Report on the German Division of the IAP
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Munich City Hall in the city square. All these buildings were restored to their original state after the destruction of WW2.
Under the leadership of Rudolph Virchow (1821–1902), Professor of Pathology at Charite Hospital in the Humboldt University of Berlin, Germany became a powerhouse of pathology in the late 1800’s and early 1900’s. Virchow was ably assisted by a number of others including Robert Koch (1843–1910) the microbiologist at Charite Hospital. Their influence spread to neighbouring European countries and further afield to many other parts of the world, including particularly, Japan and South American countries such as Brazil, Argentina and Chile. This tradition was carried on into the 20th century, and perhaps Ludwig Aschoff (1866–1942) could be regarded as being the leader during his time as Professor of Pathology in Freiburg. Aschoff was a foundation member of the International Association of Medical Museums (which became the International Academy of Pathology) and its fifth President (1914–1916). Germany’s pre eminence in pathology retreated for a time following WW2. In the past few decades however, it has undergone a dramatic resurgence, which is quite apparent when one visits some of the leading centres in Germany, as I have had the privilege and pleasure of doing in recent years. Reports on some of these visits including to the rejuvenated Department of Virchow in Berlin, have been published in previous editions of the News Bulletin.
Twelfth meeting of the German Society of Pathology held in Kiel in 1908. How many names can you recognise? The number gives an indication of the strength of pathology in Germany at that time. It was the first time that the pathology society had met on its
own and not as part of a meeting with another group.
1. Lubarsch, 2. Aschoff, 3. Schmorl, 4. Orth, 5. Heller, 6. Marchand, 7. Baumgarten, 8. M.B. Schmidt,9. Verse, 10. Ziegler jun, 11. Wilke, 12. H. Quincke, 13. Simmonds, 14 Henke, 15. E.Frankel, 16. Apolant, 19. Jores, 20. Rossle, 21. Herxheimer, 22. Strobe, 29. Durck30 Monckeberg 31. Sternberg (of the SR cells in Hodgkin’s disease), 35. Fahr, 38. Beitzke 39. Maresch. 43. Saltykow, 52. Dietrich, 57. R Beneke, 58. Thorel, 60. P. Huebschmann, 61. R. Meyer, 62. v. Gierke. (Photo courtesy of Gunter Kloppel, former head of the Department of pathology, Kiel)
Entrance to the Pathology Department, Kiel in 2007. The building was completed in 1878 and the photograph of the 1908 meeting was taken on these steps.
Gunter Kloppel, Karl Lennert and Robin Cooke, Kiel, Feb 21 2007
Vladimir Tatovic pathologist Secretary for 30 years.
Munich City Hall Glockenspiel. The figures move at 11 am each day.
In this article I would like to focus on the activities of some of the current German pathologists whom I observed during a visit to Bonn for the annual meeting of the German Division of the IAP in February, 2007.
Starting with an historical perspective, Gunter Kloppel, in Kiel showed me photographs of some of the previous generation of famous pathologists who have worked in that university department, as well as pathologists who now hold some of the most prestigious chairs of pathology in the country. A particularly interesting photograph is a group photo of those attending the 12th meeting of the German Society of Pathology held in Kiel in 1908. Virchow founded this society which is still functioning, and the present President is Thomas Kirschner, Professor of Pathology in the Maximillians University in Munich. The meeting in Kiel was the first to be held as a stand alone meeting of the society of Pathology. The previous meetings had been held in association with those of other groups, mainly surgeons. In this photo one sees Lubarsch and Henke of the famous Henke Lubarsch Handbook of Pathology. Otto Lubarsch was Director of Pathology in Kiel from 1913-1917. The pathologists in the photograph are all numbered and their names are recorded along the left side of the picture. Many of them are well known names in pathology and many have diseases named after them.
