Bulletin
No. 114 (January 2019)
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APSR News

Happy New Year
from the Bulletin's new editor
and chair of the Education Committee

First of all, I'd like to thank you very much for your vitally important support for our Society and your great cooperation with the Education Committee. In addition, I send my sincere thanks to Dr David C L Lam, my predecessor as chair of the Committee, for his great job editing the APSR Bulletin for many years. Through his great cooperation, I succeeded his position right after the APSR 2018 annual congress in Taipei.

As you are aware, we're in an era when the world has been changing very rapidly in such a short time. The amount of information has increased exponentially over in the last decade, where changes on the other side of the world can be observed here instantly. Medical advances are no exception. Academic information arrives, though the actual medical practice is highly dependent on the domestic economic situation.

The role of the Education Committee is to cooperate with APSR members, en bloc member societies and multiple Assemblies, and distribute accurate information to the right place. Currently, as information spreads beyond national borders, we want to share information beyond our medical area while correcting the differences in values.

Needless to say, I'll strive to improve the respiratory pathology and medical practice of the Asia-Pacific region. From this point of view, I believe the APSR Bulletin is one of the most important publications to share such valuable information with you.

Finally, on behalf of the Committee, I wish you all a wonderful holiday season and happy and productive 2019. I really look forward to work closely with you, and welcome any news from you.

Enjoy your New Year holiday!

Arata Azuma
Chairperson, APSR Education Committee

This is our world

Here's the start of an interactive map which we hope will eventually provide a useful resource of data for your research.

apsresp.org/education/asia-pacific-health/map.html

This beta test version needs more data and we'd welcome details of any source of reliable data for adding to the map.

Please send ideas, suggestions, and data sources to APSRinfo@theapsr.org.

These are your assemblies

The APSR assemblies today are very different from when they were first formed.

They have evolved in both size and function, and it's time to re-assess whether we need more assemblies, or merge some that overlap, to provide better patient care.

Click the signboard to tell us what you think.

Message from an assembly head




Watch this 36-second video clip
of Dr Nobuhiro Tanabe,
Head of the Pulmonary Circulation Assembly

Assembly Newsletter

This new initiative is due to launched over the next couple of months.

Please contact your Assembly Head with any items or topics of interest relating to your assembly,

Congress news

Resounding success!

2018 Congress banner

As expected, the Taiwan Society of Pulmonary and Critical Care Medicine, ensured the Congress in Taipei was a tremendous success with delegates from over 40 countries across the Asia-Pacific region and beyond.

The president of APSR2018, Dr Chong-Jen Yu, and the president of TSPCCM, Dr Meng-Chih Lin, reported:

Thank you for not only attending the meetings, but also the social events. Each day, we saw you attending scientific programmes, asking questions, interacting with speaker/chairs, visiting exhibition booths, and connecting to each other. we believe the APSR 2018 has successfully fulfilled its duty to serve as an educational and networking platform for all respiratory specialists in the Asia-Pacific region. We're also confident that you must have enjoyed the beauty of Taipei, the delicious food, as well as safe and comfortable atmosphere when strolling in the city.

On behalf of the Local Congress Committee, I would like to express sincerest gratefulness to you. Thank you again and looking forward to an eternal linkage between you and Taiwan PCCM doctors.


(click photo to enlarge)

Dr Irene Rosellen P Tan, RMT, MD, from the Philippine General Hospital, was the official Congress Correspondent and regularly tweeted and uploaded messages into social media, posting "blow-by-blow updates of the events".

Perhaps unexpectedly, she was able to meet some of the most prominent respirologists from around the world and is shown on the right with the APSR President, Dr Fong. Her report indicates she thoroughly enjoyed the congress and meeting so many interesting people

Hundreds of other photos were taken at the congress and they will appear on the APSR website soon

Thank you for coming, for getting involved, and for sending feedback of how much you enjoyed the Taipei Congress. Thank you especially for the valuable comments on how we can improve things for future congresses.

2019 Congress banner

The next congress will be 14-17 November 2019 in Hanoi, Vietnam; a popular and exotic location for you to broaden your expertise, share research with your peers, and find valuable new contacts from the thousands of other delegates.

The congress website should be online soon, and meanwhile, updates will be posted on the APSR website

2020 Congress banner

After Hanoi the 26th Congress on 15-18 October 2020 will be in Kyoto, Japan, a city chosen for its popularity at the previous congress there in 2006, and on a date when you can enjoy the spectacular autumn colours at that time of year.

2021 Congress banner

And then the 27th Congress on 18-21 November 2021 in Seoul, Republic of Korea, for which the organisers are already considering ideas for the scientific programme.

Great things ahead!

Leadership changes


Dr Matsunaga

Dr Eng

Dr Philip Eng has now completed his two-year term as chair of the Central Congress Committee, a most challenging role tackled most successfully. He has worked tirelessly to ensure the 2017 congress in Sydney and the 2018 congress in Taipei were conducted at the highest-possible standard. Liaising with those two Local Congress Committees, the two congress organising companies and venues in different countries, 16 APSR assemblies, the other major global respiratory societies, major global industry sponsors, and of course the hundreds of speakers and thousands of congress delegates, it is truly amazing that the congresses ran so smoothly!

