Croatian Society of Radiology (1928–2008), the Croatian Medical Association – 80 years of existence and activity

Often and in various connotations one can hear or read the following syntagma: “Let’s leave the past in the past - and turn to the future”. Even more frequent and numerous are opposite opinions, e.g. “There is no future without past”, “Future is built on past” or “Remembering our past – reaching for our future”, and many more.


The first practical use of X-rays in medicine
In the very same year (1895) as Francis Joseph I, the Austro-Hungarian emperor, ceremonially opened a new building of the Croatian National Theatre in Zagreb, Wilhelm Konrad Röntgen, a German physicist (Lennep 1845-Munich 1923, in his experimental laboratory in Würzburg discovered the radiation until then unknown, which he called X-rays. As a proof then, he also published the first roentgenogram -an image of his wife's hand with a ring on the middle finger. He was awarded the first Nobel Prize in physics (1901) for this extraordinary discovery, and the newly discovered rays were named the Roentgen rays in his honour. The discovery gave origin to a new profession (science) radiology (roentgenology), which enabled a fresh impetus in the development not only of medicine, but of many other human activities.
The first practical use of X-rays in medicine in this region was recorded in Rijeka (1897), when a roentgen apparatus was acquired, Prof. Dr. Peter Salcher presented at the Naval Academy an X-ray of a hand with a ring on the baroness Vranyczány's finger. Thereafter followed Ogulin, Šibenik and Srijemska Mitrovica (1898), Zagreb (1901), Osijek (1902 and Lepoglava (1904) -let us remember that the Paulists of Lepoglava, in rivalry with the Jesuits, started providing university education (1656) with lectures in logic. The roentgen apparatuses were then obtained in Pula, Split, Dubrovnik, Bjelovar (1905), and Varaždin, Karlovac, Vinkovci and Nova Gradiška (1911), and Sisak (1912. We may also mention that the roentgen radiation was for the first time used for the research in palaeontology by Prof. Dragutin Gorjanović-Kramberger (1902), a Croatian natural scientist of world-renowned, a geologist, palaeontologist and anthropologist, for taking X-ray of the Krapina early man's jaw. 1

Organizations in Croatia
Organised medical work in Croatia started with the establishment of the Društvo slavonskih liječnika (Slavonian Medical Association) in Osijek (1874), that started publishing the Glas slavonskih liječnika (Slavonian Medical Journal) (1877) -the today's "Medicinski vjesnik" (Medical Journal), published by the University Hospital Osijek, the Faculty of Medicine in Osijek, and other regional medical centres. A few months later, in the same year (1874), the Sabor liečnika kraljevine Hrvatske i Slavonije As the aggression on Croatia started (1991), the Medical Association of Croatia freezed (on 26 th February 1991), and subsequently broke off all the relations (on 30 th September 1991) with the Union of Medical Associations of Yugoslavia. We were also obligated to do so by the UN Security Council Resolution no. 757/1992, stating that "....any activity in the area of science, technology, information sciences, education, culture and sports, even publishing activity, with the SFRY /Socialist Federative Republic of Yugoslavia/ shall be suspended...". In that period, and observing the then-valid and customary schedule of rotating the seats of the leadership of a particular professional association during a 4-year mandate, Zagreb was the seat of the Yugoslav Society of Cardiology, the Yugoslav Association of Pulmonology and Phthisiology, the Association of Yugoslav Clinical Cytology, the Yugoslav Association of Anaesthesiologists, the Yugoslav Association of Dermatology, and the Yugoslav Society of Radiology and Nuclear Medicine. All the presidents, vice-presidents and secretaries of these associations resigned their duties, and on behalf of their respective associations renounced any further cooperation. The Section of radiology of the Medical Association of Croatia, in accordance with this, broke off (on 4 th October 1991) the cooperation with the Yugoslav Society of Radiology and Nuclear Medicine, and returned the mandate for presiding the Society for the period 1988 -1992, and renounced to the obligation of organising the 14 th Congress of the Yugoslav Society of Radiology and Nuclear Medicine planned for 1992, informing about it all the professional associations of the then Yugoslav republics and provinces.