Lymphoma Symposium speakers. 5th from left, Harald Stein, 6th Konrad Muller Hermelink, 8th Dietmar Schmidt, 9th Martin Hansmann,10th. Inset: A photograph of Karl Lennert taken at his home a few days before the meeting, was present in spirit.
The microscope tutorial room with 60 microscopes for seminars.
One half of the catering area outside the slide seminar room.
German Division Committee 2007 (l to R) Reinhard Buttner, Bonn University; Klaus Muller from Munster, Treasurer and editor of the journal, ‘Der Pathologie;’ Ruth Knuchel-Clarke, Aachem; Deitmar Schmidt, Mannheim, retiring President; Margarete Radtke (full time secretary for the past 30+ years); Martin Hansmann, Frankfurt, (incoming President); Kurt Schmid, Innsbrugh, retiring Past President.
Thomas Kirschner the present Director of Pathology in the Maximillians University, Munich, and Peter Meister a previous Director with a bust of Max Borst the first Director who wrote one of the first treatises on Soft Tissue Tumours.
The Institute of Pathology in Kiel was directed for many years by Karl Lennert who attained a worldwide reputation in Malignant Lymphomas. Students from his department became professors in other cities, and as a group they contributed significantly to the present day understanding of these diseases. One of his pupils was Konrad Muller-Hermelink, from Wurzburg. The Saturday of the annual meeting of the IAP in February 2007 was devoted to a Festschrift to honour Konrad who was about to retire. The speakers were either pupils of Lennert or of Muller- Hermelink. and they included many famous names in this area of expertise including Harald Stein, Professor at the Frei University of Berlin, and Martin-Leo Hansmann Professor at the Goethe University in Frankfurt. Martin and his associates added to the discoveries of Sternberg (seen in the group photo in 1908) by showing that the SR cells of Hodgkin’s disease are B cells and not T cells as was previously thought. Martin is the current President of the German Division of the IAP.
The German Division is one of the oldest and one of the largest Divisions of the IAP. It has its headquarters in the top floor of a converted factory building in Bonn. There is a spacious teaching room that contains 60 microscopes and has up to date projection facilities. Adjacent to this is a kitchen/dining area and a rooftop outdoors area that can be used in fine weather. This allows for catering and socialising by the student groups. The rest of the space is used as office space for the staff.
The office of the German Division of IAP occupies the whole top floor of this renovated factory building which is close to the main railway station (two IAP Secretaries at the entrance).
The market in the old town of Munich where you can buy almost anything from anywhere in the world.
The current full time secretary is Mrs. Margarete Radtke who has been in the position for over 30 years and is the driving force behind the Division. Vladimir Tatovic the pathologist secretary for 30 years, before he retired oversaw the refurbishment of the present headquarters building.
The Division conducts an active educational programme that consists of an annual general meeting and many satellite meetings, conjoint meetings with Divisions in neighbouring countries, and increasingly, in more distant countries. This continues the ‘outreach’ activities started by the original German pathologists. On most Saturdays of the year specialist microscopic training sessions are conducted at the Bonn centre for trainee pathologists. They run from 9 am to 6 pm. The Office is within 10 minutes walk of the main railway station for Bonn, so it is possible for students from nearby cities to attend these sessions.
In a new initiative, the President, Martin Hansmann has designed an International Junior Academy which is aimed at providing a 4 day course for trainee pathologists in Europe. It is envisaged that the lecturers will live with the attendees to allow social contact as well as professional contact to occur. The first of these will be run from August 21-24, 2008.
The former President of the Division, Dietmar Schmidt has a large pathology private practice in Mannheim. Private practice is very strong in Germany and a number of pathologists engaged in private practice attended the annual meeting in Bonn.
The Maximillians University Institute for Pathology is another of the many strong pathology departments in Germany that has a long history of excellence and outreach activities. It is situated in Munich the capital of the southern province of Bavaria. Munich which is centrally placed in Europe, has the touristic charms of other European cities, and facilities that can cater for large conventions.
