Pathology in Turkey: A historical survey

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Seyda Erdogan, Ilhan Tuncer, Melek Ergin Department of Pathology, Çukurova ÜNİVERSİTE Medical Faculty, Adana, Turkey Accepted for publication on 13 July 2005 In this monograph, we reviewed the history of pathology in Turkey since the era of Ottomans and tried to sum up the pathologists who took part in this survey. Keywords: History, pathology, Turkey During Ottoman Empire in 1827, Sultan Mahmut II had founded Military School of Medicine & Surgery in Istanbul. It was the first medical school in modern terms at those times. Although the teaching was initially in French, the language then changed to Turkish in 1841. Medicine in Ottomans had undergone an enormous evaluation, after Dr. Bernard from Vienna School of Medicine became the director of the school. A greater degree of knowledge on gross anatomy and anatomic pathology had been achieved following permission given by Sultan Abdulmecid to necropsy in 1841. The first official permission for cadaver studies in Ottomans was given in 1842. Pathology training in medical school was first begun with Ahmet Hilmi Paşa at the end of the 19th century. Kırımlı Aziz, Ohannes Tabibyan, Ahmet Ferit and Rıfat Hüsamettin Paşa were the other lecturers of pathology in medical school up to the beginning of 20th century.1–6 Hamdi Suat Aknar (1873–1936) was supervised to go to Germany by Dr. Robert Rieder for qualification in pathology after he graduated from Gülhane Military Academy of Medicine. He came back in 1904 and had worked for a long time in the field of pathology. He was an eminent scientist and investigator and had published many works in Turkish, German and French. He took part in the editorial board of “Acta Canceroligica” and founded “Turkish Association of Cancer and Research”. He also established the first pathology museum with 1800 specimens at Gülhane Military Academy. He died because of tuberculosis and took his part in the history as the leader of pathology in Turkey. He was awarded by TUBITAK in 1974 due to his great contributions to pathology.1–5 Pathology in Turkey – as in most other Eurepean countries – has undergone a great evolution since the second world war. A group of German professors was invited to Turkey from Germany in 1933 by Mustafa Kemal Atatürk; founder of Republic of Turkey. Of those, there were a number of specialists such as Nissen in surgery, Schwartz and Oberndorfer in Pathology, Winterstein in Physiology, Frank in Internal Medicine, Max Clara in Embryology, and Stary in Biochemistry. These political refugees contributed a lot to found the ÜNİVERSİTE of Istanbul, previously called as "The House of Arts", a modern contemporary ÜNİVERSİTE. At the beginning, they had lectured in German with simultaneous translation to Turkish. Later, the lectures were given in Turkish. In the meantime, the teaching of pathology had been undertaken by two German professors; Prof. Siegfried Oberndorfer (1876–1944), and Prof. Phillip Schwartz (1894–1978). Prof. Oberndorfer was the first director of the newly organized “General and Experimental Pathology” and on the other hand Prof. 124 Seyda Erdogan, Ilhan Tuncer, Melek Ergin © 2005 Aegean Pathology Society, APJ, 2, 123–126 Schwartz was the head of the “Pathological Anatomy” in the pathology department of the Medical Faculty of Istanbul ÜNİVERSİTE. They both distinguished themselves by giving excellent lectures and writing the textbooks of pathology in Turkish.1–4,7 Prof. Schwartz not only had organized the microscopical examinations but also focused on performing autopsies and organizing the pathology archive. He trained many qualified pathologists like Besim Turhan, Kemal Akguder, Ihsan Şükru Aksel, Süreyya