Following the disintegration of the Socialist Federative Republic of Yugoslavia, and the founding of the Republic of Croatia, with its international recognition, the conditions were met for the direct membership of Croatian professional associations in international professional institutions, so that the Croatian Medical Association also became a full member of the World Medical Association (1992), i.e. the Croatian Medical Association.
Although the radiology profession and science in this region was being applied soon after the respective discovery (Rijeka 1897), the roentgenologists / radiologists were formally organised only in 1928, through the foundation of the Society of Roentgenology (1928)(1929)(1930)(1931)(1932)(1933)(1934)(1935), which changed the name into the Section of Radiology, Electrophysiology and Balneology (1935)(1936)(1937)(1938)(1939)(1940)(1941)(1942)(1943)(1944)(1945). After the Second World War, the Society was reorganised again and the name changed to the Section of Radiology and Nuclear Medicine , having radiologists, radiotherapeutists, oncologists and nuclear medicine practitioners as members. The development of nuclear medicine and the growing number of educated nuclear medicine practitioners lead to the separation of these experts into two independent sections, so that ours changed the name into the Section of Radiology of the Medical Association of Croatia (1984 -1992).
As the Croatian Medical Association became a member of the World Medical Association, all the Sections were entitled to a higher level of membership, i.e. to receive the title of a society, so that on this basis the present-day Hrvatsko društvo radiology (HDR) -The Croatian Society of Radiology (CSR) was founded and named at the Founding Assembly held on 22 nd April 1992, in the Great Hall of the Croatian Medical Association, being the successor of all the already mentioned Associations of Radiology in Croatia.
Immediately after its foundation, the CSR obtained right to apply for an independent direct membership in international institutions. Firstly, all the required documentation for the membership in the European Association of Radiology -EAR was collected and submitted (a written application and an explanation in English, an English version of the Statute of the Croatian Medical Association and the Rules of Procedure of the Society, and the list of the Society's members). The application was examined in the General Assembly of the European Association of Radiology at the time of the European Congress of Radiology, in Vienna 1993. The application was granted unanimously, and the CSR became a regular and full member of the EAR.
An application for the membership of the International Society of Radiology -ISR followed. In accordance with the same procedure, the application waited for the General Assembly and the International Congress of Radiology to be held -in Singapore 1994, when the CSR became a member of this society as well.

Professional activities
The Croatian radiologists have always had a significant impact on the organization and participation in various radiology events in the then  Yugoslavia (1992) was supposed to be held in organisation of the Croatian radiologists, but due to the known war situation, Croatia renounced the task.
In the period from 1978 to 1992, and owing to Prof. Dr. Sc. Duško Katunarić and Prim Dr. Krešo Pavleković, the president and the secretary respectively of the then Section of Radiology, the Section organised Scientifics Meetings of Radiologists of Croatia in various towns in Croatia, followed an alternating "continent -seaside" territorial principle. Even though in those times the meetings were of mere republic-importance, they had wide reverberation across the entire then Yugoslavia, both among the participants and the lecturers, so those meetings were considered to be at the "level" of a congress. There were ten meetings held in total: in Šibenik (1978) (Figure 1), Plitvička jezera (1979), Split (1981), Osijek (1982, Pula (1985), Karlovac (1986), Opatija (1987, Požega (1989), Zadar (1990) and Varaždin (1992). The total of 776 lectures were held at the meetings (752 national authors and 24 foreign authors -5 from Germany, 5 from Switzerland, 2 from Italy, 2 from Norway, 2 from the USA, 1 from France, 1 from Belgium, 1 from Sweden), and 102 lectures at three Courses (on Radiology of Kidney, on Radiology of Mediastinum, and on CT in Neuroradiology).
