the Editor's Desk
Happy spring to all. I hope everyone enjoyed
Vancouver as much as I did. Seeing mountains and ocean in the same vista
is a rare experience. The photos at the end of the newsletter are worth a
look. Please enjoy the messages from the President and past President, who
raise important issues. The committee reports are informative, as always.
The newsletter will be published semiannually instead of quarterly from
now on, unless we find that we need more frequent publication. Committee
reports comprise the bulk of each issue, and the committees meet
semiannually. The content of the other two issues in the past was often
quite sparse. Our webmaster, Mark Luquette, keeps us informed of
significant new postings on the website between issues of the newsletter,
and I think this works well. By all means, please communicate to me any
issues, concerns, suggestions, etc for the newsletter. Several recent
Presidents of the Society have brought our attention to medical needs
around the world. Please see the announcement concerning the need for
medical texts in Iraq in the announcements section.
Many organizations follow cyclical patterns. There are periods of growth, and periods of stasis. There are times of energy and enthusiasm, and times of stagnation. Reasons for these cycles are not always apparent. In some measure they are in response to the people, the stage of development of the organization, as well as the external environment. In other words we are affected by the same things that influence any growing organism.
The SPP has changed much since its casual conception, with early rapid growth through an adolescence, into a young yet mature professional organization. We have an excellent journal. Our meetings continue to improve, with the Interim meetings being an annual highlight. These meetings are part of the wonderful glue that has solidified us as a group. We have accredited fellowship programs, a vibrant and successful CME program, and our own subspecialty boards. We are recognized by universities, hospitals, and our colleagues for what we do and our uniqueness. The list server and the WWW allow a rapid and free exchange of ideas and advice. Few would have predicted these developments and the degree of our success those brief years ago when a handful of pathologists, with a similar interest in children's diseases, got together to meet for the first time.
At the Vancouver meeting this spring, I sensed a new level of energy. Those who founded the society or, like me, were part of the first generation of fresh young members are ageing. An entirely new generation of pediatric pathologists is emerging, spawned in a different era, with different experiences, expectations and technologies. Demands of the profession, academics, government regulation, and home life have all changed. Many of us are being asked to do more with less. All of us are challenged to find the time to volunteer for an organization like the SPP. This reality was recognized a number of years ago when we engaged a professional management firm to help run our affairs. Most of these are now handled with great skill by Jim Crimmins, Carolyn Lane and colleagues, of the USCAP. Onerous tasks have been largely automated. The demands at work and home still limit the amount of time any one of us can devote to the Society. But we remain at heart a volunteer organization and need a constant supply of committed pediatric pathologists to review abstracts, staff committees, write and review manuscripts, organize and run workshops, assist in the governance, and bring fresh ideas into the society.
For all these reasons we must ensure that our operation is efficient. We must be careful that the tasks we ask of people are doable and meaningful. It is time to re-examine our governance, committee structures and functions, and bylaws, and update them if needed to meet all the exigencies of today's world. We must ensure that this new generation of pediatric pathologists has an organizational structure that will help them meet their expectations for a satisfying and successful career. During the coming year, Dr. Beverly Rogers, the president-elect, and I, together with council, will work hard to involve and help this new vibrant group of young pathologists benefit from their membership in the SPP.
Past President's Message
Derek de Sa
As I prepared to step down from the post and hand it over to Denis Benjamin, I found myself experiencing a variety of emotions.
Holding the title of President of this Society is a great honour and I will always be grateful for having been given this unique opportunity. Henry Krous referred to growing up in Indianola, and how the Society demonstrated its very accepting nature when it elected him. The tolerance of the Society must have been stretched even more when I was nominated!! I thoroughly enjoyed the year in office, and particularly enjoyed signing the certificates for the winners of our awards. I resisted the temptation to record this event with television cameras and a photograph or two, but only just!
I enjoyed having the talking stick in my office at home, and when our house was broken into just before Christmas, the sense of relief that the stick had not been damaged or stolen was palpable.
