Official Publication of the FAR EASTERN UNIVERSITY Dr Nicanor Reyes Jr School of Medicine Alumni Foundation ECTOPIC MURMURS

Volume 21 Number 5 December 2010 Opinions and articles published herein are those of the authors and do not necessarily reflect that of the FEUDNSM Alumni Foundation

36 th Annual Balik -FEU DR DANIEL FABITO is Dean To attend the 36 th annual Balik-FEU scientific program, Lauro Panganiban memorial lecturer simply arrive first thing in the DANIEL FABITO MD as leader, general surgical surgeon, morning on the first day, Thursday, January 13, 2010, at the 33 rd annual Dean Lauro golfer, father, and husband. 64 the FEU-NRMF Dr Ricardo Panganiban memorial lecturer He belongs to Class . He Alfonso Conference room, and will speak on surgical had a rotating internship and register for the meeting, where management of abdominal residency at the Evangelical you can also reserve and pay the aortic aneurysm: the silent Deaconess Hospital of fee to attend for the Saturday, killer on Milwaukee WI, and later at the January 15, 2010 grand reunion Thursday University of Missouri and dinner dance to be held at morning, Missouri Baptist Medical Crowne Plaza Galleria at January 13, Center in St Louis MO. Ortigas and EDSA. Class 57 , Class 58 , Class 59 , 2010 at the He had a busy practice in 60 61 85 FEU- general, vascular and bariatric Class Class , and Class are free. NRMF Dr surgery in the St Louis area for Fees for the rest are, as DANIEL Ricardo at least 35 years. He was also follows: life members P500, and FABITO MD Alfonso affiliated with St Louis spouses/ guests P1200. Conferen University School of Medicine To be certain of your Room. Dr Fabito is the epitome as a clinical associate professor registration and reservation, you of a student leader, medical continue to page 13 can also email so for this purpose the alumna in charge of the MESSAGE from the event, LINDA TAMESIS MD, BOARD CHAIRMAN [email protected] continue to page 11 Philippines. Although I do not get home as often as I would MESSAGE from the President like, I can well remember the The contracts for the beginnings of the 2011 events were signed. The Christmas Winter Board meeting will be Season. held in Long Beach CA. The The first signs are date is March 26, 2011. the Christmas Renaissance Hotel will be the songs ringing out site of our board assembly. PEPITO C RIVERA MD from the radio. Twenty (20) rooms have been I wrote this column in early This is quickly reserved for Friday, March October. It brings to mind that OSCAR C 25 th and Saturday, March 26th followed by TUAZON MD Christmas preparations are displays of lovely rooms. The rate is $99/night. already in the process in the decorations The hotel is a sister company continue to page 13 of the Marriott Hotels. continue to page 12 Abstract proportional to aneurysmal flank, or abdominal pain and ABDOMINAL AORTIC diameter and intraluminal or varying degree of shock. Distal systolic blood pressure and embolization, thrombosis and ANEURYSM inversely related to wall thickness. duodenal or ureteral compression The Silent Killer* The incidence of AAA has can produce symptoms. DANIEL C FABITO MD 64 increased significantly and is Fifty percent of AAA are The attributed to increased detection identifiable on physical management of with the use of ultrasound and examination as a pulsatile mass at abdominal computer tomographic (CT) scan or above the umbilicus. aortic and aging population. Small Radiological evaluation includes aneurysm (<5 cm) account for abdominal cross-table lateral films, aneurysm 50% of all recognized AAA which ultrasonography, CT scan and (AAA) is important since much of the magnetic resonance imaging. requires uncertainty surrounding Operative approach is either the DANIEL understanding management concerns aneurysm traditional midline abdominal FABITO MD of the natural <5.5-cm AAA are diseases of the incision or left retroperitoneal, history, elderly diagnosed in the 6 th and 7 th especially obese patients, those diagnosis and treatment decades of life. with COPD, or with previous modalities. The development of Rick factors include intraabdominal surgeries. Unstable endovascular procedures has hypertension, chronic obstructive patients with presumed diagnosis added management option in pulmonary disease, smoking, of ruptured AAA are gently treating AAA. A carefully atherosclerosis, male gender, resuscitated and transferred to the family history of AAA, and operating room for surgery. planned elective treatment peripheral arterial disease. The Endovascular aneurysmal repair before elective surgical expansion rate of AAA is 2-3-mm (EVAR) was introduced by resection before complication of per year and increases as the Parodin in the early 1990s and is rupture, thrombosis and aneurysm enlarges. Twenty now the operative approach for embolism continues to provide percent of AAA expand at a rate of half of AAA treatment in the the best results. Mortality for more than 4-mm per year. While United States. Approved by the elective repair at 2 to 5% and 80% grow at a slower pace. FDA in 1997, the first device for ruptured aneurysm repair with Population-based studies in the EVAR, and since then with 50–70% repair underscores the 1990s show that rupture risk does expanded use, it has a positive importance for early recognition not increased until the aneurysm impact in the mortality associated and proper treatment of AAA. diameter has reached 5 cm. with AAA repair. EVAR involves Rupture risk for small aneurysm, passage of self expandable, Aneurysm results with the e.g., <5 cm, is 1% per year; 5-10% covered stent into the aorta loss of structural integrity of the per year for medium-sized (5.5 to through the femoral artery using arterial wall, namely 7 cm) aneurysm, and 10 to 25% fluoroscopy and contrast degradation of the network of per year for large (>7-cm) arteriography. EVAR is associated structural proteins, such as aneurysms. reduction of perioperative elastin and collagen in the In the UK, small aneurysm and morbidity and mortality, shorted middle and outer layers. The the detection and management, duration of hospitalization and less weakening advances to according to the Adam Trial has blood transfusion. dilatation and aneurysmal shown no benefit to early open Currently, 5.5-cm AAA is the formation, which is at least 1.5 repair of aneurysm between 4 to appropriate threshold for repair. times the normal diameter of 5.4-cm. Safe observations of these There is no justification that aneurysms include ultrasound EVAR should change accepted the aorta. The risk of rupture is every 3–6 months. All good-risk size threshold for repair between described by the law of Laplace patients presenting with aneurysm open repair and EVAR. which places arterial wall stress 5.5-cm or larger undergo a contrast Patients’ preference is also of in relation to vessel diameter enhanced aortic CT scan and are great importance; and patients and arterial pressure. Rupture offered endovascular repair. should be well informed to make occurs when the intraluminal About 75% of AAA are such choices. pressure exceeds the tensile asymptomatic and are found rd strength of the wall of the aorta. incidentally. Aneurysm expansion *33 Annual Dean Lauro The risk of rupture is therefore or rupture may cause severe back, Panganiban Memorial Lecture IF YOU DREAM profession. To me, it was a that each class of alumni be dream coming true. I call it the asked to donate $2,000 as early IT, DO IT #3 best days of my life. Those days as possible. I exchanged letters THE STORY OF had given me an evergreen with Dr de la Rosa and assured 42 MICROSCOPES impact in my mind, a him that we were