Julián Podoba was an internationally recognized representative
of the Slovak scientific community. He was the founder of the Institute
of Endocrinology in Bratislava and of the Slovak Endocrine Society
at a time when Slovakia was still part of Czechoslovakia. He was
a member of the Executive Committee of the European Thyroid Association
between 1968 to 1972.
Julián Podoba was born in 1916 in a small rural village in
western Slovakia. His father was a farmer. He had been the mayor
of his village for 20 years and a member of the Czechoslovak Parliament
in Prague during the first Czechoslovak Republic. From 1934 to 1940,
Julián Podoba studied medicine at the Medical School of Comenius
University in Bratislava. In 1943, he joined the team of Prof. Ladislav
Dérer, the founder of modern internal medicine in Slovakia.
He had to resign from the University Hospital as a result of his
disagreement over the alliance of the Slovak State with the Nazi
Germany. He then became Head of the Department of Internal Medicine
at the Hospital of the Workers Social Security Alliance in Bratislava.
After World War II, Prof. Dérer
regained his responsibilities as Head of the Department of Internal
Medicine at Comenius University Medical School in Bratislava.
He advised Podoba a study sojourn at the 3rd Clinic of Internal
Medicine with Prof. Pelnar and later, with Prof. Josef Charvát
of Charles University in Prague where he acquired a large amount
of experience in endocrinology (1945-48). Prof. Charvát
was considered as a founder of modern endocrinology in the renewed
Czechoslovakia. After these years passed with Josef Charvát
and also with Prof. Karel Šilink, Head of the Institute of
Endocrinology in Prague, Julián Podoba became permanently
involved with endocrinology and above all, with thyroid diseases
and iodine deficiency disorders (IDD). He first joined the team
of Prof. Šilink and started field studies on endemic goiter
in the Czech lands(1). On the basis of this experience, he then
organized the same field program in Slovakia during the years
1949-1953.
It is worth remembering these years after
World War II. The development of modern endocrinology in Czechoslovakia
had started in the period of forced obedience of the country to
the Soviets, as other countries of Central and Eastern Europe.
From 1948 to 1989, the iron curtain was separating the Eastern
countries from Western Europe. During that period, all private
or independent medical activities were forbidden. All the State
affairs including the healthcare services were put under the strict
control of a government firmly dominated by the Communist Party.
Postal and telephone contacts with the western world were under
surveillance and any personal relationship with western people
were heavily curtailed and mostly reserved for the members of
the Communist party. Julián Podoba was not a member of
the communist party and to some extent, was also suffering from
the fact that one of his brothers, a political prisoner, had succeeded
to escape to Canada in 1948.
During these difficult years, the attendance
to foreign congresses and the acceptance of invitations to visit
or to stay abroad in scientific centers were strictly limited.
As a consequence of this situation, the intellectual exchanges
and the transfer of medical and technical expertise became almost
impossible. The resources remained very limited and the lack of
foreign currencies prevented the import of modern technologies
(equipment, specific chemicals, etc). A continuous aggravation
of the medical and scientific gap between the Eastern and Western
Countries was unavoidable. Such a situation did not prevent the
efforts of the czechoslovakian scientific community to keep going
on with research. One example has been endemic goiter present
in the country. Podoba investigated the etiological factors responsible
for the disease, particularly iodine deficiency and systematically
organized adequate campaigns in order to eradicate the disease.
The support of the state public health organizations undoubtedly
reinforced his action.
Around the 1950s, Šilink and coworkers
examined 215,019 individuals in 156 districts of Bohemia and Moravia(2)
while in Slovakia Podoba and his team examined 157,865 subjects
of all age groups(3) . In several slovak regions, the
prevalence of goitre in women reached 80% and that of endemic
neurological cretinism 3%. A severe degree of iodine deficiency
was confirmed in the majority of the regions. The urinary iodine
excretion averaged 25–50 mcg/24 hrs and in the most severely
affected areas an ioduria below 25 mcg/day was observed. The survey
had some original features: (a) 5% of the population was examined,
(b) the survey covered uniformly all the country, (c) ioduria
was measured in a statiscally representative part of the population
and (d) the role of naturally occurring goitrogens was investigated.
Podoba also investigated the role of genetic factors in the development
of endemic goiter(4). Using perchlorate and phenylthiocarbamide
tests and analyzing the consanguinity in sibships, the importance
of genetic factors was also demonstrated (5).