With the development of radiology and an increasing number of specialists in radiology, as well as their professional and scientific orientation, the conditions were met, as per the Statute of the Croatian Medical Association and the Rules of Procedure of the Croatian Society of Radiology, for the establishment of particular sections. Firstly, the Section of Neuroradiology (1933) was foundedthe first president was Prof. Dr. Sc Nada Bešenski. Then followed the establishment of the Junior Radiologists Forum (1994) -encouraged by the Junior Radiologist Forum (JRF) of the European Association of Radiology -the first president was Dr. Franka Jelavić -Kojić. The third to be established was the Section of Ultrasound in Medicine (1994) -the first president was Prof. Dr. Sc. Ivo Drinković. Then the Section of Interventional Radiology (2000) -the first president was Prof. Dr. Sc. Josip Mašković, and the Section of Thoracic Radiology (2001) -the first president was Prof. Dr. Sc. Zlata Herceg -Ivanovi.
On several occasions the Section / the Society took part in specialised programmes of the international fair "Medicine and Technology" at the Zagreb Fair. The Symposium on Interventional Radiology The emergence of therapeutic procedures in interventional radiology and our first experiences were presented at the CSR expert meeting: the Round Table on Interventional Radiology (1980) -chaired by S. Šimunić, also published in a book: "Okrugli stol o intervencijskoj radiologiji. Šimunić S, Gürtl R, editors, 1981". The CSR has had an intensive, long-term cooperation with members of other professions and institutions. It has endeavoured to approach and solve a number of common problems with the related Radiation Protection Association. It used to cooperate, at the time, with radiologists of the Department of Roentgenology and Physical Therapy of the Faculty of Veterinary Medicine in Zagreb (Prof. Dr. Sc. Mensur Šehić). With the Ministry of Health and Social Welfare of the Republic of Croatia and the Croatian Institute for Health Insurance, the CSR discussed various professional, status and organisational issues on the regular basis. Expert meetings are well-attended and held regularly (9-10 times per year), in cooperation with other clinical professions (internal medicine specialists, paediatricians, neurosurgeons, urologists, orthopaedists, otorhinolaryngologists, etc.) Various business partners, manufacturers and suppliers of equipment, accessories and expandable supplies presented to us regular basis novelties in their assortment of products: Siemens, General Electric, Philips, Shimadzu, Bayer Health Care, Schering, Farma, Sonimed, Thomy Frey East, Mark/De Plano, Medtronic, OptiMed, Bard, Abbot, Bracco, Cook and many others.
A long-term professional, loyal and friendly cooperation with the Hungarian Radiological Society ("Societatis Radiologorum Hungarorum") was particularly emphasized, dating back since 1985, when the Vereinbarung über die Ungarischen und Jugoslawischen Radiologischen Gesellschaften was signed (signatories: Gy Vargha and B. Fornet -Budapest; M. Radojević -Skopje; S. Šimunić -Zagreb and L. Popović -Novi Sad. At the same year, during the International Fair "Medicine and Technology", at the Zagreb Fair, within the frame-work of professional events at the Symposium on Percutaneous Organ and Organic Systems Drainage, the lectures were given by Gy Vargha and T. Baranyai (Debrecen), L. Horváth (Péch) and Lélek (Zalaegerszeg). The cooperation was continued through regular joint Croatian-Hungarian Radiological Symposiums: Kőszeg (1999) and Opatija (2000), after which Slovenia also joined this cooperation, so the symposia were thereafter held under the name Hungarian-Croatian-Slovenian Radiological Symposia: Pécs (2001), Maribor (2002), Koprivnica (2003), Héviz (2004), Maribor (2005). It was at that point decided that the symposia were to be held biannually from then: Vukovar (2007) and Kehidakustanyi (2009). The participants of the meeting in Vukovar visited and paid respects by placing wreaths at the Stone Cross, on the confluence of Vuka and Danube, and at the Memorial Cemetery of the Homeland War victims on Ovčara. 2 The CSR gave an appreciation award to the Hungarian Radiological Society for the close longterm cooperation, and the same award was also given to the following individuals: Gy Vargha, G. Vadon, J. Kénez, B. Fornet, and L. Hórvath at the congress in Tihany, in 1996. N. Bešenski was awarded a certificate -Honorary Member of the Hungarian Society of Neuroradiology (7th Annual Meeting of the Hungarian Society of Neuroradiology -Györ 1997).