working hard CESAR D CANDARI MD 61 dreamer who was ready to to grant his request. In 1998, during the embrace life with passion. Thereafter, on July 12,1999, chairmanship of Dr Daniel I believe that we gain a lot I wrote a letter to each class more than just an education president, from Class 57 to Fabito of the 89 FEUDNRSM from our medical school Class and the jubilarians. This Alumni and it is imperative that we try letter was also printed in the Foundation, I to give back as much as we can. ECTOPIC MURMURS. was the vice- We must realize that we are Dear… president of the giving back for the future and Our medical school in the board trustees. continued development of our new facility in Fairview, institution. Our donations go a Quezon City, will soon be CESAR I was assigned CANDARI MD to chair an ad- long way to sustain our Alma inaugurated. hoc committee to respond to the Mater in its regular programs In the recent Board of letter of Dr Liberato C de la and initiatives to support Trustees meeting in Atlantic Rosa, chairman of the deserving students. It will help City on July 9, 1999, I department of Microbiology improve the education and presented a request from our and Parasitology, FEU-NRMF, curriculum being offered by our medical school for 60 brand- Institute of Medicine. I was alma mater. I have volunteered new microscopes that are extremely happy to chair this my time as service to give back, intended for the medical committee (for no reason, there realizing that I am helping students in the Department of was no members). It has given someone gain the valuable asset Microbiology and Parasitology. me the inspiration and of a quality education in my The Board of Trustees has enthusiasm to be of service to medical school. approved this request in our organization. To me, it was Dr de la Rosa to Dr. Fabito principle pending your a challenge, a prestige, and a stated, We would like to request participation. bigger chance to fortify a dream some help from you in This letter is to solicit your to help my beloved Alma improving our laboratory generous support by Mater. In one of the meetings of facilities being used by our contributing two or three the Board, I presented with students. We need about 60 microscopes. With each complete slide demonstrations binocular microscopes in the donation of a microscope by a of binocular microscopes and department of microbiology and graduate class member or a their prizes. Could you imagine parasitology. group of members, the name of what we had when we were in It was at the time when the the donor or the class year will the old Morayta medical new building and laboratory at be engraved into the school? Fairview Quezon City was microscope. The cost of each First of all, it is my ardent about to be completed. Dr de la microscope is P41,000 opinion that my Alma Mater Rosa quoted that the Philippine (approximately $1,025). In can be compared to my price for each Norinco order to make a successful dear parents who made me to be microscope was P41,000. The donation campaign and to what I am now. This statement US price of an Olympus insure that our medical school could be true to anyone. It is not microscope was $1025. will be the most prestigious and an exaggeration when I say that On May 15, 1999, I wrote a the best-equipped with state-of- ninety percent are nostalgic memo to Dr Fabito stating that the-art facilities in the Far East, about the time they spent in the in my opinion the Olympus was the minimum donation we are school and/or university they a much better microscope and I asking for is one microscope for graduated from in their chosen suggested that I would negotiate each individual donor or two or the price. I strongly suggested more microscopes for each the request for the microscopes Quezon City. Although it took a class donor. and finally, it was unanimously long time, I had accomplished Since each class has approved. Dr Emelie Ongcapin, the service I was asked to do. resources that are available the investment and financial To me, it was incredibly from the Silver Jubilarian coordinator, was instructed by memorable. Sorry, the names of funds, we are hoping that each Dr Fabito to release the funds donors or class were not class president will allow the for the purchase of 60 CH20 engraved in each microscope as Board of Trustees to use these Olympus microscopes with a planned. I was not privy to funds for this endeavor. Please quoted price of P28,000 per where the money came from. specify the amount that your scope. class will be able to donate. We Finally, Dr de la Rosa wrote TENDERLY YOURS need your response as soon as me a letter on October 30, 2000 NOLI C GUINIGUNDO MD 62 possible in order to be able to stating that 42 microscopes A nice meet the needs of our young were purchased and expressed article was medical students as our medical his appreciation and thanks to sent to me school opens in a few the officers and members of the by Bing, months. FEUDNRSM Alumni one of my We thank you for your Foundation. Dr Ed Relucio the classmates. support, and we know your chairman of the Alumni The article donation will help create and Foundation that year, was NOLI C was written maintain an institution worthy present during the opening of GUINIGUNDO MD by a of your dedication and the boxes of microscopes in the Brannie Ware. Of all topics it profession. department of microbiology and was about dying. The article is At the winter meeting of the parasitology. It was on time for all about the top five regrets of Board in St. Louis, Missouri, in the inauguration of the new the dying, whether man or March 2000, I presented again Medical Complex in Fairview, woman. They all seem to share the same regrets. THE HOLY LAND, WE WERE THERE! Let me enumerate the top CELSO DEL MUNDO MD 62 five regrets but without explanation as this might The holiest of the Holy, it is the birthplace of the Messiah, In a small town of Bethlehem, in a manger, where He was born, change the original explanation We were there, have touched and felt the places where lies His immortal soul, of Ms Ware. From Nazareth to Mount Tabor, Tiberias, Migdala and Capernaum. #1 - I wish I had the courage to live a life true to myself not We were lucky to trace the holy places where the Lord Jesus spread His Gospel the life others expected of me. The same place where, he taught the kindness and the road to salvation, #2 - I wish I had not worked We walked through Golgotha, and traced His agony and suffering, so hard. And never in my life I felt so close to the son of God, our Savior.. #3 - I wish I had the courage We enjoyed the peaceful ride on a wooden boat in the Sea of Galilee, to express my feelings. In this kind of boat He taught many things while floating above the sea, #4 - I wish I had stayed in Jesus chose His disciples and performed His miracle and mystery, touch with my friends. Where He took five loaves and two fish to feed the multitude who were hungry, #5 - I wish I had let myself be happier. We were all blessed to touch, feel and wade in the Jordan river, Where Jesus saw the spirit of God as a dove, descending upon Him, After reading all of the He was baptized by John the Baptist, and we were all baptized in the same water, above, I had a good friend who And cleansed our spirit and soul, how lucky we were to feel His blessing.! died not too long ago. Ding and I had intended to visit with him We were there atop the Mount Olive and we could feel the serenity, this summer but he stopped us Down below we can admired the beauty of the garden of Gethsemane. from seeing him. Since this was We could feel His presence where He prayed on His last days by the olive