He has now passed the role to the committee's chair-elect Dr Kazuto Matsunaga who, like Dr Eng, has been actively involved in running the APSR for many years. We are confident that you will thoroughly enjoy and benefit from the congresses ahead.


Dr Azuma

Dr Lam

Dr David Lam has now handed over his position as chair of the Education Committee to the chair-elect, Dr Arata Azuma.

Dr Lam has been on the Education Committee for ten years; the past eight being the committee's chair. During that time, he has increased the membership of the committee and created a strong team. In addition to managing educational projects (most often single-handedly), he has been Editor-in-Chief of Respiratory Updates for the past eight years, and coordinator of this monthly Bulletin, making sure that every issue over the past ten years has been produced and distributed on time. He provided valuable advice in the creation of the Teaching Library and other projects, but has not restricted himself to these in-house activities. For example, he has given advice and support for many workshops such as the 27 ESAPS that have taken place all over the Asia-Pacific region. All this, in addition to is regular work as a practicing physician, researcher, consultant and other important responsibilities.

Dr Azuma is fortunate that the Committee and its activities he inherits are so well established, but he will still need and appreciate your support to continue the work.



Dr Lam (6th from the left) receives his certificate of appreciation from APSR President Dr Kwun Fong
(Click image to enlarge)


Dr Eng (7th from the right) receives his certificate of appreciation from APSR President Dr Kwun Fong
(Click image to enlarge)

Our Members, Our Future

We are delighted to launch this new series with a tribute to the late Ann Janet Woolcock, prepared by Dr Sandra Anderson who delivered the Woolcock Memorial Lecture at the APSR 2018 Congress in Taipei.

This series complements our APSR Members' Honour Roll, on which as a member, you are welcome to add your appreciation of your mentor(s) at any time.

Recollections of the early research by Ann J Woolcock MD FRACP

I was introduced to Ann in Sydney in 1970 when I was briefly home on a visit. I was living in London at the time studying exercise-induced asthma in the Department of Paediatrics at the Brompton Hospital. Later Ann visited me at the Brompton and we spoke about her early research in lung volumes in asthmatics during an exacerbation. Her findings had influenced me to make the same measurements before and after exercise had provoked an acute attack of asthma.

Ann had received her Bachelor of Medicine degree from the University of Adelaide but the research for her MD degree was carried out at the University of Sydney and the Royal Prince Alfred Hospital (RPAH) with Professor John Read in the Department of Medicine in the mid 1960's. Ann had the opportunity to measure, by helium dilution, the lung volumes of patients hospitalised for asthma. She reported, for the first time, that the obstruction observed in the asthmatics was associated with marked lung hyperinflation with increases in total lung & functional residual capacities. She repeated the lung volume measurements over a number of days and reported resolution of the hyperinflation, after treatment but in the absence of changes in spirometry in some patients. (Woolcock AJ & Read J Lancet 1965;2:(7426):1323-5, & J Am J Med 1966;41(2):259-73). She also showed that this hyperinflation was associated with a loss of lung elastic recoil, another new finding. (Woolcock AJ & Read J Am Rev Respir Dis 1968;98(5)788-94).

After she had finished her MD she travelled to Montreal to work with Dr Peter Macklem at McGill University. She performed some important studies in animals, the end-result of which gave insight into the frequency dependence of compliance. (Woolcock AJ et al J Clin Invest 1969,48(6):1097-106).

In 1977 she wrote an important article on inhaled drugs in the preventions of asthma (Woolcock AJ Am Rev Respir Dis 1977;115(2):191-4). From her studies in New Guinea Ann had become interested in epidemiology particularly in the frequency of asthma in the community. I joined her study on the prevalence of bronchial hyperresponsiveness (BHR) in the Busselton cohort in 1981. This involved the inhalation of histamine in increasing doses from a hand-held nebuliser until the FEV1 had fallen by 20%. This rapid method was very suitable to use for epidemiological studies and had been developed in Ann's lab in Sydney (Yan K, Salome C Woolcock AJ Thorax 1983;38(10):760-5) This method allowed a small group of us to investigate 916 subjects in just 14 days. (Woolcock AJ et al Thorax 1987; 42(5):361-8.)

An important contribution of Ann's was her identification of a plateau in the airway response of normal subjects to increasing doses of bronchoconstricting agents. The last study that we were both involved in was the inhibitory effect of inhaled cortico-steroid therapy treatment on the response to both to inhaled histamine and inhaled mannitol (Leuppi JD et al Am J Res Crit Care Med 2001;163:406-12).

Ann's contribution to respiratory medicine over 35 years was quite extraordinary – but then she was quite an extraordinary lady.

Prepared by Sandra D Anderson AM, PhD, DSc, MD (Hon)
  • Principal Hospital Scientist Department of Respiratory and Sleep Medicine,
    Royal Prince Alfred Hospital, Camperdown NSW
    1979-2009
  • Part time 2010-2014 Clinical Professor
    Sydney Medical School, University of Sydney NSW Australia
    2006-present

Young Investigator Award opportunities

Here's your last chance to apply for two prestigious travel awards:

  1. APSR Travel Award to the ATS International Conference in Dallas, TX, USA, 17–22 May 2019

    See apsresp.org/awards/2019/apsr-yi-to-ats.html for details.

