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Prof Henry Kasozi

Prof Henry Kasozi

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Prof Henry Kasozi trained in medicine at Bezanson University, France, completing with an MD in 1972. He went on to train in Radiology at the universities of Glasgow and Bristol in the UK. He returned to Uganda in 1974, to be immediately recruited by Makerere University as Head and lecturer in the Department of Radiology. In 1982 Doctor Kasozi was promoted to the position of Associate Professor of Radiology having a year earlier started training Ugandan Doctors to the level of M. Med Radiology At Mulago. He had also, persuaded Makerere University to award, Diploma in Radiography then being offered by the school of Radiography. The Diploma was in 2002 upgraded to a BMR Degree offered at Makerere University Medical School.With colleagues, Professor Kasozi refurbished the Mulago Hospital X-ray. Department with new imaging equipments in 1981 shortly afterwards started training Ugandan radiologists at Mulago, introduced Mamography and Ultra-sound Imaging in 1988. He tirelessly worked on the creation of a Radio-therapy Unit in 1988, for which he was donated a STABILIPAN 2 machine by SIEMENS.

In the decade starting 1990, with Ugandan colleagues, Prof Kasozi founded the Uganda Society for Sonography (UGASON) and was one of the founder members of imaging professional societies in Uganda and East Africa namely; Uganda Society for Advancement of Radiology and Imaging (USOFARI) and Pan African Congress of Radiology and Imaging (PACORI). He was nominated Presi-dent of these bodies. Many confer-ences of the above organizations took place in Uganda, Kenya, Tanzania and in 2001, Professor Kasozi, led a team of Ugandan Radiologists to a MASU conference in Florence Italy.

At that conference Professor Kasozi was named deputy President of Mediterranean and African Society of Ultrasound.

After building and heading Kadic Hospital Bukoto for 17 years, Profes-sor Kasozi retired and lives in Ntinda with his beloved Sayuni, surrounded by their seven Children and 18 Grandchildren. Professor Kasozi though retired continues to be the Principal of ECUREI, a degree awarding institution specializing in Diagnostic Imaging, Physiotherapy and Biomedical Engineering.

Email: kasozishenry@gmail.com

 

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Prof. Dr. Hadi Özer

Prof. Dr. Hadi Özer

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Prof. Dr. Hadi Özer, as the founder of Turkish US Society, could you summarise for us, the historical events that led to the foundation ?

My first experience with A-mode echoencephalography was at the Hospital of Women’s Medical College of Philadelphia. The indication was to explore why a calcifed pineal gland of a patient had shifted from midline. We also tested a prototype portable US machine, made by Smith-Kline company, to verify the shift of the pineal gland. The date was unforgettable; Nov. 23, 1963. That day President Kennedy was assassinated.

The first B-mode gray-scale US; articulated arm Picker’s Echo-view EDC machine with a 2.5 mHz transducer was installed in Prof. Herbert L. Abrams’ Radiology Department at Peter Bent Brigham Hospital in 1970. As a member of staff, I witnessed this event and attended the lecture given by Dr. Hans Henrik Holm, who was visiting the department. Abdominal US studies had been started by my colleague Dr. Edward H. Smith.During the next 2 years I worked at the same department and learned the basics of US. In June 1972, I returned to Turkey. In 1974, in Ankara University Radiology Department, I used a Siemens machine to perform probably “the first abdominal US” in Turkey. The same year I became the Chairman of the Department of Radiology in Ege University.

I started to use a Picker US machine. Together with my colleague E. Alp Niron, who was educated in USA, we increased the patient numbers in US practice, and started to perform US-guided biopsies. Meanwhile our team also concentrated on imaging hydatid disease. Our studies on hydatid cyst classification were published in British Journal of Radiology in 1981, almost simultaneously with Gharbi’s famous paper. Early US studies done by radiologists and gastro-enterologists, led to a spreading interest in Turkey and many US machines from Siemens, Kretz, and Pie-Data were imported. In parallel with the huge interest, the need for US education was obvious and Turkish US Society (TUD) was founded in 1985, by 10 colleagues from different specialties.

 

 

What has changed since those times in the arena of ultrasound?

Starting from 1987, Turkish Ultrasound Society has organised US Congresses and has participated in scientific activities of MASU and EFSUMB. We have observed and witnessed a huge development in technology along with advancement of the applications of the anatomical and functional imaging.

What are your thoughts about the future of ultrasound in the world?