tree, his wish, we did not insist on Willingly gave His life, suffered and agonized to save humanity. seeing him. We have not seen him for several years and we education meeting of the coughing spells. Cough may were really anxious to see him Philippine Medical Association last for weeks or even months. inspite of his sickness. Our in Chicago, suipported by For prevention, a booster intention was really good and Sanofi Avanetis vaccine, TDAP (tetanus, pure, but it was regrettable Pharmaceuticals. diptheria, and acellular about his decision not to let us Pertussis, an important pertussis) is available to protect visit with him. After a few health issue due to the rise in its against pertussis, at the same weeks, he was dead. I am sorry incidence in the recent years, is time protects against two other for him. I regret it but it was caused by Bordatella pertusis . important diseases, tetanus and one of those things that The organism is a fastidious, or diphtheria. Two TDAP vaccines happened anyway. difficult to culture. It was are currently available for use in Since we are on the topic, let reported to have an all time low the United States, namely: me enumerate again Dr in 1976 with only reported ADACEL (Sanofi Pasteur) for Elizabeth Kubler-Ross On cases of over 1000. In 2005, use in persons 11 to 64 years of Death and Dying stages of however. there were 25,616 age and Boostrix (GalaxoSmith) dying: denial and isolation, cases reported to the CDC, but for use in persons 10 to 18 years anger, bargaining, depression, an estimates of true incidence of age and acceptance. The book dealt range from one to three million The CDC recommends that with several interviews of cases annually, because vast adults 19 to 64 years old, and patients in different situations, majority of cases are adolescents 11 to 18 years old, different ages, different unreported. receive a single dose of TDAP diseases. People faces death Pertussis immunity wears in place of TD I (tetanus, differently. Denial has its own off, leaving adults and diphtheria ) booster previously reason. Own reason for denial adolescents at risk for recommended for all adults. of death. # 30 infections. Adults and The CDC also recommends that adolescents can spread the adults in close contact with infections to infants who have infants younger than 12 months not have their vaccines even old, healthcare personnel with FYI before cough develops. Among direct patient contact especially For Your Information those with immunization, with infants younger than 12 immunity declines after 3-5 months old, and pregnant CELSO DEL MUNDO MD 62 years, and becomes an infection women directly after delivery In this control issues. receive a single dose of TDAP. issue, I will Infants have the highest rates Dr Dworski also gave an be reviewing of pertussis complication and excellent review of influenza, pertussis and deaths. Parents, grandparents commonly known as the flu, influenza and older siblings are often the which is a timely lecture in this virus source of pertussis in infants. coming flu season. CELSO infections, These are the individual who Flu is an infectious disease DEL MUNDO MD which have needs vaccination and booster caused by RNA viruses of the become important health issues administration of pertusis family Orthomyxo-viridae, the due to emerging infections in vaccine. influenza virus) that affects different population group Early symptoms are similar birds and mammals. The most world wide. to common colds or bronchitis commons symptoms are chills, Mark Dworski MPH TM, and may include runny nose, fever, sore throat, muscle pains, clinical associate professor of sneezing, and low grade fever. severe headaches, coughing, medicine and biostatistics at the Spasm of coughs may become weakness and fatigue. University of Illinois at progressively worse, Serious cases develop Chicago, provided a very accompanied by vomiting or pneumonia which could be informative lecture on incontinence. Sometimes with a fatal, particularly in the young pertussis and influenza during whoop sound occurs with and elderly. the last continuing medical gasping of breath at the end of In virus classification, medications and groups of influenza viruses are RNA people with increased of 32 nd Annual Reunion viruses that make up of three of infection: the five genera of the family Children younger than 2 & Scientific Convention Orthomyo-viridae, the influenza years old, adults 65 years or June 15 – 18, 2011 A, B and C viruses. older, pregnant women and Monte Carlo Hotel Resort Typically, influenza is women up to 2 weeks Las Vegas NV transmitted through the air postpartum, including (droplet) by cough or sneeze, pregnancy loss, and persons Celebrants: containing the virus. Influenza with following conditions, Class 61 (Golden Jubilee) can be transmitted by direct namely: COPD, cardiovascular, Class 86 (Silver Jubilee) contact with bird droppings or renal, hepatic, hematological Class 66 (Sapphire Jubilee) nasal secretions. (including sickle cell disease), 71 Influenza virus can be or metabolic disorder including Class (Ruby Jubilee) 76 inactivated by sunlight and diabetes mellitus. Class (Coral Jubilee) detergents. As the virus can be Those with disorders that Class 81 (Pearl Jubilee) inactivated by soaps, frequent can compromise respiratory Class 91 (20th Anniversary) hand washing reduces the risk function, or the handling of Class 96 (15th Anniversary) of infection. Seasonal respiratory secretions, or that Class 01 (10th Anniversary) epidemics occur, resulting in can increase aspirations, e.g. the deaths between 25,000 to cognitive dysfunction, spinal If you belong to the above 50,000 every year. It may reach cord injuries seizure disorders classes, please come forward, million in pandemic years. or other neuromuscular volunteer as a lecturer or Often new strains appear conditions. moderator, help organize your when an existing flu virus These are also the group of Jubilee celebration, and be spreads to human from other population who require counted! animal species, or when an influenza vaccination on an existing human strain picks up annual basis to prevent new genes from a virus that morbidity, mortality, and usually infects birds or pigs. prevent possible endemic to An avian strain named H5N1 pandemic infections. Editorials raised the concern of new Vaccine available is the most commentary, influenza epidemics after it common human vaccine, the news releases, emerged in Asia in the 1990s trivalent influenza vaccine letters to the editor, In April 2009, a novel flu (TIV) that contains purified and column proposal and strain evolved from the inactivated material from viral manuscripts are invited. combined genes ofhuman, pig strains. and bird flu, initially dubbed The TIV carries no risk of Email submission, swine flu and also as influenza transmitting the disease and it including figures or pictures, A/ H1N1 which has raised has a very low inactivity. A is preferred. concern of influenzas vaccine formulated for one year pandemic. may be ineffective for the The WHO officially declared following year, because the ECTOPIC the outbreak to be pandemic on influenza virus may evolve June 11, 2009. Among the rapidly and new strains quickly MURMURS people who become infected replace the older ones. Antiviral with 2009 H1N1, are certain drugs can be used to treat Deadline for the groups who appear to be at influenza with neuraminidase January 2011 issue: increased risk of complications. inhibitors being particularly Friday, December 17 2010 These are the population effective. group who may benefit from an Email to [email protected] early treatment with antiviral