  2. At the same conference is a joint one-day session with APSR and ISRD (International Society for Respiratory Diseases), to which all APSR members are cordially invited to attend.

    Travel awards are available for Young Investigator speakers at this session and details are at /awards/2019/apsr-yi-to-isrd.html.

For those requiring a visa for the US, please note that processing can take a long time, depending on nationality and location. Contact your nearest US Embassy for details.

Details of several other 2019 awards can be seen at apsresp.org/awards/index.html

APSR Secretariat office, New Year break

As with the rest of Japan, the office in Tokyo was open as usual over the Christmas period, closed for New Year and will reopen on Monday 7 January.

The staff at the APSR Secretariat office wish you a very happy, healthy and peaceful 2019!

Respiratory Updates

The December issue (Vol 10.12) features Tobacco/Smoking Cessation:

  • A pragmatic trial of e-cigarettes, incentives, and drugs for smoking cessation.
  • Smoking cessation, weight change, type 2 diabetes, and mortality.
  • Cardiovascular and neuropsychiatric events after varenicline use for smoking cessation.
  • The effects of smoking on treatment outcome in patients newly diagnosed with pulmonary tuberculosis.
  • Perception and current use of e-cigarettes among youth in China.
  • Income disparities in smoking cessation and the diffusion of smoke-free homes among U.S. smokers: Results from two longitudinal surveys.
  • Support for a point-of-sale cigarette display ban among smokers: findings from the international tobacco control (ITC) Netherlands survey.
  • Tobacco Dependence Predicts Higher Lung Cancer and Mortality Rates and Lower Rates of Smoking
  • Acute effects of electronic and tobacco cigarettes on vascular and respiratory function in healthy volunteers: a cross-over study.
  • Global economic cost of smoking-attributable diseases.
  • Analysis of Article 6 (tax and price measures to reduce the demand for tobacco products) of the WHO's Framework Convention on Tobacco Control.

Inside Respirology

Respirology Vol. 24 Issue 1

EDITORIALS
1Triaging treatable traits in asthma
Christina Baggott MBChB Richard Beasley MBChB, DSc
10.1111/resp.13406
5What triggers acute exacerbations of COPD? Why not ask the patient!
Stephen Milne M.B. Don D. Sin M.D.
10.1111/resp.13384
7Towards a refined definition of combined pulmonary fibrosis and emphysema
Jeffrey J Swigris DO, MS
10.1111/resp.13426
9Predicting response to bronchial thermoplasty in patients with severe uncontrolled asthma: An elusive goal
Chase S Hall MD Mario Castro MD, MPH
10.1111/resp.13424
11Clinical utility of pulmonary function and blood biomarker measurements
Ross Vlahos PhD
10.1111/resp.13430
COMMENTARIES
13Targeting reactive oxygen species for respiratory infection: Fact or fancy?
Stavros Selemidis PhD
10.1111/resp.13417
15Remarkable progress in cystic fibrosis – But why?
Catherine Rang BA(Hons), MB BChir, MA, MRCP; John Wilson AM, BSc(Hons), PhD, MBBS, FRACP
10.1111/resp.13440
INVITED REVIEW SERIES
Molecular Techniques for Respiratory Diseases
17The contribution of respiratory microbiome analysis to a treatable traits model of care
Steven L Taylor Hannah E O'Farrell Jodie L Simpson Ian A Yang Geraint B Rogers
10.1111/resp.13411
19Transcriptomics and single-cell RNA-sequencing
Daniel C Chambers Alan M Carew Samuel W Lukowski Joseph E Powell
10.1111/resp.13412
ORIGINAL ARTICLES
Asthma and Allergy
29
Treatable traits can be identified in a severe asthma registry and predict future exacerbations
Vanessa M McDonald, Sarah A Hiles, Krystelle Godbout, Erin S Harvey, Guy B Marks, Mark Hew, Matthew Peters, Philip G Bardin, Paul N Reynolds, John W Upham, Melissa Baraket, Zaheerodin Bhikoo, Jeffrey Bowden, Ben Brockway, Li Ping Chung, Belinda Cochrane, Gloria Foxley, Jeffrey Garrett, Lata Jayaram, Christine Jenkins, Constance Katelaris, Gregory Katsoulotos, Mariko S Koh, Vicky Kritikos, Marina Lambert, David Langton, Alexis Lara Rivero, Peter G Middleton, Aldoph Nanguzgambo, Naghmeh Radhakrishna, Helen Reddel, Janet Rimmer, Anne Marie Southcott, Michael Sutherland, Francis Thien, Peter A B Wark, Ian A Yang, Elaine Yap, Peter G Gibson
10.1111/resp.13389

We assessed the prevalence of treatable traits in severe asthma compared with non-severe asthma, and assessed the relationship between treatable traits and future exacerbation risk. We demonstrate the usefulness of the treatable traits approach in severe asthma and which specific treatable traits are predictive of future asthma attacks.