Robin Cooke
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Philipp Franz von Siebold
(1796 – 1866)
the German doctor who brought Western Medicine to Japan in 1823
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Siebold in the Japanese medicinal garden that he established, University of Leiden
Philipp Franz was born in Wurzburg in the state of Franconia, southern Germany where he studied medicine in the University in which the Siebold family dominated for about 100 years from 1760. After graduation he travelled to Holland to get employment. He was appointed surgeon in the Dutch East India Company in their trading post in Nagasaki, Japan. At that time Japan had a closed society and only allowed trading contact with the outside world through China and Holland. The Dutch had to conduct their business in Japan from the island of Dejima in Nagasaki Bay.
From this base, Philipp Franz made a great impact which resulted in his being revered in Japan, and especially in the city of Nagasaki. He married a Japanese woman and they had a daughter who became a prominent doctor in Nagasaki. When he returned to Europe he settled in the University city of Leiden where he wrote treatises on the material he had collected during his years in Japan. In the University grounds he established a medicinal herbal garden in which he planted some of the botanical specimens he brought with him from Japan.
The Dutch government would not allow him to bring his Japanese family with him from Japan, so he married a German woman and had a son, Alexander who became a doctor. Alexander accompanied his father to Japan on his second visit there in 1859, married a Japanese woman and remained to work as a doctor in Japan. None of Siebold’s Japanese family had visited Wurzburg until a few years ago when a fifth generation daughter married to an American serviceman based in Wurzburg delivered their first daughter in the Elias von Siebold Maternity Hospital.
Aya Matsubara standing near the Siebold memorial after graduating in medicine from the University of Nagasaki in April 2008
Aya Matsubara at the home of Jan and Marijka van den Tweel in Utrecht, Netherlands
Siebold memorial park Nagasaki
A canal passing through the grounds of the University of Leiden. The medicinal botanical garden is behind the trees on the right
Grave of Siebold in Munich. Inscription on the grave of Siebold ‘Explorer of Japan’ in German and Japanese.
Siebold spent the last years of his life in Munich. He is buried in a cemetery across the road from the Ludwig Maximillians University pathology department. His tombstone bears his coat of arms and has written on it in German and Japanese ‘Siebold, Explorer of Japan.’
In 1996, 200 years after Siebold’s birth, the universities in the three cities in which he worked - Wurzburg, Nagasaki and Leiden joined together to honour the memory of ‘the explorer of Japan.’ A congress was organised in each of these Universities during 1996, and from these meetings three measures to commemorate the achievements of Philipp Franz von Siebold were agreed to:
Siebold lectures by distinguished scientists from each of the three Universities.
Scientific co-operation by exchanges of post doctoral staff.
Exchange of senior medical students between the 3 Universities.
In 2007 the first of the proposed student exchanges occurred. Aya Matsubara, a final year medical student was one of the 4 students from Nagasaki University to visit the Leiden University medical centre in Holland for a 5 week period of study. She reports on her experience as follows:
In Japan, medical students spend 2 years in a general education programme, 2 years in basic medicine and the final 2 years in clinical training. Except for the work of general practitioners there seems to be little difference between medical practice in Japan, and that in the Netherlands. I was interested to see that women students constituted 70% or more in all the universities in the Netherlands while in Japan over 50% are males.
The most impressive thing for me was the Dutch respect for ‘free will.’ Students are expected to study independently, researching subjects for themselves. Even the patients decide themselves which therapy to accept, and to say ‘No’ to the doctors if they do not want to have a certain type of treatment. I think it is this outgoing attitude of the Dutch that has made it possible to maintain a long-term friendship between our two countries with each respecting the other`s culture.
Spring in the Netherlands was a beautiful season with countless tulips in the Keukenhof garden and windmills under a clear blue sky. I was charmed by the harmonious coexistence of the modern art and architecture, and the older art forms and the very old historical monuments in this beautiful landscape. In Leiden city, bronze statues of Siebold are seen everywhere. In the Siebold Art Museum I was surprised by the breadth of Siebold’s collection of Japanese artefacts. I saw elegant, beautiful antique gold objects, pictures of animals and plants.
