Proper use of T-lymphocyte immunity and interferon during KOVID-19 infection / Монголын Анагаах Ухаан

@#The risk of reinfection of the across mutation SARS-CoV-2 set the task of medicine to look for new ways to solve. One of these areas is the strengthening of innate T-lymphocyte immunity. Research on the use of an interferon inducer by stimulating innate T-lymphocyte immunity in order to innate prevent КОВИД-19 and its mutant forms and during the rehabilitation period after an illness, they give good scientific results and one of the future promising directions of prevention and treatment of КОВИД-19. Researchers have warned that the side effects of SARS-CoV-2 drugs include respiratory failure, decreased blood albumin levels, decreased red blood cells and platelets, anemia and coagulation disorders, jaundice, and liver damage. Adverse drug reactions include drug intoxication and adverse reactions, as well as immune reactions. For these reasons, the need to seek new methods of treatment and prevention and drugs has become one of the most pressing issues in modern medicine.

Contribution of HBV and HCV infection in mortality of B cell non-Hodgkin’s lymphoma subjects / Монголын Анагаах Ухаан

Background@#The correlation between hepatitis B, C viruses (HBV, HCV) and B cell non-Hodgkin’s Lymphoma (B-NHL) and reducing mortality have been studied extensively worldwide@*Objective@#In this study, we aimed to determine the prevalence of HBsAg and anti-HCV positive cases among B-NHL patients and its influence on the survival rate of these patients (on ≤12 months).@*Materials and Methods@#We have done a retrospective analysis on patients who aged over 20 years and newly diagnosed at the Hematology Center of the First State Hospital between 2015-2018. The patients’ information was collected according the study ethics. We divided the patients into 2 groups, survival rate less than 12 months (≤12 months) and survival rate more than 13 months (≥13 months), and compared them regarding age, gender, seroprevalence, and Ann-Arbor stage. @*Results@#Overall, 226 patients (107 males and 119 females with average 54.4) were enrolled in the study. There were 15% HBsAg positive and 41,6% anti-HCV positive cases, while Baatarkhuu et al. (2005) reported (11.8%, 15.6%; p=0.160, p<0.00001) and Bekhbold et al. (2013) reported (11.1%, 10.6%; p=0.055, p<0.00001) in apparently healthy population. Moreover, anti-HCV positive cases among B-NHL patients were higher (p<0.00001) than those (27%) among hepatocellular carcinoma (HCC) patients and same (p=0.404) with those (39%) among liver cirrhosis patients in Mongolia (Bolormaa et al., 2009). Furthermore, 72.0% of all subjects in III-IV stages was accounted for HBsAg, anti-HCV positive group which had ≤12 months, while 52.1% of them was accounted for HBsAg, anti-HCV positive group which had ≥13 months and was statistical significantly lower (p=0.02).@*Conclusion@#Anti-HCV and HBsAg positive cases might contribute to survival rate with the B-NHL patients diagnosed at the III-IV stages. HCV prevalence among B-NHL subjects was significantly higher than that among the general population prevalence and was same with anti-HCV positive prevalence among the HCC.

The results of acute exacerbation of chronic C hepatitis among Mongolian adults with B-Non-Hodgkin Lymphoma / Монголын Анагаах Ухаан

Background@# Chemotherapy-related acute exacerbation or hepatitis flares related to HCV positive B cell non-Hodgkin’s lymphoma (B-NHL) is one of the significant clinical issues@*Material and Method@#We studied anti-HCV incidences among patients newly diagnosed with B-NHL, from 2015 to 2018. Survey data were collecting from medical history, electronic medical record system of First Central Hospital was acquired and collected according to the research ethics (approved by Ethics Committee of Ministry of Health, No.4 on June 19, 2017). Also, cases of chemotherapy-related acute exacerbation (AE) for HCV-RNA positive cases were studied. Student’s t-test or nonparametric statistics were utilized to test for statistically significant differences in continuous variables, whereas the chi-square or Fisher’s exact test was used for categorical variables. p<0.05 was considered statistically significant.@*Results@#The study showed that 39.5% of 233 cases with B-NHL are anti-HCV positive. Anti-HCV positive prevalence among B-NHL subjects was significantly higher compared to the general population. Chemotherapy-related AE occurred in 21.05% for the anti-HCV positive group and 36.36% for HCV-RNA positive group. Furthermore, before chemotherapy alanine aminotransferase (ALT) median was 15.2 for the group without AE, whereas it was 48.2 for the group with AE (p<0.01).@*Conclusions@#Our study showed that the prevalence of anti-HCV positive among B-NHL patients was significantly higher than the general population prevalence. For all cases of AE, HCV-RNA was positive, and these patients were treated with only chemotherapy without any anti-viral treatment. Anti-viral therapy needs to be introduced urgently to prevent AE since liver fibrosis is aggravated quickly after AE.