COPD
37Towards an assessment of perceived COPD exacerbation triggers: Initial development and validation of a questionnaire
Chelsey A Werchan, Ashton M Steele, Thomas Janssens, Mark W Millard, Thomas Ritz
10.1111/resp.13368

The present study sought to develop a psychometrically valid measure of perceived triggers of exacerbations in chronic obstructive pulmonary disease (COPD) patients, the COPD Exacerbation Trigger Inventory (CETI). Patients' trigger classes and their controllability are associated with clinical outcomes and their assessment may prove useful in research and clinical settings with COPD patients, aiding exacerbation prevention and disease management.

Interstitial Lung Disease
48
Effects of emphysema on physiological and prognostic characteristics of lung function in idiopathic pulmonary fibrosis
Hee-Young Yoon, Tae Hoon Kim, Joon Beom Seo, Sang Min Lee, Soyeoun Lim, Han Na Lee, Namkug Kim, Minkyu Han, Dong Soon Kim, Jin Woo Song
10.1111/resp.13387

Patients with idiopathic pulmonary fibrosis (IPF) and emphysema exceeding 10% had more preserved lung volume and lower rates of decline in forced vital capacity (FVC) than those with no or trivial emphysema. Diffusing capacity of the lung for carbon monoxide (DLCO) was the most significant prognostic factor in these patients.

Interventional Pulmonology
55Bronchodilator responsiveness as a predictor of success for bronchial thermoplasty
David Langton, Alvin Ing, David Fielding, Wei Wang, Virginia Plummer, Francis Thien
10.1111/resp.13375

This study, in patients with severe asthma, compares the outcomes from bronchial thermoplasty (BT) in patients with fixed airflow obstruction, with patients with bronchodilator reversibility. The study concludes that both groups of patients benefit equally well from this therapy and that bronchodilator reversibility need not be a selection criterion for BT.

Lung Function
63Decline in lung function is associated with elevated lipoprotein (a) in individuals without clinically apparent disease: A cross-sectional study
Jonghoo Lee, Hye Kyeong Park, Min-Jung Kwon, Jae-Uk Song
10.1111/resp.13370

Reduced lung function and high Lp(a) levels are risk factors for cardiovascular disease (CVD). High Lp(a) levels were associated with reduced lung function in this large study. Thus, Lp(a) may be the link between increased CVD risk and reduced lung function.

Pleural Disease
68Risk factors for pleural effusion recurrence in patients with malignancy
Horiana B Grosu, Sofia Molina, Roberto Casal, Juhee Song, Liang Li, Javier Diaz-Mendoza, Chakravarthy Reddy, Lonny Yarmus, Dante Schiavo, Michael Simoff, Jared Johnstun, Abu-Awwad Raid, David Feller-Kopman, Hans Lee, Sarina Sahetya, Finbar Foley, Fabien Maldonado, Xin Tian, Laila Noor, Russell Miller, Lakshmi Mudambi, Timothy Saettele, Macarena Vial-Rodriguez, Gerogie A Eapen, David E Ost
10.1111/resp.13362

Factors such as larger pleural effusion size, amount of pleural fluid drained, LDH and pleural fluid cytology were found to be risk factors for pleural fluid recurrence. Knowing what risk factors are associated with recurrence of pleural effusion would allow physicians to identify patients who are more likely to recur.

LETTER FROM ASIA-PACIFIC REGION
76Letter from Vietnam
Giap Van Vu MD, PhD
10.1111/resp.13403
CORRIGENDUM
83This article corrects doi.org/10.1111/resp.12486

Inside Respirology Case Reports

The following cases have been selected for inclusion in the January 2019 Respirology Case Reports, Volume 07 Issue 1, and the February 2019 Respirology Case Reports, Volume 07 Issue 2

Volume 07 Issue 1

Case Series

The significance of non-occupational asbestos exposure in women with mesothelioma
Nonhlanhla Tlotleng, Kerry Sidwell Wilson Nisha, Naicker, Coenraad F N Koegelenberg, David Rees, James Ian Phillips
DOI: 10.1002/rcr2.386

In this report we highlight three cases of mesothelioma in women with diverse environmental exposures.

Evaluation of expiratory capacity with severe asthma following bronchial thermoplasty
Satoru Ishii, Motoyasu Iikura, Yukiko Shimoda, Shinyu Izumi, Masayuki Hojo, Haruhito Sugiyama
DOI: 10.1002/rcr2.387

Bronchial thermoplasty (BT) is a bronchoscopic treatment for severe asthma using thermal energy to reduce the amount of smooth muscle in the bronchial wall. In the present study, expiratory computed tomography (CT) imaging was performed before and after BT, and changes in expiratory lung capacity were measured. Use of CT for evaluation of expiratory volume may be a method for assessing the effectiveness of BT.