It has become customary to participate in one another's national, i.e. Croatian and Hungarian, radiology congresses: in Miskolc 1994, Opatija 1994Tihany 1996, Osijek 19983 , Pécs 1998, Split 2002., but also in the Hungarian Society of Neuroradiology congresses.
The cooperation with the Združenje radiologov Slovenije (the Slovenian Association of Radiology) went back long ago. There used to be held (1958)(1959)(1960)(1961)(1962)(1963)(1964)(1965)(1966)(1967)(1968)(1969)(1970)(1971)    The CSR and its members were entrusted the organisation of the "Workshop -New Application of CT and MRI" -Elscint, Zagreb, 1996; "Visiting Junior Radiologists to Eastern Europe", Zagreb, 1995, 1997; a "Crash Course in CT", on the occasion of the acquisition of a large number of CT devices by the Ministry of Health of the Republic of Croatia, and the Croatian Institute for Health Insurance.
It is worth remembering, recording and saving from oblivion the works on radiology, from the old days, but also from the most recent times, written by radiology experts and teachers. Among them, the book of Hodges et al was the first comprehensive teaching material and great help to students in acquiring necessary knowledge, in addition to lectures, seminars and exercises for the Radiology course (Table 1).
In addition to the publications listed in Table 1, the CSR members radiologists published countless number of articles and chapters in journals, encyclopaedias, and books, both in Croatia and around the world, those being not only in the field of radiology but also in other professions:  (1914-1979) -in 1987. A Celebration of the 65 th Anniversary of the Croatian Society of Radiology (1928-1993) was held, with art programme and a performance by the Physicians Singers of Zagreb choir, and a historical overview in presence of numerous members of the CSR and the invitees. On that occasion, the first logo of the CSR was also presented, designed by Krešimir Ivanček, academic painter -graphic artist, Studio Color Soft, of Bjelovar, and after our ideas and efforts made by Prim. Dr. Luka Ježek,  [4];1990), 10 of them (37%) were from Croatia.
A joint journal has been published since 1992 -Radiology and Oncology, a journal devoted to the publication of original contributions in diagnostic and interventional radiology, CT, US, MR, nuclear medicine, radiotherapy, clinical and experimental oncology, radiobiology, radiophysics and radiation protection. The founders and publishers are the Slovenian Association of Radiology, the Slovenian Nuclear Medicine Society, the Slovenian Society for Radiotherapy and Oncology and the Slovenian Cancer Society, and the Croatian Medical Association / Croatian Society of Radiology. The associated societies are also the Societas Radiologorum Hungarorum and the Friuli-Venezia Giulia regional group of La Società italiana per la radiologia medica (SIRM). The first editor-in-chief for many years was Tomaž Benulič (now editor-in-chief-emeritus). He was succeeded by Gregor Serša. Out of the 38 Editorial Board members (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)

Current activities and congresses
Regular monthly expert meetings (8-10 times per year) are held as a rule in the Great Hall of the Croatian Medical Association, in Šubićeva Street in Zagreb. These meetings used to be held occasionally also in institutions out of Zagreb: in Bjelovar, Sisak, Karlovac, Varaždin, Krapinske toplice and even in Osijek, Split and Pula.
Since the independence of Croatia and the founding of the Croatian Society of Radiology, five Elective Assemblies were held: 1992, 1996, 2000, 2004 and 2008. Thus, the conditions were met (64 years from its foundation and continuous activities, and 95 years from the first practical application of X-rays in Croatia) for holding national radiology congresses.
