History

History of the Department of Dermatology (Poster)

Professor Yaoju Tsutsui

Yaoju Tsutsui was born in Shingu City, Wakayama Prefecture, in 1863 (Bunkyu 3). He worked as a kendo master for several generations of the Shingu clan. During this era, each prefecture competed to establish a medical school. In 1877, Tsutsui entered the Mie Prefectural Medical School. However, because of a prefectural decree, he proceeded to the University of Tokyo after two years; via preparatory school, he graduated from the Faculty of Medicine in 1889. After graduating, he studied surgery under Dr. Julius Scriba; at the time, surgical studies included not only dermatology and urology, but also otorhinolaryngology and dentistry. In September of the following year, Tsutsui was appointed as a professor at the Medical School of Chiba First Senior High School (present-day Chiba University School of Medicine) and as a deputy head physician (and later head physician) of Chiba Prefectural Hospital, where he was in charge of surgery, dermatology, and sexually transmitted diseases. That year, Tsutsui published?Rinshoiten (Rules for Clinicians), a translation of the German language medical book?Vienna Clinic. At the time, a new age was dawning for medicine, and though unthinkable today, it was not rare to translate and publish Western medical texts as a student. Tsutsui had received intensive training in German at the University of Tokyo’s preparatory school, where German language classes were taught by teachers from Germany; thus, the language proficiency level among students was quite high. Tsutsui actively published other works, one after another. In addition to?Rinshoiten, he published?Hifubyogaku (Dermatology)?in 1896 (sixth edition in 1917),?Karyubyogaku (Sexually Transmitted Diseases)?in 1897 (sixth edition in 1908),?Hifubyozufu (An Illustrated Reference of Skin Diseases)?in 1900,?Shinsengekashujutsu (Selected Surgical Operations)?in 1904, and?Karyubyoukowa (Lectures on Sexually Transmitted Diseases)?in 1908. In addition, he presented a number of groundbreaking treatises. Tsutsui spent two years studying abroad in Germany as a Ministry of Education exchange student, beginning in 1899. He received instruction from the renowned physicians Johann von Mikulicz-Radecki and Albert Ludwig Sigesmund Neisser at the University of Breslau (located in present-day Poland). In 1908, after returning to Japan, he was awarded with the Doctor of Medicine degree; furthermore, he had the pleasure of giving his lecture?Kagakuryouhouzai Sarubarusan ni tsuite?(“On the Therapeutic Agent Salvarsan”) at Chiba Medical College in the presence of His Imperial Highness Prince Yoshihito (Emperor Taisho). Yukiyoshi Suga served as the headmaster of Okayama Medical College, formerly Okayama Prefectural Medical School, for 33 years. However, he clashed with Fujiro Katsurada, The Japan Academy’s award-winning professor of pathology, who discovered the Oriental blood fluke. Katsurada was let go from his position after the headmaster was assigned as a direct report to the Ministry of Education; subsequently, students organized a strike in protest of Katsurada’s departure. Suga then took responsibility for the chaos on campus and stepped down as headmaster. This incident became known throughout Japan as the famous “Okayama Medical College Strike.” Naturally, resolution of the strike was a major issue for the school and the Okayama area, as well as for the Ministry of Education. In the wake of this incident, Tsutsui was appointed to succeed Suga as headmaster. In 1913, when Tsutsui received the request from the Ministry of Education to be installed as the headmaster of Okayama Medical College-the sole medical training institution in the Chugoku and Shikoku regions of Japan-and the director of Okayama Prefectural Hospital, he was an influential professor at Chiba Medical College. The history of the Department of Dermatology at Okayama University Medical School begins with the establishment of the Department of Dermatology and Sexually Transmitted Diseases. In addition, the underlying principle of Tsutsui’s philosophy as the headmaster and director was not only to deal with students, but also to promote a spirit of peace and mutual harmony among professors. Thus, he quelled the campus disputes that had gained nationwide attention and succeeded in neutralizing the crisis that had gripped the school. On January 28, 1921, as the new building and hospital to which the school was moving to from Uchisange neared completion, he passed away at age 57 from esophageal cancer-just before the Medical College achieved university status. Tsutsui was only in office for seven and a half years, but he is known as the headmaster who played a major role in reforming Okayama Medical College and facilitating its recognition as a university. The creed of educators who teach doctors is “There are no ranks in our profession. However, doctors must not forget that this is the noble profession of saving valuable human lives/only good people can become good doctors.” Tsutsui was the headmaster who distinguished the history of this school, and his name deserves recognition. Starting with the translation of a medical book early in his academic career-his master work?Rinshoiten-his life was characterized by enthusiasm, and this book has maintained an unbelievably long shelf life. As headmaster of a medical college, a professor, and an author, Tsutsui accrued a long list of contributions to the field of medicine beyond Okayama and Chiba. Okayama University Medical School Alumni Association Newsletter, No. 77, October 1, 1994. Excerpts and edits from headmaster Yaoju Tsutsui and?Rinshoiten.