Case Reports

Transbronchial lung cryobiopsy: a novel confirmatory tool to diagnose asbestos-related pulmonary fibrosis
Marta Zajaczkowska, Anthony Johnson, Luis Gallur, Joo Shin, Christopher Henderson, Jonathan Williamson
DOI: 10.1002/rcr2.380

Transbronchial cryobiopsy appears to be an effective way of obtaining parenchymal lung samples of sufficient size to diagnose asbestosis when clinical uncertainty exists.

Pleuritis with pleural effusion due to a Bacillus megaterium infection
Ernesto Crisafulli, Ilaria Aredano, Ilaria Valzano, Barbara Burgazzi, Francesco Andrani, Alfredo Chetta
DOI: 10.1002/rcr2.381

We report a case of a hospitalized male for a pleuritis with pleural effusion caused by a Bacillus megaterium infection, a Gram-positive, aerobic, spore forming and rod-shaped bacterium. To our knowledge, our case report is the first evidence of pleuritis due to B. megaterium. In the literature, up to now B. megaterium infection has only been reported to involve eye, skin and brain.

Aorto-pleural fistula successfully treated by one-lung ventilation and Endobronchial Watanabe Spigots
Takunori Hozumi, Koichiro Kajiura, Kei Nakamura, Haruki Taniguchi, Takao Goto, Michitaka Nasu
DOI: 10.1002/rcr2.382

Aorto-pleural fistula (APF) is a rare, potentially fatal condition that should be immediately treated by an endovascular or surgical approach. In this case, we treated APF by bronchial occlusion with Endobronchial Watanabe Spigots (EWS) after controlling massive bleeding by one-lung ventilation.

Gastric perforation related to concurrent use of nintedanib and ramucirumab
Saeko Takahashi, Saori Murata, Yudai Yoshino, Yosuke Kobayashi, Morio Nakamura
DOI: 10.1002/rcr2.383

We report the first case of 70-year-old man taking nintedanib for his progressive idiopathic pulmonary fibrosis (IPF) and treated with ramucirumab plus docetaxel as a seventh line therapy for his pulmonary adenocarcinoma. On day15 of chemotherapy treatment cycle2, after taking nintedanib for nine days, he developed gastric perforation.

Diffuse pulmonary lymphangiomatosis treated with bevacizumab
Ernest Onyeforo, Adrian Barnett, Debbie Zagami, David Deller, Iain Feather
DOI: 10.1002/rcr2.384

Diffuse pulmonary lymphangiomatosis (DPL) is a rare disease caused by uncontrolled lymphatic vessel proliferation resulting in respiratory dysfunction. We believe this is the first case of DPL to report lung function improvement (forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and DLCO) following bevacizumab therapy.

Effectiveness of benralizumab for allergic and eosinophilic predominant asthma following negative initial results with omalizumab
Daisuke Minami, Hiroe Kayatani, Ken Sato, Keiichi Fujiwara, Takuo Shibayama
DOI: 10.1002/rcr2.388

We present a patient with both allergic and eosinophilic predominant asthma whose asthma symptom control and sinusitis were improved by benralizumab following negative initial results with omalizumab.

Clinical Image

Autoimmune pulmonary alveolar proteinosis presenting peripheral ground-glass opacities
Keishi Sugino, Masahiro Ando, Kiyoshi Mori, Eiyasu Tsuboi
DOI: 10.1002/rcr2.385

Autoimmune pulmonary alveolar proteinosis should be considered in the differential diagnosis of peripheral ground glass opacities.

Volume 07 Issue 2

Case Series

Management of malignant carinal involvement using 'side-by-side' method of bilateral self-expandable metallic stents
Takayuki Takeda, Hideki Itano, Ryo Wakasa, Masahiko Saitoh, Sorou Takeda
DOI: 10.1002/rcr2.396

Central airway obstruction (CAO) is critical and life-threatening for cancer patients and is categorized as an oncological emergency that requires urgent intervention. Malignant carinal involvement is considered one of the most difficult situations among CAO, which is usually treated by rigid bronchoscopic intervention under general anaesthesia. The application of 'side-by-side' method of bilateral self-expandable metallic stents has been reported in the management of malignant carinal involvement. This technique is useful in the treatment of patients of poor performance status who would not tolerate general anaesthesia. We retrospectively analysed six patients who were treated by this method in terms of effectiveness, tolerance, and safety of the procedure.

Case Reports

Coexistent sarcoidosis and lymphangioleiomyomatosis in a patient with cystic lung disease
Sarah Cullivan, Peter De La Harpe Golden, Deirdre Doyle, Kishore Kumar Doddakula, Louise Burke, Desmond Michael Murphy
DOI: 10.1002/rcr2.389

This is an interesting case of coexistent lymphangioleiomyomatosis and pulmonary sarcoidosis in a 45-year-old lady with cystic lung disease. This case highlights important clinical, radiological, and physiological features of both conditions and suggests a potential shared disease mechanism.

Pleural anthracosis presenting with massive effusion: a rare entity
Rayhan Amiseno, Andrea Yu-Lin Ban, Noraidah Masir, Lizawati Rasul Hamidi, Mohamed Faisal Abdul Hamid
DOI: 10.1002/rcr2.390

This article is about a patient with recurrent admissions for symptomatic pleural effusion. Diffuse hyperpigmentation in both parietal and visceral pleural was visualised, and biopsy demonstrated granuloma with foreign body giant cell (anthracosis). This case highlights the unusual presentation of pleural anthracosis with pleural effusion.

