratory-confirmed had been reported to National Center for CommunicableDiseases (NCCD). Of these cases reported, 9 people died.METHODS: The objectives of the study were to describe patients who admitted and hospitalized at NCCD and to determineoverall attack rates among health workers, secondary attack rates among students of colleges and universities. Datawas analyzed using Epi-Info2000.RESULTS: Among 929 of laboratory-confirmed cases, 50.3% (95% CI 43.0-57.5) were males aged 23 (±14.9) in averagewith youngest – 7 months, oldest – 76 years old. Data analysis by districts among the hospitalized patients, showed32.8% (139) of total cases in Bayanzurkh district including the first case of the pandemic influenza infection. The majorityof patients who admitted and hospitalized to NCCD mostly experienced fever (288, 68.1%), dry cough (251, 59.3%),headache (203, 48.0%), sore throat (175, 41.6%). With 1020 physicians and health workers in total, 41.4% (422) ofthem work at NCCD, 35.4% (361) – at MCHRC. 11.1% of health workers out of total become ill with pandemic H1N12009 (overall attack rate 11.1%) with the most common symptom, 380C and higher fever (100.0%, 113), sore throat(83.2%, 94), cough (76.1%, 86) and runny nose (59.3%, 67). The higher attack rates of health workers by occupationwere doctor (18.0%) and auxiliary (13%). The secondary attack rates among university students for influenza-likeillness(ILI) were 12.9%. These secondary attack rates were higher among students of art’s college as compared withother universities (52.4%). For students, the main clinical symptoms were fever + sore throat (75.0%, 18), fever+ cough(70.8%, 17).DISCUSSION: In China, as of 27 September, 2009, from reported total 19981 cases infected with pandemic influenza,61.0% were males, mean age was 17, mainly affected with 83% school students that consistent with our study result.The similar results on clinical symptoms were obtained in Russia. Out of 130 patients, 28.6% had 380Ñ and higherfever, for 54.3% the body temperature reached 38.1-390Ñ where as 17.1% - higher 390Ñ and 96% had cough, 89%had muscle ache, 65% had headache, 14% had diarrhea.