Published on January 13, 2006

A Thai doctor could be about to make medical history with his production of an invaluable resource for medical students around the world, unfortunately the rights will probably be sold overseas

A Thai medical specialist is claiming a world first in a very unusual and high-tech field, creating what international colleagues have already labelled a work of art: the world’s largest histology atlas.

Histology is a branch of biology concerned with the microscopic structure of tissues. It is therefore a subject vital to the education of future medical personnel. That is why Dr Wichai Ekataksin has spent as long as six months stitching together just one huge picture of tissue taken from a clitoris.

Taken with a 12-megapixel digital camera connected to a microscope, the actual size of the picture of the clitoris tissue, in gigabytes, is about 100 square metres. But it will be adjusted downwards to create just one page of the atlas of human tissue, illustrating its microscopic subject in the finest of detail.

To capture such detail, Wichai used no zoom lenses or digital image magnification. Instead, the assistant dean for educational and information technology at Mahidol University’s Faculty of Tropical Medicine began with a tiny microscope slide containing a dyed specimen of clitoris tissue. Through a microscope, he took about 3,000 shots of the specimen in a non-stop effort that lasted about six hours. Then he spent months weaving all the shots together manually to create one complete and hugely-detailed picture of clitoris tissue. Finally, to maintain all the details, sharpness and clarity, the picture was resized to about one metre by one metre, or big enough to use in teaching human histology to groups of medical students.

Wichai said he mulled over the technique for seven years before being able to prove it was feasible. The chance came when he put it to the test with a giant inkjet printer at a printing technology road show. After a bit of trial and error using his own money, he sought and received a research grant of about Bt14 million from the Science and Technology Ministries “reversing brain-drain” project, to develop the giant histology atlas.

There was no initial intention to set new world records with the atlas. Its main purpose was to present pictures of human tissue with sufficient detail and clarity to be used in training medical students.

Atlas a Bible to medical students

In the same way as a mechanic has to know and understand all the parts of an engine as well as how to repair it, doctors need to know about human histology – or the study of cells and tissues at a microscopic level – to understand diseases and how to deal with them.

Normally, each medical student is required to study about 300 microscope slides of cells and tissue from about a hundred different organs and parts of the human body to understand the detailed structure of anatomy. Any atlas of histology is therefore like a student’s bible. It resolves the total inadequacy of textbook learning and the practical impossibility of getting all the students in one class to examine the details of just one microscopic specimen.

Medical schools outside the cities also use projectors or TV screens to show students magnified images of histology slides, methods that Wichai regards as useless because they lose the all-important detail students must understand.

Gruelling tasks

Imagine you are making a map of Khao Yai [National Park], and you’ve got to take thousands of photographs of the entire area from a bird’s-eye view, say, from a helicopter, said Wichai. Then you have to reconstruct the map out of all those shots. It’s like making a huge jigsaw puzzle.

As the job requires a great deal of uninterrupted time, Wichai usually takes his pictures at night. While taking the thousands of shots required to make up one complete image, he doesn’t rest for a moment. To do so would risk problems of distortion.

He starts by mentally dividing the histology slide into about 200 rows. Then he takes as many as 100 shots of each row. The job requires intense concentration and any small interruption during the photography could leave him in trouble.

The computer connected to the camera and the microscope requires more than one terabyte, or one million million bytes, of memory to store the huge number of high-resolution pictures. Printouts are stored in about three rooms, centred on a giant table with a sliding drawer.

So far, Wichai’s efforts have produced about 50 histology pictures, including tissue samples from a liver, an eight-week old embryo, a testicle, a spinal cord and, of course, the clitoris. The goal is to produce a collection of at least 300 pictures of about 100 organs, the usual study requirement for medical students.

World’s largest?

Wichai claims that, when finished, his atlas will be the largest in the world. He is sure of his claim because he is not only familiar with the histology atlas that is currently the world’s biggest, but he also took part in its production. This atlas was produced by his master while Wichai was studying medicine in Japan.

Wichai now has a collection of about 130 tissue samples from human organs. All were taken in Japan, where he gained a PhD degree in medicine. Making histology slides is one of Wichai’s areas of special expertise and he regards his set of slides as a treasure.

Although far from completed, Wichai has had offers to buy the atlas. At an exhibition in Boston, an Italian professor asked to buy it, exclaiming: “This is not science, its art!”

Another professor from France, hearing the offer, told Wichai: “This is not for an Italian. It’s the heritage of all humanity, so it should be put in a museum.”

Going along with the joke, Wichai asked the French professor how much he would bid for the atlas. Without hesitation, he replied: “One million euros.”

“Make it two million,” Wichai urged, but the Frenchman backed off.

Wichai laughs about the incident, recalling it later. “We didn’t want to sell it at the time. That’s why I dared to demand two million,” he said.

However, realising that Wichai was not going to sell him the atlas, the Italian professor offered to lay down a 20-euro deposit. When he returned to Bangkok, Wichai printed a set of pictures in a smaller size and sent them to the Italian professor as a gift.

When it is finished, Wichai’s histology atlas will be sent to medical publishers, perhaps in Japan, Germany or the United States, for commercial reproduction. Much as Wichai doesn’t want this piece of Thai intellectual property sold to foreigners, he accepts that Thailand cannot afford to publish and sell the atlas without overseas input.

“We have skills in Thailand and we have the original version of the atlas, but we have neither marketing expertise nor a distributor,” he said.

For its part, the Science and Technology Ministry is considering opening the Bangkok Planetarium to exhibit Wichai’s atlas of histology to the public when it is completed.

Arthit Khwankhom

The Nation

Post your comment to this story here