specimens, and clinical records. MY BLOG Recut from paraffin-embedded tissue blocks were stained with CIRCUMCISED Weigert’s method for elastic PHIMOTIC fibers and Mayer’s FORESKIN: Revisited mucicarmine procedure. CESAR V REYES MD 68 As normal controls, sections stained with hematoxylin-eosin, INTRODUCTION. Weigert’s elastic method and Phimosis refers to a narrowed Mayer mucicarmine from 30 prepuceal opening and its newborn circumcised foreskins inability to were examined.

retract over the RESULTS. The ages of the Figure 2 – LSA lichen sclerosis et glans penis. It 179 patients at the time of atrophicus is most circumcision ranged from 42 to (HE stain, x100) commonly an 67 years with a mean of 54 acquired years. There were 95 CESAR V REYES MD condition Caucasians and 84 Afro- associated with Americans. chronic inflammatory process Additional preoperative and usually corrected with diagnoses included redundant circumcision. foreskin in 32 cases, Routine pathologic paraphimosis in 18, and characterization of circumcised balanitis in 14. phimotic skin seems to lack details, or if the specimen is examined microscopically at all. The histologic evaluation of 69 consecutive cases of such tissue materials were reviewed and compared with those of lichen Figure 2 – LP lichen planus (HE stain, x100) sclerosis et atrophicus (LSA)

and lichen planus (LP) which Figure 1 – Gross appearance of phimosis marked by edema, are not uncommonly diagnosed discoloration and mixed-type in excised phimotic foreskin. inflammation (arrow). The clinicopathologic data from these evaluation and the Microscopically, 69 out of respective patients, and brief the 179 foreskins showed review of pertinent literature histopathologic features that form the basis of this report. were akin to those of LSA, MATERIALS and namely: epidermal atrophy, METHODS. From July 1984 to hydropic degeneration of the Figure 4 – Toxic eruption of dermal July 2009, the surgical basal cell layer, pronounced chronic perivasculitis and lichenoid epidermal changes (HE stain, x200) pathology files of Hines edema and homogenization of the upper dermal collagen, Veterans Affairs and Morris layer, irregular acanthosis with chronic cellular infiltrates in the Hospital IL, list 179 cases of saw-tooth elongation of the rete mid-dermis, and diminished phimosis. ridges, band-like chronic elastic fibers (Figure 1). The review of the inflammatory cellular infiltrates Four cases exhibited changes hematoxylin-eosin stained hugging the epidermis, and of LP, as follows: hyper- sections was supplemented by almost complete absence of keratosis, prominent granular available gross specimens, elastic fibers. photographs of excised tissue Another case histologically demonstrated concomitant TABLE I – SUMMARY OF THE MICROSCOPIC FINDINGS characteristics of LSA and LP, IN THE REMAINING 110 CASES WITH SIMILARITY TO also with striking marked LICHEN SCLEROSUS ET ATROPHICUS and decreased of elastic fibers. LICHEN PLANUS The histopathologic changes in the remaining 110 foreskins #cases percent were summarized in Table I. Elastic fiber loss 98 82% The mucicarmine stain was no Homogenized papillary dermis 70 59 formative in any of the Superficial band-like inflammation 52 44 specimens examined. Thickened epidermis 52 44 COMMENTS. LSA of the Basal cell degeneration 45 38 male genitalia often presents as Thin epidermis 31 26 monosymptomatic phimosis. Deep dermal inflammation 12 10 The lesion usually affects the

