Vol 53 No 3 2012 

Vol 53 No 3 2012 

Report on the 7th Asia Pacific IAP Congress, Taipei, Taiwan

Museums for the 21st Century

Dr. Masahiro Kikuchi

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INTERNATIONAL PATHOLOGY (ISSN 0020-8205)published quarterly by the International Academyof Pathology.Circulation 23,000 worldwide.IAP WEBSITEhttp://www.iaphomepage.orgPRESIDENTKristin HenryImperial College London atCharing Cross HospitalFulham Palace Road,London W6 8RFUKEmail: k.henry@imperial.ac.ukSECRETARYDavid F. HardwickUniversity of British ColumbiaFaculty of MedicineE-mail: iap.secretary@ubc.caTREASURERJ. Allan TuckerLouise Lenoir Locke ProfessorUniversity of South AlabamaMobile, USAatucker@usouthal.eduEDITORRobin A. CookeMayne Medical School, University of Queenslandand Pathology QueenslandBrisbane, AustraliaE-mail: cooker@ozemail.com.auDESIGNLuke Perkins GraphicsBrisbane, AustraliaEmail: l.perkins@bigpond.com
Vol 53 No 3 2012
Report on the 7th AsiaPacific IAP Congressheld in Taipei, Taiwan on May 20-24, 2011.The General Registration for the meeting was1186 and was the highest in the recent six yearshistory of Asia Pacific IAP Congress attendance.367 international visitors from 31 countries andregions outside of Taiwan were in attendance (31 %of our total registrants).Dr. Shih-Ming Jung served as Congress President.The Scientific committee was headed by ProfessorIh-Jen Su, and Professor Shiu-Feng Huang servedas vice chairperson of the scientific committee.Professor Ho-Keung Ng and Professor Tseng-tongKuo were the international advisers. Dr. Jan-ShowChu served as Congress Secretary General. Dr.Chiung-Ru Lai served as Congress treasurer. Dr.Liang-Che Chang was Secretary General of Taiwandivision of IAP.Seven plenary lectures were given by:Dr. Elias Campo (Spain),Dr. Robin Cooke (Australia),Dr. Jonathan Epstein (USA),Dr. Marc Ladanyi (USA),Dr. Sunil Lakhani (Australia),Dr. Wun-Ju Shieh (USA), andDr. Ih-Jen Su (Taiwan).SymposiumsTwenty two half-day or one day symposiums orslide seminars presented by 214 speakers were of- fered and well attended. Six lunch time symposiumswere offered. Virtual Slides for slide seminars wereposted to the Congress Website for free.Abstracts150 scientific abstracts were accepted as posters. Thescientific abstracts and symposium abstracts were
published in the journal Proceedings of Taiwan So-ciety of Pathology, volume 2, number 1, 2011, May.
AwardsThe 7 recipients of the Young Pathologist Travel
Awards were from India, Indonesia, Philippines, Vi-etnam, and Korea. Each received a monetary award
of USD 1000 (subject to a percentage of income tax)and refund of registration fee. The award fund wassupported by the IAP education committee (USD5000) and the Congress.Top: Organisers of the Congress together with organizers of sessionsfrom various countries from the Asia Paficic Region.Above: Shih-Ming Jung (President) and Jan-Chow Chu (Sec Gen)of the Congress.
Continued page 2
Robin Cooke and William Edwards in the Gordon Museum inApril 2012 discussing the posters of the Three Famous Diseasesand what else is new in the Museum.
2The board meeting of Asia Pacific Assembly of IAP washeld on May 22.In addition to the high number of attendees, the meetingwas supported by twenty-six exhibitors and booths. Rocheand Thermo were the main exhibitors.Thanks for all your support.Shih-Ming Jung, President of the Congress, and President,Taiwan Division of the IAP.
Above: Speakers at a Forensic Pathology session, last 2 on the right,Philip Beh (HK) Keith Nolte (USA).