Professor Seigo Minami

Seigo Minami was born on November 1, 1893, in Hiroshima City. In 1918, he graduated from the Medical College, Tokyo Imperial University (present-day University of Tokyo). In 1922, he went to Europe for two years as an overseas researcher for the Ministry of Education. In 1924, he became a dermatology professor at Okayama Medical College (the predecessor to Okayama University Medical School). In 1929, he presided over the 29th Annual Meeting of the Japanese Dermatological Association in Okayama. In 1931, he became a dermatology professor at Kyushu Imperial University (the predecessor to Kyushu University). In 1933, he began publishing the magazine The Dermatology and Urology. In 1939, he presided over the 39th Annual Meeting of the Japanese Dermatological Association. In 1948, he retired as a professor at Kyushu University and opened a practice in Fukuoka. It is said that he took early retirement from academia because he was disgusted with on-campus disputes and institutional financial problems. He established the Minami Syphilis Serology Research Laboratory and affiliated hospital in Fukuoka. In 1950, he was recognized as an emeritus professor of Kyushu University. In 1954, he established the “Minami Award” for the training of young dermatology researchers; it is awarded by the Japanese Dermatological Association for the best research paper of the year. In 1966, Minami received the Japan Medical Association Lifetime Achievement Award. He passed away on September 6, 1975. He was conferred the Jusanmi and Kunsanto.

Just before leaving Japan to study abroad, Minami had been commissioned by his former mentor Keizo Dohi, a dermatology professor at the University of Tokyo, to translate Sekai no Baidokushi (A World History of Syphilis) into the German language. He translated it during his voyage and completed it after arriving in Berlin, where he studied pathology under Professor Ludwig Pick of the Pathological Institute of the Friedrichshain City Hospital, Berlin. Minami’s work there was published in the Virchows Archiv as Ueber Nierenveraenderungen nach Vershuetttung; it included a pathological study of persons who had died from renal failure attributed to war wounds during World War I and the first report on crush syndrome in the world.

Professor Hiroshi Negishi

Hiroshi Negishi was born on October 19, 1899; he was the eldest son of Saburo Negishi, a physician in Saitama Village in the Kita-Saitama District, Saitama Prefecture. After graduating from Tokyo Imperial University’s Medical College, he joined the university’s Research Center for Infectious Diseases. Via the Department of Dermatology and Urology (under Professor Keizo Dohi), he was appointed as a professor of Okayama Medical College in 1931. Thereafter, for the next 24 years until his retirement in 1955, he left major footprints in the fields of medical education, research, treatment, and university administration. In 1952, he served as the head of the 51st Annual Meeting of the Japanese Dermatological Association and chairman of the 40th Annual Meeting of the Japanese Urological Association.

Negishi’s research achievements reached across the fields of dermatology, urology, and venereal disease. His thesis dissertation was Hifushikkan ni okeru Ketsuekikagakutekikenkyu (“A Hematochemical Study of Skin Disease”); it introduced advanced pathochemical aspects of thinking into the field of dermatological research, which at that time consisted mainly of traditional pathomorphologies. Negishi integrated his research findings into new trends. He conducted research on skin sensitivity during his tenure at Okayama Medical College and published several papers on its relationship to electrolytes, platelets, vitamins, and other organ functions, as well as skin tone. His research into venereal disease was influenced by his mentor, Professor Dohi, and he made extensive achievements in serological testing for syphilis; the metabolism of glucose, protein, and lipids with syphilis, the absorption and excretion of antisyphilitics, and syphilis experiments, to name a few. Furthermore, in the field of urology, he was a pioneer in experiment-based research with animals. He made highly significant achievements in studies of renal function based on dog kidney transplants, covering diseases such as urogenital tuberculosis, urinary stones, and enlarged prostate.