inner blade of the prepuce, leaving for direct absent elastic fiber network; (2) the lichenoid inflammatory examination only a non- lichenoid reaction with patchy phase with the disappearance of retractable prepuce with a interface cellular infiltrates of the elastic fibers thereafter. conspicuous distal stenosis. The lymhocytes and absent elastic CONCLUSION. A glans penis may or may not be fibers; and (3) thining of the histopathologic review of 179 affected, but it is often epidermis, vacuolar junctional consecutive cases of adult inaccessible for inspection due cellular degeneration, circumscised phimotic foreskin to the preputial stenosis. homogenization of the upper discloses changes of Therefore, circumcision for dermal collagen but with nonspecific lichenoid phimosis is often performed retention of the elastic fiber dermatitis, lichen sclerosis et without primary knowledge of networks. atrohicus , and lichen planus. It the nature of the underlying Perhaps, these observations is postulated that phimosis is a pathologic condition. relate phimosis to LSA, LP, and manifestation of the Since LSA is a chronic, lichenoid toxic eruption. aforementioned entities with slowly progressive disorder that However, since phimosis is a overlapping microscopic may recur if not excised localized cutaneous lesion features. The pathogenesis of properly, and since it is among our patients without the lesion remains unclear. associated with a risk of clinical manifestation of these The study also shows that malignancy, distinction between dermatological entities, it is despite a rather monotonous the various condition resulting possible that (a) phimosis shares clinical appearance of phimosis, in phimosis, such as LSA, LP histologic features with LSA, histologic examination discloses and other sclerosing/ fibrosing LP or lichenoid toxic eruption, a spectrum of different entities is important. and (b) some patients do have conditions. It is equally important that LSA, LP, or lichenoid toxic The treatment of these inflammatory changes eruption. conditions may differ, and preceding fully developed LSA Therefore awareness of the histologic evaluation of proper be characterized so that proper variable microscopic expression biopsies appears to be indicated treatment and control are of phimosis should prompt a so that optimal therapy can be instituted. search for other lesions of LSA, selected. The light microscopic LP, or lichenoid eruption REFERENCES. A list is findings in phimotic foreskins elsewhere in the skin. available on request. may fall into one of three With regards to the patterns: (1) lichen planus-like pathogenesis of phimosis, it reaction with basal cell vacuolar appears that the homogenization changes, dense band of of the dermal collagen with lymphocytic infiltrates, and preserved elastic fibers precedes LETTER TO THE EDITOR participation and recognition of PHILIPPINE MEDICAL Please let me share with you surgeons from Asia. my joy, pride and honor for a The OSAPS Congress is ASSOCIATION in CHICAGO title and biennial, since it started in & PMAC Auxiliary position I Tokyo 22 years ago; the invite everyone to a Philippines hosted the 11th received at Winter Scientific Seminar and Song Congress in Cebu in November the 12 th and Dance Festival 2008. Performers Congress of After Tokyo this year, the the Oriental next Congress will be in Seoul, SWU / CIM Chorale Society of Korea in 2012. Thomasian Medical Alumni FLORENCIO Q Chorale Society of Illinois LUCERO MD Aesthetic This development now Plastic places the Philippines in a UERM Midwest Chorale Surgery (OSAPS) recently held position of wider influence in MCU-FDT Medical Chorale in Tokyo last November. the growing field of aesthetic FEUMAANI Chorale Group After 22 years of being at the plastic surgery in the Asian UPMASA Chorale helm of OSAPS, Dr Kitaro region. Saturday, March 26, 2011 Hopefully, this may add Ohmori chose me to take his Hyatt Regency O’Hare Rosemont IL impetus for our local surgeons place as the secretary general Contact to seek recognition outside the NATIVIDAD B DELA FUENTE MD after getting the concurrence of Philippines. The collateral PMACA President the EXCO of the Society. effect is also more recognition [email protected] I will have a large and of the institutions that may be EMMA YEE SALAZAR MD daunting job of overseeing the involved in future activities. PMAC President activities and Congresses in ten FLORENCIO Q [email protected] countries. Facetiously, I do not LUCERO MD 70 know if I could do the job that Dr Ohmori did for the last 22 years. That small man has big shoes for me to fit in. But I APPA accepted it at the gala party in ASSOCIATION of PHILIPPINE PHYSICIANS in AMERICAN all humility in front of all SCHEDULE OF EVENTS delegates. MEDICAL SURGICAL MISSION As a background, the Talisay Negros Occidental, January 24-27, 2011 OSAPS was founded in 1988 by Monday, January 24, courtesy call to the the late Dr Seiichi Ohmori, the Negros Occidental Governor, Talisay Mayor, and Talisay Lion's club father of Kitaro, which explains Tuesday and Wednesday, January 25-26, Medical Surgical Mission why his son took care of the Thursday, January 27 Feeding malnourished children Society and Seiichi's ideals and vision for plastic surgery. Payatas Quezon City, February 1-3, 2011, Medical Surgical Mission Three Filipinos were founder members, namely, Drs Jorge Neri, SPRING MEETING Sia Tiong Gam, and yours truly. & PPSA Annual Convention, April 29-30 2010 Members come from Japan, Hilton East Hotel, 3633 Park Rast Drive, Breachwood OH Taiwan, China, Thailand, Telephone (216) 464-5950 Indonesia, South Korea, Malaysia, Philippines, Singapore, and 40 th ANNUAL CONVENTION SCIENTIFIC SEMINAR Hongkong. These countries are July 27-31, 2011 also designated affiliated national Towncenter Marriott Hotel, 200 Lee Street East, Charleston WV association for having at least five Telephone (304) 345-6500 members. Aside from the sharing of technology and expertise among RANO S BOFILL MD , President Asian plastic surgeons, Dr Seiichi had the vision of international DECEMBER IMAGES