Above: Keynote lecturer Jonathan Epstein (USA) withChin-Chen Pan (Taiwan).Right: Congress organizers Mu-Zon Wu, Ih-Jen Su,Chiung-Ru Lai (Treasurer of the Congress), Shih-MingJung, (President of the Congress), Liang-Che Chang(Secretary general of Taiwan Society of Pathology),Shiu-Feng Huang (Vice chair of Scientific committee).Left: The Trans Strait Session arranged by Shih-MingJung. 70 pathologists from China were funded toattend.Bottom left: Entrance foyer to the Convention Centre
Taipei from the dinner venue of the Taipei 101 building.
View from the Meridien Hotel
Below: Committee meeting of the AAPIAP. Front row: Kei Osamura (Japan), Bob Eckstein (Aust), Brett Delahunt (NZ), Samir Amr(Pres elect of IAP), Tseng-tong Kuo (Taiwan), Pongsak Wannakrairot (Thailand), Insun Kim (Korea), Yong-Koo Park (Korea).Middle row: Francisco Couto (India), HK Ng (Hong Kong), Osamu Matsubara (Japan), Robert Osamura (Japan), Shih-Ming Jung(Taiwan), Robin Cooke (Aust, Editor of IAP News Bulletin), Gary Tse (HK).Back row; Angela Chong (Singapore), Annie Cheung (Hong Kong), , ,Sam Boros (Australia).
The 8th Asia Pacific IAPCongressBusan, KoreaSeptember 5 to September 8, 2013.
The Congress will be organised by the Kore-an Division of the IAP.
Contact person: Angie Choiv, Manager, Con-vention Team / Coex.
Email: angie@coex.co.krHomepage address: www.apiap2013.org.Telephone: 02-6000-2506.Fax: 02-6000-1306.Mobile (cell phone): 010-6299-1260
Mailing address: 159 Samseong-dong, Gang-nam-gu,Seoul 135-731, KOREA
Korean division of IAP website www.patholo-gy.or.kr/iap.
Yong-Koo Park and Insun Kim from S Korea receive the IAP flagfrom Shih-Ming Jung
The next Congress will be held in Busan, Korea in 2013. TheKorean Division invites everyone from the Region to attend.Breast pathology: Pongsak Wannakriarot, Puay Hoon Tan, SunilLakhani, , Takuya Moriya
Left above: Neuropathology speakers; L to R : Pang-Hsien Tu
(Taiwan), Samir Amr (Saudi Arabia, Pres. Elect of IAP), Kar-ming Fung (Oklahoma city), Joe Ma (Miami), Chin-Cheng Lee
(Taiwan), Takanori Hirose, HK Ng (Hong Kong), Gerard Jansen(Ottawa), Hitoshi Takahashi (Japan).Above: Cytopathology; Andrew Field, Annie Cheung et al.Left: Session on IgG4 related diseases. Front row: , Tseng-tong Kuo(Chair of the session), Yasuni Nakanuma (Co-chair of the session),Tse-Ching Chen (Taiwan). Back row: Noriyuki Sakata, Yoh Zen,Kenichi Harada.Below: A group from Indonesia. L – R Nurjati Siregar, EningKrisnuhoni, Endang Hardjolukito, Ardiana, Lisnawati (allpathologists from Jakarta), A representative from Roche Indonesia.
Above: Genitourinary pathology: Guido Martignoni, Ai-Ying Chuang, Brett Delahunt,David Grignon, Hema Samaratunga, , John Eble.Below: Delegates at a museum on a city tour: Front: Youn-Koo Park (Korea), MidoriOsamura (Japan), Annie Cheung (Hong Kong), Tseng-tong Kuo (Taiwan), Insun Kim(Korea), Kei Matsubara (Japan), Shih-Ming Jung (Taiwan). Back: Eftika and SamirAmr (Saudi Arabia), Robert Osamura (Japan), Osamu Matsubara (Japan), FranciscoCouto (India), Robin Cooke (Australia).
Below: Molecular pathology Matt van de Rijn, Jorge S. Reis-Filho.
Gunter Kloppel (Germany),Giuseppe Zamboni (Italy).
This museum is a very good example of a
pathology museum that was almost de-stroyed, but has been refurbished as a
teaching resource for the 21st Century.Emperor Francis I of Austria founded a medicalschool in Vienna it is said ‘so that he could have hisdoctors better educated so that they would not killso many of his soldiers.’ As part of the School he
founded this museum of the Pathological-Anatom-ical Institute in 1796.