The talking stick is beautiful, but the wood (cedar) is soft and it needed maintenance after 25 years of being handed from one President to another. Jim Dimmick, a former President and, like me, a great admirer of the sheer beauty of the stick, undertook the repairs and with his son has restored the stick, smoothing out the occasional scar. It is a pleasure to acknowledge my indebtedness to both of them. It was fitting that the repairs were done in British Columbia, the original home of the tradition of the talking stick in general, and this one in particular. Sadly the art of making talking sticks is in danger of disappearing.
The talking stick was a gift to the Society from David Hardwick who presented it at the banquet in 1979 in San Francisco when he became President. When, after describing in detail all the different carved symbols on the talking stick, he reached back behind the podium and presented the stick to the audience there was a collective gasp of surprise followed by a standing ovation. It is appropriate that on the occasion of the USCAP Spring meeting in Vancouver BC (the first time that it was held in this city), David Hardwick, past-president of both the Society (or Club as it then was) and the USCAP was honoured for his huge contributions to the discipline of Pathology in all its many forms. As a relatively recent recruit to the city of Vancouver, I am only too aware that the strong Pathology Department in this city--in all the disciplines--is due in very large measure to the work of "his nibs" over the decades. That does not even take into account his contribution to the molecular basis of pediatric pathology, the "bowtie" gene!!
Another senior figure in Pediatric Pathology and USCAP spheres was also honoured in Vancouver. As pointed out in an earlier Newsletter, Daria Haust's lifetime of achievement was recognized by USCAP. Dr. Haust is so well known to the members of our Society, that anything I might add to what I said earlier will be redundant, but as a Canadian it is very satisfying to see two such prominent figures from Canada receive their honours in a Canadian city hosting USCAP for the first time ever. The similarity of initials (of both recipients) with those used in baseball ('rounders' to the cognoscenti) to describe a particular type of player to whom teams turn in difficult situations seems apt.
Other reports in this Newsletter outline the developments in our Website, activities of the Publications Committee, and other general items of interest in the fields of Practice, and Education. However, it is worth mentioning that the Publications Committee is considering several ways to strengthen our Journal in terms of using electronic publication to a greater extent, allowing rapid publication of case material for example. We will continue to offer the only truly academic vehicle for our Specialty, but it is recognized that there are always areas where we could improve, and we will.
It is a pleasure to report that I have been the recipient of a great deal of support from many members of the Society, but no one more than our Secretary-Treasurer Hal Pinar. This Society could not function without an efficient, logical presence who offers a sense of continuity while Presidents come and go. "Thank you Hal"! On several occasions, I was able to tap into many years of accumulated wisdom represented by previous Presidents and it was amusing to see that some problems never really change!
"Thank you, Council of Sages-you know who you are"! Finally Jim Crimmins and all his staff at USCAP have been most accommodating to me on many occasions.
Amid the feelings of gratitude and nostalgia, I cannot help but feel a certain amount of regret. While there has been steady progress within the Society in terms of the establishment of our website, and many other aspects of our organization, every President I suspect would like to leave some small sign of progress as a legacy. I was hoping to be able to strengthen our international links not just with other Societies, but with others around the world who share our interest in the health of children and their diseases, others who because of isolation or economic circumstances are not able to tap into the wealth of expertise that we in this Society take for granted. However, I have not given up hope yet! Maybe squeaky wheels need to squeak a bit longer or in other ears. I remain convinced, however, that the increasing use of electronic linkage will offer pathologists in remote sites an opportunity to contact others around the world and discuss difficult cases, or generally seek help. I see the development of these links as a two-way stream, because from the little I have seen it is clear that I have lots to learn from colleagues all around the world. A little eavesdropping on our Listserver makes the point I feel.