In addition, before and after the Pacific War, he served three successive six-year terms as the director of an affiliated hospital, where he worked day and night toward reconstruction of the hospital after it had been obliterated during the war. Furthermore, he made various contributions to society, such as serving on a special committee to preserve prefectural cultural assets based on his archaeological knowledge, examining the culture of the coastal area of the Seto Inland Sea through international cooperation with the University of Michigan, and taking action to prevent venereal disease as the chairman of the Okayama Three Evils Eradication Association. He also served as the chairman of the Association Franco-Japonais de Okayama, chairman of the Okayama Lions Club, and district governor.
The Japanese Journal of Dermatology: 90(8), 661-664, 1980.

Excerpts and edits from “Mourning the Passing of Dr. Hiroshi Negishi, Honorary Member of the Japanese Dermatological Association and Honorary Professor of Okayama University.”

Professor Junichi Omura

When the Department of Dermatology at Okayama University became independent from the Department of Dermatology and Urology in 1960, Professor Omura took charge of the Department of Urology. He remained in charge of the department until 1968

Professor Kihei Tanioku

When the Department of Dermatology at Okayama University separated from the Department of Dermatology and Urology in 1960, Professor Kihei Tanioku from Shinshu University was newly appointed as the first professor of the independent department. He noted, “The Department of Dermatology at Okayama University is different from each of the other universities in that the dermatology department separated and became independent, which makes it the sole department in Japan of its kind.” At the time the department was established, dermatology in Japan was mainly descriptive and based on reprinted articles. Experimental dermatology was still in its infancy in Japan; it represented a new wave. Professor Tanioku took up his post at Okayama as the standard bearer for new dermatological studies. Initially, he poured his efforts into elucidating the state of the “fields” of skin disease, emphasizing pursuit of research from both biochemical and immunological perspectives. In terms of clinical perspectives, he taught his faculty members to look into the underlying conditions associated with skin changes, focusing on dermatological expressions of internal organ lesions and looking at patients with greater discernment (rather than intuitively). Furthermore, he enumerated management of clinical allergies, chemotherapy, and plastic surgery as the three pillars of clinical treatment. Additionally, he required that each faculty member belong not only to a research team but also to a clinical treatment group.

Professor Tanioku’s initial research teams took on chemotherapy, drug rashes, and contact dermatitis; as a department, they dealt with skin metabolism of drugs, as well as onset mechanisms of contact allergies, vitamins, and metabolism of sex steroid hormones.

Along with solidifying the fundamentals of the department, Professor Tanioku chaired the Japanese Dermatological Association, the Japanese Society of Chemotherapy, the Japanese Society of Allergology, the Japanese Society for Connective Tissue Research, the Japanese Leprosy Association, and other principal societies in fields of research. Of particular mention, his formation of the Dermatological Research Association led to the development of today’s Japanese Society for Investigative Dermatology, in which young researchers play active roles.

In addition to enhancements to the departmental staff, opportunities for establishing dermatology departments at surrounding hospitals also increased. Naturally, there were demands for new personnel from various affiliations. Dermatology departments were opened at Okayama Saiseikai General Hospital, Okayama National Hospital, Kawasaki Hospital, Kagawa Prefectural Central Hospital, Okayama City General Medical Center, Kagawa Prefectural Central Hospital, Kuribayashi Hospital, Okayama Red Cross Hospital, Sumitomo Besshi Hospital, Japanese Red Cross Society Himeji Hospital, Konko Hospital, Marunouchi Hospital, Takamatsu Red Cross Hospital, and Fukuyama Medical Center. Hospitals related to the Department of Dermatology at Okayama University were also established.

International exchanges for foreign study took place with Nohara in 1966-1967, Yoshida in 1971-1973, Takaiwa in 1973-1975 and Hagiyama 1975- going to the U.S., Ueki in 1971-1973 going to Germany, Nakagawa in 1973-1974 going to the U.K., and Arata in 1973-1974 going to France.

From start to finish, Professor Tanioku maintained a passion for learning, always leaning forward with “my dream.” He always placed a strong demand on members of his faculty to follow their dreams.

Jiro Arata. “15 years of the Tanioku era: Off the top of my head,” Commemoration of the retirement of Professor Tanioku Kihei. Cited and edited from the list of achievements of the Department of Dermatology at Okayama University and commemorative retirement booklet.

Professor Nozomi Nohara

Professor Nozomi Nohara has held many important posts during his time, and he is credited with major achievements in education, treatment, and research. It is difficult to describe Professor Nohara’s personality in a concise manner, as he was harshly critical of himself but would straighten up in public and make statements based on human truths. Many medical staffers would strongly characterize the professor as a strict teacher. Unlike the present tendency to motivate people with flattery, his tendency was to treat faculty members as dermatologists and, therefore, teach them according to an adult perspective. On the other hand, many people view Nohara as a teacher of deep humanity.