Brother Phillip (left), the youngest son of Augusto Cezar Lastimosa MD and Cynthia Lastimosa RN, is blessed by Pope Benedict XVI during a recent pontifical ceremonies held in Rome and now serves as a monk in one of the Dallas churches.

During a luncheon of St Peter’s fish, we almost filled up full a restaurant The Philippine Flag was raised and the located by the northeast shore in the Sea of Galilee early on our Israel Egypt National Anthem sang in a wooden Tour. Here, with other tour groups, we also met two FEU alumni boat in the middle of the Sea of Galilee! Drs Ramon Gillego of New York and Melania Domingo of Georgia.

ECTOPIC MURMURS Volume 21 Number 5 December 2010 page 11 36 th ANNUAL BALIK -FEU SCIENTIFIC SEMINAR Highlight: Gold Class 61 and Silver Class 85 Jubilee Celebration Life after 50: Graceful & Healthy Aging

Wednesday, January 12, 2011 to be moderated by 2:00 pm Anemia in the Golf Tournament,East Ridge Elizabeth Ahyong-Reyes MD85 Elderly:Physiologic or Golf Country Club, 4:00 pm Beauty Medicine for Pathologic? Renato D Yuzon Binangonan, Rizal Seniors Grace Averilla-Obena MD 85 to be moderated by MD 85 to be moderated by Enrico E Tuy MD 85 Thursday, January 13, 2011 Benedict Carpi MD 85 2:30 pm Common 8:00 am Registration Musculoskeletal Disorders in 8:30 am Mass at FEU-NRMF Friday, January 14, 2011 the Elderly Perry P Tan MD 85 Medical Center Chapel 8:30 am The Future of to be moderated by Jose Oscar 9:30 am Breakfast Medicine: Adipose Stem Cell N Toledo MD 85 10:00 am 33 rd annual Dean Transplant Florencio Q Lucero 3:30 pm Hospice, Palliative & Lauro Panganiban memorial 70 MD to be moderated by End-of-Life Care Jaime V lecture by Daniel C Fabito 70 Leticia Lucero Palma, MD Cheng MD 85 to be moderated MD 64 on Management of 9:00 am Cerebrovascular by Leni Alojado-Stayman MD 85 Abdominal Aortic Aneurysm: Diseases in the Elderly 4:00 pm New Realities in The Silent Killer 85 Marilou Ching-Kua MD to be Medicine Based on Physics 11:00 am Student Recognition moderated by Roy B del Cesar A Reyes Sr MD 61 to be and Faculty Awards 85 Rosario MD moderated by Alfredo B 12:00 noon Symposium on 9:30 am Use of Antipsychotics Dadivas MD 85 phytotherapy for benign Among Elderly Rossano L prostatic hypertrophy by Vic Bangasan MD 85 to be Saturday, January 15, 2011 Fileto T Chua MD 85 moderated by Madeleine 6:00 pm GRAND ALUMNI supported by Pascual Mendoza-Valencerino MD 85 NIGHT Shimmering Laboratories) 10:30 am Should the Very Old Silver….Glittering Gold 1:00 pm FEU-NRMF Medical or Frail Elderly be Deprived of Honorees Class 61 , Class 65 , Alumni Society business Major Surgeries? : Mauricio N Class 70 , Class 75 , Class 80 , meeting Gatches MD 85 to be moderated Class 85 , Class 90 , Class 95 , 1:30 pm What is the Future of by James Taclin C Bañez MD 85 Class 00 , Class 05 Old Age? Alfredo U Kua MD 85 11:00 am Anesthetic to be moderated by Stevenson Implications for Geriatric L Ong, MD 85 Patients Roberto M Kong MD 85 2:00 pm Expanded Senior to be moderated by Manuel B Crowne Citizen Act of 2010 Chua Jr MD 85 Plaza MaElizabeth I Caluag MD 85 12:00 noon Benign prostatic Galleria to be moderated by Edgardo hypertrophy and erectile Manila MGonzaga MD 85 dysfunction: dilemma of the at Ortigas 85 2:30 pm The Role of Phil old Alvin G Cabreira MD Health in our Aging supported by Biomedis Life Members ………..… P500 Population Ellen delas Alas- 1:30 pm Macular Non-Life Members, Bayta MD 85 to be moderated by Degeneration: Is There spouses and guests …... P1,200 85 Class 85 , Class 61 and Geraldine Anne A Cruz MD Treatment? Roy Teodoro B 57-60 85 Classes ………….. FREE 3:30 pm Updates in HRT Principe MD to be moderated Among Postmenopausal by Annabelle Ramos-Rabino ATTIRE Black suit and black Women Lilia P Luna MD 61 MD 85 cocktail dress

