August 2005 Mentor of the Month Q&A Session: Jack Ladenson
Welcome to SYCL's Mentor of the Month.  Questions and Answers will be displayed below...

Dr. Ladenson: This is a comment rather than a question. I think you are an incredible mentor for people in both your personal and professional life. Thank you for sharing your thoughts with us. You said in your interview "Try to make sure they live a professional life that allows for them to look at themselves and be happy with what they see." This is excellent advice for evey single person in this world! I'm glad David Grenache was able to talk you into this interview!
Chicago, Il

Jack H. Ladenson, Ph.D.
Thank you for your comment.

My name is Li Jin certified in CP by ABP. MD was fr Beijing U. Sch of Med. PhD fr U. of Texas, Residencied at Peking Union Med College and U. Of Penn in Phila. Now I am a Director of Public Health Laboratory serving a pop. of 0.5 M in a municipal Ambulatory Care Center with 14 physicians of various specialties. I 'd like to get actively involved in professional societies such as AACC concern CP issues. Particular interests of mine are in the Clinical interface, point of care and its Laboratory oversight, interactions with the State and Federal Programs and regulators. I am currently a Fellow of CAP which has a lot of Anatomic Pathology component which I am getting less involved with. I 'd like to join AACC , perhaps another professional organization concerning Clinical Laboratory management. I appreciate your advice. Thank you. reply to: jinli@ci.newark.nj.us tele: 973 733 7543 Li Jin, M.D., Ph.D., F.C.A.P. Director, Public Health Laboratory Newark Dept of Health and Human Services 110 William Street, Room 101 Newark, NJ 07102
Newark, New Jersey

Jack H. Ladenson, Ph.D.
I suggest contacting the President of the AACC, Mitch Scott (E-mail: mscott@labmed.wustl.edu) and the President of the Academy of Clinical Laboratory Physicians and Scientists, Dave Sacks (E-mail: dsacks@rics.bwh.harvard.edu). You might also contact the American Society for Clinical Pathology (www.ASCP.org), Associationof Public Health Laboratories (www.APHL.org), and Clinical Laboratory Management Association (www.CLMA.org). All of these organizations share interests with yours to varying extents. I suggest you look over their programs and activities and see what you would like to get involved with.

What is the best way to assess the potential for renal damage due to myoglobin in rhabdomyolyis?
Tampa, Florida

Jack H. Ladenson, Ph.D.
Serum or urine myoglobin or total CK will certainly alert one to the severity of the rhabdomyolysis, which increases the potential for renal damage.

Dear Jack, You have been to the clinical laboratories of the developing countries like Bhutan and Nepal. How do you evaluate the major differences they have, in comparison to the laboratories of the developed countries? What suggestions/recommendations you would like to give to improve their quality? Bodhraj Acharya, Nepal
Kathmandu, Nepal

Jack H. Ladenson, Ph.D.
Hi Bodhraj, Glad you got home from the AACC meeting okay. Laboratories in developed countries generally have access to equipment, high quality reagents, instrument service and maintenance, quality assurance, and trained technologists. Even if their access to some of these is variable, it is far better than laboratories in developing countries. I think the first key to improvement in the developing countries is the desire to improve, e.g., recognize that there is a problem, and to have an individual or individuals to help lead the improvement. The relatively neglected components are service and maintenance which most grants from institutions such as USAID and the World Bank rarely include, quality assurance which is often not done or adhered to, and the training or retraining of technologists.

I would like to bring to your attention the following papers: Measurement of hematological, clinical chemistry, and infection parameters from hirudinized blood collected in universal blood sampling tubes. Semin Thromb Hemost. 2001 Aug;27(4):349-56. and Menssen HD, Melber K, Brandt N, Thiel E. AND The use of hirudin as universal anticoagulant in haematology, clinical chemistry and blood grouping. Clin Chem Lab Med. 2001 Dec;39(12):1267-77. You were the first person who proposed the use of plasma (heparinized) in place of serum. It has been reported that heparin increses the background noise intereference relative to serum. Do you think it would be worthwhile to investigate the use of r-hirudin for testing where hepatitis reduces sensitivity relative to serum? BD, Greiner Terumo, and Kendall-Tyco ignore this apparently promising universal anticoagulant for use in their blood sampling tubes. As a pioneer in use of plasma and troponin, What is your opinion on the value of further investigation on the use of this interesting anticoagulant?
Pittsburgh, PA

Jack H. Ladenson, Ph.D.
We continue to use plasma rather than serum for common chemistry tests. The biggest reason is potassium which averages about 0.2 mmol/L higher in serum but can be a lot higher depending on platelet count, white count, etc. (Amer J Clin Path (1974); 62:545-552). The problems with using heparinized plasma routinely on modern equipment are minor. On occasion, particularly in refrigerated heparinized plasma, we can see some material come out of solution necessitating recentrifugation. I dont know if hirudin improves the situation, nor do I know its expense relative to heparin.

What advice would you give a clinical pathologist in a developing country with regard to pursuit of a PhD degree?
NAIROBI, KENYA

Jack H. Ladenson, Ph.D.
Regardless of your country, the first issue is probably why you want to get a Ph.D. In a practical sense, a Ph.D. for someone who already has an M.D. and advanced resident training is not usually professionally necessary, although the training is always valuable. The practical part of what field, where to apply, etc., can be difficult. Your educational background is difficult for U.S. schools to evaluate and visas from some countries can be difficult. I would look at Europe and Australia, as well as the U.S. if you decide to pursue it.

what do you seeas the major changes for the cellular pathology in the next 10 years?
birmingham, uk

Jack H. Ladenson, Ph.D.
It is very hard to predict the evolution of a field over ten years. Cellular pathology includes a number of areas, most of which are under active investigation as regards gene and protein changes associated with the diagnosis or prognosis of an array of conditions. This research activity definitely suggests expansion of clinical testing in the future.

What color is your favorite tie?
Smallbany,NY

Jack H. Ladenson, Ph.D.
The one I'm not wearing.

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