The people of the Netherlands are very open and kind. Professor Jan van den Tweel (Professor of Pathology at Utrecht University) and his wife, Marijke who are friends of my father, (Osamu Matsubara, long time secretary and now President of the Japanese Division of the IAP [author’s note] ) invited me to their huge house and cheered me up by helping me to overcome my homesickness. Although this programme was very short, I am sure that the experience has widened my views and will help in my future as a doctor.
Ref:
Theide A, Hiki Y, Keil G 2000 Philipp Franz von Siebold and His Era, Springer, Berlin
Grateful thanks for assistance with this article go to Gerhard Stauch, Peter Meister, Jan van den Tweel, Aya Matsubara, Osamu Matsubara, Kazuaki Misugi, Helga Seifert (librarian, Pathology Department Wurzburg) and Wolfgang and Mrs. Klein-Langer (Curators of the Siebold Museum, Wurzburg)
[Aya graduated in April 2008]
Robin Cooke
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Friends of Africa
USCAP initiative Progress Report
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Friends of Africa faculty and attendees at the week long Cytopathology course conducted in association with the Anglophone division of the West African IAP.
Fred Silva USCAP in the front centre with Kunle Adesina on his left.
The “Friends of Africa-USCAP initiative” is a voluntary group initiated by Dr Fred Silva [Executive Vice President, United States and Canadian Academy of Pathologists (USCAP) a division of the International Academy of Pathology (IAP)] and a number of other pathologists who came together under the auspices of the USCAP to try to understand some of the unique challenges of the African pathologist/s and to provide some help as may be needed for our colleagues in sub-Saharan Africa.
Friends of Africa meeting at the IAP congress in Montreal, Canada, 2006. Patrick Adegboyega bending down.
The “Friends of Africa-USCAP initiative” group had its inaugural meeting in San Antonio, Texas in February 2005. A number of issues were discussed. In summary, it was agreed that efforts to support the pathologists on the continent would need to be divided into phases which for convenience are categorized as follows:
Phase 1 - To provide access to educational materials in the form of hard copies of journals, e-Journals and USCAP journal / website access etc.
Phase II - To assist in the provision of programs of continuing medical education in the form of (a) pathology updates, conferences, seminars and annual pathology courses (b) short weeklong or weekend training seminars for technologists, as well as (c) collaborative projects within Africa and outside Africa.
Phase III – To develop a coordinated “Equipment for Africa “ campaign (EFA.)
A number of institutions have indicated the availability of serviceable equipment which can be donated to needy institutions.
Achievements on Phase I goals:
(1) During the year 2005, this group was able to generate funds to pay for individual subscription to the Modern Pathology journal for 44 pathologists in 15 sub-Saharan countries. A total of 55 institutions in sub-Saharan Africa now receive a subscription to the USCAP journal Modern Pathology,
(2) A total of 65 institutions now receive the College of American Pathology (CAP) journal - Archives of Pathology and Laboratory Medicine; Courtesy of the Editor, Phil Cagle, M.D. and publisher, CAP in 2006.
(3) A grant of $1,800 for the mailing of the Archives for one year was recently awarded by the CAP.
(4) Generous free subscriptions for 65 sub-Saharan pathologists / institutions has recently been received for the following journals:
(i) Human Pathology (55 institutions) – Courtesy of the Editor Ricardo Lloyd M.D., Ph.D. and Elsevier publishers
(ii) American Journal of Clinical Pathology (65 institutions) – Courtesy American Society for Clinical Pathology
(iii) American Journal of Surgical Pathology (65 institutions) - Courtesy LWW- publishers
(iv) Journal of Neuropathology and Experimental Neuropathology to selected institutions (30 institutions) - Courtesy LWW- publishers
(5) Access to USCAP website and the knowledge hub.