Porous diaphragm syndrome with recurrent thymoma
Takayo Ota, Yoshikazu Hasegawa, Takafumi Okabe, Akira Okimura, Masahiro Fukuoka
DOI: 10.1002/rcr2.391

Porous diaphragm syndrome is a defect in the diaphragm in which substances pass from the peritoneal to the pleural cavity. Increasing intra-abdominal pressure by ascites and diaphragmatic thinning due to malnutrition by malignancies resulted in the formation of an artificial hole.

A case of Aspergillus and Nocardia infections after bronchial thermoplasty
Sachi Matsubayashi, Motoyasu Iikura, Takanori Numata, Shinyu Izumi, Haruhito Sugiyama
DOI: 10.1002/rcr2.392

Bronchial thermoplasty (BT) is a bronchoscopic procedure that uses thermal energy to reduce airway smooth muscle mass for treating uncontrolled severe asthma. Bronchial oedema and radiologic changes are generally known as the major complications of BT, but infections have rarely been reported. We describe a case of fungal and bacterial infections that developed after BT.

A 17-year-old woman with a solitary, mixed squamous cell and glandular papilloma of the bronchus
Takeshi Saraya, Masachika Fujiwara, Hirokazu Kimura, Hidefumi Takei, Hajime Takizawa

Solitary endobronchial papillomas are extremely rare, accounting for only 0.38% of all lung tumours and approximately 7% of all benign epithelial and mesenchymal lung tumours. Here, we present an unexpected case of mixed papilloma in the youngest known patient to date who suffered from chest pain and bloody sputum.

A symptomatic anterior mediastinal mass with a simultaneous Haemophilus influenzae infection
Hui Zen Hee, Chun-Ku Chen, Yi-Chen Yeh, Chien-Sheng Huang
DOI: 10.1002/rcr2.394

We describe a rare case of unanticipatedly delayed complete resection of a symptomatic teratoma with simultaneous Hemophilus influenza infection, followed by extended rupture into the pleural, lung and bronchus. The clinical presentation, microbiology and radiology features leads to an impression of lung abscess until it was proved otherwise pathologically.

Lung spindle cell carcinoma harbouring a constitutively active epidermal growth factor receptor mutation
Hiroaki Ikushima, Toshio Sakatani, Yoshio Masuda, Teppei Morikawa, Kazuhiro Usui
DOI: 10.1002/rcr2.395

Lung spindle cell carcinoma is a rare lung tumour with a poor prognosis, and its standard therapy has not been established. Furthermore, little work has been performed on the genetic characteristics of lung spindle cell carcinomas. Here, we report the first case of lung spindle cell carcinoma with an epidermal growth factor receptor mutation. The patient received gefitinib as first-line therapy.

Regional society news

The spotlight this month is on

AUSTRALIA and NEW ZEALAND

Each month we share details of activities of a particular country, region or society.

If you would like the spotlight to be on your country, region or society next month, contact the Bulletin Coordinator or APSR Secretariat.

Thoracic Society of Australia & New Zealand (TSANZ)

Summary of activities in 2018 (to 31 October 2018)

Members & Branch Events

Members:    • 1,601

Branch events:

• 44

Attendees at branch events:

• 1,796

Special Interest Groups (SIGs):

• 18

Activities

Clinical documents:    • 7 in development and 1 published so far

Research projects
in development:

• Severe Asthma Registry transition to quality clinical registry
• Cystic Fibrosis Clinical Trials Network

Advocacy:

• Over 15 submissions made so far

Awards:

• $996 000 to be dispersed at TSANZRS18
• $1,027,500 total administered funding in 2018
• 15:17 female to male diversity in recipients

Education:

• 3 courses with over 200 attendees
• 1 Ongoing competency programme
• 3 Post Graduate Workshops
• 4 Webinars held in 2018 so far

Laboratory
accreditation:

• 43 Accredited laboratories
• 71 Laboratory volunteer assessors

Other notable society events and news:

Australia

Asian Pacific Congress for Bronchology (APCB) 2019

Venue:Gold Coast, Australia
Dates:28–30 March 2019
Detailswww.apcb2019.com

The Asian Pacific Congress on Bronchology and Interventional Pulmonology (APCB 2019) will take place at the Gold Coast Exhibition and Convention Centre, Australia, 28–30 March 2019, preceding the TSANZSRS Annual Scientific Meeting (30 March – 2 April).

It will attract a distinguished audience comprised of researchers and clinicians in the field of bronchology and interventional pulmonology. The theme is "Case Based Training – Practice and Theory" and it will have a novel design with a hands-on focus; workshops will provide the core part of the Congress.

APCB 2019 promises to offer an exceptional learning opportunity. Case-based learning will take centre stage and local and international faculty have developed a range of interesting and informative cases across 9 key topics. As part of your registration package you will get to choose 4 half-day courses, which will include theory as well as plenty of time to gain hands-on practice in key procedural points relevant to the particular topic.