The museum has had some very famous Curatorssince its inception. The most famous of these wasCarl Rokitansky who was one of the importantmembers of the Faculty of the University who ledit to become a leading centre of Medical Educationin the mid and late 19th century. It had considerableinfluence in determining the curricula and teachingmethods in Medical Schools throughout the worldas medical schools moved from teaching ‘herbalmedicine’ to ‘scientific medicine.’Another of the illustrious Curators of the 19thcentury was Johann Wagner who performed a postmortem examination on Ludwig van Beethovenin 1829. The most illustrious Curator in the 20thcentury was Karl Portele who became Curator in1946 and remained in that position until his deathin 1993. He was succeeded by his former assistant,Beatrix Patzak.When the Institute of Pathology of the Universityof Vienna was reorganised in the early 1970s, thecollection was to be dissolved. Portele persistentlycampaigned for conservation of the collection in its
entirety. He was successful, and in 1971 the prepa-rations were moved (with a handcart) into the part-ly unoccupied ‘Narrenturm’ in the grounds of the
old Allgemeines Krankenhaus (General Hospital).The Federal Pathologic-Anatomical Museum in Vienna, Austria - Museums for the housed in the Narrenturm (the Fools’ Tower).21st Century
The outside of the Narrenturm in the grounds of the now closed General Hospital
Top left: One of the circular levels of themuseum with the repainted doors to three ofthe original ‘cells’ or rooms for inmates of theoriginal ‘lunatic asylum’ built to accommodateviolent psychiatric patients. This level is lined bydisplay cases. The ones on the left and the righthave some of the large number of wax models,mainly of dermatological diseases that weremade by the father and son Karl and TheodorHenning. Karl began in 1890 and continueduntil 1917. Theodor began in 1910 and
continued until 1939.Left: Skelton of a woman who had rickets.Above left: Post mortem specimen demonstratingpolyarteritis in the mesenteric arteries.Above: Heart and root of the aorta with aSyphilitic aneurysm, and probably aorticincompetence as a complication.Below: Post mortem register of the specimen asCase 6419
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by Maude Abbott in Montreal in 1906, existed fromas early as 1931 until 1949. He could not find anydefinite connection between the British Section andthe BDIAP but, if such a link were to be found, wecould be in the curious position of celebrating our50th anniversary in 2011 and our Centenary only20 years later in 2031!!
Professor Mike Wells, retiring Editor of Histopa-thology, current President of the European Society
of Pathology and President-Elect of the BDIAP, gavea masterly account of the history of our journal,Histopathology. Indeed it should be noted thatthe Cunningham Medal, awarded for distinguishedservice to the BDIAP was, in 2011, awarded to MsElizabeth Whelan of Wiley-Blackwell Publishing,Oxford. Elizabeth has been the main adviser to the
four editors of the journal Histopathology through-out its first 35 years of publication: Professors Roger
Cotton, Sir Roddy MacSween, Sir James Underwoodand Mike Wells. Now she works closely with onlythe fifth editor of the journal, Professor Alastair Burt.In further compelling addresses, Professor KristinHenry, President of the International Academy ofPathology, described the international challengesin pathology and Professor Sir James Underwoodoutlined some of the professional challenges facingpathologists. Finally, Professor Peter Furness, the
outgoing President of the Royal College of Pathol-ogists and former Divisional Editor of the BDIAP,
talked about the future of diagnostic pathology inthe next fifty years.There were two main educational meetings in 2011.
