Winter 2002

From the Editor's Desk Guest Editorial President's Message Notes from the Secretary Committee Reports Comings and Goings Welcome New Members Other Announcements Future SPP Meetings Another Meeting of Interest Positions Available Belated Photos from the Interim Meeting Deadline for Spring Newsletter - April 1, 2002 Please direct submissions to the Newsletter to Art Weinberg, Editor This 2002 Winter Newsletter is also available in a printable PDF format.

I would like to give you feedback on the numerous responses that I received regarding PDAs, a topic about which I wrote in the last newsletter. Unfortunately, I received only one response. We appear to have a stillbirth and the parent refuses an autopsy.

Rather than expend any more of my own intellectual capital, I have decided to take Denis Benjamin up on his offer to provide the newsletter with a short seasonal essay that he wrote, but did not publish in the PDP. Please view this as an invited editorial.

Y’all come
September ’02

Medical staff evolution over thirty years: The development of clans
Denis R Benjamin

In bygone days, December was a tiresome month. Night after eggnogged night we trudged from one required cocktail party to the next. Cocktail parties are what we subject people to whom we don’t like, instead of entertaining them. Some of these affairs became quite elegant - dinner, dancing, entertainment. I was expected to attend parties for the laboratory, the hospital, surgery, pathology, laboratory medicine, the house-staff, my wife’s social work agency, the tennis club, sailing, anesthesia, the emergency room and so on. Last year I was invited to only one, an invitation I accepted under duress. The Christmas parties that were held were less elaborate than in the past, but there were still as many. The difference was that only the immediate ‘family’ was invited. Anyone perceived to be on the fringe, not part of the core group was eschewed. Outsiders were not even considered.

In the old days the hospital cafeteria always sported two large tables of physicians. As many as a dozen clustered around a table designed for four. Conversation swirled around the usual sports trivia, the latest fishing or ski report, the occasional whine about the organizational bureaucracy, the inevitable difficult diagnosis. In between the trivia, critical items of business were consummated - consultations, commitments, understandings. There was less need for formal meetings. Today the cafeteria is almost devoid of physicians. It is almost devoid of hospital staff. But back in the home departments you will find conference rooms full of staff sharing a meal. I still persist in scanning the dining hall at lunchtime, searching for a familiar face. Then I carry my tray back to the laboratory for a meal with my colleagues, who I really like - although not necessarily twelve hours a day.

In more recent times new medical staff might be around for months, sometimes years before I ever meet them. It is disconcerting to walk into the operating room with a tough frozen section diagnosis and confront a surgeon one has never met, whose style one does not know, and who has not yet developed any trust in one’s ability. Integrating new staff into the hospital “family’ has become virtually impossible, perhaps because there is no longer a ‘family’. In the same way that the ‘extended family’ is a relic of our rural social past leaving behind the rather pitiful ‘nuclear group’, the medical staff has fragmented into small units, each self-protective, exclusive and supportive to its members alone.

Does any of this matter? If these little clues of the holiday parties and the cafeteria are indicative of a shift towards tighter self-contained clans, then managers and organizational gurus had better take heed. It will be difficult to instill broad global visions and commitment in individuals who are so focused on their own small group. New techniques are needed for the management of clans. Tribalism has returned in all its guises. We may feel wistful for the past, but what is occurring is neither good nor bad - it’s merely evolution in action. Now our leaders, too, have to adapt to this new reality.

President's Message
Ron Jaffe

I’m thinking about who does things in the SPP, and how they get done. Our Society, unlike some others, is governed by a Council made up of the chairpersons (sic) of all standing committees, six at-large members (picked by the nominating committee who ensure that all elements of the Society are represented) the Secretary/Treasurer, the president, the past president and president-elect. That’s about 25 people. Committees, with over 80 Society members active, report directly to Council through their chairpersons. Council meets twice a year. In a small Society - this is participatory democracy at its finest. Democracy, however, works best by slow and careful consensus building and is not meant for speed. So an Executive Committee administers current Society affairs, and is made up by the President as Chair, the Secretary/Treasurer, immediate past President and President-elect. The Executive can operate only within the framework of existing Council policies. Day-to day management is in the hands of the Secretary/Treasurer who works with Committee Chairs, and we have a new management group, the USCAP, who handle the paper-flow.

