Karan Madan

Acute respiratory failure following traumatic tooth aspiration

Foreign body aspiration can infrequently occur following trauma. Tooth aspiration after trauma is a rare clinical scenario. Here, we report a case in which tooth aspiration after trauma led to a presentation of acute respiratory failure with clinical findings mimicking tension pneumothorax. Successful removal of the aspirated tooth was accomplished by rigid bronchoscopy. Tooth aspiration must be considered in the list of differential diagnosis for any patient having signs or symptoms of respiratory distress following trauma especially maxillofacial trauma.

In-Flight Spontaneous Pneumothorax: Congenital Cystic Adenomatoid Malformation of the Lung

Congenital cystic adenomatoid malformation (CCAM) is a rare congenital abnormality. Symptomatic presentation in adult life is extremely uncommon. The usual radiological appearance of CCAM is a cystic space-occupying lesion. Patients with underlying cystic lung disease can develop in-flight complications because of pressure-volume changes during ascent. We report the first ever case in which spontaneous pneumothorax during flight was the presenting manifestation of CCAM of the lung in a previously healthy and asymptomatic young adult. We also discuss the physiological changes during air travel which contribute to the pathogenesis of respiratory complications during air travel.

Pleural tuberculosis following lung cancer chemotherapy: a report of two cases proven pathologically by pleural biopsy

Malignancy per se and cytotoxic chemotherapy given for its treatment both are recognised risk factors for the development of tuberculosis (TB). However, individual case descriptions of pleural tuberculosis (TB-PE) following chemotherapy for lung cancer (LC) have not been published previously. We herein report the first two cases of histopathologically proven TB-PE following LC chemotherapy. The first patient was a 38-year-old man with stage IV non-small cell LC (adenocarcinoma) who developed TB-PE following four cycles of chemotherapy (pemetrexed-cisplatin). The second patient was a 49-year-old man with extensive disease small cell LC who developed TB-PE after six cycles of chemotherapy (irinotecan-cisplatin). In both patients, diagnosis of TB-PE was established by demonstration of granulomatous inflammation, caseous necrosis and positive stain for acid-fast bacilli in pleural biopsy specimens. Both cases responded to standard four-drug antitubercular therapy. These cases highlight the importance of carrying out an extensive evaluation for exudative pleural effusions in LC patients receiving chemotherapy, especially in countries with high TB prevalence. Attributing such pleural effusions to disease progression, without histopathological confirmation, may be associated with disastrous consequences.

Bronchoscopic diagnosis of pulmonary hydatid cyst

A 42-year-old previously healthy man presented to an outpatient clinic in India with a six-month history of cough, mucoid expectoration and hemoptysis. He had no history of fever or other constitutional symptoms. He was a nonsmoker and had no history of close contact with dogs or other animals. On

Malignant pleural mesothelioma in a patient with systemic sclerosis: the first report.

Malignant pleural mesothelioma (MPM) is a relatively rare but aggressive pleural tumor. Systemic sclerosis (SSc) is associated with the development of lung cancer and other malignancies. We describe a 58-year-old never-smoker female, previously diagnosed with limited cutaneous SSc, who presented with chest pain on the left side, dyspnea and circumferential nodular left pleural thickening. Fluorodeoxyglucose positron-emission tomography-computed tomography showed intense uptake in the thickened left pleura, mediastinal lymph nodes and left femur. Pleural fluid cytological examination along with nuclear and membranous positivity for Wilms tumor-1 antigen and epithelial membrane antigen on immunocytochemistry confirmed the diagnosis of MPM. To the best of our knowledge, this is the first report of MPM in a patient with SSc.

Incidental pathologically proven pulmonary hamartoma in a patient with carcinoma tongue

Pulmonary hamartomas are usually clinically silent and found incidentally on chest radiographs. They can lead to diagnostic confusion especially in patients who have been previously treated for primary cancers at other sites. This can lead to consideration of metastatic malignancy as the primary diagnostic possibility. In this case, evaluation of a solitary pulmonary nodule (SPN) in a patient with carcinoma of tongue led to the diagnosis of pulmonary chondroid hamartoma. This highlights the fact that a pulmonary nodule in a patient with progressive cancer at another site does not always indicate pulmonary metastasis.

Spontaneous pneumothorax following caesarean section under spinal anaesthesia

It is unusual for pneumothorax to occur spontaneously during pregnancy. Its occurrence during or following caesarean section is extremely uncommon with only three other cases reported previously. In none of the reported cases, was the caesarean section performed under spinal anaesthesia. We report the successful management of a multigravida female patient, who developed spontaneous pneumothorax following caesarean section, performed under spinal anaesthesia. Tube thoracostomy was required for management and the patient had an uneventful recovery.

Erasmus syndrome with pulmonary tuberculosis.