Many patients are now being “screened” with US either at the office, emergency room or at home. Multidisciplinary use of US necessitates that the learning of basics of US should start at Medical School, before residency. The advanced and comprehensive training should be given during the years of residency accordingly to the specialty chosen.

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Prof Dr. Giovanni Cerri,  WFUMB President 2006-2009

Prof Dr. Giovanni Cerri, WFUMB President 2006-2009

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How and when did you become involved in ultrasound?

I got interested in US during my Residence in Radiology in the HCFMUSP between 1977/1979. The use of US in Internal Medicine was just beginning, which was my interest at the time. After courses and trips, I introduced US in Internal Medicine in the hospital of the university and quickly this method was widely adopted.

Were there any particular people that influenced your work?

I would mention two people:Francis Weill, a great professor and humanist. He had a huge influence in my first years in ultrasonography.Barry Goldberg, also and great professor and researcher, who contributed a lot in a more mature phase of mine.The two of them became my friends and were also my predecessors in the presidency of the WFUMB.

What were your career highlights?

The foundation of the most important school in the formation of ultrassonographists of the country in the Radiology Institute of HCFMUSP, with the publication of countless papers and books that contributed to the formation of many physitians in Brazil and in other countries. As a remarkable example, I mention the professor Cristina Chammas, my great friend and exceptional professional. We worked together for many decades and now she’s the future president of the WFUMB.The presidency of the Radiological and Diagnostic Imaging Society of São Paulo (Sociedade Paulista de Radiologia), Brazilian College of Radiology (Colégio Brasileiro de Radiologia), FLAUS, WFUMB and of the World Congress of the WFUMB in Sao Paulo are part of my history in Medical Societies.Dean of the School of Medicine, University of São Paulo and president of the Hospital das Clinicas Council for two terms and secretary of Health.

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What are your impressions of the ultrasound technology available today?

I had the opportunity of working with the first static US equipment and with the first real-time machine. The transformation of ultrassonography was shocking: the expansion of its appliances, the image quality, the Doppler, the 3D and 4D, the contrasts. The most recent tecnologies with transducers of the highest definition to small parts and the Doppler resolution showed that the technique remains in evolution.

Are you still involved with the ultrasound world ?

Totally involved in the University, in a more leading and mentoring position, of course. And performing ultrasound exams as much as the time and the administrative activities allowed. My mission is to help maintain in our Institute the quality of the education and of the infrastructure that allow us to keep molding amazing practitioners and leaders of the specialty.

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George Kossoff  – ASUM President 1970-1972,  WFUMB President 1982-1985

How and when did you become involved in ultra-sound?

I graduated from the University of Sydney in March 1959 with a Bachelor degree in Science in Physics and Mathematics and a First Class Honors degree in Electrical Engineering. At that time I considered applying for a position as research scientist in nuclear physics at the Atomic Energy Commission.The day after the results were announced, Norman Murray, the Director of the Common-wealth Acoustic Laboratories, approached me and invited me to set up and head the to be formed Ultrasonics Research Section at the Laboratories. Murray had been keeping an eye on the emerging publications on medical ultrasound. He had attended a meeting of the NHMRC where concern was expressed regarding the use of X-rays in pregnancy and was aware of the first publication by Donald on the use of ultrasound to investigate abdominal masses. He felt that Australia should also begin to undertake research into this emerging field of medical ultrasound and that the Acoustic Laboratories were an appropriate venue for this research.

Norm Murray persuaded me to accept his invitation on the basis of his description of medical ultrasound as a field in the early stages development where it would be easier to make meaningful contributions. As there was no one in Australia with experience in ultra-sound I was to report directly to him as a Section Head. In recognition of this responsibility my appointment would be at a grade higher than that normally offered to a raw graduate. In other words he made me an offer which I just could not refuse and I commenced duties at the Laboratories on 10th of March 1959.

At that time seven groups were undertaking research into medical ultrasound. In the Unit-ed States, Wild and Reid in Minneapolis were investigating imaging the breast, Howry and Holmes in Denver the abdomen, Baum in New York the eye, while Fry and his team in Champaign-Urbana were using high intensity ultrasound to create trackless lesions in the brain. In Europe, Donald in Glasgow was applying ultrasound to examine the pregnant uterus while Edler and Hertz in Malmo were studying the applications of M-mode to image the heart. Finally in Japan, Wagai in Tokyo was the second investigator to begin to image the breast. Our research into obstetrical applications commenced in September 1959 with the appointment of Bill Garrett as clinical consultant to the Section. We were thus the second group internationally to begin research into imaging in obstetrics.

