The winning case report at the 2019 Congress was accepted for publication and can be seen at onlinelibrary.wiley.com/doi/10.1002/rcr2.544

Prof. Mishima

Prof. Michiaki Mishima graduated cum laude, Faculty of Medicine, Kyoto University, Japan in 1977. After his initial training in respiratory medicine, he got his PhD degree in 1986 at the Graduate School of Medicine, Kyoto University, through the studies on the peripheral pulmonary circulation time in COPD.

I met him for the first time in June 1989 at the Kyoto University Chest Disease Research Institute Hospital when he was a lecturer there in the Department of Pulmonary Physiology. I had just started my residency with him as my mentor. He was a clinician as well as a researcher full of ideas. He had been studying the physiology in COPD, expert in mathematical analysis of the uneven distribution of ventilatory blood flow, and gave a strong impression on me as a junior resident.

From 1992 to 1994, he was abroad as a visiting researcher at Meakins Christie Laboratories, McGill University, Montreal, Canada. He performed a variety of researches at Meakins including the development and model analysis of an alveolar oscillation method that measures the peripheral lung mechanics, ⁽ⁱ⁾ and the effect of pleural effusion on lung volume using chest CT volumetry in dog experiments.

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He is an attractive person and fascinates many friends with his humour and wit. The photo on the right shows young Prof. Takahide Nagase of Tokyo University and Prof. Hajime Kurosawa of Tohoku University, enjoying a Japanese-style private party at his apartment near Meakins.

When he returned Kyoto University in 1994, I had just completed medical training at an affiliated hospital and went on to the Graduate School of Medicine, meeting again with him and started my career as a physician scientist. During the next four years, I was given excellent and rigorous research guidance from him and Prof. Yoshitaka Oku, his colleague who is now a professor at Hyogo College of Medicine.

At that time, the department head was the late Prof. Kenshi Kuno, and Dr Mishima led his team as the associate professor. He managed both patient care and research such as mechanics, physiology and imaging in addition to COPD clinical research. His research team was extremely active and motivated to discover new findings. It was like a place of assemblage for the bold and ambitious.

One of his achievements was the introduction of the concept of fractals into image analysis and published a number of clinically important findings. ⁽ⁱⁱ⁾ Among the team members from those days, Yoshitaka Oku, Toyohiro Hirai (Kyoto University), Yasutaka Nakano (Shiga University of Medical Science), and myself (Nara Medical University), have been promoted to university professors.

Since the period when he began to supervise our degree work in the mid-90's, he seemed to have a hard time due to reorganization of the university, and there were a lot of difficulties in pursuing research. However, he always kept cheerful, optimistic and positive, and was able to finally overcome such rough waves.

In 1998, he introduced me to Dr Hamid in Meakins Christie Laboratories, and I was given the opportunity to learn the basics of airway inflammation. After finishing post-doctoral course in Meakins, I came back to Kyoto to work with Dr Mishima again in 2001. Immediately after that he was unexpectedly elected as a professor of respiratory medicine at Kyoto University Graduate School of Medicine.

From then until March 2016, he led the management of the Department of Respiratory Medicine, Graduate School of Medicine as Professor and Chairman. Many young respiratory physicians and researchers had come to join him, and his department evolved tremendously.

Throughout his career he has been specialized in the study of COPD. In particular, he has been engaged in the digital imaging of X-ray chest CT in respiratory diseases for more than twenty years and developed original computer software quantifying peripheral airway space and airway wall dimension in COPD or bronchial asthma. He found that these tools contributed much to the understanding of the phenotype and comorbidity of COPD⁽ⁱⁱⁱ⁾. For these achievements, his research team was awarded the 42nd Beltz Prize (First Prize) in 2005. He was also awarded John B West Medal (International Workshop of Pulmonary Functional Imaging) in 2015.

At the same time as being chairman of the Department of Respiratory Medicine, he managed all the areas of respiratory medicine: respiratory cancer, respiratory infection, COPD, asthma, interstitial pneumonitis and respiratory failure, in collaboration with Prof. Kazuo Chin who is an expert in non-invasive ventilation and respiratory care. He successfully developed a new paradigm in the regenerative study of lung tissue such as induced puluripotent stem cells with his excellent co-workers.^(iv)

In addition to his management of his own department, he had a lot of activities in public agencies. He was vice director, Kyoto University Hospital from April 2008 to March 2011, and worked as director of Kyoto University Hospital from April 2011 to March 2015. In addition to activities in the medical field, he also served as executive vice president at Kyoto University from October 2012 to September 2014. Through these activities, he has established a medical exchange programme with Bhutan, through which he sent me to that country for a short time as a respiratory physician.

He also showed his extraordinary talent for organizational management outside Kyoto University. He was the chairman of the board of directors at the Japanese Respiratory Society (JRS) from 2013 to 2015. During his chairmanship term, he introduced a web membership management system and voting at elections was conducted online. Now we have a members-only page through which we can check our number of credits earned and also change our business and personal information. In addition to respiratory medicine, Dr Mishima also held and chaired the Annual Meeting of the Japanese Society of Internal Medicine in 2015.

He has made many contributions to the APSR. He chaired the APSR Research Committee, one of the important standing committees to enlighten APSR young scientists and develop the scientific programme for them up to 2010.

In 2006, Prof Yoshinosuke Fukuchi was APSR Congress President and achieved a great success of the 11th Congress of APSR in Kyoto, Japan with 2,400 academic participants from 43 countries. This congress was led by Dr Mishima as the Congress Secretary General, closely working with him and his colleagues. In 2008, he was awarded the Harasawa Research Award^(v) as a prestigious lecturer at the 13th Congress of the APSR in Bangkok, Thailand.