Immunohistology and immunohistochemstry study of ovarian cancer / Монголын Анагаах Ухаан

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.

Results of immunohistochemistry status of HER2 expression surface epithelial ovarian cancer / Монголын Анагаах Ухаан

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.

ЭЛЭГНИЙ АНХДАГЧ ӨМӨНГИЙН ЭРСДЭЛТ ХҮЧИН ЗҮЙЛС БА ДАРХАН ГИСТОХИМИЙН СУДАЛГАА / Шинэ санаа Шинэ нээлт

@#BACKGROUND. As of 2015 39,1% of all new cancer cases in Mongolia were HCC having the highest prevalence and it has increased by 4% to the previous year. (Health indicator – 2015, CHD). Although there are quite a lot researches have been done on general cause and impacting factors of HCC, the relevance between the mechanism leading to eventual cancer and the risk factors is still unknown yet. PURPOSE: To define the relevance of the beta-catenin and P53 expression in HCC with the risk factors of HCC in Mongolia. RESULT: 1. 50% of HCV infection in men is related with alcohol consumption and 40% alcohol combined with tobacco consumption. HBV infection has relevance of 46% with tobacco and 52,8% with alcohol consumption. 2. In the first phase of research in 21 HCC cases beta-catenin was identified in cell nucleus and cytoplasm after immunohistochemistry. CONCLUSION: 1. It was to observe that HCV infection is commonly combined with alcohol consumption in HCC cases. 2. Although beta-catenin expression was high in HCV, HBV infection and alcohol high risk group, the P53 expression was high among alcohol high risk group. Р < 0.05

ХОДООДНЫ НЕЙРОЭНДОКРИНЫ ХАВДРЫГ ЭД ДАРХЛАЛЫН АРГААР ЯЛГАН ОНОШЛОСОН НЬ / Шинэ санаа Шинэ нээлт

@#BACKGROUND OF STUDY: Adenocarcinoma cancer is the most common cancer in the world and the gastric happens rare however gastric neuroendocrine carcinoma is one of the leading causes of cancer death in the world and its pathogenesis and pathology diagnosis haven’t been not studied well. Our study is based on it. AIMS: 1.To determine by age and sex the 70 adenocarcinoma cases which diagnosed by endoscope at the National Cancer Center of Mongolia in 2013-2016 and to diagnose histology method of WHO. 2. To study the gastric cancer in pathology department by immunohistochemistry. MATERIAL AND METHODOLOGY: We worked on 70 patients with gastric cancer in 4th department at the National Cancer Center of Mongolia from 2013 until 2016. RESULT OF STUDY: We determined 70 patients with gastric cancer and of the 70 patients which diagnosed by pathology and immunohistochemistry 35 cases were 50.0% (Adenocarcinoma), 15 cases were 21.4% (gastric neuroendocrinecarcinoma), 2 cases were 2.9% (GIST-gastrointestinalstromal tumor), and 18 cases 25.7% (dysplasia). By sex of the 70 patients 39 cases 56% were males, 31 cases 44% were females and by age 17 cases 24.29% were 51-60 years old, 24 cases 34.29% were 61-70 years old. This results is shown the early 40 years old people has the great risk of this cancer. CONCLUSION: In our study 35 CD56 specific tissues were diagnosed by Ki67 markers and of them 15 cases were gastric neuroendocrine carcinoma and 18 cases were dysplasia determined.

HISTO-PATHOLOGICAL CHANGES IN MICE MODEL LIVER, PANCREAS AND SKELETAL MUSCLE ASSOCIATED WITH HIGH FAT DIET / Шинэ санаа Шинэ нээлт