Were there any particular people that influenced your work?

I was very fortunate to have had capable colleagues who wanted to join our Section and to collaborate with all as an interdisciplinary team. There were no walls between researchers working on different projects nor from our medical consultants in different professions. Ideas were exchanged freely in weekly review meetings where our successes, obstacles or failures were presented and discussed. In this way we all contributed to-wards our common objective of advancing our knowledge and contributions to medical ultra-sound.

I would however like however to single out several individuals who made major contributions that influenced my work. Internationally -I was very much impressed by the work of Doug Howry and Joe Holmes who, using the water coupling technique, published detailed images of the human neck and lower limb. This was the main reason as to why our Section, later to become the independent Ultrasonics Institute, chose this approach to examine the pregnant abdomen and the breast. I also closely followed the research conducted by Bill Fry and his team who put together a team of scientists, engineers and medical doctors to produce trackless lesions in the human brain and used this method to study the interconnections between nuclei in the brain of the cat. Australia -I was introduced to various aspects of clinical practice by Bill Garrett in obstetrics and by Tom Reeve in the breast. They were both excellent teachers and with time we developed a team approach to identify the structures in the human body that had not been previously imaged by ultrasound. The imaging of artifacts posed challenges but with time we learned how to identify those and even obtain useful clinical data from their portrayal. In was not uncommon for us to publish technical or clinically oriented papers depending on who was the senior person making the original observation and putting it into practice. Dave Robinson joined the Section eighteen months after my appointment. We had mutual respect for each other abilities and developed a close working relationship. Dave was a practical man and was the person in charge of designing the electronic signal processing and mechanical requirements of our scanners. My contributions lay in the philosophical approaches as to how to handle the complex data acquired by the scanners and in the design and construction of the transducers used in our research.In 1975 we developed the UI Octoson. In this scanner the patient lay essentially on a water bed and was examined from below by eight annular array transducers. Single and com-pound scans were obtained quickly and all the features of the scanner were controlled by a computer. Many radiologists and obstetricians expressed interest in acquiring this equipment.

The Australian Government went to tender to select the company to manufacture this scanner and the Nucleus Group was selected to do so. The Chairman of the Group was Paul Trainor, an Australian enterprenor, who had set up several medical companies including Telectronics and Cochlear. Ausonics Pty Ltd was established to build the UI Octoson and I was asked to help Paul introduce the scanner to the market. This included many meetings with individuals and companies interested in the venture. Paul, a true gentleman, was an excellent negotiator and I learned a lot from him how markets work. The UI Octoson was manufactured in Sydney and over five years nearly two hundred of these scanners were sold world wide.

 

 

George Kossoff, Tom Reeve Jack Jellins (1977)

What were your career highlights?

Here is a chronological list of my career high-lights:
1959 Joined the Commonwealth Acoustic Laboratories and began research into medical ultrasound.
1962 Obtained our first black and white ob-stetrical scans. The outline of the fetal head and trunk were clearly displayed as well as some internal fetal organs such as the spine, the heart and the bladder. This allowed us to make accurate assessment of fetal wellbeing from size measurements, diagnosis of asymmetrical growth retardation and of anomalies that cause bladder obstruction.
1963 Developed techniques to measure the acoustic output of therapeutic and diagnostic transducers. This allowed us to measure the output of different transducer designs and to select those that minimized patient exposure.
1965 With Bill Garrett as senior author published the first detailed paper on our ability to visualize the fetus and the clinical relevance of this information.
1967-1969 Two year sabbatical with Bill Fry. Bill was putting together a scanner which had lesion making as well as imaging capabilities. Bill at that time was President of the AIUM and he appointed me Vice President to help stage the AIUM 1968 Congress. AIUM Congresses had been focused mainly on physio-therapy applications and biological effects. I was interested in incorporating diagnostic imaging as a major component of the 1968 Congress. Unfortunately Bill died suddenly in 1968 and, as stipulated in the AIUM by-laws, I became President for the next year and a half. This Congress marked the transition of the AIUM from a physiotherapy focused organization to one whose major interests are diagnostic applications.
1969 Establishment of ASUM Shortly before my return to AustraIia, I attended the First Congress of WFUMB held in Vienna. On my return I presented a summary of that Congress at an ad hoc meeting of the staff, our medical consultants and other individuals who had an interest in diagnostic ultrasound. At that meeting it was unanimously agreed that a society representing Australian interest should be formed and be named the Australian Society of Ultrasound in Medicine. I had the privilege of being elected Foundation President of the Society and served in that capacity for the next two years. The Society flourished and undertook action not only to promote scientific and clinical applications but also to concentrate on issues of education. One of my greatest satisfactions is to see ASUM flourish to the extent that it has achieved to date, and to see the use of ultrasound in Australia second to none.
1969 Development of Grey Scale Imaging. During the last month of my stay in Illinois, I noted that when medium levels of power out-put were used to image the liver of the cat, the soft tissues reflected echoes of similar size irrespective of the direction of the scanning beam. I realized that the texture of soft tissue reflected the ultrasound energy in a diffuse manner. This was in stark contrast to the specular echoes obtained from large inter-faces with which we were familiar. This led us to redesign transducers and signal processing to display, for the first time, the diffusely reflected echoes -in effect, the first grey scale images.
Jack Jellins and I implemented grey scale imaging late that year on our breast scanner. This scanner was installed at Royal North Shore Hospital, where Tom Reeve was our senior medical consultant on the project. The change in image quality was dramatic. Grey scale imaging allowed us to demonstrate, contrary to the generally held opinion at that time, that most malignancies were hypo rather than hyper echoic as described by Wild and Wagai.
Dave Robinson and I implemented grey scale on our obstetrical scanner early the following year, with Bill Garrett as our medical consultant. For the first time we could visualize the chambers of the fetal heart, identify the fetal umbilical vein in the fetal liver and, as an immediate pay off, visualize with near 100 percent accuracy the placenta. Bill Garrett and I mounted a display of our images at the next WFUMB Congress held in Rotterdam in 1972. The interest in these was dramatic as no one had seen such images previously.
1973 Establishment of ultrasound of the neonatal brain.That year a fetus with ventriculomegaly was observed leading us to determine if we could achieve similar results in the neonate. In consultation with radiologists from Prince of Wales Hospital, ten neonates undergoing air ventriculography were also examined by ultra-sound. Ventricular sizes measured by both methods were in agreement and all further neonatal patients from that hospital were examined by ultrasound only.
1975 Research conducted by the Section differed significantly from that undertaken by the Commonwealth Acoustic Laboratories. Encouraged by our clinical successes and interest in the equipment by clinicians and industry, the Section was formed as an independent Ultrasonics Institute in the Department of Health.
1982 I was elected President of WFUMB for the following three years. The Sydney WFUMB Congress was held in 1985 and attended by over one thousand delegates. The staff of the Institute played a major role in staging this Congress.
1989 The Ultrasonics Institute was transferred to the CSIRO (Commonwealth Industrial and Scientific Organisation) and renamed the Ultrasonic Laboratory.
1997 The Ultrasonic Laboratory was closed signaling the end to uniform ultrasound research in Australia.
1999 I was awarded the AO, an Officer of the Order of Australia.

What are your impressions of the ultrasound technology available today ?

This is a hard question for me to answer, as I have been retired for 15 years. My impression is that ultrasound technology has matured. The equipment is using modern computer technology, the frequency range has been significantly enlarged and a variety of functions have been incorporated in the equipment to facilitate its use in a variety of applications. Ultrasound has been accepted by a range of specialties, and some of the challenges of today relate to the provision of education and training in the correct use of the equipment in professions where the technique forms a small component of the practice.

Challenges and opportunities still abound. I do not know the status of ultrasound contrast agent and this could well be a major application. I am surprised that modern equipment still does not provide quantitative measurement of blood flow. The use of two dimension-al transducers appears to have stalled. The problem of overlying tissue aberration has not been solved. So opportunities exist but how well they will be addressed depends on funding in a climate where interest has shifted to MRI and molecular imaging.

Are you still involved with the ultrasound world ?

I try to follow the ultrasound literature as I am in a fortunate position to receive major journals that feature ultrasound. Until recently I have been involved with the WFUMB Council as member of its Committees on History and on Archives. At the request of Michael Claudon, Barry Goldberg and I put together a paper ” History of Ultrasound and its Presidents”. This paper is published on the WFUMB website in the section on History. Today I am not involved with any ultrasound activity.

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Hiroki Watanabe  – WFUMB  WFUMB President 2000-2003

How and when did you become involved in ultra-sound?