I have always been impressed by the fact that many of us, in North America, practice our craft in relative isolation. From a personal point of view, when I went to Hamilton (ON) from Oxford (UK) for a short while I experienced a sense of professional isolation. The city of Hamilton is not isolated in any geographic sense of the word, but as the single pathologist with an interest in perinatal pathology, it was difficult on occasion to find someone to discuss cases with. My links with our excellent colleagues of Toronto, developed through Kent Mancer, were of enormous value to me, as was the subsequent development of our Intercity Pediatric Pathology group (with good friends like John Fisher, Leon Metlay and Ross Armstrong to add to the list). The growth of other similar groups around North America proves to me that there is a need for them, and the electronic revolution offers us the possibility of making contacts far beyond the narrow confines of one state, province or country. Now all I need is the right contact to tap into some relatively small sums of money, and with the supervision of SPP and advice from other kindred bodies, we could develop a network that would greatly enhance the diagnostic capability of all who combat diseases in children.
Speaking of isolation reminds me of the intractable problem of recruitment into our specialty. Clearly, if this problem persists the sense of professional isolation will be exacerbated many times over. Our Fellowship committee has offered suggestions, and efforts to ameliorate the situation will continue. I believe that the Society has made many attempts to attract residents, and these attempts will continue. I was concerned however to hear that at the Spring meetings the SPP is seen as being less than friendly to new attendees, be they residents, students or more senior members. This was not my experience as a new member in the old Pediatric Pathology "Club", but it is more than likely that as our membership has increased, we lost the attributes of a small club. There is nothing inevitable about such a change, however, and the radically different atmosphere of our interim Meetings proves that. There is a study underway to assess the views of members as to how we can make our Spring meeting more collegial and how we could run it in a friendlier atmosphere. There will I am sure be more about this later, but for a start at the next annual meeting I would like to encourage all those who are introducing new members to shepherd them around and introduce them to as many members as possible. If they are attending the Banquet buffet-and I would strongly recommend the buffet this year- there are additional opportunities to mix and mingle. For many reasons, we may never recapture the ethos of the old PPC in our Spring meetings, but we can try and counter any negative perceptions. We need to remind the residents about the resident's breakfast on Sunday, and it may be worth considering inviting new members as well.
Finally, I believe that the Society will be served very well by our new President, Denis Benjamin. As I wish him well, I would like to offer my thanks once more to all the members of the Society for their indulgence this past year.
An Important P.S. to the Past President's message.
"One of the great pleasures of being President of our Society is being able to recognize Members who, over the years have yielded great services to our Society and to children's health in general and universally. My
choice for a President's Award was Virginia Anderson, and it was a great pity that she was unwell and unable to make the trip to Vancouver to receive the award in person. My respect for Virginia goes back to the first time we met, when she espoused some very unpopular views in a Business meeting of the Society (including some that were difficult for me to agree with). This was many decades ago , and during her terms of office with our Society (Councillor 1985-88), and in her many capacities as an officer of the IPPA she has never been reluctant to stand up for what she believes is in the best interest of children everywhere. This is not mere idle talk either, but she has acted in innumerable capacities to help children with AIDS world wide, mentored several kindred spirits from around the globe-some of whom, as in Seattle 1993, presented papers at our meetings which won Vawter awards, tried to foster outreach with attempts to develop software that could be used to scan a microscope slide even with the weakest forms of computer systems, and taught in several centres around the globe. In all these activities, her altruism has been self evident, and strikingly obvious in the recently concluded IPPA course in South Africa. This was after our meeting in Vancouver, of course, but a striking endorsement of my choice, nevertheless. It is fortunate that our Society has at least one such member to act as the yeast in our bread."
Steve Qualman, chair
||Pediatric and Developmental Pathology (PDP)
Dr. Reyes-Múgica reported a stable year of activity with 130 manuscripts received for review, and a 64% acceptance rate.
PDP membership survey
Dr. Qualman reported that nearly 100 members responded electronically or by fax. Most members rated the journal in the "good" to "very good" range, but with a substantial number of suggestions for improvement. The top ten suggestions for change will be shared with the SPP membership after more detailed analysis.
The PDP contract with Springer expires at the end of 2005. Jim Crimmins of our management office (USCAP) will examine further options with consultant help as necessary.
Dr. Mark Luquette is redesigning the webpage as a carefully coordinated effort with the publications committee. Lorence Sing of Columbus Children's Hospital was approved as an assistant editor. Potential website by-laws are still under study in an effort led by Hal Pinar.