@#BACKGROUND: According to WHO, Non-communicable disease take place 43% of morbidity as well as 63% of mortality in worldwide and it will may increased as 60% of morbidity, 73% of mortality in 2020. Therefore one quarter of NCD associated with composition and usage of foods. Obesity and Diabetes mellitus are caused by accumulating saturated fat in body due to excessive use of high calorie. High-fat diet promotes lipid deposition in solid organs including skeletal muscle which is underlying cause of insulin resistance. METHODS: Same aged, Inbred (C57BL/6J) 20 male mice are involved in this study. They are raised and fed in central core laboratory of MNUMS. Feeding of mice “Beijing Branch of the Joint Feed Co LTD” from Republic of China produces forage for laboratory animals. They were divided into two groups. A control group mice had been fed standard chow while experimental group mice had been fed 45% high fat diet for 4 weeks. The morphological effect of the a high fat diet was examined by light microscopy. RESULTS: Liver of experimental mice was seen pale and parenchyma had a fatty changes compared to control group liver in gross anatomy. Periportal necrosis and lipid droplet deposition in hepatocytes of study group were detected as microscopically. There is fatty accumulation between solid tissue of pancreas and islets of Langerhans get smaller in study group. Experimental mice which were fed by 45% of fat containing food had lipid droplets were observed in fibers. Therefore degenerated fibers showing separation from the basement membrane and acidophilic staining were observed in skeletal muscle.

Quantitive assessment of bone marrow trephan biopsy / Шинэ санаа Шинэ нээлт

In United States, person is diagnosed with blood cancer in every 3 minutes. In 2015, there were 1.665.540 total cancer cases and 9.4% of them lymphoma and leukemia . In 2015, there were 95 cases of lymphoma in Mongolia when compared 4 times increase to 2015 from 2010 . Bone marrow examination is an established diagnostic modality in the evaluation of various hematological disorders. BM examination can serve to establish or confirm a primary diagnosis of lymphoma or to determine the extent of disease dissemination for staging purposes. Biopsy is essential for diagnosis in a dry tap or blood tap which occurs when the marrow is fibrotic or densely cellular. Only a biopsy allows a complete assessment of marrow architecture and pattern of distribution of any abnormal infiltrates. In 2015.01-2016.01 fifty five bone marrow biopsies were retrieved from the files of the National First Clinical Hospital-Department of Hematology. These all statistical analysis was performed using by SPSS 17. Bone marrow processing and staining: The hematologist is instructed to place the freshly obtained BMTB specimens directly into buffer substance fixative and transport it immediately to the histopathology department, on the same day as the procedure.The next morning (after 20–24 h), the solution is decanted (with a strainer) and the biopsy specimen is washed in distilled water for 30 min. The biopsy specimens are left to decalcify for about 6 h before being processed and embedded in paraffin wax, with procedures similar as for other specimens.Sections, 1-mm thick (microtome set for 1 mm sections), are cut from the paraffin-wax blocks with the routine rotary microtomes in the laboratoryA total of 55 cases were reviewed from December 2014 to November 2015. The age of the subjects ranged from twenty two years to seventy eigth years with a male predominance (1.7:1). Data of 55 trephine biopsies were reviewed. The percentage of trephine biopsies in different length ranges was calculated. Twenty two biopsieswere of recommended length, i.e., ≥1.5 Cm while remaining 33 were less than the recommended length. The rate of positivity for diagnosis was 95.4% in group-1, 94.1% in group-2, 63.6% in group-3 and 40% in group-4 In all cases in our study 73% (n=40) were satisfactory and 27%(n=15) unsatisfactory slides .Our study showed that 40% trephan biopsies were of revommended length i.e >=1.5cm with 95.4% positive of diagnosis. However biopsies measuring 1-1.4 cm also had comparable result 94.1% .

RESEARCH THE EXPRESSION OF HIGH RISK HUMAN PAPILLOMA VIRUS AND P16 PROTEIN IN CERVICAL INTRAEPITHELIAL LESION BY IMMUNOHISTOCHEMISTRY CH ABOUT LAPAROSCOPY ASSISTED VAGINAL HYSTERECTOMY / Шинэ санаа Шинэ нээлт

