Background: Alloxan is a chemical compound commonly used in experimental animal models of diabetes. In 1943, Shaw Dunn and Mc- Letchie reported that alloxan causes specific necrosis of pancreatic β-cells in experimental animals, which led to the study of alloxan in relation to diabetes. In this study, we evaluated the structural changes in the pancreatic tissue of diabetic mice induced by alloxan. Aim: To study the structural changes in the pancreatic tissue of diabetic mice induced by alloxan. Materials and Methods: According to the protocol for establishing a diabetic model, alloxan monohydrate was injected intraperitoneally into 6- to 8-week-old C57BL/6 mice to develop a diabetic model and evaluate the structure of pancreatic tissue. Results: Alloxan induced severe degenerative changes in the centers of the pancreatic islets of mice in the diabetic group. The islet shape was irregular, and the central part was relatively sparse; dead (karyolysis) cells were observed. In the exocrine part of the pancreas, the acinar structure was preserved; the nuclei of acinar cells were stained bright blue. The plasma-particle ratio of some acinar cells was lost, the plasma contained vacuoles, and the interstitial spaces were enlarged and appeared pale. On the 7th day of the experiment, the positive expression of β-cells in the pancreatic islets of mice in the diabetic group was reduced compared to the control group, and a necrotic area was observed. On the 28th day, the positive expression of β-cells was visible in the central part of the islet. When the qualitative characteristics of the positively stained cells of the islets of Langerhans were converted into quantitative values, the percentage of the area of insulin-positive stained cells was 13.37% ± 0.89% in the control group and 6.01% ± 0.39% in the diabetic group. The percentage of glucagon-positive stained cells in the control group was 15.27% ± 1.11%, and in the diabetic group was 5.01% ± 0.58%. The islet area of the pancreatic islets of Langerhans in the diabetic group was observed to be increased compared to the control group. This is thought to be due to the swelling of the islet cells and the formation of empty spaces created by necrotic cells. Conclusion The results of the functional assay showed that glucose- dependent insulin secretion was still active after 28 days of the experiment. Alloxan-induced necrosis and apoptosis reduced the percentage of insulin- and glucagon-positive cells in the islets of Langerhans.

Background: It is stated in the Government Programme of 2016-2020 that public servants, including health care workers, shall be given a gradually increased salary based on their skill, dexterity, workload, and productivity, and such increase started from 2018 as planned. In the health sector of our country, regarding demand and regulation of the programme, the change shall be made that the system for median salary of physicians and overall staff employed at hospitals gets even constructive, and the required human resource for the sector shall be prepared. Thus, inferring from these claims, median salary, real wage, and socioeconomic condition are in critical need for further evaluation. Objective: To examine the current socio-economic condition of health care workers, and to study the influencing factors at play. Methods: In this study, we used quantitative and qualitative methods. In the survey, we involved 655 health care workers from 6 family health centers, 2 district hospitals, 3 health centers (district-based) in Songinokhairkhan, Sukhbaatar, and Baganuur districts; and Provincial hospital, regional diagnosis and health center, 16 soum health centers from Khovd, Uvs, Arkhangai, Bulgan, Khentii, Dornod, Umnugovi, and Dornogovi provinces, along with 3 National specialized health centers and 1 National central hospital. As for data gathering for the qualitative analysis, 30 focus group interviews and 47 key informant interviews were conducted for the purpose of examining socioeconomic condition, real wage sufficiency of health care workers. Results: Average household income of study participants was 1,880,269 tugrik, the real wage was 1,073,065 tugrik, and the overall household is seen to be composed of 2 different sources on average, namely, self-wage and the income coming from family members or supplement of Child Money Programme. It has come to notice that 19.5% of the participants have lower than average living standard, 89.2% have 2 different loans (mortgage, auto loan or mobile application based loans). Material deprivation index is seen to be 2.73, hence deemed as insufficient. In order to increase the real wage of those workers, it shall be taken into consideration that the basic salary is low, and some financial supplements need to be given. Furthermore, the performance based funding system of health sector is seen to be in need of improvement. Conclusion Real wage of the health care workers is, thus, insufficient. The fact that one in every five workers in this sector have lower than average living standard, and the material deprivation index is 2.73 implying that the financial lives of health care workers are immensely fragile.

Introduction : The HER2 (Human epidermal receptor 2) proto-oncogene encodes a transmembrane receptor protein involved in the development and progression of the majority of cancers. Prior studies have shown that HER2 oncogene is overexpressed in approximately 15–30% of ovarian carcinomas. However findings regarding the overexpression and prognosis are still conflicting. Goal: To determine the histomorphological structure of ovarian tumor and perform immunohistochemical analysis of HER2 in tumor tissues Materials and Methods: A total of epithelial ovarian cancer paraffin-embedded tissue blocks 11collected. 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 11 ovarian epithelial cancer tissues obtained at the time of first surgery. The staining procedure for HER2 overexpression was performed using a monoclonal antibody. Results: The positive expression rate of HER2 in this study was 81.8%. Significant association was not found between HER2 expression International Federation of Gynecologists and Obstetrics (FIGO) stage p-values of 0.196, grading 0.642 and histological subtypes. However, there were more cases of advanced-stage disease (III/IV) with HER-2 expression than early-stage EOC (I/II). HER2 positive tumor were grades 1, 2 and 3 respectively. A higher proportion of serous ovarian neoplasm and adenocarcinoma NOS was also observed to be HER2 positive. Conclusion HER2 expression was observed to increase with advanced stages of cancer and was more commonly seen in serous rather than in adenocarcinoma NOS.

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.

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: 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.

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

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.

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.

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.