REGISTER NOW

For more information, or to sign up to receive updates, please go to www.apcb2019.com

We look forward to seeing you on the Gold Coast!

2019 Local Organising Committee
David Fielding
Congress President
Asia Pacific Congress of Bronchology 2019

Japan

Japanese Respiratory Society

The 59th Annual Meeting of the Japanese Respiratory Society will be held on 12-14 April 2019 at the Tokyo International Forum.

The Meeting's president will be Prof. Koichiro Tatsumi (Department of Respirology, Chiba University)

Details: www.jrs.or.jp/english/?content_id=27

Vietnam

Vietnam Respiratory Society

Respiratory experts in Vietnam are organising an educational symposium: "Cardiopulmonary diagnostics and pediatric pulmonary function testing", endorsed by the APSR as part of the APSR's ESAP programme. It will run on 11–12 January 2019 at the University of Medicine and Pharmacy at Ho Chi Minh City, 17 Hong Bang Street, District 5, Ho Chi Minh City, Vietnam

After this workshop, participants should:

  1. Understand indications and test performance of cardiopulmonary exercise testing.
  2. Understand parameters of cardiopulmonary exercise testing.
  3. Interpret results of cardiopulmonary exercise testing in adults and children.
  4. Apply the exercise tests for management of COPD.
  5. Understand indications for lung function testing in the pediatric population.
  6. Apply the usefulness of spirometry, lung volumes, forced oscillatory technique and FeNO in pediatric population into clinical practice.
  7. Apply results of pediatric pulmonary function testing for management of asthma.

Chair: Ngo Quy Chau
Co-Chair: Le Thi Tuyet Lan

Faculty:

  • Professor Carl Mottram (USA)
  • Professor Graham Hall (Australia)
  • A/Professor Le Thi Tuyet Lan (Vietnam)
  • A/Professor Pham Thi Minh Hong (Vietnam)
  • Ms Hynes MHA RRT (USA)
  • Dr Dang Thi Kim Huyen (Vietnam)
  • Dr Vu Tran Thien Quan (Vietnam)

Primary host: Vietnam Respiratory Society
Co-host: Society of Asthma, Allergy and Clinical Immunology of Hochiminh City

Health news

HIV and TB

On 1 December 2018, the Forum of International Respiratory Societies (FIRS) issued the following press release for World AIDS Day.

Tuberculosis (TB) is the world's leading infectious disease and it accounts for one in three deaths from HIV/AIDS, according to the World Health Organization's (WHO) 2018 report on TB. This is why on World AIDS Day the Forum of International Respiratory Societies (FIRS), of which the APSR is a member, calls on governments, health advocates and non-government organisations to strengthen their response to AIDS and TB.

"AIDS and TB are a deadly combination," said Polly Parsons, MD, President of the American Thoracic Society, a FIRS founding member. "In the developing world, TB is often the first sign a person has HIV. Together, the diseases are far worse than they are alone."

Shortly after AIDS emerged, it fuelled a global resurgence of TB that continues in many low and middle-income countries. According to the Centers for Disease Control and Prevention, HIV infection is the strongest risk factor for progressing from latent to active TB.

WHO estimates that the risk of developing TB is 16-27 times greater in people who are infected with HIV than those who are not. Those infected with HIV are also at greater risk of dying from pneumocystis jiroveci pneumonia (PCP), the most common opportunistic infection of HIV, and from bacterial pneumonia and Kaposi sarcoma.

Since the beginning of the pandemic, AIDS has claimed 35 million lives and left 17 million children without one or both parents. Today nearly 40 million people are living with the disease. Of those, about 25 million live in Africa, according to the WHO.

Effective antiretroviral treatment of the disease has increased to approximately 59 percent of those infected with HIV, but the WHO's recent report on the disease highlights that people living with the disease in countries in the Eastern Mediterranean and in South-East Asia are much less likely to receive antiretroviral therapies.

FIRS believes a global response to HIV/AIDS can be strengthened by:

  • Increasing awareness of the continuing global threat of HIV-related disease and its link to TB and other respiratory diseases.
  • Improving the health outcomes of people living with HIV through patient care and research into improved treatments and treatment strategies for both HIV and TB.
  • Reducing the incidence and severity of HIV-related disease by strengthening mother-to-child transmission prevention programmes and increasing the early use of antiretroviral therapy.
  • Improving HIV education in at-risk communities to reduce the incidence of new HIV infections.
  • Reducing HIV-related health disparities and inequities.

"The world has made considerable progress in fighting both AIDS and TB through research, education and better treatments, and prevention strategies," Dr. Parsons said. "But to meet the goal the United Nations set to end the AIDS epidemic by 2030, we will have to redouble our global efforts to stop both of these deadly diseases."

View the fact sheet.