The first was the sixth joint meeting with the Patho-logical Society of Great Britain & Ireland, Ghent Pa-thology 2011, in May, organised with aplomb by the
indefatigable Professor Claude Cuvelier, the IAP’sEuropean Vice President and former President ofour Division. The second was in late November witha London-based symposium on Infectious Diseases.It was apposite that the second medal award of lastyear, the President’s Medal, should be to ProfessorSebastian Lucas, one of the leading infectious diseaseHistopathologists in the world.In October of this year, Council undertook its
second ever AwayDay. This meeting, and our subse-quent AGM, ratified the establishment of a further
Subcommittee, the International Subcommittee, todeal with our international affairs. It is excellent newsthat Dr Alec Howat, our former Treasurer and futurePresident-Elect of the Division, has agreed to chair
this committee and its workings are now well estab-lished. Of especial importance are the coordination
of our four Schools of Pathology, in Arab countriesand East Africa, in concert with the Arab and EastAfrican Divisions of the IAP respectively, and in SriLanka and Bosnia.Council of the BDIAP is very proud of its charitablepathological educational activities outside its fourmember countries and these activities are continuingto expand.Professor Neil A Shepherd, BDIAP President.
Report from the PakistanDivision
Pakistan is a country of about 180 million inhab-itants. In the initial years after independence on
14th August, 1947, the discipline of Pathology washardly in existence. However over the course of the
next few years a handful of foreign qualified pathol-ogists both in the public sector (like ‘Basic Medical
sciences Institute, BMSI, Karachi) and the ArmedForces (like ‘Armed Forces Institute of Pathology,AFIP, Rawalpindi) took the initiative and startedtraining programs.These were largely diploma courses based on theDCP of London University. They had instruction
in the four main disciplines of Pathology – histo-pathology, haematology, micro-biology and biochemistry. There
were also some more specificcourses that led to an M.Phil orPh.D. Graduates of these courses
were largely employed in medi-cal colleges teaching ‘Pathology’
to undergraduate students, and
offering a limited clinical ser-vice mainly confined to ‘Clinical
Chemistry’, ‘Basic Haematology
& Blood Banking’, and ‘Micro-biology.’
For ‘Histopathology’ there wereonly two facilities i.e., BMSI,
Karachi and AFIP, Rawalpindi. So biopsy speci-mens from all the major hospitals of Pakistan were
transported to these places. This used to take severalweeks. Most physicians & surgeons usually treatedtheir patients on their clinical acumen and did notbother to send the specimens for histopathologicalevaluations.
This scenario persisted till the early 1980’s. How-ever a paradigm shift took place in the mid 1980’s
when the state of the art ‘Clinical Laboratories ofthe Aga Khan University Hospital (AKUH)’ wereopened in Karachi. This attracted highly qualifiedand experienced pathologists both native and foreignfrom all over the world. Gradually they won theconfidence of clinicians and all kinds of specimensstarted pouring in.AKUH laboratories took another initiative andopened collection points and stat labs in all cornersof Pakistan (Currently 200 collection points andseven stat labs in Pakistan, and 7 collection pointsand one lab in Afghanistan).This was followed by a few more initiatives like‘Shaukat Khanum Memorial Cancer Hospital’ inLahore, the Shifa International Hospital, Islamabadand several other standard facilities throughoutPakistan.
Many of these facilities also started 4-5 year train-ing programs in various sub-specialties of Pathology
largely following the British system. Currently these
hospitals offer 4-5 year residency programs in ‘Clin-ical Chemistry’, ‘Haematology’, ‘Histopathology’,
‘Immunology’, ‘Microbiology’ and ‘Virology’.The College of Physicians and Surgeons (CPSP) isthe regulatory and examining body authorized by theGovernment of Pakistan. It awards an exit diplomatermed ‘FCPS’ i.e., ‘Fellow of College of Physicians
and Surgeons,’ Pakistan. This again is in line withBritish exams. Now there is a significant Pathologyworkforce in various sub-specialties of Pathology.‘The Pakistan Association of Pathologists (PAP)’
is the common platform for all Pathologists in Paki-stan. Its foundation was laid in 1975, and since the
early 1980s it regularly holds its annual conferencesin a city of Pakistan. Currently there are over 800pathologists from all sub-specialties who are regularmembers of PAP.
Over the last decade besides PAP, some sub-spe-cialties of Pathology also developed specialty specific
societies like the ‘Pakistan Society of Haematology’,‘Histopathology & Cytology Society of Pakistan’which hold annual meetings.In 1986, PAP took the initiative to form the‘IAP-Pakistan Chapter’ which was formally approvedat the IAP Vienna Congress. In 1986, at the AFIP,Rawalpindi a joint conference ofPAP & IAP-Pakistan was held.In following years the Chapter
became dormant and member-ship fees were not paid to the IAP.
