Contributed by C W K Lam , Past IFCC EB Member
Editor's Note. The Asian and Pacific Federation of Clinical Biochemistry (APFCB) is composed of clinical biochemistry societies of 13 Asian and Pacific countries (or areas): Australasia, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Pakistan, Singapore, Taiwan, Thailand, and Vietnam, 9 corporate members and 1 affiliate member. Its Scientific, Education, and Laboratory Management Committees conduct activities for the advancement of Clinical Biochemistry in the region including coordination of the IFCC Visiting Lectureship, APFCB-Beckman Coulter Education Symposium, and APFCB Traveling Lectureship.
The APFCB Traveling Lectureship 2005-2006
The APFCB was conspicuously represented at the IFCC General Conference that was held from 14 to 17 May 2004 in Sousse, Tunisia, with participation by its president, secretary, and chairmen of education and scientific committees. During the conference dinner, Education Committee Chairman Leslie Lai and Secretary Joe Lopez very kindly suggested that I should serve as the 5th APFCB Traveling Lecturer (2005-2006) following Dr Peter Garcia-Webb of Australia (1999), Professor Evelyn Koay of Singapore (2000), Professor Dennis Lo of Hong Kong (2001-2002), and Dr David Sullivan of Australia (2003-2004). The nomination was approved by the APFCB Executive Committee in July 2004.
Subsequently, Dra Endang Hoyaranda, the newly elected Education Committee Chairman for 2005-2007, in collaboration with committee member Professor S C Shiesh of CACB, very efficiently undertook scheduling of my traveling lectures in 2006. To facilitate maximum attendance, they thoughtfully arranged my visits to coincide with the annual scientific meetings of the following eight APFCB member associations / societies interested in my visit: CACB (March), SACB (March), MACB (June), JSCC (August), CSLM (October), AACB (October), IACC (November) and ACBI (November). In fact, KSCC was the first member society to request my visit in snowy February. Regrettably, the invitation could not be accepted due to too-short notice for canceling a previous commitment.
The title and contents of my Traveling Lecture underwent several consensus metamorphoses before settling for The Laboratory Medicine of Infectious Diseases covering the chemical pathology, clinical immunology, molecular epidemiology, and diagnostic virology / bacteriology of newly emerged acute infections. Cytokine and Chemokine Immunopathology of Allergic Asthma was presented whenever there was a request for an additional lecture (Taiwan, Malaysia, Indonesia, and India). This second presentation was aimed to illustrate modern methodology and instrumentation in genomics, proteomics and multi-immunofluorescence flow cytometry for laboratory diagnosis and investigation of a prevalent chronic illness. The following are brief reports of my visits to Taipei, Singapore, Kuala Lumpur, and Sapporo for APFCB traveling lectures from March to August 2006.
The 21st Joint Annual Conference of Biomedical Sciences, 18-19 March 2006, Taipei
The above conference was jointly hosted by the (1) Chinese Association for Clinical Biochemistry (CACB, APFCB member and Principal Organizer), (2) Toxicology Society of Taiwan, (3) Chinese Physiological Society, (4) Pharmacological Society in Taiwan, (5) Association of Anatomists of the Republic of China, (6) Taiwan Society for Biochemistry and Molecular Biology, and (7) Chinese Society of Cell and Molecular Biology. It enabled nearly 3,000 colleagues in related disciplines to use the excellent facilities of the gigantic National Defense Medical Centre in Taipei for simultaneous scientific sessions and a combined industrial exhibition. The executive officers of CACB comprise enthusiastic colleagues from all over Taiwan (President Professor S C Shiesh is from the prestigious
CACB Executive Committee having Japanese dinner with Chris Lam
Cheng Kung University Medical College in Tainan, a southern city). They form a collegiate and synergistic group. Many teaching, government, military, and private hospitals in Taiwan were built or rebuilt during the period of economic prosperity in the 1990s; they are huge and excellently equipped. I was very impressed that my presentations on unfamiliar topics of infectious diseases and allergy could each illicit 25 minutes of questioning and discussion by many colleagues in the audience. This gave testimony to the advanced practice of clinical and laboratory medicine in Taiwan.