ECTOPIC MURMURS Volume 21 Number 5 December 2010 page 12

demanding instruction and Chicago recruited Mr D to teach. OBITUARY emphasis on perfection produced a His dedication to his students CESAR N MAC , 70, died late generation of award-winning was legend. In a 1992 Tribune last October at St. Clares Hospital musicians. story, Mr D said he rarely took in Denville Mr D 's devotion to his students breaks for meals and gulped down NJ. became the resounding chord of sandwiches while listening to He was his musical life. In his ailing last scales. When his hair grew too born in days, many expressed their shaggy, he arranged for his barber Canlubang, gratitude by coming to his bedside, come to his Chicago home to give and lived in sitting at a digital piano and him haircuts. Manila before CESAR MAC playing for him. He became nationally renowned coming to He was born in Manila, the for developing young talent, and Seattle. He eldest of eight children born to attracted students who often drove and his wife FEMINIA MAC 68 Emilio M del Rosario Sr, an FEU hundreds of miles to study with MD moved to Parsippany NJ in professor, and Magdalena Veloso. him. 1975. His first piano teacher was his In both 1986 and 1992, Mr D In 1961 he graduated with a BS aunt, an accomplished pianist who received the distinguished teacher Electrical Engineering from started teaching him the day before award from the National FEASTI University in Manila. He his sixth birthday. Foundation of the Arts. In 2007, was an avid golfer, passionate By the end of the year, the 6- the Music Institute of Chicago ballroom dancer, loving husband year-old prodigy was playing a announced the establishment of an and dedicated father. Beethoven piano concerto. endowed Piano Chair in his honor. He is survived by his wife of 37 He began formal study at a Two years later, the Emilio del years, as well as his son and conservatory in Manila but moved Rosario Library was also daughter, and 3 grandchildren. to the United States upon receiving established after his donation of an A liturgy of Christian burial a scholarship to the prestigious extensive collection of piano music service was held at St. Peter the Peabody Conservatory in to the Music Institute of Chicago. Apostle Church in Parsippany, Baltimore. He is survived by six siblings, followed by a mass entombment At Peabody, Mr D was the first including SALVADOR DEL will take place in Holy Rood student of famed American pianist ROSARIO MD 68 . Cemetery in Morristown. and conductor, Leon Fleisher. After receiving his bachelor's and master's degrees, Mr D began PRESIDENT’s Message EMILIO DEL ROSARIO an extensive performing career that continued from page 1 JR, 76, a Filipino piano prodigy included recitals, chamber music All reservation should be done thru who emerged in the concerts, and guest appearances Marriott. US as a brilliant with orchestras in the United Our biggest event, the 33 rd performer and then States and Asia. Highlights annual grand reunion scientific earned a worldwide included performances at Carnegie convention will be held in Las r reputation as a Hall, Steinway Hall, the United Vegas NV. The date will be June gifted piano Nations, Chicago's Orchestra Hall 15-18, 2011. The site is the newly teacher, died of cancer early and with the Manila Symphony renovated Monte Carlo Grand October at a hospice in Wisconsin. Orchestra. Resort and Hotel. For more than 40 years, Mr. del He received numerous prizes, We are able to get a good help Rosario, known to his students as awards, grants and scholarships from the Las Vegas Chapter Mr D taught at the Music Institute including the Steinway Prize, the headed by the able President, of Chicago in Winnetka, sharing Paul Thomas Prize at the Peabody MELINDA FABITO MD and also his passion for piano and shaping Conservatory of Music, Concert her better half DANIEL FABITO hundreds of young people into Artists' Guild Recital Award and MD, successful concert pianists. the Philippines Outstanding Artist The rates for June 15 th -6th is To study with Mr D was a Award. $50/night, but for June 17 th –1th , privilege and he only accepted new In 1965, Herbert Zipper, then- $115/night, and taxes are not students by audition. But his president of the Music Institute of included.

ECTOPIC MURMURS Volume 21 Number 5 December 2010 page 13 DANIEL FABITO MD We are able to block 110 rooms there is a true spirit of family continued from page 1 only per night. We encourage all throughout the Philippines. of surgery. A d iplomate of the our alumni to reserve early. I remember when I was a Philippine Board of Surgery, he Reservation deadline should surgical resident at FEU Hospital, I was certified and twice recertified be made no later than May 15, received many gifts, even from my by the American Board of Surgery 2011. patients. I was given Chinese hams through the years. Daniel was also Wishing all our alumni and and other food; and I would then a fellow of the American College there family a very very merry share them with family and of Surgeons, International College Christmas and a happy prosperous friends. The closeness and of Surgeons, Philippine College of and safe and healthy New Year. camaraderie among the surgical Surgeons, Society of Philippine For those alumni and jubilarians residents was very strong and we Surgeons in America, and attending the Balik -FEU, see you supported each other through the American Society of Abdominal all in the West Fairview. season, each waiting for the time Surgeons. OSCAR TUAZON MD 74 of Christmas break. Among the many distinctions The chief resident of surgery at he had received, tops are the that time was Dr Francisco (and CHAIRMAN’s Message alumnus of the year 1980 of the Dr. Cipriano as incoming chief continued from page 1 FEUDNRSM Alumni Foundation, resident) would give us parties and both along the boulevards and in president of the Philippine Medical little gifts to celebrate the holiday the stores. I can almost feel the Association in the Greater St at the hospital. cooling air on my face. th Louis, president of the Association Noche buena on December 24 Christmas in the Philippines has of Philippine Physicians in midnight mass is a very special a different feel compare here. In America, and president of the time for family. The entire family the US, much of the season is Society of Philippine Surgeons in attends mass and then has a meal dedicated to the rush of getting America. together. This is a time strictly for from here to there and the all Daniel is also a prototypical family followed by Christmas day important shopping season . In the medical surgical missionary, celebrations with friends and Philippines, Christmas is still a having participated, led, or chaired family and many parties and visits. time for family and friends. The countless such charity, endearing I made it a point to be home during pace is slower; and much visiting and fruitful works in the various the Holidays because it is the best and good food are enjoyed. I can places of the Philippines. of both worlds. I came home with remember many times going to He retired in 2008 in Las th my family. church on December 15 with my Vegas, but continues to do many I encourage each one of you to family. The family would arrive at community, teaching, civic and embrace the Philippine tradition of the church and my parents and philanthropic services here in the family and to reach out to those siblings would go inside to hear United States and in the around you with good cheer and a Mass. However, many times I Philippines. He still devoutly peaceful heart. Enjoy your family remained outside, enjoying the serves as board trustee of the and friends, and remember your wonderful array of goodies such as FEUDNRSM Alumni Foundation roots. bibingka , puto bungbong and tea and the FEU-Nicanor Reyes Jr Support our Alma Mater and and playing with the other Medical Foundation in West our scholars and carry the feeling children. It was an Fairview QC; and he still dreams of Christmas in your heart all year. irritation to my mother that I never of a Philippine postgraduate Have a safe and happy Christmas went inside the church. medical learning center with season and I hope to see you for a Christmas season is also a time various multispecialty residency Philippine Christmas. of renewal, no matter how rich or and fellowship programs at the how poor one is. Everyone strives PC RIVERA MD FEU-NRMF medical complex. to have new shoes, shirts, and gifts for friends. Many platters of foods are prepared and in CHICAGO enjoyed. Everywhere you go, PHILIPPINE MEDICAL ASSOCIATION Annual Medical Mission January 30 - February 4, 2011 people are sharing and visiting and Bantayan Island, Cebu y Contact: EMMA SALAZAR MD, PMAC President [email protected]