Many professors have expressed their gratitude to Professor Nohara, including Hiroaki Ueki (Kawasaki Medical University), Hikotaro Yoshida (Nagasaki University), Jiro Arata (Kochi Medical School), Takashi Takaiwa (Kagawa University Faculty of Medicine), and Hajime Kodama (Kochi Medical School).

In terms of academic associations, Professor Nohara served in leadership roles as the director of the Japanese Dermatological Association, board chairman of the Japanese Society for Investigative Dermatology, and as a councilor for related associations. Against a variety of expectations, he brought together various lines of thought and enlarged the Dermatological Research Association, which had been largely formed by his predecessor, Professor Tanioku Kihei, into the Japanese Society for Investigative Dermatology. The fact that Nohara established a joint academic society equivalent to dermatology research societies in the U.S. and Europe is an achievement deserving special attention. In 1985, he became a foreign corresponding member of the French Society of Dermatology and Syphilography. In addition, he presided over academic meetings as the chairman of the West Japan Division of the Japanese Dermatological Association in 1974, the head of the Dermatological Research Association in 1979, the president of the International Workshop of Investigative Dermatology (Kyoto) in 1982, and head of the general meeting and conference of the Japanese Dermatological Association in 1985.

In terms of research, starting with syphilis experiments, Nohara has been a pioneer in biochemical research of the skin, producing solid results and realizing major achievements with infectious diseases and immunology in the field of dermatology. He was internationally recognized for his research on the lipid metabolism of skin seen in xanthoma, and he is a pioneer in dermatologic plastic surgery in Japan.

As a university administrator, Nohara has demonstrated his abilities on various committees, in addition to serving Okayama University as a councilor and performing in the roles of director of the Central Clinical Laboratory at Okayama University Medical School Hospital, director of Okayama University Medical School Hospital, and director of the Preparatory Office of the School of Health Sciences. In particular, a new outpatient ward was completed during his tenure as the director of the hospital.

Hajime Kodama. “Nozomi Nohara era of the Department of Dermatology of Okayama University Medical School.” Alumni Journal of the Department of Dermatology of Okayama University Medical School. Excerpt from the 50th anniversary of the Dermatopia course, 22-25, 2010.

Excerpt from Okayama University Bulletin No. 65, March 1987.

Professor Jiro Arata

Jiro Arata was appointed as a professor in Okayama University’s Department of Dermatology from Kochi Medical School in April 1988. Not only did he make an effort to grow the department during his 13 years there (April 1988- March 2011), but he also left major marks in the development of Okayama University and the Japanese Dermatological Association. Professor Arata has a warm and generous personality, yet he is also strong-willed, with a determination to stick to his principles. He lives up to his motto, “Keep up your passion.”

Research

Professor Arata was a member of Nohara’s skin metabolism team during the Tanioku era; he conducted research regarding the relationship between skin and vitamin B6, particularly focusing on the skin metabolism involved. Further, he had clinical responsibilities for infectious skin diseases and chemotherapy. He also continued his research into prolidase deficiency that began when he was in Kochi Medical School. His research extended through the Department of Dermatology into the sources and clinical treatments of bacterial infections of the skin, particularly Staphylococcus aureus infections, and atopic dermatitis, and into research about defensins as innate defense mechanisms of the skin. His research also included bullosis and epidermal keratinocytes. Foreign activities consisted of involvement in the atopic dermatitis research group of the Ministry of Health and Welfare and research into clarifying the conditions of Sick Building Syndrome.

Academic associations

Professor Arata presided over the Japanese Society for Investigative Dermatology in 1995, the general meeting of the Japanese Dermatological Society in 1997, and the general meeting of the Japanese Society of Chemotherapy in 2000. In addition, his involvements have included presiding over the general meeting of the Western branch of the Japanese Dermatological Association, the general meeting of the West Japan branch of the Japanese Society of Chemotherapy, the 37th Annual Japanese Symposium on Staphylococci and Staphylococcal Infections, the 12th Annual Japanese Symposium on Bacterial Adherence, and the Japanese Symposium on Atopic Dermatitis Treatment. In 1995, the Tanioku Kihei Memorial Award was established through donations, mainly from the Okayama University Department of Dermatology Alumni Association, after Professor Kihei Tanioku, who worked to establish these research dermatology associations. Every year, lectures are presented by researchers from Japan and abroad who have made notable achievements in dermatology or closely related research fields.