Tanay, Perihan Çambel, Talia Bali Aykan, Bedrettin Pars and Münevver Yenerman who had worked hard in this field for long years.1 Prof. Dr. Siegfried Oberndorfer (1876–1944) had worked in Cancer Research Institute for 11 years. He was the author of many scientific papers and a general pathology textbook. Sedat Tavas, Üveis Maskar, Osman Saka, Sati Eser were the qualified pathologists trained by him. He died of a mediastinal tumor in 1944.1–3 Prof. Dr. Kamile Şevki (1906–1987) was the first female professor in pathology and one of the assistants of Hamdi Suat Aknar. She worked with Prof. Robert Rossle in Berlin ÜNİVERSİTE for two years and appointed to Istanbul ÜNİVERSİTE as the first female pathologist when she came back to Turkey. She was appointed to Ankara Numune Hospital and founded the pathology department. This appointment lasted for 10 years. Afterwards she founded Department of Histology and Embriology in Ankara ÜNİVERSİTE Medical Faculty. Prof. Sevki had worked on “lymphogranulomatosis” and found a histochemical technique to stain the granules of chromaffin cells in the adrenal medulla which was later called as ”Sevki method”.2,3 Prof. F. Perihan Çambel (1909–1987), had done her pathology training at Pathology Department of Istanbul ÜNİVERSİTE, Medical Faculty. Carcinogenesis and biology of mast cells were the the main topics that she was interested in. She had worked as the chief of the Pathology Laboratory of Ankara Numune Hospital between the years of 1946 and 1963.1,5 Prof. Besim Turhan (1896–1973) had been the head of the Pathology Department in Istanbul ÜNİVERSİTE after Schwartz moved to USA. He had written many Pathology textbooks about general pathology, autopsy and pathology of systems.1 Prof. Necati Eranıl (1902–1989), who had finished his pathology training at Gülhane Military School, founded the Pathology Department of Ankara ÜNİVERSİTE Medical School. He is the author of two books about macroscopy and the pathology of urinary system.1 Prof. Süreyya Tanay (1901–1979), had done pathology training at Military School after graduated from Istanbul ÜNİVERSİTE. He was one of the leading persons who had founded the Pathology Department of Ankara ÜNİVERSİTE Medical Faculty in 1948. He has three books on general pathology and pathology of heart diseases.1–4 Prof. Talia Balı Aykan (1918–2003) graduated from Istanbul ÜNİVERSİTE Medical Faculty and completed her pathology training at the pathology department of the same ÜNİVERSİTE in 1943. She had been one of the assistants of Schwartz. She had completed her studies in USA working with Prof. J. Furth and Prof. H. Goldblatt. Upon returning to Istanbul, she continued her works on experimental pathology and founded an experimental pathology laboratory and she brought the experimental animals from USA on her return. Summing up the valued scientific opus of Prof. Aykan, it is worth commenting on her series of experimental investigations on brain tumors, rabies, cystosarcoma phylloides and fibroadenoma. She was appointed with Prof. Melih Tahsinoglu to found pathology department in Cerrahpaşa Medical Faculty in 1967. She is the author of three books about autopsy, kidney diseases and pathology of tumors.1,2,8 Prof. Münevver Yenerman has graduated from Istanbul ÜNİVERSİTE Medical Faculty in 1942 and finished pathology training in 1945. Between the years of 1951 and 1954, she worked with Prof. Gomori in USA about histochemistry and made studies on diabetes mellitus. Upon her return, she was appointed to Pathology Department in Istanbul ÜNİVERSİTE and holded the chair position of pathology department after the retirement of Dr.Turhan. She has published two books on General Pathology.1 Prof. Muharrem Köksal (1912–2004) graduated from Gülhane Military Medical