The persistent high-risk human papilloma virus(HPV) infection is a necessary cause for developing cervical carcinoma. Although carcinogenic HPV types are found in virtually all invasive cancer, with types 16 and 18 being found in approximately 70 percent of cases. High risk HPV types’ Е6 and Е7 oncogenes have a pivotal role in cervical carcinogenesis. The p16, the cyclin-dependent kinase inhibitor and p16 overexpression in cervical neoplasia is a surrogate marker of high risk HPV E7 mediated pRb catabolism reflecting disruption of mechanisms that control cell proliferation and indicating persistent infection with high risk of development of neoplasia.Thus in worldwide p16 had been identified as the novel biomarker in pre-invasive cervical lesions. Objective: For the purpose to detect for cervical cancer risks we examined HPV16/18 and cell cycle protein p16 expression in cervical lesions.A total of 96 specimens enrolled in this study and 50 were diagnosed as LSIL and 46 were diagnosed as a HSIL. To detect HPV16/18 and p16 in cervical lesions used immunohistochemistry. Statistical analysis was performed using SPSS 16.0. Descriptive analysis was performed by Chi- Square test and also determined sensitivity and specificity.Positive stainingfor p16 and HPV16/18 were observed whole cell, within both the nuclear and cytoplasmic subcellular regions by immunohistochemistry. 63% of specimens had only HPV16 infection and 22% of specimens had only HPV18 infection.Also 14% specimens had co-infection with two viral types and 28% specimens had not above two most HPV infection. There were a significant difference for HPV16 positivity (X2 = 4.93, P 0.05) in HSIL and LSIL groups. There were not a difference for p16 in HSIL and LSIL groups.(X2 = 0.23, P > 0.05), respectively.P16, yielding a diagnostic sensitivity for HPV 16/18 were 82% and 30%, specificity for HPV 16/18 were 40% and 80%, respectively. In conclusion it is possible to detect high risk HPV types and persistent infection by immunohistochemistry in cervical intraepithelial squamous cell lesions. There is still critical need to use HPV testing and other molecular surrogate markers of HPV such as p16 in primary screening program.

Mitotic activity in uterine leiomyoma / Монголын Анагаах Ухаан

INTRODUCTION:Uterine leiomyomas are the common smooth muscle tumors of female genital tract. Usually theirdiagnosis poses no problem. On the other hand leiomyosarcomas are highly malignant tumors.Distinction between the two poses no problem if the leiomyosarcoma shows significant dysplasia,however at times it may become a serious problem to differentiate between leiomyoma and well–differentiated leiomyosarcoma. Under such circumstances the mitotic count per 100 high powerfields considered by many as the most important criterion of distinction.MATERIAL AND METHODS:To investigate the role of mitotic activity in the growth of uterine leiomyomas, the mitotic count per100 high-power fields and the relation of this to the patient’s age (30 to 54 years) were examined intissue sections of leiomyomas from 130 surgically removed leiomyomatous uteri.RESULTS:The mean mitotic count in submucosal uterine leiomyoma was significantly higher (42.3%) than thatof the other location such as intermural and subserosal leiomyoma. We found the highest mitoticcount in a leiomyoma at the late reproductive aged women (46.1%) at early secretory phase. But therewas not a statistical correlation between women’s age and mitotic activity of uterine leiomyoma.CONCLUSION:Increased mitotic activity in leiomyomas under the late reproductive aged women suggests that thegrowth of these tumors is affected by progesterone level

Mongolian Telepathology Network (MonTelNet) / Монголын Анагаах Ухаан

IntroductionMongolian rural population lack of access to adequate health services due to the fact that they live remotefrom urban hospitals. With the rapid spread of telemedicine in most countries, has been promoted as apromising tool to address deficiencies in delivering health care in developing countries.In late 2008 the Swiss Surgical Team (SST) started the telemedicine project MonTelNet in Mongolia incollaboration and with financial support of the Swiss Agency for Development and Cooperation (SDC).GoalThis study aims at evaluating the diagnostic accuracy of such a service by reviewing 212 telepathologydiagnoses delivered to the local experts in Ulaanbaatar between January 2009 and June 2013.Materials and MethodsUnder the MonTelNet project all province (Aimag) hospitals were equipped with hardware necessaryfor practicing telemedicine, in particular with computers with digitalized microscopes and cameras. Thesoftware CampusMedicus® (CM) was developed together with Klughammer GmbH. Software and alldata and comments exchanged over the MonTelNet are stored on a central server. Each of the originaldiagnoses issued through the CM telepathology (TP) server was compared to an independent reviewdiagnosis based on the original glass slides.RESULT For 188 specimens (89.9%) the TP diagnosis were completely identical with the review diagnosison the original glass slide. 12 specimens (5.7%) showed minor discrepancies (clinically identical) and 5specimens (2.4%) showed moderate discrepancies which were not clinically relevant. four cases (1.9%)exhibited a marked discrepancy (clinically relevant) between the TP diagnosis and the review diagnosis.Three specimens were classified as “other”.DISCUSSION The results of the study show a very high accuracy of the TP diagnosis provided. The TPdiagnoses differed markedly from the review diagnoses based on the original glass slide in only 1.9%of the 212 cases. 89.9% of all cases showed complete concordance between TP and review. Thesefigures are comparable to figures from other evaluations of static image telepathology.Conclusion:1. The results of the study show a very high accuracy (94.7%) of the TP diagnosis provided. TheTP diagnoses 89.9% of all cases showed complete concordance between TP and conventionalreview.2. Problem with image selection show a different picture and occur more often in cases with markeddiscrepancies between TP and review - χ2-test shows significant correlation (p<0.001).