Upon my request, CACB colleagues very generously accommodated my wife and I in the hill-top Grand Hotel that was commissioned by Generalissimo Chiang Kai Shek and has over the years hosted several US presidents. I wanted to show my wife the spacious verandah of its over-sized guess rooms overlooking Taipei City. Many famous cities of the world have a famous river flowing through them, e.g. The Thames of London, or River Seine in Paris. Taipei has two: the Danshui and the Keelung Rivers. On Sunday, 19 March I joined my wife in taking a 40-minute train journey to Danshui City located at the outlet of the river into the Taiwan Strait. This was a small resort in relaxed and breezy spring weather with 200 shops in the Old Street area offering over 50 varieties of local foods and drinks. I dined on nano-thin fried transparent noodles (made of green-bean flour) with spinach, while listening to an artist playing the electric guitar. That simple lunch was in a different way as enjoyable as the luxurious Speakers' Banquet two nights ago, with 22 guests (one keynote speaker plus two officers and one plenary speaker from each of the seven participating societies) sitting round a single big table feasting on countless dishes originated from a substantial portion of both the animal and plant kingdoms.
SACB Annual Scientific Meeting, Singapore, 25 March 2006, Singapore
SACB colleagues are old hands in organizing scientific meetings. They always do it themselves and if they engaged a commercial organizer, they would not let go entirely so as to preserve the academic and professional essence of the conference. The programme of the Saturday afternoon ASM comprised my APFCB Traveling Lecture, followed by the inaugural Professor Tom Whitehead Memorial Lecture presented by Professor Evelyn Koay, and ended with a lecture on bio-entrepreneurship by the CEO of a biotechnology company.
As introduced by Dr Tan It Koon, the late Professor Whitehead is a most respected teacher in our region having trained several senior clinical biochemists in Singapore and conducted quality assurance courses in Thailand and Malaysia. I have previously listened to young physician scientists or scientist physicians in Singapore and Hong Kong presenting ruthless and breath-taking updates of their specialist topics in 20-minute sessions. I could therefore reliably anticipate how much Molecular Diagnostics I was destined to learn from Professor Koay in her hour-long presentation. If I were the anesthetist who prepared the audience and Evelyn were the surgeon who performed the operation, the third speaker who ended the perfect afternoon was definitely not a post mortem pathologist because he delivered the message of a new life - tomorrow's most successful entrepreneur will likely be one with a scientific or laboratory background !
Note. At the invitation of Dr Wong Mo Sim, I served as the External Examiner of the SACB Professional Examination in the morning before the afternoon lectures.
On Sunday, 26 March my wife and I took taxi journeys to visit our former residences at No. 2, Pasir Ris Terrace, Pasir Ris in north Singapore and Apartment 5, Delhi Court, 6 Westbourne Road, in the Portsdown district between the old and new university campuses. Current residents of these two addresses were exceedingly kind to let us in for reminiscence of our earlier life working in Singapore.
The 16th Annual Scientific Meeting of the Malaysian Association of Clinical Biochemists
23-24 June 2006, Kuala Lumpur
The two-day programme comprised my APFCB Traveling Lecture, two plenary lectures, three symposia and one industrial workshop, and was preceded by a one-day MACB-AACB-APFCB Quality Assurance Workshop. It was held in the nostalgic Pan Pacific Hotel, where the 8th Asian and Pacific Congress of Clinical Biochemistry (1998) was hosted. Some of the 200+ delegates whom I talked to had flown in from distant provinces of Malaysia. As I was the first speaker of the first day and last speaker on the second day, I stayed at the venue most of the time. To me the plenary lecture and symposium on endocrine testing were particularly impressive. I asked a question to the pair of clinical and laboratory speakers on the coordination of the intervention radiologist, endocrinologist and chemical pathologist in bilateral adrenal venous sampling, which can often result in a pre-analytical nightmare of sample mix-up wasting everyone's time and effort. I was gratified with the positive answers, and hoped that these colleagues were happy with their correct choice to practice clinical and laboratory medicine in their own country after overseas specialist training.
This traveling lectureship should also have benefited the spouse accompanying the lecturer. My wife habitually buys me the last supper before departure. It was a Saturday evening in Kuala Lumpur when taxi drivers were demanding exorbitant fares 3-4 multiples of the median. We decided to use the mass transit train and buy the tickets at the station counter. I smirked as I heard my wife informing the ticket staff of her destination in Malaysian language, "Plaza Rakyat". For a brief moment my imagination was that I was being taken out by a local beauty!