School in 1938 and Pathology in Turkey: A historical survey 125 © 2005 Aegean Pathology Society, APJ, 2, 123–126 completed pathology training at the same School in 1945. He was appointed as an associated professor to the Pathology Department of Ankara ÜNİVERSİTE. He went to England and worked about cell culture and mast cell granules. Back to Turkey, he had founded the Pathology Department of Hacettepe ÜNİVERSİTE Medical Faculty in 1963. He had been the rector of Ataturk ÜNİVERSİTE (Erzurum) for five months in 1964. He had taken an important role in the discipline of pathology during his life and trained so many qualified pathologists. He had written textbooks about oncology and pathology of gastrointestinal system.9 With the explosive expansion of new Medical Faculties throughout the country, many new pathology departments were founded. Some of those were headed by numerous qualified pathologists such as Prof. Necati Eranıl at the Pathology Department of Ankara ÜNİVERSİTE Medical Faculty, Prof. Kemal Akgüder at the Pathology Department of Aegean Medical Faculty in 1956, Prof. Muharrem Köksal at the Pathology Department of Hacettepe Medical Faculty in 1963, Prof. Talia Balı Aykan and Prof. Dr. Melih Tahsinoğlu at the Pathology Department of Cerrahpaşa Medical Faculty in 1967; by Prof. Arif Hikmet Yüksel at the Pathology Department of Çukurova ÜNİVERSİTE Medical Faculty in 1972. Table 1 demonstrates the history of foundation of some pathology departments. To the best of our knowledge, currently pathology departments in Turkey locate at 2 military, 40 government and 5 foundation medical faculties and at many teaching hospitals affiliated to the Ministry of Health with Pathology Departments and the overall number of pathologists is around 1500. It is obvious that the vigor of pathology in Turkey is demonstrated by the strength of the pathology societies, the potent influence of their activities, and the size of the attendance at their meetings. Regionally, there are four major general pathology societies: Turkish Society of Pathology, Ankara Pathology Society, Cukurova Pathology Society and Aegean Pathology Society. In addition, two subspeciality societies in pathology exist: Turkish Society of Cytopathology and Pediatric and Perinatal Pathology Society. During the period of last 164 years, the Pathology in Turkey has achieved tremendous qualitative and quantitative revolutions. Turkish pathologists having wide-vision, universal and scientific features on education, research and practical expertise in specific areas have been working in different fields of pathology. Today, the contemporary level of pathology that we have reached, is the result of the great studies of the leaders in the development discipline of pathology and the mile-stone scientists of the Republic of Turkiye. We commemorate all pathologists with respect for their contributions to pathology in Turkey. Their great creations and memories will be living with us forever. Acknowledgement: The authors thank to those pathology departments providing information regarding foundation years and the founders. References 1. Yıldız K. Türkiye’de Patolojinin gelişimi, tarihi perspektif, bugünkü durum, sorunlar ve öneriler. Uzmanlık Tezi, 1990. 2. Paksoy N. The history of pathology in Turkey. Pathol Res Pract 1988; 184: 128-131. 3. Seçkin S, Aksoy F. Hamdi Suat Aknar’ın Türk patoloji terihindeki yeri. Tr Ekopatol Derg 1997; 3: 58-65. 4. Tanay S. Genel Patoloji Ders Kitabı. Ankara Üniversitesi Tıp Fakültesi Yayınları, Ankara, 1967, 1-17. 5. Fırat D. Türkiye’de Onkoloji Kavramının gelişmesi ve kanserle savaşta gönüllü kuruluşlar, in Fırat D (ed). 20. Yüzyılda Türk Onkolojisine Bakış, Ankara, Ankara Ofset, 2001, 1st ed., 11-51. 