Perspectives in Pediatric Pathology and SPP Newsletter
Both publications are on pace with scheduled deadlines of production, with the Newsletter now produced twice yearly after SPP meetings.
Gareth Jevon, Chair
At its Spring meeting the Practice Committee welcomed its newly appointed members, and thanked Gloria Kohut, the outgoing Slide Survey chair, as well as Drs. Davis, Rabah, Kim and Montforte-Munoz for their contributions to the committee. According to the results of the survey of its subscribers, the slide survey continues to be an important part of the Society's educational activities. The committee thought that the slide survey could be enhanced by establishing a link on our homepage so that members may submit cases easily in the desired format. We encourage our members to submit cases from all aspects of our practice, including our perinatal and placental components, especially cases that have been prepared for presentation at rounds and other symposia. This includes cases with digital microscopic photographs. We hope to recognize the contributors by including the cases as reports in the eformat of our journal, and we plan to allow electronic submission of answers through our website. Mary Davis presented data from her survey, which focused on the demographics, practice setting and activities of the membership. The results highlight the present shortage of pediatric pathologists in North America, which will become more serious in the next few years. The data will be published, but Mary is happy to share more details with those who might need them.
Gail Deutsch, Chair
Please congratulate this year's recipient of the Young Investigator Research Grant. The awardee is Rene L. Galindo, M.D., Ph.D., from University of Texas Southwestern Medical Center at Dallas, for his proposal titled "Molecular Pathogenesis of Alveolar Rhabdomyosarcoma".
The A. James McAdams Short-term Study Stipend was not awarded this year.
Jeffrey Goldstein, Chair
I would like to gratefully acknowledge the contributions of committee members completing their terms. Laura Finn chaired the Abstract Subcommittee for the last two years and oversaw both the transition to e-mail abstract submission and digital projection. David Carpentieri, as chair of the Workshops and Symposium Subcommittee, coordinated the educational program for the spring meeting in Vancouver, and as the CME monitor for the meeting will be preparing the evaluation summary. Rebecca Baergen served on the Extramural Education Committee, but continues to be involved with the Committee as the current Perinatal Section chair responsible for the upcoming Perinatal Symposium in Little Rock. Pauline Chou served on the CME committee, and has also volunteered to serve as the CME monitor for the interim meeting this fall. This may be the only SPP committee where one's work doesn't seem to end when your term is up! On behalf of the Society, I thank these individuals both for their efforts over the last three years, and for their on-going efforts. We would also like to thank Gloria Kohut who completed her term as a liaison to the committee in her role as the chair of the Slide Survey Program.
Seventy-six abstracts were submitted with 42 accepted (55%). The number of abstracts continues to be high in comparison to prior years. Overall scores for accepted abstracts ranged from 3.06 to 4.28 (mean 3.62) for platforms, and 3.0 to 4.22 (mean 3.45) for posters. All abstracts with scores of less than 3.0 were rejected. Thanks to Laura Finn and her committee for managing and evaluating the abstracts. Special thanks to ad hoc reviewers Kevin Bove, Charles Timmons, Edith Schmidt, Drucilla Roberts, Gail Deutsch, and Brett Casey; and to Carolyn Lane at USCAP for her thorough and timely support of the abstract submission process.
Dr. Luquette reported that the Web-server based abstract submission process is on target for use for the fall meeting. A link from SPPONLINE.org will direct the author to the submission program. All editing will be done offline with pasting of text into two boxes (stripped of identifiers and complete). This will create two files of abstracts, one used for review and the other for publication. Authors will be asked to submit abstracts via e-mail as well for back-up, and will be polled about the submission process. Provided the server solution works as anticipated, e-mail back-up will not be requested for subsequent meetings.
Guidelines on use of Protected Health Information (PHI) in presentations were discussed, and information developed by an ad hoc task force chaired by Dr. Steve Qualman was reviewed. The Society has adopted a "minimal needed information" policy, and requires presenters to comply with their own institution's HIPAA compliance policy. These guidelines will be provided in instructions provided to abstract presenters.
