Evaluation of the Agatston Coronary Artery Calcium score using contrast enhanced CT-Coronary angiography / Монголын Анагаах Ухаан

Background@#In 1904, Monkeberg was first described about the coronary calcification which is the degenerative change that occurs with aging process, but the last decades many studies have been confirmed that coronary calcification was an active process same as the signaling pathways with bone mineralization. Coronary calcification increases the risk of myocardial infarction during bypass graft surgery and PCI (СМ СN. Shanahan, 1999).@*Goal@#To evaluate Agatston Coronary Artery Calcium score using contrast enhanced CT-Coronary angiography. @*Objectives@#</br>1. To assess Agatston Coronary Artery Calcium score </br>2. Age and gender relationship of coronary calcification @*Materials and Methods@#We evaluated total 215 patients who were admitted to the Reference center of Diagnostic Imaging named after R.Purev State Laureate, People’s physician and Honorary Professor of the Third State Central Hospital awarded with the Red banner of the Labor diagnosed with the coronary calcification by contrast enhanced 64 slice CT (Philips Ingenuity CT 64) between 2020 to 2022. Patient’s age was considered into 6 groups and coronary calcification was assessed by Agatston’s score. The result of our study determined by common statistical averages and errors and probabilities of the indicators were determined by Student’s criteria.@*Result@#When evaluating Agatston coronary artery calcium scoring by CT-coronary angiography, 11-400 Agatston score was predominantly in our study with p value of (P<0.001). Considering relationship of age and gender, coronary calcification occurs 42.3% of patients aged 50-69, male and female ratio was 1.7:1. @*Conclusions@#</br>1. We established Agatston coronary calcification 11-400 was occurred in 66.96% of the patients. </br>2. Coronary calcification predominantly occurred in 65% patients aged 50-69 years.

Diagnosis of coronary artery calcification by computed tomography coronary angiography / Монголын Анагаах Ухаан

@#The anatomy and diseases of the coronary artery, and number or death toll in relation to the coronary artery disease in Mongolia, CT and HRCT the pathologic physiology and risk factors of atherosclerotic calcifications of the coronary artery, the comparison between CT, HRCT and Coronary angiography of coronary arteries of the heart, the selection of a patiant, the preparation of a patient, and the steps of examination that how the patient going through ,the advantages and the disadvantages of CT coronary angiography, the limitation of use of HRCT, the indications and the contraindications to HRCT, the method and devices to reveal a calcification of the coronary artery, the AGATSTON score of calcification and its radiologic imaging, the index of calcification of the coronary artery, a guideline devoted to the patients who have coronary artery calcifications, an amount of 50 references in relation to unstable atherosclerotic plaques radiologic signs on the HRCT were used .

THE SUCCESSFUL SURGICAL TREATMENT FOR ABDOMINAL AORTIC COARCTATION AND LEFT NEPHRECTOMY / Мэс засал

Middle aortic coarctation (MAC), a variantof middle aortic syndrome, is a rare entity withonly ~200 cases described in the literature.It classically presents with early onset andrefractory hypertension, abdominal angina,and lower extremity claudication(1).A 30 years-old woman, Her systolic bloodpressure measures 180-200mm Hg and diastolicpressures measure 70mm Hg in both arms,lower extremity pressures are approximately70mm Hg. Her bilateral femoral pulses andpedal pulses are nonpalpable, but present onDoppler exam and CT-Angiography.We prepared diagnostic of CT-Angiographyand Aortography before operation. Wesuccessful operated abdominal aorticcoarctation by “Silver graft” Aortoaortic bypasson the middle aortic, left nephrectomy.She was discharged home on postoperativeday 7. Post operation is good. We werecontrolled CT-Angiography.

Some problems of roentgen, ultrasonographical and computer tomographical diagnosis of thyroid gland behind the sternum / Монголын Анагаах Ухаан