25th Summer Seminar of the Japanese Society of Clinical Chemistry, 3-5 August 2006
Thank you very much, Professor Itoh, for your exceedingly kind introduction. President Hamazaki, Chairman Chiba, distinguished colleagues, ladies and gentlemen. It is my great pleasure -----. As I bowed deeply to begin my presentation, I was not wearing any formal attire or even a necktie for the serious occasion. This was because according to the etiquette of the prestigious JSCC Summer Seminar, speakers and delegates should dress causally for the prevailing weather of the season. Coincidentally, Hong Kong has also been trying to encourage similar practice with upward adjustment of the air-conditioning temperature for energy saving and environmental protection. It has not been comfortable in our hospital to the extent that at a recent unit-head meeting, colleagues teased the Chief of Medicine to clarify what temperature was most favorable for our hypothalamic thermoregulation.
I was advised by Professor Hitoshi Chiba, Chairman of the Summer Seminar, to concentrate on SARS and avian influenza. He and several colleagues seemed keenly interested in my description of using MALDI-TOP-MS for efficient mass screening of H5N1 viral RNA during the early phase of an epidemic. This trip to Sapporo was my second visit to Japan. It was my huge pleasure meeting senior distinguished JSCC colleagues Professor Takashi Kanno, Professor Hiroaki Okabe, President Naotaka Hamasaki, and Professor Tsutomu Nobori whom I have previously acquainted and worked with for the ICCC Kyoto 2002.
After the Seminar, my wife and I were treated to a driving holiday of Hokkaido under the great friendship and tremendous hospitality by Professor Yoshihesa Itoh, Dean of Laboratory Medicine at the Asahikawa Medical College, and Professor Kiyoshi Ichihara of the Yamaguchi University School of Medicine. Yoshi and I share a long-standing interest in plasma proteins. We have worked together for more than a decade in the APFCB and IFCC. Kiyoshi has been a very close and enthusiastic collaborator in recent years on plasma proteins, ethnic differences in reference internals, and data-mining of patient information, again for projects of both the IFCC and APFCB. Within 4.5 days the four of us covered a large proportion of the Hokkaido territory in a spacious seven-seat sedan hired by Kiyoshi, visiting latent volcanoes, hell valleys, bubbling hot springs, crater lakes, mountain gaps, and lavender fields in the Furano plain.I drove under global satellite navigation for the first time, and found it an immensely comforting experience being reassured once every two minutes by a soft female voice from the navigation system that I was doing just great. In real life, Kiyoshi is as dedicated and serious about his food as when he published an academic introduction of one kind of Japanese cuisine each day in the Congress Newspaper of ICCC Kyoto 2002. We sampled all kinds of excellent and exotic food including raw fish and cooked crab, and soba noodles made from buckwheat. Kiyoshi is also critically serious on ramen noodles paying meticulous attention to the variety and quality of the three essential ingredients: noodle, toppings and soup. The rest of us were extremely lucky to have been guided by Kiyoshi for the gastronomic adventure. I have a lot to learn from him - it would be ideal if I could acquire his co-morbidity of utmost seriousness and scholastic expertise in food and research work.
We did work on 8 August at Yoshi's Division of Laboratory Medicine at the Asahikawa Medical College collecting 250 ml of fasting venous blood from Kiyoshi. This was for a new batch of reference materials for plasma proteins similar to the former IFCC CRM470. In Hokkaido, summer is short and autumn is transient before arrival of the long winter. On the last day (9 August), we visited the fish market of Sapporo at 6 am before sightseeing at 8 am the scenic Hokkaido University in late summer.
I shall report on the second half of my lectureship to China, Australia, Indonesia, and India that will take place in October and November 2006.
Motivated and led by former APFCB President Dr Tan It Koon and other distinguished colleagues, I have served in the region for many years. My observation from this lecture tour remains that variance in the level of practice of clinical biochemistry has been diminishing in our region. This is consistent with the Law of Thermodynamics that things are spontaneously evening out with continuous increase in the world's entropy. If this is a pleasing phenomenon, IFCC, APFCB and clinical biochemists from advanced nations should be thanked for having provided education and training for the less endowed. Those who have benefited must continue to accelerate. However, the situation might also have been caused by another effect of kinetics; namely, advancement of clinical biochemistry in some leading areas has decelerated. If this is really happening and we acknowledge that the universe is still expanding, senior colleagues in such areas should perform endoscopic or retroscopic examination of their new culture or practice so as to identify and remove any disease burden for maintaining their leading position.
Chris Lam and APFCB thank (1) Roche Diagnostics Asia Pacific Pte Ltd for sponsoring the airfares of the Traveling Lecturer and (2) participating member associations / societies for providing local accommodation.