DeMello organized this year's symposium, Developmental Pulmonary Pathology
which honored Dr. Lynne Reid, who attended the symposium. Dr. DeMello's
panel of experts addressed practical clinical issues in the management of
congenital diaphragmatic hernia, genetic regulation of lung development,
and bioengineering principals for the development of artificial organ
prototypes. The symposium handout included a compendium of resources for
assessing lung growth and pulmonary vascular development. We thank Daphne
for recruiting such distinguished speakers, and for creating a program
that was truly a highlight of the recent meeting.
- Two workshops were presented for the third and final time in Vancouver:
We thank Drs. Coffin, Baergen and Faye-Petersen for their workshops.
- Pediatric Soft Tissue Tumors by Dr. Cheryl M. Coffin.
- Update on Problems and Controversies in Placental Pathology by Drs. Rebecca Baergen and
- Two new workshops were offered:
- Drs. Gareth Jevon and James Dimmick presented a workshop titled An Histologic Approach to the Pediatric Liver Biopsy.
- Dr. Debra Heller presented a workshop, Pediatric Gynecologic Pathology with Clinical Correlations.
- Continuing workshops included:
- Pediatric Dermatopathology: A Practical Approach to Diagnosis by Drs. Vijaya B. Reddy and Aliya N. Husain.
- Vascular Malformations and Tumors in Children by Drs. Harry Kozakewich and Paula E.
- Two new workshops for 2005 have been chosen.
- Recent Developments and Controversies in Pediatric Lung Disease by Drs. Claire Langston and Tom Stocker. Needs Assessment: Lung Pathology has been one of the most requested topics in membership polls related to workshop topics. There have been a number of changes in our understanding and classification of pediatric pulmonary conditions in recent years. This workshop will address areas of controversy and more recently identified entities.
Topics: Developmental Malformations of the Lung
Infant Lung Biopsy
Pediatric Lung Tumors
- Skeletal Anomalies
by Drs. Enid Gilbert-Barness and Theonia Boyd. Needs Assessment:
Recent survey of SPP members elicited suggestions for an advanced
perinatal workshop on skeletal anomalies. The more common skeletal
anomalies are readily diagnosable by quick text or online reference,
but unusual isolated anomalies or anomaly syndromes may be difficult
to accurately characterize. This workshop will present a systematic
approach to evaluation of skeletal anomalies, predominantly by a
regional anatomic approach, similar to that employed in clinical
genetics. Emphasis is placed on ancillary diagnostic aids, e.g.
radiologic evaluation and molecular genetic findings, that are
pertinent to or known for a given syndrome.
The spring 2005
symposium is a milestone: it will be the Society's first symposium jointly
organized with one of the USCAP companion societies, the Binford Dammin
Infectious Disease Society. The symposium will move from its usual time
slot on Saturday afternoon to Sunday morning to accommodate the joint
program. David H. Walker will serve as the moderator. Needs Assessment:
Infectious disease pathology is an area of diagnostic challenge for both
practicing pathologists and pathologists in training; in addition,
pediatric infectious disease pathology presents an unusual and interesting
set of diagnostic problems and challenges. The Society for Pediatric
Pathology and the Binford-Dammin Infectious Disease Pathology Society
determined that a joint seminar would benefit both groups. This topic has
not been previously covered in a joint seminar for either practicing
pediatric pathologists from the SPP or pathologists with an interest in
infectious disease pathology who belong to the BDS. "
- Pediatric Mycobacterial Infections: Diagnostic Challenges and New Diagnostic
Modalities; Gary W. Procop.
- Update on Perinatal Viral Infections; Edwina
- Update on Pediatric Malarial Infections: A Global Perspective;
J. Kevin Baird.
- Emerging Infectious Diseases:
Responsibilities and Resources for the Practicing Pathologist; Margie
Lisa Teot, the CME Coordinator, suggested a plan to use post-activity
surveys of workshop participants to address the ACCME's preference for
outcomes-based (rather than satisfaction) evaluations of educational
activities. We hope to implement this over the coming year. If Lisa or a
member of her subcommittee contacts you, please respond to their inquiry.