Again, unlike other Societies, in which the President may serve as a chief executive for a number of years, the SPP rotates theirs annually. The position is more of an honorary one, an expression of gratitude for services rendered and a golden handshake of sorts. When I look at the rich and varied list of my predecessors, I see that the Society has been exceptionally well served by this policy.

A President of the Society, then, has limited opportunity for the grand and sweeping gesture. There may be time to pick a theme and to try and implement an enduring program such as the Foundation for Research in Pediatric Pathology, or to arrange a retreat like Madison 1985, which transformed this Society. I have picked up on the examples of a number of members of our Society, past and present, who have made substantial contributions by sharing their expertise with those people most deeply in need of it, often in the least developed areas of the world. Most of these colleagues, too many to mention by name, gave of themselves as individuals and not through the Society as a body. Yet the Society as an entity carries considerable heft and has at its disposal an extraordinary pool of talent, experience and even some financial flexibility.

I would like to see the Society for Pediatric Pathology spread its altruistic wings and contribute some of our richness to children in parts of the world whom otherwise would not share. Denis Benjamin and an ad hoc international group have made recommendations to the Society as to how we should go about this. Essentially, people in those countries in need of our resources should be guiding the effort. We need to ally ourselves with powerful patrons (such as companies) who will help bankroll the mission.

How, exactly, we go about doing this, and what form it will take, is what we are now trying to find.

Dr. ROC Kaschula from Capetown will give the annual Farber-Landing Lecture this year on “The practice of Paediatric Pathology in Africa - current and future potential”. He has been instrumental in spreading pediatric pathology to places where it can be used, and he can give us some direction. One of the methods that he has used, as have others like Ben Landing before him, was to train visiting practitioners at his institution, after which they returned to their own.

The Society will also sponsor a visitor to our meeting who may tell the business meeting of the Society of ways in which the Society could make a difference. Our colleagues from the IPPA may also join us in this venture and sponsor a second guest to the meetings. We hope that this will enlarge our pool of contacts. If this works well, an annual visitor who spends additional time after the meeting at an institution of their choice is a possibility.

What remains to be done now is to anchor this effort in the Society. Council has already expressed interest, and the Liaison Committee seems an appropriate vehicle for maintaining momentum and moving the project forward, so that this much needed effort in international outreach becomes an ongoing project of our Society. I am counting on you to participate when called upon.

Notes from the Secretary
Deb Perry

Please remember to remit your dues and slide survey renewals to the new management firm as soon as possible. Their address can be found on our About Us page. 

[Note from spponline.org's webmaster: the links for the following information has been removed from this paragraph since this past meeting's documents have been deleted from the website.]
Information about the Spring meeting may be found on the Home page. Meeting registration and hotel information forms are available on the website and will NOT be mailed. Our site has details about the New Members & Trainee's Breakfast, to be held during the meeting (click for details).

Committee Reports

Publications Committee:
Beverly Rogers

There is a new look for Pediatric and Developmental Pathology in the January/February issue of the journal. Dr. Reyes-Mugica has been busy redesigning the front cover and will be adding additional features to the journal. We need manuscripts; the plea continues. The impact factor is rising and we need to continue to cite articles from the journal and send in quality submissions to sustain the upward course.

Hal Pinar has added some amazing new features to the web site. The site is becoming more functional as the days march on, with valuable information about job postings, meetings, and most recently a compilation of timely material about the pediatric autopsy. Take some time to browse, and give feedback to Hal.

This will be my last column as chair of the Publications Committee of the SPP. Thanks to all who have served on this committee. Larry Becker was invaluable as a source of wisdom and objectivity. Margaret Collins has taken on many tasks, including the search for Web Site Editor, with great energy and attention to detail. Katrine Hansen has been dogging ISI, who publish Current Contents, for information about impact factors. Yee Khong has been our data analyst, taking on tasks requiring great detail. Yee is also a member of the PPS, and traveled halfway around the world to our meetings. All of the members have dogged institutional libraries to increase our subscription base. Our editors have remained steadfast and accepting of change as we worked through designing the future of our publications. Our four editors will continue to do the superb job for our Society that we have become so used to - possibly even complacent about. They work hard; the rewards are frequently not tangible. I consider myself lucky to have been associated with this erudite group of individuals. You should give them your support; they are working for all of us and we should continue to support the publications with our best manuscripts.

Pat O’Shea, the new chair, will bring a new dimension to the Publications Committee. There is not a more capable person to take the reigns. I will read this column with interest as we move forward in the years to come.

