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Limas Kupcinskas is a Professor of Medicine at Kaunas University of Medicine, Lithuania, where he also studied Medicine. He trained in Gastroenterology under Dr Jonas Simanauskas, at Kaunas University Hospital, Dr Richard Mountford, at the Bristol Royal Infirmary England, and Dr Ali Keshaverdzan, at Loyola University, Chicago, USA.
His field of the research interest is in the investigation of disorders associated with Helicobacter pylori infection, such as peptic ulcer disease, functional dyspepsia, and gastric cancer, as well as inflammatory bowel disease. A team of researchers (gastroenterologists, paediatricians, pathologists, microbiologists) headed by Professor Kupcinskas, are currently investigating the prevalence, genetic charateristics, and virulence factors of H. pylori infection in Lithuania. They are also researching new methods of diagnosis, treatment, and prevention of H. pylori-associated diseases.
Limas Kupcinskas is Vice President of the Lithuanian Association of Gastroenterologists, and chairman of the Lithuanian Crohn's and Colitis organization.
Together with collaborators, he has prepared international academic Phare-Tempus projects, financed by the European Commission. These included: The Reform of Continuing Medical Education in Lithuania (1995-1998); The Reform of Gastroenterologists Training in Lithuania (1997-2000); and The Reform of Medical Studies in Lithuania in accordance with the EU Directives (1998-2000).
He is also been involved in Leonardo da Vinci projects: "The practical training of young physicians in hospitals of European countries (2000-2001)", "The training of young gastroenterologists in hospitals of European countries (2001-2002)", and "Training of medical school graduates according to EU directives and needs of Lithuanian medical labor market (2003-2004)". Acknowledgement of these projects has enabled him to create a modern Gastroenterology Training Centre at the Kaunas University Hospital. Here, specialists are trained in practical skills in accordance with the requirements of the European Gastroenterologists Diploma.
He is married to Eugenia Kupcinskiene, a Professor of Botany and Plant Ecology. They have 2 sons.
- What made you decide to become a gastroenterologist?
- After my postgraduate training, I started my career as an internist with an interest in cardiology. This specialty was very prestigious in the former Soviet Union, because the ruling gerontocracy of the Soviet Communist party were very much afraid of sudden cardiac death and devoted the main State health-care resources to the development of this specialty. Other internal medicine specialities - for example, gastroenterology - were underdeveloped. Gastrointestinal endoscopy was in the hands of surgeons - gastroenterologists did not perform endoscopic procedures. After the independence of Lithuania, I changed my speciality and moved to gastroenterology, where I saw the greatest possibilities for future activity and reforms.
- Who was the teacher you admired the most?
- I would like to mention two figures. Dr Richard Mountford, from the Bristol Royal Infirmary, was the first and the number one teacher in clinical gastroenterology. It was wonderful to see his practical work with patients and his precise endoscopies. As the Head of the Department, I had the luck to learn administrative and management skills from Professor Vilius Grabauskas, Chancellor of Kaunas University of Medicine. He was a prominent specialist in preventive medicine who had worked for eight years as Head of the Department at WHO, in Geneva. For me he was the model of a Western democratic style of administrator.
- Which research paper influenced you the most?
- The original paper by B J Marshall and R Warren on "Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration" (Lancet 1984; 1: 1311-14). I only got to read this in 1988 (because of the poor availability of Western medical and scientific literature in the countries behind the iron curtain) when I was an internist. It stimulated my growing interest in the relationship between H.pylori infection and gastroduodenal pathology.
- What is the most important fact that you have discovered?
- In the difficult economic conditions in Lithuania during the transition to a market economy, the most important fact was the discovery of the possibility of obtaining resources for the development and reforming of Lithuanian gastroenterology and medical education.
One way was by preparing international projects and programs, and by winning competitions for finance from different European Commission funds (our team has won more than 800,000 Euros for the Kaunas University of Medicine by preparation of EU Phare-Tempus and Leonardo projects). Of course, the most important scientific fact discovered by our international H. pylori research group was that tetracycline resistance in H. pylori results from an accumulation of changes that may affect tetracycline-ribosome affinity and/or other functions (perhaps porins or efflux pumps). We suggest that the rarity of tetracycline resistance among clinical H.pylori isolates reflects this need for multiple mutations and perhaps also the deleterious effects of such mutations on fitness. (Dailidiene D, Bertoli MT, Miciuleviciene J, Mukhopadhyay AK, Dailide G, Pascasio MA, Kupcinskas L, Berg DE. "Emergence of tetracycline resistance in Helicobacter pylori: multiple mutational changes in 16S ribosomal DNA and other genetic loci". Antimicrob Agents Chemother 2002; 46(12): 3940-6).
- What is the biggest mistake that you have made?
- In 1972-1974 my cardiologist colleagues performed a famous international prospective Kaunas-Rotterdam Intervention Study on a cohort of 4000 male 45-59 year-olds in Kaunas, on ischemic heart disease epidemiology. The causes of death of the participants of the study are still being registered. In 1992, when I moved to gastroenterology, I suggested that the blood sera collected at the beginning of the study should be tested for detection of antibodies against H. pylori. Our work could have been among the first well-designed prospective studies (a 20-year duration follow-up!) on the relationship (1) between H.pylori and gastric cancer, and (2) between H. pylori and ischemic heart disease as well. Unfortunately, the sera were stored only until 1991. My mistake was that I had made the suggestion one year too late.
- What is your unfulfilled ambition?
- Although to young to achieve the recognition of the Department of Gastroenterology at Kaunas University Hospital as a European Gastroenterologist Training Centre by the European Board of Gastroenterology. I hope to obtain the accreditation in the near future.
- What is your greatest regret?
- Not to have learned much more immunology and gastrointestinal pathology.
- How do you relax?
- Traveling, and reading newspaper articles on world politics and history.
- What is your favorite sport?
- Windsurfing on Lithuanian lakes, starting from 1976.
- What is your best place in the world?
- As a participant in different medical congresses and meetings, I have visited many beautiful countries in the world, but the most pleasant place for me is Lithuania, with a lot of very nice lakes, where I like to spend holidays with my family.
- What is your favorite film?
- "Orchestra" by Federico Fellini. Watching the film in my young days I understood, on the one hand, that great efforts are indispensable in creating a team to achieve a valuable goal. On the other hand, I understood that the sequel to an authoritarian leadership may be difficult to forecast.
- What car do you drive?
- A Toyota Carina.
- What is your best electronic 'toy'?
- I like computer card games, they sometimes allow me to relax.
- What book are you reading at the moment?
- Several at once, including the "The Future of Gastroenterology-Hepatology is Bright", edited by G N J Tytgat, and "Europe. A History", by Norman Davies
- Why did you get in involved in GastroHep.com?
- The future approach to continuing and life-long medical education has to be Internet-based. I want to participate in this.