FEUMAANI LAOAG CITY MEDICAL SURGICAL MISSION January 16-20, 2011 CME Schedule LAOAG CITY, Paoay, Banqui, Pagudpud and Monday, January 17, 2011 Governor Roque Ablan Provincial Hospital 7:00 am Registration, Breakfast Overall Chairperson/ President: Nida Blankas-Hernaez MD FAAP 7:10 am – 8:00 am Committee Chairman: Pascual Sales MD Immunization Update 2011 84 in conjunction with FEUDNRMS Alumni Foundation Las Vegas NV Nida Blankas Hernaez MD Chapter President Melinda Ayala-Fabito MD , and FEU-NRMF Medical Alumni Society President Linda Tamesis MD

Surgery Chair P Sales MD , with Jesse Corres MD (plastic surgery), Danny Fabito MD (general vascular surgery), Roger Bautista MD ,

Joel Bautista MD , Rene Pena MD , Edmundo Relucio MD , NIDA BLANKAS Eugene Siruno MD , Mario Reyes MD , Aristeo Villasenor MD (general HERNAEZ MD surgery); Rebecca Salvani MD (OB-Gyn); To be introduced by Ed Hernaez MD Simeon Aquino MD and Laleigh Andres MD (ophthalmology); Tuesday, January 18, 2011 Ben Bingcang MD , Alberto Clar MD , Renato Enriquez MD , 7:10 am – 8:00 am Thomas Lo MD , Wilfrido Magat MD and Salome Tacadena MD Wow Results of Common Facial (anesthesia); Gerardo Guzman MD (general practice and minor surgery); M Problems without Laser or Facial Fabito MD , Richard Mon MD , and Remedios Sales MD (internal medicine); Surgery Brenda Narcelles-Banez MD, Rodolfo Bautista MD , Ofelia Kaguyutan MD Jesse Corres MD (pediatrics); Angelito Fernandez MD , Edward Hernaez MD , Norma Arias MD , Lydia Espino MD , Gil Palacio MD , Andres Rago MD , Edith Panopio MD , Abraham Bayan MD , Pat de Leon MD , Edith Panopio MD

(family medicine); Cornelia Bincang MD and Rhodora Palacio MD JESSE (psychiatry); Cesar V Reyes MD (cytopathologist) and CORRES MD Pauline Abadilla RN and Nora Corres RN , Ming Tang RN , Patricia Bautista To be introduced by Pascual Sales MD RN , Clarita Dior RN (surgical nurse); and Elvie Fernandez RN , Aurora Wednesday, January 19, 2011 Gagni RN , Thara Gagni RN , Ester Mendoza RN , 7:10 am – 8:00 am Perlita Magat RN , Elsie Rivadelo RN , Selected Vascular Surgery Lydia Pena RN , Elsie Rivadelo RN , Naty Bautista RN , and Update Topics Lolita Villasenor RN (medical nurse); Daniel Fabito MD 64 Roy Espino (respiratory therapist); Daisy Bautista , Lauren Bautista , Ralph Salvani , Medardo Abadilla , Tito Gagni and Oscar Rivadelo (support).

Hotel Headquarter: Crowne Plaza Galleria at Ortigas & EDSA (also with Balik -FEU reunion!) DANIEL C FABITO MD Itinerary: January 16, 2011 – depart Manila to Laoag City To be introduced by Melinda A Fabito MD via Cebu Pacific Airline (30 minutes) or via bus (10 hours) Thursday, January 20, 2011 7:10 am – 8:00 am Hotel headquarter: Fort Ilocandia Hotel Resort Laoag City Selected Pathology Update

Topics Mission dates: January 17, 18, 19 and 20, 2011 68 Cesar V Reyes MD January 21, 2011 – return to Manila Friday, January 21, 2011 – audience with President Noynoy Aquino

Email to [email protected] NIDA BLANKAS-HERNAEZ MD pertinent biodata: name, practice, State license, medical school, Class year,

postal address, telephone, and email address. CESAR V Financial and in-kind donations (medical / surgical supplies, etc) REYES MD will also be appreciated. To be introduced by Elisa Reyes RN