EDUCATION COMMITTEE
Kathleen Patterson

The spring meeting planned for Feb. 22 and 23 includes a program reflecting current research activities and up-to-date clinical/pathological disease information on a wide variety of topics in the field of pediatric pathology. Saturday morning, as usual, is devoted to poster and abstract presentations. A symposium, Topics in Pediatric Neuropathology: New Directions, moderated by Hannah Kinney, MD highlights Saturday afternoon. This symposium, focused on recent advances in the understanding of developmental brain disorders includes the following topics and speakers:

Temporal Lobe Epilepsy in Children. Dawna D. Armstrong, MD, Texas Children’s Hospital, Houston, TX.

Abnormalities of the Ventral Medulla in the Sudden Infant Death Syndrome (SIDS). Hannah C. Kinney, Children’s Hospital, Boston, MA.

Malformations of the Developing Human Cerebrum, Jeffrey A. Golden, MD, Children’s Hospital of Philadelphia, Philadelphia, PA,

Periventricular Leukomalacia. Rebecca D. Folkerth, MD, Brigham and Women’s Hospital and Children’s Hospital, Boston, MA

It is hoped that these topics you will serve to increase your knowledge of:

1. recent advances in the understanding of the neuropathology of these disorders,
2. the application of basic cellular, neurochemical, and molecular probes in the study of the human brain developmental disorders
3. the integration of rapidly evolving neurodevelopmental knowledge with the delineation of pathogenic mechanisms in human developmental brain disorder

Sunday morning is again devoted to poster and abstract presentations followed by the Neustein, Vawter, and Lotte Strauss Award presentations. Sunday morning is then highlighted by the Farber-Landing Lecture, this year presented by R.O.C. Kaschula, MD, Red Cross Children’s Hospital, Cape Town, South Africa and titled The Practice of Paediatric Pathology in Africa - Current and Future Potentials. The Sunday afternoon workshops, each presented for three consecutive years, require separate registration. Attendance at the workshops is limited and many fill up early, so pre-registration for the workshops is highly recommended (forms available elsewhere on this Webpage). The workshops presented in the 1st 2-hour session (1:30 - 3:30 PM) include:

1st yr: Update on Problems and Controversies in Placental Pathology. Rebecca Baergen, MD, New York-Presbyterian Hospital, New York, NY and Ona Faye-Peterson, MD, University of Alabama at Birmingham, Birmingham, AL.

Objectives: Participants will acquire: (1) practical knowledge of gross and microscopic placental findings in intrauterine fetal demise; (2) working knowledge of clinicopathologic correlation of placental lesions associated with IUGR; (3) current overview of placental pathology in underlying maternal disorders associated with high risk pregnancy.

2nd yr: Morphology of Complex Congenital Heart Disease. William A Devine, BS, Children’s Hospital, Pittsburgh, PA and Carole A Vogler, MD, St. Louis University Health Sciences Center, Cardinal Glennon Hospital, St. Louis, MO. Objectives: Participants will: (1) develop an understanding of the “sequential segmental analysis” method for examining hearts; (2) become familiar with the morphology of a variety of complex cardiovascular malformations, (3) become familiar with methods for examining surgically repaired, palliated, and explanted congenitally malformed hearts.

3rd (final) yr: Pediatric Renal Biopsy Pathology. Helen Liapis, MD, Washington University School of Medicine, St. Louis, MO.

Objectives: For a variety of pediatric renal disorders participants will: (1) learn to recognize the diagnostic features and generate a differential diagnosis (2) gain understanding of the current knowledge of disease pathogenesis, (3) learn to evaluate prognosis and risk for recurrence based on pathology

Workshops presented in the second 2-hour session (3:45 - 5:45 PM)

1st yr: Pediatric Soft Tissue Pathology: Diagnostic Principles, Challenges, and New Concepts. Cheryl Coffin, MD, Primary Children’s Hospital, Salt Lake City, UT. Objectives: (1) Recognize the differential diagnosis of small round blue cell, spindle cell, epithelioid, and myxoid soft tissue tumors of childhood. (2) Know the most common types of childhood soft tissue sarcomas and their diagnostic features. (3) Understand how ancillary testing, including immunohistochemistry, cytogenetics, and molecular genetics are useful for diagnosis and assessment of prognosis.

2nd yr: Selected Diagnostic Problems and Controversies in Pediatric GI Pathology. Pierre Russo, MD and Eduardo Ruchelli, MD, Children’s Hospital of Philadelphia, Philadelphia, PA.