Introduction: Thyroid gland behind the sternum near the base of the neck, and it is one of the gland behind the sternum at cartilage southern centre of middle mediastinum and at back of superior middle mediastinum rarely [ R.E Gabunia.,E.K.Kolesnicova.,L.B.Tumanov.,1983; J.O.Shepard.,1991; S.K.Wernecke 1991; N. B.Litvakovskaya.,1994;V.P.Harchenko.,P.M.Kotlyarov.,R.V.Kertanov.,Z.S Tsallagova., 2002]. Goal: The research thesis aims to make diagnosing and identifying the nature and symptoms of thyroid gland behind the sternum by roentgen, US and computer tomography and developing the criterion characteristics of diagnostics. The following objectives will be resolved in order to implement the goal of research thesis: 1. To identify the symptoms of thyroid gland behind the sternum which is obtained by the roentgen? 2. To identify the symptoms of thyroid gland behind the sternum by diagnostics of US and computer tomography 3. Developing the criterion characteristics of thyroid gland behind the sternum by diagnostics of US, computer tomography and the roentgen Materials and Methods: Made conclusion at symptoms identified by diagnostics of US, computer tomography and the roentgen at 12 patients who were diagnosed with thyroid gland behind the sternum through 2005-2011. The diagnostics of thyroid gland behind the sternum was approved by the surgical operation and biopsy analysis which is a medical test involving the removal of tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease under a microscope by a pathologist. Results: The symptoms of 12 patients who were diagnosed with thyroid gland behind the sternum were identified by diagnostics of US, computer tomography and the roentgen. From the symptoms defined by roentgen images of thyroid gland behind the sternum, located in western upper south part of middle mediastinum (P<0.001), oval shaped thyroid (P<0.05), calcification osteoporosis (P<0.01), bronchus was pushed to healthy side (P<0.05), changes of middle mediastinumwas moved upward when cough, drink and make Valsalve’s test /a method for testing the patency of the Eustachian tubes. With mouth and nose kept tightly closed, the patient makes a forced expiratory effort (P<0.01) therefore there is true statistical probability. Conclusions: 1. During the thyroid gland behind the sternum, the additional changes are identified at thyroid gland behind the sternum, located in western upper south part of middle mediastinumat 75.0%, the mentioned changes are moved upward when made cough, drink and make Valsalve’s test by roentgen, lost similarity of structure and pushed the bronchus to healthy side at 66.7%, there is dominant symptoms by roentgen that gullet defined by barium substance was pushed to healthy side at 58.3%. 2. By the ultrasound analysis, during the thyroid gland behind the sternum, the changes are relevant to thyroid and vascularization at 100% , to capsule at 75% and osteoporosis at 66.7%. 3. Changes are relevant to thyroid and vascularization at 100% or oval shape more compactness was identified by the contrast substance , pushed the bronchus to healthy side at 66.7%, there is dominant symptoms by roentgen that bronchus was pushed to healthy side, 4. We established that there is thyroid gland behind the sternum. status of the additional changes of middle mediastinum , compactness, structure, capsule, size, shape of the thyroid gland behind the sternum, additional changes of middle mediastinum changes the location of the nearest organs due to thyroid, so identified the main criterions to diagnose and to identify the thyroid gland behind the sternum by roentgen, US and computer tomography.

The problems ultrasonographic diagnosis of the pancreatic tumors / Монголын Анагаах Ухаан

Introduction: Pancreatic cancer in young patients is usually correlated with chronic alcohol consumption and hereditary factor. Chronic pancreatitis, pancreatic trauma, pancreatic cyst, alcoholism, and diabetes mellitus are the most clearly established etiological factors (T.Y Flanders., W.S Foulkes., 1996). The cancer was located to the pancreatic head in 75% to the body in 15-20% and to the tail in 5-10% of cases (A.E Richard., 2005). Goal: Determination of the US signs in pancreatic cancer and establishment standard (control) US diagnostic criteria. Objectives: 1. To reveal direct and indirect US signs of pancreatic cancer. 2. To establish standardized US diagnostic criteria. Materials and Methods: A prospective study was carried out in 35 patients with pancreatic cancer in a 4 years period between 2006-2010 (Shastin Central Hospital, Achtan Clinical Hospital). To each patient has being filled special investigation chart. Diagnosis was confirmed on the result of physical examination, laboratory investigation, abdominal conventional radiography, upper gastrointestinal contrast radiography, CT, MRI, ERCP and biopsy. The results of the measurements were compared with the standardized control evaluation of Mongolian people (Ts.Badamsed.B.Tserendash). Results: Our sample represents US signs in 35 patients with pancreatic cancer. On the basis of our study US sign were divided into two categories: direct and indirect signs. Direct signs: a) irregular shape, b) irregular tumour edge, c) hypodensity, d) tumour size more than 2.1cm, e) different location. Indirect signs: a) CBD distends, b) gallbladder distends, c) intra hepatic bile duct distend, d) pancreatic pseudo cyst, e) near-aortic limp node enlargement, f) splenomegaly. We consider that the upper mentioned US abnormality can be as control standard criteria for the US diagnosis of the pancreatic tumour. According to the study of V.N.Demidov and G.P.Sidorov (1987), the pancreatic cancer is located to head in 50-80%. In our series it was about 45.7%± 8.4. Irregular tumour shape in 60.0%±8.3, tumour hypodensity 80.0%±7.2, irregular tumour edge 68.6%±7.8, tumour clear definition 71.4%±7.6 which are the same with N.M. Mukharllyamov (1987). Conclusions: 1. Were described direct and indirect US diagnostic signs in pancreatic cancer 2. The tumor location, shape, size, edge, consistency, intra and extra hepatic bile duct distend, gallbladder distend, near-aortic limp node enlargement are the basic control criteria for the diagnosis of pancreatic cancer.