The SPP-sponsored freestanding perinatal-placental course developed by Ona Marie
Faye-Petersen and other members of the Perinatal Section is scheduled for
the Omni Parker House Hotel in Boston, May 20-22, 2005. Dr. Faye-Petersen
presented a status report, updated course agenda including objectives,
reference materials list for the syllabus and an updated budget. The
course promises to be excellent. Reserve the dates on your calendar.
- Little Rock 2004. The meeting will be held October
28-31, 2004 and will feature a symposium: Modern Pediatric Forensic
- Performing the Forensic Autopsy at a General or
Pediatric Hospital: What is Essential? William Q. Sturner.
- Retinal Hemorrhages and Their Significance in Child Abuse; Harry Brown.
- The Diagnostic Criteria of Suffocation by the Presence of Iron-staining
Macrophages in the Lung; Randy Handzlick.
- Advances in the Pathogenesis of SIDS; John L. Carroll.
- Controversies in Pediatric Forensic Pathology,
with Panel Discussion; Henry Krous.
David Parham has planned an excellent
combination of scientific sessions and social activities that we all look
forward to next fall. More information will be on SPPONLINE.org. Watch for
the meeting announcement which will be in the mail soon as well.
The 2004 Perinatal Symposium will follow the main meeting in Little Rock on October
31, 2004. The Symposium, moderated by Dr. Rebecca Baergen is titled:
Chronic inflammatory lesions of the placenta: immunoregulation, host
defense and pathologic immune response. Needs Assessment: Immunology of
pregnancy and immunologic responses of the placenta were identified as
rapidly advancing areas of importance for diagnostic perinatal pathology
(see needs assessment for 2002 and 2003 symposium). Immunologic mechanisms
are crucial to the maintenance of pregnancy, and dysregulation of these
mechanisms leads to pregnancy failure and often recurrent pregnancy loss.
Many of the recent advances in understanding the immunologic mechanisms of
the placenta directly pertain to the diagnosis and treatment of
infertility and the maintenance of normal pregnancies. In addition,
various immunologic responses to infection also lead to significant
morbidity and mortality in neonates. This topic has also been requested by
former Perinatal Symposium attendees. Topics:
- Immunobiology of the Maternal-Fetal Interface; Joan Hunt.
- Chronic Placental Inflammation and Infection: The Pathologist's Perspective; Beverly Rogers.
- Immunology of Recurrent Pregnancy Loss; Neal Rote.
- Pathogenesis of Intrauterine CMV Infection;
- Tours, France 2005. This meeting will be held in
conjunction with the Paediatric Pathology Society (PPS). Scientific
sessions will be on Thursday and Friday, September 1-2, 2005 with a tour
of the Loire Valley on Saturday, September 3, 2005. The European Congress
of Pathology meeting starts on Sunday, September 4, 2005, in Paris. Dr.
Liliane Boccon-Gibod is coordinating on site logistical arrangements, and
Dr. Philip Cox from the PPS is helping us with the educational program.
The program will feature a symposium on Cutaneous Manifestations and
Complications of Hematologic Disorders, a slide seminar, and the John
Emery Lecture which will be presented by Dr. Bruce Beckwith titled
Impressions of Monstrosity: Images of Malformation Through the Ages. A
perinatal symposium is now also being planned for the Tours meeting.
Separate registration fee is not anticipated, because the perinatal
symposium will run simultaneously with an abstract platform session that
will not include perinatal papers. The symposium coordinator will be
appointed from Europe, and to control expenses, any non-member speakers
will also be invited from Europe.
- The Committee considered a proposal by Drs.
Paul Dickman and David Carpentieri from Phoenix Children's Hospital
offering to host the fall 2007 interim meeting. The proposal was
recommended to Council who accepted it. Columbus Children's Hospital,
Columbus, OH, and Dr. Steve Qualman were previously selected as the
hosts for the 2006 fall meeting.