Since 2013, he was the APSR Secretary General supporting Dr Arth Nana, APSR President, providing a lot of advice to make the Society more sophisticated and developed.

From 2014 to 2016, he was the APSR President. During his presidency, various new structures were built under his leadership such as APSR Assembly troika leadership composed by not only Assembly Heads but also Heads-Elect and Deputy Heads. He then integrated projects with congress sponsorships via the APSR Industry Task Force together with many sponsors.

In addition, as FIRS^(vi) Chairman representing the APSR, he successfully led the great success of the FIRS General Assembly Meeting in Kyoto, Japan in 2016, welcoming all leaders of major respiratory societies in the world.

Dr Mishima has been Emeritus Professor of Kyoto University and President, Osaka Saiseikai Noe Hospital since 2016, and President, Osaka Saiseokai Noe Medical Welfare Center since 2018.

He has published more than 450 scientific papers in English in international journals, 40 scientific papers in Japanese, authored and contributed to several books on respiratory science, and lung image computing sciences. He is still stimulating young doctors in respiratory medicine studies, lung image computing sciences.

The Cell and Molecular Biology Assembly aims to promote respiratory research and education for members who are interested in cutting-edge science. It makes contributions to the development of novel research techniques and distribution of up-to-date tools. It also encourages young researchers to improve their scientific skills and careers.

All APSR members who are interested in respiratory research are encouraged to join the Assembly. Especially, young members who are willing to do research, create networks, present research concepts, and improve their CV. Also senior members who wish to obtain novel knowledge and/or educate young researchers are cordially invited to join us.

Currently, our hot topics include cellular and molecular aspects of all lung diseases, especially asthma, pulmonary fibrosis, ARDS, COPD and lung cancer.

The Assembly is especially interested in

1. promotion of research skills using cellular and molecular approach
2. education and training regarding up-to-date techniques
3. distribution of scientific knowledge
4. contribution to young researchers' careers.

The Assembly members enjoyed holding successful symposia, a poster session and award presentation ceremony at the 2019 APSR Congress in Hanoi. We look forward to having fruitful symposia and poster session again at the 2020 APSR Congress in Kyoto!

The Forum of International Respiratory Societies (FIRS) Environmental Committee including our assembly head has published a review article titled "Health Benefits from Air Pollution Reduction" in 2019 for Annals of American Thoracic Society.

Activities

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On 15 November 2019, a commendation ceremony for excellent presentations on occupational and environmental lung disease was performed after our assembly meeting at the Congress in Hanoi. Three honoured Assembly Education Awardees were Dr Gihani Jayaweera from Sri Lanka, Dr Ratih DwiAry Merdekawati from Indonesia and Dr Youlim Kim from Republic of Korea.

Announcements

• Cases of occupational lung disease for the APSR Teaching Library are being collected by our assembly. Your teaching case or vignette will be uploaded into the Library after peer review. They should be simple cases for the education of young doctors and not yet published.

  If you have suitable cases, please submit them via: apsresp.org/education/teaching-library/index.php

• On 26 September 2020, a Symposium of Environmental Lung Disease Research Group of the Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) will be held at Catholic University, Seoul, Republic of Korea. Lectures on the effects of air pollution on climate change will be provided.

In the Novel Coronavirus (2019-nCoV) Situation Report-1 of WHO on 21 January 21 we read "On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia unknown etiology (unknown cause) detected in Wuhan City, Hubei Province of China...". There were 282 confirmed cases, mostly reported from China, by 20 January. The virus was named COVID-19 and quickly spread globally from Asia to Europe, Middle East, and then North and South America. On 7 March WHO posted the statement "WHO statement on cases of COVID-19 surpassing 100,000".

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat, or diarrhoea. Older people and those with underlying disease are more likely to develop severe illness. The mortality rate was around 3.5% but differed by area.

Initially, the travel history, symptoms and signs, were essential to diagnose COVID-19 infection clinically. Now we should trace a more detailed history of travel, occupation, contact, and cluster because of community infection that has occurred in many countries. Typical thoracic CT imaging is useful for diagnosis of clinical suspected patients. Finally, RT-PCR/NGS is the gold standard to confirm COVID-19 infection by positive detection of COVID-19 nuclear acid.

Many members of our Society respond quickly to the epidemic and participate in the diagnosis and treatment of COVID-19 patients, especially complicated critical cases. Much COVID-19 information is emerging. We advise all to visit the WHO website to retrieve daily "correct" updates directly or via the link on the APSR website.

Information is also available on the websites of our regional respiratory societies in other languages; for example, the Chinese Thoracic Society (Chinese), Chinese Association of Chest Physicians (Chinese), Taiwan Society of Pulmonary and Critical Care Medicine (Chinese), Japanese Association for Infectious Diseases (Japanese), Korean Academy of Tuberculosis and Respiratory Diseases (Korean), etc.

The global spread of COVID-19 infection is ongoing. We also notice nosocomial infection of COVID-19, and COVID-19 infection in health caregivers (physicians or nurses) has been reported. Pneumonia can be caused by COVID-19 and also by influenza, bacteria, or even mixed infection. We must follow the guidelines of personal protective equipment utilization when we take care of our patients. We hope for the quick ending of COVID-19 pandemic and safety for everyone.

Let's work together to improve the future management of COPD patients in our region.

Last year, the APSR COPD Assembly published a position statement in Respirology. In this, we published recommendations on several issues in the Asia-Pacific region: