History of the Neuropathology Division at UPMC

By A. Julio Martinez, M.D.

 

Presbyterian University Hospital (PUH) is part of the University of Pittsburgh Medical Center (UPMC). PUH was established in 1893, and in 1927 was affiliated with and became the primary hospital of the University of Pittsburgh School of Medicine.

 

During the past two decades thousands of physicians have been trained to treat, teach and conduct research at UPMC. PUH is an integral part of the School of Medicine, of which the Pathology Department is well represented together with other major departments performing patient care, education and research. The office and laboratories of the Division of Neuropathology are located on the fifth floor of PUH.

John Moossy founded the Division of Neuropathology at PUH. He was appointed Professor of Pathology (Neuropathology) in 1965, and stayed at PUH for 2 years and then went to Wake Forest University in North Carolina. In 1972 Dr. Moossy returned to Pittsburgh as Director and Chief of the Division of Neuropathology and as Professor of Pathology and Neurology. At that time the Division of Neuropathology at PUH consisted of 2 secretaries, 2 histotechnologists and 2 full time staff Neuropathologists. Dr. Moossy came to Pittsburgh with his associate Dr. Howard Wisotzkey, who died in August 1975 of metastatic melanoma. Dr. Moossy spent the following year searching for a new neuropathologist. In July of 1976 Dr. A. Julio Martinez arrived to the Division of Neuropathology as Associate Professor from the Medical College of Virginia (MCV).

 

John Moossy is a native of Louisiana. He attended Fordham University in New York City, served in the U.S. Navy during World War II and, after the war, received his degree in medicine from Tulane University in New Orleans (1950). After his internship and residency in neurology in New Orleans, he trained in neuropathology with Abner Wolf, M.D., and David Cowen, M.D., at Columbia University and the Neurological Institute in New York City. He is board-certified in neurology, anatomic pathology and neuropathology. From 1961 to 1962 he was director of the Cerebrovascular Disease Study of the World Federation of Neurology at the Bunge Institute, Antwerp, Belgium. He has served on the faculties of Tulane, Louisiana State and Columbia Universities, Wake Forest University and the University of Pittsburgh (1965-67 and 1972 to 1992). At Pittsburgh he was director of an active Division of Neuropathology with six other faculty members.

 

The clinical Neurohistology laboratory opened in July 1972. Margaret Vagasky Boring (HT, HTL) was hired in December 1972. The other histology technicians were Gail Taylor, followed by Ms. Betty Micic. Betty Micic came from Columbia University and the Neurological Institute in New York, working under Professors Abner Wolf, and David Cowen where Dr. Moossy did his fellowship in Neuropathology.

 

In July 1977 Marie Rozantz LeRoy was hired. She worked closely with Mrs. Boring for 16 years in the Clinical Neurohistology laboratory. At the onset the clinical Neuropathology laboratory at PUH only processed, cut and stained tissues from autopsies. Eventually the laboratory began to process all neurosurgical specimens (brain biopsies, tumors, skeletal muscle, peripheral nerve biospies, and pituitary adenomas). Research activities were initiated and grants were obtained from the NIH and the Muscular Dystrophy Association. An Alzheimer Disease Research Center grant was obtained with multidisciplinary participation. Increased workloads associated with the two grants, required additional personnel, increasing from two to four histotechnologists.

 

Enzyme histochemistry techniques were performed on muscle biopsies and the immunoperoxidase staining procedures were initiated mainly for pituitary adenomas and brain tumors. Mrs. Boring was a pioneer technician using the immunoperoxidase techniques.

 

In the late 1980’s Mrs. Boring became a member of the Core Installation Group for the Sunquest Laboratory Information System. She constructed the database for the neuropathology area. She also provided input for implementation of CoPath (CoMed) laboratory system in. As the laboratory changed so did personnel, however there were technologists and secretaries who provided years of dedicated service to the division. Those who should be acknowledged were Margaret Boring (HT, HTL), Kimberlee Kondrat, Marie LeRoy (HT), Jonette Werley (HT, HTL), Sung Hui Hong (HT, HTL), Karen Perkins Weber, Agnes Zachoszcz, and Joan Heinecke.

 

The following hospitals participated and were part of the division.

Presbyterian-University Hospital: At the central laboratory, there were four laboratory technicians and two secretaries. The office space, supplies, equipment, and salary were provided by PUH. Three technicians were supported by PUH; one additional technician was supported by contract and grant funds, and for one year funds from the Pathology Education and Research Foundation (PERF) of the Department of Pathology.

Veteran’s Administration Hospital (Oakland): Gutti Rao, M.D. was the neuropathologist at the VA. The office space, basic equipment and shared secretarial services were furnished to Dr. Gutti Rao. Trainees in Neuropathology (residents in Pathology, Neurology, Neurosurgery) rotated through the VA Neuropathology service for a portion of their training experience. Technicians and secretaries were provided by the hospital. The office space, supplies, equipment and salaries were provided by VA Hospital.

Children’s Hospital: No special space or equipment was set aside for neuropathology; however, an office was equipped for a neuropathologist. Consultation coverage was provided by Drs. Ahdab-Barmada and Moossy with assistance from Drs. A.J. Martinez and G. Rao. Technicians and secretaries were provided by the hospital. Dr. B. Zaias was the Neuropathologist until 1979. Then later the neuropathologists were R. Schuman and Robert Price.

Eye & Ear Hospital: Dr. Bruce Johnson was in charge of Ophthalmic Pathology. There were two laboratory technicians and one secretary. The office space, supplies, equipment and salaries were provided by Eye & Ear Hospital.

Magee-Women’s Hospital (MWH): Mamdouha Ahdab-Barmada, M.D. was the neuropathologist at MWH. No special facilities for neuropathology were provided, but there was sharing of laboratories, conference rooms, and equipment. Dr. Barmada’s office was equipped and furnished by the hospital. Residents from pathology, Neurology and Neurosurgery rotated through the laboratory. Technicians and secretaries were provided by Magee-Women’s Hospital.

Montefiore Hospital: Dr. Harvey Mendelow was the director of Pathology at Montefiore Hospital (affiliated with PUH). He performed neuropathology there in close collaboration with Dr. J. Moossy and PUH.

 

Residents & Interns

The Division of Neuropathology had residents, interns and medical students that rotated through the Division for three to six month. The trainees came from Pathology, Neurology, Neurosurgery, Neuroradiology, Neuro-anesthesiology and Psychiatry. The medical students who chose an elective in Neuropathology did an eight-week rotation through the Division. The Division also offered an AMA approved Fellowship in Neuropathology for residents with no less than two years of formal training in Pathological Anatomy, Neurology or Neurosurgery. Trainees are listed in Table 1.

 

In the central laboratory of the Division of Neuropathology there was a room with four cubicles for the trainees. In this room there were two four-headed microscopes and projection equipment. A small library contained select Neuropathology, Neurology, Neurosurgery and Pathology textbooks and selected current medical.

 

Formal Neuroscience conferences were organized and given on a weekly basis. Brain cutting conferences, Neuroscience Conferences, Surgical Neuropathology Sign-out Conference with Neurologists, Neurosurgeons, residents and fellows participating.

 

Dr. Moossy was appointed the Editor-in-Chief of the Journal of Neuropathology and Experimental Neurology from 1981 to 1991. The Division of Neuropathology provided consultations to medical institutions outside UPMC in Neuropathological cases in the U.S.A and overseas. On Friday June 12, 1992 Dr. Moossy resigned as Director of Neuropathology. Dr. Mark Hurtt was appointed “interim director” of the Division from July 1992 to July 1993. Dr. Barmada left the Division in 1993 to begin a private Neuromuscular practice.

 

Restructuring

Dr. Clayton Wiley was recruited, from the University of California in San Diego and arrived at UPMC in July 1993. Dr. Wiley’s mission was to build federally funded research programs on the Division’s excellent clinical and teaching foundation. Additional personnel, space and resources were required for this restructuring. Over the next 7 years several faculty joined the staff: Cristian Achim MD/PhD, Ronald Hamilton MD, David Lacomis MD, Robert Bowser PhD, Charleen Chu and Marta Couce: while during that same time Dr. Dianna Claassen moved to private practice in Idaho, Dr. Mark Hurtt moved to pharmaceutical industry and Dr. A. Julio Martinez became Emeritus Professor of Pathology. Additionally Dr. Robert H. Garman formally affiliated with the Division. In January 1997 the clinical neurohistology laboratory was closed after 25 years of service excellence, and the work transferred to UPMC Pathology Histology Laboratory.

 

Division of Neuropathology, University of Pittsburgh Medical Center, 2003:

With the dawning of the new millennium the restructuring process was complete with the following distribution of faculty and expertise:

 

Name	Title	Specialty
Clayton A. Wiley, MD/PhD	Director Division, Professor Pathology	General Neuropathology
Ronald Hamilton, MD	Associate Director, Associate Professor of Pathology	Pediatric Neuropathology
Cristian Achim, MD/PhD	Associate Professor of Pathology and Neurology	Experimental Neuropathology
Robert Bowser, PhD	Associate Professor of Pathology	Experimental Neuropathology
Charleen Chu, MD/PhD	Assistant Professor of Pathology	General Neuropathology and Ophthalmic Pathology
Marta Couce, MD/PhD	Assistant Professor of Pathology	General Neuropathology
Robert H. Garman, PhD	Adjunct Professor of Pathology	Veterinary Neuropathology
Scott Kulich, MD/PhD	Assistant Professor of Pathology VAMC	General Neuropathology
David Lacomis, MD	Associate Professor of Neurology	Neuromuscular Pathology
Gutti Rao, MD	Associate Professor of Pathology VAMC	General Neuropathology

 

Space and resources:

The Division is currently housed in Scaife Hall and the South Biomedical Science Tower. In addition to common division space (multi-headed scope room, library, gross room), each faculty member has an office and individual lab space. In total the Division occupies over 10,000 square feet of space, runs the University brain bank, research neurohistology laboratory, and confocal microscopy facility. The Division’s annual direct and indirect research budget is approximately $2,000,000 and $450,000 respectively. Specific research programs are included on each faculty member’s web page. The Division is responsible for all Neuropathology specimens from the UPMC in addition to outside consults.

 

Table 1: Individuals trained in the University of Pittsburgh Neuropathology Division.

 

Year	Name	Current Position
1972-75	Gutti R. Rao	Associate Professor, University of Pittsburgh, VAMC
1975-77	M. Abdad Barmada	Neuropathologist; Pittsburgh, PA
1980-1981	Josephine Ashmed	Neuropathologist Colorado
1981-83	Jose Cardozo	Neuropathologist; Maracaibo, Venezuela
1983-85	Diana Claassen	Neuropathologist; Idaho
7/84-6/85	Karl O. Schwartz	Neuropathologist; New Jersey
1988-91	Mark R. Hurtt	Research Scientist
1995-96	Mark Inman	Director, Pathology Fairmont General Hospital
1996-96	Hindi-Al-Hindi	Neuropathologist (Saudi Arabia)
1996-98	Virawudh Soontornniyomki	Assistant Professor of Pathology, Mahidol University
1998-00	Linda Dallasta	Pathologist Florida
2000-02	Marie Beckner	Research Assistant Professor University of Pittsburgh
2000-02	Bennet Omalu	Adjunct Assistant Professor, Allegheny County Coroner’s Office
2001-Present	Rafael Medina-Flores	Neuropathology Fellow
2001-Present	Scott Kulich	Assistant Professor, University of Pittsburgh, VAMC