Education

New educational articles

The following article has recently been selected from Respirology for its specific educational value. Previous articles on further topics can be seen at apsresp.org/education/articles/index.html


Figure 3
(Click image to enlarge)

Of special interest to those working in:
* Lung Cancer
* Clinical Respiratory Medicine

Risk factors for pleural effusion recurrence in patients with Malignancy Horiana B Grosu, Sofia Molina, Roberto Casal, Juhee Song, Liang Li, Javier Diaz-Mendoza, Chakravarthy Reddy, Lonny Yarmus, Dante Schiavo, Michael Simoff, Jared Johnstun, Abu-Awwad Raid, David Feller-Kopman, Hans Lee, Sarina Sahetya, Finbar Foley, Fabien Maldonado, Xin Tian, Laila Noor, Russell Miller, Lakshmi Mudambi, Timothy Saettele, Macarena Vial-Rodriguez, Gerogie A Eapen and David E Ost (DOI: 10.1111/resp.13362)
onlinelibrary.wiley.com/doi/10.1111/resp.13362/full (Jan 2019)

Comment by Dr Mark Lavercombe:
Although malignant pleural effusion can be treated with repeated thoracenteses, identification of patients more likely to suffer recurrence of their effusion might lead to earlier definitive intervention. The authors identify several risk factors for recurrence in their cohort, however further study is required to develop a predictive model with external validity.

APSR Membership

Donations received

have kindly sent their donations towards the Society's goals, as outlined at apsresp.org/members/donors.php.

The APSR is profoundly grateful for their generosity.

New Fellows of the APSR

Congratulations to the following members who have recently become APSR Fellows.

  • Dr Ni Wayan Candrawati FAPSR (Indonesia)
  • Dr John Noel Chan FAPSR (Philippines)
  • Jasminarti Dwi Kusumawardani Ida Ayu FAPSR (Indonesia)
  • Kazuto Matsunaga FAPSR (Japan)

New assembly members

A warm welcome to the following members who have recently joined APSR assemblies. They will undoubtedly enjoy working with and networking with their assembly colleagues.

Assemblies
Fenty Anggrainy
(Indonesia)
Clinical Allergy & Immunology
Tuberculosis
Lung Cancer
Ni Wayan Candrawati
(Indonesia)
Critical Care Medicine
Bronchoscopy and Interventional Techniques
Environmental & Occupational Health and Epidemiology
Devasahayam J Christopher
(India)
Tuberculosis
Bronchoscopy and Interventional Techniques
Interstitial Lung Disease
Tsunahiko Hirano
(Japan)
COPD
Asthma
Clinical Respiratory Medicine
Jasminarti Dwi
Kusumawardani Ida Ayu
(Indonesia)
Lung Cancer
Tuberculosis
Clinical Allergy & Immunology
Muhammad Irfan Ilmi
(Indonesia)
Tuberculosis
COPD
Asthma
Won-Jung Koh
(Republic of Korea)
Tuberculosis
Respiratory Infections (non-tuberculous)
Keiji Oishi
(Japan)
COPD
Asthma
Interstitial Lung Disease
Irandi Pratomo
(Indonesia)
Respiratory Infections (non-tuberculous)
Cell and Molecular Biology
Clinical Allergy & Immunology
Jiayuan Sun
(China)
Bronchoscopy and Interventional Techniques
Critical Care Medicine
COPD
Ye Tun
(Myanmar)
Respiratory Structure and Function
Tuberculosis
Lung Cancer

Future Pulmonology Events

Here are the main respiratory events in Asia-Pacific region for the next few months. You can see our full listing on the APSR Calendar.

  • Cardiopulmonary diagnostics and pediatric pulmonary function testing
    11-12 January 2019, Ho Chi Minh City, Vietnam
    Details)
  • 38th Annual Chest Convention
    5-8 March 2019, Edsa Shangri-La, Mandaluyong City, Philippines
    Details)
  • World TB Day
    24 March 2019, Worldwide
    Details)
  • Asian Pacific Congress for Bronchology (APCB) 2019
    28-30 March 2019, Gold Coast, Australia
    Details)
  • 59th Annual Meeting of the Japanese Respiratory Society
    12-14 April 2019, Tokyo, Japan
    Details)
  • 127th Conference of the Korean Academy of Tuberculosis and Respiratory Diseases (KATRD)
    13 April 2019, Gangwon-Do, Korea
    Details)
  • China-Japan-Korea Conference of Occupational Health
    22–24 April 2019, Nanjing, China
    Details)
  • 7th Conference of the International Union Against Tuberculosis and Lung Disease, Asia-Pacific Region 2019
    23-26 April 2019, Manila, Philippines
    Details)
  • World Asthma Day
    7 May 2019, Worldwide
    Details)
  • Asthma & COPD Outpatient Care Unit (ACOCU) Network Day
    12 May 2019, Ho Chi Minh City, Vietnam
    Details)
  • 92nd annual meeting of Japan Society for Occupational Health
    22–25 May 2019, Nagoya, Japan
    Details)
  • World No Tobacco Day
    31 May 2019, Worldwide
    Details)

For more pulmonology events, see apsresp.org/calendar.html
(These events are for information only and APSR endorsement should not be assumed.)

Contact

If you have news or announcements that may be of interest to other APSR members, please send details to Bulletin Coordinator Dr Arata Azuma (a-azuma@nms.ac.jp) or APSR Bulletin (bulletin@apsresp.org).


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