Entrance to the Cassaba – a name used in the Moorish countries of NW Africa for “the old city”

The meeting’s President was Dr. Samir Boubaker, Professor of Pathology at Tunis University. Dr. Abdelkhalek Ben Rejeb was the Chairman of the Scientific Committee. Their efforts in ensuring the success of this meeting are greatly appreciated. The meeting was opened officially by the Minister of Public Health in Tunisia Mr. Habib M’barek representing the Tunisian Government. Prof. Shinichiro Ushigome, President of IAP, Prof. Francis Jaubert, President Elect of IAP. Prof. Samir Boubaker, President of the Congress, Dr. Ghazi Zaatari, Secretary of the Arab Division, and Dr. Samir Amr, President of the Arab Division all gave speeches at the opening ceremony.

As well as the office bearers of the IAP already mentioned, the following office bearers were also present: Prof. Kristin Henry, London, England, Vice President for Europe, and Chairperson of the Education Committee of the IAP, and Prof. Antonio Llombart-Bosch, Valencia, Spain, a former President of the IAP. The Arab Division is grateful for the support of so many of the senior representatives of the IAP.

There is considerable turmoil in this part of the world and the Arab Division is working hard, against all the odds, to provide continuing professional education for pathologists from the Arabian Gulf to the Atlantic Ocean. Meetings are held alternately in countries in the East (Middle East countries), predominantly English speaking, and in the West (North African countries), predominantly French speaking. Special attention is being paid to the needs of young pathologists and pathologists in training. About 60% of pathology trainees are now women and we are trying to get them more involved in the affairs of the Division. This was very obvious at this Congress. We had a record number (297) of young pathologists entering for the Ibn Al-Nafis Award for the best poster or oral presentation by a young pathologist.

In response to this unprecedented number of entrants, one of our long time generous supporters, a lady pathologist living in Paris, kindly donated money to provide for a second award.

Prof. Abdelkhalek Ben Rejeb presented our annual lecture on history of medicine. It was entitled “Correction of the heart and discovery of the cardio-pulmonary blood circulation by Ibn Al-Nafis.”
Our annual Kamal Ishak lecture, presented this year by Prof. Ghazi Zaatari from the American University Hospital, Beirut, Lebanon was entitled “The Diffuse Neuroendocrine System. New Perspective.”

Above: The room in which the concert was held. The columns and fountain are Tunisian style. The tiles on the walls are Moorish style. The doors are Turkish style from the 19th century when the Ottoman Turks ruled in North Africa.

Presentation of awards of appreciation to distinguished guests during the dinner at Dar Al Jild Restaurant, a traditional Restaurant in the Cassaba (Old City). Left to right, Samir Amr, Ali El Hindawi, and Samir Boubaker

An all woman group of musicians playing an array of traditional instruments at the cultural evening held at the Dar-al Hikma (the house of wisdom.) The group call themselves “Firkat al Aazefat.” Which means a female group of musical instrument players.

An alley way in the Cassaba.

The town hall.

About 265 pathologists from most Arab countries attended the meeting. One Arab country (Mauritania) was represented for the first time in our meeting. Five pathologists from Iraq attended the meeting. ( Prof. Ushigome had discussions with them about their present problems.) The Arab Division covered their expenses. One pathologist from Palestine was able to attend. Arab pathologists residing in non-Arab countries came from France, UK, USA, Belgium and Norway. There was also a significant number of non- Arab attendees.

Many participants enjoyed the historical sites of Tunisia; particularly the Roman sites at the ancient city of Carthage. A dinner was held at Dar Al Jild, a traditional restaurant in the old quarter of Tunis, with typical North African koskos on the menu. At that dinner, officials of IAP (Drs. Ushigome, Jaubert and Llombart Bosch) were presented with appreciation plaques from the Arab Division for their support.