A 60-year-old male patient presented with a history of shortness of breath for 4 months and low-grade fever for 1 month. He had developed progressive skin tightening predominantly over the extremities and Raynauds phenomenon for the last 6 months. The patient was a chronic smoker and used to work as a manual labourer with nearly a 35-year history of unprotected exposure to cement dust. On examination, there was thickening of skin over the hands, face and trunk (figure 1, left panel). Skin examination demonstrated ‘salt …

Chris T. Bolliger: An Obituary

bronchoscopy and thoracoscopy, both diagnostic and therapeutic. Other interests of his were cardiopulmonary exercise testing and tobacco control with emphasis on smoking cessation. Over time, he published more than 250 articles, 14 books, and various book chapters. One of his initial publications [1] remains the basis of our daily treatment decisions in lung cancer patients. In addition to all of his clinical and research work, in 1998 he took over the position of editor-in-chief of Respiration. In the following years, he developed the journal After an acute illness Chris T. Bolliger, Director and Head of the Respiratory Research Unit and Cohead of the Division of Pulmonology of the Department of Medicine of the University of Stellenbosch, Capetown, South Africa, died on November 2, 2012, at the age of 62. With him, we have lost an experienced medical doctor as well as a friend. His great expertise and humanity towards his patients and colleagues will be sorely missed. Chris T. Bolliger was born in Switzerland. He went to medical school in Basel and Lausanne and graduated in 1976. Subsequently he finished his residency and fellowship in internal medicine with a subspecialty in pulmonology. He moved to South Africa in the early 1980s and earned a Baccalaureus with Honors (Hon. BsC) in epidemiology at the University of Stellenbosch in 1989. He then went back to Switzerland in the same year and became a consultant in the Division of Pulmonology of the University Hospital of Basel. During that time, he finished his PhD and obtained his associate professorship. In 1999, he moved back to the Faculty of Health Sciences of the University of Stellenbosch, where he was appointed cochairman of the Pulmonology Division and director of the Respiratory Research Unit. In both his research and his clinical work, he set very high standards for himself and those working with him. Most recently, he was the director and head of the Respiratory Research Unit of the Department and cohead of the Division of Pulmonology of the Department of Medicine of the University of Stellenbosch. From the beginning he developed an ongoing interest in clinical and basic research. Initially he focused on thoracic oncology with special emphasis on interventional Published online: December 13, 2012

In Memoriam Christoph T. Bolliger

board members and friends of the journal informed of the latest developments and changes to the journal. He also successfully edited the book series Progress in Respiratory Research where he initiated many outstanding and award-winning volumes of which some have become true classics in the field such as Interventional Bronchoscopy and Clinical Chest Ultrasound . Over the years, a very close and pleasant collaboration developed with the publishing house and he became a valued advisor in publishing matters. We appreciated his friendly way to motivate people, his humour, his inspiration, his deep insight and clear vision for the journal and the book series. Chris Bolliger’s sudden and untimely passing on November 2 shocked the entire editorial team of Respiration . We have lost a true leader and an extremely successful Editor, a very warm-hearted person so full of life and energy. A part of Professor Christoph Bolliger remains in all of us who had the privilege to work with him. As one of the Associate Editors of the journal so correctly wrote: ‘You can replace the Editor-in-Chief, but you cannot replace this wonderful man’. He will be sorely missed by all of us and we will do everything to secure the journal’s future and foster its reputation as one of the leading journals in the field. Thomas Nold, Thomas Karger and Gabriella Karger and the Respiration team The publisher and the editorial staff of Respiration would like to express their sadness at the sudden passing of Professor Christoph T. Bolliger. We were first introduced to Chris Bolliger by Professor Heinrich Herzog, who invited him to join the Editorial Board of the journal Respiration back in 1995. In January 1998, Professor Bolliger officially became the new Editorin-Chief of Respiration . Full of enthusiasm about his new role, he announced his visions for the future of the journal in the first of his many editorials which was entitled ‘A Wind of Change’. Chris Bolliger was not just an excellent clinician and scientist, but also a passionate editor, who had many excellent ideas for the journal and the commitment and perseverance to realise his aims to the full. Thanks to his international network he was able to provide feedback on the latest trends in medical publishing and he was continuously striving to improve the quality of the journal. During the 15 years of his editorship, the number of submissions increased by almost 300%, the impact factor climbed up to 2.5 and the rejection rate increased from 43 to 76%. We saw the introduction of many new sections to the journal, e.g. Thematic Review Series, The Eye Catcher, and Interventional Pulmonology. He ensured the journal had a truly diverse group of dedicated Associate Editors covering all fields of respiratory medicine, supported by an international Editorial Board. Dr. Bolliger’s very popular newsletter ‘News in a Nutshell’ was put out twice a year to keep authors, reviewers, editorial Published online: December 13, 2012