Objectives: Participants will acquire practical insights into: (1) the differential diagnosis of malabsorption in childhood, with emphasis on the role of the GI biopsy, (2) evaluation and significance of eosinophilia in various segments of the GI tract, (3) specimen handling and diagnosis of intestinal innervation disorders.

3rd (final) yr: Pathology of Heart, Lung, and Liver Transplantation. Aliya N. Husain, MD, Loyola University, Chicago, IL and Maria Parizhskaya, MD, Children’s Hospital, Pittsburgh, PA.

Objectives: Participants will become familiar with: (1) current terminology and grading of rejection of heart, lung, and liver with consideration of the difficult differential diagnosis; (2) pathologic features of opportunistic infections, together with the use of newer diagnostic techniques; e.g. polymerase chain reaction and in-situ hybridization; (3) pathologic features of post-transplant lymphoproliferative disorders.

ARTICLES OF INCORPORATION AND BYLAWS COMMITTEE
Glenn Dickey, MD

Following are the suggested revisions to the Articles of Incorporation and Bylaws of the Society for Pediatric Pathology, which are to be voted on by the membership at the upcoming spring meeting. Current wording is present with the wording to be changed in italics and the proposed change in bold type after the italicized segment. Where only an addition is proposed, the added wording is indicated in bold type in the location proposed.

ARTICLE V

Section 3. Duties of the President. The President shall preside over regular business meetings and will serve as Chairperson of the Executive Committee and of the Council. The President shall appoint and charge all individuals and committees as specified in the Bylaws. The President shall be responsible for the organization of the agenda for meetings of the Executive Committee and the Council, and for the annual business meeting. The President shall be bonded. The President shall be an ex-officio member of all Standing Committees and their subcommittees, as well as all ad hoc committees.

The President, together with the Secretary, may sign contracts between the Society and other organizations.

The President will select the Farber-Landing lecturer with approval of the Executive Committee and the Chairperson of the Education Committee.

ARTICLE VI

Section 7. Education Committee.

(a) Composition. This committee shall consist of a Chairperson, whose term shall be three (3) years, and of ten (10) twelve (12) members with staggered terms of three (3) years each, three (3) four (4) of whom shall be appointed annually by the President. The Chairperson of the Fellowship Evaluation Committee shall be a member of the Committee, appointed by the President as necessary. Additionally the President shall appoint an ex-officio member to the committee to serve as Coordinator of Continuing Medical Education Documentation for the duration of the CME evaluation cycle. The Chairperson shall be a member of the Liaison Committee and an ex-officio member of the Distinctions and Awards Committee.

MEMBERSHIP COMMITTEE
Carlos Galliani

The Society for Pediatric Pathologists (SPP) intends to launch a worldwide out reach campaign to help meet the needs of underserved populations. I have been asked to compile a list of physicians and scientists involved in Pediatric Pathology, in whatever capacity, from all over the globe.

Please inform contacts or friends in underserved areas that the SPP would like to hear from them as part of this outreach effort (name and address, e-mail address, affiliation and area of activity e.g. surgical path, autopsy, forensics, pediatrician, pediatric surgeon, ultrasonographer, obstetrician, neonatologist, oncologist, developmental or molecular biologist, geneticist, epidemiologist, biochemist etc).

Once compiled, the list will be forwarded to the president of the SPP and members of an ad-hoc committee.

Please forward all correspondence to my personal e-mail:
Carlos A. Galliani, M.D.
Chair, Membership Committee
cgalliani@cookchildens.org

RESEARCH COMMITTEE
Raj P. Kapur, M.D., Ph.D.

Nominations are still being accepted for both theYoung Investigator Research Grant
and the McAdam's Travel Stipend. Please see the announcements below.

Comings and Goings

Harsh Thaker writes:
Dr. M. Renate Dische passed away on Saturday, December 29th. She was 81. Those of you who have worked with her know that she was a superb pediatric pathologist, a great mentor, and a truly amazing person!

Deb Perry writes:
It is with sadness that I must tell you of the death of one of the most inspirational, caring pathologists that I have had the pleasure of knowing and calling an associate - Dr. Jerald R. Schenken. Dr. Schenken was both politically and scientifically active in Pathology, serving on the CAP and
AMA boards. He and his father were primarily responsible for all of the pediatric pathology in the state of Nebraska for a number of years. For those of you who attended the interim SPP meeting in Salt Lake City a few years back, you will remember the excellent presentation that he gave.