Thus a generation of pathologistsdid not know of its existence.Fortunately while attending aconference in 2011, I met Prof.
HK Ng from the Chinese Uni-versity of Hong Kong. He moti-vated me and helped me to revive
the IAP-Pakistan Division of
IAP. I am looking forward to rep-resenting the Pakistan Division at
the IAP Council meeting in Cape Town in October.Shahid Pervez, Secretary, IAP Pakistan DivisionProfessor of HistopathologyAga Khan University HospitalKarachi, PakistanReport from the BritishDivisionTwenty Eleven has been an important year for theBDIAP. It has been our 50th anniversary. Theoccasion was celebrated at our Annual Meeting inNovember, 2011. The Division was initiated in 1961by Dr George Cunningham, a visionary pathologistwith legendary foresight. His profound influence on
the Division, in its early days, is, to this day, celebrat-ed in two ways by the BDIAP, by the Cunningham
Medal and the Cunningham Lecture. However, thenaming of the latter has caused some confusion so,this year, Council has agreed to rename this annuallecture the Kristin Henry Lecture to honour Kristin,who has made huge contributions to the BDIAPand the IAP over many years, culminating in herChairmanship of the IAP Education Committeeand, of course, her election as President of the IAPfrom 2010 to 2012.At the 50th anniversary meeting, luminaries of theDivision gave authoritative talks on various aspectsof the BDIAP and Pathology in our four membercountries of the BDIAP, the UK, Belgium, theNetherlands and the Republic of Ireland. ProfessorChris Elston gave a comprehensive account of thehistory of the BDIAP. One curious fact emergedas a result of his research. There is documentaryevidence that a British Section of the InternationalAssociation of Medical Museums (IAMM), founded
The IAP In Action
Museums for the 21st Century continued
The collection is one of the oldest and most exten-sive of its kind in the world. It consists of maceration
preparations (human and animal), wet preparations,moulages (wax models), bones and skeletons as well asold and new medical devices.Since the 1980’s the museum has taken over manypathological collections from hospitals in Austria andeven some in Germany. It was thought that nobodyneeded such conserved preparations any more and
that their further maintenance would not be worth-while. Some important additions have come from the
following places:
• the teaching collection of the famous Semmel-weis-Klinik in Vienna,
• from a maternity clinic with attached midwife-ry-school,
• and from the Viennese Electro Pathological Muse-um.
Now the Museum is literally bursting at the seamsand in urgent need of new exhibition space. For some
years there has been very little funding for the muse-um. However, a new Minister of Health has decided
to support it with adequate and on going funding.To accomplish this it will become a branch of theMuseum of Natural History. This will allow it toextend its visitor programme both to medical visitorsand the general public. It will also allow the scholarlydocumentation and archiving of the whole collectionand make research projects possible.The Narrenturm or Fools’ TowerThis circular, 5 floor building was built around acentral core which consists of a courtyard of sorts. Itwas constructed in 1784 with personal funds fromJoseph 11, Holy Roman Emperor from 1765 to 1790.
It was purpose built to house mentally deranged pa-tients. Before this, such patients were housed either
in general hospitals or in prisons. Each floor had 28cells for patients. The dangerous patients were chainedin their cells and the harmless ones were free to moveabout. Later the cells were equipped with doors thatcontained observation windows.
From 1844 the discipline of psychiatry was de-veloped and mental patients were housed in more
appropriate accommodation. The building was finally
vacated in 1869. At first it was decided that the build-ing would be demolished, but ultimately it was used
for over 100 years as a Nurses’ living quarters. It is now
regarded as being of medical and architectural histor-ical importance and it houses the museum exhibits.
What does the future hold for the museum?The general public and the media have developed arenewed interest in seeing the exhibits and learningabout diseases that are now virtually extinct. Visitor
numbers from Austria, from other European coun-tries and from the rest of the world are increasing.