The First Congress of the Croatian Society of Radiology with International Participation was held in Opatija, from 11 th -15 th October 1994, in the Adriatic Hotel. On behalf of the European Association of Radiology, the Congress was greeted by the then president, Lodovico dalla Palma (Trieste), and other invitees and guests. Out of the total of 155 lectures and 14 workshops, there were sixteen lectures (10%) and seven workshops (50%) from abroad. Beside the Croatian and foreign expert lectures, part of the lectures was dedicated also to historic topics on the development of radiology in the region: Šimunić S. (part of Croatia); Ježek L. (Bjelovar), Kačić P. (Dubrovnik) and Lovasić I. (Rijeka). There was a book also published on that occasion: "Dijagnostička i intervencijska radiologija (Diagnostic and interventional radiology). Lovasić I, Dujmović M, Budiselić B, Riman S, editors. 13 The Second Congress of the Croatian Society of Radiology with International Participation was held in Osijek, from 23 rd -25 th April 1998, in the Croatian Army Hall. 3 Out of the total of 150 lectures and 38 posters, there were 20 lectures (13%) and 13 posters (34%) from abroad. On the same occasion a book by Frković M was presented: "Radiološki atlas probavnog sustava djece (A radiological atlas of the children digestive track)", and also a satellite mini-symposium was held: "Nonionic Radiological Diagnostic Contrast Medium -OPTIRAY (Ioversol)", by the company Byk-Gulden, Konstanz, Germany. In addition to the expert topics, the Congress also discussed historic issues related to radiology in the re-gion: Glavina K, Vugrinec M, Dlouhy B, Sontacchi B. The second section of lectures was dedicated to current organisational developments in radiology and radiation protection legislation (Hebrang A, Grgić S, Kubelka D, Vekić B). The proceedings were also published, including lectures and summaries. The

Key note lectures
The topics of expert meetings and other events in radiology were various and the intention was to follow all the new events. It is evident from the archive material that various techniques were discussed as early as in 1964: lympho-gamma-scintigraphy (Spaventi Š, Bosnar M); lymphography technique with oil contrast medium (Temer B, Beronić I), roentgen cinematography (Katunarić D), on the principles of logetron work (Katunarić D.), on rotation and pendulum roentgen therapy (Bašić M), and a Report on the 1 st Symposium on Radiology Protection (Petrovčić F), held in Portorož, was submitted.
A number of interesting radiology cases from daily practice (Hočušćak I) were discussed at the meeting held in the Varaždin General Hospital in 1965, and a lecture was given with reference to the World Congress of Radiology in Rome (Katunarić D).
More than 40 years ago (1967) the application of ultrasound in diagnosis had been discussed (Ašperger Z).
A lecture on "Lumbar myelography without anaesthesia using Mallinckrodt contrast media Conray 60" was held on an expert meeting in Pula (1969).
On the occasion of a visit paid by the colleagues from Ljubljana, two reports were submitted from the 12 th International Congress of Radiology -Tokyo 1969, Tabor L from Ljubljana and Gvozdanović V from Zagreb.
In a whole-evening expert programme on "bronchitis", the topic was discussed by pulmonologists and radiologists from the aspect of the clinical picture, the problems of public health service, the role of functional analysis of breathing and roentgen diagnostics -1970).
In a review of the 2 nd Diagnostic Course of the International Society of Lymphology (Davos 1971), Mihajlović N, Šimunić S, and Agbaba M talked about the organisation of the course, the lymphogram analysis, new nomenclature and new views in lymphography diagnostics.

Cooperations
In working and cooperating with many companies, manufacturers and suppliers of the necessary working material, there are occasionally held joined meetings aimed at providing information on new products, technologies and methods. A round table on enteroclysis was held (1992): "The small barium enema (enteroclysis) with barium and methylcellulose" and "Die Technik der radiologischen Dündarmdiagnostik -Enteroclysis", with companies Nicholas GmbH Sulzbach and Aspro-Nicholas Vienna, with the participation of lecturers: Antes G (Sulzbach) and Holacky (Vienna), and the radiologists: Mandić A, Dolenčić P, Frković M, Kapetanović D and Tonković V, and the internal medicine specialists: Papa B, Vucelić B and Bilić A of Zagreb.