6. Canda MŞ, Canda T. Başlangıçtan Günümüze Patolojinin Gelişimi. Temel Patoloji I, Sıvas Kanser Savaş derneği Yayınları/6, Sivas, 1988, 9-18. 7. Namal A. Ord. Prof. Dr. Philipp Schwartz’ın (1894-1977) Istanbul Üniversitesi Tıp Fakültesi’nde patoloji eğitimine katkıları. Türk Patoloji Dergisi 2003; 19: 1-6. 8. Sav A. Bir ışık, bir “okul” ve bir “insan”: Prof. Dr. Talia Bali Aykan. Türk Patoloji Dergisi 2003; 19: 49-52. 9. Tuncer I. Prof. Dr. Muharrem Köksal. Türk Patoloji Dergisi 2004; 20: 3-4. 126 Seyda Erdogan, Ilhan Tuncer, Melek Ergin © 2005 Aegean Pathology Society, APJ, 2, 123–126 Table 1. The founders and the foundation years of the Pathology departments of some of the ÜNİVERSİTE and Teaching Hospitals. Pathology Departments Founders Year Gülhane Military Medical School Dr. Hamdi Suat Aknar 1904 Istanbul ÜNİVERSİTE, Medical Faculty Dr. Philipp Schwartz Dr. Siegfried Oberndorfer 1933 Ankara Numune Hospital Dr. Kamile Şevki 1935 Ankara ÜNİVERSİTE, Medical Faculty Dr. Necati Eranıl, Dr. Süreyya Tanay 1948 Ege ÜNİVERSİTE, Medical Faculty Dr. Kemaleddin Akgüder 1955 Oncology Hospital, Ankara Dr. Necati Eranıl 1957 Hacettepe ÜNİVERSİTE, Medical Faculty Dr. Muharrem Köksal 1963 Atatürk ÜNİVERSİTE, Medical Faculty Dr. Recai Ilçayto 1964 Izmir Ataturk Teaching and Research Hospital, Izmir Dr. Ayhan Kara 1964 Istanbul ÜNİVERSİTE, Cerrahpaşa Medical Faculty Dr. Talia Balı Aykan, Dr. Melih Tahsinoğlu 1967 Çukurova ÜNİVERSİTE, Medical Faculty Dr. Arif Hikmet Yüksel 1972 Dicle ÜNİVERSİTE, Medical Faculty Dr. Recai Ilçayto 1973 SSK Tepecik Hospital, Izmir Dr. Turan Genç 1974 Erciyes ÜNİVERSİTE, Medical School Dr. Bedri Kandemir, Dr. Mehmet Külahçı 1975 Okmeydanı SSK, Istanbul Dr. Türkan Özgönül 1975 Uludağ ÜNİVERSİTE, Medical Faculty Dr. Oktan Erol, Dr. Ali Rıza Karaca 1976 Akdeniz ÜNİVERSİTE, Medical Faculty Dr. Kadri Bacacı 1976 Cumhuriyet ÜNİVERSİTE, Medical Faculty Dr. Şerefettin Canda, Dr. Tülay Canda 1977 Osmangazi ÜNİVERSİTE, Medical Faculty Dr. Kemal Bayrı 1977 19 Mayıs ÜNİVERSİTE, Medical Faculty Dr. Yüksel Alvur 1979 Dokuz Eylül ÜNİVERSİTE, Medical Faculty Dr. Şerefettin Canda, Dr. Tülay Canda 1979 Gazi ÜNİVERSİTE, Medical Faculty Dr. Cansen Çakalır 1980 Taksim Hospital, Istanbul Dr. Bilgin Aksoy 1984 Marmara ÜNİVERSİTE, Medical Faculty Dr. Ümit Ince 1986 Selcuk ÜNİVERSİTE, Medical Faculty Dr. Osman Yılmaz 1986 Gaziantep ÜNİVERSİTE, Medical Faculty Dr. Coşkun Özsaraç 1987 Trakya ÜNİVERSİTE, Medical Faculty Dr. Kemal Kutlu 1983 Karadeniz Teknik ÜNİVERSİTE, Medical Faculty Dr. Yavuz Özoran 1983 Fırat ÜNİVERSİTE, Medical School Dr. Ayşe Zuhal Yumbul 1988 Inönü ÜNİVERSİTE, Medical Faculty Dr. Hüseyin Üstün 1988 Behcet Uz Hospital, Izmir Dr. Necmettin Ozdemir 1988 Kartal Government Hospital, Istanbul Dr. Nusret Erdogan 1989 100.Yıl ÜNİVERSİTE, Medical Faculty Dr. Serdar Uğraş, Dr. Hüsniye Dilek Dr. Emel Akman 1994 Harran ÜNİVERSİTE, Medical Faculty Dr. Muharrem Bitiren 1995 Celal Bayar ÜNİVERSİTE, Medical Faculty Dr. Saliha Soydan 1995 Kocaeli ÜNİVERSİTE, Medical Faculty Dr. Cengiz Erçin 1995 Pamukkale ÜNİVERSİTE, Medical Faculty Dr. Ender Düzcan, Dr. Neşe (Çallı) Demirkan 1995 Adnan Menderes ÜNİVERSİTE, Medical Faculty Dr. Sema Hilal Koral 1995 Süleyman Demirel ÜNİVERSİTE, Medical Faculty Dr. Gülsen Aydın 1996 Mersin ÜNİVERSİTE, Medical Faculty Dr. Ayşe Polat, Dr. Özlem Aydın 1998 Kırıkkale ÜNİVERSİTE, Medical Faculty Dr. Önder Bozdoğan 1998 Abant Izzet Baysal ÜNİVERSİTE, Düzce Medical Faculty Dr. Murat Alper 1998 Sütçü Imam ÜNİVERSİTE, Medical Faculty Dr. Sevgi Bakariş 1999 Karaelmas ÜNİVERSİTE, Medical Faculty Dr. Gamze Numanoğlu 2000 Abant Izzet Baysal ÜNİVERSİTE, Izzet Baysal Medical Faculty Dr. Çetin Boran 2002 Mustafa Kemal ÜNİVERSİTE, Medical Faculty Dr. Esin Atik 2003

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