Government funding is being supplemented by theactivity of a ‘Friends of the Museum Association.’Prominent members of this Association include Prof.Heinrich Holzner a former Professor of Pathology in
Vienna and a senior consultant clinician, Dr. Freibau-er. For the past 9 years the Friends’ Association has
been holding a series of fund raising functions withincreasing success.Peter Hiess, Press Officer.Beatrix Patzak, Curator.
ValeMasahiro Kikuchi, 1934-2012
Fukuoka, Japan, and educated at the School of Medicine of
Kyushu University. He started his training in hematopathol-ogy under Dr. Michio Hashimoto at Kyushu University. In
1966, he started to work with Dr. Hans Jochen Stutte underDr. Karl Lennert at Kiel University, Germany and in 1973, hemoved back to Japan to work as a Professor of Pathology atthe School of Medicine of Fukuoka University.
He was energetic and enthusiastic, he loved his patholog-ical, scientific and clinical work, and he warmly welcomed
many pathologists and hematologists from all over theworld.He was a world-renowned hematopathologist and also anoutstanding general pathologist. He published over 600papers in peer-reviewed journals, as well as many scholarlytextbooks and chapters in textbooks. He worked togetherwith Dr. Karl Lennert, Dr. Hans Konrad Müller-Hermelink,Dr. Harald Stein, Dr. Stefano Pileri, Dr. Elaine Jaffe and
several others in support of the development of lympho-ma classification.
His name can be found in the chapter on adult T-cell leu-kemia/lymphoma in the third and fourth editions of the
WHO Classification of Haematopoietic and Lymphoid Tissue.His family is deeply involved in the practice of medicine.He often spoke about his happy life with his family, his wife
Makiko whose father was the famous virologist Dr. Yoh Nak-agawa, his son Hitoshi, a neurologist and his daughter Yuka,
an anesthetist. Our deepest sympathy goes out to his family.
Professor Kikuchi continued to perform pathological diag-noses until his death. His many and vital contributions to
hematopathology will be remembered by people in thefield who did not know him in person, but those who didwill especially deeply miss his active and warm personality
with which he continuously encouraged younger genera-tions of medical researchers and practitioners.
Koichi Ohshima, Department of Pathology, School of
It is with the utmost sadness that I must inform you ofthe passing away of Dr. Masahiro Kikuchi, Professor ofPathology at Fukuoka University, Japan. He died on 28
April 2012 after a 4-year fight against ALK-negative ana-plastic large cell lymphoma, the equivalent of the anaplas-tic variant of peripheral T-cell lymphoma (HTLV1-negative),
which was accurately diagnosed by Dr. Kikuchi himself.He was an outstanding hematopathologist and made amajor contribution to the establishment of the currentLymphoid Cell Tumor classification. The Kikuchi disease,which he was the first to report as ‘Lymphadenitis showingfocal reticulum cell hyperplasia with nuclear debris andphagocytes’ in Acta Haematologica Japonica in 1972, isknown worldwide.Masahiro Kikuchi was born 21 March 1934 in Kitakyushu,
Third Pilgrimage TourOctober 7 to October 13, 2013From Amman, Jordan to Jerusa- lem, Israel withJuan Rosai, ItalyJerónimo Forteza Vila, SpainManuel Sobrinho-Simões, PortugalRobert Young, USA
And their team of distinguished internation-al speakers.
This tour follows the first two similar tours thatcombined a mix of Scientific and Cultural themes,and provided a wonderful social experience forthose who participated.
The first two tours ended in Santiago de Com-postela which was approached first from Northern
Spain and then from Northern Portugal.This tour will be in the Middle East and it will
provide a different cultural and geographic experi-ence for the participants.
The tour is being organised under the auspices ofSociedad Espanola de Anatomia Patologica &International Academy of Pathology.Contacts for further information and bookings:Congrega, S.L.Calle Rosalía de Castro,13 - 1o Izq. 15004 A Coruña(Spain).Phone +34 981 216 416 Fax +34 981 217 542e-mail: congrega@congrega.esRossana Couto LagoCalle Alfonso Senra, 175 4oB 15680 Ordes. ACoruña (Spain)Phone +34 981 68 00 84e-mail: rossana@coutolago.com

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