福島県立医科大学医学部整形外科

International Collaboration Beyond the Culture Gap Pages 1 2 3 4 5 6
	The logo mark of ISSLS was designed by Dr. Pheasant of California a year or so after the first meeting, and first seen on the program of the 3rd meeting in Bermuda. This logo symbolizes international collaboration in the world of spine.
	ISSLS has awarded fellowships to promote international collaboration from the very beginning. The Macnab/Larocca Fellowship is for researchers who want to study in foreign countries to promote their research activity. It was known as the ISSLS Research Fellowship at first and the name was changed in 1994. The International Fellowship was established to support researchers in developing countries. ISSLS has contributed importantly to the promotion and extension of research activities crossing interdisciplinary and national borders.
	I will review international collaboration in the presentations at our annual meetings.　　The number of international collaboration research projects started to increase in the 1970's and then greatly increased in the 1990's up to some 20%.
	This tendency is seen in the Volvo Award more strongly. Nearly one-third of the recipient research projects have been performed through international collaboration. And this tendency can be seen among Nobel Prize winners in the field of physiology and medicine. Great scientists influence one another beyond national borders and create greater achievements.
	Now I will talk about my case. I am a typical Japanese. My study room at home is a traditional Japanese room and I sit on tatami in Japanese kimono. On the other hand, my working place is completely Western style.
	My first experience to cross the national border was brought by one great mentor. I was deeply impressed by the papers of Dr. Macnab when I worked as a resident in Japan. For the clinical facts everybody knew and accepted as natural without any doubt, he wondered, " why?" He clarified these facts with basic research and clinical examination. And he applied this knowledge to clinical work. Attracted by him, I visited him at Wellesley Hospital in Toronto in 1977. I had no connection with him nor any offer of fellowship, and I spoke very little English. He allowed me to stay as a visiting fellow and kindly taught me the way of scientific research and clinical work.
	Dr.Macnab published the paper in JBJS on the cause of failed back clarified with nerve root infiltration. When I asked him for a chance to do basic research, he challenged me to clarify why nerve root infiltration showed a tuberal form. The right figure is his note written at that discussion. He had a hypothesis that there should be some structure to keep contrast material located around the nerve root in a tubular fashion.
	Anatomical study demonstrated the presence of fibrous covering called the epiradicular sheath. Dr.Macnab's hypothesis was proved by this study and reported in some papers. In 1993, about ten years later, Dr. Wiltse reported at the ISSLS meeting that this structure played an important role for formation of hematoma or extension of tumor. The clinical significance of the epiradicular sheath and epidural membrane was emphasized again from another point of view. This fact indicates that scientific research develops crossing time and interdisciplinary and national borders.
	I first participated in ISSLS in 1978 when I stayed in Canada as a clinical research fellow. It was the 5th meeting in San Francisco. At that meeting I met many famous spine researchers and I thought I could improve myself through participation in this society.
	In 1982 I first presented a paper at the 9th meeting in Toronto with my boss, Dr. Hasue who was the local host at the 16th meeting and the president at the 18th meeting. After that, I presented a few papers of anatomical and clinical studies. Since I became a professor and chairman of Orthopaedic Department, Fukushima Medical University, we have started multidisciplinary collaboration research and presented at many meetings.
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International Collaboration Beyond the Culture Gap