A cultural evening was held at Dar Al Hikma (The House of Wisdom), a cultural centre in Tunis, on the second day. All participants attended a musical evening of Arabic and Tunisian music performed by an all woman group of musicians playing different instruments. All participants expressed their satisfaction with an enjoyable evening.
The 17th Congress of the Arab Division of IAP will be held in the Jordanian capital, Amman on November 10-12, 2005. Registration details will be announced soon.
Many members of the Arab Division attended the annual dinner held during the USCAP meeting in San Antonio in March 2005. Attendance at these dinners has increased almost exponentially each year.

Samir Amr, MD
President of the Arab Division of IAP, and Vice President for Asia.
Photographs from Tunis courtesy of Francis Jaubert and Michelle Huerre, Paris, France. Photos from San Antonio by Robin Cooke.

Above: A mainly Egyptian group and below a mixed group representing Iraq, Egypt, and Sudan. Both at USCAP 2005.

Above: A mainly Jordanian Group.

Anmar Al Rikabi (far right) and a representative group from Syria. Both at USCAP 2005.

A group of 4 of the lady delegates, all from Algeria. On the left is Asia Kaddouri, one of the 2 winners of the Ibn-al-Nafis prize for the best poster.

Sami Iskander (centre) with two friends at USCAP 2005.

(Editorial comment: I was confused by some of the terms used by my Arab colleagues, so I hope that they will excuse this over simplification which may help some of my other colleagues who are as confused as I was. An Arab may be defined as a person whose ancestors came from Arabia, who spoke the Arabic language and who for the most part were Muslims. The Moors are the Arabs who migrated right across the north of Africa and settled particularly in the countries of the North West of Africa. They invaded Europe from the South West, mainly Spain and Portugal. The main scientific language there now is French. Tunisia is in the Moorish, French speaking, area, hence the Moorish influence in the architecture, which is also seen in Spain and Portugal.
There are 21 Arab states. They include countries in the Middle East and North Africa. The Ottoman Turks were a martial tribe that came from Turkistan in central Asia. They conquered the countries of the Eastern end of the Mediterranean and adopted Islam, the religion of the countries which they conquered. They formed the Ottoman Empire and infiltrated along the SE of the Mediterranean and somewhat into the north of the Arabian Peninsular. They attacked central Europe from the East.
The scientific language of the Eastern Arabs is mainly English. So, the Arab Division has decided to hold meetings alternately in the Eastern states mostly in English, and in the Western states mainly in French).

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Raymond Yesner, New Haven, Connecticut, USA.
Raymond Yesner, now 89 years old continues to play an active role in the Research and Teaching program at Yale University. He was appointed to the staff of Yale University School of Medicine, and chief of Pathology at its affiliated Veterans Hospital in 1946, after serving 3 years as a pathologist in the Army. He was influenced by Averill Liebow to make pulmonary pathology his special area of interest. He chaired the WHO expert committee on lung cancer in Geneva and was co-editor of the 2nd edition of the WHO International Classification of Lung Tumors, published in 1987.

Early in his career he joined the International Association of Medical Musuems and continued his membership when it became the IAP. He presented his last paper at an IAP meeting at the XV11th International Congress of the IAP in Dublin in 1986. The paper was entitled “The Decline of the Autopsy in the Western World.”

Ronald (Roc) Kaschula, Cape Town, Republic of South Africa.
Roc has been a specialist pathologist for over 40 years. During most of that time he has been a paediatric pathologist at the Red Cross Childrens’ Hospital, Cape Town. He has long been recognized Internationally as a leader in his field.

From early in his career he played an active role in the South African Division of the IAP and the South African Society of Pathology. Roc attended his first International Congress of the IAP in Washington in 1976 and presented papers there. He then spent about 6 weeks visiting the leading Paediatric pathology departments in North America in company with some of the leading paediatric pathologists of that time. He was fully committed to the ideals of the IAP before this stimulating experience, but after it there was no stopping him. He became the face and the voice of pathology from Southern Africa.