(6) The Anglophone West African Division of the IAP is now up and running and formally inducted into the IAP at the IAP congress in Montreal, Canada in 2006.
(7) The East African Division of the IAP is in its formative stages and will be inaugurated after IAP council approval in October 2008.
(8) The USCAP provides the following:
(i) Scholarship in the form of waivers of fees for courses and registration fees for a number of individuals from Africa who attend the annual USCAP conference, and
(ii) The USCAP long and short courses for 2005 to 2008 and the cytopathology course in DVD or CD formats have been made available free of charge to pathologists in Africa.
Achievements on Phase II goals:
There are a number of pathologists in the USA who have indicated their willingness to donate their time and efforts free of charge to participate in conferences, teaching seminars and courses after due consultation with the hosting country or regional pathologists. Such seminars are arranged in collaboration with the regional division of the IAP or with individual institutions / organizations. The topics range from histopathology to cytology, other aspects of clinical laboratory medicine and molecular pathology as may be deemed appropriate by the hosting IAP division or African institution.
(i) A weeklong cytopathology workshop was held in collaboration with the West African Division of IAP in August, 2006 with more than 75 pathologists and trainees from Anglophone West African countries in attendance.
(ii) A second weeklong conference on Surgical Oncologic Pathology was held in August, 2007 with similar overwhelming attendance by pathologists and trainees from the Anglophone West African countries. Courses at these conferences were presented by volunteer academic pathologists from the USCAP and a number of American Universities / Institutions. We express our gratitude to the following volunteer faculty who have participated in these programs:
2006 Cytopathology and Renal pathology course – partly supported by a $5,000 educational / conference grant from the Healthy Life For All Foundation to the West African Division of the IAP.
Dr Jaiye Thomas – Louisiana State University Health Sciences Center, Shreveport, LA
Dr Jennifer Brainard – Cleveland Clinic, Cleveland, Ohio
Dr Fred Silva - Executive Director of USCAP, Augusta, GA
Dr Adekunle M. Adesina - Baylor College of Medicine, Houston, TX
Dr Patricia Thomas - University of Kansas Medical Center, Kansas
Zelma Casson - University of Missisipi Medical Center, Jackson, MS
2007 Surgical Oncologic Pathology Conference – partly supported by a $5,000 educational / conference grant from the IAP –Education committee to the West African Division of the IAP.
Dr Phyllis Huetner – Washington University, St Louis, MO
Dr Jaiye Thomas – Louisiana State University Health Sciences Center, Shreveport,, LA
Dr Brian West – Yale University, New Haven, CT
Dr Adekunle M. Adesina - Baylor College of Medicine, Houston, TX
Dr Patrick Adegboyega – Louisiana State University Health Sciences Center, Shreveport, LA
Dr Sherif Ibrahim – New York University and Memorial Sloan Kettering Cancer Center, New York, NY
(iii) The “Friends of Africa-USCAP initiative” and the Anglophone West African Division of the IAP (AWADIAP) have agreed to hold annual conferences/courses on various aspects of pathology. The third annual conference is being planned for August 2008.
(iv) The East African Division of the IAP will also be inaugurated in October 2008 and we hope to arrange similar regional educational conferences with them.
(v) The USCAP council has thrown a challenge to the Friends of Africa -USCAP initiative to raise marching funds for a grant of $50,000 to support the cost of transportation and accommodation of African pathologists and trainees to the International congress of the IAP in Capetown, SA in 2012. We are working hard to raise these marching funds.
Phase III is in its early stages and obviously requires significant funding and organization to determine the needs of various institutions and coordinate the available equipment with institutional needs as well as raise funds for shipping.
I hope the information provided is useful in helping you to understand the objectives and goals of the “Friends of Africa-USCAP initiative” and to excite you enough to want to participate in this initiative. You can always contribute time and / or money to each of these projects.
Adekunle (Kunle) M. Adesina
Chairman, Friends of Africa - USCAP Association
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