Personnel training

Professor Arata has trained many excellent leading dermatologists serving at the present core hospital. Furthermore, many young medical staffers are being sent abroad to study, including Fujimoto, Ohno, Toi, Tsuji, Nakanishi, Sato, Hirakawa, and Shirafuji.

Hospital administration

In 1998, as director of the Okayama University Medical School Hospital, Arata steadily addressed various issues, including the construction of new hospital wards, improvement of hospital management, medical safety management, shutdown of the Honjima Branch, postgraduate clinical training, establishment of a Health Science Department, and reorganization/consolidation of administrative divisions. Of special note, Okayama University handled the first live lung transplant in Japan in 1998. Additionally, Arata initiated efforts to establish a plastic surgery department, appointing Isao Koshima -an expert in the field of plastic surgery- as a professor.

Professor Keiji Iwatsuki

In 1978, Keiji Iwatsuki graduated from the Hokkaido University School of Medicine and joined the Hamamatsu University School of Medicine. Via Fukushima Medical University, he was appointed professor of the Department of Dermatology at Okayama University Medical School in 2001. Against the backdrop of the approaching millennium and changing social conditions, he pursued reforms at Okayama University. National universities had selected a path toward becoming independent administrative corporations and graduate universities; through this rebuilding of universities, they would not be reliant upon the national government. Thus, management prepared for survival, and the competition for external funding commenced. Compulsory postgraduate clinical training was instituted, and the formerly popular top-down medical office systems were headed for dissolution. The integration of university organizations proceeded, and graduate schools of medicine, dentistry, and pharmaceutical science were established.

Against this backdrop, Iwatsuki took on new projects and attempted reforms, one after another. These included digitalization of clinical photography, an annual spring seminar, and an Okayama Dermatological Research Forum. His department hosted the Okayama regional meeting of the Japanese Dermatological Association (off campus), and Iwatsuki promoted medical makeup clinic, Department of Dermatology archives (repository and publications of past achievements), the Arata Award (for best paper of the year within the department), a refractory dermatological disease support network, serialization of regional cases in the publication Iyaku no Mon (toward compilation of a dermatological disease atlas), dermatology seminars on Chinese research, a residency program, an Okayama skin disease treatment support network of NPO specialists (serving as an organizational hub), introduction of a histopathological virtual slide system, highly specialized research projects, and special seminars.

Iwatsuki’s individual history of research includes autoimmune blistering diseases, latent viral infections and host immunological responsiveness, EBV-related lymphoproliferative diseases, and cutaneous lymphomas. He has also been involved in a wide range of activities dedicated to overseas research and contributions to society. Okayama University Hospital is a core institution for cutaneous lymphoma research and the base for a nationwide registry of clinical statistical data. Furthermore, Iwatsuki has served as a representative for a survey research group investigating rare refractory skin diseases, such as pemphigus, epidermolysis bullosa, pustular psoriasis, and ichthyosiform erythroderma; he has extended considerable effort to fight such diseases. Moreover, he presided over a symposium on bullosis in 2004, a symposium on cutaneous vascular and collagen diseases in 2006, the 2008 Satellite Workshop of IID2008: Virus-Associated Lymphomas (Kyoto), and a meeting of the Japanese Skin Cancer Society in 2009. Iwatsuki jointly presided over the 2nd Eastern Asia Dermatology Congress (EADC) in 2011 (Beijing). He was asked to preside over the general meeting of the Japanese Dermatological Association in 2014 and the Japanese Society for Investigative Dermatology in 2015. Three professors emerged from among fellow students at the Department of Dermatology of Okayama University: Professor Wataru Fujimoto, Professor Mitsunori Ikeda, and Professor Takashi Oono.

Related hospitals where full-time dermatologists have been placed have increased, and the number of hospitals supporting dermatological treatment has also increased. For example, there are a number of related hospitals in the Chugoku and Shikoku regions. Based on the wealth of related hospitals and excellent teaching doctors, a residency program is being planned so that dermatology specialists can cultivate the proper level of skill.

As the deputy director in charge of medical education at Okayama University Hospital, Iwatsuki is promoting training for medical students, interns, and residents. He is also serving as the director of the Department of Blood Transfusion, the Ultrasonography Center, and the Testing Department of Okayama University Hospital.

His focus is on the training of dermatologists who have a high level of clinical ability applicable within the field of general medicine and the development of personnel aimed at investigative dermatology.