During much of this time conditions in the Republic of South Africa were quite difficult, sometimes very much so. At all times, Roc was at great pains to continue to promote the importance to Africa of the IAP and particularly to the pathologists in Central and Southern Africa. As a very strongly Christian person, he pursued the objectives of ‘holding everything together’ with huge tact and determination and without compromise on any moral or ethical matters. He nursed the South African Division, and indeed pathology in Africa, firmly but carefully and in a highly principled way.

Throughout his professional life Roc has been totally supported by his equally committed wife, Sheila, and together they have raised children who have already contributed much to their country.

Roc’s family and his many friends and admirers will be delighted that he has been given the highest honour the IAP can bestow.

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Preparations are well underway for the 100th Anniversary Congress of the IAP. Visit http://www.iap2006.com to view the scientific topics to be discussed as well as a list of convenors. For this unique anniversary celebration, we are also planning a number of special events, including the preparation of a time capsule destined for our fellow pathologists in the years to come, to which you will be invited to contribute.

To better confirm and manage your participation, the Congress is moving to an exclusively online registration process. Poster abstracts, congress registration and hotel bookings will all be available at http://www.iap2006.com. Enjoy the ease, speed and security of online registration and abstract submission. Poster abstract submissions will be accepted from mid-November through mid-March 2006 via the web form.

Known for its distinct joie de vivre, Montreal is an exciting destination that offers visitors numerous opportunities for excellent cuisine, exciting nightlife, cultural experience and outdoor activity. Plan now to come to Montreal to participate in the celebration of the 100th anniversary of the Academy.

Rick Fraser
Congress President

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In October 1998, I received a fax letter from Dr David Hardwick, my old friend and mentor at the University of British Columbia (UBC) at Vancouver. He was coming over to Hong Kong for one night and asked to meet me, if possible, at the airport. He said he had a funding to send pathology teachers from UBC to Hong Kong and China on lecture-tours. This did not sound the usual appointment. Anyway, I duly went to the airport to see him, together with Dr Wing-yin Lam, then President of the Hong Kong Division of the IAP.

We talked at the airport coffee shop. Dr Hardwick, in addition to confirming the funding, brought me a pile of information about various potential speakers or cast of UBC who could teach in China. I was younger then and did not know Dr Hardwick as well as I do now and was not yet fully immersed in the spirit of IAP. I was somewhat skeptical that this free lunch seemed too good to be true and at any rate, my friend was making too much of a fuss by coming such a long way. At that time, I was trying to create an Association of Directors of Pathology of China (ADPC), for which I had visions of intimate co-operation with the IAP. Our plans coincided. We decided on a few courses of action and Dr Hardwick crossed the Pacific to go back to Vancouver the next day as scheduled.

I subsequently learned that Dr Hardwick had established a funding in 1987 from an endowment of Mrs Jackson Wong, in memory of her brother Mr Stanley Chuck-Cheung Leung, a UBC student at the time of his death. The funding was to support teaching of pathology in China. It was further enhanced by funds from the Department of Pathology of University of British Columbia, from which Dr Hardwick left as Department Chairman to become the Associate Dean of the Faculty of Medicine of UBC. This funding is now re-named UBC-IAP Visiting Scholar Programme and will be used for the benefit of pathology education in China in conjunction with pathologists in Hong Kong.

Dr Hardwick came to Hong Kong to witness the inaugural meeting of the Association of Directors of Pathology of China (ADPC) in 1999. At the Second Meeting in Nanjing (2000), Dr Blake Gilks of UBC was the first UBC-IAP Visiting Scholar. Dr Randy Gascoigne was the UBC teacher in the Third ADPC Meeting in Chengdu in 2001 and Dr Hardwick himself taught in the Fourth ADPC Meeting in Changchun in 2002. We missed a meeting in the year 2003 due to SARS and the ADPC meeting was resumed in 2004 in Guangzhou and Dr Blake Gilks was invited back due to popular demand. Meanwhile ADPC has grown from a first meeting of about 60 people to 300 in the Fifth Meeting in Guangzhou and all participants were either chairs or vice-chairs of pathology of medical schools or hospital pathology departments throughout China. Because of the backgrounds of the participants, the influence of the UBC-IAP Visiting Scholar Programme has spread well beyond the congresses.

