As the latest event in ISN's advocacy initiative (see Budka H & Scaravilli F: Advocacy for Neuropathology in Practice: ISN information Days, Brain Pathol 2012: 22/2:i), the Fourth Information Days on Neuropathology took place in Johannesburg (South Africa) on the 23rd and 24th of September 2013, at the University of Witwatersrand. It was organised jointly by the International Society of Neuropathology (ISN) and by the Department of Pathology, University of Witwatersrand, chaired by Professor Martin Hale.
The format of the Meeting followed that already used in previous occasions. The topics presented here were selected and agreed upon by the two organising bodies.
Following a welcome to all the participants by Professor Hale, the Meeting began with two keynote lectures by the President of the ISN, Professor Herbert Budka, University Hospital of Zurich, Switzerland (Neuropathology in the 21st Century), and by Professor Pieter Wesseling, Department of Pathology, Radbound University Medical Centre, Nijmegen Med and VU University Medical Center, Amsterdam, The Netherlands (Diffuse glioma growth, a guerrilla war).
In his talk, Professor Budka gave a brief account of the history and mission of the ISN. Subsequently, he presented the ISN Information Days as a means to show what Neuropathology is able to deliver for patient service, research and teaching and its role as a bridge between clinical and basic neuroscience.
In the second keynote talk, Professor Wesseling used a guerrilla war as a metaphor for the growth of diffuse gliomas, with special attention to pathological, radiological, molecular and therapeutic aspects.
Neuro‐oncology topics continued with lectures by Professor Wesseling (Tumours in adults—recent developments including genetics and molecular biology) and Doctor Tom Jacques, UCL Institute of Child Health and Great Ormond Street, London, UK (Morphological, genetic and molecular biological aspects of tumours in children).
The main aim of the two lectures was to give an overview of how molecular neuropathology is refining treatment decisions for patients, illustrating how pathological diagnosis is a key decision point in the journey of a patient with a brain tumour. In addition, recently defined molecular and pathological tumour types were highlighted.
The first day concluded with a presentation by Professor Wesseling on The important determinants of the neuropathological diagnosis of brain tumours, and by a slide seminar organised by the local Department of Pathology, in which a number of interesting and challenging cases were presented, most of which reflected the nuances of the local African experience.
The second day started with lecture by Professor Paul Ince, Department of Neuroscience, Sheffield University, Sheffield, UK, on Neurodegenerative Diseases, focusing on Alzheimer's and Parkinson Diseases, including the clinical, pathological and therapeutic aspects. The presentation covered both the conventional models of Alzheimer's and Parkinson's diseases as specific protein aggregation disorders at the anatomical, molecular pathological, and genetic levels, together with discussion of the possible limitations of these paradigms when applied to the general population. The exciting possibilities for therapeutic development were aligned to basic and clinical science progress in these disorders.
The interpretation of paediatric muscle biopsies, including congenital myopathies, was covered by Professor Hans Goebel, Neuropathology, Charité, University of Berlin, Germany. The scope and contents of a muscle biopsy programme using unfixed frozen tissue as the main source were followed by the discussion on muscular dystrophies in which immunohistochemistry could lead to subsequent molecular analysis, by demonstrating reduced or absent sarcolemmal or nuclear proteins. Finally, congenital myopathies were discussed, which are marked not only by structural abnormalities, but also by aggregated proteins. In this field, the genetic spectrum has widened considerably during the last decade, whereas muscular dystrophies were genetically elucidated during the previous decade.
Professor Goebel's lecture was followed, in the afternoon, by that of Professor John Rodda, Chris Hani Baragwanath Hospital and University of the Witwatersrand, on Paediatric Neuromuscular Disorders, a clinical experience.
The topic of HIV infection was left to the able hands of local clinical and pathology experts. Indeed, Dr Andre Mochan, from Chris Hani Baragwanath Hospital and University of the Witwatersrand and Doctor Anita Gildenhuys, Specialist Pathologist, Department of Pathology, National Health Laboratory Service and University of Witwatesrand entertained the audience with lectures on HIV‐related neurological diseases in adults, a clinical perspective and on the Neuropathology of HIV, respectively.
The Meeting, which ended with a slide seminar organised by the ISN and chaired by Professor Pieter Wesseling and Doctor Tom Jacques, was attended by approximately 70 people, mainly from the Johannesburg and Pretoria area but also including participants from Cape Town, Bloemfontein and Rustenburg. Specialities represented included pathologists, neurologists and surgeons drawn from both the public and private sector. It was particularly pleasing that many trainee pathologists, neurologists, neurosurgeons and neuroscientists attended. In his introduction, Professor Hale also welcomed 2 young pathologists from Zimbabwe. The number decreased slightly on the morning of the second day, whilst about 40 participants took part in the afternoon session. The audience enthusiastically received the multidisciplinary nature of the symposium and the attendee use of virtual microscopy via digitised histology images from the Department of Anatomical Pathology was a great success. A more humorous side, and bringing a local flavour to the meeting, was provided by Prof John Rodda who gave a presentation on floppy trunk syndrome, in which a toxic neuropathy, possibly resulting from lead exposure, has a profound effect on the musculature of the trunk of the African elephant.
The ISN is greatly indebted to the meticulous work of preparation and organisation by Professor Hale and his team for the success of the meeting. In addition, the members of the ISN are also particularly grateful to him for the friendly and informal atmosphere he was able to create, which contributed enormously to making the two day event not only highly interesting, but also thoroughly enjoyable.
A warm thank you to all the speakers, who presented, with great skill and ability on the state of the art, aspects of neuropathology which has rightly become, in Professor Budka's words, a pivotal discipline within the wide field of neuroscience, a discipline that is able to link clinical and diagnostic aspects on the one side with the more academic and theoretical ones on the other.
The members of the ISN and local teams are happy to report the great attention with which the audience followed the various lectures, an attitude that revealed itself by the large number of questions the participants posed to the lecturers. It is hoped that this will materialise in strong support for the further development of our discipline at the local level. The ISN was thanked by the local organisers for supporting this worthwhile initiative to develop neurosciences in Southern Africa. It is the Department of Anatomical Pathology's intention to build on this and to organise similar neuroscience symposia in the future. It is also likely that this visit will stimulate collaborative academic activity between various institutions. Finally, the local delegates would like to thank the speakers for giving their valuable time and expertise, which will have a long term benefit to the practices of neuroscience and patient care.