The prophylaxis of IDD with iodinated
salt was introduced in Slovakia in 1951 (7 mg KI/kg). Since 1965,
the salt contains 25 mg KI/kg (15 – 35 mg/kg) and since
1990s, iodate progressively replaced iodide in the salt. As a
result, the iodine intake increased 3-4-times and endemic goitre
and cretinism disappeared. The legalization of iodine prophylaxis
in 1965 allowed to develop an example of what preventive medicine
can achieve. Several local and international studies have later
confirmed the sufficiency of the iodine intake as confirmed by
the European Thyromobil campaign carried out in 1994-95 under
the auspices of WHO.
With his team, Julián Podoba also
investigated the role of environmental goitrogens, particularly
of the Brassica plants. With one of his young coworkers
Pavel Langer, he extended these investigations and pointed out
the role of enhanced thiocyanates levels in the blood(6),
as later confirmed in Africa.
The preliminary promising data of IDD surveys in Slovakia resulted
in the foundation of the Institute of Endocrinogy in 1951 by the
Ministry of Health. Julián Podoba became its first director.
The research team of the Institute completed the field surveys
on IDD as initiated in 1949 and kept the responsibility of supervising
the iodine prophylaxis program until 1969. In 1954, the Institute
of Endocrinology was incorporated in the newly founded Slovak
Academy of Sciences (SAV). In 1967, It was renamed as Institute
of Experimental Endocrinology (IEE) and was several times appraised
as the best institution among all the other scientific institutes
of the Slovak Academy of Sciences. The Institute of Experimental
Endocrinology became a center of excellence for the studies performed
on the negative effects of the environmental factors as the stress
conditions and the nutritional status on the thyroid function.
The experience of the Institute was acknowledged in 2000 by the
European Commission.
It is very impressive to see that while
facing difficult working conditions, Julián Podoba was
able to develop epidemiologic studies on IDD in Slovakia and to
successfully plan a large program of iodine prophylaxis in Slovakia,
even if all the political and economical problems were against
him.
From the start, Julián Podoba had
been the drive of the Institute of Endocrinology. He resigned
from his responsbilities in 1969. He then served as Head of the
Endemic Goitre Laboratory until his retirement in 1987.
Modestly but perseveringly, Julián
Podoba worked to help his country meet all the problems related
to the difficult living conditions during and after World War
II and during the Communist regime. One of his cconcerns was the
education and training of young scientists. He managed to send
to international research centers including the USA, many of his
students and young colleagues who later reached important positions
in national and international scientific organizations or universities
as Knopp, Langer, Lichardus, Macho, Štrbák, Vigaš
and others. He launched an international journal "Endocrinologia
experimentalis" which enabled many scientists from the
eastern countries to publish their results. He was the author
of several monographies and wrote many chapters in textbooks dealing
with internal medicine and endocrinology. He directed more than
100 publications in national and international journals, mainly
related to IDD and its prophylaxis.
This extensive work brought to Julián
Podoba the acknowledgement of his work not only in Czechoslovakia
but also abroad, at many international symposia and conferences.
He became associated professor at Comenius University in 1968.
He was also President of the Slovak Endocrine society (1967 -
1975) and Vice-president of the Czechoslovakia Society of Endocrinology.
He was elected as a member of the European Thyroid Association
(ETA) Executive Committee (1968 - 1972) and hosted in Prague the
8th meeting of the ETA in 1974 with the Czechoslosvak Medical
Society J.E. Purkyne, the Czechoslovak Society of Endocrinology
and other colleagues
The life-long work of Julián Podoba
was esteemed with the highest state and scientific prizes, as
the czechoslovakian state medal "For merit of building"
(1964), the Golden medal of Jan Evangelista Purkyne (1966), the
Golden medal of the Slovak medical society (1976), the Golden
medal of the Slovak Academy of Sciences (1983) and the Cross of
the President of the Slovak Republic (2003).
The wife of Julián Podoba was
a medical doctor, specialist in internal medicine. She spent all
her professional life in the Department of Internal Medicine of
the Comenius University Medical School. They have 2 sons. The
eldest is a medical doctor continuing his father’s work
as Head of the Department of Clinical Endocrinology at the St
Elisabeth Cancer Institute in Bratislava while the youngest is
an ethnographer at the Institute of Ethnography of the Slovak
Academy of Sciences.
Christian Beckers(1), Jan Podoba(2)
and Branislav Lichardus(3)
(1) University of Louvain Medical School, Belgium
(2) St. Elisabeth Cancer Hospital,Bratislava, Slovakia
(3) Institute of Experimental Endocrinology, Bratislava,
Slovakia