Two UBC-IAP scholars are earmarked for 2005 (to make up for the missing year of 2003!) Dr Ric Hegele, formerly Acting Head of Pathology of UBC, will be teaching at the Fourth Asia Pacific IAP Meeting in Beijing in August 2005 (http://www.ciccst.org.cn/iap2005) and Dr Poul Sorenson will be a speaker at the inaugural multidisciplinary cancer research conference of Cancer 2005 in Hong Kong in April, a meeting jointly organized by the IAP and the ADPC.

The mission of the IAP is pathology education, without frontiers, without compensation and perhaps most of the time, with a passion. This has always been the driving force of all IAP congresses, meetings, schools, courses, etc. Nothing can replace the human contact, face-to-face encounter, speaking over the power points, teaching over the multi-headed microscope. I now understand why Dr Hardwick has taken the trouble to fly across the ocean just to talk to us at the airport coffee shop. This is the quintessential IAP spirit. By sending pathologists to teach in China, the UBC-IAP Visiting Scholar Programme has upheld those IAP ideals and planted them in the most populous country in the world.

H.K. Ng, Chinese University, Hong Kong
IAP Vice President for Asia.

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The last five years have been the most fruitful period in 40 years in the development of radiation therapy for the treatment of cancer. Cancer strikes approximately 40% of all people in the developed world and radiation therapy has become a mainstream treatment. In Australia, approximately 38% of all cancer patients receive radiation at some time in the course of their disease. In the United States and some parts of Europe the number is over 55%. Since the late 1960s, when routine curative radiation therapy became a reality, five-year survivals have increased from about 39% to over 62% in developed areas. At the same time, toxicity has decreased significantly.

The improvement is at least partially due to the improved conformality of radiation therapy. Using a technique called Intensity Modulated Radiation Therapy, IMRT, it is possible to shape a radiation beam in three dimensions to conform to the shape of a tumor, however irregular that shape may be. Today about 40% of modern radiation therapy centers are using this technique.
A second important, and newer advance is Image Guided Radiation Therapy, IGRT, which allows rapid, automated positioning of the patient for daily treatments, to take into account small shifts in the anatomy and respiratory motion. This technology has just become available in the last few months, and should further improve outcomes.

But, in today’s medical environment, better technology is necessary but not sufficient. The technology must be cost effective, simple, user friendly, safe, and readily usable in community hospitals as well as academic medical centers. The ability to automate the sophisticated conformality tools in radiation therapy has emerged in the last five years. Daily conformal treatments that would have taken as much as 45 minutes a few years ago, can now be carried out in 15 minutes or less. Stereotactic, single fraction treatments as a substitute for surgery that would have taken as much as 3 hours, can now be carried out in as little as 30 minutes.

The result is that more patients can be treated with the modern capabilities; equipment and treatments have become more standardized and comparable from hospital to hospital; costs are lower; and decisions by referring physicians and patients are less confusing. We have a long way to go in improving the five year survivals above the 62% level, but the enabling technology and its automation and integration is now making that possible.

This is a synopsis of a very interesting talk I heard recently at an Oncology Meeting by Dr. Dick Levy, Chief Executive Officer of the company, Varian Medical Systems, an International company that is the world leader in the manufacture of Radiation Oncology equipment.
Editor

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Report from the German Division
The News Bulletin is sent regularly to the German Division Secretariat and distributed to members.
In the business year 2003/2004 a total of 35 teaching events, including the 15 seminars which were part of the symposium, were offered to our members. A total of more than 3000 participants registered.
Two new types of teaching events were created and were successfully organized.