When I just finished the Post-graduate Doctor Course of the Tohoku University, Sendai, in 1965, I was looking for new diagnostic modality for the prostate, because only examination in our hands in those ages was very classical rectal digital palpation, which was introduced in the Greeks’ era.In the early autumn of 1967, I visited a cardiologist in the same University, Dr. Motonao Tanaka, who was a leading researcher of medical engineering. The purpose of visiting was to consult a possibility of my poor idea that some sound from urinary stream in the prostate could be detected, if an electric stethoscope was inserted into the rectal cavity. Occasionally in his laboratory, I found a strange stick. It was a special ultrasonic probe to obtain a section of the heart via the esophagus.

Were there any particular people that influenced your work?

This very new device could not, however, to be used on human subjects, because it caused too much pain to insert into the esophagus. Incidentally and luckily, I became involved in the situation. My poor idea for an intrarectal stethoscope was abandoned at once and we agreed enthusiastically to apply the new device to trying to obtain a prostatic section via the rectum.The very next day, I took a patient with benign prostatic hyperplasia to Dr. Tanaka’s laboratory. After much entreating and some threats he was laid on the bed and the probe was inserted into his rectum. The sonogram of the prostate we obtained was fantastic. This was the first section of the prostate in a living body, of which human had ever seen, because it was 10 years before the commercialization of CT and 20 years before that of MRI. The images looked to me as if it was rose colored!

We published this world’s first image modality for the prostate under the name of “transrectal ultrasonography (TRUS)” in 1968 but following near 20 years had been spent until its generalization as a routine diagnostic modality. Today, however, we can find the “TRUS machine” in any urologic clinic in the world. In October, 2017, the “50 years Memorial Symposium for TRUS” was organized in the WFUMB 2017 Congress in Taipei.

Were there any particular people that influenced your work?

As mentioned in my previous answer, Dr. Tanaka led me into the ultrasound world. At that time, he had already obtained the world’s first ultrasound tomograms of the moving human heart by means of an originally developed ECG-synchronized pulse-projecting ultrasound technique, 15 years before the appearance of real-time ultrasound. According to this technique, ultrasonograms of each phase of cardiac section were taken by a rotation of the angle of ultrasound beam little by little. Though it took more than an hour to record 20-30 sonograms of all phases, the obtained sections were far much clearer than sonograms by real-time scanner in later years. He is still active in research works even now.

What were your career highlights?

Maybe my career highlight in my memory was the establishment of “WFUMB COE (Center of Excellence)”. I served WFUMB as the President from 2000 to 2003. During this period, a matter of ultrasound education for developing countries was often discussed in the administrative councilors’ meetings. The “Global Steering Group for Education and Training in Diagnostic Imaging” in WHO once planned to establish education centers in Africa as the “African project” but no financial resources were found. Moreover, this plan seemed to me as if developed countries favored developing ones from mercy.

So I proposed my specific plan for the establishment of “WFUMB COE”, based upon a principle that “WFUMB only gives the name and local societies organize each education center for ultrasound by their own effort”. The plan was carried in the WFUMB Administrative Council Meeting in Montreal on May 31, 2003, and the first COE was established in Dhaka, Bangladesh, followed by in Kampala, Uganda, during the next year, 2004. The latter one realized the uncompleted plan of the “African project”. Right now, COE has been established in 13 countries in the world and plays one of the most important roles of WFUMB. I thank many people to support this project and to develop this much. Marv Ziskin, the next President, and Byung Ihn Choi, who led the COE Committee after me, were two key persons for this movement.

What are your impressions of the ultrasound technology available today ?

New technologies appeared in recent years are very much welcome. I think, however, much efforts to refine the image itself should be paid utilizing newly developed functions, because medical ultra-sound is essentially an “image modality”.

Are you still involved with the ultrasound world ?

Yes, I published two very important works with ultrasound during these several years. The first one was concerned with an active opening function of the human urethra, against the conventional physiology that the urethra has only closure function and the opening is due to a passive motion by urine flow. This finding was obtained by transrectal/transvaginal ultrasound (Int J Urol 2014, 21: 208-11).

The second one was concerned with a fact that the human bladder absorbs at least hundreds mL of water from urine during sleep, which is also against the conventional physiology that the bladder is a simple reservoir and absorbs nothing. We performed the periodical measurement of urine volume during sleep by transabdomi-nal 3-D ultrasound and found a definite temporary volume reduction for several times a night (Int J Urol 2016, 23: 182-7). This concept will give a serious impact to the renal physiology and the etiology of various urological diseases.

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