Slide Survey Program
Gloria Kohut reported for the Practice Committee on the
2003 Slide Survey Program. The case submission process was discussed with
a goal of increasing the diversity and number of submitted cases. More
timely feedback of answers is also desirable, and posting of discussions
and digital photographs on SPPONLINE.org may be better than mailing
discussions to subscribers. Mark Luquette volunteered to take the
photographs, review them with the discussant, and post them to the website
to ensure consistent photographic quality.
As is evident from the length of this report, the Education Committee is large with a number of ongoing
programs and projects designed to meet the various needs of the SPP's
membership. These programs could not take place without the vast amount of
time and energy dedicated by Society members who serve on the committee
and volunteer to prepare, host, and support our programs. It would be
nearly impossible to acknowledge everyone individually. As chair, I would
like to personally thank everyone, whether named somewhere above or not,
who have contributed to these efforts over the last year.
Alba Greco, Chair
Fellowship Committee Survey
The survey was conducted by e-mail by Bruce Pawel. The questionnaire was sent to all pediatric pathology fellowships listed on the WEB, and 21/27 responded as of March 15, 2004.
Programs in the survey that are actively recruiting fellows: 12/21
July 2003: 14/21
July 2004: 14/21 (1 program still interviewing)
July 2005: 4/21 (1 negotiating; 4 interviewing)
2 years: 2 programs
1 year: 9 programs
1-2 years: 10 programs
Graduates vs. available
Graduates seeking staff position: 5
available: 12 (from survey institutions)
14 (additional advertised on web; USA-10,
Canada-2, Ireland-1; New Zealand-1)
derm, molecular, neuro, CP, hematopath, combo (cyto, derm, priv pract),
perinatal, research, transfusion medicine
Carlos Galliani, Chair
The current roster of members includes:
New junior members approved in
1. Dr. Karen W. Eldin
2. Dr. Olaronke Ogunremi
3. Dr. Vivekanand Singh
4. Dr. Sara Szabo
Members changed to Emeritus Status
1. Dr. David Becroft, Auckland, New Zealand
2. Dr. Ralph Franciosi, Milwaukee, WI
3. Dr. Edith Hawkins, Houston, TX
4. Dr. E. Tessa Hedley-Whyte, Boston, MA
5. Dr. Gerald Spear, Orange, CA
DISTINCTION AND AWARDS COMMITTEE
Antonio R. Perez-Atayde, Chair
At the spring meeting in 2004, 21 abstracts were
considered for the Gordon Vawter Pathologist in Training Award, and 5 for
the Harry Neustein novel technology award.
The Vawter Award was presented
to Dr. Gino R Somers from the department of Pediatric Laboratory Medicine,
Hospital for Sick Children, Toronto, ON. His abstract was entitled:
Association of drowning and myocarditis in a paediatric population: A
clinicopathologic study. Co-authors were Drs. CR Smith, G Wilson, and GP
The Neustein Award was presented to Dr. Rocio Pena-Alonso from
Hospital Infantil de Mexico Federico Gomez and Hospital General de Mexico,
Mexico, D.F. for her paper: Analysis of the sex determining region of
chromosome-Y (SRY) by PCR and FISH in true hermaphrodites. Co-authors were
Drs. G Queipo, JC Zenteno, L Erana, L Dorantes, K Nieto, and S
Copies of the abstracts are at the end of the Newsletter.
The Lotte Strauss Prize, which is given annually to the author of the best
paper published on a subject germane to pediatric pathology in the
preceding year by an individual 40 years of age or younger, was not
awarded this year.
Several stories have appeared recently in the media and in medical publications (www.theheart.org March 23) about the state of medical care in Iraq, including at the children's hospital in Baghdad. Medical textbooks, particularly recent basic science books, are needed. Texts may be sent to the following address:
CPT Donna Kentley
415th CA BN
c/o Public Health Team
APO AE 09392
The contact person and the address have changed several times recently. Checking the address before mailing texts is wise, and as of this writing the address may be confirmed by emailing firstname.lastname@example.org
See staff and fellowship positions advertised on our website.
See upcoming meetings posted on our website:
Click Here to go to the photo gallery showing the highlights of our 2004 Annual Meeting in Vancouver British Columbia, Canada.