1. Junior Academy
60 junior members (3rd to 5th year of pathology curriculum) were housed and taught for 5 days (three all day and two half day sessions) by altogether 15 experienced tutors in the most important fields of organ pathology (gynecological, endocrine, urological, gastrointestinal, liver, heart and vascular, lung, bone, skin, and soft tissue pathology) and in methods ( cytology, immunohistochemistry, molecular pathology). Evening sessions included presentation of riddle cases, quiz show, as well as an evening excursion to old Cologne.
The tools available were microcopes, slide collections, handouts, and video demonstrations from the teacher’s microscope. Although the stage of training was different among the participants, and the respective type of presentation was quite variable, ranging from comments on microscopical slides only, to more systematic lectures, the Junior Academy was very well accepted.
The participants considered this type of event as an excellent opportunity to become familiar with diagnostic standards and problems, and to make contact with other colleagues.

2. Practical Course of Molecular Pathology
For those who had already participated in 5 theoretical seminars on Molecular Pathology, a two day practical course was given in the Department of Pathology of the University of Bonn. Only 20 participants were admitted per course. The course was repeated 4 times. Two participants in each group worked in the following practical classes - A sophisticated time sequential schedule on DNA extraction from paraffin sections; Agarose gel electrophoresis, Amplification of virus DNA by PCR, and of Microsatellite sequences by multiplex PCR; Hybridization by PCR-ELISA; and Fluorescence in situ hybridization.
In addition, quantitative PCR by light cycler and capillary electrophoresis were demonstrated.

The participants agreed that it was useful to have learned efficiently and realistically what the methods and caveats of molecular pathology are. They considered this knowledge as important, even if they had not used these methods so far in their practice.
Ulrich Pfeifer, Universtiy of Bonn, Secretary – Treasurer, German Division IAP.

The Taiwan Division of the IAP
Taiwan is an island country, also known as Formosa. The population now is approximately twenty three million and there are ten medical schools in Taiwan. The field of pathology was originally founded by the Japanese school of pathology and later greatly transformed by the American school of pathology. Currently, there are 254 active pathologists working throughout the hospitals in Taiwan.

The Taiwan Society of Pathology was established in 1967 and the pathology board certification began in 1989. In view of the rapid progress in modern pathology and the importance of interaction with regional and international pathology organizations for exchange of knowledge and ideas, the Council of the Taiwan Society of Pathology supported the proposal of current president, Dr. Tseng-tong Kuo, in mid-2003 to apply for the establishment of the IAP Taiwan Division to participate in the activities of the IAP.

The application for the establishment of the Taiwan Division was submitted to the headquarters of IAP in December 2003. The application was endorsed by the IAP Executive Committee held in Vancouver, Canada in March, 2004 during the 93rd USCAP Annual Meeting and was finally approved by the IAP Council Meeting held in Brisbane, Australia on October 10, 2004 during the 25th International Congress of the IAP. Our application was enthusiastically supported by the then IAP President Dr. Shinichiro Ushigome, Vice President Dr. H. K. Ng, Secretary Dr. Florabel G. Mullick, Dr. Kristin Henry, Dr. Robin A. Cooke, Dr. Osamu Matsubara, and Dr. Fattaneh A. Tavassoli.
The Taiwan IAP Division sincerely thank all the persons mentioned and all the council members for their support in the establishment of the IAP Division in Taiwan. The Taiwan Division is also a member of the Asia Pacific IAP.

The newly established division will actively participate in academic and educational activities of the IAP and welcome any IAP members to visit Taiwan for exchange of ideas and views.

President: Tseng-tong Kuo, MD, PhD
E-mail: ttkuo@adm.cgmh.org.tw
Secretary: Shih-Ming Jung, MD
ming22@adm.cgmh.org.tw
Treasurer: Chiang Hung, MD
hchiang@tipn.org.tw
Website: www.twiap.org.tw

On behalf of the existing members of the IAP, I welcome the new Division and hope that they will enjoy the benefits of being part of the International organisation. (Robin Cooke, Editor).

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