The family has requested memorials to the University of Nebraska Foundation, which has established a Jerald R. Schenken, M.D. Outstanding Achievement in Pathology and Microbiology Award. This award was set up earlier this year and will be presented annually to the graduating medical student in the College of Medicine who best epitomizes the professionalism and excellence for which Jerry stood. For those interested, donations can be sent to:

University of Nebraska Foundation
Jerald R. Schenken, M.D. Outstanding Achievement Award
8712 West Dodge Road, Suite 100
Omaha, Nebraska 68114-3433

Welcome New Members

The following four individual are new Regular Members to the SPP:

Other Announcements

1. To foster research within the SPP by providing funds to young investigators in pediatric pathology.
2. To fund a pilot project which will lead to long-term research support from other granting agencies.

Use of Funds: The funds are to be used to facilitate basic or applied research by a young investigator in the field of pediatric pathology. Research into any aspect of pediatric disease will be considered, including morphological, biochemical, behavioral, physiological, genetic, and epidemiological studies. Appropriate expenditures include capital equipment, reagents and supplies, research-related travel, salary supplementation, service costs (e.g., electron microscopy, histology), and animal care costs. Indirect costs are not allowed.

Eligibility: Applicants must be

• a MD or DO
  AND
• either a resident or fellow, full-time, in an accredited pathology training program or a faculty/staff person in pediatric pathology for less than 5 years
  AND
• either a member of the SPP or sponsored by a member of the SPP

Amount of Award: An annual award of $10,000 will be made.

Selection Process: the Research Committee must receive Complete applications no later than February 1, 2002. The Committee will review them and the award will be announced at the SPP meeting in March. Consideration will be given to scientific merit and the background and career goals of the applicant. Award funding will begin July 1, 2002.

Application Instructions: Application Instructions can be directly downloaded from the SPP website. Completed applications should be sent to:

Raj P. Kapur, M.D., Ph.D.
Chairman of the Research Committee
Department of Pathology - Box 357470, Room D502
University of Washington Medical Center
1959 NE Pacific Street
Seattle, Washington 98195

A. James McAdams Short Term Study
Call for Applications

Background: The Society for Pediatric Pathology and Children’s Hospital Medical Center of Cincinnati established the Short-Term Study Stipend to honor A James McAdams, M.D, by promoting opportunities for pediatric pathologists to learn investigative techniques that are not available at their institution.

Goals:

1. To honor the memory of A. James McAdams, M.D.
2. To facilitate training of pediatric pathologists in investigative techniques available at other institutions.

Use of Funds: The funds may be used to offset travel and living expenses incurred by a pediatric pathologist who visits another institution in order to develop new research skills related to either clinical or laboratory investigations.

Eligibility: Applicants must be

• a MD or DO
  AND
• either a resident or fellow, full-time, in an accredited pathology training program or a faculty/staff person in pediatric pathology
  AND
• either a member of the SPP or sponsored by a member of the SPP

Amount of Award: An annual award of up to $2,000 will be made to support travel and living expenses for up to one month.

Selection Process: the Research Committee must receive Complete applications no later than February 1, 2002. The Committee will review them and the award will be announced at the SPP meeting in March. Consideration will be given to scientific merit, the background and career goals of the applicant, the expertise and/or resources available at the remote institution. Award funding will begin July 1, 2002.

Application: An application can be directly downloaded from the SPP website. Completed applications should be sent to:

Raj P. Kapur, M.D., Ph.D.
Chairman of the Research Committee
Department of Pathology - Box 357470, Room D502
University of Washington Medical Center
1959 NE Pacific Street
Seattle, Washington 98195

Future SPP Meetings

Please see our Meetings Page for the most current list of dates and locations of our upcoming meetings.

Another Meeting of Interest

Embryos, Genes and Birth Defects
Monday 29 April - Wednesday 1 May 2002
Course Directors: Professor Robin Winter & Dr David Fitzpatrick
For further information, please contact:

Courses and Conferences Office, Institute of Child Health
30 Guilford Street, London, WC1N 1EH
Tel: 020 7829 8692 / 7813 8394 / 7905 2135 Fax: 020 7831 6902
Email: Courses@ich.ucl.ac.uk

Positions Available

Please see our Positions Page for the most current list of available positions.

Belated photos from the Interim Meeting

Ron Jaffe thanks Ashley Hill for a wonderful meeting.

Council; more or less.

Fellowship group.