The Vawter Award
ASSOCIATION OF DROWNING AND MYOCARDITIS IN A PAEDIATRIC POPULATION: A CLINICOPATHOLOGIC STUDY. GR Somers FRCPA PhD, CR Smith FRCPC, G Wilson FRCPC, GP Taylor FRCPC. Department of Paediatric Laboratory Medicine, Hospital for Sick Children; and Coroner's Office, Toronto, ON.
Drowning is the second leading cause of accidental death in the paediatric population. Autopsy studies occasionally reveal other significant findings that may indicate a more complex series of terminal events. However, the finding of myocarditis in drowning victims has only rarely been reported.
A review of autopsy records for a four year period between Jan 1998 and Jan 2002 was performed for cases of drowning in patients 0-18 yr of age (total cases reviewed = 1072).
Thirteen cases of drowning (1.2% of autopsies) were identified in 6 males and 7 females. One was deemed a homicidal drowning, the remainder accidental. The age range was 6 mo to 17 yr (mean 5 yr). The majority (54%) occurred in lakes or rivers. Four cases (31%) had coexistent myocarditis, three of which were female and one male. The age range was 23 mo to 12 yr (mean 5 yr). None of the four cases had antecedent symptomatology suggestive of myocarditis. In three of the cases, the myocarditis was in the form of a lymphocytic infiltrate; one case had a mixed neutrophilic-lymphocytic infiltrate. All four cases had foci of myocyte necrosis. One case had evidence of myocyte hypertrophy suggestive of a cardiomyopathy. In three of the cases, microbiological cultures were performed and were negative for viruses. No other significant coincident cardiac pathology was found in the remaining cases.
The association of myocarditis and drowning has only been reported in two previous cases in the English literature. The finding of myocarditis in a significant proportion of our drowning victims raises important issues regarding cause and manner of death and highlights the importance of a thorough autopsy examination in apparent straightforward cases.
The Neustein Award
ANALYSIS OF THE SEX DETERMINING REGION OF CHROMOSOME-Y (SRY) BY PCR AND FISH IN TRUE HERMAPHRODITES. Y.R. Peña-Alonso, MD, G. Queipo, MD, PhD, J.C. Zenteno, MD, PhD, L. Eraña, MD, L. Dorantes, MD, K. Nieto, BS, S. Kofman-Alfaro, MD. Hospital Infantil de México Federico Gómez and Hospital General de México. México, D. F.
True hermaphroditism (TH) is an unusual form of sex reversal characterized by the development of ovary and testis in the same person: 60% of the cases have a 46,XX karyotype, 33% are mosaics with a cell line containing chromosome-Y and 7% are 46,XY. Molecular analyses have demonstrated that the gene SRY, considered crucial in the process of testicular development, is present in only 10% of 46,XX true hermaphrodites; in the remaining 90 %, an unknown X-linked or autosomal sex determining locus could be involved in testicular development. Dual gonad development has also been associated with other genetic anomalies including SRY point mutations, chromosome-22 trisomy and hidden chromosome-Y mosaics.
TH was defined by histological findings of the gonads. DNA from peripheral leucocytes and routine-processed, paraffin-embedded gonads of seven patients with TH was PCR amplified in order to identify the gene SRY. Chromosome-Y derived sequences PABY, ZFY, AMELY, Ycen and Yqh were also explored. Positive cases were analyzed by FISH using three Y probes.
Of the cases analyzed, six were 46,XX and the other was 46,XY. The gene SRY was disclosed in three 46,XX cases: in one, SRY was present only in the gonad as demonstrated by PCR and FISH; in the other two cases, karyotype was redefined as 46,XX/47,XX del(Y)(p?) and 47,XXX/45,X/47,X del(Y)(p?)/46,XY in accordance with signals displayed by FISH.
For the first time, the gene SRY confined to gonad was displayed by FISH. The presence of hidden mosaicism of chromosome-Y derived sequences could be an alternative mechanism for dual gonad development in 46,XX true hermaphrodites.