Immunohistochemistry of prostate carcinoma / Шинэ санаа Шинэ нээлт

BACKGROUNDProstate cancer is the most frequent malignancy among men nowadays.METHODSImmunohistochemical expression of prostate-specific antigen (PSA) was retrospectively investigated in 10 patients admitted with clinical suspicion of the prostate cancer. Slides were collected from archived biopsiesandthey were stained for PSA.The final reaction product was evaluated as negative (0), weak/moderate positive (1), and intense positive (2).RESULTSGlandular prostate carcinoma was found in 40% (n=4) and undifferentiated carcinoma in 60% (n=6). The immunoreaction for PSA was intense positive in 30% (n=3), weak/moderate positive in 50% (n=5) and negative in 20% (n=2) of total cases.CONCLUSIONSWe concludethat PSA immunoreaction is helpful for the differential diagnosis based on our results.

Diagnostic value of tumor suppressor P53gene and proliferative Ki67 marker expression in uterine leiomyomas / Монголын Анагаах Ухаан

Aim was to investigate expression of tumor suppressor P53 gene, proliferating Ki-67 protein inordinary and proliferating uterine leiomyomato establish possible usefulness of these two parametersin distinguishing between ordinary leiomyoma and proliferating leiomyoma. Retrospective study of49uterine leiomyoma (25 ordinary leiomyoma, 24 proliferating leiomyoma) technically acceptable foranalysis from years 2010–2013 department of Obstetrics and Gynecology and department of Pathology,Mongolian National University of Medical Science, Ulaanbaatar, Mongolia.MethodAll tissue specimens were obtained from surgically removed tumors. Tissue was fixed in formalinand cut to thickness of 5 mm from paraffin-embedded blocks. All haematoxylineosin slides and allimunohistochemical slides for each case were reviewed by two experienced pathologist.ImmunohistochemistryParaffin-embedded tumor sections were deparaffinized and stained in automated platformDakoCytomationusing monoclonal mouse anti-human Ki-67 antigen (Dako,Glostrup, Denmark), monoclonal mouse anti-humanP53 protein (Dako, Glostrup, Denmark).Immunohistochemicalanalysis of P53 and Ki67 expression was performed. Every nuclei stained brown,regardless of shade intensivity, was considered positive. The interpretation of immunohistochemicalstaining was expressed as number of positive cells in 100 cell count in most active area of the slide.Non-parametric analysis of variance Kruskal-Walistest was performed.P53 expressionExpression of P53 was negative in 24/24 ordinary uterine leiomyoma, 2/10 mitotic activity leiomyoma,11/15 cellular leiomyoma. Expression of P53 in 1–10% of cells showed 3/10(30%) mitotic activeleiomyoma and 1/15(6.6%) cellular leiomyoma. Expression in 10-70% of cells showed 5/10(50) mitoticactivity leiomyoma, 3/15(20%) cellular leiomyoma. A significant difference in expression of P53 wasseen between ordinary and proliferative (mitotic activity and cellular) uterine leiomyoma (p<0.007, Table1).Ki-67 expressionExpression of Ki67 was negative in 20/20 (100%) ordinary leiomyoma, 4/11(36.3%) mitotic activityleiomyoma and 7/18(38.8%) cellular uterine leiomyoma. 1–10% of cells were positive in 4/11 (36.6%)mitotic activity leiomyoma, and 5/18% cellular leiomyoma. Expression was positive in 10-70%of cellsof 3/11(27.2%) mitotic activity leiomyoma and 6/18(33.3%). Statistically significant differences in Ki67expression was found between ordinary leiomyoma and proliferating leiomyoma (p<0.014, Table 2) andbetween LM and LMS (p=0.000, Table 1).Conclusion:The findings of our study in concordance with other study results are helpful information establishingmore diagnostic criteria and parameters for diagnosis in doubtful cases between two entities.Immunoassaying for Ki-67 and P53 are such parameters. The panel of their expression in specific caseeases diagnosis.