Another round table was held (1992) on "Ultrasound in algorithm of diagnostic and interventional procedures in renal disease". Introductory lectures were held by Odak D: "Ultrasound diagnostics in inflammatory and obstructive renal diseases"; Drinković I: "Ultrasound diagnostics of expansive renal processes and intervention ultrasound"; and Brkljačić B: "Possibilities of application of Doppler and colour-Doppler in renal diseases". Sabljar-Matovinović M, Mrklić B, Agbaba M, Hebrang A, Marotti M and Kunštek N participated in the discussion.
The CSR occasionally cooperates with the Slovenian colleagues -radiologists. Pavčnik D (1993), of the Institute of Diagnostic and Interventional Radiology, the University Clinical Center Ljubljana, filled the whole-evening programme with lectures on intravascular stents, microcatheters, subselective angiographies, transcatether embolizations and fibrinolysis and vena cava filters.
An ever-topical issue of the protection of patients and personnel from ionizing radiation was covered in two whole-evening programmes (1993)   The CSR contributed also to the celebration on the occasion of the 150 th anniversary of the Bjelovar General Hospital and Radiology Activities (1995), when the lectures were, beside the hosts (Ježek L and assoc.), held by Marotti M and assoc; and Papa J and assoc.
The CSR and the Radiological Diagnostics Department of the Karlovac General Hospital organised a joint expert meeting (1995), with the programme prepared by the hosts, which covered the historic development of radiology in Karlovac (Pavan G); algorithm of radiological examinations in abdominal tumour diagnostics (Pavan G and assoc.); ten years of the ultrasound application in Karlovac (Popović A and assoc.); the value of ultrasound in diagnostics of choledocholithiasis (Baškot A and assoc.).
Along with one of the expert programmes (1995), an occasional Christmas meeting was held, with a lecture on the comparison between CT and DSA in evaluating the degree of the extension of bronchial carcinoma (Marušić P and assoc.), and an occasional Christmas address was given by Msgr. Matija Stepinec, the parish priest of St. Peter's Parish in Zagreb; it was followed by a "Little Christmas Concert" (Snježana Arbanas, soprano, medical student ABD, accompanied by piano played by Hlavomirka Bledšnajder, BAMus).
In one of the meetings (1996), the Ministry of Health informed the CSR's members about the condition of the radiological equipment in the Republic of Croatia, in comparison with other countries (Hebrang A); about the ionizing radiation legislation in force in relation to world standards (Grgić S and assoc.), and about the results of the checks performed on medical sources of radiation (Tonković V).
The cooperation with colleagues radiologistsveterinary surgeons has already been pointed, but let us mention also that the CSR (1966) took part in the celebration on the occasion of the 65 th anniversary of the foundation and work of the Department of Roentgenology and Physical Therapy of the Faculty of Veterinary Medicine in Zagreb, when an overview of the historical development of the Department, and scientific and professional cooperation with human medicine were presented (Šehić M).
The CSR and the Croatian Radiation Protection Association (1966) held a joint meeting, with two particularly attractive, interesting and unusual lectures: "Control without destruction in industry" (Krstelj V, Dean of the Faculty of Mechanical Engineering and Naval Architecture in Zagreb), and "Non-destructive methods in research and protection of works of art" (Braun M, Director of the Institute for the Conservation of Objects of Art, Zagreb).
This overview of the 80 years of work is a mere attempt to remember, burdened with the present, the "good old times" and save from oblivion at least one part of our rich radiological heritage. We are well aware of many shortcomings this overview may have, being the result of unpreserved documentation from early stages, but also due to the "holes" in the memory of the past not so long ago.